Simon Gilbertson

Checklist for the qualitative evaluation of clinical studies with particular focus on external validity and model validity

BackgroundIt is often stated that external validity is not sufficiently considered in the assessment of clinical studies. Although tools for its evaluation have been established, there is a lack of awareness of their significance and application. In this article, a comprehensive checklist is presented addressing these relevant criteria.MethodsThe checklist was developed by listing the most commonly used assessment criteria for clinical studies. Additionally, specific lists for individual applications were included. The categories of biases of internal validity (selection, performance, attrition and detection bias) correspond to structural, treatment-related and observational differences between the test and control groups. Analogously, we have extended these categories to address external validity and model validity, regarding similarity between the study population/conditions and the general population/conditions related to structure, treatment and observation.ResultsA checklist is presented, in which the evaluation criteria concerning external validity and model validity are systemised and transformed into a questionnaire format.ConclusionThe checklist presented in this article can be applied to both planning and evaluating of clinical studies. We encourage the prospective user to modify the checklists according to the respective application and research question. The higher expenditure needed for the evaluation of clinical studies in systematic reviews is justified, particularly in the light of the influential nature of their conclusions on therapeutic decisions and the creation of clinical guidelines.

Improvisation and meaning

This article presents and discusses a long-term repeated-immersion research process that explores meaning allocated to an episode of 50 seconds of music improvisation in early neurosurgical rehabilitation by a teenage boy with severe traumatic brain injury and his music therapist. The process began with the original therapy session in August 1994 and extends to the current time of writing in 2013. A diverse selection of qualitative research methods were used during a repeated immersion and engagement with the selected episodes. The multiple methods used in this enquiry include therapeutic narrative analysis and musicological and video analysis during my doctoral research between 2002 and 2004, arts-based research in 2008 using expressive writing, and arts-based research in 2012 based on the creation of a body cast of my right hand as I used it to play the first note of my music improvising in the original therapy episode, which is accompanied by reflective journaling. The casting of my hand was done to explore and reconsider the role of my own body as an embodied and integral, but originally hidden, part of the therapy process. Put together, these investigations explore the potential meanings of the episode of music improvisation in therapy in an innovative and imaginative way. However, this article does not aim at this stage to present a model or theory for neurorehabilitation but offers an example of how a combination of diverse qualitative methods over an extended period of time can be instrumental in gaining innovative and rich insights into initially hidden perspectives on health, well-being, and human relating.This article presents and discusses a long-term repeated-immersion research process that explores meaning allocated to an episode of 50 seconds of music improvisation in early neurosurgical rehabilitation by a teenage boy with severe traumatic brain injury and his music therapist. The process began with the original therapy session in August 1994 and extends to the current time of writing in 2013. A diverse selection of qualitative research methods were used during a repeated immersion and engagement with the selected episodes. The multiple methods used in this enquiry include therapeutic narrative analysis and musicological and video analysis during my doctoral research between 2002 and 2004, arts-based research in 2008 using expressive writing, and arts-based research in 2012 based on the creation of a body cast of my right hand as I used it to play the first note of my music improvising in the original therapy episode, which is accompanied by reflective journaling. The casting of my hand was done to explore and reconsider the role of my own body as an embodied and integral, but originally hidden, part of the therapy process. Put together, these investigations explore the potential meanings of the episode of music improvisation in therapy in an innovative and imaginative way. However, this article does not aim at this stage to present a model or theory for neurorehabilitation but offers an example of how a combination of diverse qualitative methods over an extended period of time can be instrumental in gaining innovative and rich insights into initially hidden perspectives on health, well-being, and human relating.

A Reference Standard Bibliography: Music Therapy With Children Who Have Experienced Traumatic Brain Injury

Worldwide, childhood traumatic brain injury is a signif- icant public health issue. There is a strong need for the development and provision of relevant and effective therapeutic interventions for these children. In Ireland, as in most countries, family members are commonly the primary caregivers of children with traumatic brain injury. Directly affected by the consequences of trau- matic brain injury, they have expressed both the huge extent of burden they experience and the demand for a significant increase in effective services to provide for the needs of their children. Advances in medical care have often been accompanied with an expression of dis- satisfaction with the provision of adequate rehabilitative services (Hogan & Smyth, 2003). Music therapists have been developing therapeutic interventions during the past three decades to meet the challenges experienced by children who have traumatic brain injury. An earlier study (Gilbertson & Aldridge, 2003a) has shown that the standard of indexing of music therapy literature is severely unreliable and inaccurate. To alleviate this situ- ation, this article provides an identification strategy for music therapy literature through the example of music therapy and childhood traumatic brain injury. By doing so, the article also provides a reference standard biblio- graphy of published cases of music therapy with children who have experienced traumatic brain injury. The potential implications of the creation of reference stan- dard bibliographies in other areas of the application of music therapy are discussed.

Merging Pathways: Music Therapy in Neurosurgical Rehabilitation

Relatively few departments of Music Therapy are found within neurosurgical rehabilitation clinics. In institutions where these departments exist, music therapy has become an integral part of multi-professional treatment and research activities (Gilbertson 1999). The diverse intervention strategies in Music Therapy focus upon auditory, motor, visual, cognitive and affective processing which are all involved in receptive and expressive musical behaviour and which affect related non-musical behaviour. A clear differentiation is made between primary and adjunct therapy roles. The related fields of neuromusicology, neuroanatomy, neuropsychology, music psychology and humanistic psychology are primary sources in the development of models of clinical application (Hodges 1996). Our main interests are focussed on the following issues and areas of clinical application: The initialisation of contact with patients in vegetative status Communicative interaction with patients who can not (initially) use verbal communication (aphasic disorders) Temporal motor organisation with patients with sensomotor disorders Cognitive organisation and mnemonic framework with patients with neuropsychological functional disorders (concentration, memory, perception) Treatment of spatial perception disorders (neglect) Enhancing personal and social integration following individual isolation, social withdrawal. These topics will be discussed and highlighted with clinical examples.

In Visible Hands: The Matter and Making of Music Therapy

This study explores the topics of matter and making in music therapy through embodied reflexive retrospection with six music therapists. The participants were asked to re-enact a hand position from their memory of a significant moment in therapy. In individual research meetings, they shared their thoughts about this moment while the researcher made a body cast of their chosen hand pose. A thematic analysis of the participant narratives, the hand casts, and existing literature was used to generate the following themes: The biographic hand, The body, space, place, and time, The plural hand, Matter of the hand, and The method in hand. The research procedure facilitated an exploration of epistemological, ontological, and phenomenological perspectives in understanding music therapy practitioner experiences. The study highlights the inseparability and multiplicity of matter, making, and narrating music therapy that transcends context or therapeutic approach.

Music therapy in principle and practice

Engeström’s activity theory can be used to augment perceptions of creativity in the music classroom. Legitimation code theory is used by Alexandra Lamont and Karl Maton to address and peer deeper into the issues that contribute to the disconnect between pupils’ in-school and out-of-school musical experiences. In the informative concluding chapter, Ruth Wright considers the application of Bernstein’s democratic rights to music education through inclusion, enhancement and participation and challenges practitioners to ‘model democracy’ through our encounters with our students. This is followed by an afterword by Christopher Small. Considering music education through the lens of sociology situates teaching and teaching approaches closer to an authentically based pedagogy by providing awareness and greater connections to our students’ lives. While the editor submits this book is not an exhaustive account of the work being done in the sociology of music education it attends to a myriad of issues and, given the vastness of the sociological field, begs for further volumes.