Introduction: Facilitating any ageing group, that may include couples in which one partner lives with dementia, presents a unique challenge. This article reflects on the complex dynamics between the individual and the dyad relationships observed in a long-term music therapy group. Method: This article draws on twenty years of clinical work with an ageing group, comprising over one thousand sessions. It is informed by ongoing clinical practice and reflective analysis of therapeutic encounters within a humanistic approach. Key moments in interactions between participants, couples, and the therapist were identified through clinical writing after music therapy sessions, integrating observations, therapist experience, and participant feedback. These reflections were revisited through extensive clinical notes, enabling identification of recurring relational patterns in couples and their development through practice-oriented writing. Results: The group maintained strong consistency with the same music therapist and setting, creating a stable environment that supported the person with dementia in preserving a sense of continuity and integration. However, a paradox emerged: while participation benefits the person with dementia, it could trigger feelings of affiliate stigma in the spouse, negatively affecting well-being. Therefore, the therapist's role is essential in managing these complex challenges. Discussion: These reflections underscore the importance of a humanistic, reflexive clinical stance in managing dyadic needs in a group setting. This paper emphasizes that music therapy interventions must balance collective support for the person living with dementia with specific clinical attention to alleviating potential affiliate stigma in the partner.
IntroductionThere is an urgent need for non-pharmacological approaches to address agitation (restlessness and/or aggression) among persons with dementia. Music-based interventions could be one solution. Agitation in dementia is often conceptualised as a manifestation of a distinct neurological dysfunction, which can be targeted by a specific medication or a uniform psychosocial intervention. However, this reductionist perspective fails to account for the heterogeneity and the multifactorial nature of agitation in dementia.MethodThe article is based on extensive reading bridging findings from the research on music-based interventions, psychogeriatrics and neuroscience. We use a combination of dialectical and epistemological argumentation to discuss the legitimacy of different types of music-based approaches to mitigate agitation.ResultsWe identify three different types of music-based approaches: 1) a radical reductionist approach, which aims to treat agitation through assumed universal effects of particular music; 2) a moderate reductionist approach, with the use of music therapy in a standardised way; and 3) a contextual approach, where the impact of music therapy on agitation is understood as a side-effect of psychosocial needs being met.DiscussionWe argue that a radical and a moderate reductionist approach is insufficient in capturing both the multifaceted nature of agitation and the complexity of the impact of music-based interventions. Those approaches might therefore hinder the methodological flexibility and context sensitivity of music therapy. Music therapists should therefore avoid seeking uniform interventions and instead maintain a contextual approach to agitation in dementia.
IntroductionYoung people across Europe face unprecedented mental health challenges amidst social inequalities, environmental crisis, and technological disruption. With formal services difficult to access, everyday digital music engagement may offer therapeutic value, yet these practices remain undertheorised. This paper develops a conceptual framework for understanding how young people construct "safe spaces" through digital everyday health musicking (DEHM), examining the intersection of assemblage theory, affect studies, and sonic territorialisation.MethodWe provide theoretical analysis to underpin clinical and research investigations examining how musical engagement operates within complex socio-technical assemblages through spatial and affective frameworks.ResultsSafety in DEHM emerges as fragile and contextually negotiated rather than fixed. Through sonic territorialisation, young people construct provisional territories by modulating affective flows through musical engagement. These processes operate through structured (algorithmic, playlist-based) and experimental (exploratory, creative) digital practices, whilst also bearing risks of affective enclosure and algorithmic constraint.DiscussionDEHM represents a legitimate complement to formal music therapy, offering distinct therapeutic affordances through autonomous engagement with digital technologies. Rather than replacing professional intervention, DEHM provides frameworks for understanding how sonic practices generate therapeutic possibilities outside clinical settings, positioning young people as active agents whilst maintaining critical awareness of platform constraints. Music therapists and mental health practitioners should recognise DEHM as a valuable therapeutic resource whilst supporting critical digital literacy. Recommendations address ethics of institutional appropriation emphasising how practitioners can enable exploratory practices that enhance rather than constrain young people's existing musical agency.
