Rough and Ready Reflections :: Experiences with Adults with Learning Difficulties

The blog post below was a reflection I wrote the day before I left my temporary home in Cambridge, MA, at the end of May 2014. I discovered it in my drafts folder, and I hope the insights will be as useful to you as they are to me.

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I’ve just completed a 10 week internship at a day centre for adults with learning disabilities. I was there two days per week working on two different floors – one for adults with profound multiple learning disability (PMLD) and another for adults with moderate to severe learning disability, ASD and mental health problems. This is going to be a rough blog post of some ideas I jotted down a week back. I’m about to move continent (back to the UK, via the US West coast) and if I don’t type them up and publish them now, they will very likely languish in a dusty notebook at the back of a filing cabinet and never get synthesised into my practice. So forgive the rough readiness of this list:

  • People want to tell their stories, even people who don’t have words
  • Just because pain -mental or physical- isn’t verbally expressed, it doesn’t mean it isn’t happening. People who don’t have ready access to language still need to find ways to communicate with others, express themselves, and be listened to.
  • Songwriting is hard to facilitate! (more about this in a different blog post)
  • I’m learning more about my bottom line for practice – the negotiation between ‘perfect’ conditions and ‘nigh-on impossible to work in’ conditions. Although I have managed to work on an individual basis to work in large day rooms with many people, it’s not ideal, and should only happen as a last resort to engage someone who due to their pathology can’t be persuaded to go elsewhere e.g. severe anxiety, ASD, or because there really is nowhere else to go (this was the case at the day centre) There are several difficulties: 1. my own self-consciousness; 2. client’s attention; 3. my attention; 4. other people joining in (can be a good thing, but can be distracting, it depends on your goals if this is beneficial or actually harmful or disruptive); 5. staff see when you are not musicing when you may be note-writing, observing, listening-back – and take the opportunity to invite you to work with someone else…. and it’s hard to say no, even though maintaining concentration is really difficult without adequate processing time and breaks.
  • I had a good experience of not trying to be or do too much for a person – one client stopped coming to the day centre, and therefore to music therapy, but then turned up on my last day (coincidence, he didn’t know my dates) and wanted more music therapy from me – and I held my ground and explained no and why we couldn’t. Previously would have frantically thought, oh, I could come in on an extra day, I can be ultra flexible – not necessarily the best thing for the client though – just makes me feel better about myself, by ‘super-helping’.

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Reading these again, there are so many more things that spring to mind as I recall the experience of this internship. Staff were incredibly helpful, and I was lucky enough to be able to work with a trainee arts therapist, and the existing music therapist who were both open to reflective conversations, as well as joining in music therapy groups. And I continue to reflect on the clients I worked with, our interactions, and individual specifics of the course of music therapy that took place.

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