Music Therapy Tips and Interventions for Termination of Services

MTI Project

Dec 10

Our intern, Mary, will be diving into a variety of music therapy topics to increase her knowledge as her final project! She not only is gathering this information for herself, but also to share with you in the form of a blog post. Thanks for reading!

As I near the end of my internship, I have been thinking a great deal about termination ideas in order to make the transition smooth for my clients, recap on our time together, and provide myself some closure. I’ve compiled a blog with some information about termination as well as interventions and ideas for professionals, interns, and students.

Why is it important to value termination?

Clients can recall progress made in therapy and solidify their goals/improvements
Provide a place to make music and art around any feelings and ideas about termination
Prepare for next steps, such as moving on from therapy or transitioning to a new therapist

Research

The American Music Therapy Association’s Standards of Clinical Practice (AMTA) state termination is applicable “when the client has attained stated goals and objectives, fails to benefit from services, can no longer be scheduled, or is discharged” (AMTA, 2015). Some short-term care settings, such as hospitals or facilities, may not have the same termination process as long-term care settings, such as private practices. Within a long-term care setting, termination is a process that the therapist should prepare for. It is imperative to inform the client of termination in advance. This timeline can depend on the client, therapist, and outside factors, but I, as an intern and practicum student, have found it beneficial to make service-users aware of this change about a month before it occurs. Even if your client is not near termination, consider talking with them to see how they feel about it. This will let you as the therapist know if they need more time to process this change or if they believe it will be a simpler transition in the future. If the client plans to transition from one therapist to another, it can be beneficial to hold a transition session with the new and old therapist in order to ease the transition and help all parties feel more comfortable with the upcoming change (Hanser, 2018).

Overall, when a client progresses towards termination, it is important to bring back activities, songs, and experiences that they enjoyed or prefer. As the therapist, you want to encourage their last few sessions to be memorable and enjoyable, circumstances permitting. It can also be helpful to include a culminating intervention to recap on their experience in music therapy, or an intervention in which both parties can process any emotions they feel. Below, you’ll find some intervention ideas for music therapy termination.

Intervention Ideas

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Utilize a Transitional Object or Song

A transitional object can be a physical or symbolic object that is created by the client during the therapeutic process and references their progress and growth or offers comfort or motivation as termination occurs. Some transitional object examples include, but are not limited to…

Compose and/or record a song/experience: if you engage in a composition experience with your client, consider recording the song for them to keep. A recording can also be utilized with a re-creative or improvised experience. Make sure HIPAA and facility regulations are valued in this process, such as asking for permission for recordings as necessary.
Create an instrument: consider creating a DIY shaker or ukulele to leave with them for continued musicking.
Journals: If you utilize journal prompts with your clients, creating a collection for them to keep could be a beneficial object for termination.
Lyric/Chord Sheets: print out lyrics and chord (if applicable) sheets for your client to keep as a way for them to continue singing or practicing preferred music as well as a memento.

Composition

Write a song together! This could also be used as an artifact for the client to keep as a memory of music therapy, and/or a culminating intervention to end the treatment process. A song transformation can also be useful, especially if the client enjoys a specific song and it is relatable to termination- consider adapting it to include blanks for the client to fill in. Don’t know where to start? Download a copy of “Breakaway” by Kelly Clarkson below that Aspire’s used for a termination songwriting!

If you are a student or intern who is aware of an upcoming termination, consider beginning the songwriting process early to ensure you have plenty of time to complete before termination!

Breakaway Termination Songwriting Download

Improvisation

Facilitate a referential improvisation around the feelings surrounding termination, the thought of moving on, or struggles that may accompany this change. This improvisation can be instrumental and/or vocal. It can be helpful for clients to improvise and sit in these feelings, sometimes without providing a reason beyond the music’s explanation.

Re-creation

Re-create favorite songs by singing and playing instruments together! While it may seem simple, these experiences are the core of music therapy for a reason. There is something special about being in music with one another, especially if it is with a song that holds a great deal of meaning.

Song Sharing / Discussion

Bring in a song that reminds you of the other person, encapsulates the therapeutic process, or represents emotions felt in regard to termination. This experience was one my cohort and I did a few times throughout college, and it was always a beautiful, personal experience to end our semester(s) together. Feel free to discuss what this song means to the client and therapist, if deemed appropriate for the setting and approved by the client.

“Graduation” Ceremony

I found this idea most useful when working in a school or facility setting in which a class or group is moving on from music therapy, or “graduating” to other things. Create a diploma for each client as a way to signify their completion of music therapy services. A diploma template can be found or created on Canva!

