abstract: Adolescents experience a lot of stress from changes and difficulties in their physical appearance and their relationships—affecting their mental and emotional well-being as well as their family's relationships and functioning. Research has shown that family music therapy has been fairly successful in helping both children and adolescents and their families improve their communication and mutual attunement while encouraging self-expression in the child and teenager. However, the literature focuses mainly on families with children ages 10 and under, at-risk families, and non-clinical families. Little focus in the research literature is given to adolescents and their mental and emotional health concerns. The purpose of this thesis was two-fold: 1) to perform a systematic review and collect information from articles that used music interventions or music programs to address the mental health needs of families and adolescents, and 2) to develop a family music therapy program for teenagers with mental health concerns based on the research literature used for the systematic review. Fourteen articles were included in the study. The main interventions and programs were improvisation (n = 6), songwriting (n = 3), lyric analysis or song discussions on client-selected music for introspective and expressive purposes (n = 3), therapeutic singing (n =1) and structured group music making (n = 1). Common outcomes included improvement in the adolescents' self-expression and communication, restoration of family relationships, increased awareness of covert family issues, and improved family communication and interactions. The proposed six-week music therapy program is improvisation-based, considering the amount of improvisational interventions that were found in research. Session plans include interventions such as musical “icebreakers” and warm-ups, improvisation, lyric analysis, and a culminating songwriting experience. Keywords: family therapy, music therapy, adolescents, mental illness / Dissertation/Thesis / Masters Thesis Music Therapy 2019

Attention Deficit Hyperactivity Disorder (ADHD), the current diagnostic label for children and adults presenting with significant problems with attention, impulsivity and excessive activity is one of the most prevalent childhood psychiatric disorders (Barkley, 2014:3). This qualitative research study, situated at a school for children with ADHD, explores how involvement in Group Creative Music Therapy can promote social skills in six and seven year old children diagnosed with Attention Deficit Hyperactivity Disorder. Four weekly music therapy sessions were conducted with one class consisting of 10 students in the second grade. The class teacher was interviewed prior to and after the music therapy process and attended all music therapy sessions. An interesting component of this research was that the teacher was a music teacher who already had a wealth of experience of using music in her own life and with her classroom. The research data included interviews as well as video excerpts showing interaction between the children during music therapy sessions. The findings from the qualitative analysis of interview transcripts and video excerpts indicate firstly the value of music itself as a tool for promoting social skills. There were also many similarities between how the teacher and music therapist used music to benefit children socially, such as exposing the children to music from different cultures or using turn-taking or movement activities to encourage the children to work together. Secondly, this study also highlights the differences between the work of music therapists and music educators. The main differences include the distinctive aims, particularly in this study where the music therapist’s aim was the development of social skills and the teacher’s aim was music education - with social influences as an added benefit to the educational process. Based on their aims, music therapists and music teachers use alternate methods and ways of managing and drawing children in. The findings show how music therapy can influence the development of social skills in children with ADHD - as the music therapist uses specific clinical skills to help children engage freely and spontaneously with others, while also offering them new experiences of themselves and one another. Therefore, the findings also show helpful complementary relationships between music therapists and teachers, as music therapists can help teachers use tools and techniques from music therapy in their classes and teachers can also suggest certain music for therapists to utilise in therapy sessions. This study strongly advocates for both music education and music therapy, as the findings indicate that both fields are beneficial for this client group. / Mini Dissertation (MMus)--University of Pretoria, 2016. / Music / MMus / Unrestricted

The aims of this study were to explore parents’ and teachers’ perceptions of what music therapy entails and what value it has for children with autism. In so doing, limitations in providing information about music therapy were identified. The context for this study involved Unica School for Autism in Menlo Park, Pretoria. Unica is a Public Benefit Organisation (PBO) that provides specialised education for learners with autism between the ages of 3 and 18 years. Music therapy has been offered at Unica by both qualified music therapists and supervised music therapy students since 1995. This study was conducted within the qualitative research paradigm and, as such, sought to understand perceptions of, rather than ‘prove’, the value music therapy has for children with autism. Data collection took the form of 6 semi-structured interviews. The interviews were transcribed and data were coded, categorised and organised into themes. These themes then formed the basis for addressing the research questions. The findings of this study show, firstly, that direct contact with the music therapist, music therapy public presentations, and witnessing musical end products such as performances are the primary influences on parents’ and teachers’ perceptions of music therapy. Parents and teachers have some understanding of the objectives of music therapy. The findings show, secondly, that the parents and teachers have limited understanding of how music therapy works. This includes a lack of knowledge about clinical musical intention, intervention and the music therapy process. Finally, the findings show that parents and teachers at Unica hold music therapy in exceptionally high esteem. They are able to identify its value for children with autism in a number of areas, particularly in terms of social development and development of self, which relate directly and peripherally to the diagnosis of autism. The participants also recognise the lack of awareness about music therapy outside of the Unica environment, and express a wish for all children with autism to receive music therapy. Copyright / Dissertation (MMus)--University of Pretoria, 2011. / Music / unrestricted

