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IntroductionStroke survivors struggle to meet clinical recommendations for physical exercise duration and intensity. During the past two decades, emerging evidence has shown effectiveness of music interventions for several motor tasks in stroke rehabilitation. Additionally, music has been found effective for increasing exercise performance in athletes and clinical populations. It is postulated that the therapeutic effects of music in physical exercise are modulated by preference and task-specificity of the music.MethodsWe tested this hypothesis in a pilot study using a three-arm randomized cross-over design comprising the following auditory conditions during cycle ergometry cardiorespiratory exercise sessions: (a) a group-tailored music playlist, (b) radio music, and (c) a non-music control condition. Participants (n = 19) were inpatient stroke survivors undergoing rehabilitation between 2 and 12 weeks post infarct.ResultsOur results demonstrate that clinical characteristics are an important determinant for identifying patients who can benefit from music. Specifically, participants with a higher level of gait functioning experienced no benefit, whereas participants with a low level of gait functioning showed an increase in both exercise duration (M = 4.46 minutes) and time spent in the recommended heart rate intensity (M = 6.39 and M = 2.49 minutes for the playlist and radio condition, respectively).DiscussionThe findings suggest a beneficial role of music in rehabilitation of stroke patients with low gait functioning. Future studies should ultimately disentangle which musical parameters are more likely to induce the putative ergogenic effects. Introduction: Stroke survivors struggle to meet clinical recommendations for physical exercise duration and intensity. During the past two decades, emerging evidence has shown effectiveness of music interventions for several motor tasks in stroke rehabilitation. Additionally, music has been found effective for increasing exercise performance in athletes and clinical populations. It is postulated that the therapeutic effects of music in physical exercise are modulated by preference and task-specificity of the music. Methods: We tested this hypothesis in a pilot study using a three-arm randomized cross-over design comprising the following auditory conditions during cycle ergometry cardiorespiratory exercise sessions: (a) a group-tailored music playlist, (b) radio music, and (c) a non-music control condition. Participants (n = 19) were inpatient stroke survivors undergoing rehabilitation between 2 and 12 weeks post infarct. Results: Our results demonstrate that clinical characteristics are an important determinant for identifying patients who can benefit from music. Specifically, participants with a higher level of gait functioning experienced no benefit, whereas participants with a low level of gait functioning showed an increase in both exercise duration (M = 4.46 minutes) and time spent in the recommended heart rate intensity (M = 6.39 and M = 2.49 minutes for the playlist and radio condition, respectively). Discussion: The findings suggest a beneficial role of music in rehabilitation of stroke patients with low gait functioning. Future studies should ultimately disentangle which musical parameters are more likely to induce the putative ergogenic effects. Trial registry number: NCT05398575.

Background General mental health and interpersonal skills of families are crucial to children's development and future. Research suggests a link between participation in music activities and individuals' own sense of mental health, as well as an effect in objective measures of health such as quality of life, social skills, and rehabilitation of various kinds. However, in Denmark there are not many services for families with school-aged children (7–12 years) that focus on prevention and strengthening family interaction hereby minimising the risk of children not thriving and developing optimally in terms of social and emotional skills and competences. The purpose of this study is to investigate the effect of shared music activities on family interaction, parental stress, and child well-being. Methods The study is a controlled effect study where 40 family dyads from Aalborg and Aarhus are randomized into 4 different groups including music therapy activities, community music, family concerts and a control group. Measurements of family interaction (Assessment of Parent Child Interaction, APCI) and mental health (Parental Stress Scale, PSS, and the Strengths and Difficulties Questionnaire, SDQ) will be made at baseline/pre intervention, at post intervention and a follow-up measurement 12 month after baseline (month 1, 3 and 12) 3 times in total. Furthermore, data about the family dyad’s regular participation in music events as part of every-day life at the same measure points (month 1, 3 and 12). Since this is a planned prospective study, results are not yet available, but clinical experience from a feasibility study in 2021 were promising and expected challenges and changes are discussed in the article. Discussion Findings of this study will be relevant for all fields where music is applied for families, such as education, mental health, social work and for basic research on the study of music and interaction. Music used as a resource for families is crucial in understanding how different modalities can influence the family interaction including emotional communication and attachment. Trial registration: ISRCTN, ISRCTN17290015, Registered 03 March 2022, https://www.isrctn.com/ISRCTN17290015 Date and protocol version July 2022, version 1. Protocol is planned to be updated after finalized recruitment during second data collection point and again after the third and last data collection point (see Additional file 1: SPIRIT Checklist).

