MSc in Music Therapy
Permanent URI for this collectionhttps://eresearch.qmu.ac.uk/handle/20.500.12289/7208
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Item “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.Item 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 connectionItem 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.Item “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-centredItem 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.Item 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.Item 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.Item 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.Item 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, hospiceItem 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.