Having spent several months preparing a Master’s dissertation on Patient-Family Relationships in End of Life Care, this is a topic which is very much in my thoughts. No matter what stage of life we are at, we don’t exist on our own but in an intricate web of relationships that shape our lives.
One of the first tasks I was set when training as a music therapist was to find a mother and baby to observe. These observations served as a starting point for looking at both child development and attachment theories. We then learnt how to apply this knowledge to think about how a person’s ways of relating to you in therapy might reflect their relationships outside of the therapy room.
But what about when the family are actually there with you in the room?
There’s actually already been lot of really valuable work and research on this topic. For example music therapy is often used to promote bonding between newly adopted children and their parents. But once we move past adolescence in adulthood the literature becomes much more sparse. That’s not really surprising as children are generally more dependent on their families. Meanwhile, in our work with adults we have a need to maintain confidentiality as we might not know all the details about relationships or what information our clients would be willing to share.
And yet our relationships do continue to impact the way we behave and relate to others throughout adulthood. This can be complicated and messy. Who we see as our family can change; new relationships develop; and the function of relationships shift. For example, a partner may become a carer as a result of a life-limiting illness. As a result, the whole relationship dynamic changes and both have major adjustments to make.
If we manage to get the balance right, music therapy can be very helpful for the families of adult patients. For example, music therapy can be used to help families express their feelings more openly; improve caregiver wellbeing; or to provide an experience of togetherness at a difficult time.
In my Master’s project (dissertation) I interviewed music therapists working in adult hospices in the UK about their experience of patient-family relationships. We discussed bringing family into therapy sessions; when not to bring family into sessions; as well as the psychological presence of family members in Music Therapy and GIM sessions. There’s a real diversity among music therapist’s views on the subject, although everyone seems to agree that thinking about the patient’s relationships with family is an essential part of the work.
However, what I was lacking when writing that project was this book which was released just last month (September 2016).
With a chapter entitled ‘Families with Dying Family Members: A Holistic Approach in Palliative Care’, it would have been incredibly helpful if this book had been available when I was working on the project. However, I can only be encouraged when reading as the book reflects a lot of my own thinking.
Based on what I’ve read so far, this book must be a pretty comprehensive reflection of work with families in the music therapy profession. Written by international authors, the chapters explore the huge potential for music therapist’s working with families at all stages of life; including premature infants, refugees and palliative care. Twelve chapters are based on work with children and their families, but two chapters show an encouraging move to include work with older adults and families (dementia and palliative care).
Despite the colourful range of case studies provided, Stine Lindhal Jacobsen and Grace Thompson somehow manage to tie everything together in the concluding chapter. Included is a section on the therapist’s role in music therapy with families. Here the emphasis is on us as therapists understanding where we fit (or don’t fit) within the complex network of family dynamics. Also introduced are the approaches of ‘guiding’ and ‘challenging’ families. ‘Guiding’ families refers to using musical activities to help them interact whilst ‘challenging’ refers to telling families about areas for development directly.
Although taking a theoretical perspective, the book is filled with a wealth of practical experience and case vignettes making it an engaging and accessible read. This could be really useful for anyone considering training as a therapist, as well as health professionals who might be considering music therapy in their care. With plenty of discussion about the difficulties and challenges that come with working with families, I would recommend this to therapists across the disciplines.