Melbourne Conservatorium of Music - Theses
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ItemHow does a critical analysis of the literature inform recommendations for writing about mindfulness in music therapy practice?( 2019)Mindfulness Based Therapies have become widespread in clinical work, but so far the literature on integrating mindfulness into music therapy has been limited. The thesis presents the results of a critical interpretive synthesis (CIS) investigating the use of mindfulness in music therapy. The CIS of eight published articles examines how music therapists describe the use of mindfulness in their clinical work. A critical examination of the literature presented in the CIS finds that the use of mindfulness is described under the categories of mindfulness-based, Buddhist-influenced, or mindfulness, and discusses some of the difficulties in describing music therapy processes in this way. Based on the findings from the CIS, and drawing on research from the mindfulness literature as well as my experience as a mindfulness teacher, practising Buddhist, and registered music therapist, the thesis then offers recommendations for music therapists who are interested in using mindfulness-influenced practices in their clinical work and research. The word ‘mindfulness’ has become widespread, and can describe almost anything from relaxation to in-depth therapeutic work to the path to spiritual enlightenment. This broad use of the term can lead to a lack of clarity in how the use of mindfulness is described. The thesis will explore the use of language, including the challenges of adapting concepts from other cultures and belief systems. Research into the adverse effects of meditation is discussed, and the thesis argues that due to these possible harmful effects, music therapists using mindfulness in their work might consider additional training, ensuring they understand the theoretical basis, the benefits and the contra-indications of mindfulness-based therapies. There are also indications in the current literature on mindfulness and music therapy that music therapy processes can at times cultivate mindful states in both therapist and client. This could be an exciting area for further research, potentially leading to the development of a new theoretical model of mindfulness arising from within the creative processes of music therapy.
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ItemMusic therapy as an anti-oppressive practice: critically exploring gender and power with young people in school( 2018)This project sought to locate music therapy within broader health, research, and education contexts, as a participatory and anti-oppressive practice for young people in school to explore issues related to gender and power. In parallel, the research aimed to expand music therapy as an anti-oppressive practice (Baines, 2013), specifically focusing on deepening music therapists’ understanding of critical issues related to gender, power, and young people in education settings. Predicated on the notion that schools can be both sites of violence, and microcosms for change-making, the project occurred during a time of significant shifts across education settings worldwide to respond to endemic gender-based violence (Chandra-Mouli et al., 2017). Meanwhile, young people themselves continue to demonstrate new forms of resistance to gender-based violence and dominant gender and sexuality norms (Bragg et al., 2018; Keller et al., 2018). This project responds to a need for approaches that support young people’s autonomy and challenge processes of pathologisation and individualisation; approaches that seek to understand social structures, and the ways in which young people are shaped by their relationships with these social structures, and with each other (Brunila & Rossi, 2018). Framed broadly as a participatory action research project, the study was informed by a series of music-based workshops conducted in the first year, exploring the issues that young people identified as most important in relation to gender. The project then established a music therapy group program in a government school. The school was located in the outer suburbs of Melbourne, with an index of community socio-educational advantage below the national average, and a high percentage of students with a language background other than English. This primary project took the form of a critical ethnography, and generated a wide range of data over nine months. Interviews were conducted with five staff and sixteen of the young people who participated in music therapy groups exploring issues related to gender and power. Discourses of risk and deficit emerged as critical issues to respond to in the project, and became a key focus of the four chapters of results. The research revealed the complex forms of violence that can occur when exploring gender-based violence in a school context, and how these relate to young people’s layered subjectivities and social positioning. The findings demonstrated a need to problematise and expand upon current responses to gender-based violence in the context of Australian education settings, especially where Whiteness and colonial relations remain profoundly underexamined. Chapter Six overviews the five broad, salient themes that emerged in relation to the role of music in creating conditions for young people to explore gender. Chapter Seven outlines the role of music therapists in supporting young people to do so, the unique skillset and critical lens required in this emerging practice, and a new method developed in the project: ‘Insight-Oriented Narrative Songwriting’. Informed by anti-oppressive and decolonial approaches to reframing violence and harm, music therapy is ultimately constructed as a practice congruent with shifting understandings and paradigms related to trauma. Overarchingly, the research exposes the complex conditions of power in schools, and explicates the potential of music therapy within these conditions, to support young people to resist discursive positioning, and rewrite their own subjectivities.
