Potential vs. Actual
An individual in an adolescent inpatient psychiatric unit insists that songs with themes of suicide and depression are helpful to listen to.
Potential
Sally requests to hear a hymn. You don't like religion, so you play Carrie Underwood's "Jesus Take the Wheel".
Culturally Incompetent :(
A patient with a G-tube tripped over a box of instruments and landed on their stomach, which resulted in displacement of the tube, bleeding, and bruising.
Physical Harm
An MT presented a breathing entrainment intervention with a (unbeknownst to the MT) hypoxic patient. At the conclusion of the session, the patient’s heart rate was found to be too low and medical intervention was needed to re-stabilize the patient.
Actual
Your new client, David, indicated that he identifies as Orthodox Jewish. Your male colleague highlights the fact that within David's culture, separation between men and women is important. He offers to see David instead, and you agree to this.
Culturally Competent!
A pediatric oncology patient experiences a sudden increase in respiration and heart rate at the onset of a song the therapist chose to play while providing procedural support. The patient later described how that particular song played on the MRI playlist.
Physiological Harm
A female patient receiving treatment for an eating disorder experienced negative transference while working with a male music therapist due to harmful interactions with males in her past.
Actual
You plan a lyric substitution intervention for your adolescent group using the songs "Big Girls Don't Cry" and "Man in the Mirror". When you arrive, you realize that two new admissions have chosen to attend and one identifies as transgender. You choose to use a backup intervention to avoid any emotional discomfort on the new patient's behalf.
Culturally Competent!
A group of teenagers all experienced the loss of their fathers and asked to focus on this experience so they could connect to and heal from their loss. During the session, many group members experienced extreme emotional reactions, including one teenager who had an asthma attack due to feeling overwhelmed and unable to calm down.
Emotional Harm
An MT student presented a lyric substitution intervention to cognitively impaired patients who lacked the ability to think abstractly and respond appropriately to the intervention.
Potential
At the end of your session, Jun invites you to dinner at his house - a gesture of respect in his culture. Afraid of getting in trouble, but not wanting to upset Jun, you say "maybe" and quickly leave the session.
Culturally Incompetent :(
Patients in an adolescent psychiatric facility made complaints about not having access to music therapy services when the therapist’s schedule included multiple days away from the facility. The therapist admitted that these comments made them feel uncomfortable, contributed to personal feelings of guilt, and made it difficult for them to advocate for their self-care needs.
Relationship Harm