25 Principles of the Meet In The Music© (MITM) Program

25 Principles of the Meet In The Music ©  (MITM) Program

Implementation & Techniques

This compilation of principals offers a wealth of tips, both substantial and subtle, to serve as a valuable guide for your music therapy sessions and work. These recommendations encompass general principles to foster success and growth in your clients.  Some have been gleaned through personal success with clients, while others have emerged from learning experiences and failures. Clients themselves are our best inspiration and guides for personal and professional development.

The MITM ©  program has its roots in decades of exploring music with neurodivergent children and individuals with diverse needs. It represents the culmination of what worked and what didn’t. It is my hope that this guide, along with the curriculum, will inspire your own unique style as well as deeper connections with your clients. Together, we can craft a holistic treatment plan that nurtures comprehensive growth.  We are here as guides. Our mission is to infuse joy into the developmental journey through the transformative power of music.

1. Remember the Essence of Music Resides Within Us:  

Learn to rely on yourself, your therapeutic intuition, your voice, and your capacity to connect on a human-to-human level without the need for additional tools, including instruments. Remember, the essence of music resides within us. At times, you can be most effective by using personal touch and your singing or vocalizing voice. Sometimes instruments can get in the way.

You can sway with a client while humming, rhythmically squeeze their hands to establish a shared rhythm, perhaps accompanied by a simple vocal melody. You can clap their hands, create a beat on their knees, or even lie down together on the floor while singing and looking up. There are moments when matching the client's musical efforts can provide the containment they need. Through these strategies, you can cultivate a deeper awareness and connection.

2. Recognize the Right Time to Step Back and Allow Breathing Room:  

It's crucial not to persistently impose your own agenda, especially if the client consistently resists. Active listening and careful observation, coupled with providing space for the client to explore independently, are essential. Learning often unfolds as a self-sufficient experience that doesn't always necessitate immediate facilitator intervention.

Striking a balance between active engagement and fostering independent discovery is vital. Recognize when it's time to pause. Lessons can be open-ended; it's not always necessary to achieve a predefined objective. In the realm of music, the practitioner follows a path led by the learner and the present moment. Instead of strict goals, consider them as waypoints along the journey.

3. Leave Your Negative Voice Out of it, Let it Be :

It does you no harm to believe whatever the client believes.  Your ego can not be invested in the client therapist interaction. There are no mistakes to be made. No one is marking you on the level of your musical creativeness, personal biases, outward vulnerabilities.

When engaging in improvisation with a client, focus your presence on the client, rather than getting caught up in the complexity of the melody you're creating or whether you've altered the chord progression. Don't worry about the sound of your voice or whether you might come across as silly. Stay in the present moment. Embrace your omnigender qualities. Explore your lower and higher vocal ranges. Don't be afraid to appear a bit silly if it enhances the connection. It's the connection that truly counts.

4. Enjoy the Silence Between the Notes :

The moments of silence are just as significant as the music itself. Allow the 'electrical energy' to naturally dissipate after the music stops. For instance, when improvising, take a brief pause after the music fades away. Resist the urge to speak immediately after. Honor the music that you both created. Create a space for a moment, allowing both you and the client to absorb what just transpired. This pause is a way to honor not only the music you both created but also the interaction and connection that just took place. Be okay with the silence. Embrace the silence. Live within that silence. The impact can be profound, fostering self-awareness and an enhanced appreciation of the relationship.

5. Music as the reward:  

Music can serve as an immediate reward, acting as an internal motivator that drives sustained engagement in a musical interaction. Music, in and of itself, has the power to inspire a client to embrace new challenges, even in the face of insecurities, apprehension, or low frustration tolerance. When an individual strikes a drum or plucks a harp string, the resulting sound becomes an instant reward for their effort. In most cases, there is no need to introduce external rewards such as devices or food incentives for an individual to participate in musical experiences. However, there may be exceptions, particularly in extreme cases where a person does not respond to our initial offerings. Nevertheless, it's always advisable to consider music as the primary and most natural source of motivation and reward.

Client-preferred music activities and instruments can also serve as rewards to motivate the completion of musical tasks and experiences as outlined in the facilitator's portion of the negotiated and collaborative session plan. These client-preferred activities, musical experiences, or instruments can be strategically incorporated in the following ways:

A) Scheduled at the end of the session,

B) Provided as a reward after the successful completion of a particular activity,

C) Made available when necessary, especially for use as a motivator for "just one more turn" in an ongoing activity.

