Music Therapy Treatment of Depressive Symptoms in Adolescents in Short-Term Inpatient ...

163 Pages·2013·1.62 MB·English

by  Emily Sheehan

Music Therapy Treatment of Depressive Symptoms in Adolescents in Short-Term
Inpatient Psychiatric Settings: A Survey Study

A Thesis
Submitted to the Faculty
of
Drexel University
By
Emily M. Sheehan
in partial fulfillment of the
requirements for the degree
of
Master of Arts
in
Creative Arts in Therapy—Music Therapy
June 2013
© Copyright 2013
Emily M. Sheehan. All Rights Reserved.
ii
DEDICATIONS

To the adolescents with whom I’ve worked over the past years, and to those with whom I
will work in the future: Thank you for motivating me to delve deeper into this work.
To the music therapists and other creative arts therapists who have inspired me with your
honesty in approaching your work, and who’ve strengthened the field with deep
consideration of the implications of music therapy with adolescents.
To my parents, Carl and Becky Sheehan, for teaching me that the world is basically a
good place, though it needs some upkeep, and that everyone deserves heartfelt assistance.
iii
ACKNOWLEDGEMENTS

My deepest appreciation to Flossie Ierardi for assisting me every step of the way,
guiding me through the thesis process and responding to each and every question I asked.
Thank you for your patience.
Thank you to Dr. Francis Cornelius for your survey expertise and enthusiasm in
discussing the survey and thesis. Thank you to Jill Comins for sharing your professional
experiences with me and for your valuable feedback.
Thank you to my loving parents, Carl and Becky Sheehan, and wise siblings,
Colleen Morris and Trevor Sheehan, for endless support in my career decision and for
always believing in me. And thank you, Colleen, for the edits.
Thank you to my classmates—my friends—for being such wonderful therapists-
in-training, for inspiring me and creating such an incredible and enjoyable experience
over these past two years. Special thanks to Debra Lynn August for the consistent thesis
dates.
Thank you to my partner and friend, Gilbert Gavigan, for your endless patience
and support, for sitting with me into the late night hours so I wouldn’t fall asleep when I
needed to keep writing. Thank you for your support and love.
iv
TABLE OF CONTENTS

LIST OF TABLES........................................................................................................vii
LIST OF FIGURES......................................................................................................viii
ABSTRACT...................................................................................................................ix
I. INTRODUCTION......................................................................................................1
II. LITERATURE REVIEW...........................................................................................8
Adolescence.........................................................................................................8
Adolescent Depression.......................................................................................11
Experiences of Adolescent Depression...............................................................15
Trends in Adolescent Psychotherapy..................................................................19
Creative Arts Therapies with Adolescents: Selected Literature...........................29
Adolescents and Music......................................................................................33
III. METHODS............................................................................................................48
Design of the Study...........................................................................................48
Location of the Study.........................................................................................48
Time Period for Study........................................................................................48
Enrollment Information......................................................................................49
Subject Type......................................................................................................49
Participant Source..............................................................................................49
Recruitment.......................................................................................................49
Subject Inclusion Criteria...................................................................................50
Subject Exclusion Criteria..................................................................................50
Investigational Methods and Procedures............................................................51
v
Operational Definitions......................................................................................53
Possible Risks and Discomforts to Subjects.......................................................54
Special Precautions to Minimize Risks or Hazards.............................................55
IV. RESULTS..............................................................................................................56
Survey Respondents’ Characteristics..................................................................72
The Influence of Goals on Methods and Most Important Factors........................81
V. DISCUSSION.........................................................................................................84
Overview...........................................................................................................84
Major Findings..................................................................................................84
Clinical Applications.........................................................................................93
Limitations of the Study.....................................................................................95
Recommendation for Future Research................................................................97
VI. SUMMARY AND CONCLUSIONS....................................................................101
REFERENCES............................................................................................................104
Appendix A: Email Invitation to Participate in Survey.................................................113
Appendix B: Authorization for Use of CBMT Email Addresses..................................115
Appendix C: Reminder Email for Participation in Survey............................................116
Appendix D: Survey....................................................................................................117
Appendix E: Responses to Question 6 of Those Who Chose
“Other (please specify):”.............................................................................................130

