City Research Online

Abstract

BACKGROUND: The use of voice in music therapy is considered a powerful resource for engaging clients and facilitating change. Group improvisation is identified as one of the main techniques for working with mental health service users, particularly from a psychodynamic perspective, yet there is little evidence about the practice of group vocal improvisation (GVI) in music therapy. An exploration of the use of GVI as a specific music therapy technique may provide some insights into its clinical affordances and challenges.

METHODS: 10 mental health service users with heterogeneous diagnoses accessing secondary mental health outpatient services were recruited and allocated based on clinical assessment and preference to one of two closed groups. Both groups focused on group improvisation but one used instruments (GMT group, n=5) and the other used the voice (GVI group, n=5). Participants attended weekly group music therapy sessions for 6 months. Audio recordings of the sessions identified specific features of each modality through interaction analysis. Questionnaires measuring therapeutic alliance were compiled at the end of each session to analyse evolving therapeutic processes. End of therapy interviews explored participants’ experiences from the sessions and narratives around the engagement in music making.

RESULTS: Musical activities showed important differences in timing, distribution and format between the two groups, whilst verbal negotiation of tasks in the group provided similar group dynamics. The musical analysis indicated greater variety within musical activities for the GMT group whilst the GVI showed more musical variety across different activities. Scores of therapeutic alliance showed similar trends for both groups but the GVI showed a slower increase. Participants from the GMT group reported a greater emphasis on narrative reflection on their musical experience, whereas GVI participants described a greater impact on experiential bodily awareness and accessing new experiences.

CONCLUSION: The use of GVI was feasible clinically and showed both similarities as well as differences in interactions, therapeutic processes and change mechanisms in comparison to the GMT group. An emphasis on the physicality of singing, a greater need for structure within improvisations and a shift towards a more active therapeutic stance were the main distinct features of GVI. Further research should look into the combination of both techniques and explore the links between voice work and body work further.

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