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

Abstract

Music 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.