P 1097. How Do Parents Experience Music Therapy during Neuropediatric Early Rehabilitation?—A Qualitative Pilot Study
30. Oktober 2018 (online)
Background: Acquired brain impairment (ABI) of a child through illness, accidents, or violence leaves families with severe, to some extent traumatizing experiences of deprivation. Aggrieved parties have to cope with transitions of relationships within the families, liabilities through long-term care, financial penalties, and social exclusion.
Alongside medical supply, further possibilities of development for brain impaired children depend on a successful family sense of coherence. However, especially in rural areas, outpatient care is a desideratum to date.
Objective: It is believed that music therapy has a long-lasting effect on neuropediatric early rehabilitation. Although nothing is known about this subject, the primary objective of this qualitative study is to gain information about personal as well as retrospective processing of the experiences with music therapy during inpatient stay. This could be a ground work for further quantitative studies along with developing a concept for home-visiting music therapy.
Questions: How was neuropediatric music therapy experienced by affected parents in early neurorehabilitation? Which features were experienced as helpful/not very helpful? How did the choice of the music therapeutic intervention influence the parent’s narration in the interview?
Methods: Narrative interviews were held with aggrieved parents in the style of qualitative research. These took place 3 to 18 months after discharge from the clinic in domestic surroundings. The questions of the semistructured interviews were based on guidelines and involved improvisatory music therapy components. The latter supported and updated the experience with music therapy and facilitated the inclusion of the severely disabled child. Four families which took part in group music therapy sessions, within the early rehabilitation, were included.
The children were between 2 months and 6 years at the time of the severe ABI. The transcription of the interviews was evaluated selectively and under defined hermeneutic criteria.
Results: Music therapy appears in the parent’s memory as an interplay between desired perception and reality, search for identity and fear of loss, feeling of insufficiency and idealization. All questioned parents valuate neuropediatric music therapy not only for their child but also for themselves as an important part in the process to adjust to the new situation. In addition, they described multiple stimuli for rehabilitation, for example, the development of the children’s intentionality and the proficit-oriented cognition of the child. The atmosphere of unconditional acceptance of the music therapist and her sensitive musical approach to the minimal responsive child was impressively described.
The music was experienced as a hope and consolation carrier not only during the hospital stay but also during the interview. The confrontation is accompanied by a musical piece that had meaning for the once healthy child.
Conclusion: The results show a carryover effect of the music therapy during early neurorehabilitation. However, if no continuing music therapeutic program in form of an outpatient supply is provided, the effectivity may fade over time. Especially referring to the so-called parental reflective functioning and the family sense of coherence. The realization of an improvised music therapy program in a domestic setting is accomplishable without much effort. The first attempts are demonstrated in the interviews.
An adequate music therapy offer—enclosed to an adequate neuro- and social-pediatric supply for impaired children and their families—would be a suitable outpatient follow-up care for families with children with ABI. This approach would be necessary to establish the successes from inpatient music therapy such as the reduction of stress, fostering resources, and obviating following troubles.