Music therapy teaming and learning: How transdisciplinary experience shapes practice in a specialist school for students with autism

Music therapy teaming and learning: How transdisciplinary experience shapes practice in a specialist school for students with autism

In plain language

This article describes the results of interviews with a team of music therapists in a transdisciplinary specialist school for students with autism. Participants described a number of benefits and challenges in working alongside and sharing knowledge with staff from different training backgrounds. Themes of this study are drawn together to show how music therapists may make positive contributions to specialist school communities, and how developing long-term relationships with colleagues helps them to shape their own practice over time. 


Abstract

Music therapists are often members of teams within multidisciplinary, interdisciplinary and transdisciplinary frameworks, and occasionally, also form discipline-specific teams. Whilst research literature on collaboration between music therapists and other professions is growing, there is a lack of understanding around the varied experiences of music therapists in transdisciplinary teams. It is vital that music therapists are aware of the challenges and benefits of collaborative practice to promote professional growth and develop practice alongside colleagues. This study is set at a transdisciplinary, specialist school for students with autism. To explore the lived experience of the music therapy team and the factors informing their practice, a qualitative, phenomenological approach was taken, with data collected through semi-structured interviews. Results revealed three professional issues for music therapists in transdisciplinary teams: 1) supporting students in non-music therapy programs, 2) building collaborative and trusting relationships with support staff, and 3) the benefits and challenges of working in both group and individual programs. Implications for transdisciplinary team leaders were: 1) the preferred styles of professional learning, 2) the importance of peer support in building resilience, and 3) the value of diversity and creativity in the collaborative team space. Viewing these themes through a systems theory lens revealed interactive, yearly practice cycles, highlighting the professional responsibilities of each group necessary to ensuring an innovative, collaborative and supportive team culture. The findings of this study begin to illuminate the experience of music therapy teaming and learning, and how music therapists may make positive contributions within a transdisciplinary school setting.

Key Words: Transdisciplinary, music therapy, special education, autism, special school system, music therapy team


Citation

Arns, B., & Thompson, G.A. (2019). Music therapy teaming and learning: How transdisciplinary experience shapes practice in a specialist school for students with autism. Australian Journal of Music Therapy. Advance online publication. Retrieved from https://www.austmta.org.au/journal/article/music-therapy-teaming-and-learning-how-transdisciplinary-experience-shapes-practice 


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Date published: March 2019

Background to the setting

                  This study is set in an independent, transdisciplinary school in Australia for students with moderate to severe autism and intellectual disability, and who need significant support to engage in school life. To meet the complex needs of this student cohort, a team of music therapists, occupational therapists, speech therapists, teachers and support staff combine skills and knowledge across discipline boundaries. In this transdisciplinary model, music therapists facilitate specialist programs and also coach staff in using music to increase student engagement. The music therapists constantly move across different spaces, teams and roles, and therefore need to sustain a large number of relationships with colleagues. Maintaining an openness to learning is a necessary professional quality for the transdisciplinary music therapist in this setting.

 Literature Review

                  Recent workforce surveys have revealed that 44% of music therapists worldwide (Kern & Tague, 2017) and 48% of Australian music therapists (Jack et al., 2016) work with people with autism. Additionally, 22% of Australian music therapists (Jack et al., 2016) and 13% of music therapists around the world (Kern & Tague, 2017) work in schools.  Literature around music therapists working in teams is still focused predominantly on multidisciplinary and interdisciplinary models (Ayson, 2011; Guerrero, Turry, Geller, & Raghavan, 2014; Magee, 2014; Spring, 2010; Robinson, 2015), whereas research and writing on transdisciplinarity from the perspective of the music therapist is less common (O'Hagan et al., 2004; Twyford & Watson 2008). A shift to team-based service delivery is a current trend in early intervention (King et al., 2009; Luscombe & Dibley, 2014), schools (Cross, 2007; Savage & Drake, 2016; Zaretsky, 2007), and some Government funding models in Western Countries, such as the National Disability Insurance Scheme (NDIS) in Australia (NDIS, 2014). Therefore, it is valuable for professionals to understand how they can operate and thrive within a transdisciplinary framework.

                  The meaning of the terms multidisciplinary, interdisciplinary and transdisciplinary may vary from country to country. Choi and Pak (2006) describe multidisciplinarity as drawing on the knowledge from each discipline but remaining within professional boundaries; interdisciplinarity as coordinating links between the disciplines; and transdisciplinarity as transcending the boundaries of disciplines. Reasons for adopting a transdisciplinary model may relate to the complex needs of populations that require a high level of support (Wheeler, 2003), but also where teams need to work closely together, understanding how their colleagues work and, as a result, transforming their own practice in the process (Bock Hong & Reynolds-Keefer, 2013; Twyford & Watson, 2008).

                  Music therapists employed in specialist schools collaborate with a range of professionals, support workers, administrators, families and carers (Strange, Odell-Miller, & Richards, 2016). Being part of a team can increase collective self-esteem and foster higher levels of personal accomplishment (Hills, Norman, & Forster, 2000; Kim, 2012). Warren and Rickson (2016) revealed that a need for validation and connection with other professionals was important to music therapists, and that this could come through reciprocal professional communication between disciplines and with other music therapists. This ability to collaborate effectively in teams is mandated within the Australian Music Therapy Association Professional Competencies policies (AMTA, 2009), and is often highly valued by music therapy employers (Spring, 2010). Therefore, it is important to address this competency as part of music therapy training (Jack et al., 2016). Twyford and Watson (2008) describe some of the benefits of collaboration including greater consistency of interventions, a holistic understanding of client needs, a greater knowledge base to draw on, a deeper understanding of the roles of other team members, reduced feelings of isolation, and emotional support during challenging times. However, collaboration requires commitment, and many factors may impede its success along the way, such as communication style, a lack of flexibility or openness to learning, a fear of losing one’s professional identity, a lack of relevant university training and the adequate allocation of time (Davis, 2007; King et al., 2009; Twyford & Watson, 2008).

