The Effects of Orff-Based Music Therapy and Social Work Groups on Childhood Grief Symptoms and Behaviors
Hilliard, Russell E., Journal of Music Therapy
This study evaluated and compared the effects of Orff-based music therapy, social work, and wait-list control groups on behavioral problems and grief symptoms of bereaved school-aged children. Social work and music therapy sessions were provided weekly for one hour over an eight-week period. Participants (N = 26) attended three different public elementary schools, and each school was randomly assigned to one of the conditions. Pre and posttest measures consisted of the Behavior Rating Index for Children (BRIC) and the Bereavement Group Questionnaire for Parents and Guardians (BP). The BRIC measured behavioral distress and the BP measured grief symptoms prior to and following participation in the assigned conditions. Statistical analyses indicated that participants in the music therapy group significantly improved in the behaviors and grief symptoms, and those in the social work group experienced a significant reduction in their behavioral problems but not their grief symptoms. Participants in the wait-list control group made no significant improvements in either their grief symptoms or behavioral problems. A reduction in behavioral distress as measured by the BRIC and a reduction in grief symptoms as measured by the BP is the most desired outcome. This study supports the use of Orff-based music therapy interventions for bereaved children in a school-based grief program. Recommendations for future research are included.
Introduction and Literature Review
It is well documented in the literature that common problems for grieving children include: emotional distress, somatic concerns, disruptive behaviors, and withdrawn behaviors. Additional problems may include sleeping or eating disturbances, poor school performance and attendance, and drastic mood or behavioral changes (Lehna, 1995; Rubel, 2005; Smith & Pennells, 1995; Webb, 2004; Wolfelt, 1991). Although assumptions have been made that untreated bereavement needs lead to serious psychiatric or behavioral diagnoses, this assumption has not been proven in the research literature (Harrington, 1999). Nonetheless, more than 2 million youngsters in the United States have experienced the death of a parent, and support and guidance through the grief process may be needed for them (Christ, Seigel, & Christ, 2002). In one study, children who experienced the death of a parent reported significantly more posttraumatic stress disorder (PTSD) symptoms than children who had experienced other types of trauma (natural disaster, social/academic stressor) (Stoppelbein & Greening, 2000).
Without bereavement support, grieving children are more likely to consult their primary physician for somatic concerns. In one study, over one-third of the consultations were for symptoms unrelated to an organic cause, indicating a likely psychosomatic issue (Lloyd-Williams, Wilkinson, & Lloyd-Williams, 1998). Untreated bereavement needs may lead to more serious psychological problems (Dowdney et al., 1999) and social distress (Kirwin & Hamrin, 2005). Early grief intervention support programs help to minimize the psychological, social, and somatic distress often experienced by bereaved children (Kirwin & Hamrin, 2005).
A variety of treatment approaches for childhood bereavement have been presented in the literature. Time-limited, school-based groups have been described as a way to help children express their grief, learn basic death education concepts, and engage in peer supports (Aspinall, 1995; Cassini & Rogers, 1994; Cook, White, & Ross-Russell, 2002; Goldman, 1994; Kimble, 2001). Groups that foster peer support may be especially helpful to adolescents, who rated that peer support was one of the most useful aspects in helping them with their bereavement needs (Ringler & Hayden, 2000). Different therapeutic theories have also been presented. The use of children's stories and bibliotherapy has been encouraged (Corr, 2003-2004; Kimble, 2001). In addition, the use of psychotherapy (Tonkins & Lambert, 1996), cognitive-behavioral therapy (Brown, Pearlman, &: Goodman, 2004), creative arts therapy (Carroll Sc Griffin, 1997; Zambelli, Clark, Barile, & Dejong, 1988), and music therapy (Bergmann, 2002; Milliard, 2001; Loewy, 2004; McDonnell, 1984) have been explored. …