bluuebunny/crossref_metadata_2025 huggingface dataset:
The State of the UK Music Therapy Profession
Authors: Stewart David
Published: January 2016

This paper outlines the findings from a self-administered postal questionnaire to the UK music therapy profession carried out in June 1997. It details the background to the study, its design and methodology, the results and their implications. The survey gathered data on the personal qualities used in practice, working models, support networks and job satisfaction among UK music therapists. Taken together, these responses were deemed an indication of the overall ‘state of the profession’. Further, an attempt was made to ascertain a correlation between job satisfaction and other variables as a way of delineating a profile of a ‘job-satisfied music therapist’. Key results indicated a profession of diverse individuals, more likely to be balancing part-time music therapy work than to be employed in a full-time post. They indicated a profession with cohesive personal qualities underlying its practice, and more definitive priorities for working models. They revealed a profession more likely to describe itself as ‘supported’ and ‘satisfied’ than either ‘very supported/satisfied’, ‘quite supported/mixed feelings’, ‘unsupported/dissatisfied’ or ‘very unsupported/dissatisfied’. They identified clinical supervision and communication with colleagues and carers as the two most significant support networks among the sample. A statistically significant correlation was established between the level of professional support experienced and job satisfaction.
Variations on a Theme
Authors: Bunt Leslie , Burns Sarah , Turton Pat
Published: January 2016

Music therapy has an increasingly important role within the residential programme at the Bristol Cancer Help Centre. The main theme of this article is an emerging integrated approach to the evaluation of the music therapy intervention at the Centre. The variations referred to in the title are summaries of two earlier research projects and an analysis of a recent series of focus group discussions. Research plans are also suggested as future variations. There is a cyclical and common-sense approach to the way in which the music therapy research has developed at the Centre. All evidence has emerged and is emerging from the practice. Close links are developing between the ongoing changes in the methodologies for the music therapy research and the overall research plans at the Centre.
‘A Suspiciously Cheerful Lady’
Authors: Aasgaard Trygve
Published: January 2016

This paper presents a study of song creations in music therapy with critically ill children. It consists of three parts. Part I presents an outline of individual and environmental health concepts in relation to children (families) with cancer and music therapy – including a short introduction to the literature on song creations in paediatric oncology settings. Part II presents a case study of one song and its development and history. Part III offers an analysis and interpretation of themes relating to the song phenomena – ending with a discussion of the findings within an ecological health perspective.
‘Mummy Can Play Too…’ Short-Term Music Therapy with Mothers and Young Children
Authors: Oldfield Amelia , Bunce Lucy
Published: January 2016

This article describes two short-term music therapy groups with mothers1 and young children at the Croft Unit for Child and Family Psychiatry. As there is very little documented music therapy work with this client group, the authors examine literature that describes other therapeutic interventions and that looks at the links between mothers and young children's behaviour. This literature review suggests that early intervention with parents who are experiencing difficulties with their children is both important and useful. The article goes on to hypothesise why music therapy is a particularly effective way of working with mothers and young children and to examine the small amount of other documented work by music therapists with this client group. The two treatment groups with parents and young children at the Croft are then described and analysed in some detail. The authors reflect on the particular role music therapy plays in the treatment packages offered at the Croft.
Indications in Music Therapy: Evidence from Assessment That Can Identify the Expectations of Music Therapy as a Treatment for Autistic Spectrum Disorder (ASD); Meeting the Challenge of Evidence Based Practice
Authors: Møller Anne Steen , Odell-Miller Helen , Wigram Tony
Published: January 2016

When children with Autistic Spectrum Disorder (ASD) are assessed in music therapy, significant strengths, potentials and resources emerge that may remain hidden in other, more formalised assessments. Therefore, it is becoming more necessary to develop a systematic method of describing this responsiveness, in order to define the expectations of therapy. Music therapy is a particularly important intervention for children with ASD to engage and nurture their capacity for flexibility, creativity, variability and tolerance of change, in order to balance the more structured and behaviourally driven education that is currently popular. The potential of treatment can be defined within the context of meeting healthcare needs. A case study will illustrate a model for defining ‘expectations of therapy’, by drawing on one child's awakened capacity for interaction through shared, improvised music-making.

