MSc in Music Therapy

Permanent URI for this collectionhttps://eresearch.qmu.ac.uk/handle/20.500.12289/7208

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The challenges and the difficulties: Music therapy in end of life care
(Queen Margaret University, 2016)
Among the existing literature, there are different articles which emphasise the elevation of the therapeutic process or the benefits of music therapy in end of life care. However, a paucity of literature was found which particularly highlighted the challenges or the difficulties which music therapists and terminally ill clients as well as their families may come across in end of life music therapy. This project aims to investigate the challenges or difficulties which were reported in the existing papers. Based on a systematic online database search and a hand search, twenty-five papers were found to meet the inclusion and exclusion criteria and to be relevant to this project. After thematic and numerical analysis of the identified papers, eight categories and six charts emerged which present the challenges and the difficulties which appeared in the end of life care music therapy. The categories are: 1 Personal Challenges 2 Psychological difficulties; 3 Lack of communication ; 4 Lack of understanding ; 5 Resistance to music therapy ; 6 Paucities of resources ; 7 Training issues and; 8 Ethical and legal issues. Furthermore, the finding was examined in the discussions section. For instance, some of the challenges and the difficulties are found to be unique to the music therapy in end of life care whereas some of them also appeared in other contexts; and papers which studied the challenges and the difficulties of palliative care were much more numerous than those on bereavement services. As well as this, more attention was paid to the music therapists' psychological difficulties compared with the psychological difficulties of the terminally ill client and their families. Lastly, the limitations of this project are clarified and recommendations for further research are offered.
Newness and Ambiguous Loss: Reflections of a Music Therapy Student Working with a Patient with Advanced Dementia
(Queen Margaret University, 2016)
This case study focuses on a music therapy student's perceptions and reflections on particular events in a clinical setting. The methodology adopted for the fulfilment of the research was the Open Systems and Retrospection using a Qualitative Approach. The participant was an advanced Dementia patient selected after a significant period of months of therapy interaction in a student placement setting. The current case study focuses on two major events reflecting on weaknesses and fears concerning memory recalls. A reflective journal was employed as an event record. This work constitutes the therapist's attempt to reflect on her innate feelings and responses to the experiences of ambiguity and newness perceived during therapy sessions with the participant. "Without awareness, there is no consciousness. But awareness is hard to see. It is ever-present, like the air we breathe" (Seeman 2009). In this study awareness is reached through self-reflection engaging the music therapy student with her insights in order to self-improve as a therapist by attaining a more mindful mind. Countertransference appeared to be a core element in verbal or musical interaction where information either about the therapist or the participant seemed to emerge.
"I'm a Mental Patient": An Exploration of the Use of Rap in Music Therapy to Explore Issues of Identity in a Low-Secure Psychiatric Setting
(Queen Margaret University, 2016)
This project explores the use of rap in music therapy to explore issues of identity in a low-secure psychiatric setting. Individuals suffering mental health issues often face a loss of sense of self. Music therapy can offer an alternative form of expression and communication which can support exploration of self and identity. Recent studies have highlighted the growing use of rap as a means of expression in music therapy sessions, and studies show that identity emerges as a common theme for exploration. Examination of the literature shows that further investigation into the use of rap in psychiatric settings to explore issues of identity is required to gain knowledge and inform practice. Through the analysis of a case study of a music therapy with a 28-year-old male patient with a diagnosis of schizoaffective disorder, the use of rap in music therapy in to explore identity within a psychiatric setting is investigated. Findings show that rap can be used to rewrite and reclaim identity; provide a containing space within which different identities can be explored and performed; and to bring internal issues into the therapeutic space, where they can be explored verbally and musically with the therapist. The findings indicate that further qualitative research in this area is required to help gain understanding of the potential benefits of using rap in music therapy to explore issues of identity within psychiatric settings
Music Therapy and Sensory Processing Patterns - Microanalysis of Music Therapy Work with Children with Autism Spectrum Disorder
(Queen Margaret University, 2016)
Background: Children with autism spectrum disorders (ASD) have difficulties with social interaction, behaviour, and communication skills. Most also experience different sensory processing patterns, which result in various unusual sensory behaviours in their daily life. Music therapy, by adopting different techniques, helps them to develop their relationship forming and communication skills, and to address their core deficits. Numerous studies have shown positive outcomes of music therapy with this group of children, which may be because music therapists can be flexible in adapting various clinical techniques to suit the many different moment-by-moment needs of such young, and often non or pre-verbal children. Consequently, this study is intended to examine how a particular four-years-old ASD child's unique sensory behaviour pattern - which is a significant feature of the ASD child - informs a music therapist's practice. Aims and method: The purpose of this project was to investigate the ways by which, I, as a music therapist, adapted my professional technique to meet the needs of an ASD child who displayed unique sensory behaviours, in order to encourage him to be more interactive both with instruments and myself. Two clips from the music therapy sessions, which I microanalysed and repeatedly reviewed in order to see and understand more clearly Edam's unique sensory behaviours and his interactions with me. I also kept a reflexive journal in order to interpret our therapeutic relationship.
