Fieldwork Skills and Supervision - Essay Example

Fieldwork Skills and Supervision Essay The purpose of this essay is to describe my experience gaining fieldwork skills while going through the supervision module. First, the paper will focus on my individual experience as a participant-observer in a dance movement psychotherapy session placed in the Day Centre (with adults with learning disabilities). The use of dance movement psychotherapy has worked well with adults with learning disabilities, as research has shown (Wadsworth J and Hackett S, 2014). This paper also focuses attention to how supervision helps me and supports me throughout my own journey. I will describe my experiences and emotions from the experience, as well as the concepts and experiences that taught me the most, leading to what ai will carry away from this for the majority of my career. Each day, the session starts every day in the morning (10:15 – 11:45) and afternoon (1:30 – 3:00) sessions Most of the clients were in wheelchairs and physically unable to care for themselves. The session starts with a basic warmup for muscles and back, with balls, ribbons and other manipulatives. Communication was a challenge, as many of them relied on nonverbal cues to express their needs (Vella G and Solera ET, 2012). The morning and afternoon groups were different, which meant that both groups provided a unique set of challenges for me. In the morning sessions, I would assist the therapist to check in with individual clients to see how they were doing and if they had any particular needs. Then we would move to welcome songs (each group had its own song). After this warmup, we would work with several different games using props, including stretching ribbons and balls (Behrends, Mueller and Dziobek 2012). No matter what game we played, it involved moving in one large group and exploring the limits of the space. As the session wound down, we would go through reflections before checking out. For those who were able, it was time to communicate feelings, and with all clients, we went over the activities we went through and discussed the important movements. At the end of each session, I would be physically tired from all of the body movements. One particular area of emphasis in these sessions is the use of touching, which builds an additional affective level of connection between therapist and patient (Popa M and Best P, 2010). The therapist and I would use massage to warm up the clients’ backs and other muscles. This posed challenges at times, because some of the patients would refuse physical contact. In the beginning, I had difficulty with touching all of the clients, but it became easier over time as I developed more confidence. The afternoon session followed a similar schedule. My role in this session was that of a trainee dance movement psychotherapist. In general, the main goal for these sessions was to develop consistency as a group, so that participants would feel a sense of trust and belonging as part of a team (Burns CA, 2012). This gives patients the chance to improve their social skills in expression, communication and forming relationships. Another area of need is improving and expanding the range of motion available to each patient. Obviously, attendance is very important for patients to show development over time. Also, ensuring that each session has a clear structure from beginning to end maximizes the efficient use of each patient’s time, particularly using the beginning and the end to help patients understand and realize their own areas of improvement (Burns CA, 2012). The patients build trust through having fun and feeling safe when it comes to expressing feelings and needs (Barton EJ, 2011). In these sessions, our goal is to help our patients express themselves using bodily movements (Barton EJ 2011). The tools of nonverbal communication are vital for people at any stage of improvement, as they improve patient self-confidence by building their available toolbox of skills and resources when it comes to communicating with others and building strong habits for social interaction (Burns CA, 2012). The therapist is trying in these sessions to provide clients with the opportunity to explore the space in which their sessions take place, check in with feelings as needed, occupy the space in the room that they feel is theirs and increase their overall awareness of their own feelings (Chau 2014). Without this self-awareness, patients often become frustrated and can no longer make any progress, because they feel like no one is paying attention to them or sympathizing with their needs. Indeed, research has shown how important developing self-awareness is for improving bodily movement efficiency in therapeutic patients (Corey 2012, p. 112). Communication is an area that the therapist must stress from the very beginning. Because most of the clients have extremely limited movements, as they are in wheelchairs, and their primary form of communication is nonverbal, the challenge for the DMP therapist is to find ways to communicate through a combination of verbal language, eye contact and bodily movements (Homann KB, 2010). When I journal each session, I make general notes for each client as well as movement observations. Some examples of general notes might include physical observations such as They can’t let things go or They really enjoy playing games and listening to songs or They struggle to be released. Examples of movement observations read more like a lesson plan for the session and include observations like We used a lot of props today – balls, scarves and colored ribbons. What made this placement challenging for me was that the sessions focused on achieving personal goals, working with Adults with Learning Difficulties, who repr (McNiff 2013). In my opinion, this placement forced me to think of who I really am and where I am in life as far as progressing in the role of a trainee therapist. My beliefs and philosophy about life have undergone change over time, and these sessions have led to additional change in those areas. This is rewarding, in the sense that I can tell that change is coming in my life, but it also meant that I had to engage in a lot more reflection than I thought I would when the position began. This showed me that I had indeed chosen a difficult career. Seeing other people who had so much development to accomplish just to be able to live independently represented a positive challenge for me, as I would be able to help them meet those goals, but helping them progress also helped me think about changes I needed to make to progress personally. This came to mind after the supervision module and an