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Music Therapy Today

WFMT online journal Volume 14, No. 1

Music Therapy Today publishes articles that are related to music therapy education, practice, and research. Categories may include, but are not limited to Editorials, Presidential Notes, Position Statements, Curriculum Reports, Clinical Case Studies, Research Reports, Service Projects, World Congresses Proceedings, Interviews, Book Reviews, and Online Resources.

2018 WFMT. All rights reserved. ISSN: 1610-191X

MuSICThERAPyToday, Volume 14, No. 1, 2018

Suggested Citation of this Publication

author a. a., author B, B., & author C. C. (2018). Title of article. Music Therapy Today 14(1), pp-pp. Retrieved from


MuSICThERAPyToday, Volume 14, No. 1, 2018


The opinions and information contained in this publication are those of the authors of the respective articles and not necessarily those of editors, proofreaders, or the World Federation of Music Therapy (WFMT). Consequently, we assume no liability or risk that may be incurred as a consequence, directly or indirectly, of the use and application of any of the contents of this publication. For this issue authors have prepared their own manuscripts attending to content, grammar, language uency, and formatting. any errors may be discussed with the authors.


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Music Therapy Perspectives 2018 Edition Editor

Annie heiderscheit, Ph.D., MT-BC, LMFT

Business Manager

Melissa Mercadal-Brotons, Ph.D., MT-BC, SMTAE

Editorial Board

Juanita Eslava, Ph.D. Nancy Jackson, Ph.D., MT-BC Doug Keith, Ph.D., MT-BC Jin Lee, Ph.D. Satoko Mori-Inoue, Ph.D. Kathleen Murphy, Ph.D., MT-BC Karyn Stuart, MMT


Melissa Mercadal-Brotons, Ph.D., MT-BC, SMTAE

Graphic Design

Editorial Médica Jims, S. L.

Published by

World Federation of Music Therapy (WFMT) Music Therapy Today ISSN 1610-191X


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GRoWiNG MusiC TheRapy kNoWledGe FRoM aRouNd The WoRld ..... 31 Melissa Mercadal-Brotons TRaNsiTioNs & NeW BeGiNNiNGs ..... 31 Annie Heiderscheit

15th World Congress of Music Therapy Congress Proceedings MusiCal iNTeRaCTioN To FaCiliTaTe CoMMuNiCaTioN iN auTisM iN aN iNdiaN CoNTexT ..... 11 Baishali Banerjee Mukherjee The deVelopMeNT oF CReaTiVe TheRapy-Based play GRoups FoR pRe-sChool ChildReN aNd paReNTs iN iNNeR CiTy loNdoN ..... 13 Katherine Walters & Claire Everest lookiNG BaCk aNd MoViNG FoRWaRd: 25 yeaRs oF a MusiC TheRapy BusiNess ..... 15 Jody Conradi Stark pRaCTiCe oF FuNCTioN TRaiNiNG assiGNMeNT applied euRyThMiCs aNd JapaNese soNGs ..... 17 Inoue Kaoru esTaBlishiNG a TheoReTiCal Basis FoR eVideNCe-Based pRaCTiCe iN MusiC TheRapy ..... 20 Masako Otera ReFleCTioNs oF aN oFF-duTy MusiC TheRapisT aNd a hoMeless day laBoReR ..... 22 Eric Miller & Floyd Wilkins

aNalyTiCally iNFoRMed GRoup MusiC psyChoTheRapy helps iNCaRCeRaTed MeN TRaNsiTioN iN The CoMMuNiTy ..... 29 Amanda MacRae The ColoR oF us: MoViNG FoRWaRd WiTh iNClusioN pRoGRaMMiNG WoRldWide ..... 31 Petra Kern


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iNTeRCulTuRal CoMpeTeNCies: iNspiRiNG sTudeNTs, pRaCTiTioNeRs, aNd aCadeMiCs aCRoss GeNeRaTioNs aNd NaTioNs ..... 33 Petra Kern & Satoko Mori-Inoue

iNTRoduCTioN To healThRhyThMs® GRoup eMpoWeRMeNT dRuMMiNG ..... 35 Annie Heiderscheit & Alyssa Janney

Research Article

iMpleMeNTiNG a soNG as a ReWaRd FoR TRaNsiTioN FRoM FRee-play TiMe To a GRoup aCTiViTy ..... 37 Kumi Sato & Shigeki Sonoyama

Book Reviews

CliNiCal TRaiNiNG Guide FoR The sTudeNT MusiC TheRapisT (2Nd ed.). WRiTTeN By doNNa W. poleN, CaRol l. shulTis, aNd BaRBaRa l. WheeleR ..... 53 Melissa Mercadal-Brotons aN iNTRoduCTioN To MusiC TheRapy ReseaRCh. ediTed By BaRBaRa l. WheeleR & kaThleeN M. MuRphy ..... 56 Heidi Ahonen

aN iNTRoduCTioN To MusiC TheRapy ReseaRCh. ediTed By BaRBaRa l. WheeleR & kaThleeN M. MuRphy ..... 60 Ludwika Konieczna-Nowak

CulTuRal iNTeRseCTioNs iN MusiC TheRapy: MusiC, healTh aNd The peRsoN. ediTed By aNNeTTe WhiTehead pleaux & xueli TaN ..... 64 Ronna Kaplan WoRkiNG WiTh Goals iN psyChoTheRapy aNd CouNseliNG. ediTed By MiCk CookeR aNd duNCaN laW ..... 69 Annie Heiderscheit

Conference Report

15Th WoRld CoNGRess oF MusiC TheRapy: CoNFeReNCe RepoRT ..... 74 Annie Heiderscheit


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Presidential note GROWING MUSIC THERAPY KNOWLEDGE FROM AROUND THE WORLD In this edition of Music Therapy Today you will find an article on “Implementing a song as a reward for transition from free-play time to a group activity”. Alongside this paper, you will find five book reviews, 10 papers which were absent from the 2017 world congress proceedings, and a conference report on the 15th World Congress of Music Therapy. The WFMT journal is a peer-reviewed publication which is made possible through the editorial directorship of Dr. Annie Heiderscheit and the dedicated Music Therapy Today editorial review board comprised of reviewers from various regions of the globe. Music therapy practice is diverse around the world, and this diversity is also reflected in the publications. The purpose of the journal is to disseminate current knowledge and information about music therapy education, clinical practice, and research worldwide. I am delighted that in this edition, we have papers that represent music therapy practice and topics of interest from different parts of the globe.

The journal’s reading audience is also diverse: educators, clinicians, students and allied health care practitioners. Our aim is to attract authors from around the globe to share their clinical work and research in order to grow the body of knowledge on music therapy. The WFMT strives to produce a publication that is accessible to everyone who endeavors to continue to learn and develop their practice as music therapists and health care practitioners. The papers for this issue indicate a real desire and commitment by authors to contribute to the knowledge base of music therapy and grow our profession internationally.

I trust you will enjoy this edition and hope that it inspires you to consider submitting an article for publication in future editions. As President of the WFMT I am honoured to serve as the Business Manager for this important publication. Regards, Melissa Mercadal-Brotons, PhD, MT-BC, SMTAE

About the Author

Melissa Mercadal-Brotons, PhD, MT-BC, SMTAE Melissa Mercadal-Brotons is the Director of the Music Therapy Master Program, Escola Superior de Música de Catalunya (ESMUC), and Coordinator of Research and Master Programs at ESMUC. She is the President of the World Federation of Music Therapy (WFMT) and the Spanish Delegate of the European Music Therapy Confederation (EMTC).


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Transitions & New Beginnings Annie Heiderscheit, Ph.D., MT-BC, LMFT Chair, Publications Commission, WFMT Editor, Music Therapy Today

It is an honor and privilege to continue my service to the World Federation of Music Therapy (WFMT) by serving as Chair of the Publications Commission and as editor of Music Therapy Today. This journal is a valuable resource to the global profession of music therapy, as it serves to provide a platform to share and exchange knowledge and information. This resource strives to meet the mission of the WFMT through this exchange.

This issue of Music Therapy Today continues this tradition of sharing information from colleagues all around the world. This issue includes contributions from colleagues from Canada, India, Europe, Japan, Poland, and the United States. These contributions represent the importance of our global community and what we gain through our willingness to learn from each other.

This 2018 edition includes several World Congress of Music Therapy Proceedings that were not able to be published in the 2017 edition, so we are publishing them here. There is an original research article exploring the use of a song as a reward in helping children transition. We have several book reviews included in this issue as well. These reviews represent the continued growth in the number of texts being published related to


music therapy practice. These valuable reviews provide readers with insight into the value of these publications.

Lastly, there is a conference report. This report highlights the 15th World Congress of Music Therapy held in Tsukuba, Japan in July 2017. Documenting and reviewing our conferences provides a historical report and documentation in our professional literature and it provides information about the event for those that were not able to attend.

I would like to express my gratitude to the editorial review board for their work on reviewing and preparing manuscripts for publication. I also want to thank Dr. Melissa Mercadal-Brotons the previous publications commissions chair and editor for her assistance in transitioning the journal operations.

Enjoy reading the valuable contributions included in this issue. I hope as you read the proceedings, article, book reviews, and conference report that you may consider submitting a manuscript for the next issue of Music Therapy Today. I encourage you to join your global community in exchanging information. Sincerely,

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About the Author

Annie Heiderscheit, Ph.D., MT-BC, LMFT is the director of music therapy at Augsburg University in Minneapolis, Minnesota, where she oversees the undergraduate and graduate music therapy programs. She is currently the Publications Chair of the WFMT and the Communication Chair for the International Association of Music and Medicine. She is a senior music therapist at the University of Minnesota Masonic Children’s Hospital, maintaining an active clinical and private practice, as well as an active research practice.


15th World Congress of Music Therapy Congress Proceedings


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MUSICAL INTERACTION TO FACILITATE COMMUNICATION IN AUTISM IN AN INDIAN CONTEXT Dr. Baishali Banerjee Mukherjee Faculty and Research Associate, Chennai School of Music Therapy, Chennai; Faculty, Center for Music Therapy Education and Research, Mahatma Gandhi Medical College and Research Institute, Pondicherry, India

This case study of ten children aged between three and seven years with the diagnosis of autism was designed to investigate the facilitation and enhancement of communication and interaction skills through a number of individual sessions of musical interaction. The present research was based on evidence of beneficial effects of music therapy on communication in children with autism.

The study was conducted in United Kingdom (2003 - 2008), the data collection of which was done in India to introduce musical intervention to facilitate communication skills in autism by using Indian music. All the children participated in the study were first time exposed to such an intervention. In musical interaction with children the techniques of improvisational music therapy (Bruscia, 1987; Wigram, 2004) and the techniques of musical interaction therapy (Wimpory, Chadwick and Nash, 1995; Prevezer, 1998) were employed with tunes of Indian Ragas, Talas, structured songs and lullabies. The analysis of the study was designed to produce a detailed record of the progress in communication skills made by each child participated in the study. An effort was made to combine quantitative and qualita-


tive information/data gathered from video and audio recordings of all the sessions to demonstrate the skills progressed through musical interaction, the nature and pace of progress and the individuality expressed by each and every child during the sessions. A detailed category system to analyze communication skills was formed where performances were scored in the areas like receptive communication, emotional expressions, intentional expressions, expressive musical communication, expressive intersubjective engagement etc. Along with quantitative analysis the narrative analysis was also conducted by capturing the stories from therapist-child musical interaction leading to engagement, analyzed in the form of episodes. Later each episode was micro analyzed using computer aided software to demonstrate nonverbal-vocal and bodily expressivity by children in musical interaction. Both qualitative and quantitative analyses in an integrated form contributed to develop an insight towards the cause of progress in communication skills made by all ten children. As well as it helped to reflect individual variations in the nature and rate of progress in communication skills. The case study was an appropriate approach to use in that context as it was a first attempt by the researcher to explore whether Indian

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music used in an improvised and interactive way can enhance and facilitate communication skills in children with autism that differed from the traditional music healing practices in India. The healing potentiality of Indian music lies in its melodies, which expresses emotions through its variation in tonal quality, level and movement (Deva, 1995). The power of improvisation lies at the heart of Indian music. The principles of Improvisational music therapy (Bruscia, 1987; Wigram, 2004) which were used to match, mirror, reflect, synchronize, and accompany the children’s communicative expressions with the intention to enhance the expressions of emotions and intentional communications were compatible with the non referential nature of Indian music (Deva, 1995). Improvisation in Indian music is uninfluenced by language, express the inner state or inner music of the musician as well as it reaches to the inner most level of listener’s mind.

The therapeutic techniques adapted to interact with children with autism to facilitate communication skills through improvised vo-cal and instrumental music based on Indian melodies and rhythms had a core foundation for support of communication that naturally motivated them to express their emotions and communicative intentions and also helped to evoke that inner music or musicality in all the children which was veiled under the disability.



Bruscia, K. E. (1987). Improvisational models of music therapy. Springfield: Charles C. Thomas. Deva, B. C. (1995). The music of India: A scientific study. Munshiram Manoharlal Publishers Pvt. Ltd. Delhi. Prevezer, W. (1998). Entering into interaction: Some facts, thoughts and theories about autism, with a focus on practical strategies for enabling communication. Report published at The Elizabeth Newson Centre, 272 Longdale Lane, Ravenshead, Notts NG15 9AH. Wigram, T. (2004). Improvisation: methods and techniques for music therapy clinicians, educaors and students. London and Philadelphia: Jessica Kingsley Publishers. Wimpory, D., Chadwick, P., Nash, S. (1995). Brief report: musical interaction therapy for children with autism: An evaluative case study with two years follow up. Journal of Autism and Developmental Disorders, 25 (5), 541- 552. About the Author

Baishali Banerjee Mukherjee. Interested to introduce music therapy for children with mental challenges in India adapting objective methods and techniques of therapy from Western approaches. Email:,

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Claire Everest Community Engagement – Coram, UK


Having established a flexible method of working in children’s centres in London, Katherine realised there was a huge need for therapeutic work within this area. Parental depression and its impact on attachment was particularly prevalent. In March 2015 many state-run children’s centres (including two where Katherine worked) were closed, due to government changes. There was a general move toward fewer, more specialised services.

In the creative therapy department at Coram, there has been an increase in referrals to music and art therapy for children who present with attachment disorders. The need for early intervention alongside parents and children is therefore increasingly evident in this work.

How the groups work

Claire and Katherine launched the Under 5’s Creative Groups at Coram in May 2016. Parents, children, therapists and early years staff come together for two hours a week and participate in child-led creative activities. Parents and children attend the groups through agency or self-referrals. Referral reasons can include: social, emotional and behavioural concerns;


parent isolation; attachment difficulties; specific diagnoses such as Autism. Many families have additional needs such as overcrowded living conditions; single parenting; siblings with Autism etc.

These inclusive groups focus on nurturing early attachments and provide a space for children to develop communication in a therapeutic environment. Parents can gain advice and support from staff and each other as needed: The closed nature of the group means that stronger support-networks are formed amongst parents. This also means children who may find relating difficult, are able to progress within the predictable membership and format of the groups. Modelling a child-led approach

By participating in the groups parents and children build trust and understanding of the music and art therapists’ techniques in a nonthreatening setting. Secure attachments are fostered between parents and children through the use of modelling by staff, using motivating media. Parents are also able to attend a taster session of music therapy with the therapist and their

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child in a separate therapy room during the main group session. Here, child-led techniques are modelled by the therapist in a nurturing way and parents are given ideas of how to continue these at home.

Each group ends with a singing session: here children can develop their communication and relating skills in the familiar group setting with motivating, musical activities adapted to meet the needs of the families.

Health Care Plan. Crucially this intervention gave his mother something positive at a difficult time. Video feedback was used to show his mother and new teacher how the sessions impacted positively on his relating and communicating whilst providing an outlet for non-verbal emotional expression. References

Flower, C. & Oldfield, A. (Eds.). (2008). Music Therapy with children and their families. London: Jessica Kingsley Publishers. Levinge, A. (2011). Music therapy for depressed mothers and their infants. In Edwards, J. (Ed.), Music Therapy and Parent-Infant Bonding. Oxford, UK: Oxford University Press.

About the Authors

Staff can identify families who may benefit from further therapeutic intervention and therapy sessions can be arranged outside of the groups. Onward referrals have included a non-verbal three-year-old and his mother attending music therapy sessions: his mother was supported in getting music therapy included as part of her son’s Education &


Katherine has set up & delivered music therapy & skill-sharing projects in schools and children’s centres in London for six years. Email:

Claire delivered the Coram Early years ‘Stay and Play’ provision; coordinates the Creative Groups and leads the young Parents’ PeerEducation Programme at Coram.

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Music therapists face an increasing number of employment options in their career (American Music Therapy Association, 2016; Wheeler, 2015). One of these options is a community based private practice or music therapy business.

With 14,623 music therapists worldwide (World Federation of Music Therapy, 2012), there is an increasing need and opportunity to explore the music therapy business as a service delivery model (American Music Therapy Association, 2015; Thomas, Ledger, Kern, Lindahl Jacobsen, & Abad, 2014).

Established in 1991, Creative Arts Therapies, Inc. provides music, dance/movement, and art therapy services to community agencies and private clients throughout the metropolitan Detroit area and Southeast Michigan, USA. Individuals of all ages and abilities are served through creative arts therapy modalities in the accomplishment of therapeutic aims: addressing physical, emotional, cognitive and psychosocial and spiritual needs. This presentation looks back on the author’s experience of 25 years of music therapy business ownership, with recommendations for


moving forward into the future of service delivery.


