Creating musical life reviews with older people: a community case study.

Older people living in their homes might experience growing loneliness, detachment from their social environment, and decreased functional ability. In this community case study, we report on a project we initiated to enhance the functional ability of older people by creating musical life reviews (MLR) with them. We connected seven of our music therapy graduates (MT) to older people living in the neighborhood across the street from campus. MTs were first trained to work by a protocol for creating MLRs with older people, developed by the authors of this article. They then worked with older people from the neighborhood for 10 one-on-one sessions, on personally tailored MLRs. MTs kept on meeting in weekly group supervision sessions, thus learning from each other- and forming a community of their own. Participants expressed their high satisfaction with the process and reported that their MLRs became increasingly important to them. Most of them were interested in taking their MLR one step ahead, and playing it to family and/or friends, and, as part of the process, planned a personal event to do this. Further, two big community events were initiated by participants and MTs. To conclude, we show how the community project enhanced the functional ability of those participating in it. We also point at possible challenges and recommendations for further implementation of the project.

Home-based music therapy for persons with dementia and their spouses as primary caregivers.

Music therapy has been found to be an effective intervention for persons with dementia (PWD) and their primary caregivers (PC), yet the implementation of musical strategies to improve daily care in the home environment requires further exploration. This study developed and examined a home-based music therapy (HBMT) work model that offers weekly joint music therapy sessions, and additional bi-weekly phone-counseling sessions with the PC. This was followed by an additional 12-week support period that included 3 therapy sessions and 3 phone counseling sessions once every other fortnight, so that the same type of session occurred at a frequency of once a month. Participants were five couples (PWD + spouse as PC) who live in their home. Findings based on the qualitative multiple case study research method showed the importance of the music therapist's (MT) continuous support. The MT's presence made it possible to address the needs of both spouses, separately and together, while maintaining the required balance. Moreover, the MT's presence enabled better implementation of the musical strategies independently and this was maintained during the intervention and the support period.

Improvised herding: Mapping biobehavioral mechanisms that underlie group efficacy during improvised social interaction.

Improvisation is a natural occurring phenomenon that is central to social interaction. Yet, improvisation is an understudied area in group processes and intergroup relations. Here we build on theory and research about human herding to study the contributions of improvisation on group efficacy and its biobehavioral underpinnings. We employed a novel multimodal approach and integrative method when observing face-to-face interactions-51 triads (total N = 153) drummed together in spontaneous-free improvisations as a group, while their electrodermal activity was monitored simultaneously with their second-by-second rhythmic coordination on a shared electronic drum machine. Our results show that three hypothesized factors of human herding-physiological synchrony, behavioral coordination, and emotional contagion-predict a sense of group efficacy in its group members. These findings are some of the first to show herding at three levels (physiological, behavioral, and mental) in a single study and lay a basis for understanding the role of improvisation in social interaction.

The "Ensemble"-A Group Music Therapy Treatment for Developing Preschool Children's Social Skills.

(1) Background: Several music therapy treatments have been developed to assist children with social skill deficiencies. They lack reference to emotions and their connection to social skills and they don't deal with group dynamics and its impact on the group. We conducted a preliminary examination of the "Ensemble" treatment, which was developed to improve the social skills of children of various client populations, with the social deficiency originating from different sources; (2) Methods: 24 children in four groups went through the year-long "Ensemble" treatment. Observations of the sessions were analyzed quantitatively counting the occurrence of twelve typical socially oriented behaviors. Qualitative interviews were conducted with 24 mothers and 23 kindergarten teachers (KTs) before and after the process; (3) Results: Quantitative results show that children in all four "Ensemble" groups, improved in nine out of twelve social skills. Qualitative results show that the improvement was evident also in the home environment (as reported by mothers) and in the kindergarten environment (as reported by KTs); (4) Conclusions: A comparison between the "Ensemble" and previous music therapy treatments indicates this treatment's potential to help children with a wide variety of social skill deficiencies. Further investigation based on more rigorous research designs is recommended.