                  Music therapists are obligated to engage in ongoing professional learning throughout their careers as a requirement of most credentialing associations. However, some music therapists report difficulty with accessing research literature (Waldon & Wheeler, 2017) and may look instead to their course training and work experience for information to develop their practice (Geist, 2016). In this regard, a transdisciplinary model may offer opportunities for professional growth. Transdisciplinarity involves professionals from different disciplines loosening their specialist boundaries and utilising shared knowledge and skills so to enable role release when working alongside and apart from each other (Twyford & Watson, 2008). However, little is known about how music therapists work in transdisciplinary teams, and even less about how they experience working in music therapy teams. No research literature was found exploring the experiences of music therapy teams in schools. However, research on how teachers and nurses learn from each other in teams of professionals with varying levels of experience and skill has shown that both formal and informal learning are important in gaining contextual workplace knowledge (Hunter, Spence, McKenna, & Iedema, 2008; Sun, Loeb, & Grissom, 2017). These studies show that the flow-on effects from this interpersonal learning are improved outcomes for students and patients, as well as improved feelings of effectiveness and satisfaction for staff (Dickerson, 2017; Ronfeldt, Farmer, McQueen, & Grissom, 2015).

                  In order to explore these themes within a transdisciplinary setting, two research questions guided this qualitative study: 1) What is the lived experience of a music therapy team in a transdisciplinary specialist school for students with autism? and, 2) What are the key factors informing the practice of a music therapy team in a transdisciplinary specialist school for students with autism?

 Method

                  As this was a case exploration of a specific, specialised setting, a qualitative method, drawing influence from a descriptive phenomenological methodology was chosen to address the research questions (Husserl, 1931; Giorgi, 2009). Through phenomenological interviewing, Author 1 gathered descriptive data from the participants, and engaged in an analysis process based on descriptive phenomenology (Giorgi, 2009), the phenomenological microanalysis method (McFerran & Grocke, 2007) and the iterative stages of the phenomenological approach (Finlay, 2014). To encourage participants to freely describe their experiences, the interviews were loosely structured around five open-ended questions, with prompts and clarifying questions used to draw deeper levels of detail and reflection (Ritchie & Lewis, 2003). Given that there is scant literature describing the experience of transdisciplinary teams, this study was designed as an initial exploration focusing on individual descriptions contextualised within a specific transdisciplinary setting. Further, the music therapy team in this setting has been established for over 20 years, and these four music therapists therefore have a rich perspective to offer. The following questions were used to guide the interviews:

·       Can you tell me what led you to study music therapy and how you came to work at this school?

·       Can you describe your experience of working in a transdisciplinary specialist school for students with autism?

·       What informs you in your practice?

·       What sustains you in your practice?

·       Can you tell me about an experience at this school that has held real meaning for you?

                 Each interview lasted between 48-52 minutes, and recordings were made on an iPad using the app QuickVoice Pro, and on a laptop computer using the program Acala Audio Recorder.

                 Author 1 was in the dual role of researcher and music therapy team leader, and so it was important to consider the issue of power in the interviews, and acknowledge her own researcher position in order to openly listen to the participants’ descriptions of experience as distinct from her own. Researchers may engage a phenomenological attitude to describe lived experiences, as phenomenology is understood to be a “process of retaining a wonder and openness to the world while reflexively restraining pre-understandings” (Finlay, 2008, p. 1). Phenomenological methods were therefore appropriate for managing the subjective connections between Author 1 and the team (Finlay, 2009). Berger (2015) and Ledger (2010) describe a number of potential benefits in being an insider to research including having easier access to participants, a potential for greater buy-in from previously established relationships, a head-start in knowledge of the context, and the possibility of understanding the more nuanced reactions of participants. The blurring of boundaries and the possibility of imposing values and beliefs however is a risk of insider research (Ledger, 2010). Author 1 took several reflexive measures (Finlay, 2014) to address this including bringing assumptions into consciousness through the writing of an epoché, recruitment of participants via a third party to minimise pressure, member checking of data by the participants, and cross-checking of the data analysis with the supervisor, Author 2.

                  Purposeful sampling was used (Creswell & Plano Clark, 2011), and on this basis, the participants were all Registered Music Therapists with the Australian Music Therapy Association and currently employed at the school. Ethics approval was sought and received from the Human Research Ethics Committee through the University of Melbourne (HREC ID 1648068.1). All four members of the music therapy team agreed to participate in the study. After the interviews, they selected the pseudonyms ‘Bella’, ‘Grizelda’, ‘Louise’ and ‘Sally’ for de-identification in the results. At the conclusion, all participants reviewed the study results, and agreed to have them published in the public arena.

                  Descriptive data from the interviews was analysed using the following steps. Whilst these steps are listed roughly in order, the process was iterative, and movement backwards and forwards between the steps was necessary to ensure an accurate and reflective analysis of their experiences. Since Author 1 led the analysis, this section will be presented in first person to convey her personal engagement with the data.

                  Step 1. Seeing afresh and transcribing the interview. This involved spending time reflecting on my own pre-assumptions and leadership role, and receiving support from Author 2 in order to assume a “phenomenological attitude” of curious inquiry (Finlay, 2014, p. 122). Interviews were transcribed word-for-word including pauses and thinking words. The full transcript was then forwarded to each participant so they could remove any statements or add further information if they wished.

                  Step 2. Dwelling with the data and identifying key statements. For this step, the first interview transcript was read through several times to become familiar with the content and recall how each statement had been expressed in terms of tone, body posture, eye contact and pace. All the interviewer questions were then removed, and all participant text that was not directly related to the questions being asked.  Each of the four interviews revealed between 44-63 key statements.

                  Step 3. Creating structural meaning units (SMUs). Here began a process of conventional content analysis, drawing categories from the data itself (Hsieh & Shannon, 2005). Each statement was categorised literally according to what the participant was talking about (McFerran & Grocke, 2007). Several iterations in this process resulted in the emergence of 14 SMUs.

