No full-text available
To read the full-text of this research,
you can request a copy directly from the author.
Family-based music therapy: from dissonance to harmony
Abstract
This study is unique in that it expands the use of family music therapy to a broader range of families. It moves beyond the prevailing tendency to employ family music therapy with families of children with special needs to nonclinical families seeking therapy. Joining Alvin’s free improvisation model and Satir’s experiential family therapy, the study engages family members in mutual musical improvisation. It explores the clinical application and therapeutic value of short-term family-based music therapy with three families in a community setting. Each family received six pre-structured interventions from the dual-expertise music and family therapist. Results reveal family-based improvisations accurately accentuated family dynamics as musical representations. They provoked heightened awareness of family difficulties, which were explored using process questions and verbal reflections. Evidence suggests that family-based music therapy can serve as an effective and accurate family clinical assessment, and an intervention addressing an array of family objectives. Family-based music interventions tapped into family resources for the sake of promoting family and individual congruence and well-being. The study informs music therapists of the clinical value of adding a family-systems perspective to their professional toolbox, and family therapists and other clinicians of the potential of family-based musical interventions in family therapy.
... Creative arts are compatible with most schools of family therapy (Armstrong and Simpson 2002;Lantz and Ritz 2003;Malchiodi 2003) acting as catalysts, significantly enhancing and augmenting family dynamics, authenticity, and communication patterns. Art taps into the unconscious, bypasses habitual and conscious censors, affords opportunities for growing insight into family dynamics, and promotes change (Malchiodi 2003;Nemesh 2017b;Satir et al. 1991). ...
... Newer studies by Jacobsen and Killén (2015), Thompson (2012), Nemesh (2017b), and Pasiali (2013) provided rare examples of family-based music therapy, which focuses on the entire family as a unit, "engaging all family members to address relationship and communication difficulties" (Pasiali 2013, p. 250). They reinforced and supported the therapeutic benefits and assessment qualities acknowledged over two decades ago. ...
... They have "discover[ed] that drawing activities and other expressive media are helpful in assessment and treatment of people of all ages" (Malchiodi 2003, p. xii), thus endorsing a common use of family arts. Contrasting with the growing use of visual arts in family therapy-and despite their seemingly high potential and prospects-musical interventions are rarely used by family therapists (Nemesh 2017b;Smith and Hertlein 2016). Family-based musical interventions appear absent in family therapy clinical work and from family therapy education and training programs. ...
Although rarely used by family therapists, musical interventions have the potential to become a more common technique in family therapy. Music’s unique therapeutic properties engage families, including young children and adolescents, in a meaningful, therapeutic, “here-and-now” creative process. Musical interventions act as catalysts, enable direct communication, and augment authentic communication patterns in a playful atmosphere. The purpose of this explanatory mixed-methods research was to obtain a greater understanding of the clinical applicability, therapeutic value and future implementation of a musical intervention carried out by family therapists in a family therapy context. The study explored the outcomes of 35 participating family therapists who attended a designated workshop on a structured family-based musical intervention, 18 of whom then applied 38 family-based musical sessions focused on family roles in their clinical work. The results illustrate the family-based musical intervention is a noteworthy tool for family clinical assessment and treatment, easily applicable in a variety of private and public settings with diverse populations. Musical instruments used as intermediary objects are potent vehicles for growing family awareness, functioning, and congruence, as well as inducing opportunities for change. The family-based musical intervention manifests the potential of an interdisciplinary, holistic, biopsychosocial approach to promoting individual and family wellbeing. The article also addresses ethical considerations and implications for family therapy training and education programs.
... Tapping into the unconscious, they by-pass habitual behaviors and conscious censors. They afford new opportunities for growth, awareness, and insight into family dynamics, thus promoting a process of change (Kerr, Hoshini, Sutherland, Parashak, & McCarley, 2008;Lowenstein, 2010;Malchiodi, 2012;Nemesh, 2017;Satir, Banmen, Gerber, & Gomori, 1991). ...
... The visual arts lead the field of family arts therapies (Kerr et al., 2008). Following visual arts come the fields of family dance/movement (Dulicai, 2009), drama (Strevett-Smith, 2010, psychodrama (Flomenhaft & DiCori, 2008), bibliotherapy (Marinn-Pierce, 2015), and finally musical interventions (Jacobsen & Killén, 2015;Nemesh, 2017). All are currently being developed and integrated in systemic therapy contexts. ...
... In the early 1990s, music therapists described and used musical interventions with families of individual clients, noting their contribution to the therapeutic process and family well-being (Decuir, 1991;Hibben, 1992;Miller, 1994). Since then, musical interventions with families were mainly developed for children with various special needs and their families, primarily focusing on the individual's needs and welfare (Molyneux, 2005;Nemesh, 2017;Oldfield, Bell, & Pool, 2012;Oldfield & Flower, 2008;Pasiali, 2012;Thompson, 2012). Studies concerning family-based musical interventions where the family as an entity is the focus of the therapy remain rare and primarily involve limited case studies (Nemesh, 2017;Pasiali, 2012). ...
Family musical interventions offer significant therapeutic outcomes when applied by music therapists. Although mainly focused on individuals with special needs, interventions contribute to family well-being by promoting family communication, shared emotions, relationships, roles, dynamics, mutual trust, and parental functioning. Despite the potential, family-based musical interventions are rarely used by family therapists or studied in family therapy programs. Thirty-five family therapists participated in an explanatory mixed-methods research aimed at identifying therapists’ perceptions toward musical interventions in clinical work, illuminating numerous sources influencing therapists’ inclination to refrain from using musical interventions. This article discusses implications for promoting use of musical interventions.
