Academic journal article Australian Journal of Music Therapy

Contemporary Cultures of Service Delivery to Families: Implications for Music Therapy

Academic journal article Australian Journal of Music Therapy

Contemporary Cultures of Service Delivery to Families: Implications for Music Therapy

Article excerpt

Government policy on early years intervention and prevention programs, and family support programs, has direct and important implications for the work of allied health professionals. Such policies are fundamental to society as a whole because the years from birth to age five constitute a critical period of development within the human lifespan (Shonkoff & Phillips, 2000). Developmental research and early intervention and prevention efforts are essentially geared towards identifying and addressing risk and protective factors for families during these early child-rearing years in order to best support optimal development for all children. Programs are funded through relevant policy mechanisms on the basis of economic evidence that investment in the early years pays exponential dividends long term in relation to the productivity and wellbeing of a society (Heckman, 2011).

Over the last decade, such policies and support program funding agreements have increasingly reflected ecological understandings (Bronfenbrenner & Morris, 2006). This reflects an effort to shift the culture of service delivery away from one characterised by individual service silos towards a more integrated and seamless service experiences for families (Moore, 2009). There is also increasing concern over the extent to which early interventions are effective in reaching those families most in need of support and highly isolated families, reflected in funding and policy mandates that refer to hard-to-reach families (Cortis, Katz, & Petulancy, 2009). Within this developing policy environment, each intervention service must find a way to negotiate these cultural shifts while maintaining integrity and fidelity of the core intervention.

This paper has three aims: to provide an overview of the defining features of the contemporary culture of family service delivery in Australia; to advance an argument for the relevance of music therapy within these cultural shifts and to summarise the evidence for the efficacy of music therapy in these settings; and, to provide recommendations on the ways in which music therapy advocates, researchers, and practitioners can continue to substantiate the credibility of the field given the policy and practice environment.

Methodology and Definition of Key Terms

An integrative literature review approach was used to allow for the inclusion of a wide range of pertinent literature including policy documents, efficacy studies, and theoretical papers (Whitehorse & Kneel, 2005). First, the key themes for the review were identified through broad reading of contemporary Australian policy documents related to service-provision to families and young children (Australian Government Department of Families, Housing, Community Services and Indigenous Affairs, 2009; Council of Australian Governments, 2009a,b). A panel of experts currently involved in the field as managers of family services or music therapists were then consulted and asked to confirm the validity of the themes selected. The three final themes were: hard-to-reach families; home visiting; and, integrated and place-based service delivery. These were selected because of their widespread representation within current Australian policy and practice discourse and because of the potential of music therapy to become more active in each of these areas.

Hard-to-reach refers to those families that are underrepresented, overlooked or resistant to support services (Doherty, Hall, & Kinder, 2003). Families that are underrepresented may be marginalized, disadvantaged or socially excluded. Families that are overlooked may be those families who never engage, or disengage from services when service providers fail to cater for their needs. Families that are termed service-resistant are those who choose not to engage with services or are highly wary of becoming involved (Curtis et al., 2009). Home visiting refers to services provided in the home of the family as part of assertive outreach efforts. …

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