Case Studies:

Random Acts of Kindness Day

By Rachel Swanick, music therapist, Chroma

There have been lots of discussions on kindness in the past weeks – in the media, on social media, in life. As healthcare professionals, we are always kind, right? We always look at both sides of the argument, never judge others or get frustrated with our clients… Well, maybe not. Of course, we are human and just as easily swayed by our foibles as the next person. However, and this may sound obvious, when working with vulnerable clients and families as we do, there is an even bigger need for kindness to be at the core of our interactions.

It was whilst standing in the school yard with my children that I first started to really think about this. We spend maybe five or ten minutes each day in the yard all of the other parents. Some we will give a friendly nod or a smile, with some we may make lasting friendships. An internet meme tells me to smile at others because we don’t know what is going on the lives of others. We project our own ideas on to the parents (and people) around us based on our life experiences. The mum who is always impeccably dressed and organised – she is winning at life! The dad in his tracksuit – why is he not at work… And we really don’t know what happens behind their closed doors.

During a recent school drop off, one of the mums that I smile to was crying outside of the gates. I stopped to ask if I could help. Georgie opened up to me; one of her children was really struggling in school and he was not getting the support he desperately needed. Georgie was worn out with the battle of asking for help and not getting anything back. She talked about teachers not listening to her, even though she knew that Alex was on the autistic spectrum. Their family GP had made a referral to an Educational Psychologist and CAMHS (child mental health service).

CAMHS had not returned any of her calls for weeks and the Educational Psychologist has been rude to her in a meeting, dismissing Georgie’s concerns as not important. Unfortunately, this story is not uncommon. As I talked to the families that I work with as a Music Therapist for Chroma, most had similar stories of long waiting lists, overworked professionals not responding to them and, I think most importantly, of having their concerns and needs dismissed.

One family in particular stands out in my mind. I had met Joanne, an adoptive mother, a year before I started working with her child, Lucy. Lucy was very high need: not only had she experienced childhood trauma and multiple care placements before being adopted, she also had physical difficulties. At the time of referral, Lucy was finding it hard to be heard in her mainstream school and had been excluded twice. I realised quickly that the relationship between school and home was extremely strained and, just as quickly, I was drawn in to the dynamics of what was happening. I experienced the push and pull of a split in the relationship as both mum and school told me their experiences of each other.

The situation was not kind- on school, mum, me as the therapist and, most definitely, not on Lucy. The damage that had been done by this dysfunctional relationship between school and mum was making the therapy dangerous. Lucy and Joanne were vulnerable and this could not be thought about within the network of professionals and any support being offered was rejected. There was nothing that I could do as the dynamics were affecting the safety of the therapy space so I stopped working with the family.

This feels like an extreme account of the impact of difficulties affecting the relationship between parent and professional but I think that it shows how damaging it can be when we, as professionals, are not thoughtful about how we conduct ourselves with clients. If a mum has deep concerns about their child, we should listen as they will not be far wrong – they are living that life and we are not. As professionals, we could ask ourselves, are we judging instead of being kind? Is judgement the opposite of kindness?

As a music therapist, I often wonder about how we portray kindness to our clients and families through the music. When a child is experiencing developmental trauma, like Lucy here, it can be difficult for family members to communicate without feeling vulnerable, like Lucy’s mum, Joanne. Daniel Stern, an American psychologist, has influenced the way most therapists work with clients with his model of attunement.

Attunement is based on the mother-child relationship. When the baby communicates their feelings through crying, vocalisations or body language, and the mother responds in an appropriate way; therefore, the mother attunes to the emotional and physical needs of her baby, helping the infant feel heard and looked after.

Not all attunements go well and the mother may need to repair the relationship somehow. In a home where the parents are not attuned to the needs of the child, development trauma happens. The child has to learn to soothe themselves and there may even be cognitive damage, as well as we emotional and physical neglect. When the child is referred to therapy, the therapist can model the good enough parenting of attunement. The format of the therapy relationship (and other healthy relationships) becomes attunement – misattunment – reattunement, with the reattunement being key to normal relationship development. In music therapy, where the emphasis is on nonverbal communication, the therapist can model the relationship through musical responses.

This could be listening to the client’s sounds and picking out melodies or themes, it could be mirroring the client’s music to help foster a sense of self, or it could be providing an accompaniment and containing the music of the client so that they feel safe. The therapist is there to hear the client’s offerings and help them to make sense of that through the music: they kindly listen and respond, not judge the competence or sounds created in the therapy space.

Offering a parent or client who we are working with the chance to be heard might be the first experience of kindness they have had for a while and we could all take the time to offer someone we work with or know this space. So, in the spirit of Random Acts of Kindness, I offer you ‘The Therapist’s Tips for Kindness at Work”:

  • Ask someone how their day is going
  • Listen to the upset parent until they stop talking… smile, nod and offer tissues as necessary
  • If appropriate, send your client a text or postcard to say hello
  • Make a colleague a cup of something warm if they have had a bad day
  • Do something each day that makes YOU happy; a walk, a chat with a friend, a hobby
  • Give a compliment to your client or colleague – it could be around how hard they are working
  • Smile 🙂