Community Mental Health Music Therapy: A Consumer-Initiated Song-Based paradigm/La Musicothérapie En Santé Mentale Communautaire: Un Paradigme Basé Sur Des Chansons Où le Client Est Participatif

INTRODUCTIONIn Canada, many of our music therapy colleagues teach and practise what used to be called a client-centered eclectic model of music therapy. Therapists using this model pick and choose from all available historic and current professional music therapy practices and specifically redesign the experiences, within the parameters of the health care service delivery system in Canada, to best meet the needs of the population served. Music therapy practice in Canada has always included both clinical and community models of practice that are informed by the presenting needs of the population and the site served.In 2000 Baines published an article, "A consumer directed and partnered community mental health music therapy program: Program development and evaluation," in which she described consumer perceptions of a music therapy program based on feedback provided in survey data. The article was published in the Canadian Journal for Music Therapy andwas reprinted in Voices: A World Forum for Music Therapy in 2003. This article is also known to have been cited in four recent publications - in an article by Cynthia Chhina (2004) in the Canadian Journal of Music Therapy ("Music therapy and psychosocial rehabilitation: Towards a person-centered music therapy model"); in a book edited by Susan Hadley (2006), Feminist Perspectives in Music Therapy, in an article by Jane Edwards and Susan Hadley (2007) in The Arts in Psychotherapy ("Expanding music therapy practice: Incorporating the feminist frame"); and in an article by Barbara Wheeler (2007) in the Canadian Journal of Music Therapy ("Music therapy research: Contributions from Canada"). Having run now for 11 and 1/2 years, the program described by Baines has had a very long history, especially considering these times of ongoing fiscal restraint. Because of this history and recent interest, the current article revisits this topic, examining the process and effect of singing familiar songs in a participant-driven space with consumers with major mental illness, psychosis, or both. First, relevant literature will be reviewed and then reports on consumer and staff feedback, collected through questionnaires in spring 2008, will be presented. Added to the survey data will be interview data from five consumers of the program.LITERATURE REVIEWFour related areas of study are explored in this literature review: First, recent literature in the community music therapy field is reviewed. Then a review of related music therapy literature is presented. Next, a review of music therapy process for groups - specifically groups of people experiencing major mental illness - is examined. Finally, psychology literature that addresses data relevant to this project is explored; specifically, information on the efficacy of cons um er- drive ? and self-help groups highlighting effective leadership strategies is described.Recent Literature in the Community Music Therapy FieldIn the past, the vast majority of authors on the subject of community music therapy, including Baines (2000), start by apologizing for and then describing "clinical music therapy roots," that which has recently been termed the "consensus model" (Pavlicevic & Ans dell, 2004). This consensus model of music therapy is rooted in elements of the English approach pioneered by such eminent music therapy pioneers as Nordoff and Robbins, Mary Priestly, and Juliette Alvin. Today, much of the earlier use of pre-composed music in this model has disappeared, leaving an approach based predominantly on clinical improvisation. In Community Music Therapy, a recent book edited by Mercedes Pavlicevic and Gary Ansell (2004), 13 of the invited 17 writers hail from this tradition, regrettably limiting the scope of community music therapy practice described. However, as one of the more seasoned English authors, Leslie Blunt, reflects, "Composing songs together with a day patient. or arranging pre-composed music for a group of children. …