Therapy In Mental Health Care Research Articles

Psychiatrists’ Insights on Integrating Occupational Therapy in Mental Health Care: A Multisite Middle Eastern Study

Psychiatrists’ Insights on Integrating Occupational Therapy in Mental Health Care: A Multisite Middle Eastern Study

Dog-Assisted Therapy in Mental Health Care: A Qualitative Study on the Experiences of Patients with Intellectual Disabilities.

(1) Background: Dog-assisted therapy (DAT) is an experiential intervention to promote psychological, physical, and social functioning in children and adults. Only few studies have been conducted on DAT in adults with a mild intellectual disability or borderline intellectual functioning (MID-BIF). The purpose of this study was to explore the experiences of patients with MID-BIF undergoing DAT in a mental health care facility. (2) Method: Seven patients completed 13 to 15 sessions of DAT. Within two weeks of completing the program, they were interviewed using a semi-structured interview. The transcripts of the interviews were analysed using interpretational phenomenological analysis. In addition, the patients' relatives and the DAT therapist were interviewed, and a focus group discussion took place with each patient's treatment team. (3) Results: The patients' experiences were predominantly positive. Physical contact with the dog calmed them down. The dog offered them emotional support and helped them to make contact inside and outside the therapy and the setting where they lived. The patients also liked the fact that DAT focused on the dog rather than their problems, that the therapy was experiential and using a positive approach, and that, during the therapy, they did not feel like a patient but a human being. DAT is a promising therapy for patients with MID-BIF in mental health care facilities, but more research into its effectiveness and cost-effectiveness and ways to implement DAT in clinical practice is needed to make more definitive statements.

Moments of fun: Narratives of children’s experiences of music therapy in mental health care

ABSTRACT Introduction Mental health issues in children involve complexities and life challenges for the child and their families. Music therapy as part of treatment in mental health care focuses on interaction and communication through music, with emphasis on the children’s resources. There is a small, but growing amount of research in the field of music therapy with children in mental health care. Method This qualitative study explored children’s own experiences of music therapy in mental health care at the hospital. This was done through a multiple case study design, including semi-structured interviews with seven children and participant observations. A narrative approach informed by “portraiture” was used in the analysis process in order to highlight non-dominant experiences and allow for multiple modalities in the analysis and in the presentation of findings. Findings The children’s experiences were expressed through various modalities. These were displayed through narratives representing the core of the interview with each particular child. The word fun became a prominent emerging theme across the cases. Discussion In the children’s expressions, the word fun seemed to be a container of experiences, with rich variations and multiple meanings. Through a thorough attention to this word and the children’s actions before, after and while they spoke, multidimensional meanings of the word emerged. Through listening to the children’s own experiences, fun proved to be an essential part of music therapy in mental health care with children, not as mere entertainment, but as something of existential importance and with great therapeutic potentials.

The role of music therapy in Australian mental health services and the need for increased access to service users.

This opinion paper aims to provide an overview of the current evidence base supporting the use of music therapy in mental health care. It also aims to offer critique on the issue of access to music therapy in Australia. There is a strong evidence base for music therapy to provide symptomatic relief and improve quality of life for people living with mental illness. However, music therapy is underfunded and framed as a supplementary service within mental health services in Australia, which limits its access to consumers. Funding music therapy as an evidence-based treatment option would fill an existing service gap and provide equitable access to a cost-effective and often consumer preferred treatment option for mental health consumers.

A terapia comunitária integrativa no cuidado em saúde mental: revisão integrativa

Objetivo: Investigar a produção científica acerca do uso da terapia comunitária integrativa no cuidado em saúde mental. Métodos: Trata-se de uma revisão integrativa da literatura científica realizada em novembro de 2019, com as publicações dos últimos 13 anos, nas bases: Base de Dados de Enfermagem, Literatura Latino-Americana e do Caribe em Ciências da Saúde, Medical Literature Analysis and Retrieval System Online e Scientific Eletronic Library Online. Resultados: Foram encontrados 9.382 artigos, sendo 17 inclusos neste estudo. As principais demandas acolhidas nas rodas de terapia comunitária integrativa estiveram relacionadas com os conflitos familiares, os sentimentos negativos, as perdas, os problemas de saúde e a violência. Com relação às contribuições, participar das rodas proporcionou aos usuários autonomia, aceitação, empoderamento, resiliência e o autocuidado. Conclusão: As evidências apontaram que a terapia comunitária integrativa foi utilizada como estratégia de cuidado das demandas em saúde mental em diversos cenários, destacando-a como uma tecnologia leve, a ser aplicada coletivamente na comunidade.

Investigating the provision of occupational therapy services: A case study.

