Investigating the role of music therapy in the reduction of behavioural and psychological symptoms for people with dementia

Music Therapy (MT) literature reviews report a reduction of Behavioural and Psychological Symptoms associated with Dementia (BPSD) after MT for Persons Living with Dementia (PWD). However, a consensus on how to implement MT in dementia care is still lacking and further research is needed. This study aims to identify MT Techniques (MTTs) and significant moments, contributing to a reduction in BPSD during MT group sessions. Six groups of 3 PWD aged between 65-100 and manifesting behavioural symptoms participated in 12 weekly active Group MT (GMT) sessions. A mixed method research approach was applied. Agitation Behaviour Mapping Instrument (ABMI), Observed Emotion Rating Scale (OERS), and Music in Dementia Assessment Scale (MiDAS), quantitative direct observation tools, detected Moment(s) of BPSD Reduction (MBR) during the session. A qualitative assessment based on Interpretative Phenomenological Analysis attempted to describe how MBR occurred by identifying relevant MTTs, sonority and sound interaction at MBR (MBR descriptors). A prevalence analysis and an artificial neural network system (Auto-Contractive Map) identified qualitative data associations. A pool of four qualitative MBR descriptors (pool-components) for each of the following syndromes was identified: Aggression - Features of Clinical Environment, Calming, Pacing, and Rhythmic Grounding; Depression - Rhythmic Grounding, Introducing Change, Music Therapist’s Flexibility, and Features of Clinical Environment; Apathy - Rhythmic Grounding, Group As a Resource, Group Creation, Features of Clinical Environment; Hyperactivity - Giving, Client Validation, Giving Value to Client’s Music and Sound, Rhythmic Grounding, Making Spaces. The qualitative analysis of the nature of the pools highlighted a two-phase mechanism for MBRs. Results showed that Rhythmic Grounding, Features of Clinical Environment, Pacing, and Making Spaces were functions for preparing the conditions for MBRs in music therapy (first phase), all the other pool components were essential functions for achieving MBR in GMT (second phase). The Rhythmic Grounding technique was a constant component through all the phases and conditions for achieving MBRs. The clinical conditions expressed by the pools contribute new knowledge of the internal mechanism of MT at MBR.