Review of the Book Essentials of Music Therapy Assessment

[1] Italian Hospital of Buenos Aires, Argentina

Abstract

There will be a review of the book Essentials of Music Therapy Assessment by the author Dr. Gustavo Schulz Gattino, published for the first time in Portuguese in 2020. The parts of the book and some fundamental concepts addressed in each one will be examined. Relevant topics that were of interest to the reviewer will be highlighted, as well as a possible practical application of some content. It will provide a general notion of the context in which the book was written and disseminated in the music therapy community and its relevance to the discipline today.

Keywords: music therapy, assessment, context COVID 19 Pandemic

Gattino, G. S. (2020). Fundamentos de avaliação em musicoterapia. Forma e Conteúdo Comunicação Integrada.

I have had the opportunity to read the book Essentials of Music Therapy Assessment by the author Dr. Gustavo Schulz Gattino. Originally the book was written in the Portuguese language because it is the author's mother tongue. I have been able to access its reading in a favorable way given the similarity with the Spanish language. Assessment is a topic of great interest to me, since I practice music therapy in the clinical field as well as work as a supervisor and teacher.

From a deep reading of this book I have been able to understand that the assessment process in music therapy is ubiquitous, although sometimes we are not aware of it. In each instance of the music therapy process we are assessing in many ways. We will be able to record/ review, observe, test, and/or interview (Waldon & Gattino, 2018) according to different purposes and following the four stages of the assessment process in music therapy. These stages of assessment are: (1) preparation, (2) data gathering, (3) analysis and interpretation of data, and (4) documentation and communication of data (Goldfinger & Pomerantz, 2014).

Likewise, these assessment methods may be applied in the different stages of the music therapy process either during the (1) referral and acceptance of the treatment, the (2) initial assessment, the (3) definition of treatment plan, the (4) implementation of treatment, and the (5) discharge or termination (American Music Therapy Association, 2013; Waldon, 2013). The interrelation between the aforementioned processes can be clearly visualized in a figure proposed by the author. Sometimes we do not necessarily apply assessment tools and it does not imply that we are not assessing. The author clarifies that assessing is not synonymous with applying a specific tool (Gattino, Jacobsen, & Storm, 2018).

Unlike the book Music Therapy Assessment: Theory, Research and Application by the authors Jacobsen, Waldon and Gattino (2018), Gattino's (2020) book delves into the theoretical aspects of assessment as well as presents informal assessments such as the use of performance tasks and rubrics, not necessarily based on tests or formal tools, and that the music therapist could create based on their needs and their work context. In addition, it presents and delves into the theoretical and practical bases of each assessment method, dedicating a chapter to each one. This is how the assessment process is enriched according to the different ways of assessing and the information obtained in each of the instances.

The book is divided into six parts. In general, Part I refers to the initial considerations for the assessment. Parts II to V are written in such a way as to be able to define and conceptually differentiate the four stages of assessment in music therapy, dedicating a part to each one.

Part I deals with introductory topics such as the conceptual definition of assessment, its basic characteristics, the processes and the different contexts. Regarding this last point, it is interesting to understand the assessment in each application context, such as the educational, medical, and mental health context. It considers situations such us if the assessment is about a person or a group, if the assessment is about the patient or the music therapist, if the assessment is connected or disconnected from the music therapy process, etc. Regarding the duration, another difference could be if it is a focal or a procedural assessment. My work in varied clinical care situations has many times raised big questions as to how to adjust the assessment, what to assess, how to assess and analyze, and what to contribute and communicate to the interdisciplinary team.

Part II Preparation refers to considerations about development throughout life. This section is interesting since there are few authors in music therapy who have written on this topic (Bruscia, 1992; Ferrari, 2013). Here it could be observed that the author places a lot of emphasis on childhood, offering a broad panorama of theories that explain these processes. However, it scarcely presents specific conceptualizations about what happens when functions begin to be lost due to the deterioration of the person during late adulthood and third age, especially since it then describes existing tools for this age group. It would be interesting to know more theories that can explain to music therapists about the deterioration processes.