The World Health Organization has identified occupational therapists as integral human resources on health care teams, yet in many contexts, occupational therapy services are not adequately provided. One example is occupational therapy in mental health care in Saskatchewan. This study aimed to uncover what is known about the case of occupational therapy in the context of mental health services in Saskatchewan. An instrumental case study design was employed, applying a critical interpretive approach and thematic analysis to examine 40 publicly available documents. Three main themes (with subthemes) were identified: access (representation, funding, rural communities), awareness (comprehension, value, collaboration), and advocacy (leadership, education). This study illuminates how restricted access to, limited awareness of, and ineffective advocacy for occupational therapy impacts mental health services in Saskatchewan and provides a replicable process for other contexts where occupational therapy is underrepresented.

Music therapy’s development in mental healthcare: An historical consideration of early ideas and intersecting agents.

Considering the history and development of music therapy in mental health is important in providing practitioners of the field with an understanding of the context in which the profession has emerged. The shaping of the discipline towards professionalization has involved multiple intersecting agents, ideas and processes over many years. This paper reviews some of the milestones and significant junctures that framed the practice of music therapy in mental health care whilst noting how some of these ingredients have been amplified or diminished over time. The author observes the numerous references to the ‘soul’ and ‘spirit’ along this trajectory and asks if such narratives are being lost in descriptions of contemporary music therapy practice in mental health.

Music Therapy in Mental Health: Practice, Theory, Research, and Professional Perspectives

I am honored to have the opportunity to present this volume of Music Therapy Perspectives with a special focus on music therapy in mental health care. In envisioning such a volume, the possibilities appear endless; however, the focus of this volume offers a microcosmic but expansive view encompassing four areas: professional perspectives, practices, the voices of service users, and research.Mental Health Practice Today: Opposing IdeologiesWithin an expansive view of the field of mental health in 2015, the tension of polarities is a theme that is often encountered. Mental health care in the United States has been strongly impacted by divergent, sometimes conflicting, ideologies that have affected the nation socially, culturally, and politically. This is evident in healthcare overall, but particularly in mental health care, where the effects are evident on a structural level, with respect to reduced access to affordable mental health care (National Alliance on Mental Illness ([NAMI], 2015); in research, where pharmaceutical companies have significantly reduced funding investments for mental health disorders while increasing funding in other health areas (Hyman, 2013); and with regard to paradigms- namely, the empirical medical model versus the humanistic approach (Kogstad, Ekeland, & Hummelvoll, 2011).A discussion of how ideologies have affected both the provision of care and investment in pharmaceutical research is beyond the scope of this introduction, though they are important topics and may be of great interest to music therapists. While these factors have a strong impact on our work, we are at the same time intimately engaged with the daily struggles and victories of persons with mental health disorders, and our published works reveal how we have become adept at treating clients effectively within these challenging, and sometimes oppositional, approaches.The Recovery Model in Mental Health Practice and ResearchRegardless of the paradigms we prefer to use to guide our work, or the tensions that may exist between our personal proclivities and those of the institutions in which we work, the same concerns underlie our collective practice and research. The concern we share is how we can most effectively use the various facets of music experiences and the relationships we establish through them (Bruscia, 2014) to help our clients improve their quality of life, develop their potential, and value their unique personhood in spite of the stigma that is part of the texture of their daily lives (Link, Struening, Neese-Todd, Asmussen, & Phelan, 2014).Some research has been conducted from the stance of the recovery model approach, which appropriately locates expert knowledge with the persons who are recipients of these services. This research has provided some insight into the needs of persons with mental health challenges from their perspective. Kogstad et al. (2011) conducted a qualitative study on the narratives of recovery of persons with mental health problems and discovered that the service users challenged fundamental beliefs about what constitute effective and necessary treatment (p. 479). The authors also noted that Strauss (2005, as cited in Kogstad et al., 2011) questioned why there was a resistance in the field of psychiatry to include research that focused on recovery and that favored the service users' views. The authors theorized that reductionist and symptomoriented views of mental disorders privileged by the medical profession are challenged by orientations that emphasize working toward the resolution of existential dilemmas, which are essential daily considerations for persons with mental health concerns.In the recovery approach, humanistic or client-centered and existential models are well suited to address the resolution of existential dilemmas, as are the more recent methods and techniques that have evolved from these approaches, such as motivational therapy (Miller & Rollnick, 2009). …

On the Neural Mechanisms of Music Therapy in Mental Health Care: Literature Review and Clinical Implications

