Melbourne Conservatorium of Music - Research Publications
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ItemA Light at the End of the Tunnel: The Experiences of Members of a Therapeutic Community Choir for People Living with Dementia and their Care-Partners who ‘Went Online’ During the COVID-19 Pandemic – an Arts-Based Phenomenological Study(GAMUT - Grieg Academy Music Therapy Research Centre (NORCE & University of Bergen), 2023)Background: This paper presents the results of an arts-based, phenomenological research project in which members of a therapeutic community choir for people living with dementia and their family and friends reflected on their experiences of singing together pre and post the transition to online sessions as a result of the COVID-19 pandemic. Method: Eleven choir members (three living with dementia and eight family care-partners) participated in interviews about their experience of the choir and its transition to an online format during the COVID-19 pandemic. Interviews were conducted in either a traditional, semi-structured interview format, or as a collaborative songwriting session, and participants were able to choose the format that they preferred. Transcripts of the interviews and songs that were composed were analysed using an adapted Interpretative Phenomenological Analysis and arts-based research method. Participants verified key themes that emerged from the analysis, which formed the basis of an 18-part Song Cycle, which included two original songs by participants, and 16 songs composed by the first author. Results: Eighteen sub-themes were generated from the analysis, which are expressed as songs and grouped into four overarching themes or ‘Movements’: i) the dementia experience; ii) the choir experience; iii) the COVID-19 experience; and iv) the virtual experience. The songs depict how participants experienced each of the overarching themes, and revealed challenges, new opportunities and resilience. Conclusion: Navigating COVID-19 while living with or caring for someone with dementia was challenging. The virtual choir format was acceptable, provided relief from the stress of COVID-19, and kept members connected, however, there were technological limitations that made the experience challenging at times.
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ItemLearning to use music as a resource: the experiences of people with dementia and their family care partners participating in a home-based skill-sharing music intervention: a HOMESIDE sub-study(FRONTIERS MEDIA SA, 2023-05-18)An increasing number of people with dementia receive informal care from family members to help them remain living in the community. Music therapy is particularly beneficial for supporting the wellbeing of people living with dementia. However, little is known about how music therapy might support people with dementia and their family care partners as dyads. This study explored the experiences of six dyads participating in a 12-week home-based skill-sharing music intervention facilitated by a music therapist. We examined their experiences during the intervention period and in the 3-6 months following. This study was conducted within a larger randomised control trial, HOMESIDE. Data was collected through video-recorded music-based interviews, participant diaries, and a semi-structured interview. Data was analysed using an abductive and relational-centred research approach in consideration of the Contextual Connection Model of Health Musicking for People Living with Dementia and Their Family Care Partners. The study found fifteen themes that describe dyads' supported experiences of sharing music in their homes. These were organised into three global themes: (1) experiences were shaped by complex influences; (2) a connected musical ecosystem; and (3) music was a resource for wellbeing. This study highlighted the important role of personalised facilitation and the therapeutic relationship as dyads learned to use music as a resource through a process of trial and error. The implications for skill-sharing, indirect music therapy and direct music therapy practice are discussed.
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ItemNo Preview AvailableMusic interventions for acquired brain injury(John Wiley & Sons, Ltd, 2017)Background: Acquired brain injury (ABI) can result in impairments in motor function, language, cognition, and sensory processing, and in emotional disturbances, which can severely reduce a survivor's quality of life. Music interventions have been used in rehabilitation to stimulate brain functions involved in movement, cognition, speech, emotions, and sensory perceptions. An update of the systematic review published in 2010 was needed to gauge the efficacy of music interventions in rehabilitation for people with ABI. Objectives: To assess the effects of music interventions for functional outcomes in people with ABI. We expanded the criteria of our existing review to: 1) examine the efficacy of music interventions in addressing recovery in people with ABI including gait, upper extremity function, communication, mood and emotions, cognitive functioning, social skills, pain, behavioural outcomes, activities of daily living, and adverse events; 2) compare the efficacy of music interventions and standard care with a) standard care alone, b) standard care and placebo treatments, or c) standard care and other therapies; 3) compare the efficacy of different types of music interventions (music therapy delivered by trained music therapists versus music interventions delivered by other professionals). Selection criteria: We included all randomised controlled trials and controlled clinical trials that compared music interventions and standard care with standard care alone or combined with other therapies. We examined studies that included people older than 16 years of age who had ABI of a non‐degenerative nature and were participating in treatment programmes offered in hospital, outpatient, or community settings. We included studies in