Selected contemporary approaches to music therapy in psychiatry

Abstract Working with music therapy within a psychotherapeutic understanding in psychiatry has a tradition of over fifty years. An overview of music therapy for adults in a psychiatric context and essential results of effect and process research are presented. Psychodynamic music therapy with its free musical improvisation creates a connection between patient and therapist through which a complex relationship can become audible. Effectiveness studies in the psychiatric context show satisfactory to good results. From the perspective of psychiatric patients on music therapy, the shared musical experience and the positive influence on mood are described as strengths. On the one hand, process research emphasises the potential of improvisation for musical attunement and synchronisation; on the other hand, the careful dosage of closeness and distance in shaping relationships must be observed. The recognition that relationships are characterised by attunement and also by inevitable mismatch has gained central importance in recent years. Difficulties, such as misattunement that arise within the therapeutic relationship are not seen as an obstacle, but on the contrary, as an opportunity for change. The concept of Alliance Rupture and Repair is related to music therapy, including a case study. Finally, future fields of research are described.