Nathan's Music Therapy Study

A child with a profound intellectual disability frequently displays self-stimulating behaviors, including moving his fingers in front of his eyes. Which of the following would be the MOST effective use of music to decrease self-stimulating behavior? A. Give the child a maraca and play preferred music when he shakes the maraca. B. Withhold preferred music when he moves his fingers in front of his eyes. C. Play loud, unfamiliar music during instances of self-stimulating behavior. D. Play preferred calming music any time the child moves his fingers in front of his eyes.

ANSWER: A A. A child with profound intellectual disability may seek sensory input in a manner that isolates him from others. It is the therapist's job to redirect this behavior and provide reinforcement when appropriate. Giving the child a maraca provides an alternative, more socially appropriate form of stimulation. Playing preferred music when he shakes the maraca would help reinforce the alternative behavior. B. This would only work if the child is able to understand the connection between his self-stimulating behavior and the withdrawal of music. It is generally more effective to teach an alternative behavior than to completely extinguish a behavior without offering an alternative. C. This method may seem punitive and could cause the child to seek to avoid the music therapist. D. This method may potentially reinforce the self-stimulating behavior.

A music therapist is arranging the music therapy setting prior to conducting a reminiscence group for four clients diagnosed with dementia. To facilitate the clients' therapeutic involvement, the BEST arrangement for the chairs is a A. semicircle with the therapist facing the group. B. straight line with the therapist facing the group. C. circle with the therapist sitting between the clients. D. circle with the therapist sitting in the middle of the circle.

ANSWER: A A. A semicircle arrangement allows for group members to be equidistant from the therapist, an equitable arrangement with regard to facilitation. It also allows the therapist to attain and maintain eye contact with each individual. B. The chairs in a straight line will not facilitate the clients' therapeutic involvement with other group members because they may not be able to make direct eye contact with anybody except the therapist. C. A circle is not the preferred arrangement because it would be difficult to have direct eye contact with the clients sitting adjacent to the therapist. D. If the therapist sat in the middle of the group, the therapist's back would always be toward one group member. Having one's back to a group member does not enhance therapeutic interactions.

A client has met the stated goals and objectives for music therapy, and the treatment team feels the client has received the maximum possible benefit from these services. The client is away on vacation and will not return for 4 weeks. Which of the following is the music therapist's BEST action? A. Schedule 1 or 2 additional sessions upon the client's return to address closure. B. Notify the client in writing that music therapy services are terminated. C. Request that services be extended for another 3 months to prepare the client. D. Ask the caregiver to communicate this information to the client.

ANSWER: A A. Adequate notice of impending termination should be given whenever possible and the persons involved be allowed time to review and evaluate the course of treatment, to express feelings, to project into the future, and to say goodbye. B. The client cannot process closure of this therapeutic relationship if it is not face-to-face. C. A 3-month extension is too long considering the client is no longer benefiting from services. D. The client cannot process closure of this therapeutic relationship if it is not face-to-face.

A recently board-certified music therapist will begin to facilitate an outpatient support group for cancer patients at a local hospital. She has a variety of patients in the group, including patients recently diagnosed, those currently undergoing treatment, and cancer survivors. Which of the following is the music therapist's BEST action to prepare for the first group? A. Review current research and literature in music therapy related to cancer care. B. Attend rounds on the oncology units to meet with physicians and nurses. C. Find music activities online that are appropriate for adults in cancer treatment. D. Interview other music therapists who work with cancer patients and survivors.

ANSWER: A A. As part of evidence-based practice (research, client needs, clinician expertise), a music therapist must integrate the best available research into clinical practice, and in cancer care, understand the differences between patients currently diagnosed, undergoing treatment, and in survivorship. B. Oncology rounds may not include outpatients and would not provide the music therapist with information specific to music therapy treatment. C. These online activities may not be evidence based or goal directed. D. Although helpful to gain insight, other music therapists may not have stayed up to date on research and literature in the field.

A patient in a geriatric setting tells the music therapist that he enjoys bluegrass music and requests it for the next session. This genre of music is not in the therapist's repertoire. Which of the following is the music therapist's BEST action? A. Agree to learn bluegrass music for the next session. B. Explain that this genre is not in the repertoire and suggest alternatives. C. Dismiss this request and sing another genre. D. Inform the client that bluegrass music is available online.

ANSWER: A A. As part of the Professional Development and Responsibilities, music therapists are required to expand music repertoire. B. A different genre may not be as effective since it is not the patient's preferred music. C. This approach is evasive and does not validate the client's request. D. While providing the client with information to find music is a good strategy, it does not directly respond to the client's request.

Exploring the ways in which clients passively accept their circumstances and surrender control in order to make choices and start to consciously take charge of their own lives, is employing principles from which of the following psychotherapeutic models? A. existential therapy B. psychoanalytic therapy C. cognitive behavioral therapy D. reality therapy

ANSWER: A A. Existential therapy focuses on recognizing passive acceptance and taking conscious control of one's own life. B. Psychoanalytic therapy adopts a deterministic view and unconscious factors that motivate behavior. C. Cognitive behavioral therapy focuses on how thinking affects behavior. D. Reality therapy focuses on helping a client to have a satisfying or positive relationship with another person.

A music therapist is assisting a terminally ill client who is preparing for his impending death. The BEST choice of music for the client's final hours is music that has been A. selected by the client. B. designed to elicit relaxation. C. selected previously by the family or significant others. D. designed for spiritual transformation.

ANSWER: A A. It is important for a client to experience a sense of control. Allowing the client to select music addresses this need. B. Music designed to elicit relaxation may not have the desired effect in every client. C. Only when the client is unable to select music should music be selected by the family or significant others. D. Music designed for spiritual transformation may or may not be appropriate for a given client.

A music therapist is leading a group of children with an array of developmental disabilities. The therapist pays close attention to whether the clients seem bored or frustrated at different points of the session. Which of the following is the music therapist monitoring to ensure the children's success? A. pacing B. structure C. environment D. curriculum

ANSWER: A A. Pacing is most important to keep clients engaged and on-task. If pacing is too fast the clients can become frustrated, but if it is too slow they can become bored. B. Although structure is important, it has more to do with the contour of the session and how goals will be met. C. If the therapist is monitoring boredom and frustration, they are monitoring pacing and not the environment. D. Curriculum refers to the content being taught or addressed. Although the curriculum could cause boredom or frustration, the therapist is more likely to be monitoring pacing because pacing is something the therapist could modify, whereas the curriculum is more fixed.

When using music to facilitate and enhance functional movements, it is MOST important to provide music that A. supports the temporal, spatial, and muscular dynamics of the movement. B. has been chosen by the client as their preferred music for movement. C. promotes movement exploration through varying rhythmic patterns. D. provides a novel experience to motivate, focus, and engage the client.

ANSWER: A A. Research has shown that elements of music such as rhythm, pitch, dynamics, and harmony can drive the spatial, muscular and timing aspects of a movement and therefore shape movement trajectory patterns. B. While preferred music is motivating, it is often more of an accompaniment than a facilitator of movement. C. Functional movement implies that the goal is more than movement exploration and that there is a target for how the movement should look. D. Functional movement may be facilitated and enhanced even if the music experience is not novel.

Which of the following interventions BEST demonstrates how a music therapist could use music as a cue for a relaxation response when helping a patient prepare for a painful medical procedure? A. Teach the patient to practice breathing deeply while listening to a soothing piece of music. B. Encourage the patient to participate in a lyric analysis to initiate a discussion about coping skills. C. Engage the patient in improvisational drumming to distract them from the procedure. D. Help the patient write a song expressing how they feel about the procedure.

ANSWER: A A. Teaching the patient to practice breathing deeply while listening to a soothing piece of music is an example of using music as a cue for a relaxation response. Repeatedly rehearsing a relaxation response by breathing deeply while listening to the same music would build an association between the music and the relaxation response. B. Encouraging the patient to participate in a lyric analysis to initiate a discussion about coping skills could promote coping skills, but would not necessarily cue an immediate relaxation response. C. Engaging the patient in improvisational drumming to distract them from the procedure could provide distraction, but would not necessarily cue a relaxation response. D. Helping the patient write a song expressing how they feel about the procedure could facilitate emotional expression, but would not necessarily cue an immediate relaxation response.

During a music therapy session, a client experiences an emotional reaction related to an impending loss. This is typically referred to as A. anticipatory grief. B. affective state. C. bereavement. D. complicated grief.

ANSWER: A A. The emotional reaction that a client may experience before an impending loss is typically referred to as anticipatory grief. B. Affective states are psycho-physiological constructs and much broader than anticipatory grief. C. Bereavement is the period of grief and mourning after a death. D. Complicated grief describes a pervasive and often debilitating period of bereavement.

In inpatient pediatric medical care, children may begin to experience developmental delays or regression. This is MOST likely a result of A. long-term hospitalization. B. psychotropic drug use. C. unresolved feelings of anger. D. lack of interaction with peers.

ANSWER: A A. The longer children are hospitalized and removed from their typical environment, the more at risk they become for experiencing developmental delays. B. It is rare that a child would be exposed to the long-term use of psychotropic drugs that would cause developmental delays. C. Unresolved feelings of anger could account for many different situations but are not specific to developmental delays. D. Lack of interaction with peers is a factor in the developmental delays that may result from long-term hospitalization but does not give the full picture.

A music therapist is playing "If You're Happy and You Know It" on the guitar. The group of students with Attention-Deficit/Hyperactivity Disorder are provided with castanets and instructed to play them only at the cued time. The goal is MOST likely to improve A. impulse control. B. endurance. C. trust. D. reality orientation.

ANSWER: A A. The structure and predictability of the musical cue in this song facilitates attentive behavior. B. Endurance may be secondary to addressing impulse control if the therapist decides to prolong the duration of this song. C. Playing castanets on cue with the therapist does not necessarily address trust. D. Students with Attention-Deficit/Hyperactivity Disorder rarely require reality-based interventions.

A student with social (pragmatic) communication disorder occasionally verbally interrupts at inappropriate times, becoming disruptive in social settings. To BEST address social language use, the music therapist should first sing a phrase from a song, make eye contact with the student, and then sing A. "Now it's your turn." B. "Look at me." C. "I like to sing." D. "Let's sing together."

ANSWER: A A. This phrase would help structure a turn-taking experience in which the student waits for their turn to sing, which is a skill that could be transferred to group social settings. According to the DSM-5, inappropriate responses in conversation are a characteristic of social (pragmatic) communication disorder. B. Although eye contact is cueing the student to attend to the music therapist's non-verbal behavior, it is not cueing the student to wait for their turn to sing. C. This does not facilitate independence in listening, waiting, and responding at the appropriate time. D. This does not facilitate independence in listening, waiting, and responding at the appropriate time.

Which of the following adaptations would BEST allow a client who has a weak palmar grasp to play the xylophone? A. Velcro® shaker B. mallet cuff C. weighted glove D. instrument mount

ANSWER: B A. A Velcro® shaker is used for shaking, not for striking a xylophone. B. A mallet cuff would help the mallet stay in the client's hand, allowing him to hold on to the mallet. C. This would not assist a client in playing the xylophone. D. An instrument mount is used to secure an instrument to a tray or table and would not be helpful in improving a client's grasp.

A music therapist is assessing adult clients with chronic psychiatric needs for possible inclusion in an outpatient music therapy psychosocial rehabilitation group. What is the BEST non-music assessment tool or procedure to use with these clients to determine appropriateness for music therapy services? A. a background survey B. an individual interview C. an intelligence test D. a personality inventory

ANSWER: B A. A background survey provides information related to a client's past history and experiences but may not capture current presenting problems or changes associated with current treatments and medications. B. The interview is a common and well-established method of non-musical assessment in psychiatric care; music therapists often use this format for collecting information about social interaction, musical experiences, music preferences, and other relevant information that may influence group dynamics and interactions. C. The assessment may require specific training to administer and interpret and does not typically assist in determining eligibility for music therapy or psychiatric services. D. This type of assessment may require specific training or certification to administer the test and interpret the results; this assessment typically does not assist in determining eligibility for music therapy or psychiatric services.

Which of the following are the MOST common indicators of pain in a hospice patient who is non-verbal? A. anxiety and involuntary movement of the face and jaw B. tense muscles like clenched fists and facial grimacing C. restless behavior and increased verbalizations D. eyes tightly shut and yawning

ANSWER: B A. Anxiety can be a symptom of pain which manifests in physical behaviors. Involuntary movement of the face and jaw can be symptoms of Tardive Dyskinesia. B. Tensed muscles like clenched fists and increased pacing are symptoms of pain. Lower functioning patients could also exhibit pain by increased agitation, pulling away or hitting when touched, decreased appetite, eyes tightly shut, facial grimacing, restlessness, and irritability. C. Restless behaviors are symptoms of pain; however, increased verbalizations are not. Repeating words or phrases could be considered a possible indicator of pain. D. Eyes tightly closed is a symptom and a common way for lower functioning patients to express pain. Yawning is not considered an indicator for pain.

