Music in mind, a randomized controlled trial of music therapy for young people with behavioural and emotional problems: study protocol

Aims. This article is a report of a trial protocol to determine if improvizational music therapy leads to clinically significant improvement in communication and interaction skills for young people experiencing social, emotional or behavioural problems. Background. Music therapy is often considered an effective intervention for young people experiencing social, emotional or behavioural difficulties. However, this assumption lacks empirical evidence. Study design. Musicinmindisamulti-centredsingle-blindrandomizedcontrolledtrial involving 200 young people (aged 8–16 years) and their parents. Eligible participants willhaveaworkingdiagnosiswithintheambitofInternational ClassificationofDisease 10 Mental and Behavioural Disorders and will be recruited over 15 months from six centres within the Child and Adolescent Mental Health Services of a large health and social care trust in Northern Ireland. Participants will be randomly allocated in a 1:1 ratio to receive standard care alone or standard care plus 12 weekly music therapy sessions delivered by the Northern Ireland Music Therapy Trust. Baseline data will be collectedfromyoungpeopleandtheirparentsusingstandardizedoutcomemeasuresfor communicative and interaction skills (primary endpoint), self-esteem, social functioning, depressionandfamilyfunctioning.Follow-updatawillbecollected1and13 weeks afterthefinalmusictherapysession.Acost-effectivenessanalysiswillalsobecarriedout. Discussion. This study will be the largest trial to date examining the effect of music therapy on young people experiencing social, emotional or behavioural difficulties and will provide empirical evidence for the use of music therapy among this population. Trial registration. This study is registered in theISRCTNRegister,ISRCTN96352204. Ethical approval was gained in October 2010.

Recruiting Participants for Randomized Controlled Trials of Music Therapy: A Practical Illustration

Background: Failure to recruit sufficient numbers of participants to randomized controlled trials is a common and serious problem. This problem may be additionally acute in music therapy research.

Objective: To use the experience of conducting a large randomized controlled trial of music therapy for young people with emotional and behavioral difficulties to illustrate the strategies that can be used to optimize recruitment; to report on the success or otherwise of those strategies; and to draw general conclusions about the most effective approaches.

Methods: Review of the methodological literature, and a narrative account and realist analysis of the recruitment process.

Results: The strategies adopted led to the achievement of the recruitment target of 250 subjects, but only with an extension to the recruitment period. In the pre-protocol stage of the research, these strategies included the engagement of non-music therapy clinical investigators, and extensive consultation with clinical stakeholders. In the protocol development and initial recruitment stages, they involved a search of systematic reviews of factors leading to under-recruitment and of interventions to promote recruitment, and the incorporation of their insights into the research protocol and practices. In the latter stages of recruitment, various stakeholders including clinicians, senior managers and participant representatives were consulted in an attempt to uncover the reasons for the low recruitment levels that the research was experiencing.

Conclusions: The primary mechanisms to promote recruitment are education, facilitation, audit and feedback, and time allowed. The primary contextual factors affecting the effectiveness of these mechanisms are professional culture and organizational support.

"Thought-Tormented Music": Joyce and the Music of the Irish Revival

"In this special issue's opening essay, Martin Dowling devotes almost half of "'Thought-Tormented Music': Joyce and the Music of the Irish Revival" to what he calls "the situation of music in the Irish literary revival." He focuses chiefly on 1904, which was both an intensely productive period for the revival movement and a year chock-full of crucial events and decisions for Joyce. Drawing on the works of Pierre Bourdieu and Jaques Lacan, Dowling explores the revivalists' efforts to "de-anglicize" Irish music, to remove foreign influences that distorted the "pure tradition of Irish song," and to achieve an improbable harmony between the music favoured by the disappearing Anglo-Irish aristocracy and the Irish-speaking peasantry. Inevitably, disputes occurred over what constituted "authentic" Irish music. Factions quarrelled over whether pristine Irish music existed in the Atlantic seaboard or more inland; whether "authentic" songs were sung with or without instrumental accompaniment; and whether the piano, rather than the traditional harp, was a legitimate instrument of accompaniment. Having delineated the historical and theoretical context, Dowling offers a richly detailed analysis of Joyce's story "A Mother." He reveals how almost every element in the story--from the Eire Abu Society to the Antient Concert Rooms, from the conflict between Mrs. Kearney and Hoppy Holohan to the plight of Kathleen Kearney--is charged with meaning by the subtextual conflicts of the revivalists' agenda. Dowling explains also the "authenticity" in Joyce's depiction of vocal performances of "The Lass of Aughrim" in "The Dead" and "The Croppy Boy" in "Sirens," which he calls two "true gems" of authentic Irish music." --Introduction by Charles Rossman and Alan W. Friedman, Guest Editors, pp. 409-410

The Sound of Becoming: Moving Towards a Virtual Music

In 1985 Jacques Attali proposed a new modality for music. He suggests that there be “not a new music, but a new way of making music... a radically new form of the insertion of music into communication” (Attali 134). What Attali foretold has become a firm reality in contemporary musical practice. One has only to look at any current musical activity to encounter work that relies heavily on real-time interaction and dynamic generation and/or modification of materials. But why is this ontologically different ‘mode of essentially interactive and transformative existence’ (Ziarek 195), this ‘new way of making music���, so attractive to contemporary artists? What is motivating artists to abandon a production model in favor of a model of real-time interactive exploration? I will argue that at the foundation of this new artistic ontology lies Deleuze’s concept of the virtual. It is a recognition of the virtual power of music, that music making can be an act of invention, a process where one can discover something never before experienced.

