Music Therapy Sessions Research Articles

520 AN EVALUATION OF VIRTUAL MUSIC THERAPY TO PATIENTS ON AN ACUTE HEALTH CARE OF OLDER PEOPLE WARD DURING THE COVID-19 PANDEMIC

IntroductionMusic therapy has been shown to reduce anxiety and social isolation for elderly patients in the acute hospital setting. At Nottingham University Hospital NHS Trust a programme of live, face-to-face music has been delivered by Wellspring Music on Healthcare of Older Peoples wards since 2015. In response to COVID-19, face-to-face delivery was stopped and a virtual method was proposed. This project investigated feasibility of virtual live music delivery.MethodTwelve, two-hour music therapy sessions were delivered by Wellspring Music to 41 patients over six weeks. The validated Arts-obs tool was used by staff members facilitating the sessions to record observations of patient mood, relaxation, and distraction from the ward setting on Likert scales. Patient, ward staff, and facilitator feedback were also recorded. Qualitative and quantitative analyses were conducted by an Occupational Therapist.ResultsData from the Arts-obs tool showed that thirty-two patients had an observable improvement in mood, seven had no mood change, and two presented a slightly worsened mood. Fourteen patients were fully engaged with the music therapy, sixteen were partially engaged, and eleven were focussed on the hospital environment. Thirty-four patients were visibly more relaxed, and seven showed no change. Patient feedback ranged from gratitude and expressions of enjoyment of the session to finding it too loud. Ward staff feedback ranged from appreciation to finding the music too distracting. The Wellspring musician and staff facilitators reported occasional loss of internet connection, and patients sometimes focusing on the facilitator rather than the musician.ConclusionIt is feasible to deliver virtual music therapy to inpatients on Health Care of Older People wards. Feedback shows that this was largely acceptable to staff and patients. Improvements in mood, relaxation and distraction were found.

Virtual Mind-Body Programming for Patients With Cancer During the COVID-19 Pandemic: Qualitative Study.

BackgroundPatients with cancer are particularly vulnerable to stress and anxiety during the COVID-19 pandemic. Social distancing is critical for patients with cancer; however, it can also reduce their access to psychosocial coping resources.ObjectiveThe aim of this study was to explore patient experiences to generate a model of how virtual mind-body programs can support the psychosocial well-being of patients with cancer.MethodsWe conducted a qualitative study among patients (aged ≥18 years) who participated in a virtual mind-body program offered by a National Cancer Institute–designated Comprehensive Cancer Center during the COVID-19 pandemic. The program consisted of mind-body group therapy sessions of fitness, yoga, tai chi, dance therapy, music therapy, and meditation. Live integrative medicine clinicians held each session via Zoom videoconferencing for 30-45 minutes. In semistructured phone interviews (n=30), patients were asked about their overall impressions and perceptions of the benefits of the sessions, including impacts on stress and anxiety. Interviews were analyzed using grounded theory.ResultsAmong the 30 participants (average age 64.5 years, SD 9.36, range 40-80, 29 female), three major themes were identified relating to experiences in the virtual mind-body program: (1) the sessions helped the patients maintain structured routines and motivated them to adhere to healthy behaviors; (2) the sessions enhanced coping with COVID-19-related-stressors, allowing patients to “refocus” and “re-energize”; and (3) the sessions allowed patients to connect, fostering social relationships during a time of isolation. These themes informed the constructs of a novel behavioral-psychological-social coping model for patients with cancer.ConclusionsVirtual mind-body programming supported patients with cancer during the COVID-19 pandemic through a behavioral-psychological-social coping model by enhancing psychological coping for external stressors, supporting adherence to motivation and health behaviors, and increasing social connection and camaraderie. These programs have potential to address the behavioral, psychological, and social challenges faced by patients with cancer during and beyond the COVID-19 pandemic. The constructs of the conceptual model proposed in this study can inform future interventions to support isolated patients with cancer. Further clinical trials are needed to confirm the specific benefits of virtual mind-body programming for the psychosocial well-being and healthy behaviors of patients with cancer.

Attention Span of Children With Mild Intellectual Disability: Does Music Therapy and Pictorial Illustration Play Any Significant Role?

