Insight Therapy: Guided Imagery and Music in a Forensic Psychiatric Setting

Abstract

Two different music therapy approaches in the short-term treatment of an assaultive patient are described in this paper: I) supportive music therapy group, followed by 2) insight-oriented guided imag ery and music. These two approaches are illustrated by a case study of a patient who had been incarcerated for assault, then sent to psychiatric care after a suicide attempt. The therapy progression is described, with emphasis on the guided imagery process. Its role in aiding the patient to deal with his conscious and unconscious prob­ lems is shown, including descriptions of the sessions, the music, and the patient’s behavior. The relationship of this work to other forensic music therapy is discussed. The use of music therapy with short-term forensic patients is a relatively recent phenomenon (Nolan, 1981; Zwerling, 1979). Most short-term for­ ensic treatment occurs within psychiatric hospitals; however, some prison systems have recently begun providing mental health services for inmates. Results of a recent study within Philadelphia County Prisons support the need for increased mental health services for inmates during incarceration. The study indicates that 33% of all prisoners have had documented psychi­ atric intervention at some point. Of the inmates admitted to the Philadel­ phia Prisons, 60% present a need for some mental health services (Guy, Zwerling, & Platt, Note I).