I recently had the opportunity to have a conversation with my good friend Katy Gorski, MT-BC about Autism and her approaches to working with this population.
When asked about her music therapy journey, Katy explained that she has a very musical family. Katy also has a brother who has autism. She told me that at first, her brother was non-verbal, but he eventually started to sing Disney songs. Her family would sing Disney songs to him, and that helped Katy develop her personal relationship with music—which is very interactive.
Katy is currently working towards her master’s degree in music therapy at Temple University. She initially started school as a oboe performance major, but she felt that something was missing. Katy decided to study Music therapy after graduation. At this point, Katy is board certified in music therapy and practicing! She will be graduating from Temple’s master’s equivalency program here at the end of the semester!
To kick off the interview, I asked Katy what her thoughts were regarding the potential switch from a bachelors entry to the profession to a master’s entry level. “It’s actually really interesting that you ask that, Becky, because I’ve been thinking about that a lot—obviously, I’m about to graduate now with a masters. And I do have my MT-BC now, but I do honestly have mixed feelings. I absolutely, hands down loved my experience at Temple. And it’s been very enriching and has changed my life, really. But the problem with the equivalency program I think is that when I entered, I had just graduated from my undergraduate degree and then I was taking classes with freshmen who were just starting. They were not even really committed to music therapy—more like, they just didn’t even really know what they wanted to do. I found that very frustrating because I felt that I wasn’t being taken seriously as a graduate student.” Katy continued acknowledging, “But then at the same time, I would then have a class with people who are getting their doctorate, or other masters degree an hour later. So I was really spread thin, and on edge in that regard. But it also really showed me that the undergraduate students are at a totally different stage in their life—honestly.” Which is a valid point. There was a time when I was working towards my bachelor’s degree in music therapy where I felt like I didn’t even know who was in my class anymore because so many of my peers had dropped out of the program! We started in the double digits and only graduated 6 students with degrees in music therapy at my University. Music therapy isn’t the easiest degree program to pursue, and it certainly takes maturity and responsibility to be successful.
Katy elucidates, “I think there should be a distinction [between bachelors and masters level MT-BC’s]. Of course there are exceptions to this. In general, a lot of the younger people just haven’t had the life experience. I think to be a good therapist, you need that emotional experience so that you’re able to empathize, but you also have to be a really strong musician. To have both of those pieces, at least from what I’ve observed, having the master’s degree is what’s enabled me to get that. […] I feel like with some populations, they really should require the masters.” Which is also very true, although ethically one must be responsible for knowing their own limits as a therapist.
We then got off on a tangent, and spoke briefly about New York state and their LCAT requirement. For those who are not familiar with the, “LCAT,” or “Licensed Creative Arts Therapist,” it is a credential that one must attain before practicing music therapy in NY state. One must attend an approved university in the state of New York and receive their masters in Creative Arts Therapy and complete a 1500 hour internship with a Licensed Creative Arts Therapist to become one themselves. Katy commented, “I do like the idea, honestly though, demanding more respect for the field. You know? Because a lot of the time it’s overlooked. It’s really important to make a distinction between community musicians and music therapists and what the difference is between a music therapist and a music educator.” I agreed, wholeheartedly. It can be a struggle to explain the distinction between musician, educator, and therapist to those who are not familiar with what we do as music therapists. Not only having the MT-BC, but having a second credential that is more broad (for all arts therapies, like the LCAT) could be beneficial in advocating to the greater population. Simply because it draws attention to the fact that creative arts therapies are a profession that is serious enough to need a license to practice (even if it can be an extra hurtle to achieve before practicing ).
I next asked Katy, “When was it that you knew that you wanted to work professionally with individuals with autism?” She responded candidly stating, “To be honest, there’s not a specific moment. Obviously, it was always in the back of my mind because of my brother, and I grew up that way, you know? Also, I think that because I grew up with it, it was kind of normalized for me. In terms of, I didn’t necessarily differentiate between him and everyone else. And I still don’t differentiate between children with autism and other school children, within that same age range. […] I’ve seen how music can provide opportunities for them to be, “normalized,” you know what I mean? In terms of, they have an equal role in their community. Just because maybe they are lacking in some other social skills—they have a lot of other strengths! And you [as a music therapist] are able to emphasize those strengths in a setting with their peers, so then they get validation from others and build their self-esteem, and overall just become resilient. Because with autism, I feel like a lot of the issues with that being seen as a disability is the constraints placed on them by society rather than their actual issues. So, for me that’s sort of why I view it as a way to help them be accepted and have a valuable role in the community. And that’s really meaningful.” Providing those, “third spaces,” or places that are not school/work or home is vital for everyone. As a therapist, you can create a safe, therapeutic environment for individuals with autism to have an equal footing with their school-aged peers. What an empowering experience for all!
