Music therapy in a recovery-oriented unit. A qualitative study of user's and staff's experiences with music therapy in mental health care

Service provision within mental health care is shifting toward services that maximize personal recovery. In a Norwegian context, national treatment guidelines have recently recommended that music therapy be part of such service provision. This study explores the implementation of music therapy in a recovery-oriented unit of a community mental health institution. Users and staff were invited to participate in focus groups with the intention of gaining knowledge about how music therapy fits in with, and contributes to, the overall service provision while supporting recovery. The findings document aspects of how music therapy can support personal recovery, adds to the service provision as a distinctive therapeutic alternative, and interacts with other treatment options on the unit. In sum, participants' experiences with music therapy within this specific facility highlight music therapy's role as a potential resource that contributes to recovery-oriented service provision.acceptedVersio

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.publishedVersio

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

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.publishedVersio

Resource-oriented music therapy for psychiatric patients with low therapy motivation: Protocol for a randomised controlled trial [NCT00137189]

BACKGROUND: Previous research has shown positive effects of music therapy for people with schizophrenia and other mental disorders. In clinical practice, music therapy is often offered to psychiatric patients with low therapy motivation, but little research exists about this population. The aim of this study is to examine whether resource-oriented music therapy helps psychiatric patients with low therapy motivation to improve negative symptoms and other health-related outcomes. An additional aim of the study is to examine the mechanisms of change through music therapy. METHODS: 144 adults with a non-organic mental disorder (ICD-10: F1 to F6) who have low therapy motivation and a willingness to work with music will be randomly assigned to an experimental or a control condition. All participants will receive standard care, and the experimental group will in addition be offered biweekly sessions of music therapy over a period of three months. Outcomes will be measured by a blind assessor before and 1, 3, and 9 months after randomisation. DISCUSSION: The findings to be expected from this study will fill an important gap in the knowledge of treatment effects for a patient group that does not easily benefit from treatment. The study's close link to clinical practice, as well as its size and comprehensiveness, will make its results well generalisable to clinical practice

Music therapy in everyday life, with "the organ as the third therapist"

Music therapy in mental health care usually unfolds over a limited time and in a limited space, often through weekly sessions which last for a certain period during a person’s stay at an institution. Nevertheless, music therapy is inevitably situated in a broader social, cultural and political context, and to various degrees will the engagement in music therapy involve levels of interaction with other contexts in turn, such as the client’s everyday life context. In this text I will explore the interaction between music therapy and the use of music in everyday life contexts. The empirical basis for this exploration is interviews with a client and her music therapist. This is in turn linked to a multiple case study aiming towards more understanding of client’s agency in the process of music therapy, that is, what clients do to make music therapy work. The study is situated within a resourceoriented perspective of music therapy practice in mental health care, and combine theoretical perspectives from contextual models in psychotherapy and recovery. The text provides an individual narrative of how music therapy is intertwined with and a part of everyday life uses of music. The main focus will be the client’s agency in linking experiences and pursue goals across various contexts

“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 semistructured 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, wellbeing, 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

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. (PsycINFO Database Record (c) 2017 APA, all rights reserved

Therapy as Empowerment: Clinical and Political Implications of Empowerment Philosophy in Mental Health Practises of Music Therapy

In this article the clinical and political implications of empowerment philosophy are elaborated with music therapy practices in mental health services as the point of departure. The concept and the philosophy of empowerment are discussed through a review of literature from community psychology, sociology and feminist psychology. Empowerment is connected to a resource-oriented perspective on music therapy that implies a focus upon the client's strengths and potentials and emphasizes the importance of collaboration and equality in the relationship between therapist and client

Music therapy in a recovery-oriented unit. A qualitative study of user's and staff's experiences with music therapy in mental health care

Service provision within mental health care is shifting toward services that maximize personal recovery. In a Norwegian context, national treatment guidelines have recently recommended that music therapy be part of such service provision. This study explores the implementation of music therapy in a recovery-oriented unit of a community mental health institution. Users and staff were invited to participate in focus groups with the intention of gaining knowledge about how music therapy fits in with, and contributes to, the overall service provision while supporting recovery. The findings document aspects of how music therapy can support personal recovery, adds to the service provision as a distinctive therapeutic alternative, and interacts with other treatment options on the unit. In sum, participants' experiences with music therapy within this specific facility highlight music therapy's role as a potential resource that contributes to recovery-oriented service provision