... People can freely choose their preferred types of music, allowing for a personalized music experience that enhances subjective well-being. Additionally, listening to music may promote interaction and communication among family members, enhance family harmony, and is associated with higher levels of overall happiness [15]. People who frequently listen to music generally report recovering more quickly from negative emotions and experiencing more joy and satisfaction in their daily lives [16]. ...
This study examines the association between listening to music at home and subjective well-being, using data from 14,162 respondents in the China General Social Surveys conducted in 2015, 2017, and 2021. Among the respondents, the average happiness score was 3.958. Regression analyzes indicate that frequent music listening is significantly associated with higher happiness levels, with coefficients of 0.384 in the baseline model and 0.570 in the model with control variables. Robustness checks performed across different models support these findings. Instrumental variable analysis, using Mandarin proficiency, yielded a coefficient of 0.212, indicating a robust association despite a slight reduction in magnitude. Heterogeneity analyzes showed consistent associations across genders, religious beliefs, and regions, with slightly stronger associations observed for females and non-religious individuals. Mediation analysis identified mental health and class identity as significant mediators, contributing to a total association of 0.146. These results highlight the positive correlation between music listening and well-being, suggesting the potential value of integrating music resources into well-being strategies.
... Contemporary research and practice widely use the SGM in areas such as life meaning enhancement (Wang & Peng, 2017), negative emotions transformation , and suicidal ideation intervention (Romney, Hawkins, & Soloski, 2020), and so on. In recent years, researchers have enriched SGM's application by combining it with therapies such as music therapy (Nemesh, 2017), emotion-focused therapy (Brubacher, 2006), and sandplay therapy (Wang & Peng, 2017). Kim (2007) explored the SGM's value in career interventions for college students in Korea, and found that the intervention improved career decision making and career decisionmaking self-efficacy. ...
This study introduced Satir Growth Model (SGM) into career intervention to enhance Chinese college freshmen’s career adaptability. The effect of SGM-based career intervention was examined by the randomised controlled trial design. Results indicated that the experimental group experienced a significant increase in career exploration and career adaptability after seven sessions of the SGM-based career intervention. Our study also found that career exploration could partly mediate the relationship between experimental condition and career adaptability. One year later, the experimental group accomplished a follow-up test, which showed that the effect of SGM-based career intervention could remain in a long run. These results suggested that the SGM-based career intervention could be a new approach for the enhancement of career adaptability.
... The themes described above demonstrate that shared music-making using Additionally, these findings contribute to knowledge about ecological approaches to music therapy with families (Thompson, 2014), by exploring the use of Figurenotes to facilitate music-making by families, and by further elucidating the role of music-making in enhancing family relationships (Nemesh, 2017). ...
Figurenotes is a simplified visual music notation system developed in Finland in the mid-1990s for
people challenged by the abstract nature of conventional music notation. The system facilitates
music reading and instrument playing, thus allowing active participation in music-making. The use of
Figurenotes in both educational and therapeutic settings is now spreading to other countries. This
thesis examines specifically the effectiveness and applicability of Figurenotes as a tool to facilitate
music-making by children with autism in Australia, through the lens of a journey in reflective practice
by the researcher-practitioner.
The study involved three phases: in the first phase, eight individual children aged 6 to 13 years with
autism participated in eight weekly sessions; in the second phase, two school groups of children with
autism participated in an eight-week phase, and finally the families of the initial eight individuals
participated in an additional phase of four weekly sessions each. Sessions involved the use of
Figurenotes in rhythmic and creative activities, participating in ensembles, and developing playing
technique using digital keyboards and tuned percussion instruments. The action research
methodological approach allowed flexibility in study design, incorporating cycles of reflecting,
planning, acting, and observing within the three phases of the study. Data were obtained through
video observation, interviews, and researcher notes on participants’ development. Case studies of
selected participants were compared with outcomes for the cohort as a whole. Thematic analysis
combined with observer ratings to enable the investigation of four key focus areas: music-making
skills, social interaction, self-concept, and reflective practice.
Figurenotes was found to be an effective tool that allows children with autism to engage successfully
in music-making independently, with peers, and with family members. The action research approach
allowed novel interventions using Figurenotes which facilitated the development of participants'
music-making skills and also their creativity. Participation in musical interactions was found to be
associated with improved social interactions with peers and family members. Development of
music-making skills was also associated with improvements in participants' self-concept through
positive changes in participants' self-perception of their competence. Additionally, action research
was found in this study to be an effective methodology in facilitating reflective practice when
working with children with autism. The multiple beneficial outcomes demonstrated in this research
warrant the further use and development of Figurenotes, and point to the value of further research
in the development of music-making skills and creativity in children with autism.
