Voices ResourcesA website for the worldwide community around the journal Voices: A World Forum for Music Therapy

In 1998 I established a research unit at the University of Melbourne, which has as its purposes to promote postgraduate research studies, and to develop collaborative research projects. We now have a healthy number of 15 postgraduate students who are researching in a diverse array of music therapy efficacy projects. And we have collaborations with the University of Aalborg in Denmark and the University of Witten-Herdecke in Germany.

Closer to home we have strong links with the major hospitals here in Melbourne that provide music therapy services in paediatrics, oncology, palliative care, cancer care, rehabilitation and aged care. The one area that still needs to be developed however, is in psychiatry.

In the last week I have met with the Professor of Psychiatry at the University of Melbourne, and found I was challenged as many different levels. Psychiatry was one of the pioneering areas of music therapy when the profession was established here in Australia. As early as 1905, a branch of the International Society for Musical Therapeutics was providing concerts for patients in psychiatric hospitals in Sydney. And in the 1950s the Red Cross also arranged concerts in hospitals in Melbourne and in Brisbane. Out of these efforts the profession of music therapy was built, and in the 1970s in Melbourne we had music therapy positions in most of our major psychiatric hospitals.

During the 1980s however, the rigorous de-institutionalisation of our psychiatric hospitals saw the abolition of music therapy positions. Patients were moved out into the community and day programs were established to meet their psychosocial needs. Some music therapists have been employed part-time in these day programs, and are constantly challenged by the changing composition of participants within group sessions, and the lack of stable attendance needed to carry out "in-depth" therapy. Instead, music therapy must provide something that enables them to be integrated into the wider community. This often results in working toward a performance, or concert of some kind. Some exciting music therapy programs have emerged from this change in philosophy of care, and participants are able to perform their own songs and poetry, that lyrically express a range of emotions about their life (Colegrove, 1998). However many music programs are provided by volunteers, or other professionals outside of the music therapy profession. In fact the Professor Psychiatry with whom I met last week is one! He has established a program whereby music performance students (that is, NOT music therapy students) put on concerts for his patients within an acute-care ward of a major hospital where patients stay on average for 4-5 days. The Professor has received considerable media coverage for this "innovative" project.

When I met with him to explain what music therapists could provide for the in-patients during their 4-5 days of hospital stay, I searched for music therapy literature that would aptly describe clinical outcomes. Silverman's (2003a) meta-analysis of the effects of music on symptoms of psychosis identified only 19 studies since 1952 that met the criteria for analysis. I also needed literature on the efficacy of music therapy as an interactive form of therapy. Pavlicivic, Trevarthan and Duncan's (1994) study was useful in describing the outcomes of improvisation, and Silverman's (2003b) case study was helpful in illustrating song writing with a client diagnosed with schizophrenia.

My proposal to the Professor of Psychiatry was to do an efficacy study involving song writing with the patients on the acute ward at his hospital. However he was not convinced that this was a good starting point, instead suggesting that first of all we should survey patients about the influence of music in their lives, and how music might help them in their recovery. Initially I found my resistance rising: wasn't this just re-inventing the wheel? Surely music therapy has advanced far enough for us to know how it influences people's lives.

On reflection I became aware of several very good reasons why a simple survey would be a good starting point:

1. We do not know what influence music has on the lives of psychiatric patients in 2004. We could surmise, based on early studies from last century, but we do not have a recent survey of this kind.
2. This could be a solid way to build a body of knowledge on music and psychiatric illness. The survey study may cement a strong collaboration between the departments of psychiatry and music, and, using the survey study as a basis, efficacy studies can follow over the next few years.

In trying to push my natural resistance aside, I sought out T. S. Eliot's poem Little Gidding, which is often cited for its eloquent phrasing about endings being beginnings. But the words that best applied to my situation were these:

We shall not cease from exploration
And the end of all our exploring
Will be to arrive where we started
And know the place for the first time" (T.S. Eliot, Little Gidding, 1942).

Perhaps we need to periodically re-invent the wheel in order to kick-start a new cycle of growth. Having worked myself in psychiatry (from 1970-1980), this new collaboration will afford me the chance to look anew at how psychiatric services are offered, and, most importantly, how music therapy can be effective in the current provision of community care. The possibilities for researching in a team also outweigh the temporary frustration at not having the profession recognised in a way that I would have preferred.

References.

Colegrove, V. (1998). Recovery through the creative process. Presentation at the VIIth International Music Medicine Symposium, The University of Melbourne. Australia.

Pavlicivic, M., Trevarthan, C., and Duncan, J. (1994). Improvisational music therapy and the rehabilitation of persons suffering from chronic schizophrenia. Journal of Music Therapy, vol. XXXI(2), 86-104.

Silverman, M. (2003a). The influence of music on the symptoms of psychosis: A meta-analysis. Journal of Music Therapy, vol. XL(1), 27-40.

Silverman, M. (2003b). Contingency songwriting to reduce combativeness and non-cooperation in a client with schizophrenia: a case study. The Arts in Psychotherapy, 30(1), 25-33.

How to cite this page

Grocke, Denise (2004). Re-inventing the Wheel. Voices Resources. Retrieved January 12, 2015, from http://testvoices.uib.no/community/?q=fortnightly-columns/2004-re-inventing-wheel