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Mindfulness-Based Music Therapy Group Protocol for Individuals with Serious Mental Illnesses and Chronic Illnesses

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Mindfulness-Based Music Therapy Group Protocol for Individuals with Serious Mental Illnesses and Chronic Illnesses MINDFULNESS-BASED MUSIC THERAPY GROUP PROTOCOL FOR INDIVIDUALS WITH SERIOUS MENTAL ILLNESSES AND CHRONIC ILLNESSES: A FEASIBILITY STUDY By Copyright 2017 Marie Lesiak Submitted to the graduate degree program in Music Education and Music Therapy and the Graduate Faculty of the University of Kansas in partial fulfillment of the requirements for the degree of Master of Music Education (Music Therapy). ________________________________ Chairperson - Abbey Dvorak, Ph.D. ________________________________ Cynthia Colwell, Ph.D. ________________________________ Deanna Hanson-Abromeit, Ph.D. Date Defended: April 20th, 2017 ii The Thesis Committee for Marie E. Lesiak certifies that this is the approved version of the following thesis: MINDFULNESS-BASED MUSIC THERAPY PROTOCOL FOR INDIVIDUALS WITH SERIOUS MENTAL ILLNESSES AND CHRONIC ILLNESSES: A FEASIBILITY STUDY ________________________________ Chairperson - Abbey Dvorak, Ph.D. Date approved: April 25th, 2017 iii Abstract Mindfulness is the practice of being fully aware of the internal and external happenings in the present moment (Kabat-Zinn, 2012). The purpose of this research study was to determine the feasibility of a mindfulness-based music therapy protocol for people with a combined serious mental illness and chronic illness. The research questions included: To what extent can the mindfulness-based music therapy protocol be delivered as intended to participants? Does this six-week mindfulness-based music therapy protocol affect (a) emotional, psychological, and social well-being and/or (b) increase mindfulness? Nine adults diagnosed with a serious mental illness and chronic illness participated in the six-week mindfulness-based music therapy protocol. Participants completed the Mental Health Continuum- Short Form (MHC-SF) (Keyes, 2009) and the Mindful Attention Awareness Scale (MAAS) (Brown and Ryan, 2003) as pre- and post-test measures. The researcher implemented the mindfulness-based music therapy protocol as intended with minor modifications. Suggestions for future implementation are indicated. Due to fluctuating attendance and limited numbers for follow-up, the researcher used descriptive statistics to analyze change from pre-test to post-test. Results indicated an overall positive change in mindfulness scores, but a decrease in well-being scores. Follow-up questionnaire responses were positive and indicated psychosocial benefits as a result of participating in the group. Clinical implications for music therapists interested in implementing a similar mindfulness-based music therapy protocol are included. iv Acknowledgments I would like to first thank Dr. Abbey Dvorak for your continual support, guidance, and patience during this journey. You have provided me with so much that I feel I will never be able to repay you. I truly appreciate all of the time you have invested in this project and me. You continue to amaze me with your knowledge of the mental health field and I am forever grateful for your sharing of this knowledge. I would next like to thank Dr. Cynthia Colwell and Dr. Deanna Hanson-Abromeit for your clinical wisdom and giving of your time and talents. I cannot express how much it means to feel supported from you two. To Dr. Bill Matney, for sharing your clinical wisdom and inspiring me to continue to work hard in my research. To my classmates Amanda, Mandy, and Megan, who even with distance, continue to encourage me and inspire me in their work as dedicated music therapists. To my parents, for sparking my interest in music and gently encouraging me and supporting me through this journey. I would like to thank my fiancé, Trent, who has been by my side since the beginning of this project. Thank you for your patience, your support, and providing me with some comic relief during the stressful times. And lastly, I would like to thank the rest of my family for their love, support, and understanding. I appreciate all the editing, writing break phone conversations, and words of encouragement. I truly could not have completed this project without you all. Thank you for believing in me and pushing me to do great things. Thank you, thank you, thank you. v Table of Contents Chapter 1: Introduction ................................................................................................................... 1 Serious Mental Illness ................................................................................................................. 1 Serious Mental Illness and Chronic Illness ................................................................................. 1 Risk Factors ................................................................................................................................ 2 Treatment for Serious Mental Illness .......................................................................................... 2 Community-based care programs ........................................................................................... 3 Dialectical Behavior Therapy ..................................................................................................... 3 DBT with People Diagnosed with Serious Mental Illnesses and Chronic Illnesses ................... 5 Mindfulness ................................................................................................................................. 6 Mindfulness and Music Listening ............................................................................................... 6 Music Therapy in Mental Health ................................................................................................ 7 Music Therapy and Chronic Illnesses ......................................................................................... 7 Music Therapy and Mindfulness ................................................................................................ 8 Music Therapy and Dialectical Behavior Therapy ..................................................................... 8 Chapter 2: Review of Literature ................................................................................................... 10 Serious Mental Illness (SMI) .................................................................................................... 10 Medication adherence ........................................................................................................... 11 Chronic Illness (CI) ................................................................................................................... 12 Health homes ........................................................................................................................ 14 Dialectical Behavior Therapy (DBT) ........................................................................................ 15 DBT and Borderline Personality Disorder (BPD) ................................................................ 15 DBT and substance abuse disorders ..................................................................................... 16 vi DBT and eating disorders ..................................................................................................... 17 DBT and depression .............................................................................................................. 18 Music Therapy in Mental Health .............................................................................................. 20 Music therapy and serious mental illnesses .......................................................................... 20 Music therapy and chronic illnesses ..................................................................................... 24 Music therapy and Dialectical Behavior Therapy ................................................................ 27 Music and mindfulness ......................................................................................................... 29 Music therapy and mindfulness ............................................................................................ 30 Mindfulness-based Music Therapy Protocol ............................................................................ 33 Music as a focus for psychophysiological connection .......................................................... 33 Music as a focus for mindful listening .................................................................................. 34 Music as a focus for mindful active engagement .................................................................. 35 Feasibility study .................................................................................................................... 36 Purpose and Research Questions .............................................................................................. 36 Chapter 3: Method ........................................................................................................................ 37 Recruitment and Informed Consent .......................................................................................... 37 Participants ................................................................................................................................ 37 Study Approach and Design ..................................................................................................... 38 Measurements ........................................................................................................................... 39 Mental Health Continuum-Short Form (MHC-SF) .............................................................
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