ABSTRACT

Individuals receiving hospice care at the end of life have a unique set of needs, requiring interdisciplinary assessment and treatment to meet their multidimensional circumstances and create a supportive and comfortable experience. Music therapy is often an integral component of hospice care utilized to treat the whole person. While there are published music therapy assessment tools for use with the hospice population, there is no assessment tool specifically aimed at understanding the role of music preference in the context of the hospice patient’s multidimensional musical ecosystem identity. The purpose of this thesis was to create an assessment tool to understand and document the individualized connections between a hospice patient’s familiar and preferred music and their musical identity, in order to increase cultural awareness and to utilize music selection with purpose while supporting and empowering the patient. The proposed music preference assessment tool utilizes an ecomap structure and combines theories and philosophies from the fields of music therapy and social work. The needs of the hospice population are identified and music therapy is discussed as a treatment modality in hospice. Existing music therapy and social work assessments are identified and examined and elements of each are utilized in the creation of the proposed music preference assessment tool. A template and example assessment tool are provided with considerations for clinical implications and uses.

This document is a proposal for a research project, submitted as an Honors Thesis to Barrett, The Honors College at Arizona State University. The proposal summarizes previous findings and literature about women survivors of domestic violence who are suffering from post-traumatic stress disorder as well as outlining the design and measures of the study. At this time, the study has not been completed. However, it may be completed at a future time.

Adolescents experience a lot of stress from changes and difficulties in their physical appearance and their relationships—affecting their mental and emotional well-being as well as their family's relationships and functioning. Research has shown that family music therapy has been fairly successful in helping both children and adolescents and their families improve their communication and mutual attunement while encouraging self-expression in the child and teenager. However, the literature focuses mainly on families with children ages 10 and under, at-risk families, and non-clinical families. Little focus in the research literature is given to adolescents and their mental and emotional health concerns.

The purpose of this thesis was two-fold: 1) to perform a systematic review and collect information from articles that used music interventions or music programs to address the mental health needs of families and adolescents, and 2) to develop a family music therapy program for teenagers with mental health concerns based on the research literature used for the systematic review. Fourteen articles were included in the study. The main interventions and programs were improvisation (n = 6), songwriting (n = 3), lyric analysis or song discussions on client-selected music for introspective and expressive purposes (n = 3), therapeutic singing (n =1) and structured group music making (n = 1). Common outcomes included improvement in the adolescents' self-expression and communication, restoration of family relationships, increased awareness of covert family issues, and improved family communication and interactions. The proposed six-week music therapy program is improvisation-based, considering the amount of improvisational interventions that were found in research. Session plans include interventions such as musical “icebreakers” and warm-ups, improvisation, lyric analysis, and a culminating songwriting experience.

Keywords: family therapy, music therapy, adolescents, mental illness

On a given night in 2018, over half a million people were experiencing homelessness in the United States, and of those, about 36,000 were youth under the age of 25. Music is an indispensable part of young people’s identities and cultures, and understanding the ways in which homeless youth define their own musical preferences and use of music can help music therapists intervene effectively in youth homelessness as part of an interdisciplinary care team. The purpose of this project was twofold: 1) to conduct a descriptive research project pertaining to homeless young adults’ use of music and 2) to develop recommendations for music therapists based on research findings from the descriptive project and extant literature. Thirty-one homeless young adults (ages 18-26) were recruited for interviews from two resource centers serving homeless youth in a large metropolitan city in a southwestern state. Template analysis was used to systematically analyze and code participants’ verbatim transcripts from the interviews into a codebook. Quotes from the interviews were used to illustrate themes. Findings included that homeless youth used music, especially metal and rap, for coping and mood regulation, and that youth are also engaged in creative music making, especially singing and songwriting for self-expression. For some youth, certain music can be identity-forming (for better or worse) and certain other music can be triggering. Results are integrated with a review of literature and recommendations for practicing clinicians are presented. Music therapy with this population would likely yield best outcomes by using short-term interventions and culturally competent application of clients’ preferred music.

Older adults diagnosed with a serious mental illness (SMI) often face a lifetime of psychiatric institutionalization, making them a very vulnerable population. However, music therapy research has not been conducted with this specific population. The purpose of this thesis was to develop an evidence-based proposed music therapy program for geriatric patients diagnosed with SMI utilizing both music-based and non-music based theoretical frameworks. The music-based approach used for the program is Dalcroze and the non-music based approach is Wellness with a focus on quality of life. The population diagnosed with SMI and the complications of aging for this population are discussed as well as the results of previous music therapy studies conducted with adults diagnosed with SMI. The components of the Dalcroze and Wellness approaches are described and the elements that are incorporated into the program include improvisation and eurhythmics and client strengths and the physical domain (movement). The proposed music therapy program will have the therapeutic goals of increased social interaction, increased self-esteem, and increased quality of life. The data collection tools are mentioned and how to measure results. The program is described in detail with session plans consisting of warm-up, improvisation, movement, and closing interventions. The recommendations for clinical evidence-based practice are discussed.

