The Scientific Clinician: Understanding, Implementing, and Integrating Scientific Evidence into Daily Practice

Abstract

As the field of Music Therapy (MT) continues to develop effective means of treatment for a large variety of populations, clinicians increasingly compete for healthcare dollars. This situation has led to greater demands to demonstrate the need for, and efficacy of, music therapy. Across healthcare, Evidence-Based Practice (EBP) has become a priority as professionals vie to either maintain their relevance or gain a foothold in their pursuit of clinical efficacy. In 2010, the American Music Therapy Association (AMTA) adopted the following definition of evidence-based music therapy practice: ''Evidence-based music therapy practice integrates the best available research, the music therapists' expertise, and the needs, values, and preferences of the individual(s) served.'' (AMTA, n.d.).The onus is placed on the clinician to know how to pursue and integrate all three areas (research, therapist's expertise, or patient preference and needs) into their daily practice. While not one of these areas is intrinsically more important than the other, the strategic priority placed on research by AMTA in 2005 (AMTA, n.d.) underscores the potential difficulties with the implementation of scientific evidence in clinical practice. Several fields have noted challenges in adhering to EBP (Bloomrosen & Detmer, 2010; Coster, 2005; Hadley, Hassan, & Khan, 2008; Kronenfeld et al., 2007; Leeman & Sandelowski, 2012; Lizarondo, Grimmer-Someers, & Kumar, 2011; Long, 2002; McCluskey & Lovarini, 2005; Robb, Burns, & Carpenter, 2011; Roe & Lancaster, 2005; Scott-Findlay, 2005; Shumway-Cook & Woolacott, 2007; Spring, 2008; Yano, 2008), such as understanding the research, being educated in EBP, applying the results of standardized research methods to individual patients, and defining clinical outcomes for EBP.One area in which music therapists have enjoyed an increasing interest is the realm of neurological rehabilitation. Advancements in imaging technology have allowed for a better understanding of the intersection between music and the neurosciences and, more importantly, how different aspects of music are processed and interact with neural functioning (Brown, Martinez, & Parsons, 2006; Koelsch, 2009; Molinari, Leggio, De Martin, Cerasam, & Thaut, 2003; Tecchio, Salustri, Thaut, Pasqualetti, & Rossini, 2000; Thaut, 2003; Wan & Schlaug 2010). Research demonstrating timing mechanisms (Harrington, Boyd, et al., 2004; Harrington, Zimbelman, Hinton, & Rao, 2009; Hinton, Harrington, Binder, Durgerian, & Rao, 2004; Paulsen et al., 2004; Rao et al., 1997; Rao, Mayer, & Harrington, 2001; Stephan et al., 2002; Thaut, Miller, & Schauer, 1998) has led to rhythmic-based interventions for gait, balance disturbance and upper limb functioning (Conklyn et al., 2010; Freedland et al., 2002; Hausdorff et al., 2007; Hayden, Clair, Johnson, & Otto, 2009; Hove, Suzuki, Uchitomi, Orimo, & Miyake, 2012; McIntosh, Brown, Rice, & Thaut, 1997; Miller, Thaut, 2005; Thaut, Leins, et al., 2007; Thaut, McIntosh, Prassas, & Rice, 1993; Thaut, McIntosh, & Rice, 1996, 1997).With the increasing awareness of this growing body of research, music therapists are finding more opportunities to work in neurological rehabilitation. While music therapy in neurological settings is not new, the interest and demand in this area has certainly increased over the past decade. As these opportunities continue to develop music therapists must be prepared to answer questions from clients, colleagues and medical directors related to music therapy's efficacy in general, and to how it can be used to address the specific needs and goals of a client (or patient). Adhering to EBP, as defined by AMTA, with an eye to integrating data from well-designed research protocols, may help advance the field, while aiding in communicating the relevance of music therapy in neurological rehabilitation.The Scientific ClinicianFor a clinician, it is important to stay abreast of advancements, both in one's field and in areas that could affect the work one does. …