Music therapy in invasive cardiac procedures: Expanded perspective

There is a need for more research on the effect and practical application of music therapy in perioperative settings. With this in mind, a randomized controlled trial was performed to evaluate the stress-regulatory effects of a specific music therapy intervention on patients ( n = 64) during cardiac device lead extraction procedures. This article presents a supplementary analysis of the randomized controlled trial to expand the perspective on the impact of the music therapy intervention related to patient anxiety and self-reported experiences. In this substudy, we analysed patients’ self-reported numeric-rated anxiety levels in relation to time and subgroups. The results were further illuminated through scores of the patients’ satisfaction with the music therapy intervention, and qualitative written patient reflections. Descriptive statistical analyses were used, and a supplementary content analysis addressed the written patient material. Results showed that levels of anxiety varied over time in all subgroups. Across different timeline profiles, most patients reported the highest anxiety levels preoperatively and the lowest postoperatively. Independent of anxiety levels, the patients reported positive experiences with music therapy related to coping with the procedure, wellbeing and satisfaction, expressed within the following four categories: (1) bodily sensations of wellbeing, (2) positive feelings, (3) presence of mind and (4) useful intervention elements.

Music therapy in the Hospital-at-home: A practice for children in palliative care

This pilot research study investigated music therapy in a hospital-at-home setting for children in palliative care, focusing on parental and nurses experiences of music therapy. Nine families included in the study were interviewed after receiving a maximum of five individual music therapy sessions at home with a Music Therapist. In addition, a focus group interview with allied health professionals involved in the patients’ care was conducted investigating the multidisciplinary team’s experiences with music therapy. Results revealed that the families drew attention to the feeling of being isolated–yet connected due to music therapy. All the families reported the importance of the relationship to the Music Therapist, while emphasizing flexibility and joint music-making. Music therapy within hospital-at-home treatment was reported as a meaningful and much appreciated form of therapy, while the multidisciplinary teamwork was highly valued by both the health personnel and the families. The results showed the need for a highly skilled Music Therapist to support the families’ complex and dynamic needs within a hospital-at-home setting. The results demonstrated the need for, and the possibilities of, a dynamic music therapy programme adapting not only to the patients’ individual needs but additionally providing family-centred care that considered shifting locations.

Improvised music to support Intensive Interaction for children with complex needs: A feasibility study of brief adjunctive music therapy

This study investigates Triadic Support of Interaction by Improvisation, an application of music therapy as a brief adjunctive therapy for children with complex needs who are receiving Intensive Interaction. A small randomised controlled trial measured changes in child-support worker interaction between the 4th and the 12th of 12 weekly sessions of Intensive Interaction. In each of two special schools, a control group of four children with complex needs received Intensive Interaction only and an experimental group of four children additionally received improvised music in sessions 5 through 8. Experienced Speech and Language Therapists made blind assessments from video recordings of sessions 4 and 12 using an adaptation of an instrument developed by a National Health Service learning disability service for tracking progress in Intensive Interaction. The experimental group at one research site showed significantly enhanced interaction (p = 0.02). This offers provisional proof of concept, provided environmental factors identified as impacting results at the other site can be resolved in future studies.

Improvised active music therapy for clients with Parkinson’s disease: A feasibility study

The purpose of this study was to test the feasibility of delivering Improvised Active Music Therapy sessions in measuring the impact of acquisition of rhythmic complexity levels on gait performance in individuals with Parkinson’s disease. In this single subject multiple baseline design, the study measured the ability of three right-handed participants with Parkinson’s disease to acquire greater density of syncopation, as a measure of rhythmic complexity levels, while playing uninterrupted improvised music on a simplified electronic drum-set. The music content of the sessions was transformed into digital music data in real-time using Musical Instrument Digital Interface. The Musical Instrument Digital Interface data were analyzed to determine the participants’ and the Music Therapist’s density of syncopation (on acoustic guitar) during baseline and treatment conditions. Results from visual analyses and Pearson’s correlations on the outcomes indicated conflicting and inconclusive outcomes about whether higher acquisition of rhythmic complexity levels improves gait performance in individuals with Parkinson’s disease. Despite this, evidence was found to support the overall value of Improvised Active Music Therapy sessions on gait performance. The study design, the intervention, and outcome measures were found to be feasible and could be scaled-up into a larger trial.

Trends of differentiation and integration in UK music therapy and the spectrum of music-centredness

A long-standing trend to differentiate and even oppose psychodynamic and ecological approaches to practice can be identified in the UK music therapy literature. This is complicated by the way in which ecologically oriented thinking is associated with practice identified to be music-centred. While the trend to differentiate and separate approaches is most apparent in the literature, it is also evident that in practice, therapists have long integrated different perspectives and ways of working, this integral trend having its roots in the work of the UK music therapy pioneers. This article explores how the ecologically oriented thinking associated with the Community Music Therapy movement, and introduced soon after the turn of the 21st century, served in part to broaden the scope of UK practice in a progressive, integrally oriented way. However, the article also discusses the rejection of psychotherapeutically oriented thinking made by some ecologically oriented authors to make space for the new way of thinking. It is suggested that this rejection has been less helpful for the development of the profession as a whole, as the different ways of working in music therapy can be understood to address different types and levels of need. This means that psychodynamic, developmental, ecological, neurological and other perspectives are all potentially important. Case vignettes are used to illustrate this and an integral approach to working, with music-centredness discussed in a way that embraces the full spectrum of UK practice.