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How to deal music? Enhancing coping strategies in music therapy with clients suffering from addiction problems
Abstract
This article describes some of the music therapeutic techniques that the authors use in their daily treatment as music therapists and observation practice with clients suffering from addiction. The article depicts the comparisons and differences between addiction problems combined with psychiatric and forensic ones. The musical assignments stress the additional value of the action ori-ented methods of music therapy in comparison with verbal processing. A couple of key-aspects will be addressed such as: addiction, music (ther-apy), coping strategies, analogy, body-language. The two authors show their specific music therapy methodology, illustrated by examples from their practice in an addiction service respectively forensic psychiatric setting.
... Dijkstra and Hakvoort (2006), Hakvoort (2007aHakvoort ( , 2007b and Reed, 2002 describe how music therapy can be applied to improve the coping skills of forensic psychiatric patients. Some music therapy programs pay specific attention to promote alternative behaviors to drug abuse (Dijkstra & Hakvoort, 2010;Gallager & Steel, 2002;Silverman, 2003Silverman, , 2010. All the reported programs are specifically designed to meet the need principles of offenders and / or forensic psychiatric patients. ...
... Treatment modalities are for example, cognitive behavioral therapy, schemafocus therapy and psychodrama combined with neurological, biological and psychosocial orientations. Music therapy is often a part of this multi-modal treatment approach in forensic psychiatry in the Netherlands (Dijkstra & Hakvoort, 2010;Fulford, 2002;Gallagher & Steele, 2002;Reed, 2002;Wyatt, 2002). Smeijsters and Cleven (2004) interviewed music therapists (among other art-related therapies) working within forensic psychiatry in the Netherlands and showed strong consensus on the role of music therapy within the forensic psychiatric treatment program. ...
... During music therapy the observation of coping skills and possible social dysfunction and aggressive behavior will be on non-musical as well as on musical behavior and interaction (e.g., Dijkstra & Hakvoort, 2010;Gant, 2000;Hoskyns, 1995). Situations under investigation are failing, being declined, etc. during music therapy and at the living unit. ...
There is a widespread assumption that music therapy is mainly suited to improve the well-being of people. The field of forensic psychiatry is no exception. Recent music therapy literature suggests the core treatment goals of music therapy to be mental health issues of offenders or forensic psychiatric patients. These mental-health issues are defined, among others, as building self-esteem, empathy, and an improved concept of self.
The present dissertation outlines an alternative point of departure. The main argument being that music therapy—approached from a scientific, neurologic, and cognitive behavioral perspective, could offer a wider treatment perspective for forensic psychiatric patients or other offenders than mainly focusing on accommodating mental growth for this population.
In order to facilitate this step in the development of music therapy, an alternative theoretical foundation is developed for the treatment of forensic psychiatric patients with respect to the primary goals in forensic psychiatric treatment. According to the evidence-based practice in this field these goals comprise among others: the elaboration of coping skills, anger management, and aggression regulation. The present dissertation proposes that music therapy can have the potential to advance such behavioral changes in forensic psychiatric patients—changes that ultimately may help them reduce the probability of relapse.
The main goal of the present dissertation is to theoretically and empirically explore which underlying mechanisms can drive music therapy treatment to results in forensic psychiatry. At the same time the connection with evidence-based literature in this field and in the field of music therapy is considered. The core of the theoretical and empirical evidence built in forensic psychiatry points at the risk, need and responsivity (RNR) principles of forensic psychiatric patients. Using this evidence, as well as results from natural and behavioral science towards the applicability of music, we focus on developing a model of music therapy treatment that not only could accommodate mental health issues, but also might contribute to the need principles of forensic psychiatric patients.
From these considerations the main research question of this dissertation is formulated, as: “Can we create a theoretical framework —through literature review as well as empirical research—that explains possible effectiveness of music therapy within forensic psychiatry by validating core assumptions of the risk-, need and responsivity principles as well as musical ones for forensic psychiatric patients with personality disorders as their primary psychiatric diagnosis?” Different studies (literature studies, theoretical work, and empirical studies) are conducted to address four sub-questions that are derived from the main research question.
... Music could also assist the development of a trustful relationship between the therapist and the addicted individual and thus, slowly but steadily, facilitate breaking substance-addicted individuals' defences during therapy (Bednarz & Nikkel, 1992). Finally, the link between music and pop culture may also provide an additional therapeutic tool for the exploration and modification of maladaptive emotional and behavioural patterns, for facilitating emotional expression, and for promoting rebuilding of self-identity as a group member in a group therapy setting (Dijkstra & Hakvoort, 2004). ...
... Music could also assist the development of a trustful relationship between the therapist and the addicted individual and thus, slowly but steadily, facilitate breaking substance-addicted individuals' defences during therapy (Bednarz & Nikkel, 1992). Finally, the link between music and pop culture may also provide an additional therapeutic tool for the exploration and modification of maladaptive emotional and behavioural patterns, for facilitating emotional expression, and for promoting rebuilding of self-identity as a group member in a group therapy setting (Dijkstra & Hakvoort, 2004). ...
