: The current study explores how online music therapy contributes to helping people with dementia... more : The current study explores how online music therapy contributes to helping people with dementia and their relationships to their spouses. Fourteen couples participated in eight online music-therapy sessions that also included musical strategies for use between the sessions. A qualitative content analysis of the music therapists’ reports and summaries of the conversations conducted with the caregiver spouses enabled me to observe the couples’ experiences. The findings indicate that the music-therapy sessions enabled the partners to rekindle their relationship as a couple while supporting the caregiver spouse. The guiding and supportive presence of the music therapist was meaningful in this process. Online at-home music therapy for couples can thus be an essential resource for providing extended support to couples.
This study examined the associations between nursing aides' mentalization, expressed emotion,... more This study examined the associations between nursing aides' mentalization, expressed emotion, and observed sensitivity towards their residents with dementia. The study also explored whether nursing aides' mentalization and expressed emotion are relational constructs that vary with residents' characteristics and behavior. To assess mentalization and expressed emotion (i.e., criticism and positive comments), twenty nursing aides provided "Three Minutes Speech Samples" regarding two residents, one nominated by the head nurse as "difficult", and one nominated as "easy". Next, nursing aides were videotaped interacting with each of the two residents to assess their sensitivity and residents' engagement. Findings indicated that nursing aides' mentalization and positive comments were associated with their sensitivity. Nursing aides' mentalization and positive comments did not vary with residents' "easy" versus "difficult" nominations, but they were associated with residents' engagement. Results suggest training and supervision programs should involve efforts to improve nursing aides' mentalization skills and their ability to perceive their residents positively.
This study examined the associations between nursing aides' mentalization, expressed emotion,... more This study examined the associations between nursing aides' mentalization, expressed emotion, and observed sensitivity towards their residents with dementia. The study also explored whether nursing aides' mentalization and expressed emotion are relational constructs that vary with residents' characteristics and behavior. To assess mentalization and expressed emotion (i.e., criticism and positive comments), twenty nursing aides provided "Three Minutes Speech Samples" regarding two residents, one nominated by the head nurse as "difficult", and one nominated as "easy". Next, nursing aides were videotaped interacting with each of the two residents to assess their sensitivity and residents' engagement. Findings indicated that nursing aides' mentalization and positive comments were associated with their sensitivity. Nursing aides' mentalization and positive comments did not vary with residents' "easy" versus "difficult" nominations, but they were associated with residents' engagement. Results suggest training and supervision programs should involve efforts to improve nursing aides' mentalization skills and their ability to perceive their residents positively.
Dans l’étude actuelle, nous avons mené une première de son enquête en ligne genre de musicothérap... more Dans l’étude actuelle, nous avons mené une première de son enquête en ligne genre de musicothérapeutes (MT) en Israël. Bien que ce domaine se soit développé rapidement et à ce jour comprend environ 700 MTs, il n'y avait pas encore une enquête menée pour adresser leurs domaines d'intérêt, et leurs orientations cliniques et théoriques. Au total, 107 MTs, dont 48 avaient plus de 8 ans d'expérience (MEMT) et 57 avaient moins de 8 ans d'expérience (LEMT), ont répondu à un sondage sur Internet: a) les instruments et les techniques qu'ils utilisent , (B) les populations avec lesquelles ils travaillent, et (c) leur orientation théorique. Les résultats ont révélé des différences significatives entre les MEMT et les LEMT dans presque tous les domaines d'enquête. Généralement, la plupart des jeunes générations sont ouvertes à plus de techniques, maîtrisent plus d'instruments et utilisent plus de musique dans leur travail. Dans un monde continuellement en train de se...
In a growing global trend, individuals are migrating to other countries to live with and care for... more In a growing global trend, individuals are migrating to other countries to live with and care for older adults with dementia. Although this trend addresses the geriatric workforce shortage, workers and older adults often experience distress. In a pilot study in Israel, six migrant care workers participated in a six-week group intervention in which they learned to increase valued, enjoyable activities for themselves and the older adult with whom they lived (behavioral activation). After the intervention, workers reported that they increased activities for themselves and the older adult and were satisfied, and quality of life and sense of achievement showed medium and large effect sizes, respectively. Participants suggested adapting the intervention to an online format for greater access. Although findings are tentative, the study points to promising strategies for migrant home care workers: focusing on the worker and older adult and offering online interventions.
