Therapeutic Songwriting in Music Therapy Felicity Baker, Tony Wigram, David Stott, Katrina McFerran
Therapeutic Songwriting in Music Therapy Felicity Baker, Tony Wigram, David Stott, Katrina McFerran
Therapeutic Songwriting in Music Therapy Felicity Baker, Tony Wigram, David Stott, Katrina McFerran
To cite this article: Felicity Baker , Tony Wigram , David Stott & Katrina McFerran (2008)
Therapeutic Songwriting in Music Therapy, Nordic Journal of Music Therapy, 17:2, 105-123, DOI:
10.1080/08098130809478203
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RESEARCH ARTICLE
Nordic Journal of Music Therapy, 17(2) 2008, pp. 105-123.
Therapeutic Songwriting in
Music Therapy
Part I: Who are the Therapists, Who are the Clients, and Why is
Songwriting Used?
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Abstract
Songwriting as a therapeutic intervention has received increasing attention in the field of music
therapy over the past decade however much of the publications focus on clinical outcomes rather than
methods of practice. This paper, part of a two-part research report into trends in the clinical practice
of songwriting, aims to describe the most frequently employed goal areas across a range of clinical
populations and compare these findings with the published literature. Responses to a 21-question on-
line survey were obtained from 477 professional music therapists practicing in 29 countries which
focused on approaches to songwriting within their practice with a single clinical population. Chi-
square or comparable Exact tests (Fisher-Freeman-Halton) were applied to the data and significant
associations were found according to different clinical populations particularly with respect to the
aims of songwriting in clinical practice and the frequency with which songwriting is employed in
practice. The data highlights that songwriting is frequently employed in developmental disability and
ASD practice, with reports on songwriting with these diagnostic groups being underrepresented in
the music therapy literature. The survey identified that the most frequently endorsed goal areas align
with the literature base and included a) experiencing mastery, develop self-confidence, enhance self-
esteem; b) choice and decision making; c) develop a sense ofself; d) externalising thoughts, fantasies,
and emotions; e) telling the client's story; andf) gaining insight or clarifying thoughts and feelings.
contributors had developed unique ways of using various aspects of the use of songwriting in
songwriting with different clinical populations music therapy clinical practice. In particular, this
while maintaining some common elements in article focuses primarily on the demographic data
of respondents who report using songwriting, the
FELICITY BAKER, PhD, RMT, is senior lecturer frequency with which it is used within their work
and Program Director of Music Therapy Training and the aims/purpose that songwriting targets
at The University of Queensland, School of Music, with different diagnostic groups. Discussion
Brisbane, Australia. Her current research interests
will compare our findings with those reported in
include songwriting and developing interventions
that promote coping and adjustment during the literature and discuss the findings in relation
transitional stages of life. Felicity is currently Editor to clinical practice. The second article Baker,
for The Australian Journal of Music Therapy, has Wigram, Stott and McFerran (in press), reports
written and edited 2 books, and authored a number data on the therapeutic approaches to songwriting
of chapters and articles in peer reviewed journals and as they are employed with different clinical
books. Tel.: +61 7 336 53740, fax: +61 7 336 54488. populations.
Email:f.bakerl@uq.edu.au
Oncology/ Aasgaard 2001, 2005 Dalton & Krout 2005 2006 O'Brien 2005 (Australia)
Palliative Care (Norway) Krout, 2005a, 2005b (USA) O'Callaghan
Abad 2003 (Australia) Kennelly 1999 (Australia) 1990/1996/1997 (Australia)
Hadley 1996 (Australia) Ledger 2001 (Australia) Cordobés 1997 (USA)
Slivka & Magill 1986 McFerran-Skewes 2001 Dileo & Magill 2005(USA)
(USA) (Australia)
Turry 1999 (USA) Robb 1996; Robb & Ebberts
2003a 2003b (USA)
Roberts 2006 (Australia)
Neuro- Baker et al. 2005a/b/c Robb 1996(USA) Baker 2005/Baker et al.
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Table 1. Authors describing songwriting approaches according to diagnostic group, age group, and
country of origin.
they serve. The literature search indicates that the work/research documented has been with adults,
majority of authors were from the USA (n = 21) particularly in the area of psychiatry. However,
and Australia (« = 15). Very few were from the there are a number of studies in the area of
UK and Europe, and no authors were from Asia oncology/palliative care, and this tends to be
or South America. This difference may be due more focused on child and adolescent age groups.
to the primarily psychodynamic/analytical and There was noticeably very little in the area of
improvisational models practiced in Europe when developmental disability and autism spectrum
compared with the more eclectic approaches disorder (ASD) particularly given that music
practiced in the USA and Australia. Given this therapy is widely practiced with this diagnostic
difference, the authors questioned whether there group.
were any trends towards using songwriting in Table 2 presents a list of the various goals
other global regions. identified in the literature and categorises these into
Table 1 also shows that the majority of clinical the different diagnostic groups. Psycho-emotional
goals were the dominating goals emerging from cognition; decreasing stress, and 4) grief/trauma.
the literature whereas developmental goals (eg Given that children/adolescents with special needs
developing cognitive skills) were identified and aged care were the predominant diagnostic
as relevant only for neurorehabilitation and groups, it is not surprising that socialisation
developmental disability. In particular, the was so frequently identified, and that this was
table shows that the most frequently cited goal infrequently documented in the songwriting
- present in two thirds of the literature - was that literature. Similarly, there is an emphasis on
of externalising or exploring thoughts, fantasies developmental goals particularly communication
and emotions. Fifty percent of the literature also and cognition, these being appropriate for the
identified experiencing mastery, developing and predominant diagnostic group. Williamson
enhancing self-confidence/self-esteem as goals contextualises the findings by arguing that these
underpinning the choice to use songwriting. more frequently identified diagnostic groups were
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Gaining insight/clarifying thoughts and feelings, reflective of the development of music therapy
validating experiences/coping, reducing anxiety, within New Zealand.
anger and tension, offering choice and developing The findings from this literature review, and the
a sense of self were also prevalent. Songwriting methods and techniques already described in the
as used in psychiatry, had the most varied usage edited volume published on songwriting (Baker
of all the populations (16 goals documented), & Wigram, 2005) provide a clear foundation
partly explained by the greater number of studies for the most relevant areas of enquiry for a
reported but also because the term psychiatry comprehensive survey into current songwriting
encompasses a broad range of diagnoses leading practices, and to a large extent inform the method
to an extensive list of relevant goals. Literature of that enquiry.
surveyed included eating disorders, sexual abuse,
schizophrenia, and substance abuse.
A similar study to that reported here was Method
conducted by Williamson (2006), with her work
specifically surveyed the songwriting practice The Survey
trends of music therapy clinicians in New Zealand. The web-based survey comprised 21-questions
The self-administered postal questionnaire was (Appendix 1 on NJMT website: www.njmt.
completed by 11 clinicians, 10 of which reported no) seeking information about respondent
using songwriting in their clinical work. While demographics and a range of issues pertinent
this survey allowed for respondents to nominate to songwriting practice. All questions included
using songwriting with more than one clinical forced choices, and the survey could not be
population, the data showed that clinicians were electronically submitted until all questions
using songwriting predominantly with children were answered. "Other" and/or "not applicable"
and adolescents (particularly special needs, n = choices were given for six questions (#'s 6,
9), aged care (n = 4) and adults in palliative care 8, 12, 19, 20 and 21). Question #5 asked the
(n = 3). So in Williamson's case, the literature was respondent to indicate whether or not songwriting
not representative of what was occurring in New was employed within their practice. Those
Zealand practice, i.e. there were no clinicians respondents indicating "no" to this question were
using songwriting in the area of psychiatry, and then instructed to submit their survey at that point
a heavy emphasis on its use in developmental and did not complete the remaining questions.
disability.
With respect to goals addressed by songwriting, Respondents
Williamson found that the most commonly Responses were sought from clinicians practicing
reported categories in order of ranking were: 1) in a total of 40 nations within North and South
socialisation, 2) self expression; communication; America, Australasia, and Europe. Ethical
speech and language skills, 3) memory and approval was granted by the The University of
Queensland review board, and to meet ethical broader categories resulting in seven categories:
requirements, the researchers requested the oncology and palliative care, neurorehabilitation,
information be distributed through countries' dementiaandagedcare,psychiatry, developmental
professional organizations to protect privacy. disability, autism spectrum disorder, and other
Contact was made with these organizations via (details of the recoding see under Table 4).
email requesting that they distribute details of The responses to questions on use of
the survey to their members inviting them to songwriting were coded mostly into five-point
participate, rather than obtain email addresses ordinal frequency scales (typical options being
directly from the organizations. Fourteen of the "always", "often", "sometimes", "rarely" and
nations responded indicating their willingness "never"). The question addressing Goals of
to distribute the survey (Denmark, Israel, Intervention used a ten-point numercial scale
Iceland, Ireland, Luxembourg, South Africa, with the opposite ends labelled 1 = "almost
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United Kingdom, Malaysia, Norway, Canada, never applies" and 10 = "almost always applies".
China, Taiwan, New Zealand, and Austria). The The responses to the questions showed marked
United States requested that the researchers tendencies to select at the extreme margins of the
distribute the survey themselves (with emails scales and it was considered than neither mean
but no names of members provided), and the nor median responses adequately characterized
Australian association publicized the survey on the distributions. Consequently responses at
its web page. After two attempts at making email the higher frequency end of the scales ("often"
contact, no responses came from country contacts and "always") were combined and are stated as
in the seven South American nations, 12 of the percentages in the tables. Responses to Goals of
European nations and two Asian nations, and Intervention have used values of "7 and over" to
emails sent to contacts in three other European represent higher frequency responses. For ease
nations were returned undeliverable. of interpretation these responses are labelled
Respondents received an information sheet "often/always" in the Tables 6 and 7. Where
indicating the purpose of the study and an both the explanatory and the response variables
electronic link to the webpage where the survey were ordinal the chi-square tests for trends has
was being hosted. Priorto commencingthe survey, been applied. In all the remaining tables which
respondents were required to check three boxes met the Cochrane criteria, chi-square analysis
indicating that they had read the information has been used to compare the proportion of
provided about the study and consented to 'often/always' responses according to nominal
participate. Respondents were not able to submit explanatory variables (region, clinical population
the survey electronically until all questions were etc.). Adjusted standardised residuals < -2 or >
answered. On submitting the survey, respondents 2 are indicated. In those tables where Cochrane
were given an identification number for their criteria were not met, the Fisher-Freeman-Halton
records and instructed to contact the researchers Exact Test for r x c tables has been applied.
and quote this number should they choose to
withdraw their contribution at a later date.
Results
Data Respondents
Despite only receiving 16 responses from various
All data were stored on The University of countries indicating their willingness to respond,
Queensland server and were only available to data were received in total from 29 countries.
the researchers. Data were imported into SPSS Of the additional responses, six came from
(version 14) for analysis. Due to the small countries not in the initial pool of 40. It can be
number of respondents reporting work with some assumed therefore, that a) some associations had
diagnostic groups, categories were combined into members on their database from countries other
than their own; and b) despite not responding to is widely adopted in clinical practice.
emails, some countries forwarded the request Table 4 details the gender, age distribution and
to some or all of their membership without years of clinical experience of the respondents.
informing the researchers. Therefore, the total Table 4 illustrates that 91% of the respondents
pool of respondents (N=3152) who potentially are females. This corresponds with general
received the information is an estimate. A total trends in gender distribution in music therapy.
of 477 (15%) responses were submitted (Table For example, males make up only 8.4% of the
2). It should be noted however, that based on the Australian Music Therapy population and 18.5%
figures obtained from the USA, a further 11 % of if the British Music Therapy population. It is
emails were returned undeliverable and suggests noticeable that females were less predominantly
that the percentage response rate is more likely to represented in the neurorehabilitation, and to
be an underestimation. Of the 477 participants, a lesser extent psychiatry fields. Differences
419 of these indicating that they employed between clinical population and age of practioner
songwriting in their work, leaving 58 submissions are evident though not significant (p = .08).
where the respondents clearly stated they do not There is some evidence of younger music
use songwriting. Due to the small numbers of therapists (20-30 years of age) are more likely
respondents in some countries, countries were to be using songwriting with ASD groups than
combined into global regions. Table 3 indicates older therapists. With respect to the years of
that the largest proportion of respondents was clinical experience, there are some differences
from the USA and Canada, and to an extent between oncology/palliative care when compared
Australia/New Zealand, supporting the literature with ASD and dementia/aged care. In the
base which is largely from these regions (refer oncology/palliative care, clinicians who reported
Table 1). There were however, a number of using songwriting had generally more clinical
respondents from other regions suggesting that it experience in contrast to the ASD group and
2
P values .03 .08' .22'
TOTAL 418 91 40 32 19 9 17 26 22 34
the dementia/aged care group, where there were dementia and aged care patients which is
greater proportions of less experienced clinicians not unexpected given its use has only been
working with these populations. This suggests that documented by one author. At the same time, a
in general, clinicians may find working with the number of clinicians do employ songwriting at
sensitive personal issues in oncology/palliative some stage with this client group (n = 36, 9%
care to be more challenging and requiring more of total sample). Unanticipated was the finding
years of clinical experience. that 44% of clinicians within the sample working
with ASD clients adopt the intervention in their
Frequency of Songwriting work at least 1-2 times per week. This diagnostic
The frequency with which songwriting was group has been largely underrepresented in
normally used within respondents' practices are the songwriting literature. Perhaps the limited
reported in Table 5, where significant differences literature base reflects the earlier finding that
were found according to region (p = .03). clinicians in the ASD/disability fields are less
Notably, respondents from the USA/Canada clinically experienced and therefore perhaps less
were less likely to use songwriting as frequently likely to communicate their work in the music
as respondents from Australia/NZ or northern therapy literature.
Europe. This was surprising given that the largest Surprising to the authors was the low
proportion of literature was from the USA. frequency of songwriting (28% using it only
Table 5 also details the frequency with which 1-2 times per week or more often) applied in
songwriting is used according to different oncology/palliative care. There is a substantial
diagnostic groups and significant differences body of songwriting literature supporting its use
in usage were found (p <= .01). Noticeably, with this diagnostic group which would suggest
songwriting is used the least frequently with it is frequently used.
East Asia/Other 15 40 20 40
TOTAL 419 24 37 39
P value (chi-square) .03
Clinical Population
Oncology/Palliative Care 51 31 41 28
Neurorehabilitation 26 27 27 46
Dementia/Aged Care 36 44 39 17
Psychiatry 103 21 40 39
Developmental Disability 89 28 30 42
ASD 61 8 48 44
Other 53 17 32 51
TOTAL 419 24 37 39
P value (chi-square) <01
Psychiatry Subcategories
Eating Disorders 5 20 40 40
Depression/Suicide 27 22 33 44
Substance Abuse 10 10 30 60
Schizophrenia/Other Psychoses 27 19 56 26
Trauma 29 28 34 38
Anxiety, forensic psychiatry,
5 20 40 40
personality disorders
TOTAL 103 21 40 39
P value(Fisher-Freeman-Halton) .81
Bold italic values indicate adjusted standardised residuals < -2 or > +2
Table 5: Cross tabulation offrequency ofsongwriting usage across global regions and across different
diagnostic groups.
% often/always 35 62 69 66
Leisure % n/a 4 4 6 12
% often/always 31 32 65 42
Experience mastery, enhance self-confidence/esteem % n/a 4 0 3 0
% often/always 61 81 61 88
Develop a sense of self % n/a 4 0 0 0
% often/always 69 81 61 «9
Choice and decision making % n/a 0 0 3 2
% often/always 65 73 94 78
Sending messages to % n/a 0 8 6 6
significant others % often/always 82 67 44 52
Validating experiences % n/a 0 0 0 1
% often/always 90 92 67 78
Enhancing quality of life % n/a 0 0 3 3
% often/always 86 65 91 62
Gain insight or clarify thoughts and feelings % n/a 0 0 3 2
% often/always 84 89 63 S9
Develop awareness of musical/cultural identity % n/a 8 4 8 9
% often/always /5 28 24 ¥5
Life review % n/a 4 4 3 10
% often/always 7/ 44 74 52
Diagnostic purposes % n/a 24 8 17 19
% often/always 21 21 13 33
Relationship closure % n/a 4 4 14 11
% often/always 5J 28 39 44
Enhancement of spirituality % n/a 2 8 8 15
% often/always 56 33 49 32
findings. Enhancing self-esteem and self- ranked 5th in the survey, was rarely mentioned in
confidence were ranked 2nd in the literature, with the literature.
mastery and achievement ranked 5th. Within the Significant association betwen diagnostic
survey, this was the most highly endorsed goal groups and the proportions stating "often/
area. Gaining insight and clarifying thoughts and always" were found for all goal areas except
feelings were ranked equal 6th in the literature and for "diagnostic purposes." Notably, the goal
survey. Choice and decision making were ranked areas a) the development of cognitive skills (p
2nd in the survey whereas this goal area was rarely < .01); b) enhancing language, speech, and/or
mentioned within the songwriting literature. conversational skills (p < .01); and c) enhancing
Similarly, developing a sense of self was ranked social skills (p < .01), revealed a contrast
3 rd in the survey and not highly endorsed in the between ASD and intellectual/physical disability
songwriting literature; telling the client's story, (frequent use) and in oncology (infrequent
use). Choice and decision making (p < .04) use songwriting to facilitate the development
was particularly relevant in treating clients in of cognitive skills whereas more experienced
the dementia category when compared to other clinicians were more likely to use songwriting
diagnostic groups. Sending messages to others (p to assist clients to send messages to significant
< .01) and validating experiences (p < .01) were others, validate clients' experiences, enhance
highly relevant for oncology whereas gaining clients' quality of life, develop awareness of
insight (p < .01) was most highly endorsed by musical or cultural identity, for diagnostic
those respondents treating clients in psychiatry purposes, for relationship closure, and to enhance
field. Life review (p < .01) and enhancement of spirituality. It could be suggested from this, that
spirituality (p < .01) were rarely relevant goals more experienced clinicians are more confident
across the range of diagnostic groups except to deal with the more sensitive psycho-emotional
for oncology and dementia. Interestingly, the issues. This also aligns with the earlier findings
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use of songwriting for diagnostic purposes was that clinicians with less experience tended to
only relevant for psychiatry, and even so, this work with clients with disability/ASD where
endorsement was low. developmental goals may be more central to the
For the subcategories of psychiatry, significant work. At the same time, this may be correlated
differences across diagnostic groups were found with the period of time when these clinicians
for some goal areas. In particular, the telling of a underwent their training. For example, it is
client's story (p < 0.01) was particularly relevant possible that historical changes in music therapy
for the eating disordered group, substance abuse have impacted on the perceived importance of
group, and trauma group where it was a relevant cognitive, communicative, physical, psychosocial
goal in 100% of respondents' views, this being in and psychoemotional aims over the past twenty
contrast to its less relevant endorsement by other years resulting in some aims becoming less
groups. The goal area of social skills (p = .02) dominant and others more important over time.
was more frequently relevant with the substance
abuse and schizophrenia/psychoses populations
than other populations. For the goal of sending Discussion
messages to significant others, the association
with diagnostic groups approached significance As anticipated by Baker & Wigram (2005),
(p = .09) and it was most applied by clinicians this study provides evidence that therapeutic
working with eating disordered clients. Finally, songwriting is being practiced around the globe
validating thoughts and feelings was noticeably and particularly in the predominantly English
less frequently endorsed when working with speaking countries of the USA, Canada, UK,
schizophrenia/psychoses clients compared with Ireland, Australia, and New Zealand. Therapeutic
others, part of an association with diagnostic songwriting was typically used 1 -2 times per week
groups that also approached significance (p = .07) or more by the largest proportion of respondents,
Percentages of respondents and significance particularly those in Australia/NZ or northern
levels (chi-square test for trends) were calculated Europe. This high level of use of songwriting
for the goal areas according to gender and degree as a therapeutic method is not reflected by an
of clinical experience and are reported in Table 7. equal predominance in the literature. The results
There were minimal gender differences according of this survey therefore demand an increase in
to clinical population. Only with respect to investigations and discussion of this method in
"developing musical and cultural identity" and the music therapy literature.
"relationship closure" were males significantly The survey findings in relation to oncology/
more likely to respond "often/nearly always". palliative care (particularly children) support the
There were however more significant differences songwriting literature in that clinicians utilize
in the goal areas according to clinical experience. songwriting to promote the extemalization/
Less experienced clinicians were more likely to exploration of feelings, thoughts and fantasies,
and promoting coping through the validation using songwriting with AS D, further research into
of experiences. In contrast to the literature, songwriting with this population to determine its
respondents working with palliative care were full potential is recommended.
