Pioneering research

To link music therapy intervention to specific outcomes, a series of connecting projects evaluated the effects of music therapy with children with learning difficulties/special needs. Three studies were undertaken: questionnaires evaluated both the benefits to 80 children referred to music therapy as well as the attitudes of the staff involved. Changes in behaviour with music therapy were compared with an equal period without music therapy using time-based analysis of video recordings of sessions; individual play with a familiar adult was analysed. Music therapy was found to effect significant changes in the amount of playing, vocalising and looking (at the instrument, adult and away). In the third study the results from the earlier time-based measures were replicated, particularly the development of vocalisations, and the socially important behaviour of turn-taking. Leslie later set up a national charity, MusicSpace, which at its peak employed over 50 music therapists, many working with children. He established the first part-time course in music therapy now at the University of the West of England where he is Professor in Music Therapy. His services to music therapy were recognised in the 2009 Queen’s Birthday Honours with an MBE.

I analysed a year of weekly group music therapy sessions for five residents in their community home using a method called participatory action research where the voices and perspectives of the members of the group are a central feature of this study. The benefits of the music therapy included changing fixed relationship patterns and the expression of group identity: home staff and the music therapist were involved in a process of co-operative inquiry. The research indicates how people with severe learning difficulties may influence the course of the inquiry themselves, also challenging staff and institutional perceptions. The dissemination of the research has implications with the use of music therapy in this context and adds to the on-going debate on patterns in community care within health and social care practice.

This project, funded by the Music Therapy Charity has been undertaken by music therapists, Philippa Derrington (Cambridge) and Louise Neale (Hampshire). As part of her doctoral research, Philippa Derrington proposed a method which could be replicated. The lead investigation took place over a period of 19 months at The Cottenham Academy in Cambridgeshire in a first-ever study to show the quantitative benefits of music therapy for teenagers at a secondary school. Her study investigated whether music therapy can improve the emotional well-being of adolescents at risk of exclusion or underachievement. Specifically, it addressed music therapy’s impact on students’ self-esteem, anxiety, behaviour, relationships with peers and attitudes towards learning.

How music therapy is talked about has clear implications for how practice, training and research are developed. The research was a qualitative study of how music therapists talked about music therapy at three levels of discourse: spontaneously when describing their clinical work, and also how they discussed it in professional groups and wrote about it in texts. The conclusion was that music therapy was constructed around ‘music therapist’s dilemma’, that talking about music therapy is problematic because talking about musical process is. Ten years later the study and its implications can be seen as part of a ‘deconstruction’ that has allowed a more mature view of how music therapy as practice, discipline and profession evolves in concert with current theory, political strategy and cultural shifts. This now relates to the Community Music Therapy movement which relocates music therapy to a broader understanding of how music helps. Gary is currently Director of Education at the Nordoff-Robbins Centre.

To our knowledge, the CHORD manual is the first singing manual developed following the rigorous MRC “development – piloting – evaluation – implementation” model. The strength of the manual is that the contents were developed from collective experts knowledge (seven music therapists, a volunteer manager and a community musician) and we used consensus methods at each stage to ensure trustworthiness and relevance. Although the limitation of implementing a manual without face-to-face training needs to be acknowledged, the use of manual allows the intervention to be replicable, which may be useful in future studies. Music therapy interventions by qualified therapists are still necessary to meet complex needs of clients. However, there is an increasing need for music therapy skill-sharing in dementia care (McDermott et al., 2018), and the CHORD manual can contribute towards growing music therapy skill-sharing resources.

This project investigated music therapy in work with HIV/AIDS, and used musicological analysis of clinical improvisation as the method. Three individual clients were chosen and invited to be part of a research project where they could choose method and analysis as a part of the therapeutic process. Two improvisations from each client were analysed by four outside participants: a musician, psychotherapist, music therapist and the client. The findings considered the possible links between musicology and music therapy as well as considering the effectiveness of music therapy and HIV/AIDS. Colin Lee developed ‘Aesthetic Music Therapy’ (AeMT) from this research, and developed the Master’s of Music Therapy (MMT) programme at Wilfrid Laurier University, Canada, where he directs the programme. This project was the beginnings of the author’s lifetime work and could not have happened without the support of the Music Therapy Charity.

Amelia’s PhD completed in 2003, was funded by the Music Therapy Millenium PhD Award, undertaken at Anglia Ruskin University, in partnership with the NHS. Her PhD thesis focuses on two specific clinical areas: music therapy with pre-school children with autistic spectrum disorder and their parents, and music therapy diagnostic assessments with children between the ages of four and twelve who are suspected of being on the autistic spectrum. A 45 minute video which illustrates the approach with pre-school children with autism and their parents accompanies this thesis. Two outcome research investigations were carried out. The first involved studying ten pre-school children with autistic spectrum disorder and their parents who received weekly, individual music therapy sessions over a period of 18 to 26 weeks each. The sessions were video-taped and the videos analysed in detail. The parents were interviewed and asked to fill in questionnaires both pre- and post-treatment. Nine out of the ten dyads achieved some or all of the individual aims set out before treatment began. The parents all felt that music therapy had been effective. The author also looked at how she spent her time in music therapy sessions across the ten children and found that she was generally very active and spent a high proportion of her time vocalising. The second investigation compared Music Therapy Diagnostic Assessments (MTDA) with Autistic Diagnostic Observation Schedules (ADOS) carried out on 30 children suspected of being on the autistic spectrum. The two assessments showed 72 % of agreement between diagnostic categories, indicating that the MTDA was providing similar information as a recognised and established diagnostic tool. The two assessments also showed significant differences in scores of individual questions, indicating that the MTDA could serve a useful and distinct purpose in helping the psychiatric team to diagnose children with autism. The children generally enjoyed the assessments and the music therapist felt that the test was easy to carry out and score, indicating that the MTDA was ‘user-friendly’.