embodiment in the class as well as my own thoughts, reflections and ideas. Beginning the DMP sessions with new clients was challenging for both of us. I had to enter a new person’s personal space for the first time, but it was even more challenging for them, as they had a stranger with whom they had not built trust asking them to let him help them with their movements(McNiff S, 2013). It took a couple of sessions to build a level of trust for the sessions to be effective, but I think that is just a part of human nature and is normal. After all, it takes time to build trust in any context. After several sessions, we were all functioning as a team. As trust grew, so did my feeling of responsibility. This position is the first I have held that involved working with adults who suffer from learning disabilities. The sessions helped me grow more than I thought, as I learned as least as much from the patients as they learned from me, and it was my supervision that helped me understand what I was learning(Smith AH, 2011). In one session I started a motion exercise with dance movements with a client who was in a wheelchair. We were holding on to opposite ends of a colored ribbon, and we started to create a dance together. She was really working hard to replicate my movements, and she was grinning from ear to ear the whole time, and her eyes showed her happiness as well.. Even though she could not speak, I could tell from her eyes and facial expressions that this dance was something she was really enjoying. When the choreography came to an end, I created a rhythm with a ribbon, which helped her learn to count out the rhythm. After a few sessions of this, she is starting to retain the learning that we have worked on. Using the space as they want to is a departure from their routine, for the most part, as patients in this situation spend a lot of time having other people telling them what to do, so this freedom is something that they find truly rewarding. The role of the therapist, again, is to explore the kinesthetic awareness of the body, because building that awareness helps to kindle connections in the mind that might otherwise remain dormant (Kleinman S, 2012). One tool is to use one’s voice as a therapist and repeat what clients are doing. For example, when a patient is moving his legs, the therapist might say, Grover is stretching his legs. Another disorder that I observed was epilepsy, as one client had a seizure near the end of his session. I had never witnessed a seizure firsthand before, so this was a particularly memorable experience for me. I felt frozen, as my entire self was unable to move from the extreme shock. I had been working with him the whole time that session before the seizure began. When I left that day, I felt that it was my fault that he had gone through the seizure. Later, after talking to my mentor, I realized that these things happen from time to time for a variety of reasons (perhaps a missed dose of antiseizure medication, stress from other sources, lack of sleep, and so on) (Engel J 2013), and that I have to be ready for things like this to happen at any time. This means that I have to work on being adaptable as a therapist. This is what makes containment such an important concept, because if I am not ready to provide containment for seizures or other health related events, I am not providing the very best in client care. With regard to pursuing DMP therapy as a career, this is something that I will have to work on. I had the sense that the client felt lonely in his condition, and I was able to empathize to a degree, because I have also felt lonely and frightened before. Sometimes I feel quite lonely, in fact, which is what made this experience especially powerful. When I returned to discuss this with my tutor and peers, I emphasized my own feelings of worry. I really felt guilty, because I felt like I should be available all the time for all of my clients. From the moment I opted on this job as my career calling, I have felt that this was a central responsibility of mine. However, my tutor and peers gave me a bit of a dose of reality. After all, I have my own personal life and my own needs to look after as well. If I am focusing on my clients 24/7, I will not be taking care of my own needs, and as a result I will not be able to provide the quality care that they deserve (Burns CA 2012). This means that I need to develop a healthy sense of boundaries with regard to therapy (Corey G, 2012). When I know when I can say “No” to my clients, I am actually better prepared to do a solid job in therapy. In the beginning, I had a hard time refusing hugs when my clients request them, even though I have some issues with other people invading my own personal space. Developing the ability to manage my interactions with clients has been one of the most helpful aspects of my fieldwork. The role of my supervision was vital; without this support network, I would not have learned what I needed to learn in order to manage my body and feelings well. Having this support allowed me to share my feelings and thoughts, talk about the things that I learned about myself, understand the way the placement process works, and figure out how to manage the balance between providing therapy and properly establishing boundaries in my personal space. Sharing my feelings about clients with my supervisor and peers gave me a chance to learn from the experiences of my peers as well. Most importantly, I have figured out what I need to improve: my linguistic communication, my nonverbal communication skills, including using my body more effectively, and my overall confidence in the care setting. Understanding how a DMP therapist operates within her care setting is an important part of going through fieldwork. It is one thing to sit in a classroom and learn the theory behind the practice, but it is quite another to go into that setting myself and start trying to administer therapy. Until I am in that situation, I don’t have any real idea about the types of props and music I would use, or the way I would integrate physical contact into the therapy. Having this experience has shaped my own initial preferences for starting out as a therapist. Barton, E. J. (2011). 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Vella, Graciela, and Elena Torres Solera. "DEVELOPMENT OF AN INSTRUMENT FOR OBSERVATION IN DANCE MOVEMENT THERAPY (DMT)." Papeles del Psicólogo 33.2 (2012): 148-156. Wadsworth, J., & Hackett, S. (2014). Dance movement psychotherapy with an adult with autistic spectrum disorder: An observational single-case study. Body, Movement and Dance in Psychotherapy, (ahead-of-print), 1-15 Read More