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Collaboration and assistance in music therapy practice: Roles, relationships, challenges

Collaboration and assistance in music therapy practice: Roles, relationships, challenges Strange, Odell-Miller, and Richards have begun to address a substantial gap in the music therapy literature: how do music therapists collaborate with non-music therapists within their sessions? What meaningful actors (professionals, paraprofessionals, caregivers, parents) play a role in the success of music therapy? What are the qualifications needed or desired in an assistant? How are the therapeutic dynamics modified when an assistant is present? Through clinical reports and research studies, a group of clinicians and researchers engaged in meaningful reflections of collaboration and assistance in music therapy practice. The eighteen chapters could be divided into five leading themes: chapters 1 and 13 explore how music therapy sessions can impact client and assistant relationships. Closely related, chapters 6 and 16 show how music therapy can modify staff perceptions of clients. Student music therapists’ perceptions and experiences when assistants participate in their sessions are the topic of chapters 2, 3, and 17. The assistant’s role is studied and framed within different conceptual frameworks and clinical experiences in chapters 5, 7, 8, 14, and 15. Included in this group are family members, whose role as assistants is explored in chapter 4. Finally, established models of co-therapy or assistance in music therapy are discussed in chapters 9, 10, 11, and 12. One can hardly do justice to eighteen chapters full of meaningful explorations in a few lines. Only a few highlights are shared here. In chapter 1, John Strange shares his doctoral research on children with disabilities within a school system. Strange asked learning support assistants (LSAs) and music therapists (MTs) to evaluate video clips of music therapy sessions. Positive outcomes, as perceived by LSAs and MTs, included: students’ rights to self-determination, students’ and LSA’s pleasure in the interaction, increased communication skills, influence of music on both students and LSAs, and music therapy as a valuable resource. In the second part of this research project, reported in chapter 13, Strange strives to explain why the music was effective. Three music therapists independently observed session video clips with the explicit request of explaining the therapeutic function of music. Interestingly, raters did not agree on their explanations of music’s effect, but each music therapist had a consistent perspective on all video clips. The latter might indicate that the theoretical perspective, rather than an innate quality of the music, supported their explanations. Despite the evident value of this chapter, and even though this is not a journal article, greater clarity on research procedures and transparency in the evaluators’ theoretical commitments would have helped the reader understand the extent and limitations of the conclusions. Regarding the power of music to alter staff perceptions, chapter 16 addresses the benefits of music therapy within a pediatric hospital. Procedural, psychological, and environmental support, normalization, parental support, as well as continuity of care, are some of the benefits mentioned. Even though most of these elements have been explored before, Tone Leinebø and Trygve Aasgaard include a singular perspective: they mention that for music therapy to be accepted and effective in this environment, flexibility in interpreting the music therapist’s role, including how she or he is called (entertainer, musical pal, music teacher), should be exercised. I believe many readers will consider this point thought provoking. Regarding the third broad theme, student perceptions and experiences with assistants, Hannah Munro (chapter 2) explores the effect of assistants on the music therapy process through the music therapist’s eyes. Recommendations for practice are extracted (and reported in chapter 18 and the appendix), with a useful and thorough conceptual framework. A stimulating conceptualization in this chapter is the idea of a spectrum of assistant roles. Such variety could allow music therapists from different theoretical backgrounds to find the most useful explanation of assistants within their practice. Catherine Warner, in chapter 3, delves deeper as she engages in a narrative inquiry of a student’s experience with assistants. Important considerations, such as cultural differences, disagreements with supervisors, supervisor’s sensitivity, staff contributions, and search of the therapist’s professional identity, are explored in relation to the effect of assistants within music therapy sessions. Regarding the fourth theme, Helen Odell-Miller (chapter 5) reviews the assistant role in mental health and older adult mental health services. Drawing comparisons with family work, she differentiates the position of the assistant from a co-therapist, and argues that the assistant could be considered a moderator, with a possible “parental role” toward the clients. Anthi Agrotou (chapter 8) shares a fascinating psychodynamic microanalysis of music interactions where staff perceptions regarding clients are drastically modified. Her research once again supports the notion that music therapy sessions can provide a venue of interaction for otherwise severely isolated clients (and staff). Sarah Hadley (chapter 14) shares a clinical report and research project of a well-formed training program for assistants based on the concept of transient and constant practitioners. Despite the need for greater rigor in this research project, the training model for parents and staff to amplify the benefits of music therapy is compelling and worthy of attention. One of the most valuable ideas from Kaenampornpan’s work (chapter 4) is the notion of family members as co-leaders, and not as recipients of therapy, where increased control is shared with and delegated to them. Such a perception is pervasive in other fields (such as in the autism field), but scarcely explored in music therapy research. Finally, we read about three different models that have acquired substantial research and clinical support: Nordoff-Robbins, described by Fachner in chapter 10; “Music and Attuned Movement Therapy,” presented by Strange, Fearn, and O’Connor in chapter 11; and the “Music and Movement” model, explained by Strange and Weekes, in chapter 12. The most inspiring aspect of these chapters is the narrative that transpires: an urgent clinical need that was first satisfied somewhat haphazardly through interprofessional collaboration, but was later developed through strong conceptual frameworks, training models for the assistants/co-therapists, and continued questioning of roles and expectations. Exposure to this type of narrative can inform educators, students, and clinicians as to the complex processes and long time frames that might be required to develop effective music-based interventions. If any limitations needed to be pointed out, they could be the somewhat unsatisfactory rigor of some of the research presented, some dated references, and the fact that not all theoretical approaches in music therapy are represented. However, educators, students, and researchers will find enough “food for thought” in Collaboration and Assistance in Music Therapy Practice to make it worth keeping on the shelf for future reference. © American Music Therapy Association 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Music Therapy Perspectives Oxford University Press

