Tag Archives: psychology

Music & Wellbeing (Part 3): Music Therapy

Music Therapy

As a practice, music therapy sits somewhere between art, therapy, healthcare, and psychoanalysis; it ‘invites the art, science and craft of music and healing’ (Pavlicevic, 1999, p. 141). Its practice has been proven as having a ‘huge impact on confidence, and therefore improved wellbeing’ (Therapy Today, 2011, p. 5). Besides more common associations with mental health and children with special needs (SEN), music therapy has also proved to be of benefit on a much wider scale, including, amongst other areas, ‘physical impairments, people with hearing and visual problems, the institutionalised elderly, and people in the criminal justice system’ (North & Hargreaves, 2008, p. 298-299).

Within the field of music therapy, there is a history of deploying music to ‘alleviate chronic psychological disorders and problems associated with long-term physical impairment’ (North & Hargreaves, 2008, p. 298). There is evidence of music-based practices dating back prior to the beginning of recorded history. Being centred on music makes it one of the most accessible forms of treatment in terms of engagement:

Everyone has the ability to respond to music, and music therapy uses this connection to facilitate positive changes in emotional wellbeing and communication through the engagement in live musical interaction between client and therapist (British Association for Music Therapy)

The idea of creating music ‘out of thin air’ might seem like an alien concept to some. However, the process of music therapy sessions is to create something out of the patient’s feelings, situation and environment, with the assistance of the therapist (Williams, 2014). In the context of a music therapy session, there are ‘no ‘right’ and ‘wrong’ notes: all are part of possibility.’ (Pavlicevic, 1999, p. 143) Improvisation between therapist and client is key to allowing the client to experience music as a positive means of therapy:

Music therapy allows people to discover for themselves what is going on underneath, as well as allowing them to express repressed emotions or memories. If verbal communication has shut down, as with autism or stroke, it has a huge impact on a person’s confidence, which in turn affects every aspect of their life (Angela Harrison, quoted in Therapy Today, 2011, p. 5)

Just as the act of talking, or indeed writing, about one’s personal experiences can be seen as therapeutic and empowering (Newham, 1999, p. 32), so too can singing about it (Stige et al, 2010; Harrison, 2006). Due to the connections music makes with the brain and emotions, singing as a means of therapy can be seen to be even more cathartic:

To fill our memories with emotion requires us to use the full range of our voice to express the full range of feelings. And nowhere do we witness such a use of the voice more intensely than in the art of singing (Newham, 1999, p. 59)

Community Music Therapy

Such feelings of catharsis and empowerment which music therapy can provide are also useful in the context of a community. One’s place in their community has an effect on their overall wellbeing (Venkatapuram, 2013). According to Feld (1994, p. 77), ‘music has a fundamentally social life. It is made to be engaged – practically and intellectually and communally’. I agree that the main purpose of music is as a shared form of communication, much as it has been considered a language throughout history (Thaut, 2005, p. 171). This language reaches us at a level of understanding deeper than verbal communication (Harrison, 2006).

According to the National Health Service (2006) there are five evidence-based steps we can take to improve mental wellbeing:

  • Get active
  • Connect with others
  • Keep learning
  • Be aware of yourself and the world
  • Give to others

(National Health Service, 2006)

I believe that the practice of community music therapy covers all five of these points, through a variety of styles. Modes of practice, including music workshops, which act to ‘foster active and collaborative music making’ are therefore an excellent way of fostering better community wellbeing (Higgins, 2012, p. 144). Harrison (2006) believed the power of singing lay in its power to move other human beings; its ‘transformative qualities’; the way it can allow others unable to sing to feel cathartic benefits through empathic listening (2006, p. 24). I am inclined to agree with this view. I believe this element of music therapy has in fact the most potential to affect overall wellbeing, through its inherently inclusive and group-based nature. Participants, in making music with others, can experience ‘one of life’s greatest pleasures’ (Green, 1986, p. 69).

Further examples highlight to me that community music therapy might be better thought of in more broad terms, such as ‘care’ and ‘service’ (Stige & Aarø, 2012, p. 14) Like Stige & Aarø (2012), I believe it represents a group musical ‘service’ which takes place outside of the private, confidential, one-on-one setting of the traditional music therapy session. It is a means of bringing the community, and neighbouring communities, together through local music-based activities, the kind of which I have witnessed throughout my life in one form or another, without ever having identified them as ‘therapy’. These activities can take place in ‘arts centers [sic], schools, prisons, health settings, places of worship, festivals, on the streets, and in a wide range of community contexts’ (Higgins, 2012, p. 174). They can be said to be having a beneficial effect on the wellbeing of the community, and therefore the individuals within those community groups (Choi, Lee & Lim, 2008).