Asking a client to play back five notes that were just played on a piano addresses A. episodic memory. B. working memory. C. semantic memory. D. long-term memory.

ANSWER: B A. Episodic memory is the memory of autobiographical events. B. Working memory contains the information that can be held in mind and mentally manipulated in a short period of time. C. Semantic memory refers to general world knowledge that has been accumulated. D. In long-term memory, information is stored for longer periods of time than it would take to recall five notes played on a piano.

During a music therapy session a client has a grand mal seizure. Which of the following should be the music therapist's FIRST action? A. Leave the room to call for help. B. Move harmful objects away from the client. C. Restrain the client by holding his arms and legs. D. Put something between the client's teeth.

ANSWER: B A. Grand mal seizures may last for only a couple of minutes; the client should not be left alone. It is more important to ensure the client is safe during this time. B. The first action is to prevent injury by clearing the area of hard, sharp, or hot objects that the person may hit during the grand mal seizure. C. Do not try to hold the client down or restrain them. This can result in injury. D. It is a common myth that a person who is having a seizure may swallow their tongue. This is not true and placing something in the person's mouth will cause injury.

A music therapist is giving an end-of-the-school-year evaluation report for a 2nd grade student with dyslexia. The music therapist reports that the student has made significant gains during treatment; however, not all goals have been met. The music therapist also reports that the student is having difficulty with several speech sounds and has verbalized feelings of low self-worth. The music therapist's recommendations should include A. termination of music therapy services, referral for a speech and language evaluation, and a referral for counseling. B. continued music therapy services for the next school year, referral for a speech and language evaluation, and a referral for counseling. C. intermittent music therapy services for the next school year as needed, referral for an occupational therapy evaluation, and a referral for counseling. D. taking a break from music therapy for a year to focus on speech therapy and emotional concerns.

ANSWER: B A. Not all goals have been met yet, so music therapy services should be continued. B. This student needs to continue music therapy to further work on goals. She also needs a referral for a speech and language assessment and counseling. C. The music therapy program should continue (not intermittent services). Also, this student needs a speech and language evaluation-not an occupational therapy evaluation. D. Taking a break from music therapy would not be recommended as the student has not met all goals yet.

A hospice patient shares that she is very spiritual and misses the community feeling she experienced while attending worship services on Sundays. Which of the following would BEST address the patient's needs? A. Provide live spiritual music that the patient enjoys. B. Invite the chaplain and patient's family to the next session. C. Validate the patient's thoughts and feelings. D. Stream live worship services online during the session.

ANSWER: B A. Providing live spiritual music that the patient enjoys may be therapeutic but does not address the need of missing the worship experience with others. B. Inviting the patient's family and the chaplain to the next session addresses the need of community feeling through worship with others, while the chaplain's presence can approximate the experience of church. C. While validating the patient's feelings is important and should be done, it does not address the need of missing the worship experience with others. D. Viewing a live scenario does not equate to participating in the fellowship, which is what the client wants.

To produce a bass sound on a djembe, the instrument should be struck A. on the edge. B. in the middle. C. close to the edge. D. on the side.

ANSWER: B A. Striking the djembe on the edge may produce a higher pitch note called a tone or a slap rather than a bass sound. B. Striking the djembe in the middle produces a bass sound. C. Striking the djembe close to the edge will not produce a bass sound. D. Striking the djembe on the side will not produce a bass sound.

A 14-year-old boy is referred to an outpatient music therapy group. The group is learning to play a 12-bar blues pattern using guitars, keyboards, and drums. The client's records indicate low self-esteem and difficulty processing auditory information. To engage the client quickly in the group, the therapist should A. explain the chord structure of the 12-bar blues. B. play a drum along with the client in a steady beat. C. show the client how to play the chords in first position on the guitar. D. ask the client to listen while the group plays through the 12-bar blues.

ANSWER: B A. The client has auditory processing difficulties; therefore, explaining the blues structure may be overwhelming. B. Drumming with the therapist's support will provide visual cues, help compensate for difficulty with auditory processing, and create a successful experience. C. Guitar chords are difficult to learn quickly. D. Listening is passive and less effective with this client because of auditory processing difficulties.

A music therapist in a hospice setting is supervising a music therapy intern who is halfway through the internship. The intern has had two visits with his first patient with amyotrophic lateral sclerosis (ALS). The patient is declining quickly and can no longer speak or swallow. The intern appears increasingly distraught and has begun creating excuses to avoid returning to this patient. The supervisor has learned that the intern's father was recently diagnosed with ALS. The supervisor should A. reassign the patient to another therapist. B. offer support and guidance. C. encourage the intern to share his personal experience with the patient. D. refer the intern to the local ALS chapter.

ANSWER: B A. This solution does not offer the intern the opportunity to process and gain insight. B. This solution offers support and guidance that will enable the intern to process and gain insight. C. The intern has only had two visits with the patient; therefore, personal information should not be shared at this time. D. This solution may gain insight to the disease; however, it does not address immediate personal feelings.

A music therapist is writing objectives for a client whose goal is to increase self-esteem. Which of the following is an example of a measurable objective? A. "Client will display a brighter affect over the course of one session by April 15." B. "Client will improve feelings of worth and belonging by April 15." C. "Client will state a positive personal quality within one session by April 15." D. "Client will demonstrate a sense of pride after music improvisation by April 15."

ANSWER: C A. Affect is subjective without an operational definition. B. This objective is not measurable without a way to quantify these feelings, such as through self-report from the client or the use of a measurement tool. C. This is a specific behavior that can be counted and recorded objectively. D. To be measurable, this objective should include an operational definition of how the client would demonstrate a sense of pride.

A music therapist is working with a group of students with developmental disabilities. The music therapist teaches the children a song about the names of the colors to build skills in which of the following areas? A. affective B. motor C. cognitive D. social

ANSWER: C A. Affective domain focuses primarily on moods and emotions. B. Motor domain focuses primarily on physical movements. C. Cognitive domain focuses on learning skills and academic concepts. D. Social domain focuses on interaction with others.

A music therapist asks a client to close her eyes, presents a musical tone, and asks the client which direction the sound is coming from. The music therapist is assessing the client's auditory A. motor matching. B. sequencing. C. discrimination. D. sensitivity.

ANSWER: C A. Auditory motor matching is the degree to which movement to music is correctly imitated. B. Auditory sequencing is the ability to put tones in the correct order. C. Identifying directionality is an auditory discrimination ability. D. Auditory sensitivity is a measure of the client's response to sound intensity levels.

As a music therapist sings a hello song to a hospitalized infant, the infant orients to the music therapist's voice, makes eye contact with the music therapist, reaches for the music therapist's hand, and smiles and kicks legs upon hearing the infant's name being sung. Which of the following types of behaviors did the infant successfully display? A. auditory perception B. executive functions C. non-verbal expression D. motor skills

ANSWER: C A. Auditory perception refers to how the brain interprets what a person hears. This may include speech sounds as well as environmental sounds. The patient did respond to all the auditory stimulation presented; however, the patient did not display auditory perception. Making eye contact and reaching for the music therapist's hand are non-verbal expressions. B. Executive functions consist of several mental skills that help the brain organize and act on information. These skills enable people to plan, organize, remember things, prioritize, pay attention and get started on tasks. The behaviors the infant displayed required using executive functioning to process the information; however, the infant did not display executive functioning. C. All the behaviors displayed by the infant are non-verbal expressions. D. The patient kicking and reaching for the music therapist could be considered motor functioning; however, all the behaviors displayed would be considered non-verbal expressions.

A music therapy production is planned for presentation to clients, staff, and guests at an institution. The music therapist is asked to design a printed program providing recognition to the participating clients. The therapist must A. provide a printed program for the clients only. B. decline to print the program because of the potential breach of confidentiality. C. ensure that clients whose names are to be printed have signed a written release form. D. only choose clients to participate in the production who will allow the use of their names in the program.

ANSWER: C A. Distributing a program to the clients would only maintain confidentiality, but would not provide for recognition by others. B. Declining to print the program protects confidentiality, but prevents the clients from being recognized. C. This is a situation in which written release forms are required. D. Clients should not be excluded from participation because they do not want their names listed in a printed program.

A music therapist in private practice has been asked to complete a music therapy assessment for a first grade student enrolled in a public school who has an Individualized Educational Program (IEP). In order to BEST communicate the results of the assessment, the music therapist should A. complete a written report, and email it to the school principal. B. telephone the school IEP team leader and summarize the assessment results. C. attend the IEP meeting to give a written and oral summary of the results. D. give a written report to the parent who can pass it on the IEP team.

ANSWER: C A. Emailing a copy of the report does not directly communicate the information to other team members who may need it and have feedback. B. Calling the IEP team leader with an oral summary is not the best approach. A written document should always be provided to the IEP team. C. In order to best communicate the findings of the assessment to the IEP team, the music therapist should plan to attend the IEP meeting and give both an oral and written summary of the findings to the team members. D. It is the therapist's job to disseminate the information to all the team members (including the parents) who are involved in the Individualized Education Program for the student.

A music therapist who works with a student once a week in a school setting writes the following in the student's treatment plan: "The student will make eye contact while simultaneously greeting the music therapist in 3 out of 4 trials for 4 consecutive sessions." This is an example of a A. long-term objective. B. long-term goal. C. short-term objective. D. short-term goal.

ANSWER: C A. Four weeks is a relatively short amount of time when sessions occur weekly, so this would be a short-term objective. B. This statement is specific and stated in terms that would allow it to be easily measured, so it is an objective rather than a goal. A goal would be more broadly stated. Four weeks is a relatively short amount of time when sessions occur weekly, so this would be a short-term objective. C. This statement is specific and stated in terms that would allow it to be easily measured, so it is an objective rather than a goal. A goal would be more broadly stated. Four weeks is a relatively short amount of time when sessions occur weekly, so this would be a short-term objective. D. This statement is specific and stated in terms that would allow it to be easily measured, so it is an objective rather than a goal. A goal would be more broadly stated.

A preschool aged child and her new nanny arrive late to an outpatient music clinic for a music therapy assessment. The nanny and child rush into the music room. The child begins to cry, pushes instruments away, does not follow the music therapist's directions, or answer when spoken to. The therapist should conclude that A. music therapy is contraindicated since few responses were observed. B. the child does not react well to new and unfamiliar situations. C. several factors may have impeded the accuracy of the information gathered. D. the child should be brought back in 6 months for a follow-up assessment.

ANSWER: C A. It is common for young children to cry and/or display uncooperative behavior in an unfamiliar situation. It is premature to say that music therapy is contraindicated. B. Though the child did not react well in this instance, one should not generalize to all new situations. There were several factors which may have contributed to the child's responses during the assessment. C. A number of factors may have impeded the accuracy of the information gathered: -the child may not have felt comfortable with the new nanny -the child was distressed because they were late and had to rush -the child may have felt frightened or anxious in this new setting It is important to take these factors into consideration when interpreting assessment information. D. There is no reason to wait 6 months to bring the child back and delay treatment. Additional assessment information can be gathered much sooner.

A music therapist is in a session with an adult patient on an oncology unit at a general hospital. A nurse asks the music therapist to monitor and record the patient's vitals because she needs to attend to another patient. Which of the following is the music therapist's BEST response? A. Agree to help the nurse monitor and record the patient's vital signs. B. Decline the nurse's request and keep working with the patient. C. Inform the nurse that this is out of the scope of practice for music therapy. D. Look for another staff member to record the patient's vital signs.

ANSWER: C A. Nursing duties are out of scope for the music therapist. B. The nurse's request should not be ignored. The patient may be at risk for harm if proper care is not delivered. The music therapist should respond to the nurse and tell her this request is out of the scope of practice for a music therapist. C. The music therapist must practice within scope at all times and notify the nurse that a music therapist cannot perform this request. D. The music therapist should not leave the patient unattended during the session. It is not the music therapist's responsibility.

After a music therapist introduces a client to a variety of rhythm instruments, the client is asked to identify each of the instruments as it is being played behind a screen. This exercise requires the patient to practice A. aesthetic sensitivity. B. divided attention. C. auditory perception. D. impulse control.