IntroductionIn older adults, dementia and depression are associated with individual distress and high societal costs. Music interventions such as group music therapy (GMT) and recreational choir singing (RCS) have shown promising effects, but their comparative effectiveness across clinical subgroups is unknown. This trial aims to determine effectiveness of GMT, RCS and their combination for care home residents and to examine heterogeneity of treatment effects across subgroups.Methods and analysisThis large, pragmatic, multinational cluster-randomised controlled trial with a 2×2 factorial design will compare the effects of GMT, RCS, both or neither, for care home residents aged 65 years or older with dementia and depressive symptoms. We will randomise 100 care home units with ≥1000 residents in total across eight countries. Each intervention will be offered for 6 months (3 months 2 times/week followed by 3 months 1 time/week), with extension allowed if locally available. The primary outcome will be the change in the Montgomery-Åsberg Depression Rating Scale score at 6 months. Secondary outcomes will include depressive symptoms, cognitive functioning, neuropsychiatric symptoms, psychotropic drug use, caregiver burden, quality of life, mortality and costs over at least 12 months. The study has 90% power to detect main effects and is also powered to determine interaction effects with gender, severity and socioeconomic status.Ethics and disseminationEthical approval has been obtained for one country and will be obtained for all countries. Results will be presented at national and international conferences and published in scientific journals.Trial registration numbersNCT03496675; Pre-results, ACTRN12618000156280.

This article outlines a conceptual framework for organising an intervention plan for family therapy before starting the sessions. This is based on an integrative coherent theory or frame of understanding called neuroaffective developmental psychology (NADP) (Hart,). NADP is an integration of attachment theory, neuropsychology, developmental psychology, and trauma theory. It has been developed as a tool to navigate in the complex world of emotional development, intersubjectivity, family therapy, and psychotherapy to create relevant intervention plans to meet the needs of an individual family or client. NADP is used as a theoretical frame of understanding, (a) to understand emotional development, personality vulnerabilities and disorders, and the maturation of emotional capacities within attachment-based relationships, and (b) to translate this understanding into intervention plans discretely adjusted to the complexity of human development and the skills and agency of the professionals working with the families. The theory and clinical application of NADP as an organising frame within a family therapy setting is illustrated by a case example.

For parents who have experienced childhood interpersonal trauma, the challenges of parenting an adolescent may trigger memories of abuse, intensifying conflict, resulting in negative cycles of relating and poorer responsiveness to emotions when parenting. This study examined whether Tuning Relationships with Music, a dyadic therapy for parents and adolescents, increased responsive parent-adolescent interactions and parent emotion coaching whilst reducing conflict and adolescent mental health difficulties. Twenty-six parent-adolescent dyads were recruited if parents had a trauma history and the dyad were currently having high levels of conflict. Dyads were randomly allocated into intervention or wait-list control and completed questionnaires and observation assessments at baseline and 4-month post-baseline follow-up. Those allocated to the intervention condition participated in 8 sessions of Tuning Relationships with Music. Trial registration: ANZCTR: 12615000814572. Parents and adolescents reported significant reductions in conflict. Parents in the intervention condition were observed to significantly improve their nonverbal communication, emotional responsiveness and non-reactivity toward their adolescent. Although parents reported they were less dismissive and punitive, and more encouraging of their adolescent’s emotions, and both parents and adolescents reported improvements in the adolescent’s mental health, these were not statistically significant. Findings suggest Tuning Relationships with Music may assist parents with a history of childhood interpersonal trauma and their adolescent to reduce conflict and increase responsive ways of relating that may positively impact the young person’s mental health. Future trials with a larger sample are warranted.