... La Musicoterapia aplicada a la población Infantil es el área de especialización de la Musicoterapia que se ocupa del trabajo con niños/as en sus diferentes etapas: a) Primera Infancia, 0-24 meses, b) Niñez Temprana, 24 meses-5/6 años y c) Niñez Intermedia: 6-11/12 años. En este ámbito se tratan los problemas del desarrollo infantil con el fin de promover, prevenir y reestablecer la salud biopsicosocial, facilitando la comunicación, la expresión y la integración de niños de 0 a 6 años con trastornos neurológicos, anomalías genéticas, dificultades sensoriales, trastornos en la comunicación y en situaciones de riesgo social, prestando especial atención a la familia integrándolos, a ser posible, en el proceso terapéutico (Edwards, 2011;Nemesh, 2017;Oldfield y Flower, 2008). Al intervenir con la población infantil, más allá de las condiciones de salud que estos presenten, se recomienda plantear un enfoque global de la intervención terapéutica o piscoeducativa integrando la familia, las informaciones de otros profesionales, observar el estado general del infante antes y durante la intervención, valorar capacidades y limitaciones, considerar la diversidad cultural y étnica, la comunicación verbal y no verbal, la iniciativa, creatividad, flexibilidad al cambio, sociabilidad, entre otros Metodológicamente, observar los aspectos corporo-sonoromusicales, las habilidades perceptivas y expresivas y su relación con el desarrollo musical acorde a la edad cronológica y las condiciones de salud, son aspectos fundamentales para definir los objetivos, las técnicas y experiencias musicales terapéuticas a implementar, así como la modalidad de interacción musical y "qué música va a sonar" en las sesiones, para lo que se hace necesario conocer, observar y analizar la manera en la que los infantes hacen música (Sabbatella, 2014). ...
En contextos educativos y clínicos las experiencias de evaluación psico-musical se utilizan para identificar y evaluar alteraciones en el desarrollo infantil a partir de habilidades y capacidades musicales. Este capítulo delimita elementos conceptuales y metodológicos que contribuyen a la intervención y evaluación de la población infantil desde la música y la musicoterapia y presenta instrumentos de evaluación centrados en experiencias musicales terapéuticas y psico-musicales que permiten detectar y valorar las áreas psicomotriz, sensorial, psicoafectiva, relacional, comunicacional y cognitiva.
... These principles underlie many of the current approaches in family-centred Music Therapy clinical practice and research. Examples hereof are the work with children with autism spectrum disorder (Thompson, 2012;Thompson et al., 2014), with at-risk families in community settings (Abad and Edwards, 2004;Nicholson et al., 2008), with children with developmental disabilities (Shoemark, 1996;Warren and Nugent, 2010), in child and family psychiatry (Oldfield et al., 2012) or with 'non-clinical' families (Nemesh, 2016). In hospital settings, Shoemark (2004) and Shoemark and Dearn (2008) discussed in detail the possibilities and challenges of providing family-centred Music Therapy in the neonatal and paediatric intensive care unit (ICU). ...
In this article, the core concepts of family-centred care will be discussed in relation to family-centred Music Therapy with preterm babies and their parents in the neonatal intensive care unit. Then, the basic pillars of a family-centred Music Therapy programme at the neonatal intensive care unit of the Hospital Centro Policlínico del Olaya in Bogotá, Colombia, will be illustrated by selected case vignettes. Parents are considered to be an important ally in caring for their baby in the neonatal intensive care unit and family-centred Music Therapy actively seeks to provide early relational and communicative experiences between parents and their babies. However, family-centred Music Therapy goes beyond the integration of parents and needs to carefully balance out the fluctuating needs of the babies, parents and the emerging relationship between them.
Introduction. Autism Spectrum Disorders (ASD) are a continuum of traits that may negatively affect social and emotional competencies of individuals, including challenges in their engagement abilities, possible limitations in reciprocal interactions, and inflexibility in initiating and sustaining communication. Such challenges may affect language development and speech acquisition. Considering their importance, this study explored the impact of a family-centered, music therapy intervention to promote preverbal and verbal communication skills of young children with ASD during parent–child, music engagement episodes. Method. A mixed-methods design was implemented to gather data on the children’s preverbal and verbal communication abilities (pre-and-post intervention data collection) and on each dyad’s musical interactions during a 16-week music therapy intervention. Quantitative outcome measures included children’s scores on the Pragmatics Profile of Everyday Communication Skills (PPECS) and the Communication and Symbolic Behavior Scales Developmental Profile (CSBSDP), to assess children’s communication, expressive speech, and symbolic behavior over time. Qualitative data were gathered through semi-structured interviews, logs, and journaling. Results. Reports from the families corroborate with quantitative results regarding changes on the children’s communication abilities after the intervention. Discussion and Conclusion. Collectively, the current study provides evidence on the potential of using music therapy interventions within a family-centered approach to enhance young children’s preverbal and verbal communication skills.
Recent scientific studies have shown that involving children in music activities influences their mental, emotional, and social development; music is, thus, being used increasingly for medical and therapeutic purposes. In order to discover whether some elements of particular methods of music therapy can be applied in music teaching in primary schools, we conducted a qualitative research in which the participants were third-year elementary school pupils in Osijek. To collect the data, we used a systematic observation procedure. Data analysis involved both qualitative and quantitative analyses. The research results show that the introduction of elements of certain methods of music therapy is possible and that pupils are happy to participate in all the activities carried out. In doing so, pupils demonstrate imagination, creativity, independence at work, and willingness to cooperate.
Music has been used for therapeutic purposes in a variety of settings; however, family therapists have been hesitant to use musical interventions in their work, although they are curious about their use (Nemesh, 2017a). This hesitancy to use music in therapy may be because therapists might not be musically inclined or trained as credentialed music therapists. Yet, the inclusion of various aspects of music in therapy does not need to be complicated. This article explains a technique, called Theme Song for Change, that uses a client’s chosen theme song as a way to access underutilized resources that can help clients live more fulfilling lives. These resources are aspects of living, such as behaviors or personality traits, the client may not have been engaging in to the level where they find it useful. This technique has been used with individuals, couples, and families where clients consider important images and themes from the lyrics of their chosen song. These themes pertain to values and practices related to their identity they may not have been honoring in their lives. These values, practices, and meanings are personal resources that can be accessed and utilized to enhance the client’s life. The rationale, application, and implications of this technique will be discussed along with brief case examples of its use with an individual, a couple, and a family.
