Music Therapy - Changing Models in a Mental Health Service

Abstract: The paper will review a music therapy service in one mental health service over a period of l0 years. It will focus upon particular issues of developing a service in the field of psychiatry, in a setting where community developments are taking place. It will examine the relationship between the changing patterns of care in clinical settings, and changing models of music therapy. Using clinical examples, both from the author's music therapy practice, and her colleagues practice within the service, it will look at the influence upon the work, both organisation and more 'unconscious'. For example, a discussion of changing patterns of nursing care from a therapeutic community oriented model, to a more medical one, will be included alongside a description of some concurrent trends in music therapy models with clients. The complex nature of the recent mental health service developments from a managerial point of view as a result of the l990 White Papers 'Working for Patients' and 'Community Care' will be discussed with a view to their clinical impact, and specifically the conflicts faced by music therapists. Examples will describe the way in which opposing theoretical frameworks within the same clinical setting can upset the particular therapeutic process for clients in music therapy. The heart of the paper will ask the questions 'Is it better to adopt a firm treatment model and stick to it, or consider the underlying principles in each clinical setting and adapt models accordingly? How best can clients receive individual care and specifically the appropriate music therapy treatment within an institutionalised framework? This paper will be published by the BSMT later in l992, price on application.

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Keyword(s): Model, change, review, mental-health-program.

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