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«SONGWRITING IN THERAPY BY JOHN A. DOWNES A Final Project submitted to the Campus Alberta Applied Psychology: Counselling Initiative In partial ...»

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to the standards of confidentiality. In the field of art therapy, Hammond (1998) views client-produced artwork as equivalent to verbal communication. Therefore, the art should be treated with the same respect as verbal communication in a session. The Canadian Art Therapy Association (CATA) Standards of Practice (1997) includes a section regarding public use and reproduction of client art, client consent regarding the use of the art, how it is displayed, identifying factors, and time constraints for use. Confidentiality is not mentioned in this section of CATA’s standards, but the assumption is that clients make the decisions regarding the choice of using their names or maintaining confidentiality and privacy when they give or refuse consent.

Principle II: Responsible Caring This principle states that the therapist’s “greatest responsibility is to protect the welfare of those in the most vulnerable position” (CPA, 2001, p. 57). The most vulnerable person in the vignette is the client, although he may not realize that fact. The enticement of recording a CD of his material may blind him to the potential detrimental factors or questions. For example, he may not consider that publishing a CD of session-based songs may give others insight into his private thoughts and therapeutic process. He may not have considered that the songs will represent him, even after he has grown beyond the issues related in the songs. The therapist needs to play the role of informer, and discuss the implications of making a CD, and weigh the risks and benefits for all parties involved.

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responsibility to be informed of issues related to the field. In this case, knowledge of copyright law would be appropriate.

The therapist in this vignette may carry out an analysis of the risks and benefits that present themselves in the situation. Assuming the therapist is willing to assign his portion of the copyright to the client, how could the client benefit or be harmed by recording his songs and having them used by the agency or himself? It would be important that the therapist clearly communicate the risks and benefits to the client as well as asking for the client’s opinions regarding this issue.

The agency’s program coordinator demonstrated a lack of sensitivity, knowledge and experience when openly suggesting to the client and therapist that a fund-raising CD should be produced. Section II.41 of the CPA Code (CPA, 2001, p. 69) encourages the therapist to address this issue directly by speaking to the program coordinator. This talk would include an outline of the implications of his suggestion.

Principle III: Integrity in Relationships The value statement of this section states “It is the responsibility of psychologists to avoid dual or multiple relationships and other conflicts of interest when appropriate and possible” (CPA, 2001, p. 75). Music therapists may find that they are regularly in dual relationships in their roles as therapist, co-creator, facilitator, recorder and performer when interacting with clients. Dual relationships can influence the client as factors such as the stability of the

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therapist-client relationship.

Dual relationships may result in both parties asking, “What is best for me?” This can be especially detrimental to the therapeutic relationship (Kitchener, 1988). A dual relationship such as the one between client and therapist in this vignette could negate the structure and safety in the sessions that is provided by clear and consistent boundaries (Borys, 1994). There is also a danger when a therapist takes on a new role or activity. The gratification of a therapist’s personal needs and influence of the inherent self-interest, in this case the pride and benefits resulting in recording a CD, may compromise objectivity when evaluating the effectiveness of the therapy (Borys, 1994). Dual relationships thus should be well managed when they cannot be avoided.

Standard III.7 in the integrity in relationships section of the code (CPA,

2001) also offers guidance regarding giving credit where credit is due. In terms of this vignette, a realistic evaluation of the therapist’s and client’s contributions to each song would be required. Standard III.14 (CPA, 2001) encourages the therapist to be straightforward and open about informed consent and written or verbal agreements. The implication here is that the therapist requires policies to cover the activities that take place in session. Standard III.31 (CPA, 2001) encourages therapists to avoid conflicts of interest such as exploiting the clienttherapist relationship for personal gain. In our vignette, the therapist could conceivably be motivated to produce a CD for reasons of personal gratification and prestige.

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for Psychologists (CPA, 2001) that relate to the ethical issue presented in this vignette. Three are under the principle of Respect for the Dignity of Persons, four are under the principle of Responsible Caring, and four are under the principle of Integrity in Relationships.

Personal Reflection The third step in the ethical decision making process is considering “how personal biases, stresses, or self-interest could influence the development of or choice between courses of action” (CPA, 2001, p. 33). For this section of the paper I will put myself in the role of the therapist in the vignette. The thoughts are presented as they occurred and not in paragraphs that flow based on a single idea, development and conclusion.

As the therapist dealing with this young man, I have been very pleased with his progress and what we have accomplished in the sessions. I admit that I have invested much time and effort in the development of treatment procedures that have facilitated the abilities of my client to contribute to the songwriting process. I am proud of his efforts, but also my own. If it was not for me, the client would not have been able to help produce a number of songs that have helped him identify his issues, express his emotions, and gain new insight into how he views the world. Much healing has taken place, and much progress has been made.