Music therapists working with families provide creative interventions that can address relationship difficulties. The purpose of this study was to describe how participation in music therapy supported parent–child interactions with a family (a 35-year-old woman, her 3-year-old daughter, and her 18-month-old son) who had experienced domestic violence. Using a constructivist grounded-theory approach, the researcher collected data by videotaping eight clinical sessions, creating analytic memos and field notes, consulting with the parent, and collecting a parent journal. Results indicated bidirectional difficulties in engaging in reciprocal parent–child interactions. Establishing routines, participating in joint-attention tasks, and incorporating child-initiated ideas into the therapeutic play became vehicles for establishing trust. Music therapy may have provided experiences that facilitated the emergence of positive interactions.
Young children with autism spectrum disorder face many developmental challenges, most notably in the area of reciprocal social interactions with family and peers. Collaborating with the families of these children in therapy sessions is fast becoming best practice in many countries. This paper presents a qualitative analysis of semi-structured interviews with 11 mothers who participated in family-centred music therapy sessions along with their child. The interview questions focussed on changes to the nature of the parent-child relationship. Analysis of the interviews identified three aspects of positive change to the parent-child relationship, namely: the quality of the relationship; the parents' perception of the child and the parents' response to the child. The changes in the relationship with their child were valued and cherished by all of the mothers, and understanding the impact a family-centred approach might have on the nature of the parent-child relationship needs further exploration.
Interactive Family Music Therapy can have a unique role to play when working as par t of a multidisciplinary team by demonstrating a capacity to ‘surprise’ a client/patient when they least expect it. It provides a positive shared experience that can add to multidisciplinary assessment and treatment planning. This article will illustrate the role Interactive Family Music Therapy has at Redbank House and includes case material.
Music therapy for hospitalised newborn infants is an emerging clinical field. While a clear picture is being built in the literature about effective methods for direct work with infants, it is more difficult to inform the clinical reality of providing services in a family-centred practice model. Beginning with a single case study, the authors engaged in lengthy discussion about the broader issues of providing effective clinical services to the families of hospitalised infants. The authors wrote their own narratives about working with families, using their practice wisdom as music therapists and their personal experiences of hospitalisation with family. These narratives were combined and framed into categories. After a rest period of several months, these categories were revisited and repetitious material was deleted and overlapping material was collapsed under major themes. Finally the authors sought validation o f the content from a colleague with 15 years experience working with families in hospital. The themes include: The necessary character of the music therapist; music therapy is a triadic relationship; endurance - the long journey; parents experience joy during music therapy; music therapy acknowledges the "whole" developing child; the contingent relationship; a whole life.
MUSIC LISTENING AND MAKING ACTIVATES A multitude of brain structures, the engagement of which is likely to have beneficial effects on the psychological and physiological health of individuals. We first briefly review functional neuroimaging experiments on music and emotion, showing that music-evoked emotions can change activity in virtually all core areas of emotional processing.We then enumerate social functions that are automatically and effortlessly engaged when humans make music. Engagement in these social functions fulfils basic human needs, is part of what makes us human, and is an important source for pleasure and happiness. Finally, we present a new method for music therapy, including an exploratory empirical study on effects of music making. Results show that the music making increased the mood of individuals compared to a control group. This music therapy method is promising in encouraging further development for the treatment of affective disorders, and can be used in both single- and double-blinded studies for empirical, evidence-based medical research.
Music making is a human activity that communicates motives – the underlying impulses for action, by which experience is gained, and which are accompanied by feelings. Music evokes narratives of experience, based on our innate ability to share the passing of expressive ‘mind time’, an ability that may be called ‘musicality’. which is inseparable from the impulse to move with anticipation of rhythmic sensory consequences and varied emotional evaluations. Communicative musicality is the source of the music therapeutic experience and its effects. An inborn musicality is clearly uncovered in acoustic analyses of parent/infant vocal interactions, where, independent of verbal communication, a shared sense of time and the shaping of jointly-created pitch contours describe phrases and narrative cycles of feeling. There is new evidence that the communication of motives and experience is supported by systems of ‘sympathy neurones’ in the regulatory core of the brain, and by the ‘vitality affects’ they generate. The music therapy relationship seeks a dance of human passion and well-being by fundamentally intuitive means. Its verbal/cognitive regulation is necessary for the cultivation and recording of its technique, but not the origin of its immediate power 1.Keywords: musicality - therapy - infants - movement - emotion - timing - communication
Phenomenology is a philosophical perspective which attempts to uncover the meaning of “phenomena” through a series of maneuvers
designed to isolate the object/event from any preconceived formulae or judgments. Acknowledging the limitations of quantitative
research, the authors present phenomenology as an alternate model for investigating the music therapy experience. A phenomenological
approach to music therapy is described and then applied to a case example of music therapy with a terminally ill client.
The positive relationship between parent-child interactions and optimal child development is well established. Families of children with disabilities may face unique challenges in establishing positive parent-child relationships; yet, there are few studies examining the effectiveness of music therapy interventions to address these issues. In particular, these studies have been limited by small sample size and the use of measures of limited reliability and validity.
This study examined the effectiveness of a short-term group music therapy intervention for parents of children with disabilities and explored factors associated with better outcomes for participating families.
Participants were 201 mother-child dyads, where the child had a disability. Pre- and post-intervention parental questionnaires and clinician observation measures were completed to examine outcomes of parental wellbeing, parenting behaviors, and child development. Descriptive data, t-tests for repeated measures and a predictive model tested via logistic regression are presented.
