Forms of attunement during the initial stages of music therapy for patients with acute psychosis - A multicentre clinical study

Metzner, Susanne; Jaeger, Ulrich; Masuhr, Oliver; Olschewski, Ulrike; Gräfe, Elisabeth; Böske, Anne Christin; Dümpelmann, Michael

doi:10.1080/08098131.2018.1478879

Cited by 10 publications

(6 citation statements)

References 30 publications

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“…Attunement refers to a process encompassing therapists’ ability to perceive and to respond to patients’ inner state [ 50 – 53 ]. Attunement was found to be relevant in different sorts of rehabilitation interventions, such as music [ 54 , 55 ] and occupational therapy [ 56 ]. However, attunement and convenient therapy periods have not been related so far.…”

Section: Discussionmentioning

confidence: 99%

Patients’ and professionals’ perspectives on the consideration of patients’ convenient therapy periods as part of personalised rehabilitation: a focus group study with patients and therapists from inpatient neurological rehabilitation

Dür

Wenzel

Simon

et al. 2022

BMC Health Serv Res

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Background Research on the optimal period for administering health services, especially rehabilitation interventions, is scarce. The aims of this study were to explore the construct of patients’ convenient therapy periods and to identify indicators based on the perspectives of patients and different health professionals from inpatient neurological rehabilitation clinics. Methods This study was part of a larger project on patients’ convenient therapy periods following a mixed methods approach. In the current study a grounded theory approach was employed based on the use of focus group interviews. Focus group interviews were conducted in three different inpatient neurological rehabilitation clinics. Patients and therapists from inpatient neurological rehabilitation clinics who were able to speak and to participate in conversations were included. Results A total of 41 persons, including 23 patients and 18 therapists, such as music and occupational therapists, participated in a total of six focus group interviews. The analysis of the focus group interviews resulted in the identification of a total of 1261 codes, which could be summarised in fifteen categories. However, these categories could be divided into five indicators and ten impact factors of convenient therapy periods. Identified indicators were verbal and non-verbal communication, mental functions, physiological needs, recreational needs, and therapy initiation. Conclusions The results provide initial evidence that convenient therapy periods are clinically relevant for patients and therapists. Different states of patients’ ability to effectively participate in a rehabilitation intervention exist. A systematic consideration of patients’ convenient therapy periods could contribute to a personalised and more efficient delivery of intervention in neurological rehabilitation. To our knowledge, this study is one of the first attempts to research convenient therapy periods.

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Section: Discussionmentioning

confidence: 99%

Patients’ and professionals’ perspectives on the consideration of patients’ convenient therapy periods as part of personalised rehabilitation: a focus group study with patients and therapists from inpatient neurological rehabilitation

Dür

Wenzel

Simon

et al. 2022

BMC Health Serv Res

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“…The continua model may bring new perspectives on synchronization and regulation. This corresponds to the musical interactions described in music therapy with psychotic patients in order to prevent fusion anxiety (Metzner et al, 2018). For music therapists working for FPP, where alliance building may be complicated by controlling and possessive behaviours, the 28 Accepted manuscript.…”

Section: Discussionmentioning

confidence: 99%

“…Based on a systematic review and meta-analysis of 18 studies, it is concluded that music therapy improves global and mental state, social functioning, and quality of life of people with schizophrenia or schizophrenia-like disorders (Geretsegger et al, 2017). For patients suffering from psychosis, music therapy is described to allow for meeting the patient's desire for interpersonal contact through synchronization and attunement (Metzner et al, 2018). Using musical improvisation, the therapist provides an unobtrusive musical space and supports with subtle rather than Accepted manuscript.…”

Section: Music Therapy With Forensic Psychiatric Patientsmentioning

confidence: 99%

“…Final version: https://www.tandfonline.com/doi/full/10.1080/08098131.2020.1827452 structured accompaniment in order to prevent experiences of fusion anxiety, enhance self-object boundaries and nurture alliance (Metzner et al, 2018). In a study including patients with schizophrenia and borderline diagnoses, music therapy showed a low drop out and maintained the patient's motivation and engagement in the therapeutic relationship (Hannibal et al, 2012).…”

Section: Music Therapy With Forensic Psychiatric Patientsmentioning

confidence: 99%

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Alliance building in music therapy for forensic psychiatric patients with schizophrenia. An exploratory case study research design

