"I Can't Think of Anything More Fulfilling": An Interpretative Phenomenological Analysis of Eight Female-Identifying Music Therapists' Career Longevity.

Although there is literature exploring burnout and music therapists who have left the profession, there is a lack of research exploring the lived experience of music therapists who have remained in the profession for their careers. Therefore, the purpose of this study was to understand the lived experience of music therapy clinicians in the United States who remained in the profession for their careers. We individually interviewed eight female-identifying music therapy clinicians who had been in the profession between 25 and 48 (M = 40.63; SD = 8.53) years. We used interpretive phenomenological analysis to analyze the data. Participants reviewed their transcripts and the results to provide credibility to the themes. We identified nine themes that described career longevity: centering service users; other professional opportunities and responsibilities; building a sustainable and thriving program; humility, professional agency, and growth; professional service to support peers and service users; training and supervising music therapists; connecting with the professional community; coping with work-related stressors; and music as a resource for resiliency. On the basis of these results, we developed a model depicting professional resiliency in music therapy that centered and revolved around the service users. In addition to their clinical expertise, there is considerable knowledge to be gained from music therapists regarding professional resiliency and career longevity. Additional scholarship in music therapy career longevity is necessary to grow the profession and increase access to services. Implications, limitations, and suggestions for future research are provided.

A Descriptive Analysis of Countries Represented by Authors' and Editorial Review Board Members' Institutional Affiliations in the Journal of Music Therapy, 1998-2022.

The Journal of Music Therapy (JMT) authors' and editorial review board members' (ERBM) affiliation locations represent an aspect of diversity through differing cultures and political, healthcare, and educational systems. Therefore, the purpose of this study was to examine the countries of JMT authors' and ERBM's institutional affiliations from 1998 to 2022. We established inclusion and exclusion criteria, operationally defined categories, and built databases. A total of 433 articles met our inclusion criteria. Most articles were published by authors/author teams located in the United States (n = 305; 70.44%) or in a single international country (n = 85; 19.63%), while fewer articles were published by author teams located in multiple international countries (n = 23, 5.31%) or in international countries and the United States (n = 20, 4.62%). Authors were from 21 countries, and there tended to be a slight decline over time in articles by United States authors. When examining the total countries represented, United States authors (n = 330) had the most articles followed by Australia (n = 32), Norway (n = 18), England (n = 14), Israel (n = 13), and Canada, Denmark, and South Korea (all n = 12). There were 632 total JMT ERBM with 470 located within the United States and 162 located internationally. Although all ERBM's affiliations were in the United States in 1998, these data gradually changed. There were more ERBM located internationally than in the United States from 2020 to 2022. Most international ERBM were from Australia, Canada, England, Israel, and Spain. Implications, limitations, and suggestions for future research are provided.

A narrative review of music therapy for neuropsychiatric symptoms in Alzheimer's disease and rationale for protocolized music teletherapy.

Introduction: Alzheimer's Disease (AD) constitutes a major societal problem with devastating neuropsychiatric involvement in over 90% of those diagnosed. The large spectrum of AD neuropsychiatric symptoms leads to polypharmacological prescribing that, in turn, poses a major risk for increased side effects. Non-pharmacological interventions such as music therapy (MT) are therefore recommended as first-line treatments. The amalgamation of an aging population, long lifespan, and shortage of qualified music therapists limits access to MT services for AD. Objective: The purpose of this paper is to provide a rationale for a protocolized music teletherapy (MTT) intervention to increase accessibility for MT as a psychosocial intervention for neuropsychiatric symptoms in people with AD by conducting a narrative review of the existing MT and AD literature. Methods: We conducted a narrative review of MT and MTT publications indexed in PubMed and Google Scholar wherein authors used the Neuropsychiatric Inventory. We examined the impact of MT on neuropsychiatric symptoms of AD and identified MTT as a way to increase access to clinical services. Results: MT can have positive impacts on neuropsychiatric symptoms in AD. However, we identified an ensuing need for protocolized MT interventions, access to services, and increased awareness. MTT is an option that can address these needs. Discussion: Although MT can have positive effects on neuropsychiatric symptoms and can be beneficial and safe for individuals with AD, the current approach to MT practice is enormously heterogeneous with studies demonstrating variable therapist qualifications, uses of music, therapy approaches, and clinical populations. Congruently, the existing literature indicates that MT has not been standardized with protocolized interventions, making it difficult for clinicians and researchers to objectively assess the evidence, and thus, prescribe MT interventions. The lack of MT standardization, coupled with a low number of music therapists relative to people with AD, result in a lack of awareness that hinders access to MT as a psychosocial treatment for neuropsychiatric symptoms in people with AD. We therefore propose that protocolized MTT interventions are needed to increase access to better address neuropsychiatric symptoms associated with AD.