ANSWER: C A. The client is not being asked about the beauty of what they are hearing. B. The client is only being asked to listen to one source at a time in order to identify what the sound is; therefore, it does not meet the definition of divided attention. C. The client is being asked to listen, perceive, and understand sounds. This is a typical example of auditory perception. D. The structure of this exercise would be very different if it were to directly address impulse control.

In a group music therapy session on an adult psychiatric unit, a client becomes upset with another and starts to escalate, yelling and threatening to harm him. The music therapist has a good rapport with the angry client. Initially, the music therapist should A. call the unit for staff to come and remove him from the session, then discharge him from the group. B. tell him he needs to leave immediately and follow up with writing a termination note in his chart. C. attempt to redirect the client and ask him to communicate his feelings verbally or musically. D. offer him hand percussion from which to pick and ask him to improvise feelings with the other client.

ANSWER: C A. This option will not allow the client to work through his feelings in a constructive way, and may increase the likelihood of his violence toward the other client at another time. B. This does not provide the client with a strategy to de-escalate the behavior. This option will not allow the client to work through his feelings C. Placing clear boundaries on the client's behavior but also offering a means through which he can express his strong feelings of anger helps to maintain safety within the group; it is also respectful of the client's feelings and his need to express them. It engages him in a process by which his strong feelings are channeled in a constructive manner. D. Without de-escalating the client, it is unlikely that he will be able to interact with the other client without continuing to yell and threaten. Immediately giving him smaller percussive instruments is potentially providing him with weapons that he could use against the other client.

In a new music therapy group of recently incarcerated women, a music therapist notices that one of the women is friendly and social with others until the session begins. Once the session begins, she does not want to participate in the music experiences other than to pick a favorite recorded song, and she is unwilling to talk about her feelings and emotions with the other group members. When assessing this client, it would be BEST for the music therapist to explore issues related to A. fear. B. resistance. C. depression. D. trust.

ANSWER: D A. A client who is fearful will probably not be socializing easily with others before the session. B. A client who is resistant will probably not participate in anything at all or may try to negatively interfere with the group process. C. Someone who is depressed will also probably not be socializing easily with others beforehand. D. A client who has trust issues may not be willing to engage in certain types of experiences that seem to require self-disclosure but may be able to appear friendly and social with others.

When working within adult oncology, which of the following is the BEST reason to prioritize a music therapy referral for a particular patient? A. isolation due to a lengthy hospital stay B. lack of family support system C. difficulty with treatment adherence D. acute pain unmanaged by medication

ANSWER: D A. Although an appropriate reason for a music therapy referral, a lengthy hospital stay would allow the music therapist to see the patient at a later time. B. Although an appropriate reason for a music therapy referral, a patient with minimal family support would not receive immediate prioritization over a patient suffering from unmanaged pain. C. Although an appropriate reason for a music therapy referral, a patient who is having difficulty adhering to a treatment plan would not receive priority over a patient suffering from unmanaged pain. D. Pain is associated with several physical complications such as increased blood pressure, respiratory rate, pulse, anxiety, fear, and distress; these symptoms may complicate medical procedures. Acute pain not well managed by medication would be the best reason to prioritize a patient referral for music therapy services.

In the weekly psychiatry rounds at a residential facility, team members note that a particular client avoids attending music therapy groups but attends art therapy and occupational therapy groups regularly. The music therapist, after discussion with the treatment team and the client, completes a termination plan from music therapy services. Which of the following reasons might be given for termination of services for this particular client? A. Client was discharged from the facility. B. Client made minimal progress in goal areas. C. Client attained therapeutic goals and objectives. D. Client displayed resistance to music therapy services.

ANSWER: D A. Although an appropriate reason for termination of services, the client is not discharging from the facility. He is continuing treatment in other areas, but not music therapy. B. Although an appropriate reason for termination of services, the client would have to attend the music therapy group for this to be determined. The client may be making adequate progress in goal areas in a different treatment group. C. Although an appropriate reason for termination of services, the client did not meet the goal and objective for music therapy services. D. Consistent client absences or lateness may indicate a problem with the therapeutic relationship and may signify resistance to a particular treatment.

A music therapist has been asked to write a song to help an adult with intellectual disabilities remember the steps involved with teeth brushing. The MOST effective song lyrics to promote functional independence includes A. "I squeeze paste on the brush" to an unfamiliar tune. B. "I like to brush my teeth" to a familiar tune. C. "My toothbrush is blue" to an unfamiliar tune. D. "I remove the cap from the tube" to a familiar tune.

ANSWER: D A. Although part of the learning sequence, the client may forget as this tune is not familiar. B. This phrase does not assist with sequencing steps. C. This phrase does not assist with sequencing steps. D. Song lyrics may provide the necessary cues and structure to help clients learn and remember the sequence of steps, especially when sung to a familiar tune.

Which of the following is a purposefully sequenced course of therapy with a specific outcome? A. assessment B. objective C. target behavior D. treatment plan

ANSWER: D A. An assessment is a test or observation used to identify a person's strengths or needs; used when designing a treatment plan. B. An objective is a statement of an observable and measurable behavior desired from therapy. C. A target behavior is a desired outcome from therapy, as stated in the goal or objective. D. A treatment plan is a hierarchy of objectives and target behaviors that outlines the expected course of therapy sessions.

A music therapist introduces instrument choices to a child, playing each instrument to demonstrate its different sounds and uses. The music therapist asks the child to choose an instrument to which he is especially drawn. The music therapist is MOST likely trying to ascertain the child's A. limits of sustained attention. B. capacity for verbal expression. C. preferences for styles of music.. D. responses to musical elements.

ANSWER: D A. Because he is trying out different instruments, the child's attention will necessarily be limited by the length of time spent on each instrument. B. A child could answer briefly and simply in response to questions about memories related to sounds. This does not reveal the extent to which he is able to express himself verbally. C. While this assessment experience might reveal the child's preferences for certain types of sounds, it will not necessarily reveal the genres and styles that he especially likes. D. Introducing different instruments and having the child respond to the sounds will reveal information about the types of timbres, ranges, and dynamics that appeal to him.

Which of the following would give a music therapist the MOST objective information about the client's existing abilities? A. collaborative work B. prompted task C. independent responses D. baseline data

ANSWER: D A. Collaborative work may give the music therapist additional information about the client's existing abilities, but it is not the most objective response. B. Prompted tasks include a stimulus that is similar to the baseline but has been changed to increase the complexity and difficulty level of the task and may require additional support from the therapist to complete. C. Independent responses demonstrate what the client is capable of doing without help. This does not provide the most objective information. D. Baseline data include what the client is currently able to do at the time of assessment.

A child with Autism Spectrum Disorder (ASD) starts pacing during a music therapy session. Which of the following is the music therapist's MOST effective response to redirect the child? A. Tap on the chair. B. Chant a rhythmic pattern "it's okay." C. Play sol-do on xylophone. D. Sing a melodic phrase "sit down."

ANSWER: D A. No words are associated with this directive to instruct the student; tapping may escalate behaviors. B. Although comforting a client who is pacing may benefit the client, option D is the most effective way to direct the client. C. No words are associated with this directive to instruct the student. D. Studies with this population have shown they can better process sung direction rather than verbal directions.

A music therapy experience that requires a client to recall information and events is addressing which of the following types of memory? A. sensory B. procedural C. working D. explicit

ANSWER: D A. Sensory memory is the immediate impression from sensory information after stimuli are presented. B. Procedural memory is unconscious memory for skills and tasks. C. Working memory is short-term memory (a few seconds) for information just acquired. D. Explicit memory is conscious recall such as for semantic or episodic memory.

A music therapist visits an older adult female with chronic obstructive pulmonary disease (COPD) at a nursing home. The client is tearful and verbalizes feelings of sadness about the recent death of her daughter, repeating the statement "If only God could have done better." What should the music therapist do FIRST to meet the spiritual needs of the client? A. Begin singing a variety of hymns to support the client's verbalizations. B. Direct the client in prayer to affirm the client's verbal responses. C. Ask the client questions about her specific spiritual affiliation. D. Facilitate fill-in-the-blank song writing using the phrase, "If only God."

ANSWER: D A. Singing a variety of hymns stereotypes the client's spiritual needs and places assumptions on the client's faith. Just because the client mentioned "God" does not automatically point to Christianity. B. The music therapist requires more information and would have to make an assumption about the type of prayer, to whom, for what, etc. C. Gleaning more about the client's spiritual needs is important, especially asking questions about the spiritual affiliation to get a complete and better handle on the situation. Actively engaging the client in a music experience should be done first. D. This provides the client with control of the lyrics, spiritual content, and easily indicates to the music therapist the client's spiritual affiliation. An improvised song is not limited to a specific genre of "spiritual" music like hymns or gospel spiritual, which would immediately stereotype the client's spiritual needs and affiliation.

A 10-year-old client with cerebral palsy and above average intellectual functioning has a goal to increase muscle control for independence in self-feeding. A music therapist should use a xylophone-playing experience to address the development of the client's A. socialization skills. B. communication skills. C. cognitive skills. D. motor skills.

ANSWER: D A. Socialization skills include eye contact and directed attention to a speaker. B. Communication skills include vocalizations and verbalizations. C. Cognitive skills include focus of attention, memory, and sequencing. D. Motor skills include holding, grasping, and moving. Rhythm instrument activities require grasp and motor control. These are skills that a student with cerebral palsy would need to improve and refine to address goals of muscle control and independence in feeding.

During a music therapy session, a 52-year-old inpatient describes his plans to kill his ex-wife. The music therapist should A. maintain confidentiality and not share this information with anyone. B. contact the family of the ex-wife and request that they tell her in person. C. post the patient's intention on the Internet to warn the public of the potential threat. D. consult federal, state, and local regulations and organizational policies and procedures to determine what to do.

ANSWER: D A. The music therapist is mandated to report this information. B. The music therapist must personally convey information to the appropriate person, not to the family of the person receiving the threat. C. Posting this information on the Internet is illegal because this information is confidential and can only be released to the proper authorities. D. The CBMT Code of Professional Practice requires the music therapist to follow confidentiality as defined by state and federal laws.

A music therapist has been jointly treating a client with vascular dementia and the client's daughter, once a week for one hour. Recently, the client has become more withdrawn, presenting with a reduced emotional response and increased passivity. Despite changes, the daughter continues to encourage the client to be active and engaged, yet the client is agitated and combative. Which of the following is the music therapist's BEST response? A. Continue treatment using the music to address agitation and combativeness. B. Discontinue treatment as the client's passivity will increase with disease progression. C. Remove the daughter from the music therapy session immediately. D. Re-evaluate the session length and interventions used during music therapy sessions.

ANSWER: D A. The music therapist needs to be aware that with the progression of a degenerative disease, a client's level of ability, as well as interest, is going to change. While the music may help alleviate symptoms related to agitation and combativeness, recognizing the need to re-evaluate treatment length better supports the client's decline. B. As a client disease progresses, preference and interest may also change, even with regards to a preferred experience, like music. Discontinuing treatment is not necessary, as this may still help to provide comfort and support. However, the music therapist needs to re-evaluate the type of interventions as well as treatment length. C. To suddenly make such a recommendation may cause feelings of guilt and isolation in the daughter. It is also contraindicated according to the treatment plan. D. When working with clients who have vascular dementia, re-evaluation of treatment length and frequency, as well as type of interventions is an important aspect of care due to the often sudden onset of symptoms and continued loss of functioning. While music therapy can be beneficial, music can also, at times, be over-stimulating, possibly causing distress.

A client with Autism Spectrum Disorder (ASD) claps to musical accompaniments, clapping when the music plays and stopping when the music stops. The music therapist uses these responses to assess which of the following areas of functioning? A. vibroacoustic B. vestibular C. proprioceptive D. sensorimotor

ANSWER: D A. Vibroacoustic stimulation uses special equipment (example, drums) to provide auditory input and vibrotactile stimulation. B. Vestibular action relates to the sense of balance; clapping does not involve balance. C. Proprioceptive action relates to spatial orientation of limbs in space; listening to accompaniment is not involved. D. Sensorimotor action of clapping involves both motor and auditory/sensory pathways.

Which of the following is a diagnosis characterized by deterioration from a previous functioning level, disorganized thinking or speech, and hallucinations or delusions? A. bipolar disorder B. schizophrenia C. depressive episode D. somatization disorder

A. Bipolar disorder is characterized by the occurrence of manic episodes, major depressive episodes, or mixed episodes. B. Schizophrenia is a group of disorders of psychotic proportion with active symptoms of some duration that may include delusions, hallucinations, and a range of cognitive and emotional dysfunctions. C. A depressive episode is characterized by symptoms such as depressed mood most of the day, markedly diminished interest in activities, feelings of worthlessness, fatigue, and insomnia. D. Somatization disorder consists of multiple, recurrent, and long-term somatic complaints that, after thorough medical investigation, cannot be attributed to any physical disorder.

