Music Therapy Practice Research Articles

Neuroscientific and neuroanthropological perspectives in music therapy research and practice with patients with disorders of consciousness.

A growing understanding of music therapy with patients with disorders of consciousness (DOC) has developed from observing behavioral changes and using these to gain new ways of experiencing this research environment and setting. Neuroscience provides further insight into the effects of music therapy; however, various studies with similar protocols show different results. The neuroanthropological approach is informed by anthropological and philosophical frameworks. It puts emphasis on a research with and not just on human beings concerning the subject/object question within a research process. It examines relational aspects and outcomes in the context of working in an interdisciplinary team. This allows a broader view of music therapy in a reflective process and leads to a careful interpretation of behavioral reactions and imaging results. This article discusses the importance of the neuroanthropological perspective on our way of obtaining knowledge and its influence on therapeutic practice. It is important to consider how knowledge is generated as it influences the results. Data from two cases will be presented to illustrate the neuroanthropological approach by comparing quantitative PET data with qualitative results of video analyses.

Effects of music therapy on pain, anxiety, and vital signs in patients after thoracic surgery

ObjectiveTo examine the effectiveness of music listening on pain, anxiety, and vital signs among patients after thoracic surgery in China. Design and settingA randomized controlled clinical trial was conducted in the thoracic surgery department of two tertiary hospitals in Wuhan, China. 112 patients were recruited and randomly assigned to either experimental (n=56) or control (n=56) group respectively. InterventionThe experimental group received standard care and a 30-min soft music intervention for 3 days, while the control group received only standard care. Measures include pain, anxiety, vital signs (blood pressure, heart rate and respiratory rate), patient controlled analgesia, and diclofenac sodium suppository use. ResultsThe experimental group showed statistically significant decrease in pain, anxiety, systolic blood pressure and heart rate over time compared to the control group, but no significant difference were identified in diastolic blood pressure, respiratory rate, patient controlled analgesia and diclofenac sodium suppository use. ConclusionThe findings provide further evidence to support the practice of music therapy to reduce postoperative pain and anxiety, and lower systolic blood pressure and heart rate in patients after thoracic surgery in China.

Kodály Approach in the Crossroad of Education and Therapy

Kodály's concept about music education is worldwide adapted to different cultures. However, the significance of his theoretical framework is almost undiscovered by music therapy. The aim of the present paper is to shed light on the common elements of Commuity Music Therapy and the Kodály Approach by literature-based Research. Kodály was a pioneer establishing a multidisciplinary dialog between musicology, philosophy, sociology and education. The practice and theory he established was a powerful response to his time’s social needs and problems. As a musician an educator he devoted himself to the popularization community music, choral singing and thus building up a better society. As a researcher he studied the therapeutic effects of his method, especially transfer effect with intellectual and social skills. His overall goal to make music accessible to everyone highly resemble with Community Music Therapy. Many of his ideas such us choral singing for social connectedness or agency and empowerment through musical education are a part of the practice of Community Music Therapy. His concept is a fundamental part of music education but music therapy also could profit more from his ideas.

The Use of Dialectical Behavior Therapy (DBT) in Music Therapy: A Sequential Explanatory Study.

There are published examples of how dialectical behavior therapy (DBT) and music therapy are effectively being used as separate therapies in the treatment of individuals with a variety of mental health disorders. However, research examining DBT-informed music therapy is limited. The purpose of this study was to determine whether music therapists working in mental health settings are implementing components of DBT in their work, and if so, how and why; and if not, why not and what is their level of interest in such work. We used a sequential explanatory mixed-methods research design implemented in two phases. Phase 1 was a quantitative survey of board-certified music therapists (n=260). Due to a low survey response rate (18%), and to enhance the validity of the findings, Phase 2, an embedded qualitative procedure in the form of interviews with clinicians experienced in the DBT approach, was added to the study. Both survey and interviews inquired about DBT training, use of DBT-informed music therapy, music therapy experiences used to address DBT skills, and experiences of implementing DBT-informed music therapy. Respondents indicating they implement DBT-informed music therapy (38.3%) are using components and adaptations of the standard DBT protocol. Advantages of implementing DBT-informed music therapy were identified, and more than half of the respondents who do not implement DBT in their music therapy practice also perceived this work as at least somewhat important. Disadvantages were also identified and support the need for further research. Components of DBT are used in music therapy and are valued, but there is a lack of empirical evidence to inform, refine, and guide practice.

Music Therapy: An art beyond words (2nd ed.)

