'Songs for Life': Group music therapy for serious and enduring mental illness (SEMI) - a randomised control trial

INTERVENTION: A group music therapy intervention comprising the following (4) treatment components: singing preferred and familiar songs; percussive improvisation; writing an original song; recording an original song. The intervention will be a 13‐week group music therapy progam, delivered by a registared music therapist (RMT). The program comprises one Introductory Session, and 12 group music therapy sessions, with session length of one hour. The original song will be recorded in a professional recording studio and a CD will be given to participants at the end of the program. Music therapy is a recognised psychosocial intervention that involves a wide range of musical applications, including improvisation, instrument playing, singing/vocalising, composition, song/lyric writing, music and movement, listening, performance and music imagery. Music therapy interventions are selected according to the unique needs of particular individuals or groups, and offer participants the opportunity to interact musically and socially in the context of a therapeutic relationship. The effectiveness of music therapy, especially active music‐making, for people with SEMI has been demonstrated (Gold, Heldal, Dahle & Wigram, 2005). CONDITION: Bipolar disorder and major depression Schizophrenia and other psychotic disorders Severe and enduring mental illness PRIMARY OUTCOME: Statistically significant changes in Quality of Life, as measured by the Quality of Life Enjoyment and Satisfaction Questionniare (Q‐LES‐Q‐18; Ritsner, Kurs, Gibel, Ratner & Endicott, 2005). The Q‐LES‐Q‐18 is an 18‐item self‐report inventory that assesses quality of life in four domains: social relationships, physical health, subjective feelings, and leisure‐time activities. The instrument represents a parsimonious subset of items that maintains the validity and psychometric properties of the longer 60‐item version. The Q‐LES‐Q‐18 is suitable for the evaluation of quality of life outcomes in clinical trials involving participants with schizophrenia, shizoaffective, and mood disorders. INCLUSION CRITERIA: The inclusion criteria are not diagnosis‐specific, such that people living with a broad range of mental illnesses can participate. Musical experience or ability is not necessary. Specific INCLUSION CRITERIA: 1) a diagnosed severe and enduring mental illness (e.g., schizophrenia, bipolar disorder, major depression) that has been present for a least two years; 2) living independently in the community; 3) currently linked with a mental health professionial, case manager, or primary care physician; 3) ability to participate in a group for 1.5 hours. SECONDARY OUTCOME: Clinically significant and self‐reported meaningful change in quality of life, perceived social support, self‐esteem, and spirituality (sense of meaning and purpose) as measured by focus group interview. Psychiatric symptoms, as measured by the Brief Symtpom Inventory (BSI; Derogatis, 1993). The BSI is 53‐item brief self‐report inventory that reflects psychopathology and psychological distress in nine symptom dimensions and three global indices. This instrument is appropriate for a broad range of diagnoses and is useful in evaluating treatment outcome. We are expecting that psychiatric symptoms will remain unchanged pre‐ and post‐intervention. Statistically significant changes in perceived social support, as measured by the ENRICHD Social Support Instrument (ESSI; Barefoot et al., 2003). The ESSI is a 7‐item self‐report inventory that has demonstrated utility in assessing the role of social support in health outcomes (Vaglio et al, 2004). Statistically significant changes in self‐esteem, as measured by the Rosenberg Self‐Esteem Scale (RSES; Rosenberg, 1965). The RSES is a widely used 10‐item self‐report inventory for evaluating individual self‐esteem. Statistically significant changes in spirituality, as measured by the Functional Assessment of Chronic Illness Therapy‐Spiritual Well‐being Scale (FACIT‐Sp; Peterman et al., 2002). The FACIT‐Sp is a popular 12‐item self‐report measure of the religious/spiritual (R/S) components of quality of life (QoL) in patients with cancer (Carmody et al., 2008). Qualitative analysis of song lyrics in the pilot study for this project revealed strong religious and meaning‐related themes. Thus, the inclusion of a quantitative outcome measure of spirituality.