Evaluating music therapy: Considering value, benefit and impact

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1 Evaluating music therapy: Considering value, benefit and impact 1 The 2 nd Nordoff Robbins Plus Conference Evaluating music therapy: Considering value, benefit and impact Tuesday 9 th June 2015 Nordoff Robbins London Centre 2 Lissenden Gardens, London NW5 1PQ Editors: Neta Spiro Camilla Farrant Giorgos Tsiris Charlotte Cripps Mercédès Pavlicevic

2 2 Evaluating music therapy: Considering value, benefit and impact The 2 nd Nordoff Robbins Plus Research Conference Evaluating music therapy: Considering value, benefit and impact 9 th June 2015, Nordoff Robbins London Centre, United Kingdom The 2 nd Nordoff Robbins Plus Research Conference is a collaboration between Nordoff Robbins Research Department and Barchester Healthcare. Conference committee members: Mercédès Pavlicevic, Neta Spiro, Giorgos Tsiris, Camilla Farrant, Sarah Boyce, Charlotte Cripps Copyright Nordoff Robbins 2015 All Rights Reserved. No part of this document may be reproduced without written consent from the Nordoff Robbins Research Department. Creative Commons Attribution Non-Commercial No Derivatives 3.0 Unported Nordoff Robbins Research Department 2 Lissenden Gardens, NW5 1PQ, London, United Kingdom Tel: +44 (0) research@nordoff-robbins.org.uk Web: Suggested citation: Spiro, N., Farrant, C., Tsiris, G., Cripps., C., & Pavlicevic, M. (Eds.). (2015). Evaluating music therapy: Considering value, benefit and impact (The 2 nd Nordoff Robbins Plus Research Conference, 9 th June 2015). London: Nordoff Robbins.

3 Evaluating music therapy: Considering value, benefit and impact 3 CONTENTS TIMETABLE... 5 WELCOME & INTRODUCTIONS A note by Julie Whelan, CEO of Nordoff Robbins. 8 The Nordoff Robbins Plus Research Conference Series. 8 Introduction to Nordoff Robbins Research. 9 Introduction to the Conference ABSTRACTS KEYNOTE Lost in translation: The problem with music therapy evaluation (Stuart Wood).. 12 RESPONSE TO KEYNOTE: Lost in translation (Trish Morris-Thompson) PRESENTATION 1 Delivering music therapy, evaluating services and valuing partnerships: What matters and whose priorities? (Oksana Zharinova-Sanderson, Giorgos Tsiris and Mercédès Pavlicevic) 14 PRESENTATION 2 Evaluating music and arts in healthcare: Reflections from the field (Norma Daykin). 15 PRESENTATION 3 Making sense of complex interventions and their evaluation (Martin Orrell) THEME A: APPROACHES TO ASSESSMENT [Posters 1-5] POSTER 1 Child musical development and music therapy assessment: Designing an assessment procedure for children with developmental disorders (Patricia Sabbatella and Paola Lazo) 18 POSTER 2 The Music Therapy Outcomes Star (Jackie Lindeck).. 20 POSTER 3 The impact of trauma on musical engagement and preferences: Data from a large internet study (David M. Greenberg and Peter J. Rentfrow).. 21 POSTER 4 Musical indicators of awareness of children with severe and profound intellectual disabilities (Sara Knapik-Szweda).. 22 POSTER 5 Music in recovery from paediatric surgery: Can music reduce post-operative pain and anxiety? (Suzanne Capps, Solveig Baltzer Nielsen, Lauren Stewart and Daisy Fancourt)... 24

4 4 Evaluating music therapy: Considering value, benefit and impact THEME B: EVALUATION OF SERVICES AND PROJECTS [Posters 6-12] POSTER 6 An evaluation project of music therapy at St Christopher s hospice (Giorgos Tsiris, Tamsin Dives and Gerry Prince) POSTER 7 Evaluating the music therapy service in a neuro-rehab day centre for adults (Naomi Lander). 29 POSTER 8 Music, arts and death education: The St Christopher s health promotion project (Giorgos Tsiris, Marion Tasker, Virginia Lawson, Gerry Prince, Tamsin Dives, Mick Sands and Andrew Ridley) POSTER 9 An evaluation of group music therapy as a non-pharmacological intervention in dementia care (Sachiko Richerby). 32 POSTER 10 A music therapy provision for teenagers with cancer (Jimmy Lyons). 33 POSTER 11 MUSIC MAKERS Collaborative transition project: Hampshire Music Service & Key Changes Music Therapy (Debbie Mellors and Diane Byrne) 34 POSTER 12 Navigating space: Using music therapy well in a children's hospital (Veronica Austin and Stephen Sandford). 35 THEME C: COLLABORATION AND NEW PROSPECTS [Posters 13-17] POSTER 13 The challenges and benefits of a genuine partnership between music therapy and neuroscience (Lauren Stewart, Wendy Magee and Candida Godbold) 38 POSTER 14 A different approach to focus groups: How can we include the voices of children with severe communication difficulties? (Emma Maclean) POSTER 15 Community music in the digital age: Transitions in technology use (Mao Mao, Alan F. Blackwell and David A. Good) POSTER 16 Can specialised digital musical instruments aid stroke rehabilitation? (Pedro Kirk) POSTER 17 Why people sing together: Choral experiences in a virtual choir (Anna Snowman) LIST OF DELEGATES 45

