Thursday, June 25, 2009

Day 16 - MTECP: Details (con't)

After re-reading my last post, I felt that there was some information missing that may be useful for those of you considering joining the MTECP crew.

A. Advantages and Risks


I will say it first (and get it out of the way) - everyone participating in this project is a volunteer. This means NO financial compensation. That said, everyone who participates will be given credit in a list of contributors and collaborators.

In the process of creating the final project, you may be exposed to new ideas, you may develop an interest and insight into in a particular specialty within music therapy and finally, you may indeed be contributing to the future of music therapy education! (I am hoping that this project will serve as a model for future learning about, and teaching of, music therapy. I am also hoping that it will serve as a model for the development of/transfer of additional course materials into a digital/online format).


1. Inequity of participants/participation.

This is a collaborative effort. Not everyone will be able or willing to put in the same amount of time and commitment that you may put in. This might mean that individuals are recognized for very little contribution.

2. Personal/Professional attacks and/or insult.

I am hoping that by first ensuring that persons involved in MTECP are members of a professional music therapy association we will avoid the pitfalls of non-ethical treatment of fellow participants. If ethical concerns arise during the course of the project, you can be assured that you will "have an avenue for recourse". I will personally retain confirmation of membership (in good standing) for each member, in a encrypted and password protected file folder on my computer, which is itself password protected.

B. Openness

As mentionned previously, the final MTECP content will be made available via a Creative Commons license. I truly believe that this is the future of education, where knowledge is shared and is open to public scrutiny/criticism. The flip side - more people will know about, and may participate in, music therapy!

The use of Moodle is another attempt to open up this information to a wider public audience. We are not restricting access to those who may be financially disadvantaged, or geographically isolated. "Open source" software is capable of running on a variety of operating systems (not just Windows or Macintosh) and is, in most cases, available free of charge. It can operate on systems based on dial-up speeds through high-speed/T1 connections (although it does operate more efficiently on the later). Finally, it is not dependant on you being located in a major city, educational institution, or specific country. You will be able to access this information anywhere, at any time, in any place, as long as you have a reliable internet connection.

C. Reliability/Consistency of information?

Does the fact that information is coming from digital and online sources pose a challenge and potential for misinformation to occur? As we all know, the internet is a source of much information based on correct facts and theory, and a source of much incorrect or false information. By having groups of individuals involved in/being educated in music therapy review materials before they are shared globally (a back channel review process), we will hopefully prevent the spread of misinformation and promote the sharing of "good, quality" material.

As well, I hope that information will be updated regularly (at least annually). As a consequence, viewers will receive the latest, and most up-to-date information. This is not possible through the use of text-based materials, especially in the field of music therapy, where new editions may be many years in the making (i.e. There was a lag-time of nine years between the 2nd and 3rd editions of the textbook that we will be using as a basis for this project!).

D. Research

As stated earlier, I hope that this project will generate new way of thinking and dicussion around music therapy and music therapy practice. I also hope that it will generate some research, qualitative and quantitative. I don't want this to be a static resource but rather a dynamic and evolving resource.

Once again, I ask you to consider joining me in this exciting project!

To do so, please contact me using the information provided below.

John Lawrence MMT, MTA
Edmonton, AB CANADA
E-mail: (Put "MTECP" in the subject line)
Twitter: @JLisaMT
Ph: (780) 477-3948

Tuesday, June 23, 2009

Day 15 - MTECP: The details

First, thank-you to everyone who has been following this blog and waiting patiently for details about the MTECP or Music Therapy Educational Collaborative Project. Secondly, I hope that you will begin to spread the word. As this is a collaborative project, we need lots of participants and ideas!

How did the project come about?

I teach an "Introduction to Music Therapy" course at a local college-university (an institution that began as a college and now offers both three-year certificates and four year degrees). The course is a full semester in length (approximately 13 weeks), 3 hours a week and it is offered through the continuing education/special sessions department, in conjunction with the department of music. At this point, there is no "music therapy degree track" so the course is most often used as an elective by the music and/or education students. The last two offerings of this course have used a traditional classroom format, enhanced by the use of a course management system (CMS) called Moodle. Although the use of Moodle is encouraged by the administration, support for faculty and actual use is minimal. Hence, my incorporation of Moodle has been somewhat unique and a source of constant revision and development.

During the last offering of the introductory course I received a variety of positive and negative comments from the students regarding the incorporation and usefulness of Moodle in their learning process. My own perception was that, while useful, there was much more that I could do as an educator/collaborator. This perception was further confirmed when I attended the 2009 MoodleMoot conference in Edmonton, AB, hosted by Athabasca University. It was very enlightening to see how others were using Moodle in new and unique ways, some of which I had not before considered. Following this conference, I began to consider and conceptualize MTECP.

Basic concepts behind the MTECP

Initially, the MTECP will be structured as an independent, non-credit introduction to music therapy available to anyone who is interested, anywhere in the world. It is NOT designed to certify individuals as music therapists and there is no supervision or recognition of completion of the project for any individual participant. In the future, it is possible that the course might be run as a supervised, institutionally approved and recognized course that could lead to admission into/progress towards a degree in music therapy. This, however, is not the initial aim of the project.

In order to provide a common starting point for participants, the textbook entitled, Introduction to Music Therapy: Theory and Practice (3rd ed.) by William Davis, Kate Gfeller and Michael Thaut will be used. This textbook is available from the American Music Therapy Association. As well, participants in this project will use English as a means of correspondence and online discussion/presentations.

Participants/Collaborators for this project will be drawn from interested music therapy professionals, educators, students and hopefully, the authors of the textbook themselves. (I am personally hoping that participants will come from a variety of countries, in order to provide the maximum diversity and range of experiences.) Everyone will be a volunteer, with no monetary compensation offered. Indeed, the public face of the project will be visible to the general public through a non-commercial, non-derivative Creative Commons license. Everyone will be expected to follow the ethical and professional codes of conduct of their respective music therapy association. Membership, in good standing, of an association for music therapy will be confirmed via e-mail prior to full acceptance into the project. Participants are free to leave the project at any point without penalty or consequence.

At this point, the aim of the MTECP will be to examine and explore the role that online learning can play in the enhancement of individual/student learning. Through the use of small working groups of participants, identification of digital resources, development of new activities and resources, and distribution of a final product is expected within a period of no longer than one year. Timetables for completion of expectations will vary depending on the complexity and variety of materials identified/created as well as the number of registered participants.

