Client Experiences in Music Therapy in the Psychiatric Inpatient Milieu

Abstract

In acute inpatient psychiatric settings, music therapy groups can play a role in bringing patients together, creating social interactions and musical experiences that tap into their unique strengths and abilities. These experiences in the music and in the dynamic interactions that are an intrinsic part of it are multifaceted and can be creative, challenging, enlightening, motivating, relieving, or relaxing.Yet, for the client who arrives in the inpatient unit, there is often impaired judgment, acute feelings of distress and confusion, and the bewilderment of an unfamiliar environment. For some, music therapy may be a new experience and not at all what they might expect to be doing in a treatment setting. For these reasons, a question arises about how music therapy might be perceived.As clinicians and researchers, we are aware that in the psychiatric milieu, music therapy has the ability to meet a patient's needs on all levels of the biopsychosocial framework. Music therapy can address issues of isolation, anxiety, self-expression, identity awareness, and distortions of reality (jensen, 1999). Music therapists have identified the benefits that music therapy brings to individuals with a psychiatric illness: it decreases negative symptoms (Tang, Yao, & Zheng, 1994; Ulrich, Houtmans, & Gold, 2007; Mossier, Chen, Heldal, & Gold, 2011); can be significantly effective in reducing symptoms of psychosis (Silverman, 2003); increases levels of interest (Tang et al., 1994); provides structure and allows the possibility of integration, relaxation, concentration, and creativity (Blake & Bishop, 1994); increases social functioning and leads to socially acceptable behaviors (Mossier et al., 2011; Ficken, 1976; Tang et al., 1994; Ulrich et al., 2007); leads to the improvement of day-to-day functioning (Smeltekop & Houghton, 1990; Mossier et al., 2011); and decreases anxiety and depression (Mossier et al., 2011).Descriptions of the efficacy of music therapy, such as those listed above, communicate through clinical language what has happened for clients as a result of their experiences with music therapy. This language comes from clinicians, based on their observations and assessment of the clients' reporting of their experiences. While this language provides a valuable and useful description of the effectiveness of music therapy, it is unable to communicate a full description of the client's lived experience of it.To capture a broader and more client-focused perspective on what happens during music therapy, scholarship and research have developed a more adequate means to elucidate the client's experience. Case studies (Bruscia, 1991; Hadley, 2003; Meadows, 2011), and narratives of client's experience (Hibben, 1999), had aided the field in illuminating these phenomena, through more detailed clinical descriptions that share client's reactions, or the client's own words.In order to understand client experience in music therapy with greater depth and breadth, this author employed a phenomenological research method. Phenomenology is a form of research inquiry that attempts to render the fullest description of the lived experience of particular phenomena in the voice of the person who has experienced it. It is recollective and retrospective, and seeks to articulate the meaning of an experience for the person, with the potential to relate the essence of complex and multifaceted experiences (Forinash & Grocke, 2005).Music therapy, involving the creative process of music, the omni-directional interplay of therapist, client(s), and music, including the therapeutic intention of the therapist and therapeutic needs of the client, is just such a complex and multifaceted phenomenon, one that stands apart from other experiences that may occur during a psychiatric hospitalization. Clinicians' descriptions cannot fully tell the tale of what is experienced in music therapy, nor can research methods that attempt only to give concrete details or outcomes of the experience (Forinash & Gonzalez 1989). …