Lisa OtterBarry

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• Lisa Otter-Barry
• Soundwell Co-ordinator and Music Therapist
• Emma Weatherup
• Soundwell Development Worker and Music Therapist

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• A qualitative study
• exploring the perceived impact of a
• community-based music therapy service
• Dr Sarah Wall
• Mental Health RD Unit
• June 2009

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• Agenda
• Introduction to study
• Soundwell
• Music Therapy
• Rationale
• Methodology
• Analysis
• Findings
• Soundwells response

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• Introduction to Study
• A qualitative study exploring the perceived
  impact of a
• community-based music therapy service
• Study Author - Dr Sarah Wall
• Mental Health Research and Development Unit
• Ethics approval - Bath Research Ethics Committee
  
• This study period 2006-2008.

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• Soundwell
• Summary of overall aim
• To enhance the mental health of people
• experiencing emotional and mental distress
  by
• promoting and providing an inclusive,
  accessible
• community-based music therapy service.

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• Soundwell
• Where?
  
  Wiltshire, BNES and North
  Somerset.
• What?
• Registered charity since 2000 providing
  community based
• ongoing and brief music therapy groups
• outreach workshops
• individual sessions
• support groups using music, for carers

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• Previous Soundwell Outcomes (aims)
• increased self-esteem, confidence and motivation,
• reduced stress/anxiety
• reduced isolation, and improved
  communication/relationship skills  
• increased independence
• improved mental health, less support required
  from CMHTs

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• Music Therapy
• The use of musical instruments and sounds
  promoting change and recovery.
• Communication when its difficult to find the
  words.
• A variety of instruments invite self-expression
  and interaction.

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• Study Rationale
• To obtain independent and multi-faceted
  perspective on previous Soundwell evaluation
  outcomes
• Funder demands
• Shortage of studies of Music Therapy mental
  health in community settings
• Neglected area of research service users
  /carers experience.

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• Researchers MHRDU
• Dr Sarah Wall Research Officer (author of
  study)
• Dr Willm Mistral - Research Manager
• Siobhan Floyd Research Associate
• Rosemary Stevens Service User Researcher

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• Methodology
• Steering group
• Focus groups and individual interviews
• Explore perceived impact of Soundwells service
  
• Four different perspectives
• Service user
• Carer
• Health worker
• Music therapist

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• About the Focus Groups
• 1 pilot focus group to inform the protocol
• 7 further focus groups
• Rationale for using groups
• Facilitated by 2 researchers - music therapists
  not present
• Content recorded on flip chart

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• The 8 Focus Groups - Participants
• 4 focus groups for mental health service users of
  working age
• Older adults with mental health needs/dementia
• Health care workers of older adults
• Carers of adults with mental health needs
• Music therapists

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• Variety of Music Therapy Experience Evaluated
• Ongoing music therapy groups 2 focus groups
• Brief groups 1 focus group
• One-off outreach workshops 1 focus group
• Ongoing individual sessions 2 individual
  interviews
• Support groups using music, for carers 1 focus
  group

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• About the Interviews
• 2 individual music therapy service users
• 5 referring health care workers- phone

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• Analysis
• Thematic analysis
• Triangulation of 4 perspectives
• Comparison and contrast

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• Findings
• Themes arising
• 6 distinct core themes primary positive
  impacts
• Commonality of themes across 4 perspectives
• Focus group structure not pre-designed - Themes
  arose naturally

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• Findings 6 Core Themes
• Theme 1 - team spirit
• Social functioning, reduced isolation and
  strengthening
• relationships
• Relationships built within and beyond sessions
• vignette
• Acceptance and inclusion
• Therapeutic relationship

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• Theme 2 - An Outlet
• The exploration and appropriate expression of
  difficult
• emotions
• Complex/intense emotions non-judgmental space
• Therapeutic environment
• feel safe in expressing myself (Service User)

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• Theme 3 - Courage
• Improvements in self-esteem, confidence and
  motivation
• Increased confidence and self esteem
• Learning how to interact
• Increased motivation to be creative

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• Theme 4 Freeing
• The experience of freedom and creativity
• non-prescriptive working
• A deeper exploration of the self
• Focus and escapism (carers)

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• Theme 5 Unable to Express in Words
• An alternative form of communication
• Music as therapeutic tool
• Communication opportunities
• Value of listening without judgement

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• Theme 6 An Open Door
• Individual choice and suitability
• Any level of musical skill/experience
• Apprehension and support
• Not everyones cup of tea

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• Additional Theme - Practicalities
• Session length
• Variability of instruments
• Location
• Referral time
• Transport
• Publicity and evidence

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• Discussion
• Positive experiences of Soundwell endorsed across
  four perspectives
• Minor differences of emphasis
  freedom/creativity (SUs)
• Significance of social benefits for very isolated
  and under-served individuals
• Key quality non verbal interaction

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• Discussion (cont)
• Benefits transferable into daily lives
• Concurrence of themes irrespective of
• diverse music therapy experiences
• diversity in musical ability
• mental health problem
• stage of recovery

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• Limitations
• Anxiety and communication issues
• Mental health issues preventing participation in
  study
• Small sample size anonymity
• Participants contact with Soundwell

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• Conclusions
• Service has wide-reaching and positive impact
  on
• social functioning and isolation
• experiences of anxiety and frustration
• self-esteem, confidence and motivation
• feelings of freedom, relaxation and creativity
• communication of difficulties without the need
  for words.

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• Conclusions
• Includes participants with high support needs
• Small scale study
• Insight into a neglected area of research the
  service users and carers experience.

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• Concluding Comments
• Such benefits are recognised by the
  project users,
• and observed by the music therapists during
  the sessions,
• as well as being witnessed by the carers and
  healthcare professionals
• in the project users lives beyond the
  therapeutic environment.
• Dr Sarah Wall

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• Soundwells Response
• Concurrence of participant feedback with previous
  findings
• Significance of findings in the context of
  participants lives
• Steps towards recovery - impact beyond music
  therapy space
• The future how study evidence can support
• Expansion and sustainability of Soundwells
  service
• Increased use of arts therapies to promote good
  mental health

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• Thank you to study participants
• project users
• carers
• healthcare workers
• and to the research team for giving them a voice

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