This article includes a long appendix providing an evidence-based review and recommendations regarding assessment and referral criteria based on current research and clinical evidence.
Supervision or Double Vision
Authors: Levinge Alison
Published: January 2016

Supervising clinical material that is expressed in musical language but which is discussed and articulated predominantly in words can make the development of a supervisory relationship a complex process. This paper examines how certain elements within the clinical material of a musical therapeutic relationship may give rise to material of a primitive nature, and how this can become unconsciously expressed within the supervisory relationship.
Music Therapy References Relating to Cancer and Palliative Care
Authors: Aldridge David
Published: January 2016

Hospitals and clinics worldwide have incorporated music therapy in their work with cancer patients and in palliative care. As the music therapy profession has developed internationally, so has its role in palliative care. The arts and creative arts therapies are being seen as a form of spiritual care in healthcare settings, particularly where individuals are confronting life-threatening illnesses. By offering opportunities to engage in the arts and develop creative expression, people with cancer can be enabled to mourn, grieve, celebrate life, be empowered to endure their situation, and find healing and meaning. In many studies we find that music therapy is not simply used with the identified patients but also with their families and carers. As well as noting the importance of work with patients and their families, music therapists also emphasise the importance of music for their own healing. This is necessary to meet personal needs when working with the dying and in the context of a broader hospital milieu of colleagues and friends.

The World Health Organisation's recommendations for cancer relief and palliative care are to affirm life and regard dying as a normal process, to provide relief from pain and distressing symptoms, to integrate the psychological and spiritual aspects of patient care, to offer a support system to help patients as actively as possible until death, and to offer a support system to help the family cope during the illness and in their own bereavement. Music therapy has the potential to meet all of these recommendations.
An Investigation into Short-Term Music Therapy with Mothers and Young Children
Authors: Oldfield Amelia , Adams Malcolm , Bunce Lucy
Published: January 2016

This paper describes an outcome investigation into two clinical groups of mothers and young children receiving short-term music therapy. The first group was a closed group of mothers and toddlers receiving six-weekly music therapy sessions. The second group was an ongoing group of parents and babies receiving one music therapy session followed by a discussion of videotaped excerpts of this music therapy session a week later. As a point of comparison, a group of children and parents attending a local nursery school receiving six-weekly music sessions run by a music therapist was also investigated. Video analyses, audio analyses and parent's questionnaires were used to measure results. Comparing information collated from the questionnaires to results of the video analyses revealed that parents attending the clinical group viewed their children's behaviours in a less positive light than control group parents.

The article is written from the music therapist's viewpoint. This group music therapy work is described and reflected upon in a more qualitative way in a previous article entitled ‘“Mummy can play too…” Short-term music therapy with mothers and young children’ published two years ago in the BJMT.
‘New York Mining Disaster’
Authors: Glyn John
Published: January 2016

This paper describes a four-and-a-half year period within the long-term music therapy treatment of a mentally ill forensic psychiatric patient. It charts the development from an exclusively music-based approach to one in which words played a key part, in the form of song material, the use of spoken interpretations by the therapist, and the patient's own verbal responses. Clinical descriptions are set alongside attempts to understand the material using a psychoanalytic model. In particular, it is suggested that the patient's emptying out and deadening of lively contact constitutes a psychotic defence against feelings of loss and dependency. The article also looks at issues of denial, specifically in relation to the patient's offence and his position within the institutional system, but also in terms of the therapeutic relationship: is the patient able to find a place from which to observe and acknowledge the relationship that is taking place? Or does his defensive organisation dictate that no third position can be admitted?
The Immediate and Long-Term Effects of Singing on the Mood States of People with Traumatic Brain Injury
Authors: Baker Felicity , Wigram Tony
Published: January 2016

Mood changes in four male participants with traumatic brain injury (TBI) were observed following their participation in a 15-session song-singing programme. An analysis of the song material was undertaken to categorise the songs according to the predominant mood they portrayed. Results showed significant differences between participants for all moods (p<0.001). Immediate effects were reversed where participants experienced increases in sadness, anger, fear and fatigue. Long-term effects were significant for some participants who reported increased feelings of happiness and decreased feelings of sadness, fear, confusion, tension and fatigue in the long-term. Characteristics of the songs chosen for therapy were typically representative of feelings of sadness. Findings suggest that immediate effects of song-singing intensify and provide cathartic experiences for people with TBI who may have no other space for which to express negative emotions. Long-term effects of song singing have a positive effect on mood state.
International Interview Series
Authors: Sutton Julie
Published: January 2016

Expanding on the central theme of this issue, three music therapists give their responses to questions concerning the development of the profession in different areas of Europe. These three views of different aspects of the development of music therapy in a variety of countries place the work of the UK profession into perspective, as well as raising some important further questions for the future.

