B A C K G R O U N D
Description of the condition
Schizophrenia is a serious mental disorder with considerable impact on individuals and their families. It may take a life-long
course, although full recovery is also observed in a proportion of
cases. Symptoms of schizophrenia are usually classified as ’positive’ (where something is added, such as hallucinations or paranoid ideation; also classified as schizophrenia type I) and ’negative’
(where something is missing, such as the ability to express oneself
emotionally or to form satisfying relationships with others; also
classified as schizophrenia type II). The aspects of schizophrenia
that are linked to losing and regaining creativity, emotional expressiveness, social relationships, and motivation may be important in
relation to music therapy (Gold 2009).
Description of the intervention
Music therapy is generally defined as “a systematic process ofintervention wherein the therapist helps the client to promote health,
usingmusicexperiencesandthe relationshipsthatdevelopthrough
them as dynamic forces of change” (Bruscia 1998). It is often perceived as a psychotherapeutic method in the sense that it addresses
intra- and interpsychic, as well as social processes by using musical
interaction as a means of communication, expression, and transformation. The aim of the therapy is to help people with serious
mental disorders to develop relationships and to address issues they
may not be able to using words alone.
Recognition of music therapy as a profession (with its own academic and clinical training courses) was first introduced in North
and South America in the 1940s. The first European countries
(Austria and England) followed in 1958, and soon after that many
other countries followed (Maranto 1993). It is now a state-registered profession in some countries (Austria, UK). A survey based
in Germany showed that music therapy was used in 37% of all
psychiatric and psychosomatic clinics (Andritzky 1996).
Music therapy models practised today are most commonly based
on psychoanalytic, humanistic, cognitive behavioural or developmental theory (Gold 2009; Wigram 2002). Generally, behavioural
models are more prevalent in the USA, whereas psychodynamic
and humanistic models dominate in Europe. However, the competing theoretical models in music therapy and their applications
do not necessarily form distinct categories, but rather prototypical
positions in a varied but coherent field.
Other than by their theoretical orientation, approaches in music
therapy may also be described by their modality (’active’ versus
’receptive’), their level of structure, and the focus on the music
itself versus on verbal processing of the music experiences. The
active modality includes all activities where clients are invited to
play or sing. This includes a variety of activities ranging from free