Mercédès Pavlicevic

The 'ripple effect': Towards researching improvisational music therapy in dementia care-homes

Increased interest in, and demand for, music therapy provision for persons with dementia prompted this study’s exploration of music therapists’ strategies for creating musical communities in dementia care settings, considering the needs and resources of people affected by dementia. Focus group discussions and detailed iterative study of improvisational music therapy work by six experienced practitioners clarify the contextual immediacy and socio-musical complexities of music therapy in dementia care homes. Music therapy’s ‘ripple effect’, with resonances from micro (person-to-person musicking), to meso (musicking beyond ‘session time’) and macro level (within the care home and beyond), implies that all who are part of the dementia care ecology need opportunities for flourishing, shared participation, and for expanded self-identities; beyond ‘staff’, ‘residents’, or ‘being in distress’. On such basis, managers and funders might consider an extended brief for music therapists’ roles, to include generating and maintaining musical wellbeing throughout residential care settings.

What Does the Past Tell Us? A Content Analysis of the First Quarter-Century of the British Journal of Music Therapy

Professional journals have a legitimating and sanctioning role in the development of disciplinary knowledge, as well as professional practices and identities. The British Journal of Music Therapy (BJMT) – the only UK-based peer-reviewed music therapy journal – has portrayed research, theory and accounts of practices, reflecting trends and developments in the field of music therapy since 1987. Marking the 25th anniversary of the BJMT and looking into its future development, a content analysis of the journal since its inception (1987–2011) was conducted with the aims of (i) tracing trends and developments of music therapy praxes and professional identities, and (ii) exploring the journals engagement with disciplinary discourses and practices alongside and beyond those of music therapy. The study provides an overview of the BJMT in terms of 1) paper types, 2) authorship: numbers and professional titles, 3) countries of project sites and countries of authors, 4) sample conditions, sizes and ages, 5) formats of practices, and 6) models and themes. The results show that the majority of the articles published in the BJMT are theoretical, focus on one-to-one sessions, are single authored by music therapists and are UK-focused in terms of authorship, project site and models. This study brings to the fore questions for the future development of music therapy as profession and discipline.

Responding to the Challenge: Between Boundaries and Borders: A Response to Alison Barrington's Article Challenging the Profession

1. Are recent developments in music therapy (such as the Community Music Therapy movement) compromising a primary attention to peoples needs? 2. Are such developments also threatening the professional survival of music therapy? 3. Is the perceived critique of the hard-won achievements of music therapy professionalisation an unfair one? 4. What is the real challenge to professional music therapy now?

What an I Doing Here? Exploring a Role for Music Therapy with Children Undergoing Bone Marrow Transplantation at Great Ormond Street Hospital, London

This paper draws upon a dissertation for a Master of Music Therapy undertaken at the Nordoff-Robbins Music Therapy Centre, London. Music therapy is not currently an established part of bone marrow transplantation (BMT) care for paediatric patients in Britain and consequently little research has emerged in this area of clinical work in the UK. This study explores the psychosocial needs of children and their families during BMT, and demonstrates how music-centred co-improvisatory music therapy can address these needs. It is written from the point of view of the therapist. Drawing from interviews with patients, families and staff who have experience of music therapy within the area of BMT, and clinical vignettes from the first authors music therapy practice1, this paper highlights four areas of psychosocial needs that music therapy can address: a sense of agency, pleasure, cultural identity and normality. Each of these is discussed in relation to both the child and the family. The study suggests that the use of a music-centred, co-improvisatory approach to music therapy appears to be especially flexible in meeting and supporting the variety of psychosocial needs experienced by both children undergoing a bone marrow transplantation and their families.

Between practice, policy and politics: Music therapy and the Dementia Strategy, 2009.

Does current music therapy practice address the goals encapsulated in the UK Department of Health document, Living well with dementia: a national dementia strategy (the Dementia Strategy) published in 2009? A survey elicited the views of clients, family members, music therapists, care home staff and care home managers, about this question by focusing on the relationship between music therapy and the 17 objectives outlined in the Dementia Strategy. The results showed that the objectives that are related to direct activity of the music therapists (such as care and understanding of the condition) were seen as most fulfilled by music therapy, while those regarding practicalities (such as living within the community) were seen as least fulfilled. Although the responses from the four groups of participants were similar, differences for some questions suggest that peoples direct experience of music therapy influences their views. This study suggests that many aspects of the Dementia Strategy are already seen as being achieved. The findings suggest that developments of both music therapy practices and government strategies on dementia care may benefit from being mutually informed.

Music and HIV/AIDS orphans: Narratives from Community Music Therapy

Abstract This position paper situates music – and Community Music Therapy in particular – within the socio-political narratives of the HIV/AIDS pandemic in South Africa. Two narratives are selected from current thinking in two public spaces, one political and the other academic. The first is embodied in a 2004 Unicef document that explicitly sanctions the linking of music and HIV/AIDS. The document states that youth groups need to be organised to ‘use drama and music to encourage HIV prevention, and compassion for people living with AIDS, their families and orphans’. The second is the notion put forward by music sociologists and cultural musicologists: that music affords social identity and social cohesiveness, as well as social collaboration. This paper is an attempt at knitting together these discursive fields through the applied discipline of Community Music Therapy, and is in two parts. The first outlines the socio-cultural construction of HIV/AIDS with particular reference to the psycho-social needs of HIV/AIDS orphans; the second suggests that community music therapy may be useful in repairing the ‘spoiled identity’ that results from the double status of being orphaned, and especially being orphaned as a result of HIV/AIDS.

Taking music seriously: Sound thoughts in the newer South Africa

The Easter Sunday service in downtown Johannesburg is dragging: energy levels are low, the priest drones on,the congregation yawns away and the readings are interminable. Finally, the choir begins the Responsorial Psalm, slowly building energy, tantalising the congregation until, irresistibly, it is drawn into singing. Growing insistently, the music gathers together Italians, Portuguese, the French, Greeks, Nigerians, Congolese, the small, the young, the bored and the very old.The service shifts into a new gear and remains energised until the concluding hymn.

Repositioning music therapy service evaluation: a case of five Nordoff-Robbins music therapy service evaluations in neuro-rehabilitation

ABSTRACT Service evaluations in music therapy often have local, functional and immediate goals, such as ensuring quality and continuing funding. However, given the amount and type of information collected in service evaluation projects from therapists, clients and those around them, such – often unpublished – projects may constitute a hidden treasure trove of information particularly about the perceived impact of music therapy services. In addition to exploring potentially challenging aspects of service evaluations in music therapy, this article considers how these can contribute to the understanding of music therapy through analysis of five service evaluations. These service evaluations share a common approach (Nordoff-Robbins) and area of work (neuro-rehabilitation) and were informed by sociocultural epistemologies underpinning contemporary Nordoff-Robbins practices. Such epistemologies consider people’s everyday experiences and contexts, and encourage an exploration of the music therapy service in its entirety. It is from this perspective that this study explores the impact of music therapy services in neuro-rehabilitation settings as perceived and reported by clients and those around them. Although the perceived impact of music therapy beyond the client has been previously discussed, this seems to have been less emphasised in neuro-rehabilitation settings where the focus tends to remain on the client and their rehabilitation progress. We discuss how the context-sensitive nature of such evaluations can enable the potential for identification of areas of impact that can feed back into practice as well as generate research questions.