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 performances with pre-adolescent children and families living in crisis: an interpretative phenomenological analysis( 2014)Living in crisis due to homelessness and family violence is associated with feelings of fear, chaos and uncertainty, yet little is known about how music therapy may assist children and families at this immensely challenging time of their lives. The development of community music therapy as a theoretical framework has drawn attention to the potential value of including performance in community programs. However, the majority of research focusses on adult and adolescent populations, rather than children. Considering family members and supportive networks are likely to be audience members at children’s performances, the inclusion of performance in music therapy with children presents different challenges as well as opportunities. This qualitative project explored the experience and meaning of a music therapy performance for pre-adolescent children and their families living in crisis due to homelessness and family violence. Three children aged 11 and 12 participated in a 14-week music therapy group that culminated in the sharing of a musical performance with their families. After the performance, semi-structured interviews were conducted with the children who participated in the performance, as well as their parents. This project sought to understand the phenomenon of the performance itself, rather than the process leading up to it. The performance was a multifaceted experience for the children and their families. An interpretative phenomenological analysis (Smith, Flowers and Larkin, 2009) uncovered some of the positive and negative aspects of the performance, and these were explored in detail at an individual and family level. A cross case analysis explored some of the similarities and differences in participants’ experiences and identified three recurrent themes: the children experienced intense, but mixed emotions; the performance connected the children to their family and peers; and the audience played an active role in the performance. Adopting flow as a theoretical lens provided a possible explanation for the children’s internal and external responses that contributed to their experience of the performance. At an internal level, the children described intense emotions that were similar to flow experiences. At an external level, the children’s parents and the entire audience played an integral role in supporting the children and provided some of the conditions for flow to occur. The findings from this project may help music therapists to understand the potential therapeutic outcomes for the inclusion of performance with children and families living in crisis. However, further research focussing on the ways that music therapists and families might support children’s complex needs throughout the performance experience is required.
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ItemUsing song-choice in music therapy to improve the communication skills of adults with profound and multiple disabilities( 2009)A multiple case study design was used to examine the effect of a song-choice intervention on the communication skills of adults with profound and multiple disabilities in individual music therapy. Five females participated in three song-preference assessment sessions and ten song-choice intervention sessions on a weekly basis. In the preference assessment sessions, each participant was provided with a different set of eight songs that were sung with guitar accompaniment by researcher. Affective responses to each song were analyzed and four preferred and non-preferred songs were identified. In the 30-minute song-choice intervention, each participant was offered four song-choice opportunities, with each allowing for several attempts. When the participant clearly indicated their choice of song between a pair of preferred and non-preferred songs, the researcher verbally validated it and immediately sang the chosen song, actively interacting with the participant. All sessions were video-taped and the participants’ and therapist’s behaviors during the song-choice processes were analyzed. The analysis of this data resulted in three clear outcomes. First, most participants expressed consistent affective responses to different songs and it was more obvious when provided with a highly preferred song. Second, all participants were able to choose songs which were intentional decisions as they selected their preferred songs 73 % of the time. Third, most participants gained improved communication skills. Specifically (a) two participants developed intentional choice-making behaviors such as alternating eye-gaze between a song-card and the researcher, and picking up a song-card from two song-cards, and (b) three participants improved intentional communication skills by clearly displaying their facial expressions and voices. The findings have implications for providing adults with profound and multiple disabilities with opportunities to express preference and choice, which ultimately improve their quality of life.
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ItemAn investigation of premature infant response to recorded music with maternal involvement versus no maternal involvement: a randomised control trial( 2011)The incidence of premature birth has increased over the past two decades in Australia. While survival rates have improved and stabilised, there has not been a decrease of neuro-developmental and behavioural problems arising from prematurity. Because of this, there is an increasing understanding of the need to address non-medical needs of the premature infant in hospital including the integral role of the family during this time. In a repeated-measures randomised control trial, this study sought to determine the effect of maternal presence on the premature infant’s physiological and behavioural response to recorded music and on infant status overall. Participants were 22 clinically stable premature infants (born at >28 weeks gestation and enrolled at >32 weeks gestation) and their mothers in the NICU. Both Experimental and Control groups were exposed to one session consisting of a baseline of 6 minutes of ambient noise, followed by two alternating 6 minute periods of music and no-music (total 30 minutes). The Experimental group infants had the mother present for the first twelve minutes (baseline and first music period) compared to the Control group without mother present at any time. The auditory stimulus was the NICU ambient noise, and the music stimulus was recorded lullaby music. Physiological monitoring included heart rate and oxygen saturation. The infant's behavioural state was classified using the Six Derived States of Behaviour classifications (Thoman, 1990). A Restricted Maximum Likelihood (REML) model was used to analyse the physiological and behavioural responses. There were no significant effects of maternal presence on physiological or behavioural outcome measures in either group over time. The Experimental group had consistently lower heart rate than the Control group. There was a significant difference in oxygen saturation (p< 0.05) between the Mother Present and Mother Absent periods in the Experimental group and infants responded to music with more Quiet Sleep and higher oxygen saturation in the presence of the mother. Findings from this study suggest that maternal presence had a positive effect on premature infant physiological and behavioural status during music and no music periods and a significant effect on oxygen saturation. This finding is worthy of more substantial investigation.