A music therapist working with a mental health group facilitates an opening song in which clients are asked to participate verbally by stating their names. This exercise primarily assesses A. reality orientation. B. affective state. C. musical behavior. D. sensorimotor skills.

ANSWER: A A. As the clients state their names, the music therapist may quickly assess orientation to self. B. Although client affect while answering may provide helpful information, this is not the primary area being assessed. C. Although some clients may sing, their musical behavior is not the primary area being assessed. D. Clients are not required to move during this intervention.

To receive third party reimbursement for music therapy services, a music therapist is required to include a code for the specific procedures used in music therapy treatment. These codes are defined in the A. Current Procedural Terminology® (CPT). B. Prospective Payment System (PPS). C. Minimum Data Set (MDS). D. Physicians' Desk Reference® (PDR).

ANSWER: A A. CPT provides numeric codes for the services that are provided. B. PPS is the mechanism by which hospitals are reimbursed by Medicare. C. MDS is used by facilities for Medicare reimbursement. D. PDR provides information about prescription drugs and does not have anything to do with procedural codes.

When a music therapist arrives to work at a memory care facility, the spouse of a client expresses sadness that his loved one with late-stage dementia does not recognize him. When the music therapist enters the client's room, the client is sitting in the corner of the room and staring at the floor. Which of the following strategies should the music therapist include in the session? A. Use the client's favorite song to facilitate a musical interaction between the spouses. B. Play calming music to diminish the client's agitated behaviors. C. Present a list of preferred songs for the client to select. D. Improvise a song about love and marriage with the spouse present.

ANSWER: A A. Care recipients with late-stage dementia often respond to loved ones singing while making eye contact or by vocalizing at particular points in a song. B. Although this may be comforting, there is no mention of agitated behaviors and it would be paramount to include the available spouse to enhance the client's interactions. C. A client with late-stage dementia has impaired cognition and would have difficulty selecting songs from a list. D. Improvised music would not provide the structure or the familiarity needed.

Which of the following must be submitted to third-party payers when seeking reimbursement for music therapy services? A. diagnostic codes, music therapy credentials, and billing forms B. cost-benefit analysis, diagnostic codes, and music therapy credentials C. billing forms, cost-benefit analysis, and music therapy treatment plan D. music therapy treatment plan, music therapy credentials, and diagnostic codes

ANSWER: A A. Diagnostic codes provide the classification of disease by diagnosis and are required by third-party payers when seeking reimbursement. Music therapy credentials are required to prove certification before practitioners can be included in insurance plan networks. Billing forms are required in order to bill for services. B. A cost-benefit analysis is not required to show to third-party payers. C. A music therapy treatment plan and a cost-benefit analysis are not required to show to third-party payers. D. A music therapy treatment plan is not required to show to third-party payers.

A music therapist is designing a group experience for adults in a psychiatric hospital who are reluctant to verbalize. Which of the following experiences will MOST likely encourage non-verbal expression? A. improvisational drumming B. exercise with music C. guided imagery D. progressive muscle relaxation

ANSWER: A A. For many clients with mood disorders, music seems to be a "safer" vehicle than words for experiencing and expressing feelings and emotions. B. Although movement does not require verbalization, this would not necessarily encourage non-verbal expression. C. When imagery is guided, it severely limits self-expression. D. Although progressive muscle relaxation does not require verbalization, this would not necessarily encourage non-verbal expression.

When a music therapist arrives for a group music therapy session at a residential psychiatric treatment facility for adolescents, the therapist finds five group members sitting together laughing and talking loudly. A new patient is sitting alone and appears quiet and sullen. The therapist notices bandages wrapped around the new patient's wrists. One of the group members tells the therapist the patient is new to the unit and none of them even know her name. After introductions, the therapist should A. invite the new patient to join the group and encourage other group members to share their music therapy experiences. B. proceed with the group as planned and invite the new patient to observe the group. C. orient the new patient to the policies and procedures of the treatment facility. D. ask the new patient to explain why she is in the facility and share her musical background.

ANSWER: A A. Inviting the new patient to join the group and encouraging the other members to share builds rapport in a nonthreatening way. B. Inviting the new patient to observe discourages rapport and is less engaging than inviting the patient to join. C. Ideally, orienting a patient to a new facility would take place outside and prior to the therapy session. D. Asking the new patient to explain why she is in the facility is threatening at this early stage and is contraindicated for creating trust.

A music therapist is completing an assessment for a 5-year-old girl with Rett Syndrome. Which of the following music therapy assessment experiences would BEST assess the client's motor skills? A. singing a rhythmic marching tune while the client plays a maraca B. observing the client's facial expressions while she listens to a recording of her preferred music C. recording the number of vocalizations as the client sings her favorite song D. presenting the client with instrument choices and observing her nonverbal communication

ANSWER: A A. Maraca playing assesses fine and gross motor skills, hand grasp, and ability to match a rhythmic stimulus. These are all skills one would observe when doing an assessment for a child with Rett Syndrome. B. Facial expressions in response to music listening would indicate an affective response, not a motor skill. C. Vocalizations are communication skills. D. Non-verbal communication is not a motor skill.

A music therapist is working with an older adult client diagnosed with depression. Which of the following is the music therapist's BEST approach to help elevate the client's mood? A. Incorporate progressively more stimulating client-preferred music. B. Introduce the client to a new song to stimulate interest. C. Play slower, somber music to match the client's activity level. D. Sing an upbeat song with positive lyrics.

ANSWER: A A. Progressively more stimulating client-preferred music can increase motor activity and physical responses by increasing heart rate and oxygen saturation. Coupled with pleasant associations with preferred music, these responses can be effective in elevating mood. B. Introducing a new song would not necessarily elevate the client's mood. C. Playing slower, somber music may meet the client where they currently are, but this option does not indicate what will be done to move the client forward. D. This approach would not match the client's current mood which could cause disengagement.

A child with Autism Spectrum Disorder (ASD) who communicates non-verbally spends much of the initial session exploring the environment of the room, touching the walls, and playing instruments that the music therapist has set out in the treatment room. Which of the following should the music therapist concentrate on FIRST? A. engaging the child by reflecting the child's actions and mood through improvisation B. developing compliance for in-seat behaviors through positive reinforcement C. increasing the child's attention span through listening experiences requiring discrimination of the instruments heard D. encouraging the child to vocalize while playing instruments

ANSWER: A A. Reflecting the child's action and mood will establish rapport necessary for treatment. B. This may be beneficial for a child with ASD; however, developing rapport is of primary importance. C. See explanation B. D. See explanation B.

A music therapist is planning a session for a group of residents in a nursing home, focusing on reality orientation and reminiscence. To increase the number of reminiscent statements that the residents make during the session, the music therapist should plan to focus their attention on A. singing client-preferred songs from the residents' young adult years. B. viewing sentimental album covers from various decades. C. playing popular musical instruments from the residents' teenage years. D. interviewing each other about musical events they attended in their youth.

ANSWER: A A. Research suggests that singing client-preferred songs can elicit strong memories and reminiscent statements. B. This option does not actively use music. C. It would be more difficult to have the clients play authentic instruments. D. This option does not actively use music.

A music therapist works in a remote area where the field is not prominent and there are no other practicing music therapists. The music therapist is feeling isolated. Several clients at the hospital where he works are challenging, and he feels that he could really benefit from another person to "bounce ideas off of." Which of the following is the MOST effective way to address the music therapist's immediate need? A. Seek peer supervision through an online community of music therapists. B. Connect with a non-music therapy co-worker who can listen and offer feedback. C. Find a therapeutic outlet by playing recreationally with local musicians. D. Attend a conference session that focuses on the music therapist's concerns.

ANSWER: A A. Seeking a peer supervision through an online community of music therapists would meet the immediate need. B. Connecting with a non-music therapy co-worker may be beneficial, but will not meet the need of feedback in the area of music therapy. C. Reaching out to local musicians in town who can provide a therapeutic outlet for the music therapist may be beneficial, but will not meet the need of feedback in the area of music therapy. D. Attending a national or regional conference session that focuses on the areas of concern for the music therapist may be helpful, but will not solve the immediate need as conferences are only offered periodically.

A patient with late-stage dementia has not vocalized in several years. During the assessment process, the patient makes ongoing attempts to sing "Na, na, na, na" when presented with childhood chants. The music therapist should conclude that music therapy may A. elicit vocal responses. B. restore lost speech skills. C. be met with frustration. D. not effectively benefit this patient.

ANSWER: A A. Singing familiar songs of childhood may elicit vocal responses in late-stage dementia patients who otherwise are non-verbal. B. It is not the intention to restore lost speech skills in late-stage dementia patients. C. The assessment reveals a positive response to music therapy with no frustration indicated. D. Based on the patient's initial responses, this patient would be a good candidate for music therapy services.

A music therapist is facilitating a song choice and discussion intervention for adolescents in an inpatient psychiatric setting. One of the adolescents is new to the unit, and although verbal and articulate during an individual assessment, he declines to share within the group, even when his preferred song is played. The MOST likely reason for this behavior is that the adolescent A. may be guarded and not willing to share because he does not yet feel comfortable with others in the group. B. has low tolerance for the song choices of others in the group and is being quiet out of frustration. C. has difficulty expressing his thoughts, feelings, and insights and may not have anything to add to the discussion. D. may be experiencing active symptoms of psychosis in which he has difficulty concentrating on the music.

ANSWER: A A. The adolescent appears to be verbal and articulate and could share if he chose to do so. When adolescents do not know each other, they may not be comfortable sharing anything in the group until rapport is better established. B. Although this may have been the case when other songs were shared, his lack of participation during his own preferred song does not make this the best answer. C. The adolescent was verbal and articulate during the assessment. Although presenting behaviors change from day to day, chances are the client could express his thoughts and add to the discussion if he chose to do so. D. A song choice and discussion intervention would not be appropriate for an adolescent who was actively psychotic. From the information given, the adolescent did not display any behaviors indicative of psychosis.

At the beginning of a session, a client is asked to choose an instrument and play along. The music therapist improvises a chant about the client's instrument choice, the view from the therapy room window, and the fact that they are together for music time. The therapist is MOST likely addressing which of the following objectives? A. improving orientation to the environment B. enhancing decision-making skills C. increasing the client's self-esteem D. providing opportunities for musical self-expression

ANSWER: A A. The chant helps to increase the client's awareness of his own actions (self), his environment (space), and the fact that they are together in the music session (time). B. Although the client was asked to choose an instrument, this does not appear to be the primary focus of the opening of the session. C. Although the therapist's improvisation may improve the client's self-esteem, this does not appear to be the primary focus of the opening of the session. D. When a client is invited to play an instrument, it provides the client with an opportunity for self-expression, but this is not the objective the therapist is addressing at this time.

When playing a song for a group of clients, the music therapist is reminded of feelings of love for a romantic interest. The therapist should A. continue working and internally acknowledge these feelings. B. block these feelings out and focus on the clients' needs. C. share these feelings with the clients when the song is over. D. play this song in future sessions only when feeling uninspired.

ANSWER: A A. The therapist is human and may have reactions to music. To maintain presence and authenticity, it is best to internally acknowledge spontaneous personal feelings while continuing to work toward the clients' best interests. B. Blocking feelings completely can decrease the therapist's ability to be present and authentic. C. Being authentic with clients in the moment is not the same as personal disclosure, which may put the therapist's needs before those of the clients. D. Interventions should be determined by the clients' needs rather than the therapist's feelings. It may not be possible for the therapist to meet the clients' needs if this song can only be played when the therapist is feeling a certain way.

A music therapist is facilitating a music therapy group for children with emotional and behavioral disorders. One of the goals of the group is to improve social skills. The therapist is attempting to structure and organize music therapy experiences within the session to create a therapeutic contour focused on this goal. Following a greeting song, which of the following interventions should be the music therapist's NEXT step? A. an improvisational experience that facilitates turn-taking and interaction B. rewriting a popular song to reflect appropriate emotional self-regulation strategies C. breathing and movement to practice relaxation using a repetitive guitar chord progression D. live guitar and singing of a closing song using a client-preferred music genre

ANSWER: A A. This intervention is developmentally appropriate, addresses social skills, and builds group cohesion. B. Although this intervention may be used with this population, the focus is on emotional self-regulation, not social skills and interactions. C. Breathing and movement to practice relaxation using a repetitive guitar chord progression may facilitate stress reduction; however, it is not addressing the goal area. D. This intervention would be appropriate at the end of a session to provide closure; however, this is not directly addressing the goal area.

