Music Therapy and Therapeutic Alliance in Adult Mental Health: A Qualitative Investigation.

Therapeutic alliance has been consistently linked to therapeutic outcome. Although music therapists often emphasize the role of music for developing therapeutic alliance when treating adults in mental health settings, there is a lack of research into how the therapeutic alliance is developed. The purpose of this exploratory interpretivist investigation was to understand how music therapists develop therapeutic alliance with adults in mental health settings. The investigator conducted semi-structured interviews with eight music therapists who worked with adults in health settings. Participants had between 1 and 29 years of clinical experience in various types of inpatient mental health facilities conducting both group-based and individual treatment, represented diverse philosophical orientations, and used a variety of interventions. Emerging themes and subthemes were identified though thematic analysis and member checking and trustworthiness used to verify results. Due to the clear differences in how participants described techniques to develop therapeutic alliance, 8 emerging themes, supported by 14 subthemes, were divided into music and non-music factors. As therapeutic alliance represents a crucial aspect of treatment and is linked to outcome, music therapy clinicians can use emerging themes and subthemes to help guide their interactions to expediently establish and augment therapeutic alliance with adults in mental health settings. Implications for clinical practice, limitations, and suggestions for future research are provided.