6. First Encounter- Meeting in the Music:  

In the first session, the interaction can commence at an instrument that piques the client's interest. If the client exhibits apprehension or does not readily explore the space, it is beneficial to initiate the session with a gentle hello song. Position yourself at a comfortable distance from the client, such as sitting on the floor with a guitar or at the piano. In cases where a client approaches the session space in a dis-regulated, apprehensive, or anxious state, consider keeping the door ajar and softly playing the chords of the hello song as the client enters the space. This approach establishes an inviting atmosphere, encouraging the individual to enter and begin exploring.

Upon entering the session space, if the client doesn't take the initiative to explore, you can provide a range of instruments for exploration and structured activities for assessment. Here are some possible assessment experiences:

1) Encourage exploration of a novel instrument, such as a guitar, piano, drums, cabasa, or autoharp.

2) Utilize engaging manipulatives (e.g., scarf songs).

3) Incorporate songs that involve picture cards.

4) Offer an array of small percussive instruments.

For clients displaying anxious behavior, minimize verbal interaction. Allow space to meet in the music.

7. Discovering Your Music Magic :    

A client's musical preferences, (just like your own), is what sets the tone. For music therapists, it’s essential to consider a client’s favored music genre, instrument timbres, singers, composers, or bands. Preferred music has the power to engage a listener and ignite active involvement. To foster active engagement and strengthen the connection, it's advantageous to either grant clients the freedom to choose the music or tailor it to align with their individual tastes.. In that first session, when meeting in the music, meet them in their music. If possible, discover what their favorite songs, the bands they adore, and weave it into that first session. Dance to the rhythm, play along or sing along with them.  Meet there.

However, it's important not to underestimate the value of introducing new music genres to clients. After trust, rapport, and routine have been firmly established, exploring a diverse range of musical genres can expand opportunities for learning, cultivate appreciation, and encourage self-reflection. Embracing and accepting new musical universes can be enlightening and contribute to personal growth and character development.

8. A Song is like a house and home:  

Songs can wield immense power for neurodivergent children and individuals with diverse needs. A song can be likened to a house and a home. Just as a house offers safety, shelter, and security for a client, a home provides a sense of comfort and fosters self-identity and confidence through daily routines, rituals, and constancy. Similarly, a song fulfills all of these essential aspects for autistic individuals and those with diverse needs. Its structured nature, with unchanging rhythms, lyrics, and melodies, can offer a sense of constancy. Songs can, therefore, become ritualistic elements that clients can rely on, anticipate, and predict with ease and familiarity.

Within MITM©, there are six original hello songs and six goodbye songs. These can be applied in a developmental sequence or used in any order that suits the client. When working with clients at an average rate of once per week, it's recommended to rotate these songs every 6-12 months. This time frame allows clients to learn the sequence, lyrics, and increase active participation and verbal/communicative responses.

The ultimate goal is to have the client sing an entire verse of a hello or goodbye song back to the facilitator. The exact duration for each hello or goodbye song's implementation can vary based on the facilitator's expertise and their assessment of each individual client.

If the session structure begins with a hello song, it's a great way to immediately orient and engage the client. You can achieve this by playing the hello song chords as soon as the client enters the room, optionally with the assistance of a caregiver or other support. You can then begin singing the song as soon as the client has finished or is in the process of removing their shoes, coat, or placing their backpack down. Meeting in the Music starts now!

9. Assessment:  

The initial assessment phase typically spans 2-4 sessions, though assessment remains an ongoing process. This assessment is a blend of formal and informal methods, often relying on an individual’s responses during regular activities and music interactions that occur in standard therapy sessions. From the individual’s perspective, assessment sessions should be indistinguishable from typical music therapy sessions.

For collecting data and generating results for a client, it is advisable to utilize the Meet In The Music© (MITM©) Assessment, which aligns with the MITM© program’s skill domains and employs a 4-point rating scale for scoring (as outlined in the program templates).  

10. Unveiling of New Instruments:

Honor each musical object by introducing it with care and celebration. Present each instrument in a ceremonial manner that draws the client in. Handle the instrument as if it were a cherished object to be revered. Indeed, from the wood, strings, or metal of this instrument will emanate original sounds and music, crafted by the client and/or yourself. These sounds are extensions of the self, one’s self expression.