Finally, there will be a public face and a private face to the project. As stated earlier, the completed project will be available for any member of the public to see. However, there will also be a restricted discussion/collaborative environment where registered individuals can contribute and discuss ideas/concepts. The discussion of ideas and creativity of registered participants is essential to the progress and growth of this project. I cannot emphasize this enough!

Please join me in this exciting and dynamic project!

John Lawrence MMT, MTA
Edmonton, AB CANADA
(780) 477-3948

Wednesday, June 17, 2009

Day 14 - Introducing the Music Therapy Educational Collaborative Project (MTECP)

How do you educate someone in order that they become an effective and active music therapist? What balance do you strike between research and skill-based education? Is face-to-face contact necessary in evaluating student personality and suitability for a helping profession such as music therapy? Are students "of the digital generation" being effectively and meaningfully engaged by traditional classroom teaching or would on-line training promote more effective learning? These are just some of the questions that I, and other participants, will be addressing as we explore the creation on an online "Introduction to Music Therapy" course. Entitled the Music Therapy Educational Collaborative Project (MTECP), we will work through what is possible and not possible via an on-line exchange and review of ideas, concepts and theories. I hope to have individuals from both within and without the music therapy profession, from novice beginner to long-term professional, from many areas of the world, participate in this project.

Online learning is the subject of much current debate. There are some that argue it is the "wave of the future" or "an inevitable evolution within educational teaching and training" (Horizon Report, 2008; Shea, Pickett, Li, 2005; Stoerger, 2008). Others would argue that it is an experiment that has failed and that is detrimental or too costly (Attwood, 2009; Bennet, Maton & Kervin, 2008; Thompson, 2009). I tend to believe the former, in part due to my experience with a course management system (CMS) called Moodle ( and two recent offerings of an introductory course in music therapy.

Online learning also takes place in a variety of formats. Initially, online learning was simply the addition of a few links to information on the internet, in a course that took place in a traditional institutional environment. This evolved into hybrid learning environments where students were educated in both a traditional environment, part of the time, and part of the time in an online environment. Quality and quantity on online learning was highly dependant upon the instructor motivation and institutional support. More recently, courses offered in a digital or online environment have been created. Students may never set foot in a "traditional" classroom, achieving their degree requirements through online discussions, readings, projects and presentations (i.e. Microsoft Learning - Online Course. Website available at:

This last form of online education necessitates a variety of different and unique relationships from those found in a traditional classroom setting. In an online classroom/course, the instructor is viewed more as a collaborator rather than the sole source of knowledge and expertise. Indeed, students may be part of constructing their own knowledge about a subject, assisted by their peers and the instructor/guide (AllthingsPLC website, n.d.; DuFour, 2003). Secondly, there is a new relationship in terms of how, when, and where material pertinent to a particular topic is shared. Students are no longer restricted to "office hours" or "classroom hours", but rather can participate in both dedicated and non-specific periods of time. This is exemplified by a frequently cited credo of "Anytime, Anyplace, Anywhere" (Coleman, S., 2005). Indeed, students may be in an entirely different geographical and chronological location compared with their fellow students and the instructor. Finally, there is an immediacy to the education that was not possible previously. Whereas student previously had to wait for an instructor to grade, and then post, marks on a quiz or examination on-line environments allow for instantaneous and direct real-time feedback from peers and instructors alike. This can be accomplished through self-marking quizzes, and a variety of digital mediums such as wikis, blogs, and social networking sites such as Twitter.

Online environments have also brought about a significant change in the ways in that research findings, opinions, and knowledge about a particular subject are distributed to a wider public audience. The creation of "open access journals", "open courseware", "open textbooks", and projects such as Google Books has moved knowledge from a specific location, such as a university or institutional library, to a non-specific location where anyone can access this information. Traditional institutions are being encouraged to establish "digital repositories" where created materials can be reused, repurposed, and shared. Finally, the creation of flexible copyright protection, through organizations such as Creative Commons has enabled creators of new digital materials the flexibility to share information without the loss of control over ownership that a creator might see when material is plagarized or "borrowed" without permission.

How does this all relate to the Music Therapy Educational Collaborative Project? I'll continue the discussion in my next posting!

P.S. If you have a "sexier" name that MTECP, please feel free to suggest it :-)


AllthingsPLC. n.d. About PLCs: History of PLCs. Retrieved on June 17, 2009 from,

Attwood, R. (2009, June 4). Questions of cost and usefulness dog e-learning. Retrieved on June 13, 2009 from,

Bennett, S., Maton, K., & Kervin, L. (2008). The 'digital natives' debate: A critical review of the evidence. British Journal of Educational Technology, 39(5), 775.-778.

Coleman, S. (2005). Why do students like online learning. WorldwideLearn. Retrieved on July 17, 2009 from,

DuFour, R. (2003, May). Building a professional learning community. American Association of School Administrators. Retrieved on June 17, 2009 from,

Horizon Report. (2008). The Horizon Report: 2008 Edition. A collaboration between The New Media Consortium and the EDUCAUSE Learning Initiative (ELI) an EDUCAUSE program. Retrieved on June 16, 2009 from,

Shea, P., Pickett, A., & Li, C. (2005). Increasing access to higher education: A study of the diffusion of online teaching among 913 college faculty. The international review of research in open and distance learning, 6(2).

Stoerger, S. (2008, June). Book Review - Collaborative learning: Two perspectives on theory and practice. International Review on Research in Open and Distance Learning, 9(2). Retrieved on June 16, 2009 from,

Thompson, E. (2009, June 3). Dumbest Generation? Professor blames technology. USA Today [Online edition]. Retrieved on June 3, 2009 from,

Sunday, June 14, 2009

Day 13 - Brain Plasiticity and Brain Research

Right now, my brain is firing on "all neurons". I've just watched an amazing video about the growth and development of the area of brain research called Brain Plasiticity. My head is full of questions and ideas so forgive me if this post is a bit "scatterbrained" LoL!

For unknown reasons, many of the recent publications and internet based media that has caught my attention has dealt with the subject of brain plasiticity, or the ability of the brain to change and adapt to new and/or odd situations, resulting from brain damage or injury. A couple of the resources that I have come across include (in no particular order):

1. Levitin, D. J. (2007). This is your brain on music: Science of a human obsession. London, England: Plume. ISBN: 978-0-452-28852-2. 322 pgs.