Musical Playlist Timeline

This activity can be done by the client but can also include the therapist. Encourage clients to think of songs that relate to specific moments in their music therapy journey. Create a timeline of events through different songs, which can then be added to a playlist for the client to listen to whenever they please.

Song Suggestions

While saying goodbye to a client can be difficult, it is important to keep a professional relationship amidst the varying emotions both parties may feel. Depending on client preferences and themes, these songs may be used in a termination session.

Theme: Gratitude/Reflection

You’ve Got a Friend in Me by Randy Newman from Toy Story
You’ll Be In My Heart by Phil Collins from Tarzan
Unwritten by Natasha Bedingfield
Count On Me by Bruno Mars
You’ve Got a Friend by Carole King
Long Live by Taylor Swift

Theme: Moving Forward

Unwritten by Natasha Bedingfield
Wide Open Spaces by The Chicks
Butterfly Fly Away by Miley Cyrus & Billy Ray Cyrus
Rivers and Roads by The Head And The Heart
Let It Be by The Beatles
Ob-La-Di, Ob-La-Da by The Beatles
Breakaway by Kelly Clarkson

Theme: Farewell

So Long, Farewell by Hammerstein & Rodgers from The Sound of Music
Goodbye Yellow Brick Road by Elton John
Over the Rainbow by Harold Arlen & Yip Harburg as sung by Judy Garland in The Wizard of Oz
What A Wonderful World by Louis Armstrong
See You Again by Wiz Khalifa & Charlie Puth
One Last Time by Ariana Grande

Creative Arts

When creating art with clients, remember that there is no right or wrong. Each client will create a unique art piece that is inherent to their experience! It is important for the therapist to validate and compliment the client’s artwork. These art interventions may have a theme or referent, similar to improvising, but they can also be open for client interpretation. Create a piece of art together while listening to preferred music:

Collage

Create a collage that references music as well as the client’s time in therapy. Old magazines are a great tool to use as content for a physical collage, while Canva can be helpful for digital collages.

Painting

Paint a memorable piece of artwork that the client can keep. An example of this art-to-music experience could be free painting while listening to preferred music or a playlist created specifically for termination interventions.

Mandala

Similar to a painting activity, allow the client to independently draw, paint, color, etc. on a provided mandala with art utensils of their choosing while listening to relevant music, such as calming instrumental tunes.

Album Cover

An album cover is another art project that can serve as a transitional object for the client. Encourage the client to create their own album cover and provide support if needed. They can also include songs/experiences that were most memorable throughout treatment!

Make a Personal Card (Art Time for the Therapist!)

As the therapist, it can be nice to make a card for your client as they move onto their next adventure. This card could include best wishes for them, as well as fond memories of your time together. A card template can be found on Canva or handmade!

Finding Closure

Outside of the treatment setting, you may feel a certain way about the treatment process or client(s) you are planning to leave or have since left. It is important to take care of yourself and find the closure you need to fully move on. Your feelings should be acknowledged, and all emotions are valid! Here are some ideas for processing through your own emotions surrounding termination.

Create Your Own Music/Art

When music is your job 24/7, it is sometimes difficult to remember that we can pick up the guitar for fun. We can also lean on that love for music to aid us in processing our feelings. Singing a favorite song or writing your own can be a helpful way to end the treatment experience.

Journal

Another great way to process your emotions is through writing them down. Consider responding to a journal prompt, such as…

How did I grow as a therapist through this relationship?
What were the most significant moments in my work with this client/group?
How has this termination impacted me personally and professionally?
What moments do I wish I handled differently with this client/group, and how can I learn from them?
How can I honor the work we did together while also letting go?
What self-care practices do I need to focus on after this termination?

Practice Self-Care

As a music therapy student, intern, and professional, it can be difficult to balance your needs and responsibilities. You know yourself best. Prioritize your needs while also keeping yourself accountable to complete necessary tasks. Some time management skills that can help with this balance include…

Utilize a planner: There are so many ways to organize your schedule from a physical planner, phone app, and Google calendar!
Make a to-do list for each day:When I feel busy and overwhelmed, I have found it most helpful to make a to-do list for the day in order to complete all my tasks. Try using a to-do list to see if it helps you stay organized and productive!
Set a limit for yourself on social media/screentime: Even if you use your phone, computer, or social media accounts for your job, it is important to put it down at a reasonable hour in the evening. I like to set a screen time limit for my apps, such as TikTok, since I have a tendency to waste too much of my time scrolling!