This study was concerned with the effectiveness of Nordoff-Robbins Music Therapy (NRMT) carried out within a Developmental, Individual-Difference, Relationship-based (DIR®)/Floortime Framework in addressing the individual needs of children with autism. In NRMT, the child is an active participant in the music making process, playing various instruments that require no formal training. The therapist's task is to improvise music built around the child's musical responses, reactions, responses, and/or movements to engage him or her in a musical experience that will facilitate musical relatedness, communication, socialization, and awareness. The DIR® model provides a comprehensive framework for assessing, understanding, and treating the child. It centers on helping the child master the building blocks of relating, communicating, and thinking through the formulation of relationships via interactive play, using Floortime (a systematic way of working with the children to help them reach their developmental potential). This study sought to determine the effectiveness of NRMT in meeting musical goals specifically established for each individual child, and to conclude if progress in musical goals paralleled progress in non-musical (DIR®) goals. / Music Therapy

This study examined the relationship between music therapists' spiritual beliefs and their clinical practices. A survey was sent to 4243 members of the Certification Board for Music Therapy, using an electronic program, SurveyMonkey. There was a return rate of 32%. The survey contained two parts; Part I was the Music Therapy Questionnaire, and Part II was the Spiritual Involvement and Beliefs Scale (SIBS). Data were analyzed using a combination of Kruskal-Wallis Anova, Mann-Whitney U, and Spearman Rho correlation tests to analyze both the relationships as well as significant variations in responses between the survey questions and the SIBS scores. Research questions focused on the relationships between the music therapists' spirituality scores (SIBS) and their demographics, their reported spiritual beliefs and practices, and their clinical practices. Statistical analyses revealed significant differences in the relationship between SIBS scores and gender, age, and years of professional experience; however, there were no significant differences between SIBS scores and education level, regions of AMTA, or client populations served. Significant correlations were found between SIBS scores and music therapists' personal appraisal of their own spirituality, their use of music as a spiritual experience, the use of music in their own personal practice, and their belief in the importance of some type of contemplative experience in their own personal lives. Further statistical analyses also revealed significant correlations between music therapists' SIBS scores and the following clinical practices: 1) the role of spirituality as a sustaining force in their music therapy career, 2) their spiritual ideals as exemplified in their work, 3) attention to their own spirituality in their role as a music therapist, 4) their spiritual growth as a music therapist, 5) the classifying of their work as a spiritual endeavor, 6) their choice of music therapy as a profession. Additional positive correlations were found between music therapists' SIBS scores and the reported influence of spirituality on their choice of population, their comfort in addressing clients' spiritual needs when they are similar to their own, and their comfort in addressing clients' spiritual needs when they are different from their own. / Music Therapy

