Therapy process research helps delineate common and specific elements essential to positive outcomes as well as develop best practice training protocols. Child involvement and therapist flexibility were rated in 63 anxious youth (ages 8-14) who received cognitive-behavioral therapy. Therapist flexibility, defined as therapist attempts to adapt treatment to a child's needs, was hypothesized to act as an engagement strategy that serves to increase child involvement during therapy. Flexibility was significantly related to increases in later child engagement, which subsequently predicted improvement in posttreatment diagnosis and impairment. Therapist flexibility was not associated with earlier measures of child engagement, so a mediation model could not be supported. It was also hypothesized that the impact of flexibility would be greatest for cases who began treatment highly disengaged (i.e., early involvement would moderate the effect of flexibility). Basic descriptive data supported this model, but formal analyses failed to confirm. Further descriptive analyses suggest therapists employ a range of adaptations and a profile of flexible applications within a manual-based treatment is provided. Treatment, measurement, and dissemination issues are discussed.

J Clin Psychol. 2009 Jul;65(7):736-54. Chu BC, Kendall PC. Department of Clinical Psychology, Graduate School of Applied and Professional Psychology, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA. BrianChu@rci.Rutgers.edu

OBJECTIVE: The role of music therapy in psychiatric care in Australia is briefly traced from the early 1990s to the present. With the shift to community-based care, contemporary music therapy practice for the severely mentally ill is reappraised alongside the principles of the recovery model. CONCLUSIONS: Music therapy is a viable option within the creative arts therapies for enhancing quality of life in people with severe and enduring mental illness.

Australas Psychiatry. 2008 Dec;16(6):442-5. Grocke D, Bloch S, Castle D. National Music Therapy Research Unit, Faculty of Music, University of Melbourne, VIC, Australia. d.grocke@unimelb.edu.au