any language, published and unpublished. Data collection and analysis: Two review authors independently extracted data and assessed the risk of bias of the included studies. We contacted trial researchers to obtain missing data or for additional information when necessary. Where possible, we presented results for continuous outcomes in meta‐analyses using mean differences (MDs) and standardised mean differences (SMDs). We used post‐test scores. In cases of significant baseline difference, we used change scores. We conducted a sensitivity analysis to assess the impact of the randomisation method. Main results: We identified 22 new studies for this update. The evidence for this update is based on 29 trials involving 775 participants. A music intervention known as rhythmic auditory stimulation may be beneficial for improving the following gait parameters after stroke. We found a reported increase in gait velocity of 11.34 metres per minute (95% confidence interval (CI) 8.40 to 14.28; 9 trials; 268 participants; P < 0.00001; moderate‐quality evidence). Stride length of the affected side may also benefit, with a reported average of 0.12 metres more (95% CI 0.04 to 0.20; 5 trials; 129 participants; P = 0.003; moderate‐quality evidence). We found a reported average improvement for general gait of 7.67 units on the Dynamic Gait Index (95% CI 5.67 to 9.67; 2 trials; 48 participants; P < 0.00001). There may also be an improvement in gait cadence, with a reported average increase of 10.77 steps per minute (95% CI 4.36 to 17.18; 7 trials; 223 participants; P = 0.001; low‐quality evidence). Music interventions may be beneficial for communication outcomes in people with aphasia following stroke. Overall, communication improved by 0.75 standard deviations in the intervention group, a moderate effect (95% CI 0.11 to 1.39; 3 trials; 67 participants; P = 0.02; very low‐quality evidence). Naming was reported as improving by 9.79 units on the Aachen Aphasia Test (95% CI 1.37 to 18.21; 2 trials; 35 participants; P = 0.02). Music interventions may have a beneficial effect on speech repetition, reported as an average increase of 8.90 score on the Aachen Aphasia Test (95% CI 3.25 to 14.55; 2 trials; 35 participants; P = 0.002). There may be an improvement in quality of life following stroke using rhythmic auditory stimulation, reported at 0.89 standard deviations improvement on the Stroke Specific Quality of Life Scale, which is considered to be a large effect (95% CI 0.32 to 1.46; 2 trials; 53 participants; P = 0.002; low‐quality evidence). We found no strong evidence for effects on memory and attention. Data were insufficient to examine the effect of music interventions on other outcomes. The majority of studies included in this review update presented a high risk of bias, therefore the quality of the evidence is low. Authors' conclusions: Music interventions may be beneficial for gait, the timing of upper extremity function, communication outcomes, and quality of life after stroke. These results are encouraging, but more high‐quality randomised controlled trials are needed on all outcomes before recommendations can be made for clinical practice.
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ItemNo Preview AvailableMusic Interventions for Acquired Brain Injury: Findings From a Cochrane Review(Elsevier BV, 2018-10)
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ItemThe HOMESIDE Music Intervention: A Training Protocol for Family Carers of People Living with Dementia(MDPI, 2022-12)Background: The number of people living with dementia (PwD) worldwide is expected to double every 20 years. Many continue living at home, receiving support from family caregivers who may experience significant stress, simultaneously to that of the PwD. Meaningful and effective home-based interventions to support PwD and their caregivers are needed. The development of a theory- and practice-driven online home-based music intervention (MI) is delivered by credentialed music therapists, nested within the HOMESIDE RCT trial. Methods: Dyads including the PwD and their family carer are randomised to MI, reading (RI) or standard care (SC). MI aims to support health wellbeing and quality of life by training caregivers to intentionally use music (singing, instrument playing, movement/dancing, and music listening) with their family member (PwD) in daily routines. MI is underpinned by cognitive, relational, social, and psychological theories of mechanisms of change. Results: Preliminary sub-cohort results analyses show MI can be delivered and is accepted well by participants and music-therapist interventionists across five countries. Conclusions: The specialist skills of a music therapist through MI enable carers to access music when music therapists are not present, to meet carer and PwD needs. Music therapists embrace this changing professional role, observing therapeutic change for members of the dyads.
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ItemTherapeutic Choirs for Families Living with Dementia: A Phenomenological Study(ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD, 2023-01-02)This paper seeks to represent the perspectives of community-dwelling people who are living with dementia and their family care-partners, who participated community-based, therapeutic choirs that were formed as part of the Remini-Sing project. Interpretative Phenomenological Analysis (IPA) was used to analyze data from interviews with fourteen participants (7 people living with dementia [4 women, mean age = 82] and 7 care-partners [5 women, mean age = 68]). Eight themes identified the perceived benefits of choir singing and elements of the choirs and research project more broadly that influenced participation. Findings support past research that suggests choir singing is an accessible and enjoyable activity that can support the health and wellbeing of people living with dementia and their family care-partners. Challenges with recruitment and sustainability of programs post-research are highlighted.