Significant improvements pre to post intervention were found for parent mental health, child communication and social skills, parenting sensitivity, parental engagement with child and acceptance of child, child responsiveness to parent, and child interest and participation in program activities. There was also evidence for high parental satisfaction and that the program brought social benefits to families. Reliable change on six or more indicators of parent or child functioning was predicted by attendance and parent education.
This study provides positive evidence for the effectiveness of group music therapy in promoting improved parental mental health, positive parenting and key child developmental areas.
Research into the value of music therapy in pediatric palliative care (PPC) has identified quality of life as one area of improvement for families caring for a child in the terminal stages of a life-threatening illness. This small-scale investigation collected data in a multisite, international study including Minnesota, USA, and Melbourne, Australia. An exploratory mixed method design used the qualitative data collected through interviews with parents to interpret results from the PedsQL Family Impact Module of overall parental quality of life. Parents described music therapy as resulting in physical improvements of their child by providing comfort and stimulation. They also valued the positive experiences shared by the family in music therapy sessions that were strength oriented and family centered. This highlighted the physical and communication scales within the PedsQL Family Impact Module, where minimal improvements were achieved in contrast to some strong results suggesting diminished quality of life in cognitive and daily activity domains. Despite the significant challenges faced by parents during this difficult time, parents described many positive experiences in music therapy, and the overall score for half of the parents in the study did not diminish. The value of music therapy as a service that addresses the family-centered agenda of PPC is endorsed by this study.
Sing & Grow is a 10-week group music therapy intervention to promote positive parenting and child development for marginalized parents of birth to 3-year-old children. This paper examined whether changes from pre to post intervention varied according to implementation site, when the intervention was taken to scale nationally. Outcomes for 850 participants were compared for the site where the program was first established against three new locations; one site where implementation processes were more favorable relative to the other two sites. Overall, the findings provided only limited support for differential outcomes by site of implementation. Participants showed significant improvements in parent-reported parenting and child outcomes from pre to post that were similar across all sites. For clinician-reported outcomes, improvements over time were generally greater in the original site and the well-supported site compared to the sites where there were more implementation difficulties. These differences were partly accounted for by differences in the characteristics of participants receiving programs in different sites and differences in the clinicians' ratings of program quality and the levels of support and training provided. However, confounding by the source of measurement requires cautious interpretation of clinician data. This study further highlights the potential for music therapy as an early parenting intervention, and the need for more rigorous evaluations in this field.
The term 'gay affirmative therapy' (GAT) was coined by clinical psychologist Alan Maylon (1982) in an article defining GAT.It emphasises an affirming, non-pathological view of therapy, with and for lesbian, gay and bisexual (LGB) persons. Develop din the 1970s and 1980s, it was the first therapeutic movement that acknowledged harm done to LGB individuals through heterosexist socialisation and institutional homophobia (Lev, 2005). GAT services to: 1) counter negative sociocultural and and familial environments of LGB clients; 2) address the negative effects of growing up in an oppressive society; and 3) facilitate the coming out process and the development of a positive LGB identity (Milton and Coyle, 2002). GAT has been refined and adapted by many therapists, and is currently viewed as an approach rather than a theoretical model of psychotherapy (Davies, 1996). This approach highlights the misunderstanding of unique challenges facing LGB clients (Garnets and Kimmel, 2003); introduces possibilities for resolving one's heterosexist prejudices and homophobia (Harrison, 2000); and familiarises therapists with models of sexual identity development (Davies, 1996) and LGB culture and society (Milton and Coyle, 1999)
In a cancer setting, patients and their families often report feelings of physical and/or emotional pain. The use of songs
in music therapy is effective in providing them with important means for support and tools for change. The verbal messages
about people, places, feelings, events, and desires encourage resolution of issues and processing of grief. This article reviews
some of the needs of cancer patients and their families and the goals and stages in music therapy. It then explores song choice
themes and methods for achieving therapeutic goals. Two case studies are presented to demonstrate the work.
The purpose of this exploratory mixed-methods study was to determine the effects of family-based educational music therapy on acute care psychiatric patients and their families. Participants (n = 11 patients and n = 21 family members) were randomly assigned to one of three treatment groups: educational music therapy, education or music activity. The therapist’s treatment notes from each session were thematically analysed. Although the sample size was small and quantitative results were not significant, patient and family member participants in the educational music therapy condition tended to have more positive post-test means. Emerging themes from treatment notes included: (a) complexity of treatment required attentive approach; (b) song lyrics provided action-oriented future dialogue; (c) song- writing provided needed structure; (d) participants were eager for interventions; (e) problem-solving techniques were effective; (f) flexibility required of the therapist; and (g) enjoyment and appreciation expressed by participants. Family-based educational music therapy may be an engaging illness management technique for psychiatric consumers and their families. Limitations, implications for clinical practice and suggestions for future research are provided.
Sing & Grow began in July 2001 as a Playgroup Queensland initiative with the initial 2-year funding period extended by 12 months. Funding
is provided by the Australian Government Department of Family, Community Services & Indigenous Affairs. This paper provides
a description of the project development, the intervention used, and a summary of achievements during this initial 3-year
period.
The researcher investigated the effect of prescriptive therapeutic songs on promoting social skills acquisition by children
who have autism. Participants were three children with autism. The researcher created an individualized song for each participant,
the purpose of which was to decrease an undesirable behavior identified by the parents. The researcher developed the lyrics
of each song by following the current guidelines for writing the text of social stories. “Social stories” is a strategy developed
by special educators for modifying problematic behaviors of children with autism. The adapted lyrics were then set to the
tune of a favorite song of the child. The song intervention was implemented during the treatment phases of the ABAB reversal
design. Even though the results are not conclusive, there is some indication that prescriptive songs are a viable intervention
with children who have autism.
