Publications by authors named "Felicity A Baker"

34 Publications

Therapeutic music interventions with people with dementia living in residential aged care: Perspectives of residents, family members and care home staff from a cluster randomised controlled trial.

Int J Older People Nurs 2022 Jan 13:e12445. Epub 2022 Jan 13.

Creative Arts and Music Therapy Research Unit, Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, Victoria, Australia.

Background: Despite growing support for the benefits of music interventions in dementia care, the perspectives of people with dementia, their families and carers are often missing from the research. This study explored multiple perspectives and first-person experiences of group music interventions delivered within a large cluster randomised controlled trial examining the effectiveness of group music therapy (GMT) and recreational choir singing (RCS) with people with dementia living in residential-aged care (RAC) settings.

Methods: Focus group and individual interviews with residents with dementia (n = 4), family members (n = 5) and care home staff (n = 15) were conducted following completion of the 6-month GMT and/or RCS intervention and analysed using inductive thematic analysis.

Findings: Three main themes were identified as follows: (1) direct and indirect intrapersonal benefits, (2) direct and indirect interpersonal benefits and (3) therapeutic music interventions versus entertainment. GMT and RCS supported residents' mood, enjoyment, engagement and connectedness to self and others within and post-sessions, with flow-on effects to family members, care staff and the care home environment. Participants differentiated GMT and RCS from other forms of music engagement in the RAC facilities and described feelings of post-programme loss, highlighting ongoing meaning in active therapeutic music interventions.

Conclusion: This research highlights the need for increased access to sustainable and meaningful activities, such as purposefully designed therapeutic music interventions in RAC. Improving knowledge about the distinct benefits of therapeutic music interventions compared with other forms of music engagement in RAC may assist nursing staff to make appropriate treatment planning decisions regarding therapeutic music programmes to meet the complex needs of residents with dementia.
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http://dx.doi.org/10.1111/opn.12445DOI Listing
January 2022

ParkinSong Online: protocol for a telehealth feasibility study of therapeutic group singing for people with Parkinson's disease.

BMJ Open 2021 Dec 20;11(12):e058953. Epub 2021 Dec 20.

Centre for Neuroscience of Speech, The University of Melbourne, Melbourne, Victoria, Australia.

Introduction: Parkinson's disease can be associated with speech deterioration and low communication confidence which in turn compromises social interaction. Therapeutic singing is an engaging method for combatting speech decline; however, face-to-face delivery can limit access to group singing. The aim of this study is to test the feasibility and acceptability of an online mode of delivery for a Parkinson's singing intervention (ParkinSong) as well as remote data collection procedures.

Methods And Analysis: This ParkinSong Online feasibility trial is a single-arm, pre-post study of online singing delivery and remote data collection for 30 people living with Parkinson's. The primary outcome measure is feasibility: recruitment, retention, attendance, safety, intervention fidelity, acceptability and associated costs. Secondary outcomes are speech (loudness, intelligibility, quality, communication-related quality of life) and wellbeing (apathy, depression, anxiety, stress, health-related quality of life). This mode of delivery aims to increase the accessibility of singing interventions.

Ethics And Dissemination: Ethics approval was obtained from The University of Melbourne Human Research Ethics Committee (2021-14465-16053-3) and the trial has been prospectively registered. Results will be presented at national and international conferences, published in a peer-reviewed journal, and disseminated to the Parkinson's community, researchers and policymakers.

Trial Registration Number: ACTRN12621000940875.
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http://dx.doi.org/10.1136/bmjopen-2021-058953DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8689189PMC
December 2021

How Singing can Help People With Dementia and Their Family Care-Partners: A Mixed Studies Systematic Review With Narrative Synthesis, Thematic Synthesis, and Meta-Integration.

Front Psychol 2021 11;12:764372. Epub 2021 Oct 11.

Faculty of Fine Arts and Music, University of Melbourne, Melbourne, VIC, Australia.

Recent research on the efficacy of music-based interventions for people with dementia have focused on specific outcomes and methods, and singing has been noted as a particularly beneficial activity. However, due to heterogeneity of research methods, there is a need to synthesise the findings of both quantitative and qualitative research in order to better understand both the impact and potential mechanisms of singing for people in this population. This systematic review included quantitative, qualitative and mixed-methods studies, and analysed these using a systematic mixed-studies synthesis (with a results-based convergent approach). Quantitative and qualitative data were initially synthesised using a narrative synthesis and thematic synthesis method, respectively, before a final meta-integration method was used to synthesise common themes across the two data forms. Electronic and hand search strategies revealed 1,815 relevant studies, 40 of which met the full eligibility criteria. Narrative synthesis of quantitative data revealed six key outcome areas (quality of life; psychological well-being; cognition; engagement; activities of daily living; care-partner well-being), and thematic synthesis of qualitative data generated seven themes relating to the impact and mechanisms of singing (pragmatic elements; social benefits; mood; identity; memory; flow-on effects; and relationships). Meta-integration identified four key areas relating to the impact and mechanisms of singing for people with dementia and care-partners: psychological well-being, quality of life, cognition, and care-partner well-being. Results from the syntheses suggest that singing can positively impact the lives of people with dementia and their care-partners, although due to heterogeneity of study design and outcome measures, it is difficult to draw conclusions based on quantitative data alone. Qualitative data provides further context and insights from participant perspectives, and when integrated with quantitative data, contextual factors that may influence the benefits that participants experience from singing are revealed.
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http://dx.doi.org/10.3389/fpsyg.2021.764372DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8542693PMC
October 2021

From Therapeutic Factors to Mechanisms of Change in the Creative Arts Therapies: A Scoping Review.

Front Psychol 2021 15;12:678397. Epub 2021 Jul 15.

SRH University Heidelberg, Heidelberg, Germany.