In South Africa music therapy as a profession is still in its infancy and not yet firmly established, hence music therapists have struggled in the past to secure full-time employment. It is important to ascertain the current state of music therapy in Tshwane as this will offer suggestions about what needs to be addressed in the future. In this project two research questions were explored: 1. What are the experiences of music therapists, as well as the perceptions of other professionals working in the health and education sectors in Tshwane, regarding music therapy as a profession? 2. What do these experiences and perceptions suggest about the current state of the music therapy profession in Tshwane? This research project used questionnaires to generate data pertaining to the experiences of music therapists and perceptions of allied professionals about the music therapy profession in Tshwane. The experiences of music therapists currently practising in Tshwane shed light on the present situation of music therapy in Tshwane. The allied professionals’ perceptions of music therapy had implications regarding the recognition of the profession which impacts directly on the availability of jobs, funding and resources available to music therapists. Questionnaires generated both quantitative and qualitative data through the use of closed questions that were analysed using descriptive statistics that were generalised and openended questions analysed through the process of coding and categorising for emerging themes that were discussed. Results obtained from the questionnaires indicated that not enough is being done to promote the field as music therapist respondents (n=4) do not create or set up new music therapy employment. This accounts for the fact that at present other professionals working in the health and education sectors (n=27) have a varied understanding of what music therapy comprises. Because of this varied understanding music therapy is not always valued by these professionals. Collaboration with allied professionals was an important theme which recurred throughout the data and seems to have been the most successful way of furthering the profession so far in Tshwane. By promoting music therapy, especially through collaboration with others, awareness of music therapy should be enhanced, others’ knowledge and understanding of music therapy may be expanded and music therapy may ultimately find its valued place among other therapeutic interventions. / Mini Dissertation (MMus)--University of Pretoria, 2009. / gm2014 / Music / Unrestricted

Children diagnosed with Autism Spectrum Disorder (ASD) are challenged with communicative skills, which can negatively influence their emotional development. As children with ASD in the local school were not demonstrating functional communication skills as measured by the Assessment of Social Skills for Children with Autism (ASSCM), music therapy was introduced as remediation. The purpose of this study was to determine the extent to which music therapy increased the ASSCM scores. This single subject design study was guided by Bronfenbrenner's ecological theory, which holds that individuals are impacted by various environmental systems around them. The research question addressed the extent to which 9 weeks of music therapy increased ASSCM scores of 6 children with ASD that participated in weekly music therapy. The deidentified secondary data showed initial ASSCM scores were 32 on a scale from 30 to 90. The scores of the 6 students that attended the weekly music therapy increased by 36 points. The Percentage of Data Points Exceeding the Median (PEM) effect size used in single subject studies to determine potential statistically significant performance improvement over time was 100%, meaning that all students exceeded the median pretest score. A professional development program was designed to assist the school district's special education teachers in the use of music therapy. Positive social change implications may include the ability for children with ASD to communicate with their peers and hence, integrating them into the classroom and school environment. After all, school is not only about learning academic subjects but an opportunity to interact and function in a social setting, increasing the social and emotional well-being of children.

This study examined the effects of music on improving quality of sleep. Participants were randomly assigned to either a music assisted relaxation or a relaxation alone condition. Individuals in both groups were taught varying relaxation methods and were provided with a relaxation script which incorporated each of the methods. Those in the music assisted relaxation condition were allowed to select their top two pieces from a list of relaxing music. The selections were placed on a CD being played in the background while a relaxation script was read. Those in the relaxation alone condition received a CD with the same relaxation script heard by those in the music assisted relaxation condition. Global sleep scores (as measured by the Pittsburgh Sleep Quality Index) were taken on the first and last days of the experiment. Examining individual and group scores showed no statistically significant difference between music assisted relaxation and relaxation alone. Discussion focuses on the implications for future research in the area of music's effect on sleep quality.

Music therapists have utilized technology in their clinical work for decades. Yet music therapy delivered in a telehealth model – telemusic therapy – has rarely been described in the literature until recently. This study stems from telemusic therapy services the researcher-interventionist was contracted to provide to adult acquired brain injury (ABI) survivors. The existing literature has primarily reported on synchronous telemusic therapy conducted via internet-based videoconference platforms with individual clients or groups who were colocated but not face-to-face with the clinician. Technological issues were cited as limitations. Only one article described small group telemusic therapy where participants were each located at their individual homes; no literature was found for large groups of non-colocated participants. Further, the telemusic therapy literature very rarely reports empirical data. This thesis presents the results of a pilot study exploring the feasibility and effectiveness of telemusic therapy on well-being for adult brain injury survivors who participate independently from their homes. This retrospective study utilized a quasi-experimental, pre/post-session repeated measures design to examine data from a 20-session, 10-week, group telemusic therapy program (N = 15). Clinician-developed pre/post measures of well-being were administered each session. A Qualtrics Likert scale survey exploring audiovisual quality, emotional support, the therapeutic relationship, and social-emotional connection between participants was issued during the 5th and 10th weeks. Results: Mean and median difference of pre/post measures were significant for increasing well-being at α = 0.5. Frequency distributions of the survey ratings of more than or very much adequate for quality of audio and video: 78.6% – 85.7%; ratings of more than or very much adequate for emotional support, formation of a therapeutic relationship and creating connections with other participants, respectively: 85.7%, 78.6%, 92.9 %. The results support the feasibility and effectiveness of group telemusic therapy for increasing well-being in adult ABI survivors who attend from their individual homes. Study limitations include small N, low return rate for surveys, and unvalidated measures.It is noteworthy that in each session, the music therapy group successfully engaged in real-time active music making with all members playing and all microphones on. No audio delay was detected. This phenomenon has been described in the literature as improbable. The cause of such low latency is unknown. These findings demonstrate that participants using personal computers or laptops and residential broadband Internet experience the audio and visual components of synchronous music therapy as more than adequate. A real-time telehealth model is a viable means for providing group music therapy. / Music Therapy

