Investigating Music Therapy Students: Understanding of Goal-Oriented Treatment Planning
Cynthia Briggs & Soo-Jin Kwoun (Maryville University of St. Louis)
The present study examined music therapy practicum students’ learning treatment goals and objective writing within an action research framework. Participants of this study were music therapy students enrolled in music therapy practicum from the fall and spring semesters of the 2007-08 academic year. To investigate the research questions, the modified problem based approach was adopted throughout the semester. That is, two faculty members as well as students presented their client cases, followed by group discussions as to developing appropriate treatment goals, objectives and interventions for those cases. The data were collected through surveys, a posttest and students’ online journals.
The results of the study indicate participants’ enhanced understandings of definition of goals and objectives as well as their perceived confidence in mastering goals and objectives writing. This suggest that a group discussion format using real client cases is a beneficial teaching method in enhancing students’ conceptual understanding of treatment goals and objectives. Researchers’ reflections as well as suggestions for further studies were discussed.
Music Therapy Social Skills Interventions for Children with Behavioral and Emotional Disabilities or Autism
Laura S. Brown & Cathy H. McKinney (Appalachian State University)
This study explored music therapy as an intervention to improve the social skills of elementary school children grades 3-5 provided with special education due to behavioral or emotional disabilities or autism. Both structured and improvisational experiences were provided in 27 group music therapy sessions. Types of structured experiences included songwriting, active music making, and movement to music. Repeated measures analyses of variance were used to determine changes in social skills as measured by observational data, the Social Skills Rating System (Gresham & Elliot, 1990), and behavioral data from the school. The SSRS parent and student forms revealed that participants' social skills significantly improved. Music therapy was associated with a large effect on following directions with the two participants with most difficulty with that skill. Office referrals were also reduced to zero by the last 2 months of treatment. In addition to improving social skills as measured by the dependent variables, music therapy facilitated group cohesiveness among participants.
An Analysis of Songbook Series for Older Adult Populations
Andrea M. Cevasco (University of Alabama) & Kimberly VanWeelden (The Florida State University)
The primary purposes of this study were to: 1) create an alphabetical list of songs by decade from the 1900s-1960s from four songbook series which music therapists might utilize to locate songs for older adult populations, and 2) compare the songbook series list with the list from the VanWeelden and Cevasco (2007) study. Four songbook series were selected and analyzed for song title, publication date, publisher information, ISBN numbers, and number of pages for each volume. Duplicate listings were deleted so song titles were only listed once, regardless of decade, and compiled resulting in a master list of a total of 1,896 songs. Eighty-six of these songs were listed in all four series. Of the 288 songs listed from the VanWeelden and Cevasco (2007) study, 200 songs were also found within the master list in at least one of the four songbook series. Further results and clinical training implications are provided.
The Effects of Music Therapy on Physiological Measurements of Older Adults with Alzheimer’s Disease and Other Related Dementia (ADRD): A Pilot Study
Andres M. Cevasco (University of Alabama)
Researchers have investigated the effects of music therapy on cortisol levels for various age groups and populations. Currently, there is a paucity of research regarding the effects of music therapy on physiological measurements of adults with Alzheimer’s disease and other related dementia (ADRD) as related to duration and accuracy of participation. The purpose of this study is four-fold: To determine 1) the effects of music therapy on physiological and behavioral measurements of individuals with ADRD, 2) if relationships exist between duration and accuracy of participation and physiological functioning, 3) if relationships exist between duration and accuracy of participation and mood state, and 4) if relationships exist between self-reported mood and physiological data. An additional purpose of this study is to compile specific therapeutic interventions and techniques and provide clinicians an evidence-based approach of music therapy for individuals with ADRD. Participants will engage in various music therapy interventions for 45 minutes per day over a two-week period, and cortisol levels, blood pressure, and oxygen saturation levels will be taken pre and post music therapy sessions. In addition, participants will be rating their mood prior to and following sessions.
A Qualitative Study on the Influence of Prior Instrumental Training on Applied Vocal Study
Elizabeth M. Cheney (Western Illinois University)
The purpose of this qualitative study was to determine the perceived influence of prior instrumental training on applied vocal study. Interviews with 5 vocal music majors, whose applied area of study was voice and a vocal applied professor, as well as the researcher’s private journal reflecting on her own instrumental training prior to vocal training, were used in this study. Through these three perspectives, triangulation was observed. Participants completed a recorded interview of approximately 10 minutes with the researcher. The recordings were transcribed and themes were examined. Transcriptions were highlighted to determine themes between the interviews. Once the transcripts were highlighted by the researcher, a peer reviewer reviewed the transcripts for additional themes. Major themes that arose were audiation and hearing skills, general musicianship, breathe technique, and reading and performing rhythm notation. These skills were introduced during instrumental training and ensembles and were seen to benefit these participants when they began their vocal studies. Overall, the present study demonstrated that a background in instrumental training was beneficial toward the participants applied vocal study.
Elders’ Music Preference, Physiological Response and the Effect of Familiarity on Listening of Classical Music
Hsin-Yi Cheng (National University of Tainan, Taiwan)
The purpose of this study is to know preference and finger surface temperature responses to music elements, the relation between these two responses and understand the effects of familiarity while listening to classical music in elders. The subjects were the elders who liked or disliked classical music most, each group contains 15 persons. For listening, four classical music excerpts were selected from Puccini La Bohème, Mozart Laudate Dominum aus "Vesperae solennes de confessore", KV.339, Haydn Symphony No.104, mvt I and Holst First Suite in E flat, Op.28, No.1, each played twice. Subjects moved the Continuous Response Digital Interface (CRDI) dial during listening to show their likeability individually. The CRDI allows listeners to respond non-verbally across 256 degrees, and the data were collected per second. The finger surface temperatures were also detected through a finger surface temperature monitor continually per second when the subjects showed their likeability to music. Through analyzing continuous data, the researcher focused on the music elements while responses changed, concerned the relation between likeability rating and finger surface temperature and compared the response of first and second listening.
Music and Sign-Language to Promote Infant Toddler Communication and Enhance Parent-Child Interaction
Cynthia M. Colwell (University of Kansas), Anne Meeker Miller (Blue Valley School District) & Jenny Memmott (University of Kansas)
The purpose of this study was to determine the efficacy of using music and/or sign-language to promote early communication in infants and toddlers. There were three groups used for this study: 1) Music, 2) Sign Language, and 3) Music and Sign Language. All received instruction that is play-based (incorporates both group experience and small group free play). Each group was a four-week program that met for 45 minutes each week.
The Effects of Rhythmic Auditory Stimulation on Gait Performance in the MS Patient
Dwyer Conklyn, Darlene Stough, Sarah Paczak, Francois A. Bethoux, & Kamal Chemali (Cleveland Clinic Foundation & The Music Settlement)
Background: Few interventions have been successful in improving gait disturbance in patients with Multiple Sclerosis (MS). Rhythmic Auditory Stimulation (RAS) has demonstrated positive results on gait performance in other neurologically impaired populations.
Objective: To measure the effects of RAS on quantitative gait parameters in ambulatory patients with MS.
Setting: neurorehabilitation clinic within an outpatient MS center.
Methods: 10 MS subjects with gait disturbance were enrolled and randomly assigned to receive RAS versus no intervention for 2 weeks. All subjects received RAS for another 2 weeks. Between weekly visits, subjects were provided with MP3 players containing songs whose tempo was 10% above their spontaneous cadence and instructed to walk to the music 20 minutes daily. Quantitative gait parameters were collected using the GaitRite® system.
Results: A statistically significant change for double support time (left p=.0176 and right p=.0247) was found between groups while medium to high effect sizes were found for all other outcome measures. A pooled within-group analysis showed significant improvement of cadence, stride length, step length, velocity, and normalized velocity after 1 week of treatment compared to baseline. At final visit 80% of subjects improved in at least 9 of 11 gait measures. Satisfaction level with RAS was high.
Conclusions: These preliminary results suggest a beneficial effect of RAS on gait performance in MS patients, but need to be confirmed on a larger sample.
The Effect of Intergenerational Choir, Band, and Orchestra Performances on Participants Attitudinal Statements Toward Youth and Older Persons
Alice-Ann Darrow (The Florida State University), Melita Belgrave (The University of Missouri-Kansas City), & Christopher M. Johnson (The University of Kansas)
Intergenerational programming is one of the interventions that has been used to improve older adults’ cognitive, physical, social, and emotional well-being. Intergenerational programs were first developed to fill the generation gap that occurred as family structures changed and became more fragmented. At one time in our history it was common for older adults to live with their adult children and young grandchildren in a multigenerational household; however, such close living arrangements no longer exist for many families. Adult children do not always reside in the same city or state as their elderly parents, and consequently, an increasing number of older adults are moving into adult living communities. Both of these changes in proximity have contributed to misconceptions, stereotypes, and negative cross-age attitudes between older and younger persons (Administration on Aging, 2007; Newman & Smith, 1997).
Younger generations that are often involved in intergenerational programs are typically-developing preschoolers, elementary-age children, adolescents, and college-age young adults as well as young persons who are at-risk and have learning and developmental disabilities. Older adults who participate in intergenerational programs consist of individuals 65 years or older with varying physical and cognitive functioning levels. Intergenerational programs engage both generations in structured activities to decrease negative cross-age attitudes. Activities employed in intergenerational programs have included choirs, mentoring programs, weekly visits, and pen-pal and reading programs (Angelis, 1992; Cherry, Benest, Gates, & White, 1985; Cole, Mosher, Ashley, & Kiernan, 2002; Darrow, Johnson, Ollenberger, 1994; Dellmann-Jenkins, Fowler, Lambert, Fruit, & Richardson, 1994; Dunkle & Mikielthum, 1983; Kaplin & Larkin, 2004; Meshel & McGlynn, 2004).
