Depressed adults’ experiences of listening to their own clinical improvisations at home : A process evaluation of the music therapy homework

Introduction Depression has a negative impact on millions of people worldwide, necessitating research into appropriate therapeutic methods. The aim of this qualitative study is to investigate how music therapy clients experience listening to their own clinical improvisations at home, as a part of treatment for depression. Method Adults with major depressive disorder were offered 12 individual sessions of bi-weekly integrative improvisational music therapy, as part of a randomised controlled trial. Participants were asked to complete an online diary after listening to their clinical improvisations. Reflexive thematic analysis was performed on diary entries, and content analysis was applied to music therapists’ reports. Results Fourteen of 32 participants submitted a total of 58 diary entries. Participants' experiences were represented by five themes: music (playing, listening, music perception, music parameters), therapy (therapeutic processing, illness, music therapy trial), emotions (positive emotions, negative emotions, other emotions), embodiment (body parts, sensations, actions) and narrative (chronology, symbolic references). Music therapists’ reports indicated that low compliance and negative experiences during the task could be affected by severity of depression, and ease of use of the technological interface. Discussion Participants’ experiences varied from extremely negative to positive in every theme, finding music they produced beautiful or hideous, feeling proud or ashamed of making it, being energised, or exhausted by it, feeling supported or pressured by the music therapist, and recalling happy or terrifying memories. The findings suggest that a homework task can affect the therapeutic process in both positive and negative ways and should be further researched before implementation.