                  Step 4. Creating experienced meaning units (EMUs). At this stage, I began searching for more abstract meanings, necessitating a re-shuffling of key statements and a fresh approach. This stage involved the first imaginative variation (Moustakas, 1994). Here each statement was carefully read and reflected upon, this time considering the implicit meanings behind what the person was trying to say.

                  Step 5. Languaging the individual distilled essences. In this step, the EMUs were combined into a narrative. Cross-checking was carried out in consultation with Author 2, (Reiners, 2012) and I also approached the participants for their opinion of the essence created (Colaizzi, 1978). Participants were asked the question: “Does this meet with what you meant to say in the interview, and if not, how does it differ?” Participant feedback therefore shaped the final flow of the essences.

                  Step 6. Explicating the whole through identifying group themes. Here commonalities across the descriptions of participants were sought through the “rather messy process” of explication (Finlay, 2014, p.131). For each EMU, the implicit meanings behind the description were again considered. A reflexive process of collaboration between the Authors resulted in 13 group themes with contextual knowledge enabling a deeper understanding of the language used by participants and its meaning.

                  Step 7. Languaging the global meaning units (GMUs) and the final distilled essence. In this final stage, group themes were gathered into groups of statements conveying related meanings. Through extensive reflection and imaginative variation, I also brought personal knowledge and experience into the larger issues and ideas of the emerging global themes. This resulted in five GMUs. These were then joined together to form a narrative statement (McFerran & Grocke, 2007) that others might read, and possibly find concepts that resonated with their own experience.

 Results

                  The analysis resulted in an individual distilled essence for each participant, with the individuals’ EMUs forming the basis for determining the group themes and final distilled essence. The full individual distilled essences are presented in Appendix A. Here we present the group themes, and the final distilled essence, followed by a discussion placing the themes into context.

                  Group themes.

                  Table 1 shows the fourteen group themes as drawn from a comparative analysis of EMUs from all participants. For each group theme the number of contributing participants data is also listed.

 Table 1.

Group themes

Final distilled essence.

                  The final distilled essence drew the group themes into a flowing, narrative statement capturing the experiences and factors informing the practice of the four participants:

The transdisciplinary practice of these music therapists is strongly influenced by the shared knowledge and experience of their colleagues. Trust and respect within their teams supports them in developing more meaningful working relationships with students. These eclectic music therapists seek out innovative knowledge from a range of academic and practical resources. Observing techniques and methods demonstrated through online videos or in person enables them to confidently apply this knowledge creatively and responsively in their practice. These music therapists find it hard to employ a therapeutic sensibility in targeting individual social goals when only working with groups, within a pre-determined curriculum, and using musical improvisation with students who have difficulties regulating themselves. They draw additional support and inspiration by accessing self-care and supervision outside the school setting. Transdisciplinary practice brings satisfaction and motivation to these music therapists through developing strong student relationships grounded in trust, meaningful achievements and shared pleasure in making music together.

 Discussion

                  Reflecting further on the individual distilled essences and group themes illuminated three professional issues and benefits for the music therapist in transdisciplinary teams: 1) supporting the students in non-music therapy programs, 2) fostering trusting relationships with support staff, and 3) the nature of working primarily with groups of students rather than individuals within a school curriculum framework. The participants also highlighted three aspects of their practice experience that may have implications for those leading transdisciplinary teams: 1) ensuring that professionals have access to the professional learning that best shapes their practice, 2) encouraging peer support and professional supervision, and 3) fostering a value of creativity and diversity within teams, particularly music therapy teams, for addressing complex issues through collective knowledge and experience.

                  Professional issues and benefits for the transdisciplinary music therapist.

                  Being part of a transdisciplinary team involves taking on duties and responsibilities not typically seen as part of music therapy practice. Bella described how her working relationships with students are better informed by seeing them in a range of settings and engaged in a variety of activities. She commented that:

“I think it’s something that not every music therapist may get to see if you just come in for the session of music and then you’re gone. But we see our students in many different environments, even going on camp with them, bunking down with them for the night and just seeing how they get through their day It gives a much deeper understanding” (Bella).

                  Bolger (2015) proposes that collaborative relationships grow through engaging in a “hangout period” (p. 102) that may not involve music related activities, and she considers that this involvement is essential in supporting buy-in from music therapy participants. Whilst a small number of music therapists write about engaging in extra-musical activities as part of their work (Cobbett, 2009; Derrington, 2012), these do not seem to be for regular and extended periods of time, but rather during lunch or leisure breaks, or as a prelude to a short-term music therapy program. In contrast, the participants in this study were involved across the whole school program and were therefore completely immersed in the student’s day. This immersion potentially gives the music therapist a more rounded understanding of school life for their students, and this knowledge enables them to adapt the music therapy programs to fit with the flow, demands and shifting needs of students across the day.

                  Participants also commented on how working across the school day also offers chances to transfer skills and joys discovered in music sessions to other times, and to share them with a broader range of people in the student’s lives. As students with autism can often limit the places and people with which their skills can be seen, the participants described this constant generalisation as a positive outcome for students, families and staff. This aspect of role release is a positive feature of the transdisciplinary model that aims to support more wide-spread use of music in all programs for student engagement in learning and with families in the home environment.

                  Some participants described the benefits of developing trusting, collaborative relationships with support staff as being equally important to the relationships with professional staff from other disciplines. They described the indispensable role of support staff in music therapy sessions in helping to manage any physical risk from challenging behaviour, and they welcomed their involvement as models and social partners in music-making. A recent qualitative study similarly describes how music therapists may need to work with support staff to manage safety concerns within sessions (Munro, 2017). The importance of trust between the music therapist and support staff became apparent in the participants’ responses, particularly in being able to maintain positive engagement with the students in music therapy sessions.

