Week 6: Out of Office Experiences

Alright, it’s time for some visuals. I have a terrible habit of never taking a photo record of what I do, so it won’t be photos, but my blog has lacked some color for the last few weeks, and that’s no way to be writing about a creative arts therapy internship.  Besides, this week was colorful; I spent a lot of time doing things out of the office! 

More cross modality geekiness…

In group supervision this week, we discussed scenarios the interns had observed this week, how the other interns had incorporated  or might have incorporate Music Therapy into them, and our ideas for continuing to work on therapeutic goals for that client population with a cross modality approach. It was a pretty lively discussion, and we all geeked out about the possibilities.  It was a great moment.  Next week we’re doing hands on application of cross modality ideas, and we’re all bringing in potential interventions (activities we may use to address a therapeutic goal in session) to try out on one another! My supervisor invited me to bring in a drama therapy intervention or two, so I’ll get to try something out.  I’m psyched. 

Teaching is the best way to learn. 

This is the poster from the fair where I represented ITA at a table on Saturday. 

 Turns out I love talking to people. This is no surprise to myself or anyone else, but I was reminded on Saturday how much I love teaching people about things I’m into. Creative Arts Therapy is exciting and not a lot of people know about it.  I love telling everyone about who ITA is and what we do, sharing my knowledge of our organization even if I’ve only been there a few weeks. Talking to other people also helps me recognize how much I’ve learned about CAT and ITA in those weeks, though, and even more since the last fair I went to on ITA’s behalf. My explanations were more comprehensive and I did less of the “I’m not sure, let’s ask so-and-so” in response to questions. The more I practice my “elevator speeches”,  the more I understand myself about what CAT is, and how each of the modalities can be used. 

Money’s the worst.

Furthermore, the fair reminded me of how much I would like to work for an equal opportunity organization.  ITA does great work. There are financial aid applications available, and we take Blue Cross Blue Shield insurance (if you’re working with a licensed, not just board certified, therapist).  I’m realizing how important it is to me to do work that does not turn people down based on inability to pay or, better yet, offers services targeted at a financially disadvantaged population. One of the parts I loved about my internship last summer was being able to give access to services people may not otherwise be able to afford, and ITA has a similar accessibility. Unfortunately, for an organization like the former to function, there needs to be funding from an outside source, sometimes private but usually from the federal government.

Dance: It’s like talking, but with your body.

On Tuesday I went down to Northwestern Memorial Hospital (cool connection: my parents  did residencies at Northwestern when they were in med school) and observed ITA’s Dance Movement Therapist in session with a Parkinson’s Disease patient and caregiver monthly support group. I observed her session, and then the social worker who ran the group invited me to stay for the rest of the afternoon.  This was the schedule:

10:30 a.m. – 11:15 a.m.  Dance Therapy

It was awesome. I had an absolute blast and was reminded again how much I love dancing, music, and human connection through movement. 

11:15 a.m.- 12:00 p.m.   Physical Therapy

As much as I’ve heard about people having PT, growing up around doctors, having family friends who are PTs or OTs, I’d never seen PT in action.  This one was kind of like an exercise group, with specific, prescribed movements clearly focused on developing certain muscle groups.

12:00 p.m. – 1:00 p.m.    Lunch & Discussion Groups

The group split into caregivers and everyone else; I ended up talking to a really amazing guy who recently moved back to Chicago from overseas after his diagnosis.  I’m sure we were able to have a more open, full, honest conversation because of the connections we’d make an  hour previously in the Dance Therapy session.

1:00 p.m. – 2:00 p.m.   Depression and Parkinson’s Disease Presentation

2 pharmacists presented on the relationship and overlap between the two, specifically from a pharmaceutical perspective. This was followed by an “Ask The Pharmacist” where people could ask anything they wanted. The majority of the questions ended up being about alternative treatments for Parkinson’s and was really interesting (did you know there’s a study being conducted right now on the effectiveness of cinnamon on reducing Parkinson’s progression?)

After the DMT session, the dance therapist talked to me a little about the goals of the group, etc and told me staying to watch physical therapy would give me a better  understanding of the different aspects of the self being addressed by different therapies.  She was right.  The way she explained it, both DMT and PT use the body to improve aspects of the self. Both are scientifically based and proven, they are just different. 

PT targets the physical aspects of a patient. Patients are given regimented movements and specific sequences which improve specific physiological aspects of person. This makes it easier for people to quantitatively calculate benefits; range of motion can have measurable increases, strength can remain constant or improve, etc. 

DMT is harder to quantify,  as it, in this case, targets the mental and emotional aspects of a client.  There are situations in which DMT may be used in a more PT-like setting, to improve coordination or physical ability, etc, but this group uses DMT in collaboration with PT for a holistic approach to address mental, emotional, and physical aspects.  Especially when many clients have some involuntary movements as a result of their diagnosis, many experience negative mental/emotional changes as their Parkinson’s progresses. Locus of control may shift to be more external as they lose their ability to control their own bodies, and a feeling of helplessness is not uncommon as people become more physically disadvantaged.  Dance movement therapy, then, can serve as an opportunity to accept their own bodies and come to terms with their disease’s effects, while physical therapy improves their physical ability. The mind-body connection allows both therapies to help with each other.

The goals for the DMT session in this group included:

1) Self Expression: A slogan that ITA uses is “When words are not enough, the arts can help.”  It’s true- sometimes people need to communicate what they’re feeling through movement.  It’s commonly accepted that “talking it out” can help someone to psychologically work through an issue simply by verbally processing. The same phenomenon occurs when someone uses movement as their mode of communication, kinesthetically processing and “dancing it out”. 

2) Witnessing: In talk therapy, often all people need another human being to listen to them and respond. In dance language, watching someone move is “listening” to them dance, and moving together with them, whether that’s mirroring or having a movement conversation, is response. 

and 

3) Body Acceptance through Dance: The other key part of witnessing is providing a space where it’s okay to move however your body wants to move. When everyone is allowed to “free dance” and the therapist sets the guidelines (sometimes verbally, sometimes by modeling) that all motion is okay, encouraged, and beautiful, people believe it.  The more you are told, especially as someone with a disease that affects motor coordination, that your movements are acceptable, beautiful, and contribute to the group, the more you realize that you, too, are acceptable, beautiful, and contribute to the group. 

We so often associate psychotherapy with talk therapy. Dance movement therapy, it turns out, is not that different structurally, it just uses movement instead of speech as the primary mode of communication.  The same can be said of the other creative arts modalities: same psychotherapeutic goals and outcomes, different technique.

 Oh yeah, regular clinical time, too....

I didn't even talk much about my regular clinical sessions in this post.  They both went well, and I am continuing to develop relationships with the clients. Per my supervisor's request, I started "taking more initiative" in my Thursday MT sessions, and I have a more active role there now.  In supervision we went over the data for the group, and I got to practice assessing whether or not clients had met their goals.  In my Wednesday DT sessions, more of the same storytelling/improvising, and I'm learning to analyze more of how the drama therapist creates the comfortable, free flowing environment so similar to the "free dance" concept and so vital to his group goals for social interaction.

One of the clients in the geriatric facility I work in told goodbye, that he was excited to see me next week on my way out, another at a different session said "oh no" when she learned I had two more weeks... just as soon as I'm getting to know the clients well and get attached, I'll be leaving.  That's why I'm thinking so seriously about this field, though: the clients, the relationships.   I'll be sad to leave but grateful to have rubbed noses with some great clients and therapists.