Contemporary Possibilities of Music Therapy in Social Psychiatry and Alcohology

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Summary - This paper presents the contemporary possibilities of music therapy in social psychiatry and especially in combating alcoholism, based on the pieces of experience from the Department of Psychiatry within the Sestre milosrdnice University Hospital, Zagreb, and on the activities related to music therapy with the short-time patients, mainly alcoholics,who were first treated in the hospital and later in the clubs of treated alcoholics. (Alcoholism 2005; 41: 107-111)

Key words: Psychiatry, Music therapy; Alcoholism; Club of treated alcoholics

Within the framework of restructuring or reorganizing of social classes, the modern social psychiatry witnesses the appearance of new disturbances, new diseases surface, and some great, especially marginal social groups are created.1 Therefore, the new methods of treatment are needed which would aid a larger number of people, generally the marginal groups. Owing to a multitude of patients, the treatment is possible only in groups, using also the pieces of knowledge from social sciences.2 There is a tendency to create institutions close enough to the patients' places of residence or rather as near as possible to their real, ordinary, "normal" life. Patients should be activated in such life - within the therapeutic community and aided by therapists, and especially by themselves - to persist in detecting their personal wrong attitudes and adjusting to worthly group living and particularly in helping the others.3 For the purpose of adaptation to the real conditions, some new forms of institutions have been created, duration of stay in institutions has been shortened, the emphasis has been laid on treatment in community i.e. regional treatment in the outpatient departments, health care centers and especially the treated patients clubs.

Therefore, the music treatment, otherwise fairly recognized worldwide in terms of classic psychiatry, must be adapted to such circumstances.4 There is no question about the asylum-related creation of "exemplary orchestras", long-term learning of instruments, without thinking of the needs of patients after their leave the institution (that they often did not leave anyway) and the attitude of quiet awaiting in motivating and socializing the patients.5 However, clear, relatively modest and close goals are necessary, where a "part of the job" is left to music therapists in regional institutions. Almost all patients have to become qualified to leave the institution. None of them is imperceptive for music, so it is often necessary to work a lot with all of them, and even more effort ought to be taken in more difficult cases.

Music is a suitable, acceptable and very efficient means to bring a man back to society, create a good mood, but also to promote the discipline, which is necessary in every.6,7 In order to educate the patients in musical terms, theoretically and practically, to play an instrument, which he needs to get along better and for be better accepted in the society to which he will come back soon, we must use the abbreviated methods of teaching the simple instruments, such as guitar, harmonica (mouth organ), percussion instruments, melodicas (mouth-pianos), and especially our national instrument "tamburitza" (whose some accompanying larger forms such as alt tamburitza,8 bass and others can be learned in its fundamentals in a couple of days or during several rehearsals). People have to be stimulated and get used to play by ear, to know how to join the quickly created groups or bands where the mutual cohesion and technical and human composition has to be quickly achieved. The music we select may have some educational elements, but the patient has to be approached during a short period primarily with the music known to him.9 We apply the music therapy in the frame of all forms of institutional medical treatment - from day-hospital treatment to weekend-treatment, and if necessary, even through night hospital treatments, especially in the afternoon treatment types for alcoholics who work regularly at their workplaces during the morning hours. …