Monika Nöcker-Ribaupierre is based in Germany, leading the music therapy training course in Munich, and is the current General Secretary of the European Music Therapy Confederation; also in this edition we publish a review of her most recent publication Music Therapy for Premature and Newborn Infants (Barcelona Publishers). Tracey Jones works in Dublin and heads the Music Therapy Department at Cheeverstown House. Tracey is an active member of the Irish Association of Creative Arts Therapists (IACAT), an organisation that is involved in new developments in the creative arts therapies professions in Ireland. Claire Flower is the Chair of the British Society for Music Therapy and well-known both in the UK and internationally as a clinician, presenter and author.
Holding a Steady Beat: The Effects of a Music Therapy Program on Stabilising Behaviours of Newly Arrived Refugee Students
Authors: Baker Felicity , Jones Carolyn
Published: January 2016

Vulnerability to crisis in newly arrived refugee youth is common as they try to come to terms with past traumatic experiences and acculturate to the new country in which they have settled. This study examined the effects of a short-term music therapy program on the changes to the Behaviour Symptom Index (BSI, Reynolds and Kamphus, 1998) of 31 new refugee youths attending an English language reception centre in Brisbane. A cross-over design with two five-week intervention periods was employed with group music therapy sessions conducted one-two times per week. Results indicate that changes to BSI scores approached significance indicating trends that music therapy affected a positive change on generalised behaviour. Findings are discussed with reference to stabilizing and preventing crises with this population.
Whose Power of Music?
Authors: Rolvsjord Randi
Published: January 2016

This article considers questions concerning the ontology of music in relation to music therapy. Contemporary musicology emphasises the cultural context of music and the role of individual experience and interpretation. The concepts of musical affordance and musical appropriation offer a representation of music centred around the contextually situated individual without neglecting the aesthetic qualities inherent in musical structure and performance. This article considers music as a potential health resource that can be accessed and used in multiple ways, linking this with a contextual approach to therapy. Political implications are discussed in relation to the accessibility and power of music in music therapy.
Evidence and Effectiveness in Music Therapy
Authors: DeNora Tia , Wigram Tony
Published: January 2016

Adopting a knowledge-based controversy perspective, this article considers critically the ‘fit’ or appropriateness of the so-called ‘gold standard’ of assessment – the Randomised Controlled Trial. It sets the growing dominance of this method within music therapy in the contexts of medical work and the changing social relations of medical expertise, the importance of local practice in music therapy (and healthcare more widely), and the politics of representation as they apply to medical modes of accounting and measurement. I then consider what is overlooked when experimental models are used as the prime mode of perceiving the music therapeutic process and suggest that they may not provide a good or appropriate way of observing, accounting for and assessing music therapy. I suggest that they are not amenable to the observation and documentation of temporal and local craft practices and that these practices provide the active ingredients of music therapy's effectiveness. I conclude that music therapy is poised to highlight the radical performative and social features of health status and that these features have far-reaching implications for our concepts of illness and the aetiology of illness and, most importantly, for the ways in which we conceptualise and implement therapeutic procedures of all kinds.
Music Therapy in Special Education: Do We Need More Evidence?
Authors: McFerran Katrina , Stephenson Jennifer
Published: January 2016

The evidence-based framework underpins the field of special education research. Many educational researchers and administrators accept this model, and expectations of research are rapidly changing as it gains prominence. This dialogue explores the impact of the evidence-based model through a debate between two researchers in the field – a special education academic with a positivist agenda and a music therapy researcher with qualitative inclinations. Through a series of questions designed to illustrate their complementary perspectives, the authors provide opinions on what constitutes evidence in special education and consider the music therapy literature from these perspectives. Ultimately, they propose a research study that pragmatically accepts the evidence-based framework as one valid approach to research. This research project is seen as one step in a series of studies that have international collaborations as their basis.
Adding Humour to the Music Therapist's Tool-Kit: Reflections on its Role in Child Psychiatry
Authors: Haire Nicky , Oldfield Amelia
Published: January 2016

In this article we reflect on the use of humour in music therapy on a children's psychiatric unit. We review the current literature and, by providing detailed case vignettes, identify four characteristics of humour in music therapy in this context as well as listing the main functions of humour here. We find that humour is a highly subjective experience and that due consideration of the intention behind any use of humour by the music therapist is crucial. Awareness and attunement to one's client are considered vital when dealing with such a powerful multi-faceted phenomenon.
Quietening the Voices
Authors: Dunbar Nicola
Published: January 2016

The article presents a case study of individual music therapy with an elderly Iraqi refugee in a day hospital for the elderly mentally ill. It highlights themes that arise from working with a traumatised client of a different culture and different generation, and the range of ways in which music was used. It draws on psychological theories to shed light on the developing relationship between therapist and client.
Meaning and Relevance in a Therapeutic Journey: An Exploration of the Relevance of Fairy Tales to Work with Older Learning Disabled Clients Who Have Been Institutionalised
Authors: Margetts Lisa
Published: January 2016

