Depression is a highly prevalent and seriously impairing disorder. Evidence suggests that music therapy can decrease depression, though the music therapy that is offered is often not clearly described in studies. The purpose of this study was to develop an improvisational music therapy intervention based on insights from theory, evidence and clinical practice for young adults with depressive symptoms. The Intervention Mapping method was used and resulted in (1) a model to explain how emotion dysregulation may affect depressive symptoms using the Component Process Model (CPM) as a theoretical framework; (2) a model to clarify as to how improvisational music therapy may change depressive symptoms using synchronisation and emotional resonance; (3) a prototype Emotion-regulating Improvisational Music Therapy for Preventing Depressive symptoms (EIMT-PD); (4) a ten-session improvisational music therapy manual aimed at improving emotion regulation and reducing depressive symptoms; (5) a program implementation plan; and (6) a summary of a multiple baseline study protocol to evaluate the effectiveness and principles of EIMT-PD. EIMT-PD, using synchronisation and emotional resonance may be a promising music therapy to improve emotion regulation and, in line with our expectations, reduce depressive symptoms. More research is needed to assess its effectiveness and principles.
Probation and after-care service is of great social importance and you want to do a proper job. ‘Doing a proper job’ tends to revolve around effective interventions or instruments. Which is important, but doing a proper and effective job involves more than that. We distinguish three forms of effectiveness: -Effective methods: what works? For example, working according to the principles of Risk, Needs and Responsivity6. Or structured behavioural training according to the cognitive-behavioural model. Or working according to the Good Lives Model7. Or the network approach. Methods are referred to as ‘effective’ if there is scientific evidence that they increase the chances of achieving the probation objectives. The risk of recidivism decreases if you work according to these methods. Proper coordination of the working method with specific clients is always part of an effective methodology. -Effective professionals: who works? Methodologies do not lead a life of their own, they only become effective in the hands of professionals8. Effective professionals are rooted in professional values, work with theoretically consistent methods, stand behind their working methods, are able to interact with different types of people (also with people who find this difficult) and systematically provide specific feedback on their actions and results. The importance of effective and open client feedback is important in this. Furthermore, an effective professional attempts to connect his own experiential knowledge to scientific knowledge to the best of his ability. A professional who meets these characteristics is in a better position than other professionals to ‘ensure the effectiveness’ of the method. -Effective interactions: the working alliance (how does it work?) Methodologies and professionals gain meaning in proper interaction with clients and other stakeholders (for example, social network and volunteers). A proper quality of the working alliance increases the chance of successful completion of a probation programme. The risk of problems within the process is reduced and the risk of dropout (no-show or a negative report) decreases.
OBJECTIVES: To explore the perceived working mechanisms of psychosomatic therapy according to patients with persistent somatic symptoms (PSS) and their psychosomatic therapists.DESIGN: Qualitative study using semistructured face-to-face interviews and focus groups. All interviews were audiorecorded, transcribed verbatim and analysed, by two researchers independently, based on the thematic analysis.SETTING: Alongside a randomised controlled trial to establish the (cost-)effectiveness of psychosomatic therapy in patients with PSS in primary care, we conducted a process evaluation with a qualitative study. Patients were recruited in general practice in three regions in the Netherlands.PARTICIPANTS: Interviews were conducted with twenty patients with PSS who received psychosomatic therapy and 25 psychosomatic therapists. In addition, two focus groups were conducted with six and seven psychosomatic therapists, respectively.INTERVENTION: Psychosomatic therapy, delivered by specialised exercise and physical therapists, is a multimodal and tailored treatment based on the biopsychosocial model.OUTCOME MEASURES: Experiences, opinions and views from patients' and therapists' perspective on psychosomatic therapy were identified.RESULTS: A total of 37 interviews with patients, 25 interviews and two focus groups with therapists were analysed. Three main themes emerged from the data of the patients: (1) continuous alternation of psychosocial conversations and body-oriented exercises; (2) awareness of body-mind connection and (3) good relationship with therapist. Four main themes emerged from the data of the therapists (1) building rapport; (2) continuously searching for common ground; (3) making patients aware of the interaction between body and mind; and (4) continuous alternation between exploration and treatment.CONCLUSION: According to patients as well as therapists, the continuous alternation of psychosocial conversations and body-oriented exercises to provide awareness of the interaction between body and mind are the perceived working mechanism of psychosomatic therapy. Therapeutic alliance and finding common ground between patient and therapist are prerequisites for the success of psychosomatic therapy.TRIAL REGISTRATION NUMBER: NL7157 (NTR7356).
