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Ghetti CM, Hjelmbrekke S, Morken K, Dahl T, Stige B. Steering the energy with music: hermeneutic phenomenological study of user perspectives of music and music therapy for co-occurring ADHD and substance use problems. Subst Abuse Treat Prev Policy 2024; 19:10. [PMID: 38263064 PMCID: PMC10807156 DOI: 10.1186/s13011-024-00594-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 01/09/2024] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND User perspectives and involvement are crucial for improving substance use treatment service provision. First-hand accounts provide rich perspectives on how users experience change within therapeutic approaches like music therapy. People with substance use problems have a higher incidence of experiencing challenges with impulsivity, hyperactivity and inattention. Such challenges can negatively affect social functioning and outcomes of substance use treatment. Music therapy can offer people a means to regulate emotions and facilitate social relationships. There is a lack of research on user perspectives of music therapy in substance use treatment, and we could identify no studies that explore user perspectives of music therapy for adults with substance use problems and co-occurring impulsivity, hyperactivity and inattention. METHODS The aim of this phenomenological study was to center the voices of people living with co-occurring attention deficit hyperactivity disorder (ADHD) and substance use disorder (SUD) to understand how they experience music and music therapy in their process of recovery. We used a hermeneutic phenomenological approach to qualitative analysis of transcripts from in-depth interviews with 8 adult service users from a Norwegian substance use treatment facility. RESULTS Our main finding was that music and music therapy enabled experiences of motivation and mastery that ultimately afforded social belonging. The participants demonstrated detailed and nuanced understanding of how they use music to steer the energy and restlessness that are characteristic of ADHD, to change mood, and to shift negative thought patterns. These forms of music-centered regulation served as pre-requisites for more active and gratifying participation in social communities. For several participants, musicking offered a means of establishing drug-free identity and fellowship. The motivation and mastery experienced during musicking lowered the threshold for social engagement, and served as an incentive for continuing substance use treatment for some participants. CONCLUSIONS The nuanced descriptions from our participants illustrate the importance of motivation, and how music therapy can contribute to motivation in substance use treatment. In particular, the context surrounding musicking, adaptations from the music therapist, and social affordances of such musicking contributed to pleasure, mastery, participation, development of identity and social belonging, which in interaction generated motivation.
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Affiliation(s)
- Claire M Ghetti
- GAMUT-The Grieg Academy Music Therapy Research Centre, The Grieg Academy-Department of Music, University of Bergen, 5020, Bergen, Postbox 7805, Norway.
| | - Steinar Hjelmbrekke
- Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
| | - Katharina Morken
- Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - Therese Dahl
- Albatrossen Aftercare Center (The Albatrossen Foundation), Bergen, Norway
| | - Brynjulf Stige
- GAMUT-The Grieg Academy Music Therapy Research Centre, The Grieg Academy-Department of Music, University of Bergen, 5020, Bergen, Postbox 7805, Norway
- Polyfon Knowledge Cluster for Music Therapy, Bergen, Norway
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Oedegaard CH, Engrebretsen IMS, Veseth M, Blindheim A, Stige B. Health care workers’ perspectives on the challenges and possibilities of music therapy within medication-free treatment services. Nordic Journal of Music Therapy 2022. [DOI: 10.1080/08098131.2022.2115530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Christine Henriksen Oedegaard
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | | | - Marius Veseth
- Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - Anne Blindheim
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
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Oedegaard CH, Ruano AL, Blindheim A, Veseth M, Stige B, Davidson L, Engebretsen IMS. How can we best help this patient? Exploring mental health therapists’ reflections on medication-free care for patients with psychosis in Norway. Int J Ment Health Syst 2022; 16:19. [PMID: 35379290 PMCID: PMC8978409 DOI: 10.1186/s13033-022-00529-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 03/16/2022] [Indexed: 11/24/2022] Open
Abstract
Background Since 2015, Norwegian Regional Health Authorities have followed new government policy and gradually implemented medication-free services for patients with psychosis. The aim of this qualitative study was to explore the tension between policy and practice, and how health care workers in Bergen reflect on their role in implementing medication-free treatment. Methods We performed three focus group discussions including 17 therapists working within medication free services, asking about their experiences with this new treatment program. We used Systematic Text Condensation for data analysis. The findings were discussed using Michael Lipsky’s theoretical framework on the role public health workers play in policy implementation. Findings Following Norway’s new policy was challenging for the therapists in our study, particularly balancing a patient’s needs with treatment guidelines, the legal framework and available resources. Therapists had an overarching wish to help patients through cooperation and therapeutic alliance, but their alliance was sometimes fragile, and the therapists worried about patients’ conditions worsening. Conclusions Democratization of treatment choices, with the aim of empowering patients in mental health care, challenges the level of professional discretion given that patients and therapists might have conflicting goals. Balancing the desire to help, professional responsibility, the perceived lack of resources, and certain patient choices created conditions that can leave therapists feeling disempowered in and alienated from their work. Trial registration: N/A. Supplementary Information The online version contains supplementary material available at 10.1186/s13033-022-00529-8.