Empirical studies in the creative arts therapies (CATs; i.e., art therapy, dance/movement therapy, drama therapy, music therapy, psychodrama, and poetry/bibliotherapy) have grown rapidly in the last 10 years, documenting their positive impact on a wide range of psychological and physiological outcomes (e.g., stress, trauma, depression, anxiety, and pain). However, it remains unclear and the CATs have positive effects, and which therapeutic factors account for these changes. Research that specifically focuses on the therapeutic factors and/or mechanisms of change in CATs is only beginning to emerge. To gain more insight into how and why the CATs influence outcomes, we conducted a scoping review ( = 67) to pinpoint therapeutic factors specific to each CATs discipline, joint factors of CATs, and more generic common factors across all psychotherapy approaches. This review therefore provides an overview of empirical CATs studies dealing with therapeutic factors and/or mechanisms of change, and a detailed analysis of these therapeutic factors which are grouped into domains. A framework of 19 domains of CATs therapeutic factors is proposed, of which the three domains are composed solely of factors unique to the CATs: "embodiment," "concretization," and "symbolism and metaphors." The terminology used in change process research is clarified, and the implications for future research, clinical practice, and CATs education are discussed.
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http://dx.doi.org/10.3389/fpsyg.2021.678397DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8336579PMC
July 2021

Strategies for Recruiting People With Dementia to Music Therapy Studies: Systematic Review.

J Music Ther 2021 Nov;58(4):373-407

Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, UK.

Positive effects of music therapy for people with dementia and their family carers are reported in a growing number of studies. However, small sample sizes or low recruitment rates often limit the success of these research studies. More adequately powered evidence-based studies are needed to impact policy and funding in dementia care. This systematic review examined recruitment strategies in music therapy clinical trials involving people living with dementia and/or their family carers. Eligible studies described enrolment, consent, accrual, or recruitment methods as well as recruitment or consent rates. Thirty studies with a total of 1,192 participants were included. Recruitment and conversion rates in residential aged care facilities (RACFs) (14 studies) were substantially higher than in community-based studies (16 studies). Whereas studies in RACFs most commonly recruited participants through staff approaching residents face-to-face or conversing with residents' legal guardians, community-based studies utilized a vast array of strategies, including staff referral, demonstrations/information sessions by researchers, advertisements, and direct contact with residents. Recruitment rates are likely to be higher when recruiters have an existing relationship with potential participants and when an independent third-party dementia organization is involved. Randomized controlled trials led to equally or greater recruitment conversion rates than other designs. Findings suggest that recruitment in dementia trials is complex, challenging, and needs thorough planning and consideration to be time- and cost-effective. Future studies should include reporting of recruitment strategies, enrolment rates, and related aspects so that researchers can better design recruitment strategies and estimate resources needed to reach the target sample size.
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http://dx.doi.org/10.1093/jmt/thab010DOI Listing
November 2021

"Doing Things Together Is What It's About": An Interpretative Phenomenological Analysis of the Experience of Group Therapeutic Songwriting From the Perspectives of People With Dementia and Their Family Caregivers.

Front Psychol 2021 31;12:598979. Epub 2021 Mar 31.

Melbourne Conservatorium of Music, Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, VIC, Australia.

Background: The wellbeing of people living with dementia and their family caregivers may be impacted by stigma, changing roles, and limited access to meaningful opportunities as a dyad. Group therapeutic songwriting (TSW) and qualitative interviews have been utilized in music therapy research to promote the voices of people with dementia and family caregivers participating in separate songwriting groups but not together as dyads.

Procedures: This study aimed to explore how ten people with dementia/family caregiver dyads experienced a 6-week group TSW program. Dyads participated in homogenous TSW groups involving 2-4 dyads who were either living together in the community (2 spousal groups) or living separately because the person with dementia resided in a care home (1 family group, 1 spousal group). The TSW program, informed by personhood, couplehood, family centered and group process frameworks, involved creating original lyrics through song parody and song collage. Qualified Music Therapists facilitated sessions and interviewed each dyad separately. Interviews were analyzed using interpretative phenomenological analysis.

Findings: Five recurrent group themes were developed, indicating group TSW: (1) was a positive shared experience, benefiting both members of the dyad and motivating further engagement with music; (2) stimulated mental processes and reignited participants' interests and skills; (3) provided meaningful opportunities for reflection and connection with memories and life experiences; and (4) prompted interaction and collaboration, leading to social connections, empathic relationships and experiences of inclusion. Participants also highlighted how: (5) the facilitated process supported engagement, highlighting abilities and challenging doubts.

Conclusion: Dyads identified group TSW as an opportunity to recognize strengths, voice ideas and opinions, share meaningful experiences, and do "more with music." Participants valued TSW as a new, creative and stimulating experience that enabled connection with self and others and led to feelings of pride and achievement. Our findings further recognize how therapeutic intention and approach were reflected in participants' engagement and responses regardless of dementia stage and type, dyad relationship, or musical background. This research may broaden perspectives and expand understanding about how people with dementia and their family caregivers access and engage in music therapy.
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http://dx.doi.org/10.3389/fpsyg.2021.598979DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8044441PMC
March 2021

Resource assessment in trials undertaken in residential care homes: Experiences from the Australian MIDDEL cluster randomised controlled trial research team.

Contemp Clin Trials Commun 2020 Dec 25;20:100675. Epub 2020 Nov 25.

Creative Arts and Music Therapy Research Unit, The University of Melbourne, Melbourne, Australia.

Background: The resources involved in delivering a clinical trial in residential aged care facilities (RACFs) are significant and the success of a trial is dependent upon adequate planning, including appropriate timelines for each component of the study and the required budget. This paper describes process and resource assessment during recruitment, collection of outcome measures and intervention delivery, and presents learnings and considerations for conducting trials in RACFs with people living with dementia.

Methods: Data were collected across 24 clusters in 12 RACFs over 18 months during a cluster randomised controlled trial which was testing the effectiveness of music interventions in people living with dementia. Data were collected on resources required for recruitment and assessment of baseline data, as well as reasons for participant non-attendance at the interventions.

Results: Time between contacting next of kin and receiving formal consent often exceeded 45 days. The ratio of time between direct and indirect research activity was approximately 1:2. Participant intervention adherence is at risk from unplanned RACF lockdowns and reasons for non-attendance include those both related directly to the participant and to staff resources, scheduling or other practical considerations.

Conclusions: Research planning should focus on building relationships with RACF staff and resident families, factor in adequate time for recruitment in the study timeline and consider budgeting for backfill of RACF staff during data collection phases to expedite the process and ensure adherence to study protocol timelines.

Trial Registration Australian And New Zealand Clinical Trial Registry Anzctr12618000156280 1/02/2018 Http//anzctrorgau/trial/registration/trialreviewaspx?actrn=12618000156280: A.
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http://dx.doi.org/10.1016/j.conctc.2020.100675DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7711137PMC
December 2020

"It's Feasible to Write a Song": A Feasibility Study Examining Group Therapeutic Songwriting for People Living With Dementia and Their Family Caregivers.

