MSc in Music Therapy
Permanent URI for this collectionhttps://eresearch.qmu.ac.uk/handle/20.500.12289/7208
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Item Exploring mentalization-based music therapy in an adult acute psychiatric inpatient unit: a case study(2022) Unknown authorSet within an adult acute psychiatric care unit, this case study explores the emerging approach to music therapy that blends features of mentalization-based treatment (MBT) and psychoanalytically informed music therapy. Reflexive investigation was employed using a clinical example to illustrate how ‘mentalizing’ unfolds in the process of music therapy practice. Additionally, the experience of the researcher as a trainee practitioner is considered. Literature on the subject of mentalization-based music therapy (MBMT) suggests that music can be utilised by a practitioner to regulate arousal (facilitating successful mentalization), and to validate both internal emotional states and external expression, building ‘epistemic trust’ and understanding of interpersonal processes. This can be achieved using both active and receptive interactions with music, as well as explicit verbal reflective discussion. Inductive thematic analysis of reflexive session transcripts revealed that there is significance in understanding the implications of ‘promoting agency’ within MBMT – namely, how a patient feels when in or out of control and how capacity to mentalize is gained or lost in these situations. Three other themes (being present, the value in ‘not knowing’ and epistemic trust) are revealed from the case study analysis and discussed as important aspects of both MBT and psychodynamically informed music therapy. Additionally, the importance of supervision and attention to reflection is re-confirmed as a way to aid practitioners in remaining in the ‘here and now’ when with a patient, and to gauge when the patient or practitioner is in a non-mentalizing state.Item Attachment Trauma and the use of Music Therapy to support children and young people experiencing it: A narrative literature review(2022) Unknown authorThe concepts of complex trauma, insecure attachment, and C-PTSD have grown in popularity both in the general public as well as scientific research over the last decade. Music therapy is one of the modalities that is used as a treatment method supporting people experiencing what can be summarised under the term attachment trauma. However, there is an incoherence and a certain unclarity in the definitions and connections between these different concepts. This is reflected in the music therapy literature addressing such concepts. The context section provides clarification of the several terms. This narrative literature review synthetises and analyses music therapy research addressing the experience of attachment trauma in children and young people regarding its focusses and cohesiveness. It aims to contribute to the growing body of literature researching therapeutic interventions for people with a history of complex trauma and to examine the role of music in such interventions. The findings section provides an analysis of different therapeutic concepts, approaches, and techniques. The inherent relation between musicality and early attachment suggests the usefulness of music therapy as a treatment method. The specific use of music therapy in delineation to other creative therapies is outlined and the limitations and implications for the field of music therapy are discussed.Item “Connecting the Dots”: An Autoethnographic Exploration into the Potential of Cross-modal Creative Approaches in Music Therapy with Adolescents in a Mainstream Secondary School.(2022) Unknown authorThis is an autoethonographic practice-based project that describes a Music Therapy learner’s exploration into the potential of cross-modal creative approaches within which there is an examination of cross-modal occurrences in practice during a final year practice placement in a mainstream secondary school while working with adolescents. By using three narratives describing turning points in practice that led to questioning around cross-modal approaches in Music Therapy, this dissertation will explore the potential of using other modalities such as Art and Play in Music Therapy sessions with adolescents and examine the wider potential of cross-modal creative approaches through the lens of the Music Therapist’s experience. Data around cross-modal occurrences were collected and analysed using Thematic Analysis. Data sources such as clinical, process and reflection notes as well as audio recordings and artwork made by the Music Therapist provide insight into the experience cross-modal creative occurrences and approaches in individual and group sessions with adolescents as well as becoming part of a creative reflection process for the Music Therapist. From this analysis, four main themes arose: what do adolescents bring and take from sessions, what do client(s) and therapist interactions require when working with cross-modality, ambivalence about musical foundations and cross-modal transference between therapy and school. From the findings, the enquiry concludes that adolescents often bring a curiosity about using cross-modal ways of engaging in Therapy such as drawing and games, and within these modes, they often express feelings about school including peer and staff interpersonal relationships. The implication of this finding is that adolescents may bring cross-modal ways of learning into therapy as a familiar pathway to approach expression within sessions thus linking their therapeutic experience with their educational experience. This autoethnographic exploration also found creative approaches to reflection also arose from a need to understand cross-modal occurrences within therapy sessions.Item Facilitating group music therapy for adults with learning disabilities - an explorative case study(2022) Unknown authorThis research presents an explorative case study describing experiences of facilitating group music therapy sessions with six adults with learning disabilities at a community centre. Group music therapy can provide opportunities for social interaction, independence, and address a wide variety of other issues and difficulties. Through group improvisation and other music making activities music therapist’s can work in partnership with people encouraging growth, self reflection and creativity. In this case study I use a phenomenological approach for investigating the experience of my role as group facilitator conducting this new group. A phenomenological approach to music therapy is then described and applied to a case example of three sessions using an adapted seven step analysis procedure. The