Frederiksen

Ridder

Pedersen

2020

Nordic Journal of Music Therapy

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Introduction: Forming therapeutic alliance with forensic psychiatric patients with schizophrenia is challenging, and there is a gap in knowledge about the dynamics in the initial phase of psychotherapy and how collaboration and trust is developed. Music therapy is described as a motivating approach enhancing the forensic psychiatric patient`s ability to engage in a relationship. The purpose of the study was to explore and identify dynamics in the process of forming therapeutic alliance in music therapy for forensic psychiatric patients with schizophrenia.Method: The study adopted an exploratory case study design with data from multiple perspectives providing thick descriptions. Four patients with schizophrenia from a medium secured unit at a forensic psychiatric hospital were offered weekly music therapy sessions for six months. An inductive process based on a hermeneutic phenomenological epistemology and a nine step procedure for the analysis led to a final abductive synthesis.Findings: Each of the following themes formed a continuum of dynamic interactional processes within the development of therapeutic alliance with forensic psychiatric patients with schizophrenia in music therapy and were presented as a condensed continua model; 1) Control, 2) Closeness/distance, 3) Structure, 4) Process/product, 5) Focus of attention, 6) Interaction, and 7) Verbal dialogue. A case example is provided.

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“…This approach has been especially relevant in clinical contexts where a wide range of interactive behavior (including a total absence of interaction) is possible. Metzner et al (2018) developed a scale for use in listening analysis that considers if and how musical output is temporally structured and whether the therapist and client play in parallel or interactively. Wigram (2007) described a procedure for event-based analysis of improvisations.…”

Section: Imitation and Conflict In Musical Featuresmentioning

confidence: 99%

Interfaces of Dialogue: A Mixed Methods Approach to Investigating Intersubjectivity in Dyadic Improvisations

Smetana,

Bishop,

Stepniczka

2023

Music & Science

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Music therapy provides a complex and dynamic environment and as such offers space for the emergence of nonverbal dialogue. We aimed to capture the relational, musical, and physiological aspects of intersubjectivity emerging during dyadic piano improvisations between music therapists and adult participants in a non-clinical feasibility study. Various data from 17 partner improvisations with adult participants and music therapists were collected, including audio, video, and MIDI recordings, physiological (ECG and EDA) measures, questionnaires, and semi-structured debriefing interviews. Parts of these data sets served for a mixed methods analysis to show (1) how instances of intersubjectivity were experienced by therapists and participants (drawing on interview data), (2) how their shared experiences were supported by coordination and contrast at the level of musical features (drawing on musical data), (3) how physiological arousal was compared between an initial resting baseline and the improvisation, and (4) how patterns in the event related electrodermal activity data related to qualities of intersubjectivity and musical interaction in an example of two case studies. In conclusion, intersubjectivity was characterized by overlapping experiences of relational qualities and complex patterns of musical interaction, including contrasting elements of convergence (in pitch contour) and divergence (key velocity and timing). Further, the case studies showed how differently-interpreted experiences can emerge from a homogenous musical structure, and how stronger intersubjectivity may be associated with more active experiential phenomena such as disruption or reciprocity (versus relaxation or security). Additionally, our findings highlight the complexity of musical interaction as an enactive process. Bringing together multi- and interdisciplinary perspectives enhanced a shared understanding of how subjective experiences that arise during dyadic improvisations relate to measures of musical coordination and physiological arousal. The complex mixed methods design proves to be feasible and, as a consequence, can be transferred to clinical settings in the future.

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Forms of attunement during the initial stages of music therapy for patients with acute psychosis - A multicentre clinical study

Cited by 10 publications

References 30 publications

Patients’ and professionals’ perspectives on the consideration of patients’ convenient therapy periods as part of personalised rehabilitation: a focus group study with patients and therapists from inpatient neurological rehabilitation

Patients’ and professionals’ perspectives on the consideration of patients’ convenient therapy periods as part of personalised rehabilitation: a focus group study with patients and therapists from inpatient neurological rehabilitation

Alliance building in music therapy for forensic psychiatric patients with schizophrenia. An exploratory case study research design

Interfaces of Dialogue: A Mixed Methods Approach to Investigating Intersubjectivity in Dyadic Improvisations

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