This article describes aspects of long-term work with a learning disabled adult over the period of time during which he made use of a story. This is given in detail from a point at over 5 years into the therapy when an initial question about the story was presented to the therapist. The article shows the ways in which the story was incorporated into the overall musical work. These sessions are placed into the context of the therapy as a whole, the ways in which story and music were combined, the central place that this work took and how this resonated with the client's life. The article concludes with thoughts about work with learning disabled clients and how the use of story can bring about new spaces in the clinic room. The concept of institutionalisation, along with broader questions about social change and the potential impact upon learning disabled clients will also be explored, with questions raised for the music therapy profession to consider further. The article is illustrated with colour plates from the book used during the therapy.
A Death in the Family
Authors: Tyas Rosanne
Published: January 2016

The subject of death is one that is not easily addressed. Learning disability (and in particular profound learning disability) throws up uncomfortable issues which also are not easily dealt with. Therefore there is often a struggle in addressing the needs of this client group when bereaved. I believe that the arts therapies have an important role in assisting the grieving process of adults with a profound learning disability. This paper focuses on bereavement sessions, jointly run by a music therapist and an occupational therapist. These are set in the context of other interventions addressing aspects of grief. Case examples are drawn from the author's 25 years' experience in this field, in providing music therapy and wider bereavement services to adults with complex needs.
Organisational Anxiety, Envy and Defences: In and Out of the Music Therapy Room
Authors: Neale Louise
Published: January 2016

This article grew out of experiences while training and is viewed from the perspective of a number of post-training years. The focus is the underlying processes at work in organisations and their effect on music therapy work. A brief chronological summary of literature is given, including the theories of Klein and Bion in relation to organisational dynamics. The dynamics between clients, staff and the organisation are considered particularly in terms of anxiety and envy, and how defences are put in place in order to manage these feelings. A case study from short term work in a psychiatric intensive care unit undertaken as part of the author's music therapy training is given to illustrate these points.
The Clinical Application and Relevance of Resource-Oriented Principles in Music Therapy within an International Multicentre Study in Psychiatry
Authors: Mössler Karin , Fuchs Katharina , Heldal Tor Olav , Karterud Inger Marie , Kenner Jason , Næsheim Sissel , Gold Christian
Published: January 2016

This article is based on an international randomised controlled trial (RCT) in psychiatry investigating the effects of music therapy on difficult to treat psychiatric clients who show a lack of motivation to attend therapy. Previous research has shown that music therapy can be an alternative therapeutic treatment for this client group and this RCT aimed to address this observation.

The RCT was a collaboration between music therapists from different therapeutic cultures - Norway, Austria and Australia. Consequently, the music therapy provided was influenced by different training backgrounds. To provide a common methodological basis the therapists also focused on resource-oriented principles. These were especially developed for the study to ensure treatment fidelity, yet first of all have an important impact on the practical work.

Five case vignettes depict how different therapists made use of these principles and in which ways these affected the therapeutic process. It will be shown how these principles serve as a methodological tool for reflecting the therapist's attitude towards the client.

The relevance of the principles in terms of the establishment of a therapeutic relationship as well as the importance of a resource-oriented focus both in long-term and short-term therapeutic settings is highlighted. Finally, it can be assumed that resource-oriented principles exist at least implicitly throughout music therapeutic cultures and that these emphasise the relationship between therapist and client.
Lighting the Way: How Journeying with David, an Adult with a Learning Disability and Mental Health Problems, Helped a Student Music Therapist Make Sense of the Connections between Theory and Practice
Authors: Bennetts Rachel
Published: January 2016

This essay describes the journey of a student music therapist working with David, an adult with a learning disability and mental health problems. Through thinking about this work I present an overview of changes in my approach and understanding of learning disability. This is followed by a discussion about mental health, the complexity of diagnosis, and the prevalence of mental ill-health in people with learning disabilities. I consider Sinason's theory of Secondary handicap and link this with (omit Carol) Robbins and Robbin's notion of ‘the condition child’, and via the clinical work with David I think about how music therapy might help reveal a ‘music child’.
Text Watch
Authors: Strange John
Published: January 2016

The BJMT Text Watch appears in the second issue of each volume. It aims to raise awareness of music therapy writing outside the principal English language music therapy journals, and to act as a guide to the proliferating literature of our profession. It seeks to draw attention to relevant material from publications that may be less accessible to music therapists, and which therefore might otherwise be overlooked.1

Text Watch includes music therapy and related publications in English that have been published in the current or previous calendar year2- books, chapters, articles, published conference papers and other published media (CD-ROMs, videos, etc).

