Evaluation of client progress in music therapy: an illustration of an N-of-1 design in individual short-term improvisational music therapy with clients with depression

ABSTRACT

This article introduces music therapy clinicians to a research design that can be easily implemented in clinical practice to evaluate and monitor the impact of interventions on individual clients: the systemic N-of-1 design. In this single-case design, the client’s network, consisting of professional and non-professional network members, assumes the role of evaluators of the given treatments. The systemic N-of-1 design is illustrated with a small empirical study with nine clients with symptoms of depression within a single private practice. The study participants received individual short-term improvisational music therapy (ISIMT) consisting of seven weekly sessions. One week before the first session and one week after the last session, the Inventory of Depressive Symptomatology (IDS) was completed by the clients, their professionals and network members. Applying the systemic N-of-1 design produced valuable individualised and group information about the effects of ISIMT on depressive symptoms. The systemic N-of-1 design can be used in clinical practice by music therapists to systematically monitor the outcome of their therapies. Pooling systemic N-of-1 designs by collaborating music therapists may provide valuable information about the efficacy of music therapy.

KEYWORDS:

• Single-case design
• systemic N-of-1 design
• improvisational music therapy
• depression

Acknowledgements

Special thanks go to the clients who participated in this research. Also, we would like to thank psychiatrists and psychologists who advised music therapy and participation in this study for their clients, the Master of Arts Therapies of Zuyd University of Applied sciences, in particular, Annemiek Vink and Sabine van Linden for their coaching and Ruth Freeman for her kind assistance and editorial advice.

Additional information

Notes on contributors

Sonja Aalbers

Sonja Aalbers MMTh, PhD student at the VU Amsterdam, the Netherlands. She accomplished her master’s degree in Music Therapy at Zuyd University of Applied Sciences, Heerlen, in 2013, and her bachelor’s degree in Music Therapy at Utrecht University of Applied Sciences (HU), Amersfoort, in 1991. She is a music therapist, coach and supervisor in her private practice, a researcher, lecturer and supervisor at Stenden University of Applied Sciences, School of Social Work and Arts Therapies, Leeuwarden, a member of the Committee on Care Standard Depression and Dysthymia of Trimbos-instituut [Trimbos Institute], a member of the Committee on Multidisciplinary Guidelines of the Federatie Vaktherapeutische Beroepen (FVB) [Federation of Arts Therapies] and the chair of Music Therapists in Private Practises (ZGMT) of the Nederlandse Vereniging voor Muziektherapie (NVvMT) [Dutch Assembly of Music Therapy].

Marinus Spreen

Marinus Spreen PhD, sociologist and methodologist, is a professor of Social Work and Arts Therapies at Stenden University of Applied Sciences, Leeuwarden and head of the research department at forensic psychiatric centre Dr. S. van Mesdag, Groningen. His research is about treatment evaluation methods in single subject and small population studies.

Linda Bosveld-van Haandel

Linda Bosveld-Van Haandel MD, psychiatrist since 2005, is currently finishing her education as a psychoanalyst. She is a psychiatrist in her private practice. In the past years, she was team manager at an outpatient department for clients with depressions. Earlier, she published research regarding schizophrenia.

Stefan Bogaerts

Stefan Bogaerts PhD, psychologist, criminologist and psychotherapist, is a full professor of forensic psychology at Tilburg University and head research and treatment innovation at the forensic psychiatric centre Kijvelanden/dok. His research is about deregulation processes in forensic populations. He has published more than 150 articles and book chapters in the field of forensic psychology and victimology in (inter)national journals and books.