Music Therapy Practice Exam (with explanations)

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?

• Talk to the physical therapist about how the physical therapy sessions have progressed.

• Use an appropriate standardized measurement tool that is also used in physical therapy.

• Observe one of the client’s physical therapy sessions to compare progress.

• Develop a music therapy evaluation to use specifically with this client.

A music therapist is working with a client who is depressed and withdrawn.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?

• improvement in sustained attention

• increased emotional expressiveness

• demonstration of sensory awareness

• response to musical behavioral cues

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

• encourage the child to touch 'stop/go'.

• teach the child hand gestures for several song lyrics.

• ask the staff to sing for the child.

• pre-record song lyrics onto the system.

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

• continue working and internally acknowledge these feelings.

• block these feelings out and focus on the clients' needs.

• share these feelings with the clients when the song is over.

• play this song in future sessions only when feeling uninspired.

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?

• vibroacoustic

• vestibular

• proprioceptive

• sensorimotor

Determining a client's musical background and skills is an important task during which phase of the music therapy plan?

• evaluation

• termination

• implementation

• assessment

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

• detailed instruction which create context

• exaggerated verbal and nonverbal prompts

• simple singing of directions through a song

• simple non-verbal cues and gestures

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?

• Seek peer supervision through an online community of music therapists.

• Connect with a non-music therapy co-worker who can listen and offer feedback.

• Find a therapeutic outlet by playing recreationally with local musicians.

• Attend a conference session that focuses on the music therapist's concerns.

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?

• Tap on the chair

• Chant a rhythmic pattern "it's okay"

• Play sol-do on xylophone

• Sing a melodic phrase "sit down"

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?

• Refer the student to a non-musical social skills group.

• Ignore the student and focus on the remaining group members.

• Position the student in a leadership position.

• Dismiss the student from the group until he can demonstrate cooperation.

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?

• social and interpersonal relationships

• learning styles and academic skills

• music background and preferences

• responses to tempo and pitch

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?

• Have each woman talk to the group about her fears.

• Let the group pick songs they especially like to sing together.

• Do a vocal call-and-response with the therapist leading.

• Help them write a group song using words from each woman.

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?

• music improvisation in which clients play a variety of unpitched instruments focusing on themes of trauma

• music-centered relaxation in which clients practice progressive muscle relaxation with recorded music

• group singing in which clients sing along to an original recording of another song with a therapeutic theme

• fill-in-the-blank songwriting in which clients insert their own words and phrases into the song

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

• reflective

• clinical

• authentic

• accessible

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

• appropriation

• misplacement

• transference

• resistance

Which of the following is a purposefully sequenced course of therapy with a specific outcome?

• assessment

• objective

• target behavior

• treatment plan

During a music therapy session a client has a grand mal seizure. Which of the following should be the music therapist's FIRST action?

• Leave the room to call for help

• Move harmful objects away from the client

• Restrain the client by holding his arms and legs

• Put something between the client's teeth

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

• "I squeeze paste on the brush" to an unfamiliar tune.

• "I like to brush my teeth" to a familiar tune.

• "My toothbrush is blue" to an unfamiliar tune.

• "I remove the cap from the tube" to a familiar tune.

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?

• treatment summary of the client's progress, date for the last session, and recognition of feelings regarding termination

• recognition of feelings regarding termination, transition plan to another expressive arts therapy, and date for the last session

• treatment summary of the client's progress, date for the last session, and summary of music therapist's feelings about the client

• recognition of feelings regarding termination, date for the last session, and summary of client's goals and progress to the client's family

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?

• Determine the goals and objectives with the nursing staff.

• Consult with the interdisciplinary team for best practices.

• Research clinical literature for evidence-based protocol.

• Ask the parents or caregivers for additional information.

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

• singing client-preferred songs from the residents' young adult years.

• viewing sentimental album covers from various decades.

• playing popular musical instruments from the residents' teenage years.

• interviewing each other about musical events they attended in their youth

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?

• Ask the client to pick up the drum and return it to the instrument box.