Please note that articles published in English language music therapy journals are listed in Journal Watch (included in the first issue of each volume).
Group Music Therapy on a Dementia Assessment Ward: An Approach to Evaluation
Authors: Melhuish Ruth
Published: January 2016

This article presents an approach to evaluating a music therapy pilot project carried out on a dementia assessment ward, and introduces the framework for evaluation developed by the music therapist. This framework aims to describe and categorise patients' involvement in sessions, which may help to define clear outcomes for patients. It also highlights the relevance of music therapy treatment to the goals of the multi-disciplinary team on the ward, and to current thinking and policy about dementia care, as described in the National Dementia Strategy (DoH 2009).

The project was a collaboration between the local NHS trust (Older Adults Therapies Team), Soundwell Music Therapy Trust and the hospital League of Friends. Soundwell is a specialist mental health music therapy charity, founded in 2002 to provide music therapy and music support groups for mental health service users and unpaid carers in Wiltshire and Bath & North East Somerset (B&NES). A further, extended pilot project is being planned, subject to funding. It is hoped that this will offer the opportunity to trial the evaluation approach more extensively.
“That's the Joy of Music!” An Evaluation of Partnership Working with a Teacher in Planning and Delivering a Music Therapy Group for Three Children with Autistic Spectrum Conditions
Authors: Pethybridge Emma
Published: January 2016

In educational settings in Scotland Allied Health Professionals (AHPs) are currently being guided towards working in partnership with other professionals, particularly to develop roles as consultants, advisors or trainers within schools (Scottish Government 2010). AHPs are being encouraged to meet therapeutic objectives indirectly and decrease the hours of direct work with pupils. This study aimed to evaluate ways in which a music therapist might support a teacher to offer interactive group music-making to children with additional support needs. Themes were generated from the analysis of a semi-structured interview with a nursery teacher who, together with the author, was involved in planning and delivering an eleven-week intervention for three children on the autistic spectrum. Responses from two questionnaires completed by classroom assistants who also supported children in the group as well as the experience of the therapist in collaborative work added to the discussion and reflection. Findings suggest that the flexibility of the music therapist in direct work is highly specialised and cannot be easily replicated in other classroom music activities, but that experiential music therapy groups offer some level of transferable learning for teaching and support staff and potential for developing more indirect approaches.
Inner Spirit: Investigating How Music Therapists' Experiences of Their Spirituality May Be Relevant to Their Work
Authors: Barton Marion , Watson Tessa
Published: January 2016

This article describes research undertaken by Marion Barton into the spirituality of music therapists in relation to their work. While much has been written about the spirituality of the client, this project aimed to consider the spiritual outlook of the therapist and how this influenced, supported or challenged their practice. Interviews were undertaken with three music therapists; the results were then transcribed and analysed using interpretative phenomenological analysis and various themes were identified. Results from the research showed that therapists do use their spirituality as a resource in their work and that music is intrinsically linked with the spiritual for many. It was also recommended that therapists work carefully in supervision to understand the spiritual connections that can take place in music therapy and as part of boundaried practice. Further conclusions and recommendations for additional research are also discussed as part of this article.
The Music Therapist in School as Outsider
Authors: Annesley Luke
Published: January 2016

This essay examines the institutional commonalities among several schools in which I have worked as a music therapist, illustrating how thinking about my role as an outsider has informed my therapeutic approach. I refer to the broader concept of the outsider as it relates to both fictional and historical figures and in particular to Sherly Williams's article ‘The Therapist as Outsider: The Truth of the Stranger‘ (1999) in which she compares the therapist to the archetypal figures of the fool and the seer. Finally, I link these ideas to Winnicott's concept of play, presenting the music therapist's role in school as that of an advocate for fostering creative impulses, which can at times be at odds with (or perhaps complementary to) the central educational aims of the school.
Music Therapy in a General Hospital's Psychiatric Unit — A ‘Pilot’ Evaluation of An Eight Week Programme
Authors: Bunt Leslie , Pike David , Wren Vanessa
Published: January 2016

Within Great Britain music therapy is developing a presence in the field of mental health. There is a history of work within the large institutions and there are present moves to develop more work in community based day hospitals and units. This paper charts the setting-up of a short period of eight sessions for a group attending a unit based within a general hospital. Positive results from a simple evaluation from both clients and staff point to the need for further studies to be set up when more detailed questions can be addressed.
Music Therapy with Parkinson's Disease
Authors: Selman Jennie
Published: January 2016

Disabilities which start in adulthood produce great frustrations as a result of the loss of skills and abilities. These losses have considerable influence on relationships and social skills. Parkinson's Disease patients encounter these problems and the inevitable psychological and emotional problems which they cause.