5 Evaluating music therapy: Considering value, benefit and impact 5 TIMETABLE 9:15 Registration & Tea and coffee 9:45 Introductory remarks 10:00 Keynote presentation Lost in translation: The problem with music therapy evaluation Stuart Wood 10:45 Response to keynote Lost in translation Trish Morris-Thompson 11:15 Coffee break 11:45 Delivering music therapy, evaluating services and valuing partnerships: what matters and whose priorities? Oksana Zharinova-Sanderson, Giorgos Tsiris & Mercédès Pavlicevic 12:30 Any questions 12:45 Lunch and poster session 14:00 Evaluating music and arts in healthcare: Reflections from the field Norma Daykin Making sense of complex interventions and their evaluation Martin Orrell 15:35 Any answers Panel discussion 16:15 Close

6 6 Evaluating music therapy: Considering value, benefit and impact

7 Evaluating music therapy: Considering value, benefit and impact 7 WELCOME & INTRODUCTIONS

8 8 Evaluating music therapy: Considering value, benefit and impact A note from Julie Whelan, CEO of Nordoff Robbins A very warm welcome on behalf of the Nordoff Robbins trustees and colleagues to the Nordoff Robbins Plus Conference With our sister organisation Nordoff Robbins Scotland, our goal is to bring music s transforming power to as many children and adults in the UK as possible, through the delivery of music therapy services, the training of skilled practitioners, and research to demonstrate and enrich our work. This conference, which is shared with Barchester Healthcare, signals Nordoff Robbins commitment to engaging in collaborative dialogues across sectors, academic disciplines and research institutions. We hope that this event in the Nordoff Robbins Plus series will broaden, test and enrich the work that we do throughout the UK to transform the lives of people of all ages through the power of music. Julie Whelan CEO of Nordoff Robbins The Nordoff Robbins Plus Research Conference Series After the success of the inaugural Nordoff Robbins Plus event in 2013, the series continues to invite collaboration among researchers, practitioners and institutions to explore music-centred topics. Nordoff Robbins Nordoff Robbins music therapy practitioners have worked in health, education, social care and community settings for over fifty years. Our research, Masters and PhD programmes attend closely to cross-disciplinary knowledge, and music therapy thrives on inter-disciplinary and inter-institutional collaboration. Plus This research conference series Nordoff Robbins Plus aims to provide shared platforms and forums for multi-disciplinary and cross-institutional thinking. It brings together leading researchers and practitioners in creative conversations that question traditional assumptions, and venture beyond familiar knowledge and methods. Prof Mercédès Pavlicevic Director of Research Dr Neta Spiro Conference Chair

9 Evaluating music therapy: Considering value, benefit and impact 9 Introduction to Nordoff Robbins Research Building on an established tradition of critical attentiveness to practice and theory, the Nordoff Robbins Research Department was formally established in An injection of funds from the Board of Trustees in 2006 helped Nordoff Robbins Research to grow to its present configuration. Research at Nordoff Robbins has focused on studying music therapy with music therapists, families, care workers and clients, and on developing cross-disciplinary and institutional collaborations in order to explore music in health and society. Current projects are clustered in four themes: musical interaction; music therapy methods and tools; music, society and culture; music therapy history and development. Nordoff Robbins Research provides research information for practitioners, and our monitoring and evaluation (M&E) projects evaluate services throughout the UK. The Nordoff Robbins Research and Education Departments instituted the UK s first MPhil / PhD programmes in Music Therapy and Music, Health, Society. More information can be found online at:

10 10 Evaluating music therapy: Considering value, benefit and impact Introduction to the Conference Welcome to the second research conference in the Nordoff Robbins Plus series. The conference, which focuses on evaluation in music therapy, is organised by the Research Department at Nordoff Robbins and Barchester Healthcare. Nordoff Robbins is delighted to bring together leading researchers and practitioners to consider, discuss and debate evaluation in and around music therapy. There is growing pressure to provide evidence of music therapy impact and benefit, and there are debates as to what methods are appropriate. In considering value, impact and benefit, this conference revisits the kinds of questions that need to be asked and answered when seeking to describe, understand, test and communicate about music therapy. Also up for debate is how goal-directed, outcome-focused evaluation approaches fit with the interactive, multi-faceted and creative basis for music therapy. In the spirit of the Nordoff Robbins Plus series, speakers and respondents from adjoining disciplines, together with poster presentations and panel discussions, will offer multi-disciplinary perspectives leading to robust discussions and debate. Our keynote speaker is Stuart Wood who trained as a music therapist at Nordoff Robbins and is a recent graduate of the Nordoff Robbins PhD programme. He is Head Music Therapist at Barchester Healthcare, where he manages 30 music therapy posts in nursing homes and psychiatric hospitals across the UK. The respondent to this keynote is Trish Morris-Thompson, Director of Quality and Clinical Governance at Barchester Healthcare whose talk will be followed by a series of speakers from a range of disciplines. We also have 17 posters that are grouped in 3 themes: Approaches to assessment; Evaluation of services and projects; Collaboration and new prospects. Many people use evaluation as a means of appraisal and feedback from the perspective of music therapy service providers. Another emerging area of interest is the evaluation of new approaches in an evolving technological age. A range of issues concerning which measuring tools should be utilised in various contexts are reflected in the conference abstracts: from the issue of client representation when evaluating, to the role, practicalities and desirability of replicable results in music therapy. During the conference we invite you to discuss and reflect on what broad research and evaluation questions would be useful both including and beyond the realm of service providing that we should perhaps consider when discussing value, impact and benefit. The research team would like to thank Ben Chad, Elizabeth Charlesworth, Sarah Cosby, Harriet Crawford, Nilton Dorigo, Meire Galvani, Laura Hattemore, Lucy Jackson, Arnold Johnson, Louisa Newby, Tanya Mehmet, Pauline Murphy, Steve Scott and our CEO Julie Whelan for their help in preparing this conference. I hope you enjoy your time here. Dr Neta Spiro Conference Chair