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ItemHow Singing can Help People With Dementia and Their Family Care-Partners: A Mixed Studies Systematic Review With Narrative Synthesis, Thematic Synthesis, and Meta-Integration(FRONTIERS MEDIA SA, 2021-10-11)Background: Recent research on the efficacy of music-based interventions for people with dementia have focused on specific outcomes and methods, and singing has been noted as a particularly beneficial activity. However, due to heterogeneity of research methods, there is a need to synthesise the findings of both quantitative and qualitative research in order to better understand both the impact and potential mechanisms of singing for people in this population. Method: This systematic review included quantitative, qualitative and mixed-methods studies, and analysed these using a systematic mixed-studies synthesis (with a results-based convergent approach). Quantitative and qualitative data were initially synthesised using a narrative synthesis and thematic synthesis method, respectively, before a final meta-integration method was used to synthesise common themes across the two data forms. Results: Electronic and hand search strategies revealed 1,815 relevant studies, 40 of which met the full eligibility criteria. Narrative synthesis of quantitative data revealed six key outcome areas (quality of life; psychological well-being; cognition; engagement; activities of daily living; care-partner well-being), and thematic synthesis of qualitative data generated seven themes relating to the impact and mechanisms of singing (pragmatic elements; social benefits; mood; identity; memory; flow-on effects; and relationships). Meta-integration identified four key areas relating to the impact and mechanisms of singing for people with dementia and care-partners: psychological well-being, quality of life, cognition, and care-partner well-being. Conclusion: Results from the syntheses suggest that singing can positively impact the lives of people with dementia and their care-partners, although due to heterogeneity of study design and outcome measures, it is difficult to draw conclusions based on quantitative data alone. Qualitative data provides further context and insights from participant perspectives, and when integrated with quantitative data, contextual factors that may influence the benefits that participants experience from singing are revealed.
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ItemMaking Qualitative Interviews in Music Therapy Research More Accessible for Participants Living With Dementia - Reflections on Development and Implementation of Interview Guidelines(SAGE PUBLICATIONS INC, 2021-09-14)Purpose. This paper reports findings from a project that sought to develop accessible guidelines for including people with dementia in qualitative interviews in a music therapy study, based on experience from people previously involved in qualitative music therapy research. Method. People with previous experience of qualitative music therapy research were invited to participate in semi-structured interviews about how the interview process could be made more accessible. Participants included four family-caregivers and three music therapy-researchers. Interview data were analysed using thematic analysis. Findings were used to develop guidelines for a subsequent study; reflections on the implementation of these guidelines are provided. Results. Five themes were identified: (a) motivators and barriers to participating in interviews; (b) pragmatic elements that impact interview participation; (c) relationship dynamics may impact the interview; (d) familiarity fosters comfort, enables preparation and support and (e) broader considerations for accessible research design. Conclusions. Themes identified align with reports from the extant literature. Reflections on implementation of the guidelines reveal the need for more clarity around the ethics of building rapport in qualitative research. Implications about future uses of the guidelines, including the use of music as a research tool are discussed.
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ItemNo Preview AvailableEmpowering Caregivers of People Living with Dementia to Use Music Therapeutically at Home: Design Opportunities(ACM, 2020-12-02)Human-computer interaction researchers have explored how to design technologies to support people with dementia (PwD) and their caregivers, but limited attention has been given to how to facilitate music therapy in dementia care. The use of music to help manage the symptoms of dementia is often guided by a music therapist who adapts the intervention to respond to the changing needs of the person living with dementia. However, as the incidence of dementia increases worldwide, individualised therapy programs are less feasible, making it valuable to consider technology-based approaches. In this paper, we analyze data from case studies of home-based music therapy training interventions with two families. The findings show that embodied interactions supported the therapist in responding to the needs of the PwD and built an empathic environment that empowered the caregivers' learning. We discuss opportunities and challenges for designing technologies that support family caregivers' therapy-informed music use in dementia care.
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Item“Doing Things Together Is What It’s About”: An Interpretative Phenomenological Analysis of the Experience of Group Therapeutic Songwriting From the Perspectives of People With Dementia and Their Family Caregivers(Frontiers Media SA, 2021)Background. The wellbeing of people living with dementia and their family caregivers may be impacted by stigma, changing roles, and limited access to meaningful opportunities as a dyad. Group therapeutic songwriting (TSW) and qualitative interviews have been utilized in music therapy research to promote the voices of people with dementia and family caregivers participating in separate songwriting groups but not together as dyads. Procedures. This study aimed to explore how ten people with dementia/family caregiver dyads experienced a 6-week group TSW program. Dyads participated in homogenous TSW groups involving 2–4 dyads who were either living together in the community (2 spousal groups) or living separately because the person with dementia resided in a care home (1 family group, 1 spousal group). The TSW program, informed by personhood, couplehood, family centered and group process frameworks, involved creating original lyrics through song parody and song collage. Qualified Music Therapists facilitated sessions and interviewed each dyad separately. Interviews were analyzed using interpretative phenomenological analysis. Findings. Five recurrent group themes were developed, indicating group TSW: (1) was a positive shared experience, benefiting both members of the dyad and motivating further engagement with music; (2) stimulated mental processes and reignited participants’ interests and skills; (3) provided meaningful opportunities for reflection and connection with memories and life experiences; and (4) prompted interaction and collaboration, leading to social connections, empathic relationships and experiences of inclusion. Participants also highlighted how: (5) the facilitated process supported engagement, highlighting abilities and challenging doubts. Conclusion. Dyads identified group TSW as an opportunity to recognize strengths, voice ideas and opinions, share meaningful experiences, and do “more with music.” Participants valued TSW as a new, creative and stimulating experience that enabled connection with self and others and led to feelings of pride and achievement. Our findings further recognize how therapeutic intention and approach were reflected in participants’ engagement and responses regardless of dementia stage and type, dyad relationship, or musical background. This research may broaden perspectives and expand understanding about how people with dementia and their family caregivers access and engage in music therapy.