Purpose

1. Purpose • It is widely acknowledged that ABI to a large extend affects psychosocial functioning (Morton and Wehman, 1995). Research indicate that active music therapy can have an positive effect on interaction competences (Barker and Brunk, 1991, Nayak et al., 2000, Purdie, 1997) • Musical interaction relies on many different networks of the brain working together(Peretz and Zatorre, 2005). When persons with ABI actively do music, they are offered an opportunity for simultaneous activation of the emotional-, motoric-, cognitive- and communicative structures of the brain. • When client and music therapist play music together, their musical interaction behavior is continually adjusted. When interacting musically they use interpersonal communication competences such as empathy, self-disclosure, social relaxation, expressiveness, empathy, etc. It is the studies general hypothesis that an overall gain in doing music therapy in neurological rehabilitation is improved interpersonal communication competences. • Music therapy method • The client’s rehabilitation needs are clarified using a proxy Rehabilitation Needs Questionnaire(RNQ) addressing; physical, cognitive, psychological, and social rehabilitation needs. The therapists adapts and develop music therapy methods to address rehabilitation needs. Verbal dialog in music therapy addresses issues from; everyday life, rehabilitation needs, musical performance and interaction. The client's preferences of music and instruments is an important guideline in choosing intervention. In this study group therapy ended with a concert. • Research question • What effect does music therapy have on interpersonal communication competences in people with acquired brain injury? • What is the effect of 20 music therapy sessions on interpersonal communication competences in musical improvisations? • What is the effect of 20 music therapy sessions on interpersonal communication competences in daily life? • Is there a correlation between interpersonal competences in music and daily life? • Design • The correlation hypothesis was tested on 18 participants having suffered from ‘medium’ to ‘servere acquired brain injury (ABI). To test the interpersonal effect of music therapy a randomized cross-over design (AB-BA) was assigned on 11 participants who have lived with their injury for more than five years. ‘A’ was twenty group music therapy sessions and ‘B’ was 4-5 months of standard rehabilitation. 3 participants got very ill and left the study. • The 7 participants who had acute ABI were allocated to music therapy condition or standard rehabilitation, based on treatment considerations. Communication competences in daily life was measured with an altered version of Rubin and Martin (1994) Interpersonal Communication Competence Scale (ICCS) deployed on relatives, staff and participants. Interpersonal communication competences in music were measured by blinded raters using an adapted version of Bruscia’s (1987) Improvisation Assessment Profile -autonomy profile (IAP-Aut.) and an alteration of the ICCS questionnaire into musical means. • Measurements • Questionnaires • ICCS_Proxy - Staff and relative evaluation of ICC in daily life • ICCS_ABI - Self evaluation of ICC in daily life • ICCS_MU - Music therapist evaluation of client after MT assessment • ICCS_MU_OWN - Self evaluation after MT assessment • RNQ – Relatives, Staff and self evaluation of rehabilitation needs • Musical exercises • Dialog (self chosen instrument) • Follow the therapist (on piano) • Hold on to a phrase while the therapist challenge • Free improvisation • Blinded rating • ICCS_RAT - Blinded rater evaluation of ICC based on the four musical exercises. • IAP_AUT - Blinded rater evaluation of autonomy in improvisation • Interpersonal Communication Competence Scale (ICCS) (Rubin and Martin, 1994) • The communication experts Rubin and Martin (1994) made a search for common understanding of interpersonal communication competences and ended up with ten subgroups regarding interpersonal interaction. Their work resulted in a 30 items questionnaire with a five point Likert type scale (Almost always (5), often (4), sometimes(3), seldom (2), and almost never (1)). The ICCS subgroups are: Participant Flow chart Søren Hald – Denmark hald@hum.aau.dk Rating musical exercises Two music therapy students were trained in using Brusia’s (1987) Improvisation Assessment Profile (Autonomy), and assigned ICCS-music rater questions. The four musical exercises (dialog, follow, hold on, and free impro.) done pre and post 20 sessions were analyzed by the two raters. The raters fist evaluated the four exercises with the ICCS – music rater tool, followed by IAP autonomy rating. The raters were blinded in regards to pre/post order of video clip. Development of ICCS questions ACTIVE MUSIC THERAPY, ACQUIRED BRAIN INJURY, AND INTERPERSONAL COMMUNICATION COMPETENCESRandomized cross-over study on active music therapy and neurological rehabilitation Improvisation Assessment Profile - Autonomy Preliminary results from cross over study References: BAKER, F. & TAMPLIN, J. (2006) Music therapy methods in neurorehabilitation, London, Jessica Kingsley Publishers. BARKER, V. L. & BRUNK, B. (1991) The Role of Creative Arts Group in the Treatment of Clients with Traumatic Brain Injury. Music therapy perspectives, 9, 26-31. BRUSCIA, K. E. (1987) Improvisational models of music therapy, Springfield, Ill., Charles C. Thomas. MORTON, M. V. & WEHMAN, P. (1995) Psychosocial and emotional sequelae of individuals with traumatic brain injury: a literature review and recommendations. Brain Injury, 9, 81-92. NAYAK, S., WHEELER, B. L., SHIFLETT, S. C. & AGOSTINELLI, S. (2000) Effect of music therapy on mood and social interaction among individuals with acute traumatic brain injury and stroke. Rehabilitation Psychology, 45, 274-283. PERETZ, I. & ZATORRE, R. J. (2005) Brain organization for music processing. Annu.Rev.Psychol, 56, 89-114. PURDIE, H. (1997) Music Therapy with Adults who have Traumatic Brain Injury and Stroke. British Journal of music Therapy, 11, 45-50. RUBIN, R. B. & MARTIN, M. M. (1994) Development of a Measure of Interpersonal Communication Competence. Communication Research Reports, 11, 33-44. WIGRAM, T. (2004) Improvisation : methods and techniques for music therapy clinicians, educators, and students, London ; Philadelphia, J. Kingsley Publishers. Søren Hald - Aalborg University - 2011 Høskoven Trænings-, Bo-, og Aktivitetshus

2. Interpersonal Communication Competences (ICC) (Rubin and Martin, 1994) Self-disclosure Being open and personal Empathy Feeling as, and with others Social relaxation Feeling relaxed with others and the ability to deal with their oddity without stress Assertiveness Express yourself and your point of view in an appropriate manner – plus the ability to stand on ones rights Alter centrism Negotiating subjects, taking turns, starting and ending Interaction management Flexibility and attention to the others thoughts and nonverbal signals Expressiveness Verbal (finding the right words), nonverbal (facial expressions, prosody, gesture, etc.) Supportiveness Non judging, open, spontaneous and problem solving Immediacy Eye contact, open body language, obligingness Environmental control Ability to solve problems together with others and make others go for ones ideas

3. Interpersonal communication competence questions Søren Hald - Aalborg University - 2011

4. Søren Hald - Aalborg University - 2011