There is now an accompanying 6 part video series, entitled, "The Musical Brain" staring Dr. Levitin with guests such as Sting, and Yo-Yo-Ma.

2. Lopez, S. (2008). The soloist. New York: Berkley Books. ISBN: 978-0-425-22600-I

This book has become a major motion picture available in mainstream theatres. While not necessarily about "brain plasiticity" it does reflect the power of music to transform lives.

3. Music and the brain: Are humans wired for music. [Video]. Available from:

4. The songs they can't forget. [Blog posting]. Available from:

5. The brain that changes itself. ["Nature of Things" Video documentary]. Available from:

So why discuss this topic on a blog? Music therapists have long contended that music has the ability to modify and change "neural pathways" in the brain (Davis, Gfeller & Thaut, 2008; Hummelsheim, 1999; Levitin, D. J., 2007). I have personally and professionally seen the effects of a long term relationship with a person with Alzheimer's type dementia who "can't remember what they had for lunch" but recognize that "You've been gone for a long time" or "You're going to play ME some music!". I've also seen the impact that music can make on the partial recovery of function in individuals following brain injury and stroke.

For those music therapists who wish to delve deeper, or who may wish to undertake training in "neurological music therapy (Thaut), I encourage you to look at the following websites (again in no particular order):

1. The centre for biomedical research in music (CBRM) located at:

2. McMaster institute for music and the mind (MIMM) located at:

3. Getting in tune [pdf file) located at:

4. Exploring the musical mind located at:

Finally, I would encourage you to Tweet or contact Nikki Belshe (@nikkibelshe) who has trained and become a Neurological Music Therapist.

Q: What information has tweaked your interest lately and why?

Day 12.5 - Frustrations and Rewards

When you first looked at the title of this blog, you might have thought - "He's going to be looking at behavioural modification therapy and music therapy!". Sorry to disappoint - no, I won't be looking at behavioural modification techniques today.

As readers of my blog, you will have noticed that I have not kept up with the "daily" part of my postings. I had originally conceived this blog to be updated daily, in much the same way as a photographer might complete a "365 project". The reality, I am finding, is much harder. There are a myriad of reasons that I could give for my tardiness and lack of posts however it comes down to motivation and interest. Am I really willing to put the time into the regular posting of comments? Upon reflection, I would have to say; no, not on a daily basis. That said, I remain committed to updating and posting on a regular basis a couple times a week. I must also apologize to those of you who were hoping for better.

Content quality is paramount. I remain committed to ensure that what I write is appropriately researched and documented. I don't want to post short "snippets" of information for the sake of fulfilling my posting ambitions. This means that sometimes it will take me longer than a day to post.

Content sourcing is complex. There are a myriad of sources available for searching and researching new topics and information. My browser bookmarks of "reference tools" is long and varied. However, like many people, I often use Google to search out topics (at least as a STARTing point). Many educational professionals bemone the fact that students often "Google" something and take the first couple references that they are given. The difficulty with that approach is, quite simply, that many search engines like Google post items based on "popularity" and not necessarily on "quality". Thus, a much better article might exist on page 3 of the search results. I want this post to be about the location and distribution of significant and meaningful information about a particular topic. This means that sometimes it will take me longer than a day to post.

I want to learn too! It is well and good for me to post my opinions and findings, but I would be nieve to think that I know everything that there is to know about a particular subject. That is, in part, why I try to come up with a question at the end of my posts. The are both a challenge to you, the reader, and to me, the creator. In this way, we can both benefit from the exchange of information and ideas.

To conclude - please continue to follow this blog. I can no longer say that I will be posting on a daily basis but I do commit to posting on a regular basis.

Wednesday, June 3, 2009

Day 12 - Recent finds

Today's post is all about resources that I have found in researching for this blog and navigating the internet. Some of them are fun, some are directly related to work that I do as a music therapist. I do not intend it to be a complete list, nor do I profess any professional training in library literacy/searching. I do, however, profess to be a life-long learner with an interest in adding to my knowledge of, and practice of, music therapy! Please note - resources are listed alphabetically with no intended inference to a ranking of preference.


Center for Lifelong Music Making


I received an e-mail that stated that a personal profile had been set up for me on this website. I'm not sure how I feel about that? The information, however, was correct and linked to activity that I undertake on the net such as this blog. The website also contains links to conferences/training that I was not aware of previously. I'll keep you posted on my opinions of this website after I've had more of a chance to explore it.

Teenager Listening Test*

*Not that teenagers listen to anything resembling music today anyways LoL

Who says music doesn't make a difference?


Music Therapy at The Hospital for Sick Children (Toronto, ON CANADA)

Nordoff-Robbins Music Therapy Video Portrait (Part 1)

The Music Instinct (PBS)*

*Note: Available as a 2 hr documentary on DVD (
To be released June 24, 2009). Several interesting segments are available via this website pre-distribution.

Podcasts/Mp3 Clips*

*Note: I hesitantly suggest this link because it is only available to members of the American Music Therapy Association (AMTA). Hopefully they will consider releasing some of the material via a restricted Creative Commons License. (Hint, hint!)


Of course, I recommend that you revisit previous postings to find links and resources that have been suggested or mentioned.

If you have any suggestions or resources that have been helpful to you, PLEASE comment away!

Tuesday, June 2, 2009

Book Review: This is your brain on music

Levitin, D. J. (2007). This is your brain on music: The science of a human obsession. London, England: Plume. ISBN: 978-0-452-28852-2. 322 pgs.

One of the advantages of travelling by train - lots of time to read, think, and generally de-stress! The book listed above was one of two books that I picked up for reading on my recent train vacation. The first, Travels with Farley, was excellent but more geared towards the "recreational reading" side of my brain. This book was the second that I read, however, I had picked it for professional, rather than recreational, reasons.

The book, quite simply, is a great read for the professional and non-professional alike. Although the concepts can be quite involved, Levitin does a great job of writing the book, "for the general reader and not for my colleagues... (p. 12)". It is easily understood and yet I found that I needed to take the book in chunks, reading a maximum of two chapters at a time before setting it aside and contemplating the deeper meanings and relationships to my work as a music therapist.

