Integrating Music Therapy into the Evidence-Based Treatments for Psychiatric Consumers

Evidenced-based practice is drawing increased interest due to financial constraints and the desire to provide the highest quality of care possible in a timely and efficient manner (Dobson & Dobson, 2009). Mental healthcare is not an exception and researchers have determined a number of evidence-based treatments to be highly effective in helping psychiatric consumers live successfully in the community. While evidence-based music therapy is far too large a concept to describe in a single paper, the purpose of this paper is to explore the established evidence-based treatments for psychiatric consumers and apply these interventions to psychiatric music therapy clinical practice and research.Review of LiteratureThe terms "evidence-based treatment" (EBT) and "evidence-based practice" (EBP) are often misused and confused. EBTs are interventions that have been proven to be effective via numerous rigorous well-controlled and randomized research methodologies. Typically, EBTs have a number of high-quality systematic investigations and meta-analyses that show statistically significant results for specific problems. EBP, however, refers to a decision making process that integrates the best available research, expert opinion, and individual client characteristics. It "is an approach that enables clinicians to provide the highest quality of care in meeting the multifaceted needs of their patients and families" (Melnyk & Fineout-Overholt, 2005, p. 3). The decision making process is based upon interventions that have been systematically studied and have consistent evidence showing improved outcomes for consumers (Drake et al., 2001; Sackett, Straus, Richardson, Rosenberg, & Haynes, 2000). While EBT is an intervention and specific type of treatment, EBP isa philosophical approach to treatment guided by the collection, interpretation, and integration of research. Furthermore, EBP differs from the term research utilization in that EBP takes the practitioner's expertise and patient values and preferences into account whereas research utilization typically relies upon results from a single study (Barnsteiner & Prevost, 2002).EBP not only relies on scientific evidence, but also takes patient preferences, values, situations, and characteristics into clinical decision making. Both EBT and EBP have been applied to improve the quality of clinical judgments and promote costeffective treatment by incorporating the scientific method as opposed to practice that is based on opinion, folklore, tradition, or loose bodies of knowledge. Researchers have found that patients treated using methods derived from evidencebased approaches have 28% better outcomes than patients who receive traditional forms of practice (Heater, Becker, & Olson, 1988).EBP is a derivative of evidence-based medicine (EBM), which sought to assess the quality of evidence relevant to the risks and benefits of treatment or lack thereof (Elstein, 2004). Originators of EBM noted that it is the judicious use of the best evidence available to make decisions about the care of individuals, rather than relying on statements from medical experts (Sackett, Rosenberg, Gray, Haynes, & Richardson, 1996). The term "evidence-based" (EB) was first used in 1990 (Eddy, 1990, 2005) while the term EBM first appeared in the medical literature in 1992 (Guyatt et al., 1992). David Eddy, who applied mathematics to practitioner decision making, was the first to use EBM as a term (Arzin & Goldman, 2005). The EB movement was founded by British epidemiologist Dr. Archie Cochrane (Melnyk & Fineout-Overholt, 2005), often referred to as the "godfather of evidence-based medicine" (Arzin & Goldman, 2005, p. 70) and strong supporter of the randomized controlled clinical trial.As the theories from which EBP originated began in medical care, it seems appropriate that theories of EBP are becoming increasingly common in nursing (Duffy, Fisher, & Munroe, 2008). …