This case study concerns work with a patient using music as a channel for the feelings of frustration. The shared improvised music aids and allows the establishment of a relationship with strong emotional contact and communication.
An Assessment of the Benefits of Micro Technology in Music Therapy
Authors: Fitzwilliam Andrea
Published: January 2016

This article aims to summarise the main facilities made available to the music therapist by developments in micro technology, and to assess their benefits. All issues discussed relate to the author's own personal experience of using such equipment in working with handicapped adults. The survey covers computer hardware and software developments, from specially developed computer input devices to facilities made available by MIDI (Musical Instrument Digital Interface).
Questions and Reflections on Research
Authors: Warwick Auriel
Published: January 2016

At the outset, I would describe this paper as an attempt to assimilate questions, thoughts and experiences which have arisen from research into music therapy with autistic children and their mothers, carried out from September, 1986, until July, 1987. The research was undertaken in partnership with Pierrette Muller, a research psychology student working for her Ph.D. Although results are not yet available, the actual experience of being involved in the project with the follow-up of what has happened since the specified research period ended, raises a number of questions in my mind together with a number of philosophical reflections. These I wish to share with you and emphasise that they are subjective.
Music and the Listeners
Authors: Priestley Mary
Published: January 2016

This paper outlines fourteen sessions of analytical music therapy (Priestley 1975) spread over six months and a follow-up session thirteen weeks later. The client was a self-referred lady psychotherapist aged 60. She had one isolated problem which many sessions of psychotherapy had failed to touch, so in fact this was a focal music therapy. Her problem was that she could not play, or even practise the piano, if she felt anyone (including her teacher) was listening. If she did she had feelings of panic and had to stop. This reduced her playing to the very minimum and naturally hindered her progress and her enjoyment of this art. As she was approaching a more leisured time of life she felt that it was now crucial to try and overcome this anxiety.

This paper is based on brief notes made after her sessions and a re-hearing of the recorded improvisations. The client's name and some circumstances have been concealed to preserve confidentiality. She has seen the case study and has given her permission to publish. In order to give the feeling of the inner meaning and emotional flavour of an utterance, words or sentences in quotes are the client's own. Discussion recorded before the improvisation took place before we played. The supervisor mentioned twice is the Jungian analyst, Dr. Redfearn, with whom the writer has discussed her work for several years. The 50-minute sessions were weekly as far as possible, but dates are given.
Music Therapy Training: A Personal Experience
Authors: Webster Judith
Published: January 2016

This article explores a personal experience of a music therapy training course. It attempts to identify that which constitutes the change from a musician to a music therapist, looking specifically at the personal challenge of self-discovery which is involved in that process.
Role Limits in Music Therapy
Authors: Cowan Janet
Published: January 2016

Often through the course of work with a patient, issues arise which challenge one's role as a music therapist, and which lead one to question the limits of the experiences being offered to the patient. In this paper I describe my work with a woman who initially avoided and resisted shared music-making, and who gradually became more able to be involved in spontaneous activity. I tried to find ways of understanding the issues at the root of our relationship, in order to build on the musical interactions. From this case, I intend to illustrate the deeper questions which, I believe, are pertinent to be asked more generally about the limitations attending the role of the music therapist.
The Use of Pre-Composed Songs with a Highly Defended Client
Authors: Heal Margaret
Published: January 2016

This paper illustrates how pre-composed songs which have special meaning for the client can serve as an intermediary phenomenon in psychoanalytically-informed individual music therapy, providing opportunities for the therapist and client to develop shared meanings within the therapeutic boundaries. The client is a teenage boy with moderate learning difficulties who has suffered abuse and deprivation. He is seen as highly defended, presenting an ‘opportunist’ secondary handicap (Sinason 1986) in response to earlier traumas, and as having a limited potential space (Winnicott 1971). Pre-composed songs which had special meaning for him were able to contain his emotions in a structure that was digestible for him. The use of these songs was not seen as a substitute for free improvisation, but as a necessary precursor.

