Applying a social learning theoretical framework to music therapy as a prevention and intervention for bullies and victims of bullying

Bullying is a growing worldwide problem largely affecting school-aged youth and, to date, there is no music therapy literature specific to bullying. As a result, there is no guidance for applying theoretical frameworks or for developing music therapy interventions for bullies and victims of bullying. After synthesizing the literature and determining the characteristics and behaviors of bullies and victims, the authors applied social learning theory as a framework to conceptualize the behaviors and cognitions of bullies and victims and to design age appropriate music therapy interventions. Based from concepts of social learning theory and existing music therapy research with adolescents, the authors provide suggestions of music therapy interventions for both bullies and victims. It seems that a social learning theory approach to music therapy interventions might represent an appropriate approach to frame treatments for both bullies and the victims of bullying. Prevention and intervention efforts at various age and developmental levels using music therapy may be more engaging, motivating, and effective than prevention and intervention efforts without music. The proposed interventions may be a helpful initiator for music therapists working with school-aged populations on the issues of bullying.     

Is there a role for music therapy in the recovery approach in mental health?

The recovery approach in mental health care emphasises the importance of the service user leading a fulfilling, meaningful life beyond the limitations of illness or symptomatology. This approach to care is increasingly included as a central part of mental health policy and service provision in a number of countries including the UK and Ireland, to address the needs of people who have severe and enduring mental disorders. It is an autonomous, holistic and empowering way of working with individuals as they journey towards healing. Fundamental to this model is the relationship fostered between service users and health professionals. The recovery philosophy of care mirrors some of the core principles of music therapy, including the importance of the therapeutic relationship and the possibilities for change and growth within this. This paper explores the congruence between music therapy and the recovery approach by providing: (1) An overview of current published evidence for music therapy in mental health care. (2) A discussion of this psycho-social creative arts therapy intervention within the specialized area of recovery in psychiatry, and (3) case vignettes to illustrate the application of this philosophy in music therapy work within a recovery service.     

Mental health implications of music: insight from neuroscientific and clinical studies

Neuroscientific and clinical studies of music over the past two decades have substantially increased our understanding of its use as a means of therapy. The authors briefly review current literature related to music's effect on people with different mental illnesses, and examine several neurobiological theories that may explain its effectiveness or lack thereof in treating psychiatric disorders. Neuroscientific studies have shown music to be an agent capable of influencing complex neurobiological processes in the brain and suggest that it can potentially play an important role in treatment. Clinical studies provide some evidence that music therapy can be used as an alternative therapy in treating depression, autism, schizophrenia, and dementia, as well as problems of agitation, anxiety, sleeplessness, and substance misuse, though whether it can actually replace other modes of treatment remains undetermined. Future research should include translational studies involving both neuroscience and clinical medicine that investigate the long-term effects of music intervention and that lead to the development of new strategies for music therapy.     

Development of a music therapy assessment tool for patients in low awareness states

People in low awareness states following profound brain injury typically demonstrate subtle changes in functional behaviors which challenge the sensitivity of measurement tools. Failure to identify and measure changes in functioning can lead to misdiagnosis and withdrawal of treatment with this population. Thus, the development of tools which are sensitive to responsiveness is of central concern. As the auditory modality has been found to be particularly sensitive in identifying responses indicating awareness, a convincing case can be made for music therapy as a treatment medium. However, little has been recommended about protocols for intervention or tools for measuring patient responses within the music therapy setting. This paper presents the rationale for an assessment tool specifically designed to measure responses in the music therapy setting with patients who are diagnosed as minimally conscious or in a vegetative state. Developed over fourteen years as part of interdisciplinary assessment and treatment, the music therapy assessment tool for low awareness states (MATLAS) contains fourteen items which rate behavioral responses across a number of domains. The tool can provide important information for interdisciplinary assessment and treatment particularly in the auditory and communication domains. Recommendations are made for testing its reliability and validity through research.     

Music Interventions for Children with Autism: Narrative Review of the Literature

It is widely reported that music can be beneficial to individuals with autism. This review was undertaken to determine the evidence base for the use of music as an intervention for children with autism. After searching relevant databases, 128 articles were identified of which 20 articles met the study’s inclusion criteria. Composed songs and improvisational music therapy were the predominant music techniques used. There was somewhat limited evidence to support the use of music interventions under certain conditions to facilitate social, communicative and behavioural skills in young children with autism. The implications of these findings in terms of use of music interventions, issues related to generalization and maintenance, and future research are discussed.     

