Felicity Baker

Therapeutic songwriting in music therapy Part I: : Who are the therapists, who are the clients, and why is songwriting used?

Songwriting as a therapeutic intervention has received increasing attention in the field of music therapy over the past decade however much of the publications focus on clinical outcomes rather than methods of practice. This paper, part of a two-part research report into trends in the clinical practice of songwriting, aims to describe the most frequently employed goal areas across a range of clinical populations and compare these findings with the published literature. Responses to a 21-question online survey were obtained from 477 professional music therapists practicing in 29 countries which focused on approaches to songwriting within their practice with a single clinical population. Chi–square or comparable Exact tests (Fisher-Freeman-Halton) were applied to the data and significant associations were found according to different clinical populations particularly with respect to the aims of songwriting in clinical practice and the frequency with which songwriting is employed in practice. The data highlights that songwriting is frequently employed in developmental disability and ASD practice, with reports on songwriting with these diagnostic groups being underrepresented in the music therapy literature. The survey identified that the most frequently endorsed goal areas align with the literature base and included a) experiencing mastery, develop self-confidence, enhance self esteem; b) choice and decision making; c) develop a sense of self; d) externalising thoughts, fantasies, and emotions; e) telling the clients story; and f) gaining insight or clarifying thoughts and feelings.

An investigation of long-term effects of group music therapy on agitation levels of people with Alzheimer's Disease

This study aimed to investigate the long-term effects of group music therapy on agitation manifested by nursing home residents with Alzheimers disease. A non-randomised experimental design was employed with one group receiving weekly music therapy (n = 26) and another group receiving standard nursing home care (n = 19). Agitation levels were measured five times over one year using the Cohen-Mansfield Agitation Inventory (Cohen-Mansfield, J. (1989). Agitation in the elderly. In N. Billig & P. V. Rabins (Eds.), Issues in geriatric psychiatry (pp. 101–113). Basel, Switzerland: Karger). Although music therapy participants showed short-term reductions in agitation, there were no significant differences between the groups in the range, frequency, and severity of agitated behaviours manifested over time. Multiple measures of treatment efficacy are necessary to better understand the long-term effects music therapy programs have on this population.

‘To be heard’: The social and mental health benefits of choir singing for disadvantaged adults

Compared with other members of the general population, adults living with a chronic mental illness or disability tend to participate less frequently in occupational and social interactions. This may exacerbate problems such as emotional flattening and social isolation. Supported activities like choir singing present an opportunity for meaningful activity and social connectedness for these individuals. The aim of this study was to explore the personal experiences of choir members (89% of whom experienced chronic mental health problems, 28% physical disabilities and 11% intellectual disability) in relation to their wellbeing using interpretative phenomenological analysis (IPA). Semi-structured interviews were carried out with 21 members of the choir at three time points in the choir’s inaugural year: at the inception of the choir, after six months, and after 12 months. Three content themes emerged: (1) personal impact (positive emotions, emotional regulation, spiritual experience, self-perception, finding a voice); (2) social impact (connectedness within the choir, connection with audience, social functioning); and (3) functional outcomes (health benefits, employment capacity, and routine). A fourth theme of time was also apparent in the data. Results of this study were consistent with the social identity theory notion that forming a new and valued group identity (as a choir member) was associated with emotional and health benefits for the participants.

Can music preference indicate mental health status in young people

Objective: In the aftermath of the double suicide of two teenage girls in 2007, the media linked the themes of ‘emo’ music and the girls’ mental state. But it is not just emo music that has been the subject of scrutiny by the media. Rap music, country, and heavy metal have also been blamed for antisocial behaviours including violence, theft, promiscuity and drug use. It remains an important research and clinical question as to whether music contributes to the acting out of behaviours described in the music lyrics or whether the preferred music represents the already existing behavioural tendencies in the subject. This paper surveys and discusses the relevant literature on music preference and adolescent music listening behaviours, and their links with adolescent mental health. Conclusion: Studies have found a relationship between various genres of music and antisocial behaviours, vulnerability to suicide, and drug use. However, studies reject that music is a causal factor and suggest that music preference is more indicative of emotional vulnerability. A limited number of studies have found correlations between music preference and mental health status. More research is needed to determine whether music preferences of those with diagnosed mental health issues differ substantially from the general adolescent population.

Therapeutic songwriting in music therapy, Part II: Comparing the literature with practice across diverse clinical populations

A growing body of literature on therapeutic songwriting with diverse clinical populations indicates that clinicians employ a wide range of approaches. The purpose of this research was to establish trends in the clinical practice of songwriting as implemented across a range of clinical populations. Responses to a 21-question online survey were obtained from 419 professional music therapists practicing in 29 countries which focused on approaches to songwriting within their practice with a single clinical population. Results suggest that, in general, the literature provides good representation for what is occurring in clinical practice. Generally, songs were composed with individual clients in single sessions, with lyrics created prior to the music. Clinicians had a significant role in creating the music with improvised and pre-determined musical structures being equally employed. Chi-square or comparable Exact tests (Fisher–Freeman–Halton) were applied to the data and significant associations were found according to clinical populations, particularly with respect the number of sessions required to complete a song, approaches to composing lyrics and music, the context with which songwriting was employed, and the types of allied health professionals involved in the songwriting interventions. There is a distinct absence of songwriting literature as applied in developmental disability, autism spectrum disorder, and aged care contexts so the resulting practice trends offered here contribute to the increasing body of knowledge about songwriting practices.

