Vol 17 No 1 2003

What am I doing here?

Exploring a role for music therapy with children undergoing bone marrow transplantation at Great Ormond Street Hospital, London  p8 - p16

Nicky O'Neill and Mercédès Pavlicevic

Abstract

This paper draws upon a dissertation for a Master of Music Therapy undertaken at the Nordoff-Robbins Music Therapy Centre, London.  Music therapy is not currently an established part of bone marrow transplantation (BMT) care for paediatric patients in Britain and consequently little research has emerged in this area of clinical work in the UK.  This study explores the psychosocial needs of children and their families during BMT, and demonstrates how music-centred co-improvisatory music therapy can address these needs.  It is written from the point of view of the therapist.

Drawing from interviews with patients, families and staff who have experience of music therapy within the area of BMT, and clinical vignettes form the first author's music therapy practice, this paper highlights four areas of psychosocial needs that music therapy can address: a sense of agency, pleasure, cultural identity and normality.  Each of these is discussed in relation to both the child and the family.

The study suggests that the use of a music-centred, co-improvisatory approach to music therapy appears to be especially flexible in meeting and supporting the variety of psychosocial needs experienced by both children undergoing a bone marrow transplantation and their families.

Music Therapy References Relating to Cancer and Palliative Care  p17 - p25

David Aldridge

Abstract

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 setting, 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 enable 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 simple 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 therapist also emphasise the importance of music for their own healing.  This is necessary to meet personal needs when working with 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 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  p26 - p45

Amelia Oldfield, Malcolm Adams and Lucy Bunce

Abstract

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 therapy 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.

Book Reviews  p46 - 50

Analytical Music Therapy, Edited by Johannes Th. Eschen/Reviewed by Averil Williams 

Musical Identities, Edited by Raymond Macdonald, David Hargreaves and Dorothy Miell/Reviewed by Simon Procter

Approaches to communication through music by Margaret Corke/Reviewed by Sylvia Raine

Vol 17 No 2 2003

The whole is greater than the sum of its parts: experiences of co-working as music therapists 

p67 - p75

Mary-Clare Fearn and Rebecca O'Connor

Abstract

This paper describes the experiences of two music therapists who have been working together for ten years and the benefits of this partnership.  It shows how working practices and therapeutic processes have evolved over a decade.  It demonstrates that working as a team over this length of time resulted in significant improvements to the therapy given to children with special needs aged between 2 and 18 and also to the support offered to their parents.

The various topics covered include the development of a co-therapy assessment procedure, group psychodynamic music therapy for children with special needs, sessions for children and their parents, the significance of counter-transference and the importance of supervision.

Service evaluation: music therapy and Medicine for the Elderly p76 - p89

Hillary Moss

Abstract

This paper describes a six-month evaluation of the music therapy service in a Medicine for the Elderly unit.  It describes the unit and introduces the role of music therapy in this clinical area, with reference to relevant literature.  The service evaluation is then described in detail.  Four evaluation methods are presented.  A user feedback questionnaire, which was designed by the writer for music therapists, is presented with results and discussion.  A twelve-week music therapy group is observed and evaluated using rating scales to measure the level of patient communication and interaction within and outside the group.  Two clinical vignettes are presented and, finally, qualitative observations are outlined.

The paper then describes how these four methods were used to produce management recommendations for future service planning.  It highlights the need for service providers to engage in consultation with service users when planning and reviewing services.  It emphasises how important it is for music therapists to evaluate their services, and sets out this model in the hope that it will provide ideas and guidance for therapists wishing to do the same.

The longest goodbye - a case study p90 - p96

Christine Atkinson

Abstract

This article is a case study of a client whom I shall call Simon.  He attended music therapy with me for four years.  In this paper I aim to explore the concept of containment and the provision of a safe, facilitating environment, illustrating in the case material how integral they are to my work as a music therapist.  Using the material, I demonstrate how Simon moved from being chaotic and uncontained in his self-expression to a place where he was able to explore his feelings and share them with me.

From early on in the  music therapy with Simon, 'ending' became a dominant theme.  I aim to explore the reasons why endings were so significant, how Simon responded to endings and how we negotiated the important ending of our therapeutic relationship.

'New York Mining Disaster' p97 - p104

John Glyn

Abstract

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?

Book Reviews p104 - p110

Contemporary Voices in Music Therapy:  Communication, Culture and Community, Edited by Carolyn Kenny and Brynjulf Stige/Reviewed by Cathy Durham

The Science and Psychology of Music Performance: Creative Strategies for Teaching and Learning, edited by Richard Parncutt and Gary E. McPherson and reviewed by Alexandra Lamont

Art Therapies and Progressive Illness: nameless dread, edited by Diane Waller and reviewed by David Aldridge

Culture-Centered Music Therapy, edited by Brynjulf Stige and reviewed by Mercédès Pavlicevic