main conclusions of this study outlines how developing a person centred and flexible approach as group facilitator provided a therapeutic space where unique opportunities for the group to experience different roles and find new ways to be together through music could be explored. The experiences examined confirmed that group music therapy with adults with learning disabilities can be beneficial when used thoughtfully and appropriately.Item Allies or enemies? Multiple case studies of individual music therapy work exploring my practice-based learning experience in working with accompanying ward staff members in inpatient learning disabilities services for adults in a psychiatric hospital(2022) Unknown authorThis project was inspired by my experience and feelings in working with other staff members in music therapy sessions during my second-year practice-based learning working in inpatient learning disabilities services for adults in a psychiatric hospital. A review of existing literature discussed findings about staff’s influence on music therapy perceived by music therapists working in different settings and with different years of experience. A research gap is found where the potential changes in the therapist-client-staff relationship over time are under-researched. In the context of my journey in the placement setting, this project aims to 1) explore different roles of accompanying staff members during music therapy sessions; 2) explore their influence on therapeutic relationship and process throughout the therapy; and 3) explore their influence on my developing identity of trainee therapist throughout the therapy. Underpinned by hermeneutic phenomenology, this project used multiple cases studies to illustrate my clinical work with three clients and the staff members who accompanied the sessions. Thematic analysis (Braun and Clarke, 2006) was adopted to generate findings from process notes, reflective journal entries and supervision notes. Fifteen themes were identified and presented in the initial, middle, and later phases of the course of therapy. In the initial phase, although staff’s pre-existing relationship with clients facilitated my initial connections with clients, the lack of understanding and trust between staff and me produced some negative feelings which were reflected in the therapeutic space. In the middle phase, I started to initiate more communications with staff so that we understood each other more, thereby enabling a more harmonious space for therapist-staff-client relationship to further develop. In the later phase, I felt more confident and autonomous in therapy and the therapist-client relationship started to provide positive influences on the staff-client relationship and the wider care setting. This project illustrated the relationship between therapist, staff, and client, as well as the trainee therapist’s identity would change and develop concurrently throughout the course of therapy.Item An exploration of the use of the single-line instrument and the relationship to the learning experiences(2022) Unknown authorMusic therapy training in the UK encouraged trainees to establish clinical improvisation skills on the instruments they are proficient at. However, compared with the studies on the accompanying instrument, voice and percussion, literature regarding the use of single-line instruments was relatively rare. Studies have also shown that a majority of orchestral music therapists may reduce their use of single-line instruments. This study aimed to discover the potential reasons for this phenomenon and drew attention back to students’ learning experiences. To achieve the above aim, semi-structured interviews were conducted with four individuals who were: 1) a student music therapist who is studying at an HCPC-approved university; 2) confident in playing with at least one single-line instrument such as clarinet, flute, violin and trombone; 3) and have at least a year of clinical experience through placement. Through analysing each case in-depth with Interpretative Phenomenology Analysis (IPA), four cluster themes central to the learners' experiences of using the single-line instruments in practice and the relation to their learning experiences throughout their life have been emerged: (1) the single-line instrument has or will become part of the participant’s identity; (2) using the single-line instrument in practice brought both support and challenges; (3) applying the learning in practice; (4) discovering the music therapist’s voice and the influence of online learning. These findings indicated that the therapeutic characteristics and the personality characteristics of the single-line instruments influenced their use in practice. Additionally, the study reflected the learning journey from a musician’s perspective to a music therapist’s perspective and highlighted online learning during the pandemic. This study, however, was limited to a small sampling size and further studies with wider context and diversity were suggested.Item How does my background as a performing musician compliment or disrupt a music therapy process with adults living with a traumatic brain injury?(2022) Unknown authorThis autoethnographically informed self-reflexive case study explores how a background as a performing musician compliments or disrupts a music therapy process with adults living with a traumatic brain injury. The study is set in a neurorehabilitation centre and aims to investigate the concept of the self as performer or therapist and how both are present within a therapeutic space. It also explores how music therapy methods such as improvisation, receptive music therapy and songwriting can differ between the performative and therapeutic self. The literature available suggests that performance with clients has been used and researched in multiple context settings. However, the research was found to be limited in respect of the perception of the therapist and how a performative background affects decision making in the therapeutic space. A qualitative approach, guided by a thematic analysis, identified several instances where the researcher contemplated over his decisions due to contradicting thoughts on whether it was more entertainment than therapeutic work. Key findings indicate that transferences and countertransferences played a significant role in thought processes that occurred in music therapy sessions. Another finding was the adult attachment style of one client and how this behaviour influenced decisions made in the therapeutic work. The thematic analysis was undertaken using data collected through reflective journals, clinical notes and audio recordings. The methodology was effectively a multiple case study based on sessions with three clients during a university placement in a neurorehabilitation centre. However, the work was based on one therapist’s experiences and thought processes. It was established that a performative background can encourage complimentary and disruptive therapeutic outcomes. If the therapist was able to avoid making decisions based on their own desires, be fully present with the client and work with the clients’ interests in mind, then therapeutic was achievable. Limitations included the risk of biased research and small sample size, however, future research involving more participants and opinions could lead to more informed outcomes and conclusions.Item What can an open music therapy group offer in an adolescent psychiatric inpatient unit? Reflections from practice-based learning.