Polyphonic perspectives: a focus group study of interprofessional staff's perceptions of music therapy at an inpatient unit for children in mental health care.

PURPOSE: In an inpatient unit for children in mental health care, a variety of services are provided through interprofessional collaborations. Music therapy is a relatively recent proposition in this context, but there is increasing acceptance for music therapy as a therapeutic method. However, there is limited knowledge about music therapy in this field, and this study aims to address this research gap. METHOD: Through focus group interviews with staff at an inpatient unit in mental health care for children, this article explores interprofessional perspectives of music therapy. A thematic analysis with an inductive approach informed by constructivist grounded theory was used in the analysis of the interviews. FINDINGS: Several dimensions were involved in the findings, concerning the children and the interprofessional collaboration. The two main categories that emerged were: "What music therapy offers the children" and "What music therapy contributes to the interprofessional understanding of the children". CONCLUSION: The interprofessional perspectives of music therapy revealed potentials for emotion regulation, and experience of identity and freedom for the children. As part of the integrated services, music therapy provided a new perspective of the child and enhanced relationship between the child and the health services.

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.

"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 semi-structured 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, well-being, 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.

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.

Toward Understanding Music Therapy as a Recovery-Oriented Practice within Mental Health Care: A Meta-Synthesis of Service Users' Experiences.

BACKGROUND: The perspective of mental health recovery is increasingly shaping mental health care policies. Current texts in music therapy identify the importance of this critical and user-oriented perspective, but the relevance and implications for music therapy need to be outlined. OBJECTIVE: This study explores service users' experiences of music therapy in mental health care, and the potential role of music therapy in the development of recovery-oriented service provision. METHODS: We conducted a qualitative meta-synthesis of studies examining service users' experiences in music therapy; included were 14 studies with a total of 113 participants. Both first-hand account of participants and the researchers' representations of such statements were taken into account in the analysis. FINDINGS: A taxonomy of four areas of users' experiences was identified: "having a good time;" "being together;" "feeling;" and "being someone." These core categories point towards music therapy as an arena that can be used by persons with mental health problems in their personal and social recovery process. Music therapy can contribute to the quality of mental health care by providing an arena for stimulation and development of strengths and resources that may contribute to growth of positive identity and hope for people with mental illness. CONCLUSIONS: The findings from this meta-synthesis indicate that the provision of music therapy closely resembles recognized benefits of a recovery-oriented practice. Awareness of users' self-determination and the development of a strength-based and contextual approach to music therapy that fosters mutual empowering relationships are recommended.

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.