[Research]

Situation Songs—Therapeutic Intentions and Use in Music Therapy with Children

By Agnes Kolar-Borsky & Ulla Holck

Abstract

The aim of this study was to examine the various therapeutic intentions behind the use of one particular improvisation method applied in pediatric music therapy, called the situation song (from the German term “Situationslied” Plahl & Koch-Temming, 2008, p. 180). According to Plahl & Koch-Temming, the term situation song describes an improvised song, which is sung by the therapist and/or the child. The song relates to the actual occurrence in the moment and within the therapeutic relationship. The study focuses on the therapist’s singing only and on the various intentions behind the use of this specific method.

The study was conducted in stages: An elaboration of the first author’s clinical experience with situation songs (preunderstandings), a systematic analysis of relevant literature, followed by semi-structured interviews with three music therapists from Denmark, Austria, and Germany. A flexible investigation approach was used, following hermeneutic principles.

The findings of the study show that pediatric music therapists regularly use situation songs, especially with children who are at an early developmental age. The various intentions behind the use of situation songs can be summarized as such: to create a therapeutic space; to support the therapeutic relationship; to enhance experience and development in the fields of emotion, behavior, expression and social skills; to express messages in language and to give structure to the child. The overall aim behind the use of situation songs is to offer essential experiences to the child in order to support his or her development.

This study attempts to give an impulse to more international exchange of clinical terms applied in music therapy. The study was submitted as the first author’s master thesis in music therapy at the Aalborg University in Denmark. The second author supervised the process of the master thesis.

Keywords: Situation song, pediatric music therapy, therapeutic intentions, developmental delay, autism, children


 

Introduction

“When a song reflects something of the essence of the child’s character or state of mind – at this stage of development, at this present moment in therapy – playing and singing it brings to expression the quality and content of the relationship forming between you. As the child listens to, or sings the song, or beats it, he has the possibility to live in this musically generated bond between you, and find in it healing and strengthening experiences of selfhood” (Nordoff & Robbins, 2007, pp. 242-243).

In pediatric music therapy, songs play an important role. The term song generally refers to pre-composed songs, which are repeatable and structured and are supposed to support the feeling of safety. Contrary to this, improvisation refers to a more open and non-predictable approach, expected to encourage new experiences (Austin, 2008; Jones, 2006; McFerran, 2011). Literature examples can also be found, where song and improvisation are combined such as songs that are improvised in the moment. In the English and German music therapy literature, various terms are used to describe such a song: improvised song (Oldfield & Franke, 2005; Robarts, 2003; Turry, 1999; Wigram & Baker, 2005), spontaneous singing (Austin, 2008), spontaneous tunes (Stegemann, 2007), play song (Gold, Wigram & Voracek, 2007), individual improvised song (Nordoff & Robbins, 2007) and situation song (German Situationslied in Plahl & Koch-Temming, 2008; Stegemann, 2007; Schumacher & Calvet-Kruppa 2008; Voigt, 2008; and English situation song in Gold, 2003). The term, improvised song is the most commonly used term in the English literature. In most cases it refers to the client’s active spontaneous singing about themes in the child’s world (Oldfield & Franke, 2005; Robarts, 2003; Turry, 2009).

The German term Situationslied [situation song] defines an improvised song which is “directly related to the actual therapeutic occurrence”… and is “invented spontaneously by the therapist for the child, together with the child or by the child himself/herself within the situation” (Plahl & Koch-Temming, 2008, p. 108, author’s translation). In English music therapy literature no common term currently exists, which describes the characteristics of the situation song, whereas the clinical phenomenon behind the term is described (as can be seen in the quotation of Nordoff & Robbins, 2007, above). However, the specific method is rarely a central issue in the literature. The phenomenon is mostly mentioned between the lines.

Situation songs can be sung by the therapist, the child, or both together. In this study however, it was not intended to investigate the child’s use of situation songs as an active way of expression. The focus lies only on the therapist’s singing and on the various intentions behind the use of this specific method.

