Playing with Distinction? Music Therapy and the Affordances of Improvisation

This is the final version of the article. Available from the publisher via the link in this record.In the United Kingdom (UK), improvisation seems to be regarded as central to, and even defnitional of, the practice of music therapy. This article considers reasons why improvisation might be professionally prized in this way but also turns to Tia DeNora's (2003) notion of musical afordance to consider what in practical terms improvisation may have to ofer within music therapy practice, focusing on two vignettes from a mental health environment

Kris Kristofferson/John Holt—‘Help Me Make It Through The Night’

As with all the contributors here, my chosen song comes from fieldwork. I spent time in an urban UK mental health community setting, a place which nobody has to attend (it is not part of the statutory psychiatric system), but where people choose to spend time to gain various kinds of support – formal and informal – whilst in other respects living independently despite (in most cases) having a psychiatric diagnosis. Most service users with whom I spent time were male, over forty, long-term unemployed, living on the economic edge, ever fearful about having their benefits withdrawn, and diagnosed with some form of mental illness, most commonly paranoid schizophrenia. My primary reason for being there was to participate in and observe the various interactions around the provision of music in general and music therapy in particular

Music therapy: what is it for whom? An ethnography of music therapy in a community mental health resource centre

Music therapy is widely portrayed either as a paramedical practice within which music is a technology applied as a form of treatment or as a form of psychotherapy within which the music plays a primarily symbolic role or acts as a lead in to verbal consideration of the patient’s presenting issues. Music therapy research currently focuses predominantly on demonstrating “evidence of effectiveness” in terms of symptomatic outcome, thus preserving a focus on the individual congruent with the medical model. In contrast, this thesis seeks to examine ethnographically the ways in which music therapy gets accomplished as a situated social practice within a community mental health resource centre in a UK urban area. Drawing both on the observations and experiences of the researcher (a music therapist already working within this setting) and on formal and informal interviews with the centre’s members and staff, it seeks to identify ways in which music therapy gets done and value ascribed to it. Observations are compared with the “norms” portrayed by dominant professional discourse, and reasons for discrepancies considered. Particular attention is paid to self-awareness, intimacy and conviviality as facets of what music therapy has to offer in such a setting, and to social capital theory and Goffman’s dramaturgical approach as broader conceptual frameworks for such affordances. Consideration is also given to the “fit” between the affordances of music itself, and the “craft” required of diverse actors in order that music therapy can be considered to offer an ecology which promotes health and well-being. Finally, the findings are re-addressed towards music therapy itself via the lens of what it means to be “clinical” in order that a sociological “craft” perspective maybe brought to bear within the discipline

Towards a generic research data management infrastructure

Until recent years, a focused and centralized strategy for the annotation, storage and curation of research data is something that has not been widely considered within academic communities. The majority of research data sits, fragmented, on a variety of disk structures (Desktops, network & external hard drives) and is usually managed locally, with little interest paid to policies governing how it is backed up, disseminated and organized for short or long term reuse. Recognition of how current practices and infrastructure present a barrier to research, has resulted in several recent academic programmes which have focused on developing comprehensive frameworks for the management and curation of research data1-3. Many of these frameworks (such as the Archer suite of e- Research tools1), however, are large and complex, and have an overreliance on new and novel technologies making them unwieldy and difficult to support. The paper discusses the development of a simpler framework for the management of research data through its full lifecycle, allowing users to annotate and structure their research in a secure and backed up environment. The infrastructure is being developed as a pilot system and is expected to work with data from approximately a dozen researchers and manage several Terabytes of data. The technical work is a strand of the MaDAM (Manchester Data Management) project at The University of Manchester which is funded by the JISC Managing Research Data Programme.

Development of a pilot data management infrastructure for biomedical researchers at University of Manchester – approach, findings, challenges and outlook of the MaDAM Project

Management and curation of digital data has been becoming ever more important in a higher education and research environment characterised by large and complex data, demand for more interdisciplinary and collaborative work, extended funder requirements and use of e-infrastructures to facilitate new research methods and paradigms. This paper presents the approach, technical infrastructure, findings, challenges and outlook (including future development within the successor project, MiSS) of the ‘MaDAM: Pilot data management infrastructure for biomedical researchers at University of Manchester’ project funded under the infrastructure strand of the JISC Managing Research Data (JISCMRD) programme. MaDAM developed a pilot research data management solution at the University of Manchester based on biomedical researchers’ requirements, which includes technical and governance components with the flexibility to meet future needs across multiple research groups and disciplines

Music therapy for in-patients with schizophrenia: exploratory randomised controlled trial.