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ItemAn emergent exploration into the musical beginnings of parental identity across the neonatal journey( 2018)This thesis describes an emergent research project exploring the musical beginnings of parental identity in the neonatal unit setting. While scholarship is calling for parentally- inclusive practices that support optimal health and well-being of premature infants and their parents (Benzies, Magill-Evans, Hayden & Ballantyne, 2013), there exists little music therapy research exploring parents’ unique experiences of appropriating music with their baby in this context. Moreover, research highlights the need to foster the process of becoming a parent to a premature baby in the neonatal unit to support the critical development of the parent- infant relationship (Gibbs, Boshoff & Stanley, 2015). However, no studies have examined music therapy’s role in contributing to parental identity constructs in the neonatal unit. This project aimed to respond to this gap through exploring parents’ experiences of musical engagement with their baby in the neonatal unit through a phenomenological inquiry, followed by a grounded theory study. Parents were recruited from across two in-patient, neonatal hospital facilities in Melbourne. An initial inquiry, adopting Interpretative Phenomenological Analysis (Smith, Flowers & Larkin, 2009) methodology explored nine parents’ experiences and perceptions of singing and using their voice with their premature baby in the neonatal unit. Findings emerged across four waves of analysis. Recurrent themes included: the intrinsic role of singing and voice to support the developing identity of parents and act as a fundamental bridge of connection to their premature baby; the supportive role of voice to meet the emotional needs of parents; and act as a self-soothing coping tool. The concept of time across differing stages of the acute neonatal journey and its influence on parents’ experiences and perceptions of voice inductively emerged across cases. Findings also highlighted parents’ singing and voice interactions with their baby as a critical dialogical encounter of perceived connection and recognition. Finally, the role of the music therapist was acknowledged as supportively educating and facilitating parents to ‘find their voice’ and connect with their baby. The second study of this thesis expanded on an interesting aspect of these initial findings that illuminated singing and voice interactions leading to the validation of a parent’s identity through their baby’s perceived recognition of their voice (McLean, 2016a). This grounded theory study explored how parents’ musical engagement with their baby contributed to their parental identity across their neonatal journey. Interviews with nine parents of a premature baby across varying time points in their hospital journey took place. To generate theoretical understandings of this topic, a Constructivist Grounded Theory approach was employed (Charmaz, 2014), with influences from Strauss & Corbin’s (1998) approach to analysis. Findings in the form of a substantive grounded theory illuminated the contribution of parents’ musical engagement on their sense of parental identity. Specifically, the centrality of their baby’s response during musical interactions as influencing these parents’ capacity to engage in musical dialogue with their baby emerged. It was through these early musical encounters, involving their baby’s powerful response, that parents’ emerging sense of identity across their neonatal unit journey was supported. This enabled parents to ‘do something musical’ for their baby and receive an ‘identifying response from their baby’. Specific conditions that acted as both barriers and fosters in parents’ musical engagement across a high- risk pregnancy and hospital admission also emerged.
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ItemFrom social connectedness to equitable access: an action research project illuminating the opportunities and the barriers to accessing music for young people with disability transitioning from school to adult life( 2017)The action research project described in this thesis emerged from a partnership between the Community Inclusion Team of a large, not-for-profit disability service organisation in Australia (the Organisation) and the National Music Therapy Research Unit at the University of Melbourne (NaMTRU). The project developed following a question from the Organisation about how music could be an engaging part of young people’s lives as they transitioned from school to adult life. Community inclusion team members of the Organisation had identified that young people who accessed their services, many of who live with more complex disabilities, often experienced challenges in establishing a sense of social connectedness during the transition. The Organisation were interested in how involvement in music may play a role in addressing this challenge. As such, the project began with a focus on the role of music in social connectedness for young people. However, as the project unfolded, the focus began to broaden into the more pressing issue of equitable access to music. The project developed amid the backdrop of the introduction of a new disability funding model in Australia, the National Disability Insurance Scheme (NDIS). This change within the disability sector has had a significant influence on many aspects of this inquiry. An action research approach (Reason and Bradbury, 2008) was used for the project within a transformative paradigm (Mertens, 2009) as it relates to issues of social justice and human rights. This framework encompasses the aim of personal and social transformation within communities that experience oppression and discrimination. Grounded in community music therapy theory and disability studies, the project took the form of four cycles of planning, action and reflection. Cycle 1 involved a critical interpretive synthesis of the literature. Cycle 2 involved semi structured interviews with young people accessing the Organisation to learn about their experiences of social connectedness. Cycle 3 involved focus group discussions with facilitators of music programs accessible to young people to begin building a picture of opportunities to access music and finally, cycle 4 involved the establishment of an ongoing, collaborative community music program with a group of young people. Findings indicate that young people with disability lack sufficient opportunities to access music as a resource in their lives. A variety of opportunities exist that offer different ways of participating in music, but barriers to this participation are continually faced. These include limitations on independent access to information about the existence of programs and opportunities, inadequate funding for independent action and a lack of community infrastructure to accommodate people with differing needs. Once an opportunity was made available in this project, young people embraced the chance to work collaboratively to create the music program into what they needed. This included growing the group membership to satisfy social needs, taking on leadership and marketing roles, making group decisions about the music, the venue and performances. The research project outcomes have implications for roles and actions for music therapists and other facilitators of music programs aimed at a structural level to increase opportunities for young people to access music as a resource in their lives.
