On behalf of The Rebecca Center for Music Therapy at Molloy College, I would like to thank all of our 400+ fans (on facebook) for following us as we continue this journey of improving the quality of life of children with autism through effective and cutting-edge music therapy interventions. We have been on a mission, and in essence creating a movement through educating and promoting humanistic and developmental interventions that promote initiative, creativity, and high regard for human relationships. We have come to the realization that autism is not a disorder of memory or a disorder of behavior (whatever that means)…it is a disorder of  RELATING AND COMMUNICATING (When I say communication, I mean functional and conversational back and forth signaling between 2 or more individuals- with the INTENT to express and idea, thought, etc.) So, if that’s the case, why is it that most children with autism are being treated with memory-based/behavioral interventions? why? why? why?

If communication and language are based on symbolism, abstract thinking and initiating ideas through a wide range of affects/emotion, how can we facilitate these skills through memorized responses using prompts? Does that make sense? How do you teach a child to initiate ideas if there always being prompted? How do we teach a child to formulate ideas and be symbolic if they are always being provided with the ideas in terms of always being “asked” to do something for something? (“say this,” “do that, ” “good job”) the answer, I feel, is very simple…: the same way we facilitate reciprocal interactions, symbolism and language in typical developing babies/children- through a continuous flow of back and forth interaction! That being said, when I say back and forth interaction I am not referring to a scenario in which you tickle a baby, he laughs, you tickle him/her again, he/she laughs. What I mean is, you tickle a baby, he/she laughs…then, you slowly move away with a smile and wait, stop, use a facial gesture, little Tommy looks and smiles in anticipation and cues you when to come back and tickle him. Then you get closer and he initiates a tickle.

Yes, of course it’s hard work when trying to relate to a child who may not be wired, neurologically for relating…but isn’t it all about the relationship?- the process and the hard work in creating this creative and playful  space between the child …I think words relating and relationships are the keys words.

All of this being said, how do we do this in music therapy? How do we create interactive musical experiences through musical play? How can we create this musical “play area” in which you and the child are involved in affective and reciprocal musical interactions that do not rely on the child’s memory, but instead facilitate here-and-now musical responses? How can we as music therapists, use the elements of music spontaneously to generate an interaction that facilitates constant thinking of the child while being involved in a back and forth flow of musical dialogue through a wide range of emotions?

Thoughts? Ideas? Feedback? Agree? Disagree? Let’s problem-solve folks…I’ll stop the ranting now…:):)

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About drjohnmtbc

John A. Carpente, PhD, MT-BC, LCAT, NRMT, Assistant Professor in Music and Music Therapy at Molloy College, is the Founder and Executive Dir

23 responses »

  1. Brian Abrams says:

    Great topic/question. Here is a potential point of interest that may be relevant.

    In 1959, Chomsky published an important critique of B.F. Skinner’s book on language acquisition in functional, learned behavioral terms. Chomsky favored a psycholinguistic approach, positing innate structures for syntax, capable of creatively organizing linguistic components into meaningful expression. For Chomsky, a functionalist explanation was superficial and ignored important questions, including the issue of accounting for generative grammar, rapid language acquisition of children, and universally creative language use of competent native speakers. Chomsky’s notion of an innate linguistic capacity ran counter to Skinner’s radical behaviorism.

    It would be interesting to link this contrast to a child’s innate capacity for experiencing meaningful, musical interactions with others in a wide variety of ways, even when there are specific neurological issues involved (i.e., autism). It may be that certain children do this differently, but perhaps it is fair to say that all can do it in some way (i.e., that all have a “music child,” to coin the phrase from Nordoff-Robbins MT…if one is willing to take a psycholinguistic/cognitive view in place of the more humanistic view that usually goes with NRMT, with respect to this particular question).

    Just a thought…

    • amanda says:

      I think this is an amazing forum and a very important area of discussion – intentionality is a personal element of the psyche – it impacts our decisions and connections to the world outside of ourselves – often I wonder how clear our intentions are even to ourselves – when logic and words and pictures fail, warmth, love, and musicality always prevail – I had a student long ago who was often so sensorilly overloaded by what was being spoken to her it seemed as if they were painful for her to hear, when these same words were sung to her, there was a clarity and understanding that bridged the gap that for so long stood between us as a team working towards her security and learning – it was amazing that once this key was turned in the way we approached her that she was able to drastically improve her receptive understanding of language and soon began singing herself – the first time her parents heard the words I love you, they were sung 😉 Most recently a child boastfully sang out while making up a song in a play session “Everything is music to me! Everything in the world is muuuuuusic to me!” So while I dont think that memory is the enemy, it is most certainly not the basis on which all learning is formed and yes, caring about interactions, and understanding why they matter to us is the greatest motivator to relating to the world around us! Bravo John for a great discussion forum here! Please feel free to connect to the blog on our website http://www.emergeandsee.net to share some of your thoughts and upcoming events as well!

      • drjohnmtbc says:

        Hi Amanda,
        Thanks for that beautiful clinical excerpt! and i think that you have pointed out something some critical in teaching children, regardless of their needs– the ability to adapt the learning environment and intervention based on the child’s biological differences, as opposed to try and “fit” the child intoa 1-size-fits-all. your example clearly shows a child that had some sensory “road-blocks” that preveted her from interacting. Rather then try and ignore the road blocks, or use aversive measures, you found a way to by-pass the road blocks in order to facilitate an interaction! that’s awesome!
        thanks for sharing.