Kalli and Sofi: An exploration of the use of iPad in music therapy with older adults, examining and reflecting on its impact on both the clients and the therapist and their clinical relationship.
(Queen Margaret University, 2016)
Music technology has demonstrated an exponential evolution over the years. Incorporated in the medical and educational arena, Electronic Music Technologies (EMT) became established as a pressing need for music therapists to clinically implement. Tablets, the iPad in particular, are one of the most affordable and accessible EMTs to art therapists as well as their clients, rendering them a valuable therapeutic tool (Hoesterey and Chappelle 2012). Being the leader of tablet software technology, Apple, since the launch of the first iPad in 2010, has developed a profusion of software applications (apps) useful to music therapists (Knight and LaGasse 2012). Apps for recording, playing back, listening to music, musical instruments, composition, notation, data storage, organization and assessment/evaluation, and audio-visual activities constitute only a tiny example of the apps that have been designed and are applicable in clinical practice (Knight 2013). The huge variety of apps in combination with their light size and portability has rendered iPad popular among art therapists and general health care practitioners. The purpose of this explorative study is to investigate the role of iPad and its applications in music therapy. An interpretative phenomenological analysis of a music therapist's reflections upon her use of iPad in a therapeutic setting and upon its impact on the clients and their relationship with the therapist is carried out. Observation, analysis and reflections upon the use of iPad apps in an open day centre with two clients presenting mental, cognitive, emotion and communication difficulties are introduced. An empirical exploration of the possible adaptation of musical and game oriented apps from music therapists in order to improve their clinical practice and assist their clients in achieving their personal therapeutic goals is made. This thesis discusses the potential of iPad apps to be as effective and engaging as conventional activities in achieving the client's personal therapeutic goals, using a carefully planned model of practice and following a client-centred approach.
Music Therapy with a patient who experienced child abuse: a case study
(2018)
This study aims to illustrate the journey of music therapy with an adult patient who experienced physical child abuse. Literature on domestic violence and music therapy has focused almost always on women, with significant results of music therapy as a means of self-expression, selfawareness and empowerment. Most studies are based among the work of groups with survivors of domestic violence, using improvisational methods, with the use of precomposed songs, lyric analysis, and composition. Domestic violence is very broad topic that encompasses the forms of physical abuse, sexual, verbal/emotional and neglect. Even though there are several case studies under the term domestic violence and child abuse in music therapy, the form physical child abuse and music therapy is still an under researched area. With the use of a hermeneutic phenomenological approach, this study aims to reveal the story of a female adult patient who experienced child abuse and to analyse the lived experience of our journey and our therapeutic relationship in music therapy. Using thematic analyses, I will give an insight of the whole experience by interpreting meanings and themes arise throughout our sessions. Furthermore, this case study reveals the challenges for the therapist when working with a survivor of abuse, the process of the therapeutic relationship and how music therapy helped the patient. Using mostly improvisational methods with the use of instruments and voice, pre – composed songs and composition, our sessions offered a safe space for this patient to: recall unpleasant memories from the past and allowed space for self-expression, self-acceptance and a sense of a ‘pleasant escape’, where the patient felt free by gaining back her inner strength. Also, music therapy offered a preparation for this patient to continue further personal psychodynamic counselling. Keywords: case studies; domestic violence; child abuse; physical abuse; music therapy
An exploration into what an open music therapy group within an acute psychiatric inpatient ward offered a patient diagnosed with schizophrenia.
