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I Ny forskning i musikterapi får du en kort opdatering over, hvad der har rørt sig i musikterapiforskningsmiljøet på Aalborg Universitet i halvåret siden sidste nummer af Tidsskriftet Dansk Musikterapi. Herudover får du indblik i den nyeste internationale forskning i musikterapi eller forskning, som har relevans for faget

Introduction: Music is of vital importance for cognition, human care, and the formation of social communities throughout life. Dementia is a neurocognitive disorder that affects cognitive domains, and in late-stage dementia, care is needed in all aspects of daily living. Within residential care home contexts, carers play a significant role for the “caring culture” but often lack professional training in verbal and nonverbal communication skills. Thus, there is a need for training carers to respond to the multidimensional needs of persons with dementia. Music therapists use musical interactions but are not trained to train carers. Therefore, our aim was to explore person-attuned musical interactions (PAMI), and additionally, to develop and evaluate a training manual to be used by music therapists when supporting and training carers in nonverbal communication with persons with late-stage dementia in residential care home contexts. Research process: With a realist perspective and systems thinking and within the framework for complex intervention research, the research group integrated several overlapping subprojects by applying a non-linear and iterative research process. Core elements related to person-centred dementia care as well as learning objectives were considered through the following four phases; Developing, Feasibility, Evaluation, and Implementation. Results: The result was a training manual for qualified music therapists to use when teaching and collaborating with carers about how to implement PAMI in dementia care. The manual included comprehensive resources, a clear structure for training, defined learning objectives, and integration of theory. Discussion: With increased knowledge about caring values and nonverbal communication, residential care home cultures may develop carer competencies and provide professional attuned care for persons with dementia. Further piloting and testing to examine the general effect on caring cultures is needed. Introduction: Music is of vital importance for cognition, human care, and the formation of social communities throughout life. Dementia is a neurocognitive disorder that affects cognitive domains, and in late-stage dementia, care is needed in all aspects of daily living. Within residential care home contexts, carers play a significant role for the “caring culture” but often lack professional training in verbal and non-verbal communication skills. Thus, there is a need for training carers to respond to the multidimensional needs of persons with dementia. Music therapists use musical interactions but are not trained to train carers. Therefore, our aim was to explore person-attuned musical interactions (PAMI), and additionally, to develop and evaluate a training manual to be used by music therapists when supporting and training carers in non-verbal communication with persons with late-stage dementia in residential care home contexts. Research process: With a realist perspective and systems thinking and within the framework for complex intervention research, the research group integrated several overlapping subprojects by applying a non-linear and iterative research process. Core elements related to person-centered dementia care as well as learning objectives were considered through the following four phases; Developing, Feasibility, Evaluation, and Implementation. Results: The result was a training manual for qualified music therapists to use when teaching and collaborating with carers about how to implement PAMI in dementia care. The manual included comprehensive resources, a clear structure for training, defined learning objectives, and integration of theory. Discussion: With increased knowledge about caring values and non-verbal communication, residential care home cultures may develop carer competencies and provide professional attuned care for persons with dementia. Further piloting and testing to examine the general effect on caring cultures is needed.

Birgitte Clausen og Birgit Hvass har udgivet en sang- og dansebog med titlen ”Åh disse minder”. Til den er der også udgivet en melodibog. I forordet til melodibogen skriver Ældre Sagens adm. direktør Bjarne Hastrup: ”Sang og dans er godt for både krop og sjæl. Når vi danser og synger sammen, bidrager vi til fællesskabet og oplever inklusion og tilknytning. Det styrker vores velbefindende og vejrtrækning, og det styrker vores erindringer, koordination og holder hjernen frisk.”

Specialeafhandlinger i musikterapi, nyt om forskning i musikterapi fra AAU, effektundersøgelse om musikterapi på Bari hospital i Italien for børn med kræft.