This is the second edition of a book appearing 20 years after its initial publication. The first edition was authored by Leslie Bunt, and Brynjulf Stige has been added as the coauthor for the second edition. It is intended as an introduction to the current international practice of music therapy as seen through seven contemporary perspectives: medical, behavioral, psychodynamic, humanistic, transpersonal, culture centered, and music centered. The scope of these perspectives indicates the authors’ intent to be broadly inclusive and comprehensive in their account. The nine chapters of the book include three introductory chapters focusing on what music therapy is, how it has developed, and information on its basic building blocks. The four chapters that follow introduce clinical work organized by four stages of life: childhood, adolescence, adulthood, and older adulthood. The book concludes with two chapters exploring the profession and discipline of music therapy as a community resource with a hybrid identity.

Expanding perspective on music therapy for symptom management in cancer care.

Symptom management is a frequently researched treatment topic in music therapy and cancer care. Representations in the literature of music interventions for symptom management, however, have often overlooked the human experiences shaping those symptoms. This may result in music therapy being perceived as a linear intervention process that does not take into account underlying experiences that contribute to symptom experiences. This study explored patient experiences underlying symptoms and symptom management in cancer care, and examined the role of music therapy in that clinical process. This study analyzed semi-structured, open-ended exit interviews obtained from 30 participants during a randomized controlled trial investigating the differential impact of music therapy versus music medicine interventions on symptom management in participants with cancer. Interviews were conducted by a research assistant not involved with the clinical interventions. Exit interview transcripts for 30 participants were analyzed using an inductive, latent, constructivist method of thematic analysis. Three themes-Relaxation, Therapeutic relationship, and Intrapersonal relating-capture elements of the music therapy process that (a) modified participants' experiences of adjustments in their symptoms and (b) highlighted the depth of human experience shaping their symptoms. These underlying human experiences naturally emerged in the therapeutic setting, requiring the music therapist's clinical expertise for appropriate support. Symptom management extends beyond fluctuation in levels and intensity of a surface-level symptom to incorporate deeper lived experiences. The authors provide recommendations for clinical work, entry-level training as related to symptom management, implications for evidence-based practice in music therapy, and methodology for future mixed methods research.

A Guide to Selected Alternate Guitar Tunings for Music Therapists

While every music therapist is familiar with standard guitar tuning, fewer music therapists are comfortable using alternate guitar tunings, even though this skill is included in the Professional Competencies document of the American Music Therapy Association (2013). Specifically, within the music foundations section, guitar skills subsection, there are two competencies relevant to the topic of alternate tunings: (a) tune guitar using standard and other tunings, and (b) perform a basic repertoire of traditional, folk, and popular songs with or without printed music. Likewise, from the Scope of Practice document of the Certification Board for Music Therapists (2010), within the professional development and responsibilities section, professional development subsection, the following item has relevance: (a) expand music skills.At the core of the professional competencies is the idea that music therapists should be familiar with a wide variety of musical styles and idioms in order to re-create composed songs, create original songs, and facilitate improvisations appealing to their clients in order to address the clinical work to be done in the session. Even when the music therapist uses the right chords and an appropriate accompaniment pattern, some songs never sound like the recording, which is generally what clients desire when they request a specific song or artist. Sometimes the key issue is that the performer is using an alternate tuning in order to create different chord voicing and effects. With practice, music therapists can learn and easily make use of alternate tunings within the clinical setting.In order to assess the prevalence of this topic in guitar method books and music therapy journal articles, the author reviewed 12 guitar method books in her personal collection and university music library (see Appendix A for list of titles) and searched the PsyclNFO and ERIC databases for information about alternate tunings. The search revealed three guitar methods including alternate tunings (Kuhn & Reid, 1984; Meyer, DeVillers, & Ebnet, 2010; Oden, 2014) and two music therapy articles with information about alternate tunings (Kennedy, 2001; Shoshensky, 2005). Therefore, the purpose of this article is to provide information about selected alternate guitar tunings to music therapists. The following topics will be addressed: (a) relevance of alternate tunings to the AMTA Professional Competencies and the CBMT Scope of Practice documents, (b) how to create nine alternate tunings, (c) tips for retuning strings, (d) listening guide for each tuning, and (e) a description of combining alternate tunings in the clinical setting to facilitate clients' use of the guitar.Creating Alternate TuningsWhile many online and text resources list alternate tunings and corresponding pitches, the sheer number of possibilities and applications can be overwhelming. Indeed, Joni Mitchell is credited with using over 50 different tunings in her music (Drozdowski, 2012). With the variety of options available, it can be challenging to determine the most useful alternate tunings for use in music therapy practice. See Table 1 for nine alternate tunings selected for this article based upon their frequency of use by musicians and ease of use for music therapists. Certainly, other music therapists might compile a different list, but this brief listing of nine options is a good place to start with alternate tunings. Several online and text resources are available with chord diagrams for alternate tunings (Gallagher, 2004; Hanson, 1995; Johnson, 2002; Mohr & Klein, 2002).Ups for Retuning StringsWhile music therapy students and professionals are familiar with the process of guitar tuning, some reminders are useful when experimenting with alternate tunings. First, clip-on tuners can be helpful for accurate and rapid retuning, especially in a session space with a great deal of ambient sounds. Clip-on tuners attach directly to the headstock and tune through vibrations traveling through the instrument. …