When introducing new instruments enclosed within cases (such as the autoharp, melodeon, flute, tone bars, and more), it’s essential to establish a ritual for their presentation.  Foster curiosity by asking questions like, “What might be hidden inside?” or “Could it be a drum?” Encourage the client to engage by guiding THEM to undo snaps, clasps, and other closures, slowly opening the lid, and gradually revealing the instrument within.

11. Inspire Curiosity to New Horizons:  

People of all ages, especially children, tend to embrace new learning and skills more deeply when inspired by inner motivation and curiosity. Observe where your client naturally gravitates within the room, which instruments capture their attention, and what actions hold their fascination. Craft interactive experiences tailored to these interests. Is your client drawn to percussion, tapping walls and windows? Do they thrive on movement? Perhaps they have a preference for stringed instruments or structured, sit-down activities. Alternatively, are they visually inclined, preferring music experiences with picture cards?

But what if your client doesn't seem interested in any instrument at all? Perhaps they're fixated on a sunbeam dancing on the floor. Start there. Create an original musical experience using their unique interests as the foundation. I once had a client who repetitively ascended and descended the three stairs in the music therapy studio. I transformed this into a song, employing the concertina and my voice. With each step, I sang a single word to reinforce the action, harmonizing "up the stairs, down the stairs" with the concertina's open-close motions.My client cherished this musical reflection of their actions, repeating the stair routine with enthusiasm. I mirrored their movements, introducing alterations in speed to encourage them to follow. Gradually, I involved myself in the process, suggesting variations. After a few sessions, my client entrusted me to take the stairs, assuming the roles of singer and concertina player. This transition was empowering for them. For months, following our initial greeting song, we engaged in this heartwarming and reassuring ritual for ten minutes before exploring other activities. Eventually, the shine wore off for him with this particular ritual. We then embarked on creating fresh, interactive experiences together.

12. Immersed Observation:  

Immersed observation of a client's sensory state can significantly contribute to their self-regulation. Once a facilitator becomes familiar with a client, identifying their sensory triggers and recognizing times when they might experience sensory overload, it becomes possible to preemptively address dis-regulation. For example, I had a client who relied on vestibular stimulation to maintain regulation. After intense focus during a seated activity, he needed to engage in spinning on the floor 10-15 times. Following this sensory activity, he was prepared to participate in another musical activity for another 15 minutes. It can be as straightforward as that.

In many cases, it's advantageous to discuss these sensory needs with the occupational therapist on the team or seek guidance from an OT colleague if the client doesn't have one. The key is to strike the right balance, avoiding overstimulation while maintaining an appropriate arousal level conducive to effective learning and engagement.

Once you become adept at acutely reading your clients, you can anticipate the onset of disengagement and make timely adjustments to maintain their interest. This proactive approach can lead to fewer disruptive behaviors in your clients as you address them before they escalate. It involves making subtle adjustments as needed along the way.

Maintaining a keen awareness of the client's engagement level is essential. Be prepared to:

A) Adapt the session plan as necessary,

B) Provide opportunities for the client to take the lead,

C) Negotiate the number of repetitions or turns before transitioning to the next activity.

13. Momentum:

Balancing the ebb and flow of momentum within a session can be challenging. Occasionally, in a music therapy session, we may find ourselves thinking, 'I'm losing their engagement.' It's important to recognize that music experiences and activities should continue only as long as the client remains genuinely engaged. When their interest begins to wane, it's a signal to introduce a change. This might mean they've exhausted their interest in the current activity, or it's time to introduce a different component or variation, such as a new instrument, rhythm, action, and more.

Strive to minimize downtime between activities and keep the session flowing smoothly. Keep things moving. Limit ‘down time’. Be well-prepared by having your materials ready and strategically positioned for quick access before the session begins. The primary exception to this rule is when the setup or cleanup process for an activity is itself a targeted objective.

14. Wait, Listen & Trust:

During improvisation, it's common to get ‘stuck’ in a specific tonality, chord progression, or rhythmic/melodic pattern that can be challenging to break out of if introduced too early. Consider waiting for the client to establish a connection with the instrument before promptly joining and contributing to the musical dialogue. Trust that the client will provide you with a musical 'nugget,' even if it's a simple musical idea, which you can then develop.

While looking for potential tonal connections among the client's notes, it is crucial to focus on the overall level of intensity, mood, and intention conveyed through their music. What is the client attempting to express? In improvisation, strive to match the intensity level of the client's music as it's offered.