Likewise, it mentions the different perspectives in music therapy, such as the GIM Model, Improvisational, Feminism, Behavioral, etc., offering a very large panorama about how to think about the assessment according to each one. Ethical aspects are also addressed in this part, highlighting the importance of informed consent about the actions that the music therapist performs around the assessment. This aspect is significant since the context of virtual attention has raised many questions about data protection. The author concludes this part with a review of the research in which studies were compiled where various assessment tools are presented, applied, validated, or reviewed. I personally had no notion of the large number of studies referring to these issues. Based on this research, the author highlights the idea of being able to deepen the applications of existing tools, perfecting their usefulness in different contexts and circumstances in order to improve and increase their evidence of validity.

Part III Data Gathering dedicates a chapter each to the conceptualization of each type of assessment method (review, observation, interview, and test). The contribution of Chapter 13 is interesting, in which Gattino explains different ways of creating, adapting and translating assessment tools. This chapter has been of great help to me as I am writing and validating a new assessment tool for the context of Autism (Marsimian, 2019). Likewise, chapter 14 provides some guidelines to select the type of assessment method to use (Gattino, Jacobsen, & Storm, 2018) from a questionnaire of 13 questions that function as a practical guide for this task.

In Part IV the author explains the different ways to analyze and interpret the data obtained from the assessment process. A chapter is devoted to analysis, detailing the variety and breadth of data types that can be collected as well as quantitative, qualitative, and mixed analyzes. In the chapter on interpretation he explains the different forms, such as the “suspicious,” phenomenological, empathic, hermeneutical, actuarial, psychometric, interpretative, etc. Here the most interesting contribution is the decision tree based on Bonde (2016) to select the interpretation modalities, which helps to visualize the different options and how they are related according to the level of objectivity and subjectivity. Regarding its practical application, the author provides a clinical example of how to interpret the data obtained from a musical experience with a patient. I believe here that it would have been useful to provide an example where several tools and types of data are used in the same patient to understand how to integrate them and make consistent interpretations. This type of exemplification could be shown in a future publication based on this writing, with contributions from different music therapists and in diverse populations and contexts.

Part V is related to the communication and documentation of the assessment results. Regarding the communication chapter, the author provides clinical examples and specific strategies of how to communicate, both orally and in writing, assertively and effectively, what was assessed. Regarding the chapter on documentation, the author focuses on how the music therapist generates different types of documents according to the music therapy process stage and according to the different purposes for its practice. Throughout it the author provides different document and form templates, resulting in a very didactic way of transmitting these ideas. Some suggestions on how to organize and categorize these documents were interesting to me, given that over time there may be many patients with whom we work and many kinds of information to manage.

From a personal point of view, the book has given me the opportunity and the challenge to develop a deeper understanding of the actions that I take in my clinical practice related to assessment. Before reading this book, I believed that the assessment in music therapy was synonymous with the initial assessment (Ferrari, 2013). After reading it, I realized that assessment is a much more complex concept and that it goes through the different stages of the music therapy process.

As a contribution to putting into practice the ideas transmitted throughout the book, in the following table I was able to capture and visualize the continuous assessment process considering the tools, methods and objectives of each action at each stage of the process in music therapy that I carry out in the context of clinical care for children and young people on the Autism Spectrum (Marsimian, 2021). Performing this exercise could be interesting for any music therapist who wants to rethink their interventions from the point of view of assessment.

Table 1

Assessment Actions Aimed Along the Music Therapy Process for Children and Young People on the Autism Spectrum.