                  Alvin and Warwick (1992) refer to the dynamism of therapy assistants being crucial to the success of music therapy programs. Within the context of this study, support staff are encouraged to use exaggerated expressions, gestures and a communicative style that enables greater emotional comprehension and engagement from students. Munro (2017) describes how having good relationships with support staff enables the music therapist to keep the flow of the session moving, rather than stopping and starting to support participants. These sentiments were echoed by one participant: 

“You’re singing a song with a student and they’re not holding the microphone properly. I’m in the middle of a phrase of the song and I can’t help them. Having someone who knows exactly what that student needs right now, jumping in and pre-empting what they need. Which makes it so much easier to keep the flow of the music. There’s the odd person who, when you’re with them, you know you are going to have a good session” (Bella).

                  It appears that for these participants, having a shared understanding of student needs and outcomes with support staff enables them to find positive ways to engage students in music therapy programs. In this setting, the transdisciplinary team approach valued the input of all staff in sessions, regardless of their professional background or qualification.

                  The participants described how the current philosophy of this school setting promotes group-based music therapy programs ahead of individual sessions, although this has shifted back and forth over time. This philosophy requires that multiple staff participate in sessions, which in turn creates more opportunities for collaboration between different disciplines. The focus on group programs is also linked to students’ social goals, and to budgeting considerations. The participants acknowledged that working in groups had many social benefits for their students, particularly when it came to addressing joint action, synchrony and imitation. However, some participants described frustration in not being able to be responsive at an individual level when the needs of the group could not be put on hold for any length of time. Louise describes this challenge:

“If you’re in a group, and you get that connection with one student and you know you could easily keep going, just with that one person but you can hear it all getting a little bit chaotic, so you have to cut short that moment. And that just breaks my heart sometimes, you have to do that, you have to go back to bringing the class in. I feel that sometimes there are some missed opportunities there” (Louise).

                  Juggling the needs of the individual and the group can be challenging, particularly when students are unable to wait or occupy themselves whilst another is the focus of individual attention, resulting in disruptions to the group dynamic (McFerran & Wigram, 2007). One participant struggled with her role in facilitating group improvisation for this reason. The participants’ contributions to this theme suggest that while they valued the collaborative philosophy of transdisciplinary practice, this was sometimes at the expense of individually tailored programs. There is a sense that the participants wished to advocate for more balance in group and individual programs, and that a valuable aspect of an intimate therapeutic relationship through music therapy was sometimes missing.

                  Implications for leaders of transdisciplinary teams.

                  The participants’ descriptions of working in a transdisciplinary music therapy team illuminated the complex layers of transdisciplinary teaming within the specialist school setting, represented by Figure 1. While it is beyond the scope of this paper to discuss each aspect in full, several key aspects are highlighted below (a full description can be found in Arns, 2017).

Figure 1. Teams as learning spaces for the music therapist 

                  A commitment to professional development by the music therapists became evident through their various self-directed learning strategies. Online learning resources present as highly convenient to busy music therapists (Vega & Keith, 2012), and information presented through case studies and video demonstration were identified by these participants as particularly helpful, as they enabled the music therapist to visualise themselves integrating the information into their practice. 

“When you’re quite time poor and a busy person, you need something quick, you need to be able to access the information as quick as you can and use it. So, if it’s really wordy and becomes very academic, I would probably not read as much of it” (Sally).

                  In terms of team-based learning, Hamilton (2005) found that interactions with professionals from other disciplines can be crucial for building clinical confidence, particularly in the early years of practice. Similarly, the participants in this study spoke of the value of observing music therapists and other colleagues at work and engaging in feedback. These informal conversations and the opportunity to co-facilitate programs with other professionals also provided rich opportunities for learning from colleagues.

                  Being in constant, close contact with other disciplines led one participant (Grizelda) to describe their resultant learning as “transdisciplinary knowledge” which was experienced as different to that gained from a formal training session. In this sense, a transdisciplinary music therapist’s knowledge is formed through context, skill and experience. It appears important that transdisciplinary music therapists accumulate a broad knowledge base over an extended period of time, and this might result in having the confidence to apply their ongoing learning in their practice. This sentiment is echoed in the ways participants referred to aspects of the role release process, which included role extension, enrichment, expansion, exchange and support (King et al., 2009). Grizelda describes:  

“If I came from purely a music therapy approach here, there’d be a whole depth of knowledge from the other disciplines that I’d be missing out on. I think that knowledge gives me a wholistic approach to the student. There’s a lot more tools in my tool kit than there were before” (Grizelda).

                  It appears that the transdisciplinary music therapist has a great deal to gain from having an outlook that embraces opportunities for learning, both at formal and informal levels, alongside colleagues from a range of training backgrounds. Actively pursuing opportunities to learn from and take on roles from other disciplines, as well as releasing aspects of the music therapy role to others, has the potential to offer role enrichment to all members of the transdisciplinary team (King et al., 2009) and ultimately, to the students in their care. In reflecting on the views of these participants, it appears that transdisciplinary teams may promote greater commitment amongst staff to implementing new ideas and approaches.

                  Whilst the value of peer support is commonly mentioned in transdisciplinary literature (Bock Hong & Reynolds-Keefer, 2013; King et al., 2009; Twyford & Watson, 2008), the role that professional supervision plays in supporting team members is not often discussed. All four participants commented on how peer support from their colleagues, as well as professional supervision accessed outside of the school, shaped and sustained their practice. Within the music therapy team discussions, the participants appeared to value being able to discuss difficult work-place issues, and they felt supported by hearing a variety of fresh perspectives. They also differentiated between the peer support within their transdisciplinary teams and the music therapy team in subtle ways. For example, one participant who was struggling with the demands of the job, described how she looked to the music therapy team particularly for trusted peer support. Here, the unidisciplinary team may be particularly important in providing more specific discipline-based support.

“It’s kind of a joy that feeds itself because you’re faced with challenges and you’re challenging yourself in what you feel you can and can’t do, and you get support from the [music therapy] team. So, because you’re supported you can learn better and enrich your work and then you can give back more to the students” (Bella).