The purpose of this study was to investigate the formation of music preference in an effort to identify specific ages when preferred music is likely to be discovered. One hundred one individuals participated in an online survey, answering questions about their listening habits, music preferences, and the social elements that contributed most to those preferences. Participants were asked to identify their current, second, and third favorite music at the time of the study and whether their preferences had changed over time. According to findings, males were likely to discover their current favorite music at the age of 12.46 years, and females were likely to discover their current favorite music at the age of 13.23 years. Parents, friends, and the radio were shown to be the most common influences towards preference discovery. Of those surveyed, 69.3 % of participants acknowledged that their preferences had changed over time. However, the current methodology lacked the specificity to determine the scope of that change, leaving room for future study. The results hold implications for not only the field of music therapy, but also for any other fields utilizing preferred music to achieve a specific result.

Singing is often used in music therapy sessions. It can provide physiological, psychological, and interpersonal benefits, and music therapists use it to address clinical goals including improved blood oxygenation, emotional expression, and increased interpersonal engagement between clients and their family members. Singing uniquely combines musicality, the body as the instrument, and meaningful words. Furthermore, the voice is a personal instrument, which makes musical engagement accessible to many people. Though singing can provide various benefits, many people experience singing negatively, especially when singing with an exposed voice, i.e., when others can hear their singing voice. Whidden (2015) found that one can easily develop a non-singer identity, i.e., the belief that one is not capable of singing, by hearing a negative comment about one’s singing in childhood. Studies also have found that people can feel vulnerable and embarrassed when singing. It is important to understand how people experience singing, especially with an exposed voice, and how past experiences with singing shape one’s singer identity so that clients can benefit from singing without experiencing unnecessary discomfort. The research questions that guided this study were: What are the experiences of non-musician adults when singing with an exposed voice? How do past experiences with singing shape one’s identity as a singer? A phenomenological design was used with interviews of nine participants who were non-musicians in non-clinical live music experience sessions. The participants joined the researcher in singing a song of their choice and a predetermined well-known song. Five themes emerged including 1) the onset of insecurity; 2) singing together; 3) right here, right now; 4) that’s my song! and 5) I’ve got the music in me. These were each accompanied by song lyrics that capture the meaning. The results show how one’s singer identity and experience of singing in the present moment can be impacted by past experiences and that preferred songs are often emotionally evocative. These findings provide insights for use in music therapy practice, including a simple assessment question to evaluate a client’s singer identity.

EEG biofeedback training, known as neurofeedback, has been explored as a nonpharmacologic prophylaxis for migraines. Based on the conceptual model of disregulation of central arousal function, the Othmers proposed a protocol in migraine prophylaxis by raising the sensory motor rhythm (SMR, 12- 15 Hz), accompanied by an inhibition of theta ( 4- 7 Hz) frequency. Relaxation with music, on the other hand, is another type of nonpharmacologic prophylaxis for migraines and is used to reduce perceived psychological and/or physiological stress and pain. Studies showed that an effective relaxation with music program is one that integrates certain relaxing musical characteristics and personal factors. Six female participants (29 to 57 years of age) previously diagnosed with migraines participated in this single-subject design study. This study employed two independent variables- the SMR/theta training and music therapy, and the dependent variables were the SMR and theta recording registration. Each participant first participated in the EEG Base-rate recording session, and was then randomly assigned to the following treatment conditions: SMR/Theta training only, music therapy only, and SMR/Theta training and music therapy." Counterbalancing of the treatment conditions was applied across participants, two sessions weekly for a total of 13 sessions, 30 minutes each session. In SMR/Theta training only, participants were instructed to raise their SMR while inhibiting theta. In music therapy only, participants were instructed to select their relaxation CD music to be played during the sessions. The SMR and theta data were graphed for each participant and implications were discussed. Graph analysis indicated that two participants were responsive to SMR/Theta training and music therapy and SMR/Theta training only respectively. Overall, all participants acquired relaxation skills and seemed better at adapting themselves to a stressful environment.