Family-centered practice is a widespread approach guiding how early intervention services support families with children with special needs such as autism spectrum disorder. An important feature of this support is its provision in natural settings such as the home environment. Ultimately, family-centered practitioners endeavor to embed therapeutic approaches into the child's daily routines so that they can be facilitated in part by the family. This approach is particularly useful with young children with autism spectrum disorder as a way of promoting interpersonal engagement and therefore the development of early social and communication skills. A model for applying family-centered practice to music therapy methods is discussed through reflections on practice and case examples.
The present article has a dual focus: it illustrates aspects of music-centered thinking in music therapy with examples from
Nordoff-Robbins music therapy while at the same time providing insight into Nordoff-Robbins practice by explaining the music-centered
rationales that support it. A brief introduction to the origins and defining characteristics of music-centered thinking is
offered that utilizes David Elliott’s notion of musicing and John Dewey’s aesthetic theory and its differentiation of means
from media. Some of the more central practices and precepts of music-centered thinking are elaborated upon including the convergence
of musical and personal processes, the intrinsic value of musical experience, and the use of music as an autonomous clinical
force. Central notions of Nordoff-Robbins music therapy such as the music child, the concept of quickening, the idea of establishing
a musical world for a client, and the relationship between music and personal identity are reviewed. The article concludes
with a brief exploration into the implications of Nordoff-Robbins practice and music-centered thinking for the future of music
therapy.
Virginia Satir developed her therapeutic model over 4 decades. Her ability to be fully present, caring and accepting, open and genuine led many people to assume that her personality was responsible for the good therapeutic results she achieved with her clients. She had a strong belief that positive, growth-oriented change is always possible, both for individuals and for interpersonal systems. Satir’s work developed through different stages from the time she saw her first family in 1951 until her death in 1988, including the communication stage, the validation model, the change model, and finally, transformational systemic change. To bring about transformational change, however, there therapist has to ensure that five essential elements are present in the therapeutic relationship, namely it is experiential, positively directional, and change focused, it works within both the intrapsychic and interpersonal systems, and it draws on the self of the therapist in a congruent manner to engender hope and new possibilities. Accordingly, therapists use the transformational change process to assist couples and families in resolving differences rather than using conflict or distance as ways of coping with stress. By exploring intrapsychic impacts rather than exploring events and situations, clients become aware of their family members’ patterns of coping. They can then make experiential decisions for internal change and for relational change, leading to deeper connection, acceptance, and intimacy.
It is well known that infants as soon as they are born tend to use fist, fingers, thumbs in stimulation of the oral erotogenic zone, in satisfaction of the instincts at that zone, and also in quiet union. It is also well known that after a few months infants of either sex become fond of playing with dolls, and that most mothers allow their infants some special object and expect them to become, as it were, addicted to such objects. There is a relationship between these two sets of phenomena that are separated by a time interval, and a study of the development from the earlier into the later can be profitable, and can make use of important clinical material that has been somewhat neglected. Those who happen to be in close touch with mothers' interests and problems will be already aware of the very rich patterns ordinarily displayed by babies in their use of the first 'not-me' possession. These patterns, being displayed, can be subjected to direct observation. There is a wide variation to be found in a sequence of events that starts with the newborn infant's fist-in-mouth activities, and leads eventually on to an attachment to a teddy, a doll or soft toy, or to a hard toy. It is clear that something is important here other than oral excitement and satisfaction, although this may be the basis of everything else. Many other important things can be studied, and they include: 1. The nature of the object. 2. The infant's capacity to recognize the object as 'not-me'. 3. The place of the object – outside, inside, at the border. 4. The infant's capacity to create, think up, devise, originate, produce an object. 5. The initiation of an affectionate type of object-relationship.
Background:
Given that music therapists work across a wide range of disabilities, it is important that therapists have at least a fundamental understanding of the neurophysiology associated with the client/patient populations that they serve. Yet, there is a large gap of evidence regarding the neurophysiological changes associated with applying music as therapy.
Objective:
The purpose of this article is to provide music therapists with a general background in neuroplasticity principles that can be applied to the use of music therapy with multiple populations.
Methods:
This article will review literature on neuroplasticity and literature supporting the specific attributes of music therapy that apply to neuroplasticity. Finally, examples of how to use neuroplasticity principles to explain and support clinical music therapy will be provided.
Results:
Using the material presented in this review, music therapists will be equipped with information to effectively communicate why music therapy works using three neuroplasticity principles; increase in dopamine, neural synchrony, and a clear signal.
Conclusion:
Music therapy is a powerful tool to enhance neuroplasticity in the brain.
The focus of this article is the theoretical understanding behind, and the clinical application of, a newly developed music-therapy assessment tool, Assessment of Parenting Competencies (APC). While the psychometric properties have been analyzed successfully in prior publications, the advantages and challenges of a nonverbal and emotional interactional medium such as music in assessing parent–child interaction and parental capacity are presented and discussed. The assessment model relates to theories of attunement, autonomy, and attachment, and clinical relevance for practice within the field of child protection is addressed according to clinical application of the tool.
How can the scores of APC be interpreted and how are they clinically relevant? With the combination of a playful and rigorous approach, APC can provide useful information to families, family therapists, and other social-service professions within the field of child protection, including level of mutual attunement, nonverbal communication skills, emotional parental response, and possibly indications of attachment behavior in the child. APC can thereby help indicate the severity of the situation and the possible therapeutic direction for the family in question.