Music Therapy Practices and Processes with Foster-Care Youth: Formulating an Approach to Clinical Work

Music Therapy Practices and Processes with Foster-Care Youth: Formulating an Approach to Clinical Work

The Use of Music Therapy as a Factor of Sustainable Development

Abstract Sustainability in music therapy scheduling refers to assuming responsibility for this possibility and maximizing the potential of music therapy programs in order to have a positive impact on the participants. This paper proposes that sustainability, along with other treatment methods, to be taken into account in all music therapy practices. The intention of this article is to explain the way in which it can implement the music therapy, under present conditions in Romania. Even if there is a legal framework of employment for an indefinite period of a music therapist in State institutions, he can sustain the music therapy at some relatively affordable cost even for people who earn a minimum wage. Implementing music therapy in kindergartens, it will open a new road for this form of therapy which helps in curing certain diseases, culturalisation and innovation of the education system but also on the health service.

Mixed-Methods Survey of Professional Perspectives of Music Therapy Practice in Mental Health

The field of music therapy in the United States is undergoing a transformation that has been fueled by changes in healthcare, insurance reimbursement criteria, and requirements of evidence-based research in clinical practice. In addition, requirements within the profession as a whole are changing the landscape of education and specialization. One response to these changes is evident in the training of music therapists (MTs), as the American Music Therapy Association (AMTA) and its members consider the relative advantages of creating a Master's-Level Entry (MLE) into the profession. Healthcare delivery in the field of mental health, in particular, has been transformed, as advances made in the pharmaceutical treatment of psychiatric disorders has shifted care from the acute inpatient setting to the recovery community model. This change in treatment approach has resulted in increasingly shorter length of inpatient stays. An average length of stay of a 1987 inpatient cohort was 22.6 days (Weiden & Oltson, 1995, table 1 ), but it had fallen to 8 days in 2005 (Stranges, Levit, Stocks, & Santora, 2011) and is estimated at 7.2 days in 2015 (Centers for Disease Control and Prevention, 2015).This new treatment model is reflected in the recent music therapy literature, where short-term acute stays have resulted in a need for practices that are focused on single sessions (Carr, Odell-Miller, & Priebe, 2013; Jones, 2005; Silverman, 2014'), and address immediate areas of concern (e.g., de l'Etoile, 2002; Silverman & Rosenow, 2013,) rather than provide process or depth-oriented therapeutic experiences with a goal of insight as the outcome (Carr et al., 2013). Carr et al/s (2013) systematic review of music therapy practices in psychiatric acute care in the United States and Europe provides insight into some of the ways that music therapists have adapted to these changes. These authors found that MTs conducted a high number of sessions per week, and that the music experiences they implemented required greater therapist direction, flexibility, and predictable musical structure. This review also indicated that music therapists often found it difficult to engage patients in music therapy, especially early in their care. Because of the constant changes in group participants and functioning levels, fostering group process was often not a realistic goal. Patients in the acute unit are often in crisis; thus, goals for inpatients were focused primarily on symptom management and fostering relationships with peers and healthcare professionals in the here and now (2013). Carr et al. (2013) concluded that the current music therapy models of Guided Imagery and Music (GIM), Analytical Music Therapy (AMT), and Nordoff Robbins Music Therapy (NR) have been developed with depth-oriented care in mind and may not address the needs of acute-care patients.This interpretation may be supported by recent music therapy research literature in the acute-care setting, wherein the focus has been on single sessions that use interventions such as music games (Silverman, 2005, 2014), music games and other recreational activities (Silverman & Rosenow, 2013), music psychoeducation (Silverman, 2009, 2014), and songwriting (Jones, 2005; Silverman, 2012b; Silverman & Leonard, 2012). In contrast, in the recovery or community treatment setting, MTs use music experiences in a different way, or use other music experiences that may be more suitable for longterm treatment. This includes choirs (Bailey & Davidson, 2003; Eyre, 2011), songwriting (Vander Kooij, 2009), songwriting and recording (Grocke et al., 2014), Sound Training for Attention and Memory protocol (Ceccato, Caneva, & Lamonaca, 2006), and adapted GIM (Moe, Roesen, & Raben, 2000). Although some studies have been carried out in the community setting (e.g., Grocke, Bloch, & Castle, 2009), there is a relative lack of research and clinical literature that focuses specifically on music therapy in the community setting. …

