- Musical interests and responses;
- Spiritual needs;
- Communication skills;
- Cognitive function;
- Physical mobility; and
The information gathered in our traditional assessments IS important. Yet, I have come to believe we are missing some key questions.
In “Being Mortal: Medicine and What Matters in the End” Atul Gawande identifies four vital questions. These questions are informed by his work as a surgeon. They are an outgrowth of both his personal and professional experiences. While shared in a book on end of life care, Gawande states these questions are important for all.
- What is your understanding of the situation and its potential outcomes?
- What are your fears and what are your hopes?
- What are the trade-offs you are willing to make and not willing to make?
- What is the course of action that best serves this understanding?
In my opinion, questions 1, 2, and 4 are appropriate for music therapy. Question 3 becomes: What do you see as the role of music therapy services?
Why add these questions?
Considering the client’s understand of their situation and the potential outcome is informative. When these are incorrect, you add the step of informing other healthcare providers.
Fears and hopes may vary in importance. With some clients, both may be appropriate to address. With others, the hopes may guide the goals or approaches.
Asking the client their views of the role of music therapy will let us know if they need:
- More information,
- Examples of service options,
- Services other than music therapy.
The answers to these three questions and the assessment will inform the course of action.
What to assess
Searching on Google Scholar there were over 27,000 articles in 2015 on assessment and treatment. What we assess informs the goals and treatment plan. Yet the data gathered rarely captures the individual – their priorities, their story and the uniqueness they bring to life.
An assessment is a snapshot in time. Over the years I’ve read some that provide insufficient information. (An activity assessment that says “likes music” but provides no details.) A few times I’ve read histories and physicals that provide tons of details (such as “this 88 year old woman is not pregnant”) but nothing of the person, what is important to them.
In my opinion, a perfect assessment is lacking that will fit everyone within a set age or diagnosis. If this were otherwise, why are those so many articles just in 2015?
As our profession grows and as our evidence deepens, we need to revisit our assessments. Let’s begin now.