(2018)
Music therapy has an increasing evidence base within the treatment of schizophrenia however it has been found that for there to be significant results the treatment needs to be longterm and of high-frequency. Such interventions as these are difficult to establish and maintain within an acute psychiatric inpatient setting where length of stays are often sporadic and short. As a result of this, very little literature shows what music therapy can offer a patient with schizophrenia within an acute psychiatric ward in particular reference to short-term treatment. This project explores the diagnosis of schizophrenia itself providing an overview of its physical and social characteristics and what impact they can have for someone diagnosed with schizophrenia. The project then seeks to explore current research for music therapy within the treatment of schizophrenia and also the use of its use within acute psychiatric inpatient settings. A single case was chosen from the data source in order to explore what an open music therapy group offered a patient during his time within the ward. The data was analysed through a process of interpretative phenomenological analysis and presented within a single-case study and discussion. The findings showed that for the individual, music therapy offered a sense of control, interaction with others and a space to reflect. This project highlights that music therapy within an acute setting can provide a means of expression, empowerment and facilitate interactions with others during what is a difficult time in a patient’s life. From this it can allow them to become active participants in their own recovery. Keywords Schizophrenia, psychosis, music therapy, acute, psychiatric inpatient and short term
Reflections, Observations, Doubts and Questions on Introducing Music Therapy to an NHS Elderly Psychiatry Ward: An Autoethnographic Case Study.
(2018)
This is an autoethnographic case study that explores a final year music therapy student’s experience of introducing music therapy to an NHS elderly psychiatry ward, which considers the challenges, doubts and questions that this experience raised. Process notes and observations are analysed through thematic analysis. The project discusses three emergent themes and categories concerning therapist authenticity, patient uncertainty and therapist reactions to the medicalised ward environment, which are illustrated by extracts from written process notes and observations and expanded upon. In the literature review and discussion, the position of music therapy as a profession within psychiatry is considered in how it may impact music therapy practitioners and ultimately the patient experience. The overall purpose of this project is to offer a personal account of my student experience within an NHS elderly psychiatry ward as a means to contribute to the ongoing exploration of (student) practitioner experiences within this under-researched area; with the hope that by sharing my experience, findings and discussion in relation to current music therapy literature will resonate with readers in the issues it raises. The project advocates for further qualitative research that focuses on patient, staff and music therapy experience in order to contribute to a more balanced consideration of music therapy within psychiatric care where at present the evidence bases relies heavily on RCTs.
Music therapy in a short-term acute psychiatric inpatient setting: an explorative case study series
(2018)
This case study series explores the potential benefits of music therapy for patients in a short-term acute psychiatric inpatient unit. Special thought has been given to aspects of the music therapeutic relationship and therapy approach that emerged as important in this setting, informed by psychodynamic theory. Though outcome evidence and qualitative studies indicate music therapy is beneficial for people with mental health conditions (Carr et al. 2013) very few studies have explored the mechanisms of music therapy in acute psychiatric settings, and no qualitative studies have yet explored music therapy within a naturalistic inpatient setting where patient stays are shorter four weeks or less. Information was collected from the music therapist’s reflective process notes, audio recordings of sessions and anonymous patient feedback sourced from the same setting of the study. Data was coded using descriptive open analysis letting themes emerge inductively, within and across cases. Four cases were chosen to represent the diagnostic diversity of the setting. The study found music therapy offered patients emotional expression, emotional awareness, emotional regulation, interpersonal interaction, relaxation, anxiety reduction, distraction, escapism, and the building personal or musical resources, such as confidence, agency or strength. A supportive therapist approach involving holding, containing, attunement and structured music seemed to provide a safe therapeutic space. It is thought in short-term work music therapy operates in the early stages of the process (Winnicott 1971; Pederson 1999), which is why a more supportive approach was taken. However perhaps due to the limited time, it seemed difficult meeting in the music with a number of patients. There were more similarities than differences across the studies, suggesting it may not be useful to focus on diagnoses alone (Rolvsjord 2010) Keywords: music therapy; acute psychiatric care; mental health, short-term