This study investigated the effects of music therapy and pictorial illustration on the attention span of children with mild intellectual difficulties. A pre-test, post-test and control group quasi-experimental research design was used with a sample of children diagnosed with mild intellectual disability from three special schools in Ibadan, Nigeria. Fifty children were randomly selected and assigned to one of three groups: music therapy, pictorial illustration, or control (N = 50, male = 25, female = 25, mean age = 11.6 years). Twenty-four sessions of music therapy and pictorial illustration classes were held with the experimental group only. The Moss Attention Rating Scale was used before and after the intervention to collect data on participants’ attention span. Analysis of Covariance indicated that there was a significant statistical difference between pre-test and post-test results of the two groups. The estimated marginal means of post-attention span by treatment indicated that pictorial illustration had the highest post-attention span score, followed by music therapy, while post-attention span score for the control group was the least. Based on the findings, it is recommended that teachers, caregivers, and parents of children with mild intellectual disability adopt pictorial illustration and music therapy as teaching strategies to enhance their attention span.

Neurophysiological Synchrony Between Children With Severe Physical Disabilities and Their Parents During Music Therapy

Although physiological synchronization has been associated with the level of empathy in emotionally meaningful relationships, little is known about the interbrain synchrony between non-speaking children with severe disabilities and their familial caregivers. In a repeated measures observational study, we ascertained the degree of interbrain synchrony during music therapy in 10 child-parent dyads, where the children were non-speaking and living with severe motor impairments. Interbrain synchrony was quantified via measurements of spectral coherence and Granger causality between child and parent electroencephalographic (EEG) signals collected during ten 15-min music therapy sessions per dyad, where parents were present as non-participating, covert observers. Using cluster-based permutation tests, we found significant child-parent interbrain synchrony, manifesting most prominently across dyads in frontal brain regions within β and low γ frequencies. Specifically, significant dyadic coherence was observed contra-laterally, between child frontal right and parental frontal left regions at β and lower γ bands in empathy-related brain areas. Furthermore, significant Granger influences were detected bidirectionally (from child to parent and vice versa) in the same frequency bands. In all dyads, significant increases in session-specific coherence and Granger influences were observed over the time course of a music therapy session. The observed interbrain synchrony suggests a cognitive-emotional coupling during music therapy between child and parent that is responsive to change. These findings encourage further study of the socio-empathic capacity and interpersonal relationships formed between caregivers and non-speaking children with severe physical impairments.

Neonatal Music Therapy and Cerebral Oxygenation in Extremely and Very Preterm Infants: a Pilot Study

Music therapy is a novel intervention that may minimize neonatal stress. The mechanism of action is still largely unknown. We hypothesized that one mechanism of action regards altered brain oxygenation (either due to altered cerebral perfusion or altered cerebral oxygen consumption). We measured cerebral oxygenation before, during and after music therapy sessions using Near-Infrared Spectroscopy (NIRS). We extracted data on cerebral oxygen saturation (rcSO2) and calculated cerebral fractional tissue oxygen extraction (cFTOE). In addition, we measured heart rate. We included 20 infants, receiving 44 music therapy sessions. Median gestational age was 27 weeks, the majority were males. We identified two distinct reactions: in one group rcSO2 increased and cFTOE decreased during therapy compared with before therapy, whereas in the other group rcSO2 decreased and cFTOE increased during therapy compared with before therapy. The first may indicate a sedative effect, whereas the second may reflect a hyperalert state. The observed changes in heart rate may contribute to these observations through altered cerebral perfusion. The clinical significance of these two distinct reactions for music processing and (future) neurological functioning in these infants warrants further investigation.

Music Therapy and Post-operative Pain Management: Improved Outcomes

To identify and build upon successful strategies for providing music therapy as a standardized, non-pharmacologic intervention for relief of postoperative pain in a pediatric tertiary medical center. This presentation will describe initial research completed with pediatric patients following scoliosis surgery and subsequent strategies currently underway to expand services to other pediatric patients undergoing painful surgeries. Video clips describing a music therapy session and case studies will be provided throughout the presentation.

