Expanding access to group singing for people with dementia: implications of music therapy skill sharing for research and practice

Dowson, Elizabeth Rebecca Mary (2020) Expanding access to group singing for people with dementia: implications of music therapy skill sharing for research and practice. PhD thesis, University of Nottingham.

[img] PDF (Thesis - as examined) - Repository staff only - Requires a PDF viewer such as GSview, Xpdf or Adobe Acrobat Reader
Download (4MB)


Background: 850,000 people in the UK are estimated to be living with dementia. The importance of supporting people with dementia and their carers through psychosocial interventions is widely acknowledged. The potential of music-based interventions to provide this support is becoming well-recognised, but demand exceeds supply. Group singing is an increasingly popular activity for people with dementia and their carers, and a growing number of community based singing groups are being implemented. However, to date there have been no large-scale studies demonstrating the benefits of community group singing for this population. Music therapy skill-sharing is a way of supporting facilitators without formal therapy training, and increasing capacity to provide singing opportunities, but we need to know how these skills can be communicated most effectively and efficiently. The CHORD (Chorus Research in Dementia) manual has been developed by music therapists to provide guidance to singing group facilitators.

Aims: The aim of this doctoral study is to investigate ways to expand access to singing groups for people with dementia by testing an approach to skill-sharing (the CHORD manual), understanding the perspective of group attendees, and by evaluating commonly-used ways of measuring the benefits of singing.

Methods: The design was conceived as a mixed-methods feasibility study, supported by two complementary literature reviews. A novice singing group facilitator used the CHORD manual to lead 10 weekly singing sessions for people with dementia and their carers. Data was collected from participants using measures of mood, quality of life, and musical engagement, as well as interviews and focus groups. All the sessions were video recorded. Following data analysis, qualitative and quantitative results were synthesised.

Results: The synthesis of the two literature reviews indicated that there were some differences between the outcomes prioritised in music therapy practice and research, with research tending to focus on the reduction of neuropsychiatric symptoms. The feasibility study showed that the novice facilitator found the CHORD manual an effective and accessible tool which enabled her to lead a successful group. Participants reported that the facilitator’s openness to sharing her challenges established a point of commonality with the group members. Exploratory analyses of the quantitative data revealed no effects of the singing group on mood and quality of life, but a range of benefits were qualitatively reported, with social benefits being a particularly prominent theme. Synthesis indicated dissonance between quantitative and qualitative results on a case level as well as within groups. Although the research methods were acceptable to the participants, the chosen outcome measures did not detect the changes which were qualitatively described by participants.

Conclusion: Skill sharing initiatives such as the CHORD manual have potential to provide an accessible way of expanding access to music-based interventions, but care must be taken to ensure that the skills which are shared are suitable for dissemination in this way. Response to group singing is complex and individual, and measuring its benefits is a challenge for research. There is a need to develop methodological solutions which provide reliable evidence for the value of the arts at a meaningful level without undermining the flexible and intuitive essence of the intervention which they are designed to evaluate.

Item Type: Thesis (University of Nottingham only) (PhD)
Supervisors: Schneider, Justine
McDermott, Orii
Keywords: Dementia, Music, Music therapy, Singing, Skill-sharing, Mixed methods, Feasibility study
Subjects: M Music and Literature on music > ML Literature of music
R Medicine > RC Internal medicine
Faculties/Schools: UK Campuses > Faculty of Social Sciences, Law and Education > School of Sociology and Social Policy
Item ID: 60507
Depositing User: Dowson, Elizabeth
Date Deposited: 24 Jul 2020 07:50
Last Modified: 24 Jul 2020 07:50
URI: https://eprints.nottingham.ac.uk/id/eprint/60507

Actions (Archive Staff Only)

Edit View Edit View