Collaboration and assistance in music therapy practice: Roles, relationships, challenges

Music Therapy Perspectives , Volume Advance Article – Jun 16, 2017

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Publisher
Oxford University Press
Copyright
© American Music Therapy Association 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com
ISSN
0734-6875
eISSN
2053-7387
DOI
10.1093/mtp/mix008
Publisher site
See Article on Publisher Site

Abstract

Strange, Odell-Miller, and Richards have begun to address a substantial gap in the music therapy literature: how do music therapists collaborate with non-music therapists within their sessions? What meaningful actors (professionals, paraprofessionals, caregivers, parents) play a role in the success of music therapy? What are the qualifications needed or desired in an assistant? How are the therapeutic dynamics modified when an assistant is present? Through clinical reports and research studies, a group of clinicians and researchers engaged in meaningful reflections of collaboration and assistance in music therapy practice. The eighteen chapters could be divided into five leading themes: chapters 1 and 13 explore how music therapy sessions can impact client and assistant relationships. Closely related, chapters 6 and 16 show how music therapy can modify staff perceptions of clients. Student music therapists’ perceptions and experiences when assistants participate in their sessions are the topic of chapters 2, 3, and 17. The assistant’s role is studied and framed within different conceptual frameworks and clinical experiences in chapters 5, 7, 8, 14, and 15. Included in this group are family members, whose role as assistants is explored in chapter 4. Finally, established models of co-therapy or assistance in music therapy are discussed in chapters 9, 10, 11, and 12. One can hardly do justice to eighteen chapters full of meaningful explorations in a few lines. Only a few highlights are shared here. In chapter 1, John Strange shares his doctoral research on children with disabilities within a school system. Strange asked learning support assistants (LSAs) and music therapists (MTs) to evaluate video clips of music therapy sessions. Positive outcomes, as perceived by LSAs and MTs, included: students’ rights to self-determination, students’ and LSA’s pleasure in the interaction, increased communication skills, influence of music on both students and LSAs, and music therapy as a valuable resource. In the second part of this research project, reported in chapter 13, Strange strives to explain why the music was effective. Three music therapists independently observed session video clips with the explicit request of explaining the therapeutic function of music. Interestingly, raters did not agree on their explanations of music’s effect, but each music therapist had a consistent perspective on all video clips. The latter might indicate that the theoretical perspective, rather than an innate quality of the music, supported their explanations. Despite the evident value of this chapter, and even though this is not a journal article, greater clarity on research procedures and transparency in the evaluators’ theoretical commitments would have helped the reader understand the extent and limitations of the conclusions. Regarding the power of music to alter staff perceptions, chapter 16 addresses the benefits of music therapy within a pediatric hospital. Procedural, psychological, and environmental support, normalization, parental support, as well as continuity of care, are some of the benefits mentioned. Even though most of these elements have been explored before, Tone Leinebø and Trygve Aasgaard include a singular perspective: they mention that for music therapy to be accepted and effective in this environment, flexibility in interpreting the music therapist’s role, including how she or he is called (entertainer, musical pal, music teacher), should be exercised. I believe many readers