(2022) Unknown authorThis project examines and discusses what an open music therapy group can offer in an adolescent psychiatric unit, through my personal reflections from my work as a music therapy trainee. A literature review is presented in the beginning, using secondary resources about adolescent mental health, music therapy in adolescence, music therapy in inpatient units, and group music therapy. A gap was identified in the literature regarding the use of open groups in adolescent psychiatric inpatient settings, which this project aimed to explore. Using a qualitative phenomenological approach, I collected my data through my personal notes from the fourteen open group sessions in the inpatient unit during my placement, and these were analysed via thematic analysis. Findings that emerged from the data analysis were that the open group provided opportunities for building relationships, supported the individual music therapy sessions, contributed to feelings of usefulness and achievement for staff and young people, provided an opportunity for distraction after mealtimes for people with eating disorders, and had a ripple effect outside the music therapy sessions, while it was important to acknowledge the dynamics of the group and feelings of rejection and withdrawal. These findings are presented and accompanied by examples from practice and clinical vignettes, and they are combined with relevant literature at the end of the project for the formation of conclusions. Limitations and future directions are also provided at the end.Item An exploration into what individual music therapy offered a man diagnosed with schizophrenia and learning disability in a low secure forensic psychiatric setting: a case study(2022) Unknown authorMusic therapy is now recognised as an established intervention for treating people with schizophrenia and learning disability. However, there is little research in current literature to highlight the use of music therapy for both conditions occurring simultaneously. In addition, literature would suggest medium to longer term settings are most suitable to facilitate therapeutic change in a client with both diagnoses. In low secure forensic settings, long-term individual therapeutic intervention is possible, however the stability and structure of sessions are harder to establish due to patient diagnoses. Furthermore, dual diagnoses are even more challenging to facilitate interventions due to the complexity of symptoms. This subsequently means that there is a large gap in literature surrounding individual music therapy with patients with comorbidities, specifically schizophrenia and learning disability. This project seeks to explore the complexity of the comorbidity of schizophrenia and learning disability and investigate the potential for individual music therapy as treatment for this client group, with specific reference to a two-month intervention with a man with this dual diagnosis. Additionally, this project will explore the role and purpose of music therapy in low secure forensic mental health settings. Data obtained was analysed using the hermeneutic phenomenological framework and the findings presented through a single case study. This was followed up through supervision and personal reflections on music therapy sessions, taking account of relevant literature. The study found that music therapy offered the man an alternative way of expressing his thoughts, a space to explore new sounds, leading to an improvement in general wellbeing. Overall, this study highlights the need for further research into the best methods and practice for music therapy with individuals with a comorbidity of schizophrenia and learning disability. It also highlights the challenges of working in a low secure forensic setting and demonstrates the need for further research to create an effective framework for individual music therapy work in this setting, which considers the continuity of care for the individual.Item How can meditation practice and theory shine light on the encounter between client and music therapist?(2022) Unknown authorAs a music therapist who regularly meditates, I will be exploring how meditation, with its roots in Buddhist philosophy, can shine a light on the therapeutic relationship as a whole, and also how it influences my own perspective within the dyad. I will view my clinical work, which took place as part of a counselling service offered to teenagers in high schools, through the lens that meditation offers. My method, which resonates with auto-ethnographic and phenomenological approaches, involved looking through my reflective notes from my sessions with clients and identifying moments that relate to my understanding of meditation. I identified four key themes which I will present. Examples from my clinical practice will be interwoven throughout my narrative with insights from literature and my meditation practice. I will begin with an examination of mindfulness, which fosters a nonjudgemental acceptance of events and helps me to be conscious of countertransference reactions. I will then examine attentive presence, which involves deeply listening to whatever arises implicitly within the intersubjective exchange, and not rushing to impose ideas. With enough discernment we discover sunyata, the emptiness of the self when it is freed from conditioned habit patterns and defences. This involves embracing vulnerability and a mutual willingness to enter a third space where the participants surrender to a new, co-created pattern within the music. This grounds us as persons, connected to one another in an interdependent web, and has implications for the assumed power dynamics within the therapeutic dyad. In summary, I found that music therapy, and meditation, can allow the individual's habit of mind to change, so that he can relate to internal conflict in a new way, with a wider understanding of self.