Musical pathways to the peer community: A collective case study of refugee children’s use of music therapy

ABSTRACT Introduction The quality of refugee children’s social life in the host country is essential to their health and development. Both practice and research indicate the relevance of music therapy in this respect, but our understanding of how music therapy can contribute to refugee children’s social wellbeing is still limited. This article explores how participation in music therapy in a public primary school can nurture refugee children’s readiness to collaborate with peers. Method The study is situated within a hermeneutic research tradition and is designed as a single-site, collective case study consisting of four cases. Empirical material consists of logs and audio-recordings from music therapy sessions. Results Results are presented as four case narratives that describe processes related to collaboration with peers. Discussion Based on abductive analysis, this article discusses the practice of music therapy in terms of the processes of regulating, negotiating, and building a sharable repertoire. The article suggests that music therapy nurtures the child’s capacity to regulate emotions and engage in social participation: an ongoing negotiation of interpersonal relationships is combined with the cultivation of a shared repertoire that creates bridges to other practices and larger social configurations.

Music therapists’ empathic experiences of shared and differing orientations to religion and spirituality in the client-therapist relationship

This paper reports on the findings of a study with 14 music therapists, exploring how they experienced (a) the interface/overlap between their own religious and/or spiritual beliefs and those of their clients; (b) the navigation of this interface/overlap within music therapy practice; and (c) whether/how they used empathy when engaging in this navigation. Four main findings were identified through thematic analysis of in-depth interviews. Firstly, according to these music therapists, spirituality and/or religion frequently play an important role within music therapy sessions. Secondly, these music therapists described cognitive and affective empathic experiences with clients as well as experiences of spiritually resonant empathy and transpersonal empathy. Thirdly, they identified relationships between their own religious and spiritual journeys, their experiences of identifying and/or not identifying with their clients, and their experiences of empathy. Fourthly, the intersections between what they felt they “should” do as music therapists and what they felt they “should” do in light of their religious/spiritual orientations informed their styles of practice and elicited challenges in the therapeutic process which they used particular strategies to navigate.

Impact of Music Therapy on Preoperative Anxiety and Degree of Cooperation With Anesthesia Induction in Children With Simple Congenital Heart Disease

PurposeTo evaluate the impact of music therapy (MT) on preoperative anxiety and degree of cooperation with anesthesia induction in children with simple congenital heart disease (CHD). DesignA randomized controlled clinical study. MethodsNinety children were randomly assigned to the MT and control groups. The MT groups underwent a preoperative 30-minute session of MT, whereas the control group did not listen to any music and had the same amount of quiet time. The modified Yale Preoperative Anxiety Scale-Short Form (mYPAS-SF) was used to evaluate the patients' preoperative anxiety on entering the anesthesia waiting area (T1), 10 minutes after entering the waiting area (T2), and during the initiation of anesthesia induction (T3); the degree of cooperation with anesthesia induction was assessed using the Induction Compliance Checklist. The mean arterial blood pressure (MAP) and heart rate (HR) at T1, T2, T3, and T4 (the time of successful anesthesia) were also recorded. FindingsOne child was excluded from the MT group, and one was excluded from the control group. No difference was found in the mYPAS-SF score, MAP, or HR between the two groups at T1. The mYPAS-SF scores of the MT group were significantly lower than those of the control group at T2 and T3. At T2, T3, and T4, the MAP and HR of the MT group were lower than those of the control group. A statistically significant difference was found in the Induction Compliance Checklist score between the two groups. ConclusionsMT can reduce preoperative anxiety and improve the degree of cooperation with anesthesia induction.

Effectiveness of music therapy on reading skills of pupils with intellectual disability

Objective: Reading is an indispensable skill. The study investigated the effects of music therapy on the reading skills of pupils with intellectual disability. Methods: An experimental research design was used. The sample was purposively selected from two special schools for pupils with intellectual disability in Ibadan, Nigeria. Seventeen pupils were randomly assigned to two groups (music therapy and control groups). Eighteen sessions of music therapy were conducted with the experimental group only. The Reading Skills Test was used before and after the intervention to collect data. Analysis of Covariance (ANCOVA) was used for data analysis. Results: The data indicated that there was a significant statistical difference between pre-test and post-test results. The interaction effect of treatment and parents’ socio-economic status was not significant for the participants’ reading. Conclusion: Music therapy enhanced the reading skills of pupils with intellectual disability and should be adopted in teaching pupils with intellectual disability.
 