A group of clients in an outpatient mental health setting have verbalized that they lack healthy support systems. Which of the following interventions BEST addresses this within the music therapy context? A. songwriting that focuses on qualities of positive relationships B. group singing of popular songs chosen by the group members C. rhythmic improvisation within a framework provided by the music therapist D. structured group movement exercises to upbeat and rhythmic music

ANSWER: A A. This intervention would facilitate a discussion of what makes a relationship positive and supportive, and could lead into a discussion of who might fit those criteria in the clients' lives. B. This intervention would not specifically address support systems. C. See explanation B. D. See explanation B.

A music therapist is working with a client who is depressed and withdrawn. In an improvisational dyad, the music therapist gradually changes the tempo, range, and articulation, while reflecting and supporting any change in playing by the client. Which of the following is the music therapist MOST likely attempting to encourage? A. improvement in sustained attention B. increased emotional expressiveness C. demonstration of sensory awareness D. response to musical behavioral cues

ANSWER: B A. Poor attention might be a symptom of depression, but it is unlikely to be a focus of treatment interventions for depression. B. Encouraging the client to be more musically expressive can be helpful in mobilizing emotions, which often is an important step in helping the client to examine their experience of depression. C. A decrease in sensory awareness may be a symptom of depression but is typically not a focus of treatment. D. Ability to respond to behavioral cues is not typically a focus of treatment for depression.

A music therapist in private practice has been working with an adult outpatient client for a year and all goals have been met. Ongoing assessment indicates no new goals and the client has been functioning well for some time now. As the music therapist prepares the client for termination, which of the following are important to consider? A. treatment summary of the client's progress, date for the last session, and recognition of feelings regarding termination B. recognition of feelings regarding termination, transition plan to another expressive arts therapy, and date for the last session C. treatment summary of the client's progress, date for the last session, and summary of music therapist's feelings about the client D. recognition of feelings regarding termination, date for the last session, and summary of client's goals and progress to the client's family

ANSWER: A A. Treatment summary of the client's progress in music therapy, date for the last session, and recognition of feelings regarding termination are all required for termination. B. Recognition of feelings regarding termination and date for the last session are required for termination, but a transition plan to another expressive arts therapy is not indicated here. C. A treatment summary of the client's progress in music therapy and date for the last session are required for termination, but providing a summary of the music therapist's feelings about the client is not a typical practice. D. Recognition of feelings regarding termination and date for the last session are required for termination, but disclosure of client's goals and progress to the client's family would not be indicated.

A music therapist is working with a respiratory therapist to regulate a patient's breathing during weaning from the mechanical ventilator. Which of the following would be the MOST effective? A. rhythmic music matched to the patient's target breathing rate B. patient-preferred music to calm the patient C. music to support imagery during weaning from ventilation D. music to distract the patient from the ventilator

ANSWER: A A. Using principles of rhythmic entrainment, the music therapist would match the patient's breathing rate before, during, and after the weaning procedure for the purpose of stabilizing respiration rate and sustaining oxygen saturation levels during the procedure. B. Patient-preferred music may calm the patient; however, it may also excite the patient and elevate the rate of breathing. The use of preferred music does not directly address the objective of regulating the patient's breathing. C. Imagery would not directly address the objective of regulating the patient's breathing. D. Distraction techniques would not directly address the objective of regulating the patient's breathing.

A student who typically communicates non-verbally becomes more vocal during a session, with increased humming and babbling. Which of the following should the music therapist do FIRST to facilitate increased vocal production? A. Imitate the student's sounds. B. Play a familiar song. C. Add rhythmic accompaniment. D. Introduce additional sounds.

ANSWER: A A. Vocalizations can be encouraged and shaped as the therapist imitates the student's spontaneous sounds and then shapes structures through vocal/instrumental improvisations. B. It is best practice to follow the student's lead on already existing vocalizations. C. Adding a rhythmic accompaniment would not be the first step for facilitating vocal production. D. It is best practice to follow the student's lead on vocal production at first rather than introducing additional sounds.

A music therapist in a private school setting conducts a weekly social skills group for students with high-functioning Autism Spectrum Disorder (ASD). Goals include controlling impulses, turn-taking, and reciprocity. Data indicates three of the four students are making progress towards their goals, but one student expresses "music is stupid" and records indicate he participates less than 5% of the time. Which of the following is the music therapist's BEST action? A. Refer the student to a non-musical social skills group. B. Ignore the student and focus on the remaining group members. C. Position the student in a leadership position. D. Dismiss the student from the group until he can demonstrate cooperation.

ANSWER: A A. When compliance is a problem, it may indicate that a musical intervention is not appropriate for that individual. B. Placement of the disruptive student in a group may inhibit other group member's progress. C. This tactic is reinforcing the student's inappropriate behaviors. D. This method is punitive and is not addressing his social skills needs.

At the end of an initial music therapy assessment in a skilled nursing facility, a music therapist noted that a client with Parkinson's disease who rarely had mobility issues paused at the door to the treatment room for 30 seconds, and seemed to have trouble initiating the movement necessary to walk through the door. When interpreting the results of the assessment, the MOST likely conclusion the music therapist should make is that the client may have A. already developed a strong attachment to the therapist, which should be discussed in the next session. B. been experiencing effects of changes in medication which could affect movement, and limit the accuracy of the assessment findings. C. serious deficits in fine motor skills, which should be included as a goal for music therapy treatment. D. cognitive deficits that require further evaluation using a standardized non-musical assessment tool.

ANSWER: B A. Although a strong attachment to the therapist may occur, a change in medication would be the first possibility to consider if a client with Parkinson's disease suddenly has trouble initiating movement. B. Clients in a skilled nursing facility with Parkinson's disease may experience changes in medication and may have occasions where their motor skills are more impaired than usual, requiring caution when interpreting assessment results in this situation. C. Although some clients with Parkinson's disease have deficits in fine motor skills, a change in medication would be the first possibility to consider if this client suddenly has trouble initiating movement. D. Although some clients with Parkinson's disease have cognitive deficits, a change in medication would be the first possibility to consider if this client suddenly has trouble initiating movement.

A music therapist worked with an 8-year-old patient for 2 weeks prior to a surgical procedure. To create comfort through structure and familiarity immediately preceding the surgery, the music therapist should A. use puppets or stuffed toys. B. provide known experiences in a predictable order. C. use a songwriting experience to express feelings. D. introduce a new relaxation intervention.

ANSWER: B A. While this may be inviting, the unfamiliarity may be frightening, particularly in a stressful situation. B. Providing a structured, familiar environment aids in coping with a stressful situation. C. Facilitating a songwriting experience immediately preceding surgery, although may be distracting, will not necessarily create comfort. D. An introduction of a new technique may create anxiety or be counterproductive.

A music therapist is writing a treatment plan for a 6-year-old student with Autism Spectrum Disorder (ASD) addressing areas of impulse control and expressive language. The student has a tendency to become distracted during transitions between activities, frequently getting out of his chair to try to play other musical instruments in the room. Which of the following should the music therapist plan to do to help keep the student on task? A. Make sure no activity within the session lasts longer than two minutes in order to maintain the student's attention. B. Create a transition song to sing at the end of each activity that prompts the student to choose, from two options, which activity will come next. C. Offer a contingency whereby the student can engage in a preferred activity for five minutes at the end of the session if he demonstrates on-task behavior. D. Eliminate all transitions and spend the entire session focusing on one activity to remove opportunities for off-task behavior.

ANSWER: B A. Brief activities may keep the student on task; however, it may limit opportunity to address goal areas. B. A transition song prepares the student and outlines expectations. By allowing the student to make a selection, communication goals are also being addressed. C. The student may be too young to understand the contingency, and may not have the impulse control or attention span to remain on-task for the whole session without structuring transitions. D. Focusing on one activity for 30 minutes is not appropriate for a client of this age and diagnosis. In addition, a single activity may not allow the music therapist to address all of the student's goals.

A music therapist records observations of a client's self-stimulatory behaviors every 2 minutes. This type of recording is referred to as A. continuous. B. interval. C. duration. D. event.

ANSWER: B A. Continuous recording involves observing and making note of all target behaviors throughout the observation time period. B. Interval recording involves making one observation during a designated period of time. C. Duration recording involves measuring the length of time a client engages (or does not engage) in a target behavior during the observation period. D. Event recording involves counting the number of times a target behavior occurs during the observation period.

Which of the following is a method of stress reduction that involves tensing and releasing of the body? A. guided imagery. B. progressive muscle relaxation. C. autogenic training. D. systematic desensitization.

ANSWER: B A. Guided imagery may involve relaxation, but its focus is not on relaxation, nor does it involve tensing and releasing of muscle groups. B. This is a correct description of the progressive muscle relaxation model. C. Autogenic training involves verbal suggestions to redirect blood flow in the body to bring about relaxation. D. Systematic desensitization, which is preceded by relaxation induction using one of many methods, involves imagining oneself in progressively more anxiety-producing situations while in a relaxed state.

During an assessment, a music therapist observes that a client responds better to visual cues than verbal directions and excels while using a hands-on approach to manipulate objects. How should the music therapist categorize this type of information? A. preference B. learning styles C. clinical history D. resources

ANSWER: B A. In most cases, preference means music preferences and no music preferences were listed. B. Learning styles are often described as visual, oral, verbal, physical, logical, social, or solitary. The items list those preferences for visual learning where the learner prefers using pictures, images, and spatial understanding. C. In most cases, clinical history includes diagnosis, medical conditions, current symptoms, previous medical assessments. None of the items listed pertained to clinical history. D. See explanation B.

A patient with late-stage dementia has aphasia, difficulty following directions, and significant memory loss. To develop a treatment plan that reflects the patient's needs and interests, which of the following should be the music therapist's FIRST action? A. Interview the patient to determine music preferences. B. Consult with the patient's caregiver to determine music preferences. C. Ask the patient to indicate preferences after listening to a variety of recorded music. D. Give the patient a questionnaire about music preferences.

ANSWER: B A. It would be extremely difficult for a patient with aphasia and late-stage dementia to respond to interview questions. B. The patient's caregivers are the best source of this information in the absence of the patient's ability to provide it. C. It is possible that the patient could nonverbally indicate preferences to recorded music. However, given the severity of the patient's condition, additional sources of information are needed. D. It would be extremely difficult for the patient to complete a questionnaire because the patient has difficulty following directions and significant memory loss.

A group of 25 to 36-month-old toddlers gather for a weekly music and movement group. To learn an entire dance routine, the music therapist sets a storybook to music. Dance movements are introduced one at a time, and assigned to each page as the story is sung/read. Which of the following techniques is being used to integrate movement with music? A. modeling B. chaining C. errorless learning D. group contingences

ANSWER: B A. Modeling is demonstrating the behavior instead of using verbal directions. Modeling the movement would be a great example of how to accomplish each movement, but this technique is not illustrated in the example. B. Chaining is the process of two or more responses being joined together systematically one at a time to teach the desired outcome. The pages of the storybook contain visual and musical cues that correspond with a specific movement. When presented this way, the learner is not inundated with too much information and links the movements to each other to result in a dance routine. C. Errorless learning is a procedure that structures the learning without any errors. This technique is not illustrated here. D. Group contingencies are a strong means of managing client behavior by using peer pressure to lead the group towards a common good, usually seen in young adult/adult groups. This technique is not illustrated in this example.

During a music therapy session, a client demonstrates a pattern of behavioral responses towards the therapist based on a significant past relationship outside of music therapy. This is referred to as A. appropriation. B. misplacement. C. transference. D. resistance.

ANSWER: C A. Appropriation usually refers to taking on as one's own an action or a behavior that belongs to or is demonstrated by an outside source, such as appropriating a style of music from another culture. B. While transference might sometimes be behavioral responses that are displaced, they may also be reasonable responses to a relationship that has common characteristics with others that the client has experienced. C. Transference is the acting out in the present of behavioral patterns that were learned in a previous, significant relationship. D. Resistance refers to an unwillingness to actively engage in an interaction or therapy process.

A client with Parkinson's disease is experiencing decreased volume and a breathy, hoarse quality to his voice. Which of the following interventions should the music therapist use to MOST effectively address these vocal production issues? A. Progressive muscle relaxation specifically addressing the vocal apparatus. B. Structured vocal exercises using piano accompaniment and a small pitch range. C. Singing familiar songs while varying the pitch range from high to low. D. Unstructured a cappella improvisation encouraging vocal exploration.