BACKGROUND: Music therapy may provide a means of improving mental health among people with schizophrenia, but its effects in acute psychoses have not been explored. AIMS: To examine the feasibility of a randomised trial of music therapy for inpatients with schizophrenia, and explore its effects on mental health. METHOD: Up to 12 weeks of individual music therapy plus standard care were compared with standard care alone. Masked assessments of mental health, global functioning and satisfaction with care were conducted at 3 months. RESULTS: Of 115 eligible patients 81 (70%) were randomised. Two-thirds of those randomised to music therapy attended at least four sessions (median attendance, eight sessions). Multivariate analysis demonstrated a trend towards improved symptom scores among those randomised to music therapy, especially in general symptoms of schizophrenia. CONCLUSIONS: A randomised trial of music therapy for in-patients with schizophrenia is feasible. The effects and cost-effectiveness of music therapy for acute psychosis should be further explored in an explanatory randomised trial

Memetic: from meeting memory to virtual ethnography & distributed video analysis

The JISC-funded Memetic2 project was designed as knowledge management and project memory support for teams meeting via the Access Grid environment (Buckingham Shum et al, 2006). This paper describes how these capabilities also enable it to serve as a novel distributed video analysis tool to support interaction analysis. Memetic technologies can be used to record, annotate and discuss sessions recorded within a flexible, visual hypermedia environment called Compendium. We propose that beyond the use originally conceived, the Memetic toolset could find wide ranging applications within social science for virtual ethnography and data analysis

Long-term healthcare utilisation, costs and quality of life after invasive group B Streptococcus disease: a cohort study in five low-income and middle-income countries

Introduction There are no published data on the long-term impact of invasive group B Streptococcus disease (iGBS) on economic costs or health-related quality of life (HRQoL) in low-income and middle-income countries. We assessed the impact of iGBS on healthcare utilisation, costs and HRQoL in Argentina, India, Kenya, Mozambique and South Africa. Methods Inpatient and outpatient visits, out-of-pocket (OOP) healthcare payments in the 12 months before study enrolment, and health-state utility of children and caregivers (using the EuroQol 5-Dimensions-3-Level) were collected from iGBS survivors and an unexposed cohort matched on site, age at recruitment and sex. We used logistic or Poisson regression for analysing healthcare utilisation and zero-inflated gamma regression models for family and health system costs. For HRQoL, we used a zero-inflated beta model of disutility pooled data. Results 161 iGBS-exposed and 439 unexposed children and young adults (age 1–20) were included in the analysis. Compared with unexposed participants, iGBS was associated with increased odds of any healthcare utilisation in India (adjusted OR 11.2, 95% CI 2.9 to 43.1) and Mozambique (6.8, 95% CI 2.2 to 21.1) and more frequent healthcare visits (adjusted incidence rate ratio (IRR) for India 1.7 (95% CI 1.4 to 2.2) and for Mozambique 6.0 (95% CI 3.2 to 11.2)). iGBS was also associated with more frequent days in inpatient care in India (adjusted IRR 4.0 (95% CI 2.3 to 6.8) and Kenya 6.4 (95% CI 2.9 to 14.3)). OOP payments were higher in the iGBS cohort in India (adjusted mean: Int$682.22 (95$364.28 to Int$1000.16) vs Int$133.95 (95% CI Int$72.83 to Int$195.06)) and Argentina (Int$244.86 (95$47.38 to Int$442.33) vs Int$52.38 (95% CI Int$−1.39 to Int$106.1)). For all remaining sites, differences were in the same direction but not statistically significant for almost all outcomes. Health-state disutility was higher in iGBS survivors (0.08, 0.04–0.13 vs 0.06, 0.02–0.10). Conclusion The iGBS health and economic burden may persist for years after acute disease. Larger studies are needed for more robust estimates to inform the cost-effectiveness of iGBS prevention