“Daddy died of a grumpy illness” – Music therapy with a bereaved child in a mainstream primary school
(2019)
This case study explored the experience of music therapy for a bereaved 7-year-old child in a mainstream primary school, who was referred to music therapy as she exhibited aggressive behaviour in school. The study aimed to explore what music therapy offered her and how music therapy facilitated her therapeutic journey. Within the literature review, I examined the impact of the loss of a parent in childhood, discussed how culture plays a role in a child’s experiences of death and bereavement, provided an overview of therapeutic interventions currently available to support bereaved children, and highlighted music therapy as a suitable intervention for bereavement work with children, supporting this with observations across a range of case studies. Through the thematic analysis of my process notes, I generated two themes and eight sub-themes that informed the aim of the study. The first theme related to factors that seemed to have facilitated the music therapy, discussed through three sub-themes – the client’s readiness for music therapy, the establishing of a connection, and the provision of a safe space. The second theme related to how the client seemed to have used the music therapy space as a transitional space. Within this space, the five sub-themes discussed how the Hello Song appeared to have been used as a transitional object, and how processes of mourning seemed to have taken place through splitting and projection, manic defences, playful control, and reparation. These findings This case study contributes to the limited literature describing how music therapy can be used in bereavement work with children, and how such work can be situated within mainstream primary schools, where currently limited resources are available to support bereaved children. were discussed with links drawn to data from the process notes, and also in relation to theory.
An exploration into what individual music therapy offered a man diagnosed with schizophrenia and autism spectrum disorder on an acute psychiatric in-patient ward
(2019)
Music therapy is now recognised as an established intervention in the treatment of both schizophrenia and autism spectrum disorder. However, there is very little evidence in current literature which highlights music therapy as treatment when both conditions co-occur in the same individual. Furthermore, current research would suggest medium to long-term music interventions are necessary to facilitate therapeutic change in relation to both population groups. In acute psychiatric care, long-term individual therapeutic interventions are almost impossible to establish, due to short hospital admissions and a high turnover of patients. This subsequently means there is a huge gap in the literature relating to individual music therapy work in this context. This project seeks to explore the complexity of the comorbidity of schizophrenia and autism spectrum disorder, as well as the potential for individual music therapy as treatment for this population group, in relation to a six-week intervention with a young man living with this dual diagnosis. Secondary to this, the project will also explore the role and purpose of individual music therapy in an acute psychiatric in-patient setting. Data was analysed through a hermeneutic phenomenological framework, and the findings presented in the form of a single case study, followed by interpretations and further discussions in relation to the literature. The study found that individual music therapy offered this man an alternative way to communicate his thoughts and emotions through music and a space where he could begin to exercise greater freedom of expression, leading to a noticeable improvement in overall wellbeing. Overall, this project highlights the need for further study and research into best methods and practices for individual music therapy when a complex dual diagnosis is present. It also illustrates the challenges of working within an acute psychiatric setting and highlights the need for further research to establish an effective framework for individual music therapy in this context, which considers the continuity of care for the individual.
