Reparative musicing: thinking on the usefulness of social capital theory within music therapy

Exploring Wellbeing and Creativity Through Collaborative Composition as Part of Hull 2017 City of Culture

Several studies have highlighted the positive effects of group music-making and have suggested that it may be the creative and social aspects of such activities, which have a positive effect on participants’ wellbeing. Collaborative composition offers strong examples of both aspects as participants work together to create new material. However, although it seems likely that participants’ influence over and ownership of the creative material contributes to these positive effects, studies have yet to examine these elements in detail. Through analysis of video observations, pre- and post-project interviews, video recall interviews, and questionnaires, this article aims to: (1) evaluate the impact of participation in collaborative composition workshops on the subjective and psychological wellbeing of older adults and (2) identify skills and approaches employed by the composer-facilitators in order to understand more fully the approach and skills employed to engage participants effectively in the creative process. This second aim is of particular interest given the current movement toward social prescribing and arts and health interventions in the UK. Analysis revealed that all dimensions of the PERMA framework for subjective and psychological wellbeing were present in this collaborative composition project. The specific nature of collaborative composition is considered in comparison with other forms of group musical engagement. For older adults, collaborative composition has much to offer as an activity encouraging social interaction with others with shared interests, increasing positive affect, and enhancing self-esteem. Analysis of workshop videos and interviews with composers identified various facilitation skills employed by the composers to establish safe creative space and to encourage participants to engage in the process of collaborative composition.

“A great moment . . . because of the music”: An exploratory study on music therapy and early interaction with children with visual impairment and their sighted caregivers

The focus of this article is on how musical interaction can contribute to bonding and early interaction. This article is based on a music therapy project in a pedagogical institution for people with visual impairment. The study is qualitative and exploratory, where children with visual impairments (aged 1–4 years) and their caregivers participated in music therapy sessions over 10 weeks. Data have been collected by participant observation, video recordings, and interviews. Moments of positive interactions in music were selected and analyzed, and the selections were triangulated by interviews with the caregivers. The data material indicates that music therapy promotes positive bonding patterns and enhances early interaction. Musical interaction facilitates elements of early interaction that can be challenging for children with visual impairments and their sighted caregivers. Both caregivers and children seemed to experience one another as a source of joyful interaction. This article discusses the findings in the broader perspective of disability studies and community music therapy and argues that music therapy promotes positive interactions and empowerment of children with visual impairment and their caregivers.

Concepts of context in music therapy

In contemporary music therapy as well as in related interdisciplinary fields, the importance of context in relation to theory, research, and practice has been emphasized. However, the word context seems to be used in several different ways and conceptualizations of contextual approaches vary too. The objective of this theoretical article is to clarify traditions of language use in relation to context in music therapy. In reviewing and discussing the literature, we focus on the field of mental health care. When discussing issues related to context, this literature partly focuses on the surroundings of music therapy practice, partly on the ecology of reciprocal influences within and between situations or systems. On this basis, three types of context awareness in music therapy are identified: music therapy in context; music therapy as context; and music therapy as interacting contexts. The identified types of context awareness are exemplified through references to music therapy literature and then discussed in relation to two very different metaphors, namely context as frame and context as link. Implications for practice, research, and theory development in music therapy are suggested.

MTUK: Collaboration for the Future

MTUK (Music Therapy United Kingdom) – a perspective. This article was first presented as a keynote speech at the inaugural conferences of the British Association of Music Therapy in February 2014. It presents ideas about historical divisions and different approaches, and how these might be broached and mended, informed by the author's own experience of practising and being supervised within different approaches. The paper traces some of the history of MTUK and suggests possible future developments.

Music therapy for prisoners: pilot randomised controlled trial and implications for evaluating psychosocial interventions

Mental health problems are common among prison inmates. Music therapy has been shown to reduce mental health problems. It may also be beneficial in the rehabilitation of prisoners, but rigorous outcome research is lacking. We compared group music therapy with standard care for prisoners in a pilot randomised controlled trial that started with the establishment of music therapy services in a prison near Bergen in 2008. In all, 113 prisoners agreed to participate. Anxiety (STAI-State [State-Trait Anxiety Inventory], STAI-Trait), depression (HADS-D [Hospital Anxiety and Depression Scale]), and social relationships (Quality of Life Enjoyment and Satisfaction Questionnaire [Q-LES-Q]) were assessed at baseline; every 2 weeks in the experimental group; after 1, 3, and 6 months in the control group; and at release. No restrictions were placed on the frequency, duration, or contents of music therapy. Duration of stay in the institution was short (62% stayed less than 1 month). Only a minority reached clinical cutoffs for anxiety and depression at baseline. Between-group analyses of effects were not possible. Music therapy was well accepted and attractive among the prisoners. Post hoc analysis of within-group changes suggested a reduction of state anxiety after 2 weeks of music therapy (d = 0.33, p = .025). Short sentences and low baseline levels of psychological disturbance impeded the examination of effects in this study. Recommendations for planning future studies are given, concerning the careful choice of participants, interventions and settings, comparison condition and design aspects, choice of outcomes, and integration of research approaches. Thus, the present study has important implications for future studies evaluating interventions for improving prisoners' mental health.

TRIAL REGISTRATION

ISRCTN22518605.

Battling illness with wellness: a qualitative case study of a young rapper's experiences with music therapy

Mental health difficulties are connected with major interpersonal and social challenges. Recent qualitative research indicates that music therapy can facilitate many of the core elements found to promote social recovery and social inclusion, findings also reflected in results from a growing body of effect studies. The objective of this study was to explore how music therapy might afford possibilities for social recovery to one man with psychosis admitted to a psychiatric intensive care unit. This was achieved by means of a qualitative case study featuring a description of the music therapeutic process alongside first-hand accounts of the participant’s subjective experiences. The data were analysed using interpretative phenomenological analysis (IPA). The findings are presented in a narrative form reflecting processes and activities considered particularly important for the process of social recovery. Theoretical perspectives from the recovery literature and current perspectives in music therapy are discussed with a view to the possible use of music therapy for strengthening agency, (re)building identity, developing positive relationships, and expanding social networks.

Individual music therapy for mental health care clients with low therapy motivation: multicentre randomised controlled trial

BACKGROUND

Music therapy (MT) has been shown to be efficacious for mental health care clients with various disorders such as schizophrenia, depression and substance abuse. Referral to MT in clinical practice is often based on other factors than diagnosis. We aimed to examine the effectiveness of resource-oriented MT for mental health care clients with low motivation for other therapies.

METHOD

This was a pragmatic parallel trial. In specialised centres in Norway, Austria and Australia, 144 adults with non-organic mental disorders and low therapy motivation were randomised to 3 months of biweekly individual, resource-oriented MT plus treatment as usual (TAU) or TAU alone. TAU was typically intensive (71% were inpatients) and included the best combination of therapies available for each participant, excluding MT. Blinded assessments of the Scale for the Assessment of Negative Symptoms (SANS) and 15 secondary outcomes were collected before randomisation and after 1, 3 and 9 months. Changes were analysed on an intention-to-treat basis using generalised estimating equations in longitudinal linear models, controlling for diagnosis, site and time point.

RESULTS

MT was superior to TAU for total negative symptoms (SANS, d = 0.54, p < 0.001) as well as functioning, clinical global impressions, social avoidance through music, and vitality (all p < 0.01).

CONCLUSION

Individual MT as conducted in routine practice is an effective addition to usual care for mental health care clients with low motivation.