Caterina and Ana

Caterina is a student on our MA Music Therapy degree. As part of the course she attended a clinical placement under the supervision of Ana at Hollanden Park Hospital, further developing the skills she learned on the course with real-world practice and patients.

Tell us a little about who you are and your roles on the placement

Caterina: I'm currently in my second year of studying the full-time music therapy degree at ARU. I attended the placement twice a week, and had a month of shadowing Ana and seeing what she did, how she worked with patients. Then I was given three patients to work with, and had the opportunity to lead my own music therapy sessions one-on-one.

I also shared a group with an occupational therapy student who was on placement at the same time. That was very interesting because I had the opportunity to see how other therapies worked and collaborate with them.

Ana:  I work for Renovo Care Group, and I'm based at one one of their sites, Hollanden Park Hospital, and I'm their lead music therapist. We specialise in rehabilitation, mainly with acquired and traumatic brain injury patients.

How well prepared did you feel when starting the placement Caterina, and how much support did you receive from ARU and your placement provider?

Caterina: It was completely different to anything I've ever done before because I'd come from a background of working with children with additional needs and profound and multiple learning difficulties, so I’d never worked with adults, and the thought was quite daunting and a bit overwhelming, but I said to myself ‘You’ll never have this much support ever again, so throw yourself in and just give everything’, and that’s what I did. I just went in with an open mind, ready to experience whatever it was.

I had great support throughout it. I had supervision with Ana once a week in the hospital, then small group supervision at university once a week with a few of my peers and one of my course lecturers. That was really useful because we got to share work, and I saw what my peers were doing and we could talk about it.

How did you find the placement in the first place?

Caterina: I had a chat with my placement organiser on the course, and we spoke about the experiences that I’d had with work and what I was used to working with. What I could do that was different and would benefit me the most. We also spoke about things that I found scary, and working with adults was one of them. So we said ‘Ok, let’s work with adults’.

Being in my first year, I wouldn't have gone out of my way to do this if not for the placement, just because of the worries of the challenges you might find and the lack of confidence that you have. So doing this has given me a lot more confidence to work with adults in the future.

Were there any particular breakthrough moments with patients, when you suddenly felt the approach you were taking was working?

Caterina: I don’t think of it in terms of working or not, but there were definitely some incredible experiences with all the patients, and these experiences I was actually able to understand and process thanks to the supervision I did with Ana.

One of the patients I worked with, we had a very rocky relationship from the start. From the beginning I was rejected by them, and they didn’t want anything to do with me – or at least that’s how I felt when working with them. Then slowly, every week, we built a closer relationship that started off with them throwing a tambourine across the room, to them coming to the music therapy room with me, sitting next to me at the piano and slowly opening up and breaking down this wall. I think we actually ended up having a very beautiful and humorous relationship full of jokes.

They were non-verbal, so we didn’t speak. This was all done through being in a room together and interpreting the emotions that I felt afterwards. By the end of my placement we would sit together and, after a bit as I was playing, they would fall asleep – which doesn’t sound like much, but to have this person that was pushing me away at first become so vulnerable and just let go to the point of falling asleep and being ok with it was really special. Ana told me the week after I’d left that they’d returned to the music therapy room – I’ll never know if they were looking for me or not, but they went back and knocked, and were looking round then left.

Other patients as well that again at the start were very close and scared, slowly opening up – their bodies opening up, and their faces opening up. It’s just beautiful to think back and reflect on these changes.

How do you feel Caterina progressed during her placement, Ana?

Ana: Caterina did really, really well. She’s a mature student. She has a really good intuition, so she blended in really well since the beginning.

In fact she wrote a reflective piece on her placement that was published by the Neuro Rehab Times. So yes, she did really well, and was well supported, not only by myself but by the whole multidisciplinary team, and by ARU.

What are the kind of qualities you look for in a placement student, Rebecca?

R: Openness to anything. Not being scared off by a lot of things. A lot of the clients that Madelaine came into contact with and supported don’t have any of the usual neurotypical markers that you think they would need to take part in therapy. One of our clients is completely non-verbal, you often have no real idea of how much information she’s able to process. Her learning disability is incredibly profound, but she was as in need of therapy as anyone else, and we worked it out together, how to communicate with her.

