Forms of attunement during the initial stages of music therapy for patients with acute psychosis - A multicentre clinical study

Abstract

The aim of this non-experimental follow-up study was to specify and quantify rhythmic attunement processes within free improvisations in the early phase of psychodynamic music therapy in order to investigate its predictive value for therapeutic change. Twenty-one in-patients diagnosed with psychosis (ICD-10F20, 23, 25) were included in the study. Participants received five sessions of individual music therapy as per usual. Improvisations were audio recorded. The initial and final improvisations were analysed with the Rhythmic Attunement Scale for Psychosis (RAS-P), which was specifically developed for the project. Clinical measures included external and self-report assessments (BPRS, Dührsen and Happach, TAS 20). Analysis of the audio recordings revealed early occurrence of rhythmic attunement on a stable and qualitatively high level. BPRS scores showed a post-treatment decline of 20%. There was no significant difference for the Dührsen and Happach and TAS 20 scores. Statistical analysis revealed that when initial rhythmic attunement occurred further into the first session, it was a predictor for the decline of psychotic symptoms. Evidence of carefully organised rhythmic attunement suggests beneficial effects on patients with psychosis through improvisational music therapy. Results are limited due to a small sample size and lack of a control comparison.