Music Therapy in Mental Health: Practice, Theory, Research, and Professional Perspectives

I am honored to have the opportunity to present this volume of Music Therapy Perspectives with a special focus on music therapy in mental health care. In envisioning such a volume, the possibilities appear endless; however, the focus of this volume offers a microcosmic but expansive view encompassing four areas: professional perspectives, treatment practices, the voices of service users, and research.Mental Health Practice Today: Opposing IdeologiesWithin an expansive view of the field of mental health in 2015, the tension of polarities is a theme that is often encountered. Mental health care in the United States has been strongly impacted by divergent, sometimes conflicting, ideologies that have affected the nation socially, culturally, and politically. This is evident in healthcare overall, but particularly in mental health care, where the effects are evident on a structural level, with respect to reduced access to affordable mental health care (National Alliance on Mental Illness ([NAMI], 2015); in research, where pharmaceutical companies have significantly reduced funding investments for mental health disorders while increasing funding in other health areas (Hyman, 2013); and with regard to treatment paradigms- namely, the empirical medical model versus the humanistic approach (Kogstad, Ekeland, & Hummelvoll, 2011).A discussion of how ideologies have affected both the provision of care and investment in pharmaceutical research is beyond the scope of this introduction, though they are important topics and may be of great interest to music therapists. While these factors have a strong impact on our work, we are at the same time intimately engaged with the daily struggles and victories of persons with mental health disorders, and our published works reveal how we have become adept at treating clients effectively within these challenging, and sometimes oppositional, treatment approaches.The Recovery Model in Mental Health Practice and ResearchRegardless of the paradigms we prefer to use to guide our work, or the tensions that may exist between our personal proclivities and those of the institutions in which we work, the same fundamental concerns underlie our collective practice and research. The fundamental concern we share is how we can most effectively use the various facets of music experiences and the relationships we establish through them (Bruscia, 2014) to help our clients improve their quality of life, develop their potential, and value their unique personhood in spite of the stigma that is part of the texture of their daily lives (Link, Struening, Neese-Todd, Asmussen, & Phelan, 2014).Some research has been conducted from the stance of the recovery model approach, which appropriately locates expert knowledge with the persons who are recipients of these services. This research has provided some insight into the needs of persons with mental health challenges from their perspective. Kogstad et al. (2011) conducted a qualitative study on the narratives of recovery of persons with mental health problems and discovered that the service users challenged "fundamental beliefs about what constitute effective and necessary treatment" (p. 479). The authors also noted that Strauss (2005, as cited in Kogstad et al., 2011) questioned why there was a resistance in the field of psychiatry to include research that focused on recovery and that favored the service users' views. The authors theorized that reductionist and symptomoriented views of mental disorders privileged by the medical profession are challenged by orientations that emphasize working toward the resolution of existential dilemmas, which are essential daily considerations for persons with mental health concerns.In the recovery approach, humanistic or client-centered and existential models are well suited to address the resolution of existential dilemmas, as are the more recent methods and techniques that have evolved from these approaches, such as motivational therapy (Miller & Rollnick, 2009). …