American Music Therapy Association. (2016). 2016 AMTA member survey and workforce analysis. Silver Spring, MD: American Music Therapy Association. American Music Therapy Association. (2015). Leading the way: Music therapy businesses of the future: A workbook. Silver Spring, MD: American Music Therapy Association. Thomas, T., Ledger, A., Kern, P., Lindahl Jacobsen, S., Abad, V. (2014). The economics of therapy: Clients, colleagues, cash, and competition. In J. Fachner, P. Kern, & G. Tucek (Eds.). Proceedings of the 14th World Congress of Music Therapy. Special issue of Music Therapy Today 10(1), pp. 266267. Retrieved from Wheeler, B. L. (2015). Music therapy as a profession. In B. L. Wheeler (Ed.), Music therapy handbook. New york, Ny: Guilford Press. World Federation of Music Therapy. (2012). Accreditation and Certification Commission: Music therapy certifications and licenses worldwide. Retrieved from http://

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About the Author

Jody Conradi Stark, Ph.D., MT-BC is President/Owner of Creative Arts Therapies, Inc., Site Director of Music Therapy Clinical Services at Michigan State University Community Music School - Detroit, and Part Time Lecturer and Music Therapy Clinical Supervisor at Eastern Michigan University. Email:


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In my facility [image 0-1], clients who are separated into seven care-levels train altogether while sitting in armchairs to improve their function. It is difficult to train per individual. Therefore, we practice the activities of [Beat + Time] [Basic-rhythm] [Poly-rhythm] which is Eurhythmics. We started Eurhythmics including [Muscle training of leg] [range of motion exercise] [flexibility exercise of ribcage].


Image 1-1. Step

Image 0-1. Facility Image 1-2. Deep breath


With singing [Dokokade haru ga (Spring is Everywhere)], clients step the part of the first tune Dokokade haru ga~ and the second tune Dokokade Hibari ga~ [image 1-1].

They sing with hand motion breathing deeply during the third tune yama no sangatsu~ by 8 beats [image 1-2].



Clients sing [Mame(beans)maki] with stepping a quarter note (named Human) [image 1-1] or [image 2-1]. They sing stepping a half note (named Turtle) and a eighth note (named Rabbit).

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Image 4-2. 2nd beat

Image 2-1. Clap stick March

Clients swing at a half note with singing [Edo komorisuta (Edo lullaby)] as if they hold baby in their arms [image 3-1].

Image 4-4. 4th beat The rule


Image 3-1. Swing

With singing [Haru no Ogawa (Whisper, Whisper Little Stream)], clients raise arm (the first beat) [image 4-1] -open hand (the second beat) [image 4-2] -close hand (the third beat) [image 4-1] -down arm (the fourth beat) [image 4-4].

Image 4-1. 1st beat & 3rd beat


Five points when all could do well; 4 points when almost could do well; 3 points when the half could do well; 2 points when few could do well; 1 point when nobody could do well. According to this rule, we total the average of months. This was conducted 14 times in a month.

A table (Leader-style) 4.21-4.43-4.57-4.71, B table (Following level of A) 3.29-3.36-3.863.93, C table (Following level of B) 2.43-3.293.50-3.57, D table (Mainly Men) 2.29-3.003.07-3.14, E table (Long-term care level 5) 0.43-0.50-0.64-0.77.

Even though the point difference by table is large, every tables could increase points. The body movement of participants became bigger and accurate. Introduction of the assignments

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made the repetition of function training possible such as function training-assignmentfunction training. Therefore, the amount of time that participants move their body with keeping their concentration increased. Also, middle and serious care level participants, who are likely to fall behind, could move actively. Light and middle care level participants embodied their goals by being evaluated, and completed both step 1 and 2 assignments every month. We are supposed to continue the assignments and to try more accurate quantitative evaluation as positive proof could be obtained. References

Takahashi, T. (2006). Hokan Daigae-iryo Ongaku-ryoho Supplement and Replacement Medicine Music Therapy. Kato, M., Niikura, A., & Okumura, T. (2000). Ongaku-ryoho no Jissen koresha/kanwakea no genbakara. Practice of Music Therapy from the field of care for seniors/ palliative care.


Eurythmics Research Center (1994). Kodomo no tameno Rythmique~Nenkan curriculum to sonojissen~ (Eurythmics for Children~annual curriculum and the practice~). Mini-Biography of presenter

Inoue Kaoru. Graduated from musical education and a special study of Rythmique in Kunitachi Music College, Bachelor of arts, RMT (Japan). E-mail: Reference music score website hp?id=200 hp?id=240 6%88%B8%E5%AD%90%E5%AE%88%E5% 94%84 hp?scoreID=77

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This paper focuses on evidence-based practice (EBP) in music therapy, providing an overview of EBP discussions in music therapy, existing issues on the EBP movement, and theoretical discussions based on Structural Constructivism to establish a foundation of evidence and for the existence of multiple types of evidence in music therapy.


Evidence-based practice (EBP) as a movement in music therapy has been a subject of discussion regarding accountability to music therapy clients and for music therapy to gain social recognition as a new profession. Otera (2013) reviewed EBP discussions on music therapy through 2012 and noted the following issues based on Saito’s (2012) discussion of evidencebased medicine. First, it is important that music therapists are aware of the ways that they recognize or understand EBP and evidence because different interpretations of EBP and evidence could cause unnecessary confusions and conflicts. Second, some discussions have suggested that the definition of evidence in EBP should not be limited to quantitative results. However, a problem remains regarding how to incorporate multiple different types of evidence into EBP. Previous studies have criticized narrowly defined evidence (Aigen, 2015) and have attempted to classify different types


of evidence (Abrams, 2010). Although their conclusions suggest the existence of multiple types of evidence, discussion is needed to overcome the conflict between quantitative and qualitative evidence, establish a theoretical basis for evidence, and determine the existence of multiple types of evidence in music therapy. Kyougoku (2008) theoretically demonstrated the idea of multiple types of evidence using Structural Constructivism, which is an epistemological framework presented by Saijo (2005). A core concept of Structural Constructivism is intention-correlation. This proposition states that all objects and events around us are cons-tructed from individual intentions and, therefore, multiple realities of constructed structures are unavoidable. The intention-correlation principle supports the idea of multiple types of evidence. Kyougoku (2008) proposed that all evidences are intention-correlation constructed structures. Individuals’ intentions regulate their reasons to use evidence. In other words, the use of evidence depends on the individual’s purpose. Kyougoku (2008) asserted that “evidence is a tool for achieving a purpose of solving clinical questions regarding prevention, diagnosis, prognosis, treatment, causal relationships, process, values, meanings, and needs” (p. 1070). He presented Structure-Construction Evidence-Based Practice (SCEBP) and demonstrated the use of multiple types of evidence according to the reason to practice. SCEBP has a five-step exercise similar to that of the origi-

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nal EBP. However, the SCEBP has relatively better flexibility for formulating clinical questions, searching, examining, and applying evidence to clinical practice, and the intention-correlation principle in Structural Constructivism is a theoretical basis supporting the flexible exercises.


The author suggests that SCEBP is applicable to EBP in music therapy and that a new methodology of EBP in music therapy could be established by incorporating new ideas and philosophies, such as SCEBP. Because music therapy is a new profession, music therapists should take advantage of learning new theories and avoid unproductive conflicts of belief, such as quantitative versus qualitative or benefits versus detriments of EBP, which people in other professional fields have previously experienced. The establishment of a new EBP methodology could benefit clients and their families and could advance clinical practice and research in the field of music therapy.


Abrams, B. (2010). Evidence-based music therapy practice: An integral understanding.


Journal of Music Therapy, 47(4), 351-379. doi:10.1093/jmt/47.4.351 Aigen, K. (2015). A critique of evidence-based practice in music therapy. Music Therapy Perspectives, 33(1), 12-24. doi:10.1093/ mtp/miv013 Kyougoku, M. (2008). Atarashii EBM-SCEBP ga motarasu kanosei [New EBM - The potentiality of SCEBP], Japanese Journal of Nursing, 72(12), 1070-1075. Otera, M. (2013). Is the movement of evidence-based practice a real threat to music therapy? Voices: A World Forum for Music Therapy, 13(2).doi:10.15845/ voices.v13i2.696 Saijo, T. (2005). Kozokoseishugi toha nanika? [What is Structural Constructivism?]. Kyoto, Kitaoji shobo. Saito, S. (2012). Iryo ni okeru naratibu to ebidensu. tairitsu kara chowa e [Reconciliation between narrative and evidence in medicine: Beyond the dichotomy]. Tokyo, Tomi shobo. About the Author

Masako Otera is an associate professor at Shikoku University, Junior College. Contact:

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Floyd Wilkins Smashville Badminton Center


This phenomenological inquiry explores the development of a shift in consciousness from that of habitual incarceration to freedom, through the vehicle of musical expression. Floyd’s thirty-plus years in prison contributed to a way of thinking that might be characterized as “institutionalized,” or “confined.” Here, an off-duty music therapist runs with a hunch that tapping into musical expression could create a way to literally think outside the box. Together, the two document the process of Floyd’s rise out of homelessness consciousness via a youTube video called “Choices.” Ethical issues are considered.


Day-in, day-out, Floyd and I were just two guys on a construction site, nailing down flooring, putting up insulation and drywall, painting, drilling metal, and sawing wood together – and, of course, listening to music while we worked.

How often does a music therapy professor get a chance to leave the ivory tower and work deep in the trenches? I suspect not that often. I actually felt I had more latitude with what I could do, being “off-duty” and not in a


professional or therapeutic relationship! As both a quantitative and qualitative researcher, as well as humanistic clinician, I resonate with Ken Aigen’s identification of the importance of the therapist’s creativity, intuition, and flexibility (Aigen, 1993) as integral to a client-centered approach.

I started off by teaching Floyd how to use a power drill, circular saw, and tape measure. From day one, it was abundantly clear that Floyd LOVED MUSIC and practically required his radio in order to work! After a couple of months, I showed him a few riffs on the bass guitar.

Floyd had been in prison off-and-on since age 15. He was 52 now. This was his first time typing on a computer. He told me that he couldn’t do it, but I suggested that it was really kind of like texting on his cell phone. He gave it a shot. Floyd:

My name is Floyd Wilkins. Before I entered this program, I was messed up on drugs and alcohol. I was homeless and living on the streets of Pottstown. During the day, I did whatever I had to do to get money for drugs and alcohol. I pan-handled, conned, and even

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robbed people to support my habit. I had just been released from jail.


I was coordinating the renovation of a dilapidated attic into an arts and badminton center. All of a sudden, my construction crew vanished! The head worker got a DUI and could not drive any more; his assistant stopped returning phone messages. I was stuck and needed some labor help big time!

There were a lot of street people in Pottstown, and periodically some would ask if I had work. Most of the time, you could smell the alcohol when they came near, or they looked like they were high on drugs. Pottstown has a thriving heroin epidemic. We have robberies and shootings in the neighborhood regularly. Maybe I was just desperate for help, but I thought there was something different about Floyd. He carried himself differently and referenced God a lot in his pitch – actually, a bit too much. There was still a distinctive aroma of hard liquor, but he spoke coherently and I got the sense that he genuinely wanted to work. He had a nice rhythm to his patter. Floyd:

With no skills and nowhere to go, my family didn’t want to deal with me because of my past history of drug abuse. My drug abuse had me living like an animal on the streets. I moved into a crack house where I was accused of murdering the lady who allowed me to move in with her.

I was innocent, but that only drove me deeper into my addiction. I was a lost soul wandering the streets until I met Eric who got me involved in his badminton program.



Floyd had over 30 years total behind bars in prison, and I felt like I had no clue as to how he would be able to change his thinking – let alone, behavior – to adapt to life on the outside. He had a habit of going back to jail after being out for short periods. He even described trying to get back to jail!

One thing, however, was abundantly striking – this man LOVED music. As soon as he hit the work floor, on went the radio. Song after song played over a gritty old radio speaker, ad infinitum. Floyd also sang along and had a rich expressive voice, perfectly in key! However, when asked, he said he did not sing or play music. I wondered if he might change his perception of himself if he could see his own talent – maybe in a recording or video.


This man taught me about trust, self-respect, responsibility, and self-worth. He gave me a job and taught me a few skills to help me support myself.

Myself – Ever since I’ve been in the program, I realize that I am becoming a better man than I use to be.

I’m drug free and I’m working a new job. Thanks to the program, I’m back with my family. I’m healthier and I’m involved with the family business. I don’t associate with negative people from my past. I’m going to church and bible study. I try to go to as many meetings as possible for my drug addiction. This program is very important to this community. It gives the younger generation something to look forward to after school besides being around negative influences.

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I was intrigued by Floyd’s writing about his experience working at Smashville as a “program.” Floyd himself talks about being “institutionalized,” so it might seem to be the norm that wherever he is, he is part of a “program” that is attempting to help in its own particular way. For me, actually not being part of a program opened up new avenues for potentially beneficial experiences. For example, if I was “on-duty” – say, working with an outpatient at a counseling agency in session with a homeless alcoholic – I might have a discussion about the impact of alcohol on their life and advise attending AA meetings. Being on a construction site however, Floyd and I could go for a beer during dinner break and listen to live acoustic music at a classy restaurant down the street! This kind of “real-world” experience appeared to have a big impact. It was something outside of his typical range of activities, and he really enjoyed it. Maybe it helped him feel more a part of the “outside” world. I’m not sure if I would call these outings, or even working with him on the bass guitar, “therapy” – despite its seeming to have a clear impact.

One theory of addiction posits the necessity of a “spiritual emergence” in order to become free of the power of the substance. Drugs and alcohol are great at filling a spiritual void with a substitute “feel good” feeling, albeit temporary. I started to wonder about the possibility here of a “musical emergence!” I have previously written about the impact of music on the biological, psychological, and social aspects of addiction (Miller, 2011); however, my emphasis at that time was on physiological self-regulation via biofeedback. Here, I was most interested in the spiritual experience that helps break the cycle of addiction. Specifically, I was curious


if the experience of playing music and seeing oneself playing might alter self-perception and maybe tap into a spiritual connection.

I had started a work pattern of changing the tasks at hand from one day to the next – from painting and flooring to electrical wiring and drywall. While initially, Floyd voiced his preference to just stick with the same job, after a while he appeared amused, wondering “what the Boss had in store” for the day. So on the day I suggested we start a music video, Floyd’s reaction was partly skeptical and partly amused – “There goes the Boss again!” I showed him the root notes of the two-chord vamp on the chorus of Reeling in the years. Floyd loved Steely Dan and played his Mp3s daily. Floyd picked it up – no problem. The verse was a little more complicated, but he was able to hit the descending line most of the time. Most challenging was the 3rd bar of the verse where the descending line changes from diatonic to a chromatic run – going back and forth between the two lines up to tempo was difficult. We managed to get enough clean passages over several video takes. I was able to complete a successful edit between cuts of Floyd, perfectly in tune and on beat with Steely Dan!

How was playing at first with just the bass and guitar? Floyd:

Tricky – that’s the word that describes it. I had to really listen and pay attention to every note. Once I heard the beat and applied it to the chords on the bass, it was magical! It took me a minute to get it on the bass, but once my teacher, Eric, showed me how to listen and play the bass at the same time, it was a wrap. That truly was a beautiful thing!

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How did you like seeing your first video playing Steely Dan? Floyd:

It blew my mind! I never knew I had it in me to make a video, much less learn the bass!

All my life I’ve been into negative things, but learning something new like playing the bass opened up a whole new world to me – learning that Steeley Dan song was hard, but my boss hung in there with me until we got it done. Seeing that video after it was done was special.


Around this time, we were doing some fundraisers to help raise Floyd out of homelessness. He had picked up enough badminton to be able to play in a tournament fundraiser. I also taught him racquet stringing so that once construction work was finished, he could have an ongoing role with a skill that was needed by our players. I was impressed with how quickly he picked up racquet strin-ging after a little initial frustration. Once through that first learning phase, stringing racquets to music started to look almost like meditation. I was also very glad to have replaced that junky radio with a nice sound system playing portable mp3s and Spotify channels. That old radio had been driving me crazy! Why do you think you watched that video of you playing to Steely Dan so many times? Floyd:

That goes back to one word – positivity. After coming up in the mean streets of Philly, I al-


ways stayed in some type of trouble, be it in the streets or with the law. Negativity was my life. Crime and destruction was my life. All that changed, thanks to Eric Miller and the Smashville organization. The reason I look at that video so much is because that video is one of the first positive things I did in my life. Eric:

My wife, Lynn, is also a music therapist and a fantastic singer. She would periodically come by the work site and help with painting and cleaning, and would supervise Floyd working on those jobs. He would refer to Lynn as “Mom” and appeared to have a lot of respect for her. Floyd was amidst a relapse as I was mixing down the audio tracks of a new recording, and I asked Lynn if she would like to sing a message to him. He had never heard her sing live, so the first time he heard Lynn’s singing voice was on an early audio mix-down of the Choices soundtrack.

What was it like hearing “Mom’s” singing for the first time?


It was a thing of beauty! you have to understand that Ms Miller – “MOM” (that’s what I called her because she treated me like family) never judged me. She accepted me for who I was. This beautiful woman has seen me at my best and my worst. Even after seeing me in another world and under the influence of drugs, she never turned her back on me. Of course, she was disappointed, but all that made her do was tighten up on me. yeah, she was up my ass for awhile but she never gave up on me. I’ll be the first to admit that I was making some messed up decisions that were destroying my life, but Mom hung in to the end. I make better choices now because life

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has so much to offer. Mom was the person who sung the hook to our video, Choices. To be honest with you, I didn’t know Mom could sing. Boy was I wrong! Mom took that song and ran away with it. Mom gave that song so much soul. I still get a little misty eyed when I hear her voice on that song. Eric:

After numerous mix-downs and 12 video edits, we had a final version of our video “We All Have Choices” ( watch?v=7mzhORxHWvE). In this video, we juxtapose the building of the Smashville Badminton center with Floyd’s story of being released from prison and developing essential skills needed to make it on the outside. I put in a huge amount of hours editing, and was quite satisfied with the final result. Of course, when I watch it, there are always a couple of small things I see that I would do over.