... Music could also assist the development of a trustful relationship between the therapist and the addicted individual and thus, slowly but steadily, facilitate breaking substance-addicted individuals' defences during therapy (Bednarz & Nikkel, 1992). Finally, the link between music and pop culture may also provide an additional therapeutic tool for the exploration and modification of maladaptive emotional and behavioural patterns, for facilitating emotional expression, and for promoting rebuilding of self-identity as a group member in a group therapy setting (Dijkstra & Hakvoort, 2004). ...
... Music could also assist the development of a trustful relationship between the therapist and the addicted individual and thus, slowly but steadily, facilitate breaking substance-addicted individuals' defences during therapy (Bednarz & Nikkel, 1992). Finally, the link between music and pop culture may also provide an additional therapeutic tool for the exploration and modification of maladaptive emotional and behavioural patterns, for facilitating emotional expression, and for promoting rebuilding of self-identity as a group member in a group therapy setting (Dijkstra & Hakvoort, 2004). ...
... Music could also assist the development of a trustful relationship between the therapist and the addicted individual and thus, slowly but steadily, facilitate breaking substance-addicted individuals' defences during therapy (Bednarz & Nikkel, 1992). Finally, the link between music and pop culture may also provide an additional therapeutic tool for the exploration and modification of maladaptive emotional and behavioural patterns, for facilitating emotional expression, and for promoting rebuilding of self-identity as a group member in a group therapy setting (Dijkstra & Hakvoort, 2004). ...
... Music could also assist the development of a trustful relationship between the therapist and the addicted individual and thus, slowly but steadily, facilitate breaking substance-addicted individuals' defences during therapy (Bednarz & Nikkel, 1992). Finally, the link between music and pop culture may also provide an additional therapeutic tool for the exploration and modification of maladaptive emotional and behavioural patterns, for facilitating emotional expression, and for promoting rebuilding of self-identity as a group member in a group therapy setting (Dijkstra & Hakvoort, 2004). ...
Artiklen omhandler et forskningsprojekt på Sct. Hans Hospital, hvor effekten af receptiv korttidsterapi med misbrugspatienter undersøges. Atten patienter med misbrugsproblematik deltog i et kognitivt terapi-program, som inkluderede receptiv musikterapi i en gruppesetting. Størsteparten af deltagerne havde udover en alvorlig misbrugsproblematik en diagnose indenfor ICD 10s spektrum af personlighedsforstyrrelser. Effekten af musikterapien blev undersøgt ved hjælp af Antonovskys spørgeskema Oplevelse Af Sammenhæng (OAS-29), og et semistruktureret interview efter terapiperioden på ti sessioner. Interviewet fokuserede på patienternes opfattelse af, hvad de havde haft mest gavn af i terapiperioden. Resultaterne viste en signifikant fremgang i alle tre OAS sub-skalaer (meningsfuldhed, begribelighed, håndterbarhed), og alle deltagerne fandt at musikterapidelen af deres program var en betydningsfuld udvidelse af den kognitive terapi. For flertallet af deltagerne spillede musikterapien en væsentlig rolle i deres restitueringsproces, og specifikke billeder, symboler og følelser fra musikterapien gjorde stærkt indtryk på dem. Artiklen præsenterer udvalgte musikeksempler og kliniske vignetter.
Onderwerp van het artikel is de relatie tussen muziektherapie en psychotherapie. De theorievorming op dit gebied, die de laatste
jaren internationaal tot ontwikkeling kwam, wordt weergegeven met de bedoeling nauwkeuriger de kenmerken waarin muziektherapie
en psychotherapie overeenstemmen en verschillen aan te geven. Aan de hand van een definitie van ‘indicatie’ wordt nader bepaald
wanneer muziektherapie de aangewezen therapie voor psychische stoornissen is. Het zijn vooral stoornissen met een non-verbaal
of preverbaal karakter waar muziektherapie een rol van betekenis speelt, mits het psychische proces waardoor de stoornis kan
verminderen in het muzikale gebeuren weerspiegeld wordt. Aan de hand van een definitie van analogie worden voorbeelden gegeven
van overeenkomsten tussen psychische en muzikale processen, zoals verbrokkeling, aanpassing, afstand en nabijheid.
This report examines the prevalence of personality disorders among hospitalized alcoholics and polydrug addicts and the extent and nature of the overlap between different axis II disorders. Subjects were 178 alcoholics admitted to a diagnostic unit of an addiction treatment institute and 86 polydrug addicts admitted to the therapeutic community of the same institute. Substance abuse was diagnosed according to DSM-III-R, and patients were assessed with the Structured Interview for DSM-III Personality Disorders (SIDP). In the alcohol group, 78% of the patients had at least one personality disorder and the average number of personality disorders was 1.8 per patient. In the polydrug group, 91% of the patients met criteria for at least one personality disorder and the average number of personality disorders was 4.0 per patient. No single "addictive personality" emerged. These findings raise questions about the validity and usefulness of the distinction between axis I and axis II disorders in patients with substance use disorders, and do not lend support to the validity of the categorical classification of personality pathology.
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