Musikterapeutisk sangskrivning med en kraeftramt kvinde i palliativ behandling med et eksistentialistisk og relationelt fokus - et kvalitativt single-casestudie

Therapeutic songwriting with a woman with breast cancer in end-of-life care with an existential and relational focus - a qualitative single-case study

Ehlers, Kasper Spring

4. semester

Musikterapi, Kandidat

2020

2020-06-02

80

Dette kvalitative enkeltsagsstudie undersøger, hvordan terapeutisk sangskrivning blev brugt sammen med en kvinde i midten af 50’erne i palliativ pleje for metastatisk brystkræft, set gennem eksistentiel terapi. Studiet ser også på, hvordan relationen mellem terapeut og patient udviklede sig under sangskrivningen. Sagen stammer fra et fire måneders praktikforløb i musikterapi på Peter MacCallum Cancer Centre i Melbourne, Australien. Over otte dage deltog patienten i seks musikterapisessioner. De første sessioner anvendte modtagende metoder – lytning til improviseret musik – for at støtte afslapning, livskvalitet og smertehåndtering. Efter at patienten beskrev levende naturbilleder og minder, der opstod under lytningen, introducerede vi terapeutisk sangskrivning. De sidste tre sessioner blev brugt på at medskrive en sang; én af dem blev optaget. Sangen blev færdiggjort og indspillet i et studie. To dage senere døde patienten, og sangen blev spillet ved hendes begravelse. Studiet anvender en kvalitativ, eksplorativ, hermeneutisk tilgang (en fortolkende metode med fokus på mening). Med et bottom-up-design blev lyd fra en sangskrivningssession transskriberet og analyseret med tematisk kodning for at finde tilbagevendende emner og mønstre. Begreber fra eksistentiel terapi blev anvendt til at fortolke materialet og uddybe forståelsen af både sangskrivningsprocessen og den terapeutiske relation. Resultaterne viser, at sangskrivningen gav plads til flere eksistentielle temaer: mening og meningsfuldhed, oplevelse af sammenhæng (en følelse af at livsbegivenheder er forståelige og hænger sammen), indsigt og afklaring; samt kropslighed og at finde ro. I forhold til den terapeutiske relation var processen præget af respekt, engagement, en fælles proces og nænsom vejledning. Refleksioner over relationen pegede også på de flydende grænser for personlig og følelsesmæssig distance mellem terapeut og patient ved livets afslutning.

This qualitative single-case study explores how therapeutic songwriting was used with a woman in her mid-50s receiving palliative care for metastatic breast cancer, viewed through the lens of existential therapy. It also examines how the therapist-patient relationship unfolded during the songwriting process. The case comes from a four-month music therapy placement at the Peter MacCallum Cancer Centre in Melbourne, Australia. Over eight days, the patient took part in six music therapy sessions. The early sessions used receptive methods—listening to improvised music—to support relaxation, quality of life, and pain management. After the patient described vivid images of nature and memories that arose while listening, therapeutic songwriting was introduced. The final three sessions were devoted to co-writing a song; one of these was recorded. The song was completed and recorded in a studio. Two days later, the patient died, and the song was played at her funeral. The study uses a qualitative, exploratory, hermeneutic approach (an interpretive method focused on meaning). Following a bottom-up design, audio from one songwriting session was transcribed and analyzed using thematic coding to identify recurring topics and patterns. Concepts from existential therapy were then applied to interpret the material and to deepen understanding of both the songwriting process and the therapeutic relationship. Findings show that the songwriting work brought forward several existential themes: meaning and meaningfulness, a sense of coherence (a feeling that life events are understandable and connected), insight and clarification; and, additionally, embodiment (awareness of the body) and finding peace. In relation to the therapeutic relationship, the process was marked by respect, engagement, a shared process, and gentle guidance. Reflecting on this relationship also pointed to the fluid boundaries of personal and emotional distance between therapist and patient at the end of life.

[Dette resumé er omskrevet med hjælp fra AI baseret på projektets originale resumé]

Music therapy ; Therapeutic songwriting ; Existential therapy ; Therapeutic relationship ; Breast cancer ; Palliative care ; End-of-life care

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