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Stige B. In memory of Wita Szulc. Nordic Journal of Music Therapy 2022. [DOI: 10.1080/08098131.2022.2024986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Brynjulf Stige
- Founding editor of Nordic Journal of Music Therapy (1992-2006)“The Grieg Academy Music Therapy Research Centre, University of Bergen, Bergen, Norway”
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Affiliation(s)
- Kaja Elise Aaslid Enge
- Faculty of Arts and Physical Education, Volda University College, Volda, Norway
- The Grieg Academy Music Therapy Research Centre, University of Bergen, Bergen, Norway
| | - Brynjulf Stige
- The Grieg Academy Music Therapy Research Centre, University of Bergen, Bergen, Norway
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Oedegaard CH, Davidson L, Stige B, Veseth M, Blindheim A, Garvik L, Sørensen JM, Søraa Ø, Engebretsen IMS. "It means so much for me to have a choice": a qualitative study providing first-person perspectives on medication-free treatment in mental health care. BMC Psychiatry 2020; 20:399. [PMID: 32770965 PMCID: PMC7414551 DOI: 10.1186/s12888-020-02770-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 06/29/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND In 2016, the Western Norway Regional Health Authority started to integrate more evidence-based psychosocial interventions into the existing mental health care, emphasizing the right for persons with psychosis to choose medication-free treatment. This change emerged from the debate on the effectiveness and adverse effects of the use of antipsychotic medication. Aspects beyond symptom reduction, such as interpersonal relationships, increased understanding of one's own pattern of suffering, hope and motivation, are all considered important for the personal recovery process. METHODS This study explores whether these aspects were present in users' descriptions of their recovery processes within the medication-free treatment programme in Bergen, Western Norway. We interviewed ten patients diagnosed with psychosis who were eligible for medication-free services about their treatment experiences. Data were analysed using Attride-Stirling's thematic network approach. RESULTS The findings show a global theme relating to personal recovery processes facilitated by the provision of more psychosocial treatment options, with three organizing subthemes: interpersonal relationships between patients and therapists, the patient's understanding of personal patterns of suffering, and personal motivation for self-agency in the recovery process. Participants described an improved relationship with therapists compared to previous experiences. Integrating more evidence-based psychosocial interventions into existing mental health services facilitated learning experiences regarding the choice of treatment, particularly the discontinuation of medication, and appeared to support participants' increased self-agency and motivation in their personal recovery processes. CONCLUSION Health care in Norway is perhaps one step closer to optimizing care for people with psychosis, allowing for more patient choice and improving the dialogue and hence the interpersonal relationship between the patient and the therapist. Personal patterns of suffering can be explored within a system aiming to support and have a higher level of acceptance for the discontinuation of medication. Such a system requires personal agency in the treatment regimen, with more focus on personal coping strategies and more personal responsibility for the recovery process.
