Considering the ways in which anti-oppressive practice principles can inform health research

‘Autism is a way of being’: An ‘insider perspective’ on neurodiversity, music therapy and social justice

Neurodiversity (the idea that autism is a natural part of human diversity) is a concept that is only just beginning to be explored in music therapy research. The idea of neurodiversity can be viewed as an important part of the emerging discourse around diversity and social justice in British music therapy, with a potentially radical influence on both music therapy practice and the way in which autistic clients and colleagues are viewed. This article, written from the ‘insider perspective’ of an autistic Music Therapist, explores the origins of the concept of neurodiversity, the emerging strand of music therapy research concerning neurodiversity, the re-framing of autistic characteristics such as stimming within the concept of autistic culture, and the potential influence on music therapy practice and discourse of a wider paradigm shift towards the neurodiversity paradigm. These topics are considered within a social justice context, situating autistic / neurodivergent people as a minoritized identity within society and examining the potential influence of power dynamics, unconscious bias and privilege within the therapeutic relationship. The characteristics of a neurodiversity-affirmative style of music therapy are considered, and a need is identified for more music therapy research in order to elucidate this way of working.

Anti-oppressive pedagogy as an opportunity for consciousness raising in the music therapy profession: A critical disability studies perspective

In pedagogic literature informed by critical disability studies, academia is widely cited as an ableist institution: the training ground for the professions of normalcy. Music therapy could readily be complicit in this normalising discourse with its potential to pathologise participants and to maintain a strict ‘normative divide’, between professionals it trains and participants who engage with its provision. Activists, advocates and disabled therapists have posed a welcome challenge to this positioning in recent publications, but the pedagogical dimensions of music therapy training in this area have received less attention. The emerging signature pedagogy of music therapy and its omissions will be considered, which may explain the need for an increased social justice focus in music therapy curricula. This article considers the potential of applying Kumashiro’s typologies of anti-oppressive education in music therapy training: problematising existing pedagogies and critically reflecting upon the potential of a social justice informed curriculum. These approaches have the potential to reframe Otherness by acknowledging expertise in lived experience. Through introducing these frameworks for socially just, anti-oppressive pedagogies, this article invites consciousness raising in music therapy pedagogy through engagement with critical disability studies theory and philosophy.

Key recommendations for developing a national action plan to advance the sexual and reproductive health and rights of women living with HIV in Canada

Action on the World Health Organization Consolidated guideline on sexual and reproductive health and rights of women living with HIV requires evidence-based, equity-oriented, and regionally specific strategies centred on priorities of women living with HIV. Through community–academic partnership, we identified recommendations for developing a national action plan focused on enabling environments that shape sexual and reproductive health and rights by, with, and for women living with HIV in Canada. Between 2017 and 2019, leading Canadian women’s HIV community, research, and clinical organizations partnered with the World Health Organization to convene a webinar series to describe the World Health Organization Consolidated guideline, define sexual and reproductive health and rights priorities in Canada, disseminate Canadian research and best practices in sexual and reproductive health and rights, and demonstrate the importance of community–academic partnerships and meaningful engagement of women living with HIV. Four webinar topics were pursued: (1) Trauma and Violence-Aware Care/Practice; (2) Supporting Safer HIV Disclosure; (3) Reproductive Health, Rights, and Justice; and (4) Resilience, Self-efficacy, and Peer Support. Subsequent in-person (2018) and online (2018–2021) consultation with > 130 key stakeholders further clarified priorities. Consultations yielded five cross-cutting key recommendations:

1. Meaningfully engage women living with HIV across research, policy, and practice aimed at advancing sexual and reproductive health and rights by, with, and for all women.

2. Centre Indigenous women’s priorities, voices, and perspectives.

3. Use language that is actively de-stigmatizing, inclusive, and reflective of women’s strengths and experiences.

4. Strengthen Knowledge Translation efforts to support access to and uptake of contemporary sexual and reproductive health and rights information for all stakeholders.

5. Catalyse reciprocal relationships between evidence and action such that action is guided by research evidence, and research is guided by what is needed for effective action.

Topic-specific sexual and reproductive health and rights recommendations were also identified. Guided by community engagement, recommendations for a national action plan on sexual and reproductive health and rights encourage Canada to enact global leadership by creating enabling environments for the health and healthcare of women living with HIV. Implementation is being pursued through consultations with provincial and national government representatives and policy-makers.

Music, Rhythm and Trauma: A Critical Interpretive Synthesis of Research Literature

Recent theorizing about the connection between the brain and trauma (Perry, 2009; Porges, 2011; van der Kolk, 2015) has led to a burgeoning of interest in the provision of music-based programs with people who have had adverse experiences. Although there has been critique of the lack of scientific basis of these theories and their implications for practice (McLean, 2016), they remain popular with practitioners who are keen to introduce innovative and potentially beneficial approaches to the people with whom they work. Music therapists have a long tradition of working with traumatized clients, however, the brain-based rationales did not seem congruent with the less predictable and more idiosyncratic benefits reported, which seem to occur through more psychodynamic mechanisms of action. In order to unravel what seemed to be a body of literature plagued by the conflation of theories, we undertook a critical interpretive synthesis of literature in the past 10 years to cross-examine the ways that music and trauma have been connected. To do this we extracted data from 36 identified articles to distinguish what music methods were used, what claims were made about benefits, what theoretical justifications were provided and how much research basis there was for the claims being made. Having systematically disentangled the various dimensions, we then constructed a spectrum of approaches that offers a logical categorization of four different ways of using music with people who have had adverse life experiences. These included using music for stabilizing, entrainment, expressive and performative purposes. Specific music-based methods were proposed for those associated with brain-based rationales, and more responsive, multi-method approaches were congruent with recovery and social change models. Future research would benefit from a more clearly articulated connection between theoretical rationale, music-based methods, benefits and research approaches. The resultant spectrum may provide useful guidance for both practice and research design.

Integrating Emotions Into the Critical Interpretive Synthesis

Critical interpretive synthesis is a particular form of systematic review that critically examines the decisions made by authors while conducting and publishing about their research and practices. It differs from empirical syntheses of qualitative research by emphasizing the interpreted and constructed nature of this form of secondary analysis. In this article, we extend previous literature on critical interpretive syntheses by highlighting the integration of emotional responses when developing critical questions for interrogating the literature and interpreting results. Our extension of the critical interpretive synthesis is illustrated through examples from five studies examining literature in our own field of music therapy, as well as related fields of disability studies, mental health, music psychology, and child welfare. The methodology we have refined uses an iterative and recursive method that promotes increased critical awareness of the assumptions driving the production of research in health contexts.