Journal of Music Therapy最新文献

Change in music therapy is often modeled linearly. In linear analysis, change is represented as the difference between the scores recorded before and after treatment, where changes in the input are proportional to the output. However, changes in complex systems are often not linear and depend on time. We propose Dynamic Systems Theory (DST) as a means to overcome the shortcomings of linear analysis and enrich the study of change in music therapy. This article aims to introduce and critically discuss the applications of DST in music therapy, focusing on its theoretical and methodological aspects. DST offers a meta-framework to model nonlinear change in music therapy, considering time as continuous. The application of DST can further enhance the understanding of how music therapy works, the shape of the change, and how the relevant therapeutic processes within music therapy support therapeutic change. An introduction to DST theory is provided along with its history, implications, assessment methods, statistical analyses, mathematical modeling, and implementation examples in music therapy research.

The concept of self-care for music therapists is not a new topic in the literature, yet music therapy students' perspectives have largely been excluded from formal discussions and research studies. For this reason, this study aimed to examine music therapy students' conceptualizations of self-care and identify practices that students frequently engage in for self-care. As part of a national survey, music therapy students currently enrolled in an academic degree program for music therapy within the United States defined self-care and identified up to three of their most frequent self-care practices. We analyzed the student self-care definitions and self-care practices using inductive content analysis. Two primary categories emerged from the student definitions-the Act of Self-Care and the Desired Outcomes of Self-Care-with several more detailed subcategories. Additionally, we grouped participants' most common self-care practices into 10 categories and identified two emergent areas for exploration: self-care practices done with others/done alone and engaging in self-care practices that intentionally do not involve anything related to academics/coursework/clinical work. Together, these findings indicate that students' conceptualizations of self-care and their self-care practices have similarities and differences with music therapy professionals' perspectives and practices. We discuss these findings in depth and provide recommendations for future self-care discussions that emphasize the need to prioritize students' perspectives and to expand conceptualizations of self-care to include contextual and systemic impacts and factors that influence the individual self-care experience.

The number of people living with Alzheimer's disease and related dementias (ADRD) is growing proportional to our aging population. Although music-based interventions may offer meaningful support to these individuals, most music therapy research lacks well-matched comparison conditions and specific intervention focus, which limits evaluation of intervention effectiveness and possible mechanisms. Here, we report a randomized clinical crossover trial in which we examined the impact of a singing-based music therapy intervention on feelings, emotions, and social engagement in 32 care facility residents with ADRD (aged 65-97 years), relative to an analogous nonmusic condition (verbal discussion). Both conditions were informed by the Clinical Practice Model for Persons with Dementia and occurred in a small group format, three times per week for two weeks (six 25-minute sessions), with a two-week washout at crossover. We followed National Institutes of Health Behavior Change Consortium strategies to enhance methodological rigor. We predicted that music therapy would improve feelings, positive emotions, and social engagement, significantly more so than the comparison condition. We used a linear mixed model approach to analysis. In support of our hypotheses, the music therapy intervention yielded significant positive effects on feelings, emotions, and social engagement, particularly for those with moderate dementia. Our study contributes empirical support for the use of music therapy to improve psychosocial well-being in this population. Results also highlight the importance of considering patient characteristics in intervention design and offer practical implications for music selection and implementation within interventions for persons with ADRD.

Guided Imagery and Music (GIM) is a range of therapeutic practices in which clients listen to music selected by a trained practitioner with the aim of gaining cognitive insight through evoked imagery that may be beneficial in working through various inner experiences, pain, or trauma. It is crucial to this process that the chosen music is tailored to the client's therapeutic goals and receptiveness. Wärja and Bonde [(2014). Music as co-therapist: Towards a taxonomy of music in therapeutic Music and Imagery work. Music and Medicine, 6(2), 16-27.] developed a taxonomy consisting of nine categories of musical-psychological characteristics and constructs (e.g., tempo, instrumentation, and mood) aligning with various therapeutic contexts (e.g., supporting and exploring) for helping GIM practitioners select appropriate music; however, its reliability has never before been assessed. In this paper, we present a listening study carried out with 63 GIM therapists and trainees, in order to measure the inter-rater agreement in (1) classifying 10 randomly selected pieces from 30 into one or more categories of the Wärja and Bonde [(2014). Music as co-therapist: Towards a taxonomy of music in therapeutic Music and Imagery work. Music and Medicine, 6(2), 16-27.] taxonomy, and (2) identifying for each piece heard one or more adjectives from the Hevner mood wheel that best characterize it. Our results indicate participants who utilized all categories but with slight to fair overall agreement; however, largely moderate agreement was reported for less musically complex pieces as well as across all pieces when considering only the three primary categories. Our findings not only support the continued use of the taxonomy and mood for helping select GIM music but also suggest the possible need for clearer descriptions in its subcategories and further training of practitioners who employ it in practice.

The purpose of this secondary analysis was to explore physiological, psychological, and situational influencing factors that may affect the impact of a mindfulness-music therapy intervention on anxiety severity in young adults receiving cancer treatment. Young adults receiving cancer treatment for ≥ eight weeks were recruited from adult and pediatric oncology outpatient centers at Dana-Farber Cancer Institute. Participants were asked to attend up to four, in-person (offered virtually via Zoom video conference after the onset of the COVID-19 pandemic) 45-min mindfulness-based music therapy sessions over twelve weeks with a board-certified music therapist. Participants completed questionnaires about anxiety, stress, and other cancer treatment-related outcomes before and after participating in the intervention. Changes in anxiety (i.e., PROMIS Anxiety 4a) over time were compared among baseline physiological (e.g., age or sex), psychological (e.g., stress), and situational influencing (i.e., intervention delivery format) factors using Wilcoxon-rank sum tests. Thirty-one of the 37 enrolled participants completed the baseline and post-intervention measures and were eligible for inclusion in the secondary analysis. Results revealed that higher baseline physical functioning (median change = -6.65), anxiety (median change=-5.65), fatigue (median change = -5.6), sleep disturbance (median change = -5.6),
female sex (median change = -5.15), or virtual intervention delivery
(median change = -4.65) were potential physiological, psychological, or situational influencing factors associated with anxiety improvement following mindfulness-based music therapy. Additional investigation into physiological, psychological, or situational influencing factors associated with anxiety response will help to tailor the design of future mindfulness-music therapy interventions to decrease psychological distress and address the unique psychosocial concerns among young adults receiving cancer treatment. Trial Registration ClinicalTrials.gov Identifier: NCT03709225.