Front Psychol 2020 7;11:1951. Epub 2020 Aug 7.

Melbourne Conservatorium of Music, Faculty of Fine Arts and Music, University of Melbourne, Melbourne, VIC, Australia.

Background: Psychosocial interventions for people with dementia and their family caregivers together may sustain relationship quality and social connection. No previous music therapy research has examined the effects of group therapeutic songwriting (TSW) attended by people with dementia/family caregiver dyads.

Methods: This pre-post feasibility study aimed to examine the acceptability of a group TSW intervention for people with dementia/family caregiver dyads and test the sensitivity of the following outcomes: Quality of the Caregiver-Patient Relationship (QCPR, primary); Cornell Scale for Depression in Dementia (CSDD) and Quality of Life-Alzheimer's Dementia for people with dementia, Patient Health Questionnaire-9, Assessment of Quality of Life-8 Dimensions (AQoL-8D); and Zarit Burden Interview for family caregivers. Six weekly 1 h sessions guided participants to identify preferred music, brainstorm ideas, create lyrics, and record songs. Qualitative interviews were conducted with dyads who completed the intervention.

Results: Fourteen dyads were recruited and completed baseline assessments. Participants with dementia were aged 62-92 years ( = 77, SD = 11). Caregiver participants (11 spouses, two daughters, one son) were aged 54-92 years ( = 67, SD = 10.1). Four dyads withdrew owing to declining health or inconvenience before the program commenced ( = 2) and after attending 1-2 sessions ( = 2). Ten dyads formed four homogeneous TSW groups (71% completion). No statistically significant changes were detected for any measure. High QCPR ratings at baseline ( = 57.1) and follow-up ( = 57.4) demonstrated sustained relationship quality. For participants with dementia, large effect sizes for the CSDD suggested trends toward decreased depression ( = -0.83) and improved mood ( = -0.88). For family caregivers, a large effect size suggested a trend toward improvement for the AQoL-8D sub-domain examining independent living ( = -0.93). Qualitative data indicated that session design and delivery were acceptable, and TSW was a positive shared experience with personal benefits, which supported rather than changed relationship quality.

Conclusion: High retention and qualitative data indicate that TSW was well received by participants. Effect sizes suggest that group TSW for dyads may have beneficial impacts on depression for people with dementia and quality of life for family caregivers. Future research with a fully powered sample is recommended to further examine the psychosocial impacts of group TSW for people living with dementia/family caregiver dyads.
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http://dx.doi.org/10.3389/fpsyg.2020.01951DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7426520PMC
August 2020

ParkinSong: Outcomes of a 12-Month Controlled Trial of Therapeutic Singing Groups in Parkinson's Disease.

J Parkinsons Dis 2020 ;10(3):1217-1230

Centre for Neuroscience of Speech, The University of Melbourne, Carlton, Victoria, VIC, Australia.

Background: Parkinson's disease (PD) frequently causes progressive deterioration in speech, voice and cognitive aspects of communication. These affect wellbeing and quality of life and are associated with caregiver strain and burden. Therapeutic singing groups can ameliorate PD-related communication disorders and increase social interaction and wellbeing for caregivers and care recipients.

Objective: To analyse the effects of ParkinSong group singing sessions on Parkinson's communication and wellbeing outcomes for people with PD and caregivers over 12 months.

Methods: A 4-armed controlled clinical trial compared ParkinSong with active non-singing control conditions over 12 months. Two dosage levels (weekly versus monthly) were available for each condition. ParkinSong comprised high-effort vocal, respiratory and speech exercises, group singing, and social interaction. PD-specific outcomes included vocal loudness, speech intelligibility, maximum phonation time, respiratory muscle strength, and voice related quality of life (QoL). Wellbeing outcomes were also measured for caregivers and care recipients.

Results: We recruited 75 people with PD and 44 caregivers who attended weekly ParkinSong, monthly ParkinSong, weekly control or monthly control groups. We found significant improvements in the primary outcome of vocal loudness (p = 0.032), with weekly singers 5.13 dB louder (p = 0.044) and monthly singers 5.69 dB louder (p = 0.015) than monthly controls at 12 months. ParkinSong participants also showed greater improvements in voice-related QoL and anxiety. Caregivers who attended ParkinSong showed greater reductions in depression and stress scores.

Conclusions: This 12-month controlled clinical trial of ParkinSong demonstrated improvements in speech loudness and voice-related QoL for participants with PD, and enhanced wellbeing for both caregivers and care recipients. No adverse effects were reported over 12 months and improvements were sustained.
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http://dx.doi.org/10.3233/JPD-191838DOI Listing
September 2021

The Resilience Songwriting Program for Adolescent Bereavement: A Mixed Methods Exploratory Study.

J Music Ther 2019 Nov;56(4):348-380

Drexel University, Philadelphia, Pennsylvania.

Music therapy research with youth who are grieving often reports on a combination of interventions, such as lyric analysis, improvisation, and/or songwriting. Unfortunately, the lack of theoretical transparency in how and why these interventions affect targeted outcomes limits interpretation and application of this important research. In this exploratory study, the authors evaluated the impact of an 8-session, theory-driven group songwriting program on protective factors in adolescent bereavement, and also sought to better understand adolescents' experiences of the program. Using a single-group, pretest-posttest convergent mixed methods design, participants were enrolled from three study sites and included 10 adolescents (five girls and five boys), ages 11-17 years, who self-identified as grieving a loss. Outcomes measured included grief, coping, emotional expression, self-esteem, and meaning making. Qualitative data were captured through in-session journaling and semi-structured interviews. There were no statistically significant improvements for grief, self-esteem, coping, and meaning making. Individual score trends suggested improvements in grief. The majority of the participants reported greater inhibition of emotional expression, and this was statistically significant. Thematic findings revealed that the program offered adolescents a sense of togetherness, a way to safely express grief-related emotions and experiences verbally and nonverbally, and opportunities for strengthening music and coping skills. These findings suggest that engaging in collaborative therapeutic songwriting with grieving peers may decrease levels of grief, enhance creative expression, and provide social support. More research is needed on measuring self-esteem, emotional expression, coping, and meaning making outcomes in ways that are meaningful to adolescents.
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http://dx.doi.org/10.1093/jmt/thz011DOI Listing
November 2019

ParkinSong: A Controlled Trial of Singing-Based Therapy for Parkinson's Disease.

Neurorehabil Neural Repair 2019 06 12;33(6):453-463. Epub 2019 May 12.