Thesis (MMus) -- University of Stellenbosch, 2003. / ENGLISH ABSTRACT: There is a growing interest in the investigation of the value of music to the development of cognitive, social, personal and motor skills pertaining to infants. Research has shown that the inclusion of music in intervention programs for physically and cognitively disabled children could have a positive influence on the development of several of their skills. Against this background the reactions and development of four children with Down syndrome from a school for the disabled in Bellville were investigated from a holistic point of view during their participation in a music stimulation program. The music stimulation program presented in this study was compiled after consulting existing well-proven music appreciation programs for non-disabled children. Some of the activities extracted from these programs were adjusted where necessary. At times nonmusical activities were also combined with music in order to address a diversity of skills by means of music. Results after the completion of the program indicated that music has the potential to enhance the development of several skills and intelligences, as identified and described by Gardner (1983), of children with Down syndrome. Although it was difficult to determine whether music was responsible for some of the improvements that were observed, the results from this study indicated that children with Down syndrome can benefit from a structured music stimulation program. / AFRIKAANSE OPSOMMING: Die waarde van musiek ten opsigte van die ontwikkeling van kognitiewe, sosiale, persoonlike en motoriese vaardighede by kleuters word toenemend ondersoek. Navorsing het getoon dat die insluiting van musiek by intervensieprogramme vir fisies en kognitief gestremde kinders die ontwikkeling van verskeie vaardighede positief kan beïnvloed. Teen hierdie agtergrond IS die reaksies en ontwikkeling van vier kinders met Downsindroom vanuit 'n holistiese oogpunt tydens deelname aan 'n musiekstimuleringsprogram ondersoek. Hierdie kinders het 'n skool vir gestremdes in Bellville bygewoon. Die musiekstimuleringsprogram wat tydens die studie gebruik is, is saamgestel deur bestaande musiekwaarderingsprograrnme vir nie-gestremde kleuters wat oor 'n aantal jare beproef is te raadpleeg en, waar nodig, die aktiwiteite aan te pas. Nie-musikale aktiwiteite is soms met musiek gekombineer ten einde 'n verskeidenheid van vaardighede deur middel van musiek aan te spreek Die resultate van die voltooiing van die program het daarop gedui dat musiek die potensiaal het om 'n positiewe invloed op die ontwikkeling van verskeie vaardighede en intelligensies, soos geïdentifiseer en beskryf deur Gardner (1983), op kinders met Downsindroom uit te oefen. Hoewel dit soms moeilik was om te bepaal of musiek verantwoordelik was vir sommige van die verbeterings wat opgemerk is, het dit uit die resultate van hierdie studie geblyk dat kinders met Downsindroom kan baat vind by 'n gestruktureerde musiekstimuleringsprogram.

Thesis (MA) -- University of Stellenbosch, 2004. / ENGLISH ABSTRACT: This study was undertaken with a view to evaluate the effect of music education on the self-concept of the learner with attention deficit hyperactivity disorder. Four learners diagnosed with attention deficit hyperactivity disorder were asked to participate in a music program presented for two terms by the researcher. The selfconcept of the learners was recorded through interviews and questionnaires by the learners and their parents before the study commenced. Observations by the researcher and objective observer were used to monitor the learners' progress during the course of the lessons. After the completion of the music program the learners and their parents were again asked to participate in an interview and to complete a questionnaire. This study revealed that music education is a great enjoyment to these learners and the self-concept and self-confidence of some of the learners improved. A literature review was done in order to obtain a perspective on attention deficit hyperactivity disorder. A historical overview provided insight into the development of this disorder necessary to describe it properly. The study also focuses on various intervention techniques which can be used by parents and teachers. In addition, the study focuses on the role of music education and music practice on the various developmental levels of the learner and how music can indeed affect relaxation and be responsible for lifelong learning. It is recommended that the learners continue with mUSIC education, because it provides them with a sense of success and it plays a vital role in the cognitive development of the learner. This, in tum, leads to lifelong learning: an influence that will remain an irrevocable part of the child for the rest of his/her life. / AFRIKAANSE OPSOMMING: Hierdie studie is onderneem met die doelom die uitwerking van musiekonderrig op die selfbeeld van die leerder met aandagafleibaarheid-hiperaktiwiteit te evalueer. Vier leerders wat gediagnoseer is met aandagafleibaarheid-hiperaktiwiteit is genader om 'n musiekprogram, aangebied deur die navorser, vir twee kwartale by te woon. Die selfbeeld van die leerders, wat vooraf deur middel van onderhoude en vraelyste deur die leerders en hulouers voltooi is, is geëvalueer. Die leerders se vordering is tydens die lesse deur middel van observering en objektiewe waarneming bepaal. Na afloop van die musiekprogram is die leerders en hulouers weer gevra om 'n onderhoud en vraelys te voltooi. Uit die studie blyk dit dat musiekonderrig 'n groot mate van genot vir die leerders is en daar was 'n verbetering in selfbeeld en selfvertroue by sommige van die leerders. 'n Literatuuroorsig bied insig oor die omvang van aandagafleibaarheid-hiperaktiwiteit en 'n historiese oorsig oor die verloop van die proses wat tot 'n beskrywing van die versteuring lei, word bekyk. Die verskeie intervensie-tegnieke wat deur ouers en opvoeders toegepas kan word, word bespreek. Verder word die rol wat musiekonderrig en musiekbeoefening op die verskillende ontwikkelingsvlakke van die leerder speel aangespreek, asook hoe musiek 'n ontspannende effek kan hê en verantwoordelik kan wees vir lewenslange leer. Dit word aanbeveel dat leerders volhou met musiekonderrig, omdat dit 'n gevoel van sukses verskaf en 'n belangrike rol speel in die leerder se kognitiewe ontwikkeling. Laasgenoemde is gevolglik verantwoordelik vir lewenslange leer: 'n onherroeplike invloed op die leerder vir die res van sy/haar lewe.