After an introduction, the first five music therapy sessions will be described, followed by a conclusion discussing the underlying therapeutic processes. The setting is a secondary special school in north London. Music therapy is the only formal therapy offered for children who have been deprived, neglected, and/or abused, and who struggle with the reality of handicap every day.
Structural Analysis of Post-Tonal Therapeutic Improvisatory Music
Authors: Lee Colin Andrew
Published: January 2016

The analytical investigation examining tonal therapeutic improvisatory music (Lee, C. A., 1989) would seem to indicate that music therapy should be exploring its own investigative form of analysis. The adoption of a Schenkerian construct of analysis accommodates music therapy perhaps more clearly than the often complex statistics and pitch classes that, for the most part, concern the analysis of atonal music. The tonal infrastructure can normally be described in direct relation to its harmonic foundation. With atonality, however, such reference points are not easily available, except in serialism or similar theoretical forms of music. It is the intention of this article to investigate the diverse constructs of post-tonal analysis and consider their validity in exploring atonal issues of therapeutic improvisation. Initial focus will be on formal analysis of the improvisation, interspersed with a more informal subjective framework of enquiry endeavouring to evaluate relationships between both areas.

The passage of improvisation selected is taken from a different session with the same client, thus enabling various parallels to be drawn.
Music Therapy and Elective Mutism: A Case Discussion
Authors: Davies Alison , Mitchell A. R. K.
Published: January 2016

This paper describes individual music therapy sessions with a 20-year-old man with specific communication difficulties manifested as inappropriate behaviour and elective mutism in his daily life. It shows how music therapy was a particularly relevant treatment in the context of the Unit where he was being helped. It illustrates firstly how aspects of play can be embraced in the therapeutic relationship, and secondly how problems can be worked through in the experience of both musical and non-musical interaction. The therapist uses a psychodynamic viewpoint in her understanding and interpretation of the sessions.
Music and the Mentally Handicapped — The Effect of Music on Anxiety
Authors: Hooper Jeff , Lindsay Bill
Published: January 2016

This study reports the effects of music on the anxiety and agitation of four women with moderate and mild mental handicap. Music therapy and recorded music were compared with a control condition using controlled case studies. Two measures of anxiety were recorded — pulse rate and a behavioural rating. No improvement was found under the control conditions, while both music conditions produced some improvements. Variations in the pattern of responses to each form of music are discussed.
Behind Closed Doors: A Case Study
Authors: Ritchie Fiona
Published: January 2016

This case study focuses on a man who exhibits learning difficulties and disturbed behaviour. It attempts to give an account of the deprivation that he has had to live with over many years, and how he manages to cope with his isolation, but yet allows a few rays of sunshine into his otherwise dark existence. During three years of music therapy, John has started to build his trust in people, a feat in which he has shown great courage and determination.
On Music Therapy, Fairy Tales and Endings
Authors: Blackburn Ruth
Published: January 2016

This article opens by questioning the validity of making a close therapeutic relationship within an institution. In attempting to resolve this dilemma, it then looks at the function and nature of fairytale as a way of describing music therapy. Two analogies are used: one emphasising the facing of inner problems and conflicts, the other emphasising escape from the problems of the outer world. In conclusion, it looks at fairy tale endings in order to pose a solution for the opening question.
Teaching Music Therapy Students on Practical Placements — Some Observations
Authors: Oldfield Amelia
Published: January 2016

In this article the author makes observations about some of the difficulties that music therapy students experience while they are on clinical placements. Suggestions are made about how to help and teach students during their clinical placements. After some general observations, the author talks at length about how to help the student with “clinical improvisation” and then considers two other important areas: “the ability to form a relationship with the client” and “learning to fit into a team of other professionals”.
A Study of the Way Music Therapists Analyse Their Work
Authors: Oldfield Amelia
Published: January 2016

At present there is no standardised procedure for music therapy assessment in the UK. Music therapists use a wide variety of methods to review their clients' progress. This paper begins by examining some of these different procedures and looking at their advantages and disadvantages.

A particular system of analysis developed by the author is then explained in detail. Information about four different clients with severe learning difficulties from this analysis is compared to information gained simultaneously through video-analysis. The results seem to indicate that the author's assessment procedure is an efficient way of collecting information about music therapy sessions with these clients. The paper then looks at whether this same procedure can be used with other types of clients. Suggestions for further investigations are made.
Music in the Pastoral Care of Emotionally Disturbed Children
Authors: Butterton Mary
Published: January 2016

This article sets out to describe some of the content of a recent Ph.D. thesis (Birmingham University) entitled ‘Music in the Pastoral Care of Emotionally Disturbed Children’. The thesis attempts to articulate an understanding at theoretical and practical levels of what it is in the process of music in the pastoral care of emotionally disturbed children that brings about a degree of transformation in the client. The theory gradually evolved through the practice of music therapy with emotionally disturbed children in a residential school over a two-year period. Three case studies are described in the thesis: one of these is included in this article.

