Examining the dyadic music therapy treatment (DUET): the case of a CP child and his mother

Abstract

Children with cerebral palsy (CP) experience not only motor disabilities but other, emotional, communicative, and social impairments. The relationship between caregivers (usually mothers) and CPs as well as their communication patterns might also be impaired. Music therapy was found to be effective with CPs and dyadic treatment has been found to be effective in facilitating mother–child relationships. However, music therapy and dyadic treatment were never combined to address CPs and their mothers. We present the dyadic music therapy treatment (DUET) and report of a preliminary study that examined if it was effective. The DUET of one dyad was videotaped and subsequently analyzed according to the mixed methods approach. Qualitative analysis resulted in 10 types of communication patterns, seven being non-verbal, two musical, and one verbal. Twenty-two types of relationship were found, 17 being coordinated relationships and five uncoordinated ones. Analyzing the frequencies of these types across the DUET sessions showed that dyadic communication increased significantly, especially in the second half of the treatment. It was also found that relationship types became more coordinated as the treatment progressed. The functions of music in the DUET are discussed and recommendations for future research are provided.

Keywords:

• music therapy
• cerebral palsy
• dyadic therapy
• short term therapy
• mother–child relationship, mother–child communication patterns

Acknowledgement

We would like to dedicate this article to Dr. Yosef Gilboa who added valuable comments and additions to this manuscript but did not live to see it published.

Notes

¹This article is based on the second author's Master's thesis which was submitted to the Music Department, Bar-Ilan University, Israel.

²Former experience with the model showed that in the context of the kindergarten it was more effective when implemented with mothers. However, it might be that under different circumstances a father–child DUET would be in place.

³According to attachment theory (Bowlby, 1969), the mother and her baby are involved in a flux of behaviors which is intended to facilitate and preserve their relationship, which is a condition for the survival of the baby. Behaviors such as eye contact and smiling as a reaction to the mothers' voice improve the probability that mothers stay in physical proximity to their babies and protect them. In a successful process of development the baby forms a mental representation of its caregiver and develops a sense of a ‘secure attachment’. Ainsworth (1967) referred to three types of attachment in babies: The secure type (about 65% of the children) who draw confidence and comfort from their caregiver and continue to function if left alone; the avoidant type (about 25% of the children) who tend to avoid their caregiver especially after a period of absence. These babies might not reject attention from a parent, but neither do they seek their comfort or contact; and the ambivalent type (about 10% of the children) who tend to be extremely suspicious of strangers. They display considerable distress when separated from a parent or caregiver, but do not seem reassured or comforted by the return of the parent. In some cases, the child might passively reject the parent by refusing comfort, or may openly display direct aggression toward the parent.

⁴Any activity that changes the balance of a person such as a summersault and swaying.

⁵Names are fabricated for ethical reasons.

⁶Mixed methods involve collecting and analyzing of both quantitative and qualitative data. Various mixed-methods designs are available, depending on the sequence in which the qualitative and quantitative data are collected and analyzed (i.e., concurrently or sequentially), on the way in which the types of information are merged (i.e., one type leads to another, one type is embedded in the other, types of information are merged), and on the weight which each research method has (i.e., equal weight, quantitative emphasis, or qualitative emphasis). In the present study, an exploratory design was applied, and more specifically, the taxonomy development model variant of this design. According to this model, the initial qualitative phase is conducted to identify emergent categories and the secondary quantitative phase examines the prevalence of these categories (see Creswell & Clark, 2007, 75–79).

⁷Aspects regarding therapists' different types of intervention were also analyzed but they are reported elsewhere.