IntroductionHow can music therapy contribute to emotional health from a neurobiological perspective? Music's role in mediating emotions has been investigated for decades by researchers in psychology, neuroscience, and music therapy, among other disciplines. However, many questions remain largely unanswered-particularly those related to the potential of music to promote healthy emotion regulation. This is especially relevant to music therapists in mental health settings.Psychology researchers have already provided models to help understand the connection between music and emotions. Juslin and Vastfjall (2008) describe seven ways in which musical stimuli can induce emotions. First, musical elements can trigger brainstem reflexes related to survival mechanisms. For instance, a fast tempo or a surprisingly loud sound might cause arousal. Second, music that is repeatedly paired with positive or negative stimuli can be classically conditioned to induce emotions. Third, features of music that mimic other emotional contexts can lead to a contagious effect; consider the slow, soft voice of a violin and emotions linked to slow, soft speech. Fourth, music can lead to new mental imagery. Fifth, music can also conjure episodic memories, or old mental imagery. Sixth, features of musical syntax can mediate emotions through musical expectancy, such as a chord progression without harmonic resolution. Finally, the presence of music can directly affect personal/therapeutic goals of any listener, such as the sound of sedative music helping someone fall asleep.Juslin and Vastfjall's (2008) model provides a psychological foundation for music-induced emotions. However, it does not account for emotional processes that uniquely affect active music-making or the interpersonal emotional possibilities of group/dyad music therapy. Nor does it explain (or attempt to explain) the connections between music-induced emotions and non-musical components of therapeutic practice, such as verbal processing and the client-therapist relationship.Similarly, the neurobiology literature is primarily focused on emotional mechanisms during music listening, although some investigators have also explored active music-making. Chanda and Levitin (2013) summarize evidence that demonstrates how music can influence neurochemistry in four ways. First, music listening has been shown to affect neurotransmission in the brain's reward pathways. Second, music can influence hormonal levels via the hypothalamic-pituitary axis. Listening to relaxing music, for instance, has been shown to decrease blood levels of cortisol-a marker for stress. There is also evidence for decreased cortisol following music therapy interventions, such as Guided Imagery and Music (Burns, 1999; McKinney, Antoni, Kumar, Tims, & McCabe, 1997). Third, Chanda and Levitin cite drum circle studies that have shown increased immunological measures among participants-such as increased natural killer T-cells and 5-DHA-to-cortisol ratio (Bittman et al., 2001). Fourth and finally, the authors describe evidence of music's impact on hormones related to social affiliation (to be addressed further herein). Although their literature review does not focus specifically on music-induced emotions or mental health treatment settings, the biological mechanisms they discuss have applications in both of these realms.Within the body of music therapy literature, researchers have repeatedly demonstrated that music-based interventions can affect emotional patterns in individuals receiving mental health treatment (Bensimon, Amir, & Wolf, 2008; Bloch, Reshef, Vadas, Haliba, & Ziv, 2010; Carr et al., 2012; Cevasco, Kennedy, & Generally, 2005; Hammer, 1996; Kerr, Walsh, & Marshall, 2001). But what mechanisms of music-induced emotions are most responsible for the efficacy of music therapy interventions? How do these mechanisms differ between different music therapy interventions? And how can the neurobiological effects of music influence the client-therapist relationship? …

What clients do to make music therapy work: A qualitative multiple case study in adult mental health care

The importance of clients’ agency and involvement in therapy has been emphasized in music therapy as well as in the broader interdisciplinary field of mental health and psychotherapy. Although the quickly growing discourse and research base of music therapy in mental health care increasingly include user perspectives, most of the existing research and literature focus on the therapists’ interventions. This article reports a qualitative multiple case study of clients’ contributions within therapeutic collaborations in the field of adult mental health care. Data were collected through semi-structured interviews with clients and therapists including an adapted procedure of interpersonal process recall (IPR). Through a thematic analysis four main categories of clients’ agency in the therapeutic process were identified taking initiatives, exerting control in sessions, commitment to the relationship and engagement across contexts. The findings documented clients’ actions as well as their intentions and reflexivity regarding such actions.

“The Opposite of Treatment”: A qualitative study of how patients diagnosed with psychosis experience music therapy

Previous research studies regarding music therapy and severe mental illness have mainly adopted quantitative methodologies in order to study the effectiveness of music therapy interventions. Studies that have explored service users’ experiences of participation in music therapy are small in number, and almost nonexistent in the field of psychosis. This study aimed to explore how mental health patients with a diagnosis of psychosis experienced participation in music therapy, in general, and more specifically how they experienced music therapy in relation to their current mental state and life situation. Nine inpatients with psychosis were interviewed using a semi-structured interview focusing on the participants’ experiences of music therapy in individual sessions, groups, and performances. Through the use of interpretative phenomenological analysis, four super-ordinate themes central to the participants’ experiences were found: freedom, contact, well-being, and symptom reduction. Based on the findings, mental health recovery, positive mental health, and agency are proposed as constituting a better framework for music therapy in mental healthcare than a primary focus on symptom remission and functional improvement.