Smärta i alla dess dimensioner är ett tillstånd av ohälsa samt ett problem som påverkar hela individens livsvärld. Samtidigt är musik något som alla individer har en subjektiv upplevelse av vad det innebär och hur kroppen och sinnet påverkas av dess rytm, harmoni och melodi. Studien syftade därför till att undersöka hur musikintervention upplevdes smärtlindrande. En litteraturstudie användes som metod där 11 vetenskapliga artiklar av både kvalitativ och kvantitativ ansats granskades. Resultatet delades upp genom att kodord placerades under smärtans dimensioner och visade att musiken påverkade individens upplevelse av smärta i samtliga dimensioner. Den fysiologiska dimensionen, som fokuserade på de fysiologiska orsakerna bakom smärtan visades påverkas starkast av musikintervention. Svagaste påverkan hade musiken på den sociokulturella dimensionen, som fokuserade till stor del på hur smärtan manifesterades på omgivningen. I resultatet framkom även att det viktigaste för att musikintervention skulle upplevas smärtlindrande var att attraktionskraften till musikstycket var tillräckligt uppskattat hos individen. / Pain in all its dimensions is a state of ill health as well as a problem that affects the entire life-world of the individual. At the same time, music is something that all individuals have a subjective experience of what it means and how the body and mind are affected by its rhythm, harmony and melody. Therefore the study aimed to investigate how music as an intervention was perceived as a relief in pain. A literature study was used as method, where 11 scientific articles of both qualitative and quantitative approach was reviewed. The result was divided by code words and placed under the different pain dimensions. The result demonstrated that the music affected the individual's experience of pain in all of the dimensions. The physiological dimension, which focused on the physiological causes of the pain appeared most strongly influenced by the music intervention. Weakest influence the music had on the socio-cultural dimension, which focused largely on how the pain was manifested in the surroundings of the individual. The results also revealed that the most important thing for music intervention to be perceived as reliving in pain was that the piece of music was sufficiently appreciated by the individual.