Situation songs focus on the current interpersonal dynamics (Gold, Wigram & Voracek, 2007; Plahl & Koch-Temming, 2008). In practice, this means that the therapist and/or the child improvise lyrics to an improvised melody and thereby express themselves both musically and verbally. Music therapists often choose to support this vocal music by a rhythmical or harmonic foundation, e.g. drums, guitar. The songs are often simple and repetitive. Situation songs can also evolve from known songs, e.g. children’s songs, or rap. The lyrics of situation songs contain greetings, calls and introductions, statements, e.g. about the location, time and setting, descriptions and observations, e.g. about the child’s and/or therapist’s current activity or behavior, expressions, e.g. about current sensations, feelings and thoughts; the latter for example about the believed current needs of the client, questions, e.g. about the client’s interests, wishes and needs, discussions or humorous comments (this list can be extended). Essential to all the above examples is that the focus lies on the here-and-now (situation) and the you-and-me (relationship).

In the first author’s clinical work in pediatric music therapy with children with severe learning difficulties and developmental delays, situation songs are a frequently used method. To give an example: When a child is moving restlessly through the room, I start to sing a simple situation song. I sing the child’s name, who I am, where we are, and what we are doing right now. If it feels appropriate, I sing how I perceive the child in his or her current state of being, how I feel in this moment, and what I believe the child might need right now. This can lead to various forms of dialogues between the child and me. The dynamic and atmospheric quality of situation songs varies between quiet lullaby-like songs, energetic reaching-out-calls, lively discussion-songs, and moments of joined humor and laughter.

I am trained in psychodynamic music therapy and I believe that therapeutic change happens within the therapeutic relationship rather than through the mere use of specific methods. I am convinced that the phenomenon of countertransference (Bruscia, 1998) is an essential aspect of the therapeutic relationship. Observing the feelings and sensations of countertransference can help to facilitate essential healing experiences (Austin, 2008). I experience, that singing about the situation has a magnificent effect on the relationship between the child and me, on the atmosphere in the room and on the shared focus between us. Singing about the situation helps me further to cope with difficult situations, for example, when the client shows destructive behavior by harming him or herself, me, or the instruments. Singing about these situations helps me to secure the therapeutic space and keep my therapeutic attitudes.

On the basis of these clinical experiences and preunderstandings, a study was set up to investigate, 1) if situation songs are regularly used in pediatric music therapy, 2) what kind of therapeutic intentions lead to the use of situation songs, and 3) if other music therapists experience that singing situation songs helps them to cope with difficult situations during the music therapy sessions. Do other music therapists find situation songs helpful securing their therapeutic attitude and the atmosphere during difficult moments within the process?

This article presents the results of the study and attempts to give an impulse to a more international exchange of clinical terms and applied clinical methods. Sharing experiences about the use of specific clinical methods in regards to specific client groups is an important step towards the development of our clinical repertoire. The focus on a specific method deepens knowledge not only regarding the method as such, but broadens our understanding of general therapeutic attitudes, aims and priorities in relation to the specific group of clients, incorporating different schools of music therapy.


Method

Methodology

The study followed a flexible and qualitative approach (Robson, 2011; Stakes, 2010) with the principles of hermeneutic inquiries (Gadamer, 2004; Kvale & Brinkmann, 2009) as the primary guidelines. Based on the first author’s own clinical use of situation songs, music therapist literature was studied and analyzed. Building upon these finding, an interview study was conducted. Every step in the process of the study led to a reciprocal reflection on previous knowledge in the sense of the “hermeneutic circle” (Kinsella, 2006).

Further research orientation was found in phenomenology as a philosophy (Kvale & Brinkmann, 2009). The personal experience and perspectives of the other was the central issue both during the literature study and during the interviews. Since the data was interpreted based on pre-knowledge, the approach was not strictly phenomenological (Forinash & Grocke, 2005). A systematic coding strategy was followed in order to analyze the data: creating, merging and refining codes (open coding), bundling codes to categories (axial coding), and finally putting these into a broader context of understanding (selective coding) (Robson, 2011).


Preunderstandings

The investigation started with a thorough elaboration on the first author’s clinical experience with situation songs. This led to the realization that situation songs were used for various intentions, which can be assorted into two categories:

  1. to show appreciation and create a therapeutic space and
  2. to form a therapeutic relationship between the client and the therapist.

These two categories were the starting point for further investigations.


