Giving voice to service user choice: music therapy as an anti-oppressive practice

Societal structures create and maintain disparities between persons of dominant and non-dominant status affecting all aspects of the community including healthcare service delivery. Music therapists as healthcare providers have a responsibility to explore ways that social justice approaches can address and mitigate discrimination in music therapy education, research, and practice. Anti-oppressive practice (AOP) offers a systematic way to disassemble inequity in practice and to inspire inclusive practices. In order to consider how music therapy can operate as an anti-oppressive practice, this thesis explored the question; What are the experiences of residents and staff in music therapy as an anti-oppressive practice? Interviews were conducted with older adults in a residential setting who were living with complex health conditions including dementia, and with residents who have dual-diagnosis intellectual deficit/mental illness referred to an assessment service for teens and adults. Analysis of the interviews using Constructivist Grounded Theory indicated that music therapy is perceived as valuable in providing a broad spectrum of support including in improving socialization, mood, and communication, but potential negative impacts can occur if music is not provided sensitively. Music therapy was additionally observed to foster positive relations between staff and residents although some staff considered music therapy was a hassle for them. The song-based music therapy service model developed by the author and described by interviewees were contextualized through a reflection on the service development and training experiences of the author. This is provided through historical description and critical autoethnography. The wider literature about music and human experiences was consulted for further context and rationale. The research processes and findings of the interviews and autoethnography revealed that it is the inclusive collaborative expertise of the music therapist which allows the social justice framework of anti-oppressive practice to be evident in her music therapy service and music therapy research.