ANSWER: B A. Progressive muscle relaxation is an overall relaxation technique that isolates muscles in the body. While it may have some effect, it may not isolate vocal structures and therefore is not the most effective. B. Structured, predictable, and repetitive vocal exercise using a very limited pitch range have been shown to increase vocal output in this population. C. Varying pitches from high to low would not necessarily address decreased volume or breathy hoarse quality. D. Unstructured improvisation without any accompaniment would not provide the structure necessary to prime the patient's vocal output. Structured exercise would be more effective.

A music therapy treatment approach that focuses on how music interventions stimulate the brain to influence a client's affective, cognitive, and sensorimotor behaviors is A. psychodynamic. B. neurologic. C. holistic. D. behavioral.

ANSWER: B A. Psychodynamic music therapy is based on the idea that a person's past influences their present behaviors and that the unconscious also strongly influences behavior. B. A neurologic approach to music therapy puts a strong emphasis on the findings of neuroscience research and how musical responses can affect nonmusical responses. C. A holistic approach emphasizes wellness in multiple aspects of a client's life with the assumption that there is a connection between the various domains of wellness. D. A behavioral approach to music therapy assumes that changes in a person's behavior will affect changes in other areas of their functioning. While similar, a neurologic approach emphasizes the connection to brain stimulation.

A music therapist records the following responses after the initial assessment of an infant: - When the music therapist played a maraca in front of the infant, the infant reached for the maraca. - When the music therapist played and moved a bell, the infant tracked the bell. - When the music therapist sang the infant's name, the infant kicked his legs and smiled. What domain is the music therapist primarily assessing? A. cognitive B. sensorimotor C. physiological D. emotional

ANSWER: B A. See explanation B. B. During the sensorimotor development stage, an infant learns about the environment through senses and motor activity. As the baby matures, they will fix attention on a singer or musical instruments and respond to musical sounds and voices. All of the examples illustrate both sensory stimulation and motor activity. C. See explanation B. D. See explanation B.

A music therapist facilitates a music experience in which the client plays an instrument while the music therapist plays the piano, pauses when the music therapist stops playing, and waits to continue when the music therapist resumes playing. Which of the following is the MOST likely goal of this intervention? A. nonverbal expression B. impulse control C. auditory discrimination D. motor skills

ANSWER: B A. The client could engage in some nonverbal expression, but it would not be the main focus of the intervention. B. This intervention would provide the structure for the client to know when to play and when to wait and would require the client to practice impulse control while waiting. The therapist could gradually increase the length of the pauses as the client's impulse control increased. C. This intervention does not require discriminating between two different sounds, other than music and silence. D. This intervention would require motor skills but would not be the main purpose of the intervention.

When asking a client to improvise a melody using only the black keys on a piano, the music therapist should provide an accompaniment based on which of the following scales? A. ionian B. pentatonic C. whole tone D. chromatic

ANSWER: B A. The ionian, whole tone, and chromatic scales contain notes other than the black keys on the piano. B. The black keys on the piano comprise the pentatonic scale. C. See explanation A. D. See explanation A.

A music therapist is working in a hospital with an older adult patient who has Generalized Anxiety Disorder and a low tolerance for pain. The patient will be undergoing a painful medical procedure and expresses that she wants her children in the room with her during the procedure. She appears anxious before the procedure starts and is verbalizing that she is afraid of how much it is going to hurt. The music therapist should A. improvise music to distract the patient from her anxiety, and redirect her focus to the procedure. B. use familiar music to engage the patient and decrease her fears so her pain perception will be diminished. C. invite the family members to participate by singing along so the patient feels supported. D. talk the patient through the procedure and provide relaxing music after it is completed.

ANSWER: B A. The music therapist should not use unfamiliar music or direct patient's focus on the procedure. B. Familiar music decreases fear and anxiety, which will decrease pain perception. C. Inviting family members to sing may be supportive but may be too over-stimulating to the patient during a medical procedure thus increasing pain perception. D. The music therapy intervention should be administered during the medical procedure, not after the procedure.

Children with Down syndrome often have mild hearing loss that can be difficult to detect. During the music therapy assessment, this hearing loss would MOST impact which of the following responses? A. social B. communicative C. emotional D. physiological

ANSWER: B A. Though mild hearing loss may affect social ability, it would have a greater impact on communication. B. Communication is the most pervasive domain related to hearing loss. C. Though mild hearing loss may affect emotions, it would impact them most in the communication domain. D. Mild hearing loss is a physiological problem, but it would impact them mostly in the communication domain.

When a client reaches some of his goals in less time than expected, the music therapist should A. terminate treatment. B. revise the treatment plan. C. consult with other professionals. D. write up a treatment summary.

ANSWER: B A. Treatment should not be terminated until all goals have been met. B. A music therapist needs to review and revise the treatment plan continually in order to best meet the needs of the client. C. Consulting with other professionals does not address what a therapist needs to do when a client has met some of the goals. D. Writing a treatment summary does not address what a therapist needs to do when a client has met some of the goals.

A 6-year-old client with Autism Spectrum Disorder (ASD) is consistently meeting his communication goals during music therapy sessions, but the family reports that music therapy is the only place where the child willingly engages in his environment. To facilitate transfer of progress into the client's everyday life, which of the following is the music therapist's BEST action? A. Explain to the family that it is typical for children with ASD to not transfer behaviors from therapy. B. Discuss ways the family can independently integrate music at home to encourage interaction. C. Continue current music therapy interventions, to enforce stronger brain connections. D. Explore ways to incorporate additional musical involvement through adaptive music lessons.

ANSWER: B A. While this may be typical, it is the therapist's responsibility to help make those connections. B. The therapist cannot be with the child all of the time, so it is important to educate the family on how to facilitate and reinforce communication at home. C. If the child does not see the connection, it will be very unlikely that they will independently make this transfer. D. Adaptive music lessons may be fun for the child, but do not facilitate transfer of communication skills.

A music therapist is working with an adult inpatient psychiatric group. The therapist is leading an instrument improvisation experience and notices that one of the men in the group begins breathing rapidly and beating his drum very intensely. He gets up from his chair, throws his drum to the floor, starts pacing around and hitting his mallet aggressively on chairs in the circle. Which of the following should be the music therapist's FIRST action? A. Ask the client to pick up the drum and return it to the instrument box. B. Tell the client he needs to leave the group immediately and not return until he has calmed down. C. Ensure the group members' safety and call for help from another staff member. D. Ignore the client's behavior as he will work through it on his own.

ANSWER: C A. A client may not be able to follow a verbal direction when he is that agitated, and the other clients in the group are at risk for injury. B. A client may not be able to follow a verbal direction when he is that agitated, and asking him to leave the group may cause his behavior to escalate more quickly. The other clients in the group and the therapist are at risk for injury. C. The music therapist must protect the safety of the clients in the group by recognizing clear and present danger and asking for help as needed. D. Ignoring the behavior could result in an injury to the client or someone else in the group.

A music therapist writes an objective that is well-defined, specifies the criteria for the behavior, and establishes a timeline. This type of objective is A. translatable. B. defendable. C. measurable. D. enforceable.

ANSWER: C A. A well-defined objective should not need to be translated for anyone - it should clearly communicate the necessary information on its own. B. While a good objective is indeed defendable, that does not describe the specific parameters that should be met in forming a good objective. C. Measurable is the correct term and is the standard for music therapy objectives, especially when services are reimbursable. D. Objectives are not rules to be applied to clients and have nothing to do with enforcement.

Which of the following interventions BEST addresses a goal of increased self-esteem? A. lyric analysis B. guided imagery C. performance ensemble D. music appreciation

ANSWER: C A. Although lyric analysis could address self-esteem, the client would be discussing self-esteem rather than engaging in an active process that would allow them to experience feelings of self-esteem. B. Guided imagery would allow a client to experience increased relaxation but would not directly address self-esteem. C. A performance ensemble would allow a client to engage in a process in which they experienced a sense of success, which would increase feelings of self-esteem. D. A music appreciation session would allow a client to experience enjoyment of music and possibly increase self-awareness, but would not directly address self-esteem.

A music therapist is working with a group of young women with eating disorders. The goal is to verbalize thoughts and feelings. The music therapist wants to lead a group vocal improvisation, but the women find it difficult to use their voices in a free and expressive way. Which of the following is the music therapist's BEST action to prepare the group for vocal improvisation? A. Have each woman talk to the group about her fears. B. Let the group pick songs they especially like to sing together. C. Do a vocal call-and-response with the therapist leading. D. Help them write a group song using words from each woman.

ANSWER: C A. Although talking may help to alleviate some fears about vocalizing musically, it will not prepare them for vocal improvisation. B. Pre-composed songs provide too much structure to help overcome fears about vocally expressing oneself in a free format like improvisation. C. A call-and-response feels safer than improvisation, but allows the therapist to introduce more and more creative vocal sounds to get clients to feel more comfortable using their voices freely. D. Writing a song will not help clients vocalize in a creative and expressive manner.

A military veteran undergoing treatment for Post-Traumatic Stress Disorder is enrolled in beginning guitar lessons with a volunteer instructor at the Veterans Affairs (VA) hospital where he receives his treatment. The veteran experiences recurrent distressing memories of his combat experiences, hypervigilance, and difficulty experiencing positive emotions. The veteran tells the music therapist during a large group session that he is enjoying guitar lessons and is using the guitar to relieve stress. Which of the following is the music therapist's BEST action? A. Encourage the veteran to write songs independently with positive lyrics, so he can perform them on the guitar and retrain himself to feel happiness. B. Give the guitar instructor advice on what techniques to teach the veteran that will help him manage his symptoms and provide greater relaxation. C. Recommend that the veteran further explore how to use music independently for self-care in individual music therapy. D. Suggest that the veteran make a list of songs that remind him of his time in active duty and have the guitar instructor teach him to play those songs.

ANSWER: C A. Although the veteran has difficulty experiencing positive emotions, this suggestion is an oversimplified solution and would be unlikely to work, especially without guidance from a therapist. B. The guitar instructor does not have the qualifications to address the veteran's symptoms. C. The music therapist can facilitate the guitar playing as a self-care tool, whereby the veteran can use guitar and other music techniques as part of his treatment, as well as a leisure skill. D. Using songs that relate to the veteran's active duty could traumatize him again, and the guitar instructor would not have the training to handle this.

A music therapist receives a request to take over treatment of a colleague's private client, a 4-year-old girl with a developmental delay. The colleague reports that the child was initially uncomfortable leaving the classroom to go to the treatment room with an unfamiliar person and cried and resisted. To ensure a successful transition for the client, the music therapist should A. arrive at the classroom several minutes early to allow sufficient time for the transition to the treatment room. B. arrange to co-treat with her colleague for a few sessions so that the child can get used to the music therapist. C. schedule the first session in the client's classroom to facilitate an easier adjustment to the new music therapist. D. conduct the initial session when the client's parents can also be present to provide a familiar stimulus while the client adjusts.

ANSWER: C A. Arriving at the classroom early to allow more time for the transition to the treatment room does not address the issue of adjusting to the new music therapist. More time may simply allow more time for crying and negative reactions. B. It is unrealistic that the terminating music therapist would be available for multiple co-treatment sessions, as well as difficult to ensure that both music therapists get paid for those sessions. C. Scheduling the first session in the client's classroom may facilitate an easier adjustment to the new music therapist since it will be in a familiar place, using successive approximations to help the client to adjust. D. Having the client's parents attend the session will further complicate the client's routine as the parents are not typically present at the school. This may only function to further confuse the child and slow the transition process.

A music therapist is aware of what she is thinking and feeling during the session and can communicate this to clients when appropriate. This is an example of developing the therapeutic relationship by being A. reflective. B. clinical. C. authentic. D. accessible.

ANSWER: C A. Being reflective implies that a music therapist is able to restate and clarify the content of the session in order to further therapeutic progress. B. Being clinical involves multiple aspects of the therapy process, not specifically the characteristics of the therapist. C. Being authentic means being open and experiencing the session in the moment with the client. This enhances the therapeutic relationship by allowing the client to feel that they can trust the therapist to be present, genuine, or congruent. D. Being accessible involves being available to the client directly and indirectly. This does not necessarily address feelings of authenticity.

During a weekly hospice visit, a client and her daughter give a piece of piano sheet music to a music therapist, stating that it was a favorite of the client's deceased husband. The music therapist is unfamiliar with the song. Noticing that the client appears eager to hear the song, which of the following is the music therapist's BEST action? A. Decline to play the song, stating that it is unfamiliar. B. Assure the client that the song will be played the following session. C. Sight read the piece, playing a reduced piano part. D. Suggest another song that the client likes.