Literature Review and Analyses

English and German literature about pediatric music therapy was reviewed. The phenomenon “situation song” was often described between the lines. Music therapists tend to write about the assumed effect of the situation song on the child rather than their therapeutic intentions behind the use of situation songs. The data were therefore translated from the assumed effects on the client to the therapist’s intentions. Building onto the categories found during the elaboration on the first authors’ clinical use of situation songs, the literature data were analyzed and sorted into eight categories of intentions (see Figure 2).


Interview Conduction and Analyses

A semi-structured interview guide (Kvale & Brinkmann, 2009) was created, inspired by the research guidelines of Kvale & Brinkmann (2009), Stakes (2010) and Robson (2011). This interview guide consisted of four parts: 1) asking for an introduction example, 2) asking for follow up examples, 3) exhibiting questions referring to the literature findings, and 4) exhibiting questions referring to the first author’s experience regarding the effect of situation songs on the ability to cope with difficult situations and to secure the therapeutic attitude and space. A mixed interview style was used to actively seek specific knowledge while also being open to unexpected findings (Kvale & Brinkmann, 2009).

Three pediatric music therapists (Denmark, Austria, Germany) were interviewed via Skype[1] (all interviews in English). Each interview lasted 50 minutes. The interviewees were informed beforehand via email about the subject matter and the definition of situation song as described by Plahl and Koch-Temming (2008). The audio data of the interview was recorded using Pamela professional software[2]. A precise guide of analyzing procedure was developed (see Figure 1), which allowed all three interviews to be evaluated side by side for equal data analysis (Bruscia, 2005). The text was transcribed by the software program Express Scribe[3] and analyzed by the use of software AtlasTi[4]. This program allowed the researcher to mark patches of interest, to attach codes to these patches, to merge codes into less codes of the same meaning, to refine the codes, to group the codes into categories, to merge and refine again - an often repeated process (see Figure 1)

The categories of the interview data were built upon the categories of the literature analyses (in a hermeneutic sense). It became clear, that three further categories were needed and the names of some categories needed a small redefinition to fit the interview data (see Figure 3). Some codes fit into more than just one category (Robson, 2011). A primary category was specified for these codes.

Figure 1 : My step by step guide to the interview analysis (Kolar-Borsky, 2013, p. 39)

Step 1: The actual interview sending interpretations back (Kvale & Brinkmann, 2009)

Step 2: Brain storm – first meaning condensation and codes (Robson, 2011; Lindvang, 2010)

Step 3: Transcription (Kvale& Brinkmann, 2009)

Step 4: Member checking of the transcription (Kvale & Brinkmann, 2009)

Step 5: Patches of interest (Bruscia, 2005)

Step 6: Coding (Robson, 2011)

Step 7: Reading first notes (Step 2), altering codes.

Step 8:Categorizing (Robson, 2011)

Step 9: Meaning condensation of each interview (Kvale & Brinkmann, 2009)

Step 10: Member checking of the meaning condensation (Robson, 2011)

Step 11: Integration and interpretation of data (Robson, 2011)

Results

Codes and Categories of the Literature Finding

The findings of the literature review and analyses (see Figure 2) show that pediatric music therapists used situation songs regularly by. The music therapists listed in Figure 2 work with pediatric clients with various diagnoses, such as developmental delays, autism spectrum disorders, and behavioral difficulties. Therapists, who specialize in work with children with developmental delays or/and autism spectrum disorders, tend to use situation songs for a wider range of reasons than therapists who work with children in general. This implies a more frequent and a wider use of situation songs with clients with developmental delays and autistic spectrum disorders than with other diagnoses.

Situation songs are used on the basis of a wide variety of intentions. These intentions were summarized into five categories:

  1. Appreciation & space,
  2. Contact & relating,
  3. Regulating emotions,
  4. Structuring sessions & process,
  5. Progress enhancing & pedagogic aspects.