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ItemParents' and music therapists' reflections on the experience of music and home-based music therapy for paediatric palliative care patients and their families, who come from diverse cultural backgrounds( 2017)Music can be an important part of many young children’s lives, especially when a child is unwell, or dying. In recent years, the use of music therapy with children in paediatric palliative care (PPC) has become more widespread, across hospice, hospital and home settings. This qualitative inquiry investigated the experience of music, and home-based music therapy for PPC patients and their families, who come from diverse cultural backgrounds. The inquiry employed a constructivist approach and was informed by grounded theory and meta-ethnography. The inquiry examined how children in PPC and their families experience music, and music therapy in PPC, with a focus on how cultural beliefs and practices shape experience. The inquiry also identified barriers to accessing PPC, music, and music therapy for children and families of diverse cultural backgrounds. Four studies were conducted as part of this inquiry. Study One employed a repeated-interview design to interview six parents of children in PPC about their experience of music and music therapy in caring for a child in PPC. Five mothers and one father participated in an initial interview; and three of the mothers also participated in a six-month follow-up interview, to capture in-the-moment experiences and changes over time. Study Two employed a focus group design to interview three music therapists about their experience of providing music therapy for children and families of diverse cultural backgrounds in home-based PPC. Study Three employed an ethnographic approach for the author to reflect on her work in home-based PPC music therapy with 34 children and their families. Twenty themes emerged from the analysis of Studies One to Three, based around three distinct foci: the palliative care journey; the experience of music; and the experience of music therapy. Study Four conducted a meta-ethnography of Studies One to Three. The meta-ethnography provided a rich and detailed description of how children and families from diverse cultural backgrounds experience PPC, music and home-based music therapy; and also identified barriers to access. Key findings included: 1) Migration, length of time in Australia and cultural shaming can impact isolation, coping, and access to support; 2) Families want music therapy for their child, even if music is not part of their culture or family life; 3) Music can support family health and wellbeing, although the presence of multiple stressors in the family’s life can inhibit use of music; 4) Families use music to express their culture and maintain their cultural identity; 5) Music therapy can support families who have few/no family or other supports, reducing carer stress and isolation, and enhancing parental coping; 6) music therapy can uphold and support cultural and community patterns of relationship in the face of life-threatening illness; 7) child and family experiences of palliative care can be transformed in MT, positively impacting parental coping; and 8) the emotional intensity of music therapy in end-of-life-care can be overwhelming, and lead to family disengagement from music therapy. The thesis makes an important contribution to the fields of music therapy and PPC, in developing understanding of how culture impacts family experiences of PPC, music, and music therapy; and also offers insight into the complexities of conducting research with the highly vulnerable population of children in PPC.