1 The University of Melbourne, Melbourne, Victoria, Australia.

. Communication impairment is one of the most common symptoms of Parkinson's disease (PD), significantly affecting quality of life. Singing shares many of the neural networks and structural mechanisms used during speech and, thus, has potential for therapeutic application to address speech disorders. . To explore the effects of an interdisciplinary singing-based therapeutic intervention (ParkinSong) on voice and communication in people with PD. . A controlled trial compared the effects of the ParkinSong intervention with an active control condition at 2 dosage levels (weekly vs monthly) over 3 months, on voice, speech, respiratory strength, and voice-related quality-of-life outcomes for 75 people living with PD. The interdisciplinary ParkinSong model comprised high-effort vocal and respiratory tasks, speech exercises, group singing, and social communication opportunities. . ParkinSong intervention participants demonstrated significant improvements in vocal intensity ( = .018), maximum expiratory pressure ( = .032), and voice-related quality of life ( = .043) in comparison to controls. Weekly ParkinSong participants increased vocal intensity more than monthly participants ( = .011). Vocal intensity declined in nontreatment control groups. No statistical differences between groups on maximum phonation length or maximum inspiratory pressure were observed at 3 months. . ParkinSong is an engaging intervention with the potential to increase loudness and respiratory function in people with mild to moderately severe PD.
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http://dx.doi.org/10.1177/1545968319847948DOI Listing
June 2019

A therapeutic songwriting intervention to promote reconstruction of self-concept and enhance well-being following brain or spinal cord injury: pilot randomized controlled trial.

Clin Rehabil 2019 Jun 22;33(6):1045-1055. Epub 2019 Feb 22.

1 Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, VIC, Australia.

Objective: To determine the size of the effects and feasibility (recruitment and retention rates) of a therapeutic songwriting protocol for in-patients and community-dwelling people with acquired brain injury or spinal cord injury.

Design: Randomized controlled trial with songwriting intervention and care-as-usual control groups, in a mixed measures design assessed at three time points.

Participants: A total of 47 participants (3 in-patients with acquired brain injury, 20 community participants with acquired brain injury, 12 in-patients with spinal cord injury, and 12 community participants with spinal cord injury: 23 1208 days post injury).

Interventions: The intervention group received a 12-session identity-targeted songwriting programme, where participants created three songs reflecting on perceptions of past, present, and future self. Control participants received care as usual.

Measures: Baseline, postintervention, and follow-up measures comprised the Head Injury Semantic Differential Scale (primary outcome measure), Patient Health Questionnaire-9, Emotion Regulation Questionnaire, and Satisfaction with Life Scale.

Results: No significant between group pre-post intervention differences were found on the primary self-concept measure, the Head Injury Semantic Differential Scale ( p = 0.38, d = 0.44). Significant and large effect sizes from baseline to post between groups in favour of the songwriting group for Satisfaction with Life ( p = 0.04, n = 0.14). There were no significant between group pre-post interaction effects for the Emotion Regulation Suppression subscale ( p = 0.12, n = -0.08) although scores decreased in the songwriting group over time while increasing for the standard care group. There were no significant differences in baseline to follow-up between groups in any other outcome measures. Recruitment was challenging due to the small number of people eligible to participate combined with poor uptake by eligible participants, particularly the in-patient group. Retention rates were higher for the community-dwelling cohorts.

Conclusion: This study demonstrates the challenges in recruitment and retention of participants invited to participate in a music therapy study. Findings suggest this identity-focused therapeutic songwriting protocols may be more beneficial for people who have transitioned from in-patient to community-contexts given the greater proportion of participants who consent and complete the intervention. Preliminary effects in favour of the intervention group were detected in a range of well-being measures suggesting that a larger study is warranted.
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http://dx.doi.org/10.1177/0269215519831417DOI Listing
June 2019

Treatment Fidelity in a Music Therapy Multi-site Cluster Randomized Controlled Trial for People Living With Dementia: The MIDDEL Project Intervention Fidelity Protocol.

J Music Ther 2019 May;56(2):125-148

NORCE, Bergen, Norway.

High-quality clinical trials testing music therapy interventions have become more prevalent over the past decade. However, recent reviews of published music therapy trials reveal that reporting of strategies used to ensure treatment fidelity is lacking. Treatment fidelity refers to methodological strategies, put in place prior to clinical trial implementation, to strengthen the reliability and validity of intervention delivery and, therefore, safeguard research quality. This paper outlines strategies developed and implemented during the pilot phase of a randomized controlled trial involving the testing of music interventions for people living with dementia and presenting with symptoms of depression. We discuss the five recognized components of fidelity (study design, training intervention providers, treatment integrity, treatment differentiation, and treatment receipt) and describe our methods for training music intervention providers and testing interventionist competence prior to trial commencement, approaches to intervention delivery supervision, and methods for assessing intervention protocol adherence.
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http://dx.doi.org/10.1093/jmt/thy023DOI Listing
May 2019

Creative Arts Interventions to Address Depression in Older Adults: A Systematic Review of Outcomes, Processes, and Mechanisms.

Front Psychol 2018 8;9:2655. Epub 2019 Jan 8.

Music Therapy Lab, Faculty of Applied Social Sciences, University of Applied Sciences Würzburg-Schweinfurt, Würzburg, Germany.

Depression experienced by older adults is proving an increasing global health burden, with rates generally 7% and as high as 27% in the USA. This is likely to significantly increase in coming years as the number and proportion of older adults in the population rises all around the world. Therefore, it is imperative that the effectiveness of approaches to the prevention and treatment of depression are understood. Creative arts interventions, including art, dance movement, drama, and music modalities, are utilized internationally to target depression and depressive symptoms in older adults. This includes interventions led by trained arts therapists as well as other health and arts professionals. However, to date there has not been a systematic review that reports effects and examines the processes (why) and mechanisms (how) of creative arts interventions are used to address depression in this older age group. This systematic review of studies on creative arts interventions for older adults experiencing depression examined: outcomes of four creative arts modalities (art, dance movement, drama, and music); with particular attention paid to processes documented as contributing to change in each modality; and mechanisms considered to result from these processes. Our analysis of 75 articles (17 art, 13 dance, 4 drama, and 41 music) indicates mostly significant quantitative or positive qualitative findings, particularly for interventions led by creative arts therapists. Mechanisms of change gleaned from the studies that were common across modalities include physical (e.g., increased muscle strength; neurochemical effects, such as endorphin release), intra-personal (e.g., enhanced self-concept, strengthened agency and mastery; processing and communication of emotions), cultural (e.g., creative expression, aesthetic pleasure), cognitive (e.g., stimulation of memory), and social (e.g., increased social skills and connection), that were all considered to contribute to reduced depression and symptoms. Recommendations for future research includes stronger focus on testing of processes and mechanisms.
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http://dx.doi.org/10.3389/fpsyg.2018.02655DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6331422PMC
January 2019

Remini-Sing: A Feasibility Study of Therapeutic Group Singing to Support Relationship Quality and Wellbeing for Community-Dwelling People Living With Dementia and Their Family Caregivers.

