Exploring the Listening Experiences during Guided Imagery and Music Therapy of Outpatients with Depression

門診憂鬱症患者於引導想像音樂治療之聆聽經驗分析

周美嫻(Mei-Hsien Chou)；林梅鳳(Mei-Feng Lin)

引導想像音樂治療 ； 聆聽經驗 ； 憂鬱症 ； guided imagery and music therapy GIM ； listening experiences ； depression

The Journal of Nursing Research

14卷2期（2006 / 06 / 01）

93 - 102

英文

本研究擬初步探討門診憂鬱症患者參與引導想像音樂治療之聆聽經驗，採立意取樣，在2003年4月至2004年6月期間，以南部某醫學中心門診之憂鬱症患者為研究對象，共五位個案參與，提供每位個案八次的個別音樂療程，研究者除現場觀察外，在每次治療後的24-48小時內再利用半結構訪談大綱進行電話深度訪談，每位個案共訪談八次，再依內容分析法進行資料分析。結果個案主觀認定有55段自覺印象深刻之聆聽經驗，共歸納為五個主題，包括：(1)敞徉自然風景的悠閒；(2)創造超現實的虛擬場景；(3)憶起過往的生活經驗；(4)沉浸音樂的主題旋律；(5)感受各樣的身體放鬆體驗。而引發原因包括有：音樂、個人、治療師及環境等四個因素，個案想像主題的出現受此四個因素所共同影響，其中又以音樂因素影響最大。本研究擬初步呈現憂鬱症患者於引導想像音樂治療聆聽經驗，建議未來可再繼續探討音樂想像經驗對個案後續的衝擊與改變，以作為未來相關臨床實務或研究參考。

The purpose of this preliminary study was to explore the listening experiences of outpatient depression sufferers who underwent guided imagery and music therapy (GIM). A purposive sampling method was performed at the psychiatric outpatient clinic of a medical center in southern Taiwan from April 2003 to June 2004. The five subjects in this study all underwent a total of eight sessions of individual GIM therapy. The researcher invited a therapist to implement the GIM therapy sessions. Researchers conducted a semi-structured, in-depth telephone interview with each subject within 24 to 48 hours after each therapy session. Eight interviews were accomplished and transcribed for each case, and then subject to content analysis. The results showed a total of 55 important listening episodes, which could be categorized into the following 5 themes: (1) leisurely wandering in very natural sceneries; (2) creation of surreal virtual surroundings; (3) recollection of past life experiences; (4) submersion in thematic music melodies; and (5) experiencing various physical relaxation events. The triggering effect represented a combination of multiple factors, including music, the individual, the therapist and environment. The theme of each patient's imagery episode was a result of the effect of the four factors, with music having the greatest impact. This study hopes to present the listening experiences of depression sufferers in GIM therapy; to make suggestions for future investigations into subsequent impacts and changes that GIM has on patients; and to, perhaps, serve as references for future clinical practice or studies.

1. Bonny, H. L.(1989).Sound as symbol: Guided imagery and music in clinical practice.Music Therapy Perspectives,6,7-11.
2. Brooks, D. M.(1998).Philadelphia,University of Temple.
3. Burns, D. S.(2001).The effect of the Bonny method of guided imagery and music on the mood and life quality of cancer patients.Journal of Music Therapy,38(1),51-65.
4. Chen, C. H.,Liu, C. Y.(1995).Chinese culture and postpartum depression.The Journal of Nursing,42(1),91-94.
5. Chou, K. R.(2002).Childhood adolescent with depression.The Journal of Nursing,49(3),16-23.
6. Christopher, D.(2000).Problem solving treatment and group psychoeducation for depression: Multicentre randomized controlled trial.British Medical Journal,321,1450-1456.
7. Chung, C. H.(1999).Music therapy practices in clinical medical.The Journal of Chang Gung Nursing,10(3),53-55.
8. Crowe, M.,Luty, S.(2005).Recovery from depression: A discourse analysis of interpersonal psychotherapy.Nursing Inquiry,12(1),43-50.
9. Fang, L. H.,Chen, J. J.,Chen, C. C.(1998).Therapy for depression.Formosan Journal of Medicine,2(4),456-463.
10. Gold, C.,Voracek, M.,Wigram, T.(2004).Effects of music therapy for children and adolescents with psychopathology: A meta analysis.Journal of Child Psychology and Psychiatry,45(6),1054-1063.
11. Goldberg, F. S.,T. Wigram (Eds.),B. Saperston (Eds.),R. West (Eds.)(1995).The art and science of music therapy: A hand book.Chur, Switzerland:Harwood.
12. Grocke, D. E. (Eds.),K. E Bruscia (Eds.)(2002).Guided imagery and music.Barcelona:Phoenixville.
13. Grocke, D. E.,T. Wigram (Eds.),J. D. Backer (Eds.)(1999).Clinical applications of music therapy in psychiatric.London:Jessica Kingsley.
14. Hildebrandt, M. G.,Stage, K. B.,Kragh-Soerensen, P.(2003).Gender and depression: A study of severity and symptomatology of depression disorders in general practice.Acta Psychiatvica Scandinavia,107,197-202.
15. Hollon, S. T.,Thase, M. E.,Markowitz, J. C.(2002).Treatment and prevention of depression.American Psychological Society,3(2),39-77.
16. Hung, H. J.,Wang, J. S.(1999).The last melody-music therapy in nursing care of cancer patients.The Journal of Nursing,46(5),81-85.
17. Lai, Y. M.(1999).Effect of music listening on depressed women in Taiwan.Issues in Mental Health Nursing,20(3),229-246.
18. Laurie, R.(2000).Music as a vehicle for inner exploration: The Bonny method of guided imagery and music (GIM).Guidance & Counseling,15(3),23-28.
19. Lee, H. L.,Ku, N. P.(1999).Music therapy in oncology nursing.VGH Nursing,16(1),51-55.
20. Lee, S.,Lieu, L. F.,Chen, S. L.(1999).Clinical applications of music therapy in nursing profession of Taiwan.The Journal of Nursing,46(1),25-30.
21. Lincoln, Y. S.,Guba, E. G.(1985).Naturalistic inquiry.Newbury Park, CA:Sage.
22. Liu, K. H.(1994).The Journal of Guidance and Counseling.The theory and practice with music therapy,104,21-25.
23. McKinney, C. H.,Antoni, M. H.,Kumar, M.,Tims, F. C.,McCabe, P. M.(1997).Health Psychology.
24. McKinney, C.,K. E. Bruscia (Eds.),D. E. Grocke (Eds.)(2002).Guided imagery and music.Barcelona:Phoenixville.
25. S. P. Jacqueline (Ed.)(2000).Music therapy: An introduction.Springfield, IL:Thomas.
26. Valente, S.,Nemec, C.(2006).An evidence-based project to improve depression and alcohol use screening.Journal of Nursing Care Quality,21(1),93-98.
27. Whooley, M. A.,Kiefe, C. I.,Chesney, M. A.,Markovitz, J. H.,Matthews, K.,Hulley, S. B.(2002).Depressive symptoms, unemployment, and loss of income.Archives Internal Medicine,162,2614-2620.

1. (2024)。團體音樂治療對改善急性精神病房住院病人憂鬱及焦慮之成效。志為護理-慈濟護理雜誌，23(2)，71-84。