        Best,

        John

    • drjohnmtbc says:

      Brian,
      That very interesting stuff, Brian (as you usually do)! If you have the article could please forward it? I’d love to read it in its entirety.
      I think you make a nice connection here. And, you bring up another question that I happened to bring up in a lecture last week: “How do we know when the music child has been activated?” is it activated when a child is simply playing, singing, or moving to music in some sort of related manner? If this were true, would the music child be present in a child that is beating in a “pathological manner” (i.e. beating a drum in a perseverative way)? Or, is the music child revealed (in music) when there is an emotional connection being evoked or facilitated in and through the music making (i.e. tempo mobility, changes in dynamics, etc.)?
      If we look at the later, it looks like we are favoring Chomsky’s view: “For Chomsky, a functionalist explanation was superficial and ignored important questions, including the issue of accounting for generative grammar, rapid language acquisition of children, and universally creative language use of competent native speakers.” What would Chomsky say of the music-child? I mean there’s making music and then there’s making music…
      Also, to back track a bit, your comparison reminds me of a quote of Lovaas (the inventor of ABA) that he saidhis book, The Autistic Child (1977):
      “the methods such as ABA that use “artificial motivational reinforcers” are “makeshift solution(s), with a number of drawbacks”…and that “it is probably impossible to build a flexible, highly articulated, ‘fluent’ speech usingfood and other artificial reinforcement”
      Thanks again!
      John

  2. Bill Matney says:

    Hello Dr. Carpente, and thank you for your thoughts! I have enjoyed watching videos of engaging sessions, and am so appreciative of your ability to be in the music with your clients. I wish to offer personal responses that will hopefully be considered simultaneously supportive and challenging.

    First, it seems to me autism, as a disorder, needs to be recognized for its existence across a spectrum. As such, it can affect language, communication, and relationships on varying levels. As such, it also can affect cognitive processing, attention, focus, and yes, even memory. As such, it can also affect sensory processing, and sensorimotor development. Autism is, most importantly, a complex disorder that affects individuals in many, many individual ways.

    Secondly, it seems to me that (and this is a premise I philosophically agree with) that all conscious existence is dependent upon an awareness of relationships and communication; it seems to me that any interaction, regardless of the lens it is viewed through (behavioral, neurological, developmental, psychoanalytic) can likely be broken down into a series of relationships and interactions.

    Thirdly, it seems to me that therapy, in its largest sense, exists in the realm of creating opportunity and possibility for clients. Bruscia noted “If therapy is about finding preferred alternatives that clients have not been able to discover on their own, then it seems self-evident that therapists have to be personal experts at exploring alternatives, their own as well as their clients.”

    I have had the opportunity to work with several board-certified behavior analysts, as well as behavior interventionists, in various school districts. I have worked with many who I would consider very strong, very knowledgeable, and very effective. I have worked with a few who I would consider not as strong. The most capable BCBA’s and interventionists were those that developed strong relationships with their clients. They were also the ones who did not eliminate possibilities, including their use of a developmental perspective in those instances where the goals and the client were best met from that perspective. This would seem to run on par with a previous article posted by the Rebecca Center.

    So, the question must be asked. Why the dichotomy? Are “we” willing to put down the flags from “our” respective Ivory Towers and really engage what quality practice looks like from both a developmental perspective and a behavioral perspective? Shall we even take a further step back and note the value of both structuralist approaches and functionalist approaches? Is it possible that both sets of perspectives have their arenas of effectiveness, particularly when related to a disorder that runs along a variegated spectrum? Is it possible that both have inherent strengths and inherent weaknesses that can be detailed? Are we willing to take the steeper learning curve so that we achieve a higher level of possibilities for our clients? Or, shall we look to deconstruct and problematize the other perspective with only a marginal understanding of what such entails? I ask myself these questions as much as I sincerely offer them to you. For many reasons, they have weighed on my mind heavily as of late.

    • drjohnmtbc says:

      Hi Bill, Thanks so much for your thoughts and ideas. I greatly appreciate your views
      I agree with you that autism can disguise itself in many ways, however, in looking at the DSM it appears that core deficits of ASDs revolve around relating and communicating. Of course other areas may be affected, such as motor-planning, sensory processing, auditory processing, etc. however, the biological differences mentioned are areas that each affect the child’s ability to relate and communicate. That being said, if we are working with a child who has poor motor-planning ability, we may work on this in and through the relatihshiop. Everything is realized through the interaction and the child’s ability to relate and communicate
      Yes, I agree that everything can be viewed as a series of relationships and interaction, however, the key, I think, is the level of importance of the relationships. If someone is working with a child 1:1 and all of sudden the child jumps out of his chair and begins to aimlessly roam around the room (may be due to the child seeking vestibular input), the behavioral lens usually focuses on the behavior and then begins to strategize and use an intervention (or refer to the behavioral protocol manual) on how to get the child to sit. Sometimes this intervention may be aversive and sometimes maybe not- in any event, the focus is not on interaction or the relationship. The focus is on the behavior. The lens, at that moment, is not looking at the “whole” child, and it is certainly not trying to decipher what may be causing the child to roam. That being said, a developmental lens may focus on the child, and begin to formulate strategies of “how can I meet this child during this movement craving moment in order to engage and facilitate relatedness and communication?” If a behaviorist is observing my intervention, they may say, “by doing that, you are reinforcing this type of behavior.” That comment alone is telling that the focus is on the behavior. To complete the example, my belief is that by meeting the child where he/she is, in this case moving and interacting with the child, the goal is to deepen his/her experience in the relationship/interaction (through music making) whereby the child will discover strategies of how to self-regulate—the motivator is joy of interacting. So, he wants to be related just for the sake of wanting to be in a relationship with other people as opposed to external motivator.
      I also agree with your quote of Bruscia, however, I look at it as being expert in other areas within a philosophical foundation. For example, I too use interventions that behaviorists would say are behavioral interventions, such as limit setting, boundaries, prompt, etc., however, I implement them through a DIR, humanistic, etc. perspective.
      I also agree with you that in all disciplines and models there are effective clinicians. I have had the pleasure of knowing very effective ABA folks, however, it’s all how one view effectiveness. If effectiveness means seeing a child alter his behavior through behavioral protocols then yes, that is effective. It all depends on what we are looking at. What I see as being effective, im sure ABA may not, and vice verse.

      In addition to being a clinician, I am also an educator and a clinical supervisor. Being an educator, it’s my job to share all information with my students regardless of my opinion (just as I did when I posted the info on the use of both developmental and behavioral interventions). It’s up to the individual to decide on how they want to work.
      My perspective is just that- it’s my perspective. It’s what I believe. It’s how I work, and it’s where my passion lies. It is never my intent to display arrogance, or to be disrespectful to other model, clinicians, etc.
      That being said, I do feel that children with ASDs can benefit from using both developmental and ABA approaches. I have experienced this first hand, many times. I think that using both models simultaneously may be counter-productive.
      I really appreciate your thoughtful response. And look forward to hearing more of your ideas!
      All the best,
      John

      • Bill Matney says:

        Hello John,

        Thank you for your reply. I feel that these discursive opportunities only help to serve us as a community.

        It is perhaps important here for me to return the favor of context. I am also a clinician, a clinical supervisor, and a university educator. I am also, of course, a life-long student of our profession. As such, I have engaged in opportunities to study and utilize multiple “methods” in my work. I am a staunch supporter of music-centered clinical improvisation, and believe me, I have swum against the tide when I utilize such in behavioral environments.

        I am willing to consider, and potentially utilize, an integrationalist perspective in my work. In some respects, I believe what many see in this case as problems of “perspective” are often, although perhaps not always, problems of terminological difference. I hope it is understood that the questions I pose are and have been directed towards both models/philosophical takes being discussed.

        Onward with the spirited dialogue!

        You noted….
        _________
        “the behavioral lens usually focuses on the behavior and then begins to strategize and use an intervention (or refer to the behavioral protocol manual) on how to get the child to sit. Sometimes this intervention may be aversive and sometimes maybe not- in any event, the focus is not on interaction or the relationship. The focus is on the behavior. The lens, at that moment, is not looking at the “whole” child, and it is certainly not trying to decipher what may be causing the child to roam.”
        _________

        In my experience, the focus is not only on the behavior, but also the cause for that behavior. A common term used in ABA to describe what happened before the child behaved a certain way is “antecedent.” Furthermore, the result of that child’s behavior is analyzed. This is commonly called a “consequence.” So we have the terms antecedent, behavior, and consequence. These items tend to be considered in detail, and many antecedents and consequences are categorized and named. In my experience, the process of motivation is considered.

        While some BCBA’s may communicate their behavioral perspective in the way you describe, I work with BCBA’s who thrive on their relationships with their clients, and the interactions that take place. I can not agree with your proposition that interaction and relationships are not included in the ABA perspective.

        Motivation, action, reaction, interaction…..
        Antecedent, behavior, consequence, intervention….

        A true difference in perspective, or a difference in terminology? If we are going to consider the function and structure of language for our clients (Skinner, Chomsky, Deridaa, Deleuze) should we not explore the ramifications of language and meaning for ourselves? Thoughts?

        “Pathological” beating….

        What exactly is pathological beating? Is this not describing a behavior and its “disease-ridden” cause? How is this phrase more child-centered than a behavioral description? I’ve been curious about the CMT considerations of this “Categories of Rhythmic Response” for a while. My tendency has been to side with the more, from my understanding, neutral and relationship-termed IAP’s related to rhythm. But again, there may be more to the NR terminology than I have been privy to. Perhaps it’s another terminology issue, and perhaps not. Perhaps it’s a matter of taking the phrase out of context. Perhaps such is a matter of the age of the material (1971), and our progression as a field. Thoughts?

        You noted from The Autistic Child (1977)::
        _______
        “makeshift solution(s), with a number of drawbacks”…and that “it is probably impossible to build a flexible, highly articulated, ‘fluent’ speech usingfood and other artificial reinforcement”

        It should be understood that a book from 1977 does not hold as the contemporary book on “verbal behavior.” The most recent work in verbal behavior was written by Mark Sundberg. Like any substantiated technique within a particular modality, the process has its successes and limitations. Perhaps what I am most interested in is an honest discussion about what works and what doesn’t in relation to our own perspectives. I fail to see that kind of bold honesty very often. When I do, I find it immensely refreshing.