IntroductionThe 2023 Israel-Hamas War created a prolonged collective trauma, with large-scale displacement and ongoing danger for Israeli civilians. In this context, "collective trauma" refers to disrupted communal continuity and shared meaning. This study explored how music therapists worked with displaced civilians during wartime displacement.MethodFifteen Israeli music therapists (aged 36-59) providing individual and group music therapy to civilians affected by the war participated in semi-structured interviews and follow-up member-checking. Data were analyzed using inductive thematic analysis, through which the A-CARE model was developed.ResultsAnalysis identified five themes describing wartime music therapy. First, therapists treated the setting as portable and ethically adaptable, assembling spaces across homes, hotels, shelters, and evacuation centers. Second, they prioritized containment and stabilization through calming timbres, constrained harmony, breath-aligned singing, and embodied rhythms that helped ground clients in a safer, more tolerable present. Third, they restored agency through client choice, structured playfulness, micro-level control of intensity, and consent-sensitive pacing. Fourth, they fostered creative authorship through layered recording, arrangement, and revisitable musical artifacts. Fifth, they supported community functions through shared rituals, spiritually resonant repertoire, group singing as a holding environment, and musical activity in protected rooms during sirens.DiscussionThe five themes form the A-CARE (Adapt, Contain and stabilize, Activate agency, Relate, Express) model of adaptive wartime practice. The model links adaptation as the overarching platform with four connected components addressing regulation, agency, creativity, and communal restoration, and offers guidance to music therapists and allied professionals working with civilians during violence and displacement.
Introduction: A dyadic music therapy treatment protocol was developed to enhance family therapy outcomes in an intensive child and youth mental health day program. The approach is informed by Mentalization-Based Treatment (MBT) and Circle of Security principles, supporting caregivers and children to reflect on their own and each other's mental states. Method: Within the day program context, dyadic music therapy is used to augment family therapy. Caregivers and children engage in musical improvisation, followed by facilitated reflection to support mentalizing. The music therapist scaffolds interactions by creating a safe environment and supporting caregiver-child responsiveness to musical and verbal cues. This clinical practice article draws on therapist reflections, using two case examples to illustrate how improvisation can reveal relational patterns and support mentalizing capacity. Results: Reflections suggest that dyadic music therapy fostered playful, attuned interactions, enabling caregivers and children to reflect on internal experiences. Musical improvisation provided an accessible context for caregivers to strengthen their mentalizing skills, while children experienced being accurately mentalized. These processes appeared to enhance relational attunement and supported emotional expression and understanding within the dyad. Discussion: Dyadic music therapy may strengthen connections between children's internal experiences and caregiver responses, forging stronger and more attuned dyadic relationships, thus improving mental health outcomes.
Introduction: The COVID-19 pandemic thrust telehealth practices, education, and clinical training into the professional conversation. However, regulations for telehealth practice are lagging. We sought to assess how music therapy (MT) educators include telehealth training in their curriculum. Method: We globally distributed a cross-sectional online survey with 32 questions to MT educators covering four sections: (a) demographic information, (b) Telehealth Music Therapy (TMT) education and training at participants' institution, (c) educator training/perspectives/perceptions on TMT, (d) resources participants use to teach TMT. We used descriptive statistics and correlation analysis for quantitative data and thematic analysis for qualitative responses. Results: Sixty-one music therapy educators responded to the survey. Most respondents (n = 51, 85%) do not require students to practice TMT as part of their training nor offer opportunities for telehealth placements (n = 36, 60%), yet the majority believe TMT should be taught in all programs and therapists should offer accessible services for clients in isolated contexts. Several respondents reported that technology was the largest challenge in teaching TMT. Respondents also noted the complexities of building online relationships, along with balancing a busy curriculum. Finally, culture was highlighted, with differing perceptions and relevancy of TMT across the globe. Discussion: While the professional music therapy associations responded quickly with guidance for clinicians during the COVID-19 pandemic, we found that education and training vary between institutions and across countries, which points to the need for TMT to be formally included in music therapy training and education programs.
IntroductionThe prevalence of behavioural problems among children has increased sharply in recent years, highlighting the need for preventive and therapeutic interventions. Music therapy offers a valuable means for children with internalising or externalising difficulties to express and regulate their emotions through music. This study investigates the effectiveness and mechanisms of change of music therapy interventions for primary school children exhibiting such problems.MethodsThis study protocol describes a mixed-methods design employing a cluster-randomised experimental approach complemented by group discussions. It will be conducted across 20 primary schools in Germany. Students are randomly assigned to one of three conditions: a music therapy intervention, an alternative play activity, or a waitlist control group.ResultsBased on findings from a previous pilot study, a manualised music therapy intervention comprising 20 sessions was developed for this study. The study protocol adheres to established guidelines for the description and evaluation of music-based interventions. Outcomes will be assessed at both the individual (e.g. self-esteem and aggressive behaviour) and the classroom levels (e.g. class climate) to provide a comprehensive understanding of the intervention's effects. Quantitative data will be analysed using repeated-measures analyses, while qualitative data will undergo thematic analysis to explore participants' experiences and contextual factors. Integration of the quantitative and qualitative findings will offer deeper insights into the intervention's effectiveness and underlying mechanisms.DiscussionGiven the growing recognition of the importance of mental health in educational settings, it is crucial to understand the therapeutic benefits of musical interventions.