Front Med (Lausanne) 2018 31;5:245. Epub 2018 Aug 31.

Faculty of Fine Arts and Music, University of Melbourne, Melbourne, VIC, Australia.

Living at home following a diagnosis of dementia can be difficult for both the person living with dementia (PwD) and their family caregivers (FCG). Active group music participation may provide an avenue for emotional release, offer psychosocial support to caregivers and stimulate meaningful interaction between caregivers and loved ones with dementia. Therapeutic music interventions also have the capacity to facilitate reminiscence and social engagement and can help to manage challenging symptoms associated with dementia, such as anxiety, apathy, and agitation. This feasibility study examined the acceptability of a 20-week therapeutic group singing intervention (Remini-Sing) and quantitative research assessments for PwD/FCG dyads living in the community. Quantitative measures for the following outcomes were tested for sensitivity and acceptability: relationship quality (PwD and FCG); life satisfaction, caregiver satisfaction, flourishing, and depression for FCGs; and anxiety, apathy, agitation, and quality of life for PwD. Quantitative assessments were conducted before, during (midway) and after 20 weeks of participation in a therapeutic singing group attended by the PwD and FCG together. The Remini-Sing intervention incorporated vocal warm ups, singing familiar songs, learning new songs, and opportunities for social interaction. Qualitative interviews were conducted with all dyads that completed the intervention. Twelve PWD/FCG dyads were recruited and enrolled in the study. High participation and retention rates indicated that the intervention was received favorably by participants. There were no statistically significant changes on measures from pre to post intervention. However, favorable baseline scores on relationship quality and wellbeing measures were sustained over the 20-week intervention. The testing of these measures for feasibility also revealed that some were too difficult for PwD and thus yielded questionable results, some were potentially less relevant, and there were likely floor and ceiling effects on several of the measures utilized. This study demonstrated good feasibility for a research protocol and therapeutic group singing intervention for community-dwelling PwD and their FCGs. Participant reflections and researcher observations yielded useful information guiding the selection of quantitative outcome measures for future research in this area.
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http://dx.doi.org/10.3389/fmed.2018.00245DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6127293PMC
August 2018

Meaning Making Process and Recovery Journeys Explored Through Songwriting in Early Neurorehabilitation: Exploring the Perspectives of Participants of Their Self-Composed Songs Through the Interpretative Phenomenological Analysis.

Front Psychol 2018 7;9:1422. Epub 2018 Aug 7.

Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, VIC, Australia.

This pilot study examined how 15 participants in early rehabilitation described their self-composed Songs 6- to 12-months following participation in a 6-week identity-focused songwriting program. Specific focus was given to the process of meaning making and identity reconstruction in the participants' self-composed songs. Data were collected through individual semi-structured interviews ( = 15) and analyzed using interpretative phenomenological analysis. Findings were developed idiographically as super-ordinate themes unique to each participant, then analyzed across cases to identify recurrent themes and subthemes. Participants described the songwriting process as taking them through one of four distinct recovery journeys described by individuals following acquired neurodisability who underwent a focused therapeutic songwriting program. These included (1) re-conceptualizing values and shifting perspectives about self (my body is broken but my mind has been set free); (2) recognizing acquired inner resources to negotiate discrepancies in self (hope is there); (3) confirming existing values and identifying resources and coping strategies (I have what I need to move forward); (4) confirming previously held values and ongoing process of negotiating discrepancies in self (I don't yet have the answers). The current study provides insight into the nature and process of meaning making and recovery journeys perceived by individuals with neurodisability. Our findings suggest that songwriting could be a therapeutic tool to facilitate identity reconstruction in neurorehabilitation.
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http://dx.doi.org/10.3389/fpsyg.2018.01422DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6090445PMC
August 2018

Community-Dwelling People Living With Dementia and Their Family Caregivers Experience Enhanced Relationships and Feelings of Well-Being Following Therapeutic Group Singing: A Qualitative Thematic Analysis.

Front Psychol 2018 30;9:1332. Epub 2018 Jul 30.

Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, VIC, Australia.

The progression of dementia can severely compromise interpersonal connection and relationship quality between people living with dementia (PwD) and their family caregivers (FCG), leading to social isolation and poor quality of life for both. Therapeutic group singing (TGS) is a socially engaging, stimulating, and supportive pursuit that community-dwelling PwD and their FCG can participate in together. This study aimed to build on the findings from previous research by undertaking a thematic analysis of interviews with nine PwD (five women, four men; mean age = 79.1 years) and nine FCG (five women, four men; mean age = 75.7 years). The interviews explored participants' perspectives and experiences of a 20-week TGS intervention, underpinned by Kitwood's model of person-centered care. Inductive thematic analysis resulted in the emergence of five themes which described how TGS for PwD and their FCG: (1) included supportive therapeutic facilitation and design features; (2) made group singing more accessible; (3) fostered new empathic friendships; (4) enhanced relationships between PwD and FCG; and (5) led to personal feelings of wellbeing for both PwD and FCG. Affinity with others who had similar life experiences and challenges created a sense of mutual understanding and camaraderie, which made group singing accessible without fear of judgment and social stigmas. For some PwD/FCG dyads, TGS meant they could continue a lifelong passion for singing together, while others enjoyed participating in singing together for the first time. Both PwD and FCG participants described personal feelings of acceptance, improved social confidence, mood, and purpose. Further, participants valued mental stimulation from TGS such as learning new skills and memory support. A model explaining relationships between themes suggests that TGS with person-centered facilitation features for PwD/FCG dyads led to affinity among group members with ripple effects, which enhanced accessibility to group singing, the formation of empathic friendships, PwD/FCG relationship quality, and personal wellbeing for both PwD and FCG. Psychoemotional, social and cognitive benefits from TGS described by participants in this study are known to promote self-identity, healthy relationships, and quality of life. This research highlights a need for improved availability of TGS for community-dwelling PwD/FCG dyads.
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http://dx.doi.org/10.3389/fpsyg.2018.01332DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6077620PMC
July 2018

A Group Therapeutic Songwriting Intervention for Family Caregivers of People Living With Dementia: A Feasibility Study With Thematic Analysis.

