Music therapy in a short-term acute psychiatric inpatient setting: an explorative case study series

Abstract

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