Background: Vocal improvisation is known as beneficial in promoting well-being, yet not much is k... more Background: Vocal improvisation is known as beneficial in promoting well-being, yet not much is known about using vocal improvisation with healthy older adults. While the emphasis in music therapy on studying interventions with clinical populations of older adults is important, the challenges and stressors facing healthy older adults require more investigation. Methods: This qualitative study analyzed the experiences of 54 older adults, ranging between 60 and 93 years (M=71.07), who participated in 12 weekly vocal improvisation group meetings that incorporated various voice improvisation techniques. Data was gathered using qualitative semi-structured group interviews with 12 focus groups (pre- and post-intervention). Results: A qualitative content analysis revealed that the vocal improvisations created the sense of an open space where participants could express and explore their own voices. The intervention has changed their attitudes regarding their own voices and led to meaningful...
Objectives This study examined the emotional availability of nursing aide-resident with dementia ... more Objectives This study examined the emotional availability of nursing aide-resident with dementia dyads in a long-term care-facility. Emotional availability refers to the nursing aide’s sensitivity toward the resident, structuring their interactions in a non-intrusive and non-hostile manner and the resident’s responsiveness to and involvement of the nursing aide. The study evaluated the reciprocity in the emotional availability of nursing aides and the residents and examined whether emotional availability varies with the level of difficulty of taking care of the residents and with the context of the interaction. Method The study was conducted in three wards in one long-term care-facility. Twenty nursing aides and 40 residents took part in the study. Each nursing aide was videotaped during feeding, structured and unstructured interactions, with two residents, one that was nominated by the head nurse as difficult to take care of and one that was nominated as easy to take care of. The i...
Due to the Covid-19 pandemic globally enforced safety precautions were implemented resulting in i... more Due to the Covid-19 pandemic globally enforced safety precautions were implemented resulting in increased social distancing and isolation especially among people with dementia and their caregivers. This critical situation intensified the need to reach and support this already vulnerable population. Music therapists have answered the challenge by providing telehealth music therapy. However, the new online setting raises questions and dilemmas. As music therapists who have worked for many years with people with dementia and their caregivers, we pause to reflect on the new path we took and consider what we can learn and embrace from this new modality of practice.
While singing in music therapy with people with Alzheimer's disease (AD) is vastly documented... more While singing in music therapy with people with Alzheimer's disease (AD) is vastly documented, scarce research deals with the impact of singing on their language abilities. This study addressed the issue of language decline in AD and explored the impact of group singing on the language abilities of people with moderate to severe-stage AD. Participants were randomized to experimental (n=16) or wait-list control (n=14) groups. The experimental group received eight music therapy group sessions, which focused on singing, while both groups received the standard treatment. The data analysis included pre-post picture description tests and examination of speech parameters throughout the group sessions. A significant difference was demonstrated between the groups in the proportion of non-coherent speech in relation to total speech used by participants. The experimental group did not exhibit a deterioration in coherent speech, while the control group exhibited an increase in non-coherent ...
In recent years, HIV-associated neurocognitive disorders (HAND) have become more common as people... more In recent years, HIV-associated neurocognitive disorders (HAND) have become more common as people with HIV live longer due to advances in anti-retroviral medications. The symptoms of HAND are often associated with mild-to-severe cognitive impairment and depression, which may lead to burden and burnout among the certified nursing assistants (CNAs) of individuals with HAND. Music-based interventions provided by paid caregivers have been shown to have positive effects for people with cognitive impairments, depression, and HIV. However, little is known about the benefits of music-based interventions for people with HAND and depression. In this concurrent nested, mixed-methods experiment, 12 nursing home residents with HIV-associated neurocognitive disorders and depression participated in 4 weeks of music-assisted caregiving with 5 CNAs. The music-assisted caregiving intervention significantly decreased depressive symptoms among the residents and personal achievement improved among the C...
Abstract A collaborative music and drama therapy initiative with performing arts students and peo... more Abstract A collaborative music and drama therapy initiative with performing arts students and people with dementia yielded an innovative framework. Twelve people with dementia residing in a nursing home and twelve students from a performing arts school took part in two consecutive groups (6 residents and 6 students in each group). Each group was 10 sessions long. The groups were co-facilitated by a music therapist and a drama therapist. A qualitative research embracing action research ideas was used, and content analysis of all written documents revealed three major categories: (1) Combining music and drama expanded the emotional and creative modes of expression for people with dementia, (2) The supporting engagement of performing arts students helped people with dementia to play an active role in the musical-dramatic space, and (3) The joint framework enabled people with dementia to participate as actors in the final performance of an auto-biographical therapeutic theatre. Promoting modes of creative self-expression for people with dementia is important when autonomy is gradually lost with the progression of the disease. A new perspective of viewing people with dementia as ‘spect-actors’, moving from spectators to actors, contributes to various aspects of autonomy, such as mastery, dignity and independence.
