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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ItemExploring the Self through Songwriting: An Analysis of Songs Composed by People with Acquired Neurodisability in an Inpatient Rehabilitation Program(Oxford University Press, 2017-03-01)Background: Neurological trauma is associated with significant damage to people’s pre-injury self-concept. Therapeutic songwriting has been linked with changes in self-concept and improved psychological well-being. Objective: This study analyzed the lyrics of songs composed by inpatients with neurological injuries who participated in a targeted songwriting program. The aim of this study was to understand which of the subdomains of the self-concept were the most frequently expressed in songs. Methods: An independent, deductive content analysis of 36 songs composed by 12 adults with spinal cord injury or brain injury (11 males, mean age 41 years +/– 13) were undertaken by authors 1 and 2. Results: Deductive analysis indicated that when writing about the past self, people created songs that reflected a strong focus on family and descriptions of their personality. In contrast, there is a clear preoccupation with the physical self, on the personal self, and a tendency for spiritual and moral reflections to emerge during the active phase of rehabilitation (song about the present self). Statistical analyses confirmed a significant self-concept subdomain by song interaction, F(10, 110) = 5.98, p < .001, ηp2 = .35), which was primarily due to an increased focus on physical self-concept and a reduced focus on family self-concept in the present song, more than in either past or future songs. Conclusions: The analysis process confirmed that songwriting is a vehicle that allows for exploration of self-concept in individuals with neurological impairments. Songwriting may serve as a therapeutic tool to target the most prevalent areas of self-concept challenges for clients undergoing inpatient neurological rehabilitation programs.
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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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ItemExploring the feasibility of a music-assisted relaxation intervention to assist with the initiation of non-invasive ventilation in people with Motor Neuron Disease(International Association for Music & Medicine, 2017)Background: Transitioning to non-invasive ventilation (NIV) can cause anxiety in people with Motor Neuron Disease (MND), which may reduce adherence rates. Music therapy has demonstrated positive effects with mechanical (invasive) ventilation. Method: This feasibility study examined the effects of music-assisted relaxation (MAR) on NIV adherence, anxiety, and quality of life for people with MND. Data were collected at baseline, 7-days post, and 3-months post NIV implementation. Results: Of 18 consenting participants, 15 chose the MAR condition. Results suggested that supporting NIV transition within the first 7 days may be advantageous for long-term adherence. No effects were found for anxiety or quality of life. Limitations included small sample size, lack of an adequate control, and possible ceiling effects on the instruments used. Qualitative data indicated most participants considered the relaxing and distracting effects of MAR were useful. Conclusions: In this small sample, we found some demand for and acceptability of a music-based intervention in this setting. Participants reported differing experiences of using MAR, and there were technical and logistical issues regarding timely and accessible provision of a MAR intervention within the treatment trajectory of NIV implementation. Conflicting quantitative and qualitative data support the need for mixed method research in this area.
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ItemTherapeutic singing protocols for addressing acquired and degenerative speech disorders in adults(Oxford University Press, 2017)The ability to communicate and make oneself understood is integral to a person’s quality of life. It affects social interaction, educational and vocational opportunities, and ultimately independence and sense of self. Unfortunately, speech production is often impaired as a result of neurological damage (e.g., traumatic brain injury, stroke) or disorders (e.g., Parkinson’s disease). There are many similarities and shared neural mechanisms between speech and singing. For example, both singing and speech utilize rhythm, pitch variation, tempo, dynamics, articulation, and respiratory support. Music therapists manipulate these elements of music when addressing therapeutic goals for people with neurogenic speech disorders. Many clinical protocols to address speech disorders in adults have now been published to guide clinical practice in music therapy. This paper summarizes existing music therapy and singing-based protocols used to address commonly occurring acquired or degenerative speech disorders, namely dysarthria, dysphonia, dysprosody, and apraxia of speech. We examine individual and group therapy protocols used in medical and community settings for people with neurogenic speech disorders caused by traumatic brain injury, stroke, spinal cord injury, and Parkinson’s disease. We highlight the strengths and limitations of these protocols and make recommendations for clinical practice.
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ItemNo Preview AvailableParkinSong: A Controlled Trial of Singing-Based Therapy for Parkinson's Disease(SAGE PUBLICATIONS INC, 2019-06)Background. Communication impairment is one of the most common symptoms of Parkinson's disease (PD), significantly affecting quality of life. Singing shares many of the neural networks and structural mechanisms used during speech and, thus, has potential for therapeutic application to address speech disorders. Objective. To explore the effects of an interdisciplinary singing-based therapeutic intervention (ParkinSong) on voice and communication in people with PD. Methods. A controlled trial compared the effects of the ParkinSong intervention with an active control condition at 2 dosage levels (weekly vs monthly) over 3 months, on voice, speech, respiratory strength, and voice-related quality-of-life outcomes for 75 people living with PD. The interdisciplinary ParkinSong model comprised high-effort vocal and respiratory tasks, speech exercises, group singing, and social communication opportunities. Results. ParkinSong intervention participants demonstrated significant improvements in vocal intensity (P = .018), maximum expiratory pressure (P = .032), and voice-related quality of life (P = .043) in comparison to controls. Weekly ParkinSong participants increased vocal intensity more than monthly participants (P = .011). Vocal intensity declined in nontreatment control groups. No statistical differences between groups on maximum phonation length or maximum inspiratory pressure were observed at 3 months. Conclusions. ParkinSong is an engaging intervention with the potential to increase loudness and respiratory function in people with mild to moderately severe PD.
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ItemPersonal identity narratives of therapeutic songwriting participants following Spinal Cord Injury: A case series analysis(Taylor & Francis, 2018-07-04)Context/Objective: Spinal Cord Injury (SCI) patients face unique identity challenges associated with physical limitations, higher comorbid depression, increased suicidality and reduced subjective well-being. Post-injury identity is often unaddressed in subacute rehabilitation environments where critical physical and functional rehabilitation goals are prioritized. Therapeutic songwriting has demonstrated prior efficacy in promoting healthy adjustment and as a means of expression for post-injury narratives. The current study sought to examine the identity narratives of therapeutic songwriting participants. Design: Case-series analysis of the individual identity trajectories of eight individuals. Setting: Subacute rehabilitation facility, Victoria, Australia. Participants: Eight individuals with an SCI; 7 males and 1 female. Intervention: Six-week therapeutic songwriting intervention facilitated by a music therapist to promote identity rehabilitation. Outcome Measures: Identity, subjective well-being and distress, emotional state. Results: Three participants demonstrated positive trajectories and a further three showed negative trajectories; remaining participants were ambiguous in their response. Injury severity differentiated those with positive trajectories from those with negative trajectories, with greater injury severity apparent for those showing negative trends. Self-concept also improved more in those with positive trajectories. Core demographic variables did not however meaningfully predict the direction of change in core identity or wellbeing indices. Conclusion: Identity-focused songwriting holds promise as a means of promoting healthy identity reintegration. Further research on benefits for those with less severe spinal injuries is warranted.