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Affiliation(s)
- Christine H. Oedegaard
- grid.412008.f0000 0000 9753 1393Haukeland University Hospital, Kronstad DPS, Pb 1400, 5021 Bergen, Norway ,grid.7914.b0000 0004 1936 7443Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Pb. 7804, 5020 Bergen, Norway
| | - Larry Davidson
- grid.47100.320000000419368710Department of Psychiatry, Yale Medical School, New Haven, Connecticut USA
| | - Brynjulf Stige
- grid.7914.b0000 0004 1936 7443The Grieg Academy, University of Bergen, Pb. 7800, 5020 Bergen, Norway
| | - Marius Veseth
- grid.7914.b0000 0004 1936 7443Department of Clinical Psychology, University of Bergen, Pb. 7807, 5020 Bergen, Norway
| | - Anne Blindheim
- grid.412008.f0000 0000 9753 1393Haukeland University Hospital, Kronstad DPS, Pb 1400, 5021 Bergen, Norway
| | - Linda Garvik
- Hvite Ørn User Organisation, Thomles gt. 4, 0270 Oslo, Norway
| | | | - Øystein Søraa
- Hvite Ørn User Organisation, Thomles gt. 4, 0270 Oslo, Norway
| | - Ingunn Marie Stadskleiv Engebretsen
- grid.7914.b0000 0004 1936 7443Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Pb. 7804, 5020 Bergen, Norway
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Janus SIM, Vink AC, Ridder HM, Geretsegger M, Stige B, Gold C, Zuidema SU. Developing consensus description of group music therapy characteristics for persons with dementia. Nordic Journal of Music Therapy 2020. [DOI: 10.1080/08098131.2020.1779790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Sarah I. M. Janus
- Department of General Practice and Elderly Care Medicine, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Annemieke C. Vink
- Academy of Music, Music Therapy Department, ArtEZ University of the Arts, Enschede, The Netherlands
| | - Hanne Mette Ridder
- Doctoral Programme in Music Therapy, Department of Communication and Psychology, Aalborg University, Aalborg, Denmark
| | - Monika Geretsegger
- GAMUT - The Grieg Academy Music Therapy Research Centre, NORCE, Bergen, Norway
| | - Brynjulf Stige
- Grieg Academy – Department of Music, Faculty of Fine Art, Music and Design, University of Bergen, Bergen, Norway
| | - Christian Gold
- GAMUT - The Grieg Academy Music Therapy Research Centre, NORCE, Bergen, Norway
| | - Sytse U. Zuidema
- Department of General Practice and Elderly Care Medicine, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
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Gold C, Eickholt J, Assmus J, Stige B, Wake JD, Baker FA, Tamplin J, Clark I, Lee YEC, Jacobsen SL, Ridder HMO, Kreutz G, Muthesius D, Wosch T, Ceccato E, Raglio A, Ruggeri M, Vink A, Zuidema S, Odell-Miller H, Orrell M, Schneider J, Kubiak C, Romeo R, Geretsegger M. Music Interventions for Dementia and Depression in ELderly care (MIDDEL): protocol and statistical analysis plan for a multinational cluster-randomised trial. BMJ Open 2019; 9:e023436. [PMID: 30928926 PMCID: PMC6475205 DOI: 10.1136/bmjopen-2018-023436] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
INTRODUCTION In older adults, dementia and depression are associated with individual distress and high societal costs. Music interventions such as group music therapy (GMT) and recreational choir singing (RCS) have shown promising effects, but their comparative effectiveness across clinical subgroups is unknown. This trial aims to determine effectiveness of GMT, RCS and their combination for care home residents and to examine heterogeneity of treatment effects across subgroups. METHODS AND ANALYSIS This large, pragmatic, multinational cluster-randomised controlled trial with a 2×2 factorial design will compare the effects of GMT, RCS, both or neither, for care home residents aged 65 years or older with dementia and depressive symptoms. We will randomise 100 care home units with ≥1000 residents in total across eight countries. Each intervention will be offered for 6 months (3 months 2 times/week followed by 3 months 1 time/week), with extension allowed if locally available. The primary outcome will be the change in the Montgomery-Åsberg Depression Rating Scale score at 6 months. Secondary outcomes will include depressive symptoms, cognitive functioning, neuropsychiatric symptoms, psychotropic drug use, caregiver burden, quality of life, mortality and costs over at least 12 months. The study has 90% power to detect main effects and is also powered to determine interaction effects with gender, severity and socioeconomic status. ETHICS AND DISSEMINATION Ethical approval has been obtained for one country and will be obtained for all countries. Results will be presented at national and international conferences and published in scientific journals. TRIAL REGISTRATION NUMBERS NCT03496675; Pre-results, ACTRN12618000156280.
