Purpose: Telehealth provides psychotherapeutic interventions and psychoeducation for remote populations with limited access to in-person behavioural health and/or rehabilitation treatment. The United States Department of D efense and the Veterans Health Administration use telehealth to deliver primary care, medication management, and services including physical, occupational, and speech-language therapies for service members, veterans, and eligible dependents. While creative arts therapies are included in telehealth programming, the existing evidence base focuses on art therapy and dance/movement therapy, with a paucity of information on music therapy. Methods: Discussion of didactic and applied music experiences, clinical, ethical, and technological considerations, and research pertaining to music therapy telehealth addresses this gap through presentation of three case examples. These programmes highlight music therapy telehealth with military-connected populations on a continuum of clinical and community engagement: 1) collaboration between Berklee College of Music in Boston, MA and the Acoke Rural Development Initiative in Lira, Uganda; 2) the Semper Sound Cyber Health programme in San Diego, CA; and 3) the integration of music therapy telehealth into Creative ForcesV R , an initiative of the National Endowment for the Arts. Results: These examples illustrate that participants were found to positively respond to music therapy and community music engagement through telehealth, and reported decrease in pain, anxiety, and depression; they endorsed that telehealth was not a deterrent to continued music engagement, requested continued music therapy telehealth sessions, and recommended it to their peers. Conclusions: Knowledge gaps and evolving models of creative arts therapies telehealth for military-connected populations are elucidated, with emphasis on clinical and ethical considerations. ä IMPLICATIONS FOR REHABILITATION Music therapy intervention can be successfully adapted to accommodate remote facilitation. Music therapy telehealth has yielded positive participant responses including decrease in pain, anxiety, and depression. Telehealth facilitation is not a deterrent to continued music engagement. Distance delivery of music through digital platforms can support participants on a clinic to community continuum.

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The use of music performance in music therapy with military service members is discussed as a vehicle for social transformation and reintegration. The use of performance in music therapy is not without controversy primarily because therapy is considered a process, not a product, and confidentiality and privacy are essential components of therapy. However, others have argued that public performances can validate therapeutic changes in clients, give voice to their experiences, raise awareness of social issues within their communities, transform perceptions of injury, or illness in audience members, and may result in the clients gaining support and validation from their communities. We discuss the potential of music performances to contribute to individual development, reinforce rehabilitation, enhance function, and facilitate change at the community level to support reintegration of military service members. We illustrate this through two brief case reports of service members who received music therapy as part of their treatment for post-traumatic stress disorder, traumatic brain injury, and other psychological health concerns at the National Intrepid Center of Excellence, a Directorate of the Walter Reed National Military Medical Center, Bethesda, MD, United States. The service members wrote, learned, and refined songs over multiple music therapy sessions and created song introductions to share with audiences the meanings and benefits gained from integrating performance in music therapy. The case reports also include excerpts of interviews conducted with these service members several months after treatment about their experiences of performing and the perceived impact of their performances on the audience and greater community.

Music therapy has optimized the rehabilitation of a service member through assisting the recovery process on a continuum from clinic to community. Implications for Rehabilitation Music therapy in stand-alone sessions and in co-treatment with traditional disciplines can enhance treatment outcomes in functional domains of motor, speech, cognition, social integration, and quality of life for military populations. Music therapists can help ease discomfort and difficulty associated with rehabilitation activities, thereby enhancing patient motivation and participation in interdisciplinary care. Music therapy assists treatment processes from clinic to community, making it highly valued by the patient, family, and interdisciplinary team members in military healthcare. Music therapy provides a platform to prevent social isolation by promoting community integration through music performance.

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Based on the growing need for music therapy programming at military treatment facilities and clinics that specialize in the rehabilitation of service members, this article describes a music therapy group protocol and the findings of 201 post-session evaluations. In addition, we present clinical perspectives and recommendations from three music therapists who have facilitated this group protocol on four military bases across the United States. The group session outlined in the protocol is intended as an introduction to music therapy. It familiarizes service members to various music therapy experiences specifically structured to enhance feelings of safety during emotional risk-taking. In addition, the protocol functions as an initial assessment of service members’ responses to the various receptive and interactive music experiences and includes psychoeducation regarding the role of music therapy in an interdisciplinary treatment model. The post-session evaluation data suggest that service members endorsed this introductory group as moderately to very helpful. Perceived benefits included the opportunity to express various emotions and increased awareness of somatic responses through music. A large number of requests for continued music therapy services following the introductory session suggest that the protocol is successful in facilitating understanding in service members regarding the potential benefits of music therapy in interdisciplinary treatment. Feedback from the music therapists indicated that the group protocol is a helpful initial experience for service members to acclimate to music therapy and for music therapists to learn about their patients’ specific needs to inform subsequent treatment.

The use of telehealth within music therapy practice has increased through necessity in recent years. To contribute to the evolving evidence base, this current study on Telehealth Music Therapy (TMT) was undertaken to investigate the telehealth provision experiences of music therapists internationally. Participants completed an anonymous online cross-sectional survey covering demographics, clinical practice, telehealth provision, and telehealth perceptions. Descriptive and inferential statistics, in combination with thematic analysis, were used to analyze the data. A total of 572 music therapists from 29 countries experienced in providing TMT took part in this study. The results showed that the overall number of clinical hours (TMT and in-person hours combined) declined due to the pandemic. Participants also reported reduced perceived success rates in utilizing both live and pre-recorded music in TMT sessions when compared to in-person sessions. Although many music therapists rose to the challenges posed by the pandemic by incorporating TMT delivery modes, there was no clear agreement on whether TMT has more benefits than drawbacks; however, reported benefits included increased client access and caregiver involvement. Furthermore, a correlation analysis revealed moderate-to-strong positive associations between respondents who perceived TMT to have more benefits than drawbacks, proficiency at administering assessments over telehealth, and perceived likelihood of using telehealth in the future. Regarding the influence of primary theoretical orientation and work setting, respondents who selected music psychotherapy as a primary theoretical orientation had more experience providing TMT prior to the pandemic while those primarily working in private practice were most inclined to continue TMT services post-pandemic. Benefits and drawbacks are discussed and future recommendations for TMT are provided.

Music therapy is becoming increasingly prevalent in rehabilitation programs serving military and Veteran populations in the United States. Music therapy is integrated into interdisciplinary models and positioned to treat brain injury, post-traumatic stress disorder, and other psychological health conditions at military installations and Veteran medical centers nationwide. Phased group music therapy is delivered in a longitudinal treatment model to assist in the rehabilitation of service members and Veterans. Different phases of group music therapy are aligned with a treatment trajectory that exists on a clinic to community continuum to support recovery and reintegration. This article provides a description and case presentations of clinical programming. Information was accessed from patients' electronic medical records, clinical documentation, therapist observation, and patient interviews. Interviews were transcribed and a content analysis was conducted by the authors. Emergent themes from the patient interviews included social relationships, community reintegration and transition, and post-military occupational success. Patients reported that group music therapy provided skill-building opportunities that were helpful for them during military service transitions, specifically active duty to Veteran status. Support skills included rapport-building and enhanced camaraderie. Furthermore, music therapy appeared to bolster peer connections through shared experiences, which decreased isolation, increased socialization, and supported reintegration.