• Tell the client he needs to leave the group immediately and not return until he has calmed down.

• Ensure the group members' safety and call for help from another staff member.

• Ignore the client's behavior as he will work through it on his own.

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?

• engaging the child by reflecting the child's actions and mood through improvisation

• developing compliance for in-seat behaviors through positive reinforcement

• increasing the child's attention span through listening experiences requiring discrimination of the instruments heard

• encouraging the child to vocalize while playing instruments

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?

• ionian

• pentatonic

• whole tone

• chromatic

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?

• affective

• motor

• cognitive

• social

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

• translatable

• defendable

• measurable

• enforceable

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?

• psychodynamic

• holistic

• humanistic

• cognitive

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?

• Use the client's favorite song to facilitate a musical interaction between the spouses.

• Play calming music to diminish the client's agitated behaviors.

• Present a list of preferred songs for the client to select.

• Improvise a song about love and marriage with the spouse present.

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

• elicit vocal responses

• restore lost speech skills

• be met with frustration

• not effectively benefit this patient

Which of the following interventions BEST addresses a goal of increased self-esteem?

• lyric analysis

• guided imagery

• performance ensemble

• music appreciation

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?

• Explain to the family that it is typical for children with ASD to not transfer behaviors from therapy.

• Discuss ways the family can independently integrate music at home to encourage interaction.

• Continue current music therapy interventions, to enforce stronger brain connections.

• Explore ways to incorporate additional musical involvement through adaptive music lessons.

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?

• an improvisational experience that facilitates turn-taking and interaction

• rewriting a popular song to reflect appropriate emotional self-regulation strategies

• breathing and movement to practice relaxation using a repetitive guitar chord progression

• live guitar and singing of a closing song using a client-preferred music genre

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

• Current Procedural Terminology® (CPT).

• Prospective Payment System (PPS).

• Minimum Data Set (MDS).

• Physicians' Desk Reference® (PDR).

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?

• songwriting that focuses on qualities of positive relationships

• group singing of popular songs chosen by the group members

• rhythmic improvisation within a framework provided by the music therapist

• structured group movement exercises to upbeat and rhythmic music

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?

• Give the guitar instructor advice on what techniques to teach the veteran that will help him manage his symptoms and provide greater relaxation.

• Recommend that the veteran further explore how to use music independently for self-care in individual music therapy.

• Encourage the veteran to write songs independently with positive lyrics, so he can perform them on the guitar and retrain himself to feel happiness.

• 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.

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?

• Interview the patient to determine music preferences.

• Consult with the patient's caregiver to determine music preferences.

• Ask the patient to indicate preferences after listening to a variety of recorded music.

• Give the patient a questionnaire about music preferences.

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?

• social

• communicative

• emotional

• physiological

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?

• Continue to try other techniques until finding something that the client responds to.

• Communicate only verbally, without music, until the client makes progress.

• Conclude that the client has become resistant to music therapy.

• Consider termination of music therapy and referral to another therapy.

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?

• Incorporate progressively more stimulating client-preferred music.

• Introduce the client to a new song to stimulate interest.

• Play slower, somber music to match the client's activity level.

• Sing an upbeat song with positive lyrics.

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

• selected by the client.

• designed to elicit relaxation.

• selected previously by the family or significant others.

• designed for spiritual transformation.

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

• invite the new patient to join the group and encourage other group members to share their music therapy experiences.

• proceed with the group as planned and invite the new patient to observe the group.

• orient the new patient to the policies and procedures of the treatment facility.

• ask the new patient to explain why she is in the facility and share her musical background.

The act of focusing on a particular object for a period of time while simultaneously ignoring irrelevant information that is also occurring is

• sustained attention

• arousal

• vigilance

• selective attention

Which of the following must be submitted to third-party payers when seeking reimbursement for music therapy services?

