Critical interpretive synthesis is a particular form of systematic review that critically examines the decisions made by authors while conducting and publishing about their research and practices. It differs from empirical syntheses of qualitative research by emphasizing the interpreted and constructed nature of this form of secondary analysis. In this article, we extend previous literature on critical interpretive syntheses by highlighting the integration of emotional responses when developing critical questions for interrogating the literature and interpreting results. Our extension of the critical interpretive synthesis is illustrated through examples from five studies examining literature in our own field of music therapy, as well as related fields of disability studies, mental health, music psychology, and child welfare. The methodology we have refined uses an iterative and recursive method that promotes increased critical awareness of the assumptions driving the production of research in health contexts.

This article presents the results from a critical interpretive synthesis that examined the prevalence and presentation of therapeutic boundary themes in music therapy case studies. Conventional boundary theories are often defined as the parameters of practice that encourage the clinician to perform boundary processes in a certain way. These theories pertain to practical and interpersonal elements when negotiating the therapeutic relationship and include features such as boundary crossings and boundary violations. A carefully selected set of case studies were examined and interrogated to determine the presence and type of boundary themes. These were analysed by distilling narrative descriptions from the case studies and comparing them with information about population, age of clients, theoretical approach and cultural setting. Musical intimacy emerged from the analysis as a concept that contained a myriad of boundary challenges, which often appeared to contrast conventional ideas on boundaries. The results of this critical interpretive synthesis are discussed along with recommendations for music therapy practice.

Conventional understanding of therapeutic boundaries is a common concept present across a range of health care practices. Many therapists in music and health care work adopt these ideals to govern their ethical behaviour in practice. For some therapists, these practices may still be extremely appropriate. However, music practitioners working in newer therapeutic models or more contemporary contexts, such as community music therapy, may value a much more intuitive and reflexive approach to boundaries. In addition, the influence of culture and context are also important, as well as the impact of music. Music practitioners experience powerful moments of connection through music making with people. Music is a medium that invites intimate and personal interactions, and should also be considered in the context of therapeutic boundaries. The new term musical intimacy may help therapists to be aware of the intimate nature of making music with people and the potential vulnerabilities that it can reveal. In addition, this may encourage therapists to explore and reflect upon the boundary complexities that can be present when using music in health and well-being work.