not as likely to endorse the promotion of mastery, Given the prevalence of literature documenting
achievement, and enhancing self-esteem/ songwriting within the psychiatric groups (see
confidence. This might suggest that there were Table 1); it was not surprising that the survey
a substantial number of respondents working in found a high usage of the intervention. Aligning
palliative care with adults where mastery and closely with the literature, songwriting was
achievement may not be as important to address commonly employed to address emotional and
as might be the case with children where much psychological issues: externalizing thoughts,
of the songwriting literature in palliative care fantasies and feelings; developing self-confidence
focuses on. However, the present study did and enhancing self-esteem, developing a sense of
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identify sending messages to significant others self and gaining insight or clarifying thoughts
and enhancing quality of life, these being goals and feelings. In terms of externalising thoughts
identified in O'Callaghan's (1996) study but not and feelings, Davies (2005) reports in her work
otherwise mentioned in the literature. in child and adolescent psychiatry that "...many
Notably, there was an absence of songwriting children who are unable to express themselves
literature specifically working with ASD and verbally feel able to do so through the medium
developmental disability so comparisons with of song." Davies offers a case example of a
this diagnostic group were not possible. One young adolescent who found it very difficult to
explanation for this absence in literature could be talk verbally about his problems, especially to
that the large number of respondents working with his mother, and for whom songwriting offered a
these populations is less clinically experienced "more socially acceptable and creative form in
and therefore less likely to be documenting which to channel difficult emotional experiences"
their work in music therapy publications. (Davies 2005, p. 46). Rolvsjord also addresses
Alternatively, the bulk of the work with these the value a written song can have as a container
populations is more developmental in nature and for emotions in her work in mental health in
only innovative or novel areas of work such as the Norway, reporting that "Emotional involvement
more psycho-emotional objectives are considered is inevitably part of any musical interaction, but
interesting to publish. Consequently, this survey in the process of songwriting this is explicated
provides new evidence that songwriting can within the song product" (Rolvsjord, 2005, p. 98).
serve many functions with these diagnostic For clients with psychiatric diagnoses,
groups. Respondents indicated that the most songwriting was considered to provide a medium
frequently relevant goal for this population is for telling the client's story, a point already raised
the enhancement of social skills. Derrington by Day (2005). When clients have experienced
advocates the social relevance of the songwriting physical, emotional, psychological, or sexual
experience as important to "...teenagers who abuse, they often have a story to share but
put so much emphasis on social status and may have difficulty articulating this within the
others opinions" (Derrington, 2005, p. 81). Also normal context of verbal therapy. Placing the
relevant to songwriting with clients with ASD client's story within the context of a song may
were the developmental goals of: developing be experienced as less threatening and a more
cognitive skills, enhancing language, speech and/ appropriate medium to share their story with
or conversational skills, and choice and decision significant others.
making, in addition to psycho-emotional goals Therapeutic songwriting can be regarded as an
of encouraging the externalization of thoughts, important intervention within neurorehabilitation
fantasies and feelings, developing a sense of self as indicated by the substantial number of
and promoting mastery, self-confidence and self- respondents using it 1-2 times per week.
esteem. Given the extensive number of clinicians Typically, goals associated with songwriting
were focused on adjustment issues including positive or negative. Further, 40% of the sample
the externalization of thoughts, fantasies and was in the 20-30 year old age group which may be
emotions; telling the client's story; developing a a biased sample of music therapists who may be
sense of self; validating experiences; and gaining more comfortable with using the internet. Further,
insight and clarifying thoughts and feelings. only a small number of contributions were from
These findings supports the research of Baker et Europe and an absence of contributions from
al. (2005a, 2005b, 2005c) who found adjustment South and Central America prevented a more
issues were frequent themes within clients' songs. comprehensive comparison of trends between
Although Baker (2005) and Baker & Tamplin regions. In addition, the sample size of clinicians
(2006) described the way songwriting can be receiving the invitation to participate is an estimate
used to redevelop, speech and language skills, due to limited information provided by some
and cognition, these more functional areas were professional bodies with respect to the specific
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less endorsed when compared with the psycho- number of members on their distribution list and
emotional goals. the number of undeliverable email responses.
When compared with other diagnostic groups, Therefore, it is unclear whether the sample
songwriting was employed the least frequently obtained for the study is truly representative of
within the aged care/dementia population (17% clinicians across the globe. However, it can be
of sample indicating using it 1 -2 times per week). argued that a representative sample of clinicians
This low endorsement is reflected in the literature who do use songwriting have responded to the
where only one study has been published (Silber invitation and therefore trends in best practice
& Hes, 1995). Nevertheless, trends were evident can be determined based on the large N obtained.
in its application with this population. The most If there had been more respondents reporting non
frequently endorsed goals were those of choice use of songwriting, it would have been possible
and decision making (94%) and enhancing quality to clarify the percentage of users of this medium
of life (91%). Life review (74%) and telling the from the total estimated sample. The study
client's story (72%) were also important goals employed the use of ordinal scales to determine
of the songwriting intervention, this previously degree. However, due to small sample size in
described by Silber & Hes (1995) who suggested subcategories, amalgamation of categories was
themes to their clients for song lyrics based on undertaken which does to some degree result in a
different life stages (life review). less detailed analysis.
disability and ASD (36% of the sample), and that Themes in songs written by clients with
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