Intergenerational programs are successful because individuals in both generations have needs that can be met through interactions inherent in multi-age activities. Intergenerational programs meet these needs because the foundation of any type of interpersonal interaction is social, though sometimes the task of an intergenerational group is academic as well as social—such as improving math skills through mentoring programs, or fostering prosocial behaviors such as sharing and cooperating with others. Other objectives of intergenerational programs have included improving the self-esteem of elementary-age children, increasing adolescents’ knowledge of the aging cycle, encouraging young adults to work in gerontological related careers, fostering positive cross-age interactions, and enhancing older adults’ psychosocial well-being (Cole, Mosher, Ashley, & Kiernan, 2002; Cummings, Williams, & Ellis, 2003; Dellman-Jenkins, Lambert, & Fruit, 1999; Hill, 2007; Lowenthal & Egan, 1991; Kassab & Vance, 1999; Marx, Pannell, Parpon-Gil, & Cohen-Mansfield, 2004; Rosenberg, 1993; Underwood & Dorfman, 2006). For young people to be successful in life, they must develop a variety of social skills as they age. For older people to age and maintain their emotional well being, they must not be isolated or forgotten.
Needs of children, adolescents, and young adults are different, and thus drive the objectives of and activities employed in intergenerational programs. The activities employed in intergenerational programs become more sophisticated as the age of the younger person increases. For example, music is a common activity employed in many intergenerational programs. However, the function of the music changes because the skills required of adolescents and young adults to complete music activities are more advanced than the skills needed by young children. The body of research conducted in intergenerational settings is growing; however, the majority of this research focuses on the benefits afforded to the younger generation (Cole, Mosher-Ashley, & Kiernan, 2002; Dellmann-Jenkins, Fowler, Lambert, Fruit, & Richardson, 1994; Femia, Blair, Jarrott, & Bruno, 2008; Kassab & Vance, 1999), with only few studies focusing on the benefits older adults receive from these interactions (Newman, Karip, & Faux, 1995; Underwoood & Dorfman, 2006; Ward, Kamp, & Newman, 1996).
Improvisational Music Therapy for the Treatment of Depression: A Randomized Controlled Trial
Jaakko Erkkilӓ (University of Jyvӓskylӓ), Christian Gold (University of Bergen), Jurg Fachner, Esa Ala-Ruona & Marko Punkanen (University of Jyvӓskylӓ)
Background
Music therapy is frequently offered to individuals suffering from depression. Despite the lack of research into the effects of music therapy on this population, anecdotal evidence suggests that the results are rather promising. The aim of this study is to examine whether improvisational, psychodynamically orientated music therapy in an individual setting helps reduce symptoms of depression and improve other health-related outcomes. In particular, attention will be given to mediator agents, such as musical expression and interaction in the sessions, as well as to the explanatory potential of EEG recordings in investigating emotion related music perception of individuals with depression.
Methods
85 adults (18-50 years of age) with depression (ICD-10: F 32 or F33) will be randomly assigned to an experimental or a control condition. All participants will receive standard care, but the experimental group will be offered biweekly sessions of improvisational music therapy over a period of 3 months. A blind assessor will measure outcomes before testing, after 3 months, and after 6 months.
Discussion
This study aims to fill a gap in knowledge as to whether active (improvisational) music therapy applied to people with depression improves their condition. For the first time in this context, the mediating processes, such as changes in musical expression and interaction during the course of therapy, will be objectively investigated, and it is expected that the results will provide new insights into these processes. Furthermore, the findings are expected to reveal whether music related emotional experiences, as measured by EEG, can be utilized in assessing a depressive client’s improvement in the therapy. The size and the comprehensiveness of the study are sufficient for generalizing its findings to clinical practice as well as to further music therapy research.
Becoming a Culturally Responsive Music Therapist and Using a Culturally Sensitive Assessment
Seung hee Eum (Michigan State University)
The purpose of this research paper is to discuss what music therapists should understand, know, and be trained to consider while becoming a culturally sensitive music therapist. For this, first, misconceptions about multicultural music therapy will be discussed. While talking about these misconceptions, an assessment model, designed by Pamela Hays (2008), called ADDRESSING (Age and generational influences, Developmental disabilities, Disabilities acquired later in life, Religion and spiritual orientation, Ethnic and racial identity, Socioeconomic status, Sexual orientation, Indigenous heritage, and National origin, and Gender) framework, will be introduced. And then, clinical considerations about how to be a culturally responsive music therapist will be suggested.
Becoming a Feminist Music Therapist: Toward a Feminist Community Music Therapy Using the Bonny Method of Guided Imagery and Music and Analytical Music Therapy
Seung hee Eum (Michigan State University)
The purpose of this research paper is to present my belief in and philosophy of feminist music therapy and also to discuss a Feminist Community Music Therapy (FCoMT) from my perspective as a feminist music therapist. While discussing this, I will present how Bonny Method of Guided Imagery and Music (BMGIM) and Analytical Music Therapy (AMT) are effective therapeutic methods for a Feminist Music Therapy.
The Use of the Multigroup Ethnic Identity Measure (MEIM) with American Music Therapists
Seung hee Eum (Michigan State University)
The purpose of this study is to verify that the Multigroup Ethnic Identity Measure (MEIM) is reliable to measure the ethnic identity of American music therapists. The participants (N=74) were American music therapists. The MEIM included 14 items, focusing on three aspects of ethnic identity: Positive Ethnic Attitudes and Sense of Belonging, Ethnic Identity Achievement, and Ethnic Behaviors or Practices. In order to establish the reliability of this new criteria measure of the three aspects of ethnic identity, reliability coefficients (Cronbach’s ) were used; in order to decide the intercorrelation of the construct as measured, Pearson product-moment correlations were calculated. In order to verify mean differences of ethnic identity between groups (age, ethnicity, and gender) ANOVA and T-test were used. Overall, the MEIM was reliable, but the reliability of the component 3 of the ethnic identity was less reliable. When the groups were analyzed based on age, ethnicity, and gender, there were no mean differences. However, there were mean differences when participants over 60 years of age were compared with all younger age groups and when white participants were compared with non-white participants. Based on these outcomes, there is a limitation to this research study: the sample size was small. There is a need to increase the sample size for future study.
Increasing Social Responsiveness in a Child with Autism: A Comparison of Music and Non-Music Interventions
Emily Finnigan & Elizabeth Starr (University of Windsor)
Background: Many children with autism have difficulty engaging in social interaction with others. Unlike most typically developing children who initiate interaction with others, children with autism tend to remain isolated and do not acknowledge the people in their environment for social contact. Instead, many children with autism typically only interact with others to satisfy a want or need, such as to obtain a desired object or to satisfy hunger (Scott, Clark & Brady, 2000). This lack of social acknowledgement also affects areas such as engaging in eye contact, body language, imitation and play.
One intervention that has been used to increase social skills in children with autism is music therapy, an established healthcare profession that uses music to address physical, emotional, cognitive, and social needs of individuals of all ages (American Music Therapy Association, 1999). Music therapy is being used on an increasing basis for children with autism therefore, it is necessary to establish its effectiveness as an evidence-based intervention, in addition to its use purely for fun for children with autism.
Objectives: This study sought to determine the effect of using music therapy on the social responsiveness and avoidant behaviours of a preschool child with autism using an alternating treatments single-subject design (Horner et al., 2005). Specifically, it was hypothesized that the child would engage in a greater number of social responsive behaviours and fewer avoidance behaviours in a music therapy condition than in a non-music condition in which the same activities are completed sans music
Method: This research used a single subject design with alternating treatments to evaluate the effects of both music and non-music interventions on the social responsive behaviours of a preschool child with autism. The non-music and music interventions were designed and implemented in an identical fashion the only difference being the addition of music. Each intervention used toys (e.g., non-music = maracas, stacking cups and plastic animals; music = car, drum, and ball) as a means to offer the child opportunities to engage in social responsive behaviours using either a spoken script or a sung melody. Social responsive behaviours were defined as eye contact, imitation, and turn-taking whereas social avoidant behaviours where defined as pushing the toy away, pushing the adult away and moving away, all which were measured in terms of frequency. An equal number of both interventions were randomly conducted with the child in an alternating manner and after a total of 12 treatment sessions.
Furthermore, The Rating Scale for Child Affect (Interest and Happiness) and General Behaviour was also used in the study to determine the general effects that the intervention may produce. This scale was adapted from Dunlap & Koegel (1980) and was implemented to determine and compare the child’s level of interest, happiness and general behaviour during the baseline and the intervention phases.
The Effect of Video Exposure on Perceived Clinical Applications of Popular Music in the Field of Music Therapy: A Pilot Study
Lori F. Gooding & Satoko M. Inoue (The Florida State University)
The purpose of this study was to examine the effect of video exposure on students’ perceptions about the clinical applications of popular music in the field of music therapy. Upper level music therapy students (N=30) at a large southeastern university were assigned to two groups; the listening group (n=15) received song lyrics and listened to a recording of a popular song. The video group (n=15) received the lyrics and watched a music video recording of the same popular song. All participants were asked to complete a brief questionnaire indicating appropriate population(s), age range(s) and target objective(s) for use of the song in a music therapy session. Participants were also asked to indicate the most appropriate population, most appropriate age range, and most appropriate target objective. All participants were asked to indicate familiarity with the song using a Likert-type scale. Additionally, those in the video condition were asked to indicate their familiarity with the video as well as the impact of the video on their choices for clinical applications. Data for each of the categories (age, population, target objective and most appropriate age, population and objective) were analyzed using Sign Tests; no significant difference was found between the two groups for any of the overall categories. Two specific items, bereavement as a selected population/most appropriate population and the selection of specific age ranges (pre teen/young adult/mature adult) were selected for further analysis because of their relationship to video content. A Significant Differences between Two Individual Proportions Test revealed a significant difference between the video and listening groups for the bereavement population as well as a significant difference for the age ranges chosen as appropriate. Results of this pilot study suggest that video exposure to popular music could have an impact on how students implement songs in the field of music therapy.
Test Instruments Used by Journal of Music Therapy Authors from 1998 – 2008
Dianne Gregory (The Florida State University)
This article updates a previous compilation of test instruments used by Journal of Music Therapy (JMT) authors from 1984-1997 (Gregory, 2000). Current listings are compared with the earlier compilation in which 115 different test instruments were categorized as either a JMT researcher-constructed test, an unpublished test (available from any peer-reviewed journal article or its author, only) or a published test (appears in Tests in Print and reviewed in Mental Measurements Yearbooks and available from commercial publishers). The present study used the same categorization criteria. Between 1998 and 2008, 144 experimental and descriptive JMT research articles included test instruments as primary measures resulting in 117 different tests. Changes in the earlier predetermined categories were noted: JMT researcher-constructed instruments decreased from 25% to 11%; non-commercial unpublished tests from other research articles increased from 35% to 64%; and commercially published tests decreased from 40% to 25%. In addition, few authors selected test instruments used by other JMT authors in the earlier review. In the updated review six published tests were used by 28 different authors. Another interesting comparison became apparent. Visual analog scales, commercially produced, published as research adaptations, or adapted by a JMT author were not found in the previous review but were used by 7 different authors in the update. Generally speaking, the slight decrease in JMT researcher-constructed tests and the greater increase in published test instruments may reflect not only practical communication through publication but replicable methodology within the broader research community.