11 Evaluating music therapy: Considering value, benefit and impact 11 ABSTRACTS

12 12 Evaluating music therapy: Considering value, benefit and impact KEYNOTE 1 Lost in translation: The problem with music therapy evaluation Stuart Wood Barchester Healthcare This paper is a response to my experiences in music therapy practice where I have struggled to communicate the value of my work through standard evaluation formats. In particular, it reflects the challenges of evaluating music therapy in health and social care, where there is a diverse range of agendas, interests and discourses at play. At play also are concepts of outcome and impact, which take on different meanings within each discourse. Drawing on theories of performativity, ecology and community music therapy, this paper offers a case study of evaluation within a large UK healthcare company and music therapy charity. It asks how evaluation of music therapy is performed, what its networks of interest are like, and how they share information about music therapy within their systems. The paper suggests that all arts practitioners in healthcare settings face problems of translation: not only from aesthetic experience into language, but then from their own professional discourse into the proliferation of discourses that surround them. Biography Stuart Wood trained as a music therapist with Nordoff Robbins He is Head Music Therapist for Barchester Healthcare, managing music therapy services in 30 care settings, including nursing homes and psychiatric hospitals. His research interests include community music therapy, performativity, management studies and aesthetics. He gained his PhD with Nordoff Robbins / City University in January 2015.

13 Evaluating music therapy: Considering value, benefit and impact 13 RESPONSE TO KEYNOTE Response to Lost in translation Trish Morris-Thompson Barchester Healthcare Biography Professor Trish Morris-Thompson (RN RM MBA BA(Hons)) was appointed to the Board of Barchester Healthcare Limited as Director of Quality and Clinical Governance on the 1st April She has over 30 years experience working in the NHS, with over 12 years as an executive director. Trish s extensive experience was undertaken in London, East Midlands, West Midlands and South Australia before returning to London in She became Chief Nurse in NE London Strategic Health Authority from 2003 to 2006, before being appointed as Chief Nurse for NHS London in October In 2012, Bucks New University assigned her as Professor of nursing and midwifery leadership; the Royal College of Nursing awarded her a clinical fellowship for services to nursing and patient care that same year. In addition, she has been appointed Trustee to Shooting Star Chase Hospices in July 2013 and to the Florence Nightingale Foundation, where in 2011/12 she was a Florence Nightingale Foundation Burdett Scholar. A well-established author of articles for a range of professional publications, Director of the Woman of the Year, and founder of Britain s Nurses, Trish also has an honorary contract with Kingston NHS Trust to practice midwifery.

14 14 Evaluating music therapy: Considering value, benefit and impact PRESENTATION 1 Delivering music therapy, evaluating services and valuing partnerships: What matters and whose priorities? Oksana Zharinova-Sanderson, Giorgos Tsiris & Mercédès Pavlicevic Nordoff Robbins Establishing and sustaining the delivery of music therapy services with partner organisations that have differing as well as common values, agendas and funding criteria, requires close negotiation. Evaluation activities and reports need to speak to constituencies within both partners: clients and their families, therapists, multidisciplinary colleagues, managers and funders and at times, to the general public. This presentation considers the nature of 'professional music therapy information' in its different guises; from service contract agreements and delivery, evaluation activities, to funding and communications expectations. Each of these has distinctive priorities and discourses, which can range from evidence-based descriptions of music therapy work and its impact, to the kind of information that attracts funding and headline communications. All of these have implications for how to prepare, conduct and report on service evaluations. Through examples from our experiences in developing, providing, managing and evaluating music therapy services at Nordoff Robbins Music Therapy, we propose some anchors for developing and sustaining an evaluative ethos; collaborative attitudes that value a range of information media and formality, and that aim to be an aesthetic and systematic portrayal of the service delivered. While considering the collaborative ways of working with the multiple (and, at times, conflicting) agendas and values embedded in any kind of partnership, this presentation aims to illustrate the ways in which evaluation can be an integral part of service provision and development. Biographies Oksana Zharinova-Sanderson has worked as a music therapist in a variety of contexts in Germany and the UK, where she set up and established new music therapy projects. Since 2004 she has been heading Nordoff Robbins Music Services in the North West of England focusing on setting up, developing and promoting Nordoff Robbins services within this geographic area. Oksana is also a tutor and Placement Coordinator on the Nordoff Robbins MMT training programme. Giorgos Tsiris is a researcher at Nordoff Robbins. He also works as a music therapist with terminally ill adults and bereaved families and children at St Christopher s Hospice. He is the founding editor of Approaches: Music Therapy & Special Music Education. Mercédès Pavlicevic (PhD) is Director of Research at Nordoff Robbins, Research Associate at the School of Oriental and African Studies, University of London, and Associate Professor at the University of Pretoria, South Africa.