Recent development within the field of arts and health in Denmark is presented, with the use of music in a specific “arts on prescription” model carried out in Aalborg Municipality. A brief overview of established arts and health strategies in the rest of Scandinavia and the UK is followed by an introduction to a Danish project called “Culture Vitamins.” The use of music and music intervention is presented in detail. “Music intervention” draws on two different fields from clinical practice, including “music medicine” and “music therapy.” Music medicine is mainly a stimulus-response-focused model, whereas music therapy is a psychodynamic-humanistic model focused on interpersonal communication. Finally, political issues, applicability, and future research options are discussed.

Using a music therapy approach to assess emotional communication and parent–child interaction is new to the field of child protection. However, musical improvisations in music therapy has long been known as an analogue to affect attunement and early non-verbal communication between parent and infant, which called for an investigation of the value of music therapy within the field of family assessment and family therapy. More specifically, we wanted to investigate and further strengthen assessment of parenting competencies (APC). We developed scores and examined the psychometric properties of the APC-R (revised version) in a quantitative study including a small, embedded qualitative component. A total of 52 dyads of children and their parents participated of whom 18 were in residential center to address emotional neglect and 33 functioned as a non-clinical comparison (children aged 5–12). All dyads underwent two video recorded music therapy assessment sessions. Video analyses focused on autonomy relationship, turns, and parental response types producing scores on Mutual Attunement, Nonverbal Communication Skills and Emotional Parental Response. Psychometric analyses of the APC-R included interrater reliability, test re-test reliability, internal consistency, and concurrent validity. We concluded that APC-R is reliable and valid and adds to the existing observational instruments of parent–child interaction.

The focus of this article is the theoretical understanding behind, and the clinical application of, a newly developed music-therapy assessment tool, Assessment of Parenting Competencies (APC). While the psychometric properties have been analyzed successfully in prior publications, the advantages and challenges of a nonverbal and emotional interactional medium such as music in assessing parent–child interaction and parental capacity are presented and discussed. The assessment model relates to theories of attunement, autonomy, and attachment, and clinical relevance for practice within the field of child protection is addressed according to clinical application of the tool.How can the scores of APC be interpreted and how are they clinically relevant? With the combination of a playful and rigorous approach, APC can provide useful information to families, family therapists, and other social-service professions within the field of child protection, including level of mutual attunement, nonverbal communication skills, emotional parental response, and possibly indications of attachment behavior in the child. APC can thereby help indicate the severity of the situation and the possible therapeutic direction for the family in question.

Background: Work with families and families at risk within the field of music therapy have been developing for the last decade. To diminish risk for unhealthy child development, families with emotionally neglected children need help to improve their emotional communication and develop healthy parent-child interactions. While some researchers have investigated the effect of music therapy on either the parent or the child, no study has investigated the effect of music therapy on the observed interaction between the parent and child within the field of child protection.Objective: The purpose of this study was to investigate the effect of a dyadic music therapy intervention on observed parent-child interaction (mutual attunement, nonverbal communication, emotional parental response), self-reported parenting stress, and self-reported parent-child relationship in families at risk and families with emotionally neglected children, ages 5–12 years.Method: This was a randomized controlled trial study conducted at a family care center in Denmark. Eighteen parent-child dyads were randomly assigned to receive 10 weekly music therapy sessions with a credentialed music therapist (n = 9) or treatment as usual (n = 9). Observational measures for parent-child interaction, self-reported measures for parenting stress and parent-child relationship were completed at baseline and 4 months post-baseline assessment.Results: Results of the study showed that dyads who received music therapy intervention significantly improved their nonverbal communication and mutual attunement. Similarly, parents who participated in dyadic music therapy reported themselves to be significantly less stressed by the mood of the child and to significantly improve their parent-child relationship in terms of being better at talking to and understanding their children than parents who did not receive music therapy. Both groups significantly improved in terms of increased positive and decreased negative emotional parental response, parenting stress and stress in general. There were no significant between group differences in self-perceived autonomy, attachment, and parental competence.Conclusions: The dyadic music therapy intervention examined in this study improved emotional communication between parent and child and interaction after 6 to 10 sessions and can be considered as a viable treatment alternative or supplement for families at risk and families with emotionally neglected children.