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Affiliation(s)
- Christian Gold
- GAMUT - The Grieg Academy Music Therapy Research Centre, NORCE Norwegian Research Centre, Bergen, Norway
| | - Jasmin Eickholt
- Faculty of Applied Social Sciences, University of Applied Sciences Würzburg-Schweinfurt, Würzburg, Germany
| | - Jörg Assmus
- GAMUT - The Grieg Academy Music Therapy Research Centre, NORCE Norwegian Research Centre, Bergen, Norway
| | - Brynjulf Stige
- GAMUT - The Grieg Academy Music Therapy Research Centre, NORCE Norwegian Research Centre, Bergen, Norway
| | | | - Felicity Anne Baker
- Faculty of Fine Arts and Music, University of Melbourne, Southbank, Victoria, Australia
| | - Jeanette Tamplin
- Faculty of Fine Arts and Music, University of Melbourne, Southbank, Victoria, Australia
| | - Imogen Clark
- Faculty of Fine Arts and Music, University of Melbourne, Southbank, Victoria, Australia
| | - Young-Eun Claire Lee
- Faculty of Fine Arts and Music, University of Melbourne, Southbank, Victoria, Australia
| | | | | | - Gunter Kreutz
- Department of Music, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| | | | - Thomas Wosch
- Faculty of Applied Social Sciences, University of Applied Sciences Würzburg-Schweinfurt, Würzburg, Germany
| | - Enrico Ceccato
- Department of Mental Health, Azienda ULSS 8 Berica, Vicenza, Italy
| | - Alfredo Raglio
- Music Therapy Research Laboratory, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Mirella Ruggeri
- Public Health and Community Medicine, University of Verona, Verona, Italy
| | - Annemiek Vink
- Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Music therapy Department, Academy of Music, ArtEZ University of the Arts, Enschede, The Netherlands
| | - Sytse Zuidema
- Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Helen Odell-Miller
- The Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, UK
| | - Martin Orrell
- Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Justine Schneider
- School of Sociology and Social Policy, University of Nottingham, Nottingham, UK
| | - Christine Kubiak
- European Clinical Research Infrastructure Network (ECRIN), Paris, France
| | - Renee Romeo
- King’s Health Economics, King’s College London, London, UK
| | - Monika Geretsegger
- GAMUT - The Grieg Academy Music Therapy Research Centre, NORCE Norwegian Research Centre, Bergen, Norway
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Abstract
Public interest in the benefits of music for people with dementia has rapidly increased in recent years. In addition to clinical work with clients, music therapists are often required to support and train staff, families, and volunteers and skill-share some music therapeutic skills. Six music therapy researchers from six countries agreed it was timely to organize a roundtable and share their indirect music therapy practice and examples of skill-sharing in dementia care. This article was developed following the roundtable at the World Congress of Music Therapy in 2017 and further discussion among the authors. This process highlighted the diversity and complexity of indirect music therapy practice and skill-sharing, but some common components emerged, including: 1) the importance of making clinical decisions about when direct music therapy is necessary and when indirect music therapy is appropriate, 2) supporting the transition from direct music therapy to indirect music therapy, 3) the value of music therapy skill-sharing in training care home staff, 4) the need for considering potential risks and burdens of indirect music therapy practice, and 5) expanding the role of music therapist and cultivating cross-professional dialogues to support organizational changes. In indirect music therapy practice, a therapist typically works with carers and supporters to strengthen their relationships with people with dementia and help them further develop their self-awareness and sense of competence. However, the ultimate goal of indirect music therapy practice in dementia care remains the wellbeing of people living with dementia.
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Affiliation(s)
| | | | | | - Thomas Wosch
- University of Applied Sciences Würzburg-Schweinfurt
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Abstract
This article explores how the members of Me and THE BAND, a rock band consisting of three ex-inmates and a music therapist, experienced playing together, how it helps them, and whether and how this can be related to the concept of self-help. Focus group interviews were conducted to explore the members’ experiences, analysis was grounded in a hermeneutic philosophical understanding and the theoretical framework is based in a community music therapy approach. The study indicates how musicking helped the band members of Me and THE BAND’its to create agency, structure, meaning and community. The band appeared to function through collaborative processes, and the music therapists as facilitator need to prepare the qualities of equality, mutuality and participation. As a conclusion, the members of Me and THE BAND’its do not identify as being a self-help group, although they clearly report that musicking helps them. The crux of this paradox is that it is important for the group members to identify as a band, but they still include self-help concepts and traditions. They maintain their own uniqueness and independence, while making musicking a possible way out of criminality.