The main impulse behind the use of situation songs is to make contact and to relate (see category 2). Most music therapists use situation songs further to respond to the child (category 2c) and to give feedback category 2e & 2f). Situation songs are also frequently used as a tool to create a therapeutic space and to show the child appreciation (category 1), to give comfort (category 1b), to give reassurance and to show acceptance (category 1d). Some music therapists make use of situation songs to regulate the emotional state of the child and of themselves (category 3), to organize and structure time and sessions (category 4) and to set gentle but direct impulses to emphasize developmental progresses in therapy (category 5). In the literature about Nordoff & Robbins Music Therapy, situation songs are described as being used for the widest range of reasons throughout the listed categories, with all five categories being as significant as the other. Only one literature source could be found, where the benefit of situation songs for the therapist is mentioned: Schumacher refers to the opportunity to sing situation songs in situations which are difficult for herself, specifically in order to cope with a child’s demands for constant repetitions (category 3d).

Figure 2: Codes and categories from the literature review (Kolar-Borsky 2013, p. 32)
Therapists L-H N&R T V S P&K-T GR B
Client groups, diagnoses Children and adolescents in general Developmental delay, autism, behavioral difficulties Cancer Developmental delay Autism Children in general Children with severe disorders, various diagnoses Speech & language disorders
Codes of intentions  
  Category 1: Appreciation & space
a) to nurture   x            
b) to comfort   x x       x  
c) to give the child the feeling of a caring and emphatic vis-à-vis   x         x  
d) to give personal reassurance on behavior, show acceptance   x     x   x  
  Category 2: Contact & relating
a) to create nearness, reach out, send signals   x   x x   x  
b) to create distance             x  
c) to respond to the child x x x x x x x  
d) to encourage shared play moments/sequences       x x      
e) to give feedback on the child’s actions and being   x x x x   x  
f) to give feedback on one’s own thoughts and feelings x x x   x x    
g) to let the child feel, that the therapist “lives in music”   x            
h) to prepare for verbal interpretations             x  
  Category 3: Regulating emotions
a) to soothe     x          
b) to regulate state of arousal, change mood of child   x   x   x    
c) to enhance experiences of deep emotions   x            
d) to create humorous/joyful moments x x   x        
e) to cope with situations (constant repetitions)         x      
  Category 4: Structuring session & process
a) to offer structure in time (linking activities together)   x   x x      
b) to offer variations to stay at an activity       x x      
c) to indicate beginning and end of activity   x     x      
d) to expand the child’s attention span       x        
e) to mediate the therapy progress through music   x            
f) to move from music and play towards verbal psychotherapy             x  
  Category 5: Progress enhancing & pedagogic aspects
a) to encourage progress (expression) and reinforce x x     x   x  
b) to celebrate progress   x            
c) to set boundaries x              
d) to give instructions, make suggestions x x         x x
e) to support the development of listening skills               x
f) to support the development of awareness of others       x       x
g) to support the development of impulse control               x
A: Aigen (1998); B: Beer (2011); GR: Grinnell, quoted by Bruscia (1987); L-H: Lutz-Hochreutener (2009); N&R.: Nordoff& Robbins (2007); P&K-T.: Plahl & Koch- Temming, (2008); S: Schumacher (1994); Schumacher & Calvet-Kruppa (2008); Turry, (1998); T: Turry(1999); V: Voigt (2008);

Codes and Categories of the Interview Analysis

The coding results of the interviews with three music therapists about their intentions to sing situation songs are presented in Figure 3. The findings show, that the situation song is regularly used by two of the interviewees and sometimes used by interviewee C. The interviewees work as music therapists with children with various diagnoses, such as developmental delays, severe physical impairments, attachment disorders, behavioral disorders, and early childhood trauma. The intentions behind the use of situation songs were summarized into eight different categories:

  1. Appreciation & space,
  2. Relationship,
  3. Emotion & mood regulation,
  4. Structure of activity,
  5. Social skills & pedagogic aspects,
  6. Behavior,
  7. Expression, and
  8. Language.

Category 2, Relationship, was split into two subcategories:

  • Relating to the child (category 2child) and
  • Relating to oneself & coping with difficulties (category 2therapist).

All three therapists use situation songs to create a basic therapeutic space (category 1). They want to give the child feelings of security (category 1e) and of being cared for (category 1b & 1c). Through the recognition of the child’s individual needs (category 1f), through hope for the child’s development (category 1g), and through acceptance of the child and his or her behavior (category 1a), the child shall experience appreciation. All three music therapists mention situation songs as a means of working on the relationship (category 2) to create nearness and make contact (category 2childa) for example. Interviewee B refers to the opportunity to create distance when this seems necessary (category 2childb).