Hvert år rammes omkring 17.000 danskere af en hjerneskade som følge af hjerneblødning, blodprop, tumor, eller skader efter slag, forgiftning og iltmangel. Hjerneskade er den hyppigste årsag til erhvervet handicap i de vestlige lande. Over halvdelen af de ramte har efterfølgende behov for tværfaglig og personligt tilrettelagt rehabilitering. I Danmark tilbydes patienter rehabilitering på hospitaler og efterfølgende i kommunalt og regionalt regi. I en række vestlige lande anvendes musikterapi i neurorehabilitering, mens det i Danmark endnu er i sin spæde start med kun et fåtal ansatte musikterapeuter. Vi vil i denne artikel give et indblik i musikterapi i genoptræning og uddybe, hvordan Line Malmskov, som er førsteforfatter til artiklen, integrerer musik i sit arbejde på Bispebjerg Hospital ud fra hendes model, MTIN (Musikterapi i Neurorehabilitering). Vi illustrerer musikterapien med anonymiserede vignetter fra Lines arbejde og efter godkendelse fra hendes ledelse.

Musikterapi er en psykosocial praksis, hvor oplevelser med musik anvendes med et terapeutisk formål. Sundhedsstyrelsen anbefaler at overveje at tilbyde musikterapi til behandling af adfærdsmæssige og psykiske symptomer hos personer med demens. Her er det ikke bestemt musik, som fx Mozart, der anbefales, men handlinger og samvær med udgangspunkt i musik, og med målet at ”tilbyde kontakt, kommunikation og relation og derigennem imødekomme vigtige psykosociale behov”. Sundhedsstyrelsen anbefaler bl.a. fysisk træning, reminiscens og søvnhygiejne til at forebygge adfærdsmæssige og psykiske symptomer hos personer med demens, og anbefaler også musikterapi som psykosocial intervention til behandling af symptomerne. Baggrunden er, at musik ikke alene kan fremme psykologiske, kognitive, funktionsmæssige og sociale ressourcer hos personer med demens, men ligeledes kan bidrage til at udtrykke og regulere følelser. I kapitlet gennemgås evidens for musikterapeutisk behandling, musik som kommunikation, musik og kognition, virkningsmekanismer ved musik, sang som terapeutisk indsats ved svær demens samt sang og musik i en tværfaglig indsats.

Musik er en ressource for mange. Derfor kan musikalsk samvær tænkes ind som potentiale i den sociale indsats for borgere med erhvervet hjerneskade i den stabile vedligeholdende fase. I et aktionsforskningsprojekt indgik borgere med erhvervet hjerneskade, socialpædagoger samt forsker i udviklingen af musikalske samhandlinger. Det empiriske materiale bestod af videoobservation, interviews og feltnoter, som blev analyseret med fokus på det, musikforskeren Frede V. Nielsen kalder ”kropslige og strukturelle meningslag i musikken”. Borgernes og pædagogernes musikalske ressourcer og musikalske samhandlinger blev således beskrevet gennem fire tidsdimensioner ud fra Nielsens ”Model af genstandsfeltet for musikpædagogisk forskning”. Ved analyse af udvalgte aktionseksperimenter, som er funderet i Nielsens teorier, fandt vi, at bevarede musikalske kompetencer kunne aflæses i det musikalske samvær, når indholdet tog udgangspunkt i borgernes personlige erfaringer med musik, og at de mestrede tekniske, kognitive og sociale færdigheder på en sådan måde, at det opfyldte det fælles indsatsformål om positive oplevelser i sociale sammenhænge.

Introduction In 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 analysis This 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 dissemination Ethical 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.

Anne Steen: Kære Hanne Mette. Det er helt forrygende som musikterapi i ældreplejen er kommet på landkortet og på alles læber. Jeg ved, at du har lavet et kæmpe arbejde for at nå hertil. Kan du give en oversigt over den proces, som du har styret gennem årene og hvilke planer og visioner der er for de kommende år? Tak for din indsats, som kommer alle musikterapeuter til gode.Hanne Mette: Det styrer for vildt for musikterapi i demensområdet. Så tak til dig, Anne, for opfordringen til at stoppe op og gøre lidt status. Jeg blev rigtig glad for dine anerkendende spørgsmål, men billedet af at det er mig styrer, vil jeg gerne dementere. Jeg er vist i en båd der ikke kan styres. Der er ingen ror, og den vipper så meget at man ikke engang kan stå op. Det må være en slags riverraftingtur ned af en fossende elv. Havde jeg været alene, var jeg for længst blevet tippet rundt eller kastet ind mod klipperne langs kanten. Heldigvis er båden fyldt af gode kolleger og med hver vores pagajer og med fælles hjælp får vi styret os med i den hvirvlende strøm.