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Helle-Valle A, Binder PE, Anderssen N, Stige B. Is restlessness best understood as a process? Reflecting on four boys' restlessness during music therapy in kindergarten. Int J Qual Stud Health Well-being 2017; 12:1298266. [PMID: 28532331 PMCID: PMC5510212 DOI: 10.1080/17482631.2017.1298266] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
ADHD can be considered an internationally recognized framework for understanding children’s restlessness. In this context, children’s restlessness is understood as a symptom of neurodevelopmental disorder. However, there are other possible understandings of children’s restlessness. In this article, we explore four boys’ collaborative and creative process as it is described and understood by three adults. The process is framed by a community music therapy project in a Norwegian kindergarten, and we describe four interrelated phases of this process: Exploring musical vitality and cooperation, Consolidating positions, Performing together, and Discovering ripple effects. We discuss these results in relation to seven qualities central to a community music therapy approach: participation, resource orientation, ecology, performance, activism, reflexivity and ethics. We argue that in contrast to a diagnostic approach that entails a focus on individual problems, a community music therapy approach can shed light on adult and systemic contributions to children’s restlessness.
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Affiliation(s)
- Anna Helle-Valle
- a Department of Psychosocial Science, Faculty of Psychology , University of Bergen , Bergen , Norway
| | - Per-Einar Binder
- b Department of Clinical Psychology, Faculty of Psychology , University of Bergen , Bergen , Norway
| | - Norman Anderssen
- a Department of Psychosocial Science, Faculty of Psychology , University of Bergen , Bergen , Norway
| | - Brynjulf Stige
- c Grieg Academy - Department of Music, Faculty of Fine Art, Music and Design , University of Bergen , Bergen , Norway
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Abstract
In this article I discuss some questions on meaning in music therapy by taking as my point of departure the different perspectives of two British music therapists, Mary Priestley and Gary Ansdell. Since all discussions of meaning – even when considering ‘non-verbal phenomena’ – are based on an understanding of language, I have found the philosophy of Ludwig Wittgenstein an interesting port of entry to this topic. Following an introduction to Wittgenstein's concepts of ‘language game’ and ‘family resemblances’, I give a brief discussion of Wittgenstein's relevance for aesthetic understanding, highlighting the concept of ‘intransitive understanding’. These three concepts will then be used as a basis for examining the differences between Priestley's and Ansdell's perspectives, which may serve to expand our thinking about meaning in music therapy.
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Abstract
This article explores ideas around the potential value of pleasure within music therapy processes. It sets out to review and develop theory through the use of an abductive approach whereby texts are related to clinical experience and empirical material. As an initial context for the exploration, the music therapy literature is searched for reflections on pleasure. The question of whether pleasure is worth pursuing is addressed through a brief exploration of some relevant texts in Western philosophy and psychology. These literature reviews suggest that there is need for more exploratory and reflective work on pleasure within music therapy. As a contribution to this, material from a qualitative research interview with a client is presented. This material is seen in relation to relevant theories on music, mood and emotion, and implications for music therapy theory and practice are then examined.
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Helle-Valle A, Binder PE, Stige B. Do we understand children's restlessness? Constructing ecologically valid understandings through reflexive cooperation. Int J Qual Stud Health Well-being 2015; 10:29292. [PMID: 26701898 PMCID: PMC4689122 DOI: 10.3402/qhw.v10.29292] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/16/2015] [Indexed: 11/18/2022] Open
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is the most widely used children's mental health diagnosis today, but the validity of the diagnosis is controversial, for instance, because it might conceal relational and ecological dimensions of restlessness. We invited parents and professionals from one local community in western Norway to participate in cooperative group discussions on how to conceptualize and understand children's restlessness. We carried out a thematic and reflexive analysis of the cooperative group discussions on ADHD and children's restlessness, and present findings related to three ecological levels inspired by Bronfenbrenner's ecological systems model. At the level of the individual, restlessness was discussed as individual trait, as the expectation to be seen and heard, and as a result of traumatization. At the level of dyad, group or family, restlessness was discussed as a relational phenomenon and as parents' problems. At the level of community, restlessness was discussed as lack of cooperation and lack of structures or resources. Our findings show how contextualized and cooperative reflexivity can contribute to more valid understandings of children's restlessness, and how cooperative inquiry can stimulate reflections about solidarity and sustainability in relation to adult's actions.
