Melbourne Conservatorium of Music - Research Publications
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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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ItemNo Preview AvailableBecoming a ‘good enough’ mother: The importance of singing for baby, singing for self.(International Journal of Birth & Parent Education, 2015)
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ItemA preliminary evaluation of the interpersonal music-communication competence scales(The Grieg Academy Music Therapy Research Centre, 2015-12-16)The Grieg Academy Music Therapy Research Centre With the aim to develop and test a reliable and valid measure of communicative competencies in music for use in acquired brain injury rehabilitation settings, the interpersonal music-communication competence scale (IMCCS) was constructed, adapted from the interpersonal communication competence scale. Fifteen participants with medium to severe acquired brain injury, one music therapist and two blinded raters were involved in testing the IMCCS-Participant, the IMCCS-Therapist and the IMCCS-Rater versions of the scale. Before and after 20 music therapy sessions, each participant performed four music-based improvisational exercises in 1:1 sessions with the therapist (dialogue with the therapist, follow the musical ideas of the therapist, maintain musical phrases while therapist intentionally interrupt/challenge, and free improvisation with the therapist). Immediately following these improvisations, the participants and therapist completed the IMCCS. Two blinded raters completed the IMCCS-Rater after viewing video recordings of the exercises. Results revealed that the IMCCS-Therapist has good internal consistency (α = .89), the IMCCS-Participant has excellent internal consistency (α = .93), and the IMCCS-Rater has excellent internal consistency (α = .90). The two raters’ scores correlated significantly (r(26) = .54 to .73, p < .004), and a Cohen’s kappa analysis indicated a good agreement (Kw = .60). In addition, the correlation between the IMCCS-Rater and IMCCS-Therapist scores was adequate (r = .64, p = .005). All scales have satisfactory internal consistency and inter-rater reliability. These findings suggest that the IMCCS is a reliable measure of interpersonal communication competencies in music for people with acquired brain injury.
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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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ItemEffects of professional music therapy supervision on clinical outcomes and therapist competency: a systematic review involving narrative synthesis(The Grieg Academy Music Therapy Research Centre, 2015-02-20)The Grieg Academy Music Therapy Research Centre Supervision for music therapists is often regarded as useful for professional development, and for processing clinical and non-clinical issues, which arise from practice. However, little is known about the research evidence, which informs this practice and its links to improved professional competency and clinical outcomes. A narrative synthesis was conducted to map the types of supervision literature, identify corresponding research evidence and examine effective models of music therapy supervision. Relevant databases were searched and the authors identified a considerable body of literature relating to professional supervision (n = 48), with only five, mostly qualitative, research studies identified. Review results show that supervision is useful for assisting a therapist’s professional and personal insight into clinical practice although the effects of the intervention remain unknown. Two core interactive ingredients constitute professional supervision: (1) flexible and creative approaches towards practice and learning, including the use of music as a supervision tool; (2) a supervisory relationship, which is fundamental to the process. These ingredients are shaped by three underlying concepts: (1) shared experience between supervisor and supervisee; (2) improved insights; and (3) qualities of an effective supervisory relationship. Results revealed an overall lack of evaluation studies and an over-reliance on qualitative design. The discipline would now benefit from research that measures the effects of professional supervision on patient outcomes and professional competencies.
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ItemA preliminary psychometric evaluation of the interpersonal communication competence scale for aquired brain injury(Informa Healthcare, 2015)PRIMARY OBJECTIVE: To evaluate the psychometric properties of two adapted versions of the interpersonal communication competence scale (ICCS) that were applied to people with acquired brain injury (ABI). Construct validity was tested for both new scales and a factor extraction was performed on the proxy-rating version aiming to establish if it revealed meaningful constructs. METHODS: ICCS was translated from English to Danish language, pilot tested and slightly modified for use as a self-rating scale with people with ABI. A relative/staff version of the scale was also constructed for testing. Participants with medium-to-severe ABI self-rated their interpersonal communication skills using the modified ICCS. Cronbach Alpha test was performed on both scales followed by a correlation analysis. RESULTS: Seventeen participants with medium-to-severe ABI and staff and relatives (n = 37) were involved in testing the ICCS-staff/relative rating and ICCS-self-rating. The ICCS-Staff/Relative showed an overall Cronbach alpha of α = 0.774 and the ICCS-Self-rating α = 0.675. A factor extraction of the ICCS-Staff/Relative revealed six meaningful sub-groups that corresponded well with the original ICCS. There was a low but significant correlation between the ratings performed by the two staff members most familiar with the participants (r = 0.280, p = 0.04). CONCLUSIONS: The ICCS-Staff/Relative revealed a good overall internal consistency, whereas the ICCS-Self-rating revealed acceptable internal consistency. The factor analysis of the proxy-rating revealed six meaningful sub-groups of interpersonal communication competencies.
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