Music therapy in an acquired brain injury rehabilitation centre: exploring a therapeutic relationship with a service user with traumatic brain injury
(2019)
There is a growing evidence base concerning music therapy and acquired brain injury, and music therapy and acquired brain injury in rehabilitation settings. Research into this area has broadly focused on the use of music therapy to promote functional improvements in aspects of disabilities, conditions, disorders and impairments stemming from acquired brain injury. Current literature highlights a need for further qualitative investigation regarding what music therapy may offer as a form of emotional intervention to acquired brain injured individuals in rehabilitation settings, focusing on the significance of the therapeutic relationship within the context of a secure, residential, and medicalised environment. This project explores a therapeutic relationship with a traumatically brain injured service user within an acquired brain injury rehabilitation centre. The nature of acquired brain injury, associated consequential characteristics, and health implications for those affected are investigated within the project and research concerning music therapy and acquired brain injury, and music therapy and acquired brain injury in rehabilitation settings is also reviewed. A hermeneutic phenomenological approach and single case study method was adopted for the project to explore and present aspects of the therapeutic relationship and investigate what music therapy offered a service user within a rehabilitation setting. The process of data analysis was conducted through an adapted version of Therapeutic Narrative Analysis. This project highlights the unique potential of music therapy within a goal orientated and outcome focused setting, and the significance of a therapeutic relationship in promoting self-expression, self-identity, self-agency, creativity, and emotional wellbeing of a service user with traumatic brain injury living in a restricted environment.
An exploration of the influences on the choices of theoretical frameworks which inform music therapy practice when working with adults within a forensic mental health service
(2019)
Forensic Psychiatry is a specialised field of medicine which incorporates both general psychiatry and the criminal justice system. This is involves the safe assessment and treatment of Forensic patients who are subject to compulsory measures under mental health legislation and may present a risk to themselves or others. Forensic Patients may present with enduring problems, potentially traumatic childhood experiences as a wide range of offending behaviours and as such require specialist treatment under secure conditions. Music therapy practice occurs within the frameworks of many different psychotherapeutic theories. Some music therapists may adopt several different approaches in their work whilst others will follow one particular model of music therapy. Psychodynamic, humanistic and behavioural are some such psychotherapeutic orientations which have informed music therapy practice. The paper provides an exploration around the field of music therapy in forensic psychiatry with a focus on which theoretical frameworks are helping to inform music therapy practice in this specialised area. Through a thorough review of the literature using a traditional review approach, themes highlighted some of the potential influences on the choices of theoretical frameworks. However the study suggests that continued exploration in this area may encourage more transparency around the profession of music therapy, and help to work towards a cohesive staff team approach.
Case study: understanding the interaction of a primary school-aged girl with emotional and behavioural needs with a music therapy student
(2019)
As music therapy has become a well-known intervention in the field of working with children with additional special needs (ASN), it provides an evidence base for professionals and non professionals to understand the practice. However, the umbrella term of ‘ASN’ covers various categories and one of these, ‘emotional and behavioural needs’, is seldom explored in music therapy research. A review of the current literature finds only a few case studies in music therapy that focus on a child with emotional and behavioural needs. Thus, the following clinical case study explores the interaction between a school-aged girl with emotional and behavioural needs and a music therapy (MT) student. This study takes place in a mainstream school in Scotland and focuses on work with a ten-year-old girl with emotional and behavioural needs over the course of fifteen music therapy sessions. The aim is to explore what the client gains from interactions with a MT student by tracing any changes that occur over the sessions. This case study follows a qualitative methodology and uses interpretative phenomenological video analysis (IPVA) to analyse the collected data. The concluding discussion of this study focuses on changes in the client: the client’s choice of instruments and her musical and non-musical interactions with the MT student. It finds that the client presents her energy through music playing, dancing in the music therapy space and expressing herself within the therapeutic relationship. However, some limitations to the study become clear when attempting to explore correlations between the client’s nurturing experience and her emotional and behavioural needs. Therefore, this study concludes by encouraging further study of this client group in mainstream schools.
Individual or Couple Music Therapy? Autoethnographic Reflections on the Process of Working with a Couple Affected by Advanced Alzheimer’s Disease
(2019)
To date there is very little music therapy literature that concerns and discusses couple work, where one of them living with dementia in a care institution setting. This autoethnographic reflection explores my experiences of working with a couple, Wendy and Tony, in an NHS nursing home for people with advanced dementia and behaviours that challenge. Wendy was diagnosed with advanced Alzheimer’s disease, and has been one of the residents at the home for many years. Tony, her husband, visits her on a regular basis. Music therapy with the couple started unexpectedly with two of them together, which brought many questions and challenges to the process. The study used my process notes from the first ten sessions with them and highlights my own reflections on the therapeutic process, with a particular stress on challenges relating to Tony. The process notes are coded and analysed through thematic analysis. Four themes were discovered from the analysing process: my contrasting views and feelings associated with Tony and Wendy, the process of working with varying focus within the sessions, the similar patterns between Tony and myself, and the decision-making process regarding Tony’s role, impact, and participation in the music therapy sessions. How these themes link to a wider context of music therapy profession are also explored, such as the potential impact that the decisions made relating to Tony had on the therapeutic process and the therapeutic relationship between three of us.