• diagnostic codes, music therapy credentials, and billing forms

• cost-benefit analysis, diagnostic codes, and music therapy credentials

• billing forms, cost-benefit analysis, and music therapy treatment plan

• music therapy treatment plan, music therapy credentials, and diagnostic codes

During a music therapy session, a client experiences an emotional reaction related to an impending loss. This is typically referred to as

• anticipatory grief

• affective state

• bereavement

• complicated grief

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

• to the patient's right side and place a mallet in each hand.

• to the patient's right side and place a mallet in the right hand.

• to the patient's left side and place a mallet in the right hand.

• directly in front of the patient and place a mallet in the right hand.

The appropriateness of a referral for music therapy is ultimately determined by the

• speech therapist

• physician

• counselor

• music therapist

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?

• imitate the student's sounds

• play a familiar song

• add rhythmic accompaniment

• introduce additional sounds

When working within adult oncology, which of the following is the BEST reason to prioritize a music therapy referral for a particular patient?

• isolation due to a lengthy hospital stay

• lack of family support system

• difficulty with treatment adherence

• acute pain unmanaged by medication

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?

• fading

• chaining

• sequencing

• shaping

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

• reality orientation

• affective state

• musical behavior

• sensorimotor skills

Which of the following is the MOST valid and reliable way to document functional outcomes related to specific goals and interventions?

• digital media systems

• an interval recording schedule

• online outcome measures

• standardized measurement tools

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

• already developed a strong attachment to the therapist, which should be discussed in the next session.

• been experiencing effects of changes in medication which could affect movement, and limit the accuracy of the assessment findings.

• serious deficits in fine motor skills, which should be included as a goal for music therapy treatment.

• cognitive deficits that require further evaluation using a standardized non-musical assessment tool.

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?

• fading

• reinforcement

• chaining

• generalization

Which of the following standardized assessments would give a music therapist information about the client's functioning level in the sensorimotor domain?

• Khan-Lewis Phonological Analysis

• Mini-Mental State Examination (MMSE)

• Hamilton Anxiety Rating Scale

• Berg Balance Scale

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?

• Look at the library for recent books about the client’s diagnosis.

• Discuss the client with a supervisor in the facility.

• Confer with a colleague about possible interventions.

• Use a database to find music therapy research on the diagnosis.

When a client reaches some of his goals in less time than expected, the music therapist should

• terminate treatment

• revise the treatment plan

• consult with other professionals

• write up a treatment summary

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

• psychodynamic

• neurologic

• holistic

• behavioral

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

• preferences for styles of music.

• limits of sustained attention.

• capacity for verbal expression.

• responses to musical elements.

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

• stop the music until the client's verbalizations have ended.

• adjust the tempo of the song to correspond to the client's rocking behavior.

• sing and play the song at a higher volume to mask the client's verbalizations.

• refocus the client by directing her to sing along with the therapist.

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?

• nonverbal expression

• impulse control

• auditory discrimination

• motor skills

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

• motor matching

• sequencing

• discrimination

• sensitivity

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

• develop therapeutic music lessons to teach basic music literacy.

• move from song-writing to active music listening to broaden clients' exposure to new musical styles.

• adapt the clients' preferred music to the styles with which the therapist is most comfortable.

• seek out resources to learn more contemporary music styles.

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?

• improvisational drumming

• exercise with music

• guided imagery

• progressive muscle relaxation

Which of the following is a method of stress reduction that involves tensing and releasing of the body?

• guided imagery

• progressive muscle relaxation

• autogenic training

• systematic desensitization

Which of the following is a diagnosis characterized by deterioration from a previous functioning level, disorganized thinking or speech, and hallucinations or delusions?

• bipolar disorder

• schizophrenia

• depressive episode

• somatization disorder

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?

• singing a rhythmic marching tune while the client plays a maraca

• observing the client's facial expressions while she listens to a recording of her preferred music

• recording the number of vocalizations as the client sings her favorite song

• presenting the client with instrument choices and observing her nonverbal communication

Which of the following interventions MOST directly addresses social language use?

• Write tongue twister songs using a variety of consonants and vowels.

• Stimulate spontaneous completion of song lyrics in a familiar song.

