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• W2164807148 abstract "Arts therapies treatments offer patients therapy through primarily nonverbal means (i.e., art forms such as music, art, drama, and dance movement). They are particularly effective when normal communication is absent or has broken down. This study used a randomized control design and involved a treatment (n /10) and a control (n /15) group. Treatment was one of four arts therapies delivered in group or individual format. The authors used four separate questionnaires, administered over a 6-month period, to measure effectiveness. There was also a qualitative interview at the end of that period for the treatment group patients. The numerical results were not conclusive owing to high variability and small sample size, but the qualitative data reveal interesting facets of the process (e.g., that the therapists’ and patients’ perceptions of the treatment coincided in all treatment cases). This article aims to investigate the arts therapies as a treatment for adults with continuing mental health problems. The authors’ background is in the United Kingdom, where the arts therapies are now offered in all four modalities (music, art, drama, and dance movement) in some hospitals. Music, art, and drama therapists (although not dance movement therapists as yet) have now achieved state registration, so that their professional titles are protected. The arts therapies are used in a variety of settings but are particularly useful for people who find meaningful verbal communication difficult or impossible. The mechanism by which each therapy operates varies according to the setting, structure, and particular orientation of the therapist. Briefly, arts therapies provide a psychotherapeutic intervention that enables patients to effect change and growth using art materials to gain insight and promote the resolution of difficulties. Dance movement therapists focus on the use of body movement and dance, and the connections among mind, body, and emotion, in working toward changes in perception of their body and their difficulties. Dramatherapists also encourage patients to experience their physicality, to develop an ability to express the whole range of their emotions, particularly using drama, storytelling, and role-play. This, in turn, can increase their insight and knowledge of themselves and others. Music therapists facilitate interaction and development of insight into patients’ behavior and emotional difficulties through music making, often using live, improvised music working with rhythm, pitch, tonality, and mood. Previous literature on their effectiveness in psychiatry in the United Kingdom was often based on case studies (Davies, 1995; John, 1992, Odell-Miller, 1991, 1995b; Payne, 1993). Although some scientific outcome studies have been carried out (Odell-Miller, 1995a; Wilkinson, Srikumer, Shaw, & Orell, 1998), these have been mainly concerned with people older than 65 years with dementia and related diagnoses. There is a need for outcome-based research with a younger population. In response to that need and to the clinical governance agenda in the National Health Service (NHS) and within local mental health services, this project aimed to investigate the effectiveness of arts therapies through numerical measures and through qualitative interviews. The need for an outcome study for this client group is further highlighted by the variable recognition of arts therapies as a treatment of choice in the NHS. Developing the methodology: Literature review A specialized literature review was carried out in the field of arts therapies and this population. Also relevant psychotherapy literature was examined concerning rapport and alliance, because these Correspondence: H. Odell-Miller, Music Department, Anglia Polytechnic University, East Road, Cambridge CB1 1PT, United Kingdom. E-mail: h.odell-miller@apu.ac.uk Psychotherapy Research, January 2006; 16(1): 122 /139 ISSN 1050-3307 print/ISSN 1468-4381 online # 2006 Society for Psychotherapy Research DOI: 10.1080/10503300500268342 were areas thought to be particularly crucial in any arts therapies treatment with this population. One such study (of 143 patients with schizophrenia) influenced the design of the current study (Frank & Gunderson, 1990). This study showed no distinct difference in active engagement between supportive and insight-oriented treatments, but in both groups the facilitation of a good rapport, or alliance with the therapist, made for a good outcome. There is also evidence that patients who formed good alliances with their therapists in the first six months of their treatment were significantly more likely to remain in psychotherapy, comply with their medication regimens, and achieve better outcomes after two years, with medication, than patients who did not. This points to the importance of a good alliance, which anecdotally before the study, arts therapists reported as something patients seemed to achieve often more readily through art forms than talking in some cases. It also supports the 6-month measuring period, which was in the design of this arts therapies study but which could have been thought of as quite short. Many people have addressed the problem of how arts therapists carry out research in both specific and general terms. The dilemma for the therapist is always whether to look at process or outcome. Can meaningful outcome be measured without looking at the art medium? Aldridge (1996) examined both categories and discussed the importance of recognizing the force of the art form for people who communicate nonverbally while maintaining rigorous research methodology. Brotons (2000) had completed the Cochrane Review of Music Therapy and Dementia, which, although providing evidence for a possible beneficial effect on various symptoms of dementia, also highlighted the need for further well-designed randomized controlled trials (RCTs) in this field. However, this is with a different patient population than that studied here and thus is not discussed in detail. Tang, Yao, and Zheng (1994), in their study of patients with schizophrenia, show that music therapy decreased negative symptoms and increased the ability to converse with others. In addition, an increase in outside events was shown as a result of a randomized trial over a 1-month period. This is significant, although both passive listening and active singing of songs are described in the method of music therapy rather than extensive use of improvisation. Pavlicevic and Trevarthern (1989) show musical similarities to other behaviors found in other studies involving people with schizophrenia (Fraser, King, Thomas, & Kendell, 1986; Lindsay, 1980). However, although this confirms the use of music therapy as a possible diagnostic tool, it looks in detail at what happens in music therapy rather than at outcome related to the life of the patient in general outside of the therapy session. Bunt, Pike, and Wren (1987) used a questionnaire evaluation method on a residential psychiatric ward to assess outcome. The methods of evaluation were mainly related to the actual sessions themselves, although the patients were also asked about any effects the treatment had on them." @default.
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• W2164807148 title "The Practice Of Music Therapy For Adults With Mental Health Problems: The Relationship Between Diagnosis And Clinical Method" @default.
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