Speciale og ph.d.-afhandlinger i musikterapi. Nyt fra forskerprogrammet. Forskningsprotokol og review-artikler. Effektundersøgelser, bogudgivelser og meget mere.

Et menneske er andet og mere end ord. Der er mange måder, vi kan kommunikere på, og det er skadeligt og stigmatiserende at se demente som umælende.FORTÆLLINGEN om det, der skete i går, gør mig til den, jeg er i dag. Det, vi fortæller om vores liv, giver os en identitet og en retning. Derfor er fortællinger om os selv omdrejningspunktet i narrativ psykologi. Med hvad så, hvis man begynder at glemme, og ordene til at fortælle forsvinder, forsvinder identiteten så sammen med fortællingen? Hvis man får en demenssygdom, går det så lige lukt mod en tilstand som grøntsag, som det så ofte hævdes?

Public interest in the benefits of music for people with dementia has rapidly increased in recent years. In addition to clinical work with clients, music therapists are often required to support and train staff, families, and volunteers and skill-share some music therapeutic skills. Six music therapy researchers from six countries agreed it was timely to organize a roundtable and share their indirect music therapy practice and examples of skill-sharing in dementia care. This article was developed following the roundtable at the World Congress of Music Therapy in 2017 and further discussion among the authors. This process highlighted the diversity and complexity of indirect music therapy practice and skill-sharing, but some common components emerged, including: 1) the importance of making clinical decisions about when direct music therapy is necessary and when indirect music therapy is appropriate, 2) supporting the transition from direct music therapy to indirect music therapy, 3) the value of music therapy skill-sharing in training care home staff, 4) the need for considering potential risks and burdens of indirect music therapy practice, and 5) expanding the role of music therapist and cultivating cross-professional dialogues to support organizational changes. In indirect music therapy practice, a therapist typically works with carers and supporters to strengthen their relationships with people with dementia and help them further develop their self-awareness and sense of competence. However, the ultimate goal of indirect music therapy practice in dementia care remains the wellbeing of people living with dementia.

Nyt fra Forskerprogrammet i musikterapi. Review-artikler vedr. musikterapi og onkologi og demens. Særnummer i Approaches om Europæisk GIM forening. Bogudgivelse: Lindvang & Beck (Red). Musik, krop og følelser. Neuroaffektive processer i musikterapi samt Jensen (Red.) Kultur og Sundhed. TV-serie serien ”Lyden af Liv”. Forskningsbevilling til skandinavisk børneonkologisk musikterapiprojekt v. Ilan Sanfi.

Music in Dementia Assessment Scales, MiDAS, er udviklet til at vurdere ændringer i trivsel hos borgere med demens som har deltaget i musikterapi. Målingen udføres af 1) personale før og efter musikterapien for at vurdere om der er en indflydelse i hverdagssituationer efterfølgende, eller af 2) musikterapeuten umiddelbart efter sessionen for at vurdere forandringer i selve sessionen. Der har været stor interesse for at anvende MiDAS i flere Europæiske lande, herunder Danmark. Derfor undersøgte udviklerne af MiDAS hvilke procedurer der anvendes til oversættelse og kulturel tilpasning af assessmentredskaber, og anbefalede på den baggrund en ti-trins procedure. Vi anvendte denne procedure til oversættelsen af MiDAS og således udviklingen af den danske MiDAS-DK. Den danske version af MiDAS er afprøvet af mere end 20 fagpersoner på baggrund af 296 udfyldte MiDAS-skemaer. Målet med artiklen er at beskrive oversættelsesprocessen fra engelsk til dansk og at præsentere den endelige MiDAS-DK. Music in Dementia Assessment Scales, MiDAS, has been developed to evaluate changes in wellbeing in persons with dementia participating in music therapy. The MiDAS forms should be completed: 1) by the caregiver before and after the music therapy session to assess an impact in everyday life, or 2) by the music therapist immediately after the session to evaluate changes within the session. There was a great interest in using MiDAS in several European countries, including Denmark. Therefore, the developers of MiDAS explored which procedures is used for outcome measure translation and cultural adaptation, and based on this recommended a ten-step procedure. We applied this procedure in order to translate MiDAS and hereby develop the Danish MiDAS-DK. The Danish MiDAS version has been tested by more than 20 professionals and based on scoring of 296 MiDAS forms. The aim with this article is to describe the MiDAS translation process from English to Danish and to present the final MiDAS-DK.