Floyd was impressed and amazed by the video. He listened to the audio alone over and over, sometimes 20-30 times a day. Once when I asked him how many times he listened, he said, “you don’t even know!” After that, he watched the video numerous times on end, as well.

Why do you think you watched the Choices video so many times?


The reason I watched that video so much is because that video hit on a lot of things I wasn’t ready to deal with. It was one of the hardest things I ever had to do. In the beginning, I was sort of oblivious to what we were doing. We didn’t just go out there and make a video. No – we talked about it; we suggested things; and imagined what we would need to make


our video powerful. We did things to make that video no one else in their right minds would. If the truth be known, we almost got arrested in the course of making that video! Let’s just say the cops don’t like being put on film. We knew some of the things we did was risky, like filming cops while they were pulling people over, but at that time, we were in that “getting our video done by any means necessary” phase. Once it was done and I saw it, it hit me hard. Eric really caught the true essence of who I was as a man. He didn’t pull any punches. He showed the good, the bad, and the ugly part of my life.

In that video, you see the hurt and pain – the destruction of what drugs and hardship did to the area of the city I lived in. Eric Miller took you on a journey into my world, where drugs and crime were an everyday occurrence. He took you through the jails and prisons I’ve been in. He did this in one video. The first time I saw it, I literally cried right in front of Eric. The reason I watch that video so much is because it’s the raw truth about my life! Eric:

“Choices” is, in fact, a powerful video. I have also watched it numerous times in the postediting phase. We presented it at a social workers’ conference in Atlantic City for almost a thousand attendees, where it was exceptionally well-received. The “Choices” video presents stark contrasts in ways of life and ways of thinking, and tells an unlikely story of transformation against the odds through musical expression. There are interesting questions that arise here for music therapists. I showed the video to one of my MT classes, split into two groups of students and asked them if “music

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therapy” occurred, given that the music therapist was off duty, and Floyd articulated several beneficial outcomes. I loved the class response! One group argued that music therapy did not occur due to context, citing Bruscia and AMTA. The other group also cited Bruscia and AMTA and argued that music therapy did occur in the form of “recreational music therapy!” Ethical questions could be considered if MT did occur as to what responsibilities the music therapist had. More broadly, however, one might ask if it is possible for an off-duty music therapist to not think or even play music as a music therapist.


you should ask me if my life was any different after making that video!


Was life any different after the video? How did your family react seeing what you were into now? Was it unexpected? Why? Floyd:

Was life any different after the video? To be honest, No! I continued to make bad choices. At the time, I was working for Eric and Mark, money was plentiful. Every day, the more money I made, the worse my choices became. I was living in a high drug area and I was fighting my demons. I don’t have to tell you that on a lot of nights, that demon got me. Life was definitely different. Things got so bad that messing with drugs landed me in the hospital for almost two months. And yes, my family was a little shocked to see me involved in something so positive, especially when they knew I was still out here getting high and wasting my money.



I was often mind-boggled by how Floyd could seemingly be on a new positive track, looking well-groomed, talking about saving money, working and going to church, and then come in to work late and flat broke, asking for a few quarters for smokes. Saving money was not his forte, and cash was a pretty strong relapse trigger, but for a few weeks he kind of latched on to the suggestion of putting 5 or 10 dollars per pay away into savings. I suppose from his perspective, I’m the one who was terribly inconsistent by always changing up the tasks for the day! Floyd:

I must admit that I’ve had a rough past, and struggled through a lot of trials and tribulations. I’ve had my ups and down, but through the grace of God, today I can actually say I’m a changed man.

Being involved with Smashville, things have changed miraculously. People, places, and things – that’s an expression that’s used a lot in recovery. Well, I’ve found it to be true. I’m around good people most of my day. Every day when I wake up, I love the person looking back at me. I never knew I would enjoy badminton so much. I’ve learned about discipline, self-control, and anger management. Well, I won’t lie – I still get a little upset when I lose. But, hey, who doesn’t? LOL! My family has embraced me with open arms because even they can see the changes I’ve made in my life.

It’s funny how your life can change when you make a decision to put all the bull behind you. It’s all about keeping the faith. you have to believe in yourself. you have to love yourself. you have to believe that there isn’t anything

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in life you can’t do. Today, I have two job opportunities I’m working on. I’m healthy and I make better choices. you might not believe this, but I credit a lot of the changes in my life to that video I participated in called – now get this – CHOICES! The reason this video means so much to me is because of the simple fact that life is based on the choices we make every day. I’m making better choices. I’m living better. I’ve stopped dealing with negative people, places, and things. Life is good, and for once I can truly say that things are looking up. I’m content and happy, and truly blessed. THAT SONG, CHOICES, BECAME My INSPIRATION AND MOTIVATION TO FIGHT My DEMONS AND TRy HARDER TO MAKE BETTER DECISIONS AND CHOICES.


Aigen, K. (1993). The Music Therapist as Qualitative Researcher. Music Ther 12 (1): 16-39 doi:10.1093/mt/12.1.16 Miller, Eric (ericmiller58). 2016, April 16. We All Have Choices. Retrieved from: https:// Miller, E (2011). Bio-Guided Music Therapy. Jessica Kingsley, London About the Authors

Eric Miller, Ph.D., is the author of Bio-guided Music Therapy (2011) Jessica Kingsley Pub-


lishers of London. He is certified in music therapy and biofeedback and directs the Ott Lab for Music & Health at Montclair State University. Miller holds a doctoral degree from the Bryn Mawr Graduate School of Social Work and Social Research. International presentations include sessions at the World Music Therapy Congress in Seoul, S. Korea, Hsien Chuan University in Tapei, Taiwan, and workshops in Switzerland, France and Italy. Dr. Miller was the keynote at a 2012 Bangalore University conference on music and mental health in India. Miller has vast clinical experience serving children, adolescents and adults for over 25 years in inpatient, outpatient, crisis and community settings. He was Executive Director of nonprofits Music for People, Expressive Therapy Concepts and founded the Biofeedback Network. Miller collaborated with Grammy-winning cellist, David Darling on the instrumental CD: Jazzgrass.

Floyd Wilkins is a writer and videographer with experience in recovery from addictions and expertise in the US penal system. He serves as Director of Community Outreach for the Smashville Badminton and Fitness Center in Pottstown, Pennsylvania. Mr. Wilkins also coaches community badminton players and has become well-known in elite player circles for his expert racquet stringing. When not at the Badminton center, Mr. Wilkins may be found blogging on Facebook and posting youTube videos.

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Persons who are incarcerated for any period of time may experience difficulty when the time comes to reintegrate into the community. These difficulties have the potential to become compounded when these persons also experience mental, and developmental, health challenges. Accordingly, a music therapy group was designed to assist four men who had been incarcerated for over five years each, to address concerns surrounding transition into the community, and to provide them with the necessary tools to improve the likelihood of success upon release. Group Description

Group members were identified based upon their impending release dates. Due to time constraints, and in order to provide more group structure, group members were given a ten-week time-frame. Sessions were held at the same time each week for 50-minutes, and were facilitated by a board-certified music therapist (MT-BC) and a board-certified behavior analyst (BCBA). Group goals were set by the music therapist and were as follows: 1) to recognize changes in one’s environment, 2) to adapt to changes in one’s environment, and 3) to recognize personal strengths. The overarching aim of the group was to improve the client’s readiness for discharge into the


community by means of improving his ability to think independently.

Sessions began with a brief, unstructured improvisation followed by verbal processing. The body of each session also included structured music interventions designed to address specific areas of need, such as problem solving, self-awareness or environmental awareness. Roles

The role of the music was to allow for safe expression of thoughts and feelings, and to facilitate access to uncomfortable or unconscious material. The role of the therapists was to support, and encourage, clients while they explored these expressions. Analytical Music Therapy Techniques

Holding – the therapist provides musical support in any manner that will allow the clients to feel safe to express their thoughts and feelings.

Free association – used when the client is not yet able to verbalize material to be worked with therapeutically.

Subverbal communication- used to allow the client to express thoughts and feelings that may either be uncomfortable, or consciously inaccessible (Priestley, 1994).

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Throughout the group’s therapeutic process, there were several themes that emerged while verbally processing musical material. These themes directly related to their impending release and they were as follows: Fear of judgement, the need for acceptance (of self and from others), communication and making meaningful connections with others, owning personal strengths, taking personal responsibility, and using isolation as a coping mechanism. Through verbal discourse, the men were challenged to relate these themes to their impending discharge.


Despite several challenges, such as participation resistance, cognitive deficits which impeded client’s ability to fully recognize and explore expressed material, and client’s difficulty with thinking independently there were a number of positive outcomes. Upon completion of the group, follow-up communication with the BCBA who co-facilitated the group revealed the following outcomes: 1) three of the four members displayed increased social awareness, 2) two of the four


members were able to channel their thoughts towards problem-solving when angry (as opposed to behaving aggressively without thinking), and 3) one of the four members was willing to become involved in the development of a relapse prevention plan (which he was unwilling to do prior to the group). Future Considerations

Longer time frame. Standardized measurement tools to conduct research. References

Priestly, M. (1994). Essays on analytical music therapy. Phoenixville, Pa.: Barcelona Publisher.

About the Author

Amanda MacRae is a PhD candidate at Temple University, in the final phase of Analytical Music Therapy training, and has over ten years of experience working with men diagnosed with co-occurring developmental and mental health challenges and are incarcerated.

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Worldwide, professional music therapists advocate and support the concept of including young children with disabilities in their communities. yet, inclusion practice varies greatly. This paper provides a snapshot of five countries regarding a) the status of including young children with disabilities, b) music therapy inclusion practice, and c) potential contributions of music therapists to the inclusion movement. U.S.A.

In the U.S.A., inclusion of young children with disabilities has been mandated by federal laws and policies since 1975. A large body of research supports the positive effects of inclusion practices for children with and without disabilities alike. yet, access to high-quality early childhood inclusion programs and services vary from state to state. While research in music therapy inclusion practice is sparse, music therapists across the country offer inclusive services in various settings through small group sessions or consultation with parents and educators. In the future, music therapists should be part of systemlevel supports for inclusion, engage in music therapy-based inclusion research, and promote inclusion practices in collaboration with various organizations.



In Japan, considered a Cohesive Society, all people respect each other and actively participate in society despite having a disability. Therefore, the Japanese government has built an inclusive education system that allows children with disabilities to learn in regular classes and receive special education services in separate settings. Inclusive music therapy sessions are mainly coled with childcare professionals or related therapists. Parents typically attend the sessions, which allows them to learn about their child’s abilities, developmental needs, and parenting skills. While inclusive music therapy programs are emerging, more are needed to support the core values of Japanese’s Cohesive Society.


In Argentina, inclusion programming has becoming more popular, but it is not supported by law. While some preschool settings accept as small number of children with special needs, educators are usually not trained to provide effective inclusion services. The primary roles of music therapists are to support children of all abilities to function independently, to demonstrate the benefits of music therapy interventions, and to learn about successful music therapy inclusion programs for possible future implementation.

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In Thailand, the government introduced and funded inclusion programs since 1999. There are currently over 22,000 schools providing inclusive programs. yet, challenges are the lack of qualified teachers, resources, and modified environment offer challenges. Because music therapy is a new discipline in Thailand, music therapists are primarily working in private and hospital settings. As the profession grows, opportunities for research and practice in special education settings should emerge.


In Poland, inclusion is legally grounded, thus ensuring all children the right to education based on their abilities and needs. Over the years, many education institutes embraced the idea of inclusion, but have faced the challenges of negative attitudes and lack of knowledge about disabilities and inclusion practices. While music therapists increasingly have offered services in schools, educators and musician implement Mobile Musical Recreation, a method presented for inclusive groups. Clarification of roles, goals, benefits, and services will be necessary before music-therapy based inclusion programs can develop. Conclusion

Inclusion matters and should concern people around the world as it targets equal ac-


cess, participation, and supports for children of all abilities. Music therapists can be critical partners in providing inclusive learning opportunities across a variety of contexts, activities and routines. Ultimately, inclusive programming will support children with disabilities to become full members of their communities and society at large – a noble goal for all. References

Kern, P., & Fienman, R. (2015). Color of us: Inclusion programming worldwide. imagine 6(1), 110-121. Contributing Authors

Petra Kern (USA) Kumi Sato (Japan) Gabriel F. Federico (Argentina) Patchawan Poopit-yastaporn (Thailand) Krzysztof Stachyra (Poland).


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Satoko Mori-Inoue yamato International School, Japan


Due to the globalization of the world, cultural diversity and intercultural connections have become facts of today’s life and therefore also have impacted music therapy research, education, and practice worldwide. More than ever, intercultural competent music therapists need to be aware of their own cultural identities, values, beliefs, and attitudes while being confident in implementing culturally-sensitive repertoire (e.g., songs, rhythms, scales) to overcome cross-culture boundaries and shape a common future of the field. Furthermore, music therapists across generations and nations must address resilience – a topic that invites debate on preserving or respecting tradition vs. cultural evolution and modernity (Hadley & Norris, 2015; UNESCO, 2013).

Attaining Intercultural Competences

Intercultural competences refer to knowledge about particular cultures and issues that may arise when interacting with different cultural groups. Basic requirements to attain intercultural competences include respect, selfawareness/identity, seeing from other perspectives/worldviews, listening, adaptations,


relationship building, and cultural humility (UNESCO, 2013). Intercultural competences are necessary for music therapists in today’s globalized world; they provide the foundation of meaningful music therapy services. ~Kumi Sato (Japan) Culture Context

The increasing diversity of cultures implies intercultural competences in various contexts. Deciphering other cultures promotes mutual understanding, solitary, and peace (UNESCO, 2013). Cultural context shapes music therapy practice as music is strongly influence by culture. ~Kazumi Yamaura (USA) Resilience Debate

Resilience is a core issue one must face when looking at different cultures’ handling of tradition and modernity. Preserving and respecting traditions while embracing innovation and change in creative ways is key for moving forward as a society and profession in a global world (UNESCO, 2013). In Japan, the resilience debate in music therapy should address the generational and training differences. ~Keiko Shiokawa (Japan)

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Cultural Concepts

Social codes such as the Japanese Uchi-soto describe interrelationships and appropriate behavior between individuals and groups across situations. Intercultural competences embody respecting these concepts and learning to be flexible across cultural groups (UNESCO, 2013). “Moving forward in music the- rapy” in Japan means to integrate different cultures and expand cultural concepts ~ June Katagiri (Japan) Tips for Being Interculturally Competent

Becoming an interculturally competent professional requires KNOWING about cultures, DOING by interacting with cultural others, and BEING reflective about one’s place in the world Intercultural citizens engage in clarifying, teaching, promoting, and supporting intercultural competences (UNESCO, 2013). Music therapists across generations and nations should be sensitive and respectful of other cultures, because it has meaning for individual clients and the therapeutic process. ~Makiko Chiashi (Japan) Conclusion

Past, present, and future generations of music therapists need to think within a local


and global context not only to find their own place, but also to develop the field in a ra-pidly evolving cultural landscape. Gaining intercultural competences is a lifelong task, evolving over time through experience, exchange, and ongoing critical reflection (UNESCO, 2013). There is no better way to move forward with music therapy than discovering cultural similarities and differences during an intercultural event such as the 15th World Congress of Music Therapy in Tsukuba, Japan. References

Hadley, S. & Norris, M. S., (2015). Musical multicultural competency in music the-rapy: The first step. Music Therapy Perspectives. Advanced Access December 7, 2015. United Nations Educational, Scientific, and Cultural Organization (UNESCO) (2013). Intercultural Competences: Conceptual and operational framework. Paris, France: UNESCO.

Contributing Authors

Dr. Kern and Dr. Mori-Inoue lived, studied, and worked in various countries. In-text statements provided by contributing authors who are bi-cultural music therapists as well. Email:

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INTRODUCTION TO HEALTHRHYTHMS速 GROUP EMPOWERMENT DRUMMING Annie Heiderscheit Augsburg University, Minneapolis, MN, USA Alyssa Janney Remo, Inc., Valencia, CA, USA

HealthRHyTHMS速 is an evidence-based group empowerment drumming program that builds and fosters socialization, connection, camaraderie, respect, communication and personal expression. Group empowerment drumming can be implemented in a variety of clinical settings and the wide array of benefits of this therapeutic strategy. Music therapists from around the world have received Health RHyTHMS速 training and are utilizing group empowerment drumming the following types of clinical settings: long-term care, mental health day programs, chemical dependency treatment programs residential care and therapeutic day programs and public schools.

Active music making & group drumming

Active music making and group drumming are effective ways to engage clients in a variety of clinical and community based settings. Research demonstrates that actively making music provides a variety of health and wellness benefits. These benefits include improved mood states (Bittman, et al, 2004), stress reduction (Bittman et al, 2001), decreased burnout rates (Bittman et al, 2003a), increased natural killer cell activity (Bittman et al, 2001), and improved creativity and bonding in seniors (Bittman et al, 2003b).