Music Therapy & Dementia

The term dementia, generally associated with old age or degenerative neurological diseases, is displayed as memory loss and difficulties with thinking, problem-solving or language, the most common form of which is Alzheimer’s Disease (Alzheimer’s Society). Alzheimer’s is characterised by changes in nerve cells and neurotransmitter levels, as well as destruction of synapses (Levitin, 2006, p. 231). In many cases, short term memory is largely absent, creating frustration among patients (Pavlicevic, 1999, p. 130). However, music therapy has proven to be of enormous positive effect in improving the wellbeing of Alzheimer’s patients (Lee & Thyer, 2013; Stige et al, 2010). Levitin goes on to report an interesting observation in the musical memory of Alzheimer’s patients:

As the disease progresses, memory loss becomes more profound. Yet many of these old-timers can still remember how to sing the songs they heard when they were fourteen. Why fourteen? Part of the reason we remember songs from our teenage years is because those years were times of self-discovery, and as a consequence, they were emotionally charged; in general, we tend to remember things that have an emotional component because our amygdala and neurotransmitters act in concert to ‘tag’ the memories as something important (Levitin, D. 2006, pp. 231-232)

Music’s innate ability to hone in on these ‘tags’ seems to almost reverse the symptoms of dementia for a brief time; play or sing a song from their past and they are once again ‘present’ (Sacks, 2008, p. 377). The practise of community music therapy has also been seen to have a positive effect in regards to Alzheimer’s patients, due to the added social factor involved (Stige et al, 2010, p. 266).

Music as alleviation to anxiety and depression

The frustration experienced by many people with dementia can often lead to frustration and agitation (Clare, 2004). While research on the subject is limited, music therapy has been proven as a noticeably effective, low-cost, non-pharmacological intervention (Blackburn & Bradshaw, 2014). Music-based interventions have yielded positive results in easing depression among adults without dementia (Chan et al, 2012). Occasionally studies note reduced anxiety as a by-product of alleviating another condition (Hargreaves & North, 2008).

There has been found to allow improvements to self-esteem and reduced depression in children and adolescents with behavioural and emotional problems, which were sustained over a prolonged period (Therapy Today, 2014, p. 6). One particular advantage of music therapy over talking therapies is that younger people seem more open to participation:

The most popular activity was song-writing or writing their own lyrics to music, which seemed to benefit their ability to communicate their feelings more generally, she said. Nearly all — 97 per cent — chose to write autobiographically about how they were feeling, where they were at. This age group tend to find talking therapies slightly more challenging but our psychology colleagues tell us that, as a result of the music therapy, these children are more open to engaging with them in their sessions and more able to express how they were feeling. (Therapy Today, 2014, p. 6)

The level of effectiveness music has in relieving stress varies ‘according to age, the type of stress in question, the means by which the music was used, the listener’s musical preference, and their prior level of music experience’ (Hargreaves & North, 2008, p. 307). This brief overview highlights to me that music therapy is of intrinsic value to our wellbeing. As well as the areas mentioned above, music therapy has seen measurable success relieving anxiety in a variety of settings (Hargreaves & North, 2008). It is also useful in treatment as therapy for drug and solvent abuse (Oklan & Henderson, 2014; Silverman, 2009).

REFERENCES

Alzheimer’s Society (2015) What is Alzheimer’s disease? Available at: http://www.alzheimers.org.uk/site/scripts/documents_info.php?categoryID=200171&documentID=100&gclid=CI_j59OHv8UCFYgIwwodCqUAPA (Last accessed: 06/05/2015).

Blackburn, R., & Bradshaw, T. (2014) ‘Music therapy for service users with dementia: a critical review of the literature’, Journal of Psychiatric & Mental Health Nursing, Vol. 21, No. 10, pp. 879-888. Available from: 10.1111/jpm.12165.

British Association for Music Therapy (2012) What is music therapy? Available at: http://www.bamt.org/music-therapy/what-is-music-therapy.html (Last accessed: 12/05/2012).

Chan, M., Wong, Z., Onishi, H., & Thayala, N. (2012) ‘Effects of music on depression in older people: a randomised controlled trial’, Journal of Clinical Nursing, Vol. 21, No. 5/6, pp. 776-783. Available from: 10.1111/j.1365-2702.2011.03954.x.

