Dementia and the Power of Music Therapy.

Dementia is now a leading cause of both mortality and morbidity, particularly in western nations, and current projections for rates of dementia suggest this will worsen. More than ever, cost effective and creative non-pharmacological therapies are needed to ensure we have an adequate system of care and supervision. Music therapy is one such measure, yet to date statements of what music therapy is supposed to bring about in ethical terms have been limited to fairly vague and under-developed claims about an improvement in well-being. This article identifies the relevant sense of wellbeing at stake in the question of dementia therapies of this type. In broad terms the idea is that this kind of therapy has a restorative effect on social agency. To the extent that music arouses a person through its rhythms and memory-inducing effects, particularly in communal settings, it may give rise to the recovery of one's narrative agency, and in turn allow for both carer and patient to participate in a more meaningful and mutually engaging social connection.

A Survey Study of Pre-Professionals' Understanding of the Canadian Music Therapy Internship Experience.

BACKGROUND: There is limited research to date on the clinical music therapy internship experience from the perspective of the pre-professional. Further study is required to advance this significant stage in clinician development, as it is an intense period when pre-professionals apply and integrate theoretical knowledge about music therapy into their clinical practice. OBJECTIVE: This study aimed to: (1) assess the skills, competence, comfort, concerns, issues, challenges, and anxieties of Canadian undergraduate students at two stages in the internship process (pre- and post-internship); and (2) examine whether these perceptions are consistent with published research on internship. METHODS: Thirty-five pre-professionals, from a pool of 50 eligible respondents (70% response rate), completed a 57-question survey using a five-point Likert scale ranking pre- and post-internship experience and participated in an interview post-study. RESULTS: Survey results indicate a statistically significant increase in pre-professionals' perceived clinical, music, and personal skill development from pre- to post-internship. Areas of desired skill development included counseling, functional guitar, and clinical improvisation. CONCLUSIONS: Recommendations for educators and supervisors are provided with respect to areas of focus in undergraduate education and during clinical internship.

Gatekeeping practices of music therapy academic programs and internships: a national survey.

BACKGROUND: Gatekeeping safeguards access to the practice of a profession to ensure the quality of clinical services. It involves selective admission, continuous evaluation, and timely and ethical decisions in response to trainees with severe professional competency problems (SPCP). To date, little information is available concerning gatekeeping practices in the field of music therapy. OBJECTIVE: This study investigated the extent and outcomes of gatekeeping practices across academic programs and National Roster internship sites approved by the American Music Therapy Association. Specifically, it examined the prevalence of trainees with SPCP, program-wide precautionary measures, common indicators of trainees with SPCP, remedial strategies, and supports and barriers to effective management. METHODS: Thirty-two academic program directors and 77 internship directors completed an online survey. Responses were compiled into aggregate form (frequencies & percentages) for analysis. Chi-square tests with Yates' correction were applied to compare the differences between academic programs and internships. RESULTS: A significantly higher percentage of academic programs (93.8%) reported having at least one trainee with SPCP over the past 5 years than did internships (66.2%). The most common indicators of competency problems included inadequate music skill development, emotional instability, limited communication skills, deficient interpersonal skills, defensiveness in supervision, and lack of insight. Typical remedial methods included referral to personal therapy, increased supervision, and repetition of practicum or extension of internship. CONCLUSIONS: Issues regarding trainees with SPCP are frequently addressed by academic and internship program directors. Improving clarity within professional guidelines and establishing more rigorous and consistent standards across training programs are recommended.

Percussion use and training: a survey of music therapy clinicians.