Using a music therapy approach to assess emotional communication and parent–child interaction is new to the field of child protection. However, musical improvisations in music therapy has long been known as an analogue to affect attunement and early non-verbal communication between parent and infant, which called for an investigation of the value of music therapy within the field of family assessment and family therapy. More specifically, we wanted to investigate and further strengthen assessment of parenting competencies (APC). We developed scores and examined the psychometric properties of the APC-R (revised version) in a quantitative study including a small, embedded qualitative component. A total of 52 dyads of children and their parents participated of whom 18 were in residential center to address emotional neglect and 33 functioned as a non-clinical comparison (children aged 5–12). All dyads underwent two video recorded music therapy assessment sessions. Video analyses focused on autonomy relationship, turns, and parental response types producing scores on Mutual Attunement, Nonverbal Communication Skills and Emotional Parental Response. Psychometric analyses of the APC-R included interrater reliability, test re-test reliability, internal consistency, and concurrent validity. We concluded that APC-R is reliable and valid and adds to the existing observational instruments of parent–child interaction.
This paper discusses the nature of group music therapy when its practice involves both free musical improvisation and verbal exchange. It considers in particular how music therapists may valuably draw upon group analytic theory, both traditional and contemporary, to inform their thinking about clinical events and their practice as group conductors. In addition, it examines what verbal therapists may gain from music therapy tradition. Music itself, and the conductors implicit understanding of it, may enable the group to pursue its processes, conscious and unconscious, through shared, nonverbal expression.
This review updates similar articles published in the Journal of Family Therapy in 2001 and 2009. It presents evidence from meta-analyses, systematic literature reviews and controlled trials for the effectiveness of systemic interventions for families of children and adolescents with various difficulties. In this context, systemic interventions include both family therapy and other family-based approaches such as parent training. The evidence supports the effectiveness of systemic interventions either alone or as part of multi-modal programmes for sleep, feeding and attachment problems in infancy; child abuse and neglect; conduct problems (including childhood behavioural difficulties, attention deficit hyperactivity disorder, delinquency and drug misuse); emotional problems (including anxiety, depression, grief, bipolar disorder and self-harm); eating disorders (including anorexia, bulimia and obesity); somatic problems (including enuresis, encopresis, medically unexplained symptoms and poorly controlled asthma and diabetes) and first episode psychosis.
This review updates similar articles published in JFT in 2000 and 2009. It presents evidence from meta-analyses, systematic literature reviews and controlled trials for the effectiveness of couple and family therapy for adults with various relationship and mental health problems. The evidence supports the effectiveness of systemic interventions, either alone or as part of multi-modal programmes, for relationship distress, psychosexual problems, intimate partner violence, anxiety disorders, mood disorders, alcohol problems, schizophrenia and adjustment to chronic physical illness.
This article describes three pieces of short-term music therapy work with three different families. The work took place in a unit for child and family psychiatry. Three music therapists were involved both in the treatment and in group supervision. They were inspired to write this paper partly because family work and short-term work are still relatively unusual in clinical music therapy. In addition the projects were significant because in all three of the cases described here the parents were enabled, through music therapy, to gain fresh insights into their relationships with their children. Through reflection on the clinical work and study of relevant literature, the authors observed some common trends: •When working with families there appears to be a tendency to focus first on the child's difficulties and then, later in the treatment, on family relationships and the parents’ difficulties.•In many cases involving music therapy work with families, non-verbal, improvised music-making and playful musical exchanges seem to be key components in facilitating family interactions.•The gender and past experience of music therapists carrying out family work can be a point of consideration in order to address the needs of some families.
Music Together is a community based music therapy program for "well" families with preschool aged children. The program reflects a developing perspective that music therapy can be a preventative intervention. Music Together is available to all families within the community, not just those with a diagnosis, disability, or identified as "at risk". This article describes the challenges facing Australian families, the need for social support, and the application of traditional early intervention music therapy techniques to support "well" families. Results of a program evaluation are presented to substantiate this application of music therapy.
This article explores how the Satir model facilitates the development of the self of the therapist, which Virginia Satir strongly advocated. Discovering and developing creative ways to externalize the internal hidden processes of people, she invited therapists to work on their own unresolved issues in their training through various methods such as: family of origin, family reconstruction, ingredients of an interaction, and parts party. Her goal was to increase self-esteem, foster better choice making, increase responsibility, and facilitate personal congruence through a therapeutic process. Although very relevant in the training and professional development of therapists, there has been little exploration or research of this topic.
This text explores the phenomenon of affect attunement, elucidated through a musical improvisation with a young man suffering from an eating disorder. The empirical data stems from a qualitative research study, based on a phenomenologically inspired procedure for data analysis. Affect attunement is a term to elucidate the sharing of inner feelings states. In such a sharing there is a matching going on, a cross–modal way of relating. What is at stake is how the interaction moves along, rather than merely the themes or the musical actions per se. Essential elements in such a musical experience are timing, intensity, and form. Based on analysis, we propose a musical relating experience, followed by verbal processing, to provide a link between body and mind, which subsequently support a more coherent sense of self Hence, a musical narrative based on a real experience may contribute to semantic meaning, which supports symbolic emergence.
Music therapists working with families address relationship and interpersonal communication issues. Few controlled studies exist in the literature but a growing body of documented practice is emerging. This study makes a contribution by documenting how music therapy supports mutuality and reciprocity in parent-child interactions.