Effects of music therapy on positive and negative affect and pain with hospitalized patients recovering from a blood and marrow transplant: A randomized effectiveness study

Due to the extensive procedures surrounding treatment, cancer patients often experience a variety of physical and psychological symptoms and side effects that negatively impact their quality of life and ability to cope with and manage an illness. Providing a choice of music during a receptive music therapy session may not only distract the patient from negative affective states, but also may provide a sense of autonomy and control over a patient's immediate environment. The purpose of the study was to determine whether receptive music therapy can improve two general dimensions of emotional experience and pain in a single session for hospitalized patients recovering from a blood and marrow transplantation (BMT) procedure. The guiding research question was: Will participants experience improved positive and negative affect and pain immediately following a patient-preferred live music therapy session? Participants (N = 32) were randomly assigned to experimental or wait-list control conditions and completed the Positive and Negative Affect Schedule (Watson, Clark, & Tellegen, 1988) Short Form version and a Likert-type Pain Scale as a pre- and posttest within a single-session design. In an attempt to provide support, autonomy, and distraction, patient-preferred live music was used in receptive music therapy sessions as previous music therapy researchers indicated patient-selected live music is preferred and can be effective. There were no between-group differences at pretest. Concerning posttest analyses, there were significant between-group differences in positive and negative affect and pain, with experimental participants having more favorable scores than control participants. From the results of this randomized effectiveness study, it seems that a single receptive music therapy session can be an effective intervention concerning positive and negative affect and pain for hospitalized BMT patients. As higher levels of patient engagement may result in stronger treatment effects, future research encouraging hospitalized BMT patients to engage in different types of active music therapy interventions is warranted. Limitations of the study, implications for clinical practice, and suggestions for future research are provided.     

Effectiveness of music therapy for children and adolescents with psychopathology: A quasi-experimental study

Abstract

Music therapy has been found to be effective for children and adolescents with psychopathology, but its effectiveness in routine practice is unknown. The aim of this study was to examine whether individual music therapy as provided in outpatient services is an effective treatment for this group of clients and to examine potential predictors of its effectiveness. The authors assessed symptoms, competencies, and quality of life in children and adolescents with psychopathology (N=136) before and after up to 25 weekly sessions of individual music therapy or corresponding waiting time. No significant interaction effects were identified, although quality of life showed a tendency in favor of music therapy. Effect sizes were smaller than in previous experimental research. Effects on symptoms depended on the presence and severity of comorbid medical conditions. The results suggest that music therapy as provided in routine practice is effective for some but not all groups of clients.     

The effect of music therapy sessions on compassion fatigue and team building of professional hospice caregivers

The purpose of this study was to evaluate the effects of music therapy on compassion fatigue and team building of professional hospice workers. Participants were nurses, social workers, and chaplains and were employed for at least one year in hospice care. Seventeen participants engaged in one of two experimental music therapy groups. Experimental group 1 utilized an ecological music therapy approach with an open, free form without structure and encouraged participation in the live music experiences of instrumental improvisation as well as toning and chanting. Experimental group 2 utilized a didactic music therapy approach with a structured format wherein interventions were planned and facilitated by the music therapist a priori. Such interventions included guided meditation with live music, lyric analyses, and music and movement. To measure compassion fatigue, the Compassion Fatigue Scale (CFS) was used as a pre- and post-test measure in each group. To measure team building, the Team Building Questionnaire (TBQ) was used as a pre-and post-test measure in each group. Statistical analyses indicated a significant improvement in team building in both groups but no significant differences with regard to compassion fatigue. Further research studying the effects of music therapy on compassion fatigue and team building of professional hospice caregivers is recommended.     

Psychedelics and music: neuroscience and therapeutic implications

Abstract

From the beginning of therapeutic research with psychedelics, music listening has been consistently used as a method to guide or support therapeutic experiences during the acute effects of psychedelic drugs. Recent findings point to the potential of music to support meaning-making, emotionality, and mental imagery after the administration of psychedelics, and suggest that music plays an important role in facilitating positive clinical outcomes of psychedelic therapy. This review explores the history of, contemporary research on, and future directions regarding the use of music in psychedelic research and therapy, and argues for more detailed and rigorous investigation of the contribution of music to the treatment of psychiatric disorders within the novel framework of psychedelic therapy.     

Combined treatment using acupuncture and music therapy on children with cerebral palsy Gross motor function measure comparison in 60 cases