Understanding the Past to Inform the Future: Development of the Undergraduate Music Therapy Degree Program at the University of Iowa
Deanna Hanson-Abromeit (University of Missouri-Kansas City)
The past is prologue, the introduction to the present and future. Unfolding the experiences of the past and collecting information from events that have already occurred can guide decisions for the future. Music therapy is moving beyond the prologue. Gaining a historical perspective can sustain the fluidity of the profession in research, theory, clinical services and training. Analyzing historical trends can impact current curricular attitudes and influence future development.
Curriculum development is a dynamic process. It should be reflective of the demands of an ever-changing society in its content and quality in both theory and practice. Academic programs have a responsibility to be the driving force behind curriculum development as the training ground for future professionals. Through regular examination and proactive adaptation of academic programs, music therapy could benefit in greater acceptance within the medical community and a higher level of competency and success for entry-level therapists. Students would be better prepared for clinical work if the curriculum were modified in conjunction with emerging trends and documented theories in health care, education, and science. [1]
Much of the study of the history of ideas and events comes from examining those whom are highly visible and influential. It can also come from a small group of individuals working toward a common goal. The music therapy program at The University of Iowa has emerged as a model of excellence for education, research and leadership in the field of music therapy. The purpose of this paper is to trace the formation of the undergraduate music therapy program at The University of Iowa as an example of a curriculum that developed in response to changes in professional and cultural demands.
The emergence of the music therapy program at the University of Iowa was influenced by the clinical program, started in the 1950s, at the University of Iowa Hospitals, and Erwin Schneider, a music education faculty member with an interest in music therapy. In 1976 The University of Iowa was one of seventeen colleges and universities granted approval by National Association for Music Therapy (NAMT) to offer a degree in music therapy.[2] This program started during a time of tremendous growth for NAMT.
Growth in NAMT may have been influenced by the social, political and economic changes in the United States from the late 1950s into the 1970s. Changes such as the Civil Rights Movement of the 1950s and 1960s, the Vietnam War, and particularly President Lyndon Johnson’s Great Society Programs of 1964-1967 contributed to increased activism and awareness toward the needs of the whole society. Alternative opinions promoted through these events, and substantial legislation passed as part of The Great Society Programs were indicative of a shift in the United States from a manufacturing economy to a service based economy. This shift impacted the future growth of the music therapy profession.
During the last thirty years the University of Iowa music therapy program has had a long-standing association with the clinical program at the University of Iowa Hospitals and Clinics and has continued to change with the demands of the evolving profession. These changes have involved curriculum revisions, the addition of a second faculty, and a Master of Arts degree in music therapy, as well as community involvement that strengthens the program and bring an awareness of music therapy and its efficacy to the community.
Tracing the development of music therapy academic and clinical programs can provide the music therapy profession with insights into how successful programs meet the current and future needs of the culture. The American Music Therapy Association recently celebrated its 10th anniversary. At the same time there is an increased public awareness and demand for music therapy, a focus on professional advocacy, and the establishment of advanced clinical competencies. Additionally, the United States is experiencing a shift in administrative leadership, dramatic changes in its economic stature, and proposed modifications to healthcare policies and practices. Historical perspectives provide relevant views during significant milestones. Social, political, and economic shifts have influenced music therapy in the past and will continue to do so in the future. The development of the music therapy program at The University of Iowa in the mid-1970s is one illustration of how legislation and social awareness can create opportunities for growth. Examining the evolution of music therapy academic programs, such as the program at the University of Iowa, informs professional and institutional curricular decisions that prepare future music therapists for changing clinical applications and ensures the viability of academic programs.
Music Therapy with Premature Infants: Preliminary Outcomes from an
Integrative Review
Friederike Haslbeck (Childrenshospital Bethel/Bielefeld, Germany)
Research on music therapy with premature infants is expanding globally. This research provides an overview of existing international experimental research. Strategies and challenges of reviewing literature of music therapy in the NICU are presented as well as outcomes and future direction of music therapy with premature infants.
Music Preference Assessment in Mechanically Ventilated Research Subjects: Importance of a Dynamic Process
Annie Heiderscheit & Linda Chlan (University of Minnesota)
Mechanical ventilation is a frequently utilized treatment modality in the Intensive Care Unit (ICU). Sedative agents are frequently administered to reduce anxiety, manage stress and promote tolerance of mechanical ventilation. The side effects of sedation include: muscle weakness, mental status changes, prolonged ventilatory support and extended ICY stay. Clinical guidelines suggest implementing non-pharmacological strategies to reduce patient distress before administering sedation. Research demonstrates that non-pharmacological strategies are under utilized in the ICU.
The purpose of the study is to determine if patient directed music listening is an effective anxiety self-management intervention for mechanically ventilated patients. The study includes the collaboration of a multi-disciplinary research team and is a four-year study funded by the National Institutes of Health. Subjects for the study are ICU patients enrolled as a part of a multi-site clinical trial from five sites around a major metropolitan area. Subjects are randomized to patient directed relaxing music, noise cancelling headphones or usual care groups. The outcomes for this study include: anxiety ratings, length of time on mechanical ventilator, length of ICU stay and level of stress.
A Method of Applying Body Sway as an Index to Evaluate Music Therapy
Tomoko Ichinose (Mukogawa Women’s University, Japan), Hiroki Hasegawa (Mukogawa Women’s University, Japan), Sachiko Ohta (Tokyo Medical and Dental University, Japan), & Ken’ichi Ohta (Mukogawa Women’s University, Japan)
The purpose of the present study is to develop a simple and practical method of applying body sway as an index to evaluate music therapy effects. Earlier studies suggest that the extent of body sway is affected by physical factors including fatigue (Nardone et al, 1997), age, (Fujita et al, 2005; Demura & Kitabayashi, 2006; Røgind et al, 2003), and psychological factors (Saito, 2002; Wada et al, 2001). We also measured the change in finger plethysmograph, and analyzed singing sessions in order to support body sway measurement as a valid type of data.
Twelve female university students aged 20 or 21, who were all non music majors, participated in the study. The participants sung songs for approximately 90 minutes in a singing session. The subjects sung each fifteen minute song six times, about ninety minutes in total. Before, after and during the session, each subject’s upper body was videotaped for 60 seconds. During the session, finger plethysmograph was measured four times for each subject to analyze plethysmographic waves and changes in entropy value from the degree of chaos.
The videotaped pictures were resolved into still and individual frame images. The positions of the selected parts on the resolved frames were detected by using a method of pattern matching, were recorded, and were then converted into metric information to acquire time-series data on body sway in right, left, and horizontal directions. Based on the data obtained, the locus length, the numbers of the changes of the right and left directions, and the ranges of the body sway were computed.
An Examination of Regret as Expressed in the Life Reflections of Older Adults: Implications for Music Therapy
Connie Isenberg (Université du Québec à Montréal, Quebec), Dolores Pushkar, June Chaikelson, Michael Conway & Sheila Mason (Concordia University, Quebec)
The life review as conceptualized by Butler (1963, 1974) refers to a process whereby, spurred by awareness of their mortality, individuals look back upon their life and reassess their past, thus prompting a return to consciousness of past experiences and unresolved conflicts. These conflicts may be reintegrated and in the process, enhance and add meaning to the individual’s life. According to Butler, the life review may be influenced by current experiences as well as by character and may, in turn, contribute to well-being. Music therapists have recognized the importance of life review and reminiscence in therapy with older adults (Ahonen-Eerikäinen, 2007; Ashida, 2000) as well as with patients in palliative care (Cadrin, 2006). A common tool used for life review and reminiscence in music therapy is the song, the methods derived from song use being referred to in various ways including song lyric discussion (Grocke & Wigram, 2007). Although Butler’s (1963, 1995) conceptualization of the life review provides support for an association between acceptance of the past and life satisfaction he describes a continuum of intensity so that life review may be reflected in increased reminiscence, mild nostalgia and mild regret, or alternately, it may be reflected in an obsessive preoccupation with the past. In the latter situation, the excessive focus on the past may elicit regret so painful as to generate anxiety, guilt, despair and depression. Consequently, a general understanding of regret in older adults and specifically, how personality and dispositional variables are associated with regret and how being high in regret may be associated with reduced well-being, may contribute to music therapists’ ability to determine when music life review may be beneficial and when it may be contraindicated.
This study focused on the experience of regret in older adults as expressed within the context of a life history interview, using a mixed method qualitative-quantitative approach. The goals were to explore the differential impact of demographic, personality, dispositional and other relevant variables on frequency and intensity of lifespan regret, the impact of both intensity and frequency of regret on psychological and physical well-being of older adults, to examine regret themes and dimensions of regret as derived from an in-depth life history interview and on the basis of qualitative data, to arrive at high- and low-regret profiles that may indicate proneness to regret. Interviews yielded measures of intensity and frequency of regret, emergent values, quality of experience of aging and physical well-being. A battery of self-report questionnaires assessing personality, dispositional optimism, intolerance of uncertainty, depression and happiness was also completed.
A Qualitative Exploration of a Music Therapist’s Writing on Medical Music Therapy
Jennifer D. Jones (Western Illinois University)
Communication is a necessary part of the human experience and comes in many forms, including written and oral. Patient care is best rendered when both oral and written communication among caregivers is clear. The communication of music therapists is no exception, however, music therapists are asked to describe nonverbal and ineffable experiences. Documentation by music therapists intended for non-music therapist readers is rather common, while music therapists writing clinical documentation for other music therapists is rare but worthy of exploration. The writings examined in this study were written by a seasoned music therapist undertaking a service-learning course in a medical setting. One hundred Contact Notes, 22 Reactions, and a Final Summary were used to illuminate themes. Themes include naming patients using musical and non-musical pseudonyms. Musical names connected the therapist immediately to the memory of the experience with her patients. By selecting writings that contained emphasis (i.e. font style, quotations), new discoveries were revealed about the author herself and her understanding of clients. Personal discoveries included self-care and emotional guarding while client-related discoveries included the power of parent-child relationships. Patient comments on music, the emergent therapist, and reactions versus reflections were final topics. While music therapists who journal about the clinical process must protect patient anonymity, the researcher endorses such writing as a means of supervision and self-awareness.