        There is no doubt that the ability to interact through music has powerful potential, regardless of what words or perspectives we engage in the process. I thank you for sharing your use of such.

        -Bill

  3. Roia says:

    John, I absolutely agree with you! Of course, I work with adults and not children who are on the autism spectrum, but it’s the same thing. It’s about the relationship.

    I just had this conversation with a staff person today who wasn’t understanding why I do what I do (which is build relationships with my clients through music). I tried to explain to her that without a relationship there is no earthly reason for my client to have any investment or interest in growing (emotionally, cognitively, etc.), let alone taking part in music therapy.

    As to the how, the first step (and likely the second, third and fourth) is to pay very close attention. What I’ve been taught is to reflect musically and to begin to build meanings together as I begin to see responses to my attention (in other words, interpret what I see and check with my client(s) to find out whether or not I’m on the right track).

    Just this evening I had the double pleasure of hearing one of my clients engage with me musically for a sustained period of time (twice in one session), clearly responding to my sung “invitation” (the second time, she initiated the inviting). The second pleasure was the fact that her staff person noticed it. Granted, she thought it was “cute” (rather than understanding the effort this woman was making to begin to take part in a relationship), but at least she took the first step of noticing it.

    • drjohnmtbc says:

      Hi Roia,
      Thanks for sharing your story! yes, the relationship is key, and that’s where “non-relationships based” interventions differ. we are not looking at isolated behaviors, but viewing the “whole-person,” whihc of course includes the behaviors, however, the later is not our focus. our focus is to deepen the person’s expereince with us to generate or facilitate higher levels of thinking of whatever that may be depending on the goals and needs of the client.
      the “cute” comment i’m sure we all can relate to. it shows how we all take things for granted, and sometimes are blind to all of the “small” variables that are involved on such an interaction.
      Thanks again for posting!

      Best,

      John

      • drjohnmtbc says:

        Hey Bill,
        Thanks again for your thoughts!
        I am not saying that interaction and relationships are not a part of ABA. It’s just been my experience that the behavior of the individual took precedent and was the main focus (i.e. trying to get the child to do something or stop the child from doing something).
        “Motivation, action, reaction, interaction…..
        Antecedent, behavior, consequence, intervention…. “
        I would say that interaction comes first, followed by following the child’s wish/lead and joining into whatever the child is doing.
        This is a big question that you pose, and I understand what you’re saying “A true difference in perspective, or a difference in terminology? If we are going to consider the function and structure of language for our clients (Skinner, Chomsky, Deridaa, Deleuze) should we not explore the ramifications of language and meaning for ourselves?”
        However, in putting this in the context of working with child with ASDs, functional language, I would say, it the use of words to express ideas and communicate ones self. We know that words are built from symbols and emotion. Everything we say has some sort of affect attached to it. Without it, words are hallow, with no meaning. They become rote and scripted. This is a result of learning words through memory based interventions as opposed to a thinking based intervention. In your perspective or framework, how would you facilitate symbolism and abstract thinking when working with a child with ASDs? How would you facilitate initiation and intentionality? Prosody?
        “Pathological” beating…. This is an NR term- categorizing various forms of drumming, relating to the music-child concept. I don’t think the words or terms make up a model. It’s more about application and philosophical underpinning.
        I understand what you are saying in regards to contemporary books, however, coming Lovaas it’s saying a lot, and to me it makes sense in following along with child development as stated above in regards to facilitating “functional” language.
        Once again, thanks again for the food for thought. I thoroughly enjoy the back and forth exchanges!
        Best,
        JOhn

  4. Bill Matney says:

    Hello John,

    Thank you for your quick response. My thoughts and replies below:

    ________________
    You note: “I am not saying that interaction and relationships are not a part of ABA. It’s just been my experience that the behavior of the individual took precedent and was the main focus (i.e. trying to get the child to do something or stop the child from doing something
    ________________

    The reason for this, as I am familiar with it, is largely a consideration of practicality. We are ineffable, complex, and subtle (and thank goodness!). We are immeasurable. Our relationships are immeasurable.
    Behaviors and skills are measurable. When therapy seeks to assess what change has taken place (if any), we utilize that which allows us to measure in a concrete fashion. A practical way for us to identify personal/interpersonal development is through measuring behaviors or skills that we commonly associate with such. The use behavior as a context for measurement is rather common in many forms of therapy, including NR.

    It seems to me that relationships are an inherent aspect of therapy. It seems to me that teleos (purpose, change) is an inherent aspect of therapy. It seems to me that measurement, if not inherent, is at least a commonality in therapy practice (and in music therapy, I would say such is inherent). I’m certainly not looking to sell this reconciliation to anyone else, but I fail to find a reason to believe that these behavioral and interactive frameworks are demonstrably different.

    If you believe strengths exist within the ABA model, what might you consider those strengths to be?

    If you believe weaknesses to exist within the DIR floortime model, what might you consider those weaknesses to be?

    ________________
    You note: “I would say that interaction comes first, followed by following the child’s wish/lead and joining into whatever the child is doing._
    ________________

    I am a big believer in the above. We can (although, we are not limited to) potentially view these steps following the developmental play patterns. After this is accomplished, and you’ve created increased levels of engagement and rapport, where do you go from there?