15 Evaluating music therapy: Considering value, benefit and impact 15 PRESENTATION 2 Evaluating music and arts in healthcare: Reflections from the field Norma Daykin University of the West of England There is an increasing awareness of the role of arts and music interventions and their value in contributing to health and social care priorities. The development of the evidence base is often stated as a critical priority for the emergent arts and health sector, especially in the context of austerity-led decision making. While there is no clear consensus about how to assess the value and impacts of arts on health and wellbeing, there is a strong desire within the sector to understand and improve evaluation approaches and methodologies. Not surprisingly, practitioners, drawn mainly from arts backgrounds and not from health or social sciences, sometimes report a lack of confidence relating to evaluation. They face a myriad of quantitative and qualitative approaches, underpinned by a complex range of underpinning theories that are reflected through the lenses of a wide range of disciplinary perspectives. They also report that arts perspectives are marginalised in evaluation discourse. This presentation reports insights and findings from the author s research and evaluation of a range of projects, including evaluation of music and music therapy in cancer care, mental health, youth justice, military and community settings. It also reports on outcomes from a long term collaboration with Willis Newson Arts Consultants. The most recent Knowledge Exchange project, Creative and Credible, ( seeks to strengthen practice led evaluation for the arts and health field by providing resources to support reflexive engagement with evaluation and commissioning agendas. There is no one size fits all approach to evaluation. Rather, we need to move towards a shared understanding that recognises the value and contribution of a range of methodologies within a complex, progressive, multidisciplinary research and evaluation programme. Biography Norma Daykin is an established social scientist who specialises in arts and health. Her PhD focused on young people s health and she has subsequently gone on to undertake research and evaluation in a wide range of applied health and policy contexts. Her award winning arts and health research has encompassed the role of participatory arts and music making in diverse settings including primary care, mental healthcare, dementia care, cancer services and youth justice. Her current work, funded by the ESRC, is a knowledge exchange project supporting best practice by providing tools and resources for evaluating the impact of participatory arts and music on health and wellbeing. In her research on arts and health practice Norma draws on her own experience as a musician and composer. She currently directs the Bristol Reggae Orchestra, an award winning community project that draws together musicians from diverse backgrounds to create, perform and celebrate new music. Norma is Professor Emerita of Arts in Health at UWE, Bristol; Visiting Professor at the Sidney De Haan Research Centre for Arts and Health; and RKE Fellow at the Centre for Research into the Arts as Wellbeing at the University of Winchester. She is a Fellow of the Royal Society of Public Health, having twice received the RSPH Award for Arts and Health Research, for her significant and innovative contribution to music and health research. She is co-executive editor of Arts and Health an International Journal of Research, Policy and Practice, published by Taylor and Francis.

16 16 Evaluating music therapy: Considering value, benefit and impact PRESENTATION 3 Making sense of complex interventions and their evaluation Martin Orrell University of Nottingham The new generation of psychosocial interventions for dementia has been characterised by great improvements in methodology and high quality randomised controlled trials (RCTs) including costeffectiveness analyses. Significant progress has been made with RCTs improving cognition (eg CST), activities of daily living, mood and behaviour. There is evidence on interventions that can help delay nursing home placement including counselling and support programmes for carers and people with dementia. The systematic reviews so far have concentrated on quantitative data derived from analyses of RCTs or other trials. This has enabled a considered assessment of the clinical effectiveness of interventions in relation to defined outcomes but has told us less about the general characteristics of successful interventions and the best context for them to operate within. Qualitative studies can provide an understanding of the various difficulties inherent in translating psychosocial interventions from RCTs into practice, and can also help identify the barriers to implementation and how to overcome them. Even for psychosocial interventions shown to be both clinically effective and cost effective, there are considerable obstacles to getting them into widespread practice. Many interventions have either no practice manual or one that is so poorly specified that the intervention cannot be reliably replicated in practice. Training may be hard to access or not widely available. The lead researchers may lose interest and move on to other projects, particularly if no resources for an implementation study are forthcoming. In contrast, drug companies devote very considerable resources not only to drug development and clinical trials, but also to publicise the study results, and to promote the use of the drugs in practice. However, whereas drugs have a daily cost, the expertise derived from manuals and training can be used on a whole series of patients. The new generation of psychosocial interventions, a number of which have been shown to be effective in practice, can often provide excellent value. However, there is a pressing need for further research to promote implementation in practice. The progress of psychosocial interventions in dementia care will be illustrated with a description of the development and implementation of CST in the context of the MRC Framework for complex interventions. Biography Professor Martin Orrell (FRCPsych, PhD) is Director of the Institute of Mental Health, University of Nottingham. Until February 2014 he was Professor of Ageing and Mental Health at University College London and Director of Research and Development at North East London Foundation Trust. He is a Visiting Professor at City University and Honorary Professor at the University of Liverpool. He is Chair of the Memory Services National Accreditation Panel (MSNAP) and a member of the Prime Ministers Challenge on Dementia Research Group. He holds 5 major dementia grants totalling 11 million on psychosocial interventions for dementia care and is co-applicant on a further 9 million. He has published over 200 academic papers. He is a Board member of both INTERDEM and the International Psychogeriatric Association. In 2014 he was elected President of the European Association of Geriatric Psychiatry. He is Editor of the journal Aging & Mental Health.