BACKGROUND: Percussion instruments are commonly used in music therapy practice; however, the body of published literature regarding music therapy-related percussion training and practice is limited. OBJECTIVE: The purpose of our survey study was to describe: (a) clinician perspectives of their academic percussion training; (b) use of percussion testing during academic training; (c) clinician perspectives on relevance, adequacy, and importance of academic percussion training; (d) clinician perspectives of their nonacademic percussion training; and (e) current use of percussion in clinical practice. Through comparisons of these parameters, we sought to provide information that may inform future percussion use and training. METHODS: Participants were selected using an email list from the Certification Board for Music Therapists. Board-certified music therapists (MT-BC) were provided with a researcher-created survey about academic percussion training, nonacademic percussion training, and use of percussion in clinical practice. RESULTS: Survey response rate was 14.4% (611/4234). We used demographic data to address potential nonresponse error and ensure population representation for region of residence and region of academic training. Results revealed concerns about perceived adequacy of percussion training received during music therapy education (14.6% reported receiving no academic percussion training; 40.6% reported training was not adequate), and absence of percussion-specific proficiency exams. Of the training received, 62.8% indicated that training was relevant; however, a majority (76.5%) recommended current music therapy students receive more percussion training on instruments and skills most relevant to clinical practice. CONCLUSIONS: Comparisons between academic training, perceived needs in academic training, and clinical usage may inform future training and clinical competency. We provide suggestions for developing future training, as well as for furthering clinical implementation and research.

Music therapy career aptitude and generalized self-efficacy in music therapy students.

BACKGROUND: While the Music Therapy Career Aptitude Test (MTCAT) provides a measure of student aptitude, measures of perceived self-efficacy may provide additional information about a students' suitability for a music therapy career. OBJECTIVE: As a first step in determining whether future studies examining combined scores from the MTCAT and the Generalized Self-Efficacy (GSE) scale would be useful to help predict academic success in music therapy, we explored the internal reliability of these two measures in a sample of undergraduate students, and the relationship (concurrent validity) of the measures to one another. METHODS: Eighty undergraduate music therapy students (14 male; 66 female) completed the MTCAT and GSE. To determine internal reliability we conducted tests of normality and calculated Cronbach's Coefficient Alpha for each measure. Pearson correlation coefficients were calculated to ascertain the strength of the relationship between the MTCAT and GSE. RESULTS: MTCAT scores were normally distributed and had high internal consistency (Cronbach's α = 0.706). GSE scores were not normally distributed, but had high internal consistency (Cronbach's α = 0.748). The correlation coefficient analysis revealed that MTCAT and GSE scores were moderately correlated ((r = 0.426, p < 0.0001). CONCLUSION: MTCAT scores can be used to partially determine perceived self-efficacy in undergraduate music therapy students; however, a more complete picture of student suitability for music therapy may be determined by administering the GSE alongside the MTCAT. Future studies are needed to determine whether combined MTCAT and GSE scores can be used to predict student success in an undergraduate music therapy program.

'Caregivers' Experiences of a Singing Training Program to Support Person-Centered Dementia Care.

Music-based interventions are acknowledged to be accessible and beneficial to people living with dementia. As part of an over-arching research project exploring the contributions of person-centered caregiver singing (PCCS) intervention to caregiver's provision of care, this study aimed to explore caregiver's experiences of a PCCS training program. 8 caregivers across 2 care homes in South Africa participated in 4 iterative participatory cycles aimed at refining the training protocol. We completed a thematic analysis of semi-structured interviews of caregivers' experiences of the training. 3 themes emerged: workshop components contributed to positive learning experiences; caregivers' increased knowledge and insight into dementia, music, and personhood; and caregivers' enhanced self-efficacy which encompassed their emotional wellbeing, self-awareness, and confidence. Our study highlights caregivers' self-efficacy, self-hood, and personhood as valuable benefits in person-centered care training. Caregivers experienced training as both professionally and personally beneficial. While PCCS supported a shift toward a person-centered care approach, further research would help establish approaches to support sustainability of PCCS training and use in wider contexts.

Music therapy services for individuals with autism spectrum disorder: a survey of clinical practices and training needs.