MUSIC THERAPY PROCESS ASSESSMENT TOOLS ASSESSMENT METHODS ASSESSMENT PURPOSES
REFERRAL AND ACCEPTANCE Semi-structured interview INTERVIEW
  • To know the patient and their family

  • To know everyday contexts and routines

  • To give guidelines and guidelines for treatment

  • To get the informed consent

  • To set the indication to music therapy (Ferrrari & Marsimian, 2013; Møller et al., 2002)

Admission Form RECORD/ REVIEW
DOCUMENT
Informed consent Form RECORD/ REVIEW
DOCUMENT
MEL Assessment
(Gottfried & Thompson, 2012)
TEST

INITIAL ASSESSMENT
IDEA Inventory (Riviere, 1997) TEST
  • To establish the therapeutic bond

  • To get to know the patient in various musical experiences

  • To know the functionality of the patient

  • To know the patient´s strengths and difficulties

  • To know the patient´s musical interests and other ones

  • To know the supports the patient should need

  • To record sessions

ASD Severity Level (American Psychiatric Association, 2013) OBSERVATION
MFAP (Marsimian, 2019) OBSERVATION
AQR (Schumacher & Calvet, 2007) TEST
Review patient reports (medical, school, other therapies) RECORD/ REVIEW
DOCUMENT
Record session form
IRS (Ferrari, 2013)
MIRS (Pavlicevic, 2007)
RECORD/ REVIEW
DOCUMENT
TEST
Initial Assessment report RECORD/ REVIEW
DOCUMENT
DEFINITION OF TREATMENT PLAN Interview with parents INTERVIEW
  • To plan treatment: Design therapeutic goals and therapeutic supports.

  • To communicate the treatment plan and goal

Treatment plan report RECORD/ REVIEW
DOCUMENT
IMPLEMENTATION OF TREATMENT Record session form
IRS (Ferrari, 2013)
MIRS (Pavlicevic, 2007)
RECORD/ REVIEW
DOCUMENT
TEST
  • To establish transversal support strategies together with the interdisciplinary team

  • To communication with family, team and school.

  • To carry out re-evaluation of treatment goals

  • To communicate with external health entities

  • To record sessions

Interviews INTERVIEW
Evaluation report RECORD/ REVIEW
DOCUMENT
External reports RECORD/ REVIEW
DOCUMENT
DISCHARGE/ TERMINATION Final interview INTERVIEW
  • To communicate objectives achieved

  • To give suggestions for future treatment

  • To discharge or refer to another professional

Final treatment report RECORD/ REVIEW

In the last chapter the author discusses on the special considerations that arose around the COVID-19 Pandemic, making reflections and their impact on assessment practices. This is the case of the particularities in virtual care and the challenges for the assessment, needs, and care that arose for face-to-face care, and the issues around teaching and the transmission of knowledge to students and music therapists supervising their practice. In this section the author omitted the implications for the families of the patients/users who accompanied the processes in tele-care. From my experience as a clinician, I believe that this point was crucial in this context given that the roles were redefined and that part of our work had to do with carrying out a new assessment and helping the adult to be able to accompany properly, becoming an assistant for the music therapist intervention.

Throughout 2020 and in the context of the COVID-19 Pandemic, the author held virtual meetings to communicate some of the guidelines set out throughout the chapters. I was able to participate in them and exchange impressions and ideas on each topic raised. This form of writing and presentation to the community was novel, given the complex context. I think having feedback during the process of writing and reviewing the book was enriching to the writing. It also managed to generate content exchange and promotion networks, without having to wait for its official publication.

I believe that the richness of this publication has to do with the depth to describe each of the instances of assessment in music therapy, resulting in a kind of practical and useful manual, both for students, for music therapist who are just starting out, as well as for music therapist with vast clinical experience. Another of the book's strengths is being able to compile, organize, and describe a large quantity and quality of information.

Finally, the opportunity for it to be translated into several languages ​​and its open access will allow for dissemination of this knowledge in different countries of different socioeconomic levels, thus being able to provide opportunities to access information at a global level for all music therapists.

About the Author

The author has a degree in Music Therapy from Universidad del Salvador, Argentina. She has completed a Hospital Career in Music Therapy and Medicine at Rivadavia Hospital in Buenos Aires. She was a music therapist for the Developmental Disorders Team at the Italian Hospital in Buenos Aires. Since 2014 she has been Director of Music Therapy and Autism Spectrum Postgraduate Course at the Italian Hospital University Institute. She was a teacher in the Music Therapy Career at Buenos Aires University. She has training in Microanalysis, PECS Program, ABA Model, Functional Behavioral Analysis, DIR Floortime Model, Denver Model and Mindfulness. She works privately as a music therapist for different populations since 2006.