17 Evaluating music therapy: Considering value, benefit and impact 17 THEME A: APPROACHES TO ASSESSMENT [Posters 1-5]

18 18 Evaluating music therapy: Considering value, benefit and impact POSTER 1 Child musical development and music therapy assessment: Designing an assessment procedure for children with developmental disorders Patricia L. Sabbatella 1,2 and Paola K. Lazo 3 1 Music Therapy Department, University of Cádiz; 2 Instituto Politécnico do Porto; 3 Universidad del Salvador Background: Music therapy literature informs us that music-centred experiences are used in assessment procedures for screening children s developmental stages and for finding correspondences between musical and non-musical areas (Bruscia, 1987; Gainza, 1982; Grant, 1995; Lazo, 2005; Sabbatella, 2003, 2012; Sabbatella & Lazo, 2008; Wigram, 1995). The authors of this poster have designed a musical assessment procedure for children diagnosed with developmental disorders (aged 3-6 years-old), called the Music Therapy Assessment Protocol. Aims: This work describes theoretical and methodological details concerning the design of the Music Therapy Assessment Protocol. Methodological approach: Administration of the Individual Music Therapy Assessment Protocol involves the child and the music therapist taking part in active music making, based on the another assessment technique, called the Sound and Musical Experiences and Games (SoMEG) (Lazo, 2005). Data is collected by observing musical responses, using the Scale Psycho-Evolutionary Musical Skill's Observational Form (PEMuS) (Delalande, 1995; Winnicott, 1971); this indicates developmental stage through sensory-motor play to symbolic play (Piaget, 1964). Results and uses for data: Data interpretation informs us about: a) the child s levels of development in musical and non-musical areas; b) his/her potential in musical and non-musical domains, which helps towards outlining therapeutic interventions; c) describes musical developments in a situation of interactive music-making, based on sound-musical experiences and games (SoMEG). Results of the assessment are useful for outlining individual designs for Music Therapy treatment, as well as ongoing evaluation, and evaluating the efficacy of treatment. Conclusion: Results of Multiple Single-Case analysis show that the PEMuS and SoMEG seem to be appropriate for the assessment of children diagnosed with Developmental Disorders (aged 3-6 years old), when focused on sound-musical development in a music therapy context. References Bruscia, K. (1987). Improvisational Models of Music Therapy. Springfield, IL: Charles C Thomas. Delalande, F. (1995). La música es un juego de niños. Buenos Aires: Ricordi. Gainza, V. (1982). La Actividad Musical como Diagnóstico de Problemas. En Gainza, V.: Ocho Estudios de Psicopedagogía Musical. Buenos Aires: Paidos. Grant, R. (1995). Music Therapy Assessment for Developmentally Disabled Clients. In T. Wigram, B. Saperston & R. West (Eds.), The Art and Science of Music Therapy: A Handbook. The Netherlands: Harwood Academic Publishers. Lazo, P. (2005). El Juego sonoro-musical. Guía de observación musicoterapéutica en los problemas del desarrollo infantil. Tesis. Universidad del Salvador. Buenos Aires: No Publicado. Piaget, J. (1964). Seis estudios de psicología. Barcelona: Planeta-Agostini.

19 Evaluating music therapy: Considering value, benefit and impact 19 Sabbatella, P. (2003). La Evaluación en la Práctica Profesional de la Musicoterapia: Un Estudio Descriptivo en el Contexto Iberoamericano. Tesis Doctoral. Universidad de Cádiz. UMI. ISBN: ProQuest Digital Dissertations. Sabbatella, P. (2012). La Evaluación de Personas con Discapacidad en Musicoterapia: Orientaciones Teóricas y Metodológicas. En M. Brotons, & P. Martí (Coord.), Música, Musicoterapia y Discapacidad. Barcelona: Editorial Médica JIMMS. Sabbatella, P., & Lazo, K. (2008). Valoración Inicial en Musicoterapia Infantil. Actas II Congreso Nacional de Musicoterapia (Pág ). Asociación Aragonesa de Musicoterapia. Trehub, S. (2001). Musical Predispositions in Infancy. Annals New York Academy of Sciences, 930, 1-6. Wigram, T. (1995). A Model of Assessment and Differential Diagnosis of Handicap in Children through the medium of Music Therapy. In T. Wigram; B. Saperston & R. West (Eds.), The Art and Science of Music Therapy: A Handbook. The Netherlands: Harwood Academic Publishers. Biographies Patricia L. Sabbatella (PhD; EMTR-Supervisor; MTAE) is the senior lecturer at the University of Cádiz (UCA, Spain) and director of the Joint Music Therapy Training Programme offered by the University of Cádiz and the Instituto Politécnico do Porto (IPP, Portugal). She is involved in research activities that focus on Music Education and Music Therapy with children, teenagers and adults. Paola K. Lazo (BA; MTAE) is Director of the Can Pau Music Therapy Centre for Early Intervention and gained her Batchelor s Degree in Music Therapy from the Universidad del Salvador (AR). Paola is also a music education teacher and has a postgraduate training in Early Child Rehabilitation. She is specialised in early intervention with toddlers as well as children with psychosis, autism disorders and developmental delay.