Background: Conducting research with people living with dementia presents unique methodological and ethical challenges, particularly when attempting to access subjective experiences and uphold participant voice. Traditional research tools often fail to accommodate the progressive cognitive changes of dementia, raising questions about inclusion, agency, and meaningful participation. Purpose: This reflective article examines the complexities of dementia research through the lens of music therapy, exploring how musical engagement may serve as both a therapeutic intervention and a mode of inquiry. Method: Drawing on three decades of clinical and research experience, this practice-based reflection presents vignettes that illustrate key challenges in dementia research: the limitations of verbal communication, consent as an evolving process, and the recognition of non-verbal expression as meaningful data. Results: Three insights are offered: (1) Music-based recognition tasks can substitute cognitively demanding direct questions, allowing participants to demonstrate familiarity through engagement; (2) Consent in dementia research requires ongoing attunement to verbal and non-verbal cues of assent or dissent; (3) Spontaneous comments within music therapy sessions may offer authentic insights into participants' subjective experiences without relying on formal interviews. Conclusions: Music therapy invites a reconsideration of how data are understood within qualitative dementia research. When musical interaction is recognized as a site of knowledge generation, intervention and inquiry become intertwined. This perspective highlights how experience, agency, and participation may be expressed and recognized within the therapeutic encounter itself. Future research may benefit from designing qualitative studies that attend to these interactional processes as integral to data generation.
Introduction Acquired communication impairments (ACIs) in children can significantly hinder the development and functioning of speech, language, and communication skills, impacting their ability to interact and engage with others. Collaborative music therapy and speech and language therapy (MT-SLT) has gained increasing recognition for its potential to support communicative rehabilitation. Method This study explores the therapeutic response of young children (ages 2-6 years) with ACIs to a joint MT-SLT programme through a multiple case study design. Four children receiving inpatient neurorehabilitation participated in twice-weekly collaborative sessions. Video data from these sessions was collected and analysed thematically. Results Three shared themes were developed from the data: (a) leveraging familiar song to build vocal expression, (b) fostering social reciprocity and turn-taking through active musical play, and (c) supporting choice-making through immediate contextualisation. Findings indicate that collaborative MT-SLT can enhance engagement, strengthen foundational communicative skills, and promote greater communicative intent within this population. The interactive musical context provided children with structured yet flexible opportunities to initiate, sustain, and develop communicative exchanges, supporting both pre-verbal and verbal communication. Discussion Collaborative interventions between music therapists and speech and language therapists demonstrate significant potential in fostering communicative development in children with ACIs. There remains a clear need for isolated evaluation of collaborative practices using objective outcome measures, a prospect that will remain unfeasible until appropriate observation tools are developed for this cohort. In the absence of such tools, this study advances the field by moving beyond intervention descriptions to closely examining therapeutic engagement and emerging communicative responses.
IntroductionTinnitus describes the acoustic perception of sounds or noises without an external sound source. Comorbid affective symptoms often occur and have a negative impact on the experience of tinnitus. Despite the high prevalence of chronic tinnitus, there is still no universal treatment. Given the proven effectiveness of music therapy in treating mental disorders, our goal was to use music therapy to reduce the burden of tinnitus.MethodsIn a single group pre-experimental design with pre (T0), post (T1) and follow-up (T2, after six months) measures, the effectiveness of outpatient group music therapy on the subjective burden of chronic tinnitus was investigated. A professional music therapist applied an internally developed multimodal concept of music therapy, relaxation techniques, and psychodynamic talk therapy over 10 weekly sessions of 90 minutes each. Tinnitus severity was recorded using the Mini-Tinnitus Questionnaire (Mini-TF), the impairment by tinnitus (TBF-12) and stress due to affective disorders (BSI).ResultsThe subjective burden of tinnitus (n = 78) was significantly reduced by at least one degree in 60% of recruited participants (f = 0.67), which was further enhanced six months later through self-application of the techniques (95% confidence intervals). The emotional-cognitive impairment was significantly reduced (f = 0.48). This effect was not achieved indirectly through a reduction in comorbid affective disorders.DiscussionOur results suggest that outpatient group music therapy may reduce the subjective burden of tinnitus regardless of accompanying emotional stress. This treatment complements existing concepts for chronic tinnitus in individual settings and represents a resource-efficient alternative.