Appendix F: Responses to Question 8 of Those Who Chose
“Other (please specify):”.............................................................................................131

Appendix G: Responses to Question 10 of Those Who Chose
“Other (please specify):”............................................................................................132

Appendix H: Responses to Question 11 of Those Who Chose
vi
“Other (please specify):”.............................................................................................133

Appendix I: Responses to Question 15 of Those Who Chose
“Other (please specify):”............................................................................................134

Appendix J: Responses to Question 18 of Those Who Chose
“Other (please specify):”............................................................................................135

Appendix K: Open-Ended Responses to Question 19 “Please explain:”.......................136

Appendix L: Open-Ended Responses to Question 20 “Please explain:”.......................137

Appendix M: Open-Ended Responses to Question 22 “Please explain:”......................138

Appendix N: Responses to Question 25 of Those Who Chose
“Other (please specify):”............................................................................................139

Appendix O: Responses to Question 26 of Those Who Chose
“Other (please specify):”............................................................................................140

Appendix P: Responses to Question 27 of Those Who Chose
“Other (please specify):”............................................................................................141

Appendix Q: Responses to Question 28 of Those Who Chose
“Other (please specify):”............................................................................................142

Appendix R: Responses to Question 31 of Those Who Chose “Other
Techniques/Additional Comments:”.................................................................143

Appendix S: Responses to Question 32 of Those Who Chose
“Other (please specify):”.............................................................................................145

Appendix T: Open-Ended Responses to Question 34...................................................146

Appendix U: Open-Ended Responses to Question 35...................................................148

Appendix V: Permission for Reprinting of AMTA 2011 Workforce Profile Data........151
vii
LIST OF TABLES

4.1. Most Important Factors Contributing to Successful Treatment:
by General Theme................................................................................................71

4.2. Aspects of Treatment Focused Upon in “Most Important Factors” Question..........72

4.3. Themes of Agency in “Most Important Factors” Question.....................................73
viii
LIST OF FIGURES

4.1. Years of Experience Working As a Music Therapist..............................................58
4.2. Respondents’ Experience Working with Adolescents in Short-Term Inpatient
Psychiatric Settings............................................................................................58

4.3. Average Length of Hospitalization for Adolescents...............................................61

4.4. Treatment Team Members Collaborated with to Develop Treatment Goals............62

4.5. Treatment Team Members Collaborated with to Provide Treatment.......................62

4.6. Diagnoses of Adolescent Patients Treated for Depressive Symptoms.....................64

4.7. Top Goals When Treating Adolescents With Depressive Symptoms in Music
Therapy................................................................................................................65

4.8. Methods Frequently Used When Treating Adolescents
With Depressive Symptoms..................................................................................66

4.9. Methods Chosen As Effective In Alleviating Depressive Symptoms
in Adolescents......................................................................................................68
ix
ABSTRACT
Music Therapy Treatment Of Depressive Symptoms in Adolescents in Short-Term
Inpatient Psychiatric Settings: A Survey Study
Emily M. Sheehan

Music therapists work with adolescents in inpatient psychiatric settings. While diagnoses
of adolescents admitted to inpatient psychiatric settings range from psychoses to mood
disorders, depressive symptoms are a prevalent problem. Some of the adolescents are
admitted to inpatient psychiatric settings with Major Depressive Disorder, while others
have symptoms of depression along with other diagnoses. There is a lack of current data
about the music therapy treatment of depressive symptoms in these situations. Thus, this
study sought to determine the goals and methods of music therapists working to treat
depressive symptoms in adolescents in short-term inpatient psychiatric settings, as well as
music therapists’ perceptions of the most important factors that influence successful
treatment of depressive symptoms in adolescents. A survey completed by 36 board-
certified music therapists yielded information about the practices of music therapists
working in the milieu of the short-term inpatient setting. Results show that the top goals
of music therapists are to increase ability to cope with negative feelings/mood states,
increase positive social interaction, and increase self-esteem. Responding music
therapists reported most frequently using the methods of lyric analysis, rhythmic
improvisation, and music listening. They found lyric analysis, rhythmic improvisation,
and songwriting to be the most effective methods to treat depressive symptoms in
adolescents in short-term inpatient psychiatric settings.