An exploration of the role of movement in music therapy with an older person with dementia.
(2019)
The role of movement in several creative arts therapies are frequently studied, yet movement and gesture and their effects on music therapy remain unclear. This is particularly pressing for clinical populations with verbal communication challenges. Despite research into the role of movement in music therapy being undertaken in an array of other client groups, there is a paucity of research for people with dementia who have pronounced verbal communication difficulties. Accordingly, this project explores the role of movement in music therapy for both the therapist and participant through a single case study of a person living with dementia. By participating in multiple sessions of music therapy and recording video footage combined with interpretative phenomenological video analysis (IPVA), this study examined closely the means by which movement and gestural expression modulate music therapy and the relationship between therapist and participant. Three critical themes were discovered to be pertinent to movement and music therapy: holding, communicating through cues, and subjective relationships. This, the current author argues, supports mother-infant interaction holding theories, promoting communication in music therapy for those challenged by verbal modes, and facilitates a healthy therapeutic relationship between the therapist and participant. Here it is concluded that although music is the primary medium in music therapy, based on mother-infant relationship theory and the results of this project, a thoughtful blend of movement with music can significantly enhance communication and the potential to negotiate interpersonal connection
“You can say something in music”: a single-case study of music therapy with a person living with chronic aphasia
(2019)
Studies to date on music therapy and music-based therapeutic interventions for people living with aphasia have mainly focused on functional language outcomes, and have been quantitative in nature. Whilst early music-based interventions have used a manualised method focusing on improving functional language output, subsequent variations with more of a music therapy orientation have introduced improvisational elements. However, the study of these improvised elements and the role they may play within a therapeutic relationship has been largely overlooked. The purpose of this single-case study is to explore what it might have meant for a person living with aphasia to “say something in music”. The author takes the position that for a person to feel that something has been said, they must also perceive it to have been comprehended and responded to by an ‘other’. Hence a relation-centred method of inquiry was adopted to study the ways in which a therapeutic alliance was formed and reformed in the moving-along process of music therapy, within both music and words, intra-subjectively and inter-subjectively. The author concludes that a psychodynamically informed, improvisational approach to music therapy with a person living with aphasia is congruent with a value-based person-centred approach to forming a socially constructed therapeutic relationship. The use of a relation-centred method of inquiry may also offer an ethical approach to researching the lived experience of people with aphasia within music therapy encounters. Key words: Aphasia, music therapy, improvisation, psychodynamic, relation-centred
Reflections on a student’s placement experience in a hospice: Setting up a new music therapy service.
