Involving services users in music therapy evaluation

Service users’ perspectives on music therapy services can play a powerful role in examining and enhancing the impact and quality of music therapy services, securing continued funding for music therapy services, enhancing understanding of music therapy as a healthcare service and formulating recommendations for future research. In this issue, several articles focus on music therapy service evaluation and the importance of gaining experiential knowledge from service users. Giorgos Tsiris, Neta Spiro and Mercédès Pavlicevic (p. 3) discuss how music therapy service evaluations can contribute an important form of evidence to music therapy practice and play an essential role in the development of music therapy research agendas. They report on the analysis of five service evaluations of Nordoff–Robbins Music Therapy services in different neuro-rehabilitation contexts as perceived by clients, their families, music therapists and staff. Triona McCaffrey reports on an evaluation study of adult service users of music therapy in statutory mental health services in Ireland (p. 28). Through semi-structured interviews, she sought to obtain experiential knowledge from service users in order to enhance understanding of what music therapy services can offer to service users in mental health care contexts. McCaffrey argues that as recovery-oriented services become more prominent in mental healthcare, it is necessary for music therapists to actively engage service users in research endeavors. One way to accomplish this is by conducting service user evaluation studies. Monique van Bruggen-Rufi, Annemieke Vink, Wilco Achterberg and Raymund Roos conducted focus groups with healthcare professionals about their perceptions of music therapy services with people with Huntington’s disease (p. 44). The focus groups helped to identify the role music therapy could play in improving the quality of life of people with Huntington’s disease. The findings of this qualitative exploratory study were subsequentially used for the development of a large music therapy trial to examine the effects of music therapy on quality-of-life outcomes in this patient population. Finally, Bolette Daniels Beck and colleagues reported on a feasibility study of trauma-focused guided imagery and music with adult refugees diagnosed with PTSD in preparation of a large-scale randomized controlled trial (RCT) (p. 76). An important aspect of this feasibility study was the evaluation of acceptance of the music therapy intervention by the refugees. Although RCTs are aimed at measuring treatment efficacy and may not (always) incorporate service user perspectives on the intervention, the preparatory work for a high quality RCT typically includes feasibility studies. Such studies often include obtaining user experiences of the intervention to determine if the intervention is perceived as meaningful and acceptable. Feasibility studies may lead to further refinement of the intervention and additional preliminary studies before an RCT is conducted. Increasingly, clinical trials of behavioral interventions use mixed methods research designs so that study participants’ experiences of the interventions can be captured, analyzed and integrated with quantitative outcome data (Creswell & Plano Clark, 2018).

This issue also contains a Letter to the Editor and a Response to the Letter to the Editor. In his Letter to the Editor (p. 87), Alan Turry critically examines some aspects of the TIME-A trial that was published in JAMA (Bieleninik et al., 2017). This study was a large international multisite RCT examining the effects of improvisational music therapy vs. enhanced standard care on symptom severity among children with autism spectrum disorder. The letter and the response by the study authors (p. 89) offer an interesting and, at times, provocative discussion of challenges in selecting appropriate outcome measures and standardization of the music therapy intervention. We encourage our readers to submit a Letter to Editor to comment on articles published in the Nordic Journal of Music Therapy as engaging in critical dialogue about published research and theories are essential in enhancing music therapy practice and research.