Resonance is often used to characterize relationships, but is a complex concept that explains quite different physical, physiological and psychological processes. With the aim to gain a deeper insight in the concept of resonance, a group of ten music therapy researchers embarked on a joint journey of exploration. This included an aim to let the internal learning process be disseminated in a way where others could get insight from not only the findings, but also the process. Findings include a double understanding of Resonance as (1) a visible and ordered phenomenon consisting of physical vibrations and acoustic sounding that offers a clear logic, (2) a metaphorical conceptualization used to describe and understand complex psychological processes of human relationships. The process of collaborative writing led to the discovery or development of a nine-step procedure including different collaborative, resonant writing procedures and musical improvisation as well as a series of metaphors to explain therapeutic interaction, resonant learning and ways of resonant exploration. Resonance is often used to characterize relationships, but it is a complex concept that explains quite different physical, physiological and psychological processes. With the aim of gaining deeper insight into the concept of resonance, a group of ten music therapy researchers, all colleagues, embarked on a joint journey of exploration. This included an aim of letting the internal learning process be disseminated in a way that could give others insight, not only from the findings, but also from the process. Findings include a dual understanding of resonance as (1) a visible and ordered phenomenon consisting of physical vibrations and acoustic sounding that offers a clear logic, and (2) a metaphoricalconceptualization used to describe and understand complex psychological processes of human relationships. The process of collaborative writing led to the discovery or development of a ninestep procedure including different collaborative resonant writing procedures and musical improvisation, as well as of a series of metaphors to explain therapeutic interaction, resonant learning and ways of resonant exploration.

Bogen er skrevet i de rolige stunder hvor Lene, som har Alzheimers sygdom, sover. Den er skrevet af en pårørende som sidder der midt i sin hverdag med demenssygdommen helt inde på livet. Han er samtidig en pårørende som kan noget med ord og som formår at indfange nuet og oplevelserne. Som læser får vi åbnet døren ind til stuen med ham og Lene, ind til mødet med lægen, i dagtilbuddet, på weekend, i trafikken, og ind til de mange andre nu’er, han oplever i livet med Alzheimer. Han beskriver sin kone Lenes tryghedsbehov, der er gigantisk som et lille barns, men uden at man skal opdrage – måske nærmere neddrage. Med forfatteren Thomas Bredsdorffs egne ord: Fanden til opgave.

Musik, sang og dans benyttes målrettet og struktureret i sundhedsfremmende og -bevarende arbejde med mennesker med demens. Det beskriver vi i kapitlet her som indledes med et overblik over brugen af musik og sang i demensomsorgen og som herunder giver et indblik i spontane erindringer og hvordan de udløses af musik. Derefter fokuseres der empirisk på projektet ”Erindringsdans”, som gennemførtes af Alzheimerforeningen 2014-2016 (med fortsættelse i 2017) i 39 kommuner på 181 Plejecentre, med 397 uddannede instruktører (medarbejdere på plejecentrene). Vi omtaler projektet kort og præsenterer en tematisk analyse af instruktørernes logbøger, skrevet efter hver enkelt af de 9 danse-sessioner. I diskussionen drøfter vi, hvordan kendte sange og danse fra barndom og ungdom kan spille en vigtig rolle i hverdagen for mennesker med demens, og hvordan musikterapeuter og personale i demensomsorgen benytter denne viden på mange forskellige måder i hverdagen.