Performative, Arts-Based, or Arts-Informed? Reflections on the Development of Arts-Based Research in Music Therapy.

Arts-based research (ABR) has emerged in music therapy in diverse ways, employing a range of interpretive paradigms and artistic media. It is notable that no consensus exists as to when and where the arts are included in the research process, or which music therapy topics are most suited to arts-based study. This diversity may pose challenges for music therapists who are developing, reading, and evaluating arts-based research. This paper provides an updated review of arts-based research literature in music therapy, along with four questions for researchers who are developing arts-based research. These questions are 1) When should the arts be introduced? 2) Which artistic medium is appropriate? 3) How should the art be understood? and 4) What is the role of the audience? We argue that these questions are key to understanding arts-based research, justifying methods, and evaluating claims arising from arts-based research. Rather than defining arts-based research in music therapy, we suggest that arts-based research should be understood as a flexible research strategy appropriate for exploring the complexities of music therapy practice.

Book Review: Developments in Music Therapy Practice: Case Study Perspectives

Book Review: Developments in Music Therapy Practice: Case Study Perspectives

Single Case Design Studies in Music Therapy: Resurrecting Experimental Evidence in Small Group and Individual Music Therapy Clinical Settings

The profession would benefit from greater and routine generation of causal evidence pertaining to the impact of music therapy interventions on client outcomes. One way to meet this goal is to revisit the use of Single Case Designs (SCDs) in clinical practice and research endeavors in music therapy. Given the appropriate setting and goals, this design can be accomplished with small sample sizes and it is often appropriate for studying music therapy interventions. In this article, we promote and discuss implementation of SCD studies in music therapy settings, review the meaning of internal study validity and by extension the notion of causality, and describe two of the most commonly used SCDs to demonstrate how they can help generate causal evidence to inform the field. In closing, we describe the need for replication and future meta-analysis of SCD studies completed in music therapy settings. SCD studies are both feasible and appropriate for use in music therapy clinical practice settings, particularly for testing effectiveness of interventions for individuals or small groups.

Embedding Innovation into the Counterpoint of Music Therapy Practice Today

When Alexia founded Music as Therapy International, the music therapy profession seemed very different. Who has changed? The author or the profession? Or both? The author will present her experiences of being a threat, a novelty and now a welcome contributor to practice, and consider the changing professional context against which (and within which) her work has unfolded. The article will trace the development of Music as Therapy International's work in Romania, as the country's care system has progressed through dramatic reforms following the crisis in care revealed after the fall of Communism in 1989. The author will explore how the consequent portfolio of activities devised by the charity has since proven relevant in other countries and has become increasingly influential in the UK. Specific relevant projects will be presented, including the six-week introductory training project model (international), the distance learning programme (Romania), the training DVD (Rwanda), the UK continuing professional development seminars and interactive music-making (a university credit-rated course for UK practitioners working with under-5s). The paper will also refer to responses to these projects from the profession and the relevant practice of others over the years.

‘Through music and into music’, through music and into well-being: Dalcroze eurhythmics as music therapy

There is a longstanding relationship between music therapy and Dalcroze Eurhythmics, an approach to music education that had its beginnings in the reform pedagogy movement of the European fin de siècle. Émile Jaques-Dalcroze (1865-1950), the founder of the approach, initially focused on educational aims, but was soon to include therapeutic ones as well. During the early twentieth century, Dalcroze teachers applied the approach to their work with disabled children. Such applications have continued to develop to the present day and have expanded to include palliative treatment in HIV/AIDS and gerontology.There are many theoretical and technical similarities between Dalcroze Eurhythmics and improvisational music therapy, including communication through musical improvisation and attunement in playing for movement. However, many of these similarities remain to be discussed in relation to the literatures on music therapy and communicative musicality. To address this gap, this article takes a transdisciplinary approach, making conceptual connections between the theory and practice of both Dalcroze Eurhythmics and music therapy. Implications for future training, practice and research in Dalcroze Eurhythmics are discussed.

