Music Therapy Clinician: Supporting reflective clinical practice Volume 1 | Page 23

FACING REALITY:
An honest discussion about the clinical implications of
beginning motherhood while working in long term care
as a music therapist
Allison Vovk, MA, MT-BC
Pretty early in my pregnancy, I developed a fantasy
about how being a pregnant music therapist working
with adults who have developmental disabilities would
all play out. I had a picture in my head of what I would
do and how this would go: I would give them advance
notice, we would use the music to talk about their
feelings as they began to notice my changing body,
we’d all be perfectly prepared for my leave of absence,
and it would be fabulous — bright sunshine and roses
— because...well, why wouldn’t it work?
I pride myself on having taken the last four and a half
years to develop a solid therapeutic relationship with
my clients. We’ve worked hard at creating a safe space
in our weekly sessions: we have a predictable routine
so everyone knows and understands when and where
music therapy takes place, and we (usually) begin and
end our sessions the same way. I have worked at
addressing thoughts and feelings as they come up,
even when they’re about our therapeutic relationship.
Things such as their being angry when I get to leave
the facility to go on vacation, which is something they
can’t necessarily do.
Even before venturing into the world of motherhood, I
thought of myself as maternally-natured. In my
previous job, working as a recreation counselor with
adolescents in a residential psychiatric facility, I had
hoped they’d perceive me as “motherly.” When I
changed jobs, I noticed I felt just as strong a
connection to the caregiver role in relation to my clients
with disabilities. Because I receive supervision, I’m
conscious of the clinical implications of that fact. Add
to that, my clients have a great sensitivity to discussing
anything parent-related. Mother’s and Father’s Days
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are rough holidays for them, because they often have
conflicted feelings about their parents. Discussing
parents during sessions brings up feelings of
abandonment, feelings of failure for being disabled,
and a multitude of grief and loss issues. And here I
was, a therapeutic mom, in the process of becoming
an actual mom in front of them.
As it turned out, I was ready for the clinical issues, and
any other curveballs, that could arise with my clients.
There turned out to be lots of technical details and
other stuff. I couldn’t have anticipated until I was
actually in the middle of things. For one thing, guitar
classes don’t cover topics such as how to play with a
giant belly while, being kicked from the inside out,
sometimes rhythmically, sometimes not.
I started to experience motherly guilt around about the
middle of my second trimester. Here’s why: My clients
spend a great deal of their day waiting— for the
bathroom, for their turn to get on or off the van, for the
nurse, and for lots of things — and I was conscious of
my slower moving and awkward pregnant body adding
to their already lengthy waiting time. They were used
to my quick responses. Now when they asked for help,
it took a lot longer for me to assist them. They were
frustrated, I felt guilty. To a certain extent, it was a
normal day in long term care.
Under non-pregnant circumstances I multi-task to the
extreme, simultaneously keeping the music going
while redirecting a client to keep their clothes on, timing
a seizure, and alerting staff to said seizure if they aren’t
seeing it…As a pregnant person, I had to do all this