A Cluster-Randomized Comparison of Music Therapy Interventions as Measured by Craving and Commitment in Adults on a Detoxification Unit.

Background: Music therapy can positively impact craving, treatment readiness, and motivation in adults with substance use disorder (SUD) on a detoxification unit. However, the existing research is primarily comprised of studies with a single pre- or posttest and there is a need for randomized controlled studies that compare within-session changes resultant of various music therapy interventions to determine best practice. Objective: The purpose of this single-session study was to compare within-session changes between group motivational and educational songwriting (MESW) and group recreational music therapy (RMT) on craving and commitment to sobriety in adults with SUD on a detoxification unit. Method: Participants (N = 100) were cluster-randomized to group MESW or group RMT conditions and completed established psychometric instruments measuring craving and commitment to sobriety at pre- and posttest. Results: Within-group changes were significant in all measures, indicating that music therapy was effective within the temporal parameters of a single session. Although between-group differences were not significant, mean within-session improvements in expectancy, compulsivity, emotionality, total craving, and commitment to sobriety were larger in the MESW condition than the RMT condition. Additionally, the MESW group tended to have slightly more favorable posttest scores than the RMT group in all measures. Conclusion: Despite the temporal limitations of single-session therapy common on detoxification units, both MESW and RMT protocols resulted in significant within-session changes in measures of craving and commitment to sobriety. Implications for clinical practice, limitations of the study, and suggestions for future research are provided.

A Descriptive Analysis of Collaboration and Funding of Articles in the Journal of Music Therapy, 1998-2021.

Music therapists may have strategic advantages for collaborative and interdisciplinary research. As such, there is a need to analyze authorship teams as well as funding in the premiere United States-based music therapy research journal. The purpose of this descriptive study was to analyze independent, collaborative, interdisciplinary, and funded research in the Journal of Music Therapy (JMT) from 1998 to 2021. We built a database of JMT articles from 1998 to 2021 and (1) counted the number of authors contributing to articles, (2) categorized articles as independent, collaborative, or interdisciplinary, and (3) counted the number of articles that received funding. From 1998 to 2021, there were 423 total articles that met our inclusion criteria published in JMT. Although two or more authors contributed to most papers, a high percentage of articles were published by single authors (n = 185, 43.74%). More articles were interdisciplinary (n = 162, 38.30%) than collaborative (n = 90, 21.28%). There was a trend for fewer independent articles in more recent years. Although most articles were not funded (n = 312, 73.76%), interdisciplinary articles were most likely to be funded (n = 72, 64.86% of funded articles) while independent articles were least likely to be funded (n = 17, 15.32% of funded articles). General trends indicate higher frequencies of funded papers in more recent years. Research articles published in JMT have become increasingly team-based, interdisciplinary, and funded. Implications regarding the future of music therapy research, Music Therapy Research 2025, limitations of the study, and suggestions for future research are provided.

An Interpretive Investigation of Music Therapists' Experiences in Rural Communities of the United States.

