The purpose of this study was to determine whether therapeutic music affects the patient’s perception of pain, postoperative day 1 after knee replacement surgery in an inpatient hospital. In addition to the patient’s pain levels, the study was an analysis of the quantity of opioids the patient was requested, the length of stay, and the physiological parameters, which included blood pressure, heart rate, respiratory rate, and oxygen saturation. Sixty knee replacement patients were randomly placed in the music group or the quiet group. The Faces Pain Scale Revised with Numeric Rating Scale was used to measure pain levels. Statistical analysis between the music group and the quiet group indicated a significant difference in patient’s pain levels (F = .298; p = .037). Study results support music decreasing patient’s perception of pain. Nurses can suggest music intervention to decrease pain with this patient population knowing evidence based practice supports the efficiency of music.

Stroke is the fifth leading cause of death in the U.S. with approximately 795,000 Americans experiencing a stroke each year. In addition to common difficulties with communication and physical impairments following stroke, psychosocial impacts warrant assessment and treatment. Experiencing a stroke can lead to depression, mood disorders, and difficulties with emotion regulation. It is well documented that post-stroke depression (PSD) affects a third of stroke survivors. Higher levels of depression and depressive symptoms are associated with a less efficient use of rehabilitation services, poor functional outcomes, greater odds of hospital readmission, negative impacts on social participation, and increased mortality. The acute phase of stroke recovery may be a key factor in influencing the depression trajectory with early depression predicting poor longitudinal outcomes. The current approach to treating PSD is medication. However, psychotherapy approaches have demonstrated more promise in preventing PSD. Investigations into music-based treatments have shown encouraging results following acquired brain injuries with active music therapy interventions demonstrating large effect sizes for mood improvement. Therefore, the purpose of this three-part dissertation was to examine the effects of active music therapy on mood and describe the clinical decision making process of using music therapy to target mood elevation for hospitalized adults following a first-time acute ischemic stroke. The first study examined the effect of one treatment of active music therapy on mood following a first-time ischemic stroke during acute hospitalization. Active music therapy was defined as music making interventions that elicit and encourage active participation from participants. The Faces Scale was used to assess mood immediately prior to and following treatment. Forty-four adults received at least one treatment. A significant change in mood was found following one treatment. Comment analysis indicated that participants viewed music therapy as a positive experience. The second study investigated the impact of receiving two treatments of active music therapy on mood as compared to one. No significant difference was found between those who received one treatment and those who received two. Both dosing groups demonstrated significant mood improvement; however Group 2 (two treatments) had more severe strokes and did not improve until the second session. The purpose of the third study was to describe the clinical decision-making (CDM) process of a music therapist targeting mood elevation for hospitalized patients following a first-time acute ischemic stroke. The Three Phase Process Model of Collaborative Self-Study was selected as a guiding qualitative methodological framework. Data was collected from four sources: (a) electronic medical records, (b) audio recordings of eight music therapy treatments, (c) a researcher journal, and (d) patient and caregiver/visitor comments. Results indicate that factors influencing CDM included progression through a four-stage treatment process, use of a variety of music-based and therapy-based techniques, and the monitoring and influencing of participant levels of arousal, affect, salience, and engagement. In conclusion, active music therapy during acute hospitalization following a first-time ischemic stroke is effective in significantly improving mood. Components of clinical decision making to elevate mood are illustrated in a provided conceptual framework. Continued investigation is warranted with consideration of stroke severity, dosing amounts, and additional outcomes of interest. Longitudinal investigation is needed to evaluate the impact of treatment on the trajectory of post-stroke depression.

The population of people experiencing homelessness has decreased less than 15% in the last ten years, but issues like mental illness and substance use are rising. There are many misconceptions about race, gender, location and age of people experiencing homelessness. Music therapy research about the homeless population is minimal and often focused on just one setting or treatment location. The purpose of this study was to better understand the relationship between music therapists and people experiencing homelessness. A survey of 365 music therapists in the United States revealed just under half of working clinicians provide services to people experiencing homelessness. Results from the survey revealed the most common settings where music therapists provided service to people experiencing homelessness were mental health, medical, and school systems. Additionally, the results discussed people experiencing homelessness’ demographic differences in clinician’s experiences versus annual reports. Results are not to be generalized but to be used as a tool to better understand people experiencing homelessness.

Visual supports, which provide information presented in a visual format to enhance achievement toward specific goals, can be very helpful for individuals who have autism spectrum disorder (ASD). Music therapists often use visual supports in their practice; however, research exploring how they do so is limited. In the present study, the researcher used a mixed-methods research design to explore music therapists’ use of visual supports for individuals who have ASD. The researcher e-mailed a survey to board-certified music therapists who opted to receive e-mails from the Certification Board for Music Therapists (CBMT), 525 of whom completed the entire survey. Approximately 70% of participants reported using visual supports “always” or “very often.” Participants most frequently reported using pictures with written words and visual schedules. Visual supports are most often used by music therapists in children’s facilities/schools and to address communication skills when working with individuals who have ASD. Participants most frequently reported using visual supports to generally enhance the session/interventions, using them to provide routine, predictability, and clear expectations for individuals who have ASD. Resources and recommendations provided by participants are also summarized. Open-ended responses were coded into themes, and most participants recommended specific software or applications and encouraged others to use certain visual supports, such as visual schedules and “real” pictures. Future researchers should examine the effectiveness of visual supports when used in music therapy sessions for individuals who have ASD.