This study investigated mutually responsive orientation (MRO) behaviors of young children (aged 3-5) and their family members during music therapy.
Participants were 4 families with low income and history of maternal depression as common risk factors. Data were collected by videotaping sessions, creating field notes and analytic memos, conducting parent interviews and reviewing parent journals. A cross-case analysis using MRO theory as a conceptualizing framework was used for the purpose of data reduction.
Greeting and farewell rituals, and the flexibility of music-based therapeutic applications facilitated development of coordinated routines. Therapist's actions (e.g., encouraging and modeling musical interactions) and bidirectional parent-child actions (e.g., joint attention, turn-taking, being playful) facilitated harmonious communication. Behaviors promoting mutual cooperation were evident when adults attempted to scaffold a child's participation or when children sought comfort from parents, engaged in social referencing and made requests that shaped the direction of the session. The novelty of musical tasks captivated attention, increasing impulse inhibition. Parent actions (e.g., finding delight in watching their child participate, acting silly) and parent-child interactions (e.g., play exploration, shared excitement, cuddling) contributed to positive emotional ambiance. Conclusion: Music therapy assisted development of MRO within parent-child dyads by providing opportunities to rehearse adaptive ways of connecting with each other. Results of this study may serve as an archetypal model guiding clinical treatment planning.
The assessment for parenting competencies for parents of children potentially in need of care involves an evaluation of their relationship with their child, and the interaction that underpins that relationship. The “Assessment of Parenting Competences” (APC) music therapy assessment provides a structured series of interactional exercises that allow the therapist to explore the nature of the relationship both as a tool in every day clinical work and as a research method. The method of the assessment involves free improvisation, tum–taking exercises, and following leading exercises and is evaluated using the autonomy profile of the Improvisation Assessment Profiles. Results demonstrate the strengths, weaknesses, and potential in the parent, and quantifiable observed musical events in the gradients of autonomy provide evidence of positive and/or negative interactional behaviour. The therapist has a unique role both as a participant in a parent–child interaction, and as an observer.
In Section 1 the author suggests that child and family therapists rarely or reluctantly include young children in cross-generational
sessions. The work of several child and family therapists who have bridged the gap between the enactive modes of child learning
and the verbal modes of the adults in family sessions is presented. In Section 2 the author reviews the writings of several
arts therapists who use action-oriented, symbolic experiences or tasks that work well with children in family therapy. In
Section 3 the author presents music therapy practices with families. The author suggests that improvisational music in the
family session is similar to play and that songs in the sessions function similarly to a co-therapist. Finally, a case study
illustrates the value of music in helping generations communicate, and in objectifying and working through family alliances
and roles.
Why does music have such a powerful effect on our minds and bodies? It is the most mysterious and most intangible of all forms of art. Yet, Anthony Storr believes, music today is a deeply significant experience for a greater number of people than ever before. In this challenging book, he explores why this should be so.
Music is a succession of tones through time. How can a sequence of sounds both express emotion and evoke it in the listener? Drawing on a wide variety of opinions, Storr argues that the patterns of music make sense of our inner experience, giving both structure and coherence to our feelings and emotions.
Here he [the author] explains how, in a culture which requires us in our daily working lives to separate rational thought from feelings, music reunites the mind and body, restoring our sense of personal wholeness. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
The family therapy approach to treatment is an outgrowth of individual therapy and can present optimal opportunities for the
use of music therapy. Three major schools of thought in family therapy—systemic, structural, and strategic—provide treatment
objectives that lend themselves to musical intervention. The structural family therapy school of thought in particular lends
itself to music intervention due to its concern with balance of power, limits, boundaries, and family roles, which can be
addressed through various musical exercises and techniques. Musical intervention within a family therapy context is a new
and relatively unexplored avenue of treatment deserving of further research.
Autism spectrum disorders are characterized by impairment in communication, abnormal social interactions, abnormal responses
to sensory stimuli, and restricted, repetitive and stereotyped behaviors. While there is no cure for autism, active interventions
that include family involvement can bring about positive changes. Music therapy has been recognized as an effective treatment
for children with autism spectrum disorders. This study examined parents' perceptions of a 7-week family-based group music
therapy intervention. Data were collected through pre-interview sessions with the parents and post-intervention focus group.
Parents reported positive responses to the intervention and were able to articulate new insights about themselves and their
children.
The purpose of this exploratory study was to test a caregiver-administered music program with family members who have dementia. The music protocol was designed to reduce distress and enhance satisfaction with caregiving, while offering the person with dementia the potential to improve mood and psychological state. Fourteen elders with dementia and their family caregivers were recruited, and 8 completed the protocol. Both caregivers and care recipients improved self-reported relaxation, comfort, and happiness, when mean scores were compared between baseline and music conditions. Caregivers showed the most benefit. While drop-out was high (6 families dropped), and caregiving satisfaction failed to improve over time, caregivers expressed enjoyment in reminiscing and participating in musical activities with their loved ones. More direct intervention by a music therapist is recommended to improve impact.
National experts have recommended that children with life-limiting illnesses receive integrated palliative and medical care. These programs offer a variety of services, including music therapy. Using survey data from parents whose were enrolled in Florida's Partners in Care: Together for Kids (PIC:TFK) program, this study investigates parents' experiences with music therapy. About 44% of children with life-limiting illnesses and 17% of their siblings used music therapy. For children who used music therapy, multivariate results suggest that their parents were 23 times as likely to report satisfaction with the overall PIC:TFK program (P < .05) versus parents whose children did not use music therapy. Pediatric palliative care programs should include music therapy, although recruiting licensed music therapists may be challenging.