 Keywords: Music therapy; parents’ socio-economic status; pupils with intellectual disability; reading skills

Implementing music therapy in a Norwegian neonatal intensive care unit.

Neonatal intensive care unit (NICU) music therapy is an emerging discipline. There is a growing evidence base supporting its use, with an emphasis on the immediate and short-term positive effects on infants' physiological responses and parents' experiences. To explore the implementation of music therapy aligned with standards of neonatal care and as an integral part of the care routinely provided in a Norwegian NICU. Parents of infants hospitalised in the NICU were offered music therapy sessions based on the First Sounds: Rhythm, Breath and Lullaby model. Before discharge from the NICU, parents were asked to complete an electronic survey about their experiences of music therapy. Nurses' feedback and observations were also elicited and collected. A total of 16 parents completed the survey. Overall, their experiences of music therapy were positive, and they noted several benefits for themselves and their infant. In addition, nurses observed that parents' interactions with their infant increased after participation in music therapy. However, nurses reported it was challenging to invite parents to participate in music therapy at a time of uncertainty, anxiety and grief. Nurses also found it challenging to disseminate information about music therapy to parents from other cultures. Furthermore, it was identified that most parents learned about the music therapy sessions from the music therapist, rather than from NICU medical or nursing staff, which indicates that music therapy was not fully integrated among the unit's multidisciplinary team. Music therapy can reinforce family-centred care and promote parent-infant bonding, but additional efforts are required to integrate it into the care routinely provided by the NICU multidisciplinary team.

Music therapy was noninferior to verbal standard treatment of traumatized refugees in mental health care: Results from a randomized clinical trial

ABSTRACT Background: Many people with refugee backgrounds suffer from trauma-related complex social and psychological problems, and compliance with standard psychological treatment tends to be low. More culturally adaptable treatment options seem to be needed. Objective: We aimed to investigate whether the music therapy method: ‘trauma-focused music and imagery’ (tr-MI), characterized by a particular focus on arousal and affect regulation, would be equally effective as the standard psychological talk therapies for ameliorating trauma symptoms in Danish refugees. Methods: A pragmatic, noninferiority, parallel, randomized controlled trial with six-month follow-up was carried out at three clinics for refugees in the public mental health services of the Psychiatry (DK). Seventy-four adults diagnosed with posttraumatic stress disorder (PTSD) were allocated to either music therapy sessions (tr-MI, N = 39) or psychological treatment as usual (TAU, N = 35). Western classical music, new age music, and music from the participants’ own national culture were used to generate inner imagery, following a phased treatment protocol. Homework entailed listening to music. The primary outcome was the measurement of trauma symptoms by the Harvard Trauma Questionnaire, section IV (HTQ-IV); secondary measures were somatoform and psychoform dissociation (DSS-20), SDQ-20), attachment (RAAS), and well-being (WHO-5). Treatment effects reflected by primary and secondary measures were estimated using linear mixed models. Results: Tr-MI was noninferior to TAU (mean difference at follow-up HTQ-IV: 0.14, CI (−0.10; 0.38), with a − 0.3 noninferiority margin). A high dropout rate of 40% occurred in the TAU group, compared to 5% in the music therapy group. Secondary measures generated small to medium effect sizes in both groups, with significant medium effect sizes for well-being and psychoform dissociation at follow-up in tr-MI. Conclusions: Tr-MI is an innovative form of psychological treatment in refugee mental health services. Trials comparing music therapy to standardized therapy are needed to substantiate the evidence base for tr-MI therapy.

Implementing Telehealth Music Therapy Services in an Integrative Oncology Setting: A Case Series.