    ________________
    You note: However, in putting this (large philosophical question) in the context of working with child with ASDs, functional language, I would say, it the use of words to express ideas and communicate ones self. We know that words are built from symbols and emotion. Everything we say has some sort of affect attached to it. Without it, words are hallow, with no meaning. They become rote and scripted. This is a result of learning words through memory based interventions as opposed to a thinking based intervention.
    ________________

    I assume we can agree that therapy, through whatever modality, tends to work on goal/objective areas that can be generalized.

    I agree that communication is symbolic and affect-related. I agree that communication is also about relationships. I assert that there is a functional component to language that is memory-based, because memory is also symbolic and affect-related. Memory plays a role in our constantly developing language. We formulate word schemas, or word-relationships, through the process of associating words (and their associative experiences) with other words (and their associative experiences).

    A mand (one verbal operant within the theory of Verbal Behavior) is certainly affect-related, and is related to motivation/desire. A mand, in many cases, is a person’s request for an item, that request often occuring due to item’s absence. The desire for the item motivates the communication. The relationship with the item motivates the desire. Contemporary ABA practice, as I have witnessed it, seeks to create opportunities for client-initiated communication. A non-verbal gesture or a vocalization, is considered to be functional in terms of demonstrating desire and affect, but not functional when the person being communicated to (i.e. the relationship) does not understand what is desired. How do we seek to achieve a communicative connection between what is desired and what is understood? Through an interactive experience, a BCBA shapes their interactions to facilitate the clients use of the object’s word. The way this occurs differs depending upon, yes, the client. It is not extrapolated or deduced out of a manual any more than our work is extrapolated out of a book. The goal is to take the child’s current communication abilities and assist their movement towards communications that will allow ease of understanding amidst a multitude of potential receivers. It is motivation based. It is relationship-based. It is measured by tangible behaviors.

    I would like to note that ABA, when used successfully, does not seek to achieve at its endpoint an ungeneralized, rote-memorization of a word/concept. In actuality, techniques are utilized in an attempt to avoid this problem.

    I believe that words may very well offer us an expanded ability to express ourselves, and to increase our affective possibilities. The interaction between words and affect appears, to me, to be a two way street.

    _________
    You ask: In your perspective or framework, how would you facilitate symbolism and abstract thinking when working with a child with ASDs? How would you facilitate initiation and intentionality? Prosody?
    _________

    I look forward to answering these five questions. In order to find the best means/meeting points of communicating such, I would appreciate your description of:

    a. symbolism
    b. abstract thinking
    c. intentionality

    _________
    You note: “Pathological” beating…. This is an NR term- categorizing various forms of drumming, relating to the music-child concept. I don’t think the words or terms make up a model. It’s more about application and philosophical underpinning.
    _________

    Yes, the “categories of rhythmic response” are noted in multiple books, including “Therapy in Music for Handicapped Children.” As a percussionist who is very interested in how percussion is used in therapy, I have sought (and continue to seek after) the various branches of percussion use as they have developed. I certainly admire the NR approach to music therapy. I also think it is healthy for us to look critically at how the language we use shapes the way we view our philosophy. I see such as an opportunity for growth.

    ________
    You note: I understand what you are saying in regards to contemporary books, however, coming Lovaas it’s saying a lot, and to me it makes sense in following along with child development as stated above in regards to facilitating “functional” language.
    ________

    One of the beautiful things about the statement is that it notes a potential weakness in the author’s personal philosophy; I am viewing this as an honest self-critique. As mentioned before, this type of “concession” is highly refreshing to me. What an honest challenge to place for the proceeding development of ABA. In the past 30+ years since that concern was written, has the author’s challenge been met by contemporary ABA practitioners? If so, how? One can only know by looking at more contemporary work regarding Verbal Behavior, or other contemporary ABA practices, or even multidisciplinary approaches (utilizing the strengths of ABA and DIR) such as SCERTS.

    As I sit here, snow begins to fall in Texas. We shall only receive a pittance of precipitation compared to you all up north. I hope all is well up there. Please tell Keith hello for me.

    • Keith says:

      I think an important element to consider is that of paradigm. The reality is that when you have two different perspectives, there will be a difference of opinion, a dichotomy if you will. When reading these back and forth comments, I visualize two neighboring back yards that are separated by a wooden fence. Bill, it seems as though you are perhaps jumping up to look over the fence and are spotting things in your neighbor’s fence that are similarly found in yours, like a hose, a garden, wood shed, etc… But, you will not fully know what it is like to work in that person’s yard unless you hop over and work in that field, in that world/plane. I think it best to understand that there is a difference between humanism and behavioralism. Although there are different terms to perhaps describe the same things, the philosophy, the approach and perspective is and will always be different.

      I feel where you’re coming from though. We, despite our philosophical differences, should find a common ground. I find it best to accept those differences. However, I accept those differences while working/playing and celebrating in my yard while not worrying too much about the fence. But the challenge arises when the kid that is coming to work in my backyard gym plays in the neighbors gym too. In most cases, we work together for 30 mins, 1X per week while he’s working with the neighbor for several hours 5X per week (ABA)!