• Create a musical improvisation that simulates a question/answer dialogue.

• Have client play a drum while following the dynamic changes in the music.

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 lyric analysis intervention in which participants relate the lyrics of the song to their personal lives.

• A music and imagery intervention in which participants visualize successful involvement in stressful situations.

• An adaptive guitar lesson in which participants learn to accompany breathing exercises using a simple chord progression.

• A songwriting intervention in which participants write a song about things they can do to help themselves when faced with stressors.

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?

• Make sure no activity within the session lasts longer than two minutes in order to maintain the student’s attention.

• 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.

• 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.

• Eliminate all transitions and spend the entire session focusing on one activity to remove opportunities for off-task behavior.

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?

• rhythmic music matched to the patient's target breathing rate

• patient-preferred music to calm the patient

• music to support imagery during weaning from ventilation

• music to distract the patient from the ventilator

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?

• relaxation sessions for stress management

• improvisation to address bereavement

• intergenerational choir for socialization

• music lessons for cognitive functioning

Which of the following adaptations would BEST allow a client who has a weak palmar grasp to play the xylophone?

• Velcro shaker

• mallet cuff

• weighted glove

• instrument mount

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?

• movement to music

• playing a rhythm instrument

• singing a familiar song

• improvising on the piano

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?

• Decline to play the song, stating that it is unfamiliar.

• Assure the client that the song will be played the following session.

• Sight read the piece, playing a reduced piano part.

• Suggest another song that the client likes.

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

• music therapy is contraindicated since few responses were observed.

• the child does not react well to new and unfamiliar situations.

• several factors may have impeded the accuracy of the information gathered.

• the child should be brought back in 6 months for a follow-up assessment.

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

• impulse control

• endurance

• trust

• reality orientation

To produce a bass sound on a djembe, the instrument should be struck

• on the edge

• in the middle

• close to the edge

• on the side

A music therapist records observations of a client's self-stimulatory behaviors every 2 minutes. This type of recording is referred to as

• continuous

• interval

• duration

• event

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?

• Question the administration about the severe restrictions.

• Bring in small instruments based on best professional judgement.

• Request permission to bring in small instruments.

• Adhere to the instructions.

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?

• Teach the patient to practice breathing deeply while listening to a soothing piece of music.

• Encourage the patient to participate in a lyric analysis to initiate a discussion about coping skills.

• Engage the patient in improvisational drumming to distract them from the procedure.

• Help the patient write a song expressing how they feel about the procedure.

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?

• harmonies

• lyrics

• tempo

• dynamics

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?

• modeling

• chaining

• errorless learning

• group contingencies

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?

• Progressive muscle relaxation specifically addressing the vocal apparatus.

• Structured vocal exercises using piano accompaniment and a small pitch range.

• Singing familiar songs while varying the pitch range from high to low.

• Unstructured a cappella improvisation encouraging vocal exploration.

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

• the client does not feel the need to address the trauma in music therapy sessions.

• the therapist should be more persistent in using follow-up questions after engaging in musical interaction.

• the client’s cultural group may have a different perspective regarding questions of a personal nature.

• the client may have doubts about the music therapist’s ability to address the trauma.

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?

• preference

• learning styles

• clinical history

• resources

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?

• improving orientation to the environment

• enhancing decision-making skills

• increasing the client's self-esteem

• providing opportunities for musical self-expression

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

• use puppets or stuffed toys.

• provide known experiences in a predictable order.

• use a songwriting experience to express feelings.

• introduce a new relaxation intervention.

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?

• musical skills

• medication regimen

• cultural

• family support structure

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?

• Research current assessment procedures and conduct the assessment.

• Ask a speech-language pathologist in the community for an assessment recommendation.

• Search for a music therapist trained in this area and refer the family at discharge.

• Offer an alternative music therapy technique that the therapist is trained to implement.

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

• call the school where the student attends and schedule an observation.

• ask the principal for permission to visit with the student during music class.

• email his therapists and ask for the student's current progress.