Front Med (Lausanne) 2018 22;5:151. Epub 2018 May 22.

Faculty of Fine Arts and Music, University of Melbourne, Melbourne, VIC, Australia.

This study aimed to test the feasibility of implementing a group songwriting program with family caregivers (FCGs) of people living with dementia. Fourteen FCGs consented to participate in either the songwriting group ( = 8) or control condition ( = 6). Participants completed baseline and 7-week measures of depression (PHQ-9), perceptions of their caregiving experience (PACQ), and perceptions of their relationship with the care recipient (QCPR). A six-session group songwriting program was implemented across two sites, focusing on participants co-creating a song about their caregiving experiences. Participation and retention rates were high suggesting the intervention was acceptable. An observed pre-post effect size for the PHQ-9 in the experimental group ( = 0.64) and control group ( = -0.33) suggests the measure is sensitive to change over a short period of time in this population and has the potential to detect significant change in a larger controlled trial. Qualitative analysis of focus group interviews suggested the songwriting process allowed participants to share their entire caregiver journey with others, differentiating the intervention from standard carer support groups. Participants described group songwriting as enabling them to find connections with other caregivers, create a group identity, and gain insight into their carer journey, subsequently leading to the development of inner strength and personal growth. Qualitative findings suggest coping may be a more relevant construct to measure than caregiver-patient relationship quality or caregivers' perception of caregiving.
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http://dx.doi.org/10.3389/fmed.2018.00151DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5972290PMC
May 2018

A systematic review of the efficacy of creative arts therapies in the treatment of adults with PTSD.

Psychol Trauma 2018 Nov 4;10(6):643-651. Epub 2017 Dec 4.

Phoenix Australia Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne.

Objective: There is a growing body of literature supporting the use of creative arts therapies; however, the efficacy of creative arts therapies in the treatment of posttraumatic stress disorder (PTSD) has not been systematically evaluated. The aim of this systematic review was to examine the efficacy of creative arts therapy including music therapy, art therapy, dance/movement therapy, and drama therapy, in the treatment of PTSD.

Method: Ten databases were searched for peer-reviewed literature published from inception to December 2016. Studies were included in the review if they used a randomized controlled trial (RCT), a pseudo RCT, or a controlled study design; tested the efficacy of one of the creative arts therapies described above; and reported changes to PTSD diagnosis or symptomatology.

Results: From an initial yield of 1,918 records, 1,653 records were screened on title and abstract and 125 were screened at full-text. Seven studies met the inclusion criteria for review, with four studies investigating art therapy, two studies investigating music therapy, and a final study investigating drama therapy. Individual studies were initially rated on a standardized quality and bias checklist, and then GRADE was used to rate the overall evidence for each intervention. The evidence for music therapy, art therapy, and drama therapy was ranked as low to very low, with no studies found for dance/movement therapy. Generally, the quality of the trials was very poor. Future directions for this field of research are to improve the scientific quality of the research trials in this area. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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http://dx.doi.org/10.1037/tra0000353DOI Listing
November 2018

Professional Supervision as Storied Experience: Narrative Analysis Findings for Australian-Based Registered Music Therapists.

J Music Ther 2017 Mar;54(1):80-107

King's College London.

Background: Limited research exists to inform a music therapist's supervision story from their pre-professional training to their practice as a professional. Evidence is needed to understand the complex nature of supervision experiences and their impact on professional practice.

Objective: This qualitative study explored the supervisory experiences of Australian-based Registered Music Therapists, according to the: 1) themes that characterize their experiences, 2) influences of the supervisor's professional background, 3) outcomes of supervision, and 4) roles of the employer, the professional music therapy association, and the university in supervision standards and practice.

Methods: Seven professionals were interviewed for this study. Five stages of narrative analysis were used to create their supervision stories: a life course graph, narrative psychological analysis, component story framework and narrative analysis, analysis of narratives, and final integration of the seven narrative summaries.

Results: Findings revealed that supervision practice is influenced by a supervisee's personal and professional needs. A range of supervision models or approaches is recommended, including the access of supervisors from different professional backgrounds to support each stage of learning and development. A quality supervisory experience facilitates shifts in awareness and insight, which results in improved or increased skills, confidence, and accountability of practice. Participants' concern about stakeholders included a limited understanding of the role of the supervisor, a lack of clarity about accountability of supervisory practice, and minimal guidelines, which monitor professional competencies.

Conclusions: The benefits of supervision in music therapy depend on the quality of the supervision provided, and clarity about the roles of those involved. Research and guidelines are recommended to target these areas.
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http://dx.doi.org/10.1093/jmt/thw019DOI Listing
March 2017

Exploring the Self through Songwriting: An Analysis of Songs Composed by People with Acquired Neurodisability in an Inpatient Rehabilitation Program.

J Music Ther 2017 Mar;54(1):35-54

Monash University.

Background: Neurological trauma is associated with significant damage to people's pre-injury self-concept. Therapeutic songwriting has been linked with changes in self-concept and improved psychological well-being.

Objective: This study analyzed the lyrics of songs composed by inpatients with neurological injuries who participated in a targeted songwriting program. The aim of this study was to understand which of the subdomains of the self-concept were the most frequently expressed in songs.

Methods: An independent, deductive content analysis of 36 songs composed by 12 adults with spinal cord injury or brain injury (11 males, mean age 41 years +/- 13) were undertaken by authors 1 and 2.

Results: Deductive analysis indicated that when writing about the past self, people created songs that reflected a strong focus on family and descriptions of their personality. In contrast, there is a clear preoccupation with the physical self, on the personal self, and a tendency for spiritual and moral reflections to emerge during the active phase of rehabilitation (song about the present self). Statistical analyses confirmed a significant self-concept subdomain by song interaction, F(10, 110) = 5.98, p < .001, ηp2 = .35), which was primarily due to an increased focus on physical self-concept and a reduced focus on family self-concept in the present song, more than in either past or future songs.