      So, I guess what I am saying is: perhaps the first step forward is to understand that the two playing fields are different. There may be commonalities, but they will always be different and disagree in many areas. Accepting that…now what? What’s the next step? I think accepting that there is a dichotomy is the first step. If it is beneficial for the therapist to take from the other paradigm and beneficial for the kid, then the manner in which that is incorporated is unique to that therapeutic relationship (ahh, the magic r-word). Although there will always be a dichotomy, the therapist can be as flexible as he or she wants. I think the best step forward is to see what we can learn from each other, accepting our difference in opinion.

      • drjohnmtbc says:

        Hey Keith,
        Thanks for you thoughts and your nice analogy! i do agree with you in that we do have 2 different playing fields, and although we can say that there are some similarties, the bottom line is the philosophical underpinnings and lens that we choose to see the client through, and, what and how we view as being salient in the therapy process. it’s great that we can all exchange our ideas- leaves so much food for thought. thanks folks!
        John

  5. Bill Matney says:

    Hello Keith,

    Thanks for your input.

    I hope I’ve made it clear that my personal philosophy doesn’t rest in the behavioral realm, and it never has. What I have noticed is an all too often intent to challenge, often on unfounded grounds, the “kids playing in the other yards.” I find that unfortunate.

    I continue to believe that a lens is not the only mechanism that guides my view, but also the aperture….an aperture which I may control the expansion of.

    For me, it is precisely in the progressive knowledge of theoretical orientations with which a dynamic, not static, dichotomy is defined. This is not something new in music therapy. In fact, the schema considerations I’ve brought up are inspired by the recent work of Kenneth Aigen, who also happens to see such as a potential connection to Thaut’s work.

    ___________
    You note:
    “If it is beneficial for the therapist to take from the other paradigm and beneficial for the kid, then the manner in which that is incorporated is unique to that therapeutic relationship (ahh, the magic r-word). Although there will always be a dichotomy, the therapist can be as flexible as he or she wants.” I think the best step forward is to see what we can learn from each other, accepting our difference in opinion.
    ___________

    Absolutely! Again, for me, it is the amount with which we take the opportunity to expand our ‘field of play’ (with no reference to Kenny, here, but rather to your backyard analogy), that allows us to incorporate a slew of possibilities within a therapeutic experience.

    best to all of you!
    Bill

    • drjohnmtbc says:

      Awesome back-and-forth folks! lets keep it going, guys!
      Best,

      John

      • drjohnmtbc says:

        And i think i finally figured out how to reply so my comments in the proper area…yes!! hahaha ):) Bill, thanks again for your contributions. in regards to last post, i feel that to challange brings out some great dialogue and wonderful exchanges, at least for me anyway. so let’s play in each others yard—chips on the ball!- it makes me think more deeply about my views and others too!
        thanks for that.

        John

      • Bill Matney says:

        Hello John,

        So, in the spirit of give and take, I’ll re-offer these questions from a previous post. Regardless of whether you, Keith, or I answer these questions publicly or not, I do think that personally answering them (and their respective inverse questions) for ourselves may be a worthwhile dialectic exercise.

        “1. If you believe strengths exist within the ABA model, what might you consider those strengths to be?”

        “2. If you believe weaknesses to exist within the DIR floortime model, what might you consider those weaknesses to be?”

        Alright, off to sleep!

        Bill

  6. Bill Matney says:

    Hello John and Keith,

    I’m offering this as my final note to what has been an elucidating thread. I wish to offer some points that may clarify my impetus. You are more than welcome to respond to me here, or to respond personally via email to continue the dialogue.

    Imagine yourself attending a national conference presentation about working with children with autism, using a particular set of techniques. The presentation is being co-presented by a psychologist and a music therapist. You work with children with autism. You’ve developed an entire approach that has been demonstrated as effective through a combination of approaches, including your own well-researched and practiced perspective. You are familiar with the techniques in general, having used them in other settings but this appears to be exciting and fresh material. The session begins, and the first words out of the psychologist’s mouth are “Creative Music Therapy is dead.”

    How would you respond to that? What type of relationship has now been developed between you and the presenters? What level of perceived credibility would you give the presenter from that point on, considering their intitiation? I know it’s a different setting, but is this really meeting the participants where they are at?

    I have a music therapy colleague who experienced this first hand this past conference, but the phrase used was “Behaviorism is dead.”

    My music therapy colleague is well-versed, well-practiced, and highly effective. Her approach to working with children with children who have autism utilizes and accepts the strengths of Verbal Behavior as it is currently practiced. My colleague has developed a music therapy model that utilizes motivation, relation, improvisation, behavior, cuing, and most importantly, relationships. When my colleague walks into a classroom, students with autism run to her and hug her. They communicate with her through whatever means they have developed, and she is in part credited for facilitating their increased interaction and communication.

    My colleague has utilized floortime techniques in past work. She was excited to learn how she may utilize new ideas to further develop her approach. She was immediately met with the phrase, “Behaviorism is dead” at the outset. Quite an evocative and dubious statement, it appears to me to scream “pick your side, and make sure you are on the right one.” Is that meeting the participant where they are at?

    By no means is this thread anywhere near as ascerbic as that experience was, but I am wondering if this is the direction that the strengths of this approach can be best disseminated and received . As I mentioned, I am hoping to appear simultaneously supportive and challenging of your comments.