                  Alongside peer support within teams, access to professional supervision is beneficial for gaining professional and personal insight into music therapy practice (Kennelly, Daveson, & Baker, 2016). Furthermore, access to informal networks of support outside of the workplace is recommended in order to prevent burnout and maintain satisfaction in one’s work (Clements-Cortes, 2013). Participants also described the importance of accessing supervision to help them deal with the emotional and physical demands of managing risk and engagement within music therapy practice.

“There are some things that you can discuss within the school environment, but sometimes it’s good to get an objective viewpoint as well. Particularly with kids that I am struggling with, that I’m unsure how to move forward with, because their behaviours are so unpredictable” (Grizelda).

                  In this context it appears that accessing professional supervision and creating a culture of peer support in teams may also lead to a greater willingness to share knowledge and loosen discipline boundaries for role release in programs. The leader of transdisciplinary teams has a key role to play in creating a supportive culture through modelling and providing opportunities for staff to support each other in formal and informal settings.

                  All participants spoke of the diverse range of skills and training within the music therapy team, and that the eclectic, creative process energised their transdisciplinary practice. Odom and colleagues (2012) noted that a technical eclectic approach, one that synthesizes expertise from a range of models and disciplines, can be effective with children with autism if it is “conceptually grounded, incorporates evidence-based focused intervention practices, and is well implemented” (p. 270). There is a sense that this diversity was a strength of the team, rather than a barrier to creativity and team discussions. When describing the different approaches within the music therapy team, Bella and Grizelda said:

                  “Everyone has a different interpretation, and a different emphasis in how they would create an activity” (Bella).

                  “You sort of pull together and you get this really lovely depth of musical experience for the students” (Grizelda).

                  The participants’ comments on learning from the other music therapists may be imaginatively viewed as a hive mind. Oxford Living Dictionaries (2017) define the hive mind as “a notional entity consisting of a large number of people who share their knowledge or opinions with one another, regarded as producing either uncritical conformity or collective intelligence”. In this interpretation, the music therapy team, although small in number, share their knowledge and opinions with one another, share the workload of creating resources, and in one sense become a more cohesive group in the process. It is through the sharing of collective knowledge and skills that they are able to draw on the music therapy team as a resource for their students. Together, the music therapy team may then determine how resources and strategies may be released to other members of the transdisciplinary team across the day.

                  Reflections on the transdisciplinary music therapist through a systems theory lens.

                  Throughout the interviews, participants made various comments about their interactions with colleagues and the broader school system. As a further reflection, Author 1 considered the experiences of the participants alongside her role as a member of the school leadership team. A systems theory approach places emphasis on the inter-connectedness of individuals with their environment and their society (Bronfenbrenner, 1979). It is precisely this focus on the relationships between the components of a system, rather than their distinctions, that make systems theory particularly relevant to this final reflection of a transdisciplinary context. Three layers of the system’s yearly cycle were identified, as depicted in Figure 2. Key actions for each layer of the school’s system, as well as the responsibilities and goals of each stage in the process of work across a school year, were considered.

                  At the beginning of the year, all members of teams plan professional learning based on student need, individual skills and experience, school budget, values and priorities. Within a transdisciplinary philosophy, time to meet, collaborate and consult together is prioritised. During the year, teams participate in these identified external learning opportunities, and continue to collaborate, provide peer support and build trust with each other. Meanwhile, leaders facilitate the ongoing implementation of professional learning and fostering a respectful culture through cross-disciplinary initiatives and provision of additional resource support. Special events often occur, such as arts access experiences and festivals, and these increase the blurring of boundaries between disciplines, since all members of the transdisciplinary team combine knowledge and skills to maximise student engagement in these wider life experiences. At the closing of the school year, teams review the previous 12 months, drawing satisfaction from student achievements and forging stronger professional relationships as a result of sharing knowledge across discipline boundaries. Learnings from the school year then feed forward into the following year, influencing further professional learning and team collaboration needs. The key positive outcome for this transdisciplinary school is the developing of stronger teams through increased professional knowledge, skills and trusting relationships

                  When the three layers of this process cycle are combined, they show a complex, interactive system. Systems theory (Bronfenbrenner, 1979) and parallel processes (Smith, Simmons, & Thames, 1989) are useful lenses through which to consider how the layers of a system interact with one another. “When two or more systems – whether these consist of individuals, groups or organizations – have significant relationships with one another, they tend to develop similar affects, cognition and behaviours” (Smith, Simmons, & Thames, 1989, p. 13.

 Figure 2. School system practice cycle

For example, when the school principal is supportive and treats the staff with positive regard, encouraging learning and reflection, this leadership influence flows through the school leadership team, and to the class and therapy team leaders by encouraging them also to set directions in a consultative, positive manner. This positive flow of influence then re-appears in how individual staff treat students, in supportive and engaging ways that respect their rights to make choices and direct their own learning as much as possible. As a member of several teams across programs, the music therapist has a key role to play in sharing knowledge, releasing aspects of their work, and collaborating with all levels of the system to build a culture of respect between disciplines.

 Conclusion

       Music therapists in transdisciplinary teams are faced with a number of benefits and challenges through being involved in multiple layers of professional learning, collaboration and role release. The four music therapists who participated in this study identified several key considerations for their roles within transdisciplinary teams. They found that supporting students in non-music therapy programs actually enriched their understanding of student needs and connected them strongly within teams. They revealed that the transdisciplinary learning that occurs on an interpersonal level by releasing expert boundaries between professionals of the same or differing disciplines, had an immediate and lasting impact on their work. However, there could be disadvantages to working alongside each other in groups for the majority of the time, as seen in the absence of individual music therapy programs that may be beneficial and necessary for some, if not all students. For music therapists working within teams, it is important to view how the wider school system operates, and to navigate their responsibilities within that system to sustain and grow their practice. This first, exploratory study into a school-based transdisciplinary music therapy team suggests that by actively participating in learning and collaboration within and across disciplines, transdisciplinary music therapists have the potential to make significant contributions towards positive outcomes for students within the specialist school system.