Along the way, there were a number of surprises. The first, that neuroscience divides the "Study of the mind" and "Study of the brain". He explains it this way:

I am not interested in going on a fishing expedition to try every possible musical stimulus and find out where it occurs in the brain...The point for me isn't to develop a map of the brain, but to understand how it works, how the different regions coordinate their activity together, how the simple firing of neurons and shifting around of neurotransmitters leads to thoughts, laughter, feelings of profound joy and sadness, and how all these, in turn, can lead us to create lasting, meaningful works of art (p. 96).
I had always considered neurology and neuroscience to be concerned only with how the individual parts of the brain were related to music appreciation and interpretation.

The second surprise came from evidence that suggests that memory strength, "is also a function of how much we care about the experience (p. 197)." Professionally, this was a reminder that the work that we do must be client centered, in order to help them to assimilate and consolidate the musical experiences that we/they create during a session.

Finally, there was a discussion of "the music listener" vs. "the music performer/expert". According to the author, "music making has become a somewhat reserved activity in our culture, and the rest of us listen (p. 7)". As music therapists, we encourage everyone to make music, accepting the results as skillful and a reflection of the clients' inner being. Are we simply too accepting or is their something different about how we are wired, such as a desire to see everyone succeed as a "performer of music"?

If I could criticize one aspect of the book, it would be the selection of music. As a music therapist, I use the general rule of thumb that the most significant music for most clients will be music that they experienced in their late adolesence to early adulthood. Levitin seems to fit this mold perfectly with most of the musical examples coming from the 70's and the rock and roll genre. Arguably, no one book can faithfully represent all time periods and musical genres however I would have preferred to see a wider variety of musical genres, and diversity in time periods evident in the musical examples chosen as illustrations.

Professionally, this book was a great confirmation of the meaningfulness of music therapy and the work that I do on a daily basis. I highly encourage everyone to pick up a copy and give it a read. I'll leave you with a challenge that Levitin describes being given by a friend and colleague (p. 51).

Challenge: In six songs, capture the essence of a musical genre such as rock and roll or jazz?

Good luck!

Monday, June 1, 2009

Day 11 - On the Rebound

It is said that "there are two sides to every story". The same can be said of vacations!

As readers of this blog know, I have recently taken a 2 week train vacation. It was, absolutely, one of the best vacations that I have ever taken. I visited our cottage, a few "historic" sites from my childhood and renewed acquaintances with friends that I haven't seen for a few years. Returning home to Edmonton, my children were eager to visit me, and I soon felt like I needed another vacation after my vacation! Among my "to do" items yet to be completed, a big belated thank-you to my guest bloggers. I really enjoyed your posts and I look forward to working together in the future. A special note about the third guest author (

Saturday, May 16, 2009

Guest Post - Rhythm in Art

"Cattle Cadence" pastel by Robin Maria Pedrero
John, thank you for inviting me as a guest to post on your Music blog. I am always intrigued at how all of the arts inspire and influence one another. Masterpieces encompass multiple art forms; performance, film, fine art, music, dances, etc. Interestingly rhythms in one art form like music can inspire rhythms or creativity in another form like fine art or dance. Rhythm usually brings music or dance to mind, yet it plays more than one part in the life of visual artists. Often I will listen to the same music or series of songs while working on a piece of art. Music sets a mood. We rely on all of our senses to create and music can be stimulating even intoxicating as we inhabit our own world of creation. I play particular music to accommodate looseness in my motions to carry through to the work or another style of music for more detailed concentration. The movements I make in creating can carry the rhythm of what I hear. Many titles to my works of art reference music.
"Ripples in the Pond" pastel by Robin Maria Pedrero

Rhythm is also a visual tempo or beat within the artwork itself. Rhythm is an art principle. Artists create visual rhythm by repeating art elements and patterns. The repetition of elements adds balance and harmony to artwork. Alternating lights and darks gives a sense of rhythm. The shapes, colors, lights and darks are the instruments an artist uses to give rhythm to their creations. Rhythm is a principle of design with regular repetition of elements that produce the look and feel of movement. It can be achieved through the careful placement of repeated components which invite the viewer's eye to jump rapidly or glide smoothly from one to the next. Rhythm is important to composition and harmony in a work of art. Elements can carry their own separate rhythms; color rhythms, line rhythms, and form rhythms.

"Deja Vous" pastel by Robin Maria Pedrero

Let’s look at some possible rhythms; the most common type, visually could be dark light - dark light - dark light or insert another element like a shape, line or color. There are alternating rhythms. Progressive rhythms occur when there is a gradual increase or decrease in the size, number, color, or some other quality of the elements repeated. Rhythms can flow and also be random. "Rhythm is as necessary in a picture as pigment; it is as much a part of painting as of music." (Walter J. Phillips) My motto as I mentor is "Pay Attention" by that I call you to do what we as artists do, in our job we take time to look, really experience the moment in the present with all of your senses. Can you feel the rhythm?

Thursday, May 14, 2009

Guest Post - Person-First Terminology

Person-first terminology, also commonly referred to as person-first language, is currently utilized across many professional fields, from special education to health care to therapeutic settings to public school systems. But why is it important? What’s the big deal?

Person-first terminology is not quite how one of my college professors explained it to our Special Education 101 course. Her explanation? Instead of saying, “That Autistic girl’s name is Sally,” her explanation was to say “Sally is Autistic.” Close – oh so close! But still not quite the concept! Person-first terminology does not mean that you call a person by their name.

Thankfully, my music therapy professor explained it with much more accuracy.

Person-first terminology suggests we state phrases stressing the person (name or pronoun) first, followed by their disability or diagnosis.
  • “Matthew is a Downs kid” becomes “Matthew has Down Syndrome.”
  • “ He is ADHD” becomes “He has ADHD.”
By a simple grammatical change, the focus is shifted from the disability to the person, hence person-first. By utilizing person-first terminology, dehumanization is avoided. The person is not the disability that they might have.

Similarly, this can be compared to the movement to remove outdated words from our vocabulary that have since developed new and often offensive connotations. For example, the words idiot, retarded, imbecile, handicapped, and mongoloid were once more widely accepted. In modern times, these terms are usually considered derogatory. The Education for All Handicapped Children’s Act of 1975 has even been revised and given the name IDEA, or Individuals with Disabilities Education Act.

While this movement in semantics means well, many differing points of view exist on the matter. Some prefer person-first terminology and find it politically correct and a little more dignifying, but some think that this effort takes away from their identity. For example, those involved in Deaf culture (with a capital D) sometimes feel that their deafness is not a disability at all but a mere trait. Many people with blindness and Autism feel the same way and do not mind being called “blind” or “Autistic.”

