Northern Ireland Music Therapy Trust
In 2000 the Northern Ireland Music Therapy Trust received funding from the Music Research Institute to carry out research into the efficacy of music therapy as an intervention for young people aged between 11-18 years presenting with Post Traumatic Stress Disorder Symptomatology.
Initially we felt this piece of research could be completed in a time frame of between 12 - 18 months. Unfortunately this has not been possible for a number of reasons, these include:
- poor uptake and referral by consultant psychiatrists and community groups
- recruitment of participants
- awareness of the project
- personnel changes
1. Poor uptake
In the initial stages of the research the NIMTT undertook an extensive mail out to consultant psychiatrists throughout Northern Ireland inviting referrals to the study. The response to this produced three referrals, however there were no other responses. Five months later we sent further letters and information about the study to all consultant psychiatrists and on this occasion received a further two referrals. Over the next six months further letters and telephone calls resulted in four more referrals.
At this point we also decided to open the study up to community groups as we became aware that there was a history in Northern Ireland of patients not always seeking the assistance of the statutory organisations. During the period known as "The Troubles" more and more people relied on support from grass roots organisations.
The response from these organisations was good, however two issues arose with potential referrals. Some groups felt that their clients would have difficulty with the requirement to have a psychiatric screening and as a result stated that they could not refer clients. Others felt that potential clients would not travel to our clinic at Knockbracken Healthcare Park because it was 'out of their area'. The NIMTT has a small therapist base and could not offer a service in disparate locations. This has meant that potential community referrals have not been forthcoming.
2. Recruitment of Participants
As previously stated the difficulties regarding referrals have impacted on the study and of the nine referrals received only four clients of the ten required have been involved in the study.
Two referrals were not within the time frame specified for inclusion in the study and therefore could not be included. Two referrals attended for their psychiatric screenings but would not commit to the therapy sessions when these were arranged. One referral did not attend for any screening appointment and could not progress on to the music therapy sessions as a result.
The inability of some potential clients to engage with and participate in the research is undoubtedly as a result of their symptomatology and highlights the difficulties these clients experience. This difficulty has been highlighted in previous feedback reports to the MRI.
3. Awareness of the Project
For a small charity raising awareness and maintaining awareness of any study is difficult particularly in light of the issues highlighted in point one. Due to poor mental health provision for patients aged between 11-18 years in Northern Ireland it has been difficult to engage in sustained contact with dedicated adolescent psychiatrist.
Our therapists are engaged in clinical work across a number of care programmes and disciplines and a lack of mainstream music therapy provision in adolescent psychiatry creates further difficulties in raising awareness of the study.
4. Personnel changes
One of the most significant problems for the study has been changes in personnel.
Initially the psychiatrist involved in the study held the position of Senior Registrar and as such had time available each week to engage in research. However, when they were successful in obtaining a Consultant Psychiatrist post their time commitments altered significantly. They initially felt that they cold remain involved in the study if some others could agree to undertake the screenings required. Unfortunately no one has been identified and the Consultant Psychiatrist has been difficult to contact and meet with.
Within NIMTT our therapy team has changed and, due to an increase in demand for services, it has been difficult to identify a therapist to remain 'available' for referrals to the study as they have been made on an inconsistent basis.
What are our options?
Recruitment of Participants
Undoubtedly recruitment and retention of participants will continue to be a difficulty, however all the other issues can we believe be resolved.
Awareness and availability of personnel
The NIMTT recently received project funding under the Victims Strategy for a project which will employ a Senior 1 therapist for an 18-month period to work with victims and survivors of 'the Troubles'. This project can have a positive impact on the PTSD study for the following reasons as it:
- an in-depth needs assessment of need across the statutory and voluntary sector in Northern Ireland therefore providing an excellent opportunity to raise awareness of the existence of this study.
- dedicated therapist will be available to undertake work in this area and will be able to offer a service based at 'grass roots' level where previously we were limited to our clinic.
At a recent International Conference on Trauma in Belfast the Head Therapist was invited to host a workshop where participants included the Trauma Advisor for the Eastern Health Board area, the Director of a large trauma counselling and support network which has groups across Northern Ireland and two Programme Managers for Adolescent Mental Health programmes in NI. These participants expressed interest in the study and have been in contact since the conference to explore referrals.
The Head Therapist has been in direct contact with a number of consultant psychiatrists in the community who have expressed an interest in assisting with the screening required for the study these contacts will be formalised in the near future. She has also been exploring the possibility of identifying another psychiatrist to oversee this aspect of the study - two individuals are currently being discussed. This will require the formal resignation from the study of the previous psychiatrist and the study will then become a purely NIMTT driven project.
We remain fully committed to completing this research and as can be seen we are actively taking the process forward; we believe that it can and will be completed.