Academic journal article Canadian Journal of Music Therapy

Music Therapy and Psychosocial Rehabilitation: Towards a Person-Centered Music Therapy model/La Musicothérapie et la Réhabilitation Psychosociale: Vers Un Modèle De Musicothérapie Centré Sur la Personne

Academic journal article Canadian Journal of Music Therapy

Music Therapy and Psychosocial Rehabilitation: Towards a Person-Centered Music Therapy model/La Musicothérapie et la Réhabilitation Psychosociale: Vers Un Modèle De Musicothérapie Centré Sur la Personne

Article excerpt

Music-making has so much to do with building on people's experience of who they are and what they can do - Simon Proctor

The application of music therapy interventions with an adult psychiatric population has received substantial attention in music therapy research and literature. A broad range of practice exists and varies in relation to practitioners' individual philosophies, training backgrounds, and workplace contexts (Bednarz & Nikkel, 1992; Bohnert, 1999; Baines.S., 2003; Ficken, 1976; John, 1992; Langdon, Pearson, Stasny, & Thorning, 1989; Nygaard Pederson, 1997; Pavlicevic, Trevarthen, & Duncan, 1994; Silverman, 2003a; Silverman, 2003b; Unkefer & Thaut, 2004; Wigram & De Backer, 1999; de l'Etoile, 2002; Stephens-Langdon, 1989; Slotoroff, 1994). Grocke (2004) recently addressed difficulties encountered within a medical and educational community as they attempted to articulate the role of music therapy in psychiatry. Specifically, the question was posed: "How can music therapy be effective in the current provision of community mental health care?" Grocke also recalled a second question in which a colleague proposed that she should ask the patients how music might help them in their recovery. These questions are timely in our current mental health care context. In an initial response to these questions, the intent of this article is to synthesize existing music therapy practice for adults experiencing mental illness, with current psychiatric rehabilitation theory.

This article will examine the theoretical underpinnings of psychosocial rehabilitation. These underpinnings will then be reviewed and applied to the existing literature on psychiatric music therapy practice. A general model of psychiatric music therapy is proposed. This model is broad enough to promote continued evolution, while at the same time clarifies the multifaceted role of clinical psychiatric music therapy practice.

This discussion paper and model of practice identify music therapy concepts intended for adults diagnosed with severe and persistent mental illnesses. The term severe mental illness (SMI) will be used throughout this paper and is defined in relation to the concepts of duration, disability, and diagnosis. Diagnoses include schizophrenia, mood disorders, anxiety disorders, and organic brain syndrome. Disability refers to the experience of difficulties related to the illness that interfere or severely limit an individual's capacity to function in one or more major life activities. Duration refers to an ongoing, or an intermittent but persistent period of time during which a client experiences significant symptoms (Schinnar, 1990). The symptoms and cognitive/emotional deficits experienced by persons with serious mental illness can lead to impairments in the areas of self-care, social relationships, information processing, cognitive, attentive, and independent functioning, ultimately decreasing role performance (Hughes & Weinstein, 2000).

DEFINITION OF PSYCHOSOCIAL REHABILITATION

The lack of effective rehabilitation services provided to people with SMI became evident in the early 1970's when as a result of de-institutionalization people with severe mental illness were exposed to living in the community. Psychosocial rehabilitation (PSR) evolved out of the necessity to serve the unique challenges and needs of these individuals. Psychosocial rehabilitation is summarized as "the process of assisting people to acquire and to use the internal and external skills, supports, and resources necessary to be successful and satisfied living, learning, and working in the environments of their choice. At its most basic level, psychiatric rehabilitation seeks to help people to determine and prioritize their goals, to identify paths for achieving these goals and to develop the needed skills and supports to achieve these goals" (Anthony, Rogers, & Farkas, 2003). Table 1, summarizes the core values and principles of psychosocial rehabilitation. …

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