Response to "Why Provide Music Therapy ..."

By Jeffrey Clark, music therapy student, Lesley University.

I found this article to raise many important points about the use of music therapy in community settings in America, even though it was written about music therapy practices in England. I was also glad to see benefits and treatment outcomes of music therapy in the community adult mental health population. Benefits of long term care are mentioned in the article that result from an engagement in music therapy for periods of two to four years, once or twice a week include: a decrease in breakdown as well as a decrease in readmission to the hospital. I have often heard it mentioned in the international community that American mental health treatment is too focused on quick fixes. Many short term units will focus on treatments such as cognitive-behavioral therapy, dialectical-behavioral therapy, and psychopharmacology. Though I believe that treatments such as these focused on stabilization and maintenance are appropriate, and necessary, in the long term I believe it does not address the full spectrum of long-term mental health. I believe the use of music therapy in community mental health setting is also important for long term psychiatric health considering some of the many challenges faced my music therapists in acute psychiatric settings.

Many inpatient stays due to insurance coverage and managed care in the US can be limited to seven to ten days. Because of the rate of turnover in acute care many patients are only able to see a music therapist once within this setting. Carylbeth Thomas said "Since acute care essentially demands assessment and treatment of the client simultaneously, there is often little time for individual interviews, testing or ability to review existing information prior to actual treatment. The music therapist must rely mostly on observation and intervention concurrently in order to work effectively and successfully in acute care settings. In these kinds of settings, each session needs to be considered in its own right as a one time experience. The music therapist is often expected to assess several new individuals during this process." (Crowe and Cowell 2007)

Work with this population, along with simultaneous assessment and treatment also requires a music therapist to build what they can of a therapeutic relationship in a single session. Seeing a music therapist for a single session also would not offer the therapeutic benefit of the stable containing space that Odell-Miller talked about in reference to a community setting.

The acute care music therapist is also challenged to work towards goals that are attainable in the time alloted. Carylbeth Thomas went on to discuss some possible music therapy goals in the acute care setting. "More generalized goals such as behavioral containment, emotional support, structure of experiences, involvement with others, and validation of the individual are always to be considered with all clients." (Crowe and Colwell 2007)

To conclude I will say that I believe there is much potential and therapeutic change to be found in community based adult mental health music therapy in America to which the arguments are similar to the arguments of Odell- Miller in her article. It can address long term benefits such as a long term containing therapeutic space, and could go beyond short term treatment goals stabilization and reduce rates in the long-term of relapse and re-hospitalization. It could address transference and countertransference relationships in a way that a short term psychiatric unit does not address. Given the challenges of music therapy with acute care patients, I believe community based treatment with the adult mental health population not only has the opportunity to address a completely different assortment of goals, it also adds a new level of potential to the outcome of a music therapy based intervention.

Reference

Crowe and Colwell (2007). Music Therapy for Children, Adolescents, and Adults with Mental Disorders (p.128-129). American Music Therapy Association.