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Affiliation(s)
- Anna Helle-Valle
- GAMUT-Grieg Academy Music Therapy Research Centre, The Grieg Academy-Department of Music, University of Bergen, Bergen, Norway;
| | - Per-Einar Binder
- Department of Clinical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Brynjulf Stige
- GAMUT-Grieg Academy Music Therapy Research Centre, The Grieg Academy-Department of Music, University of Bergen, Bergen, Norway
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Metell M, Stige B. Blind spots in music therapy. Toward a critical notion of participation in context of children with visual impairment. Nordic Journal of Music Therapy 2015. [DOI: 10.1080/08098131.2015.1081265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Abstract
In contemporary music therapy as well as in related interdisciplinary fields, the importance of context in relation to theory, research, and practice has been emphasized. However, the word context seems to be used in several different ways and conceptualizations of contextual approaches vary too. The objective of this theoretical article is to clarify traditions of language use in relation to context in music therapy. In reviewing and discussing the literature, we focus on the field of mental health care. When discussing issues related to context, this literature partly focuses on the surroundings of music therapy practice, partly on the ecology of reciprocal influences within and between situations or systems. On this basis, three types of context awareness in music therapy are identified: music therapy in context; music therapy as context; and music therapy as interacting contexts. The identified types of context awareness are exemplified through references to music therapy literature and then discussed in relation to two very different metaphors, namely context as frame and context as link. Implications for practice, research, and theory development in music therapy are suggested.
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Affiliation(s)
- Randi Rolvsjord
- GAMUT, The Grieg Academy – Department of Music, University of Bergen, Norway
| | - Brynjulf Stige
- GAMUT, The Grieg Academy – Department of Music, University of Bergen, Norway
- GAMUT, Uni Health, Uni Research, Bergen, Norway
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Gold C, Assmus J, Hjørnevik K, Qvale LG, Brown FK, Hansen AL, Waage L, Stige B. Music therapy for prisoners: pilot randomised controlled trial and implications for evaluating psychosocial interventions. Int J Offender Ther Comp Criminol 2014; 58:1520-1539. [PMID: 23985355 DOI: 10.1177/0306624x13498693] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
UNLABELLED Mental health problems are common among prison inmates. Music therapy has been shown to reduce mental health problems. It may also be beneficial in the rehabilitation of prisoners, but rigorous outcome research is lacking. We compared group music therapy with standard care for prisoners in a pilot randomised controlled trial that started with the establishment of music therapy services in a prison near Bergen in 2008. In all, 113 prisoners agreed to participate. Anxiety (STAI-State [State-Trait Anxiety Inventory], STAI-Trait), depression (HADS-D [Hospital Anxiety and Depression Scale]), and social relationships (Quality of Life Enjoyment and Satisfaction Questionnaire [Q-LES-Q]) were assessed at baseline; every 2 weeks in the experimental group; after 1, 3, and 6 months in the control group; and at release. No restrictions were placed on the frequency, duration, or contents of music therapy. Duration of stay in the institution was short (62% stayed less than 1 month). Only a minority reached clinical cutoffs for anxiety and depression at baseline. Between-group analyses of effects were not possible. Music therapy was well accepted and attractive among the prisoners. Post hoc analysis of within-group changes suggested a reduction of state anxiety after 2 weeks of music therapy (d = 0.33, p = .025). Short sentences and low baseline levels of psychological disturbance impeded the examination of effects in this study. Recommendations for planning future studies are given, concerning the careful choice of participants, interventions and settings, comparison condition and design aspects, choice of outcomes, and integration of research approaches. Thus, the present study has important implications for future studies evaluating interventions for improving prisoners' mental health. TRIAL REGISTRATION ISRCTN22518605.