Even Ruud indleder bogen Musikkvitenskap med at mene at det første møde med musikvidenskab for mange vil opleves som uoverskueligt, overvældende og ugennemtrængeligt. Jeg vil give ham ret i at det lyder af nodeanalyser og tørre teorier. Men tag ikke fejl. Hvis vi skal forstå musik, som den egenart, den er, forklarer Ruud, må vi kigge på hvordan vi omgives af musik og konstant møder musik i medierne, i den digitale verden, i hverdagen når vi kører bil, køber ind, dyrker sport, møder folk, går til fester, osv. ”Musikvidenskab handler om at sætte musikken ind i en større sammenhæng” (s. 13). For at nærme sig dette enorme felt uden at blive væltet over ende har Ruud sat ‘musikken i centrum’ og beskrevet den ud fra otte forskellige fagdiscipliner: musikpsykologi, musikterapi, musikantropologi, musiksociologi, musikæstetik og musikfilosofi, musikhistorie og historiografi, musikanalyse og endelig musikpædagogik.

Neuroaffektiv udviklingspsykologi 1, 2 & 3 af Susan Hart Harts trilogi handler om børns følelsesmæssige, personlighedsmæssige og sociale udvikling. Min faglige interesse i hendes teorisyntese er at forstå samspil mellem voksne, og specifikt hvordan mennesker med en svær demenssygdom formår at indgå i samspil med deres nærmeste omsorgsgivere. Når Hart i den tredje bog samler teorierne i ”De neuroaffektive kompasser” og påpeger at børns udvikling ikke kan forceres, bliver det tydeligt for mig hvordan afvikling hos demensramte ofte, men utilsigtet, forceres af social isolation, identitetsnedbrud og endda af fejlmedicinering med psykofarmaka. Derfor ser jeg også hvordan Harts neuroaffektiv udviklingspsykologi kan bidrage til at beskrive og forstå hvad der sker for voksne, der mister samspilskompetencer (pga. sygdom eller hjerneskade), og til at forstå hvordan professionelle kan blive bedre til at tage ansvar for at mødes i gensidige interaktioner i behandling og omsorg. Flot samspil af teorier Hart skriver om menneskeligt samspil. For at forstå noget så komplekst er hun nødt til at trække på teorier fra mange videnskabsgrene og koble dem. Måske der er en parallel til samspil også på teoriplanet – for at få bl.a. neurofysiologi, udviklingspsykologi og traumeteori til at spille sammen. Ikke så lidt ambitiøst! Min baggrund er i musik og kommunikation, og jeg bemærker at begreber som ”timing”, ”toneleje”, ”koreografi”, ”resonans”, ”synkronisering” samt ”leg” og ”kreativitet” naturligt indgår i begrebsapparatet. Det er fornyende når teorisæt bevæger sig ud over faggrænser og mødes. Teorien repræsenterer en position der stiller os til ansvar for de samspil, vi indgår i, og det er der i høj grad brug for. Således slutter Hart også af med at ønske at de tre bøger vil ”give et lille bidrag til udviklingen af en højere grad af empati og menneskelighed i en verden, der trænger til det”.

Dementia is a syndrome that affects memory, thinking, behavior, and the ability to perform activities of daily living. Therefore caregiving gradually becomes an essential part of the lives for people with dementia. This chapter draws on literature and research in order to understand the “family” caregiver role and the implications of caregiving on wellbeing and health. With this as the starting point, the role of music therapy in communication and interaction in the caregiver-care recipient dyad is elaborated.

Background: Dementia is a neurocognitive disease with a high risk of social isolation due to loss of cognitive functions and subsequent behavioural and psychological symptoms. Mutual communication between a person with dementia and a caregiver is crucial to maintain the quality of life of the person.Methods: The research team will explore a psychosocial model of care based on a humanistic, person-centred approach with a particular emphasis on maintenance of identity of the person and musical engagement. A qualitative, explorative study design will be applied to integrate different types of data (video recordings, interviews and consensus meetings). Two manuals: “Person Attuned Interaction” and “Person Attuned Music Interaction (PAMI)” for caregivers working with people with dementia will be developed and evaluated.Results: This study is ongoing. Preliminary results from focus groups and consensus meetings with caregivers and music therapy clinicians and the first elements of the PAMI manual will be presented.Discussion/Conclusions: Integration of person-centred care and mutual musical interactions between the person with dementia and caregivers is essential.

