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Music and dementia: Observing effects and searching for underlying theories

Is music helpful for people with dementia, and if so, why? Opinions are divided: on the one hand, the Cochrane Review of music therapy for people with dementia concluded that there was ‘no substantial evidence to support nor discourage the use of music therapy in the care of older people with dementia’ (Vink, Birks, Bruinsma, & Scholten, 2006); on the other hand, small–scale studies have suggested that music is useful in improving the state of individuals with dementia (Brotons, Koger, & Pickett—Cooper, 1997; Sherratt, Thornton, & Hatton, 2004a; Witzke, Rhone, Backhaus, & Shaver, 2008). This question is particularly important as dementia care constitutes an ‘unsolved’ problem. Though pharmaceutical treatments have been developed, there are many aspects of the condition that remain untreatable using these methods from which there are also often unwanted side effects. There is much debate regarding the extent to which music is therapeutically useful in dementia. On the practical side, there are many music therapists worldwide working with individuals with dementia, and outreach programs that include music are increasing in popularity. As in other areas of music therapy, however, there is insufficient rigorous evidence about the effect of music in the form of systematic testing or randomised controlled trials. Moreover, there is only partial understanding of the processes underlying the interventions and results of music therapy. Three dominant groups of symptoms of dementia, which have been suggested to be positively influenced by music, form the focus of the current discussion: memory (particularly autobiographical memory) and language retention; mood and depression; and aggression and agitation. However, a lack of an evidence base for the use of music in dementia care, and an understanding of the underlying processes related to behavioural observations, remain. This Editorial illustrates the evidence to date and, in an attempt to explore the possible reasons for the reported success of music in this context and better understand these underlying processes, brings together evidence and theories from the fields of music and dementia, music psychology and the study of diverse health conditions. In order to contextualise the existing evidence, and possible underlying processes and approaches to investigating those processes, a brief discussion of the types of dementia that have been focussed on in music research and definitions of music in therapeutic and other contexts is presented. Dementias: Definitions and needs

The Form of Performance: Analyzing Pattern Distribution in Select Recordings of Chopin's Mazurka Op. 24 No. 2

Performances of the same piece can differ from one another in innumerable ways and for many different reasons. The aim of the current study is to analyze the timing and dynamic patterns of a large sample of performances in order to explore the musical reasons for both the occurrence of such patterns and the differences in their location and characteristics. The investigation focuses on twenty-nine performances of Chopins Mazurka Op. 24 No. 2, which features clear four-bar phrases and correspondingly consistent sectional units, but which also has characteristics such as a steady crotchet accompaniment that remain constant throughout. This results in a potential tension between “through-performed” and sectionalized features. In this study we examine the performances accordingly, investigating the relationship between the works structural and thematic characteristics on the one hand and the timing and dynamic characteristics of performances on the other. Following this, we narrow our investigation of these and other features by undertaking a comparative analysis of three recordings by the same performer, Artur Rubinstein. A toolkit of methods is employed, including an approach that has been little used for this purpose: Self-Organizing Maps. This method enables the systematic analysis and comparison of different performances by identifying recurrent expressive patterns and their location within the respective performances. The results show that, in general, the structure of the performed music emerges from and is defined by the performance patterns. Particular patterns occur in a range of contexts, and this may reflect the structural and/or thematic status of the locations in question. Whereas the performance patterns at section ends seem to be most closely related to the large-scale structural context, however, those within some sections apparently arise from typical features of the mazurka genre. Performances by the same performer over a 27-year span are characterized by striking similarities as well as differences on a global level in terms of the patterns themselves as well as the use thereof.

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.

Look, listen and learn: Exploring effects of passive entrainment on social judgements of observed others

Music is widely acknowledged to have social efficacy at the group level. This effect is hypothesised to be underpinned at least in part by entrainment. During collective musical behaviours, entrainment – the shared synchronisation of internal oscillators – is suggested to afford the perception of actions, intentions and motivational states as joint action, shared intentionality and mutual motivational states, which in turn fosters interpersonal affiliation and prosocial behaviours, including trust. However, it is unknown whether entrainment’s effects on prosociality persist when we are passive observers. In this study, 44 participants (21 women; average age = 28; average years of musical training = 10) watched audio-visual tokens in which a) the footsteps of an actor were entrained (synchronised) with a drumbeat, b) the footsteps were disentrained (unsynchronised) with the drumbeat and c) the soundtrack was grey noise (control condition). Participants were subsequently required to decide if the actor was engaged in a trustworthy or untrustworthy activity. Results show that participants were more likely to judge the actor as trustworthy in the entrain condition than the disentrain condition, but that the entrain condition was not significantly different to the control condition. Furthermore, this pattern of results was only found for a subgroup of the stimuli. There were no effects of age, gender or musical training. Given the nature of the task, which encourages passive entrainment rather than active movement, these findings indicate that the prosocial outcomes of musical engagement may be more common and have a broader significance than previously suggested.