Situation songs are used to describe and contain the child’s emotions (category 3), as sensed by the therapist (category 3a) and sometimes to regulate the current mood of a child (category 3b & 3d). All interviewees state, that they do not use situation songs to use directive structure and to regulate the therapy process. Structure (category 4) is nevertheless an important aspect of situation songs – not in the sense of influence on the process, but to offer the child feelings of security - a “securing structure” (category 1e, as quoted by interviewee B).

The situation song can also be used as a means to foster the development of social skills (category 5); for example to encourage a child to follow instructions (cat. 5a), to expand her/his repertoire of actions (category 5d) and to integrate a child in a group (category 5b).

Three therapists use situation songs regularly to give feedback on the observed behavior (category 6). Two of the interviewees sing situation songs to give feedback on their own thoughts and feelings in regard to countertransferences (category 2childe). One interviewee sings situation songs to give feedback on the interviewee’s own uncertainties and hopes (category 1g, category 8e).

Two interviewees mention the aspect of expression (category 7): Situation songs can be used to “give the child a voice” (category 7a, quoted by interviewee A) and to support the child’s awareness of his or her own expressional abilities (category 7b).

An important further aspect of situation songs is the opportunity to send a message through language (category 8). Through the song, the child can be told something concrete and specific, which cannot be told through music alone (category 8d). The child’s understanding of an instruction, his or her mood and emotions and the specific situation can be enhanced through the situation song (category 8b). The song can be further used to show a child with severe physical impairment recognition of his or her intellectual abilities (category 8g).

When asked about the effects of singing situation songs on themselves, the three interviewees responded very diversely. Interviewee A mentions the importance of creating room for herself at times and presumes to use situation songs to do so (category 2therapista, category 2therapistb). Interviewee B sings situation songs to regulate her emotional state at times, for instance when she finds it hard to cope with the knowledge about a child’s difficult life situation (category 2therapistc). Interviewee C states, that she does not use situation songs or other forms of musical improvisation to regulate her own wellbeing within music therapy sessions.

Figure 3. Codes and categories from the interview analysis (Kolar-Borsky, 2013, p. 39)
Therapists Interviewee A Interviewee B Interviewee C
Client groups, diagnoses developmental delays, severe physical impairments developmental delays, behavioral disorders attachment disorders, early childhood trauma
Codes of intentions      
  Category 1: Appreciation & space
a) to show acceptance x   x
b) to give to the child/to nurture x   x
c) to create a situation that is good for the child x    
d) to give the child the feeling of a present vis-à-vis   x x
e) to give child feeling of security x x  
f) to recognize child’s needs/show understanding x   x
g) to build up hope for child's progress x    
  Category 2child: Relating to the child (equivalent to Contact & Relating)[5]
a) to create nearness/to make contact x x x
b) to allow distance   x  
c) to show child, that it is seen and heard/to respond x   x
d) to meet child’s interests x    
e) to give feedback on own thoughts/feelings x x  
f) to create shared focus     x
g) to suggest something/to invite the child x x x
  Category 2therapist: Relating to oneself & coping with difficulties new subcategory)
a) to give room to oneself/care for own needs x x  
b) to show own self x x  
c) to regulate own thoughts and emotions x x  
  Category 3: Emotions & mood regulation (equivalent to Regulating emotions)
a) to describe/name probable emotions x x x
b) to help the child to regulate his moods/to soothe x   x
c) to motivate child x    
d) to create humorous and joyful moments x    
  Category 4: Structure of activity (equivalent to Structuring session & process)
a) to create a structure/a frame x x x
  Category 5: Social skills & pedagogic aspects (equivalent to Progress enhancing & pedagogic aspects)
a) to teach the child to follow an instruction x    
b) to support child's integration in group setting     x
c) to support development of child’s listening skills x    
d) to support child to expand his repertoire of actions/foster new experiences x    
  Category 6: Behavior (new category)
a) to give personal reassurance on behavior/to contain it x    
b) to give feedback on the child's actions x x x
    Category 7: Expression (new category)  
a) to give the child a voice x   x
b) to support the child’s consciousness of his own voice x    
  Category 8: Language (new category)
a) to describe/name atmosphere or situation x x x
b) to support the child’s understanding x x  
c) to give a verbal meaning to the music x   x
d) to tell the child something specific x x x
e) to express uncertainties x    
f) to stimulate the child's language x    
g) to recognize the child’s intellectual abilities x    