Providing music therapy in a medical setting has necessarily undergone major changes during the COVID-19 world pandemic. Many programs had to discontinue while others were able to transition to a telehealth model. This paper describes the process of conducting telehealth-based music therapy sessions within an integrative oncology setting in a large cancer hospital. Patients provide feedback regarding benefits and challenges of inpatient, outpatient, and group music therapy using a telehealth model. Benefits include anxiety reduction, increased coping skills, and increased social support. Unique challenges include technology limitations. We share examples of how we successfully adapted our workflows to provide telehealth-based music therapy in inpatient, outpatient, and group settings.

An evaluation of a developmental individual differences relationship-based (DIR®)- creative arts therapies program for children with autism

Both developmental, individual-differences, relationship-based (DIR®) and creative arts therapy (CAT) intervention methods have demonstrated positive effects for individuals with autism spectrum disorder (ASD); however, they have not been evaluated in combination. The study evaluated whether a DIR®-based CAT program met its stated goals to stimulate individualized social-emotional growth for children with ASD. A summative, longitudinal program evaluation research design was used to examine the program’s fidelity and outcomes. The evaluation included assessments for pre- and post-test quantitative standardized measures for data collection and analysis. The study also collected data from treatment logs to document the fidelity to the treatment model. The study was conducted in a non-profit, parent-founded private day school in a large city on the East Coast of the United States. Twenty one students (age 5–21 years old) participated in a comprehensive DIR®-based CAT program compromising weekly individual and group-based dance, music, and art therapy sessions across six months. The study found moderate evidence supporting the proposition that children who participated in a DIR®-based creative arts therapy program experienced increased and improved social/emotional skills. Implications of this program evaluation for future research and therapeutic service for individuals with ASD will be discussed.

Music Therapy Interventions for Stress Reduction in Adults With Mild Intellectual Disabilities: Perspectives From Clinical Practice.

Stress is increasingly being recognized as one of the main factors that is negatively affecting our health, and therefore there is a need to regulate daily stress and prevent long-term stress. This need seems particularly important for adults with mild intellectual disabilities (MID) who have been shown to have more difficulties coping with stress than adults without intellectual disabilities. Hence, the development of music therapy interventions for stress reduction, particularly within populations where needs may be greater, is becoming increasingly important. In order to gain more insight into the practice-based knowledge on how music therapists lower stress levels of their patients with MID during music therapy sessions, we conducted focus group interviews with music therapists working with adults with MID (N = 13) from different countries and clinical institutions in Europe. Results provide an overview of the most-used interventions for stress reduction within and outside of music. Data-analysis resulted in the further specification of therapeutic goals, intervention techniques, the use of musical instruments, and related therapeutic change factors. The main findings indicate that music therapists used little to no receptive (e.g., music listening) interventions for stress reduction, but preferred to use active interventions, which were mainly based on musical improvisation. Results show that three therapy goals for stress relief could be distinguished. The goal of “synchronizing” can be seen as a sub goal because it often precedes working on the other two goals of “tension release” or “direct relaxation,” which can also be seen as two ways of reaching stress reduction in adults with MID through music therapy interventions. Furthermore, the tempo and the dynamics of the music are considered as the most important musical components to reduce stress in adults with MID. Practical implications for stress-reducing music therapy interventions for adults with MID are discussed as well as recommendations for future research.

Effect of music therapy on nursing students' first objective structured clinical exams, anxiety levels and vital signs: A randomized controlled study

BackgroundMusic is a tool that can be used to reduce stress and anxiety, maintain vital signs at normal levels, and increase exam success. ObjectivesThis study aimed to determine the effect of music therapy on nursing students' first objective structured clinical exam success, anxiety levels, and vital signs, and to reveal their views about music therapy in the context of an exam. DesignMixed-pattern single-blind randomized controlled qualitative study. SettingDepartment of Nursing, Faculty of Health Sciences, Ankara, Turkey. ParticipantsFirst-year students enrolled in the Fundamentals of Nursing II course were randomly assigned to an experimental (n = 61) or control group (n = 64). Twenty-two (22) experimental group students provided the sample for the qualitative stage. MethodsData were collected between February and June 2018 using the Informative Features Form, State-trait Anxiety Inventory, Vital Signs Assessment Form, Skill Checklists, and Focus-group Interview Form. All students completed the theoretical classes, laboratory classes, and small-group studies. The experimental group participated in five music therapy sessions two weeks before the exam. All students' vital signs were measured before and after the exam. Three focus group interviews were conducted with the 22 experimental group students in the week after the exam. ResultsThe blood pressure values of the experimental group before and after the exam were significantly lower than those of the control group (p < 0.05). No significant difference was observed between exam success and anxiety levels between the two groups. In the focus group interviews, students said they found music therapy suitable for reducing anxiety in their daily lives, but not before the exam. ConclusionsMusic therapy had positive effects on the students' blood pressure but had no effect on exam success or anxiety levels. This study suggests that more music therapy sessions be conducted with different groups of students in greater numbers before different exams.