The particular contribution of this thesis is that it suggests and describes a direct link between the elemental dynamics of music and the elemental dynamics of people in relationship in the context of creative musical play. This play is then considered as a medium in which transformation of damaged people in relationship may occur.
Perspectives on Music Therapy with People Suffering from Anorexia Nervosa
Authors: Robarts Jacqueline Z. , Sloboda Ann
Published: January 2016

This paper * explores the process of music therapy in the treatment of people suffering from anorexia nervosa, with reference to individual clinical work undertaken at an acute psychiatric unit specialising in eating disorders, and at an in-patient child and adolescent psychiatry unit. Case material illustrates ways in which music therapy supports the individual while addressing the often deeply-rooted problems commonly associated with eating disorders. These problems include issues of personal identity, negative self-image, distorted body-image, intellectualisation, difficulty in relationships, and issues of autonomy and control. Dynamic forms of spontaneous improvisational music-making and musical therapeutic intervention are discussed.
Music Therapy and Forensic Psychiatry — Choice, Denial and the Law
Authors: Loth Helen
Published: January 2016

This paper looks at aspects of work in the forensic psychiatric setting. It is based on music therapy work in a Medium Secure Unit, situated within a general psychiatric hospital. It was felt that there were several important differences in working in this unit of the hospital which often seemed to question the feasability and existence of a music therapy group. This paper concerns itself with these differences. A brief introduction to forensic psychiatry and secure units is given first. This is followed by a short case study of an eight-week music therapy group from which material is used to look at the themes identified. These are summarized into the headings of choice, denial and the law. Their effect on the patients is discussed and the ways in which the music therapy group can address the issues involved are highlighted.
Music Therapy, a Description of Process: Engagement and Avoidance in Five People with Learning Disabilities
Authors: Toolan Peter , Coleman Shirley
Published: January 2016

A number of approaches exist within the field of music therapy. Some models for evaluating the efficacy of therapy have been adopted in the UK in recent years. These have measured the occurrence of specific behaviours within therapy, or compared music therapy with other interventions. There is a need to find reasonably reliable methods of describing change and the therapeutic process occurring within music therapy. This paper describes change occurring in five people with learning disabilities, in terms of their levels of engagement in therapy and in the therapeutic relationship. A method is provided, to evaluate independent observers ‘perceptions of change in the patients over a 30-session period of therapy. A significant increase in levels of engagement over time was found. It was also found that the degree of change over time was not related to the mean level of engagement. We discuss some subtle factors involved in therapeutic engagement for the five patients in the study, and stress the importance of a therapy which emphasises the dynamics of interpersonal communication for people with limited opportunities to express thoughts and emotions.
A Natural End: One Story about Catherine
Authors: Ibberson Cathy
Published: January 2016

This article describes my work as a music therapist in a children's hospice. It gives an account of 13 music therapy sessions with a girl, Catherine, who reached just 13 years of age before her death. During this short but intense span of time, Catherine showed great courage not only in coming to terms with the recent death of her younger sister, but, as it transpired, in preparing for her own death. As the therapeutic relationship developed, music became an invaluable source of communication, exploring the anxieties and confusion that Catherine faced as grief and fear came to the fore, while nurturing her innate zest for life.
Music Therapy with Anorexia Nervosa: An Integrative Theoretical and Methodological Perspective
Authors: Smeijsters Henk
Published: January 2016

The article starts with an overview of the theoretical concepts, the aetiology and the guidelines that have been developed in verbal psychotherapeutic treatment of anorexia nervosa. Next, the views of music therapists working with anorectic clients are compared to the ideas of verbal psychotherapists, and it is shown that there are many points of agreement. In the most important part of the article the following issues are presented: the way in which anorexia nervosa is expressed in musical behaviour, reasons why music therapy should be indicated and, finally, examples of musical playforms and techniques that can influence typical aspects of anorexia nervosa.
Supervision in Context: A Balancing Act
Authors: Brown Sandra
Published: January 2016

This paper explores the concept of supervision in general, and music therapy supervision in particular. It suggests factors which have to be taken into account in each supervisory relationship, and looks at finding a balance in accommodating these factors within a clear supervisory frame. This is illustrated by case material from the author's own supervisory work.
Naming Things … But Can We Astonish the Gods?
Authors: Robarts Jacqueline
Published: January 2016

‘Things die a little when we name them.’

‘Things are what they are. That is their power. They are all things we think they are, all the things we sense they are, and more. They are themselves. If they meant something they would be less.’ Ben Okri (1995)