Bakgrund: Den palliativa vården skall omfamna och ta hand om människan då sjukdomen inte längre är botbar. Inom palliativ vård är det viktigt att inte enbart behandla den fysiska smärtan utan tillgodose och ha människans alla dimensioner i åtanke. Människan som vårdas palliativt kan lida fysiskt, psykiskt, psykosocialt och existentiellt. Det är önskvärt att se över vilka alternativa behandlingsmetoder som kan stötta dessa dimensioner för patienter som vårdas palliativt. Musik har sedan urminnes tider haft förmågan att beröra människan på flera olika plan. Konstformen kan användas i vardagen såväl som i terapeutiskt syfte. Musik som används i terapeutiskt syfte är ett eget kunskapsområde och har namngetts musikterapi. Syfte: Beskriva patienters upplevelse av musikterapi inom den palliativa vården. Metod: I litteraturöversikten har vetenskapliga artiklar samlats in via olika databaser med sökorden music och palliative care. Till resultatet valdes 11 artiklar som bearbetades med en analys av Friberg för litteraturöversikter. Därefter sammanställdes resultatet med hjälp av teman och subteman. Den teoretiska referensramen som användes var Katie Erikssons caritativa vårdteori. Resultat: Litteraturöversiktens resultat visar att musikterapi kan ge positiva upplevelser för människan som vårdas palliativt. Musikterapin har en värdefull inverkan på hela människan – fysiskt, psykiskt, existentiellt och psykosocialt. De fysiska aspekterna som påverkades var hjärtfrekvens, andning, oro, vakenhet och smärta. De psykiska var att musikterapi bidrog till att lindra oro och ångest, samt verkade psykiskt avkopplande. Patientens existentiella dimension påverkades av musik genom att den bidrog till livsreflektion och meningsskapande. Patientens psykosociala sida stöttades genom att de upplevde en ökad samhörighet och kontakt med närstående och andra patienter. Resultaten påvisade även negativa risker med musikterapi, som terapeuten måste vara uppmärksam på. Dessa var att musiken kunde skapa starka, negativa känslor och minnen. Patienten kunde även känna hopplöshet över att inte orka delta i terapin eller ha för låg kunskap om instrumenten. Diskussion: Musikterapi har en förmåga att ge positiva upplevelser inom den palliativa vården och bör implementeras mer i omvårdnaden. Resultaten som musikterapin ger får stöd av styrdokument och mål för palliativ vård. Studier behövs som undersöker om musikterapi skulle kunna innebära en minskning av läkemedel. Resultatet bidrar till att förbättra det praktiska vårdarbetet genom att patienten får omvårdnad ur ett helhetsperspektiv och kan delta i terapin trots sviktande funktioner.

In work with clients having profound learning disability, music therapists may include in sessions assistants not trained as music therapists. This study is a qualitative inquiry addressing the questions: 1) How does improvised music influence the interaction between teenagers with profound and multiple disability and learning support assistants? 2) Which aspects of the music are associated with any influences found? A survey of music therapists, exploring how assistants are used and how effectively they perform their role, found that assistants are often used as ‘interaction partners’. To explore how the therapist may facilitate client-assistant interaction, about which little is known, video clips from the writer’s clinical practice were purposively selected in order to illustrate an approach entitled Triadic Support of Interaction by Improvisation (TSII). Seven learning support assistants (LSAs) each viewed a video clip showing her own interaction with a teenager having profound disability, supported by the writer’s improvised music. Semi-structured interviews explored the LSAs’ understanding of the behaviour and inferred mental processes of the teenagers, their own behaviour and mental processes and the music improvised by the therapist to support the interaction. A variant of Interpretative Phenomenological Analysis generated shared themes, which included concern for the teenagers’ autonomy, interest in their communicative behaviour and understanding of the mutuality of interaction. The therapist’s improvisation was seen by the LSAs as influencing only the teenagers. All the clips were also viewed by three music therapists, who used a mechanical continuous response device to register the influence of the therapist’s improvisation on four ‘scenarios’: the teenagers’ behaviour, their inferred mental processes, the LSAs’ behaviour and their inferred mental processes. Inter-rater agreement between the three therapists’ continuous responses was generally low, but some intra-rater correlations were found between pairs of scenarios, which the music was perceived as influencing in similar ways. This finding supports the conclusion that musical influences, although they may be analysed according to the four scenarios, actually function as a mutually inter-related system rather than as four independent processes. Each therapist selected decision points from the graphic record of her/his individual responses to discussed with the other therapists as a panel. Positive evaluations were made of the role of TSII in supporting the observed teenager-LSA interactions and the inferred underlying mental processes. This research design was exploratory, and not intended to test specific hypotheses about the mechanisms of musical influence. Tentative suggestions of associations between influences and musical features are however offered by the writer. Indications for the use of TSII are given and other applications suggested for novel aspects of the methodology developed for this study. A refinement of the continuous response task is proposed, and the requirements for any future formal evaluation of TSII are outlined.

