Art Work(s)

A Case Study of Musical Improvisation in a Young Woman with Intensive Support Needs

Authors

  • Annet ten Brug The Unit of Inclusive and Special Needs Education, Department of Pedagogical and Educational Sciences, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, The Netherlands https://orcid.org/0000-0002-0898-1988
  • Richard Lekkerkerk Hanze University of Applied Sciences, Research Group Healthy Ageing, Allied Health Care and Nursing, Groningen, The Netherlands
  • Gineke Hanzen The Unit of Inclusive and Special Needs Education, Department of Pedagogical and Educational Sciences, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, The Netherlands; Royal Dutch Visio-de Brink, Vries, The Netherlands https://orcid.org/0000-0002-3190-9335
  • Aly Waninge Hanze University of Applied Sciences, Research Group Healthy Ageing, Allied Health Care and Nursing, Groningen, The Netherlands; University Medical Center Groningen, Department of Health Psychology, Groningen, The Netherlands https://orcid.org/0000-0002-2316-2577
  • Annette A.J. van der Putten The Unit of Inclusive and Special Needs Education, Department of Pedagogical and Educational Sciences, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, The Netherlands https://orcid.org/0000-0003-4226-8147

DOI:

https://doi.org/10.15845/voices.v26i1.4582

Keywords:

music, profound disability, intervention, improvisation, therapy

Abstract

IImprovisational music therapy may be valuable for persons with intensive support needs because of its possibilities to connect to preferences and abilities. This study aims to explore the form, use, and active elements of improvisational music therapy for a person with intensive support needs by describing the application of this therapy in detail. A case study was conducted in which an improvisational music therapy session was recorded with a young woman with intensive support needs. Two interviews were conducted with the music therapist (MT). The interviews were transcribed, coded, and thematically analyzed. The case was described based on four themes: behavior and interaction, the course and application of music therapy, the rationale behind the choices made, and the MT's reflection. Distinctive features of improvisational music therapy were the multiplicity of sounds, timbre, and the versatile use of the voice. Other features included its multi-sensory nature, repetition, adaptability, and focus on interaction. The music therapy followed a clear structure with fixed elements enhancing recognizability and familiarity, the improvisation facilitated continuous attunement to the person with intensive support needs. Besides distinctive elements of improvisational music therapy, other elements (e.g., repetition) are more frequently seen in interventions aimed at persons with similar support needs.

Author Biographies

Annet ten Brug, The Unit of Inclusive and Special Needs Education, Department of Pedagogical and Educational Sciences, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, The Netherlands

Annet ten Brug, PhD studied educational sciences and works as assistant professor at the Department of Inclusive and Special Needs Education. Her work centers on improving the quality of life for people with intensive support needs. Building on her dissertation (2015) on the application and effects of multi-sensory storytelling, her research focuses on the development, evaluation, and implementation of interventions within the social and cultural domain, specially aimed at people with profound intellectual and multiple disabilities. She is involved as co-supervisor in several projects such as snoezelen, the use of technology, loneliness, and inclusive societies.

Richard Lekkerkerk, Hanze University of Applied Sciences, Research Group Healthy Ageing, Allied Health Care and Nursing, Groningen, The Netherlands

Richard Lekkerkerk, MSc MA is a cellist and music therapist. He obtained his Master of Arts degree at Codarts University of the Arts. During his training in music therapy, he completed an internship working with people with profound intellectual and multiple disabilities and conducted research on the application of music therapy within this population. After graduating, he became involved as a researcher at the Academic Collaborative Center PIMD. Richard combines his work as a researcher, cellist, and independent music therapist with his work in mental health care and elderly care. His work focuses on the development and application of music therapy for people across the lifespan.

Gineke Hanzen, The Unit of Inclusive and Special Needs Education, Department of Pedagogical and Educational Sciences, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, The Netherlands; Royal Dutch Visio-de Brink, Vries, The Netherlands

Gineke Hanzen, PhD is a postdoctoral researcher at the Academic Collaborative Centre related to people with PIMD. In addition, she is working as a physiotherapist with people with visual and intellectual disabilities at Koninklijke Visio. She focuses on ways to improve participation of the target group. She does this by developing/researching methods to actually promote participation.

Aly Waninge, Hanze University of Applied Sciences, Research Group Healthy Ageing, Allied Health Care and Nursing, Groningen, The Netherlands; University Medical Center Groningen, Department of Health Psychology, Groningen, The Netherlands

Aly Waninge, PhD is physiotherapist, professor at the Hanze University of Applied Sciences, and associate professor at the University Medical Center, University of Groningen in Groningen. From this background, she is member of the management team of the Academic Collaborative Center for PIMD. Her research focuses on the Participation and Health of persons with severe or profound intellectual, visual and multiple disabilities. She is co-supervisor of several PhD projects at the intersection of participation and health, for example about healthy lifestyle, health issues, pain observation, visual rehabilitation, and palliative care.

Annette A.J. van der Putten , The Unit of Inclusive and Special Needs Education, Department of Pedagogical and Educational Sciences, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, The Netherlands

Prof. dr. Annette A.J. van der Putten is a professor at the Special and Inclusive Needs Education: Learning and Development department at the University of Groningen. She supervises numerous research projects in the field of education and support for children and adults with profound intellectual and multiple disabilities and their relatives. As chair of the academic collaborative center she oversees that (scientific) knowledge about people with multiple disabilities is created in close collaboration with relatives and professionals, and is then disseminated and implemented in daily practice, both in care organizations and families.

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2026-03-03

How to Cite

ten Brug, A., Lekkerkerk, R., Hanzen, G., Waninge, A., & van der Putten , A. A. (2026). Art Work(s): A Case Study of Musical Improvisation in a Young Woman with Intensive Support Needs . Voices: A World Forum for Music Therapy, 26(1). https://doi.org/10.15845/voices.v26i1.4582

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Vol. 26 No. 1 (2026)

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Research

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Copyright (c) 2026 Annet ten Brug, Richard Lekkerkerk, Gineke Hanzen, Aly Waninge, Annette A.J. van der Putten

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