Logotherapy, existential analysis, music therapy: Theory and practice of meaning-oriented music therapy

Meaning is a distinct resource and indicator of human health and well-being. Meaning in life and the search for it predict subjective well-being. In logotherapy and existential analysis, the human will to meaning is considered the prime motivation in human life. Founded by Viktor Emil Frankl, this meaning-centered approach in psychotherapy is often called the Third Viennese School of Psychotherapy. Although there is evidence that meaning can be actualized through music, music therapy has hitherto hardly focused on the concepts and theory of logotherapy and existential analysis. This contribution closes this gap by introducing a meaning-oriented approach to music therapy and an adaption of Frankl’s model of meaning fulfillment to music therapy. A case example demonstrates the practical application in the clinical context of palliative care. Meaning-oriented music therapy is not a separate form of music therapy, but complements existing concepts and theories in modern music therapy. It is indicated when meaning-related topics take center stage in music-therapy sessions.

Music therapist collaboration with teaching assistants for facilitating verbal and vocal development in young children with special needs: A mixed methods study

Music Therapists increasingly work collaboratively alongside other professionals and families. This article presents research into transdisciplinary work with teaching assistants in a school. A mixed methods investigation was carried out to evaluate the development of verbal and vocal skills in young children who received both individual music therapy and additional music sessions carried out by teaching assistants. Qualitative data were gathered to support quantitative video analysis results. The Music Therapist organised music sessions for the teaching assistants to carry out independently, to assess whether this enhanced the children’s verbal development. Statistical analysis of vocal scores from video material utilising bootstrapping techniques indicated that there was a statistically significant difference pre- and post-intervention for the children who had additional teaching assistant music sessions. This indicated that the collaborative approach was effective in enhancing verbal skills. The qualitative evidence also supported this theory. Due to the small number of participants, these results cannot be generalised to other situations and larger scale research could be carried out to demonstrate conclusive results. This study shows that Music Therapists and teaching assistants in schools can work collaboratively and this may potentially enhance the progress children make, with reinforcement of verbal development strategies in the class context.

Music Therapy Programming for Persons With Eating Disorders

Eating disorders are serious disturbances in eating habits, body image attitudes, and weight that affect overall well-being and can have life-threatening consequences. Participation in music therapy sessions may allow for healing of anxiety, self-worth, and body-image challenges that each person may face. In this manuscript we examined the music therapy literature pertaining to clinical work with persons who have eating disorders. We describe six techniques (clinical improvisation, song autobiography, song discussion, songwriting, music assisted relaxation/imagery, and Bonny Method of Guided Imagery and Music) and their reported uses in the literature. While the evidence supports that these techniques are effective, we acknowledge that what works in one context may not be culturally relevant or effective in another. The overview of the evidence in the literature corroborates how therapists who work with persons who have eating disorders tend to use music therapy techniques as pathways for contributing to sense of self. For each technique, we provide clinical examples with a strong element of the need to redevelop or discover identity.

Music therapy for people with substance use disorders

Objectives This is a protocol for a Cochrane Review (intervention). The objectives are as follows: Main objective To compare the eGect of music therapy (MT) in addition to standard care versus standard care alone, or to standard care plus an active control intervention, on psychological symptoms, substance craving, motivation for treatment, and motivation to stay clean/sober. Secondary objective To assess the impact of the number of MT sessions on study outcomes.