Correlation of Acoustic Analysis of Pitch/Rhythm with Perceptual Impression Evaluations after Singing Training for Dysarthria Patients
Maki Kato, Kazumasa Yamamoto & Seiichi Nakagawa (Toyohashi University of Technology, Japan)
This study was achieved through singing instruction exercises and analyses of the vocal pitch (Fundamental frequency "F0") of dysarthria patients. The exercises characterizes the intermediated step between a pretest and a posttest.
The four subjects on this research lived at a facility for the physically disabled, two were patients with residual disability after a head injury, one was a Parkinson’s disease patient, and one was a cerebrovascular accident patient. They had dysarthria, which induced the production of unclear and breathy verbal sounds, and limited voice articulation.
Initially in this study, the singing pitch and speaking sounds of each patient were recorded and the pitch was recorded and analyzed by a phonetics analysis software (Praat – www.praat.org) in the pretest. After these analyses, oral, breathing, and singing exercises were given to the patients during two months of music therapy sessions (16 times in total). Such exercises varied from patient to patient depending on his/her necessity. Finally, a posttest was performed in the same conditions as the pretest. A song ‘Fuji no yama’ (Mt. Fuji) was used for singing exercises and for a pretest and a posttest. This song was chosen because all patients had learned it at their elementary schools and remembered the melody and the rhythm quite well compared to other old folk songs or songs they had learned in school days.
The Effect of Familiar and Unfamiliar Melody on Visual Working Memory
Mirna Kawar (University of Missouri-Kansas City)
A copious amount of research has been conducted in order to find techniques to enhance short-term memory and, more specifically, working memory. Auditory working memory capacity was found to be larger than visual memory. Moreover, debate continues as to whether adding a melody to text is a sufficient technique to improve working memory or if spoken rhythmic structure of the text is enough to enhance recollection of the words. The purpose of this study was to investigate the possible effect of auditory stimulus on the capacity of visual working memory. Participants were randomly assigned to one of three groups observing the visual stimulus: control group, familiar melody, and unfamiliar melody. Each group was asked to free recall the items afterwards. Results suggest that adding a familiar melody to text presented in a visual stimulus enhances the capacity of visual working memory, whereas, unfamiliar melody reduces it.
With Love from Me to Me: Using Songwriting to Teach Coping Skills to Caregivers of Those with Alzheimer’s and Other Dementias
Claire M. Klein & Michael J. Silverman (University of Minnesota)
This study compared the effects of songwriting and open discussion as methods for teaching coping skills and self-care to caregivers of those with Alzheimer’s and other dementias. The primary researcher led an open-ended psychoeducational discussion (n = 7) and a songwriting (n = 7) session to a group of caregivers, focusing on self-care. After each session, participants answered two open-ended questions that were analyzed by finding themes in the responses, by using the Linguistic Inquiry and Word Count (LIWC) program, and by having music therapy students (N = 9), blind to conditions, categorize each response. Themes found included: distraction from stress; reiteration of subject matter; fun; group cohesiveness and camaraderie; therapeutic insight and generalization; appreciation; comment on presentation; and left blank. The music therapy condition had more responses in the "fun," "appreciation," and "comments on presentation" than the control condition. LIWC results were similar between groups. The students categorizing each response misidentified comments from the talk therapy condition as music therapy comments. Implications for clinical practice and limitations of the study are included. Future research warrants utilizing a larger sample size, psychometric instruments, and follow-up procedures.
Developing a Music Therapy and Speech-Language Pathology Collaborative Treatment Model for Children with Auditory Processing Disorder
Andrew J. Knight & Sarah Robinson (University of North Dakota)
The purposes of this paper are twofold. The first purpose is to propose an evidence-based practice model for collaborative clinical work with a sound theoretical basis. Research between music therapists and speech-language pathologists in the area of auditory processing disorders is not prominent in the literature. The second purpose is to suggest future studies that include randomized controlled trials (RCT) to compare two methods of intervention (music therapy/speech linguistic intervention versus speech linguistic intervention only) for children with a diagnosis of auditory processing disorder.
Exploring Parents’ Expectations of Creative Music Therapy for Children with Autism Spectrum Disorders
Hui-Yu Lee (Yuan’s General Hospital, Taiwan)
Creative Music Therapy (CMT) is well accepted as the intervention for children with autism spectrum disorders (ASD). It is generally agreed that coherent expectations between parents and music therapists of clients who have music therapy are important for clients’ growth in music therapy. That is, coherent expectations might be resulted from trusting parents- therapist relationship. However, most existed reference focuses on music therapists’ expectations for children with ASD rather than parents’ expectations of music therapy for their children with ASD. Therefore, this study investigated parents’ expectations of this intervention in terms of process.
The Effect of Music on Reducing Anxiety in Surgical Procedures: A Meta-Analysis
Sang Eun Lee (Michigan State University)
The purpose of the present meta-analysis is to examine the overall efficacy of music for anxiety reduction in patients undergoing surgery. Studies were sought from published and unpublished articles in English through the year 2008. They were collected through online databases and manual search which included Music Therapy, Journal of Music Therapy, and Music Therapy Perspectives. Finally, this study compiled the results of 29 research reports with a total of 1781 subjects, and analyzed eight categorical variables as moderator variables: year of study, publication source, type of measurement, age, gender, intervention period, music preference, and type of control group. Coded quantitative data from 29 studies were converted to an effect size (ES) according to meta-analysis procedure by Glass, McGaw, and Smith (1984). To compute overall mean effect size, one effect size per study was computed, and effect sizes and the correlation coefficient were produced by the Effect Size Determination Program by Lipsey and Wilson (2001). The statistical analysis of the overall mean effect size and homogeneity test was performed by SPSS Macro program. To explain variability between each sub-categorical variable across each categorical variable, the analog to the ANOVA was performed by SPSS Macro program.
Personality, Mood, and Music Listening in a High-Cognitive Demand Occupation: Implications for Music Therapists in Organizations
Teresa Lesiuk, Alexander Pons & Peter Polak (University of Miami)
This research examines personality type, trait mood and use of music listening by 32 professional computer information systems developers (CISD) from two different IT environments in south Florida. Improved quality-of-work via use of individually preferred music listening has previously been reported in CISD. Music listening, offering an opportunity for improved positive mood, has been shown in the psychological literature to improve workplace task problem-solving and cooperative behaviors. Prevalence of basic personality type preferences was measured with the Myers-Briggs Type Inventory (MBTI). Trait mood, also known as individuals’ emotional dispositions, was measured with the Multiple Affect Adjective Check List (MAACL). Results from this exploratory pilot survey indicate a significant prevalence of Introversion, Thinking, and Judging types in CISD with greater negative trait mood for Introversion and Feeling types. Music listening trends by type are reported, including findings such as Extraverts listen to music twice as much than Introverts, and Feeling types twice as much as Thinking types. The findings and recommendations have important implications for managers of computer information systems developers and, as well, have implications for music therapy practice in organizations.
Client Experiences in Music Therapy in Psychiatric Inpatient Milieu
Scott MacDonald (Temple University & Albert Einstein Healthcare Network)
Objectives: The purpose of the study was to gain an understanding, through a qualitative methodology, of the experiences in music therapy for individuals within an inpatient psychiatric milieu. Of particular interest were the ways in which therapeutic factors arose from the descriptions of music therapy, and to which elements of the therapeutic process the participants attributed these factors. Method: Participants- Six psychiatric inpatients (3 women and 3 men) with diagnoses including bipolar disorder, schizophrenia, schizo-affective disorder and depression and who had attended at least one music therapy group took part in the study. Design-At the time of their discharge, participants were engaged in semi-structured, retrospective interviews about their experiences in music therapy groups while on the inpatient unit. Data Analysis- The interviews maintained a phenomenological stance, focusing on the first-person, lived experience of these groups from each patient's perspective. Interview responses were coded and organized according to content area. Results/Discussion: 21 themes emerged that were grouped into 7 categories of experience in music therapy: relief/healing, shared experiences, musical focus, motivation, learning, expression, and negative experiences. Each theme was described using the client’s own words and, where necessary, included inferences from the investigator/therapist to provide a sense of the clients’ situatedness in relation to the statements that they were making. From these categories and their related themes, a further level of analysis was applied, connecting each theme with the dynamic forces in the music therapy process- music, therapist, group members, as well as self, for those experiences that seemed to be motivated by the inward process of the individual. An additional dynamic, spiritual, was added to describe an experience in one participant's response of a dynamic interaction with a higher power relative to his group experience. Emergent themes from the experience of music therapy were also compared to the therapeutic factors identified by Irvin Yalom (1996) as significant in the group therapy process. Conclusion: The study reveals a range of therapeutic factors experienced by clients in music therapy in the inpatient psychiatric setting, factors which are revealed in breadth and depth through the client’s own words. These responses may allow therapists working in similar settings to appreciate the depth of client experience. Additionally, it is evident that people in music therapy groups may engage in a variety of dynamic relationships, each of which may offer different and significant possibilities for therapeutic growth.
Music as Competition for Focus of Attention
Clifford K. Madsen, Frank M. Diaz & John M. Geringer (The Florida State University)
The thrust of the current line of research is to test the performance of listeners in regard to their attentive listening versus their attention to other tasks when both are presented simultaneously. The study constituted a partial replication of a very large study done over 20 years ago (Madsen, 1989). The current investigation used exactly the same materials as the previous study and replicated the three main groups from the original study. That is, while there were six separate groups in the original study three of these groups were intended as "control" groups. In the current investigation subjects took the GRE-type test only, the music test only or a combination of these two during a 40 minute time span. Subjects that attempted to complete both tests simultaneously went back and forth from one task to the other much like a computer "timeshares." Results from the current investigation replicate almost exactly the same scores found in the previous study. Even though some people believe that they efficiently multitask this study demonstrates again that there is no such thing as simultaneous multitasking, without a loss in one and/or more of the tasks and again strongly suggests that the ability to concentrate on more than one aspect of a given task at a time is not be possible.
