Stine Lindahl Jacobsen

Music Therapy for the Assessment of Parental Competencies for Children in Need of Care

The assessment for parenting competencies for parents of children potentially in need of care involves an evaluation of their relationship with their child, and the interaction that underpins that relationship. The “Assessment of Parenting Competences” (APC) music therapy assessment provides a structured series of interactional exercises that allow the therapist to explore the nature of the relationship both as a tool in every day clinical work and as a research method. The method of the assessment involves free improvisation, tum–taking exercises, and following leading exercises and is evaluated using the autonomy profile of the Improvisation Assessment Profiles. Results demonstrate the strengths, weaknesses, and potential in the parent, and quantifiable observed musical events in the gradients of autonomy provide evidence of positive and/or negative interactional behaviour. The therapist has a unique role both as a participant in a parent–child interaction, and as an observer.

Clinical application of music therapy assessment within the field of child protection

The focus of this article is the theoretical understanding behind, and the clinical application of, a newly developed music-therapy assessment tool, Assessment of Parenting Competencies (APC). While the psychometric properties have been analyzed successfully in prior publications, the advantages and challenges of a nonverbal and emotional interactional medium such as music in assessing parent–child interaction and parental capacity are presented and discussed. The assessment model relates to theories of attunement, autonomy, and attachment, and clinical relevance for practice within the field of child protection is addressed according to clinical application of the tool. How can the scores of APC be interpreted and how are they clinically relevant? With the combination of a playful and rigorous approach, APC can provide useful information to families, family therapists, and other social-service professions within the field of child protection, including level of mutual attunement, nonverbal communication skills, emotional parental response, and possibly indications of attachment behavior in the child. APC can thereby help indicate the severity of the situation and the possible therapeutic direction for the family in question.

Effects of a Dyadic Music Therapy Intervention on Parent-Child Interaction, Parent Stress, and Parent-Child Relationship in Families with Emotionally Neglected Children: A Randomized Controlled Trial

BACKGROUND Work with families and families at risk within the field of music therapy have been developing for the last decade. To diminish risk for unhealthy child development, families with emotionally neglected children need help to improve their emotional communication and develop healthy parent-child interactions. While some researchers have investigated the effect of music therapy on either the parent or the child, no study has investigated the effect of music therapy on the observed interaction between the parent and child within the field of child protection. OBJECTIVE The purpose of this study was to investigate the effect of a dyadic music therapy intervention on observed parent-child interaction (mutual attunement, nonverbal communication, emotional parental response), self-reported parenting stress, and self-reported parent-child relationship in families at risk and families with emotionally neglected children, ages 5-12 years. METHOD This was a randomized controlled trial study conducted at a family care center in Denmark. Eighteen parent-child dyads were randomly assigned to receive 10 weekly music therapy sessions with a credentialed music therapist (n = 9) or treatment as usual (n = 9). Observational measures for parent-child interaction, self-reported measures for parenting stress and parent-child relationship were completed at baseline and 4 months post-baseline assessment. RESULTS Results of the study showed that dyads who received music therapy intervention significantly improved their nonverbal communication and mutual attunement. Similarly, parents who participated in dyadic music therapy reported themselves to be significantly less stressed by the mood of the child and to significantly improve their parent-child relationship in terms of being better at talking to and understanding their children than parents who did not receive music therapy. Both groups significantly improved in terms of increased positive and decreased negative emotional parental response, parenting stress and stress in general. There were no significant between group differences in self-perceived autonomy, attachment, and parental competence. CONCLUSIONS The dyadic music therapy intervention examined in this study improved emotional communication between parent and child and interaction after 6 to 10 sessions and can be considered as a viable treatment alternative or supplement for families at risk and families with emotionally neglected children.

Music therapy assessment: bridging gaps

Background: Members of this round table have recently formed the International Music Therapy Assessment Consortium. The purpose of this collaboration is to strengthen the field of music therapy by ensuring development and standardization of research-based assessment tools, increase awareness of use of assessment within and outside of the field, and strengthen clinical application of assessment.Objective: Looking across disciplines, standards of music therapy assessment needs to improve to ensure the quality of the entire profession. Does this require a change of culture inside the music therapy community? To enable a joint discussion and broaden the perspective of music therapy as a field the panel will focus on the meta-perspectives of music therapy assessment including rationale for assessment, research design and psychometrics, social services and business, assessment training and clinical application.