This outcome study investigates whether music therapy can improve the emotional well-being of adolescents who are at risk of exclusion or underachievement. Specifically, it addresses music therapy’s impact on students’ self-esteem, anxiety, attitude towards learning, behaviour and relationships with peers. The setting for the research was a mainstream secondary school and its federated special school for students with emotional and behavioural difficulties. Over nineteen months, a mixed methods design was used to observe change in students before and after music therapy. One group received twenty, weekly, individual sessions, and the other formed a wait-list group for comparison and then received the same treatment. At four different times during the project quantitative data were collected from students, teaching staff and school records, and qualitative data from semi-structured interviews with the students before and after their period of intervention. The study found that music therapy made a positive difference. The high level of treatment adherence (95%) of all twenty-two students confirmed music therapy’s appeal to this client group. The majority of teachers (58%) reported improvement in students’ social development and attitude overall, and for some mainstream students (56%) recognition of self-concept increased. The conviction with which students conveyed their positive experiences of music therapy was striking. The study supports the author’s argument for therapeutic support to be made available at secondary schools and promotes a student-centred approach, as exemplified in the thesis. It concludes that music therapy can be effective for youth at risk but requires more participants in subsequent investigations for it to be proved statistically.

Injuries to the brain are the leading cause of permanent disability and death. Survivors of acquired brain injury (ABI) experience cognitive impairments and emotional problems. These often persist into community rehabilitation and are among the most significant needs for those in chronic stages of rehabilitation. There is a dearth of research providing evidence of music therapy addressing cognitive deficits and emotional needs in a holistic approach. This research answers the question how can brief group music therapy address cognitive functional gains and emotional needs of people with acquired brain injury. A mixed methods design was used to investigate the effect of 16 sessions of weekly group music therapy on attention and memory impairments, and emotional needs of ten ABI survivors in community rehabilitation. Quantitative data were collected to determine the effect of treatment on attention and memory functioning, mood state, and the satisfaction of emotional needs. Qualitative data were collected to reveal survivors’ experiences of brain injury and brief group music therapy. Analysis of the data showed that the intervention improved sustained attention (p<.05, r=.80) and immediate memory recall (p>.05, r=.46), and that the effect of treatment increased with dosage. Overall, the intervention was more effective than standard care, and cognitive functional gains continued after treatment for some ABI survivors. The intervention addressed emotional needs of feeling confident (p<.05, d=.88), feeling part of a group (p<.05, d=.74), feeling productive/useful (p<.05, d=.90), feeling supportive (p<.05, d=.75), feeling valued (p<.05, d=.74), and enjoyment (p<.05, d=.34). Improvements in these domains were observed in the immediate term and over the course of therapy. Music therapy enabled emotional adjustment through the development of selfawareness and insight. This study offers a music therapy method to deliver a holistic approach in rehabilitation. It demonstrates that music therapy can provide a cost effective, holistic treatment for ABI survivors.

Music therapy is widely portrayed either as a paramedical practice within which music is a technology applied as a form of treatment or as a form of psychotherapy within which the music plays a primarily symbolic role or acts as a lead in to verbal consideration of the patient’s presenting issues. Music therapy research currently focuses predominantly on demonstrating “evidence of effectiveness” in terms of symptomatic outcome, thus preserving a focus on the individual congruent with the medical model. In contrast, this thesis seeks to examine ethnographically the ways in which music therapy gets accomplished as a situated social practice within a community mental health resource centre in a UK urban area. Drawing both on the observations and experiences of the researcher (a music therapist already working within this setting) and on formal and informal interviews with the centre’s members and staff, it seeks to identify ways in which music therapy gets done and value ascribed to it. Observations are compared with the “norms” portrayed by dominant professional discourse, and reasons for discrepancies considered. Particular attention is paid to self-awareness, intimacy and conviviality as facets of what music therapy has to offer in such a setting, and to social capital theory and Goffman’s dramaturgical approach as broader conceptual frameworks for such affordances. Consideration is also given to the “fit” between the affordances of music itself, and the “craft” required of diverse actors in order that music therapy can be considered to offer an ecology which promotes health and well-being. Finally, the findings are re-addressed towards music therapy itself via the lens of what it means to be “clinical” in order that a sociological “craft” perspective maybe brought to bear within the discipline.