Toward Understanding Music Therapy as a Recovery-Oriented Practice within Mental Health Care: A Meta-Synthesis of Service Users' Experiences.

The perspective of mental health recovery is increasingly shaping mental health care policies. Current texts in music therapy identify the importance of this critical and user-oriented perspective, but the relevance and implications for music therapy need to be outlined. This study explores service users' experiences of music therapy in mental health care, and the potential role of music therapy in the development of recovery-oriented service provision. We conducted a qualitative meta-synthesis of studies examining service users' experiences in music therapy; included were 14 studies with a total of 113 participants. Both first-hand account of participants and the researchers' representations of such statements were taken into account in the analysis. A taxonomy of four areas of users' experiences was identified: "having a good time;" "being together;" "feeling;" and "being someone." These core categories point towards music therapy as an arena that can be used by persons with mental health problems in their personal and social recovery process. Music therapy can contribute to the quality of mental health care by providing an arena for stimulation and development of strengths and resources that may contribute to growth of positive identity and hope for people with mental illness. The findings from this meta-synthesis indicate that the provision of music therapy closely resembles recognized benefits of a recovery-oriented practice. Awareness of users' self-determination and the development of a strength-based and contextual approach to music therapy that fosters mutual empowering relationships are recommended.

Muslim Middle Eastern clients' reflections on their relationship with their occupational therapists in mental health care

Persons with a Middle Eastern background represent a minority in Sweden which has significantly increased in size over recent years. The purpose of the present study was to explore the elements that shape the experiences and perceptions of clients with a Middle Eastern background living by Muslim norms who received occupational therapy in mental health care at the time of participating in the study. The study included interviews with 11 clients who received occupational therapy in mental health care. Data collection and analysis were carried out in accordance with the grounded theory approach. One core category, desiring a union, described the clients' desire for an alliance with the therapists that encompassed the realities and truths embedded in their values, preferences, world-views, and belief systems, as well as a wish to reconstruct their abilities to function and perform daily life tasks within their cultural contexts. The core category included sub-categories: desiring relationship, desiring affiliation, and desiring affirmation as well as some related components. The overall findings showed a tentative model in which the notion of mahram affinity was embedded. The results demonstrated that the clients' views regarding desiring a union had their support in collectivistic world-views that often clash with those of the therapists.

Is there a role for music therapy in the recovery approach in mental health?

The recovery approach in mental health care emphasises the importance of the service user leading a fulfilling, meaningful life beyond the limitations of illness or symptomatology. This approach to care is increasingly included as a central part of mental health policy and service provision in a number of countries including the UK and Ireland, to address the needs of people who have severe and enduring mental disorders. It is an autonomous, holistic and empowering way of working with individuals as they journey towards healing. Fundamental to this model is the relationship fostered between service users and health professionals. The recovery philosophy of care mirrors some of the core principles of music therapy, including the importance of the therapeutic relationship and the possibilities for change and growth within this. This paper explores the congruence between music therapy and the recovery approach by providing: (1) An overview of current published evidence for music therapy in mental health care. (2) A discussion of this psycho-social creative arts therapy intervention within the specialized area of recovery in psychiatry, and (3) case vignettes to illustrate the application of this philosophy in music therapy work within a recovery service.

Future of Mental Health Occupational Therapy: Student Perspective and Concerns

Occupational therapy has been gradually slipping away from its foundation in mental health practice. In order to provide the best services to individuals with mental health disorders, the occupational therapy profession must maintain and expand its involvement in this area of practice. The purpose of this paper is to explore the threats and opportunities to promote education and practice in mental health from a student perspective. The authors reviewed the literature, distributed questionnaires, and conducted focus groups with occupational therapy students at a southeastern university. Based on findings in the literature and of the focus groups with students, the authors have drawn a list of suggestions to improve the visibility of occupational therapy in mental health care. These suggestions are for occupational therapy educational programs, mental health practitioners, AOTA, and state associations.

Future of Mental Health Occupational Therapy: Student Perspective and Concerns

Occupational therapy has been gradually slipping away from its foundation in mental health practice. In order to provide the best services to individuals with mental health disorders, the occupational therapy profession must maintain and expand its involvement in this area of practice. The purpose of this paper is to explore the threats and opportunities to promote education and practice in mental health from a student perspective. The authors reviewed the literature, distributed questionnaires, and conducted focus groups with occupational therapy students at a southeastern university. Based on findings in the literature and of the focus groups with students, the authors have drawn a list of suggestions to improve the visibility of occupational therapy in mental health care. These suggestions are for occupational therapy educational programs, mental health practitioners, AOTA, and state associations.

Cognitive Behavioural Therapy in Mental Health Care

Cognitive Behavioural Therapy in Mental Health Care