• get a signed release from his parent to speak to his teacher and therapists at school.

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

• arrive at the classroom several minutes early to allow sufficient time for the transition to the treatment room.

• arrange to co-treat with her colleague for a few sessions so that the child can get used to the music therapist.

• schedule the first session in the client’s classroom to facilitate an easier adjustment to the new music therapist.

• conduct the initial session when the client’s parents can also be present to provide a familiar stimulus while the client adjusts.

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?

• Identify expected behaviors for the group and set contingencies for non-desired behaviors.

• Allow the clients some time to talk about other things, but refrain from answering personal questions.

• Play music that is popular with the clients' age group as a means to get them engaged in music.

• Redirect the group to talk together about group goals and enlist their help in making group rules.

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?

• pacing

• structure

• environment

• curriculum

Which of the following BEST represents a keyboard accompaniment rhythm for the jazz waltz style?

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?

• cognitive

• sensorimotor

• physiological

• emotional

To fully assess a client for music therapy services, a music therapist should use

• a variety of musical assessment procedures.

• non-musical standardized assessment tools.

• both musical and non-musical assessments.

• existing assessment tools and procedures.

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

• improvise music to distract the patient from her anxiety, and redirect her focus to the procedure.

• use familiar music to engage the patient and decrease her fears so her pain perception will be diminished.

• invite the family members to participate by singing along so the patient feels supported.

• talk the patient through the procedure and provide relaxing music after it is completed.

In inpatient pediatric medical care, children may begin to experience developmental delays or regression. This is MOST likely a result of

• long-term hospitalization.

• psychotropic drug use.

• unresolved feelings of anger.

• lack of interaction with peers.

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

• may be guarded and not willing to share because he does not yet feel comfortable with others in the group.

• has low tolerance for the song choices of others in the group and is being quiet out of frustration.

• has difficulty expressing his thoughts, feelings, and insights and may not have anything to add to the discussion.

• may be experiencing active symptoms of psychosis in which he has difficulty concentrating on the music.

When using music to facilitate and enhance functional movements, it is MOST important to provide music that

• supports the temporal, spatial, and muscular dynamics of the movement.

• has been chosen by the client as their preferred music for movement.

• promotes movement exploration through varying rhythmic patterns.

• provides a novel experience to motivate, focus, and engage the client.

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?

• Client was discharged from the facility.

• Client made minimal progress in goal areas.

• Client attained therapeutic goals and objectives.

• Client displayed resistance to music therapy services.

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?

• existential therapy

• psychoanalytic therapy

• cognitive behavioral therapy

• reality therapy

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

• long-term objective.

• long-term goal.

• short-term objective.

• short-term goal.

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?

• Agree to learn bluegrass music for the next session.

• Explain that this genre is not in the repertoire and suggest alternatives.

• Dismiss this request and sing another genre.

• Inform the client that bluegrass music is available online.

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

• explain the chord structure of the 12-bar blues.

• play a drum along with the client in a steady beat.

• show the client how to play the chords in first position on the guitar.

• ask the client to listen while the group plays through the 12-bar blues.

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

• fear

• resistance

• depression

• trust

Which of the following would give a music therapist the MOST objective information about the client’s existing abilities?

• collaborative work

• prompted task

• independent responses

• baseline data

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?

• "Client will display a brighter affect over the course of one session by April 15."

• "Client will improve feelings of worth and belonging by April 15."

• "Client will state a positive personal quality within one session by April 15."

• "Client will demonstrate a sense of pride after music improvisation by April 15."

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

• termination of music therapy services, referral for a speech and language evaluation, and a referral for counseling.

• continued music therapy services for the next school year, referral for a speech and language evaluation, and a referral for counseling.

• intermittent music therapy services for the next school year as needed, referral for an occupational therapy evaluation, and a referral for counseling.

• taking a break from music therapy for a year to focus on speech therapy and emotional concerns.

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?

• Schedule 1 or 2 additional sessions upon the client's return to address closure.

