• Line Brink-Jensen
4. term, Music Therapy, Master (Master Programme)
Goodbye & hello
- a theoretical and empirical research
on non-specific factors in a music therapeutic process

In this masters thesis I focus upon non-specific factors in an instrumental case study in music ther-apy. The thesis consists of four parts. In part I, the inductive background for the thesis is explained, the research question is presented and I explain how I presume to answer it. Next, I describe the scientific and methodological procedures used throughout the thesis.

After an observational internship in the Spring of 2009 - at a special school for children and adoles-cents with attachment disorders and relational difficulties - I did a project about attachment. As a continuation of the observational internship and the project, I started an internship at the school in the Fall of 2009. During the internship, I had a music therapeutic case, which later became the start-ing point of this thesis.
The case in question concerns a client whom I call Pia. Pia is a 14-year-old girl, diag-nosed with ADHD, and attending the school because of her behaviour. Pia lives with her mother and father with a younger sister; she has also got an older sister who lives by herself. Pia has prob-lems with establishing friendships, as with controlling delimitation, and her talkativeness sometimes makes her seem dominating. She was referred to the school shortly after her aunt committed suicide; a theme that becomes the centre of the music therapy sessions.
Pia is a very reflecting and mature girl, who has a great need for telling people about her life and to feel understood. She talks passionately about tragic events, but doesn’t seem to be-come emotionally touched by the stories. We talk about her experiences around the suicide of her aunt and agree on the main-theme being “clarity”. This refers to Pias desire for clarity regarding her aunt leaving this world. To assist this process of clarity we used three music therapeutical methods: clinical improvisation, therapeutical songwriting and Guided Imagery and Music (GIM). During the music therapy, which lasted 11 sessions, I started to wonder about the therapeutical growth that occurred in the relationship. I experienced the methods as appropriate, but believed that other fac-tors were also involved. Therefore, I chose to examine which other factors were influencing the growth that occurred.
I came across psychotherapist Esben Hougaard (2004). Hougaard examines non-specific factors in verbal psychotherapy with adults. The concept of ”nonspecific factors” refers to the meaning of factors in psychotherapeutic treatment which are present whatever the therapist's theoretical and methodological views. Hougaard seeks to define what characterizes the therapeutic effect, when different treatments provide the client with the same result. He works with three main factors: the therapist-client relationship, the expectation factors, and the common clinical strategies. Underneath these main factors a line of factors, which I call sub-factors, decide the actual quality of the factor. These are explained in chapter 6 and illustrated in bilag 1. To examine non-specific factors in the case with Pia, examples from the process are analysed, and a hypothesis about affect attunement is tested.
As part of the process, Pia evaluated the music therapy as it was coming to an end. She found that a growth in relation to the main-theme had taken place, and believed that the clarity that she had achieved in the music therapy would continue after the therapy had ended. The re-search question is therefore:

A. Which nonspecific factors, as understood by Hougaard (2004), have influenced the therapeutic growth, in a specific music therapeutical process with a 14-year-old girl, di-agnosed with ADHD and struggling with attachment problems and relational difficulties?
B. As Hougaard’s model about nonspecific factors has been developed for verbal psycho-therapy with adults, I furthermore examine whether all the sub-factors are relevant in this actual case.

The research question is answered throughout the thesis by a deductive, theoretical literature review in part II, and an analysis of an instrumental case study in part III. To strengthen the validity of the thesis I use a peer-debriefing in the analysis. During the analysis the hypothesis is confirmed. Affect attunement turns out to enhance the occurrence of non-specific factors in the case of Pia, and the reason that non-specific factors are so important for successful therapy might even stem from de-velopmental psychology. Affect attunement is therefore a component of the thesis in the theoretical part as well as in the empirical part. In the analysis begins the abduction which continues to part IV where I discuss and evaluate the research. Finally, I make a conclusion about the significance of the non-specific factors in a therapeutical relationship, placing great importance on affect attunement.
Publication date28 May 2010
Number of pages72
Publishing institutionMusikterapistudiet, Institut for kommunikation - Aalborg Universitet


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