Inclusive Band at ASU started in Fall 2017. The group started with four Music Students (individuals with special needs) and a fifth one joined in Spring 2018. The Music Students stuck with the same ASU students (Peer Mentors) from the start until Spring 2019 when there was a shift in membership. This caused the Peer Mentors to have to move to new groups. Some moved to a Music Student that played the same instrument while others were because a member graduated or left Inclusive Band and were replaced by new members. This transition was hard for both Peer Mentors and Music Students. The Music Students were used to their Peer Mentors and built a strong friendship with them. Losing them was hard and some still struggle with it several months later. The Peer Mentors also had difficulties adjusting to teaching a different Music Student. They did not know their strengths and weaknesses or the best way to teach them. This challenge led to the creation of the handbook, which is a guide for future members of Inclusive Band to aid with the transition from semester to semester.

Although music is regarded as a universal language, it is rare to find musicians of different ages, ability levels, and backgrounds interacting with each other in collaborative performances. There is a dearth of mixed-ability-level wind band and string orchestra repertoire, and the few pieces that exist fail to celebrate the talents of the youngest and least-experienced performers. Composers writing music for school-age ensembles have also been excluded from the collaborative process, rarely communicating with the young musicians for whom they are writing.

This project introduced twenty-nine compositions into the wind band and string orchestra repertoire via a collaboration that engaged multiple constituencies. Students of wind and string instruments from Phoenix’s El Sistema-inspired Harmony Project and the Tijuana-based Niños de La Guadalupana Villa Del Campo worked together with students at Arizona State University and composers from Canada, Finland, and across the United States to learn and record concertos for novice-level soloists with intermediate-level accompaniment ensembles.

This project was influenced by the intergenerational ensembles common in Finnish music institutes. The author provides a document which includes a survey of the existing concerto repertoire for wind bands and previous intergenerational and multicultural studies in the field of music. The author then presents each of the mixed-ability concertos created and recorded in this project and offers biographical information on the composers. Finally, the author reflects upon qualitative surveys completed by the project’s participants.

Most the new concertos are available to the public. This music can be useful in the development and implementation of similar collaborations of musicians of all ages and abilities.

According to the National Center on Family Homelessness (2017), Homelessness affects 2.5 million children annually (n.p). Children who are exposed to homelessness many times also suffer from adverse childhood experiences (ACEs) which can hinder a younger person's development cognitively, socially, and can cause health problems such as heart disease later on in life. Examples of an ACE are death of a family member, witnessing or experiencing violence, economic hardship, or having a parent with a alcohol or drug addiction. About 70,000 of children in Arizona suffer from five or more ACEs. In this project music therapy interventions such as songwriting, lyric analysis, and recreative instrument play were used to address psychosocial needs for teens at a homeless shelter. The areas of psychosocial needs addressed in the music therapy group were: group cohesion, communication, and self regulation. Objectives were set each session in an eight week program to track progress of the above goals that were created based on the needs of the clients in this setting.

A music therapy informed music group program was created and implemented at the Maricopa Reentry Center in Phoenix. This program \u2014 entitled Building Hope Through Music \u2014 utilized music therapy techniques including lyric analysis, songwriting, singing, musical games, and guided visualization in order to improve self-awareness, provide a medium for self-expression, increase teamwork and collaboration, promote relaxation, facilitate emotional processing and awareness, and improve tolerance of non-preferred activities in participants. This group was conducted for seven months and had participation from over 400 male ex-offenders.

Curative arts and art therapy have been increasingly implicated in promoting health and well-being for patients, but little research has been done for the benefits of drawing therapy for stress management or individuals in a non-diseased state. College students and healthcare professionals are particularly susceptible to high levels of stress, as I experienced firsthand as a medical scribe in the Emergency Room during my undergraduate experience. For this reason, I wanted to focus on using curative arts as a mediator for high-stress situations. My creative project is therefore a portable framework for curative drawing. The framework is designed to help people process complex emotional states in a more effective way using mark-making and color. Specifically, the framework is designed for those who have limited experience with art making but can be used by anyone who feels a need for curative drawing. I used this framework in both individual and group settings, culminating in a final gallery show in which viewers were able to participate in the framework and take home a booklet with the framework printed inside. In conjunction with outside research, the help of my thesis committee, and the students of Drawing and Painting as Seeing and Thinking, the final project can be viewed as one part of the intersection between art and medicine in our ever-changing healthcare environment.