 Acknowledgements

       With thanks to Dr Katrina Skewes McFerran from the University of Melbourne who provided supervision and academic mentorship during the analysis of the data. Many thanks also to the music therapy team at Giant Steps Sydney for generously sharing their insights into transdisciplinary practice.

 

References

Alvin, J., & Warwick, A. (1992). Music therapy for the autistic child (2nd ed.). Oxford, England: Oxford University Press.

Arns, B. (2017). Music therapy teaming and learning: How transdisciplinary experience shapes practice in an autism specialist school (Master’s thesis). Retrieved from http://hdl.handle.net/11343/212464

Australian Music Therapy Association. (2009). Competency standards in music therapy. Retrieved from https://www.austmta.org.au/system/files/Competency%20standards%20document%2009.pdf

Ayson, C. (2011). The use of music therapy to support the SCERTS model objectives for a three-year-old boy with autism spectrum disorder in New Zealand. New Zealand Journal of Music Therapy, 9, 7-31.

Berger, R. (2015). Now I see it, now I don’t: Researcher’s position and reflexivity in qualitative research. Qualitative Research, 15(2), 219-234. doi: 10.1177/1468794112468475

Bock Hong, S., & Reynolds-Keefer, L. (2013). Transdisciplinary team building: Strategies in creating early childhood educator and health care teams. International Journal of Early Childhood Special Education (INT-JECSE), 5(1), 30-44.

Bolger, L. (2015). Being a player: Understanding collaboration in participatory music projects with communities supporting marginalised young people. Qualitative Inquiries in Music Therapy, 10(1), 77-116.

Bronfenbrenner, U. (1979). The ecology of human development: Experiments by nature and design. Cambridge, MA: Harvard University Press.

Choi, B. C. K., & Pak, A. W. P. (2006). Multidisciplinarity, interdisciplinarity and transdisciplinarity in health research, services, education and policy: Definitions, objectives, and evidence of effectiveness. Clinical & Investigative Medicine, 29(6), 351-364. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/17330451

Cobbett, S. (2009). Including the excluded: Music therapy with adolescents with social, emotional and behavioural difficulties. British Journal of Music Therapy, 23(2), 15-24.

Colaizzi, P. F. (1978). Psychological research as the phenomenologist views it. In R. S. Valle & M. King (Eds.), Existential-phenomenological alternatives for psychology (pp. 48-71). New York: Oxford University Press.

Clements-Cortes, A. (2013). Burnout in music therapists: Work, individual, and social factors. Music Therapy Perspectives, 31(2), 166-174. doi: 10.1093/mtp/31.2.166

Creswell, J. W., & Plano Clark, V. L. (2011). Designing and conducting mixed methods research (2nd ed.). Los Angeles, CA: SAGE Publications.

Cross, R. J. (2007). Using a transdisciplinary service delivery model to increase parental involvement with special education students. Paper prepared for the 2008 Hawaii International Conference on Education. Retrieved from https://files.eric.ed.gov/fulltext/ED497695.pdf

Davis, S. (2007). Team around the child: Working together in early childhood intervention. Wagga Wagga, New South Wales, Australia: Kurrajong Early Intervention Service.

Derrington, P. (2012). 'Yeah I'll do music!': Working with secondary-aged students who have complex emotional and behavioural difficulties. In J. Tomlinson, P. Derrington & A. Oldfield (Eds.), Music therapy in schools: Working with children of all ages in mainstream and special education (pp. 195-212). London, Great Britain: Jessica Kingsley.

Dickerson, J. (2017). Team nursing: A collaborative approach improves patient care. Nursing, 47(10), 16-17. doi: 10.1097/01.NURSE.0000524769.41591.fc

Finlay, L. (2008). A dance between the reduction and reflexivity: Explicating the phenomenological psychological attitude. Journal of Phenomenological Psychology, 39(1), 1-32. doi: 10.1163/156916208X311601

Finlay, L. (2009). Debating phenomenological research methods. Phenomenology & Practice, 3(1), 6-25. Retrieved from http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.969.7340&rep=rep1&type=pdf

Finlay, L. (2014). Engaging phenomenological analysis. Qualitative Research in Psychology, 11(2), 121-141. doi: 10.1080/14780887.2013.807899

Geist, K. (2016). Sources of knowledge in music therapy clinical practice (Doctoral dissertation). Ohio University, OH. Retrieved from http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1478173980933032

Giorgi, A. (2009). The descriptive phenomenological method in psychology: A modified Husserlian approach. Pittsburgh, PA: Duquesne University Press.

Guerrero, N., Turry, A., Geller, D., & Raghavan, P. (2014). From historic to contemporary: Nordoff-Robbins music therapy in collaborative interdisciplinary rehabilitation. Music Therapy Perspectives, 32(1), 38-46. doi: 10.1093/mtp/miu014

Hamilton, H. (2005). New graduate identity - discursive mismatch. Contemporary Nurse: A Journal for the Australian Nursing Profession, 20(1), 67-77. doi: 10.5172/conu.20.1.67

Hills, B., Norman, I., & Forster, L. (2000). A study of burnout and multidisciplinary team-working amongst professional music therapists. British Journal of Music Therapy, 14(1), 32-40. doi: 10.1177/135945750001400104

Hive mind. (2017). In Oxford Living Dictionaries. Retrieved from https://en.oxforddictionaries.com/definition/hive_mind

Hsieh, H., & Shannon, S. E. (2005). Three approaches to qualitative content analysis. Qualitative Health Research, 15(9), 1277-1288. doi: 10.1177/1049732305276687

Hunter, C. L., Spence, K., McKenna, K., & Iedema, R. (2008). Learning how we learn: An ethnographic study in a neonatal intensive care unit. Journal of Advanced Nursing, 62(6), 657-664. doi: 10.1111/j.1365-2648.2008.04632.x

Husserl, E. (1931). Ideas: General introduction to pure phenomenology. London, England: Allen & Unwin.