Choi, A., Lee, M., & Lim, H. (2008) ‘Effects of group music intervention on depression, anxiety, and relationships in psychiatric patients: a pilot study’, Journal of Alternative & Complementary Medicine, Vol. 14, No. 5, pp. 567-570. Available from: 10.1089/acm.2008.0006.

Clare, M. (2014) ‘Soothing sounds: reducing agitation with music therapy’, Nursing & Residential Care, Vol. 16, No. 4, pp. 217-221.

Feld, S. (1994) ‘Communication, music, and speech about music’, in Keil, C. & Feld, S. (eds.) Music grooves: essays and dialogues. United States of America: The University of Chicago Press, pp. 77-95.

Green, B. (1986) The inner game of music. United States: Pan Books.

Harrison, P. (2006) The human nature of the singing voice: exploring a h basis for sound teaching and learning. Great Britain: Dunedin Academic Press.

Higgins, L. (2012) Community music: in theory and in practice. United States: Oxford University Press.

Lee, J., & Thyer, B. (2013) ‘Does Music Therapy Improve Mental Health in Adults? A Review’, Journal of Human Behavior in the Social Environment, Vol. 23, No. 5, pp. 591-603. Available from: 10.1080/10911359.2013.766147.

Levitin, D. (2006). This is your brain on music: understanding a human obsession. Great Britain: Atlantic Books.

National Health Service (2006) Wellbeing self-assessment. Available at: http://www.nhs.uk/Tools/Pages/Wellbeing-self-assessment.aspx (Last accessed: 11/05/2015).

Newham, P. (1999) Using voice and song in therapy: the practical application of voice movement therapy. United Kingdom: Jessica Kingsley Publishers.

North, A. & Hargreaves, D. (2008) The social and applied psychology of music. United States: Oxford University Press.

Oklan, A., & Henderson, S. (2014) ‘Treating inhalant abuse in adolescence: A recorded music expressive arts intervention’, Psychomusicology: Music, Mind, and Brain, Vol. 24, No. 3, pp. 231-237. Available from: 10.1037/pmu0000058.

Pavlicevic, M. (1999) Music therapy: intimate notes. United Kingdom: Jessica Kingsley Publishers.

Sacks, O. (2008). Musicophilia: tales of music and the brain. 2nd Edition. United Kingdom: Vintage Books.

Silverman, M. (2009) ‘A descriptive analysis of music therapists working with consumers in substance abuse rehabilitation: Current clinical practice to guide future research’, The Arts in Psychotherapy, Vol. 36, pp. 123-130. Available from: 10.1016/j.aip.2008.10.005.

Stige, B., Ansdell, G., Elefant, C. & Pavlicevic, M. (2010) Where music helps: community music therapy in action and reflection. Great Britain: Ashgate.

Stige, B. & Aarø, L. (2012) Invitation to community music therapy. United Kingdom: Routledge.

Thaut, M. (2005) ‘Rhythm, human temporality, and brain function’, in Miell, D., MacDonald, R. & Hargreaves, D. (Eds.) Musical communication. United States: Oxford University Press, pp. 171-191.

Therapy Today (2011) ‘NHS urged to pay for music therapy to cure depression’, 2011, Therapy Today, Vol. 22 (No. 7), p.5.

Therapy Today (2014) ‘Music therapy helps beat depression’, (2014) Therapy Today, Vol. 25, No. 9, p. 6.

Venkatapuram, S. (2013) ‘Subjective wellbeing: a primer for poverty analysts’, Journal of Poverty & Social Justice, Vol. 21, No. 1, pp. 5-17. Available from: 10.1332/175982713X664029.

Williams, T. (2014) ‘A journey to music therapy’, Exceptional Parent, Vol. 44, No. 4, pp. 30-32.

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Music & Wellbeing (Part 2). I feel good: Music and feelings of pleasure

Continuing this blog’s mini-series on the the value of music in our wellbeing, today’s post examines how & why we feel pleasure upon hearing music.