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ItemEffectiveness of SAMONAS Sound Therapy (SST) in improving social engagement of children with Autism Spectrum Disorder( 2016)Atypical sensory reactivity has been included in the latest diagnostic criteria for Autism Spectrum Disorder (ASD). Compared to typically developing children, children with ASD are more likely to demonstrate atypical sensory responses, such as adverse reactions or indifference to sensations. An increasing body of literature has explored the connections between auditory processing and social engagement. Difficulty orienting towards a parent’s voice has been suggested to have a detrimental impact on a child’s ability to engage with the social world. Severe auditory processing difficulties can be disabling for a child and his or her family. A child with poor auditory filtering might not respond when being called, have difficulty following verbal instructions, and struggle with social engagement and interaction. Treatment options for auditory-based difficulties for children with ASD are, however, limited. For this reason, parents seek other therapies such as sound therapy to help their children. SAMONAS Sound Therapy (SST) is a sound therapy method that involves listening to electronically modified music through headphones over a period of time with the aim of improving listening skills. Evidence of the effectiveness of sound therapies with children with ASD is scarce and limited to studies examining language and behavior. There have not been any studies published on the impact of SST on children with ASD. This Singapore-based study aimed to investigate whether SST impacts social orienting, joint attention, and social interaction of children with ASD. Eleven Asian children between ages four and six years were recruited for the study. All children had severe ASD, difficulty focusing on the voices of their parents, and low cognitive, verbal, and adaptive functioning. Double-blinded randomised controlled trial with repeated measures was employed. The children, randomly allocated into SST and music listening groups, received a combination of clinic- and home-based treatments. Measurements were taken before and after a two-week clinic-based intervention, after an eight-week home program, and at three-month follow-up. Clinician-administered tests were supplemented with parent and teacher questionnaires, parent interviews, and observations of parent–child free play. Statistical analysis of standardized and non-standardised measures indicated a significant effect in favour of SST in some, but not all, clinician-administered measures. SST was more effective than music listening in improving joint attention and reciprocal social interaction in children with ASD. Treatment gains were maintained at three-month follow-up. There were, however, no differences between groups on social orienting. An important finding of this study was that the positive results achieved in the context of therapist–child interaction did not simultaneously generalise to parent–child interaction. Incorporation of parent training is recommended for SST treatment and future trials. These outcomes offer the first indication that SST may be a useful tool for children with severe ASD in particular areas of social engagement.
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ItemMusical intimacy and the negotiation of boundary challenges in contemporary music therapy practice( 2016)This thesis details a grounded theory study that examined the new concept of musical intimacy. This research began with an initial interest in therapeutic boundaries, exploring how they interact with music in music therapy practice. Through a critical interpretive synthesis, examining the prevalence and presentation of traditional boundary ideas, musical intimacy emerged as a new boundary theme. Musical intimacy was an interesting concept that seemed to capture the complexities of musical experiences, and their unique interaction with therapeutic boundaries. It was the discovery of this concept that led me to explore it in more detail. A grounded theory study was conducted, interviewing 20 music therapists from locations in Australia, the USA, Canada, the UK, Denmark and Norway. I used intensive interviewing to explore the music therapists’ experiences and understandings of what musical intimacy could be. Through this, I was also keen to examine how the music therapists were managing musical intimacy, and if they had experienced any boundary challenges within that context. The interviews were conducted in person across a three month period. A grounded theory analysis, influenced by both Charmaz’s constructivist grounded theory (2014) and analytic strategies from Corbin and Strauss (2008), was applied to the interview transcriptions. The analysis process included: 1) data collection and initial analysis, 2) initial coding, 3) focussed coding, and 4) synthesizing to form the theoretical framework. Throughout the analysis process, the grounded theory technique of ‘memoing’ was used, as well as many reflexive strategies to reveal my influence on the emerging findings. This analysis allowed me to move back and forth between data and analysis, involving many streams of analysis, where I returned to the data to expand, confirm or challenge my initial ideas and themes. Through this process, a theoretical framework of musical intimacy and boundaries has emerged. The grounded essence of the musically intimate experience emerged as the core defining feature of musical intimacy. The grounded essence is: the therapist experiences a powerful moment of connection in and around the music that triggers an acute sense of vulnerability and reveals the need for boundaries to keep things safe. There were two main themes that emerged, which contributed to the musically intimate experience for these participants. These were: the ‘interpersonal experiences’ and the ‘intrinsic components of music’. The music therapists described a spectrum of experiences, which were a complex web of powerful moments of connection and challenging experiences. They also described their ‘ways of being and responding’ to the musically intimate experiences, which detailed how they managed boundaries in these moments. The most interesting aspect of this research is the emergence and definition of musical intimacy. Musical intimacy captures a complex aspect of music therapy that was experienced by all 20 of the music therapists involved in this study. Musical intimacy provides a way for music therapists to conceptualise boundaries in their practice. It alludes to powerful moments of connection we can experience, and how there can be challenging moments in and around the music in music therapy. The ‘ways of being and responding’ are the beginnings of developing a new understanding of boundaries in music therapy practice. It is my belief that through this theoretical framework of musical intimacy and boundaries, we can begin to understand the complex nature of music and boundaries in a contemporary approach to music therapy practice.
