Considering Musical Dimensions in Relationship-based Work: New Directions in Music Therapy

Treatment Planning

-John A. Carpente, Ph.D., MT-BC, LCAT -Gerard Costa, Ph.D.

-Brian Abrams, Ph.D., MT-BC, LPC, LCAT -Jill Lucente, M.S., MT-BC, LCAT

-Suzanne Sorel, D.A., MT-BC, LCAT -Gabriela S. Ortiz, M.S., MT-BC, LCAT

Molloy College Suffolk Center, Farmingdale, NY

October 11, 2013

A Look at the day…

•Overview of IMCAP-ND

•Infant & mental health supporting IMCAP-ND constructs & ideas

•Music-centeredness to create the identity of the MT & role within an interdisciplinary team

•Practical use of IMCAP-ND in the clinic in terms of - goals writing & evaluating progress

•Self-assessment of the MT based on IMCAP-ND

IMCAP-ND: A Developmental

Relationship-based Framework for Assessing Musical-Play Interactions

John A. Carpente, P.h.D., MT-BC, LCAT

Nordoff-Robbins Music Therapist

DIR/Floortime Practitioner

Founder/Director, Rebecca Center for Music Therapy

Assistant Professor, Music Therapy, Molloy College

IMCAP-ND: Clinical Manual

•Developmental relationship-based framework on how clients perceive, interpret, and create music with therapist

•Rating musical: 1) emotional responses, 2) cognition and perception, and 3) preferences, perceptual efficiency, and self-regulation

Carpente, J. (2013). Individual Music-Centered Assessment Profile for Neurodevelopmental Disorders (IMCAP-ND): A Clinical Manual. Baldwin, NY: Regina Publishers

IMCAP-ND features:

• Three developmentally based, quantitative scales

Guiding principles for conducting assessment process

•Protocols, rating scales, procedures for support, intake forms, and evaluation report templates

Carpente, J. (2013). Individual Music-Centered Assessment Profile for Neurodevelopmental Disorders (IMCAP-ND): A Clinical Manual. Baldwin, NY: Regina Publishers

IMCAP-ND may be used:

• clinical goals and treatment plans

•musically guide therapist in how to work with the client

•communicate information to parents and treatment team

•pre- and posttest measures to evaluate client progress

Population Specific: Neurodevelopmental Disorders

To name a few: • Autism spectrum disorders • Attention deficit hyperactivity disorder • Motor disorders • Traumatic brain injury (including cerebral palsy) • Intellectual developmental disorder • Communication disorders (speech & language disorders • Genetic disorders, such as fragile-X syndrome] • Down syndrome

Note: Evaluate clients at various developmental levels & chronological ages

from children to adults

APA (2013). Diagnostic Statistical Manual Mental Disorders- DSM 5. (5th ed.): American Psychiatric Publishing.

Foundations of IMCAP-ND

IMCAP’s 3 Rating Scales

•Scale I: Musical Emotional Assessment Rating Scale (MEARS) •Scale II: Musical Cognition/Perception Scale (MCPS) •Scale III: Musical Responsiveness Scale (MRS)

B) 5 music domain areas: 1) musical attention, 2) musical-affect, 3) adaption to musical-play, 4) musical engagement, and 5) musical interrelatedness. C) Scoring: 1) frequency, 2) support, & 3) media. ***REFER TO IMCAP-ND MANUAL FOR OPERATION DEFINITIONS***

Scale I: Musical Emotional Assessment Rating Scale

A) Examine client’s ability to react, focus, recall, follow, and initiate five musical elements B) Scoring: 1) frequency, & 2) media

Scale II: Musical Cognitive Perception Scale

Einstein: "Not everything that counts can be counted, and not everything that can be counted counts"

Value of rating scores/numbers

• Help clinician conceptualize clients

• All relative to therapist’s clinical musicianship, knowledge of NDs, and understanding of IMCAP constructs

• Comparing client's to themselves

• Scores express within the context of interactions & relatedness

• Yes, they are quantitative, but is the scorer?

