Exploring experiences of music therapy service development in intellectual disability services in Ireland: "The future is the community"

When developing new music therapy services in ID settings, music therapists are often required to introduce their role to other healthcare professionals (OHPs) who often have little or no experience of music therapy when developing new music therapy services in ID settings. While some research has explored how to successfully integrate music therapy services into established healthcare organisations and account for the current challenges of working in healthcare settings (Clarkson & Killick, 2016; Darsie, 2009; Miller, 2008; Ledger et al., 2013; Ledger 2016), to date no studies have considered development of music therapy services in ID contexts. This study addressed this issue through carrying out ethnographic inquiry into music therapy service development in ID organisations in Ireland.

The overarching aim of this ethnographic study was to highlight the experiences of music therapists and OHPs related to developing music therapy services, with the intention of providing a valuable resource to inform development of future music therapy services in ID  in Ireland. This began with a curiosity to explore my own experiences of developing a music therapy service in an ID setting and led to me keeping a reflective journal. As the research progressed, it became apparent that gleaning a wider range of perspectives on the topic of music therapy service development was needed to explore the unique working culture and contexts of ID organisations in Ireland. This was achieved through an online anonymous survey among OHPs at the ID organisation where I developed a music therapy service. It also involved semi-structured interviews with six music therapists and three managers in other ID settings across Ireland. 

This ethnographic study aimed to answer the following research questions: 

1. What are the expectations of a music therapist when developing a service to support  those with intellectual disabilities in Ireland, and to what extent are those expectations  realised in the development of a new music therapy service? 

2. What are other healthcare professionals’ values and practices that influence the development of a music therapy service in intellectual disability services in Ireland?

3. How does a music therapist navigate any differences in expectations, values and practices when developing a new music therapy service into intellectual disability services in Ireland?  

Upon compiling all data sources, findings revealed music therapists held expectations around a) a smooth transition from training to practice, b) a one-sided approach to education,  c) being recognised and valued for their role and, d) the idea that hard work pays off.  Furthermore, OHPs’ values and practices may further influence the development of a music therapy service. Findings suggested that such influences lie in OHPs’ care and protection for  those they support, allocation of funding whereby different funds bring various implications  to service development, in addition to the influence of a manager’s background which lead to different perspectives around the trajectory of music therapy service development. Finally,  findings also highlighted how music therapists might navigate any differences in expectations, values and practices when developing a new music therapy service in ID settings in Ireland. It is recommend that music therapists: a) be flexible yet boundaried, b) embrace curiosity and action around organisational change and, c) work with others for better service provision. 

Due to the unique culture and context of each ID organisation, is it not possible to offer a definitive pathway towards successful music therapy service integration. Instead, this study puts forward a number of key recommendations to aid other music therapists as they embark on the task of music therapy service development in ID contexts in future.