BACKGROUND: Over the past decade, the definitions, diagnoses, prevalence rates, theories about the causes, evidence-based treatment options, and practice guidelines pertaining to Autism Spectrum Disorder (ASD) have undergone numerous changes. While several recent studies evaluate the effects of music therapy interventions for individuals with ASD, no current review reflects the latest music therapy practices and trends. OBJECTIVES: The purpose of this study was to evaluate the status of music therapy practices for serving clients with ASD, the implementation of national ASD standards and guidelines, the awareness of recent developments, and training needs of music therapists. METHOD: Professional members of the American Music Therapy Association who are working with individuals with ASD served as the sample for this national cross-sectional survey study (N = 328). A 45-item online questionnaire was designed and distributed through email and social media. Participants accessed the online survey through SurveyMonkey®. RESULTS: Findings suggest music therapy practices and services for individuals with ASD have shifted and now reflect a slightly higher percentage of caseload, a broader age range of clients, and a trend to serve clients in home and community settings. Most therapeutic processes align with recommended practices for ASD and incorporate several of the recognized evidence-based practices. Less understood or recognized are inclusion practices and latest developments in the field of ASD. CONCLUSIONS: Music therapists have a solid understanding of providing services for individuals with ASD, but would benefit from advanced online training and improved information dissemination to stay current with the rapidly changing aspects pertinent to this population.

A nationwide survey of nurses' attitudes toward music therapy and their need for education in its application.

BACKGROUND: Music therapy is increasingly used to help heal patients. However, there is a significant gap in the literature about nurses' attitudes toward and need for education in music therapy for nursing practice. This cross-sectional study was conducted to describe nurses' attitudes toward music therapy and determine their need for education in music therapy. METHODS: Participants included 1,197 nurses who were recruited from hospitals in different regions of Taiwan. RESULTS: Participants expressed positive attitudes toward music therapy. Most participants were willing to learn about music therapy. "Skill in using musical instruments" was the most frequently identified educational need. Further study of the discrepancy between the attitudes toward "performing music therapy" and "learning music therapy" is needed to clarify why nurses expected that they would receive no support for attending music therapy education. CONCLUSION: Given participants' attitudes toward music therapy and their motivation for learning, nursing administrators and educators may consider developing policies to further the advancement of music therapy in educational programs and practice.

"Taking Time": Exploring Music Therapy Student Self-Care Definitions and Practices.

The concept of self-care for music therapists is not a new topic in the literature, yet music therapy students' perspectives have largely been excluded from formal discussions and research studies. For this reason, this study aimed to examine music therapy students' conceptualizations of self-care and identify practices that students frequently engage in for self-care. As part of a national survey, music therapy students currently enrolled in an academic degree program for music therapy within the United States defined self-care and identified up to three of their most frequent self-care practices. We analyzed the student self-care definitions and self-care practices using inductive content analysis. Two primary categories emerged from the student definitions-the Act of Self-Care and the Desired Outcomes of Self-Care-with several more detailed subcategories. Additionally, we grouped participants' most common self-care practices into 10 categories and identified two emergent areas for exploration: self-care practices done with others/done alone and engaging in self-care practices that intentionally do not involve anything related to academics/coursework/clinical work. Together, these findings indicate that students' conceptualizations of self-care and their self-care practices have similarities and differences with music therapy professionals' perspectives and practices. We discuss these findings in depth and provide recommendations for future self-care discussions that emphasize the need to prioritize students' perspectives and to expand conceptualizations of self-care to include contextual and systemic impacts and factors that influence the individual self-care experience.

Music education for improving reading skills in children and adolescents with dyslexia.