15. Encouraging Exploration :

We serve as guides, partners, and at times, the catalyst for clients, helping them nurture and broaden their exploration within the musical realm. What should you do when a client repetitively plucks each note on an autoharp or guitar, observing the vibrations, or plays each individual note on the piano, repeatedly, from top to bottom? Navigating these limited or rigid explorations can be tricky.

Start by mirroring the same action, sharing in their experience, and finding joy in it together. Indulge them. Engage with them. In the moment, create a simple, playful, interactive game stemming from their action. For example, if their piano exploration is systematically moving from top to bottom, try counting keys and playing from the opposite end of the piano, meeting the client in the middle of the piano (middle C). Again, meet them in the music. When hands meet in the middle, they can collide or create a chord, leading to an organic cause-and-effect game. This approach allows you to gradually expand the parameters of the improvisation, encouraging deeper exploration of the instrument and the client's musical expression.

16. Use Declarative Language:

Meeting your clients in the music is a joyful experience. Declare your enjoyment in the moment. Use phrases that reaffirm the present experience and its connection to self-identity, emotions, and the bond between the client and therapist. For instance, say things like 'this is fun!', 'I'm dancing!', or 'We did this together!'   Your voice and expressive gestures can also serve as vehicles for conveying joy. People can sense when someone is genuinely savoring an interactive experience with them. This is an excellent opportunity to model these phrases and demonstrate how to engage in self-reflection, share pleasure, and celebrate the joy derived from the shared experience.

17. Limit Use of “Good Job”:  

Now, the choice is entirely yours, but here's some food for thought: 'Good job!' doesn't necessarily provide a client with an understanding of what they did correctly or why. It's essentially a judgment statement that may not guide the client on how to proceed or how to build upon their positive action. Moreover, the word 'job' carries certain connotations. While holding a mallet or engaging in a new musical interaction may indeed require effort on the client's part, it might not be best presented in that context.

Instead of using 'good job!', each time a client succeeds (in their own unique way), try offering comments about WHAT they did. Here are some examples:

1) 'Hey, you played that drum by yourself!'

2) 'We were really listening to each other with our drums.'

3) 'That was your very own rhythm!'

4) 'You waited for me to have a turn!'

The objective is for the client to develop inner pride and not solely rely on external approval. Your client will feel your praise and validation through your enthusiastic facial expressions, eye contact, and tone as you comment on their accomplishments.

18. The Debrief:

The language and depth of the debrief should be tailored to each client's level of comprehension. It can be as simple as touching on one or two sentences, such as 'That was tough before, I know, but you were flexible, and you worked through it.' Don't be hesitant to bring it up again; it won't trigger another dis-regulation episode. Instead, it will create space for self-reflection and a sense of pride in the client's ability to navigate through challenging moments in life.

After a crisis occurs in a session and self-regulation is restored, it's crucial to revisit the experience through discussion and debriefing at the END of the session. At this point, the client can engage in more subjective thinking. They are no longer reacting solely based on their heightened emotional or physical state. Post-crisis, they are better equipped to reflect on the process and resolution, which can inform future learning.

19. Environmental/ Psychological/ Physical Acclimation

While keeping point 13: MOMENTUM, in mind, allocate time to guide the client through the process of setting up materials for an activity, aiming to engage their executive functioning skills. Instead of giving direct instructions and delegating tasks, encourage the client's involvement by asking questions like 'What do we need for this game? What do we need to gather? What items would you like to put away, and where should they go? What can I help put away or get for you?'

If relevant, you can refer to a PEC (PICTURE EXCHANGE COMMUNICATION) card if the client uses that system. This approach extends to transporting and arranging instruments, fostering a sense of ownership in the musical experiences they are about to create.

Plan for additional time in the session, adapting to the flow and response time of each individual client. When someone takes part in the setup process and assumes responsibility, they may become more emotionally invested in the experience.

20. The client as an Empowered Leader:

The MITM© curriculum transcends mere imitation goals, with its ultimate aim being leadership and the development of ideation of thought. As a result, interventions progress towards the client taking on a leadership role within the activity when applicable. Virtually any structured music therapy intervention and improvisation can provide opportunities for client leadership.

The leadership role offers valuable learning experiences for the individual, even in highly structured activities. It actively engages one's executive functioning skills, as the client must 'keep it all together,' remember, explain, and adhere to the rule structure, address 'incorrect' responses from others, and formulate a plan. These components collectively provide opportunities to practice the executive functioning skills necessary for navigating through life.

