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Opponent Associate Professor Stine Lindahl Jacobsen (University of Aalborg) and Custos Associate Professor Esa Ala-Ruona (Ģ��ֱ��).
The doctoral dissertation is held in English.

English abstract

Psychoanalyst and paediatrician Donald W. Winnicott states “There is no such thing as an infant” (Winnicott, 1960, p. 587). A child does not exist without somebody who takes care of him or her. Early interaction and family centered work are, from this perspective, a relevant part of rehabilitation and treatment especially when it comes to children and families at risk.

The dissertation includes three articles which have been published in peer reviewed international journals. The structure proceeds from the initial articles which examine early childhood music therapy, family centered music therapy practice and finally one specific intervention for young children and their foster parents. The intention is to provide a comprehensive overview of early childhood music therapy and family centered practice through literature review, international survey, and interview study. This includes former knowledge and experiences gathered from published books and journals in the literature review, today´s understanding of professional music therapists through the survey and the viewpoints of clients themselves from the inter-view study. The aim is to map the field of family centered music therapy practice, conceptualize it and to increase understanding on how the actual work is done and the phenomena experienced.

The first article examines music therapy literature from 1990 to 2012 focusing on children aged 0 to 5 years old. The literature includes clinical descriptions, research articles, chapters in books, peer reviewed electronic publications, and peer reviewed journals. Altogether 125 different texts were found which fulfilled the criteria for inclusion. Simple quantitative analysis led to guidelines for deeper, comparative qualitative analysis. According to the data, the older children were more often written about than younger children. Historically the dominance from individual work has been shifting to dyad-ic/family work. The active methods most commonly utilized were singing and playing with instruments. Children with autism spectrum disorder (ASD) were most strongly represented together with paediatric patients and children with developmental disabilities. Interaction between family members and the positive factors were emphasized in the articles. The importance of fun and enjoyment was underlined throughout all client groups. (Tuomi et al., 2017.)

Music therapists have described the importance of working collaboratively with family members in various populations throughout the history of the profession. Despite the growing amount of literature, not enough is known regarding the scope of theoretical perspectives and therapeutic ap-proaches that guide family centered music therapy. The aim of the second article, an international survey study, was to better understand the professional perspectives and approaches of music therapists who work with families around the world. This article presents the results of the survey where a total of 125 responses were analysed. Participants’ responses indicated that music therapy with families is well established as an important field of practice that includes a large range of populations across the life span. Music therapists working with families emphasize that the work is holistic and flexible, both in terms of the theoretical approaches that inform their work and the methods/techniques that are included in sessions. The participants in this study advocated for more continuing professional development opportunities to further deepen and develop their practice. (Tuomi et al., 2021.

An insecure attachment history puts foster children at risk for many kinds of difficulties which may include psychopathology. Nurture and play (NaP) for foster families - intervention is aimed for children aged one to five years of age, aims to support the new attachment relationship between foster parents and their young children to develop in a secure direction. The aim of the third article is to gain deeper understanding on how foster parents use their mentalization skills to reflect the different meanings of the NaP for foster families -intervention. A stimulated recall method was chosen to correspond to these research targets. It was revealed that parents´ reflections were evidently focused on the child, the importance of safety and the meaning of change during the process. Emotional qualities concerning both the child and the adult were also emphasized. The foster parents were able to utilize their reflections within a wider context of place, relationships, and time. The results of the study and the core concepts of attachment theory are strongly related to each other. (Tuomi & Ala-Ruona, 2022.)

The dissertation and its outcomes offer suggested priorities and suggestions for future research including the need for more specific and deep probing information, different perspectives, and emphasis on focus.

Permanent link to publication:

Further information: Kirsi Tuomi, kirsi.tuomi@myllytalo.fi, 0405443784