As a musician, I am flattered when someone comments on the quality of my work. I recognize the potential of flattery as a tool for manipulation. I would like to someday put out a CD of my own music. The music produced in session

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commercial use, but rather for the therapy of my client.

My job at the agency is contractual, and therefore I need to maintain good relationships with the program coordinator in order to ensure contract renewal.

My relationship with my client is also important to me, and so I struggle with what he wants and what the code suggests is appropriate in terms of ethical behaviour.

Alternative Courses of Action and Evaluation The fourth step in the ethical decision-making model is the development of alternative courses of action. The fifth step is to evaluate each alternative in terms of positive and negative effects and short and long term consequences of each choice for each individual or group involved in the vignette. These steps are included in the following section. Three alternatives approaches are explored.

Alternative one. Alternative one is to take the program coordinator’s suggestion and make a CD of the client and therapist’s music for use as a fundraiser for the agency. This course of action requires the client and therapist to sign releases for the material, likely giving up all claims to copyright except for the moral rights. The agency is then responsible for providing information to the client so that he may grant fully informed consent to this project and the use of materials he helped construct. He needs to fully understand the implications of having his name associated with the CD, and how the CD could be used both in the present and in the future. For his own protection and confidentiality, he could choose not to have his name associated with the materials on the CD.

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costs involved in the production of the CD. The agency would also have to pay for the therapist’s time, and would likely offer the client some compensation for time spent on the production of the CD and an honorarium for the use of his materials. Positive results of this arrangement could include possible financial gain for the agency and some financial gain for the therapist and client. The benefits for the music therapist include increased exposure for the music therapy program and bolstering the music therapist’s reputation as a musician and therapist. The benefits for the client include an increased sense of self-esteem, knowledge of the process of recording and producing a CD, knowledge of a possible career choice, some financial compensation, and concrete evidence of the work he did in therapy and his ability to create meaningful lyrics and music.

A possible negative result for the agency could be that the CD does not sell, and thus there is a financial loss. The agency may also not take care in providing the client with a legal release or consent form, in which case they may be susceptible to a possible lawsuit in the future. Possible negative results for the therapist include being associated with a process that is not as ethical as it could be, especially if the CAMT code is amended to include standards that dictate the handling of client-therapist constructed musical material. Despite taking precautions such as using informed consent, the therapist is in a dualrelationship and not be following other CPA standards, as identified earlier.

Negative results for the client could include feeling used by the agency and breaking the trust bond between therapist and client. This could lead to the loss

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relationship between therapist and client would likely mean that music therapy sessions would not continue due to the change in relationship.

Alternative two. Alternative two is to refuse the program coordinator’s suggestion, but foster the client’s wishes to record a demo CD using computer software and agency resources such as a quiet room, microphones and instruments.

This course of action would require the therapist to explain to the program coordinator the complicated nature of using session-based client/therapistproduced materials for a fund-raising CD. All the issues regarding copyright, consent, dual relationships and confidentiality would need to be explained.

Mention of possible lawsuits and legal ramifications as well as the costs involved in CD production would likely dissuade the director from pursuing the idea.

The therapist needs to be aware of copyright issues if he is going to give the songs a life outside of the therapy setting. He could choose to wave his copyright and make a gift of the songs to the client, thus giving up all legal rights to the music he has composed or facilitated. The therapist must also provide information to the client concerning the possible results of sharing his sessionbased songs outside of the therapy context. The client needs to be aware of how his music may be viewed by others, how that might affect his reputation, and how deeply personal his songs really are. The client needs to understand the issues around confidentiality and give fully informed consent before agreeing to record the songs. In today’s world, once a song is recorded in digital format it is no

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Internet with little or no control from the creators.

One positive result of this course of action is keeping the agency from getting involved in a very risky endeavor. Positive results for the therapist may include getting consent for use of the recording from the client so that this recording can be shared in conference presentations. This could result in more work opportunities. Positive results for the client may include boosting his selfesteem, learning digital recording skills and possibly fostering a career path in songwriting or studio work.

Negative results of choosing this alternative could include having a dual relationship between the client and therapist that stresses the original working alliance as the focus of working together would shift from therapy to production of a flawless recording. This could set up possibilities for conflict between the therapist and client resulting in an end of their relationship in the music therapy context. The client may be affected negatively when he finds that his demo CD does not spark any outside interest and that he is unable to produce songs independently. In the end, he may find that he has shared something deeply personal and is rebuffed by those he would most like to impress. That could have a serious impact on his self-esteem.

Alternative three. The music therapist talks to the program coordinator and explains why the client’s songs are not appropriate to use for a fund-raising CD.

The materials presented in the songs are akin to sensitive session content and should be treated with the same respect and confidentiality as verbal

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songs, no consent would be given. The coordinator would be asked to take back his suggestion and in cooperation with the therapist, explain to the client why this decision has been reached. The ethical concerns and copyright implications would need to be explained. The therapist could then suggest other means of songwriting that would not be as complicated by dual relationships.

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