Jack, N., Thompson, G., Hogan, B., Tamplin, J., Eager, R., & Arns, B. (2016). My profession, my voice: Results of the Australian Music Therapy Association's 2016 workforce census. Melbourne, Australia: Australian Music Therapy Association. Retrieved from https://www.austmta.org.au/download-publication/2920/247

Kennelly, J. D., Daveson, B. A., & Baker, F. A. (2016). Effects of professional music therapy supervision on clinical outcomes and therapist competency: A systematic review involving narrative synthesis. Nordic Journal of Music Therapy, 25(2), 185-208. doi: 10.1080/08098131.2015.1010563

Kern, P., & Tague, D. B. (2017). Music therapy practice status and trends worldwide: An international survey study. Journal of Music Therapy, 54(3), 255-286. doi: 10.1093/jmt/thx011

Kim, Y. (2012). Music therapists’ job satisfaction, collective self-esteem, and burnout. Arts in Psychotherapy, 39(1), 66-71. doi: 10.1016/j.aip.2011.10.002

King, G., Strachan, D., Tucker, M., Duwyn, B., Desserud, S., & Shillington, M. (2009). The application of a transdisciplinary model for early intervention services. Infants & Young Children, 22(3), 211-223. doi: 10.1097/IYC.0b013e3181abe1c3

Ledger, A. (2010). Exploring multiple identities as a health care ethnographer. International Journal of Qualitative Methods, 9(3), 291-304. doi: 10.1177/160940691000900304

Luscombe, D., & Dibley, R. (2014). Early intervention best practice discussion paper. NSW, Australia: Early Childhood Intervention Australia NSW Chapter. Retrieved from https://www.ecia.org.au/documents/item/114

Magee, W. (2014). Interdisciplinary care of patients with prolonged disorders of consciousness: The role of music therapy. Journal of the Australasian Rehabilitation Nurses Association, 17(3), 16-21.

McFerran, K., & Grocke, D. (2007). Understanding music therapy experiences through interviewing: A phenomenological microanalysis. In T. Wosch, T. Wigram & B. L. Wheeler (Eds.), Microanalysis in music therapy: Methods, techniques and applications for clinicians, researchers, educators and students. London, England: Jessica Kingsley.

McFerran, K. S., & Wigram, T. (2007). A review of current practice in group music therapy improvisation. Voices: A World Forum for Music Therapy, 7(2). Retrieved from https://voices.no/index.php/voices/article/view/496/403

Moustakas, C. E. (1994). Phenomenological research methods. Thousand Oaks, CA: Sage Publications.

Munro, H. (2017). Music therapists' experiences of working with staff in sessions. In J. Strange, H. Odell-Miller & E. Richards (Eds.), Collaboration and assistance in music therapy practice: Roles, relationships, challenges. London, England: Jessica Kingsley.

National Disability Insurance Scheme. (2014). Operational guideline - planning and assessment - supports in the plan – personal care supports. Australia. Retrieved from https://www.ndis.gov.au/html/sites/.../og_plan_assess_supp_plan_assistive_tech.docx

Odom, S., Hume, K., Boyd, B., & Stabel, A. (2012). Moving beyond the intensive behavior treatment versus eclectic dichotomy: Evidence-based and individualized programs for learners with ASD. Behavior Modification, 36(3), 270-297. doi: 10.1177/0145445512444595

O'Hagan, S., Allen, D., Bennett, M., Bridgman, A., Lumsden, K., & Wallace, L. (2004). Transdisciplinary teamwork improves care: Five disciplines combine skills to assist people with intellectual disabilities. New Zealand Journal of Music Therapy(2), 50-57.

Reiners, G. M. (2012). Understanding the differences between Husserl’s (descriptive) and Heidegger’s (interpretive) phenomenological research. The Journal of Nursing Care, 1(119). doi: 10.4172/2167-1168.1000119

Ritchie, J., & Lewis, J. (2003). Qualitative research practice: A guide for social science students and researchers: London, England: SAGE Publications.

Robinson, A. S. (2015). Interdisciplinary collaboration with music therapy during routine pediatric dental procedures. (Masters thesis). Retrieved from uknowledge.uky.edu/cgi/viewcontent.cgi?article=1042&context=music_etds

Ronfeldt, M., Farmer, S., McQueen, K., & Grissom, J. (2015). Teacher collaboration in instructional teams and student achievement. American Educational Research Journal, 52(3), 475-514.

Savage, M. J., & Drake, S. M. (2016). Living transdisciplinary curriculum: Teachers' experiences with the International Baccalaureate's Primary Years Programme. International Electronic Journal of Elementary Education, 9(1), 1-20. Retrieved from https://files.eric.ed.gov/fulltext/EJ1126686.pdf

Smith, K. K., Simmons, V. M., & Thames, T. B. (1989). 'Fix the women': An intervention into an organizational conflict based on parallel process thinking. Journal of Applied Behavioral Science, 25(1), 11-29. doi: 10.1177/0021886389251002

Spring, E. K. (2010). The Interdisciplinary collaborative competency in music therapy: Terminology, definitions, and teaching approaches. (Masters thesis). Retrieved from https://etd.ohiolink.edu/rws_etd/document/get/ohiou1275666925/inline

Strange, J., Odell-Miller, H., & Richards, E. (2016). Collaboration and assistance in music therapy practice: Roles, relationships, challenges. London, England: Jessica Kingsley.

Sun, M., Loeb, S., & Grissom, J. A. (2017). Building teacher teams: Evidence of positive spillovers from more effective colleagues. Educational Evaluation and Policy Analysis, 39(1), 104-125. doi: 10.3102/0162373716665698

Twyford, K., & Watson, T. (2008). Integrated team working: Music therapy as part of transdisciplinary and collaborative approaches. London, England: Jessica Kingsley Publishers.

