Academic journal article Australian Journal of Music Therapy

'Circuit Breaking' the Anxiety: Experiences of Group Music Therapy during Supported Post-Meal Time for Adults with Anorexia Nervosa

Academic journal article Australian Journal of Music Therapy

'Circuit Breaking' the Anxiety: Experiences of Group Music Therapy during Supported Post-Meal Time for Adults with Anorexia Nervosa

Article excerpt


Eating Disorder Treatment and Meal support therapy

Anorexia nervosa (AN) is a mental illness which is characterised by intense fear of weight gain, low weight and a disturbance in the perception of body weight or shape (Phillipou, Gurvich, Castle, & Susan, 2015). Goals for treatment of AN in an inpatient setting are medically and psychologically focused. A treatment plan for admission is developed by the consumer in collaboration with their multi-disciplinary team which focuses on goals for health restoration and therapeutic treatment for long-term recovery (Hay, Touyz & Sud, 2012; Newton, 2012).

Mealtimes can be a highly distressing and anxiety provoking time for people with AN (Hage, Ro, & Moen, 2015). Eating and weight gain is often associated with feelings of fear and anxiety (Bremer, 2003; Harvey, Troop, Treasure, & Murphy, 2002). People with AN can experience psychological and physical discomfort after meals, becoming preoccupied with feelings of guilt and thoughts of purging (Leichner, Standish & Leichner, 2005). Risk to self and safety concerns are increased during this time, with some people being prone to self-harm as weight restoration occurs, intense suicidal ideation and increased compensatory behaviours (Hage et al., 2015).

Support from staff during meal times is recognised as important for decreasing meal-related distress in an inpatient setting (Clinton, Bjorck, Sohlberg, & Norring, 2004; Federici & Kaplan, 2008; Long, Wallis, Leung, & Meyer, 2012; Offord, Turner & Cooper, 2006). Although supported mealtimes are generally viewed as positive by consumers with AN (Lindstedt, Neander, Kjellin, & Gustafsson, 2015) there is little research into what specific therapeutic activities are helpful for reducing anxiety during supported post-mealtimes (Long et al., 2012).

Collaborative music therapy approaches and mental health recovery

It is well documented that music therapy can improve the quality of life and relationships of people with mental illness (Grocke, Bloch & Castle, 2009; Hayashi et al., 2002; Mossler, Chen, Heldal, & Gold, 2011). Psychodynamic, cognitive-behavioural, humanistic and ecological approaches are commonly used in music therapy work specifically with people with eating disorders (McFerran & Heiderscheit, 2016). In this study, a collaborative and resource-oriented approach to practice was used since it is congruent with the collaborative conceptualization-based treatment approach (Newton, 2012) used in the eating disorders unit where the study was conducted. Through collaborative and resource-oriented practice, music therapy can promote autonomy during mental health recovery (Rolvsjord, 2010). Mental health recovery emphasises empowerment, collaboration, lived experience and looks beyond the limitations of 'illness', for health (Banfield. Barney, Griffiths, & Christenson, 2014; Slade, 2009). Recovery values the consumer's perspective together with the skills and knowledge of mental health workers, challenging traditional understandings of power and knowledge in mental health care (Commonwealth of Australia, 2013). The relationship between music therapy practice in mental health care and the emphasis on empowerment and consumer led processes in contemporary recovery-oriented mental health practice is congruent (Baines, 2003; Procter, 2002; Rolvsjord, 2010; Solli, Rolvsjord & Borg, 2013). Like recovery-oriented practice, resource-oriented and collaborative music therapy practices promote principles of empowerment and self-determination by collaborating with consumers and focusing on their strengths and resources (Rolvsjord, 2010). Collaborating with people with eating disorders in their mental health recovery can promote feelings of empowerment and equality, which are important in inpatient eating disorder settings that may otherwise offer minimal opportunity for self-determination (Dalton, Elias & Wandersman, 2001; Fitzsimons & Fuller, 2002). …

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