This presentation will give attendees an introduction to the HealthRHyTHMS速 group empowerment drumming program and share the various settings and ways this is being implemented by professionals all around the world. The presenters will also share the research surrounding this program. The presenters will facilitate portions of the protocol to allow attendees to experience the power of actively making music as a group, as well as examples of the use of empowerment drumming in clinical practice. The presenters will also explore how to potentially utilize this type of active music making in their own facility and community and ways this may be adapted to meet they specialized and unique needs of clients. References

Bittman, B., Felten, D., Westengard, J., Simonton, O., Pappas, J., & Ninehouser, M. (2001). Composite effects of group drumming music therapy on neuroendocrine-immune parameters in normal subjects. Alternative Therapies Health Medicine, 738-47. Bittmans, B., Bruhn, K., Stevens, C., Westengard, J. & Umback, P. (2003). Effectiveness for employee burnout & turnover reduction. Advances in Mind-Body Medicine, Fall/Winter, 19 (3/4), 4-13

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Bittman, B., Bruhn, Lim, P., Neve, A., Stevens, C. & Knudsen, C. (2004). Recreational music -making inspires creativity & bonding in long-term care residents. Provider, November, 39-41 Bittman, B. Snyder, C., Bruhn, K., Liebfried, F., Stevens, C., Westengard, J., Umback, P. (2004). Recreational music-making: An integrative group intervention for reducing burnout and improving mood state ins first year associate degree nursing students: Insights and economic impact. International Journal of Nursing Education Scholarship, 1(1), 1-26.


About the Authors

Annie Heiderscheit, Ph.D., MT-BC. LMFT is the Director of Music Therapy at Augsburg University in Minneapolis, MN. She is the Chair of the Publications Commission WFMT. Annie is also an endorsed facilitator of HealthRHyTHMSÂŽ.

Alyssa Janney, MBA is the Health Program Development & Marketing Manager at Remo, Inc. She is an executive board member of the SCV Education Foundation, board director for International Foundation for the Healing Arts and serves on the Able Arts Work Wellness and Research Advisory Council.

Research Article


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Implementing a Song as a Reward for Transition from Free-Play Time to a Group Activity

Kumi Sato Shigeki Sonoyama

Abstract Even though there are substantial numbers of studies investigating transition strategies, there is still an interest in and the need for research on transition due to its frequent occurrence in everyday life. Research suggests implementation of music as a prompt effective to promote smooth transitions; however, the effect of music implemented as a reward has not been discussed yet. Since rewards are used as commonly as prompts in educational settings, the current study examined the effect of a song as a reward for younger children with developmental disabilities during transitions, in comparison with the effect of a song as a prompt. The participants were three children at the age of 3 or 4, who required support to initiate and complete transitions, especially from free-play time to a group activity. The result indicates two of the participants initiated the transition faster when the song was implemented as a prompt (Intervention A), whereas the time they took after initiation of the transition was reduced when the song was implemented as a reward (Intervention B). For the other participant, implementing the song as a reward was effective to decrease the time needed for initiating and completing the



A pesar de que hay un número considerable de estudios que investigan estrategias de transición, todavía existe un interés y la necesidad de investigar sobre la transición debido a su frecuente ocurrencia en la vida cotidiana. Los estudios existentes sobre este tema sugieren la implementación de la música como un medio eficaz para promover transiciones sin problemas; sin embargo, el efecto de la música implementada como recompensa no se ha discutido aún. Debido a que las recompensas se utilizan con tanta frecuencia como pautas en entornos educativos, el estudio actual comparó el efecto de una canción como recompensa para niños con trastornos del desarrollo durante las transiciones, con el efecto de una canción como aviso. Los participantes eran tres niños con edades de 3 ó 4 años, que requerían apoyo para iniciar y completar las transiciones, especialmente del tiempo de juego libre a una actividad grupal. El resultado indica que dos de los participantes iniciaron la transición más rápidamente cuando la canción se implementó como aviso (Intervención A), mientras que el tiempo que tomaron después del inicio de la transición se redujo cuando la canción se implementó como recompensa (Intervención B). Para el otro par-

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transition. The effect of these interventions on their independence during the transition will be discussed also.

Keywords: song, reward, transitions, children with developmental disabilities, single-subject research design

Implementing a song as a reward for transition from free-play time to a group activity as interest in and needs of therapeutic use of music is growing in the area of education, researchers have investigated its effect to teach children, especially individuals with disabilities who need special support. Since learning in a similar environment, which children without disabilities have, is one of the general goals for children with disabilities, research in music therapy has shown how music can assist them acquiring necessary or expected skills (Katagiri, 2009; De Mers, Tincani, Van Norman, & Higgins, 2009; Register, Darrow, Standley, & Swedberg, 2007). Some studies were conducted in a school or home setting so that the participants can maintain the skills after termination of the music therapy intervention without additional training (Kern, Wakeford, & Aldridge, 2007; Kern, Wolery, & Aldridge, 2007; Pasiali, 2004; Register & Humpal, 2007). Music was used to deliver a cue or create a structure in these studies; in other word, music was provided to promote specific behaviors before the target behaviors occur.

In practical educational settings, however, rewards are selected and offered as much as prompts, depending on social context and environmental conditions, to enhance appropriate behaviors of children. Therefore, ha-


ticipante, la implementación de la canción como recompensa fue efectiva para disminuir el tiempo necesario para iniciar y completar la transición. También se discutirá el efecto de estas intervenciones en su nivel de independencia durante la transición.

Palabras clave: canción, recompensa, transiciones, niños con discapacidades del desarrollo.

ving a larger selection of alternative rewards would be beneficial for practitioners because they can attempt to find which type of rewards is suitable for the child and provide the best support. Contrary to importance and popularity of rewards in educational settings (Hoffmann, Huff, Patterson, & Nietfeld, 2009), research on use of music as a reward is limited in music therapy literature. Lim (2010) stated that music stimuli worked as both a prompt and an automatic reward, but the function of music as a reward was not directly examined in this study. Although research has explored effective use of music as a prompt, potential effect of music as a reward has not investigated yet.

Research on effective strategies incorporating rewards is needed in other area of disciplines also. Sterling-Turner and Jordan (2007) conducted a literature review of research on interventions to support transitions in individuals with autism, and they pointed out most of the available studies examined interventions using some kinds of prompts including verbal prompts/audio cues, visual support, and video priming. They argued the need for further studies investigating consequent components in transitions. Even though there is a substantial number of empirical studies about promoting smooth transitions, interest in research

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associated with transitions is ongoing due to its frequent occu-rrence in daily life and the likelihood that children with disabilities find it challenging.

A few studies about the effect of rewards in transition times include the research conducted by Waters, Lerman, and Hovanetz (2009). The participants were two 6-year old boys diagnosed with autism, and they had difficulty terminating a preferred activity and initiating a non-preferred activity. The results indicate that a visual schedule, which is a commonly used prompt, would not be effective by itself, and it should be combined with appropriate rewards and limited access to preferred activities, that is extinction. Cote, Thompson, and McKerchar (2005) provided three typically developing toddlers with interventions for transitioning from the play area to the toileting area. They found that the participants’ compliance increased if access to preferred activities was not allowed after the initial instruction; moreover, the effect was even more significant when a reward (e.g. a toy to carry with) was delivered with the extinction procedure, compared to when a verbal warning was given 2 minutes prior to a transition. Hanley, Tiger, and Ingvarsson (2009) investigated strategies to increase preschoolers’ selection of non-preferred but academically important activities during free-play time. Although their research was not conducted in scheduled transitions, they encouraged the participants to transition from a preferred activity to a non-preferred activity in the free-play period. The results revealed embedded reinforcement, such as decorating the activity area with popular children’s cartoon characters, increased and maintained the participants’ engagement in originally non-preferred activities.


The effect of music in promoting smooth transitions has been examined also (Gadberry, 2011; Register & Humpal, 2007). The results of these studies demonstrated musical interventions decreased transition times as well as increased independence in the participants during transitions. In the guideline for identifying appropriate transition support, music and singing are also listed as an example of auditory prompts besides verbal warnings and timers (Hume, Sreckovic, Snyder, & Carnahan, 2014). However, music was incorporated as a prompt in these models. Therefore, the current study will examine the effect of music provided as a reward in transition times, compared to the effect of music provided as a prompt.

Furthermore, since transition requires a sequence of tasks including terminating an engaged activity, physically moving or shifting attention, and preparing for the next activity, what part of transition a child find it challenging should be different. Some children might need support to start physically moving even though they can finish the previous activity without any prompts (Sterling-Turner & Jordan, 2007). Others might need prompts to terminate an engaged activity though they can quickly clean up and move to a different area once they finish the previous activity. Hume, Sreckovic, Snyder, and Carnahan (2014) argued how important it is to individualize transition support because the best intervention and when it should be implemented varies depending on the child’s chronological/developmental age or abilities. In addition to comparing the effect of music as a reward and its effect as a prompt during transitions, the authors will deeply discuss how differently each participant in this study, who had different learning needs, responded to the interventions.

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Method Setting

This study was conducted at a day treatment facility in Japan, which provides services for children with developmental disabilities under 6 years old. Children and their parents can decide how many days in a week they use the services depending on the child’s learning needs. Most of the children uses the services approximately 3 hours a day to learn self-care or academic skills, which cannot be addressed on an individual basis at regular preschool/kindergarten and go to regular preschool/kindergarten for the rest of the day. Some children come to the facility to practice learning in a group before they start going to regular preschool/kindergarten.

After a circle time in the morning, at this facility, each child follows a schedule shown on own schedule board, which is planned for individual learning needs to be addressed. The basic schedule includes: circle time, toilet, hand washing, snack, pre-academic tasks, free-play time (i.e. unconstructed play), group activity, lunch, tooth brushing, and going home. In this daily schedule, not all of the children were able to have smooth transitions from free-play time to group activity. Therefore, music intervention was implemented to encourage children finish playing, putting toys away, and having a seat for the next activity.


The purpose of this study and its procedure was clearly explained to parents of three children who needed support during transitions from free-play time to group activity. Their parents understood: (a) this study was approved by the University of Tsukuba Ethics Committee for Research in the Faculty of Human Sciences;


(b) pseudonyms would be used as information of their child would be kept strictly confidential; and (c) they had a right to withdraw from the study if they thought their child would not benefit by participating in it. All of the parents were willing to have their child participate in the study and signed the consent form.

Kenta was a 4-year-old boy diagnosed with Autism Spectrum Disorders. His score on the Tsumori-Inage Infant Developmental Scale, which is a parent questionnaire–based test commonly used in Japan (Kurita, Osada, Shimizu, & Tachimori, 2003), was 75 indicating the severity of the disability was mild. Improving attention span was one of the challenges for him and he required frequent prompts to stay on task. Sometimes he didn’t use the bathroom even though he spontaneously said he wanted to use it and went into the room. Kenta could engage in a task/activity relatively longer if there were no peers around; in other words, he was greatly influenced by other peers’ behaviors. When he heard the timer, which was used as the signal for cleaning up at the day treatment facility, he often said “It’s time to clean up” or “Let’s put toys away” to peers. However, he didn’t finish playing if other peers were still engaging in the play.

Sara was a 4-year-old girl who had no specified developmental delays. According to the Tsumori-Inage Infant Developmental Scale she took at 27 months, her developmental age was diagnosed as 21 months (DQ 78). At the time of the study, Sara had no difficulty understanding verbal directions or expressing her needs in words except when she had tantrums. She also spoke to her peers often though she rarely played interactively with them. Sara was able to perform most of the tasks independently without much physical support; however, she spent long time completing a task since her movements were

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slower generally. She had a tendency to refuse new or unfamiliar activities because of her anxious personality.

Masa was a 3-year-old boy diagnosed with no specified developmental delays. His DQ score on the Tsumori-Inage Infant Developmental Scale, that he took at 26 months was 62. However, by the time of the study, he was able to communicate verbally with adults or peers. Although he had the ability to perform most of the tasks, the child care aides consistently needed to provide prompts for him. Masa particularly had difficulty in finishing his play. He understood he was supposed to put toys away if he heard the sound of a timer, but he often said “I don’t want to” or “Wait!” and refused to finish playing.


The authors conducted a brief analysis of children songs to investigate some characteristics in popular and well-known children songs in this culture. A CD set with 100 children songs (Minnna, 2014) was selected for the analysis because it included both new and traditional songs. Table 1 shows the characteristics of well-known children songs. It implies songs in a major key, in 4/4 beats, and at a faster tempo are preferred. Moreover, 53 out of 100 songs used repeated sounds, words, or onomatopoeia to create some rhythmic patterns. Table 1. Brief analysis of 100 children songs in Japan. major




92 3 5

*Others include traditional folk songs using special melodic scales.



4/4 3/4

64 3





**These two songs are played in 6/8 beats.



Moderato Andante Adagio Largo

Tempo (BPM) (168-208)






(108-120) (66-76) (40-66)

16 3 8

Based on the brief analysis, two original songs were composed for this study; “Clean Up, Up, Up!” was to use as a prompt to encourage children putting toys away, and “Well Done, Finished!” was to use as a reward to praise for cleaning up (See Appendix). Both songs were composed in a major key in 4/4 beats and played at a faster tempo between 120 and 168 BPM. Additionally, repeated sounds were included in the lyrics to create some rhythmic patterns.

Prior to the study, many of the child care aides reported they felt uncomfortable leading the songs because they didn’t have an advance music educational background. Some studies indicated live music was more effective than recorded music (Gadberry, 2011). However, since the authors placed importance on developing teaching strategies, which can be implemented easily without special instruction, the songs were recorded instrumentally and played with a CD player for the child care aides

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to sing along in this study. Two recorded CD were placed at the facility for the child care aids to learn the songs. Procedure

This study was conducted using a single-subject research design across participants. The data was collected for four weeks in each phase and follow up data was taken one month after the termination of interventions. The latency until the participant initiated the cleaning task, the total transition time until the participant required to have a seat for the next activity, the number and kinds of prompts provided, toy categories the participant was playing with, and the child care aide who supported the participant were recorded. A video camera was set up in the corner of the room to record the latency, the total transition time, and the prompts later; in addition, the first author was present every time to record the toy categories and the child care aides on a data collection sheet.

Baseline. When a timer rang as a signal to finish playing and put toys away, the child care aides gave a verbal prompt such as “Please put your toy away.” Then, they waited for 1 minute without providing any other prompts to see if the participants spontaneously start cleaning up. Additional prompts were given as much as the participants needed to finish playing, put toys away, and have a seat for the next activity after the 1-minute interval. Verbal praises were provided for completing the cleaning task as it had been practiced at the facility.

Interventions and follow-up. The basic procedures during Intervention A (the song provided as a prompt) were identical to those in the baseline phase except that the song “Clean Up, Up, Up!” was played with a CD


player when the timer rang, instead of providing a verbal direction. For Intervention B (the song provided as a reward), the basic procedures during were identical to those in the baseline phase except that the child care aides sang “Well Done, Finished!” along with the participants after they had a seat, instead of providing verbal praises. In the follow-up session, the procedure was identical to the baseline phase.

Interobserver agreement. The first author watched the video recordings of all sessions as the first observer. Then, the second observer, who was a doctoral student studying special education, watched the video recordings and collected the data for 40% of all sessions for Masa, 38% of sessions for Kenta, and 35% of sessions for Sara. The IOA rate was assessed by the length of time each participant required after the initiation of the cleaning task, which was calculated by subtracting the latency from the total time taken. The mean duration per occurrence IOA was 97% for Masa, 96% for Kenta and Sara.

The number of verbal, visual, and physical prompts were recorded separately by the same observers. Any verbal directions were defined as verbal prompts, and visual cues including pointing, showing a picture card, presenting a box to put the toys in, or demonstrating the cleaning task were defined as visual prompts. Physical contacts including tapping, holding a hand, or holding the participant up were defined as physical prompts. The exact agreement IOA for Masa was 67% in verbal prompts, 100% in visual prompts, and 78% in physical prompts. The exact agreement IOA for Kenta was 60% in verbal prompts, 100% in visual prompts, and 100% in physical prompts. The exact agreement IOA for Sara was 80% in verbal prompts, 60% in visual prompts, and 100% in physical prompts.

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Figure 1 shows the total transition time as well as latency to initiation of the cleaning task, which required the participants to fi nish an engaged activity, and the time after initiation of the cleaning task, which re-

quired the participants to complete the cleaning task, physically move to another area, and have a seat for the next activity. The number of data points is different since how many days in a week each child used the facility was decided by their parents, depending on their learning needs. Kenta required slightly less time for the transition during Intervention A, while the transition time Sara took was reduced in Intervention B. The total time Masa spent on the transition decreased when the song was implemented as a reward; however, it increased again as the intervention continued.

Table 2 shows the mean time of before (i.e. latency) and after initiation of the cleaning task in each phase respectively. Kenta and Masa initiated the cleaning task faster during Intervention A; on the other hand, in regard to the time required after initiation of the task, their compliance was increased in Intervention B, when the song was delivered as a reward. They did not spend much time once they finished playing and started putting toys away. Sara was stably able to start putting toys away within 100 seconds during Intervention B. Although she completed the cleaning task quickly during Baseline without considering the toy categories she was playing, she required less time after initiation of the task in Intervention B, in a comparison between Intervention A and B.

Figure 1. The filled circles represent the total transition time. Two different dotted areas represent the latency to initiation of the cleaning task (low density) and the time after initiation of the cleaning task (high density) respectively. The blank circle in the follow-up session represents the latency.


Table 3 shows the average number of prompts provided for each participant. For Sara and Masa, the number was the minimum in every kind of prompts during Intervention B. Although the number of prompts provided for Kenta decreased in Intervention A, it increased again in Intervention B. He required more verbal and physical prompts in this phase compared to baseline.

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Table 2. The mean of latency and the time after initiation of the task in each phase.

