Defining Attachment and Bonding: Overlaps, Differences and Implications for Music Therapy Clinical Practice and Research in the Neonatal Intensive Care Unit (NICU)

Preterm birth and the subsequent hospitalization in the Neonatal Intensive Care Unit (NICU) is a challenging life event for parents and babies. Stress, anxiety, and depressive symptoms, limitations in holding or touching the baby, and medical complications during the NICU stay can negatively affect parental mental health. This can threaten the developing parent-infant relationship and might adversely impact child development. Music therapy in the NICU is an internationally growing field of clinical practice and research and is increasingly applied to promote relationship building between parents and babies. The two most commonly used concepts describing the early parent-infant relationship are ‘attachment’ and ‘bonding’. While frequently used interchangeably in the literature, they are actually not the same and describe distinctive processes of the early relationship formation. Thus, it is important to discuss the overlaps and differences between attachment and bonding and the implications for music therapy clinical practice and research. Whereas providing examples and possible scenarios for music therapists working on either bonding or attachment, the distinction between both concepts is relevant for many health care professionals concerned with early parenting interventions in the NICU. This will hopefully lead to a more precise use of theory, and ultimately, to a more informed clinical practice and research.publishedVersio

Multicultural Considerations in Music Therapy Research

Our society has become more diverse in the past decade, as evidenced by the influx of immigrants, multiracial and minority groups, and the increasing age gap between generations (Population Reference Bureau, 2015). Consequently, culture has been regarded as a significant construct among researchers. By proposing Culture-Centered Music Therapy, Stige (2002) encourages “all music therapists [to be] more culture-centered in their work and thinking, not by labeling their work as such but integrating cultural perspectives in their thinking” (p. 5). As our own worldviews influence all aspects of music therapy (Dileo, 2000; Wheeler & Baker, 2010), cultural factors provide a significant foundation to all music therapy research. With this perspective, music therapy researchers are essentially multicultural researchers. Moreover, this professional role is not only part of a scholarly endeavor, but also “our ethical and moral obligation” (Vera & Speight, 2003, p. 270)

“It’s Not What’s Done, But Why It’s Done”: Music Therapists’ Understanding of Normalisation, Maximisation and the Neurodiversity Movement

This position paper offers our personal reflections as five music therapists from varying social and international contexts attempting to understand and engage with the theory, politics and implications of the Neurodiversity Movement. We begin by positioning our views on the importance of the therapist’s intentionality when working with individuals for whom this social, cultural and political movement may represent central beliefs and values. The evolution of the Neurodiversity Movement is discussed, growing from the social model of disability and Disability Rights Movements to present a challenge to the dominant, medicalised model of disability. Throughout the paper, we invite critical debate around the role, position and attitude of the music therapist when working with neurodivergent participants, taking the powerful words of Autistic author and activist, Penni Winter, as our provocation. Finally, we offer our interpretation of key concepts and dimensions of this discourse, before sharing examples of how we might apply these understandings to tangible tenets of music therapy practice in different contexts through a series of brief composite case stories. Through critical reflection and discussion, we attempt to draw together the threads of these diverse narratives to challenge a normocentric position, and conclude by posing further questions for the reader and the wider music therapy profession

Potential Psychological and Biological Mechanisms Underlying the Effectiveness of Neonatal Music Therapy during Kangaroo Mother Care for Preterm Infants and Their Parents

Neonatal music therapy (MT) has become more accessible worldwide. Previous research suggests multiple benefits of MT for preterm infants and their caregivers; however, far too little attention has been paid to understanding the mechanisms of change in previous Neonatal Intensive Care Unit (NICU)-MT research so far. This perspective article describes potential mechanisms of MT interventions exposed during kangaroo mother care on the preterm infant’s response (behavioral and physiological outcomes) and the mother-infant relationship. The paper focuses on the hypothalamic–pituitary–adrenal axis’ role in stabilization of behavioral state, the autonomic nervous system’s role in stabilization of physiologic state, as well as co-regulation as a potential mechanism for the developing of the parent-infant relationship. Mechanisms play a pivotal role in understanding variables related to the therapy course and well as in generating new knowledge regarding treatment susceptibility and optimizing resources. Understanding of the mechanisms of how interventions may lead to specific outcomes plays an important role in addressing the issue of improvement of currently available approaches of MT used in the NICUpublishedVersio

Parental Attitudes toward Consent for Music Intervention Studies in Preterm Infants: A Cross-Sectional Study

(1) Background: This study investigated parents’ motives for enrolling preterm infants into music therapy intervention studies during Neonatal Intensive Care hospitalization. (2) Methods: We surveyed Israeli parents of preterm infants after they consented or refused to participate in such studies. The pre-piloted questionnaires evaluated attitudes toward research and music therapy intervention studies. The study included 116 (57%) parents who agreed to participate in music therapy studies and 87 (43%) who declined. (3) Results: Infants of those who agreed to participate were younger (17 ± 2.3 vs. 28 ± 4.7 days old, p = 0.03) and sicker (Clinical Risk Index for Babies score 6.1 ± 2.7 vs. 3.68 ± 4.1, p = 0.04). More single-parent families declined to participate (p = 0.05). Parents agreed to participate because they thought the study might help their child, would improve future care of preterm infants and increase medical knowledge (all p < 0.05). In addition, they perceived music as beneficial for brain development, thought it might improve bonding, and routinely listened to music daily. (4) Conclusions: When recruiting parents and preterm infants for music therapy intervention studies, one should highlight potential contributions to the child’s health, future children’s health and medical knowledge. Stressing music as a potential tool for brain development and augmenting bonding is important. The best time to recruit is when improvements are still anticipated.publishedVersio