ABSTRACT This study presents a technique that is used to create an elderly person’s musical autob... more ABSTRACT This study presents a technique that is used to create an elderly person’s musical autobiography in a one-on-one interview format as a means of promoting well-being and enabling a different connection between the elderly person and the interviewer. Forty-three interviewers’ essays documenting these meetings and written in the past 4 years (2012–2016) were analyzed. The interviewers were from diverse disciplines (music therapists, social workers, occupational therapists, physical therapists), who participated in different courses pertaining to music and the elderly. A qualitative analysis based on grounded theory paradigm revealed three main categories: (1) The elderly presented mostly musical memories from their childhood and youth, a period when music played a significant role in their lives; (2) The mutual musicking vividly elicited remote memories and emotionally impacted both parties; and (3) The mutual musicking revealed new and unfamiliar facets of the elderly. The findings suggest that creating a Musical Auto-Biography Interview (MABI) through a process of music and reminiscence strengthened the elderly’s sense of self-identity, illuminated hidden facets, and changed attitudes toward the elderly. Theoretical viewpoints as well as practical suggestions for music therapists and other practitioners are discussed, suggesting using MABI as an effective technique to promote well-being and redefine the elderly’s status in society.
In the present study we conducted a first of its kind online survey of music therapists (MTs) in ... more In the present study we conducted a first of its kind online survey of music therapists (MTs) in Israel. Though this field has been growing rapidly and to date includes about 700 MTs, there was not yet a survey conducted to adress their fields of interest, and their clinical and theoretical orientations.A total of 107 MTs, 48 of which had more than 8 years of experience (MEMT) and 57 of which had less than 8 years of experience (LEMT), answered an internet survey examining: (a) the instruments and the techniques they use, (b) the populations they work with, and (c) their theoretical orientation. Results indicated significant differences between MEMTs and LEMTs in almost all fields of inquiry.Generally, most of the younger generation is open to more techniques, proficient with more instruments, and uses more music in their work. In a continuously globalizing world, the results of this study are relevant to not only Israeli music therapists, but others as well since the local situatio...
: The current study explores how online music therapy contributes to helping people with dementia... more : The current study explores how online music therapy contributes to helping people with dementia and their relationships to their spouses. Fourteen couples participated in eight online music-therapy sessions that also included musical strategies for use between the sessions. A qualitative content analysis of the music therapists’ reports and summaries of the conversations conducted with the caregiver spouses enabled me to observe the couples’ experiences. The findings indicate that the music-therapy sessions enabled the partners to rekindle their relationship as a couple while supporting the caregiver spouse. The guiding and supportive presence of the music therapist was meaningful in this process. Online at-home music therapy for couples can thus be an essential resource for providing extended support to couples.
This study examined the associations between nursing aides' mentalization, expressed emotion,... more This study examined the associations between nursing aides' mentalization, expressed emotion, and observed sensitivity towards their residents with dementia. The study also explored whether nursing aides' mentalization and expressed emotion are relational constructs that vary with residents' characteristics and behavior. To assess mentalization and expressed emotion (i.e., criticism and positive comments), twenty nursing aides provided "Three Minutes Speech Samples" regarding two residents, one nominated by the head nurse as "difficult", and one nominated as "easy". Next, nursing aides were videotaped interacting with each of the two residents to assess their sensitivity and residents' engagement. Findings indicated that nursing aides' mentalization and positive comments were associated with their sensitivity. Nursing aides' mentalization and positive comments did not vary with residents' "easy" versus "difficult" nominations, but they were associated with residents' engagement. Results suggest training and supervision programs should involve efforts to improve nursing aides' mentalization skills and their ability to perceive their residents positively.
This study examined the associations between nursing aides' mentalization, expressed emotion,... more This study examined the associations between nursing aides' mentalization, expressed emotion, and observed sensitivity towards their residents with dementia. The study also explored whether nursing aides' mentalization and expressed emotion are relational constructs that vary with residents' characteristics and behavior. To assess mentalization and expressed emotion (i.e., criticism and positive comments), twenty nursing aides provided "Three Minutes Speech Samples" regarding two residents, one nominated by the head nurse as "difficult", and one nominated as "easy". Next, nursing aides were videotaped interacting with each of the two residents to assess their sensitivity and residents' engagement. Findings indicated that nursing aides' mentalization and positive comments were associated with their sensitivity. Nursing aides' mentalization and positive comments did not vary with residents' "easy" versus "difficult" nominations, but they were associated with residents' engagement. Results suggest training and supervision programs should involve efforts to improve nursing aides' mentalization skills and their ability to perceive their residents positively.