ANSWER: C A. By not playing the song, the music therapist is invalidating the client's request, and thereby limiting the opportunity for additional discussion and life review. B. The client appears eager to hear the song, and the situation (and potential for further life review) may not be the same at the next session. Additionally, time may not allow for future presentation of this song since this is a hospice patient. C. The music therapist can use his music training to play a reduced part that will still convey the essence of the piece, which can open the door to reminiscence and life review. D. Another song may not facilitate the same level of life review as the requested song.

Which of the following is being used when the music therapist organizes the session into a specific order, creating music experiences for the beginning, middle, and end of the session? A. fading B. chaining C. sequencing D. shaping

ANSWER: C A. Fading is the gradual removal of explicit prompts or cues in an attempt to maintain the behavior on its own. B. Chaining is the ability to learn a complex task by connecting simple tasks in a sequence instead of exposure to complex task all at once. C. Sequencing is understanding how a series of objects, events, and time occur in a specific and logical order. This illustrates sequencing the session in the order of first, middle, and last. D. Shaping is a technique for developing new behaviors by reinforcing successive approximations of the desired behavior.

A music therapist is working with a stroke patient who demonstrates left neglect and difficulty crossing midline. In order to address both needs through instrumental playing, the therapist should position a drum A. to the patient's right side and place a mallet in each hand. B. to the patient's right side and place a mallet in the right hand. C. to the patient's left side and place a mallet in the right hand. D. directly in front of the patient and place a mallet in the right hand.

ANSWER: C A. Given that the patient has left neglect, if the therapist places the mallets in both hands, the patient will more than likely use only his right hand and thus, not cross midline. B. Positioning the drum to the patient's right hand does not require the patient to use the neglected side; drum and mallet placement does not require the patient to cross midline. C. Positioning the drum to the patient's left side requires the patient to use his neglected side; drum and mallet placement requires the patient to cross midline. D. Positioning the drum in front of the client at midline does not require the patient to cross over midline or use his neglected side.

When planning a music and movement intervention for elderly adults in a skilled nursing facility, the music therapist should FIRST consider what aspect of the music? A. harmonies B. lyrics C. tempo D. dynamics

ANSWER: C A. Harmonies may indicate tension and resolution during the intervention but would be considered after the tempo. B. Lyrics could help direct the movements but would be considered after the tempo. C. The tempo of the song should correspond with the clients' physical abilities and the frequency of the movements that will be performed. D. Dynamics can cue the force or muscle strength needed to complete a movement but would be considered after the tempo.

In a group home for young male offenders, a music therapist meets weekly with a group of clients. During a session, each client is asked to pick a song recording to communicate something about themselves to the others in the group. The therapist and the group members then verbally reflect thoughts and feelings that are shared in relationship to the chosen song. It is MOST likely that the music therapist is operating from which of the following theoretical orientations? A. psychodynamic B. holistic C. humanistic D. cognitive

ANSWER: C A. In a psychodynamic approach, the therapist would be identifying and interpreting aspects of the client's choice of song and response to it in relation to his emotional development. B. This theoretical model engages the whole person (emotional, mental, and physical). This song choice activity does not encompass all of these criteria. C. This example is most closely aligned with a humanistic approach because the client is allowed to make choices and express feelings and thoughts, and the therapist is providing feedback and support in an open and accepting manner while encouraging others to do the same. D. In a cognitive approach, it is likely that the therapist's response to the client would involve more identification and problem-solving.

A patient is admitted to an acute psychiatric unit for treatment of depression 4 months after experiencing a stroke which left him with severe dysarthria. The family approaches a music therapist because they have heard about a technique which uses music to address dysarthria, and they would like the music therapist to assess whether the client would be a good candidate. The music therapist is not familiar with the technique or current assessment procedures in this area. Which of the following is the music therapist's BEST action? A. Research current assessment procedures and conduct the assessment. B. Ask a speech-language pathologist in the community for an assessment recommendation. C. Search for a music therapist trained in this area and refer the family at discharge. D. Offer an alternative music therapy technique that the therapist is trained to implement.

ANSWER: C A. It is important to always practice within training and abilities. B. A music therapist should not use a speech-language pathology assessment unless it is being used within the scope of practice. C. This option would be the most responsible, to ensure that the client and the family receive the best possible treatment. D. An alternative music therapy technique may not address the client's dysarthria.

Which of the following assessment experiences will best assess a client's functioning level, strengths, and need areas to determine goals for treatment related to expressive aphasia? A. movement to music B. playing a rhythm instrument C. singing a familiar song D. improvising on the piano

ANSWER: C A. Movement to music does not specifically assess expressive language skills. B. Playing a rhythm instrument to music does not specifically assess expressive language skills. C. Singing a familiar song specifically assesses expressive language skills and is used to assess competency. D. Improvising on the piano does not specifically assess expressive language skills.

To fully assess a client for music therapy services, a music therapist should use A. a variety of musical assessment procedures. B. non-musical standardized assessment tools. C. both musical and non-musical assessments. D. existing assessment tools and procedures.

ANSWER: C A. Only using musical assessment procedures does not give the music therapist baseline information for non-musical behaviors. B. While non-musical assessment is important, it does not give the music therapist potentially relevant information about musical behaviors and abilities. C. Using both assessment procedures will give the music therapist the most comprehensive information about the client. D. There may be times when the music therapist may need to create or adapt an assessment procedure.

A client who is originally from a different country has undergone a traumatic experience. The music therapist encounters resistance to questions about the trauma, despite the client's willingness to engage in musical interaction. The music therapist can infer from the client's responses that A. the client does not feel the need to address the trauma in music therapy sessions. B. the therapist should be more persistent in using follow-up questions after engaging in musical interaction. C. the client's cultural group may have a different perspective regarding questions of a personal nature. D. the client may have doubts about the music therapist's ability to address the trauma

ANSWER: C A. See explanation C. B. See explanation C. C. Cultural value systems are different, especially when comparing Western vs. Eastern cultures, and the music therapist's own values may not be the same as the client's. The therapist should acknowledge this bias and consider that cultural differences may limit their interpretation of the client's response. Especially if the client is from an Eastern culture, directness or assertiveness may not be understood or appreciated. D. See explanation C.

A music therapist is completing an initial assessment of an adult client in a hospital setting. The therapist reviews the patient chart beforehand to gather information about demographics, clinical history, and personal resources. During a brief interview with the patient, the therapist gathers information regarding cultural and spiritual background, family dynamics, and support systems. Which of the following additional information should the music therapist obtain that may affect the music therapy session with the client? A. social and interpersonal relationships B. learning styles and academic skills C. music background and preferences D. responses to tempo and pitch

ANSWER: C A. The music therapist gathered basic information about family dynamics and support systems. More information may be gathered throughout the interactions in the music therapy session. B. Although learning styles and academic background are important in many music therapy settings, this is not an essential assessment component with an adult in a hospital setting. C. In order to prepare appropriate music and music interventions, a music therapist should gather initial information from a client about music background and preferences. D. Responses to tempo and pitch would be difficult to assess in an initial interview, but could be assessed during the actual music therapy session.

A music therapist is working with an older adult male who leads a sedentary life style, has some interest in music, is currently medically stable, lacks strong friendships or relationships, and feels isolated after his spouse's death several years ago. Which of the following wellness programs is the MOST beneficial? A. relaxation sessions for stress management B. improvisation to address bereavement C. intergenerational choir for socialization D. music lessons for cognitive functioning

ANSWER: C A. The patient does not seem to be experiencing an unusual amount of stress. This would not be an appropriate recommendation for services. B. There could be some residual bereavement issues with the spouse's death; however, the intergenerational choir could provide the socialization and support that the patient currently needs. C. Intergenerational choir would be the most advantageous for the client because it would provide a social aspect important to the patient. D. Lessons are usually one on one, so no opportunity for socialization/support would be present and the patient is not currently showing any symptoms of decreased cognitive functioning.

A music therapist is preparing an individualized music playlist for a patient who is terminally ill. Which of the following is the MOST clinically useful information about the patient for the music therapist to consider? A. musical skills B. medication regimen C. cultural background D. family support structure

ANSWER: C A. The patient's musical skills are secondary to the music playlist which will be used for listening purposes. B. The medication regimen is not as relevant when designing the playlist. C. Research indicates that music from an individual's cultural background is most familiar and is likely to elicit the highest level of responses (cognitively, affectively, spiritually, and physically). The music therapist should also consider the individual's age, music background, and preferences. D. Although family support structure may enhance the use of individualized music playlists by the individual, it is not a variable which influences individual responses to music and would not be relevant to the choice of music.

Which of the following interventions MOST directly addresses social language use? A. Write tongue twister songs using a variety of consonants and vowels. B. Stimulate spontaneous completion of song lyrics in a familiar song. C. Create a musical improvisation that simulates a question/answer dialogue. D. Have client play a drum while following the dynamic changes in the music.

ANSWER: C A. Tongue twisters address articulation but do not address appropriate use of social language. B. Spontaneous language is automatic and does not demonstrate knowledge of social language. C. This exercise provides an opportunity to practice rules of communication through music addressing one aspect of social language use and is also known as speech pragmatics. D. Following dynamic changes does not address social language use.

A music therapy referral is made for a 31-week-old premature infant in the NICU. To ensure the music therapist is following current guidelines for clinical practice, which of the following is the therapist's BEST course of action when completing the treatment plan? A. Determine the goals and objectives with the nursing staff. B. Consult with the interdisciplinary team for best practices. C. Research clinical literature for evidence-based protocol. D. Ask the parents or caregivers for additional information.

ANSWER: C A. While the nursing staff should be a source of information and collaboration, the music therapist should be the one to determine the goals and objectives in consultation with the entire interdisciplinary team, not just the nursing staff. B. The interdisciplinary team is not the best source for best practices specific to music therapy. The music therapist should consider utilizing clinical experts and research literature to determine best practices. C. This population is medically fragile and the patient could be harmed without knowledge of advanced practice methods. The music therapist should consult The Journal of Music Therapy and Music Therapy Perspectives, along with other reputable referred journals to research evidence-based protocol and best practices. D. In most situations, it is encouraged to include input from the parents and caregivers to shape the treatment plan. However, the parents cannot be expected to have knowledge about best practices in music therapy.

The appropriateness of a referral for music therapy is ultimately determined by the A. speech therapist. B. physician. C. counselor. D. music therapist.

ANSWER: D A. Although a speech therapist's recommendation may be important in specific settings, it is up to the music therapist to determine whether music therapy is appropriate. B. Although a physician's recommendation may be important in specific settings, it is up to the music therapist to determine whether music therapy is appropriate. C. Although a counselor's recommendation may be important in specific settings, it is up to the music therapist to determine whether music therapy is appropriate. D. The music therapist is a true expert on the appropriateness of a music therapy referral.

A music therapist is working at a shelter house with women survivors of abuse and trauma. The new music therapy group seeks to empower women and facilitate emotional expression. After a lyric analysis intervention in which clients discuss themes of healing and recovery, which of the following interventions should the music therapist facilitate NEXT? A. music improvisation in which clients play a variety of unpitched instruments focusing on themes of trauma B. music-centered relaxation in which clients practice progressive muscle relaxation with recorded music C. group singing in which clients sing along to an original recording of another song with a therapeutic theme D. fill-in-the-blank songwriting in which clients insert their own words and phrases into the song

ANSWER: D A. Although this intervention may meet the goals of the group, this method is not recommended for the beginning stages of therapy where trust-building is still underway. B. Although this is a typical intervention with this population, it may be an abrupt transition from discussion to relaxation and does not best facilitate the goals of the group. C. Although group singing is appropriate for use after lyric analysis when singing the same song, choosing a different song to sing may seem like an abrupt transition. D. Fill-in-the-blank songwriting in which clients insert their own words and phrases into the song they used for lyric analysis allows for clients to express themselves but provides enough structure within an already established song for new clients to feel comfortable.

A music therapist has recently started to work in a forensic setting. The music therapist was given very clear instructions concerning safety of the clients: no instruments can be brought onto the unit, including guitar, keyboard, and percussion instruments. Which of the following is the BEST action for the therapist to take? A. Question the administration about the severe restrictions. B. Bring in small instruments based on best professional judgement. C. Request permission to bring in small instruments. D. Adhere to the instructions.

ANSWER: D A. Authority must be respected, especially in a forensic setting. When starting a new job, it is important to learn the culture of the workplace before questioning the rules. B. It is inappropriate and dangerous to defy the rules in a forensic setting. C. This option ignores the safety protocol of the institution. D. Safety and security are the highest priority in a forensic setting.

