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

Abstract

This 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.