Preterm birth and the subsequent hospitalization in the Neonatal Intensive Care Unit (NICU) is a challenging life event for parents and babies. Stress, anxiety, and depressive symptoms, limitations in holding or touching the baby, and medical complications during the NICU stay can negatively affect parental mental health. This can threaten the developing parent-infant relationship and might adversely impact child development. Music therapy in the NICU is an internationally growing field of clinical practice and research and is increasingly applied to promote relationship building between parents and babies. The two most commonly used concepts describing the early parent-infant relationship are ‘attachment’ and ‘bonding’. While frequently used interchangeably in the literature, they are actually not the same and describe distinctive processes of the early relationship formation. Thus, it is important to discuss the overlaps and differences between attachment and bonding and the implications for music therapy clinical practice and research. Whereas providing examples and possible scenarios for music therapists working on either bonding or attachment, the distinction between both concepts is relevant for many health care professionals concerned with early parenting interventions in the NICU. This will hopefully lead to a more precise use of theory, and ultimately, to a more informed clinical practice and research.

Neonatal music therapy (MT) has become more accessible worldwide. Previous research suggests multiple benefits of MT for preterm infants and their caregivers; however, far too little attention has been paid to understanding the mechanisms of change in previous Neonatal Intensive Care Unit (NICU)-MT research so far. This perspective article describes potential mechanisms of MT interventions exposed during kangaroo mother care on the preterm infant’s response (behavioral and physiological outcomes) and the mother-infant relationship. The paper focuses on the hypothalamic–pituitary–adrenal axis’ role in stabilization of behavioral state, the autonomic nervous system’s role in stabilization of physiologic state, as well as co-regulation as a potential mechanism for the developing of the parent-infant relationship. Mechanisms play a pivotal role in understanding variables related to the therapy course and well as in generating new knowledge regarding treatment susceptibility and optimizing resources. Understanding of the mechanisms of how interventions may lead to specific outcomes plays an important role in addressing the issue of improvement of currently available approaches of MT used in the NICU.

While there are numerous descriptions of the use of music and its therapeutic potential by music therapists working with nonverbal children on the autism spectrum, only limited literature focuses on exploring how music therapists use music and perceive its therapeutic potential when working with children on the spectrum who have verbal skills. This qualitative study aimed to explore music therapists’ descriptions of the use of music and its therapeutic potential in their work with children on the autism spectrum who have verbal skills. Semi-structured interviews were conducted with six qualified music therapists from Israel and then analyzed according to the principles of interpretative phenomenological analysis (IPA). Three main themes were identified: (a) musical infrastructure, which describes how the music therapists facilitated musical experiences to support the children’s ability to regulate their arousal, attention and emotions; (b) the meeting point between musical and verbal playfulness, which reflects the music therapists’ beliefs about how musical experiences add vitality and support the development of both verbal and nonverbal imaginative play; and (c) musical responses, which describes the different ways music therapists use their voice and songs to interact musically with verbal children. The experiences described by the participants emphasize the importance of the therapist musically attuning to the child’s emotional, physiological, creative, and playful qualities, even when the child has verbal skills. These musical interactions help to create a shared experience between the child and therapist that are perceived to help the child’s different forms of regulation, continuity, and vitality within the play.

In the current study, we aimed to explore the lived experience of Israeli parents who engaged in musical dialogues with their preterm infants during music therapy (MT) after being discharged from the neonatal intensive care unit (NICU), as a part of the multinational LongSTEP RCT. Seven participants of the main trial were invited to engage in semi-structured in-depth interviews intertwining listening to audio recordings from their music therapy sessions in an adapted interpersonal process recall (IPR) procedure. The interviews were transcribed and analyzed using interpretative phenomenological analysis (IPA). We understood the participants’ experiences to reflect two main themes: 1) Music therapy as a potential means of transformation in communication skills, resourcefulness and sense of agency; and 2) emotional and musical preconditions for parental engagement in MT. The findings illustrate how a specific group of Israeli parents experienced MT as offering them a means of expanding their relationship with their preterm infants after discharge. Based on our findings, we recommend that music therapists consider parents’ musical and emotional resources during post-discharge MT to meet the individual needs of families.

Music therapy (MT) is a part of standard care in neonatal intensive care units (NICU) in many countries, and in some countries is provided as a post-discharge service as well. However, it is rare t...