All in all, it comes down to what your patients / clients and their families prefer. This can become troublesome when switching terminology back and forth so as to earnestly avoid offending someone, but the effort is usually appreciated. Find out what your clients and employers prefer.

Hopefully this short introduction to person-first terminology will not only give the reader insight into a relevant concept, but perhaps it will leave the slightest thought in the back of your mind. As a therapist, educator, health care provider, or paraprofessional, how do you refer to your patients in your daily progress notes? What is your perception of your clients? How do you see them – as people with disabilities, or as disabilities who happen to be people?

Please post your thoughts and discussion questions in the comments section of this blog.

Helpful Links:

Nikki Belshe, MT-BC, NMT
Music Therapist – Board Certified
Neurologic Music Therapist
Longmont, CO

Wednesday, May 13, 2009

Guest Post - Self-Care

Anyone who has ever flown on an airplane has heard the pre-flight safety schpeel: this is where the emergency exits are, in case of turbulence return to seats and put on your seat belts, no personal electronic devices until the plane reaches the cruising altitude. We're also told, in the case that the cabin pressure drops, oxygen masks will fall down from the panels above us. The flight staff reminds us that if/when this happens, to place this mask over our own faces before assisting those next to us.

During my final music therapy practicum experience as a student, my supervisor used this example to illustrate the importance of music therapists (as well as others in helping professions) taking care of ourselves in order to provide the best quality services to our clients. We spent some time during each of our supervision sessions discussing self-care and steps we were taking to build healthy mental, physical, and spiritual habits to effectively deal with stress and burnout. Up until this point, none of my supervisors had spent much time emphasizing self-care. Today, I find myself using the same metaphor of the oxygen mask with the students and interns with whom I work as a way to illustrate the importance of self-care in our profession.

When I think about my experiences with stress as a music therapist, I can generally categorize my stress into 2 distinct areas: external and internal. External stressors are those that one has little or no control over (for example: lack of funding/resources at your facility, layoffs/hours being cut, or unrealistic expectations from your supervisor), while internal stressors are generated inside of ourselves (for example: low self-esteem, taking on too much work, or vocal health problems due to lack of proper technique). While some of these stressors are unavoidable, burnout or extreme stress reactions which take a major toll on our health are preventable. The following are some basic wellness tips that I have found to be helpful in my clinical work at as a music therapist no matter which population I am working with:

1. Use common sense: We all know that there are certain habits that are just plain good for everybody, like eating well, exercising, drinking water, and getting adequate sleep. Along with these, there are a number of other "basic" habits that music therapists should strive to develop (many of which I am guilty of neglecting!) -- things like warming up our voices prior to sessions, or taking some sort of break each day eat/recharge our batteries, for example. Even something as simple as deep breathing for a few minutes can dramatically improve acute stress reactions when we are on the job. Sometimes it may seem difficult to make these seemingly little things a part of our daily routines when we're strapped for time between sessions and meetings, but they truly make all the difference when it comes to our wellness as practitioners.

2. Ask for help: Over time, I've learned that a lot of the major stress related to my job could have been prevented if I had asked someone for help. Several years ago, a co-worker accepted a position at another unit at our facility, and I was left to cover both of our caseloads while also supervising 2 interns and preparing for special holiday events. It was important to me that all the clients participating in music therapy prior to my co-workers move continued to receive services, my interns were getting the support that they needed, and that the upcoming events were planned...but I couldn't do it all alone. Luckily, my supervisor sensed that I needed her help to stay afloat until we could hire a new music therapist, and I finally realized that I couldn't do it all by myself.

Whether it is your family, friends, co-workers, supervisor, mentor, personal therapist, or other people in your PLN (see John's posts below for more info), find someone (or several someones) who you can ask for help when you feel the stress creeping on, and call on them when you need them.

3. Get back to your roots: I have a friend who worked for several years as a hospice music therapist and absolutely loved her job. She is an incredibly talented musician, proficient on voice, piano, guitar, and violin, and often performed with different groups or got together to jam with other musicians. After awhile, however, she found that she was no longer making music for herself as a recreational activity or hobby, simply because she was so mentally and physically exhausted from the demands of her job.

Before we were music therapists, we were musicians, and we mustn't lose sight of our deep-seeded passion for our craft. Making music for yourself - whether you're involved with performing ensembles, take lessons, or simply play around for fun at home - is one of the most nuturing and loving things you can do for yourself as a music therapist.

Ultimately, music therapists have the tools to take care of ourselves, but sometimes we can all use a reminder that taking care of ourselves should be a priority -- doing so assists us in continuing to provide excellent services to our clients and ensures a happy, healthy, and long career.

Please, do post your tips and suggestions for wellness and stress management in the comments section!

-- Carolyn Dachinger, MT-BC
Boca Raton, FL

Saturday, May 9, 2009

Day 10-2 Using your PLN

Having just read my last two postings, you are probably busy figuring out who to include on your PLN (or not). Maybe you're busy signing up for new services like Twits Like Me (I love that name!). In any case, I always like to see at least one practical and useful example(s) before I jump into anything new - so here it is!

John's PLN

I will be leaving for 2 weeks vacation this evening, during which I will often be without internet. As a result, my postings to the Musictherapy365 blog over the next two weeks will be minimal. However, in order to ensure that you will have new content to view I've utilized two (and possibly three) individuals from my own personal learning network. I've left the content of the postings by these guest authors up to their own discretion. Please take the time to view their postings and comment on anything that you see or read.

Who are they?

Carolyn Dana Dachinger
MT-BC is a music therapist from Florida, whom I met through using Twitter. On Twitter she goes by @bachinaminuet. She describes herself as "...a free spirit who loves music and people. music therapist, multi-instrumentalist, soon-to-be grad student @ Uni of Miami and lover of all things 80s.".

Robin D. Pedrero is a very successful visual artist. On the Twitter network she goes by @robinpedrero. She is a great inspiration to me as a small business owner and has some great artwork for sale that you can see at: Gallery523. She also has a regular blog called Pocketful of Colors.

As you can see, not everyone in my PLN is a music therapist. I think that is a good thing - diversity and imagination are wonderful things!

Have you started setting up a formal PLN? What were the upsides, and the downsides?

I look forward to reading your comments and ideas when I am able to get online during my vacation. Since I'm taking the train (first time, 3 days each way!) I'll also be posting some photos on Flickr when I get back (Flickr username: JL Outdoor Photography).

