Life Stuff, music therapy

8 Things I Learned During My Music Therapy Internship

I initially wrote this as part of the requirements for my music therapy internship credit at the University of Iowa. But I realized that it might have some useful information for new interns so why not share publicly? I’ve been out of internship for a while and into professional MT-BC life but hopefully this post will help shed some light on some of the things I realized at the beginning of my internship.

About me:

I did my internship at University of Iowa Hospitals and Clinics. When I did this internship it was set up as three different rotations: 1) pediatric inpatient units, 2) adult psychiatry & neonatal intensive care unit, and 3) adult palliative care and child psychiatry.

A little backstory before I start rambling on…when I originally wrote this, I had just finished my rotation on the inpatient pediatric units which included working with a variety of children with a variety of diagnoses. I saw patients on the burn unit, bone marrow transplant unit, in the pediatric intensive care unit, and the general inpatient units. I saw kids with cancer undergoing treatment, kids who had surgeries, kids undergoing stem cell transplants, kids being monitored for seizures, kids who had really bad respiratory illnesses, kids with intellectual disabilities who had comorbid illnesses, and many others!


To any new (or future) music therapy intern,

For this post, I’ve decided to talk about some of the things that surprised me about being in internship, some of the things I wish someone had told me before I started, and some of the things I never thought I would need to know.

Alright…without further ado, my top 8 things about beginning internship:

1. Internship is hard 

I thought being in school with a ton of jobs was difficult; I was trying to balance homework with my other responsibilities (teaching private lessons, music interning at a church, research assistant at the hospital, recreation aide at a retirement community, not to mention hanging out with my lonely husband). I was actually looking forward to only working a 40-hour work week and coming home at a regular time. When I left my first day at internship and didn’t take any work home with me, I felt GUILTY. As the weeks progressed, that feeling of guilt quickly wore off.

Internship is difficult in ways that I didn’t think it would be. I didn’t realize how difficult it would be to see kids who are in bad home situations. Or kids who don’t have supportive families. To see that situation play out day in and day out is heart breaking. And to realize that there is really nothing you can do to fix their family situation is humbling. Also to realize that you’re not there to fix their family situation, you’re there to provide only what you can provide and hope that is is impactful in some way.

Internship is difficult because I didn’t realize how many assignments there would be. I thought “I’m done with school! I can burn all my pencils.” Unfortunately, I still need pencils. And highlighters. And post-it notes. And my computer. On top of planning individual and group sessions for the week, there are additional readings and assignments. Add that on top of learning new songs, learning the charting system, documenting, filling out assessments, observing other disciplines, learning new names, new diagnoses, new ways around the hospital, etc. and you can very easily become overwhelmed. I often found myself taking reading assignments home and spending a lot of time planning my groups at home because I just didn’t have time to do it at work. I realized quickly that I couldn’t take a ton of work home every day (see #8) and that I needed to figure out a way to get it done at the hospital. A realization I have come to in this first rotation is that I am probably prone to compassion fatigue—I put 110% of myself into the things that I do. I will work from the time I get up to the time I go to bed if I’m not careful. And I don’t want to work all the time. That’s the reason I didn’t become a doctor! Eventually, I want to have a family. Therefore, I have set some boundaries. There are some assignments that I have to work on at home and my internship supervisor has allowed a specific number of hours for work at home, but for the most part, when I come home and take my badge off, I am at. home.

2. You’re going to be really tired

This one is especially true for those introverts out there. It took me a long time to realize that being an introvert doesn’t necessarily mean that you are shy and reserved. Being an introvert means that you expend energy when you are around people. Well…I am around a lot of people at the hospital. It takes a lot of my energy to work an 8 hour day. And it takes even more energy on the days where I have to lead groups. I found that I was coming home angry for no reason and I couldn’t figure out what it was. Finally, I took a step back and thought about what I was feeling and realized that I just needed 10 minutes to myself at the end of the day where I wasn’t thinking about anything, I wasn’t driving around, I wasn’t planning or reading. So every day when I come home from the hospital, I take my badge off and take my keys out of my pocket and that is my transition into being at home. Then, I take the next ten minutes and do something that doesn’t take any brain power—whether that be quietly listen to my music, rest without listening to any sound, watch a silly YouTube video, or practice mindfulness, whatever I feel like I need to do to unwind from the day and reenergize for the evening.

I also have some new habits that I am trying out to help set boundaries for myself. For example, when I am driving to work, I will listen to music that my patients enjoy so I can learn new songs and catch up on what is current. But when I am driving from work, I listen to what I like to listen to or, sometimes I don’t listen to anything at all if it’s been “one of those days”. My new favorite activity happens on Friday after I get off work. I get home, go upstairs, get into my PJs, and get into bed. I don’t necessarily go to sleep. But it’s a very peaceful time where I can unwind and celebrate that it is the weekend!

3. You’re going to spend a lot of time planning a really great intervention or group and then the patient will decline your service or nobody will show up. 

Our professor does a great job selecting practicum sites. She tells you to set your clients up for success during your interventions. Well, she is also setting you up for success in your practicum setting! Sneaky little devil—we never even KNEW! Most of the time in your practicum setting, your clients will be there. And they will probably respond to the things that you do and the interventions that you bring. In my internship, I have spent quite a bit of time planning sessions that never actually come to fruition because the patient declined services, or discharged, or was sleeping. But hey! I have a really cool adapted piano version of Shake it Off if ever the time presents itself. And many more really cool things that I may never use.

 For my last school-age group session, I planned an entire group around discussing change and feelings. Since the seasons are changing, I wanted to talk about what else changes in their lives, how they are different from last year to this year, how they are different from when they came into the hospital to now, and how the kids feel when they’re in the hospital. I had a TON of instruments with me, a fun game to play that talked about different feeling and emotion words, a really cool Orff group improvisation. I was ready. When it came time for my group…only one kid came. And he only spoke Hebrew. So, you can probably guess how that went. We didn’t really get to talk about change or our feelings. Also, although I had planned a lot of adaptations for this group, you bet your little tooshie I did not plan to have a kid who didn’t speak any English. So, don’t get discouraged if you spend time on a plan and don’t get to do it while you’re in internship. Chances are, you’ll use it one day. But that leads me to my next really important point.

4. You have to be really. flexible. 

And I’m not talking about being able to do the splits. (Although, that’s a cool party trick.) I remember one day in my second or third week of internship, I was riding in the elevator with my supervisor on the way to see patients and she said “Alright, I’d like you to try the preschool protocol with Patient X when we get up to the unit.” And in my mind I thought “okay, I’ve played through those songs once, I don’t remember exactly what the preschool protocol is since I’ve only seen you do it once.” But on the outside I said “okay!” And I did it, and I learned from the session, and the next time I led the preschool protocol, I was much more comfortable with it.

I have learned that I have to be able to get out of my own head, be present in the moment, and react to situations that are happening in front of me. I am still working on this and will probably continue to work on this my entire professional life. But being flexible in many ways will help me become a better learner, a better musician, and a better therapist.

5. You’re going to see (and smell) some really gross things [WARNING: THIS SECTION MAY BE GRAPHIC TO SOME, IF YOU’RE SQUEAMISH, SKIP THIS SECTION. DON’T SAY I DIDN’T WARN YOU].

This mainly pertains to working in a hospital, I think. But I never thought about what exactly it means to provide procedural support. I mean, yeah, okay, we are in the room when a procedure is happening. But that means that we are in the room when a procedure is happening. When the nurses ask if you can come in and play music during a tracheotomy change, you’re going to see a hole in someone’s throat when they take the trach out and put a new one in. I played relaxation music for a patient in the PICU who was feeling very nauseous. I developed a strong enough rapport that he felt comfortable having me in the room while he was throwing up. And I felt comfortable enough that it didn’t bother me, because he told me the music helped him relax. We walked into a room after a colostomy bag had been changed, which did not smell like roses, and stayed for 35 minutes leading a session.

6. You need to have really solid music skills.

I know our professor talks about this until she’s blue in the face so I’m going to get up onto her soap box and reiterate! If you don’t have solid music skills, you will not be able to be present and in the moment with your clients or patients. If you are not confident in your music skills, you will not be able to focus on whatever group or 1:1 session you are leading. Internship is one of the first times you really get to practice your counseling skills, so if you’re confident with your music skills, you can spend a lot more time focusing on learning how to do the therapist part of the job.

7. At some point, you’re probably going to feel like you suck. A lot. 

Learning a new skill is really difficult. And it doesn’t feel that great. When you’re around professionals who have been doing this for longer than you’ve been in school, you may feel like you’re a terrible music therapist. But that’s because you haven’t been practicing your skills for very long. Give yourself a break and really take in what could be one of the last long, supervised learning opportunities you have. Your supervisors will not expect you to be perfect. If they thought you were perfect, you probably wouldn’t even have to do an internship. Take in all of the learning opportunities that you can while you can. Observe as much as you can while you can. And know that when you feel like you’re failing, you’re growing into a strong, smart, passionate music therapist.

This has been especially difficult for me. I have felt a lot of challenge in this internship. I will say that this has been one of the most difficult learning experiences I have faced. That has been frustrating for me in some ways because I want to provide a quality therapeutic experience for my patients and sometimes I feel that they get the short end of the stick because they’re with a student. I see the amazing therapeutic work being done by the other music therapists in the hospital and I strive to do that quality work. But the reality is, I can’t. I don’t have the experience that they do, I don’t have the knowledge that they do. That experience and knowledge will come with time. And if I am kind to myself, and let myself experience the growing pains of becoming who I am as a therapist, one day, I will be able to provide those quality therapeutic experiences.

8. You need to take care of yourself

This is so important. YOU are important. Without you, your therapeutic work will not occur. But, you cannot spend all of your time worrying about the patients that you work with, completing the readings and assignments, working at your internship, learning new music, etc. You have to have some boundaries. There’s no better time to start setting boundaries than during internship. Especially if you’re not getting paid ;-). Initially, I had a difficult time getting all my work and assignments done in the allotted time, so I sat down with my supervisor and let her know and we scheduled some daily office time into our schedule. I hope that you all feel comfortable enough with your internship supervisor to let them know how you’re feeling. If you’re feeling overwhelmed, tell them! They want you to be successful and want you to participate in as many learning opportunities as are available. But it’s also a very short period of time. Six months will go by so. fast. Set boundaries, do things that you enjoy, have FUN, don’t spend all your time worrying about internship. It’s not realistic and it sets you up for failure in your future job. You’ll have to take care of yourself when you’re employed, so why not learn those habits while you’re learning everything else.

All that being said. What do I know. I’m just a lowly intern :)

I miss seeing all of you around the building! But I gotta admit, I don’t miss those Dr G tests ;)

If you ever want to chat or have questions about anything feel free to comment or drop me a line! My electronic door is always open.

Peace,

—Emily

Life Stuff

When to Let Go

I’ve been holding on to something for a while now. It’s something that I hold dear. Something that means something to me. Unfortunately, that something doesn’t want or need me. How do I let that go? I’ve been holding on to this for so long it’s probably to the point of being unhealthy. That something never responds to my yearning. I get no response. I give much more than I get. But that’s because I get nothing in return. Literally. nothing.

Why is it so important for me to hold on? Maybe it’s because I’m confused about why that something has built such a rigid and impenetrable wall. Maybe I did something. Maybe it’s because my heart longs for that something that was once so important in my life. But, things change. I have been the one reaching out to that something for many years. It is clear that something wants nothing to do with me. Why can’t I let it go? What keeps me tied to that something. When obviously, that something is not tied to me.

It hurts to put so much into something and receive nothing. And yet I continue to try. I say to myself that I am done trying and then I try again.

This week in my music therapy group sessions, I talked about identity. Who we are. What makes us who we are. And how identity changes over time. It is interesting to look back on who we once were, even five years ago, and see who we are now, how far we have come. Somethings will come in and out of our lives. Sometimes, it’s easy to let go if something chooses to leave your life. Sometimes it’s not. Luckily, I have a lot of somethings that have filled my life.

And it’s okay to let go.

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Life Stuff

MT-SK-1

This Christmas, I was really lucky and received the MT-SK-1 from Boone. You may ask “what’s that?” because it has not yet been released to the public. But it’s the Music Therapy Survival Kit-1. Everything a growing music therapist needs to survive the rigors of internship.

In this kit is a brand new pair of tennis shoes since I’ll be on my feet all day long walking around the hospital. My kit also came with Hershey’s chocolate for those days that chocolate is a necessity. Which, who are we kidding, is every day. Ibuprofen for headaches and backaches. And Kleenex that fit into my scrub pockets for happy or sad tears.

You’ll also see that it came with playing cards. These playing cards have a dual purpose. First, playing cards for self-care. Each card is also worth a special favor from Boone. I can turn in a card and receive whatever the card says. For example, if I give him a “6”, I get sushi! Or if I hand in the “Queen of Chocolate” Boone has to find me wherever I am and give me chocolate–that’s my favorite card.

I think I’m a pretty lucky gal. And definitely ready to start internship! One week from tomorrow!

I hope you all had a very Merry Christmas and happy holidays and that you got everything you wanted and deserved!

Until next time, fellow BFs.

Life Stuff

Life Updates: Why I’m Still a Student

I love the Timehop app. It takes me back. Today, my Timehop reminded me that two years ago, Boone and I said goodbye to Knoxville and hello to Iowa! Sometimes I think “Wow! Has it really been two years?!” and then other times I think “Wow, it’s only been two years?!” Moving away from everything we knew was difficult. But let’s face it, people do it every single day, so we knew we would make it. And we did! We made it and, dare I say, enjoy it? Iowa has become our home over the past two years. We made a life here, we settled into a routine here, we made friends, gained new family members we never knew we had. It’s been great! And when we moved from Knoxville we thought “Okay, it’s only for two years…” Well, obviously that two years has come and gone and you all know we’re not moving back quite yet. Let me tell you why.

Technically, my program is a 2-year program with an additional 6-month internship tacked on after for a total of 2.5 years. (You’re welcome, people who aren’t good at math.) Two years have come and gone and I have completed most of my master’s degree. Now, hang on to your hats because it’s about to get confusing. Because I didn’t have an undergraduate degree in music therapy, I had some additional courses that I had to take (which all students without an undergraduate degree in music therapy have to take when getting their master’s). Unfortunately, those additional courses didn’t line up well with my professor’s schedule which caused me to miss a seminar course in the fall semester of my first year that only she teaches. Then, in the spring, she went on sabbatical and didn’t teach the seminar, obviously, because she was on sabbatical. Well, for my degree, I need to take three of those seminar courses. If you’re still doing math (good for you), you’ll see that I only had two semesters left to take three seminar courses and that doesn’t add up. The (incredibly) long story short is, I still have one seminar class to take this coming fall semester. At first, I was really upset when I found out because, believe it or not, I’m ready to not be a student. But as time went on, it made me realize that I would have more time to work on my Capstone project (the big finale project that is similar to a thesis or recital) and more time to study for comprehensive exams so I think it all worked out in the end. I’ll finish up my coursework this semester and in January of 2016, I’ll start my 6-month internship at the University of Iowa Hospital and Clinics. A year from now, I’ll be completely finished with my degree (knock on wood) and will be a real life adult who goes to work and doesn’t have to study for anymore tests (knock on wood) except maybe the Board Certification Exam if I haven’t already taken that.

Now…ask me if I’m ready to go back to school and see my eyes roll back into my head.

Until next time, fellow BFs!

Life Stuff

Ketchup. Or Catch Up.

That title probably brought you here under false pretenses. It’s not about ketchup. But how awesome would that be? A whole blog post about ketchup. Maybe that will be in the works. Stay tuned. In the meantime, it’s been a while since I’ve posted. A while…like August. So I guess we should catch up. You and me, we’re both so busy…and I’m not a very good blogger when I’m in graduate school. I think I’ve made that statement in every blog post I’ve made since I’ve been in graduate school. I originally wanted a blog so that all my friends and family members who were far, far away could keep up with the things I am doing in my life. But now I’m not updating this so that’s not really working. Well, for what it’s worth, here’s an update!

Over the summer I got to work with kids with Cochlear Implants and Hearing Aids with speech and language delays in a summer program two days a week. We worked on listening tasks like identifying and discriminating different sounds. We also worked on a variety of speech sounds by singing songs like “The hippopotamus blows bubbles through his nose, bubbles through his nose, bubbles through his nose. The hippopotamus blows bubbles through his nose, blow, blow, blow!” Wonder what sound we were working on there…!

The kids had a bubble gun and they got to make the hippo blow bubbles through his nose if they sang the song!

I also started volunteering once a week in the chemotherapy clinic playing music for patients during infusion. Over the summer, I took a keyboard and it was pretty funny to see the look on the patient’s face when I rolled my cart up with a full size keyboard and was like “Hey y’all, I’m here to play some music…” (That’s an exaggeration, by the way, I don’t say that…) But when I started back last week, I took my guitar. I stayed for three hours Christmas Eve Eve and played all kinds of Christmas and non-Christmas music for the patients and their families. It’s so much fun to listen to their stories. One of the highlights of my week for sure!

I made it through a tough semester of grad school (with straight A’s!) and am looking forward to not being in school anymore. For my practicum setting, I was working with adults with psychiatric disorders (like schizophrenia, bipolar, and borderline personality disorder). I was paired with an undergraduate music therapy student and we worked on social interaction, making positive statements, gross motor skills, and cognitive skills. Co-leading was a great experience and I’m so glad that I got to work with her! It gave me a lot of really good ideas and skills for if I ever get the opportunity to work with someone in the future.

I have 1.33 semesters of grad school left…not that I’m counting. This upcoming spring semester, I’ll take a full course load and then in the fall, I have to take one graduate class, finish up my Capstone project, and take comprehensive exams. I can do it. I hope. By this time next year, I’ll be at my music therapy internship somewhere out there in that great big world. Which is stressing me out at the moment because I don’t like uncertainty and currently, my life is full of uncertainty! One thing at a time.

I’m still teaching piano and voice lessons and have between 8-10 students. I’m about to gain a few more though because I’m going to start teaching adaptive lessons soon! That’ll be a new and exciting challenge for me because I haven’t ever taught adaptive lessons. I’m also still working as a music intern at First Presbyterian Church of Iowa City. I’ve really enjoyed my time there–singing in the choir, conducting occasional bell choir rehearsals, and I’ve even had the opportunity to conduct the choir during services! It’s been such a blessing to have such a welcoming church family. So welcoming, in fact, that they let Boone sing in the choir!

And that brings me to January 2015! That’s a really quick update of the past five months and I’ve left out a lot of details. I’m looking forward to my last semester as a full-time student. I think I’ve been a professional student for long enough and am definitely ready to enter into the real world! I’ve loved the past couple of weeks that I’ve been on break. We got to see my family and Boone’s family. We’ve watched all of the seasons of Parenthood (to be fair, we started that in November…which doesn’t make it much better…but some.) And can we just take a second to say “NO!” about Parenthood…??? Thank you.

Well, I guess that about catches you up with my life. School starts again in a little over a week which means that life ends. Let the countdown to the end of the semester begin!

Until next time, fellow BFs!

Musical Experiences

Guitar Debut

It’s amazing the things you can get done when you don’t have to go to class. Speaking of class…this semester I have been in a guitar class. I’ve been practicing pretty hard so I decided to document my progress by recording where I am at the end of this semester and comparing it to where I end up next semester after the second guitar foundations class!

This was a surprisingly difficult song to sing. Good job, Sara Bareilles, for making it sound so easy. It took me about a million recordings to get it in one take. Plus I have crazy cats knocking DVD cases all over the place, too.

Enjoy!

Until next time, fellow BFs.

Life Stuff

Options, Choices, Decisions…Iowa Stubborn

Over the past several months, I’ve been trying to decide what to do after graduation. Just getting married and experiencing one of the most exciting times of my (slash our) life is apparently not enough for me. I have to make life more challenging than it already is…

I applied to four Music Therapy master’s programs in the fall and have been waiting to hear back from them this spring. I got my first acceptance letter from Radford University, about a month later I got accepted to Illinois State, a week or so later I got accepted to Colorado State and finally I got accepted to Iowa.

