Britta Frederiksen

Britta FrederiksenBritta Frederiksen

Contact info

Britta Frederiksen, Nøddehegnet 4, Nødebo, 3480 Fredensborg,
tlf: 48480094/41415094 Musikterapi@hotmail.com, brif@regionsjaelland.dk

Qualification

Candidate in Music therapy 1997; Registred Nurse 1990

Current position

Since 1st of October 2011 part time PhD student at the Department of Communication and Psychology; Since 1st of April 2006 part time Music therapist in Forensic Psychiatry, Region Sjaelland; Private clinic

Supervisors

Music therapist MA, PhD, Head of Doctoral Programme in Music Therapy, Aalborg University Hanne Mette Ochsner Ridder
Cand.psych.aut., PhD, senior researcher, Region Sjaelland, Lise Lotte Pedersen

PhD research study

Current title of PhD research study

Music therapy with forensic schizophrenic patients – establishing a therapeutic relationship

Summary of doctoral study

Background

In the Danish Medical Bulletin, Hougaard (2006) emphazises the importance of differentiated treatment in forensic psychiatry focusing on themes like addiction, impulsivity, and aggression. In music therapy the methods are based on expression and action, and it has been found very useful when it comes to the expression of impulsivity and aggression, which are bodily based symptoms. Music therapy is found to be motivating in order to make forensic schizophrenic patients attend the therapeutic treatment. Music therapy with forensic patients primarily is an experienced based way of being together and feel alive (Meisner 2005; Roberts 2001). Most patients in forensic psychiatry are diagnosed with schizophrenia (Hougaard 2006). It is well documented that music therapy is efficient in the therapeutic treatment of schizophrenic patients (Gold, C. et al 2006). Experiences point to the fact that music therapy is useful in the first attempts to build contact and a relation to schizophrenic patients (Pedersen 1998, Frederiksen & Lindvang 2005, Lindvang 1998, Odell-Miller 1991). With these experiences in mind, the purpose of this study is: systematically to examine if music therapy is particular suitable in the establishment and consolidation of contact and relationship with forensic schizophrenic patients in the starting phase of a period of therapy.

Purpose

The purpose of the study is to examine how the use of music in music therapy contributes to the establishment of a therapeutic relationship with forensic schizophrenic patients.

Research questions

1. Can music therapy in the starting phase of a period of therapy with forensic schizophrenic patients contribute to develop contact and positive attachment in the therapeutic relationship

2. Can music therapy in the starting phase of a period of therapy, lasting at least 6 months, contribute to establish a cooperative relationship with forensic schizophrenic patients?

3. Can music therapy in the starting phase of therapy establish a balance in arousal level with forensic schizophrenic patients?

4. If the answers to the questions above are positive – which elements in the use of music in music therapy are effective in the establishment of contact, a positive and cooperative relation between the music therapist and forensic schizophrenic patients?

Method

Criteria for selection patients:
• Schizophrenic diagnosed according to ICD 10
• GAF score (Jones 1995) between 0-40
• The patients are in forensic care with a sentence to psychiatric treatment or to be placed in a forensic psychiatric institution.

In this project I want to combine subjective experiences with quantitative data to examine the development of the therapeutic relationship. The study is a case study research with a flexible design incorporating grounded theory and triangulation. The clinical period of music therapy, with each patient, lasts as aminimum 6 months

For data collection the SRS rating Scale (Duncan, B.L. et al 2003) is applied combined with semi-structured interviews in order to collect the patients’ subjective experiences of the relationship and to describe how the use of music influences the relationship. UMACL-TA – the Mood Adjective checklist (Skou 2007, Matthews 1990) and measurement of the patients pulse will be used for collecting data about the patients` arousal level.

A systematic analysis of qualitative notes from the music therapy sessions will be used together with Thorgaard´s empathy exercises (2005) in order to analyze the character and development of the relationship between the patient and the music therapist through the period of therapy. In addition, McGlashan´s 11 relational levels (Brathetland et al 1999, McGlashan 1989) and Musical Interaction Ratings Scale (MIR) (Pavlicevic 1995) will be used