BACKGROUND： The use of acupuncture has received recognition to effectively treat cerebral palsy. Moreover, music therapy can be used to modify treatment of cerebral palsy. OBJECTIVE： To study the effects of combined treatment using acupuncture and music therapy on gross motor function measure （GMFM） of children with cerebral palsy, compared with acupuncture treatment alone. DESIGN, TIME AND SETTING： Randomized, controlled, clinical study. The experiment was conducted in Shenzhen Hospital of Traditional Chinese Medicine between January 2007 and September 2007. PARTICIPANTS： All children with cerebral palsy in the trial were from the outpatient department of Shenzhen Hospital of Traditional Chinese Medicine. The children were randomly divided into two groups： 30 children in Group B received acupuncture and music therapy, while 30 children in Group A received only acupuncture therapy. METHODS： Subjects in Groups A and B received acupuncture based on syndrome differentiation. The main acupoints were necessary for all participants. At first, flash needling was applied to the acupoints. For the remaining acupoints, the technique of transverse needling was applied to the head acupoints, and perpendicular needling was used for the other points. The inserted needles were twirled and then maintained for 30 minutes. The needle was twirled for one second every other 10 minutes, without reinforcing-reducing techniques. The therapy was performed every other day. The trial consisted of three periods each, and lasted for 84 days. Subjects in Group B received music therapy. They listened to music that they preferred while acupuncture was being performed. Following acupuncture, they were allowed to perform musical activities, such as percussion, singing, and dancing. The music therapy was scheduled for one hour, including listening to music for 30 minutes and music activities for 30 minutes. MAIN OUTCOME MEASURES： The comprehensive functional evaluation scale of cerebral palsy and the GMFM were applied to test sy     

Music therapy with patients in low awareness states: approaches to assessment and treatment in multidisciplinary care

This paper outlines the rationale for and role of music therapy as a clinical intervention and diagnostic tool in multidisciplinary (MDT) rehabilitation programmes for patients in low awareness states. A review of the literature indicates that music is a useful clinical tool in stimulating a range of behavioural, physiological and expressive responses in patients in low awareness states. Referral criteria for music therapy with this patient group are provided, along with suggested methods for collaborative multidisciplinary work. A case vignette is presented of a client whose diagnosis of vegetative state (VS) was contradicted by her purposeful responses within music therapy assessment, contributing towards a changed diagnosis to minimally conscious state (MCS). The case illustrates the particular role of music therapy in assisting with diagnosis in complex cases. Music therapy provides a clinical forum in which recovery of function can be assessed in an informal way, using a medium which does not rely on language, is non-evasive and elicits emotional responses.     

The use of music to engage children with autism in a receptive labelling task

Children with autism are less engaged with social and non-social objects and activities than their typically developing peers, resulting in reduced learning opportunities. There is some support for the use of music to enhance the engagement of children with autism but there has been little research investigating the use of music to engage children in language learning tasks and determining if this impacts on learning outcomes. This study investigated the use of music to engage children with autism in a receptive labelling intervention. Twenty two children (mean age 5.9 yrs) participated in a randomised controlled cross-over design comparing sung and spoken conditions embedded into a computer based intervention. Child performance and observational data were analysed to determine relationships between music, engagement and learning outcomes. The findings from this research showed children with autism were more engaged in the sung condition compared to the spoken condition although there was considerable variability in levels of engagement between participants. Furthermore, a correlation between engagement and learning was found. Implications of these findings are discussed and recommendations made for future research.     

Immediate quantitative effects of recreational music therapy on mood and perceived helpfulness in acute psychiatric inpatients: An exploratory investigation

The purpose of this exploratory study was to determine the immediate quantitative effects of single recreational music therapy interventions on mood utilizing a pre- posttest research design. Participants (N = 41) were acute psychiatric inpatients. Using the Quick Mood Scale ( Woodruffe-Peacock, Turnbull, Johnson, Elahi, & Preston, 1998), the researchers compared pre- and posttest measures in participants’ moods with 10 different recreational music therapy interventions. Results indicated positive and significant immediate changes in four mood factors after a single recreational music therapy session: (a) wide awake/drowsy, (b) relaxed/anxious, (c) cheerful/depressed, and (d) friendly/aggressive. There were no significant between-intervention differences concerning mood or posttest measures of perceived helpfulness and enjoyment. From the results of this study, it seems that recreational music therapy interventions can have an immediate positive impact on acute psychiatric inpatients’ moods but the specific type of recreational music therapy intervention utilized does not affect outcome. Limitations, suggestions for future research, and implications for clinical practice are provided.     

Effects of music therapy with patients on a post-surgical oncology unit: A pilot study determining maintenance of immediate gains

Researchers have found that music therapy can be an effective psychosocial intervention for oncology patients. However, due to shortened inpatient hospital stays and the frequency of surgery for patients with cancer, there is a need to determine maintenance of single-session treatment gains with patients on a post-surgical oncology unit. The purpose of this pilot study was to evaluate maintenance of immediate music therapy treatment gains concerning relaxation, pain, anxiety, nausea, and perception of music therapy with patients on a surgical oncology unit. Participants were adult oncology inpatients (n = 27) and their caregivers (n = 4) receiving care on a surgical oncology unit. Participants completed five separate 10-point Likert-Type Scales at pretest, posttest, and 30–45-min follow-up. Participants received 20-min music therapy sessions consisting of patient-preferred live music. Analyses of variance (ANOVA) were computed on all patient data and indicated significant differences in relaxation, anxiety, and pain between pretest and posttest and pretest and follow-up measures. However, there were no significant differences from posttest to follow-up, indicating maintenance of treatment gains. Although generalizations are premature due to the lack of a comparison condition, it seems that beneficial effects of a single music therapy session for surgical oncology patients may be maintained in the short-term. Limitations, implications for clinical practice, and suggestions for future research are offered.     

