Melbourne Conservatorium of Music - Research Publications
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ItemThemes in Songs Written by Patients with Traumatic Brain Injury: Differences Across the Lifespan(Australian Music Therapy Association, 2005)This study aimed to identify age differences in the themes of songs written by patients with traumatic brain injury (TBI). Lyrics from 82 songs written by 11 female and 20 male patients aged between 5 and 60 years were categorised into eight themes and 24 categories. Incidence of categories and themes were calculated and compared across six age brackets. Results suggest that children, early adolescent, and middle adolescent patients with TBI focus on memories to a substantially greater degree than older patients. Early and late adolescent patient groups are most likely to be self-reflective, and to raise concerns about the future, when compared with other patient groups.
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ItemMusic Therapy Methods with Children, Adolescents, and Adults with Severe Neurobehavioral Disorders Due to Brain Injury(Oxford University Press, 2011-05-01)The purpose of this paper is to illustrate the application of music therapy intervention in neurobehavioral treatment programs with pediatric, adolescent and adult populations through the presentation of six case reports, with special reference to post-traumatic amnesia. Severe behavioral disorders stemming from brain injury are challenging for both the affected individual and their support network. Managing neurobehavioral disorders requires specialist skills and knowledge of various strategies to minimize behavioral incidents and decrease episodes of agitation. Music therapy interventions are effective in increasing orientation and decreasing agitation in people with post-traumatic amnesia following brain injury (Baker, 2001). However, there is little published guidance or research on music therapy interventions for use in interdisciplinary rehabilitation programs for patients with short-term or chronic neurobehavioral disorders following traumatic brain injury. Music therapy is well-placed as a part of interdisciplinary rehabilitation with this population, offering opportunities to enable emotional expression and improve pragmatic communication skills and social interaction. This case material provided illustrates how music therapists integrate family members into treatment programs, and work with others to enable multidisciplinary and interdisciplinary outcomes.
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ItemThe Effect of Singing Training on Voice Quality for People With Quadriplegia(Elsevier, 2014-01-01)Objectives: Despite anecdotal reports of voice impairment in quadriplegia, the exact nature of these impairments is not well described in the literature. This article details objective and subjective voice assessments for people with quadriplegia at baseline and after a respiratory-targeted singing intervention. Study Design Randomized controlled trial. Methods: Twenty-four participants with quadriplegia were randomly assigned to a 12-week program of either a singing intervention or active music therapy control. Recordings of singing and speech were made at baseline, 6 weeks, 12 weeks, and 6 months postintervention. These deidentified recordings were used to measure sound pressure levels and assess voice quality using the Multidimensional Voice Profile and the Perceptual Voice Profile. Results: Baseline voice quality data indicated deviation from normality in the areas of breathiness, strain, and roughness. A greater percentage of intervention participants moved toward more normal voice quality in terms of jitter, shimmer, and noise-to-harmonic ratio; however, the improvements failed to achieve statistical significance. Conclusions: Subjective and objective assessments of voice quality indicate that quadriplegia may have a detrimental effect on voice quality; in particular, causing a perception of roughness and breathiness in the voice. The results of this study suggest that singing training may have a role in ameliorating these voice impairments.
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ItemNo Preview AvailableThematic analysis of the experience of group music therapy for people with chronic quadriplegia.(American Spinal Injury Association, 2014)BACKGROUND: People living with quadriplegia are at risk for social isolation and depression. Research with other marginalized groups has indicated that music therapy can have a positive effect on mood and social interaction. OBJECTIVE: To gather descriptions of participants' experience of 2 types of group music therapy - therapeutic singing or music appreciation and relaxation - and to determine commonalities and differences between participants' experience of these 2 methods. METHODS: We interviewed 20 people with quadriplegia about their experience of participating in 12 weeks of therapeutic singing (n = 10) or music appreciation and relaxation (n = 10). These methods of group music therapy were the interventions tested in a previously reported randomized controlled trial. The interview data were subjected to an inductive thematic analysis. RESULTS: Six main themes were generated from the interview data. Four of these were shared themes and indicated that both types of group music therapy had a positive effect on mood/mental state and physical state, encouraged social engagement, and reconnected participants with their music identity or relationship with music. In addition, the participants who participated in the singing groups found singing to be challenging and confronting, but experienced a general increase in motivation. CONCLUSIONS: Group music therapy was experienced as an enjoyable and accessible activity that reconnected participants with their own music. Participants frequently described positive shifts in mood and energy levels, and social interaction was stimulated both within and beyond the music therapy groups.