Music as integral part of ‘Culture on prescription’

Recent development within the field of arts and health in Denmark is presented, with the use of music in a specific “arts on prescription” model carried out in Aalborg Municipality. A brief overview of established arts and health strategies in the rest of Scandinavia and the UK is followed by an introduction to a Danish project called “Culture Vitamins.” The use of music and music intervention is presented in detail. “Music intervention” draws on two different fields from clinical practice, including “music medicine” and “music therapy.” Music medicine is mainly a stimulus-response-focused model, whereas music therapy is a psychodynamic-humanistic model focused on interpersonal communication. Finally, political issues, applicability, and future research options are discussed.

Zones of proximal emotional development - Psychotherapy within a neuroaffective perspective

ABSTRACT This article outlines a conceptual framework for assessing personal and emotional functions of a person’s zone of proximal emotional development. The framework is based on the integrative theory Neuroaffective Developmental Psychology (NADP), which brings together attachment theory, neuropsychology, developmental psychology, and trauma theory. Within the NADP framework, this article describes a way of understanding children’s normal emotional mental organization and of examining how this mental organization may be developed or disturbed by relational issues. It also describes how a child’s mental organization can be disturbed and thus, without intervention, disturb the child’s personality development on a lifelong basis. The article presents three case vignettes, describing three children growing into adolescence with three different attachment patterns and suggested individually tailored intervention plans for each of them, relevant and useful for clinicians working with vulnerable children and families. Because the nervous system retains its plasticity throughout life, attachment is not necessarily an unchangeable pattern. That is why we as clinicians should develop psychotherapeutic methods and a research-based way of determining “what works for whom” by assessing the zone of individual proximal emotional development. The text outlines the characteristics of NADP and how it can be used to structure an intervention plan.

Pilot randomized controlled trial of Tuning Relationships with Music: Intervention for parents with a trauma history and their adolescent

For parents who have experienced childhood interpersonal trauma, the challenges of parenting an adolescent may trigger memories of abuse, intensifying conflict, resulting in negative cycles of relating and poorer responsiveness to emotions when parenting. This study examined whether Tuning Relationships with Music, a dyadic therapy for parents and adolescents, increased responsive parent-adolescent interactions and parent emotion coaching whilst reducing conflict and adolescent mental health difficulties. Twenty-six parent-adolescent dyads were recruited if parents had a trauma history and the dyad were currently having high levels of conflict. Dyads were randomly allocated into intervention or wait-list control and completed questionnaires and observation assessments at baseline and 4-month post-baseline follow-up. Those allocated to the intervention condition participated in 8 sessions of Tuning Relationships with Music. TRIAL REGISTRATION ANZCTR: 12615000814572. Parents and adolescents reported significant reductions in conflict. Parents in the intervention condition were observed to significantly improve their nonverbal communication, emotional responsiveness and non-reactivity toward their adolescent. Although parents reported they were less dismissive and punitive, and more encouraging of their adolescents emotions, and both parents and adolescents reported improvements in the adolescents mental health, these were not statistically significant. Findings suggest Tuning Relationships with Music may assist parents with a history of childhood interpersonal trauma and their adolescent to reduce conflict and increase responsive ways of relating that may positively impact the young persons mental health. Future trials with a larger sample are warranted.

Music therapy with children and their families

During the last years several new texts on music/the arts and trauma have eventually been published. Two of these have already been reviewed in NJMT: Music, music therapy and trauma – international perspectives by Julie Sutton (2002), and Expressive and creative arts methods for trauma survivors, edited by Lois Carey (2006). In 2008 the German book Musiktherapie und Trauma was published with Hanns-Günter Wolf as editor/author. The web site Voices (http://www.voices.no) contains many articles related to trauma and music therapy. ‘‘Big disasters are, luckily, something going on far away from home’’, many of us are calculating. What then, when one morning thousands of people are being killed in the centre of your home town? As several of the authors express in Caring for the caregiver: The shock when, all of a sudden, terror happens here! No one is safe! What’s next? In fact, very soon after the 9/11 turmoil, New York-based music therapists where using their skills and initiative in new ways, as this book amply testifies, through the American Music Therapy Association NYC Music Therapy Relief Project and the Caring for the Caregiver Program. 33 professional music therapists in the New York metropolitan area provided more than 7000 music therapy interventions over six months to children, adults, caregivers and families affected by the attacks on the Twin Towers. This book was published in 2002 and a second printing, with a new preface, appeared in 2007. The editors, Joanne V. Loewy and Andrea Frisch Hara, quite realistically, state in their preface: ‘‘In many parts of the world, a life of trauma is, in fact, the norm. Unfortunately, this was as true before September 11 as it remains today.’’ The subtitle of the book is, The use of music and music therapy in grief and trauma. Different from the aforementioned books on trauma, presenting rather international perspectives and examples, this book focuses various elements in the relief work during the first year after the ‘‘war’’ came to the US. Nordic Journal of Music Therapy Vol. 18, No. 2, September 2009, 186–190