Individual or Couple Music Therapy? Autoethnographic Reflections on the Process of Working with a Couple Affected by Advanced Alzheimer’s Disease

Abstract

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.