If Music Be the Food of Love:An Acoustic ‘Fourth World’ in Ong Keng Sen’s Awaking”

Staged as an attempt to ‘bring together Shakespeare’s plays and Tang Xian Zu’s classical Kunqu opera, The Peony Pavilion,’ (Ong, Programme Notes) Awaking stands as Singapore Director Ong Keng Sen’s most recent and prominent attempt at engaging issues of the intercultural through music and sound. While Ong’s previous intercultural projects sought to explore the politics of intercultural performance through the exchange, layering, confrontation and inter-mixing of Asian performance modes as visual aesthetics, Awaking is a performance at the borders of theatrical and musical conventions, as it features the music and musicians as central performative devices of staging the intercultural. Northern Kunqu opera, Chinese classical music and Elizabethan folk tunes from Shakespeare’s plays were re-moved, re-contextualised, and juxtaposed to explore ‘differing yet connected philosophies on love, death, and the afterlife’ (Awaking, Publicity). These humanist and ‘universal’ themes found expression in the ‘universal’ language of music. Through a study of the musicalities and sonic expressions of Awaking, the paper seeks to explore the implications of such cultural-musical juxtapositions. The paper engages, specifically, with the problematics and possibilities of music as a ‘universal language’ as implied by Ong’s concordance of Eastern and Western sounds in the final act. It further considers the politics of an intercultural soundscape and the acoustemologies of such an intercultural approach.

The whole song is greater than the sum of its parts: Local and structural features in music listening

Four experiments reported here demonstrate the importance of structural as well as local features in listening to contemporary popular music. Experiment 1 established that listeners without formal musical training regard as salient the formal structure that links individual sections of songs. When asked to listen to and assemble the individual sections of unfamiliar contemporary songs to form new compositions, participants positioned the sections in ways consistent with the true structure of the music. In Experiment 2, participants were provided with only the song lyrics with which to arrange the individual sections of contemporary songs. It was found that in addition to musical features
studied in Experiment 1, lyrical content of contemporary music also acts as a strong cue to a song’s formal structure. Experiments 3 and 4 revealed that listeners’ enjoyment of music is influenced both by structural features and local features of music, which were carried by the individual song sections.
The influence of structural features on music listening was most apparent over repeated hearings. In Experiment 4, listeners’ liking for contemporary music followed an inverted U-shape trend with repeated exposure, in which liking for music took a downward turn after just four repeated hearings. In contrast, liking for restructured music increased with repeated hearings and almost eliminated an initial negative effect of restructuring by the sixth hearing. In sum, our findings demonstrate that structural features as well as local features of contemporary music are salient and important to
listeners.

Music therapy for end-of-life care: an updated systematic review

Background: Music therapy during palliative and end-of-life care is well established and positive benefits for patients have been reported.
Aim: Assess the effectiveness of music therapy versus standard care alone or standard care in combination with other therapies for improving psychological, physiological and social outcomes among adult patients in any palliative care setting.
Data sources: In order to update an existing Cochrane systematic review, we searched MEDLINE, CINAHL, EMBASE, PsycINFO, CENTRAL, ClinicalTrials.gov register, and Current Controlled Trials register to identify randomised or quasi-randomised controlled trails published between 2009 and April 2015. Nine electronic music therapy journals were searched from 2009 until April 2015, along with reference lists and contact was made with key experts in music therapy. Only studies published in English were eligible for inclusion. Two reviewers independently screened titles, abstracts, assessed relevant studies for eligibility, extracted data and judged risk of bias for included studies. Disagreements were resolved through discussion with a third reviewer. Data were synthesised in Revman using the random effects model. Heterogeneity was assessed using l2.
Results: Three studies were included in the review. Findings suggest music therapy may be effective for helping to reduce pain in palliative care patients (standard mean deviation (SMD) = -0.42, 95% CI -0.68 to -0.17, P = 0.001).
Conclusions: Available evidence did not support the use of music therapy to improve overall quality-of-life in palliative care. While this review suggests music therapy may be effective for reducing pain, this is based on studies with a high risk of bias. Further high quality research is required.

Artificial gravity reveals that economy of action determines the stability of sensorimotor coordination.

Background
When we move along in time with a piece of music, we synchronise the downward phase of our gesture with the beat. While it is easy to demonstrate this tendency, there is considerable debate as to its neural origins. It may have a structural basis, whereby the gravitational field acts as an orientation reference that biases the formulation of motor commands. Alternatively, it may be functional, and related to the economy with which motion assisted by gravity can be generated by the motor system.
Methodology/Principal Findings
We used a robotic system to generate a mathematical model of the gravitational forces acting upon the hand, and then to reverse the effect of gravity, and invert the weight of the limb. In these circumstances, patterns of coordination in which the upward phase of rhythmic hand movements coincided with the beat of a metronome were more stable than those in which downward movements were made on the beat. When a normal gravitational force was present, movements made down-on-the-beat were more stable than those made up-on-the-beat.
Conclusions/Significance
The ubiquitous tendency to make a downward movement on a musical beat arises not from the perception of gravity, but as a result of the economy of action that derives from its exploitation.