Why Music Therapists Choose to Work with a Clinical Population: An International Pilot Survey.

(1) Background: Throughout their career, music therapists make decisions regarding the clinical population they choose to work with. Though such decisions can have broad implications on the professional development of the music therapist, not much is known about the reasons for making these decisions and whether they are affected by demographic or professional factors. (2) Methods: In this pilot study, we surveyed 439 music therapists from six countries (i.e., Austria, the Czech Republic, Germany, Israel, Spain, and Switzerland) using an online questionnaire. We asked the respondents to explain why they chose to work with their main clienteles, and we examined whether their reasons were connected to demographic factors such as country of origin, gender, and seniority, and professional factors such as experience as a music therapist and population one works with. (3) Results: The category analysis of these responses pointed at nine distinct reasons that could be grouped into "practical reasons", "reasons of connection", and "innovation". There were differences in reasoning between music therapists from different countries, and with different degrees of seniority, but not between male and female music therapists. (4) Discussion: The implications on training programs and on policy makers are discussed as well as the importance of this subject to the development of music therapists' professional identity.

Music Therapy with Neonatal Intensive Care Unit-Discharged Mother-Infant Dyads: Developing a Method for Nurturing Communicative Parental Efficacy (CoPE with Music).

While much advancement has been documented in the practice of music therapy in the neonatal intensive care unit (NICU) environment, there is currently a shortage of music therapy-based methods for NICU-discharged dyads. Back in their homes, mothers might feel alone, lacking guidance, and possibly losing their parental efficacy and their ability to communicate with their baby. In this article, we present a method for nurturing the communicative parental efficacy (CoPE) that was successfully practiced with several NICU-discharged dyads. In eight weekly sessions, the music therapist improvises with the dyad and focuses on (1) containing the mother's emotions; (2) modeling musical interactions with the baby; and (3) practicing these musical interactions with the mother, enabling her to gain communicative parental efficacy. The basic ideas of CoPE are outlined, and a short case study is then described, to demonstrate how it is used. Finally, suggestions for future directions for the development of CoPE are provided.

Adaptation of Music Therapists' Practice to the Outset of the COVID-19 Pandemic-Going Virtual: A Scoping Review.

Background: In the midst of a worldwide COVID-19 pandemic, music therapists previously not involved in telehealth had to develop effective remote forms of music therapy. The objective of this review was to systematically explore how music therapists previously working in-person adapted to the transfer to remote forms of therapy in the context of the coronavirus outbreak. Methods: We searched Scopus, Web of Science Core Collection, CINAHL, Medline, ProQuest Central, PubMed, EMBASE, PsycINFO and PsyARTICLES, grey literature (to October 2020), and websites of professional organizations. We followed the JBI methodology for scoping reviews. Results: Out of the 194 screened texts, we included ten very heterogeneous articles with an overall very low quality. Most texts described remote therapy in the form of synchronous video calls using the Internet, one paper described a concert in a patio of a residential home. We report the authors' experience with the adaptation and activities, challenges and benefits of remote forms of therapy, recommendations of organizations, and examples and tips for online therapies. Conclusions: Music therapists have adapted the musical instruments, the hours, the technology used, the therapeutic goals, the way they prepared their clients for sessions, and other aspects. They needed to be more flexible, consult with colleagues more often, and mind the client-therapist relationship's boundaries. It seems, when taken as a necessary short-term measure, online music therapy works sufficiently well. The majority of papers stated that benefits outweighed the challenges, although many benefits were directly linked with the pandemic context.

Towards sustainable implementation of music in daily care of people with dementia and their spouses.

