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.

What Does the Past Tell Us? A Content Analysis of the First Quarter-Century of the British Journal of Music Therapy

Professional journals have a legitimating and sanctioning role in the development of disciplinary knowledge, as well as professional practices and identities. The British Journal of Music Therapy (BJMT) – the only UK-based peer-reviewed music therapy journal – has portrayed research, theory and accounts of practices, reflecting trends and developments in the field of music therapy since 1987. Marking the 25th anniversary of the BJMT and looking into its future development, a content analysis of the journal since its inception (1987–2011) was conducted with the aims of (i) tracing trends and developments of music therapy praxes and professional identities, and (ii) exploring the journal's engagement with disciplinary discourses and practices alongside and beyond those of music therapy. The study provides an overview of the BJMT in terms of 1) paper types, 2) authorship: numbers and professional titles, 3) countries of project sites and countries of authors, 4) sample conditions, sizes and ages, 5) formats of practices, and 6) models and themes. The results show that the majority of the articles published in the BJMT are theoretical, focus on one-to-one sessions, are single authored by music therapists and are UK-focused in terms of authorship, project site and models. This study brings to the fore questions for the future development of music therapy as profession and discipline.

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.

Making music, making friends: Long-term music therapy with young adults with severe learning disabilities

This collaborative practitioner research study emerged from music therapists' concerns about the value of improvisational, music-centred music therapy for young adults with severe learning disabilities (SLDs), given the long-term nature of such work. Concerns included the relevance, in this context, of formulating, and reporting on, therapeutic aims, development, change; and working in 'goal-oriented' way. Focus groups with the young adults' families and a range of professionals suggest that, rather than leading to developmental change, long-term shared therapeutic musicking provides young adults with ongoing opportunities for experiencing confidence and self-esteem, with feelings of shared acceptance and success, and also provides young adults and their families with opportunities for developing and sustaining friendships. In addition, families experienced meeting other parents and carers in the communal reception area as supportive and countering their isolation. Focus groups assigned intrapersonal, relational and social values to long-term music therapy for young adults with SLDs.

The ‘ripple effect’: Towards researching improvisational music therapy in dementia care homes

Increased interest in, and demand for, music therapy provision for persons with dementia prompted this study’s exploration of music therapists’ strategies for creating musical communities in dementia care settings, considering the needs and resources of people affected by dementia. Focus group discussions and detailed iterative study of improvisational music therapy work by six experienced practitioners clarify the contextual immediacy and socio-musical complexities of music therapy in dementia care homes. Music therapy’s ‘ripple effect’, with resonances from micro (person-to-person musicking), to meso (musicking beyond ‘session time’) and macro level (within the care home and beyond), implies that all who are part of the dementia care ecology need opportunities for flourishing, shared participation, and for expanded self-identities; beyond ‘staff’, ‘residents’, or ‘being in distress’. On such basis, managers and funders might consider an extended brief for music therapists’ roles, to include generating and maintaining musical wellbeing throughout residential care settings.

"Time after time": a Quali-T method for assessing music's impact on well-being

This article considers the question of how to produce ecologically valid assessments of music's role as a health technology. To address this question, I consider critically some of the standard quantitative instruments used to assess well-being and quality of life. I suggest that these instruments do not lend themselves well to the production of ecologically valid assessments and understandings for two reasons: (1) the process of data elicitation is removed from everyday meanings and practices and therefore risks producing data that is an artifact of the situation in which it is elicited (2) standard, quantitative instruments are not neutral but are rather discursive texts that are inevitably imbued with a politics of expertise and an image of the health care client. For these reasons, I suggest that we consider the question of how to develop ecologically valid, client-centered assessment measures. To that end, I introduce a third critique of the standard quantitative instruments, namely that they are associated with, and promote, an ontology of wellness/illness that downplays the temporally variable and situationally emergent nature of both wellness/illness and musical interventions themselves. As an alternative mode of assessment, I suggest that we reconsider the value of singular case studies and I describe a set of principles that can assist researchers to produce ecologically valid assessments. To this end I introduce the concept of the musical event as a more ecologically valid means for illuminating the specific mechanisms by which music aids well-being. I suggest that the case study approach is temporally sensitive, that it lends itself to an emergent ontology of wellness/illness, and that it is client-centered (and can also be user-led).

Music in the exercise domain: a review and synthesis (Part II)

Since a 1997 review by Karageorghis and Terry, which highlighted the state of knowledge and methodological weaknesses, the number of studies investigating musical reactivity in relation to exercise has swelled considerably. In this two-part review paper, the development of conceptual approaches and mechanisms underlying the effects of music are explicated (Part I), followed by a critical review and synthesis of empirical work (spread over Parts I and II). Pre-task music has been shown to optimise arousal, facilitate task-relevant imagery and improve performance in simple motoric tasks. During repetitive, endurance-type activities, self-selected, motivational and stimulative music has been shown to enhance affect, reduce ratings of perceived exertion, improve energy efficiency and lead to increased work output. There is evidence to suggest that carefully selected music can promote ergogenic and psychological benefits during high-intensity exercise, although it appears to be ineffective in reducing perceptions of exertion beyond the anaerobic threshold. The effects of music appear to be at their most potent when it is used to accompany self-paced exercise or in externally valid conditions. When selected according to its motivational qualities, the positive impact of music on both psychological state and performance is magnified. Guidelines are provided for future research and exercise practitioners.

Quietening the Voices

The article presents a case study of individual music therapy with an elderly Iraqi refugee in a day hospital for the elderly mentally ill. It highlights themes that arise from working with a traumatised client of a different culture and different generation, and the range of ways in which music was used. It draws on psychological theories to shed light on the developing relationship between therapist and client.