A child with cerebral palsy who communicates non-verbally brings an electronic augmentative communication system to group music therapy. The BEST way to plan to accommodate this client's inclusion in a group singing experience is to A. encourage the child to touch 'stop/go'. B. teach the child hand gestures for several song lyrics. C. ask the staff to sing for the child. D. pre-record song lyrics onto the system.

ANSWER: D A. Considering this is a group experience the leadership (stop/go) needs to come from the therapist. B. A child with cerebral palsy may have difficulty gesturing, and in addition, using the child's augmentative device would facilitate independence in communication. C. Asking the staff to sing is isolating the child from the activity. D. Pre-recorded lyrics allow the child to supply words/phrases to songs and contribute most effectively.

Which of the following is the MOST valid and reliable way to document functional outcomes related to specific goals and interventions? A. digital media systems B. an interval recording schedule C. online outcome measures D. standardized measurement tools

ANSWER: D A. Digital media systems may be a useful way to document evidence, but unless they are standardized, there is no guarantee that the outcomes will be valid and reliable. B. Measuring outcomes over regular intervals may be important and useful, but does not guarantee that the outcomes will be valid and reliable. C. Online assessment measures are becoming more common, but unless standardized, they do not guarantee that the outcomes will be valid and reliable. D. Because validity and reliability testing is common practice in the development of standardized measurement tools, the results of a standardized measurement tool would be the most valid and reliable.

Determining a client's musical background and skills is an important task during which phase of the music therapy plan? A. evaluation B. termination C. implementation D. assessment

ANSWER: D A. Evaluation occurs after implementation. It is important to know a client's musical background and skills before implementation. B. Termination is when therapy is completed. It is important to know a client's musical background and skills before termination. C. Implementation is when the treatment occurs. It is important to know a client's musical background and skills before implementation. D. Determining a client's musical background and skills should occur during the music therapy assessment phase.

A music therapist receives a referral for a client who has a diagnosis that is unfamiliar to the therapist. The therapist has read the client's history and has spoken to the client's nursing staff. Which of the following should be the music therapist's FIRST action to obtain the information needed for effective treatment planning? A. Look at the library for recent books about the client's diagnosis. B. Discuss the client with a supervisor in the facility. C. Confer with a colleague about possible interventions. D. Use a database to find music therapy research on the diagnosis.

ANSWER: D A. Library books that are simply on the subject of the diagnosis may or may not be scholarly in nature and probably will not provide music therapy specific information. B. While it is highly recommended that a music therapist receive supervision when working with clients with issues that are unfamiliar to the therapist, the therapist needs to be prepared to make use of the supervision sessions. Asking a supervisor for basic information is not the purpose of supervision. C. Conferring with a colleague may be valuable; however, it is not the first step. The therapist should initially consult with current literature to formulate a better understanding of this diagnosis in order to determine a treatment plan. D. Looking at the most current music therapy research literature directly related to the client's issues is the best next step to educate the therapist about the client's needs, to prepare the therapist to make sound clinical decisions, and to make good use of supervision.

A music therapist working with an adult client diagnosed with schizoaffective disorder who exhibits restricted emotional expression has involved the client in a song discussion focusing on the affective qualities of a familiar song. As the therapist continues singing and playing the song, she notices that the client has begun talking to herself while rocking back and forth and laughing. The music therapist's BEST response is to A. stop the music until the client's verbalizations have ended. B. adjust the tempo of the song to correspond to the client's rocking behavior. C. sing and play the song at a higher volume to mask the client's verbalizations. D. refocus the client by directing her to sing along with the therapist.

ANSWER: D A. Stopping the music until the client's verbalizations have ended could encourage the client to focus on the present time and place, but it does nothing to encourage relevant expression of emotions. B. Adjusting the tempo of the song to correspond to the client's rocking behavior would probably result in the client becoming more internally focused. C. Masking the client's verbalizations neither deals with them nor refocuses the client's attention back to the therapeutic situation. D. Directing the client to sing along refocuses the client on the present time and place and facilitates the expression of emotion.

The act of focusing on a particular object for a period of time while simultaneously ignoring irrelevant information that is also occurring is A. sustained attention. B. arousal. C. vigilance. D. selective attention.

ANSWER: D A. Sustained attention is attention that is directly focused on a stimulus for the duration of a task. B. Arousal is defined as the physiological and psychological state of being awake or reactive to stimuli. C. The ability to demonstrate attention or alertness in the presence of potential dangerous or stressful stimuli. D. Selective attention is the act of focusing on a particular object for a period of time while simultaneously ignoring irrelevant information that is also occurring.

A music therapist is working with adolescents in an inpatient psychiatric unit. The goal for the music therapy group is to improve coping skills, with an objective that the adolescents identify at least one adaptive skill they can use when in distress. Which of the following music therapy interventions would BEST facilitate this outcome? A. A lyric analysis intervention in which participants relate the lyrics of the song to their personal lives. B. A music and imagery intervention in which participants visualize successful involvement in stressful situations. C. An adaptive guitar lesson in which participants learn to accompany breathing exercises using a simple chord progression. D. A songwriting intervention in which participants write a song about things they can do to help themselves when faced with stressors.

ANSWER: D A. The intervention as stated does not facilitate identification of coping skills. The intervention allows participants to express themselves and relate the song to their past or current lives but does not directly identify ways they can cope with stressors. B. Although this intervention allows the participants to practice one way to cope with stressful situations, the adolescent participants may have difficulty developmentally with the abstract thinking required to participate in the intervention. C. This intervention would involve teaching a chord progression and playing the chord progression while practicing breathing exercises; it does not require participants to identify a coping skill and would not meet the objective. D. When contributing to the songwriting task, participants would need to identify a coping skill they could use when faced with stressors. Thus, the outcome would be achieved and participants' responses could be documented.

A music therapist has been working with a client at a residential facility for children with intellectual disabilities for several years. The client was referred to music therapy due to limited communication abilities, and has made exceptional progress throughout treatment. Recently, however, the client seems to have reached a plateau and has not met an objective in several months. The music therapist has varied the strategies and techniques used with this client, but the changes have not affected the client's progress. The facility offers multiple types of therapy, but clients have limited blocks of time during which they can receive therapy services. Which of the following is the music therapist's BEST action? A. Continue to try other techniques until finding something that the client responds to. B. Communicate only verbally, without music, until the client makes progress. C. Conclude that the client has become resistant to music therapy. D. Consider termination of music therapy and referral to another therapy.

ANSWER: D A. The music therapist has already tried several different techniques without success, so this is probably not the most efficient plan. B. If not using music in the therapy sessions, it may be more beneficial to refer the client to another therapy such as speech-language pathology. C. There is nothing that indicates the client's lack of progress is due to a resistance to music therapy. D. The client may have achieved the maximum possible benefit from music therapy services, and could receive other therapy services during that time block that may allow for additional progress

A private practice music therapist is completing an assessment and treatment plan for a 7-year-old boy with Autism Spectrum Disorder (ASD) in a special education program. He has received speech therapy and occupational therapy for several years and is showing an interest in music. The mother is very concerned that her son is withdrawn and does not speak many words. The music therapist should initially A. call the school where the student attends and schedule an observation. B. ask the principal for permission to visit with the student during music class. C. email his therapists and ask for the student's current progress. D. get a signed release from his parent to speak to his teacher and therapists at school.

ANSWER: D A. The music therapist should not call and schedule an observation without permission. B. Any form of communication with other professionals regarding a client requires signed consent. C. Any form of communication with other professionals regarding a client requires signed consent. D. A music therapist should always have a signed consent to share or obtain information regarding a client.

A music therapist has recently started a new job working with inner-city at-risk adolescents at a community center. To help adolescents identify and express their emotions, she introduces song-writing activities. Though the therapist has a strong background in jazz and classical music, she notices that the clients criticize her accompaniments. To BEST meet the clients' needs, the therapist should A. develop therapeutic music lessons to teach basic music literacy. B. move from song-writing to active music listening to broaden clients' exposure to new musical styles. C. adapt the clients' preferred music to the styles with which the therapist is most comfortable. D. seek out resources to learn more contemporary music styles.

ANSWER: D A. Therapeutic music lessons do not meet the stated goal of helping the clients identify and express their emotions. In this answer, the therapist also avoids addressing her lack of certain skills. B. Moving from song-writing to active music listening experiences is another way for the therapist to avoid addressing her lack of certain skills. Again, the stated goal is not being met. C. This answer meets the need of the therapist, but not the clients. The therapist avoids addressing her lack of certain skills. D. The therapist recognizes her lack of certain skills and seeks to expand her music skills to better meet the needs of her clients.

Which of the following standardized assessments would give a music therapist information about the client's functioning level in the sensorimotor domain? A. Khan-Lewis Phonological Analysis B. Mini-Mental State Examination (MMSE) C. Hamilton Anxiety Rating Scale D. Berg Balance Scale

ANSWER: D A. This assessment is a speech/language test which analyses phonological processes and will not give information about sensorimotor performance. B. The MMSE is most commonly used to measure cognitive impairment in dementia patients. C. While this scale is a widely used and well-validated tool for measuring the severity of a patient's anxiety, it will not give information about sensorimotor ability. D. The Berg Balance Scale is used to measure balance in people with sensorimotor deficiencies.

A music therapist is working with a patient who has suffered a stroke on the left side of the brain and exhibits significant language comprehension issues. It is MOST effective to provide ongoing acknowledgement and reflection of the client's responses through A. detailed instructions which create context. B. exaggerated verbal and nonverbal prompts. C. simple singing of directions through a song. D. simple non-verbal cues and gestures.

ANSWER: D A. While it may appear that a patient needs more explanation in order to comprehend, detailed directions will only add additional comprehension difficulties. B. Although it is our nature as therapists to want to give verbal cues and feedback, it can be more effective to use nonverbal gestures with a left-sided stroke. C. Singing does not enhance a stroke patient's comprehension; it is more effective to use non-verbal gestures. D. People with a left-brain stroke do much better overall comprehending nonverbal cues and gestures. Right hemisphere strokes tend to do better with short, simple verbal cues.

A music therapist working in a community outpatient facility has a new group of adolescents in music therapy. As the session begins, the clients keep talking about outside events and topics that are not related to therapy. They also ask the music therapist personal questions related to their discussions. Which of the following is the FIRST course of action for the music therapist? A. Identify expected behaviors for the group and set contingencies for non-desired behaviors. B. Allow the clients some time to talk about other things, but refrain from answering personal questions. C. Play music that is popular with the clients' age group as a means to get them engaged in music. D. Redirect the group to talk together about group goals and enlist their help in making group rules.

ANSWER: D A. While setting expectations and boundaries for the group is important, it may hinder building rapport which is part of the therapeutic process. B. Allowing the clients to continue on with discussion that is not therapy-focused may foster off-topic behavior, where the therapist may ultimately lose control. C. While playing preferred music may get the client's attention, it alone will not refocus the group, nor will it help to set up expectations for behavior. D. Redirecting the group to actively work together to define rules that will be followed by the group empowers them to take ownership of their behavior while disallowing the unfocused discussion to continue, and will help build rapport by demonstrating that the music therapist values what they have to contribute to the group process. It also distracts from the personal questions.

A music therapist would like to compare the outcomes from a client's music therapy sessions and physical therapy sessions. Which of the following is the BEST way to do this? A. Talk to the physical therapist about how the physical therapy sessions have progressed. B. Use an appropriate standardized measurement tool that is also used in physical therapy. C. Observe one of the client's physical therapy sessions to compare progress. D. Develop a music therapy evaluation to use specifically with this client.

ANSWER:B A. Communication with the physical therapist could be helpful, but would not necessarily result in information that could be used to compare outcomes. B. Using a standardized measurement tool in both therapies would provide the same type of data that could then be compared. C. Observing a physical therapy session may give the therapist additional insight, but would not necessarily provide data that could be used to compare outcomes. D. A music therapy specific evaluation would not be used in physical therapy sessions, and thus, the data would not be comparable.

During a music therapy experience, which of the following is the term used to describe two or more processes being joined together systematically, one at a time? A. fading B. reinforcement C. chaining D. generalization

ANSWER:C A. Fading is when a stimulus is gradually and systematically removed. B. Reinforcement is a consequence that occurs after a behavior which increases the likelihood that the behavior will occur again. C. Chaining is the procedure of two or more processes being joined together systematically, one at a time. D. Generalization is the process of transferring or applying responses to a different set of stimuli, a new setting, or another behavior.