The Effect of Music Therapy on Quality of Life for Solid Organ Transplant Recipients, Donors, and their Caregivers: A Preliminary Analysis
Amy T. Madson, Melissa Huntsinger, & Michael J. Silverman (University of Minnesota)
Solid organ transplant patients typically spend extended periods of time in the hospital and often experience high levels of anxiety, nausea, and pain. These factors may negatively impact patients’ quality of life. The purpose of this study was to examine the benefit of music therapy on the perceived quality of life (QOL) in solid organ recipients, donors, and their caregivers. Participants (N = 47) were randomized into wait-list control or experimental groups and received music therapy during a 15-30 minute session. The instrument utilized in this study was the Quality of Life Inventory (Frisch, 1994) which is used rate 16 domains of life in terms of the importance of the domain to the participant, and the participant’s satisfaction with each domain. Control group participants completed the inventory before receiving music therapy and were excluded from follow-up. Experimental group participants received music therapy, completed the inventory immediately after the session, and completed a follow-up inventory after approximately 45 minutes. Demographic information included age, gender, and length of stay in the hospital. Significant between group differences were found in the health and goals/values subscales of the inventory, with the control group having higher QOL scores than the experimental group. Although not significant, in the experimental condition, many of the subscale scores improved from posttest to follow-up (n = 13; 81.25%), including the total quality of life score. This increase in quality of life happened more frequently in the patient group than the caregiver group (n = 6; 37.50%). However, the results of this preliminary analysis are currently inconclusive due to small sample sizes, large standard deviations, and the experimental group being younger and hospitalized for a longer duration than the control group. Implications for future clinical practice and research are discussed.
Group Guided Imagery and Music (GIM) for Adults in Addiction Treatment: A Pilot Study
Kathleen M. Murphy & Douglas M. Ziedonis (University of Massachusetts Medical School/UMass Memorial Health Care)
Substance abuse continues to be a major public health problem and there is a need to develop innovative treatment approaches. There is growing interest in evaluating the benefit of integrating complementary treatment approaches into standard substance abuse treatment in an effort to improve treatment outcomes, including motivation to change, self-efficacy, and mood symptoms.
A primary purpose of this music therapy study was to assess the feasibility of implementing the group version of GIM in the context of a residential substance abuse treatment program which has a strong 12-Step Facilitation and Cognitive Behavioral Therapy orientation, including considering how to adapt the approach for common addiction treatment issues and themes. Additionally, this study sought to determine the effect of Group GIM on perceived coping skills as measured by the Sense of Coherence Scale (SOC), depression as measured by the Beck Depression Inventory (BDI), and motivation as measured by the Importance, Confidence, Readiness Ruler (ICR).
Deforia Lane: Heart and Soul of an African American Clinician, Educator, and Advocate for Music Therapy
Kirk M. Niles (University of Kansas)
The purpose of this study was to investigate the life and work of Dr. Deforia Lane - African American who has been making contributions through her clinical practice, internship training and supervision, clinical administration, national and international advocacy of music therapy. This paper attempted to answer the following research questions:
(i) What were the experiences of Deforia Lane that lead to her involvement in the
American Cancer Society?
(ii) What were some of the contributions that Deforia Lane has made as a music therapy clinician and educator?
(iii) How has her advocacy impacted acceptance of music therapy among other allied health professions and interested populations?
Primary sources of data were: personal interviews with Lane, personal archives of Lane, her published autobiography and interviews with music therapists.
Effect of Music Therapy Programs on Pediatric Doctors’ and Residents’ Attitude Toward the Efficacy of Music Therapy
Whitney Ostercamp (University of Missouri-Kansas City)
The following study surveyed doctors and residents from two different hospitals on their attitude toward music therapy. Hospital 1 (N1= 41) included doctors (n= 18) and residents (n= 38) in a hospital without a music therapy program, and Hospital 2 (N2= 25) was comprised of pediatric doctors (n= 11) and residents (n= 14) in a hospital with a music therapy program. Results indicate that doctors and residents from Hospital 2 have a more positive attitude toward the efficacy of music therapy, agreement that music therapy is a healthcare profession, and are more willing to refer patients to music therapy services. Areas for further research include the attitude of others toward music therapy, and how advocacy is necessary to further the profession.
An Interdisciplinary Team Work Research Report: The Short-Term Effectiveness on Children with Multiple Physical Disabilities
Chia-Yin Pan (Eden Social Welfare Foundation, Taiwan) & Ya-Fang Liao (Fongshan Early Intervention Center, Taiwan)
The purpose of this study is to investigate the effectiveness of a six-month (March to September 2009) music therapy intervention on the improvements of the motor abilities of children with multiple disabilities. A group of twelve children, mix-gendered, ages of 2 - 6, and currently enrolling in the early intervention programs at a nationwide privately own foundation since age of 1 were invited to participate in this study. All participants are with diagnoses that affect their motor skills, such as Cerebral Palsy (N = 6), Severe Mental Retardation (N = 1), Severe Epilepsy (N = 1), Multiple Organ Impairment (N = 1), Cranial-stenosis (N = 1), Mitochondrial Defect (N = 1), and Pelizaeus-Merzbacher Disease (N = 1). All children had also been receiving interdisciplinary services, including physical therapy, occupational therapy, speech therapy and special education, prior to the beginning of the study.
Participants have attended weekly music therapy sessions in addition to the physical therapy, occupational therapy, speech therapy and special education services, and will be expected to continue the attendance throughout the entire investigation period. The music therapy sessions take place at 9:40 am to 10.10 am to ensure that participants are not hungry and sleepy. Music therapy techniques implemented in this study are in the forms of Music and Movement, Rhythm Activities and Active Music Making. The board-certified music therapist varies the activity levels to address the individualized goals and objectives of all participants. Music therapy interventions are designed according to individual’s developmental abilities and each participant has significant growing slope in at least one area. A continuing evaluation by the music therapist and physical therapist are conducted in a regular basis.
Are We Training Competent Practitioners? An Investigative Study of Resilience Among Undergraduate Music Therapy Students
Varvara Pasiali (Michigan State University)
Undergraduate music therapy students in 3 large Midwestern universities (N=60) completed the Connor-Davidson Resilience Scale (CD-RISC), a psychometric 25-item scale designed to measure personal characteristics that may help an adult cope with life stressors. Participants in this study scored significantly lower (t= -5.05, df=59, a= .0001) than the US general population mean in the original validation study. The researcher hypothesized that students who obtained low scores in psychometric resilience are more likely to experience burnout as novice practitioners. Thus, she proposed the music therapy educators develop curricular experiences that provide specific opportunities to increase self-awareness and self-care skills. The ultimate goal is to train future practitioners with socioemotional, interpersonal and knowledge-based competence.
A Survey of Music Therapy Students’ Practica Experiences in Hospice and Palliative Care Settings
Sarah E. Pitts & Andrea M. Cevasco (The University of Alabama)
The purpose of this study is to investigate music therapy students’ views on 1) death and dying, 2) professional neutrality, and 3) coursework preparation for clinical work in hospice or palliative care (HPC) settings as well as a description of HPC practicum. A total of 115 student members of completed an online survey about their own cultural beliefs on death and dying and working in HPC settings; 60 participants who had a HPC practica or internship began the survey, but only 55 participants completed the entire survey. Results showed that most students working in HPC settings believe they can maintain professional neutrality when serving clients with different beliefs. Song selection and intervention choices were similar to what professional music therapists used in HPC settings. Students listed their greatest fears about working in a HPC setting, but felt prepared and satisfied with their performance. Clinical applications are discussed.
Clinical Applications of Percussion Techniques Course Content Revision to Continue Diversity Infusion
Lee Anna Rasar, Megan Hoffman & Hana Dehtiar (University of Wisconsin-Eau Claire)
Following the pilot presentation of a newly developed Clinical Applications of Percussion Techniques Course, findings from an assessment grant revealed effective results in terms of percussion skills, clinical skills, and meeting the goals of the baccalaureate through skill development in areas related to critical thinking and broadening perspectives. However, session plans and critiques were not detailed and did not target a variety of music therapy approaches. Continuation for infusion of diversity content was needed in the areas of therapeutic programming with respect to music therapy models and techniques for percussion activities. Initial diversity content had included ethnic diversity for percussion instruments, rhythms, and the role of percussion activities within culture as well as for diversity in terms of types of populations served.
Database for Music Therapy Research: Populations, Settings, Programming Arenas and More
Lee Anna Rasar, Katie Rydlund & A.J. Schuh (University of Wisconsin-Eau Claire)
Music therapy students and their professor at this university initially developed a website to present a database of research studies from the Journal of Music Therapy in different settings with specific populations. This website was originally intended to serve as a useful resource for music therapy majors who wanted to explore how music is used therapeutically with different populations. The website was also used by the general public, by health care providers, and by people with disabilities and their families and significant others. The need to expand and organize this database became evident when inquiries were received from international physicians and therapists in other fields, revealing that this website serves more purposes than just as a student resource. The website received the StudyWeb Award of Excellence as "one of the best educational resources on the web". International contacts continue weekly and result in referrals to other sources to help promote the therapeutic use of music in geographical locations including Asia, Europe, Africa, Central and South America, and Oceania.
A History of Music Therapy Treatment Interventions for Children with Autism Spectrum Disorder
Alaine E. Reschke-Hernandez (University of Missouri-Kansas City)
Music therapists face increasing demands to provide services to children with autism spectrum disorder (ASD) and should be knowledgeable of both current research and historical treatment interventions in order to provide the best services. This poster presentation includes an historical investigation of autism identification and treatment and a review of research supporting the use of music therapy with this population. Implications for future music therapy research and practice are discussed.
Ensuring Treatment Fidelity in a Multi-Site Behavioral Intervention Study: Implementing NIH Behavior Change Consortium Recommendations in the SMART Trial
Sheri L. Robb, Debra S. Burns, Sharron L. Docherty (Duke University & Joan E. Haase (Indiana University-Purdue University Indianapolis)
PURPOSE: The purpose of this poster is to define and describe treatment fidelity strategies being used in a multi-site phase II behavioral intervention study. Treatment fidelity strategies from our trial are consistent with recommendations published by the National Institutes of Health Behavior Change Consortium Treatment Fidelity Workgroup and provide a working example of how to successfully implement treatment fidelity strategies in a large, behavioral intervention study.
