アメリカの児童擁護センターと音楽療法
進化途中の関係
DOI:
https://doi.org/10.15845/voices.v18i4.2589关键词:
音楽療法, 児童擁護センター摘要
アメリカでは、トラウマや虐待の被害をうけた子ども達は、子ども擁護センター（CACs）を通してサービスを受ける。2016年には800以上のCACsが325,000近くの子ども達に治療とサービスを提供した（(National Children’s Alliance, 2016b)。CACsは、子ども達と家族の回復を助けるために、法執執行機関、精神保健、医療、社会福祉職員を含んだ学際的なチーム（MDT）の業務をコーディネイトしている。CACsは多くの地方機関との提携で構成された独立団体である。本稿は、CACs内の音楽療法の実施状況と、治療の実施に向けた全米児童連合（NCA）の基準について記述している。文献によると、音楽療法がトラウマを経験した子ども達と家族のニーズに応えるために役に立ち、CACsにおいて有効な治療方法となり得ることが示唆されてきた。しかし、音楽療法はCACsではほとんど取り入れられていない。このことは、ひとつには、NCA基準（全米児童連合、2013）に付随される文献となるための重大な決定因子であるランダム化比較実験が欠如している結果だと思われる。音楽療法は虐待を受けた経験のある子どもや10代の臨床的なニーズに対処してきた。こうした実践は、ランダム化比較試験ではなく、臨床的省察において示される。音楽療法はエビデンスベースが明らかな不足しているために、CACsで利用される治療方法には現在含まれていない。本稿は、被虐待児に対する音楽療法の研究の現状をCACsに提供するために、入手可能な情報を統合する試みである。また音楽療法士に対しては、CACsの構造と機能に関する詳細な情報と、NCAの「実践基準」の統合を示している。本稿は、ニュージャージーのCACsにおける音楽療法サービスの実施に関して述べ、またCACsでの臨床実践の機会を求める音楽療法士のために推奨事項に関しても説明している。
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