References

 

American Music Therapy Association. (2013). Standards of clinical practice. http://musictherapy.org/about/standards.

 

American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Association.

 

Bonde, L. O. (2016). Analysis and interpretation of musical data in interpretivist research. In B. Wheeler & K. Murphy (Eds.), Music therapy research (3rd ed., pp. 1304-1385). Barcelona Publishers.

 

Bruscia, K. (1992). Musical origins: Developmental foundations for therapy. Proceedings of the Annual Conference of the Canadian Association for Music Therapy.

 

Ferrari, K. (2013). Musicoterapia. Aspectos de la sistematización y evaluación de la práctica clínica. Ediciones MTD.

 

Ferrari, K., & Marsimian, N. (2013). Criterios de Indicación y derivación a Musicoterapia. In K. Ferrari (Ed.). Musicoterapia. Aspectos de la sistematización y evaluación de la práctica clínica (pp. 139- 154). Ediciones MTD.

 

Gattino, G., Jacobsen, S. L., & Storm, S. (2018). Music therapy assessment without tools: From the clinician's perspective. In S. Jacobsen, E. Waldon, & G. Gattino (Eds.), Music therapy assessment: Theory, research, and application (pp. 66-96). Jessica Kingsley Publishers.

 

Goldfinger, K. & Pomerantz, A. M. (2014). Psychological assessment and report writing. Sage.

 

Gottfried, T. & Thompson, G. (2012). MEL: Music in Everyday Life Assessment. Spanish version. http://mel-assessment.com/spanish-version.

 

Jacobsen, S. L., Waldon, E., & Gattino, G. (2018). Music therapy assessment: Theory, research, and application. Jessica Kingsley Publishers.

 

Marsimian, N. (2019). Protocolo de evaluación de funciones musicales en Trastorno del Espectro del Autismo. Revista Digital Red Latinoamericana y del Caribe de Musicoterapia para la Primera Infancia 4(1), 29-33. https://issuu.com/redlatinoamericanademusicoterapiapa/docs/revista_digital_n_4_2019

 

Marsimian, N. (2021). Proceso y evaluación en Musicoterapia. Ejemplo de aplicación en Autismo. [Disertation]. Curso Intensivo de Actualización Musicoterapia y Autismo, 2021. Organizado por MusicoterapieaTEA.

 

Møller, A. S., Odell-Miller, H., & Wigram, T. (2002). Indications in music therapy: Evidence from assessment that can identify the expectations of music therapy as a treatment for Autistic Spectrum Disorder (ASD). Meeting the challenge of evidence based practice. British Journal of Music Therapy, 16(1), 11-28. https://doi.org/10.1177%2F135945750201600104

 

Pavlicevic, M. (2007). The Music Interaction Rating Scale (MIR-S) Microanalysis of co- improvisation in music therapy with adults suffering from chronic schizophrenia. In T. Wigram & T. Wosch (Eds.). Microanalysis in music therapy: Methods, techniques and applications for clinicians, researchers, educators and students (pp. 174- 185). Jessica Kingsley Publishers.

 

Riviere, A. (1997). Inventario del Espectro Autista (IDEA). En J. Martos & A. Riviere (Eds.). El tratamiento del Autismo.Nuevas perspectivas. Instituto de Migraciones y Servicios Sociales. España.

 

Schumacher, K., & Calvet, C. (2007). Assessment of the Quality of Relationship (AQR). In T. Wigram & T. Wosch (Eds.). Microanalysis in music therapy. Methods, techniques and applications for clinicians, researchers, educators and students (pp. 79-91). Jessica Kingsley Publishers.

 

Waldon, E. (2013). Data-based decision making in music therapy. Imagine, 4, 46 – 50.

 

Waldon, E., & Gattino, G. (2018). Assessment in music therapy: Introductory considerations. In S. L. Jacobsen, E. Waldon, & G. Gattino (Eds). Music therapy assessment: Theory, research and application (pp. 19-41). Jessica Kingsley Publishers.