Cheers everyone

Day 10 - Personal Learning Networks (con't)

In the last post, I ended with the logos of several popular social networking sites that might be useful in developing a Personal Learning Network or PLN. Today, I wanted to share some more details.

Arguably, one of the most popular social networking sites on the Internet. You can use Facebook in a number of ways. First, you can locate "Friends" or contacts from your address book and/or a search of an individual's name. (i.e. You might find a friend from your college or university days). Secondly, you can find individuals who might have similar interests by searching "interests" (i.e. Music therapist). Finally, you can search for groups/associations that have a Facebook page in your area of interest. While I have good experience with Facebook, I would tend to use this site for personal updates, rather than professional exchanges. I would also use Facebook to stay up-to-date with the happenings in various organizations and groups such as AMTA or World Federation of Music Therapy, in addition to visiting their websites.

Linkedin is one of the newer "networking" sites. In contrast to Facebook, this site is significantly more professional in content and culture. By fully setting up a "Linkedin profile", you are disclosing a great deal of information about yourself. Consequently, you need to be think carefully about your public profile before joining. (I discussed the benefits/dangers of your "public profile" in an earlier posting entitled, Day 3 - The "When" of Music Therapy). I don't yet have a lot of experience with Linkedin so I post a bit more about it later. I will say, that if you want to link in some pretty cool Web 2.0 software tools such as SlideShare, WordPress, Huddle Workspaces, and, the integration of these applications is very easy and simple. You can also post links to your website, blog, wiki, etc.

Twitter is one of the newest and most popular social networking sites. You can both "follow" friends (get their updates) and have people follow you (followers). People provide instanteous, real-time "tweets" about things that they are doing and thinking. This can range from the "I'm waking up now" to "Here's a great new link to an article". The catch in all of this is that your "tweet" can be no longer than 140 characters. This may seem like a lot of characters but it goes quickly. This leads to all kinds of short forms like "4U (for you)" and "IMHO (In my humble opinion). As mentionned, you can also include URLs or website addresses. We all know that these can be VERY long. Twitter helps with this by allowing you shorten the URL using a free service called The only role of this service is to provide a shortcut or shortform of longer URLs.

Opinions about Twitter tend to be polarized - you either like it and you stick with it, use it regularly, and find it useful, or you HATE it, use it briefly and then move on. My own personal experience has been the former - I like it. As one of the "new" kids on the block, it still has some growing pains. A search for "music therapy" will lead to a "No results" message. You have to either discover or know the name of the individual that you are trying to find. However, there are people writing secondary applications that can help you use Twitter more effectively. Some of these include: Twits Like Me (used to find Twitter followers that might share you interests), Tweetdeck (an application that lets you see your friends "tweets", direct messages, etc.) and Twackit (generates all kinds of statistics about your account and lets you follow trends on Twitter globally). For a complete list of applications that interact with Twitter, visit Twitdom.

Another way to track terms that are of interest to you is through the use of a "hashtag". Quite simply, you add a "#" sign in front of the term you want to monitor or follow (i.e. #music therapy). This sets up a custom search that finds all instances of "music therapy" in people's tweets.

I've got to go now - my son just woke up and is "dying" to use the computer :-)

Do you use any of these social networking sites? What has your experience been?

Friday, May 8, 2009

Day 9 - Personal Learning Networks (PLN's)

At a recent conference I attended, there was a discussion lead by one of the keynote speakers regarding the creation and development of a "Personal Learning Network" or "PLN". PLN's have been described in the following manner -
The members of your network should be people, both inside and outside of your work group and your company, who have the knowledge that you are trying to master and who are willing to share their knowledge and experience with you (Tobin, 1998)
There are a number of ways that you can go about developing a PLN. As a music therapy student, the most obvious method is to develop friendships and relationships amongst your fellow students whom share you interest. However, as we are often all too aware, those friendships and acquaintances can fracture easily upon graduation.

In some cases, music therapy associations provide opportunities for sharing and networking. An example of this is the Early Childhood Network, within the American Music Therapy Association (AMTA). Similarly, many organizations that represent "specialties" within the field of music therapy (e.g. Nordoff-Robbins music therapy, NICU music therapy, Neurological music therapy, etc.) maintain a list of professionals who have trained in that particular technique.

Finally, the advent of social networking tools, such as those shown below, enable the individual music therapist to seek out, find, and interact with a variety of individuals, unrestricted by geography, who share a common interest/philosophy.


I'll be writing more about PLN's tommorrow. Do you have any ideas for creating a PLN? How have you created a PLN?


Tobin, D. R. (1998). Building your personal learning network. Retrieved on May 8, 2009 from,

Thursday, May 7, 2009

Day 8 - Pondering the future

Lately, the new Star Trek movie has been all over the news. I'm a passive participant in the "Star Trek Fan Club" but all the media hype does have me thinking about a question I ponder from time to time - What is music therapy going to look like in the future?

Music therapy has certainly undergone a revolution conceptually. Initially, it was a restorative medium used to treat the "mental and physical health" of injured soldiers (Davis, Gfeller, & Thaut, 2008, p. 32). Today, it is being used to treat mental and physical health as well as it is being used for social skills training, emotional well-being, hospice and palliative care, neonatal care, spiritual health, and community based/integrated settings.

Another more recent trend has been "increasing awareness of the importance of sensitivity to cultural differences by the helping professions (Davis, Gfeller, & Thaut, 2008, p. 447)." There are a number of reasons why this change is taking place. First, music therapists, who have been trained using traditional "western music (tonally)" are taking their expertise back to their home countries and applying regional and culturally specific variations and/or modifications (Gao, 2009). Judging from the number of news reports/news articles, another hotspot for the development of music therapy appears to be taking place in India (Google search engine, daily, term "music therapy"). Secondly, individuals are much more mobile, physically, than ever before. Consequently, an increasing number of different cultures can be found in particular countries or geographic area. A perfect example can be found in the most recent edition of the Voices e-journal on music therapy that recently featured an article entitled, "Musical Preferences of Argentines Living in Australia: Implications for Music Therapy Clinical Practice". Finally, groups such as Music Therapists for Peace (Edith Boxill) and PlayingforChange have highlighted a social justice/activism role for music therapists and musicians. At the University of Windsor, the university and music therapy program are described as having a international focus and a focus on "social justice".