People in rural communities often encounter unique circumstances when accessing healthcare services and there is a lack of literature investigating music therapy in rural areas. Since nearly 20% of the United States population lives in rural areas, it is imperative to understand not only barriers in providing and accessing music therapy but potential solutions to these challenges. Therefore, the purpose of this exploratory interpretivist study was to identify barriers and potential solutions to improve music therapy access in rural communities within the United States. We conducted semi-structured interviews with five board-certified music therapists with experience working in rural communities. We used an inductive approach to thematic analysis to analyze data and incorporated member checking and trustworthiness to clarify and verify results. We identified five themes (supported by 13 subthemes): (1) General differences between rural and urban communities; (2) Factors potentially increasing therapist burnout; (3) Factors inhibiting service user access to music therapy; (4) Potential solutions to increase access; and (5) Methods to reduce therapist burnout. The emerging themes and subthemes describe insights into the experiences of music therapists working in rural communities and identify unique challenges as well as potential methods to mitigate barriers. Implications for clinical practice, limitations, and suggestions for future research are provided.

A Cluster-Randomized Trial Comparing Songwriting and Recreational Music Therapy via Craving and Withdrawal in Adults on a Detoxification Unit.

BACKGROUND: Craving and withdrawal can contribute to the development and maintenance of substance use disorder (SUD), relapse, and overdose. Although music therapy can positively impact craving and withdrawal in adults with SUD on a detoxification unit, there is a lack of randomized research comparing different music therapy interventions as well as studies measuring within-session changes in these critical constructs. OBJECTIVE: The purpose of this effectiveness study was to compare motivational-educational songwriting (MESW) and recreational music therapy (RMT) via measures of craving and withdrawal in adults with SUD on a detoxification unit using a two-group pre- and posttest design. METHOD: Participants (N = 134) were cluster-randomized to a single group MESW or RMT condition. Established craving and withdrawal psychometric instruments were used as pre- and posttests to determine potential within- and between-group differences. RESULTS: There were significant within-group differences in craving subscales of urges and coping as well as withdrawal, all p < .001. Within-group effect sizes ranged from .244 to .456 with favorable changes from pre- to posttest. There was no between-group difference among the MESW and RMT conditions, all p > .05. CONCLUSIONS: Although the specific music therapy intervention did not impact craving or withdrawal, a single MESW or RMT session can have an immediate and significant positive impact on craving and withdrawal in adults with SUD on a detoxification unit. As the MESW condition also addressed motivational and educational aspects of recovery, perhaps MESW interventions are ideal in detoxification settings.

"I've Lost My Callouses:" A Phenomenological Investigation of Music Therapists Who Left the Profession.

Although changing industries is common for many professionals, there is a lack of research regarding why music therapists have left the profession. The purpose of this phenomenological investigation was to explore why music therapists in the United States left the profession and understand how music therapy academic and clinical training might be applied across a range of occupational opportunities. We interviewed eight music therapists who had worked in and left the profession for employment in other industries. We used interpretative phenomenological analysis to analyze transcripts and incorporated member checking and trustworthiness to verify our findings. The first theme described how there were multiple factors that contributed to the decision to leave the music therapy profession. The second theme described how participants grappled with the decision to leave the music therapy profession. Regarding why music therapists left the profession and how their education and training were related to their new industry, we used a modified social ecological model to depict four superordinate themes (supported by 11 themes) that described (1) individual and interpersonal factors contributing to the need for occupational change; (2) music therapy skills that facilitated occupational change; (3) unmet professional expectations that contributed to occupational change; and (4) desired changes to the music therapy curriculum for greater career flexibility. Constituting an idiosyncratic process for each participant, leaving the music therapy profession was a complex and multifaceted phenomenon. Implications for education and greater career flexibility, limitations of the study, and suggestions for future research are provided.

Individualized Education Program Team Members' Perceptions of Music Therapy: An Interpretivist Investigation.

Although music therapists are often members of the Individualized Education Program (IEP) team in educational settings, there is a lack of research exploring IEP members' perceptions of music therapy. The purpose of this interpretivist study was to understand the perceptions IEP team members have of music therapy in educational settings; 8 professionals from a single school district who had experience working with music therapists as part of the IEP team participated in an individual semi-structured interview. We used in-vivo coding, an inductive approach to thematic analysis, and member and peer checking. We identified 3 themes: (1) Music Therapy Is Beneficial and Unique, (2) Communication With the Music Therapist is Essential, and (3) Additional Access, Education, and Advocacy Are Needed. These themes were supported by 8 subthemes. Participants identified the relevance and integral role of music therapy in addition to the unique contributions music therapists had as part of the IEP team. Moreover, participants highlighted the importance of communication, continued education for IEP team members, and the need for additional access to music therapy services. Implications for clinical practice, limitations of the study, and suggestions for future research are provided.