Conclusions: The analysis process confirmed that songwriting is a vehicle that allows for exploration of self-concept in individuals with neurological impairments. Songwriting may serve as a therapeutic tool to target the most prevalent areas of self-concept challenges for clients undergoing inpatient neurological rehabilitation programs.
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http://dx.doi.org/10.1093/jmt/thw018DOI Listing
March 2017

Older Adults' Music Listening Preferences to Support Physical Activity Following Cardiac Rehabilitation.

J Music Ther 2016 3;53(4):364-397. Epub 2016 Sep 3.

School of Allied Health, La Trobe University; Music Therapy Department, University of Melbourne.

Background: Music listening during exercise is thought to increase physiological arousal and enhance subjective experience, and may support physical activity participation among older adults with cardiac disease. However, little is known about how music preferences, or perceptions of music during exercise, inform clinical practice with this population.

Objective: Identify predominant musical characteristics of preferred music selected by older adults, and explore participants' music listening experiences during walking-based exercise following cardiac rehabilitation.

Methods: Twenty-seven participants aged 60 years and older (21 men, 6 women; mean age = 67.3 years) selected music to support walking over a 6-month intervention period, and participated in post-intervention interviews. In this two-phase study, we first identified predominant characteristics of participant-selected music using the Structural Model of Music Analysis. Second, we used inductive thematic analysis to explore participant experiences.

Results: Predominant characteristics of participant-selected music included duple meter, consistent rhythm, major key, rounded melodic shape, legato articulation, predictable harmonies, variable volume, and episodes of tension with delayed resolution. There was no predominant tempo, with music selections ranging from slow through to medium and fast. Four themes emerged from thematic analysis of participant interviews: psycho-emotional responses, physical responses, influence on exercise behavior, and negative experiences.

Conclusions: Findings are consistent with theory and research explaining influences from music listening on physiological arousal and subjective experience during exercise. Additionally, for older adults with cardiac disease, a holistic approach to music selection considering general well-being and adjustment issues, rather than just exercise performance, may improve long-term lifestyle changes and compliance with physical activity guidelines.
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http://dx.doi.org/10.1093/jmt/thw011DOI Listing
February 2017

Participant-selected music and physical activity in older adults following cardiac rehabilitation: a randomized controlled trial.

Clin Rehabil 2017 Mar 10;31(3):329-339. Epub 2016 Jul 10.

1 School of Allied Health, La Trobe University, Australia.

Objective: To evaluate effects of participant-selected music on older adults' achievement of activity levels recommended in the physical activity guidelines following cardiac rehabilitation.

Design: A parallel group randomized controlled trial with measurements at Weeks 0, 6 and 26.

Setting: A multisite outpatient rehabilitation programme of a publicly funded metropolitan health service.

Subjects: Adults aged 60 years and older who had completed a cardiac rehabilitation programme.

Interventions: Experimental participants selected music to support walking with guidance from a music therapist. Control participants received usual care only.

Main Measures: The primary outcome was the proportion of participants achieving activity levels recommended in physical activity guidelines. Secondary outcomes compared amounts of physical activity, exercise capacity, cardiac risk factors, and exercise self-efficacy.

Results: A total of 56 participants, mean age 68.2 years (SD = 6.5), were randomized to the experimental ( n = 28) and control groups ( n = 28). There were no differences between groups in proportions of participants achieving activity recommended in physical activity guidelines at Week 6 or 26. Secondary outcomes demonstrated between-group differences in male waist circumference at both measurements (Week 6 difference -2.0 cm, 95% CI -4.0 to 0; Week 26 difference -2.8 cm, 95% CI -5.4 to -0.1), and observed effect sizes favoured the experimental group for amounts of physical activity (d = 0.30), exercise capacity (d = 0.48), and blood pressure (d = -0.32).

Conclusions: Participant-selected music did not increase the proportion of participants achieving recommended amounts of physical activity, but may have contributed to exercise-related benefits.
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http://dx.doi.org/10.1177/0269215516640864DOI Listing
March 2017

A critical interpretive synthesis of the most commonly used self-report measures in Australian mental health research.

Australas Psychiatry 2016 Oct 27;24(5):453-8. Epub 2016 Jan 27.

Professor, Head of Music Therapy, National Music Therapy Research Unit, Melbourne Conservatorium of Music, University of Melbourne, Parkville, VIC, Australia.

Objective: To critically examine the self-report measures most commonly used in Australian mental health research in the last 10 years.

Method: A critical interpretive synthesis was conducted using seven outcome measures that were identified as most popular in 43 studies from three mental health journals.

Results: Results suggest that the amount and type of language used in outcome measures is important in both increasing the accuracy of the data collected and fostering positive experiences of data collection for participants.

Conclusions: Results indicate that many of the measures most often used in Australian mental health research may not align with the current contemporary philosophy of mental health clinical practice in Australia.
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http://dx.doi.org/10.1177/1039856215626646DOI Listing
October 2016

Reliability and Validity of the Meaningfulness of Songwriting Scale (MSS) with Adults on Acute Psychiatric and Detoxification Units.

J Music Ther 2016 15;53(1):55-74. Epub 2015 Dec 15.

University of Melbourne University of Minnesota University of Edinburgh.

Background: Songwriting is an intervention with demonstrated clinical benefit for a range of clinical populations. Researchers argue that positive outcomes are in part the result of the meaningfulness of the creative process. However, no measure currently exists to quantify the extent of meaning derived from songwriting processes.

Objective: To psychometrically evaluate the Meaningfulness of Songwriting Scale (MSS) as a measure of meaning of a therapeutic songwriting process.

Method: 147 participants receiving short-term mental health care (39 acute psychiatric care; 108 detoxification unit) were asked to complete the MSS and the Short State Flow Scale immediately following a songwriting music therapy session. Six hours later, participants completed the MSS a second time. Analyses were performed by participant cohort to determine the content validity, internal consistency, test-retest reliability, measurement error, and construct validity.

Results: Findings indicated that the MSS has good content validity, strong internal consistency (α = 0.98, acute psychiatric group, and α = 0.96, detoxification group), acceptable test-retest reliability (ICC2,1 = 0.93, acute psychiatric group, and ICC2,1 = 0.89, detoxification group), and construct validity (acute group was r = 0.68, p < 0.001, and detoxification group was r = 0.56, p < 0.001). Measurement error was greater in the detoxification group, suggesting that the measure may be unstable for this group.