20 20 Evaluating music therapy: Considering value, benefit and impact POSTER 2 The Music Therapy Outcomes Star Jackie Lindeck Creative Therapy, Coram Background: Coram is the UK S first children s charity and has been delivering music therapy to vulnerable children and their families since In response to the increased demand for evidence based interventions in 2011 we designed, piloted and published the Music Therapy Outcome Star (MTOS) with Triangle Consulting: a social enterprise who, since 2003 have worked with organisations to develop service led outcome measures. The MTOS is a tool that measures progress and is based on a journey of change. It is used collaboratively with service users pre and post intervention to measure the impact of music therapy. Aims: To consistently collect evaluation data using the MTOS for all children accessing Coram s music therapy provision in order to produce a data set that demonstrates the impact of music therapy with this client group. Methods: Since 2011 the tool has been used across Coram s music therapy provision. Children and young people accessing the service range in age between 18 months and 16 years. They are referred for a variety of needs including diagnosable conditions such as ASD. The MTOS is completed by the parents and referrers pre and post intervention and also by therapists after two sessions and post therapy. We are in the process of analysing around 150 data sets and preparing the results for publication. Results: Early results show positive change across all outcome areas as reported by parents, referrers and therapists. Biggest changes are reported by parents. Conclusion: Further research is needed to look at inter-rater reliability. By the end of April 2015 over 50 music therapists in the UK will have been trained in using the MTOS across a variety of children s settings. Biography Jackie Lindeck is Operational Manger for Creative Therapy at Coram where her role includes managing and supervising a team of art and music therapists working with vulnerable children and their families, writing bids and representing the service at strategic level with commissioners. She is also co-author of the Music Therapy Outcomes Star and the only licensed trainer in the country.

21 Evaluating music therapy: Considering value, benefit and impact 21 POSTER 3 The impact of trauma on musical engagement and preferences: Data from a large internet study David M. Greenberg and Peter J. Rentfrow Department of Psychology, University of Cambridge Background: Absent from the literature is a broad understanding of the role of trauma in music listening behavior in everyday life. Aims: The goal of this research was to investigate how the experience of psychological trauma in both childhood and adulthood links to musical engagement and preferences. Methods: We used data from 1,070 adult participants, who indicated their preferences for 25 musical excerpts and completed the Musical Engagement Test (MET), which is a self-report measure of five dimensions of musical engagement. Participants also reported any experience of psychological trauma experienced (familial death, parental separation, sexual abuse, and violence), along with its severity and their age when it occurred. Results: Across nearly all trauma domains, trauma severity was positively linked to emotional and narrative engagement. In particular, the severity of recent sexual abuse was most strongly linked to emotional engagement (r =.40) and narrative engagement (r =.43). Results were highly differentiated for musical preferences based on the type of trauma experienced. In particular, the severity of recent physical abuse was positively linked to preferences for mellow music (r =.25) and negatively linked to intense music (r = -.25). Conclusions: Taken together, the results suggest that people use music as a self-therapist to help cope with traumas. Future research should explore how this information can be used in clinical settings and also in industry (e.g. recommendation platforms such as YouTube, Pandora, Spotify) to help increase the well-being of those who have had a trauma. Biographies David M. Greenberg is in the final year of his PhD at the University of Cambridge where he researches the psychological mechanisms underlying musical experience. His work has thus far focused on how musical engagement and preferences link to personality and cognition, and also the role of music in autism. Dr. Peter Jason Rentfrow is currently a Senior Lecturer in the Department of Psychology at the University of Cambridge and a Fellow of Fitzwilliam College. His research concerns personenvironment interactions and focuses on the ways in which personality is expressed in everything from people's preferences for music to the places in which they live.

22 22 Evaluating music therapy: Considering value, benefit and impact POSTER 4 Musical indicators of awareness of children with severe and profound intellectual disabilities Sara Knapik-Szweda Karol Szymanowski Academy of Music Background: Awareness is the ability to perceive, feel, or to be conscious of events, objects, thoughts, emotions, or sensory patterns. Schwartz (2008) writes awareness is the first task of the growing child. Briggs and Bruscia (1985) agree that awareness is the significant beginning of a child s development. Children with severe disabilities, which are characterised by significant limitations of both intellectual functioning and in adaptive behavior (Polen, 2013) and children with multiple disabilities (clients who have concomitant impairments) (Wheeler, 2013), may have difficulties improving upon self-awareness (Wheller, Shultis & Polen, 2005). Music therapy can help these clients make progress: in particular, in terms of understanding the world in which they live (Wheller, Shultis & Polen, 2005). Aims: The poster will present how music therapy processes based on improvisational techniques enhance and improve self-awareness and awareness of having a musical bond with a therapist. The purpose of the qualitative research is to illustrate the musical indicators of awareness, through three case studies. Participant children in the case studies have severe and multiple disabilities. The therapy conducted for this study took place in an individual format. Methods: In the project, active, improvisational music therapy methods were used. Data analysis was based on recordings from the sessions, as well as on musical and non-musical reports and observations made by the therapist (Nordoff & Robbins, 2007). Each of the three cases for this study will be described with an approach that takes into consideration a range of musical factors, including reactions to adjusted music idioms, behavior of rhythms, type of instrument, and reactions to the voice of a therapist. Results and conclusions: These indicators will present the value of the music therapy process in these three cases. References Aigen, K. (1998). Paths of Development in Nordoff-Robbins Music Therapy. Gilsum, NH: Barcelona Publishers. Briggs, C.A. & Bruscia, K. (1985). Developmental models for understanding musical behaviour. Paper presented at the Joint Conference on the Creative Art Therapies, National Coalition of Arts Therapy Associations, New York. Nordoff P., & Robbins C. (2011). Clinical Improvisation: Expanding Musical Resources. The Nordoff- Robbins Center for Music Therapy, New York University. Nordoff, P., & Robbins, C. (2007). Creative Music Therapy: A Guide to Fostering Clinical Musicianship (2nd Edition). Gilsum NH: Barcelona Publishers. Nordoff, P., & Robbins, C. (1975). Music Therapy in Special Education. London: MacDonald & Evans. Pavlicevic, M. (1997). Music Therapy in Context. London: Jessica Kingsley. Pavlicevic M. (2002). Dynamic Interplay in Clinical Improvisation. Voices: A World Forum for Music Therapy, 2(2). Retrieved from:

23 Evaluating music therapy: Considering value, benefit and impact 23 Polen, D.W. (2013). Severe to profound intellectual and developmental disabilities. In M. Hintz (ed.), Guidelines for music therapy practice: Developmental health (pp ). Gilsum, NH: Barcelona. Procter, S. (2002). The therapeutic, musical relationship: A two-sided affair. A consideration of the therapeutic significance of the musical input in co-improvisation. Voices: A World Forum for Music Therapy, 2(3). Retrieved from: Schaffer, R. H. (2013). Psychologia dziecka. Wydawnictwo Naukowe PWN, Warszawa. Schwartz, E. (2008). Music Therapy and Early Childhood: A Developmental Approach. Gilsum, NH: Barcelona Publishers. Wheller, B., Shultis, C. L., & Polen D. W. (2005). Clinical Training Guide for the Student Music Therapist, Gilsum, NH: Barcelona Publishers. Biography Sara Knapik-Szweda (MA, MT-BC) is a PhD student at the University of Silesia in Katowice. She works with physically, neurologically and intellectually handicapped children and teenagers in various therapy centres in Poland. She conducts music therapy in oncology for children and cooperates with Spectrum Liberi Foundation for children with autism and Asperger Syndrome. Her research concerns music therapy and autism; interaction and communication skills in the music therapy process.

24 24 Evaluating music therapy: Considering value, benefit and impact POSTER 5 Music in recovery from paediatric surgery: Can music reduce postoperative pain and anxiety? Suzanne Capps 1, Solveig Baltzer Nielsen 2, Lauren Stewart 1 & Daisy Fancourt 3,4 1 Goldsmiths, University of London; 2 University of Copenhagen; 3 Centre for Performance Science, Royal College of Music; 4 Imperial College Background: Playing music to patients post-operatively has been shown in multiple studies to reduce pain and distress (Good, Anderson, Ahn, Cong & Stanton Hicks, 2005; Voss et al., 2004). Yet there are few studies examining the use of music with paediatric patients, despite them frequently displaying negative post-operative behaviour. A previous study with this population found beneficial effects of music presented through individual speakers (Nilsson, Unosson & Rawal, 2005); however this may block out important information from medical staff and is costly to provide. In comparison, playing music over an ambient speaker system during recovery may provide a cost-effective, beneficial intervention. Aims: The present study aims to compare the playing of relaxing music over a speaker system during the post-operative recovery period, to silence, which is currently the norm in most clinical settings, in order to understand how music can be utilised to improve post-operative outcomes. Method: Sixty participants, consisting of 2-16 year olds entering the post-anaesthesia care unit (PACU) subsequent to surgery will be included in this study. The music played will be MusiCure, comprising music specifically composed for relaxation. Observational measures of anxiety, delirium, and pain, as well as nurse stress will be obtained in the PACU. Subsequently children and parents will rate the child s anxiety using the Modified Smiley Faces Scale (Gazal, Fareed & Zafar, 2015), and perceptions of the music presented will be collected. Results and conclusions: Results will be collated and analysed during May of this year, and appropriate conclusions drawn. We anticipate completing analysis by late May. References Gazal, G., Fareed, W. M., & Zafar, M. S. (2015). Effectiveness of gaseous and intravenous inductions on children's anxiety and distress during extraction of teeth under general anesthesia. Saudi Journal of Anaesthesia, 9(1), 33. Good, M., Anderson, G. C., Ahn, S., Cong, X., & Stanton Hicks, M. (2005). Relaxation and music reduce pain following intestinal surgery. Research in Nursing & Health, 28(3), Nilsson, U., Unosson, M., & Rawal, N. (2005). Stress reduction and analgesia in patients exposed to calming music postoperatively: A randomized controlled trial. European Journal of Anaesthesiology, 22(2), Biographies Suzanne Capps is currently a student at Goldsmiths, University of London studying for an MSc in Music, Mind & Brain. She is particularly interested in the clinical applications of music in healthcare settings, and the neural mechanisms involved. She holds a first-class BSc in Psychology from Durham University. She is a passionate cellist, pianist and singer, and has played in and managed many ensembles throughout her time at university.