As always, all shares, tweets & reblogs are welcome, and comments gratefully received. See you again soon xx

I feel good: Music and feelings of pleasure

A number of studies on the human brain have noticed our ability to differentiate between ‘noise’ and ‘music’. Listening to music uses the same areas of the brain as when processing speech. (Schön et al, 2010). Music also activates sections of the brain responsible for pleasurable feeling (Salimpoor et al, 2015), known colloquially as the ‘reward centres’ of the brain (Icahn School of Medicine, 2015). Salimpoor et al’s (2015) report confirmed:

Not only is dopamine released when desirable sound events are heard, but also suggest that musical events leading up to peak pleasure moments may generate a sense of anticipation and lead to dopamine release when individuals listen to familiar music (Salimpoor et al, 2015)

Levitin goes on to explain activity in the cerebellum during his studies:

In my laboratory we found strong activations in the cerebellum when we asked people to listen to music, but not when we asked them to listen to noise. The cerebellum appears to be involved in tracking the beat. And the cerebellum has shown up in our studies in another context: when we ask people to listen to music they like versus music they don’t like, or familiar music versus unfamiliar music (Levitin, 2006, pp. 174-175)

Is timing the key difference between what makes the sounds we hear ‘noise’ and ‘music’? Schaffer (1977) reasons that the modern human, having grown up in an industrialised world, has what he refers to as ‘lo-fi hearing’. In effect, we are tuning out all of the everyday noise our environment bombards out ears with on a daily basis. A person from a time before the growth of large cities and the industrial revolution had higher definition hearing. This may also be in part due to our earlier need to rely on bird and animal calls as a means of hunting for food or for our own safety – in both cases, essential to our survival:

It can be argued that the survival of our ancient ancestors depended on their ability to detect patterns in sounds, derive meaning from them, and adjust their behaviour [sic] accordingly (Juslin, 2013)

Furthermore, Keil (1994, p. 97) refers to the social aspect of music utilised by our ancestors, stating that everyone would have been a full participant in music rituals staged by early civilisations. These participatory rituals promoted a greater interconnectedness with nature, society and an ‘ever deeper and more satisfying knowledge of who we are’ (Keil, 1994, p. 98).

Kania (2013) discusses the ‘aesthetic’ definition of music put forward by Jerrold Levinson (1990), who asserts that music is a collection of sounds, deliberately organised, with the aim of ‘eliciting a certain kind of heightened experience’ (Kania, 2013, p. 639). However, Kania believes music is more than this, finding one hole in Levinson’s argument in particular:

If you think, however, that a lullaby sung to put a baby to sleep is an example of music, then it is a counterexample to this definition, since the singer intends precisely the opposite of active engagement on the baby’s part (Kania, 2013, p. 639).

The research of Salimpoor et al (2011) found that ‘Music, an abstract stimulus, can arouse feelings of euphoria and craving’ and that during their tests, ‘we found endogenous dopamine release in the striatum at peak emotional arousal during music listening’. This illustrates the positive effect music has on the human mind’s neural pathways, resulting in a general feeling of wellbeing (Salimoor et al, 2011). However I argue that such studies don’t take into account the huge array of external factors our brains process at the same time as listening to music. Previous existing research also states the need to consider external factors and the wider social context of the subjects (Anders et al, 2012;North & Hargreaves, 2008; Mitchell et al, 2007), or, as Kieran (2013) puts it:

The pleasures afforded by sport, coffee drinking and good conversation are not wholly specifiable independently of the nature of the objects or activity involved…So too with good art generally. (Kieran, 2013, p. 290)

REFERENCES

Anders, Y., Rossbach, H., Weinert, S., Ebert, S., Kuger, S., Lehrl, S., Von Maurice, J. (2012) ‘Home and preschool learning environments and their relations to the development of early numeracy skills’, Early Childhood Research Quarterly, Vol. 27, pp. 231–244. Available From http://dx.doi.org/10.1016/j.ecresq.2011.08.003.

Icahn School of Medicine (2015). Brain reward pathways. Available at: http://neuroscience.mssm.edu/nestler/brainRewardpathways.html (Last accessed: 24/04/2015).

Juslin, P.N. (2013) ‘Review: From everyday emotions to aesthetic emotions: Towards a unified theory of musical emotions’, Physics of Life Reviews, vol. 10, pp. 235-266. Available from: 10.1016/j.plrev.2013.05.008.

Kania, A. (2013) ‘Music’, in Gaut, B. & McIver Lopes, D. (eds.) The routledge companion to aesthetics. 3rd Edition. USA & Canada: Routledge, pp. 639-648.

Keil, C. (1994) ‘Participatory discrepancies and the power of music’, in Keil, C. & Feld, S. (eds.) Music grooves: essays and dialogues. United States of America: The University of Chicago Press, pp. 96-108.