Psychodrama-Gruppentherapie mit Kindern

The presented study demonstrates research approaches in an outpatient unit for child and adolescent psychiatry employing psychodrama group therapy for children and their parents. It is our aim to contribute to an effectiveness research that is guided by practice and a systematic reflection of group processes with children. Following an introductory presentation of the researched field as well as the practical application of group therapy, we present an outcome study with follow-up (catamnestic) inquiries and a qualitative single case study focusing on the development of the therapeutic relationship between one particular child of the group and the grouptherapist. The treatment model of this analytic orientated psychodrama group therapy with children and their parents has been developed and practiced in the unit for child and adolescent psychiatry St. Gallen, Switzerland. A cooperation with the Zurich University of Applied Sciences (ZHAW) facilitated synergies for mutual research interests, benefiting both institutions. The catamnestic study collects data from all treated children (n?=?42) and their parents at three separate points in time (beginning, completion and 1–10 years after completion). The effectiveness of the treatment is demonstrated by improvement of lifequality. Treatment satisfaction of parents and children is evaluated and reflected. The single case study analyses the therapeutic relationship between the child and the group therapist with the relationship axis of the operationalized psychodynamic diagnostics in childhood and adolescence (OPD-KJ) employing video-rating of 6 selected (from a total of 40) therapy sessions from the beginning, middle and final phase. The transformation of maladaptive patterns of interaction to adaptive patterns within the therapeutic relationship is illustrated.     

Music play therapy: An integrated approach

The concept of integrating some of the basic principles of nondirective play therapy and music therapy provides a basis for a new combined therapy modality best called nondirective music play therapy. Nondirective music play therapy takes place in a playroom supplied with musical instruments instead of toys and other traditional play therapy materials. As in nondirective play therapy, a child is free to play out his feelings. Musical instruments are both structured and unstructured. The unstructured aspect of musical instruments allows for exploration of feelings, as do traditional play therapy materials. However, musical instruments, and music itself (by virtue of the implied association), also have a strong inherent structure. A child typically soon tires of random exploration and seeks to play a specific melody or rhythmic pattern, or becomes involved in a shared musical relationship with the therapist. At this point, a child voluntarily commits himself to a structure, which can then be manipulated for his benefit. This combination of freedom and structure can be of great value for many types of children. A case study of a moderately retarded boy in a music play therapy setting is presented in detail and the clinical possibilities of this approach are demonstrated.     

'Outlook': A psychological service for children with a different appearance

'Outlook' is a unit within North Bristol Trust which has been developing a psychosocial service for children, young people and adults with a different appearance resulting from congenital abnormalities such as cleft lip and palate and also burns and other forms of trauma. This study presents data collected from 29 children aged between 5 and 16 who received individual therapeutic interventions. The baseline assessment included a semistructured interview schedule, visual analogue scales and the CBCL (Achenbach, 1991) to provide the parents' view of their children's behaviour profile. Measures were repeated post intervention and at 6 months follow-up. The intervention consisted of four sessions of cognitive-behavioural therapy (CBT) including social skills and problem-solving components. Statistical analyses revealed significant outcomes on a range of measures. At 6 months follow-up children reported a reduction in the frequency of teasing and in the degree of distress it caused both in the classroom and in the playground. Parents reported reductions in their children's' somatizing behaviour and levels of anxiety. These outcomes suggest that this approach represents an effective therapy for children with appearance-related psychological problems.     

Cognitive-behavioural group intervention for PTSD symptoms in children following the Athens 1999 earthquake: a pilot study

This study examined the effects of a short-term group cognitive-behavioural intervention in children who were experiencing PTSD symptoms following the Athens 1999 earthquake. Twenty children, aged 8-12 years, referred for treatment to a local child mental health team were assigned, depending on timing of referral to two groups-- Group 1 (N = 10), which started treatment 2 months after the earthquake and Group 2 (N = 10), which started treatment at 4 months postearthquake. A statistically significant reduction in overall PTSD (Posttraumatic Stress Disorder) symptoms across the three PTSD symptom clusters - intrusion, avoidance, and arousal--as well as in depressive symptoms was reported immediately after the intervention. The treatment also produced a statistically significant improvement in children's psychosocial functioning. Further significant improvement was reported in children at an 18-month follow-up. Treatment gains were maintained at a 4-year follow-up. Despite several limitations to this study, short-term group CBT (cognitive-behavioural therapy) was found to be a useful treatment approach, which can be offered in clinical settings, particularly if resources are limited.