Kenta Sara Masa

Latency After

Latency After

Latency After


Intervention A

Intervention B









158.7 227.5 209.9 107.0


199.2 141.9

Table 3. The average number of prompts provided for each participant.





verbal visual

physical verbal visual

physical verbal visual





Intervention A

Intervention B




3.7 1.3 3.5 2.5 1.3 5.6 4.4 2.7

The total transition time required for the transition decreased in either Intervention A or B in every participant. However, how these musical interventions functioned was different in each participant. The mean time of before and after initiation of the cleaning task implies implementing a song as a prompt was effective for Kenta and Masa to finish playing and start putting toys away, whereas implementing a song as a reward was effec-



2.4 0.6 4.6 3.8 1.6 5.7 1.0 2.9

6.0 1.4 2.0 1.4 0.6 5.1 1.0 2.4

tive for them to complete the cleaning task and be ready for the next activity in shorter time. On the other hand, for Sara, implementing a song as a reward was effective to finish playing as well as be ready for the next activity. In terms of how independently the participants completed the transition, Table 3 suggests the amount of support Sara and Masa required was decreased as the study continued, and it can be concluded they learned what is expected during the transition.

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Detailed discussion on each participant

Kenta. Kenta regularly told his peers to put toys away when he heard the sound of the timer though he did not initiate the cleaning task until the child care aides gave him the direction. He had difficulty staying on task, and his behaviors were highly influenced by other peers’ behaviors; for example, he stopped his hands and stared at a peer for a while if the peer started crying. Kenta often played with Masa, and he followed Masa especially for the initiation of the cleaning task. If Masa started the cleaning task faster, he could start it faster. If Masa took time to finish playing, Kenta needed time to finish playing.

When a song was implemented as a prompt during Intervention A, Kenta stared at the child care aide singing the song, and he was able to start putting toys away immediately after the song. He sometimes stopped his hands if he saw peers still playing, yet he could restart the cleaning task and have a seat with a few verbal prompts usually. He said “Let’s start (the next activity)” and invited peers to come after him when he became ready for the next activity. Kenta’s behaviors during Intervention B were very similar to what was observed in the baseline phase. He told his peers or himself to put toys away when he heard the sound of the timer; however, he could not spontaneously initiate the cleaning task until prompts were provided after the 1-minute interval. One of the reasons why the total transition time dropped dramatically in the followup session is that Masa was absent on that day. If Kenta was playing alone, he followed directions without difficulty.

Kenta needed fewer prompts in Intervention A, yet this is partly because he had the same child care aide for support during this phase. Although he showed a great interest in the


song implemented in Intervention B and sang it along with a smile, he required more prompts to initiate the cleaning task. Therefore, it is difficult to conclude that musical interventions helped him improve his independence during the transition. Since he still needed a certain amount of support to stay engaged, the song as a prompt would be more effective for him, in terms of the total transition time.

Sara. Sara strongly refused to finish paying and put toys away at first. She expressed her anger not only by saying “No” but also by crying loudly or thrashing her arm and legs. Thus, while she spent time regulating herself, the child care aides put most of the toys away and left one piece for her to complete the cleaning task. Due to this flexible response to her behaviors, the time required after initiating the cleaning task was significantly shorter in the baseline phase, besides the difference in the toy categories she preferred playing with in each phase. The child care aides had been struggling to have her finish playing without difficulty and put all the toys away by herself.

In the beginning of Intervention, A, Sara stared at the child care aide singing the song, yet after a while, she started refusing to finish playing. However, those behaviors were gradually decreased, and she did not exhibit any behaviors, which refuse the cleaning task, at all after Day 8. One possible reason for this sudden change is she preferred playing with the same toy from that point. It was a set of finger puppets, and she did not have to share it with other peers like blocks; therefore, she might have been highly satisfied with her playtime before finishing the play. Sara liked the song implemented as a reward and sometimes sang it by herself although she had never sung a song during music activities.

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Sara was able to put all the pieces of the toy, which she preferred playing in the second half of the study, back to the original place by herself. She spent longer time to complete the cleaning task since her movements were slow, yet the child care aides respected her independence and did not provide additional help unless she asked for it. The decrease in the number of prompts suggests her independence during the transition improved throughout the study. Although the toy categories are considered as one of the factors which reduced the total transition time, a song as a reward was more effective to address her learning needs generally.

Masa. At the beginning of the study, Masa refused to finish playing almost every time he heard the sound of the timer. He knew the timer meant it was time to put toys away because he asked the child care aides “Did it ring?” and then said “I’m not coming.” In addition, even though he put toys away, he could not have a seat immediately after that. He lied down on the floor and rolled around until the child care aid took him to the chair. Therefore, finishing the play and having a seat for the next activity were both challenging for him.

During Intervention A, the frequency of his verbal refusals to finish playing decreased gradually, and Masa became able to initiate the cleaning task with a few verbal prompts. He sometimes sang a part of the song along with the recorded music. However, he still had difficulty having a seat, thus the time required after the initiation of the cleaning task did not improve much. When the song was implemented as a reward in Intervention B, Masa showed a great interest in the song. He said “yay!” and had a seat immediately if the child care aide told him he was going to sing the song. Masa became less interested in


the song gradually, however, and this could be the reason why the total transition time he required increased towards the end again.

In the second half of the study, Masa often had a seat with a toy in his hand immediately after he heard the sound of the timer. He was redirected to put the toy back to the original place as the cleaning task was a part of the transition practiced at the facility, yet his behavior told he became able to shift his attention to the next activity in shorter time. His behaviors were easily changed by health conditions or feelings as well as how much time he could have for free-play time on the day, thus his performance during the transition was variable overall. If he could not have a smooth transition, he usually had difficulty engaging in an activity later on the day. Although there was not a significant decrease in the total transition time, some changes, which would probably lead to the decrease in the time in the future, were observed in his behaviors. Limitations and implications

In order to closely examine the difference in the effects between two interventions, Intervention A and B should have been repeated in an A-B-C-B-C design; furthermore, the combined effect needs to be investigated in addition to the independent effect of each intervention. However, besides this study was conducted at the end of a school year, Sara and Masa decided to terminate the use of the services and go to regular kindergarten/ preschool in the next school year. Additionally, since it was carried out during winter, some participants were absent for a longer period due to their health conditions, and thus it was difficult to collect data as much as scheduled.

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The authors respected the management policy of the facility and determined not to assign a specific child care aid to each participant. If each participant had the same child care aid throughout the study, however, the data, especially the number of prompts taken to analyze the change in their independence, would have been more validate.

In addition, the sample size was limited because there were not many children using the services more than three days a week regularly at the time of study. Recruiting more participants at the day treatment facility or other educational support centers is needed for future research to increase research validity as well as examine if the findings could be generalized.

The result of this study implies music as a prompt could be effective to encourage initiating a task whereas music as a reward could be effective to completing a task. Furthermore, it suggests how and when musical interventions should be implemented would be different depending on individual learning needs. Since rewards are commonly used in practical educational settings as well as prompts, additional research is needed to explore more strategies to implement music as a reward so that educators, parents, and other specialists working for children with special needs can have a larger repertoire of alternative teaching strategies. It is highly recommended future research considers use of recorded music so that those who are not music therapists or who do not have an advance music educational background can incorporate the strategy without special training. References

Cote, C. A., Thompson, R. H., & McKerchar, P. M. (2005). The effects of antecedent inter-


ventions and extinction on toddlers’ compliance during transitions. Journal of Applied Behavior Analysis, 38, 235-238. De Mers, C. L., Tincani, M., Van Norman, R. K., & Higgins, K. (2009). Effects of music therapy on young children’s challenging behaviors: A case study. Music Therapy Perspectives, 27(2), 88-96. Gadberry, D. L. (2011). The effect of music on transitions and spoken redirections in a preschool classroom (Doctoral dissertation). Retrieved from ProQuest Central; ProQuest Dissertations & Theses Global. (Order No. 3458216) Hanley, G. P., Tiger, J. H., & Ingvarsson, E. T. (2009). Influencing preschoolers’ free-play activity preferences: An evaluation of satiation and embedded reinforcement. Hoffmann, K. F., Huff, J. D., Patterson, A. S., & Nietfeld, J. L. (2009). Elementary teachers’ use and perception of rewards in the classroom. Teaching and Teacher Education, 25, 843-849. Hume, K., Sreckovic, M., Snyder, K., & Carnahan, C. R. (2014). Smooth transitions: Helping students with autism spectrum disorder navigate the school day. Teaching Exceptional Children, 47, 35-45. Katagiri, J. (2009). The effect of background music and song texts on the emotional understanding of children with autism. Journal of Music Therapy, 46(1), 15-31. Kern, P., Wakeford, L., & Aldridge, D. (2007). Improving the performance of a young child with autism during self-care tasks using embedded song interventions: A case study. Music Therapy Perspectives, 25(1), 43-51. Kern, P., Wolery, M., & Aldridge, D. (2007). Use of songs to promote independence in morning greeting routines for young children with autism. Journal of Autism & Developmental Disorders, 37, 1264-1271. Kurita, H., Osada, H., Shimizu, K., & Tachimori, H. (2003). Validity of DQ as an estimate of

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IQ in children with autistic disorder. Psychiatry and Clinical Neurosciences, 57, 231-233. Lim, H.A. (2010). Use of music in the Applied Behavior Analysis Verbal Behavior approach for children with autism spectrum disorders. Music Therapy Perspectives, 28(2), 95-105. Pasiali, V. (2004). The use of prescriptive therapeutic songs in a home-based environment to promote social skills acquisition by children with autism: Three case studies. Music Therapy Perspectives, 22(1), 11-20. Register, D., Darrow, A., Standley, J., & Swedberg, O. (2007). The use of music to enhance reading skills of second grade students and students with reading disabilities. Journal of Music Therapy, 44(1), 23-37.


Register, D. & Humpal, M. (2007). Using musical transitions in early childhood classrooms: Three case examples. Music Therapy Perspectives, 25(1), 25-31. Minnna ga Eranda Kodomo no Uta [CD]. Shinagawa, Tokyo. NIPPON CROWN Co.,Ltd. (2014). Sterling-Turner, H. E. & Jordan, S. S. (2007). Interventions addressing transitions difficulties for individuals with autism. Psychology in the Schools, 44, 681-690. Waters, M. B., Lerman, D. C., & Hovanetz, A. N. (2009). Separate and combined effects of visual schedules and extinction plus differential reinforcement on problem behavior occasioned by transitions. Journal of Applied Behavior Analysis, 42, 309313.

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This song was sung in Japanese in this study. The syllable “su” was repeated in the boxed parts. The translation of the lyrics is as follows: Let’s clean up. It’s time to clean up. We can put toys away super quickly. Let’s clean up. It’s time to clean up. How nicely done!

*This song was sung in Japanese in this study. The syllable “ta” was repeated in the boxed parts. The translation of the lyrics is as follows: We did it. We did it. We did it. Very well done, finished!


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About the Author

Kumi Sato Kumi Sato, MS, MT-BC is a doctoral student in Disability Sciences at University of Tsukuba, Japan. She received her MS in Music Therapy from State University of New york at New Paltz, U.S. After returning to Japan, she continues her study to explore the applied use of music to support children with special needs.

About the Author

Shigeki Sonoyama Shigeki Sonoyama, Ph.D. is a Professor in Faculty of Human Development at University of Tsukuba, Japan. His research focuses on development of strategies for children and adults with Autism, Selective Mutism, or Behavioral Disturbances. He has extensive experience in practical studies conducted at school, preschool, and other facilities for people with disabilities. He is the former president of the Japanese Association for Behavioral Analysis and currently serving as a board member of Japanese Association of Special Education.


Book Reviews


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Clinical Training Guide for the Student Music Therapist (2nd ed.) Written by Donna W. Polen, Carol L. Shultis, and Barbara L. Wheeler. Barcelona Publishers, Dallas, TXISBN 9781945411168 (219 pages)

Reviewer: Melissa Mercadal-Brotons, PhD, MT-BC, SMTAE

Professor and Director of the Music Therapy Master’s Program, Escola Superior de Música de Catalunya (ESMUC), Barcelona, Spain.

“Clinical Training Guide for the Student Music Therapist”, is a comprehensive book that covers a broad variety of topics related to the clinical work of the music therapist, and is conceived for music therapy students at all levels of training who are working with a wide range of populations. This volume has been written by expert music therapists Ms. Donna W. Polen, Dr. Carol L. Shultis and Dr. Barbara Wheeler, all of whom have many years of experience both in the field of music therapy and in the education of music therapists. This text goes from basic fundamental concepts such as what it means to be a music therapist to what is involved in planning and implementing active and receptive music therapy strategies, and the tasks of documenting and self-assessing as a music therapist. Music Therapy Handbook unfolds in 18 chapters which have a similar structure, with suggestions for assignments, journaling and discussion at the end of each chapter.

In Chapter 1: Doing Music Therapy, An Exploration, the authors introduce concepts to


reflect on: a) what it means to do therapy in general, and music therapy in particular, b) what is involved in the therapy process. They emphasize the importance of self-knowledge and continuous growth for the development of oneself as a therapist. This first chapter also introduces the idea of understanding the therapy process, which includes identifying client needs, understanding the therapist’s role and working with music.

In Chapter 2, the authors present different levels of involvement in music therapy clinical contexts. These levels range from observing professional music therapists to participating and assisting as a student therapist, planning and co-leading, and finally leading the session. The different responsibilities and functions are described for each of the levels of involvement.

Chapter 3 outlines the various facets in the process of becoming a music therapist, particularly focusing on how they are delineated in the United States. The first step towards becoming a professional music thera-

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pist involves the academic preparation, which occurs at three different levels: Bachelor, Master and Doctoral programs, each with its own objectives and competencies to achieve. Another part of the process is the clinical training or practical component, which occurs throughout the academic studies. Supervision is another important aspect for the music therapist, both as a student and as a professional. The MT-BC credential is the culmination of the process of becoming a professional music therapist, which is obtained after passing the CBMT examination.

Chapter 4 introduces the issues music therapists need to consider in the process of planning for music therapy: the client’s perspective, the music therapist’s perspective and ethical considerations.

Chapter 5 focuses on client assessment. This is a very comprehensive chapter, which walks the reader through the different purposes of assessment and the domains to be evaluated by the music therapist. It presents different specific music therapy assessment models, developed by music therapists to be used with a broad range of populations, from children to adults, in order to evaluate non-music skills. Chapter 6 introduces the topic of defining goals and objectives as the first part of formulating a treatment plan.

Chapter 7 focuses on aspects to consider when planning and implementing appropriate music therapy strategies, The client’s identified level of functioning, interests, goals and objectives all need to be considered when choosing music therapy experiences to use in the intervention phase. This chapter also addresses practical details that need


to be decided when planning an intervention, such as the room arrangement, equipment, instruments which will be needed and other materials which may be handy.

Chapters 8-11 describe various experiences that may take place during a music therapy session: improvising, re-creative, composition and receptive experiences, each with its own variations. The four chapters follow the same structure: an explanation of the activity itself, how it can be used with a variety of populations (from children to adults), and how their uses are documented in the literature. Also, each chapter has a section on the materials needed for each type of activity, considerations when using them, materials and tips for using each of the techniques.

Chapter 12 delves more into some of the aspects that should be considered when planning music therapy interventions. These refer to the characteristics of the client, such as diagnosis, developmental level, and the client’s needs, and how they affect the level of structure needed in the sessions, and the therapist’s self-awareness of the rationale behind whatever he or she is doing. The topic of ethics is presented here, clarifying the importance for a music therapist of following ethical standards.

In chapter 13, the authors present several verbal techniques to facilitate client responses in music therapy settings such as forms of questioning, reflecting and sharing, interpreting, confronting and providing feedback. They also describe other techniques that should be avoided as they are not helpful, such as making judgments, presenting solutions and avoiding client’s concerns. They also point out nonverbal strategies to facilitate nonverbal responses such as body language, physical proximity and the music itself.

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Chapter 14 delves more into the role of music as the main tool in the music therapist’s daily work and how it has been addressed by several authors in the music therapy field.

Chapters 15 and 16 tackle the work with groups and with individuals, respectively. The advantages and challenges of working with groups are pointed out: different levels of functioning and stages of development, types of problems, ages as well as level of structure needed for each of the participants in a group. Chapter 16 examines several factors to consider when working with individuals in order to maximize the success of the music therapy intervention.

Chapter 17 focuses on aspects of documenting and communicating client progress and presents different strategies to measure and evaluate their responses. The concept of operationally defining expected outcomes in order to choose the best measurement system is emphasized. Examples of progress notes are also included in this chapter.


The last chapter of the book, Chapter 18, is totally devoted to the music therapist and emphasizes the importance of continuous self-growth throughout his or her professional life. It includes some ideas, directions and tools which can be helpful during one’s career.

This is a wonderful reference book which walks the reader through every single aspect of the music therapy process illustrated by very clear examples. It is a significant contribution to the music therapy literature, and although it is intended for music therapy students, at all levels of training, it is also highly recommended to music therapy educators, and clinicians to refresh their skills. All of the chapters offer unique and valuable information which is applicable to many global contexts. The book is written by distinguished authors who weave research results, personal and professional experiences into their writing with great examples that bring the daily work of music therapists to life.

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An introduction to music therapy research

by Barbara L. Wheeler and Kathleen M. Murphy Dallas TX, Barcelona Publishers, 2016. ISBN: 9781945411120

By Heidi Ahonen, PhD, RP, MTA, FAMI

Professor of Music Therapy, Wilfrid Laurier University. Director of the Manfred and Penny Conrad Institute for Music Therapy Research

Through the years since finishing my PhD in 1998, I have observed first hand the noticeable climate change in the music therapy research field. I have not only witnessed the various paradigm debates but also the full circle development of music therapy research - from strictly quantitative inquiries to qualitative, and from qualitative to the home-coming of evidence-based research. At the end of the 80’s, only quantitative approaches were appropriate, but the ‘marching in’ of the qualitative approaches was already in motion, creating the attitude sometimes that they came to replace the quantitative altogether. Utilizing Wheeler’s pioneering Music Therapy Research, 1st edition (1995) during my doctoral studies became my most valuable methodological guidance, and thereafter I incorporated the second edition (2005) as the main textbook when teaching music therapy research at Laurier. While the 1st edition of Music Therapy Research introduced the two paradigms as distinctively separate, night and day worlds of music therapy research, the 2nd edition introduced the dialogue between the two.