Music therapy trios with child, parent and therapist: A preliminary qualitative single case study

There is an increasing body of literature within music therapy that describes the possible benefits of parental involvement in music therapy sessions with a child. This article describes a preliminary study into existing music therapy practice in this area within an NHS Child Development Service. The qualitative study, using video elicitation interviews, investigates a single music therapy trio of child, parent and therapist, exploring the ways in which the parent and therapist describe their experiences of music therapy. A thematic analysis of the interview data demonstrates that the music therapy trio of child, parent, and therapist, is experienced by the parent and therapist as a fluid, dynamic web of musical and interpersonal relationships, rather than a fixed entity. Within this emergent network, individuals, pairs and the triad itself assume greater or lesser significance at different points.

Does Disability Studies have Anything to Say to Music Therapy? And Would Music Therapy Listen if it Did?

In this article I enquire whether a worthwhile dialogue might be entered into between the disciplines of disability studies and music therapy. Considering disability studies alongside feminist theory, I ask whether insights from disability studies can be incorporated within music therapy education and practice. A comparative exploration of the roots and visions of both disciplines, along with a discussion of music therapy's struggle to establish an identity as a clinical profession, leads me to suggest that there are fundamental rifts which would make a constructive dialogue difficult. I draw on perspectives developed by disability studies theorists who have critiqued the development of disabling professions and discuss some examples of disability arts practice to highlight the philosophical differences dividing these two projects. I conclude by suggesting that music therapy realigns itself as a profession allied to the community rather than as a profession allied to medicine.

Destabilizing Bodies, Destabilizing Disciplines: Practicing Liminality in Music Therapy

Our project began with a consideration of how disability studies might enrich the practice of music therapy. Originally, we were interested in how a greater awareness of disability issues might help music therapists, especially because of the often medicalized (and arguably pathologized) implications of the terms (“health” and “help”) which define their field and which frame the therapist/client relationship. On these grounds, we argued that greater awareness of the cultural context for such implications might aid the therapist. At the outset, it seemed straightforward enough. But our own unstable embodiments kept disrupting our conversations. The corporeal intransigencies of our bodies as we dealt with the symptoms of Crohn’s disease, autism and multiple sclerosis moved us beyond a critique of disciplinary purity which constructs each field as distinct to an analysis of privilege, power and passing that extends to multiple disciplines and pedagogical practices. In our paper, we raise questions about how the illusion of (st)able bodies can reinforce hierarchies (between therapist/client, teacher/student, helper/helped, ablebodied/disabled), especially when the person “in charge” does not have to disclose or discuss the instability of her own body. Upon that privilege rests an array of power dynamics, and we believe that a purposeful contemplation of our own embodiment has to be more central to praxis, whether as therapists, scholars, teachers or professionals. To do this, we must be aware not only of others’ but also of our own relationship to disability -- socially, culturally, and as a marker of identity and potential (in)access to power.

Perspectives on the practice of community music therapy in rural primary schools of Malawi

The author, a board-certified music therapist, and two colleagues, a literacy specialist and a special educator, travelled to Malawi, Africa in 2013 to explore the incidences of disabilities in the schools outside of the capital city of Lilongwe. Preliminary information was collected on the educational system, the types of strategies and supports that were in place for students with special needs, and the use of music as a resource in the classrooms and the communities. A community music therapy framework was employed to contextualize the possibilities available for providing sustainable music resources to facilitate an increase in accessibility for students with disabilities and to empower classroom communities to support the needs of those with disabilities.

Music therapy in children's hospices: An evaluative survey of provision

This paper presents the results of a survey of the range of music therapy practice in children's hospices in the UK. Music therapists are challenged to work with children with life-limiting and life-threatening conditions during short periods of respite care over several years or at end of life. Flexibility is fundamental to working both individually and in small groups in response to the shifting needs of the children and their families. In the context of a children's hospice music therapists are called upon to work creatively with siblings and family members and members of the multidisciplinary team in addition to the children themselves. A questionnaire and focus group for music therapists working in the children's hospices provided evidence of the range of work, priorities and future plans for development. Telephone interviews with specialist staff at children's hospices where music therapists were not currently working provided evidence of how music and musical activities were perceived and utilised, with any plans for future provision for a music therapy service and some of the practical and resource issues being itemised.