So how does this impact music therapy? First and foremost, the musical repetoire that music therapy students are exposed to must, by necessity, include culturally specific musical examples. It is no longer sufficient to go with the standard "North American", "Western tonality" based songs such as, "You are my sunshine" and "Home on the Range". In my area of practice (working with geriatric clients) I often see that persons with Alzheimer's will often revert to their "mother tongue" as their dementia progresses, rather than retain English as their primary mode of verbal communication. I also recently completed some training entitled, "Supportive Pathways" where the need to understand culturally specific socialization patterns may impact how you deal with a particular individual. For example, in some cultures, direct eye contact with "an elder" is discouraged and frowned upon. Here in North America, we expect to see a person "look at me[us] when I am talking to you!" This might also be important to consider as part of the training of music therapy students and music therapists.

Speaking strictly as a music therapist working and practiscing in North America, I have also begun to see a generational change in the music. By this I mean that music of the 1920's and 1930's, preferred by many of my clients today, is giving way to music of the 1940's and 1950's. I am personally looking forward to working with the generation that grew up on the music of the 1960's!.

Finally, a lesser obvious impact upon music therapy practice is the proliferation of music, in terms of availability. The early 20th century, at least in North America, saw home based music making, and small publication runs of popular music. Presently, the availability of music from every conceivable genre and/or source is a given and music is becoming increasingly personalized (think iPod versus group singing). This was brought home by an assignment that I had students in my Introduction to Music Therapy course complete recently. Specifically, I had them complete a 20-minute audiobiography of their life. Unlike the previous class of students that had completed the same assignment two years ago, this class presented a more diverse pool of musical examples, including many that could be categorized as "world music" (BTW: The audiobiography assignment is a great assignment that students tend to really enjoy and take pride in, once it is complete). As music sourcing becomes increasingly diverse, and individuals seek out a wider range of music, I believe that improvisation will become an increasingly important part of training. We [music therapists] will no longer be able to learn a narrowly defined set of songs and reproduce them for group or individual consumption. Elements of music such as rhythm and harmony are common to music of a wide variety of cultural groups.

Have I reflected your thoughts about the future of the profession of music therapy or do you have some additional ideas related to "Where are we going as music therapists"?


Davis, W. B., Gfeller, K. E., & Thaut, M. H. (2008). An introduction to music therapy: Theory and practice. Silver Spring, MD: American Music Therapy Association.

Gao, T. (2009, April 30). Music therapy in China. World Federation of Music Therapy/Regional Liasons Blog. Retrieved on May 7, 2009, from,

Moore, C. C., & Baker, F. A. (2009, March 1). Musical preferences of Argentines living in Australia. Voices, 9(1). Retrieved on May 7, 2009, from,

Monday, May 4, 2009

Day 7 - The Nature of Music

I admit that there are times when I don't want to listen to music after a day of work (is that heretical?). It is not that I don't enjoy music, but sometimes I just need precious SILENCE! Apparently I am not alone - Bill Drummond has created "No Music Day", an event held annually on November 21st in Great Britain. And yet, just a few hours in the woods can reinvigorate my brain and make me seek out music with enthusiasm. So what is it, exactly, that is different? And as a music therapist, how exactly do I define music?

Music has been defined as "organized sound" (Edgard Varesé).

"After silence, that which comes nearest to expressing the inexpressible is music."
(Aldous Huxley)

And my favorite quote of all -
"Without music, life would be a mistake."
(Friedreich Nietzsche).

(You can find some other quotes about music via Wikiquote, an offshoot of Wikipedia.)

In answer to the question of "What is different about being in nature?" I can respond that perhaps it is the "disorganized" nature of the sounds that appeal to my "primitive" brain? You can't, after all, plan or conduct a chorus of birds! Perhaps it is the fact that I simply cannot, by any means, replicate some of the sounds that I hear? Any sound that is produced by a musical instrument, a machine, or by human effort, CAN be reproduced, whether by the same individual or someone else in an almost identical form. But can any instrument or individual truly replicate the sound of a waterfall?, or the rustle of wind through the leaves?

And why does this even matter? Because - I am a music therapist!. I accept what the client brings forward, through the therapeutic process. I want, and hope, that they will use "music" to communicate their thoughts and feelings, conscious and unconscious, good and bad. Moreover, I want, and hope, that I will be able to use "music" to reflect those thoughts and feelings back to them in an appropriate way that honors what they have chosen to share with me. One the greatest gifts that I was ever given by a client involved just such an interaction.

I had been working with a young lady with Cerebral Palsy for about a year and a half. While she had made some progress towards the goals and objectives that were established, progress was beginning to slow down. As a new "tween", she liked to listen to music and one of the activities she had chosen to do in each session was to "listen to a few favorite songs". On this occassion, she chose a song that she had not suggested before entitled, The Rodeo's Over by Corb Lund. The lyrics are as follows (courtesy of
the rodeo's over, the folks have gone home
and the cowboys are all down the road
well boys, she was a good un, we kicked a hole in the sky
and even the rank ones got rode
it was as wild as they come and it was almighty western
and none of us thought it would end
but finish it did, with a bang and a whisper
and now i must leave you my friend

we may do it again in some future season
but somehow it won't be the same
cuz our draws will be different and our injuries healed
and it's likely the weather will change
so take from the lessons and be glad for the memories
of the days that we rode in the sun
for after today, there’ll be no man can claim
that we didn't have us a good run

so burn all the blankets and dry all the tears
we can always go further out west
and i'll meet you out there in the vastness somewhere
i swear it but first i must rest

To me, this epitomized her desire to terminate the therapy sessions, although she was unable to verbalize her feelings. The music, verbalized these thoughts for her. Indeed, the entire mood and tonality of the song reinforced the feelings told through the lyrics.

So what do you consider to be the nature of music? Do you ever have days where you can't stand to listen to a single piece of music? And what is it that brings you back?

I look forward to reading your responses and comments!

Sunday, May 3, 2009

Where in the world?

By now you may have the idea that music therapy is an extremely diverse and complex concept, and profession, to understand. You may be thinking - "it sounds interesting but I don't know if there are any music therapists in my geographic area?" Rest assured, music therapy is a worldwide phenomena and there are many different areas of the world where music therapy is practiced. The philosophies of practice and actual working out of the music therapy may be slightly different however behind every international group of music therapists, there is the overriding belief that, "music is a powerful medium with a tremendous capacity to introduce positive change in an individual or group of individuals!"