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ItemMusical identities of young people recovering from mental illness( 2015)This thesis details a Participatory project investigating how and why promoting young people’s musical identities can facilitate their recovery from mental illness. Studies describe how young people use music listening for managing aspects of their mental health across community-based (McFerran & Saarikallio, 2014; Saarikallio & Erkkila, 2007) and mental health settings (Cheong-Clinch, 2013). Music therapy is also articulated as a way to facilitate processes of recovery from mental illness (McCaffrey, Edwards, & Fannon, 2011; Solli, Rolvsjord, & Borg, 2013). Despite growing awareness of the potential of music to support recovery from mental illness, little is known about what conditions actually facilitate growth of musical identity in ways that foster recovery processes. This project aimed to address this gap by investigating what is needed in order to promote young people’s musical identities in ways that facilitate their recovery from mental illness. The intention was to understand both the processes involved and the resources required to facilitate recovery. A Participatory orientation (Minkler & Wallerstein, 2008) was chosen to align with the recovery approach (Davidson, Row, Tandora, O'Connell, & Lawless, 2009; Slade, 2009b) of the youth mental health service where this study took place. The Participatory philosophy was also seen as appropriate to the social agenda of the study in seeking to address young people’s access to musical resources to promote their recovery. Eleven young people currently attending the music therapy program at the youth mental health service chose to participate across two emergent cycles of action and reflection. In the first cycle, young people participated in collaborative qualitative interviews exploring how their musical identities changed with experiences of mental illness and recovery. A critical interpretation of Constructivist Grounded Theory was used to gather and analyse the data. The finding from this cycle was a constructed grounded theory that detailed young people’s recovery of musical identity. A second cycle of research emerged from this theory, to explore what community-based resources are needed to further facilitate recovery. This cycle involved mapping young people’s musical needs compared to what was available and possible in the local community. Findings from this study were an identified set of musical needs of young people, and the initiation of the Youth Music Action Group to begin addressing the meeting of these needs through community partnerships and advocacy. Findings from this study indicate that promoting musical identity can facilitate young people’s recovery from mental illness by: contributing to a health-based identity, facilitating meaning-making, and supporting social participation. However, the findings indicate a number of conditions are necessary to facilitate these processes. First, the music therapy theory through which to construct these processes needs to accommodate both the pathology of young people’s expression of musical symptoms as well as acknowledgement of the resource of musical identity for recovery. Second, music therapy needs to be available to support young people’s recovery of musical identity during early stages. Third, community-based music resources need to be available and appropriate to young people immediately following their experience of music therapy. Fourth, modes of research need to expand in order to promote greater democratic participation of young people in ways that promote their equal citizenship. These findings contribute to music therapy and youth mental health knowledge, and can inform future service design.