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.

Analysing change in music therapy interactions of children with communication difficulties

Music therapy has been found to improve communicative behaviours and joint attention in children with autism, but it is unclear what in the music therapy sessions drives those changes. We developed an annotation protocol and tools to accumulate large datasets of music therapy, for analysis of interaction dynamics. Analysis of video recordings of improvisational music therapy sessions focused on simple, unambiguous individual and shared behaviours: movement and facing behaviours, rhythmic activity and musical structures and the relationships between them. To test the feasibility of the protocol, early and late sessions of five client–therapist pairs were annotated and analysed to track changes in behaviours. To assess the reliability and validity of the protocol, inter-rater reliability of the annotation tiers was calculated, and the therapists provided feedback about the relevance of the analyses and results. This small-scale study suggests that there are both similarities and differences in the profiles of client–therapist sessions. For example, all therapists faced the clients most of the time, while the clients did not face back so often. Conversely, only two pairs had an increase in regular pulse from early to late sessions. More broadly, similarity across pairs at a general level is complemented by variation in the details. This perhaps goes some way to reconciling client- and context-specificity on one hand and generalizability on the other. Behavioural characteristics seem to influence each other. For instance, shared rhythmic pulse alternated with mutual facing and the occurrence of shared pulse was found to relate to the musical structure. These observations point towards a framework for looking at change in music therapy that focuses on networks of variables or broader categories. The results suggest that even when starting with simple behaviours, we can trace aspects of interaction and change in music therapy, which are seen as relevant by therapists.

Combining Grammar-Based and Memory-Based Models of Perception of Time Signature and Phase

The present study investigates the modeling of the perception of time signature and phase using grammar-based and memorybased approaches. It explores how far note-length can be used as the sole input to a model of perception of heard music. Two models are developed: one uses a rule-based grammar and the other uses a combination of a rule-based grammar and a memory-based approach. The relative success of the two models is compared and evaluated. This study explores one dialect, solo string music by Bach: The unaccompanied Suites for Violoncello, BWV 1007-1012 and unaccompanied Partitas and Sonatas for Violin BWV 1001-1006. It is shown that the results of two approaches improve over previous models such as those of Longuet-Higgins and Steedman (1971) and Temperley and Sleator (1999) and that the combination of the two approaches is most successful.

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.

Perspectives on Music and Communication: An introduction

This special issue of Psychology of Music features work presented at the inaugural Nordoff Robbins Plus Research Conference ‘Music and Communication: Music Therapy and Music Psychology,’ which was held at the Nordoff Robbins London Centre in September 2013. The conference was co-organized by the Research Department at Nordoff Robbins and the Centre for Music and Science, Faculty of Music, University of Cambridge. The event brought together an international group of over 100 researchers, practitioners and practitioner-researchers to share ideas, definitions and methodologies, as well as technical and practical knowledge in areas related to music and communication. The conference demonstrated how rare it is – and how exciting it can be – to have a focused dialogue between those who think about music and communication from different disciplinary perspectives and across different contexts of music-making. The dialogue at the conference included keynote presentations by prominent music therapist Felicity North and leading music researcher Ian Cross, with direct responses to each presentation invited from both the music therapy research and music psychology traditions. Other presentations at the conference were in the form of posters in which the authors discussed their research with conference attendees, and the day included group discussions convened to include members of both fields. This special issue reflects the breadth of this dialogue. Each contribution was reviewed by members of both fields, with an aim of producing articles that would be both accessible and informative to multiple audiences; this was particularly important since both of us, as editors, are not trained as music therapists or music therapy researchers. Although the articles brought together here do not include the full range of what was presented at the conference, they give a sense of the wide range of topics, populations and methods the conference addressed. The topics range from the nature of intentionality and entrainment in music and speech, to how music therapy affects emotion regulation and self-esteem in children with language impairment, to the structure and organization of musical and linguistic interaction in music lessons and communicative groupings within a therapy trio. The populations studied range