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ItemA theoretical framework and therapeutic songwriting protocol to promote integration of self-concept in people with acquired neurological injuries(The Grieg Academy Music Therapy Research Centre, 2016)A positive self-concept after neurological injury is associated with enhanced quality of life and good mental health. Therefore, effective reconstruction of identity is heralded as an important goal of rehabilitation. We have developed and tested a songwriting protocol for people with acquired brain injury and/or spinal cord injury (SCI) that focuses on six domains of self-concept (physical, personal, social, family, academic/work, and moral). Over 12 music therapy sessions, people create three songs that reflect their perception of their past, present, and future selves. The therapeutic process of creating these songs aims to integrate residual components of the past self with that of the present injured self. This article outlines the theoretical foundations for the use of songwriting as a medium for change and describes the protocol in detail. We then present a case study of a man with SCI to illustrate the application of the protocol and the ensuing changes in self-concept.
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ItemNo Preview AvailableMusic-assisted relaxation during transition to non-invasive ventilation in people with motor neuron disease: A qualitative case series(SAGE PUBLICATIONS LTD, 2016-11)For individuals with motor neuron disease, the transition to using non-invasive ventilation has a number of associated stressors, which can negatively impact adherence to ventilation and its benefits to quality of life. Music listening interventions have been linked with a reduction in anxiety and physiological stress responses in mechanically ventilated patients. This article presents four case studies from a feasibility study that investigated the experience and effect of a music-assisted relaxation intervention on anxiety, quality of life, and non-invasive ventilation use during the first 3 months of using non-invasive ventilation. The experiences of these four participants demonstrated how music-assisted relaxation served to distract from non-invasive ventilation and promote relaxation, indicating that for some, music-assisted relaxation could be a useful strategy to optimize their non-invasive ventilation experience. Early music therapy intervention in motor neuron disease progression could be beneficial to address obstacles faced by one participant in using music-assisted relaxation.
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ItemFlow and meaningfulness as mechanisms of change in self-concept and well-being following a songwriting intervention for people in the early phase of neurorehabilitation(Frontiers Media, 2015-05-26)Anecdotal evidence suggests that songwriting assists people with spinal cord injury (SCI) or acquired brain injury (ABI) to explore threats to self-concept, yet studies that explore the mechanisms of change have not been reported. In a pilot study, we explored the correlations between changes in self-concept and well-being, with mechanisms of flow and meaningfulness of songwriting. Five people with ABI (all male) and 5 SCI (4 males, 1 female) (mean age 38.90 years, SD = 13.21), with an average 3 months post-injury, participated in a 12-session songwriting program that targeted examination of self-concept. Measures of self-concept, depression, anxiety, emotion regulation, affect, satisfaction with life, and flourishing were collected pre-, mid-, and post-intervention, and compared with repeated measures of flow and meaningfulness of songwriting. Medium effects were found for changes in self-concept (d = 0.557) and depression (d = 0.682) and approached a medium effect for negative affect (d = 0.491). Improvements in self-concept over time were associated with decreases in depression (rp = −0.874, n = 9, p < 0.01), anxiety (rp = −0.866, n = 9, p < 0.01), and negative affect (rp = −0.694, n = 10, p < 0.05), and an increase in flourishing (rp = +0.866, n = 9, p < 0.01) and positive affect (rp = + 0.731, n = 10, p < 0.05). Strong experiences of flow were not positively correlated with positive changes to self-concept and well-being, whereas deriving high levels of meaning were associated with increased negative affect (rp = +0.68 p < 0.05), increased anxiety (rp = +0.74, p < 0.05), and reduced emotional suppression (rp = −0.58, p < 0.05). These findings show that the targeted songwriting intervention appears to be positively associated with enhanced well-being outcomes. However, the findings also suggest that people who find the songwriting process has strong meaning for them might be more likely to start accepting their emotions and as a result experience an increase in anxiety and depression, although full, mediated regression analyses with larger sample sizes are required to explore this further. Acknowledging their changed circumstances may nonetheless assist people with SCI and ABI to grieve their losses and facilitate the building of a healthy post-injured self-concept. We propose that there may be other mechanisms more critical in facilitating the positive changes in self-concept and well-being than flow and meaning, such as the role of story-telling and the impact of music in facilitating the consolidation of self-concept explorations in memory.
