Alliance building in music therapy for forensic psychiatric patients with schizophrenia. An exploratory case study research design. Issue 2 (15th March 2021)

• Record Type: Journal Article
• Authors: Frederiksen, Britta; Ridder, Hanne Mette Ochsner; Pedersen, Liselotte
• Is Part Of: Nordic journal of music therapy. Volume 30:Issue 2(2021)
• Page Start: 157
• Page End: 178
• Publication Date: 2021-03-15
• Subjects: Forensic psychiatric patients -- schizophrenia -- music therapy -- psychotherapy -- trust -- therapeutic alliance; Music therapy -- Scandinavia -- Periodicals; Music Therapy -- Periodicals; 615.85154
• DOI: 10.1080/08098131.2020.1827452
• Languages: English
• ISSNs: 0809-8131

Abstract

ABSTRACT: Introduction : Forming therapeutic alliance with forensic psychiatric patients with schizophrenia is challenging, and there is a gap in knowledge about the dynamics in the initial phase of psychotherapy and how collaboration and trust is developed. Music therapy is described as a motivating approach enhancing the forensic psychiatric patient's ability to engage in a relationship. The purpose of the study was to explore and identify dynamics in the process of forming therapeutic alliance in music therapy for forensic psychiatric patients with schizophrenia. Method : The study adopted an exploratory case study design with data from multiple perspectives providing thick descriptions. Four patients with schizophrenia from a medium secured unit at a forensic psychiatric hospital were offered weekly music therapy sessions for six months. An inductive process based on a hermeneutic phenomenological epistemology and a nine step procedure for the analysis led to a final abductive synthesis. Results : Each of the following themes formed a continuum of dynamic interactional processes within the development of therapeutic alliance with forensic psychiatric patients with schizophrenia in music therapy and were presented as a condensed continua model; (a) Control, (b) Closeness/distance, (c) Structure, (d) Process/product, (e) Focus of attention, (f) Interaction, and (g) Verbal dialogue. A case example is provided. Discussion : The continua model may contribute to the clarification and conceptualization of the developmental dynamics in the initial phase of psychotherapy with forensic psychiatric patients with schizophrenia, and hereby contribute to a recognition of the importance of treatment efforts specifically concerned with relational and musical competencies.