will consider this point thought provoking. Regarding the third broad theme, student perceptions and experiences with assistants, Hannah Munro (chapter 2) explores the effect of assistants on the music therapy process through the music therapist’s eyes. Recommendations for practice are extracted (and reported in chapter 18 and the appendix), with a useful and thorough conceptual framework. A stimulating conceptualization in this chapter is the idea of a spectrum of assistant roles. Such variety could allow music therapists from different theoretical backgrounds to find the most useful explanation of assistants within their practice. Catherine Warner, in chapter 3, delves deeper as she engages in a narrative inquiry of a student’s experience with assistants. Important considerations, such as cultural differences, disagreements with supervisors, supervisor’s sensitivity, staff contributions, and search of the therapist’s professional identity, are explored in relation to the effect of assistants within music therapy sessions. Regarding the fourth theme, Helen Odell-Miller (chapter 5) reviews the assistant role in mental health and older adult mental health services. Drawing comparisons with family work, she differentiates the position of the assistant from a co-therapist, and argues that the assistant could be considered a moderator, with a possible “parental role” toward the clients. Anthi Agrotou (chapter 8) shares a fascinating psychodynamic microanalysis of music interactions where staff perceptions regarding clients are drastically modified. Her research once again supports the notion that music therapy sessions can provide a venue of interaction for otherwise severely isolated clients (and staff). Sarah Hadley (chapter 14) shares a clinical report and research project of a well-formed training program for assistants based on the concept of transient and constant practitioners. Despite the need for greater rigor in this research project, the training model for parents and staff to amplify the benefits of music therapy is compelling and worthy of attention. One of the most valuable ideas from Kaenampornpan’s work (chapter 4) is the notion of family members as co-leaders, and not as recipients of therapy, where increased control is shared with and delegated to them. Such a perception is pervasive in other fields (such as in the autism field), but scarcely explored in music therapy research. Finally, we read about three different models that have acquired substantial research and clinical support: Nordoff-Robbins, described by Fachner in chapter 10; “Music and Attuned Movement Therapy,” presented by Strange, Fearn, and O’Connor in chapter 11; and the “Music and Movement” model, explained by Strange and Weekes, in chapter 12. The most inspiring aspect of these chapters is the narrative that transpires: an urgent clinical need that was first satisfied somewhat haphazardly through interprofessional collaboration, but was later developed through strong conceptual frameworks, training models for the assistants/co-therapists, and continued questioning of roles and expectations. Exposure to this type of narrative can inform educators, students, and clinicians as to the complex processes and long time frames that might be required to develop effective music-based interventions. If any limitations needed to be pointed out, they could be the somewhat unsatisfactory rigor of some of the research presented, some dated references, and the fact that not all theoretical approaches in music therapy are represented. However, educators, students, and researchers will find enough “food for thought” in Collaboration and Assistance in Music Therapy Practice to make it worth keeping on the shelf for future reference. © American Music Therapy Association 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Journal

Music Therapy PerspectivesOxford University Press

Published: Jun 16, 2017

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