References

  • Brathetland, O., Dahle, A.S., Henriksen, A., Hummervold, U., Nijkamp, S., Smedvig, S., Torgrimsen, C., Tytlandsvik, M., Vevatne, K., Østerbø, G. (1999)Miljøterapi – en modell for tenkning, holdning og handling i en psykiatrisk institusjon. Stavanger: Stiftelsen Psykiatrisk Opplysning
  • Duncan b.l. et al (2003) The Sessions Rating Scale. Preliminary Psychometric Properties of at “Working” Alliance measure In: Journal of Brief Therapy, Volume 3, number 1, Fall/Winter
  • Frederiksen, B. & Lindvang, C. (1999) `Suitability for Music Therapy: Evaluating Music Therapy as an Indicated Treatment in Psychiatry` In: Stige (red) Nordic Journal of Music Therapy 8(1), pp 48-58
  • Frederiksen, B. & Lindvang, C. (2004) Evalueringsrapport for Forsøgsprojekt med Musikterapi i Sygehus-psykiatrien i Frederiksborg Amt d. 15.06.03-15.06.04. Psykiatrisk Sygehus Frederiksborg Amt, Psykiatrichefens Sekretariat.
  • Frederiksen, B. & Lindvang, C. (2005) ´ Indledning til to artikler med fokus på musikterapi med skizofrene patienter`. I: Musikterapi i psykiatrien – Årsskrift 4, s. 92-95 Musikterapi klinikken – Aalborg Universitet – Aalborg Psykiatriske Sygehus
  • Frederiksen, B (2005) ´ Casestudie – en ung pige med debuterende skizofreni`. I: Musikterapi i psykiatrien – Årsskrift 4, s. 96-105, Musikterapi klinikken – Aalborg Universitet – Aalborg Psykiatriske Sygehus
  • Frederiksen, B. & Lindvang, C. (2008) ´Fællesskabets muligheder – erfaringer fra musikterapi grupper på intensive psykiatriske afdelinger` I Holck, U. (red) Musikterapi i psykiatrien – Årsskrift 5 – 2008. Musikterapiklinikken, Aalborg Psykiatriske Sygehus, Aalborg Universitet
  • Gold, C., Heldal, T., Dahl, T., & Wigram, T. (2006) Music Therapy for Schizophrenia or Schizophrenia-like Illness. London: The Cochrane Database of Systematic Reviews. Issue 4
  • Hougaard, Helle (2006), Retspsykiatriske patienter i DK. Ugeskrift for Læger 168(23):2225
  • Jones, S.H., Thornicroft, G. et al (1995) A brief mental health outcome scale-reliability and validity of the Global Assessment of Functioning (GAF)In: The British Journal of Psychiatry (1995) 166: 654-659Lindvang, C. (1998) `Musikterapeutens rolle i opbygning af psykoterapeutisk relation med skizofrene`. I: Musikterapi i psykiatrien – Årsskrift 1,1998, s. 45-64, Musikterapiklinikken – Aalborg Psykiatriske Sygehus – Aalborg Universitet.
  • McGlashan, T.H. og Keats, C.J. (1989) `Schizophrenia: treatment, process and outcome`. American Psychiatric Press. Se Bind A s.152-53
  • Meisner, T.G. (2005) `Tværfagligt samarbejde I Retspsykiatrisk regi – med udgangspunkt I et musikterapiforløb med en patient med anden etnisk baggrund` I: Musikterapi i psykiatrien. Årsskrift 4 – 2005, Musikterapiklinikken, Aalborg Psykiatriske Sygehus, Aalborg Universitet
  • Matthews, G., Jones, D.M., & Chamberlain, A.G. (1990).´ Refining the measurement of mood: The UWIST Mood Adjective Checklist` I British Journal of Psychology, 81: 17-42
  • Pavlicevic, M. (1995): ` Interpersonal processes in clinical improvisation: Towards a subjectively objective systematic definition`. I: Wigram,T., et al (ed) The Art and Science of Music Therapy: A handbook, Harwood Academic Publishers
  • Pedersen, I. N (1998) `Musikterapi som første skridt I en psykoterapeutisk behandlinsform med skizofrene/psykotiske patienter, - en holdende og reorganiserende musikterapeutisk metode`. I: Pedersen et al (red) Musikterapi i Psykiatrien – Årsskrift 1998, pp 65-91, Musikterapiklinikken – Aalborg Psykiatriske Sygehus – Aalborg Universitet
  • Odell - Miller "Group Improvisaion Therapy: ´The Experience of One Man With Schizophrenia´ in Bruscia (1991) Case Studie in Musictherapy, Barcelona Publishers
  • Roberts, C. (2001) An exploration of the relationship between music therapy and the forensic environment. A dissertation in partial fulfilment of the requirements of Anglia Polytechnic University for the degree of Master of Arts (Music Therapy). A dissertation in partial fulfilment of the requirements of Anglia Polytechnic University for the degree of Master of Arts (Music Therapy),Submitted May 2001
  • Schou, K (2008) Musictherapy for post operative cardiac patients- A Randomized Controlled Trial Evaluating Guided Relaxation with Music and Music Listening on Anxiety, Pain, and Mood. Ph.d thesis, Department of Communication, Aalborg Universitet, Aalborg
  • Thorgaard, L. (2006) Relationsbehandling i Psykiatrien bind I- V , Hertervig forlag, Stavanger