Kieran, M. (2013) ‘Value of art’, in Gaut, B. & McIver Lopes, D. (eds.) The routledge companion to aesthetics. 3rd Edition. USA & Canada: Routledge, pp. 289-298.

Levitin, D. (2006). This is your brain on music: understanding a human obsession. Great Britain: Atlantic Books.

North, A. & Hargreaves, D. (2008) The social and applied psychology of music. United States: Oxford University Press.

Salimpoor, V., Benovoy, M., Larcher, K., Dagher, A. & Zatorre, R. (2011) ‘Anatomically distinct dopamine release during anticipation and experience of peak emotion to music’. Nature Neuroscience. Vol. 14 (No. 2, February), pp. 257-264.

Salimpoor, V., Zald, D., Zatorre, R., Dagher, A., & McIntosh, A. (2015) ‘Review: Predictions and the brain: how musical sounds become rewarding’, Trends in Cognitive Sciences, vol. 19, pp. 86-91. Available from: 10.1016/j.tics.2014.12.001.

Schafer, R. (1977) The soundscape: our sonic environment and the tuning of the world. USA: Destiny Books.

Schön, D., Gordon, R., Campagne, A., Magne, C., Astésano, C., Anton, J., & Besson, M. (2010) ‘Similar cerebral networks in language, music and song perception’, Neuroimage, vol. 51, pp. 450-461. Available from: 10.1016/j.neuroimage.2010.02.023.

Music & Wellbeing (Part 1): The Intrinsic Value of Music

The below article is an edited extract from my recent thesis for Sunderland University, on the benefits of music on wellbeing. Over the next few ‘chapters’, I shall investigate the aesthetic, holistic, physical and education angles of music as an aid to improving wellbeing.

But first, an introduction into the value of music within itself, or rather, the value we humans place upon it. I hope you enjoy reading this and the instalments to follow. If you have any comments please do not hesitate to contact me.

The intrinsic value of music

‘For humans, music is a means of expressing and experiencing ‘love, excitement, joy, sadness and even spiritual fulfilment’ (Green, 1986, p. 69). John Cage (1952) famously stated that ‘everything is music’. By contrast, Claude Debussy remarked that ‘music is the space between the notes’ (quoted in Green, 1986, p. 70). This does, however, imply that some organisation of notes is required, if only to determine the length and perceived colours of these spaces, and the impact they may have upon hearing them.

Nicholas Cook (1998) elaborates further on the meaning of music, maintaining that music’s value is paramount due to its presence at the heart of everything we are and do as a species:

Rather than being something apart, music is in the very midst of things. In fact it’s less a ‘something’ than a way of knowing the world, a way of being ourselves. (Cook, 1998, p. vii)

Some believe the meanings we take away from music will always be unique to us; that everything we feel from music, good and bad, exists solely ‘in the audience’ (Cage, 1968, p. 97). This further demonstrates a need for contextualisation or interpretation on the part of the listener. However, I believe it carries the same underlying message as Cook (1998): music is not only important to us, but the listener will apply some means of interpretation to it, whether by concentrated thought or subconsciously. What the listener may discern from these sounds is effectively up to the listener alone.

Of course, what music we chose to consume is in part formed and shaped by our social conditions, with some allowances for personal taste (Shuker, 2008, p. 173). Martin (1995, pp. 75-76) even suggested that some forms of music can be shaped based on the traits and characteristics of the society from with it originates. This sentiment is, to some degree, rebuffed by Matthew Kieran (2013), who believed certain pieces had more relevance to an individual than another might:

To value Bach’s Cello Suites just because they cheer me up implies that they are replaceable by something that performs the same function as well or better, whether it be a feel-good movie or a night out. However, to find intrinsic value in a work is to appreciate the imaginative experience it properly affords, which may be beautiful, moving uplifting, pleasurable, insightful or profound. But it is the particular nature of the work that guides our active mental engagement and responses to it. Hence there is something about the experience of a particular work, if it is intrinsically valuable, that cannot be replaced by another. (Kieran, 2013, p. 289)

Citing Barber’s Adagio for Strings as another example, Kieran (2013) made further interesting observations on the nature of music’s value to the individual as art:

In terms of technical musical complexity the piece is relatively simple and yet in terms of expressivity it is a great piece of music…It is no coincidence that the Adagio for Strings has been used for state funerals and as the thematic music for Oliver Stone’s Platoon. The piece of music may not be about anything in the strict representational sense, yet its expressive development moves between melancholy, grief and reconciliation. (Kieran, 2013, p. 289)

Kieran’s (2013) argues that while other pieces of music may express similar sentiments to Barber’s Adagio, due to subtle differences, they can never do so in exactly the same way. This implies the listener is investing emotions onto the music, rather than the other way around. This poses some difficulties in using specific musical pieces as therapy. While drugs have an overall blanket effect on the body, whether our minds will them to or not, ‘good artworks are not dispensable in the way drugs are…in the case of art the experience is a result of our active mental engagement with the work’ (Kieran, 2013, p. 290).