Change Mechanisms in Patient-Preferred Live Music: An Exploratory Interpretivist Study.

Although there is empirical support for patient-preferred live music (PPLM) in addressing affective states and pain for adults in medical settings, there is a lack of data regarding why PPLM might be effective. Identifying the underlying processes and events of change mechanisms within PPLM has the potential to improve education and clinical training, distinguish music therapy from other music interventions, and augment treatment outcomes for service users. The practitioner's expertise constitutes a component of evidence-based practice and could be used to identify change mechanisms that result in PPLM being effective. Therefore, the purpose of this exploratory interpretivist study was to understand practitioners' perceptions of PPLM change mechanisms for adults in medical settings. I conducted in-depth individual semi-structured interviews with 10 practitioners who had provided protocol-based PPLM in adult medical settings as a component of published research projects. Incorporating member checking and trustworthiness, I used an inductive approach to thematic analysis to analyze data. I identified 3 major themes: Choices within PPLM, Music-based aspects of PPLM, and Positive outcomes resultant of PPLM. These themes were supported by 17 subthemes. The subthemes helped to explain relationships between results and I developed a visual model to conceptualize PPLM change mechanisms. While previous objectivist literature has found PPLM to be an effective intervention for adults in medical settings, the results of the current study provide an evidence-based and practitioner-centric approach to PPLM change mechanisms. Implications for clinical practice, limitations of the study, and suggestions for future research are provided.

Social Skills Instruments for Children with Autism Spectrum Disorder: A Critical Interpretive Synthesis.

Identifying and critically analyzing the most frequently used social skills psychometric instruments (SSPI) for children with autism spectrum disorder (ASD) can inform future music therapy research and clinical practice. Therefore, the initial purpose of this critical interpretive synthesis was to identify the SSPI most frequently used as dependent measures in the Journal of Autism and Developmental Disorders (JADD) for children with ASD from 2012 to 2018. Results indicated that the Social Responsiveness Scale (n = 35), Autism Diagnostic Observation Schedule (n = 19), and Vineland Adaptive Behavior Scales (n = 15) were the most frequently used instruments. Congruent with critical interpretive synthesis methodology, we then identified the psychometric properties and advantages and disadvantages of the 9 most commonly used instruments. To compare these results with the existing music therapy literature, we also identified nonmusical SSPI used as dependent measures in music therapy research for children with ASD in studies published between 2012 and 2018. In comparing the data sets, music therapy researchers used 5 of the 9 SSPI we identified from our JADD review. Understanding frequently used SSPI has applications for consultation and communication with other professionals as well as how future music therapy research is conducted. Implications for clinical practice, limitations of the study, and suggestions for future research are provided.

Quantitative comparison of group-based music therapy experiences in adults with substance use disorder on a detoxification unit: a three-group cluster-randomized study.

Background: Service users' values and preferences are components of evidence-based practice and recovery. Methods: Adults (N = 113) with substance use disorder (SUD) on a detoxification unit were cluster-randomized to one of three group-based single-session conditions: Recreational music therapy (RMT), educational lyric analysis for illness management and recovery (ELA-IMR) or educational songwriting for illness management and recovery (ESW-IMR). Participants completed the Ferrara Group Experiences Scale after their session. Results: There were significant differences in the sharing of emotions and experiences subscale between the RMT and both the ELA-IMR and ESW-IMR conditions, with the educational conditions having higher scores. There was a significant difference in the total group experience between the RMT and ELA-IMR conditions, with the ELA-IMR condition having a higher score. Conclusions: Merging the results of previous literature with the current study, educational music therapy interventions can positively impact recovery-based objectives and the group-based experience in adults with SUD.

Effects of Visual and Aural Presentation Styles and Rhythm on Working Memory as Measured by Monosyllabic Sequential Digit Recall.