Flexibility is a big one as well. As much as I would like to plan the day, I’m running round like a headless chicken all the time. so Madelaine was very good at saying ‘Ok, this is my authority, this is the space and the time that I’ve asked for, but equally that person’s had a seizure, let’s give them five minutes and then they’ll be able to engage more,’ or ‘Ok, things haven’t gone great this morning, how can I accommodate your needs?’ But also I think Madelaine pushed us to be a bit more time-savvy and respectful of that therapeutic space as well. She added a lot.

What do you think was the most valuable thing that you took away from the placement, Caterina?

Caterina: Anything Ana said to me!

Ana: We spent a lot of time together. The two days Caterina was at the placement she was either with me or her patients, or another therapist. And I think that helps, to have that continuous support. Of course we have that slotted time for supervision, but we also spend time collaborating as colleagues, and that can be very, very enriching. You learn a lot just by watching.

Caterina: Yeah, you learn so much from just having a casual chat, which we did so much because it was one music therapy office. When something happens, when you have a thought, or read something, or even when you talk about anything else, like really nerdy opera stuff, or anything to do with psychoanalysis, we would just have endless conversations. You learn so much from it, and it sticks with you. It's the thing that helps you grow the most, and helps you learn how to reflect.

Ana never gave me any answers. It was always questions. Any questions I had, it would be a question back, but that was amazing because that’s how you learn to introspect, and reflect, and analyse, and be critical. And I still carry those mechanisms with me, and it’s still how I practice today, and in future probably.

Did Caterina bring anything to the role that you weren’t expecting, Ana?

Ana: Oh gosh, yes! It was a two-way avenue, and as Caterina says, we did talk a lot outside of supervision, and she had forward-thinking ideas, as other students have had. They ask the difficult questions, which is why it’s so valuable to have them.

I’m thinking of an example Caterina, you might remember this. There was a student you worked with – you guys asked the question ‘So what about sexual education after a stroke?’ And that simple question led to an internal survey, and then we discuss it in the journal club, and ended up writing another article for the Stroke Rehab Times. Just because of a question two students asked. They learn a lot, but we learn a lot as well. Students in general bring a pair of fresh eyes, and a different view to the service.

Once the placement has finished, what kind of feedback and support do you offer students? Have you ever taken any of them into employment with you?

Ana: We have recently employed a music therapist that graduated from ARU not very long ago, and I graduated from ARU as well, so it came full circle for me too.

In terms of feedback, after that first four weeks of placement I write a report, and then another at the very end of the placement. For me it needs to be a transparent process, so from the moment a student walks in, they know exactly what to expect, and that comes with regular supervision and talking through the process. So when I write their final reports there’s no surprise – often we do it together. We reflect on the questions and answers, and I find it more valuable and more meaningful this way.

Are you still hoping to do music therapy as a profession once you graduate, Caterina?

Caterina: Yeah, absolutely. I can’t wait to start working full time. I’m doing my major project on my placement in fact: Attuning to silence: how music therapists work with nonverbal adults with acute acquired brain injury who do not interact by playing music. It stems from my experience working with a patient last year who was nonverbal, and would never play an instrument or interact musically, so I found myself looking for ways to understand how to help him.

Because the amazing thing about music is that it’s so accessible to nonverbal people. You can use it to communicate, and later, as a music therapist, you can listen to the music, look back and reflect and interpret what was played to gain some answers. But what happens when you don’t have that? What do you do when the tool that you use to interact is not there?

So, for example, in my case I had to use countertransference, a psychoanalytical tool which is essentially reflecting on your own emotions that come out after you finish working with a person or session, and use those feelings to make some assumptions on what the other person might feel, or might be projecting on you. I’m curious to find out what other music therapists that might have found themselves in this situation do.

Having completed the placement, is there any advice you'd give to your younger self or other students hoping to take one?

Caterina: Ask more questions.

Ana: Then more!

Caterina: I would say to throw yourself completely into it. If you are scared of something, then that is something you should be doing.

Ana: And read the article Caterina wrote, because it’s really good.

Are there placements at Hollanden available for future ARU students?

Ana: Yes, of course. We’re very keen to have students. I’m personally very keen to have students as well because I had such as amazing experience in my own placements that I thought ‘I really want to facilitate this for other students, for future generations, and do for others what my supervisor did for me.’ I worked with dementia in my first year, then in a special school and, like Caterina, I had a music therapist that was there in the placement with me all the way. So it’s a way of paying it forward and shaping future music therapists.

We actually have a waiting list at the moment, but we welcome all students from not only music therapy, but physiotherapy, occupational therapy, speech and language. There’s a possibility if they want to come and do a placement with us. Just get in touch!