Katy continued anecdotally about her brother explaining that he was accepted by his peers when he got involved in musical theater. She continues, “He really blossomed into a person—not that he wasn’t before—but he started to develop his own identity. And especially in adolescence, that’s really important. Because otherwise, they don’t ever get the opportunity. You know? A lot of these kids with autism are always in therapy: ABA Therapy, Speech Therapy, OT, you know it’s like constantly in these therapies where the therapist is expecting and just kind of waiting for a specific response. Whereas as a music therapist, you are open to whatever they want to respond with. You’re just like a blank slate just you know? Willing to accept whatever they give you so that they can decide for themselves what they want to respond with.” Katy makes a valid point, which is one of the beauties of music therapy. There is no specific response that must be given—just playing one’s instrument is response enough—no specific rhythmic pattern is necessarily demanded of the client. Music therapists are flexible and accommodating, more often than not, meeting the client where they are at, and going forward from there together. So, rather than dictating one’s reactions or responses, within the music therapy session, one is free to engage freely and develop their own self.
Next, I asked Katy about behavioral methods. Katy shared with me that she uses a mixed methods approach, at times employing PECs, and token economy systems. She explains, “My mom is a practicing ABA therapist, and I have been trained in ABA and worked for her when I was younger—in college before I studied music therapy. So I do have an appreciation for ABA therapy. But I also feel like it needs to be supplemented. I do utilize a lot of behavioral techniques in my work but I try to gradually decrease the amount. I think in the beginning more behavioral things need to be implemented, but gradually you would decrease them. The goal, in my mind, is not to have to rely on the behavioral aspects. At the same time, I think a lot of times, because they’re also very used to those behavioral approaches, it makes it comfortable for them. It’s a little more success oriented that way, they know what to expect. And specially with autism, a lot of them have issues with flexibility tolerance. Having that rigidity is actually more beneficial for them—even though, I don’t personally care for it.” Having the flexibility to modify your therapeutic approach to better meet the needs of your clients is difficult skill to master, but ultimately a vital one. One must be able to advocate for their clients, but also use methods and techniques that will resonate with them. How can you provide care if you are unable to meet their basic needs? This is one reason why it is important to be aware of different methods and therapies out there, but we’ll touch on that more later!
With regards to the PECs system, Katy shared with me that, she does use them a great deal in her practice, especially with younger individuals depending on their communication abilities and needs. She clarifies, “I think it’s really important, first of all, for them to be able to communicate whatever it is. Always at least have them available, even if you’re trying to break away from that. They need to be able to advocate for themselves. It’s really important to focus on ways they can generalize those skills.” Katy creates a safe space for those she works with by providing them with tools that they can use to be successful in therapy, but also work towards taking the skills gained in therapy to the outside world. Katy describes, “It’s not really about what’s happening right now, it’s about how it’s going to affect everything else. And what they’re going to be able to take away from it.”
My last question for Katy was to share any resources that she has found to be incredibly helpful with her work with individuals with autism. I don’t have all the information for these books at my fingertips, so I have added links so that you can easily find them for purchase. The following are the 4 books Katy identified:
Rickson, D. & Skewes McFerran, K. Creating music cultures in the schools: A perspective from community music therapy. See Book
Katy shares one of the main themes in this book is, “The importance [of a music culture] to help [individuals with DD] learn how to participate within the community in different ways, and develop their own role. And they talk about within the music therapy setting everyone is a player, there is no client, we’re all just players in the band. So, there really isn’t a hierarchy in that sense. We’re all different players! But that doesn’t mean that we contribute any more or less than the other person. We contribute something different, and that’s what makes it a full band.”
Hintz, M. Guidelines for music therapy practice in developmental health. See Book
Katy says, “What I really like about this book, the introduction talks about how each chapter is deliberately organized in the same way so that as a clinician you can look at this and you can navigate it. You can say, ‘Okay, I need to know what to do in this situation.’ And you already know where to look. It’s so practical!”
Lim, H.A. Developmental speech-language training through music for children with autism spectrum disorders: Theory and clinical application. See Book
Katy recounts, “The reason I really like this book is that they really talk about ways to collaborate with ABA therapy. And it talks about all these different specific ways you can do that. […] Specific goals that are directed towards speech and language training in particular.”
Kern, P. & Humpal, M. Early childhood music therapy and autism spectrum disorders: Developing potential in young children and their families. See Book
And lastly, Katy explicates, “As a music therapist, I think it’s really important to have an eclectic approach, like we talked about before. This gives people information—part of it, I think I’m biased because I have an ABA background. […] These books do a really good job of explaining the aspects of those other therapies that have relevance to MT, rather than going into detail about all of them, at least all aspects of those therapies because they’re pretty rigorous. But it talks about specific techniques and how they can be used in MT and then it goes through and does some case studies, and kind of puts it into context for you.”
Thank you Katy, for sharing your thoughts and experiences with us here at the Music Therapy Repertoire Challenge! I so enjoyed having the opportunity to speak with you about Autism, and your experiences with this population! Your words have already affected my practice positively—I started using some of your songs in session this week, to be honest!
Your passion for the field and for those with autism is tangible and so inspiring. Thank you for your time!
Stay tuned everyone for our next SOTW post!