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음악적 정서 탐색 기반의 주도적 음악 활동을 통한 조현병 환자의 자기 인식 및 내재적 동기 향상

Proactive Music Activities Focused on Exploring Musical Emotion to Enhance Self-Awareness and Intrinsic Motivation in Patients With Schizophrenia

  • 김현주 (이화여자대학교 대학원 음악치료학과, 단국대학교 영미인문학과)
  • Kim, Hyun-Ju (Department of Music Therapy, Graduate School, Ewha Womans University, Department of British and American Humanities, Dankook University)
  • 투고 : 2024.03.15
  • 심사 : 2024.04.22
  • 발행 : 2024.04.30

초록

본 연구는 동기 부족을 겪고 있는 조현병 환자들에게 음악 치료가 자기 인식 및 내재적 동기 향상에 어떠한 영향을 미치는지 알아보는 것을 목적으로 하였다. 이를 위해, 본 연구자는 2023년 10월 5일부터 11월 16일까지 8주 동안 매주 60분씩 음악적 정서 탐색에 기반을 둔 주도적음악 활동을 중심으로 한 음악치료 세션을 진행하였으며, 성인 남성 3명과 여성 3명, 총 6명이 연구에 참여하였다. 본 연구는 주로 정량적 방법을 사용하되 정성적 통찰로 보완하였고, 데이터 수집 및 분석은 네 번째부터 여덟 번째 세션에 걸쳐 집중적으로 이루어졌다. 연구 기간의 제한으로 통계적으로 유의한 변화는 관찰되지 않았으나, 심층 인터뷰를 통해 얻은 정성적 자료는 참가자들의 자기 인식과 내재적 동기가 향상되었음을 나타냈다. 특히 참가자들의 감정표현과 의사소통 능력이 향상되었으며, 이는 자기 인식, 내재적 동기의 향상뿐만 아니라 자신의 삶의 질에 대한 인식의 개선으로 이어졌다. 개인별 변이성이 관찰되었으나, 이러한 결과는 음악 치료가 조현병 환자의 자기 인식을 개선하고 내재적 동기를 재점화하는 효과적인 중재 방법임을 시사하며, 향후 긴 기간 동안의 연구를 통해 이러한 결과를 더욱 확증할 필요가 있음을 제안하고 있다.

The purpose of this study was to explore the impact of music therapy on enhancing self-awareness and intrinsic motivation among patients with schizophrenia, particularly those experiencing motivational deficits. This study, primarily based on quantitative analyses supplemented by qualitative insights, included six adults (three males and three females) across 8 weekly sessions proactive music activities based on the exploration of musical emotion, each lasting 60 minutes, from October 5 to November 16, 2023. Data collection and analysis focused on the last five sessions, from the fourth to the eighth. Although no statistically significant changes were detected, likely due to the study's short duration, qualitative data from in-depth interviews indicate that music therapy contributed to enhanced motivation and improved self-perception in participants. They demonstrated better emotional articulation, self-awareness, and communication skills, which not only increased their intrinsic motivation but also led to an improved perception of their life quality. Individual variability was noted, however, indicating that these outcomes could differ among participants. These results highlight music therapy's potential as a valuable intervention for enhancing self-awareness and reigniting motivation in individuals with schizophrenia, suggesting a further research to corroborate these findings over longer periods.

키워드

참고문헌

  1. Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77-101.
  2. Catalano, L. T., & Green, M. (2023). Social motivation in schizophrenia: What's effort got to do with it? Schizophrenia Bulletin, 49(5), 1127-1137.
  3. Damore, E. (2022). Fostering self-awareness through songwriting: Development and heuristic self-inquiry of a method for graduate music therapy students (Unpublished master's thesis). Lesley University, Cambridge.
  4. Fervaha, G., Foussias, G., Agid, O., & Remington, G. (2015). Motivational deficits in early schizophrenia: Prevalent, persistent, and key determinants of functional outcome. Schizophrenia Research, 166(1-3), 9-16.
  5. Geretsegger, M., Mossler, K. A., Bieleninik, L., Chen, X., Heldal, T., & Gold, C. (2017). Music therapy for people with schizophrenia and schizophrenia-like disorders. Cochrane Database of Systematic Reviews, 5, 004025.
  6. Gold, C., Heldal, T. O., Dahle, T., & Wigram, T. (2005). Music therapy for schizophrenia or schizophrenia-like illnesses. Cochrane Database of Systematic Reviews, 2, 004025.
  7. Green, M. F., Horan, W. P., & Lee, J. (2019). Nonsocial and social cognition in schizophrenia: Current evidence and future directions. World Psychiatry, 18(2), 146-161.
  8. Hu, H. X., Lau, W. Y. S., Ma, E. P. Y., Hung, K. S. Y., Chen, S. Y., Cheng, K. S., ... