A heuristic study on music-centered supervision

This first-person study investigated how a music-centered (Modified Bonny Method of Guided Imagery and Music) supervision contributed to understanding the role of music therapy when working with clients diagnosed with a Disorder of Consciousness during a Masters Fellowship. Data was collected from three sources; a) transcriptions from Dr. Heather Wagner and Ms. Madelaine Ventre, b) personal experience, c) and mandalas drawn during the supervision session. This data was analyzed to answer the following research questions; “How does music-centered supervision help deepen my understanding of working with children diagnosed with Disorders of Consciousness? ” and “What do my mandalas reveal about my experience working with children diagnosed with Disorders of Consciousness? ” Qualitative methods of interrogation, interpretation, and triangulation were utilized in order to discover the answers to the research questions. Through careful analysis of the data, four themes were present during the music-centered supervision process: nurturance and containment, preparation, discomfort, and new energy. Each theme provided a deeper understanding to the various stages of the supervision process. This study also provides evidence of the benefits of music-centered supervision for music therapists, especially during their studies and training. Running Head: A HEURISTIC STUDY ON MUSIC-CENTERED SUPERVISION 7 Introduction This study investigated my experience with music-centered music therapy supervision to understand the impact on myself as a clinician, working with clients diagnosed with a disorder of consciousness (DOC). Supervision is a vital part of professional development in the field of music therapy (Bruscia, 2015). Board-certified music therapists need continual supervision to meet the demands of the American Music Therapy Association’s (AMTA) advanced competencies (American Music Therapy Association, 2015). Authors have noted that music therapy supervision is a useful tool that assists professionals and students in their work through a process of debriefing and consultation about clinical cases with a peer or mentor (Bonde, 2012; Forinash 2001; McClain, 2001). Supervision assists in the development of therapeutic skills and provides a mechanism for processing issues that arise in clinical work. Types of music therapy supervision differ by who participates (i.e. individuals or groups) and the supervisor’s approach. Among music therapists, music-centered approaches have been shown to help in addressing the particular challenge of translating musical moments with the client into words, during supervision (Langdon, 2001). It appears that supervision of music therapy students also presents challenges that can be addressed by a music-based approach. Music-centered supervision has also been suggested to be an effective way of addressing the specific needs of students during their clinical work (Shulman-Fagan, 2001). Missing from the literature is how music-centered supervision can benefit students during their academic work. The purpose of this investigation is to expand the knowledge of the benefits of music-centered supervision during a student’s clinical training. Literature Review Professional Context for the Study Running Head: A HEURISTIC STUDY ON MUSIC-CENTERED SUPERVISION 8 Defining supervision. Supervision is a professional relationship between a supervisor and a supervisee where both clinical and administrative evaluations take place (Corey, Haynes, Moulton & Muratori, 2014) and is defined as “a critical watching and directing as of activities or a course of action” (Merriam-Webster Online Dictionary, 2008). Others have defined it as a “concept that includes teaching, modeling, observing, shaping, coaching, and evaluating skills” (McClain, 2001, p. 9). Supervision is utilized to help therapists develop clinical and professional skills necessary for handling the variety of needs clients bring to therapists (Corey et al., 2014). The overarching goals of supervision include: a) promoting a supervisees development within the profession (i.e. competency), b) protecting the welfare of the client (Bernard & Goodyear, 2009; Campbell, 2000, 2005; Kaiser, 1997), c) evaluating performance, and d) empowering supervisees to self-supervise and learn to trust their clinical judgement (Bernard & Goodyear, 2009). Attaining these goals assists therapist in developing their therapeutic skills to meet the variety of needs that clients present. These overarching goals are also utilized no matter which format supervision is chosen. Supervision can be conducted in a variety of formats. Individual supervision is the most common, however group supervision can also be effective (Corey et al., 2014). Individual supervision allows for personalized attention to develop therapeutic skills through self-reporting, direct observation, or video recording. Group or triadic supervision, however, provides a different learning opportunity for supervisees to learn from their peers. The combination of both individual and either group or triadic supervision is most effective in developing therapeutic skills (Corey et al., 2014; York, 1997). According to Corey et al., (2014) each supervisor has their own format for conducting supervision, which is influenced by their theoretical orientation. Running Head: A HEURISTIC STUDY ON MUSIC-CENTERED SUPERVISION 9 York (1997) states that similar to any type of therapy, supervision has a variety of approaches, or models, that can help supervisees develop and learn in their professional development. A supervision model is “a theoretical description of what supervision is and how the supervisee’s learning and professional development occur” (Corey et al., 2014, p. 74). Developmental, psychotherapy-based, and integrative models are three major categories of supervisions. Each category emphasizes various parts of the supervisory relationship and how a supervisee develops as a clinician. These approaches are based on existing psychotherapy approaches that have been adapted to meet the needs faced within supervision (Corey et al., 2014). Developmental models of supervision view the development of a supervisee progressing through stages (Corey et al., 2014). In this model, the supervisor adjusts specific methods to fit the supervisee’s developmental stage, requiring the supervisor to be flexible to meet the needs of the supervisee (Borders, 2005; Corey et al., 2014). The stages of the developmental model are characterized by specific skills that the supervisee presents within supervision. These stages allow for the supervisee to progress and become more confident in their skills naturally. Contrasting to the developmental model, psychotherapy-based approaches emphasize the dynamics that occur between the supervisee and their clients (Corey et al., 2014). Supervisors examine resistance, how the supervisee reacts to clients, and the transference and countertransference that occurs within the therapeutic process. Transference is “when the client interacts within the ongoing therapy situation in ways that resemble relationship patterns previously established with significant persons or things in real-life situations from the past” (Bruscia, 2015, p. 16). Contrary, countertransference is when a therapist interacts with a client in a way that is similar to a past relationship either in the client’s or therapist’s life (Bruscia, 2015). Running Head: A HEURISTIC STUDY ON MUSIC-CENTERED SUPERVISION 10 These two concepts are central to psychodynamic-based models in supervision (Corey et al., 2014). Another concept that is discussed heavily is parallel process, which is used to process the therapeutic relationship between a supervisee and their client. Parallel process is the interaction between the supervisor and supervisee that can be equivalent to the supervisee’s relationship with their client (Corey et al., 2014; Young & Aigen, 2010). The final model of supervision is an integrative approach, which incorporates more than one theoretical approach (Corey et al., 2014). Integrative models offer flexibility because various interventions can be incorporated to fit a supervisee’s unique needs. This approach can, however, be criticized as an excuse for therapists who do not fully conceptualize their practice (Corey et al., 2014). Supervision requires that supervisors meet the variety of needs that supervisees require to develop as practitioners. Music therapy supervision is similar to traditional counseling because the profession has also developed supervision approaches based on established music therapy approaches. Music therapy supervision. Music therapy supervision is a useful tool that assists professionals and students in developing therapeutic skills, and in providing a means for processing issues that may become present in clinical work (Kennelly, Daveson, & Baker, 2016). There is an increasing body of knowledge on the effectiveness (Kennelly et al., 2016; McClain, 2001) of supervision for music therapists, which indicates that music-based supervision leads to increases in feelings of validation, awareness, empathy, support, and trust (Kennelly et al., 2016; McClain, 2001; Shulman-Fagan, 2001; Young & Aigen, 2010). However, there is inadequate evidence examining whether or not supervision improves clinical outcomes. Kennelly et al. (2016) conducted a systematic review that addresses the type and quality of literature about professional music therapy supervision, and the value of the different models. Running Head: A HEURISTIC STUDY ON MUSIC-CENTERED SUPERVISION 11 The findings showed that supervision is a useful tool for developing professional and personal insight into one’s clinical work, however the effects of specific interventions are unknown. Synthesis of the findings revealed two themes: “(1) the use of flexible and creative approaches to supervision, including using music as a tool for supervision and (2) the importance of