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ItemAdjusting to Change Through Song: Themes in Songs Written by Clients With Traumatic Brain Injury(CSIRO Publishing, 2005-12-01)Abstract The study aimed to identify themes in songs written by clients with traumatic brain injury (TBI). Lyrics (1834) from 82 songs written by 11 female and 21 male clients aged between 5 and 60 years were categorised into 8 main themes and 24 subcategories. Incidence of subcategories and themes were calculated. Self-reflections and messages were the most frequent themes portrayed within songs. Memories and reflections about significant others were also frequently communicated. It was noticeable that clients felt safer to communicate thoughts and feelings about the past and present but were less inclined to confront the future.
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Item'Stroke a Chord': The effect of singing in a community choir on mood and social engagement for people living with aphasia following a stroke(IOS PRESS, 2013)BACKGROUND: Communication deficits resulting from aphasia can negatively impact stroke survivors' relationships and social participation. Despite their difficulties, singing is accessible and enjoyable for many people with aphasia. OBJECTIVES: To explore the effects of group singing for people with aphasia. METHODS: A community choir was established and facilitated by a neurologic music therapist. Mood (General Health Questionnaire-12; Visual Analogue Mood Scale), communication, cognition and global functioning (Stroke Impact Scale-3) and social functioning (Sense of Belonging Instrument) were measured before, and at 12-weeks and 20-weeks after joining the choir. Three choir members and five caregivers also completed semi-structured interviews about their experience of the choir. RESULTS: Baselines measures were collected for 13 participants with aphasia. Prior to joining the choir, participants had higher levels of negative mood symptoms and poorer subjective sense of belonging compared to Australian general population samples. Results from the GHQ-12 suggested a trend towards reduction of psychological distress after participating in the choir. Thematic analysis of the interviews revealed five common themes: increased confidence, peer support, enhanced mood, increased motivation, and changes to communication. CONCLUSION: The strength of findings was limited by the number of participants and lack of a control group, however clear benefits of choir participation were demonstrated. Preliminary findings were encouraging and warrant further rigorous investigation.
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ItemEffect of Singing on Respiratory Function, Voice, and Mood After Quadriplegia: A Randomized Controlled Trial(W B SAUNDERS CO-ELSEVIER INC, 2013-03)OBJECTIVE: To explore the effects of singing training on respiratory function, voice, mood, and quality of life for people with quadriplegia. DESIGN: Randomized controlled trial. SETTING: Large, university-affiliated public hospital, Victoria, Australia. PARTICIPANTS: Participants (N=24) with chronic quadriplegia (C4-8, American Spinal Injury Association grades A and B). INTERVENTIONS: The experimental group (n=13) received group singing training 3 times weekly for 12 weeks. The control group (n=11) received group music appreciation and relaxation for 12 weeks. Assessments were conducted pre, mid-, immediately post-, and 6-months postintervention. MAIN OUTCOME MEASURES: Standard respiratory function testing, surface electromyographic activity from accessory respiratory muscles, sound pressure levels during vocal tasks, assessments of voice quality (Perceptual Voice Profile, Multidimensional Voice Profile), and Voice Handicap Index, Profile of Mood States, and Assessment of Quality of Life instruments. RESULTS: The singing group increased projected speech intensity (P=.028) and maximum phonation length (P=.007) significantly more than the control group. Trends for improvements in respiratory function, muscle strength, and recruitment were also evident for the singing group. These effects were limited by small sample sizes with large intersubject variability. Both groups demonstrated an improvement in mood (P=.002), which was maintained in the music appreciation and relaxation group after 6 months (P=.017). CONCLUSIONS: Group music therapy can have a positive effect on not only physical outcomes, but also can improve mood, energy, social participation, and quality of life for an at-risk population, such as those with quadriplegia. Specific singing therapy can augment these general improvements by improving vocal intensity.