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ItemCritical reflections on how research design and the attributes of a music program can affect investigations of the psychosocial wellbeing benefits of musical participation in mainstream schools( 2015)This project explores the challenges of investigating the psychosocial wellbeing benefits of musical participation in mainstream schools. For a decade, Australian policy literature has claimed these benefits are to be expected outcomes of all students’ participation in school music programs (Australian Government, 2005). Despite these claims, there is little to no consistent evidence supporting a link between musical participation and psychosocial wellbeing in this context (Grimmett, Rickard, Gill, & Murphy, 2010; Rickard, Bambrick, & Gill, 2012). The reason for this inconsistency has been linked to both the research designs and methods used (Knox Anderson & Rickard, 2007), as well as the nature of musical participation investigated (Darrow, Novak, Swedberg, Horton, & Rice, 2009). Despite the identification of these limitations, researchers have continued to use designs that contain them. This can be attributed to a lack of critical engagement with approaches to research in this field, including assumptions about the efficacy of certain research methods, and the capacity for generic school music programs to promote wellbeing. This lack of critical engagement appears to account for the enduring inconsistency of findings in this area. This thesis aims to address this lack of engagement by critically appraising the research approaches used in two small studies that aimed to demonstrate the psychosocial wellbeing benefits of school-based music programs. This was achieved by undertaking two critical reflection analyses on the methods, designs, and contexts of each study, as well as the attributes of the music programs investigated. The first of these identified a number of important research challenges related to the research methods and designs used. Among other things, these findings challenge the assumption that self-report surveys are a valid way of collecting data from students. The second analysis identified a number of music program attributes that are likely to inhibit the reporting of positive results. For example, findings suggest music education programs are unsuited to promoting psychosocial wellbeing. Based on these findings, this dissertation makes a number of recommendations for the design of future studies in this area. It is argued that research following these recommendations is crucial for this field. This is both to develop a richer understanding of the relationship between music in schools and psychosocial wellbeing, and to produce reliable evidence that is better placed to inform relevant policy. It is further argued that without such evidence, policymakers may continue to make uninformed claims regarding the link between music in schools and psychosocial wellbeing. In turn, this has the potential to destabilise policy support for music in Australian schools. Finally, this thesis calls on researchers in this field, and others, to critically engage with the way that knowledge is created. It is maintained that such engagement is the responsibility of all researchers in the social sciences, and that only when this occurs can we claim the knowledge we generate is meaningful, and serving the communities we investigate.
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ItemYou light up my life: a phenomenological study of interpersonal relationships between music therapists and adults with profound intellectual and multiple disabilities( 2014)This research is an investigation of the lived experiences of music therapists who have established meaningful interpersonal relationships with adult clients with Profound Intellectual and Multiple Disabilities (PIMD). Although music therapists in clinical practice observe the benefits of music therapy for this group of clients, there has only been four research studies conducted since 1990 (Agrotou, 1998; Lee & McFerran, 2012; Oldfield & Adams, 1995; Wigram, 1997). This presents a need to conduct an empirical research study that examines and understands the non-verbal interactions and meaningful interpersonal relationships between music therapists and their adult clients who have PIMD. This qualitative study was informed by phenomenology whereby five pairs of music therapists-clients were invited to participate. Each music therapist was interviewed and asked to describe his/her experience of building the interpersonal relationship with the client. The study also included a video recording of a single music therapy session of each pair. In the last part of the interview, the music therapist watched the video footage with the researcher and identified a meaningful moment. To analyse the interviews, a descriptive phenomenological microanalysis method (McFerran & Grocke, 2007) was used. The results of the interview analysis then informed a subsequent analysis of video footage. Interpretative Phenomenological Analysis (IPA) (Smith, Flowers, & Larkin, 2009) was used for video analysis, which further resulted in the development of a new video microanalysis method, Interpretative Phenomenological Video Analysis (IPVA). The interview analysis resulted in five distilled essences of individual experiences and a final global essence. The process of establishing interpersonal relationships with an adult with PIMD was described as requiring mutual efforts over time with the context impacting on the quality of relationship. The music therapist’s role in improving psychosocial wellbeing of the client was thought to be significant. The video analysis resulted in five thick descriptions of meaningful moments. A further interpretive analysis was conducted to discover the implicit meanings of each moment to the music therapist, the client, and the pair as were seen and perceived by their music therapists. The classification of meaningful moments suggested by Amir (1992) were utilised for this process. The results indicate that three clients experienced moments of joy and ecstasy, and two clients experienced moments of completion and accomplishment. Three music therapists experienced moments of completion and accomplishment, and two music therapists experienced moments of surprise. On the interpersonal levels, three pairs experienced moments of physical closeness, and two pairs experienced moments of musical intimacy. The findings of the current study provide a fresh perspective about the processes of music therapy with adults with PIMD. The types of moments identified also provide insights into the meaningful moments that lead to psychosocial wellbeing in a long term. Moreover, the current study incorporates descriptions of contemporary practice, that challenge some of the assumptions associated with more conventional approaches to practice with adults with PIMD. Based on these findings, the future direction of music therapy with adults with PIMD is discussed. Improving work conditions of music therapists working in community settings is highlighted as important, and Community Music Therapy is proposed as one approach that might actualise the true meaning of social inclusion and meaningful participation in community for adults with PIMD.