Stecker (1997, 2010), on the other hand, holds the view that art is instrumental in value. We value music because of the experience it affords; the ends it realises. Kieran (2013, p. 290) differentiates between Stecker’s (1997, 2010) viewpoint that art is instrumental in value, and his own belief that art has an inherent value. He argues that money, for example, has no value in itself, and is purely of instrumental value to gain materials or realise certain situations. However, the relationship of money to the ends it can supply is entirely external. The only way by which the outcome is affected by money is as means of its attainment. Meanwhile music, to paraphrase Lynn H. Hough (1920), is more about the journey than the destination. So to find inherent value in music, it can’t merely ‘be the means to a valuable end, but also the means must partly constitute and thus be internal to the ends involved’ (Kieran, 2013, p. 290).

To that end, Rycenga (1994) described how music, and her own compositional process, gave her the confidence and freedom to be comfortable and active in her own sexuality, thus highlighting the human value of music on an emotional level:

All of these summoned a strongly physical response from me. If it had not been for the ways in which music acted upon me, music acted in me, music touched me, it is unlikely that I would have been able to act as decisively in a physical sense as I did. (Rycenga, 1994, p. 276)

To be free to be yourself, comfortable in who you are, implies an improved state of wellbeing compared to a repressed individual. This is especially true in coming to terms with your sexuality (Tasker & McCann, 1999, p. 34).

So what is the value of music in relation to our own wellbeing? Can music, the planned organisation of pitch and rhythm be beneficial as an aid to our overall physical condition or improved mental health? In attempting to find the value of music in human wellbeing, I will look across three main areas. In chapter one, I will examine music’s effect on feelings of pleasure, followed by an overview of how music therapy is being used to improve mental health.

The following instalments in this blog series will feature the next chapter in my thesis, focusing on the use of music to improve physical health. This will include studies evaluating its application as a means of pain relief. Finally, following Merriam & Kee’s (2014) view that better educational wellbeing leads to an improved adult life, the following chapters will look at the application of music therapy in schools. This will include a case study, undertaken by myself, examining the benefits of music-based interventions for literacy improvement in children with special education needs (SEN). Relying on current thinking by the best practitioners and writers in this relatively new field of study, the following instalments will attempt to determine the value of music in our lives, beyond the ephemeral, beyond existing objectively as art.

REFERENCES

Cage, J. (1952) 4’33’’. Available at: https://www.youtube.com/watch?v=JTEFKFiXSx4 (Last Accessed: 12/05/2012).

Cook, N. (1998) Music: a very short introduction. Great Britain: Oxford University Press.

Green, B. (1986) The inner game of music. United States: Pan Books.

Kieran, M. (2013) ‘Value of art’, in Gaut, B. & McIver Lopes, D. (eds.) The routledge companion to aesthetics. 3rd Edition. USA & Canada: Routledge, pp. 289-298.

Martin, P. (1995) Sounds and society: themes in the sociology of music. Great Britain: Manchester University Press.

Merriam, S., & Kee, Y. (2014) ‘Promoting Community Wellbeing: The Case for Lifelong Learning for Older Adults’, Adult Education Quarterly, Vol. 64, No. 2, pp. 128-144. Available from: 10.1177/0741713613513633.

Rycenga, J. (1994) ‘Lesbian compositional process: one lover-composer’s perspective’, in Brett, P., Wood, E. & Thomas, G.C. (eds.) Queering the pitch: the new gay and lesbian musicology. Great Britain: Routledge, pp. 275-296.

Shuker, R. (2008) Understanding popular music culture. Third edition. USA & Canada: Routledge.

Tasker, F., & McCann, D. (1999) ‘Affirming patterns of adolescent sexual identity: the challenge’, Journal of Family Therapy, Vol. 21, No. 1, pp. 30-54.