Det er fantastisk at opleve hvordan der er grøde i brugen af musik i demensomsorgen. Fra at være overset og lidt glemt, er det blevet absolut in med musik. Der er et væld af initiativer, projekter, avisartikler, dokumentarfilm og YouTubeklip som viser hvordan musik skaber små hverdagsmirakler for mennesker med demens. Det pibler fra plejehjem og praksis – verden over – med brug af iPods, syngende sygeplejersker, musik i fællesrum, demenskor og erindringsdans. Samtidig er der stadig mere forskning der bekræfter overraskende velbevaret musikalsk hukommelse ved demens (Jacobsen, Stelzer, Fritz, et al., 2015) og positiv effekt af musikterapi på agitation (Ridder, Stige, Qvale & Gold, 2013) og depression (Werner, Wosch & Gold, 2015). Denne bølge af interesse for musik til demensramte giver et væld af muligheder for nyudvikling og for at øge livskvalitet og reducere medicinforbrug. Men desværre er der eksempler hvor der i begejstring gribes til metoder som passer dårligt ind i en dansk plejehjemskontekst og uden faglig indsigt i fællesnævneren mellem musik og demens. Musik kan være vidunderligt og skønt at høre på, men kan i nogle situationer føre til overstimulering eller til at folk føler sig misforstået, socialt isoleret eller direkte nedgjort og stigmatiseret. Musik er et kraftfuldt middel og må ikke bruges ukritisk. Derfor er der brug for viden om hvordan omsorgsgivere på bedste måde kan gøre brug af musik til svært demensramte. Så det kunne ikke være mere veltimet og belejligt at Veluxfonden (2015) har bevilget midler til et større forskningsprojekt som giver mulighed for at blive klogere på brugen af musik i pleje og omsorg. Fra et fokus på brug af musik til demensramte, vil forskergruppen flytte fokus til musik mellem demensramt og omsorgsgiver og med musikterapeutisk vejledning.

Overblik over musikterapidokumentation og -forskning i perioden august 2015 til januar 2016. Læs bl.a. om fibromyalgi, assessment, musik, sprog, sang og demens, syngende sygehuse og problembaseret læring.

On behalf of the European Music Therapy Confederation, I want to address my sincere appreciation to the Nordic Journal of Music Therapy (NJMT) and to the Viennese EMTC2016 Organising Committee for this printed collection of scientific conference abstracts that you have in your hands (or the electronic version on your device). Thanks to the collaboration between the NJMT and the EMTC2016 Local Organising Committee it has been possible – for the first time in the history of European Music Therapy Congresses – to present refereed conference proceedings in affiliation with a well-established, high-quality international publisher. This is an important step in the quality assurance of the music therapy profession and an important step in developing the music therapy discipline.There are several advantages in making accessible published conference proceedings. We have better possibilities for sharing clinical and scientific work in progress as well as final results and theoretical ideas. This is how we develop a rich field embracing a variety of perspectives in the understanding of the use of music in human life. In addition, this is how we open up to other fields and encourage interdisciplinarity.I am impressed to see the high quality of abstracts and to see so many countries participating in sharing their work with colleagues. Without these valuable contributions, these proceedings would not have existed, and from the European Music Therapy Confederation, I therefore direct my sincere thanks to all contributors. It is a pleasure to celebrate the 10th European Music Therapy Conference with this publication supplement of the NJMT.