IntroductionMusic therapy is increasingly recognized as a valuable psychosocial support in a Neonatal Intensive Care Unit (NICU), addressing the needs of premature infants and their parents. Preliminary studies indicate the potential for songwriting to enhance parental experience and strengthen the parent--infant relationship in NICUs. This paper explores a particular type of therapeutic songwriting to support parents of premature infants in a Norwegian NICU, in order to fill research gaps and contribute to clinical implementation of music therapy in NICU care.MethodThis hermeneutic phenomenological study used semi-structured interviews, Interpersonal Process Recall (IPR) methods for data collection, and thematic analysis methods for analysis. Thematic analysis of interview transcripts and written songs provided a nuanced perspective of parents' lived experiences. Reflexivity was integrated throughout, attending to the researcher's dual role and influence on the process.ResultsFour main themes emerged from the analysis. Therapeutic songwriting in music therapy was (1) something for the parents, (2) that brought them into a positive spiral, (3) made them think about the future with their infant, and (4) became a valuable memory.DiscussionParents experienced benefits from the songwriting process regarding their hospital experience and the parent--infant relationship. Despite these positive aspects, potential challenges include vulnerability, time capacity, and possible negative effects. The study illustrates that therapeutic songwriting in music therapy is a valuable psychosocial support service, and future research should further build upon exploring these potentials.
IntroductionThe client-therapist relationship in therapeutic work, including in music therapy, plays a crucial role in the success of mental health interventions. However, music therapy within the context of Flexible Assertive Community Treatment (FACT), a community-based mental health model, often transcends conventional boundaries of the therapeutic relationship, blending elements of professional care with a friendship-like connection. This raises ethical and practical questions about the nature and limits of therapeutic relationships. This study explores how music therapists navigate therapeutic relationships within FACT, exploring the question "Friends or not? How do music therapists in FACT reflect on boundaries in the music-therapeutic relationship?"MethodsSix music therapists from different FACT teams across Norway were individually interviewed. The study employed reflexive thematic analysis to explore themes related to the personal-professional relationship and boundaries in the music-therapeutic relationship.ResultsFindings indicate that music therapists value the closeness and personal connection developed through music therapy within FACT, which often resembles a friendship. However, they also recognise the necessity of maintaining professional boundaries. The three analytical themes "the personal-professional relationship," "the context of the relationship" and "acts of boundaries" explore how music therapists navigate dual relationships, handle situations where patients might misinterpret closeness as personal affection and enact professional boundaries through concrete practices.DiscussionThe participants highlighted the delicate balance required to maintain professionalism while engaging deeply with patients through music. The study underscores the importance of continuous self-reflection by therapists. Supervision and dialogue on ethical dilemmas within the FACT teams are warranted.
Introduction: The prevalence of mental health problems increases with age, potentially reducing quality of life (QoL) in older adults. This study explores whether group music therapy (GMT) influences QoL, anxiety, and depressive symptoms in community-dwelling older adults. Methods: We conducted a single-group pre-post with follow-up study. The GMT intervention lasted 12 weeks, with weekly 60-minute sessions. Outcomes were assessed using the brief Older People's Quality of Life questionnaire, the Geriatric Depression Scale, and the Geriatric Anxiety Inventory pre, post, and three months following the intervention. Results: Fifty-seven older adults (mean age 72.4 years, SD = 6.5) participated. Pre-intervention mean levels of anxiety and depression corresponded to the mild range, based on the cut-off scores of the assessment instruments. There was a significant improvement in both measures from pre- to post-GMT (p < .001): anxiety decreased by 1.8 points (Cohen's d = 0.33) and depression by 1.1 points (Cohen's d = 0.35). These improvements persisted in the follow-up assessment, with mean anxiety reduced by 3.7 points and depression by 1.3 points compared to pre-GMT (p < .001). No significant improvement in QoL was observed at post-GMT. However, QoL showed a significant increase between pre-GMT and follow-up assessment, with a mean score change of +2.4 points (p < .001). Discussion: GMT appears to reduce anxiety and depressive symptoms in older adults, with effects sustained over time. While immediate improvements in QoL were not observed, long-term gains suggest GMT may be a beneficial psychosocial intervention for promoting mental well-being in later life.