Vega, V. P., & Keith, D. (2012). A survey of online courses in music therapy. Music Therapy Perspectives, 30(2), 176-182. doi: 10.1093/mtp/30.2.176  

Waldon, E. G., & Wheeler, B. L. (2017). Perceived research relevance: A worldwide survey of music therapists. Nordic Journal of Music Therapy, 26(5), 395-410. doi: 10.1080/08098131.2017.1284889

Warren, P., & Rickson, D. J. (2016). What factors shape a music therapist? An investigation of music therapists’ professional identity over time in New Zealand. New Zealand Journal of Music Therapy (14), 55-81.

Wheeler, B. (2003). The interdisciplinary music therapist. Voices: A World Forum for Music Therapy. Retrieved from https://voices.no/community/?q=fortnightly-columns/2003-interdisciplinary-music-therapist

Zaretsky, L. (2007). A transdisciplinary team approach to achieving moral agency across regular and special education in K-12 schools. Journal of Educational Administration, 45(4), 496-513. doi: 10.1108/09578230710762472

 

 

Appendix A

       Individual Distilled Essences

                  Bella.

                  Bella experiences working at Giant Steps as a challenging job requiring great stamina, but she feels rewarded by seeing student gains and by having the support of her team. She loves being part of a team that is dedicated to supporting their students and is able to have fun whilst doing it. Due to her role working with students across the day, she sees great value in helping them generalise positive skills and experiences to other settings. Since students can become very bound in routine, she feels it is important for them to work on self-expression through improvisation, but that groups may not always be the best format for working on this goal.

Bella reflects on and develops her own practice by observing and speaking to other professionals at the school. She believes her practice is richer by taking on philosophies and strategies from a range of information sources. Creativity and diversity in clinical approach are absolutely essential to Bella in sustaining her ability to meet individual student needs. She also uses her intuition to sense what they need in the moment and adjusts her approach accordingly. It is important for Bella to enjoy the musical material she uses, as she knows it makes her a more effective and authentic music therapist. She draws musical inspiration and opportunities for self-care from outside the school. Being able to build a solid rapport and make deeper connections with students through music gives Bella great satisfaction. She loves seeing her problem-solving efforts result in increased student engagement and achievements made over time.

                  Louise.

                  Louise finds Gant Steps to be a challenging job with very high expectations of its staff, however being part of a team of respected music therapy professionals helps her to feel supported in meeting those challenges. Being a part of a diverse team of music therapy professionals informs her practice through planning, researching and creating resources together in a collaborative manner. Additionally, being part of a transdisciplinary team sustains her practice through solving problems together and by sharing the good and the bad days with each other. She experiences working within the school curriculum as fast-paced and highly pre-determined and having a lower capacity for flexibility than her music therapy work outside the school setting, but it also can inform her other work through transferring themed resources to other settings. At times, she finds that working in groups feels more like teaching than therapy, feeling disappointed that opportunities for sustained interaction through improvisation are often missed in the interest of keeping the group regulated.

Louise gains the most value from professional learning that is practical in nature and relevant to her work, especially when it helps to push her learning edge. Speaking to Giant Steps staff, her external peer group and other people, as well as watching the work of others in person or online influences how she approaches her work with students. Looking to her own instinct, reflection and observation of student engagement tends to guide her practice in the moment and from week to week. During school term time, Louise sources reading and information from a range of academic and general online media sources, and despite being time-poor, feels pressure to be reading more. Although she plans to read more in the school breaks, she finds it important to take a complete break from music therapy reading, planning and work at these times in order to sustain her enthusiasm. Louise finds meaning in the connections she has made with students, whether they be large or very small, and in the small but significant gains made by students within a musical relationship that has grown over a long period of time.

                  Sally.

                  Sally has experienced working at Giant Steps to be both exciting and challenging and it has allowed her to use her creativity well. She views her team as positive, equal and collaborative and trusts the information she receives when talking to them, even more than written client reports. It has been exciting for her to be part of a music therapy team where her work is understood, but she can occasionally get caught in comparing herself to others. Sally values well-structured professional learning that resonates with her own humanist, person-centred philosophy. She loves to read widely and finds that in her busy life, case studies provide information in a quick, digestible information format more so than theoretical, academic writing. Her practice is influenced by ideas adapted from a range of sources. Watching music therapists in action, either in person or on film, is useful to her as she often finds reading about music therapy techniques to be too vague. She relies on staff to help support student engagement, as she needs to remain aware of issues around personal safety. Building rapport and earning the trust of students has taken time but has also allowed her to be more confident in her practice.

Liaising with other music therapy professionals at conferences and at an external peer supervision group provides her with avenues for support. She believes it is important to sustain herself through taking breaks to do things she enjoys, including writing and making music for herself. Sally finds great satisfaction in being in the moment with students, and in seeing their progress, no matter how small. She finds great personal value in using music that she loves in her work and in exploring and learning new music for different applications. Receiving positive feedback from families, students and staff makes her feel like a valued member of the team.

                  Grizelda.

                  Grizelda is inspired and buoyed along by Giant Steps staff who are passionate about what they do and have fun while they work. Belonging to a team makes her feel supported on hard days by being willing to solve problems collaboratively and by pitching in to do what needs to be done. She believes that the diversity of experience and approaches in the music therapy team is a real asset to the school and this helps them in sharing the creative load of creating resources. In her work, Grizelda draws on a variety of methods to address student needs, but she needs to critically evaluate them first before implementing into her practice. She places great value on reading for rethinking and clarifying how she works. She also finds that the level of student engagement and energy and their learning style tends to guide her practice in the moment.

Grizelda finds value in developing skills through both music therapy and music curriculum, however she can sometimes find it challenging to focus on both, particularly within group sessions. She accumulates and articulates knowledge by collaborating with other professionals in her work. As a result, she believes that the transdisciplinary knowledge she has gained from working alongside other disciplines has greatly enriched her practice. Grizelda knows that there is a risk of burnout in this kind of work and accesses professional supervision outside of the school to help manage issues, particularly those around personal safety. She finds satisfaction in collaborating on projects that have a positive impact on families and the community outside of Giant Steps, and she feels sustained by seeing the achievements of students and how these positively influence their futures.