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Affiliation(s)
- Christian Gold
- GAMUT-The Grieg Academy Music Therapy Research Centre, Uni Health, Uni Research, Bergen, Norway
| | - Jörg Assmus
- GAMUT-The Grieg Academy Music Therapy Research Centre, Uni Health, Uni Research, Bergen, Norway Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway
| | - Kjetil Hjørnevik
- Bjørgvin Prison, Correctional Services Western Norway, Bjørgvin, Norway
| | - Liv Gunnhild Qvale
- GAMUT-The Grieg Academy Music Therapy Research Centre, Uni Health, Uni Research, Bergen, Norway
| | - Fiona Kirkwood Brown
- GAMUT-The Grieg Academy Music Therapy Research Centre, Uni Health, Uni Research, Bergen, Norway
| | - Anita Lill Hansen
- Department of Psychosocial Science, University of Bergen, Bergen, Norway Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Leif Waage
- Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Brynjulf Stige
- GAMUT-The Grieg Academy Music Therapy Research Centre, Uni Health, Uni Research, Bergen, Norway The Grieg Academy, University of Bergen, Norway
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Tuastad L, Stige B. The revenge ofMe and THE BAND’its: A narrative inquiry of identity constructions in a rock band of ex-inmates. Nordic Journal of Music Therapy 2014. [DOI: 10.1080/08098131.2014.967713] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Gold C, Mössler K, Grocke D, Heldal TO, Tjemsland L, Aarre T, Aarø LE, Rittmannsberger H, Stige B, Assmus J, Rolvsjord R. Individual music therapy for mental health care clients with low therapy motivation: multicentre randomised controlled trial. Psychother Psychosom 2014; 82:319-31. [PMID: 23942318 DOI: 10.1159/000348452] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2012] [Accepted: 01/21/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND Music therapy (MT) has been shown to be efficacious for mental health care clients with various disorders such as schizophrenia, depression and substance abuse. Referral to MT in clinical practice is often based on other factors than diagnosis. We aimed to examine the effectiveness of resource-oriented MT for mental health care clients with low motivation for other therapies. METHOD This was a pragmatic parallel trial. In specialised centres in Norway, Austria and Australia, 144 adults with non-organic mental disorders and low therapy motivation were randomised to 3 months of biweekly individual, resource-oriented MT plus treatment as usual (TAU) or TAU alone. TAU was typically intensive (71% were inpatients) and included the best combination of therapies available for each participant, excluding MT. Blinded assessments of the Scale for the Assessment of Negative Symptoms (SANS) and 15 secondary outcomes were collected before randomisation and after 1, 3 and 9 months. Changes were analysed on an intention-to-treat basis using generalised estimating equations in longitudinal linear models, controlling for diagnosis, site and time point. RESULTS MT was superior to TAU for total negative symptoms (SANS, d = 0.54, p < 0.001) as well as functioning, clinical global impressions, social avoidance through music, and vitality (all p < 0.01). CONCLUSION Individual MT as conducted in routine practice is an effective addition to usual care for mental health care clients with low motivation.
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Affiliation(s)
- Christian Gold
- GAMUT, Uni Health, Uni Research, Bergen, Norway. christian.gold @ uni.no
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Krüger V, Stige B. Between rights and realities – music as a structuring resource in child welfare everyday life: a qualitative study. Nordic Journal of Music Therapy 2014. [DOI: 10.1080/08098131.2014.890242] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abstract
OBJECTIVES Agitation in nursing home residents with dementia leads to increase in psychotropic medication, decrease in quality of life, and to patient distress and caregiver burden. Music therapy has previously been found effective in treatment of agitation in dementia care but studies have been methodologically insufficient. The aim of this study was to examine the effect of individual music therapy on agitation in persons with moderate/severe dementia living in nursing homes, and to explore its effect on psychotropic medication and quality of life. METHOD In a crossover trial, 42 participants with dementia were randomized to a sequence of six weeks of individual music therapy and six weeks of standard care. Outcome measures included agitation, quality of life and medication. RESULTS Agitation disruptiveness increased during standard care and decreased during music therapy. The difference at -6.77 (95% CI (confidence interval): -12.71, -0.83) was significant (p = 0.027), with a medium effect size (0.50). The prescription of psychotropic medication increased significantly more often during standard care than during music therapy (p = 0.02). CONCLUSION This study shows that six weeks of music therapy reduces agitation disruptiveness and prevents medication increases in people with dementia. The positive trends in relation to agitation frequency and quality of life call for further research with a larger sample.
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Affiliation(s)
- Hanne Mette O Ridder
- Doctoral Programme in Music Therapy, Department of Communication & Psychology, Aalborg University, Aalborg Øst, Denmark.
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Moltu C, Binder PE, Stige B. Collaborating with the client: Skilled psychotherapists' experiences of the client's agency as a premise for their own contribution in difficult therapies ending well. Journal of Psychotherapy Integration 2012. [DOI: 10.1037/a0028010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Abstract
Evaluation is essential for research quality and development, but the diversity of traditions that characterize qualitative research suggests that general checklists or shared criteria for evaluation are problematic. We propose an approach to research evaluation that encourages reflexive dialogue through use of an evaluation agenda. In proposing an evaluation agenda we shift attention from rule-based judgment to reflexive dialogue. Unlike criteria, an agenda may embrace pluralism, and does not request consensus on ontological, epistemological, and methodological issues, only consensus on what themes warrant discussion. We suggest an evaluation agenda-EPICURE-with two dimensions communicated through use of two acronyms.The first, EPIC, refers to the challenge of producing rich and substantive accounts based on engagement, processing, interpretation, and (self-)critique. The second-CURE-refers to the challenge of dealing with preconditions and consequences of research, with a focus on (social) critique, usefulness, relevance, and ethics. The seven items of the composite agenda EPICURE are presented and exemplified. Features and implications of the agenda approach to research evaluation are then discussed.
