Behavior Management in Music Therapy
By Alicia Coleman, MusicWorx Intern
Understanding behavior is fundamental not only to therapy, but also to live our lives and interact with others. To better understand human behavior, we examine the science of learning through the approach called Applied Behavior Analysis (ABA). ABA is a specialized therapy that uses principles of learning in relation to the environment to develop socially appropriate behaviors and reduce maladaptive ones.
Before I entered the music therapy field, I worked as a Registered Behavior Technician. In this entry-level position, also called a Behavioral Interventionist, I used principles of ABA to address maladaptive behaviors of children and teens with autism and other developmental disorders. I followed a rigid structure of interventions that emphasized consistency. The process became so ingrained in me that I even began to use ABA in my personal relationships. I would start to think, “maybe if I praise my roommate for doing the dishes, she will do them more often!” Or, “maybe…if I subtly change the subject while my friend is gossiping, she will eventually stop!” These are two techniques used in ABA: reinforcing desired behavior and ignoring and redirecting.
Even before I received my training in music therapy, I tried to incorporate music into my ABA therapy sessions any way I could. I found that clients who were disinterested in most activities lit up when music was introduced. Once, while working with a client who had limited sustained attention, I brought my guitar to session. I will never forget his reaction when I began playing a preferred song of his on my guitar. I suddenly had all of his attention, and I was ecstatic to finally get through to him! I now have the opportunity to reverse my techniques, and use helpful ABA principles in my music therapy.
Although not all who receive music therapy will be receiving ABA therapy simultaneously, the principles are undeniably beneficial to the therapeutic process and regulation of clients so that we can achieve the highest results. ABA can help us better facilitate music therapy sessions and shed light on our client’s behavior. Let’s take a look at some of the basic foundations of this concept.
Why Do We Do What We Do?
Behavior can be broken down into functions, i.e., every action we take has a motivation or reason. In ABA, it’s categorized into four functions:
Attention: We do it to get a reaction from someone, or a connection with someone.
Escape: We do it for the removal of an undesired activity or interaction.
Tangibles: We do it to gain access to a desired item.
Sensory: We do it because it feels good.
Once understanding the functions of behavior, we can analyze it in a 3-step process.
Looking at the ABC’s
What happens right before the behavior. An example of this would be when a child is presented with a task.
What happens, or the response to the antecedent. This could be an action or verbal response. An example would be when the child throws a toy and screams.
What comes directly after the behavior. An example would be when the caretaker picks up the toy and gives it back to the child. [Spoiler alert: this caretaker’s response will encourage this behavior!]
Examining the A-B-C’s can help us understand why the behavior may be happening and how altering a consequence could change the behavior. Once we better understand the behavior, we can find ways to move forward and change maladaptive behaviors to beneficial ones.
Positive Reinforcement: The Reward System
When a reward or something of value follows a behavior, we call it positive reinforcement. This is effective because, over time, we begin to pair the two, leading us to demonstrate the behavior again in order to achieve something of value. When used correctly, it encourages appropriate behavior.
Positive reinforcement can be demonstrated in a variety of ways, such as verbal praise, high-fives, tangibles, or anything preferred. Taking a preference assessment prior to the session will allow for a greater reinforcement. It’s also a good idea to use a variety of reinforcers, to keep it exciting. As no surprise, music often acts as a reward. The problem that music therapists run into when implementing positive reinforcement is…what happens when your reinforcer IS your therapy? Well, it doesn’t make a whole lot of sense to withhold music in music therapy, does it? Alternatively, the elements of music can be manipulated to resemble our reinforcers. For example, I can pause a song and wait for a desired behavior to occur, and when it does, start the music. That way, the client will pair a positive behavior with a positive reward.
Ignore & Redirect
In the function of attention-seeking behavior, we must pay attention to how we respond. In the example above, the caretaker responded to the child throwing an item by picking the item back up. This brings attention to the behavior, and therefore is more likely to be repeated. If we were to ignore the toy on the floor, the child would see that they are not getting what they want by acting that way. We can teach children more appropriate ways to gain attention. Furthermore, if we ignore the behavior and also redirect to another stimulus, it shows the child that they are still heard.
What Would ABA Look Like In Music Therapy?
In a music therapy session, the workspace can be modified in order to have a more successful session. For example, if I had instruments spread out all over the floor, clients may be tempted to grab whatever looks appealing. If I strategically display only one instrument at a time, clients would engage more successfully. Furthermore, withholding preferred music and instruments could modify consequences. For example, if a client’s goal were to increase verbal communication, I would present two instruments and ask him or her to choose in words, while playing them to demonstrate and appeal to their curiosity. I would withhold the instrument until he or she requested, “I want ___.” This would reinforce his or her communication with an instrument of choice.
Music therapists have an advantage over other therapists by utilizing a preferred stimulus as their main treatment modality. They can take therapy even deeper by incorporating a sharper behavioral understanding and treatment approach. A consistent implementation is difficult when juggling treatment goals, but if incorporated as much as possible, it eliminates the barriers of learning and allows for added growth.