In the role of a leader, the client is encouraged to employ directive leader statements such as 'try again,' 'do you need a clue?,' 'here comes the next turn,' 'you're right!,' and 'you did it,' fostering both leadership and effective communication skills.

Moreover, leadership provides opportunities for empowerment, allowing individuals to recognize their capacity to influence others, bring joy to others, and make a meaningful impact. This process promotes a stronger sense of self and self-confidence.

While some clients thoroughly enjoy being in the leadership role, others may feel inhibited or struggle to generate their own ideas. Those who prefer control may benefit from leadership opportunities that challenge their flexibility, particularly when unforeseen shifts arise in the musical interaction. For those who are more reserved or experience difficulties with generating ideas, such experiences offer a supportive environment for them to gradually gain confidence and nurture creative thinking, all while guided by the facilitator .

21. Don’t Say, Just Do:

Allow the mystery of a new experience to naturally unfold for the client. Introduce a new music activity with minimal verbal instruction- simply dive in. This spontaneous approach kindles the client’s curiosity and captivates their interest. The unknown evokes questions like, “What’s this all about?” and “What’s coming next?” Lengthy instructions or dialogues could diminish the novelty. Instead, employ gestures, facial expressions and modeling to steer the client’s involvement, leaving them curious about their role in the activity.

 

22. Gentle Sabotage:  

The chance to provide support to another individual in a music therapy session can serve as a valuable lesson in how we can be of service to others in the broader world. As previously discussed, there is a wealth of learning involved when the client assumes the role of the leader. However, what should the leader do when the participant doesn't comprehend the rules or fails to provide the correct answer? How does the leader guide and support the other person in such situations?

To help clients practice these vital social and relationship skills, it can be beneficial to employ a technique I like to call 'gentle sabotage.' In this approach, the 'participant' pretends not to understand the rules or deliberately gives the wrong answer. This challenges the client to practice compassion, understanding, patience, flexibility, and self-regulation in how they respond. It also encourages the use of supportive phrases when interacting with the participant. Such situations can offer invaluable opportunities for learning.

 

23. Fade Out Physical Support & Verbal Cues

We all want to promote the independence of our clients as much as possible. Regularly and intermittently, withdraw physical support, such as hand-over-hand guidance, to evaluate whether the client can:

1. Execute the motor plan independently,
2. Generate their own ideas and express a desire to complete the task.

Challenge the client to interpret the message through observation of gestural cues and body language, rather than relying solely on verbal cues. Gradually transition to the use of gestures, such as pointing or raising hands to signal "now what?" or giving a thumbs up.

To encourage verbal communication, progressively reduce the verbal cues at the end of the prompted phrase until the client can independently complete it:

1. "Can I have a clue, please?"
2. "Can I have a..."
3. "Can I"
4. "Can"
5. "C"
6. Silent, with mouth forming the beginning of "C"
7. Employ an arm gesture for "now what?"

24. Encourage Verbal Responses to Questions:  

Some clients may benefit from structured statements to guide their responses rather than open-ended questions, which can be too abstract for them. For instance, instead of asking, 'What is this instrument called?' try providing a sentence structure for the client to respond within, like 'This is a ___.' In place of 'What do we need to get?' begin with the statement 'To play the xylophone, we need two ___' (answer: mallets).

Additionally, it's crucial to allow enough time for the client to answer, as many may have a delayed response or require extra processing time. Using gestures for cues, instead of relying solely on verbal prompts, can often stimulate thought and ideation effectively.

25. Self Evaluation By Reflection:  

As therapists, we often tend to subjectively assess our performance without maintaining objectivity. It's crucial that self-evaluation is a positive and professionally affirming process. At the end of each week, self-evaluation becomes a vital task for us as therapists. This evaluation can take various forms, including informal reflection or the use of a formalized checklist.

Some affirming checklist items might be:

• Consistent return of clients
• Satisfied caregivers
• Observable progress towards a client's goals

Evaluation has three components: self evaluation, client evaluation, parent/guardian evaluation

Self Reflective Evaluation:

• What did I feel I accomplished successfully?
• What areas could use improvement or adjustment to enhance the environment and relationships for my clients?

Client evaluation Through Observation / Questions:

• “Did you enjoy our time together?”
• Did the client appear to be enjoying themself?

Parent/Guardian Evaluation:

• How was the client after the session?
• Did the client react in a positive or negative while at home?
• Did the client compliment or identify positively to their session?
• Did you experience a change (positive or negative)?
• What changes or recommendations do you have for me, the therapist, for future sessions?