(2019)
Background: Research has shown that a music therapy service brings value to a hospice setting. Patients receive treatment in hospices for numerous symptoms that can be experienced with terminal illness. Due to its holistic nature, music therapy is relevant to a hospice’s philosophy of care in providing psychological, physical, social and spiritual support. Music therapists at any level of practice may be involved with setting up new services in various settings a well as evaluating the perceived impact on patients and members of staff. Students may experience this process as part of their clinical placement during music therapy training. There have been studies indicating the value of music therapy within hospice settings. However, there is less research regarding student music therapists reflecting on and evaluating their work in setting up a new service in a hospice. Methods: This investigation consists of student reflections and a service evaluation component on patient and staff perceptions of the new music therapy service within a hospice. Reflections were based from the student’s reflective journal. In addition, quantitative data was collected and analysed from questionnaires containing multiple-choice questions, a Likert scale statement and a text box for further suggestions and comments. These were distributed to patients and members of staff during a seventeen-day evaluation period from 6th March until 22nd March. Results: Broader reflections from the student music therapist indicated several aspects to consider when setting up a new music therapy service such as integrating into a multidisciplinary team, advocating for music therapy and professional identity boundaries. Results from the service evaluation component showed that patients and staff perceived the music therapy service as adding value to the hospice. Patients stated that the open music therapy group sessions provided a distraction from illness, encouraged creative interactions with others, helped them to relax and made the environment more pleasant. Members of staff stated that the piano playing sessions elevated their mood, initiated conversations, made the working environment more pleasant, evoked memories, provided emotional support and helped them to be with others without having to talk. Despite the limitations, and the small scope of reflections and evaluation component, it can be concluded that music therapy impacted on patients and members of staff in a beneficial way. Conclusion: The findings from the reflections and evaluation component, to a degree, presented new information about the processes of setting up and evaluating a new music therapy service in a hospice. The evaluation component has succeeded in meeting its aims and objectives as it helped to locate aspects that worked well and areas in need of improvement. Suggestions for setting up differently were also signposted. Keywords music therapy, palliative care, student, reflections, service evaluation, hospice
Exploring the use of musical preferences in music therapy with adolescents during the assessment phase within a mainstream secondary school: A multiple-case study
(2020)
This multiple-case study explores the ways three young people engaged with their musical preferences in music therapy during the initial six-week assessment phase and explores the ways musical preferences contributed to the therapeutic relationship. The role of music in the lives of adolescents is frequently highlighted in various studies and contexts, yet the role of musical preferences in individual music therapy within a mainstream secondary school requires further investigation. Examination of the current literature shows that there are multiple ways that musical preferences can be part of the therapeutic process depending on the music therapist’s approach, interventions or techniques, especially in group work. However, the role of adolescents’ preferred music in individual music therapy sessions and the therapeutic value of the potential use of their preferred music through their own devices or playlists have not been thoroughly explored. The study aimed to investigate how adolescents engaged with their preferred music and what the use of musical preferences offered in the therapeutic relationship. Data was analysed through thematic analysis of the process notes, underpinned by a hermeneutic phenomenology framework and findings were presented within a multiple-case study. The themes and subthemes that emerged from the findings indicate that the use of preferred music can contribute to establishing connectedness, musical engagement and sharing within a potential space where young people further expand their musicality, social skills and self-expression. According to the cross-case analysis, the ways adolescents used their music in therapy differed, yet the way musical preferences contributed in facilitating a secure, potential space and further self-expression was similar among all cases. This multiple-case study highlights that the choice of adolescents to bring and share their music in music therapy within a mainstream secondary school can inform music therapy practice and this can strengthen the therapeutic relationship and enhance further aspects of self expression.
Music therapy can facilitate the exploration, preservation and restructuring of ‘self concept’ in a long-term survivor of acquired brain injury: a Case Study
(2020)
The unexpected trauma of an acquired brain injury is the cause of great loss in many aspects of a person’s life. It necessitates adapting to a new reality for both the survivor and their carers, facing a future existence vastly different to the one they may have prepared for. The threat posed to a person’s self-concept, in both their personal and social identities needs to be acknowledged further and accommodated in programmes of neurorehabilitation. Rehabilitation of bodily function is fundamental, but all domains of the self-concept require attention. Otherwise, a model of ‘disablement’ may be imposed on the survivor by self and by society which delegitimates the survivor’s capacity to preserve the essence of themselves. Preserving and restructuring the self-concept provides a sense of hope in facing a hugely different future. Further evidence is needed of the potential of music therapy, as a clinical intervention, in addressing and rehabilitating the vital area of self-concept. This case study, using a qualitative phenomenological approach, found that music therapy focused on enabling rather than disabling. It gave voice to the survivor’s own story which provided increased understanding of the lived experience of acquired brain injury and highlighted the survivor’s strengths and preferences. The interpersonal process of the therapeutic relationship afforded the opportunity and containment for the safe exploration, preservation, and restructuring of aspects of the self-concept. Keywords : acquired brain injury, self-concept, music therapy, neurorehabilitation.