The effect of music therapy services on classroom behaviours of newly arrived refugee students in Australia—a pilot study

This pilot study examined the effects of a short‐term music therapy program on the classroom behaviours of newly arrived refugee students who were attending an intensive ‘English as a Second Language’ secondary school. A cross‐over design with two five‐week intervention periods was employed with group music therapy sessions conducted one or two times per week. Data from the Behaviour Assessment Scale for Children were used to evaluate a range of positive and negative school behaviours. A significant decrease in externalising behaviours was found with particular reference to hyperactivity and aggression. No significant differences were found in other behaviours. Explanations and implications of these findings are discussed.

Effect of Singing on Respiratory Function, Voice, and Mood After Quadriplegia: A Randomized Controlled Trial

OBJECTIVE To explore the effects of singing training on respiratory function, voice, mood, and quality of life for people with quadriplegia. DESIGN Randomized controlled trial. SETTING Large, university-affiliated public hospital, Victoria, Australia. PARTICIPANTS Participants (N=24) with chronic quadriplegia (C4-8, American Spinal Injury Association grades A and B). INTERVENTIONS The experimental group (n=13) received group singing training 3 times weekly for 12 weeks. The control group (n=11) received group music appreciation and relaxation for 12 weeks. Assessments were conducted pre, mid-, immediately post-, and 6-months postintervention. MAIN OUTCOME MEASURES Standard respiratory function testing, surface electromyographic activity from accessory respiratory muscles, sound pressure levels during vocal tasks, assessments of voice quality (Perceptual Voice Profile, Multidimensional Voice Profile), and Voice Handicap Index, Profile of Mood States, and Assessment of Quality of Life instruments. RESULTS The singing group increased projected speech intensity (P=.028) and maximum phonation length (P=.007) significantly more than the control group. Trends for improvements in respiratory function, muscle strength, and recruitment were also evident for the singing group. These effects were limited by small sample sizes with large intersubject variability. Both groups demonstrated an improvement in mood (P=.002), which was maintained in the music appreciation and relaxation group after 6 months (P=.017). CONCLUSIONS Group music therapy can have a positive effect on not only physical outcomes, but also can improve mood, energy, social participation, and quality of life for an at-risk population, such as those with quadriplegia. Specific singing therapy can augment these general improvements by improving vocal intensity.

“You've got to accentuate the positive”: Group songwriting to promote a life of enjoyment, engagement and meaning in aging Australians

This study investigated whether group songwriting and performing affects peoples perceptions of quality of life and feelings of connectedness in a community of retirees. An inductive thematic analysis of data transcripts from focus groups and written questionnaires from participants and students involved in the project were undertaken, and categories generated interpreted within the framework of positive psychology. Participants reported that the programme stimulated their enjoyment, positively affected emotions and improved wellbeing. They experienced enhanced connection with each other and with others in the broader community. They experienced a sense of accomplishment, meaning, and engagement in creating and performing their own songs.

The Singer or the Singing: Who Sings Individually to Persons With Dementia and What Are the Effects?

‘‘Live’’ singing to persons with dementia (PWDs) may be an underused but highly accessible resource for their caregivers, regardless of qualifications. A systematic literature review sought to illuminate who sings to PWDs, and with what objectives and effects, to address the question of whether it is the singer or the singing which is effective. The literature revealed that music therapists seek to address cognitive, behavioral, physiological, and social factors through one-to-one singing, whereas other caregivers are more broadly concerned with quality of life, often through facilitating activities of daily living. All included studies concurred that individual singing to PWDs can be effective in a variety of ways, depending on contexts and goals. PWD’s perceptions of situations may influence the effectiveness of singing interventions. Music therapists are urged to empower professional caregivers to sing sensitively to PWDs during caregiving activities.

The effects of a song-singing programme on the affective speaking intonation of people with traumatic brain injury

Primary objective: To examine changes in the relationship between intonation, voice range and mood following music therapy programmes in people with traumatic brain injury. Research design: Data from four case studies were pooled and effect size, ANOVA and correlation calculations were performed to evaluate the effectiveness of treatment. Methods and procedures: Subjects sang three self-selected songs for 15 sessions. Speaking fundamental frequency, fundamental frequency variability, slope, voice range and mood were analysed pre- and post-session. Results: Immediate treatment effects were not found. Long-term improvements in affective intonation were found in three subjects, especially in fundamental frequency. Voice range improved over time and was positively correlated with the three intonation components. Mood scale data showed that immediate effects were in the negative direction whereas there weres increases in positive mood state in the longer-term. Conclusions: Findings suggest that, in the long-term, song singing can improve vocal range and mood and enhance the affective intonation styles of people with TBI.