About 20 years ago, I took a graduate course in marriage and family counseling, which sparked in me a desire to explore family music therapy. At the time, this was an area that was generally neglected in music therapy and yet there seemed to be much untapped potential. What I was most drawn to in the family therapy literature was the ecological focus. What felt meaningful was taking into account the sociocultural context in which we are embedded, as well as environmental factors. In my studies, I was introduced to systems theory and had discovered the importance of not just looking at the part, but also at the whole. Thus, to work with an individual outside their sociocultural and physical environment seemed to be missing a large part of the picture—I had come to understand humans as relational beings who develop in relational contexts, the primary context being the family. Given the context above, I was very excited to discover Music therapy with families: Therapeutic approaches and theoretical perspectives, co-edited by Stine Lindahl Jacobsen and Grace Thompson. In this book, 14 music therapists from a variety of backgrounds present their work with families in one of three ways: focusing primarily on the most vulnerable family member; focusing primarily on the parent/caregiver; or focusing on the family system as a whole. In each chapter, the authors describe the clinical population of those with whom they work, the theoretical underpinnings of their work, supporting research, and a description of their therapeutic approach, including goals and methods and techniques. Each author then shares a case vignette followed by a discussion. This structure unifies the book as a whole and is very helpful for the reader. In the foreword, Brynjulf Stige contextualizes the importance of working with families, emphasizing the relational nature of human beings and questioning the notion of the individual. He notes this in the context of the high value that music therapy has placed on individualization and individualism. He posits that our “individuality” comes from each person’s unique combination of webs of relationships. He also draws on performativity theory, discussing ways in which we perform not only our unique identities, but our family culture. Thus, he sees great merit in working with families as it fits his understanding of music therapy as a social practice “that is co-performed, situated, and related to other practices” (p. 11). In the preface, Stine Lindahl Jacobsen and Grace Thompson outline the importance of theory to ground our clinical practice, and provide a very brief introduction to the field of family therapy. They provide a rationale for not only how family therapy can inform music therapy, but also how music therapy with families can inform family therapy. A number of the chapters focused on the needs of the most vulnerable within the context of the parent-child dyad or within the context of the wider family unit. In chapter 1, Friederike Haslbeck describes her work with premature infants and their parents, particularly her work with a grieving mother to enhance attachment with her two surviving triplets, while mourning the loss of the other one. In this work, Haslbeck utilized improvisation, singing, and writing original lyrics to an existing melody of a song that held meaning for the mother. In chapter 3, Amelia Oldfield describes her work with vulnerable children with psychiatric disorders and their families. Offering a structured program to both the child and the parents, she works with the assumption that by working in a solution-focused and supportive way with the parents, they will be able to more effectively meet the needs of their child. In chapters 4 and 5, Grace Thompson and Tali Gottfried respectively discuss their work with families that include a child on the Autism Spectrum. Thompson’s work focuses on not only the development of the child’s social communication, but on helping the parents better understand how social communication develops and supporting families in developing a greater sense of connectedness. Gottfried provides separate but parallel treatment for the child and the parents, noting a correlation between the child’s social skills and parenting stress. In addition to individual sessions with the child twice a week, Gottfried provides music-oriented parent counseling twice a month using a resource-oriented approach. In chapter 6, Vicky Abad and Margaret Barrett describe their work with groups of parent-infant dyads, promoting musical parenting that supports cognitive, psycho-motor, communicative, and social development. Similarly, in chapter 7, Kate Teggelove describes her work in an early intervention program, Sing and Grow, with families at risk, focusing on parent-child interactions and using music to enhance attachment as well as the child’s social and communication skills. In chapter 8, Kirsi Tuomi works within a structured 27-session family-centered Theraplay approach that focuses on parent-child interactions. Her work also emphasizes attachment and affect attunement as she works with vulnerable children and their foster families or adoptive families. Chapters 12 and 13 focus on the other end of the lifespan, with Hanne Mette Ridder discussing work with families of people with dementia, focusing on the relationship between the caregiver and care recipient. In this work, communicative musicality helps restore relationships, reduce stress, and improve mood. Similarly, Signe Marie Lindstrom describes important work facilitating family communication with families who have a dying family member. Several chapters focus primarily on the family unit. In chapter 2, Annette Baron explores the context of the hospitalized child and how hospitalization impacts the whole family in terms of stress, changes in routines, and changes in roles and responsibilities. Drawing on systemic and solution-focused family therapy theory, her focus is on family relationships through communicative musicality. In chapters 9 and 10, Stine Lindahl Jacobsen and Varvara Pasiali respectively describe their work with families who are deemed at risk and who receive social services. Both emphasize restructuring family transactions and changing the family structure so that it functions more effectively; family resilience; competencies/resources within the family; focusing on attainable solutions; and, developing more effective communication and patterns of interaction (Marte Meo in Jacobsen’s chapter). And, in chapter 11, Sören Oscarsson describes his work with the families of refugee children with Pervasive Refusal Syndrome (a state of prolonged terror coupled with an apathetic lack of reaction, sometimes to the point of not moving or eating). His work draws on systemic family therapy, and he views the family as vital for the recovery of the child. As with other authors, he emphasizes resources and focuses on family resilience. To conclude, Jacobsen and Thompson provide what they see as emerging characteristics of music therapy with families. Not surprisingly, intersubjectivity was a common thread throughout the chapters, with many utilizing the theory of communicative musicality. Furthermore, many of the authors integrated a resource-oriented approach, drawing on the families’ values, beliefs, and resources in order to support and empower them. Attachment and bonding were prevalent themes in many of the chapters, as was the importance of affect attunement. The editors also explore what they see as still in need of greater examination when considering music therapy with families, including more in-depth descriptions about how to work toward specific goals, how to guide and challenge the family, and how to navigate our role within the family system without disturbing its delicate balance. These critical reflections provide a sense of where we need to continue to focus in music therapy. While the book was organized in terms of clinical population, beginning with families in neonatal care and ending with families of people at the end of life, it might have been helpful for the chapters to be organized according to the three primary foci: on the most vulnerable family member; on the parent/caregiver; or on the family system as a whole. In this way, clinicians could quickly reference work that most fits with their theoretical leanings, especially for those interested in working with the family system as a whole, an area less focused on in the music therapy literature to date. More context regarding family therapy at the beginning would have been helpful, such as providing a conceptual context for family therapy and descriptions of various models and techniques of family therapy, particularly as they relate to the work of the music therapists within the book (e.g., structural family therapy, systemic family therapy, solution-focused family therapy, psychoanalytic family therapy particularly in terms of attachment theory, experiential family therapy, behavioral family therapy, and narrative family therapy). Given the paucity of literature on music therapy with families in general, and on family music therapy more specifically, this book is a very welcome addition to the literature, and will hopefully stimulate educators to include more systemic approaches to music therapy in training programs. © American Music Therapy Association 2017. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org
Music Therapy Perspectives – Oxford University Press
Published: Aug 3, 2017
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