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ItemMusic therapy for a 10-year old child experiencing agitation during posttraumatic amnesia: an intrinsic mixed methods case study( 2010)A mixed methods case study was developed to explore the use of music therapy for children, aged 2-14 years, experiencing agitation during the posttraumatic amnesia phase of recovery following severe traumatic brain injury. The study developed pragmatically within a real world research context, and was undertaken in the Children’s Neuroscience Centre at The Royal Children’s Hospital Melbourne (Australia). The collection of qualitative data was embedded in a quantitative protocol, and data was collected concurrently. During the recruitment phase of the study, only one participant met the full eligibility criteria. The study subsequently evolved as an intrinsic case study. Data collection took place every day (excluding weekends) for the first ten days of posttraumatic amnesia. Data collection included the participant being video recorded pre, during, and post each daily music therapy intervention. The music therapy intervention involved the music therapist-researcher singing familiar songs. The aim of the quantitative data collection and analysis was to measure the effect of music therapy on agitation, and included two independent reviewers viewing the video data and rating the participant’s agitation pre, during, and post each music therapy intervention using the Agitated Behavior Scale (Corrigan, 1989). These ratings were then analysed statistically. The analysis of qualitative data aimed to explore the responses of both the participant and the music therapist-researcher during the music therapy interventions, and was an emergent process undertaken using Morse and Pooler’s (2002) tri-tiered method of analysis for videotaped data. The participant (a 10-year old girl) sustained an extremely severe traumatic brain injury as a result of a transport accident. Severe cognitive impairments and a significantly reduced level of consciousness resulted in the participant presenting with only Islands of Awareness during the music therapy interventions. Analysis of the quantitative data yielded inconclusive results as to the effect of music therapy in reducing agitation during and post each music therapy intervention. Micro-description and analysis of the qualitative data revealed that the participant displayed four distinct categories of behaviours during the music therapy interventions: Neutral, Acceptance, Recruitment and Rejection. The final three categories of participant behaviours were responses to the familiar songs. Further, the music therapist-researcher responded to the participant’s behaviours in four distinct, corresponding ways; Holding, Affirming, Enticing, and Containing. The interpretation of these categories of behaviours and responses was that through offering a consistent musical holding for the participant’s behaviours, and adaptation of the familiar songs in a contingent manner in response to the participant, the music therapist-researcher offered an Environment of Potential to maximise the participant’s Islands of Awareness. The Environment of Potential maximised early stimulation to optimise the participant’s early recovery of consciousness and cognitive abilities.
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ItemMethods used in cross-cultural music therapy in aged care in Australia( 2010)Aged care clients in Australia come from increasingly diverse cultural and linguistic backgrounds. Music therapists are being called upon to work with this changing population, an area in which both training and research are still developing, according to current literature. Music therapists have written about cross-cultural practice; yet most of these studies concern individual clients, not the group approach that is most commonly used in aged care. This study therefore addresses the shortage of research in these areas: 1) cross-cultural music therapy methods, 2) aged CALD clients and 3) group situations. The Australian Music Therapy Association (AMTA) was contacted to circulate an online questionnaire to 88 practising registered music therapists (RMTs) identified as working in aged care. A thirty-three percent response rate (30 respondents) was achieved. Data was gathered on frequently used methods (listening to music, singing and movement to music), music repertoire, genre and styles, and utilisation of cultural specific music idioms. The results suggest that cross-cultural music therapy practice in aged care is influenced by various factors, including personal experience and professional training, as well as the client’s background, abilities, level of acculturation and musical preference. Most respondents were confident in providing music therapy to CALD clients, who enjoyed an equal amount of service as non-CALD clients. However, a number of respondents expressed reservations about the level of preparedness for cross-cultural work provided by university training, preferring to emphasise the importance of personal (rather than professional) experience and interests. This study thus concludes with recommendations for training music therapists in future.
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ItemMusic and physiotherapy: evaluation of a program developed for caregivers of infants and toddlers with cystic fibrosis( 1998)Cystic fibrosis is an inherited pathological condition which can be treated but not cured and is ultimately life threatening. Those affected by cystic fibrosis require daily treatment to minimize the symptoms of the illness and retard the progression of pulmonary deterioration. An important component of the prophylactic therapy regime is chest physiotherapy which enhances the clearance of lung secretions. However, chest physiotherapy is time consuming and not always enjoyable, particularly for infants and toddlers. This study utilized an independent and repeated measures design to evaluate the effect of recorded music as an adjunct to daily routine chest physiotherapy on children's enjoyment, caregivers' enjoyment and caregivers' perception of time taken to complete the routine. Participants were caregivers of one or more children with cystic fibrosis who were aged between 4½ months and 24 months at the commencement of the clinical trial and required chest physiotherapy on a daily basis. The children's cystic fibrosis care was managed by the Department of Thoracic Medicine at the Royal Children's Hospital in Victoria. Participants were randomly allocated into treatment and control groups and were involved in the study for 12 weeks. Participants in the treatment group were given the treatment tape: a specifically compiled music tape consisting of instrumental music and children's songs, newly composed for use as an adjunct to chest physiotherapy. Participants in the control group received no tape for the first 6 weeks, then received their choice from two commercially available, children's audiocassettes) both of which were familiar to the participants. Enjoyment and perception of time were assessed at the commencement of the trial and then twice more at 6-week intervals. After 6 weeks of using the treatment tape, children's and caregivers' enjoyment of chest physiotherapy increased significantly compared to no music. There was no change in perception of time taken to complete the chest physiotherapy after using the treatment tape. Use of the familiar music tape was not associated with significant increases in enjoyment for children or caregivers. Familiar music did not alter the perception of time taken to complete the routine. The results suggest that recorded music is an effective adjunct to daily chest physiotherapy which enhances caregivers' and children's enjoyment, particularly when that music is specifically compiled for use with the physiotherapy.