Resource-oriented music therapy emphasizes the development and stimulation of client’s strengths and resources rather than the reduction of symptoms or cure of pathology. Thus, the focus in therapy is positive experiences, mastery, and coping rather than on difficult emotions, psychological conflicts, and problems. Collaboration and user-involvement is highly emphasized. Resources-oriented perspectives in music therapy are linked to movements and theoretical perspectives in an interdisciplinary field, such as the philosophy of empowerment, positive psychology, salutogenesis, recovery, and various perspectives on music and health. The emphasis on aspects of resource-orientation can be traced back in the history of music therapy, and be described as a general feature of music therapeutic practices. Yet more recently resource-oriented music therapy has been developed as a more specific approach in mental health care. In this chapter a broad “family” of perspectives within the music therapy work that highlights resource-orientation will be presented.
Background: Music therapy (MT) has been shown to be efficacious for mental health care clients with various disorders such as schizophrenia, depression and substance abuse. Referral to MT in clinical practice is often based on other factors than diagnosis. We aimed to examine the effectiveness of resource-oriented MT for mental health care clients with low motivation for other therapies. Method: This was a pragmatic parallel trial. In specialised centres in Norway, Austria and Australia, 144 adults with non-organic mental disorders and low therapy motivation were randomised to 3 months of biweekly individual, resource-oriented MT plus treatment as usual (TAU) or TAU alone. TAU was typically intensive (71% were inpatients) and included the best combination of therapies available for each participant, excluding MT. Blinded assessments of the Scale for the Assessment of Negative Symptoms (SANS) and 15 secondary outcomes were collected before randomisation and after 1, 3 and 9 months. Changes were analysed on an intention-to-treat basis using generalised estimating equations in longitudinal linear models, controlling for diagnosis, site and time point. Results: MT was superior to TAU for total negative symptoms (SANS, d = 0.54, p < 0.001) as well as functioning, clinical global impressions, social avoidance through music, and vitality (all p < 0.01). Conclusion: Individual MT as conducted in routine practice is an effective addition to usual care for mental health care clients with low motivation.
The findings from this meta-synthesis indicate that the provision of music therapy closely resembles recognized benefits of a recovery-oriented practice. Awareness of users' self-determination and the development of a strength-based and contextual approach to music therapy that fosters mutual empowering relationships are recommended.
When doing a randomised controlled trial, concrete and observable a-priori definitions and descriptions of therapy procedures are usually considered necessary for study results to be replicable, and also to enable comparisons between different therapy approaches. However, most music therapy approaches in the field of mental health cannot be defined with a fixed therapy manual without serious danger of losing their therapeutic integrity. Manuals defining therapeutic principles which can be applied flexibly, rather than a fixed set of techniques, might be more appropriate. In this article we will present the rationale for a therapy manual developed for the purpose of a randomized controlled trial on a contextual approach to resource-oriented music therapy. The article focuses upon possible ways of dealing with the tensions and contrasts that exist between the contextual and resource-oriented perspectives and the need for pre-structured definitions to meet the standards of the rigorous quantitative research methodology.
Clients and therapists in the interdisciplinary discourse of mental health and mental health care are described as dichotomous. In such a binary the client is defined in terms of weakness, pathology and passivity, while the therapist is described in terms of strengths, expertise and activity. This article aims to contribute to the destabilization of the client-therapist binary by offering a review of literature on competent clients. Perspectives from social models and cultural models in disability studies provide the theoretical frames for the discussion. Social constraints and oppression with regard to the dis-ability complex and discursive implications are discussed.
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