25 Evaluating music therapy: Considering value, benefit and impact 25 Solveig Baltzer Nielsen holds a BSc in Sociology and a BSc in Medicine both from the University of Copenhagen. She is studying for an MSc in Music, Mind & Brain, as a supplement to her study in Medicine. As a future physician she is interested in the use of music in clinical settings and in the neuroscience of music. She has a professional background in social research, and is a singer. Lauren Stewart is Professor in Psychology at Goldsmiths, where she leads a research group and MSc programme in Music, Mind and Brain. Lauren s research concerns the psychological and neuroscientific basis of music. She has published 70+ articles on topics including learning and plasticity, congenital amusia and tone-colour synaesthesia. She is currently working with music therapists to explore the therapeutic potential of music via projects focusing on stroke, childhood hemiplegia, and neurodevelopmentally at-risk infants. Daisy Fancourt is a Research Associate in the Centre for Performance Science, Royal College of Music and Imperial College. Her research area is psychoneuroimmunology; exploring the impact of music on stress and immune response in different patient populations. Her work has won over a dozen awards including silver prize in the Hektoen International Medical Humanities Competition, an Arnold Bentley New Initiatives in Psychology Award and a Young Investigator Scholarship from the American Psychosomatic Society. Alongside her research, Daisy has worked over the last six years in the UK's National Health Service, collaborating with hospitals around the country as well as the Academy of Medical Sciences, the Royal Society for Public Health, and the Wellcome Trust developing projects that turn research into practice. To date, her programmes have reached over 100,000 patients.

26 26 Evaluating music therapy: Considering value, benefit and impact

27 Evaluating music therapy: Considering value, benefit and impact 27 THEME B: EVALUATION OF SERVICES AND PROJECTS [Posters 6-12]

28 28 Evaluating music therapy: Considering value, benefit and impact POSTER 6 An evaluation project of music therapy at St Christopher s hospice Giorgos Tsiris 1,2, Tamsin Dives 2 & Gerry Prince 2 1 Nordoff Robbins; 2 St Christopher s Hospice Background: Research and evaluation play a significant role in the ongoing development of the Arts Team at St Christopher s hospice in London; they provide feedback and ensure services respond effectively to the needs of the service users, as well as the hospice as an organisation. In this context, an evaluation project took place in March/April 2010 which focused on the music therapy service provided at St Christopher s. Aims: The aim of this evaluation was to explore the perceptions and understandings of St Christopher s staff about the music therapy service, as well as about the role and input of the music therapists as part of multi-disciplinary team work. Method: For the purposes of this evaluation, a questionnaire was developed and sent to 168 members of St Christopher s multi-disciplinary team who are working at the Anniversary Centre, Wards and Home Care. In total, 80 (47.6%) staff responded and collected data was analysed using both quantitative and qualitative methods. Results: The main outcomes of this evaluation, as well as some indicators for the development of music therapy services at St Christopher s are outlined in this poster presentation. These include staff perceptions with regards to the benefits of music therapy, as well as their reasons for referring patients to music therapy. In addition, the evaluation outcomes provide some indicators with regards to the effectiveness of the communication channels between music therapists and the rest of the MDT members, as well as highlight how the music therapists role and input as part of MDT work is perceived. Conclusion: It is hoped that this presentation will provide useful insights into the role and development of the music therapy service at St Christopher s and will stimulate the conduction of other projects from practitioners in similar workplaces. Biographies Giorgos Tsiris is a researcher at Nordoff Robbins. He also works as a music therapist with terminally ill adults and bereaved families and children at St Christopher s Hospice. He is the founding editor of Approaches: Music Therapy & Special Music Education. Tamsin Dives is a music therapist at St Christopher s Hospice. Before qualifying as a music therapist, she had a successful career as an opera singer for twenty-two years. Gerry Prince came to music therapy from a background in commercial music. After graduating from the Nordoff Robbins Centre in 2007, he joined the Arts Team at St Christopher s hospice where he worked until May 2015.

29 Evaluating music therapy: Considering value, benefit and impact 29 POSTER 7 Evaluating the music therapy service in a neuro-rehab day centre for adults Naomi Lander Nordoff Robbins Background: This poster is an evaluation of the music therapy service in an adult neuro-rehab day centre. The evaluation constitutes part of the author s second placement of Masters of Music Therapy training at Nordoff Robbins. Aims: To assess the service the author was operating across the day centre and how it was received. To identify what was working well and what needed improvement. To provide a better service. Methods: Initial data came from records of music therapy sessions that had run up to that point. Further data came from questionnaires for clients as well as staff. Two vignettes of different kinds of clients provided a more specific and practical look at how music therapy was working at the day centre. Results: Overall, the service was received positively by day care residents and staff. Some clients expressed that they would have liked to learn an instrument properly, some staff members expressed that the noise level was often too loud and there were clients who would have liked more opportunities for group activities. Staff expressed a level of pride in being able to offer the music therapy service and all clients said they would recommend music therapy to friends at the day centre. Conclusions: All staff members felt proud of the service but some also wished that it did not interrupt their work as much, leading the author to search out a different location for sessions. Musical instruction was then introduced into sessions with some clients, enabling them to feel more able both in general as well as in terms of improvising with the author/therapist with increasingly perceived skill. Changing the day in which music therapy took place provided more opportunities for group sessions. Biography Having previously trained as a secondary school music teacher and specialist woodwind instrumental teacher, Naomi Lander will graduate from the Masters of Music Therapy training at Nordoff Robbins course in July this year and following registration with the Health and Care Professions Council, hopes to work with clients in dementia care, special schools and Child and Adolescent Mental Health Services.