Discussion

The literature review led to an overview on music therapists’ intentions behind situation songs throughout different music therapeutic approaches. The interview study made possible a closer focus on the therapeutic intentions behind the method. The combination of a broad literature analyses and a small interview study was the chosen method in order to support robust results.

In order to verify the hermeneutic text interpretation of the literature (as mentioned by Kvale & Brinkmann, 2009), exhibit questions were asked during the interviews. This was a way to check, whether the categories were meaningful to other music therapists. Exhibit questions were also asked, which linked the interviews to the first author’s own experience with situation songs, specifically in difficult situations, e.g. when the child shows destructive behavior. In the sense of the hermeneutic circle, knowledge was deepened and expressed more precisely.


Comparison of the Literature and Interview Findings

Due to the advantages of interviewing—asking interviewees concrete questions with focus on the precise subject—matter of the study—more codes and categories were found in the interview data than in the literature. Further, some differences were found regarding the therapeutic focus. To show appreciation and to create a therapeutic space are of major importance both for the authors of the literature as for the interviewees (category 1). In the literature the main focus is on giving comfort, on accepting, nurturing and caring. The interviewees additionally mention the intention to create a secure, safe and good situation for the child, to show recognition of the child’s individual needs and to “build up hope” (quote by interviewee A) for the child’s progress. The latter can be seen as a way of showing appreciation, believing in the child and his or her abilities, devoting oneself with empathy towards him or her. Relationship (category 2) is a primary focus both in the literature and the interview data, specifically to make contact, to allow distance, to respond and to give feedback. The interview findings show moreover, that situation songs can be used to carefully suggest something, to invite the child, to take part in a shared activity and to meet the child’s interests.

According to the interview data, singing situation songs can help the music therapist to create room for himself or herself, and to show his or her own needs to the child. Singing situation songs can further be a way to regulate his or her own thoughts and emotions. According to one literature source (Schumacher, 1994), singing situation songs can help the therapist to cope with constant repetitions. Two examples from the interviewees (as well as the example from the first author’s clinical work, see introduction) demonstrate the use of situation songs in order to express countertransference. Singing about sensations and feelings of countertransference can give room to this phenomenon so that becomes possible again to fully turn towards the child and secure the therapeutic space. The child can perceive the authenticity and presence of the music therapist—a tangible vis-à-vis.

While in the literature there is a tendency to use situation songs for the regulation of emotions (category 3) (e.g. to sooth, to motivate, to create humorous situations), the focus of the interviewees is to accept, contain, describe, and name emotions rather than change them.

In the literature, situation songs are described as a method to structure the process (category 4), e.g. by indicating beginning and end of an activity, offering variations and expanding the time of shared focus. The findings of the interview analysis show a less directive approach. Structure, for example, through the repetition of little song phrases, is used to support the child’s understanding of what is going on, so that the child feels secure and can embark on the therapeutic relationship.

The interviewees use situation songs with a focus on the child’s behavior (category 6). The intentions to give personal reassurance on behavior and to give feedback on the child’s actions were found in the literature as well, but at this stage of the study were sorted into other categories (category 1 & 2). A further aspect about the use of situation songs mentioned in the interviews is expression (category 7). The therapist can express something on behalf of the child “to give her or him a voice” (quote by interviewee A) and support the child’s awareness of her or his own expressional abilities. The intention to encourage expression was found in the literature as well. Here it relates to the child’s own creation of songs and not to subtle first attempts to use the child’s own voice or mimics and gestures.

A further aspect about the use of situation songs found in the interview data is language (category 8). The song offers the opportunity to send specific messages to the child about thoughts, uncertainties, feelings and descriptions. The child can experience, that he or she is appreciated as a human being, who lives within language, even though he or she might not be able to make use of this expressively, due to severe physical impairments.