Primary caregivers (PCs) of people with dementia deal with stressful daily living, especially spouses whose care recipient is at home. Several programs have been developed to aid caregiving by providing musical strategies, yet successful sustainable implementation of music in the daily lives of the couples awaits further research and development. To promote this, in this pilot study we proposed a music therapy program that included 12 weekly sessions with the couple in their home environment. In addition, there were bi-weekly phone counseling sessions with the PC, to reflect on the joint sessions and to help implement music in daily life. Findings based on the description, analysis, and interpretation of two cases showed that the proposed program provided a strong foundation upon which the treatment could succeed; it relied on natural forces such as the use of songs, which can empower each of the spouses individually, as well as together as a couple; and it included elements of ongoing support that enabled preservation of the accomplishments that were achieved during the sessions. Future research is required to examine whether this program is appropriate for couples in other housing contexts, and in different stages of dementia.

The relationship between physiological synchrony and motion energy synchrony during a joint group drumming task.

Coordination with others in groups is crucial to group cohesion and function, yet only scant research addressed behavioral and physiological interpersonal synchrony in groups during shared activities. We present data from 39 triads instructed to drum together. Based on video-recordings of the task and participants' electrocardiograms, we computed physiological synchrony in cardiologic interbeat intervals and behavioral motion energy synchrony among group members as they were drumming together. Overall, behavioral and physiological synchrony were positively associated with continuous shifts from positive correlations to non-significant ones throughout the task. Results shed light on the relational components of group bonding and elucidate the dynamic interactions between physiological and behavioral synchrony at the group level.

Computational Paradigm to Elucidate the Effects of Arts-Based Approaches: Art and Music Studies and Implications for Research and Therapy.

Art therapy and music therapy, as well as other arts-based approaches and interventions, help to mitigate symptoms in serious and chronic diseases and to improve the well-being and quality of life for both healthy individuals and patients. Artistic creation is also researched and practiced intending to empower and understand individuals, groups, and communities. However, much research is required in order to learn how arts-based approaches operate and to enhance their effectivity. The complex and simultaneous occurrences involving the dynamics of the creation work, the client, and the therapist in a typical arts setting are difficult to grasp, consequently affecting their objective analyses. Here we employ our Computational Paradigm which enables the quantitative and rigorous tracking, analyzing, and documenting of the underlying dynamic processes, and describe its application in recent past and current real-world art and music studies with human participants. We aim to study emergent artistic behaviors of individuals and collectives in response to art and music making. Significant insights obtained include demographic variation factors such as gender and age, empirical behavioral patterns, and quantitative expressiveness and its change. We discuss the implications of the findings for therapy and research, such as causality for behavioral diversification and audio-visual cross-modality, and also offer directions for future applications and technology enhancements.

Physiological and Behavioral Synchrony Predict Group Cohesion and Performance.

Interpersonal synchrony contributes to social functioning in dyads, but it remains unknown how synchrony shapes group experiences and performance. To this end, we designed a novel group drumming task in which participants matched their drumming to either predictable or unpredictable tempos. Fifty-one three-person groups were randomly assigned to one of two conditions: synchronized or asynchronized drumming. Outcome measures included electrocardiograms and self-reports of group cohesion and synchrony. The drumming task elicited an increase in physiological synchrony between group members (specifically their hearts' interbeat intervals). We also found that physiological synchronization and behavioral synchronization predicted individuals' experience of group cohesion. Physiological synchrony also predicted performance in a subsequent group task that involved freely drumming together. The findings suggest that the behavioral and physiological consequences of synchronization contribute to the formation of group bonds and coordination. They also confirm that insights from translational social neuroscience can inform our knowledge of the development of cohesive and efficacious groups.

Computational elucidation of the effects induced by music making.