It is now my great privilege to be given the opportunity to review the 3rd edition of Music


Therapy Research (2016) and acknowledge the overall tone of mixed-methods approach and the equal implementation of both quantitative and qualitative music therapy research designs. I believe that with the release of this inspiring book, also available as an epublication, Barcelona Publishers, Barbara Wheeler, and Kathleen Murphy have made an indispensable provision to the field of music therapy research. This book is not only an updated revision of the second edition, but a major expansion that includes new themes, topics, chapters, authors, and discussions. The massive 3rd edition of Music Therapy Research covers detailed processes and issues of music therapy research, outlining the diverse research genres for designing and conducting music therapy research, whether quantitative, qualitative, evidence-based, or practice based, or as the new book differentiates them, objectivist or interpretivist research orientations. The editors’ choice to classify the quantitative and qualitative paradigms as objectivist or interpretivist is interesting and only time will show whether or not the concepts will be adopted by music therapy researchers. As a music therapy re-

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search educator, I can see this conceptualization opening up more choices for research questions, and inviting the researchers to openly investigate their epistemological beliefs in light of different characteristics of the two paradigms as a foundation for their research rather than first deciding their paradigm. Furthermore, what I really appreciated in this book and view as one of it’s greatest strengths in this revision of the earlier editions, is the refreshing tone of a preferred dialogue between the two paradigms, avoiding the attitude of a division or ranking between them but rather emboldening the idea of having different options. Encouraging researchers to use what ever paradigm, approach, or technique as their tool to conduct a good, innovative, and ethically sound research. While reading the book I was pleased that the diverse orientations were presented as equal yet different. No paradigm was presented as more superior than another. Furthermore, as a music therapy research educator, I appreciate the provision of the clear map of both objectivist and interpretivist research paradigms, thus allowing students to comprehend the various research approaches, methodologies, and techniques, their place on this map, and their interconnections with each others. The 758 page book contains 68 chapters, and nine units: introduction, preparations, foundations and principles, methodological concerns in objectivist research, methodological concerns in interpretivist research, objectivist designs, interpretivist designs, other types of research, and evaluating, reading, writing, and submitting music therapy research.

The Introduction Unit provides an overview of music therapy research, its historical portrait, and the introduction to the relationship between research, practice, and theory1. The content is crucial for new music therapy researchers and students, giving them different ideas and solid foundations that will assist them to ground their chosen methodology with their epistemological beliefs.

Furthermore, the Preparations Unit delivers practical guidelines for new music therapy researchers and students on developing a research topic, literature review, ethics, research funding, while also providing ideas of multicultural considerations and inter/multidisciplinarity - both fresh and essential topics highlighting the current research needs and challenges2. A must-read for any research class preparing students to implement their research topic and proposal draft, before launching their journey into the deeper forest of different research methods. I particularly appreciate the practical ideas, i.e. introducing key terms, search engines, and current tendencies in research reporting.

While Unit three equally introduces the epistemological foundations and principles of both objectivist and interpretivist research3, Units four and five specialize in methodological concerns of both paradigms describing areas of data collection, analysis and interpretation of both musical and clinical data, discussing potential problems, statistical concepts, and introducing the most commonly used data analysis softwares4. I particularly found the chapters concentrating on analysis of musical and clinical data important, thus combining evidence-based and practice-

1. Chapters 1-4 by Wheeler, Bruscia, Merrill, Baker, young, Amir, Blythe LaGasse, and Crowe. 2. Chapters 5-10 by Darrow, Abbott, Murphy, Kim, Elefant, Magee, Heiderscheit, Skewes McFerran, and Hunt. 3. Chapters 11-13 by Hiller, Cohen, and Wheeler. 4. Chapters 14-23 by Waldon, Fachner, Krout, Sulliva, Meadows, Behrens, Keith, Bonde, Eyre, and Baker.


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based research. I would recommend including them into every music therapy research course outlines mandatory for all students. I would also highly recommend the The Objectivistic Design Unit for qualitative researchers who never amassed any statistics courses beyond their second year psychology as it systematically introduces the most common research designs that could be incorporated into mix-method research. On a personal level, I found the unit very concise, and well written, providing well-justified options for different research settings. I believe for students it is useful that the different designs have already been categorized as single subject/small, descriptive pre-experimental, or experimental designs. The chapters in this unit introduce different designs such as withdrawal, multiple treatment, one-sample, longitudinal, static group comparison, parallel group, crossover, and factorial designs, as well as surveys, objectivist case study, correlation and regression, economic analysis, and dephi technique5. The strength of this unit is the clarity of descriptions of the different designs and the variety of clear examples from the music therapy research.

Also useful for a new researcher and students is The Interpretivist Design Unit, which distinguishes the different approaches based on distinctive focuses such as meaning, language, theoretical, or case-study focuses. It is imperative that phenomenology is introduced as both philosophy and research inquiry as this is often confusing for students. The chapters comprehensively introduce different research inquiries such as hermeneu-

tic, ethnographic, critical, arts-based, morphological, phenomenological, first-person, or narrative, as well as grounded theory, and discourse, content, thematic, and case-study analysis6. The rich examples of current music therapy research and the clear descriptions of various research steps and different ways to analyze the data are valuable, practical information, again compulsory reading students choosing their research methodology, i.e. before submitting their letter of intent. The research examples presented in Units six and seven are also thought-provoking for music therapy practitioners, and I applaud the link between theory, research and practice being so clearly presented. Each chapter provides concrete examples with a wide variety of music therapy topics. Unit eight presents current research on microanalysis, both in objectivist and interpretivist fields, combining methods of both paradigms. The chapters also introduce the synthesis of interpretivist research and mixed methods research, as well as historical research and philosophical inquiry7. Personally, I find this unit most intriguing as it reflects the current music therapy research field and its real opportunities and challenges. I appreciate the clear rationale presented for mixed methods when researching clinical practices. I would definitely include this Unit into my research course, as a mandatory reading, during the early stages of planning the research topic as I think it could broaden a student’s perspectives, allowing them to reach new visions to challenge the traditional thinking of research. Chapter 59, introducing the syste-

5. Chapters 24-36 by Ridder, Fachner, Jones, Brown, Napoes, Curtis, Ghetti, Else, Cassity, Ledger, Jones, l’Etoile, Silverman, Wheeler, DeLoach, Murphy, and McKinney. 6. Chapters 37-53 by Stige, Ledger, Arnason, Skewes McFerran, Jackson, Hunt, Loewy, Paulander, Rolvsjord, Hadley, Viega, Forinash, Weymann, Tupker, Talbot, Ghetti, Keith, Hadley, Edwards, O’Callaghan, Abrams, Kim, Hoskyns, and Murphy. 7. Chapters 54-64 by Erkkila, Trondalen, Wosch, Burns, Masko, Magee, Zanders, Bradt, Meadows, Wimpenny, Solomon, Davis, Hadely, Stige, and Strand.


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matic review, meta-analysis, and synthesis is particularly useful for any music therapy student, as it will assist them with their literature review and reference critique.

Unit nine provides readers with comprehensive guidance in evaluating, reading, writing, and submitting both objectivistic and interpretivistic music therapy research8. The content is valuable for new researchers taking their first steps into publishing as it outlines the different sections of different types of publications in a practical manner. Chapters 67 and 68 should be incorporated into every master’s level music therapy research course outline. The unit will also prove useful for any senior level researchers conducting peer review processes. In conclusion, the 3rd edition of Music Therapy Research provides a very clear and con-

cise outline of the different paradigms, their typical research methodologies, particular focuses, specific techniques, opportunities, and challenges. This comprehensive book will bring inspiration for music therapy students, educators, research supervisors, and researchers, dispensing practical ideas, research steps, data-analysis descriptions, and diverse examples of different methods and research designs that have been utilized in music therapy research, and is a must-have in any credible graduate level music therapy training programme. Every music therapy research course should include this indispensable book as mandatory text as any current graduate level thesis must reference this book. I want to congratulate both Barbara Wheeler and Kathleen Murphy for their extensive and profound work, and their commitment to the advancement of music therapy research and practice worldwide.

8. Chapters 65-68 by McKinney, Abrams, Meadows, and Gardstrom.


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An Introduction to Music Therapy Research (3rd edition)

Edited by Barbara L. Wheeler & Kathleen M Murphy Bookreview by Ludwika Konieczna-Nowak

The Karol Szymanowski Academy of Music in Katowice, Poland

Research is an area of exceptional significance and importance as regards the development of music therapy in general. As music therapy is a relatively new academic discipline that combines clinical practice with emerging theories, it needs to be supported by studies, which will not only prove its effectiveness, but also explain the mechanisms underlying the complicated process of therapy that uses music as a tool and medium. To become a permanent element of care in various applications, such as working in different kinds of facilities and with various groups of people, music therapy has to fight for recognition and respect that are rooted in well-established standards of practice, and therefore truly deserved.

High quality research is the best weapon in this ‘peaceful fight’. Only a substantial number of studies will give music therapy a voice that will be heard and understood by other disciplines and professions; it will also inspire further inquiries that might reveal new fascinating areas in realms such as functioning of music, people, and relationships between them. It is good to remember that with proper dissemination of knowledge reaching the extensive therapeutic, academic and artistic community and therefore allowing


this practice to grow, we can expect to ultimately improve the lives of many. The body of research is growing fast in many centers, which are scattered all over the world. In many regions, however, music therapy still struggles to be recognized as a valid and science-based practice.

Doing research on music therapy is neither simple nor obvious. “Being both an art and a science practiced within an interpersonal and sociocultural matrix [music therapy] requires the integration of many seemingly contradictory elements. Music therapy can be both objective and subjective, individual and collective, creatively unique and replicable, intrapersonal and interpersonal, sociocultural, and transpersonal” (Bruscia, 2014, p. 11). Moreover, music therapy is usually placed in an interdisciplinary context, being a multi-span bridge between aesthetic, musicological, psychological, educational, medical and social territories (to name only a few). Considering such a complexity of the field and many different perspectives that inevitably arise from this richness, it becomes obvious that methodological reflection on various aspects of music therapy must also be diverse. Specific models and approaches focus rather on one component or another of the therapeutic

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process, different theories and philosophies form the basis for practice, personal beliefs and worldviews also influence the way in which one would make a move for the researching adventure within this area.

Regarding research methodology, music therapy can be proud of having a great resource – the invaluable book Music Therapy Research, whose 3rd edition was released in 2016 (edited by Barbara L. Wheeler and Kathleen Murphy). This fundamental publication gets richer and more capacious every time a new version appears.

The multidimensional picture of music therapy presented in this ‘methodological Bible’, together with its overall weight – on both literal and metaphorical levels – might be a little intimidating, especially for a less advanced music therapist or researcher. But here comes assistance for such people – a lighter and shorter publication, released by the same editors: An Introduction to Music Therapy Research (3rd edition). These two books – MTR3 and Introduction… have a lot in common, but at the same time, their strengths lie in different places.

Introduction… “was designed for those who are beginning their studies in music therapy research, and it is especially well-suited for use as an accompaniment to classroom instruction” (Bruscia, 2016). It includes twenty chapters, a foreword and a preface, a glossary and a subject index. Just to compare – the number of chapters in MTR3 is sixty-eight. Seventeen chapters (from 1 to 14 and 18 to 20) are taken directly from MTR3 and placed in Introduction…, forming a common ground for both books. The remaining three were written specifically for this book.

The structure of the book is logical and wellordered. It starts with a general overview of


music therapy research (chapter by Barbara Wheeler and Kenneth Bruscia) and an explanation of primary concepts such as objectivism and interpretivism as the ways of conceptualizing research and general classifications. A historical portrait of music therapy research follows; its development is presented starting from the so-called “preprofessional era” (understood as the times before the first professional association of music therapy in the world was established) up to this day (by Theresa Merrill). The next two chapters discuss the first stages in the research process – Developing a Topic (by AliceAnn Darrow) and Reviewing the Literature (by Elaine Abbott). These phases are in fact crucial to the progress of research and actually contribute directly to the value of the whole study, so careful considerations here are truly needed. Ethical Thinking in Music Therapy (by Kathleen Murphy) gives a broader context to the researching and the researchers themselves. It not only enhances reflection on a personal level, but also presents important practical, procedural issues that need to be taken under consideration. Usefully, it includes an appendix – information from Guidelines for Research Protocols, developed by CIOMS and WHO. The next chapter – Multicultural Considerations in Music Therapy Research (by Seung-A Kim and Cochavit Elefant) – brings a wide social context to the attention of the reader, namely reflection on how different faces of culture might and should influence the inquiry and its performers.

In MTR3 and, accordingly, Introduction…, the terms “objectivist” and “interpretivist” are introduced and used – instead of quantitative and qualitative. Using new terminology was motivated by various reasons, mostly – “to indicate the broadening of the understanding of ways if classifying research” (Wheeler &

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Rickson, 2017). Chapters 7-13, written by James Hiller, Nicki Cohen, Barbara Wheeler, Eric Walden, Arthur and John Sullivan, Anthony Meadows and Douglas Keith, respectively, are dedicated to these two kinds of methodologies and include general contexts, such as epistemological foundations and principles of both objectivist and interpretivist research, together with more “technical” aspects, like measurement issues and statistical concepts in objectivist work and data collection in interpretivist work.

The above-mentioned, newly added part of the book covers objectivist and interpretivist research designs and other types of research. This important contribution is authored by Ken Bruscia. It is concise and at the same time comprehensive, providing a bird’s eye view of different ways in which different types of research might be conducted. In the objectivist part, single subject and small n research, descriptive research, pre-experimental, quasi-experimental and experimental designs are discussed. Natural setting approaches, phenomenology, meaning-focused research, language-focused research and theoretical and case approaches are presented in the interpretivist part. Short descriptions of microanalysis, music-focused research, mixed methods research, systematic review, meta-analysis, synthesis, historical and philosophical research constituted the last of the chapters written specifically for this book. The last chapters contain information on how to evaluate both objectivist and interpretivist research (chapters by Cathy McKinney and Brian Abrams, respectively) and finally – how to read, write and submit objectivist and interpretivist manuscripts (by Anthony Meadows and Susan Gardstrom, respectively). A Glossary (the same as the one in MTR3) makes a valuable addition to the main body


of book. It is quite extensive and gives a short description of individual terms, frequently with references (name of the authors) to the chapter from MTR3, therefore the reader is able to deepen the understanding of the concept.

It seems that one of the greatest values of the book lies in the balance it keeps between objectivist and interpretivist research options. It shows that they are different on many levels, but there is neither conflict nor superiority here, and that together they can build a fuller and richer body of knowledge. A beginning researcher can therefore get a grasp of different ways that are available in doing research and follow the one that seems most appealing and convincing. After taking the first steps, one can reach for the next resource – MTR3.

It is perhaps worth noting that almost all of the authors, who contributed to this book, are US-based (one comes from Israel). This fact might be seen both as a plus and a minus. On one hand, the USA can certainly be considered a center of music therapy research, with its long traditions in the field, professional journals, vivid academic communities and ever-increasing popularity of the practice itself. On the other hand, research is also being conducted in other parts of the world, and authors from other countries and often very different cultures could very well provide valuable additional expertise and insight. Nevertheless, it should be remembered that this book is just an introduction and its point was not to present the vast variety of methodological nuances and branches but rather to outline the main trails in methodological labyrinths. The main material for music therapy researchers who want to go further – MTR3 – is much more international in its character.

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Summing up, this book is undoubtedly highlyrecommended for students and young researchers as well as all those who are not only interested in complicated relations between art, science, and human functioning, but also are looking for ways in which careful, reflective observations, analysis and interpretations can be performed. References

Bruscia, K. (2014). Defining music therapy (3rd ed.). University Park, IL: Barcelona.


Bruscia, K. (2016). Preface. In B. L. Wheeler & K. M. Murphy (Eds.), An Introduction to music therapy research (3rd ed.) Dallas, TX: Barcelona. Wheeler, B. L.,& Murphy, K. L. (Eds.).(2016). Music therapy research (3rd ed.). Dallas, TX: Barcelona. Wheeler, B., & Rickson, D (2017). The third edition of ‘Music Therapy Research’: An interview with Barbara Wheeler. Approaches: An Interdisciplinary Music Therapy Journal, First view (Advance online publication), 1-5.

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Cultural Intersections in Music Therapy: Music, Health, and the Person Edited by Annette Whitehead-Pleaux and Xueli Tan Barcelona Publishers, Dallas, TX, ISBN 9781937440978 (298 pages)

Reviewer: Ronna Kaplan, MA, MT-BC

Chair, Center for Music Therapy, The Music Settlement, Cleveland, OH, USA.

Cultural Intersections in Music Therapy: Music, Health, and the Person was edited by Annette Whitehead-Pleaux and Xueli Tan, two remarkable music therapy colleagues, with partially shared and partially disparate backgrounds and experiences. A very impressive array of 23 additional contributors, a combination of clinicians and academics, brings much richness to the personal stories and detailed information gathered therein.

Given that the mission of the World Federation of Music Therapy is “to promote global awareness of both the scientific and artistic nature of the profession, while also contributing to its development,” a review of this book devoted to cultural intersections in music therapy in the WFMT journal, Music Therapy Today, seems most appropriate.

The book is extremely well-organized. In addition to a Preface and Conclusion, there are six distinct overarching units within the volume. Unit I, “Understanding Discrimination, Oppression, and Bias” lays the groundwork for the remaining sections. Unit II explores “Cultures of Heritage,” while Unit III focuses on “Cultures of Religion.” Unit IV discusses as-


pects of “Cultures of Sexual Orientation and Gender,” while Unit V is devoted to “Cultures of Disability and Survivorship.” Unit VI relates to “Inclusive Music Therapy Education and Practice.”