BACKGROUND: Dyslexia (or developmental dyslexia or specific reading disability) is a specific learning disorder that has a neurobiological origin. It is marked by difficulties with accurate or fluent recognition of words and poor spelling in people who have average or above average intelligence and these difficulties cannot be attributed to another cause, for example, poor vision, hearing difficulty, or lack of socio-environmental opportunities, motivation, or adequate instruction. Studies have correlated reading skills with musical abilities. It has been hypothesized that musical training may be able to remediate timing difficulties, improve pitch perception, or increase spatial awareness, thereby having a positive effect on skills needed in the development of language and literacy. OBJECTIVES: To study the effectiveness of music education on reading skills (that is, oral reading skills, reading comprehension, reading fluency, phonological awareness, and spelling) in children and adolescents with dyslexia. SEARCH METHODS: We searched the following electronic databases in June 2012: CENTRAL (2012, Issue 5), MEDLINE (1948 to May Week 4 2012 ), EMBASE (1980 to 2012 Week 22), CINAHL (searched 7 June 2012), LILACS (searched 7 June 2012), PsycINFO (1887 to May Week 5 2012), ERIC (searched 7 June 2012), Arts and Humanities Citation Index (1970 to 6 June 2012), Conference Proceedings Citation Index - Social Sciences and Humanities (1990 to 6 June 2012), and WorldCat (searched 7 June 2012). We also searched the WHO International Clinical Trials Registry Platform (ICTRP) and reference lists of studies. We did not apply any date or language limits. SELECTION CRITERIA: We planned to include randomized controlled trials. We looked for studies that included at least one of our primary outcomes. The primary outcomes were related to the main domain of the reading: oral reading skills, reading comprehension, reading fluency, phonological awareness, and spelling, measured through validated instruments. The secondary outcomes were self esteem and academic achievement. DATA COLLECTION AND ANALYSIS: Two authors (HCM and RBA) independently screened all titles and abstracts identified through the search strategy to determine their eligibility. For our analysis we had planned to use mean difference for continuous data, with 95% confidence intervals, and to use the random-effects statistical model when the effect estimates of two or more studies could be combined in a meta-analysis. MAIN RESULTS: We retrieved 851 references via the search strategy. No randomized controlled trials testing music education for the improvement of reading skills in children with dyslexia could be included in this review. AUTHORS' CONCLUSIONS: There is no evidence available from randomized controlled trials on which to base a judgment about the effectiveness of music education for the improvement of reading skills in children and adolescents with dyslexia. This uncertainty warrants further research via randomized controlled trials, involving a interdisciplinary team: musicians, hearing and speech therapists, psychologists, and physicians.

Effective Ways for College Students' Mental Health Education Based on Music Therapy.

Music therapy plays a very important role in college students' mental health education. As a marginal subject, music therapy combines music, medicine, and psychology, which is beneficial to alleviate students' bad emotions and psychological problems and help college students form a sound personality. In the process of teaching in colleges and universities, it is necessary to choose teaching methods that are closer to students' real life so as to promote the healthy development of college students' psychology. From the relevant investigation and analysis, college students are interested in learning music, which provides an effective basis for college students to use music to treat psychological problems. Good policies, conditions, and a broad mass base are conducive to the application of music therapy in college mental health education. The application of music therapy in the field of college students' mental health also broadens the application field of music. This paper analyzes the application of music therapy in college students' mental health education and probes into the effective ways for college students' mental health education.

"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.

Analysis of the Effectiveness of Music Therapy on Mental Health of College Students.

Music therapy is a relatively mature marginal subject at present, and it is also a relatively common treatment method. This kind of treatment can better help college students get rid of bad psychology and guide their psychology to develop in a healthy direction. Mental health is one of the important indicators to measure the comprehensiveness of human quality and plays an important role in the sustainable development of human beings. Music therapy plays a very important role in college students' mental health education. As a marginal subject, music therapy combines music, medicine, and psychology, which is beneficial to alleviate students' bad emotions and psychological problems, and helps college students form a sound personality. Using music therapy can let college students vent their emotions in a suitable environment and atmosphere and then guide them correctly. This paper introduces the effectiveness of music therapy in college students' mental health education and then puts forward important measures to promote the implementation of music therapy in college students' mental health education.

The effect of background music on the perception of personality and demographics.