Although information is frequently paired with music to enhance recall, there is a lack of basic research investigating how aspects of recorded music, as well as how it is presented, facilitate working memory. Therefore, the purpose of this study was to determine the effects of visual and aural presentation styles, rhythm, and participant major on working memory as measured by sequential monosyllabic digit recall performance. We isolated visual and aural presentation styles and rhythm conditions during six different treatment stimuli presented on a computer screen in the study: (a) Visual Rhythm; (b) Visual No Rhythm; (c) Aural Rhythm; (d) Aural No Rhythm; (e) Visual + Aural Rhythm; (f) Visual + Aural No Rhythm. Participants' (N = 60; 30 nonmusic majors and 30 music majors) task was to immediately recall the information paired with music within each condition. Analyses of variance indicated a significant difference between the visual and visual + aural presentation style conditions with the visual + aural condition having more accurate recall. While descriptive data indicated that rhythm tended to facilitate recall, there was no significant difference between rhythm and no rhythm conditions. Nonmusic major participants tended to have slightly more accurate recall than music major participants, although this difference was not significant. Participants tended to have higher recall accuracy during primacy and recency serial positions. As participants had most accurate recall during the visual + aural presentation style conditions, it seems that the multi-sensory presentation modes can be effective for teaching information to be immediately recalled as long as they do not contain too much information and overload the limited storage capacity of working memory. Implications for clinical practice, limitations, and suggestions for future research are provided.

It's...Complicated: A Theoretical Model of Music-Induced Harm.

While literature exists supporting the use of music for health promotion, scholars have also noted the potential for music-induced harm and other maladaptive effects of music. Harm is a multifaceted construct that can include affective, behavioral, cognitive, identity, interpersonal, physical, and spiritual aspects. As music also represents a multifaceted experience, the relationship between music and harm is complex and can include numerous contextual-, deliverer-, music-, and recipient-based factors. Music-induced harm (MIH) also needs to be clearly defined to understand and protect against it. Therefore, the purpose of this article was to explore the numerous factors influencing how music can result in harm and develop a theoretical model that could be used to inform safe music practices. Drawing from existing models of emotional responses to music, music intervention reporting guidelines, therapeutic functions of music, and holistic wellness, we explored how the interplay between the deliverer, music, and recipient can result in various types of MIH in diverse contexts. We then developed the MIH model to integrate these factors and connect the model with the existing literature. The MIH model highlights the relevance of academic and clinical training, credentialing, occupational regulation, continuing education, and professional organizations that provide accredited curricular oversight to protect people from MIH. Implications for clinical application, limitations, and suggestions for future research are provided.

Music-Based Affect Regulation and Unhealthy Music Use Explain Coping Strategies in Adults with Mental Health Conditions.

While people can use music for affect enhancement and self-regulation, there is a dearth of empirical inquiry investigating if music-based affect self-regulatory factors explain coping strategies in adults with mental health conditions (MHC). Due to the relevance of coping strategies for illness management and recovery, the purpose of this study was to explore music-based affect regulation, healthy and unhealthy music use, and coping strategies in adults with MHC on an acute care unit via correlational and multiple regression analyses. Participants (N = 128) completed the Brief Music in Mood Regulation Scale, the Healthy-Unhealthy Music Scale, and the Brief COPE. Correlational and multiple regression analyses were conducted to determine if music-based affect regulation factors were related to and explained coping strategies. There were numerous significant relationships between music-based affect regulation factors, healthy and unhealthy music use, and coping strategies. Regression results indicated that discharge explained humor, mental work explained positive framing, revival explained positive reframing and acceptance, strong sensation explained acceptance and planning, and entertainment explained denial. Unhealthy music use explained denial and behavioral disengagement. Healthy music use did not significantly explain any coping strategy. Practitioners might consider including education specific to music-based affect regulation to augment the likelihood of recovery.

A randomized pilot study of music therapy in the form of patient-preferred live music on fatigue, energy and pain in hospitalized adult oncology patients on a blood and marrow transplant unit.