In the Preface the editors share how the stage was set for the book upon completion of the American Music Therapy Association (AMTA)’s 2012 Multicultural Music Therapy Institute: The Intersections of Music, Health and the Individual. Panelists from this institute, which was chaired by the book’s editors, each contributed a chapter to a manual provided for the institute. With the belief that this work was quite relevant to music therapy in all of North America, the editors went about augmenting the manual with additional chapters and creating greater depth in terms of the original topics covered. They state the purpose of the book: “to bring to the forefront of our consciousness the notion that the world is becoming more pluralistic, that it is becoming increasingly challenging to define and pigeonhole any one individual into a cultural corner fenced in by myths, assumptions and stereotypes” (p. xi). Throughout the volume the focus is placed on cultures that

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are in the minority in North America, rather than on majority cultures, including White, Christian, male, and cisgender.

Unit I (chapters 1-3) addresses discrimination and oppression, microaggressions in everyday encounters, and reflections on personal bias. These are aptly included to provide an understanding of systems that limit the voices of minorities. To develop a better grasp of the complexities involved in examining and addressing the myriad cultural intersections of music, health, and the person, the editors rightly begin with definitions of some challenging concepts, such as power, privilege, discrimination, prejudice, injustice, bias, and oppression. Presentation of Collins’ Matrix of Domination/Interlocking Systems of Oppression Theory (pp. 6-7), allows readers to examine themselves in terms of how we are oppressed, how we might oppress others, how we resist oppression and how we enable oppression. Institutional, interpersonal, and/or internalized oppression may occur with regard to sexism, racism, classism, heterosexism, ableism, ageism, genderism, imperialism, and/or Protestantism.

Reading this book has vastly increased what I had previously considered to be my already excellent vocabulary! I am now more aware of macroaggressions, which are names for overt discrimination and hate crimes, and microaggressions (most often unconscious, unintentional and automatic) and their distinct categories, microassaults, microinsults, and microinvalidations.

To sharpen the focus on the intersections of culture, health, music and the individual, and, in my opinion, to provide greater consistency, ten common themes are utilized across all chapters within Units II-V: (1) personal reflection or epoch; (2) introduction; (3) worldview


of the culture(s); (4) historical realities versus popular myths; (5) diversity within the culture(s); (6) acculturation and assimilation (more vocabulary words!); (7) minority stress, minority discrimination, and microaggressions; (8) meaning of medicine and well-being in the culture(s); (9) meaning and function of music in the culture(s); and (10) conclusion. It quickly becomes apparent that increasing familiarity with the meaning of medicine and well-being in each culture and of the varieties of meaning and function of music in the culture are crucial to assist the music therapist on the road to cultural competence.

Cultures of heritage explored in Unit II (chapters 4-10) consist of Hispanic/Latino clients, East and Southeast Asian culture, the South Asian-American diaspora, Arab/Middle Eastern culture, African-American perspectives, cultures of Native Americans/First Peoples, and identities which fall somewhere in between. Interestingly, as I was reading the chapter on Native Americans/First Peoples, I happened to be traveling through a portion of North Carolina where the Cherokee Nation resides. I believe this timing heightened the poignancy and impact of what I learned, from four embodied concepts guiding the lives of tribal people—land, ancestors, Elders, and story—to the fact that “most Americans are not aware of the continuing political and social tensions that are a reality for many modern indigenous peoples who are still suffering the effects of oppression” (p 128). Furthermore, the authors, Carolyn Kenny and Therese West, remind readers of many important lessons, including that while as therapists we are trained in observation skills, “it is important to remember that observations are influenced by who is doing the observing and the assumptions the observer brings to the situation” (p. 128) and that “identity is a

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precious thing” and we need to develop and know our identities including our cultural roots” (p. 131).

Islam and Judaism are the Cultures of Religion into which the contributors delve in Unit III (chapters 11-12). Paige Robbins Elwafi shares her unique journey of conversion to Islam, resulting in a change in her worldview as well as in her status in society, as she moved from a majority culture member to an American minority. She outlines a helpful cross-cultural music therapy plan or guide for working with Muslim clients, providing general suggestions on the use of music therapy techniques, instrument choices and musical idioms “based on the client’s level of assimilation and ethnic/religious identity” (pp. 162-164).

Chapters in Unit IV relate to Cultures of Sexual Orientation and Gender. Chapter 13 describes cultures of lesbian, gay, bisexual, transgender, and questioning communities, while Chapter 14 highlights intersections of gender and culture in great detail. One of the important generational differences highlighted by authors Spencer Hardy and Annette WhitePleaux in chapter 13 is that very few LGBTQ individuals are raised in households with LGBTQ parents. Thus, unlike in many other cultures, history and cultural norms in the LGBTQ culture are not learned from an early age. Minority stress, excessive stress individuals from stigmatized groups experience as a result of the discrimination they face, may manifest for LGBTQ individuals as significant mental health problems, including increased suicidal ideation. In chapter 14 author Sandra Curtis brings to the forefront myths specific to music therapists and cites eight areas that more globally challenge men and women as myths, stereotypes and double standards: work, education,


leadership, male privilege, gender role socialization, body politics, human rights, and violence against women (pp. 209-216).

Unit V examines the unique cultures of survivorship (chapter 15) and disability (chapter 16). Chapter 15 authors Dawn McDougal Miller, Deforia Lane and Annette WhiteheadPleaux articulate additional terminology, such as what it means to be a survivor, “survivor syndrome,” posttraumatic growth, and traumatic events. While acknowledging the many types of survivors and that survivor cultures are “cross-cultural,” this chapter focuses on cancer survivorship. We are reminded that “as music therapists, we are partners/participants in the survival of our clients” (p. 233). The reader is drawn to several generalized areas of music and its function, along with examples in each: music descriptive of the cancer experience, music that advocates for survivorship, and healing, expressive or inspirational music.

Just as individuals who are survivors are also part of other cultures, so too are individuals with disabilities members of other cultures. Chapter 16’s author Marcia Humpal remarks that often how those with disabilities are treated depends on the view held by the dominant culture in which they live. She further reports that in the USA cross-disability rights activism emerged in the 1960’s, with the African-American Civil Rights and Women’s Rights movements. More definitions and distinctions are discussed. What is an impairment? What is a disability? Finally, according to the World Health Organization (WHO) and the World Bank, as of 2011, there are “over one billion people with disabilities in the world, making this the largest minority group on earth” (p. 238).

Chapters 17-20 in Unit VI are, according to the editors, “dedicated to practical solutions

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for use by music therapists to begin to bridge these cultural divides (p. xii).” Topics are minority educators, allies for social justice, culturally competent music therapy assessments, and technology and culturally competent music therapy practice.

Chapter 18, written by Leah Oswanski and Amy Donnenwerth, addresses what appears to be a very broad topic, “Allies for Social Justice.” However, they make a strong case that for music therapists there is an “imperative need for both individual and systemic ally development, personally and professionally, in order to serve our clients and communities in an ethical and empowered approach” (p. 259). They list critical attributes of allies, published by Bishop in 2002, that are easily translatable to music therapy clinical practice: Allies possess a sense of history and knowledge, an understanding of their own roots, a solid understanding of self and an absence of an ego-driven stance on matters, knowledge of social structure concepts and shared responsibilities, a sense of process and change, and a sense of connection with all other people. They accept struggle and have an accurate wisdom of their own influence and a mindfulness regarding their own process of learning. They view their own limitation with honesty, sincerity and no embarrassment. They understand the concept of standing with others rather than over others and that good intentions have no value if there is no action against oppression.

Selfishly, I was pleased to read mention of the AMTA Diversity Task Force, which I initiated during my time as AMTA President in 2010. The task force is an example of a systemic ally group, and its initial work paved the way for an ongoing focus in AMTA on diversity and multiculturalism, with the establishment of a standing committee of the same name.


While pointing out there is no endpoint in the path to becoming an effective ally, their description of Bennett’s Developmental Model of Intercultural Sensitivity includes six stages, denial, defense, minimization, acceptance, adaptation and integration. The model is helpful and relevant to both dominant and nondominant group members in guiding us from ethnocentric to ethnorelative worldviews.

Annette Whitehead-Pleaux, Stephanie Brink and Xueli Tan present a Cultural Paradigm in chapter 19 to illustrate the hierarchy from most global cultural factors to the individual client and lay out a circle of culture types surrounding a client that may influence identity. They propose that throughout the music therapy assessment process we expand our exploration into culture(s) of heritage; culture(s) or religion; socio-economic culture(s); generational culture(s); culture(s) of gender, identity and orientation; culture(s) of location; culture(s) of disability; survivor culture(s); and culture(s) of identification. Sample questions are provided as starting points. And, as in previous chapters, we are provided with descriptions and definitions, in this case, as to what is “cultural competence” and what is “multiculturalism.”

Sandra Curtis states that music therapists have a responsibility to ensure a gender- and culturally-sensitive practice for all our clients. This “requires change that involves both actions and attitudes” (p. 219). If we are open to the work and experience, this book may help each reader in a journey to become more culturally competent. The Conclusion is a call to action for individual music therapists and our profession as a whole. This volume is a “must-read” for any music therapist or intern. Chapters 1-3, as well as

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16, 18, and 19 should be required for anyone in our profession. The first three chapters lead to a better understanding of the many complex layers of discrimination and oppression and the vocabulary used to describe these systems. Chapter 16 provides much valuable history and information related to the culture of disability, and almost every music therapist at some time works with individuals with some sort of disability. Chapter 18 affirms that the “development and practice of an ally is not optional as a music therapist, but an ethical requirement” (p. 258), and chapter 19 offers numerous significant assessment questions to make our music therapy assessment process more “culturally competent.” Contributors offer a myriad of references and resources, including articles, books and websites. Several glossaries and lists of holidays, life cycle events and customs are usefully included in appendices throughout the book. Anyone


wishing to research additional cultures could utilize the framework of common, crucial themes the editors have devised to help in their investigations.

It is not necessary to read the book all in one sitting. Rather, one can go back to it again and again, as the need arises, particularly when embarking on work with someone whose culture or cultures are not the same as the therapist’s dominant culture(s). Revisiting the book’s contents would also be beneficial as one moves through different stages of Bennett’s Developmental Model of Intercultural Sensitivity (pp. 262-264), ever striving to reach the final stage of integration, where “a music therapist is truly multicultural, moving in and out of different cultural experiences comfortably with clients while still being their authentic selves.” The book would be a very important addition to personal and organizational music therapy libraries alike.

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Working with goals in psychotherapy and counseling Edited by Mick Cooper & Duncan Law

Oxford University Press, Oxford, United Kingdom ISBN 9780198793687 (215 pages)

Reviewer: Annie Heiderscheit, Ph.D., MT-BC, LMFT

Associate Professor and Director of Music Therapy at Augsburg University Minneapolis, Minnesota, United States

Goals and objectives are a necessary aspect of clinical practice in music therapy, not only to evaluate the progress clients make during the therapeutic process, but are also documentation required by third party payers. While goals and objectives are required for prior authorization and reimbursement of services, they can also serve a variety of other functions in the psychotherapy and counseling process. This new text, while focused in psychotherapy and counseling practices, provide valuable information for music therapists working with clients in various settings.

The introduction of the book provides a clear rationale for the book and operational definitions of the terms to give the reader an understanding of how they are using terminology. The editors provide a balanced perspective as they explore the benefits, challenges, and limitations in working with goals in the psychotherapy and counseling. Copper and Law also provide an overview of the development of working with goals. They support this information with brief case vignettes that illustrate the points they are addressing. These vignettes help to demonstrate how the


client and therapist work collaboratively in identifying and developing the goals and objectives for the therapeutic process. The key aims of the book focus on addressing the different ways goals can be used in therapy, what kinds of goals may be most helpful in the therapeutic process, the best methods and practices for setting goals, and how different orientations view working with goals in therapy. Chapter 2 focuses on the philosophical, conceptual, and ethical perspectives on working with goals in therapy. For example, in some clinical settings therapeutic goals are a part of a formal therapy contract, while in other settings the goals of therapy may emerge in the process. The manner in which a therapist approaches incorporating goals in the therapeutic process is based on how they view and understand human behavior, which is informed by their theoretical orientation. This also determines whether the clinician employs a formal or informal approach with goals in the therapeutic process. The case vignettes included in this chapter help to explore how theoretical orientation informs and im-

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pacts the process. They also explore how talking with the client about goals can help them connect therapy to their everyday life and can serve as an entry point into therapy and a point of connection for the client. They discuss the benefit of co-constructing therapeutic goals with the client and how this can empower and foster a client’s investment in their therapeutic process. Ethical and value dilemmas are also discussed, as a clinician and client may have differing perspectives and values that may create conflict in developing goals. There are important points presented for clinicians to consider when they encounter these dilemmas and case vignettes also illustrate how to work through these issues. Lastly, the lived experience of setting goals in therapy is studied, as a way of helping clients explore this practice for their life outside of therapy.

Chapter 3 addresses the psychology of goals and the research surrounding the use of goals in therapy. The research on goals has been growing since the 1980’s and has explored several areas addressed in therapy. This evidence provides a way of grounding a clinician’s practice. The research surrounding this topic focus on the following: client’s awareness, client’s affective when goals are perceived as attainable, progress toward goals enhances well-being, rate of progress impacts positive affect, and that clients feel good when they achieve their goals. This evidence indicates that a process of actualization of goals holds a variety of benefits for clients. The evidence also indicates that the benefits are dependent upon the type of goals. These goals include: interpersonal, career, coping with problems or symptoms, personal growth, wellbeing, and existential and functional issues. The importance of the goal to the client is a key element in this process as well. Therefore, it is important for the clinician to unders-


tand the level of knowledge and skill needed for the client to attain the goal and help the client develop these skills. The authors also address developing approach oriented goals rather than avoidance goals. Approach goals focus on a positive and desirable outcome, rather than a focus on the negative state. Lastly, understanding the intrinsic or extrinsic nature of the goal, as intrinsic goals tend to lead to positive outcomes. The chapter explores how helping the client develop a conscious awareness of their power of choice greater impacts ability to attain their therapeutic goals. The case vignettes in this chapter further illustrate the implications of the development of goals in therapy and their impact on clients.

In Chapter 4, the focus is on the lived experience of using goals in therapy. This includes exploring the importance and challenges of setting goals, helping clients determine their goals for therapy, and disagreement about and resistance to setting goals. Each of these focus areas include clinical vignettes to illustrate how this may appear in practice and how to work through each of these issues. The authors also discuss the risks of setting unattainable and unsafe goals and include client insights on these topics as well. An open talk model is also included in the chapter to provide clinicians with an example of how to approach addressing goals with clients.

Chapter 5 explores goals in psychotherapy and how they related to clinical outcomes of therapy. In therapy, clients may have personal goals that differ from goals addressing clinical outcomes. In order to ensure that a client’s personal goals and clinical outcomes are determined, the therapist and client must work collaboratively in setting goals to meet per-

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sonal and overall treatment goals. This helps to meet the personal desires of the client, support their motivation for therapy, and connect their personal progress to desired clinical outcomes. Sections in this chapter focus on setting goals collaboratively with clients of various ages and discusses different considerations for therapists relating to child, adolescent, and adult clients.

Measuring outcomes using goals is the focus of Chapter 6. While goals are often the way in which therapeutic outcomes are tracked and evaluated, this chapter explores the use of standardized problem-based measures and the challenges and benefits of these types of measures. Psychometric tools that focus on symptomology can provide concrete evidence of progress, it does not provide a holistic view of a client’s progress in therapy. As a result, a therapist may need to consider multiple ways to track and measure outcomes to provide an effective evaluative process for client progress. Chapter 6 also includes an appendix that lists eight goal-based measures for use with adults and children. A description of each measure is included, as well as directions for administering, scoring and the psychometric properties. The overview and information of each measure provides sufficient data for clinicians to determine appropriate use in their practice.

Chapter 7 addresses a shift from problems to goals in therapy and Identifying good goals in psychotherapy and counseling. While the goals of psychotherapy are often to alleviate suffering and foster growth and development, these goals general refer to the absence and presence of a psychological state, but lack specificity. While a client seeks therapy to address a problem, it is important as a therapist to understand the problem and help the client understand the problem(s)


they are seeking help for. When this has been determined, the next step is working collaboratively to determine the goals for the therapeutic process. This chapter also includes case vignettes illustrating how clients enter therapy, present a problem, and how the therapist works to understand the problem, help the client understand the problem, and then works with the client to determine the goals for therapy. The cases illustrate some of the challenges that may arise in the process, and how to work through these issues with the client.

In Chapter 8, the focus is on the application of goals and goal setting in a goal-oriented therapeutic practice. A goal oriented practice requires the therapist to understand the presenting problem through diagnosis and formulation, and to recognize that this goal orientated focus shifts therapy from understanding to change. While a therapeutic goal does not dictate a specific therapeutic orientation, it does give direction and focus for therapy. Delineating therapeutic goals can help actively engage the client in the therapeutic process and focus their motivation. Goals can help keep clients focused in therapy and support conversations about lack of progress, and determining therapy completion and termination. Case examples explore several issues pertinent to a goal-oriented practice, such as understanding external contextual issues, developing therapeutic alliance, and assessing client readiness.

Chapter 9 addressed goal oriented practice across therapeutic orientations, including cognitive behavioral therapy, psychoanalytic psychotherapy, systemic family therapy, interpersonal psychotherapy, humanistic and existential therapy, and online therapy. An overview and description of each therapeutic orientation provided, the process of deter-

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mining, setting, and utilizing goals as a part of the specific therapeutic process. Additional resources and references are provided for each orientation as well.