This study seeks to discover stereotypes people may have about different music genres and if these stereotypes are projected onto an individual. Also, the study investigates if music therapy students are more or less biased than non-music majors in this regard. Subjects (N=388) were comprised of student members of the American Music Therapy Association (N=182) and students from a college in the southeastern United States who were not music majors (N=206). Subjects were asked to listen to a recording and complete a short survey. Subjects assigned to the control condition heard only a person reading a script. Subjects assigned to one of the four experimental conditions heard the same recording mixed with background music and ambient crowd noise, intended to simulate a live performance. Subjects were asked to rate the person in the recording on personality descriptors and predict demographic information in the survey. Many of the survey responses were significantly affected by the genre of music. For example, it was shown that when in the presence of rap or country music, all subjects rated the personality of the person in the recording significantly more negative than when in the presence of classical, jazz, or no music. There were no significant differences between the groups for any variable or condition when comparing survey responses between college students and AMTA student members.

Personal therapy for undergraduate music therapy students: a survey of AMTA program coordinators.

The primary purpose of this study was to gather information in order to understand if and how various modalities of personal therapy are employed with undergraduate music therapy students in the United States. AMTA degree program coordinators were asked about 3 therapy modalities, in particular: verbal therapy, music therapy, and expressive arts therapy (excluding music therapy). It was predicted that less than a quarter of the respondents would indicate that personal therapy of any modality was required in their undergraduate curricula, but that a larger percentage would indicate that it was encouraged. Both hypotheses were supported, with just over 14% of the respondents indicating that they require some form of personal therapy and 32% indicating that they encourage it, with 73% of this latter subgroup encouraging verbal therapy and 46% encouraging music therapy. It was further predicted that, when therapy was required or encouraged, it was most often provided by an individual who was associated with the college/university and that therapy was usually provided in a group format. Respondent comments related to these 2 questions revealed considerable confusion between experiential exercises and personal therapy, leading to dubious validity of some of the numerical data. Qualitative treatment of narrative responses illuminated 4 salient issues regarding personal therapy for undergraduate music therapy students, as follows: (a) the legal and ethical feasibility of making personal therapy a requirement; (b) the cost and availability of qualified professionals; (c) the benefits of personal therapy as an integral facet of undergraduate music therapy training and education; and (d) the appropriateness of personal therapy at the undergraduate level of training.

A descriptive study of Myers-Briggs personality types of professional music educators and music therapists with comparisons to undergraduate majors.

The purpose of the current study was to determine personality types and demographic characteristics of professional music educators and music therapists. The researchers also sought to determine if personality types of professionals were consistent with undergraduate majors in those fields and personal characteristics as suggested by The Music Education National Conference (MENC) and the American Music Therapy Association (AMTA). The research of Steele and Young (2008) found strong similarities and some differences between undergraduate music education and music therapy students. The possibility that basic types extend across the life span may strengthen understanding of job satisfaction, stress, burn out and other factors affecting retention. Participants were a voluntary convenience sample of 253 music educators (n=110) and music therapists (n=143). The highest preference for music educators was Extrovert-Intuition-Feeling-Judgment (ENFJ) and the highest preference for music therapists was Introvert-Intuition-Feeling-Judgment (INFJ). The difference in the collective type of each group was their "outlook on life", which was either Extrovert or Introvert. However, both groups were the same in their secondary type functions of "NFJ". A comparison of findings with the Steele and Young (2008) study suggested small changes in personality type over time. Caution must be exercised in generalizing findings; however this descriptive investigation may serve as the basis for future studies, which should help foster a stable work force in these professions.

The effect of music video exposure on students' perceived clinical applications of popular music in the field of music therapy: a pilot study.

The purpose of this study was to examine the effect of video exposure on music therapy students' perceptions of clinical applications of popular music in the field of music therapy. Fifty-one participants were randomly divided into two groups and exposed to a popular song in either audio-only or music video format. Participants were asked to indicate clinical applications; specifically, participants chose: (a) possible population(s), (b) most appropriate population(s), (c) possible age range(s), (d) most appropriate age ranges, (e) possible goal area(s) and (f) most appropriate goal area. Data for each of these categories were compiled and analyzed, with no significant differences found in the choices made by the audio-only and video groups. Three items, (a) selection of the bereavement population, (b) selection of bereavement as the most appropriate population and (c) selection of the age ranges of pre teen/mature adult, were additionally selected for further analysis due to their relationship to the video content. Analysis results revealed a significant difference between the video and audio-only groups for the selection of these specific items, with the video group's selections more closely aligned to the video content. Results of this pilot study suggest that music video exposure to popular music can impact how students choose to implement popular songs in the field of music therapy.