Music therapists frequently work with clients with Autism Spectrum Disorder (ASD) who use Augmentative and Alternative Communication (AAC). The purpose of this study was to gather information on music therapists’ current experiences with AAC training as well as music therapists’ perceptions of their own communication abilities when communicating with clients who have ASD using their preferred AAC system. The researcher invited 7,279 board-certified music therapists to participate in this study via email, of which 366 completed the survey. Participants reported most often providing services to children and adolescents with ASD, and frequently using electronic AAC and electronic apps with their clients with ASD. The majority (71.2%) of participants stated that they would like additional training in the use of AAC. Of the music therapists who had participated in previous AAC training, many had received training at work or by an SLP or other certified professional. Results of this study provide information about the current practices and perceptions of board-certified music therapists working with clients with ASD.

Lorinda Jones, MT-BC, is the longest practicing music therapist in Kentucky. She began her work as a music therapist in 1995 and built a private practice, which expanded over the course of the next 20 years to include services in 16 counties. Ms. Jones’ perspective on the growth of music therapy, both within the state and nationwide, as well as her extensive knowledge of Appalachian folk music, makes her an invaluable resource to Kentucky music therapists. The purpose of this study was to present a historical account of the life and career of Lorinda Jones, to gain her perspective on the field of music therapy in Kentucky, and to learn about how she incorporates Appalachian music into her work with clients. The researcher found that Ms. Jones’ impact on the field of music therapy in Kentucky goes far beyond the individuals with whom she has personally interacted and that her role as a teacher to students of music therapy continues to influence the profession.

The understanding of why students decide to become music therapists is valuable information for music therapy educators and policy makers and published information is lacking. The use of expectancy-value theory provides a framework to understand student choices. Researchers can better understand why students purse a career in music therapy by examining students’ abilities, beliefs, expectancies, and values related to the choice. The purpose of this study was to examine why current undergraduate and equivalency students want to be music therapists. Music therapy students (N = 129) throughout the United States provided insight into their decision to become music therapists by completing a survey with questions about their expectancies and values. Results indicated that both undergraduate and equivalency students tended to choose to be music therapists because they expected music therapy to be a career that requires hard work and expert knowledge while maintaining their interest and morale. Results of a correlational analysis suggest there are several choice-making variables that may influence each other, indicating that the decision to become a music therapist is a complex process for students. Finally, the results of a Mann-Whitney U test suggested that there was no significant difference between the expectancies and values that influenced undergraduate and equivalency students’ choices to become music therapists. Music therapists in many capacities may use this information to improve recruitment and engagement of music therapy students.

Thesis (M.Mus.Ther.)--New Zealand School of Music, 2009. / Includes bibliographical references.

Breast milk is considered the gold standard for infant nutrition, but many factors can hinder milk production. Mothers of infants in the Neonatal Intensive Care Unit (NICU) are especially prone to stress, which can inhibit volume of breast milk. The purpose of this study was to determine if music listening had an effect on the volume of breast milk pumped and relaxation level of mothers of infants in a NICU. A total of 28 participants, who were mothers of infants in the NICU, were included in the data analysis of this study, with 14 in the control group and 14 in the experimental group. Participants assigned to the experimental group listened to relaxing music during pumping sessions in the NICU, for the duration of their infant’s stay. Participants assigned to the control group pumped as they would normally without the music condition. Results indicated that there was a significant increase in relaxation scores in the music group, but no significant difference in volume of milk pumped. Further research should be done in this area to determine music’s effect on volume of milk pumped by mothers of infants in the NICU.

Young children who experience high levels preoperative anxiety often exhibit distress behaviors, experience more surgical complications, and are at a higher risk for developing a variety of negative postoperative consequences. A significant factor in pediatric preoperative anxiety is the level of anxiety present in their caregivers. Music therapy interventions addressing a variety of procedural outcomes have been met with success. The purpose of this study was to investigate the comparative effectiveness of two music therapy interventions on reducing preoperative anxiety in young pediatric surgical patients and their caregivers. A total of 40 pediatric patient and caregiver dyads were included in this study on various days that they were present for ambulatory surgery. Pediatric preoperative anxiety was measured pre- and post-intervention using the modified Yale Pediatric Anxiety Scale, while caregiver anxiety was measured through self-report using the short form Strait-Trait Anxiety Inventory-Y6. Participants received a randomized active or passive preoperative music therapy session. Results indicate a significant reduction in preoperative anxiety for both patients and their caregivers. Neither active, nor passive music therapy interventions were significantly more effective than the other. Future studies should increase sample size and control for various factors such as sedative premedication use.