In the meantime, a job at the University of TN opened up. It was the first year coordinator position which turned out to be pretty much exactly what I was doing at Maryville College for the past four years. So on a whim, I decided to apply as a backup plan in case I didn’t get any financial aid money from the graduate programs.

The day we before Boone and I got married, I received an offer from Illinois State — full-tuition out-of-state waiver and a part-time stipend working in the school of music office. I felt really blessed because I hit it off with the professors at ISU right away and was honored to receive a full-tuition waiver. A week or so passed and I hadn’t heard from any of the other schools so I decided to check in since I had a deadline to decide with ISU.

I received an email from Colorado State about a week and a half ago saying they had a financial aid offer for me. I opened the email, logged onto their website only to find that they had only offered me loans. A lot of loans. With ISU’s offer already on the table, I politely declined their offer.

As I was waiting to hear from the other two programs, I was invited to do a phone interview for the job at UTK. I was beyond excited about the possibility so I took the chance and set up a time for the interview for last Wednesday. The same day, only about an hour after the interview, UTK called back and invited me to an on-campus interview that Monday.

From the time that I interviewed on Wednesday to before my interview on Monday, Iowa also sent me an offer. Their original offer was only $5,000 a year. Because I had the ISU offer and UTK offer on the table, I sent an email back declining their offer and expressing my gratitude. About an hour later, I got an email back saying there might be another option. By the end of the day, I had a full-tuition research assistantship, stipend, and health insurance offer from Iowa also on the table.

Monday rolled around (which I haven’t mentioned but Monday was my deadline to accept/decline ISU’s offer) and I didn’t want to decline them. The professors at ISU were trying to find more money but they didn’t have anything more available. My interview with UTK went pretty well and I felt really good about it.

Tuesday came. UTK called with a great offer but I also had two other offers on the table. I thought, talked, discussed, cried, and prayed some more about what to do and I decided, as heart-breaking as it was, to call ISU and let them know that I wouldn’t be attending in the fall. So now I only had two offers on the table. And the more I discussed each offer with different people, the more it seemed like staying in Knoxville was the way to go. Everyone seemed to think that staying here and expanding the relationships that we’ve already built was the best choice. And I had to agree with them on a lot of levels. It would be great to be financially stable for the first three years of marriage. But…I’d be sitting behind a desk doing the same job that I have done for the past four years, just for a different institution. As I was weighing the two options, I started asking myself the questions “why do I love being in Knoxville?” and “why would I want to stay here?” to see if that would clear anything up for me. The main reason I’m so happy being in Knoxville is because I get to work with an amazing a cappella group, I have a beautiful church family that I am blessed to work with every week, and we are close to our family. Two of the three of those things would change (or so I thought…) if I stayed in Knoxville. But then, other opportunities started opening up for me as well! I could still work with reVOLution (in a different vein but would still be connected to them) and I would still have the opportunity to stay at Church Street. Of course this made the decision much more difficult. The main reasons I justified leaving were now possibilities if I stayed.

It all came down to this: I would not be happy sitting behind a desk all week long. Yes, I would love to work at Church Street. And yes, I would love to stay connected with reVOLution. But those activities would not be the main parts of my life, they would be what I “did on the side.” And the more I thought about it, the more I dreaded it…

Wednesday morning when I woke up, my head said “Emily, you should stay in Knoxville. There is a lot of stability here.” By Wednesday night, my heart took over and told me that I really needed to go to Iowa. My logical brain knows that staying in Knoxville would be beneficial in a lot of ways, but my heart says to listen to it. And Boone and I decided, if ever there is a time for us to go and do something…now is the time! We don’t have kids, we don’t have any real “ties” to Knoxville. And the longer we stay, the deeper our roots will be planted here.

My deadline to accept/decline the UTK offer was Thursday 4.18.13 at noon. At 11:50am, I called and declined the offer. The second I got off the phone, I felt at peace. Boone felt at peace. And we both are excited about our new adventure to Iowa!

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I hope that if we so choose to come back to Knoxville, our friends and family will welcome us with open arms! We will miss everyone here and it is very sad to leave a place that we have both called “home” for so long. But, as my best pal David says, “it’s all about the story!”

Iowa, here we come!

Until next time, fellow BFs!