    Western culture places large value on perceived dichotomies. We witness that in our cultures discussions of religion, politics, philosophy, and so on. We live in a polarizing “argument culture.” We even witness that in our own field.

    Of course philosophy and psychology delineate waves of thought, with essential differences. Of course that is to be accepted. But, these perspectives don’t live in a vacuum, and neither do ours. For me, the challenge is not in “defeating” the other perspective, but in truly striving to know the other perspective and to be informed by it. Ultimately, isn’t philosophy about forming relationships as well?

    ____________________
    Keith noted:

    “Bill, it seems as though you are perhaps jumping up to look over the fence and are spotting things in your neighbor’s fence that are similarly found in yours, like a hose, a garden, wood shed, etc… But, you will not fully know what it is like to work in that person’s yard unless you hop over and work in that field, in that world/plane. I think it best to understand that there is a difference between humanism and behavioralism.”
    ________________

    I have worked in “both gyms” (those being behavioral and humanistic). I understand there is a difference. I accepted that long ago. But, if I am incapable of seeing over the fence to see the inherent similarities and “fully know”, then how can someone using the same vantage point fully know the difference? How can “they” make valid judgements about what is different? Are we willing to accept that there are similarities? Is it perhaps best to, as you say, just not worry about the fence and offer the positives of what we do?

    My initial question…”Why the dichotomy?” does not question whether some essential difference exists. It questions the memetic undercurrent to challenge without knowing, to challenge without relating. If we are truly interested in relating first, let’s see that occur across the board. That will keep people like my colleague engaged, validated, excited, and developing. That will benefit everyone. I offer this as a reflection to myself as much as to anyone else interested.

    In response to Keith’s well-considered thoughts above…..a recent quote from my brother, who I am so honored to know.

    “”Learn to love some of what you hate. Place it where you place your rewards, and change how you respond to it. Not as a capitulation or surrender, rather, as a celebration of breathing while in pursuit of some other more rarefied thing you love. This is discipline.”

    sincerely,
    Bill

    • drjohnmtbc says:

      Hi Bill,
      As usual, I completely respect your opinions and ideas, and I understand what you are saying, however, I think that context is necessary. I know that conference and presentation very well, as I was the music therapist who co-presented (I’m sure you knew that already). Firstly, I apologize to your colleague if her feelings were hurt in anyway, as I’m sure that that was not the intention of Dr. Tippy. Secondly, if someone stated, at a national conference that “Creative Music Therapy was dead” (as the NAMT did to Clive and Paul way back when, when they were refused membership to the organization) I would stick around and listen to the context and where the message is coming from; and if I didn’t agree, I would I would join into the dialogue and make my stance known (is the person making the comment versed in CMT?)
      In the context of Dr T’s comment, he simply referred to the latest literature and research Also, is the person expert in CMT? Dr. T comes from an ABA background, and had studied and worked with some of the most well known ABA folks in the country. In recent years he has immersed himself in the DIR “yard”, and just authored a “DIR” based book with a highly regarded DIR “person.”
      In regards to “meeting the participants where they are at” at a conference, personally, for me, at a conference, meeting the participants “where they are at” is not my goal. When I present at a conference I’m not being a therapist. I’m there to talk about the topic at hand- of course I want to be understood.
      Yes, philosophy is about forming relationships; however, relationships can also be shown as differences. And in my mind, although there are similarities (relationships) with ABA and DIR “on paper-“ (in the words we use) one can say that things are alike, however, in practice, everything changes. How can a therapist be able to use both interchangeably? Aren’t the goals completely different? Aren’t the processes completely different? The clinical supervision (depending on the supervisor)? What would the clinical supervision look like? Would it focus on the relationship dynamics (counter-transference)? In my experiences, relationship-based therapies are more inclined to bring out counter-transferences, because the work is constantly occurring within relationship dynamics. If ABA worked in that “space” it wouldn’t be ABA, would it? Are both models really interested in the dynamics of the relationships as to what’s happening in the space between client-therapist? The titles of the Models, for me, are telling, and when you move into the other yard, what are you really doing?
      How can a therapist be an expert in several approaches? What’s wrong with having an identity? When your foot hurts, you go to a foot doctor. When your eyes are bothering you, you go to an eye-doctor. Can we be everything to everyone? Also, how can a person be properly trained in several models/approaches? For example: therapists may say, “I do NR music therapy” so I’d ask, “When did you do the training?” And he says: “never, I got the books and attended workshops. That most definitely doesn’t equal all of the course work and supervision that the training involves. I’m sure the ABA certification process is just as rigorous – both trainings, I believe, require a Master’s degree.
      I think it’s important to recognize the differences of what we do, and come to the realization that we can not be everything to everyone. I respect therapists that are ABA certified. I’m even on a board of directors of an ABA foundation and an ABA school. In addition, I helped develop a music therapy program in an ABA school. I have a tremendous amount of respect for the founders and the entire board of trustees. I support the foundation, attend fundraisers, etc. That being said, I am on opposite sides in regards to philosophy—we would get into great discussions because of our opposites and both would walk away knowing more.
      I’m sure your colleague is a terrific music therapist, and again, I’m sorry that she walked away with any negative feelings. That was not the intention.
      Ps. I’ll respond to your last post regarding strengths and weaknesses of the models next. Been away, so I haven’t been able to keep up).
      Thanks, Bill
      Best,
      John

      • Bill Matney says:

        Hello John,

        Replies below:

        _____________________
        “Firstly, I apologize to your colleague if her feelings were hurt in anyway, as I’m sure that that was not the intention of Dr. Tippy. Secondly, if someone stated, at a national conference that “Creative Music Therapy was dead” (as the NAMT did to Clive and Paul way back when, when they were refused membership to the organization) I would stick around and listen to the context and where the message is coming from; and if I didn’t agree, I would I would join into the dialogue and make my stance known (is the person making the comment versed in CMT?)”
        __________________

        And, as you can guess, such a polemic by NAMT was not, and would not, be accepted. The proof is in the pudding.