Conclusions: Preliminary evidence supports MSS use for research with inpatients on acute psychiatric units; however, cautious use is recommended for use with inpatients in detoxification units due to measurement error.
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http://dx.doi.org/10.1093/jmt/thv020DOI Listing
July 2016

A preliminary psychometric evaluation of the interpersonal communication competence scale for aquired brain injury.

Brain Inj 2015 21;29(9):1105-12. Epub 2015 May 21.

Department of Communication and Psychology, Aalborg University , Denmark and.

Primary Objective: To evaluate the psychometric properties of two adapted versions of the interpersonal communication competence scale (ICCS) that were applied to people with acquired brain injury (ABI). Construct validity was tested for both new scales and a factor extraction was performed on the proxy-rating version aiming to establish if it revealed meaningful constructs.

Methods: ICCS was translated from English to Danish language, pilot tested and slightly modified for use as a self-rating scale with people with ABI. A relative/staff version of the scale was also constructed for testing. Participants with medium-to-severe ABI self-rated their interpersonal communication skills using the modified ICCS. Cronbach Alpha test was performed on both scales followed by a correlation analysis.

Results: Seventeen participants with medium-to-severe ABI and staff and relatives (n = 37) were involved in testing the ICCS-staff/relative rating and ICCS-self-rating. The ICCS-Staff/Relative showed an overall Cronbach alpha of α = 0.774 and the ICCS-Self-rating α = 0.675. A factor extraction of the ICCS-Staff/Relative revealed six meaningful sub-groups that corresponded well with the original ICCS. There was a low but significant correlation between the ratings performed by the two staff members most familiar with the participants (r = 0.280, p = 0.04).

Conclusions: The ICCS-Staff/Relative revealed a good overall internal consistency, whereas the ICCS-Self-rating revealed acceptable internal consistency. The factor analysis of the proxy-rating revealed six meaningful sub-groups of interpersonal communication competencies.
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http://dx.doi.org/10.3109/02699052.2015.1024740DOI Listing
May 2016

Thematic analysis of the experience of group music therapy for people with chronic quadriplegia.

Top Spinal Cord Inj Rehabil 2014 ;20(3):236-47

University of Melbourne , Australia ; Institute for Breathing and Sleep, Austin Health , Melbourne , Australia.

Background: People living with quadriplegia are at risk for social isolation and depression. Research with other marginalized groups has indicated that music therapy can have a positive effect on mood and social interaction.

Objective: To gather descriptions of participants' experience of 2 types of group music therapy - therapeutic singing or music appreciation and relaxation - and to determine commonalities and differences between participants' experience of these 2 methods.

Methods: We interviewed 20 people with quadriplegia about their experience of participating in 12 weeks of therapeutic singing (n = 10) or music appreciation and relaxation (n = 10). These methods of group music therapy were the interventions tested in a previously reported randomized controlled trial. The interview data were subjected to an inductive thematic analysis.

Results: Six main themes were generated from the interview data. Four of these were shared themes and indicated that both types of group music therapy had a positive effect on mood/mental state and physical state, encouraged social engagement, and reconnected participants with their music identity or relationship with music. In addition, the participants who participated in the singing groups found singing to be challenging and confronting, but experienced a general increase in motivation.

Conclusions: Group music therapy was experienced as an enjoyable and accessible activity that reconnected participants with their own music. Participants frequently described positive shifts in mood and energy levels, and social interaction was stimulated both within and beyond the music therapy groups.
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http://dx.doi.org/10.1310/sci2003-236DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4257149PMC
December 2014

The effect of singing training on voice quality for people with quadriplegia.

J Voice 2014 Jan 2;28(1):128.e19-128.e26. Epub 2013 Dec 2.

Music Therapy Department, Melbourne Conservatorium of Music, University of Melbourne, Parkville, Victoria, Australia.

Objectives: Despite anecdotal reports of voice impairment in quadriplegia, the exact nature of these impairments is not well described in the literature. This article details objective and subjective voice assessments for people with quadriplegia at baseline and after a respiratory-targeted singing intervention.

Study Design: Randomized controlled trial.

Methods: Twenty-four participants with quadriplegia were randomly assigned to a 12-week program of either a singing intervention or active music therapy control. Recordings of singing and speech were made at baseline, 6 weeks, 12 weeks, and 6 months postintervention. These deidentified recordings were used to measure sound pressure levels and assess voice quality using the Multidimensional Voice Profile and the Perceptual Voice Profile.

Results: Baseline voice quality data indicated deviation from normality in the areas of breathiness, strain, and roughness. A greater percentage of intervention participants moved toward more normal voice quality in terms of jitter, shimmer, and noise-to-harmonic ratio; however, the improvements failed to achieve statistical significance.

Conclusions: Subjective and objective assessments of voice quality indicate that quadriplegia may have a detrimental effect on voice quality; in particular, causing a perception of roughness and breathiness in the voice. The results of this study suggest that singing training may have a role in ameliorating these voice impairments.
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http://dx.doi.org/10.1016/j.jvoice.2013.08.017DOI Listing
January 2014

'Stroke a Chord': the effect of singing in a community choir on mood and social engagement for people living with aphasia following a stroke.

NeuroRehabilitation 2013 ;32(4):929-41

Austin Health, Melbourne, VIC, Australia.

Background: Communication deficits resulting from aphasia can negatively impact stroke survivors' relationships and social participation. Despite their difficulties, singing is accessible and enjoyable for many people with aphasia.

Objectives: To explore the effects of group singing for people with aphasia.

Methods: A community choir was established and facilitated by a neurologic music therapist. Mood (General Health Questionnaire-12; Visual Analogue Mood Scale), communication, cognition and global functioning (Stroke Impact Scale-3) and social functioning (Sense of Belonging Instrument) were measured before, and at 12-weeks and 20-weeks after joining the choir. Three choir members and five caregivers also completed semi-structured interviews about their experience of the choir.

Results: Baselines measures were collected for 13 participants with aphasia. Prior to joining the choir, participants had higher levels of negative mood symptoms and poorer subjective sense of belonging compared to Australian general population samples. Results from the GHQ-12 suggested a trend towards reduction of psychological distress after participating in the choir. Thematic analysis of the interviews revealed five common themes: increased confidence, peer support, enhanced mood, increased motivation, and changes to communication.

Conclusion: The strength of findings was limited by the number of participants and lack of a control group, however clear benefits of choir participation were demonstrated. Preliminary findings were encouraging and warrant further rigorous investigation.
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http://dx.doi.org/10.3233/NRE-130916DOI Listing
April 2014
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