INTRODUCTION: There is a lack of randomized research measuring how music therapy might influence fatigue in oncology patients. OBJECTIVE: The purpose of this randomized pilot study was to evaluate the effects of music therapy in the form of patient-preferred live music (PPLM) on fatigue, energy and pain in adults hospitalized on a blood and marrow transplant (BMT) unit. METHOD: Participants (n = 35) were randomly assigned to an experimental or wait-list control group and completed the Lee Fatigue Scale and a 10-point Likert-type pain scale at pre- and posttest. RESULTS: Between-group posttest results were statistically significant for fatigue and pain, with the experimental group having less fatigue and pain than the control group. CONCLUSIONS: PPLM can be a preferred and effective intervention to immediately lessen fatigue and pain without pharmacological intervention. Implications for clinical practice, limitations and suggestions for future research are provided.

Therapeutic Songwriting for Perceived Stigma and Perceived Social Support in Adults with Substance Use Disorder: A Cluster-Randomized Effectiveness Study.

Background: Due to negative societal stereotypes associated with substance use disorder (SUD), many people with addictions experience perceived stigma and lack perceived social support. Perceived stigma can prevent people with SUD from seeking treatment while perceived social support can facilitate recovery. Objective: The purpose of this study was to determine the effects of a single music therapy songwriting intervention on perceived stigma and perceived social support in adults with SUD on a detoxification unit. Method: Participants (N = 132) were cluster-randomized to a therapeutic songwriting or control condition in a single-session design. The experimental condition received a highly structured group-based blues songwriting intervention wherein participants composed lyrics describing stigma against addiction as an inappropriate and false social construct in the first verse and coping with stigma by using social supports in the second verse. Results: Analyses of variance indicated no significant between-group difference in perceived stigma or perceived social support. Conclusions: Due to its non-threatening medium, therapeutic songwriting concerning perceived stigma and perceived social support may be clinically relevant way to target these sensitive yet essential topics. Implications for clinical practice, limitations, and suggestions for future research are included.

Songwriting to Target State Shame, Guilt, and Pride in Adults with Substance Use Disorder on a Detoxification Unit: A Cluster-Randomized Study.

BACKGROUND: Resultant of engaging in behaviors outside of their value systems to maintain addiction, many people with substance use disorder (SUD) feel shame and guilt. Although shame, guilt, and pride do not represent traditional dependent measures in SUD research, experimental studies targeting these constructs are warranted. OBJECTIVE: The purpose of this study was to determine the effects of a single songwriting intervention on state shame, guilt, and pride with adults with SUD on a detoxification unit. METHOD: Participants (N = 118) were cluster-randomized to songwriting or control conditions. To avoid testing fatigue in this single-session study, experimental participants received a group-based blues songwriting protocol targeting state shame, guilt, and pride and then completed the questionnaire. Control participants completed the questionnaire before receiving an intervention. RESULTS: While there was no significant between-group difference in state shame or guilt, there tended to be slightly lower mean scores in the experimental condition. There was a significant between-group difference in state pride (p = .012), with experimental participants having higher mean scores than control participants. CONCLUSION: Although only the state pride measure reached significance, shame, guilt, and pride represent consequential constructs for people with SUD. As addressing shame and guilt can be perceived as confrontational, group-based blues songwriting may represent a positive, engaging, and creative intervention to target these challenging but important topics. Implications for clinical practice, limitations, and suggestions for future research are provided.

Comparing Educational Music Therapy Interventions via Stages of Recovery with Adults in an Acute Care Mental Health Setting: A Cluster-Randomized Pilot Effectiveness Study.

The purpose of this cluster-randomized pilot effectiveness study was to compare two different group-based educational music therapy interventions with a control condition as measured by the stage model of recovery in adults on an acute care mental health unit. Participants (N = 69) were cluster-randomized to one of three single-session conditions: educational lyric analysis (ELA), educational songwriting (ESW), or control. ELA and ESW conditions targeted motivations for and factors contributing to recovery. Results indicated no significant between-group difference. However, ELA and ESW conditions tended to have slightly more favorable stage of recovery mean scores than the control condition. Generally, educational music therapy may be clinically relevant for impacting stage of recovery within the temporal parameters of a single session. As ELA and ESW conditions had similar results, the specific educational music therapy intervention did not affect results. Implications for clinical practice, limitations, and suggestions for future research are provided.