• Notify the client in writing that music therapy services are terminated.

• Request that services be extended for another 3 months to prepare the client.

• Ask the caregiver to communicate this information to the client.

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?

• auditory perception

• executive functions

• non-verbal expression

• motor skills

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?

• Agree to help the nurse monitor and record the patient's vital signs.

• Decline the nurse's request and keep working with the patient.

• Inform the nurse that this is out of the scope of practice for music therapy.

• Look for another staff member to record the patient's vital signs.

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?

• Begin singing a variety of hymns to support the client's verbalizations.

• Direct the client in prayer to affirm the client's verbal responses.

• Ask the client questions about her specific spiritual affiliation.

• Facilitate fill-in-the-blank song writing using the phrase, "If only God."

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

• semicircle with the therapist facing the group.

• straight line with the therapist facing the group.

• circle with the therapist sitting between the clients.

• circle with the therapist sitting in the middle of the circle.

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

• provide a printed program for the clients only.

• decline to print the program because of the potential breach of confidentiality.

• ensure that clients whose names are to be printed have signed a written release form.

• only choose clients to participate in the production who will allow the use of their names in the program.

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?

• Provide live spiritual music that the patient enjoys.

• Invite the chaplain and patient's family to the next session.

• Validate the patient's thoughts and feelings.

• Stream live worship services online during the session.

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

• "Now it's your turn."

• "Look at me."

• "I like to sing."

• "Let's sing together."

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?

• Continue treatment using the music to address agitation and combativeness.

• Discontinue treatment as the client’s passivity will increase with disease progression.

• Remove the daughter from the music therapy session immediately.

• Re-evaluate the session length and interventions used during music therapy sessions.

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?

• Give the child a maraca and play preferred music when he shakes the maraca.

• Withhold preferred music when he moves his fingers in front of his eyes.

• Play loud, unfamiliar music during instances of self-stimulating behavior.

• Play preferred calming music any time the child moves his fingers in front of his eyes.

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

• socialization skills.

• communication skills.

• cognitive skills.

• motor skills.

Which of the following are the MOST common indicators of pain in a hospice patient who is non-verbal?

• anxiety and involuntary movement of the face and jaw

• tense muscles like clenched fists and facial grimacing

• restless behavior and increased verbalizations

• eyes tightly shut and yawning

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

• call the unit for staff to come and remove him from the session, then discharge him from the group.

• tell him he needs to leave immediately and follow up with writing a termination note in his chart.

• attempt to redirect the client and ask him to communicate his feelings verbally or musically.

• offer him hand percussion from which to pick and ask him to improvise feelings with the other client.

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

• aesthetic sensitivity

• divided attention

• auditory perception

• impulse control

Asking a client to play back five notes that were just played on a piano addresses

• episodic memory.

• working memory.

• semantic memory.

• long-term memory.

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 background survey

• an individual interview

• an intelligence test

• a personality inventory

During a music therapy session, a 52-year-old inpatient describes his plans to kill his ex-wife. The music therapist should

• maintain confidentiality and not share this information with anyone.

• contact the family of the ex-wife and request that they tell her in person.

• post the patient's intention on the Internet to warn the public of the potential threat.

• consult federal, state, and local regulations and organizational policies and procedures to determine what to do.

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?

• Review current research and literature in music therapy related to cancer care.

• Attend rounds on the oncology units to meet with physicians and nurses.

• Find music activities online that are appropriate for adults in cancer treatment.

• Interview other music therapists who work with cancer patients and survivors.

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

• complete a written report, and email it to the school principal.

• telephone the school IEP team leader and summarize the assessment results.

• attend the IEP meeting to give a written and oral summary of the results.

• give a written report to the parent who can pass it on the IEP team.

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

• reassign the patient to another therapist.

• offer support and guidance.

• encourage the intern to share his personal experience with the patient.

• refer the intern to the local ALS chapter.

A music therapy experience that requires a client to recall information and events is addressing which of the following types of memory?

• sensory

• procedural

• working

• explicit