Dans l’étude actuelle, nous avons mené une première de son enquête en ligne genre de musicothérap... more Dans l’étude actuelle, nous avons mené une première de son enquête en ligne genre de musicothérapeutes (MT) en Israël. Bien que ce domaine se soit développé rapidement et à ce jour comprend environ 700 MTs, il n'y avait pas encore une enquête menée pour adresser leurs domaines d'intérêt, et leurs orientations cliniques et théoriques. Au total, 107 MTs, dont 48 avaient plus de 8 ans d'expérience (MEMT) et 57 avaient moins de 8 ans d'expérience (LEMT), ont répondu à un sondage sur Internet: a) les instruments et les techniques qu'ils utilisent , (B) les populations avec lesquelles ils travaillent, et (c) leur orientation théorique. Les résultats ont révélé des différences significatives entre les MEMT et les LEMT dans presque tous les domaines d'enquête. Généralement, la plupart des jeunes générations sont ouvertes à plus de techniques, maîtrisent plus d'instruments et utilisent plus de musique dans leur travail. Dans un monde continuellement en train de se...
In a growing global trend, individuals are migrating to other countries to live with and care for... more In a growing global trend, individuals are migrating to other countries to live with and care for older adults with dementia. Although this trend addresses the geriatric workforce shortage, workers and older adults often experience distress. In a pilot study in Israel, six migrant care workers participated in a six-week group intervention in which they learned to increase valued, enjoyable activities for themselves and the older adult with whom they lived (behavioral activation). After the intervention, workers reported that they increased activities for themselves and the older adult and were satisfied, and quality of life and sense of achievement showed medium and large effect sizes, respectively. Participants suggested adapting the intervention to an online format for greater access. Although findings are tentative, the study points to promising strategies for migrant home care workers: focusing on the worker and older adult and offering online interventions.
Background: Vocal improvisation is known as beneficial in promoting well-being, yet not much is k... more Background: Vocal improvisation is known as beneficial in promoting well-being, yet not much is known about using vocal improvisation with healthy older adults. While the emphasis in music therapy on studying interventions with clinical populations of older adults is important, the challenges and stressors facing healthy older adults require more investigation. Methods: This qualitative study analyzed the experiences of 54 older adults, ranging between 60 and 93 years (M=71.07), who participated in 12 weekly vocal improvisation group meetings that incorporated various voice improvisation techniques. Data was gathered using qualitative semi-structured group interviews with 12 focus groups (pre- and post-intervention). Results: A qualitative content analysis revealed that the vocal improvisations created the sense of an open space where participants could express and explore their own voices. The intervention has changed their attitudes regarding their own voices and led to meaningful...
Objectives This study examined the emotional availability of nursing aide-resident with dementia ... more Objectives This study examined the emotional availability of nursing aide-resident with dementia dyads in a long-term care-facility. Emotional availability refers to the nursing aide’s sensitivity toward the resident, structuring their interactions in a non-intrusive and non-hostile manner and the resident’s responsiveness to and involvement of the nursing aide. The study evaluated the reciprocity in the emotional availability of nursing aides and the residents and examined whether emotional availability varies with the level of difficulty of taking care of the residents and with the context of the interaction. Method The study was conducted in three wards in one long-term care-facility. Twenty nursing aides and 40 residents took part in the study. Each nursing aide was videotaped during feeding, structured and unstructured interactions, with two residents, one that was nominated by the head nurse as difficult to take care of and one that was nominated as easy to take care of. The i...
Due to the Covid-19 pandemic globally enforced safety precautions were implemented resulting in i... more Due to the Covid-19 pandemic globally enforced safety precautions were implemented resulting in increased social distancing and isolation especially among people with dementia and their caregivers. This critical situation intensified the need to reach and support this already vulnerable population. Music therapists have answered the challenge by providing telehealth music therapy. However, the new online setting raises questions and dilemmas. As music therapists who have worked for many years with people with dementia and their caregivers, we pause to reflect on the new path we took and consider what we can learn and embrace from this new modality of practice.