BACKGROUND: Treatment fidelity refers to the methodological strategies used to monitor and enhance the reliability and validity of behavioral interventions. Treatment fidelity influences the research team’s ability to address a variety of important study issues. These include investigators’ ability to: 1) draw accurate conclusions about treatment efficacy, 2) replicate studies, 3) identify essential features of an intervention, 4) reduce random and unintended intervention variability to improve statistical power, 5) test theoretical questions, and 6) disseminate and translate clinical findings. Yet, the use of treatment fidelity procedures is inconsistent and rarely reported in published behavioral intervention research.
In 2004, the Treatment Fidelity Workgroup of the NIH Behavior Change Consortium developed recommendations to encourage more consistent incorporation of treatment fidelity practices into behavioral intervention research. Recommendations cover 5 areas of treatment fidelity including: 1) study design, 2) training providers, 3) delivery of treatment, 4) receipt of treatment, and 5) enactment of treatment skills.
The Stories and Music for Adolescents/Young Adult Resilience during Transplant (SMART) study (R01NR008583; U10CA098543; U10CA095861) is an ongoing multi-site Children’s Oncology Group randomized clinical trial that is testing efficacy of a therapeutic music video intervention for adolescents/young adults with cancer undergoing stem cell transplant. In our final year of participant accrual, the SMART trial has been conducted at 6 children’s hospitals and 3 adult hospitals across the United States. The intervention team is comprised of 14 board-certified music therapists (interveners), who deliver a 6-session manualized intervention and low dose control condition to adolescents/young adults 11-25 years of age undergoing stem cell transplant for an oncology condition. Prior to study implementation, our investigative team established a comprehensive set of treatment fidelity procedures.
Researchers and Clinicians Engaged in SMART Quality Assurance Monitoring
Sheri L. Robb, Debra S. Burns, & Joan E. Haase (Indiana University-Purdue University Indianapolis)
PURPOSE: The purpose of this presentation is to describe researchers’ and clinicians’ perceptions of quality assurance monitoring procedures used in a multi-site randomized control intervention trial (Stories and Music for Adolescents/Young Adults undergoing Stem Cell Transplant, 1R01 NR008583; U10 CA098543; U10 CA095861).
METHODS: The SMART trial is an ongoing multi-site Children’s Oncology Group randomized clinical trial being conducted at 6 children’s hospitals and 3 adult hospitals throughout the United States. The SMART intervention team is comprised of 14 board-certified music therapists (interveners), who deliver a 6-session manualized intervention to adolescents/young adults 11 – 25 years of age undergoing stem cell transplant (SCT) for an oncology condition. Multiple clinicians delivering the same behavioral intervention to patients across multiple sites poses unique challenges and potential threats to intervention delivery. The SMART research team has implemented multiple strategies to ensure that study conditions are delivered in the same manner across clinicians and sites. Initially, all interveners receive 12 hours of in-person training on the manualized protocols. Training is followed by bi-monthly conference calls to discuss successes and challenges experienced while conducting sessions. In addition, all sessions are audio-recorded. Interveners and research personnel listen to recorded sessions and complete computerized quality assurance checklists designed for self-evaluation and external monitoring to ensure that all critical components were delivered. Self-evaluation and external monitoring continue until the intervener demonstrates competency; then 10% of subsequent sessions delivered by the intervener are randomly selected for quality assurance monitoring.
RESULTS: Definitions for each area of fidelity are provided below in italics, followed by specific strategies used in the SMART trial.
Study Design: Treatment fidelity practices related to study design are intended to ensure that a study can adequately test its hypotheses in relation to the underlying theory and clinical processes.
1. Theory of the problem: Haase’s Resilience in Illness Model
2. Theory of the intervention: Robb’s Contextual Support Model of Music Therapy
3. Use of theory to identify "active" or "essential" elements of the intervention
4. Use of theory to identify what factors to "control" for through the low-dose condition
5. Dose specifications and procedures to monitor treatment dose (i.e., frequency, duration) within and across study conditions
6. Training multiple interveners at each study site to prevent implementation setbacks
Training Treatment Providers: Provider training includes procedures to ensure that intervention providers have been satisfactorily trained to deliver the intervention to study participants.
1. Standardized treatment protocols/training manuals
2. Standardized training session content
3. Participant evaluation of training sessions
4. Role playing as an essential feature of training
5. Individualized supervision/monitoring
6. Bi-weekly intervention team conference calls
Treatment Delivery (Quality Assurance Monitoring): Treatment delivery includes procedures to monitor and improve delivery of study conditions; ensuring that treatment is delivered as intended.
1. Session-specific quality assurance monitoring checklists
2. Audio-recorded sessions
3. Intervener self-monitoring procedures
4. External monitoring procedures
5. Bi-weekly intervention team calls that include case presentation/discussion
Receipt of Treatment: Receipt of treatment focuses on the participant and includes processes to assure that the treatment was received and understood by the participant (e.g., that participant is able to perform treatment-related behavioral skills and cognitive strategies during treatment delivery).
1. Measures of patient engagement during/between sessions
2. Behavioral assessment of comprehension/intervention uptake
Enactment of Treatment Skills: Enactment of treatment skills includes processes to monitor and improve participant ability to perform treatment-related behavioral skills and cognitive strategies in relevant real-life settings as intended.
1. Qualitative interviews with study participants 100-days post-transplant
CONCLUSIONS: Increased use and reporting of treatment fidelity procedures is essential in advancing the reliability and validity of behavioral intervention research. Yet few publications detail how treatment fidelity procedures are being implemented in actual behavioral intervention studies. The SMART trial provides a strong model for integration of treatment fidelity procedures, as recommended by the NIH Behavior Change Consortium.
The Effects of Music Therapy on Feelings of Hopelessness and Personal Control for Women Affected by Domestic Violence
Jessica L. Rushing (The Florida State University)
The purpose of this study was to determine the effects of music therapy in a single session on feelings of hopelessness, feelings of personal control, and change in emotions for women with histories of domestic violence. This study also looked at emotional states prior to and after a music therapy session, thematic material derived from songwriting, and assessed the use of the Action Step Checklist handout in relation to problem solving and goal-setting. Women seeking shelter services (n = 12) and women residing in a state Correctional Institution (CI) (n = 8) served as participants. This research was comprised of two studies: Study A (women in the shelter) and Study B (women at the CI). The same design was utilized for both studies. Data were collected immediately prior to a music therapy session and immediately after the session for the Hopelessness Scale (HS) (Beck, Weissman, Lester, & Trexler, 1974) and the Personal Control and Emotional State Questionnaire (PCESQ). Participants filled out a demographic questionnaire prior to the group and the Response to Music Therapy after the group. An Action Step Checklist was completed once during the music therapy group and as a one-week follow-up for available participants. Participants wrote all songs used for analysis during the music therapy session. A Mann Whitney-U test (a= .05) was run for HS and PCESQ and showed no statistical significance between pre and posttest measures. All measures, with the exception of the follow-up Actions Step Checklist in study B, showed positive gains between pre and posttest, though not significant. Participants were found to have low levels of hopelessness, high levels of personal control, and displayed positive emotions. The Action Step Checklist determined that participants had completed an average of three to five out of seven steps, both at initial completion and at the one-week follow-up. Prominent themes found in song-writing analysis included self-knowledge/awareness/acceptance, strength/innate power, and courage/confidence. Response to the Music Therapy Questionnaire revealed that a single music therapy session had positive effects on motivation, comfort, personal decisions, decisions of the future, and desire to take action-steps. The strongest effect of music therapy in Study A was on desire to take action steps. The strongest effect of music therapy in Study B was on feelings of motivation. Results from this study suggest that participants were able to verbalize and recognize their own strength and courage through a single music therapy session focused on belief in personal control and problem solving.
A Description of Music Improvisation in Current Music Therapy Literature
Andrew Sammons (Napa State Hospital, CA)
American Music Therapy Association (AMTA) journal articles, Journal of Music Therapy (JMT) and Music Therapy Perspectives (MTP), published in 2000-2005 were scanned for the mention of music improvisation. The analysis of the articles in this study show how music therapy literature describes music improvisation in terms of the words, symbols and devices, populations, musical instruments and article degree of focus on music improvisation. Many articles analyzed in this study discuss music improvisation in a way that suggests creative process as the pinnacle of therapy. Furthermore, music therapists attribute therapeutic properties like human connection, communication and self-expression to the process of music improvisation. Yet with the many references to music improvisation there is little that reveals exactly how music therapists engage in music improvisation.
Survey of Music Therapy Educators: Implications for Feminist Music Therapy Education
Melody Schwantes (Appalachian State University) & Nicole Hahna (Slippery Rock University)
This study sought to examine the extent to which music therapy educators utilize principles from feminist education in the classroom environment. In a review of the literature, feminist pedagogy was indentified as valuing all students, acknowledging the individuality and diversity amongst students, and recognizing the power differences that exist within the classroom. Additionally, feminist pedagogy emphasizes the need for sociopolitical change as well as the concept that both students and teachers are "learners and knowers" (Riley & Murphy, 2005, p. 93). Finally, it highlights the lived experiences of the students and teachers and provides opportunities for the students to share personal stories which can help them connect classroom content to their own lives (Riley & Murphy, 2005). Hadley (2007) described her use of feminist music therapy pedagogy. She reported that her "philosophy of education is that people learn by doing and that it has a longer-lasting impact if people enjoy it and it is meaningful" (p. 397).
For the purpose of this research, Stake and Hoffman‘s (2000) four principles of feminist education were used. The principles included: (a) participatory learning, (b) validation of personal experience and development of confidence, (c) development of political/social understanding and activism, and (d) development of critical thinking and open-mindedness. These principles of feminist education were chosen based on their relationship to the music therapy field and their role within feminist education. It was hypothesized that music therapy educators would incorporate all of these principles into their teaching with the exception of (c) development of political/social understanding and activism. In addition, this survey sought to examine to what extent do music therapy educators identify themselves as feminist music therapists and feminist music therapy educators. It was hypothesized that while the majority of music therapists are women and the majority of music therapy educators are women, the number women and men identifying themselves as feminist music therapy educators or music feminist music therapists would be a small proportion of the sample.