In 2015, the World Health Organization announced a focus on dementia with the aims of increasing awareness of the public health challenges associated with dementia and highlighting the need for coordinated global action. Dementia is one of the major causes of disability and dependency among older people around the world. Alzheimer’s disease and related dementias affect neurocognition and associated functioning, including memory, thinking, behavior, and activities of daily living. Agitation in later stages of dementia is the most significant symptom contributing to patient distress and caregiver burden. In order to reduce agitation, it is important to focus on the cause and not merely the symptoms. In spite of this, agitation is frequently treated with psychotropic medications with commonly associated severe adverse effects. A growing number of studies lend evidence indicating that music therapy interventions decrease agitation. According to the latest Cochrane review (Vink, Bruinsma, & Scholten, 2011), however, studies examined as part of the 2011 systematic review were methodologically weak, resulting in authors not being able to draw conclusions regarding the effectiveness of music therapy. This paper suggests recommendations for future research focusing on the most burning issue regarding dementia – agitation – and studies that include outcome measures on agitation.

Conference: Music Therapy and Dementia Care in the 21st CenturyDementia is one of the major causes of disability and dependency among older people, with agitation in dementia as the most significant symptom causing patient distress and caregiver burden in later stages of the disease. Music in various forms (e.g. caregiver singing or music listening) is widely used in nursing homes for people with dementia; however these practices are generally little informed by music therapy theory and research. In this presentation, an overview of research in non- pharmacological approaches is given, and music therapy is described as an effective psychosocial intervention for reducing agitation in persons with dementia.I will shortly refer to an exploratory RCT where we found that 6 weeks of biweekly music therapy sessions reduced agitation disruptiveness as well as the prescription of psychotropic medication (Ridder et al., 2013). The music therapy practice in this study was informed by a psychosocial model of care (see McDermott et al., 2014). From this, I will further discuss how music therapy research may inform the culture of care for persons with dementia and how music therapy should not only be carried out as direct practice (Bunt & Stige, 2014) but also as indirect music therapy practice.Indirect practice is suggested to play an important role in future culture of care in nursing homes with the music therapist as a key ‘actor’ in implementing music interventions in daily care situations, e.g. in dyads with caregivers or relatives and the person with dementia. The aim is to provide and develop psychosocial interventions in the interdisciplinary team, and to support staff and caregivers in their use of music as part of the daily culture of care.ReferencesBunt, L. & Stige, B. (2014). Music therapy. An art beyond words (2nd ed.).London: Routledge.McDermott, O, Orrell, M. & Ridder, H.M. (2014). The importance of music for people with dementia: the perspectives of people with dementia, family carers, staff and music therapists, Aging & Mental Health, 18(6), 706-716.Ridder, H.M., Stige, B., Qvale, L.-G. & Gold, C. (2013). Individual Music Therapy for Agitation in dementia: an exploratory RCT. Aging & Mental Health, 17(6), 667-678.

Welcome to this special issue of Approaches and, indeed, there are various reasons that make this journal issue ‘special’. First of all, this is the first issue dedicated to a rather complex and delicate topic: pathways of professional development of music therapy in Europe. As a partnership between Approaches and the European Music Therapy Confederation (EMTC), this issue is the first of its kind; it is the first collaboration of Approaches with an international professional music therapy body, while at the same time it is the first journal-based publication initiative of the EMTC. Thanks to the generous funding of the EMTC, this is also the first issue of Approaches to become available not only online but also in print format. Considering the complexity of the topic of this journal issue (as well as its unusually large size!), we feel the need to write a more thorough editorial; an editorial which does not simply introduce the contents, but more importantly provides a context for understanding the background and the scope, as well as the limitations and aspirations of this publication. Welcome to this special issue of Approaches and, indeed, there are various reasons that make this journal issue ‘special’. First of all, this is the first issue dedicated to a rather complex and delicate topic: paths of professional development of music therapy in Europe. As a partnership between Approaches and the European Music Therapy Confederation (EMTC), this issue is also the first of its kind; it is the first collaboration of Approaches with an international professional music therapybody, while at the same time it is the first journalbased publishing initiative of the EMTC. Thanks to the generous funding of the EMTC, this is also the first issue of Approaches to become available not only online but also in print format. Considering the complexity of the topic of this journal issue (as well as its unusually large size!), we feel the need to write a more thorough editorial; an editorial which does not simply introduce the contents, but more importantly provides a contextfor understanding the background and the scope, as well as the limitations and aspirations of this publication.