So where can I find out more information? I'm glad you asked! The most important source of reasonably current information about music therapy in different countries, particularly those outside North America, is found in the Voices online music therapy journal. Click on the "Country of the month" link on the title bar. This site also takes you to the content in the Nordic Journal of Music Therapy published three times a year, as well as various columns and discussions. Another site that features information about various music therapy programs and associations in various countries is the website of the World Federation of Music Therapy and the European Music Therapy Confederation. Sadly, the Music Therapy Today e-journal is no longer, although back issues are archived on the MusicTherapyWorld site. In North America, you can find music therapists in your area by visiting either the American Music Therapy Association or the Canadian Association for Music Therapy website.

In addition to websites, there are a number of other resources that you can use to find and contact various associations (professional and student) throughout the world. There are a number of associations and individuals that maintain a presence on Facebook. Rather than searching through all 500 facebook groups that come up in a search of the term "music therapy", here are a few to get you started.
  1. American Music Therapy Association
  2. World Federation of Music Therapy
  3. I Support Music Therapy
  4. Top 10 Things Music Therapists Love to Hear
  5. Evidence-Based Music Therapy
Facebook is also being utilized to help assist in protesting the proposed closure of music therapy training programs and engage members in the appointment of a president-elect of the American Music Therapy Association (AMTA). (My apologies to those other music therapy programs facing closure that are not hyper-linked here).

In addition to "music therapy" proper, there are a number of other noteworthy websites/groups that may be of interest. These are generally "specialty" forms of music therapy practice, in the same way that medicine/healthcare has a number of "specialty" areas such as pediatrics, obstetrics, etc.
  1. The Association for Imagery and Music (Bonny Method of Guided Imagery and Music)
  2. The Center for Biomedical Research in Music (Colorado State University)
  3. Medical Music Therapy (Florida State University)
  4. Nordoff-Robbins Music Therapy - this is just one of many links to the Nordoff-Robbins approach to music therapy and centres located throughout the world in countries such as the United Kingdom(Britain), Ireland, and Australia.
These are but a very few of the possible websites that you can visit.

Do you have a link or an internet-based resource that I can feature in future blog postings?

Please feel free to comment or send me an e-mail: me through Twitter (Username: JLisaMT). I look forward to your comments and questions!

Saturday, May 2, 2009

Day 5 - Change is key!

Change is inevitable - that is a unchanging fact of life. How you choose to view it, positive or negative, is your decision. I would have to say that I sit on the "positive" side of the fence. One of the things I like best about my chosen career is that no two days are ever the same. Not only do I not see the same clients every day, I don't necessarily see the same client hour to hour. When working with clients with Alzheimer's type dementia, there is a period of time know as the "sundowning period". Not everyone believes that this effect occurs however I would have to say that, at the very least, it occurs quite frequently. Essentially, the agitation and restlessness of persons with Alzheimer's increases whenever "dusk" occurs. This can change throughout the year as during the winter months, the days are shorter - during the summer months, the days are longer. Music can be very beneficial in helping to increase relaxation and bring some measure of quietness on the unit. However, what worked one day may not work the next. I love the challenge of finding that "right mix of the familiar and unfamiliar" to create a positive effect in my work and clients.

This blog is another journey in change. I've never blogged before so I am not as familiar with the software as I should be. It has been a steep, but rewarding learning curve since I began this blog. Initially, I started with the simple textual based entry. I've since added a "comment" function, and you will note some major additions today. This includes a "upcoming conference and presentations" widget (or section) and a "free daily download" widget. One of my favorite musical genres is jazz. I find that, by visiting the AllAboutJazz website, I can introduce myself to artists and music that I would not ordinary find or become aware of! (And that is likely the purpose behind that widget).

Finishing up for today, I wanted to let you know that there will also be a change coming up in my postings. Between May 9th and May 25th I will be visiting my family in Ontario. As I will not always have internet access, postings may be more sporadic. I'll be taking the opportunity to work on another project - The Music Therapy Educational Collaboration Project that I will discuss further when I return home to Alberta.

Thursday, April 30, 2009

Day 4 - Considering Private Practice?

I've just finished my taxes for another year - Argh! After a late-night trip to the post office to beat the 12 PM deadline, I've got a little time to sit back, check Twitter, Facebook, and Flickr (Can you say information junkie!). My mind is full of deductions, expenses, and income statements and my living room is full of piles of paper (LoL). With that in mind, here are some of my thoughts on running a private practice or being self-employed.

When I began my first music therapy job, I didn't have a choice - it was private practice/contract or nothing. Thus began my journey into the world of self-employment and I haven't looked back since. Many people cite the ability to "be your own boss" as a benefit of private practice. What they don't say is - you also need to be the accountant, public relations person, and secretary! I also don't remember a course about "How to run a business" during my training (They should definitely include a "Business 101" course as part of the overall degree requirements).

Being the accountant means that you have to keep track of things like cancelled sessions, damgaged instruments, gas and meal receipts AND come up with a system to invoice and record expenses properly*. Another, less enjoyable, part of being the accountant is following up on deliquent or overdue accounts. Being in private practice means that you can never be sure when you will receive payment for the invoice(s) that you submitted last month. If you have a "need to know" exactly when money is to come in, don't choose private practice. (I've had some invoices that took three months to be processed). And please, if someone has a foolproof way of getting invoices paid on time - PLEASE let me know!

- find out what tax categories you will be needing and set up your annual spreadsheet accordingly - it will definitely save you a lot of time come tax preparation!! A

Being the person in charge of public relations means that you have to develop your advertising plan/brochure, arrange for pictures (remember what I said in my previous post: no pictures = no interest), and the newer responsibility of ensuring that consents and releases are obtained before you put anything in said brochure or newspaper article! In this position it pays to be an OPTIMIST. You are probably going to have quite a few "no's" before that one "maybe" or one "I think about it". It also helps if you are an "extrovert" rather than an "introvert" (coming from someone who was very shy and had difficulty expressing himself in public). I still get nervous when speaking in front of a large crowd but a measure of comfort can definitely be learned.

Finally, being the secretary means that you get any other job not covered in the previous two roles. Some examples include: writing progress reports and/or letters to funding agencies, answering calls from anxious parents, and, of course, cleaning the bathroom!

Have I made it sound like I hate being in private practice? There are certainly days when I long for a full-time position in a nursing home (my specialty is geriatric clients) and I am an employee, not a contract worker. Overall, however, I do enjoy the freedom, responsibility and challenges that come with being in private practice.

What is your opinion?