Categorization by Competency of Studies Involving Music Therapy Students in the Journal of Music Therapy
Edward T. Schwartzberg & Michael J. Silverman (University of Minnesota)
The purpose of this study was to identify and categorize research in the Journal of Music Therapy involving music therapy students. Specifically, this study identified how previous research into the collegiate preparation of music therapy students aligned with the current AMTA Professional Competencies. Sixteen research articles published between 1969 and 2008 were examined. Data from each article were placed into the following categories: Author(s); Title; Year; N; Design; Independent Variable; Dependent Variable; AMTA Competency Category; Results; and Statistics. Results from the analyses of 16 studies indicated most studies concerned music therapy competencies, followed by clinical foundations, and music foundations. Further, researchers utilized fairly large sample sizes and diverse designs in their studies. Implications for the academic and clinical training of music therapists are provided along with suggestions for future research.
The Effect of Maily Music Therapy on the Attachment Behaviors of Children and Adolescents in Foster and Adoptive Families
Kristen Seles (The Florida State University)
Children who have been neglected, abused, or abandoned, such as those in foster care and adoption, often have attachment issues. These children are at risk for developmental delays, behavioral disorders and poor emotional health, as well as life long relationship problems. Some goals addressed in this study were eye contact, turn taking, choice making, increasing touch, and expressing emotions. Although music therapy research is limited in specific work with attachment disorders, these goals are common among other populations such as autism and mental health. It was speculated that these same goals can be addressed using music therapy in working with children who are in foster care and adoption who have suffered from abuse and displacement. This study investigated whether music therapy in a family setting can be beneficial in teaching and practicing basic attachment behaviors to children who have been abused and/or and their caregivers. It was theorized that through play therapy with music involving the foster child and their foster family, trust can be built among family members, the child can be taught appropriate attachment behaviors such as eye contact and touch, and social reciprocity can be encouraged to increase positive family interactions.
Five identified children/adolescents between the ages of 5 and 18 attended family music therapy sessions with their foster or adoptive families for one hour over five weeks. The type of music therapy interventions used in this study focused on the child and caregiver connecting and attaching. Instead of a free-form structure, which is often used in play therapy, these music therapy sessions were structured to work toward specific skills and goals. The sessions consisted of activities such as instrument play, listening to music, drawing to music, and song-writing. The interventions were presented in a fun, musical form, often using music and instruments that the child was already familiar with. Using the client preferred music not only makes it more comfortable for the child to engage in, but helps to build trust in a new setting with a new adult. The caregiver was encouraged during the session to be a support to the child, offering their encouragement and engagement as the child learns to accept the music therapist and the music sessions.
This study utilized a post-test only design. A pre- and post-study questionnaire was requested by the caregiver to gather information about the common behaviors and characteristics of the child, family preferences and activities, as well as the caregiver’s impression on the effects of the sessions. Data were also collected from video recordings of the sessions where attachment behaviors of the child toward the caregiver(s) and the caregiver(s) toward the child were observed and counted to determine the effect if any of the sessions on their behaviors.
Patient and Professional Perception of Music Therapy Efficacy on an Acute Inpatient Psychiatric Unit
Emily Sevcik & Ellen Rayfield (University of Illinois)
The purpose of this study was two fold: (1) to investigate how patients and professionals perceive music therapy to be effective at addressing 10 different goal areas and (2) to understand how music therapy is viewed as an important part of patients’ treatment. A survey was distributed to patients at the time if discharge, if they had been on the unit seven days or more. In addition, all staff in direct clinical care were approached to complete the survey. Overall, both patients and staff reported music therapy to most effectively address the same three goal areas. Those top goals areas were improve mood/emotional state, express emotions, and decrease stress. Interestingly, both patients and staff found music therapy to be least effective at addressing the same two goal areas, socialization and problem solving skills. In regards to music therapy’s overall importance in treatment, a t-test was performed, and professionals significantly rated music therapy as more effective than patients.
The Effect of Assertiveness Music Therapy on Locus of Control and Quality of Life in Adult Psychiatric Inpatients: A Three Group Trial
Michael J. Silverman (University of Minnesota)
The purpose of this study was to design an assertiveness music therapy role playing intervention and collect initial data to determine its effectiveness utilizing a three group posttest only design. Participants were psychiatric inpatients (N = 133) and were randomly assigned by group to one of three conditions: 1) Assertiveness Music Therapy, 2) Assertiveness No Music, or 3) Recreational Music Therapy. Participants in both assertiveness conditions role played a number of different commonly occurring scenarios at a psychiatric inpatient facility. As hypothesized, there were no significant between group differences in posttest quality of life and various subscales. However, participants in both assertiveness conditions tended to have slightly higher internal locus of control and overall quality of life scores than participants in the recreational music therapy condition. Written responses from participants indicated participants enjoyed and benefitted from the treatments, regardless of condition. Additionally, the Assertiveness Music Therapy condition had higher attendance rates than the other conditions. From the results of this study, it seems that music therapy role play can be an effective, practical, enjoyable, and inexpensive psychosocial intervention to teach assertiveness to psychiatric patients. A protocol for the assertiveness music therapy role play treatment condition and the role playing scenarios are included for psychiatric music therapists. Future research is warranted to better identify successful protocols that can help psychiatric patients generalize skills learning in treatment to the community.
The Effect of Live Music in a University Health Clinic
Michael J. Silverman (University of Minnesota)
Although music is popular and widely used in a number of clinical and nonclinical settings, scant literature supports background music in clinical settings. The purpose of this study was to evaluate the effects of live music in the waiting room of a university clinic utilizing a two group posttest only design. Patients in the waiting room tended to give more positive satisfaction ratings in the music condition (n = 48) than the no music control condition (n = 14). Staff working at the check-in desk also had positive perceptions and quantitative ratings of the live music condition and noted it did not interfere with their ability to do their job or ability to protect patient confidentiality. Performing students had a high degree of enjoyment providing live music at a university health clinic waiting room. Limitations of the study, generalizations, and implications for practice and education are provided.
An Examination of Advanced Age Labels and Age Ranges in a Sample of Music Education, Psychology, and Therapy Dissertation and Thesis Research
David S. Smith (Western Michigan University)
An archival investigation of aging-related labels used and the ages they represent in music education, music psychology, and music therapy-focused dissertations and theses was conducted using the Dissertation and Thesis (ProQuest) database. Four search terms (music and elderly, music and older adult, music and senior citizen, music and well-elderly) elicited a pool of 122 documents. Selection criteria to create the research sample included: research involving human participants; research related to music education, psychology, or therapy issues; and access to both an abstract and a full-text document online through the database. Twenty-four documents met the criteria and were further evaluated for the target variables (age labels, age label definitions, participant descriptions, and participant age ranges), first by accessing and reading the complete abstract of each document, and then by accessing and searching the entire document for information that was not available through the abstract. Findings indicated the most frequently used aging label was "older adult," and ages representing all age labels ranged from 50s and 60s to 70s and 80s. Definitions of age labels were included in just over half of the documents and represented a mix of sources ranging from those found in previous research studies and educational specialists, to governmental, AARP, and trailer park owner mandates. Findings indicate a lack of shared understanding related to age labels and ranges, consequently the need to access the full-text of dissertations and theses rather than rely on the content included in abstracts.
A Comparison of Music Educators and Music Therapists: Personality Types as Described by the Myers-Briggs Type Indicator and Demographic Profile
Anita Louise Steele & Sylvester Young (Ohio University)
The Music Education National Conference (MENC) and the American Music Therapy Association (AMTA) have suggested characteristics of a professional. Career specific assessment instruments are not readily available by which to determine how well these professionals will succeed in their careers. Knowledge of personality tendencies based on discipline specific research may influence job satisfaction, stress, burn out, and retention. The purpose of the current study was to determine whether or not there are similarities and differences between personality types and demographic information of professional music educators and music therapists. Invitations to participant in the study were sent by electronic mail to the professional membership of the AMTA and MENC state associations. A total of 253 subjects participated (music educators, n=110, 43.5% of the total and music therapists, n=143, 56.5% of the total). When analyzed individually by group, the three highest preferences for music educators were ENFJ (n=16), INFJ (n=15), and ENFP (n=13) and for music therapists, INFJ (n=28), ENFJ (n=24), and ENFP (n=23). NF was common to both groups and is associated with the personality descriptions given by MENC and AMTA. Although the data revealed many similarities, differences occurred in "outlook on life ‘(Extrovert or Introvert) and selected demographic information related to principal instrument, volunteerism, and participation in community and church organizations during high school. As research data becomes available personality types may become more of a consideration in the descriptive profiles of music educators and music therapists as provided their professional organizations.
The Effects of Medical Music Therapy on the Patient Satisfaction Scores of Hospital Inpatients, as Measured by the Press Ganey Inpatient Survey
Olivia Swedberg (The Florida State University/Tallahassee Memorial HealthCare) & Jayne M. Standley (The Florida State University)
The purpose of this study is to compare patient satisfaction scores of hospital patients who received medical music therapy services with those of patients at the same hospital who did not receive music therapy services. Patient satisfaction is currently a driving factor in healthcare reform. Many hospitals contract with private firms such as Press Ganey Associates to measure patient satisfaction through the use of hospital-wide surveys. The Press Ganey Inpatient Survey (PGIS) contains 38 questions, divided into ten sections (Admission, Room, Meals, Nurses, Tests and Treatments, Visitors and Family, Physician, Discharge, Personal Issues, and Overall Assessment). Responses to survey questions are based on a 5-point Likert scale, which is converted to a 100-point scale for comparison purposes. Items rated "Very Good" are awarded 100 points; those rated "Good," 75 points; items rated "Fair," 50 points; "Poor," 25 points; and any items rated "Very Poor" are awarded zero points. A respondent’s individual item scores within each of the ten sections are averaged to produce a score for each section. Section scores are then averaged to become that respondent’s overall satisfaction score.
The present study takes place at a private, not-for-profit community health care system in the Southeastern United States, which includes a 600+ bed acute care hospital. The hospital utilizes the PGIS to measure patient satisfaction and drive improvement. The survey is mailed to 25% of inpatients who receive care at the hospital shortly after they are discharged. The Press Ganey 2008 Hospital Pulse Report shows that hospitals with over 600 beds have a more difficult time obtaining high patient satisfaction scores compared to smaller hospitals. One way in which this hospital has sought to provide patient-centered care and improve patient satisfaction is by making medical music therapy services available to patients who are referred by a member of the medical staff. Two board-certified music therapists provide medical music therapy services to referred patients in all units of the acute-care hospital, as well as the rehabilitation center.