        I do not speak for my colleague, or assume that her feelings were hurt. I will say that the material presented was not compelling to her in regards to demonstrating that “behaviorism is dead.” I would be happy for you to delineate that context in its entirety, including all the research that was discussed, because I also do not feel compelled to accept such a polemic either. The proof is in the pudding. I am versed enough in relationship-based practices to “assert” such, but I really fail to realize why or how that would be a qualification. I am also open enough that if the research truly shows the Nietzchean demise of Applied Behavior Analysis, then I will concede and move forward.

        ______________________
        “Yes, philosophy is about forming relationships; however,
        And in my mind, although there are similarities (relationships) with ABA and DIR “on paper-“ (in the words we use) one can say that things are alike, however, in practice, everything changes. How can a therapist be able to use both interchangeably? Aren’t the goals completely different? Aren’t the processes completely different? The clinical supervision (depending on the supervisor)? What would the clinical supervision look like? Would it focus on the relationship dynamics (counter-transference)? In my experiences, relationship-based therapies are more inclined to bring out counter-transferences, because the work is constantly occurring within relationship dynamics.”
        ___________________________

        I am saying that, in practice, as someone who has practiced behavioral-based and relationship-based approaches, they are not completely different. I’ve stated that several times now. I am saying salient differences exist. I reject the notion that, in practice, they are polar opposites. I reject the polarization. I reject the polemic.

        Countertransference is a phenomenon that exists in practice across the board, and I believe it should be taught and understood, regardless of theoretical orientation. That’s another topic. I agree that there is a qualitative difference in this regard, but I do not agree that there is a complete difference…such largely depends on the goals being addressed, and no, therapeutic goals are not necessarily, completely, different. Tendencies, gradations, qualitative differences. I agree. Polarizations…..I reject.

        When you have a chance to respond to strengths and weaknesses, I believe many of the questions you offer will be….contextualized.

        You ask:
        _________________
        “How can a therapist be an expert in several approaches? What’s wrong with having an identity? When your foot hurts, you go to a foot doctor. When your eyes are bothering you, you go to an eye-doctor. Can we be everything to everyone?”
        _________________

        I don’t recall stating that a therapist should be an expert in several approaches. I’m not sure why the question is being asked. However, if Dr. Tippy, whom in no way I am discounting for his work, is credited with having expertise in both fields, then I suppose that answers the question.

        I don’t recall saying anything about “having an identity.” I also don’t personally see that as an issue, whether one decides to embrace a specific theoretical model full-force, or decides to engage more than one theoretical model. The word “identity” encompasses something so much larger.

        What I did say is that contemporary knowledge is vitally important when interacting with theoretical orientations, whether one embraces them or questions them. I personally will continue to engage multiple theories, and utilize them in my practice, as they and I evolve. I’m not compelled to do otherwise.

        You said:
        _________________________
        I respect therapists that are ABA certified. I’m even on a board of directors of an ABA foundation and an ABA school. In addition, I helped develop a music therapy program in an ABA school. I have a tremendous amount of respect for the founders and the entire board of trustees. I support the foundation, attend fundraisers, etc. That being said, I am on opposite sides in regards to philosophy—we would get into great discussions because of our opposites and both would walk away knowing more.
        _______________________

        I’m sure that your perspective is greatly appreciated in ABA circles, both as a sounding board and a voice of differing opinion. Thanks for your thoughts.

        -Bill

      • drjohnmtbc says:

        Hi Bill,
        thanks again for your reply- just letting you know that i’m not trying to get you to concede. this dialgue, and ones to come, for me, are not about surrendering what we each bring as people, clinicians, etc. It’s more about exchanging our passions. My statements, comments and ideas are just my own personal opinions based on my clinical, personal and life experiences. I appreciate you taking the time out to participate. This back and forth, for me, is fun and stimulating.

        Best,

        John

    • Keith says:

      Just wanted to make some corrections. Earlier, I stated: “Bill, it seems as though you are perhaps jumping up to look over the fence and are spotting things in your neighbor’s fence that are similarly found in yours, like a hose, a garden, wood shed, etc… But, you will not fully know what it is like to work in that person’s yard unless you hop over and work in that field, in that world/plane. I think it best to understand that there is a difference between humanism and behavioralism.”

      – I should have said: “spotting things in your neighbor’s “yard”…and I guess it’s “behavior-ism”, not behavior-alism :). Cheers.

  7. […] when I was in internship, I took a good hour and a half to read the insightful debate generated by this post (and the comments after).  Good, good stuff, and the kind of discussions MT’s need to have to […]

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