The conclusion in Chapter 10 is brief. The authors explore the analogy of therapy as a journey. Viewing the client as the traveler, the therapist needs to understand what the client wants from the journey and where they want to go. A therapist’s theoretical orientation and the client’s motivation related to their goal(s) will determine the scope of discovery, exploration and achievement of the therapeutic goals. The process of the journey requires the therapist to know the client, to determine the pacing and interventions that will be most helpful, and work collaboratively with the client throughout the process.

Overall, Working with goals in psychotherapy and counseling, provides a thorough review and analysis of utilizing goals in the therapeutic process. The text brings a wide lens regarding therapeutic orientation, allowing the reader to explore and examine how to work


with goals from various therapeutic standpoints. Additionally, many considerations are introduced when considering a goal-oriented practice. The authors give a balanced perspective evaluating the benefits and challenges of working the goals in therapy. The case vignettes throughout the book further illustrate in real clinical examples how to approach and work through various aspects of the therapeutic process surrounding goals. The cases include clients of various ages ranges from adults, adolescents, children, and families.

The text is focused on psychotherapy and counseling, which may not apply to all clinical settings in which music therapists work. The material in this text is geared toward therapists working with clients that are able to engage in dialogue with the therapist and to work collaboratively with the therapist in identifying and determining their personal goals for therapy. For clinicians working to third party payers for reimbursement for services, this text may prove helpful to work more effectively with setting and tracking progress with goals in therapeutic practice.

Conference Report


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15th World Congress of Music Therapy: Conference Report Annie Heiderscheit, Ph.D., MT-BC, LMFT


The World Federation of Music Therapy (WFMT) has been cohosting the World Congress of Music Therapy with music therapy associations from around the world since the first congress was held in Paris, France in 1974. Congresses are held every three years and they strive to foster the development of music therapy as a profession and support the international exchange of information. Co-hosting the world congress is a key component of the vision and mission of the WFMT (Heiderscheit, Kern, Clements-Cortes, Gadberry, Milford, & Spivey, 2015). July 4-8, 2017, the 15th World Congress of Music Therapy was held in Tsukuba, Japan at the International Congress Center. The theme for the congress was, ‘Moving forward with music therapy-inspiring the next generation’. The Japanese Music Therapy Association co-hosted the congress in partnership with the WFMT. Michiko Kato served as the congress organizer, overseeing the congress planning with, and between, the JMTA and the WFMT.

The WCMT offers opportunities for current research to be shared and points for view shared from researchers and clinicians around the world, exploration of contemporary clinical applications and strategies utilized in diffe-


rent regions of the world, time to network and connect with colleagues regarding clinical practice and research, and to experience and explore the culture of the host country through music and various cultural events. The WCMT also offers opportunities and experiences for students as well. Students can engage in the WFMT Assembly of Delegates, present and attend at the student poster session, engage in multicultural jam sessions, connect with international internship sites, and learn about music therapy in various countries and cultures (Mercadal-Brotons, Clements-Cortes, Tague, & Heiderscheit, 2017).

Over 2,900 delegates attended the 15th WCMT, representing 48 countries. Additionally, nearly 400 citizens from Tsukuba City and the surrounding area attended public lectures that were made available to the public free of charge. Over the five days, the congress was comprised of 506 concurrent presentations, 246 oral communications, 168 posters, 53 workshops, 16 symposiums, 23 round tables and 4 spotlight sessions. In addition to the various congress sessions, there were cultural programs and experiences for congress participants to take part in. These included experiences like Taiko drumming, traditional tea ceremony, and flower arranging.

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Pre-congress Seminars and Events

Eight pre-congress seminars were offered prior to the official start of the world congress. The pre-congress seminars provide opportunities for participants to choose to engage in additional learning experiences prior to the official start of the congress. The sessions offered on July 4th focused on topics unique to the host country and relevant to the current clinical practice needs. These seminars included the following:

1. It all begins with the music: Developing your clinical skills through the concepts of Neurologic Music Therapy: Presented by Sara Johnson (USA) This seminar focused on the creative and musical drive of music and music therapy, and developing interventions based on scientific, therapeutic, and musical logic ba-sed on research in neurologic, physiological, and cognitive processes in music perception of Neurologic Music Therapy (NMT). The seminar included video examples and live demonstrations from the presenter’s clinical work in NMT, to illustrate the wide range of possibilities of working within NMT.

2. Let’s play on traditional Japanese drums! Basic skills and adaptation for music therapy: Presented by Michiko Kato and Natsuko yasujima (Japan) This workshop was an introduction to the traditional Japanese instruments utilized in Taiko drumming. The presenters provided an introduction to the basic skills need for this type of drumming and the importance of the use the body and voice. Attendees had the opportunity to play on different types of Japanese drums and to learn how to construct a short performance which could be adapted for different music therapy sites.


3. Mindfulness based music therapy and Buddhism meditation: Dialogue of Regulative Music Therapy and ZEN: Presented by Naoko Moridaira and Issho Fujitsu (Japan) The seminar focused on mindfulness, a technique now widely utilized in psychotherapy practice. It has its root in Buddhist meditation and is significantly influenced by the philosophy and the method of Buddhism. Additionally, Regulative Music Therapy (RMT) was developed in East Germany in 1970s, this approached focused on creating a mindfulness experience through listening to music. This hands-on workshop focused on learning the basic theory and clinical adaptations for mindfulness meditation and RMT.

4. How music helps: in music therapy and everyday life: Exploring the ‘how?’ of music’s help at micro, meso, and macro levels: Presented by Gary Andsell (UK) This seminar explored the concept of a ‘joined-up music therapy’ that links micro and macro contexts through the idea of the ‘meso’ level of working. This draws from Nordoff- Robbins Community Music Therapy traditions, and ‘commonsense’ theory, exploring how music helps in everyday life and mobilizing music’s ability to help.

5. Music therapy and palliative care for pediatric cancer patients and their families: Presented by Sheri Robb (USA) The focus of this seminar was on palliative care, which is a comprehensive system of care that provides comfort, pain and symptom management, and psychosocial support to patients and families with potentially life-threatening or chronic illnesses. Participants learned how music therapy is being used to address psychosocial and symptom management needs of children

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and adolescents with cancer and their families. Video case examples and research findings, were utilized to explore underlying theory, clinical processes, and outcomes. Therapeutic music video intervention utilizing songwriting/video production to improve positive health in adolescents/young adults during high risk cancer treatment was presented along with active music engagement intervention incorporating music-play to help young children and parents manage distress and improve health outcomes.

6. Music therapy based on Usagawa Theory for children with developmental disabilities: A systematic approach developed in Japan: Presented by Kenji Tsuchino (Japan) This seminar provided an introduction and overview of Usagawa Theory, developed Japanese developmental clinical psychologist, Dr. Hiroshi Usagawa. He established this theory that focused on “higher performance in sensory processing and movement”, which has had an enormous impact on music therapy practice for children with disabilities in Japan. Focus on assessment, goals, programs, and evaluation utilizing Usagawa Theory were presented and video clips of sessions further addressed developmental perspectives in music therapy.

7. First sounds: Rhythm, Breath & Lullaby NICU music therapy training: Presented by Joanne Loewy and colleagues (USA) This seminar educated participants on the intra-uterine sound environment which fosters a wordless and amorphous memory trace in the infant and is the template for all future rhythmic responses. Understanding this lifelong sound and rhythmic symbolic image of security, can allow clinician to provide continuity between intra- and extra-uterine worlds. The seminar


presented a range of philosophical and theoretical stances that frame the application of music in the NICU and Special Care Nurseries. Rhythm, Breath, and Lullaby (RBL) utilizes live music making between infants and their caregiver and is informed by theories of healthy dyadic, triadic, and neuropsychological development, and culturally informed applications. The interventions demonstrated encouraged and supported caregiver-infant bonding process and offer a means of coping.

8. The Bridge: from Student to Music Therapist: Presented by Amy Clements-Cortes (Canada) and Katrina McFerran (Australia) This seminar was designed specifically for students to explore the transition from school to professional practice. The presenters explored the many paths available to pursue in the field of music therapy. Topics for the seminar included: internship, education/training and research, professional advocacy, creating proposals, professional writing, and integrating research and evidence into clinical practice.

Congress Spotlight Sessions

Each day of the world congress is launched with a spotlight session. Each spotlight session is developed around an emerging or important topic relevant to the profession of music therapy. Additionally, each session includes presenters who are experts in the content area and represent music therapy from regions throughout the world. Each spotlight session is moderated by a member of the WFMT Council, with each speaker sharing their unique perspective and expertise.

Spotlight session one was entitled, ‘Music therapy and well-being of older adults’. The session was moderated by WFMT President,

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Amy Clements-Cortes (Canada) and focused on issues related to aging populations around the world. Healthcare organizations and government agencies are exploring various ways to address issues related to aging. Each speaker presented on the current situation in their respective country and reported on their unique perspectives and experiences regarding music therapy and well-being for older adults. Presenters for this spotlight session included: Imogen Clark (Australia), Hanna Mette Ochsner Ridder (Denmark), Mayu Kondo (Japan), and Karyn Stuart (South Africa).

Ridder presented on the use of music to foster interaction and wellbeing for clients with dementia and their caregivers. She explored the unique role music plays in enhancing the relationship with caregiver and client and how caregivers under estimate their ability and the impact in utilizing this attuned musical interaction. Clark discussed healthy aging policies in Australia and how music therapy is being utilized to meet to the needs of clients with dementia and cardiovascular disease. Kondo presented the state of care for the aging in Japan and how music therapy groups are being integrated community settings, care setting, and hospitals. Stuart presented a pilot study she conducted with clients and their caregivers during morning care routines.

Spotlight session two addressed, ‘Music therapy and trauma work. The incidence of disasters, wars, acts of violence, and abuse across the world continues to escalate each year. As a result, music therapists are observing an increase in the comorbidity of trauma with clients with various other diagnoses. Therefore, more than ever before it is important for music therapists to be trauma-informed and to understand research outcomes from the neurobiology of trauma literature. The spea-


kers shared concepts, protocols, research, and their experiences related to various stages of responding to trauma including disaster preparedness. The session was moderated by WFMT Global Crisis Commission Chair, Gene Ann Behrens (USA) and presenters included: Elizabeth Coombes (UK), Barbara Else (USA), Mireya Gonzales (Chile), and Sanae Hori (Japan).

Coombes presented on a project she conducted in Palestine training local staff to facilitate music groups with children to support development of healthy coping skills and resilience. Else shared the process and disaster response efforts of the American Music Therapy Association. Gonzalez discussed how music therapy is being implemented in burn rehabilitation centers in Chile. She identified the various ways music therapy methods support the unique patient care needs during burn rehabilitation. Hori presented on the 1995 Great Hanshin-Awaji Earthquake, through personal accounts she explored the impact of this natural disaster. She explored the variety of patient needs that emerge as a result from a natural disaster.

Spotlight session focused on ‘Research of Music Therapy: Evidence and Story’ and how music therapy continues to develop and advance as a profession through clinical and evidence based research. While music therapy research is conducted around the world, dissemination can be limited and impeded due to language and translation difficulties. The presenters addressed the latest trends and developments in music therapy research. The moderator for the session was WFMT Research and Publications Commissions Chair, Melissa Mercadal-Brotons (Spain) and presenters included: Hyun Ju Chong (South Korea), Jaakko Erkkilä (Finland), and Katrina McFerran (Australia).

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Chong presented her research on the use of keyboard playing in the treatment of forearm rehabilitation and discussed the importance of research evidence and patient narratives to present the impact of the intervention. Erkkilä discussed his research with clients struggling with anxiety and depression. He presented the use and potential of improvisation as a viable and safe treatment and the need for structure to in the process. McFerran encouraged and challenged music therapy researchers to conduct rigorous qualitative studies. She also focused on providing a critique and exploring the limitations of quantitative and evidence based research.

Spotlight session four addressed ‘Music in music therapy and the cultural context’, exploring how music varies from culture to culture and how the selection of music is an important consideration in the music therapy process. The presenters explored the importance of the cultural context from their own culture and how this impacts therapeutic process. The Moderator WFMT Past President Annie Heiderscheit and presenters included: Sunelle Fouché (South Africa), Rika Ikuno-yamamoto (Japan), and Brynulf Stige (Norway).

Fouché is the co-founder and executive director of MusicWorks, a non-profit organization in South Africa that provides services in marginalized communities. She discussed the challenges and complexities in working within a culturally diverse community. She encouraged music therapists to honor and value cultural differences and focus commonalities and a shared humanity. Beer focused on developing a reflective practice around the use of music from other cultures and shared examples from her own experiences with music from other cultures. She encouraged educators to integrate discussions on this topics with students and to provide


opportunities for the to engage with clinicians from other cultures. Ikuno-yamamoto presented the variety of genres of music utilized in modern Japanese daily life. She provided an overview of the changing musical landscape in Japan over the past 200 years. Stige spoke about health as a universal human right and how it is also informed and situated with culture. He encouraged and recommended that clinicians and researchers discuss the pros and cons of current medical and social models of practice in healthcare. Additionally, he suggested great exploration of ‘health musicking’ as a means of foster health and wellbeing.

At the conclusion of each spotlight session there was time for questions from participants to be addressed by the speakers. This Q & A time allowed congress participants to foster further exploration through their questions. Questions explored during this time represented some the unique challenges that music therapy clinicians and researchers encounter in their respective part of the world, as well as a desire to connect and seek out information from colleagues with diverse experiences.

Congress proceedings and congress reports

The World Federation of Music Therapy publishes Music Therapy Today. The 2017 issue of the journal includes the proceedings of the 15th World Congress of Music Therapy (WCMT). Volume 13, Issue 1 of this online journal includes 287 contributions from the music therapists, educators, researchers, and allied health care professionals that presented at the congress. The abstracts included in this issue of the journal represent all eight global regions of the WFMT. All the presenters whose papers were accepted to be presented at the WCMT were invited to submit a short paper about their presenta-

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tions. The special issue of Proceedings of the World Congress of Music Therapy is available on the World Federation of Music Therapy website and available for public access.

Disseminating information about the world congresses serves many important functions. While many music therapists attend the WCMT every three years, many are not able to make the journey across the world for the event. Congress proceedings and reports provide not serve as archival evidence, but help to inform those that are unable to attend. Boom (2017) published, Conference report: 15th World Congress of Music Therapy in Approaches: An Interdisciplinary Journal of Music Therapy. Congress highlights

Throughout the world congress there are many events and experiences to help participants experience the culture and music of the hosting country and the clinical practice of music therapy. During the congress participants meet clinicians from all over the world, build new friendships and professional collaborations. There are also opportunities to honor the work and service of music the-rapy colleagues. The WFMT accepts nominations for the various awards that are given to outstanding members of the international music therapy community during the world congress. At the 15th World Congress Barbara Wheeler (USA) was awarded the Lifetime Achievement Award, Joanne Loewy was bestowed with the Clinical Impact Award, Felicity Baker was awarded the Research and Special Projects Award, Alexia Quin was given the Advocate of Music Therapy Award, and Jen Spivey was awarded the Service Award for her many years of service to the WFMT.


The WFMT Council holds meetings throughout the congress to do the work of the organization. During each world congress the new elected council is announced. During the closing session at the congress the new WFMT President is announced. Melissa MercadalBrotons (Spain) was elected President for the 2017-2020 term. The entire 2017-2020 WFMT Council was introduced at the congress and a complete listing of the council is available at (WFMT, 2017).

While the WCMT provides opportunities for participants to engage in shared experiences, each participant has their own unique experience as well. While this congress report provides an overview of the congress, readers are encouraged to talk with colleagues that have attended to understand the close up, personal, and unique professional experience of the world congress. Each WCMT offers a variety of unique musical and cultural experiences, as well a plethora of opportunities to support knowledge and clinical development. Future Congresses

The World Federation of Music Therapy Council meets during each WCMT. One of the tasks for the council during this time is to review congress proposal bids for future world congresses. The WFMT reviews bid proposals and meets with organizational representatives that the developed the bids. The WFMT Council then discusses the bid proposals and votes on the next congress location. At the 15th WCMT in Tsukuba, Japan, the WFMT Council reviewed bids for the 2020 and 2023 congresses. The WFMT Past President then announces at the closing session of the congress the location of the next world congress. At the closing session in Tsukuba, it was announced that the 2020

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WCMT will be held in South Africa and in 2023 it will be held in Melbourne, Australia.


Boom, K. (2017). Conference report: “15th World Congress of Music Therapy ‘Moving forward with music therapy’”. Approaches: An Interdisciplinary Journal of Music Therapy, First View (Advance online publication), 1-6. Heiderscheit, A., Kern, P., Clements-Cortes, A., Gadberry, A., Milford, J. & Spivey, J. (2015). Advancing the World Federation of Music Therapy (WFMT) organization: Strategic planning process. Music Therapy Today, 11(2), 23-39.

Mercadal-Brotons, M., & Clements-Cortes, A. (Eds.). (2017). Proceedings of the 15th World Congress of Music Therapy. Special Issue of Music Therapy Today 13(1). Retrieved from proceedings/pdf/WFMT-Vol.13-1.pdf. Mercadal-Brotons, M., Gadberry, A., ClementsCortes, A., Tague, D. & Heiderscheit, A. (2017). Music Therapy World Congresses: A Unique Opportunity to Grow and Share. Presentation presented at the 2017 American Music Therapy Association Conference in St. Louis, MO. World Federation of Music Therapy (2017). Leadership: WFMT Council 2017-2020. Retrieved April 30, 2018.

Photograph of WCMT 2018 delegates gathered for a group photo (Photo used with permission of the Japanese Music Therapy Association).


Music Therapy Today WFMT online journal Volume 14, No. 1  
Music Therapy Today WFMT online journal Volume 14, No. 1