Music making, in the form of free improvisations, is a common technique in music therapy, used to express one's feelings or ideas in the non-verbal language of music. In the broader sense, arts therapies, and music therapy in particular, are used to induce therapeutic and psychosocial effects, and to help mitigate symptoms in serious and chronic diseases. They are also used to empower the wellbeing and quality of life for both healthy individuals and patients. However, much research is still required to understand how music-based and arts-based approaches work, and to eventually enhance their effectivity. The clinical setting employing the arts constitutes a rich dynamic environment of occurrences that is difficult to capture, being driven by complex, simultaneous, and interwoven behavioral processes. Our computational paradigm is designed to allow substantial barriers in the arts-based fields to be overcome by enabling the rigorous and quantitative tracking, analyzing and documenting of the underlying dynamic processes. Here we expand the method for the music modality and apply it in a proof of principle experimentation to study expressive behavioral effects of diverse musical improvisation tasks on individuals and collectives. We have obtained statistically significant results that include empirical expressive patterns of feelings, as well as proficiency, gender and age behavioral differences, which point to variation factors of these categorized collectives in music making. Our results also suggest that males are more exploratory than females (e.g., they exhibit a larger range of octaves and intensity) and that the older people express musical characterized negativity more than younger ones (e.g., exhibiting larger note clusters and more chromatic transitions). We discuss implications of these findings to music therapy, such as behavioral diversity causality in treatment, as well as future scientific and clinical applications of the methodology.

The impact of relaxing music on prisoners' levels of anxiety and anger.

Listening to relaxing music was found to reduce state anxiety and state anger among various populations. Nonetheless, the impact of relaxing music in prisons has not yet been studied. The current study examines the impact of relaxing music on levels of state anxiety and state anger among a random sample of 48 criminal prisoners. Main findings are as follows: (a) level of state anxiety decreased among the treatment group compared with the comparison group and (b) level of state anger decreased among the treatment group compared with the comparison group. Findings are discussed in light of other studies that have shown positive effects of exposure to relaxing music on levels of anxiety and anger among other populations. The final part of the study provides practical recommendations for prison administrators regarding implementation of programs of relaxing music in various prison facilities.

Accuracy of pitch matching significantly improved by live voice model.

Singing is, undoubtedly, the most fundamental expression of our musical capacity, yet an estimated 10-15% of Western population sings "out-of-tune (OOT)." Previous research in children and adults suggests, albeit inconsistently, that imitating a human voice can improve pitch matching. In the present study, we focus on the potentially beneficial effects of the human voice and especially the live human voice. Eighteen participants varying in their singing abilities were required to imitate in singing a set of nine ascending and descending intervals presented to them in five different randomized blocked conditions: live piano, recorded piano, live voice using optimal voice production, recorded voice using optimal voice production, and recorded voice using artificial forced voice production. Pitch and interval matching in singing were much more accurate when participants repeated sung intervals as compared with intervals played to them on the piano. The advantage of the vocal over the piano stimuli was robust and emerged clearly regardless of whether piano tones were played live and in full view or were presented via recording. Live vocal stimuli elicited higher accuracy than recorded vocal stimuli, especially when the recorded vocal stimuli were produced in a forced vocal production. Remarkably, even those who would be considered OOT singers on the basis of their performance when repeating piano tones were able to pitch match live vocal sounds, with deviations well within the range of what is considered accurate singing (M=46.0, standard deviation=39.2 cents). In fact, those participants who were most OOT gained the most from the live voice model. Results are discussed in light of the dual auditory-motor encoding of pitch analogous to that found in speech.

Emotional communicability in improvised music: the case of music therapists.

Musical improvisation is considered an efficient way to express emotions in music therapy. We examined the ability of music therapists (MTs) to convey emotions and their ability to accurately decode the emotional content of musical improvisations. Twenty-one MTs improvised on emotions they found difficult or easy to express in life, using or not using an emotional imagery technique. Fifty-five judges, some being MTs others nontherapists, evaluated the emotional content of the improvisations. Results showed that neither experience in therapy, nor musicianship or gender of the improviser were connected to emotional communicability (EC). Emotions that were reported as easy to express in life were communicated more accurately than those difficult to express in life. Emotional imagery did not facilitate and, to some extent, hindered emotional communicability. Some emotions were found to be difficult to express (e.g., anger) in comparison to others (e.g., happiness). MTs decoded the emotional content of the improvisations more accurately than nontherapists. Implications for the practical musical and emotional training of music therapists are discussed.