Music therapy career aptitude test.

The purpose of the Music Therapy Career Aptitude Test (MTCAT) was to measure the affective domain of music therapy students including their self-awareness as it relates to the music therapy career, value in human development, interest in general therapy, and aptitude for being a professional music therapist. The MTCAT was administered to 113 music therapy students who are currently freshman or sophomores in an undergraduate music therapy program or in the first year of a music therapy master's equivalency program. The results of analysis indicated that the MTCAT is normally distributed and that all 20 questions are significantly correlated with the total test score of the MTCAT. The reliability of the MTCAT was considerably high (Cronbach's Coefficient Alpha=0.8). The criterion-related validity was examined by comparing the MTCAT scores of music therapy students with the scores of 43 professional music therapists. The correlation between the scores of students and professionals was found to be statistically significant. The results suggests that normal distribution, internal consistency, homogeneity of construct, item discrimination, correlation analysis, content validity, and criterion-related validity in the MTCAT may be helpful in predicting music therapy career aptitude and may aid in the career decision making process of college music therapy students.

Feminist music therapy pedagogy: a survey of music therapy educators.

This study surveyed 188 music therapy educators regarding their views and use of feminist pedagogy and feminist music therapy. The purpose of this study was two-fold: (a) to determine how many music therapy educators used feminist pedagogy and (b) to determine if there was a relationship between the use of feminist pedagogy and academic rank of the participants. Seventy-two participants responded to this study, with 69 participants included for data analysis. Stake and Hoffman's (2000) feminist pedagogy survey was adapted for this study, examining four subscales of feminist pedagogy: (a) participatory learning, (b) validation of personal experience/development of confidence, (c) political/ social activism, and (d) critical thinking/open-mindedness. The results revealed that 46% (n=32) of participants identified as feminist music therapists and 67% (n=46) of participants identified as using feminist pedagogy. Results of a mixed analysis of variance revealed a statistically significant difference within the four survey subscales (p<.0001), no significant difference (p=.32) for academic rank, and no significant interaction (p=.08) of academic rank and the four survey subscales. Tukey's post hoc analysis of the data indicated that the survey subscale measuring political activism (p<.0001) was significantly lower than the other three survey subscales. In addition, a qualitative analysis on open-ended responses is also included. Discussion of the results, limitations, and areas for future research are addressed.

Clinical practice of dual-certified music therapists/child life specialists: a phenomenological study.

The discipline of child life enjoys a strong presence in many medical settings within the current pediatric healthcare environment. Due to the widespread establishment of child life programs, music therapists often find themselves negotiating their role and contributions to pediatric healthcare in relation to the field of child life. There is increasing interest among music therapy interns and clinicians in pursuing certification in child life to increase clinical knowledge and enhance marketability. A small, but strong, cohort of dual-certified music therapists/child life specialists is currently practicing in the field, but the nuances of their clinical practice have not been systematically examined. The current study used an interpretative phenomenological approach to explore the lived experiences of eight dual-certified clinicians, and to interpret how clinicians make sense of those lived experiences. Two overarching themes of identity and flexibility arose from the analysis: issues relating to establishing, challenging, and modifying professional identity; and flexibility manifested within areas of theoretical orientation, professional role, and clinical approach. Dual-certified clinicians vary in the degree to which they integrate the fields of music therapy and child life in practice, from complete and seamless integration of the two, to exclusive practice of only one field, depending upon the bounds of their positions. Participants reported that child life training is beneficial, but not necessary for achieving advanced practice in pediatric medical music therapy. Implications for the continuing advancement of music therapy in pediatric healthcare are discussed.