Integrated Model

On the basis of the findings an integrated model of the categories of intentions to use situation songs was developed (see figure 2). From this point of view, the therapeutic space (category 1) is the essential frame for any therapeutic work at any time in the music therapy process. The music therapist intends to be a present vis-à-vis for the child, to accept the child in her or his uniqueness, to show recognition of the child’s needs and to create a secure surrounding. These experiences are essential for the child, in order to be able to relate and to make progress. The child and music therapist create a dynamic relationship (category 2) with each other. The therapist intends to see and hear the child, respond to her or him, and meet her or his interests. The therapist supports the Space for the child, but also shows his or her own needs, feelings and thoughts to some extent (Space for the therapist). By doing so the therapist shows authenticity and helps the child to develop an awareness of the other. Based on new beneficial experiences within the therapeutic relationship, the child is supported to develop further in the various fields of development— emotion (category 3), expression (category 7), behavior (category 5) and social skills (category 6). The categories language (category 8) and structure (category 4) are further resources, which help to work on the various fields of development.

Experience and development never happen in just one of the above categories, but affect us in an integrated or holistic sense. To do justice to the connectedness of the different categories, the categories in Figure 4 are transparent and partly overlapping. They are closely interrelated and do not stand alone.

 

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Figure 4: Integrated model of the categories of intentions behind the use of situation songs (Kolar-Borsky, 2013, p. 62)

The categories of intentions behind the use of situation songs outline different fields of experience and development. The overall aim behind the music therapists’ use of situation songs is to offer essential experiences in order to support the child’s development.

Although the integrated model in Figure 4 refers to the intentions behind the use of situation songs only, it provides valuable information about general therapeutic intentions, aims and priorities of music therapists working with pediatric clients, beyond the use of situation songs. Especially significant is the importance of the therapeutic space (first pre-requisite) and further the therapeutic relationship (second pre-requisite), leading to learning opportunities in various fields of development.


Conclusion

The findings show that situation songs are regularly used by pediatric music therapists with various training backgrounds, especially by those who work with children with developmental delays and autism spectrum disorders. Several therapeutic intentions lead to the use of situation songs. The overall aim of the use of situation songs in pediatric music therapy is to offer beneficial experiences in order to support the child’s development.

The study further reveals the special features of the situation song—a dual-modal form of expression (verbal and musical) within the spontaneity of improvisation. Verbal content can be supported by a song melody. This can make it easier for the child to understand the words, to reach the child emotionally, and to make it safer for the child to take in information which is difficult to bear. Moreover, musical messages can be supported by song lyrics. This enhances the clarity of the musical message and gives another angle to the musical expression.

Based on the ethic belief that every client has a right to experience transparency within the therapeutic process (Plahl & Koch-Temming, 2008), situation songs can be used to include the client in this process and to show honesty. Perhaps the client comprehends more than the therapist believes or perhaps the client only understands musical messages. Using situation songs, the therapist can open communication—verbal content within a musical context—without burdening the clients.

This study gives an impulse to more international exchange of clinical terms applied in music therapy. The study focuses on English and German literature only. Therefore, further research about the subject in other languages, such as Spanish, would contribute to an even greater insight into the topic.

This study focuses on music therapists’ views on situation songs, particularly specified reasons why music therapists apply these songs in pediatric music therapy. This leads to conclusions about presumed and observed effects of situation songs on pediatric clients. Nevertheless, the actual intrapersonal effects on clients cannot be evaluated. Visible effects (reactions, change of behavior) of applied situation songs would require an investigation through video analyses. This could be a further interesting research subject.

Investigations of therapeutic intentions behind the various applied (musical) intervention method, especially through interview studies with music therapists throughout different countries could support professional and international exchange of valuable experience and the development of our professional repertoire.


Notes

[1] www.skype.com/en/ (27.04.2014)

[2] http://www.pamela.biz/en/ (27.04.2014)

[3] http://www.nch.com.au/scribe/ (27.04.2014)

[4] http://www.atlasti.com/index.html (27.04.2014)

[5] Referring to the categories of the literature review


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