A) evaluate client’s overall responsiveness and tendencies B) Scoring: 1) Frequency , & 2) Media

Scale III: Musical Responsiveness Scale

Session Format

• Individual MT

• Clinical improvisation

• Media

• Musical procedures

• Supportive procedures

• Procedural consideration

• Procedural phases

Procedures for Support Interventions: Least to Most

• Mild – verbal

• Medium – visual

• Moderate support – partial physical

• Maximum support – full physical support

Cooper, H. & Heward , H. (2007) Applied behavioral analysis. Saddle River: NJ: Pearson Publishers

Nordoff, P. & Robbins, C. (2007) Creative Music Therapy: A Guide to Fostering Clinical Musicianship. Gilsum, NH: Barcelona Publishers

***SEE IMCAP-ND MANUAL FOR SUPPORT RATING SCALES***

Scale I: 5 levels of musical responsiveness (MEARS)

1) Musical Attention

2) Musical Affect

3) Adaption to Musical-Play

4) Musical Engagement

5) Musical Interrelatedness

***REFER TO IMCAP-ND MANUAL FOR OPERATION DEFINITIONS***

Video 1

00: 40- 5:48

Preface

• Past MT work w/previous therapist

• Respecting his scripts

• Continuously altering musical content

• Checking in with him, musically i.e. is he “with us?”

• Assessing ability to engage/adapt to range of musical experiences, e.g., tempo, dynamic, & phrasing

• Primary working in procedural phases 1 & 2 (following client’s lead & 2-way purposeful musical-play)

Scale II: Musical Cognitive/Perception Scale (MCPS)

1) Reacts

2) Focuses

3) Recalls

4) Follows

5) Initiates

***REFER TO IMCAP-ND MANUAL FOR OPERATION DEFINITIONS***

Continue with Video…

11:00- 16:27

Preface

• Fixated on clock/time

• Re-directing; assessing in legato while incorporating client’s ideas/fixation

• Tempo & dynamic variation

• Primary working in procedural phases 1 & 2 (following client’s lead & 2-way purposeful musical-play)

Scale III: Musical Responsiveness Scale (MRS)

1) Musical Preferences

2) Perceptual efficiency

Self-Regulation

***REFER TO IMCAP-ND MANUAL FOR OPERATION DEFINITIONS***

IMCAP-ND being tested: Implications for Research

• Inter-rater Reliability

• Validated against ADOS & PDDBI outcomes

• Treatment fidelity against ADOS & PDDBI outcomes

References • Aigen, K. (2005). Music-centered music therapy. Gilsum, NH: Barcelona Publishers. • Bruscia, K. (1987). Improvisational models of music therapy. Springfield, IL: Charles C.

Thomas Publications. • Carpente, J. (2012). DIR®/Floortime™: Implications for improvisational music therapy.

In P. Kern & M. Humpal. Early childhood music therapy and autism spectrum disorders: Developing potential in young children and their families. Philadelphia, PA: Jessica Kingsley.

• Carpente, J. (2013). Individual music-centered assessment profile for neurodevelopmental disorders (IMCAP-ND): Clinical manual. Baldwin, NY: Regina Publishers.

• Cooper, Heron, & Heward (2007) Applied behavioral analysis. Saddle River: NJ: Pearson Publishers.

• Greenspan, S.I., DeGangi, G., & Weider, S. (2001). The functional emotional assessment scale (FEAS) for infancy and early childhood: Clinical and research application. Bethesda, MD: Interdisciplinary Council on Developmental and Learning Disorders.

• Greenspan, S.I., & Weider, S. (2006). Infant and early childhood mental health: A comprehensive developmental approach to assessment and intervention. New York, NY: American Psychiatric Association.

• Nordoff, P. & Robbins, C. (2007) Creative Music Therapy: A Guide to Fostering Clinical Musicianship. Gilsum, NH: Barcelona Publishers

Contact John A. Carpente, Ph.D., MT-BC jcarpente@molloy.edu Websites: www.therebeccacenter.org www.DMHmusictherapy.com www.musictherapy.org See IMCAP-ND Clinical Manual: www.DMHmusictherapy.com

Purchase IMCAP-ND http://www.dmhmusictherapy.com/?page_id=3822