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Stige B. Routes. Nordic Journal of Music Therapy 2009. [DOI: 10.1080/08098130309478081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Stige B. Feminine Beginnings. Nordic Journal of Music Therapy 2009. [DOI: 10.1080/08098130109478025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Stige B. People Make Music. Nordic Journal of Music Therapy 2009. [DOI: 10.1080/08098130409478093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Stige B, Keith D, Kim SA, Gjul IM, Kenny C. Book Review Summaries. Nordic Journal of Music Therapy 2008. [DOI: 10.1080/08098130809478198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Stige B. Places and Partners. Nordic Journal of Music Therapy 2006. [DOI: 10.1080/08098130609478146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Gold C, Rolvsjord R, Aaro LE, Aarre T, Tjemsland L, Stige B. Resource-oriented music therapy for psychiatric patients with low therapy motivation: protocol for a randomised controlled trial [NCT00137189]. BMC Psychiatry 2005; 5:39. [PMID: 16259626 PMCID: PMC1311735 DOI: 10.1186/1471-244x-5-39] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2005] [Accepted: 10/31/2005] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Previous research has shown positive effects of music therapy for people with schizophrenia and other mental disorders. In clinical practice, music therapy is often offered to psychiatric patients with low therapy motivation, but little research exists about this population. The aim of this study is to examine whether resource-oriented music therapy helps psychiatric patients with low therapy motivation to improve negative symptoms and other health-related outcomes. An additional aim of the study is to examine the mechanisms of change through music therapy. METHODS 144 adults with a non-organic mental disorder (ICD-10: F1 to F6) who have low therapy motivation and a willingness to work with music will be randomly assigned to an experimental or a control condition. All participants will receive standard care, and the experimental group will in addition be offered biweekly sessions of music therapy over a period of three months. Outcomes will be measured by a blind assessor before and 1, 3, and 9 months after randomisation. DISCUSSION The findings to be expected from this study will fill an important gap in the knowledge of treatment effects for a patient group that does not easily benefit from treatment. The study's close link to clinical practice, as well as its size and comprehensiveness, will make its results well generalisable to clinical practice.
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Affiliation(s)
- Christian Gold
- Faculty of Health Studies, Sogn og Fjordane University College, 6823 Sandane, Norway
| | - Randi Rolvsjord
- Faculty of Health Studies, Sogn og Fjordane University College, 6823 Sandane, Norway
- Nordfjord Psychiatry Centre, 6770 Nordfjordeid, Norway
| | | | - Trond Aarre
- Nordfjord Psychiatry Centre, 6770 Nordfjordeid, Norway
| | | | - Brynjulf Stige
- Faculty of Health Studies, Sogn og Fjordane University College, 6823 Sandane, Norway
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Rolvsjord R, Gold C, Stige B. Research Rigour and Therapeutic Flexibility: Rationale for a Therapy Manual Developed for a Randomised Controlled Trial. Nordic Journal of Music Therapy 2005. [DOI: 10.1080/08098130509478122] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Stige B, Sekeles C, Pruckner F, Hadley S, Soshensky R, Amir D, Kamml D. Book Reviews And Summaries. Nordic Journal of Music Therapy 2005. [DOI: 10.1080/08098130509478128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Stige B. Polyphonic Potentials. Nordic Journal of Music Therapy 2004. [DOI: 10.1080/08098130409478106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Stige B. Roots. Nordic Journal of Music Therapy 2003. [DOI: 10.1080/08098130309478068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Stige B. Do We Need General Criteria for the Evaluation of Qualitative Research Articles, and If We Do, How Could Such Criteria Be Formulated? Nordic Journal of Music Therapy 2002. [DOI: 10.1080/08098130209478048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Stige B. NJMT 1992–2002: Toward A Third Culture? Nordic Journal of Music Therapy 2002. [DOI: 10.1080/08098130209478037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Kenny C, Stige B. Introducing Voices: A World Forum for Music Therapy. Nordic Journal of Music Therapy 2001. [DOI: 10.1080/08098130109478012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Stige B. Beyond Objectivism and Relativism? Nordic Journal of Music Therapy 2001. [DOI: 10.1080/08098130109478011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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