While singing in music therapy with people with Alzheimer's disease (AD) is vastly documented... more While singing in music therapy with people with Alzheimer's disease (AD) is vastly documented, scarce research deals with the impact of singing on their language abilities. This study addressed the issue of language decline in AD and explored the impact of group singing on the language abilities of people with moderate to severe-stage AD. Participants were randomized to experimental (n=16) or wait-list control (n=14) groups. The experimental group received eight music therapy group sessions, which focused on singing, while both groups received the standard treatment. The data analysis included pre-post picture description tests and examination of speech parameters throughout the group sessions. A significant difference was demonstrated between the groups in the proportion of non-coherent speech in relation to total speech used by participants. The experimental group did not exhibit a deterioration in coherent speech, while the control group exhibited an increase in non-coherent ...
In recent years, HIV-associated neurocognitive disorders (HAND) have become more common as people... more In recent years, HIV-associated neurocognitive disorders (HAND) have become more common as people with HIV live longer due to advances in anti-retroviral medications. The symptoms of HAND are often associated with mild-to-severe cognitive impairment and depression, which may lead to burden and burnout among the certified nursing assistants (CNAs) of individuals with HAND. Music-based interventions provided by paid caregivers have been shown to have positive effects for people with cognitive impairments, depression, and HIV. However, little is known about the benefits of music-based interventions for people with HAND and depression. In this concurrent nested, mixed-methods experiment, 12 nursing home residents with HIV-associated neurocognitive disorders and depression participated in 4 weeks of music-assisted caregiving with 5 CNAs. The music-assisted caregiving intervention significantly decreased depressive symptoms among the residents and personal achievement improved among the C...
Abstract A collaborative music and drama therapy initiative with performing arts students and peo... more Abstract A collaborative music and drama therapy initiative with performing arts students and people with dementia yielded an innovative framework. Twelve people with dementia residing in a nursing home and twelve students from a performing arts school took part in two consecutive groups (6 residents and 6 students in each group). Each group was 10 sessions long. The groups were co-facilitated by a music therapist and a drama therapist. A qualitative research embracing action research ideas was used, and content analysis of all written documents revealed three major categories: (1) Combining music and drama expanded the emotional and creative modes of expression for people with dementia, (2) The supporting engagement of performing arts students helped people with dementia to play an active role in the musical-dramatic space, and (3) The joint framework enabled people with dementia to participate as actors in the final performance of an auto-biographical therapeutic theatre. Promoting modes of creative self-expression for people with dementia is important when autonomy is gradually lost with the progression of the disease. A new perspective of viewing people with dementia as ‘spect-actors’, moving from spectators to actors, contributes to various aspects of autonomy, such as mastery, dignity and independence.
ABSTRACT This study presents a technique that is used to create an elderly person’s musical autob... more ABSTRACT This study presents a technique that is used to create an elderly person’s musical autobiography in a one-on-one interview format as a means of promoting well-being and enabling a different connection between the elderly person and the interviewer. Forty-three interviewers’ essays documenting these meetings and written in the past 4 years (2012–2016) were analyzed. The interviewers were from diverse disciplines (music therapists, social workers, occupational therapists, physical therapists), who participated in different courses pertaining to music and the elderly. A qualitative analysis based on grounded theory paradigm revealed three main categories: (1) The elderly presented mostly musical memories from their childhood and youth, a period when music played a significant role in their lives; (2) The mutual musicking vividly elicited remote memories and emotionally impacted both parties; and (3) The mutual musicking revealed new and unfamiliar facets of the elderly. The findings suggest that creating a Musical Auto-Biography Interview (MABI) through a process of music and reminiscence strengthened the elderly’s sense of self-identity, illuminated hidden facets, and changed attitudes toward the elderly. Theoretical viewpoints as well as practical suggestions for music therapists and other practitioners are discussed, suggesting using MABI as an effective technique to promote well-being and redefine the elderly’s status in society.
In the present study we conducted a first of its kind online survey of music therapists (MTs) in ... more In the present study we conducted a first of its kind online survey of music therapists (MTs) in Israel. Though this field has been growing rapidly and to date includes about 700 MTs, there was not yet a survey conducted to adress their fields of interest, and their clinical and theoretical orientations.A total of 107 MTs, 48 of which had more than 8 years of experience (MEMT) and 57 of which had less than 8 years of experience (LEMT), answered an internet survey examining: (a) the instruments and the techniques they use, (b) the populations they work with, and (c) their theoretical orientation. Results indicated significant differences between MEMTs and LEMTs in almost all fields of inquiry.Generally, most of the younger generation is open to more techniques, proficient with more instruments, and uses more music in their work. In a continuously globalizing world, the results of this study are relevant to not only Israeli music therapists, but others as well since the local situatio...
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