Because there are no questions on the PGIS directly related to medical music therapy, informal patient satisfaction surveys developed by the hospital’s music therapy department with questions specific to the medical music therapy program are distributed to patients and family members who receive medical music therapy services. While these surveys indicate generally high satisfaction with the medical music therapy program, they do not show whether medical music therapy services have an affect on overall patient satisfaction. This study compares the overall satisfaction scores and average scores for each of the ten sections on the PGIS (Admission, Room, Meals, Nurses, Tests and Treatments, Visitors and Family, Physician, Discharge, Personal Issues, and Overall Assessment) of patients who received medical music therapy services in 2008 (n=125) with patients who received inpatient care at the hospital in 2008 who did not receive medical music therapy services (n=125).
Since the Press Ganey 2008 Hospital Pulse Report indicates that patient satisfaction varies by patients’ age and location within the hospital, patients who received medical music therapy will be sorted based on age groupings used by Press Ganey (0-17, 18-34, 35-49, 50-64, 65-79, and 80+) and the hospital unit in which they stayed (Pediatrics, Cardiac, Neurology, Internal Medicine, Diabetes, Intermediate Care, Orthopedics, and Rehabilitation). The Financial Identification Numbers (FIN) numbers of all patients who received medical music therapy in 2008 (n=500) will be provided to Press Ganey. Press Ganey consultants will match those patients who were randomly chosen to complete the PGIS (n=125) with counterparts who did not receive medical music therapy services who were randomly chosen to complete the PGIS (n=125) based on age group and hospital unit. A t-test will be used to examine differences in overall satisfaction scores and in scores on each of the ten sub-sections of the PGIS, based on subject demographics and whether patients received music therapy services. Implications of findings will be discussed as they relate to health and well-being of patients and families, economic benefits and organizational improvement opportunities for the hospital, and medical music therapy program development.
Status and Trends in Music Therapy Employment since 1998:
An Analysis of the New Job Report Data
Eric G. Waldon, Ph.D., MT-BC (The Permanente Medical Group – Stockton, CA)
The purpose of the current study was to examine the occupational trends in the music therapy profession since the inception of the American Music Therapy Association (AMTA) in 1998. Data were collected using the New Job Report sections of the AMTA Member Sourcebook starting in 1999 through 2009. Multiple analyses were used to answer the following questions: (a) Is there a relationship between membership size and the number of positions lost or gained (by region or the association as a whole) since the formation of the AMTA? (b) Do employment trends vary significantly by region? and (c) Is there a relationship between the number of private practice clinicians and rate of jobs created/lost? Average job gain (M = 71.44) exceeded mean loss (M = -14.25) for each year since AMTA was founded. Results from bivariate correlation indicate that regional membership size was significantly related to both job gains (r = .813, p < .01) and losses (r = -.429, p < .01) while total association membership was only significantly related to job losses (r = -.633, p = .027). Further analysis suggests that there was significant variability in job gains between regions (F[7,79] = 24.926, p < .000) with the Mid-Atlantic, Great Lakes, and Western Regions evidencing the most variability. There was significant variability in job losses (F[7,79] = 3.235, p = .005) with the International Region evidencing the least variability. Finally, evidence suggests that there was no significant relationship between job gains (r = .10, ns) or losses (r = .06, ns) and the number of members reporting self-employment (across AMTA).
A Phenomenological Experience of Singing Vocal Harmony with Another Person
Krista Winter (Drexel University)
The purpose of this phenomenological study was to gain insight and a deeper understanding of the experience of singing vocal harmony with another person. Semi-structured interviews were conducted with four adults capable of singing vocal harmony. Minimal prior research to explain a person’s perception and psychological experience of singing vocal harmony has been published. Through informal conversation the researcher discovered that vocal harmony is often utilized within clinical practice, but there is no literature to support its use or omission.
Four healthy adult participants met individually with the researcher for an interview that mixed verbal and musical components. During the interview, the participant recalled and described their previous experiences singing in vocal harmony, sang a song of their choice with the researcher in vocal harmony, and then described this experience. Following data analysis the major findings of this research indicate that the experience of singing vocal harmony includes the building and expression of relationships, intrapersonal and interpersonal insight, movement and action, and beauty.
This study discovered that there are implications for the clinical use of vocal harmony when working with patients who have reported prior experience and expressed a preference for vocal harmony. Recommendations were made for future research regarding vocal harmony, its use and application within the field of music therapy.
Development and Implementation of a Music Therapy Repertoire Class
Natalie Wlodarczyk (The Florida State University)
Recently, there has been increased attention given to the topic of music therapy students’ knowledge of appropriate music repertoire for adult clients. In order to assess and improve music therapy students’ knowledge of and ability to reproduce potential patient repertoire the researcher designed and implemented a music therapy popular music repertoire course. This pilot project was initially approved for the Fall 2008 semester and then upon successful enrollment and initial informal feedback it was reapproved for the Spring 2009 semester. The purpose of the class was to improve students’ knowledge of the genres, styles, and history of six genres commonly preferred by adult music therapy clients today: jazz standards, early country, Motown, rock & pop, folk, and hymns & gospel. Students were given a pre and post listening test covering popular songs and artists from these genres as well as historical and cultural references that pertain to the music. Results of a Wilcoxon Signed-Rank test showed a significant difference between pre (M = 72.3) and post (M = 90.7) listening tests, N = 20, Z = -3.91, p = .0001. Students’ (N = 20) evaluations of the class included a self-rating of their knowledge of the six genres before and after taking the class, perceptions of the general helpfulness of the class, ratings of helpfulness of each component of the class and free responses. A binomial sign test showed a significant difference between pre and post self-ratings of knowledge of each genre, x = 0(6), p = .016, with the largest gain in the early country genre. Results of the evaluation form indicated overall positive results from the perspectives of the students on course helpfulness. One-hundred percent of the students strongly agreed that the class should continue to be offered to music therapy majors.
The Effect of Audio and Visual Modeling on Beginning Guitar Students’ Ability to Accurately Sing and Accompany a Familiar Melody on Guitar by Ear
Natalie Wlodarczyk (The Florida State University)
The purpose of this research was to determine the effect of audio and visual modeling on music and non-music majors’ ability to accurately sing and accompany a familiar melody on guitar by ear. Two studies were run to investigate the impact of musical training on the ability to play by ear. All participants were student volunteers enrolled in sections of the beginning class guitar course and were randomly assigned to one of three groups: control, audio modeling only, or audio and visual modeling. All participants were asked to sing the same familiar song in the same key and accompany on guitar. Study 1 compared music majors with non-music majors and showed no significant difference between treatment conditions, however, there was a significant difference between music majors and non-music majors across all conditions. There was no significant interaction between groups and treatment conditions. Study 2 investigated the operational definition of "musically trained" and compared musically trained with non-musically trained participants across the same three conditions. Results of Study 2 showed no significant difference between musically trained and non-musically trained participants; however, there was a significant difference between treatment conditions with the audio-visual group completing the task in the shortest amount of time. There was no significant interaction between groups and treatment conditions. Results of these analyses support the use of instructor modeling for beginning guitar students and suggest that previous musical knowledge does not play a role in guitar skills acquisition at the beginning level.
The Effect of Music on Mother-Infant Interaction
Yen-Hsuan Yang (The Florida State University)
Mother-infant interaction conveys affection, joy, verbal, and non-verbal information between mothers and their babies. The purpose of this study is to investigate the effect of a designed music program with music therapy’s teaching and instructions on mother-infant interaction for infants under one-year-old. In addition, a survey about the potential use of a recorded music program in the home environment will be examined with the mothers.
The design used in this study will be the pretest-posttest control group design. Mother-infant dyads will be recruited by the researcher from mother-infant dyads who attend a developmental music group and from mother-infant dyads who do not attend a developmental music group. Male and female infants between the ages of 6 and 12 months will be included. There will be approximately 15 mother-infant dyads in both the control and experimental groups. All mother-infant dyads will be randomly placed in the control group (the non-verbal instruction group) or the experimental group (the verbal instruction group).
A recorded music program, which is based on a developmental design consisting of three music activities with movement or instrument and three singing activities, will be implemented with all mothers and infants in order to assist in mother-infant interaction. For the experimental group, the music therapist will teach the mothers about mother-infant interaction techniques including observing infants, giving immediate feedbacks to infants, responding to the facial expression of infants, giving positive statements of infants, and providing touch and affection to infants. The structured instructions for each music activity and massage techniques will be provided. In addition, when the mothers interact with their infants using the recorded music program, a board with icons cuing the mother-infant interaction techniques and the song lists will be placed in the room. For the control group, the information about mother-infant interaction techniques will be delivered through the handout with no cuing board. Mothers in the control group will be encouraged to create their own ways to interact with their babies during the music program.
The intervention will be implemented with each mother-infant dyad individually in a quiet, self-contained environment in order to ensure the quality of mother-infant interaction without disturbance from others. After the music therapist teaches the techniques to the mothers or gives them the handout, only mothers will interact with the infants during the music program.
The evaluation used in the experimental and control conditions will be pre-test and post-test behavioral observations. Five minute video recordings of free toy-play will be taken during the pre-test and post-test. These recordings will be evaluated using behavioral observations examining the mother-infant interaction techniques in the areas of gaze, facial expression, vocalization, and touch on both mothers and infants. In addition, negative behaviors displayed by the mothers and infants will be evaluated to assess interaction skills. A statistic analysis of ANOVA will be used to analyze pre-test and post-test behavioral rates.
Mothers who participate in the research project will complete a questionnaire about demographic information, the preference for each music activity in the recorded music program, the importance of music activities for mother-infant interaction, the willingness to use the music program in the home environment and the potential use of the music program with other family members. A descriptive analysis of the questionnaire will be applied to the interpretation of quantitative data.
The idea of this study is to build an accessible and effective music program for mothers to use at home with their infants in order to improve the quality of mother-infant interactions. Infants during this developmental stage who experience this program will also benefit from receiving sensory stimulation, motor movement, pre-language concept, cognition concept, verbal communication and non-verbal communication through the music activities. The further study of establishing this kind of music home-program for mothers who have children with special needs or developmental delays is recommended.
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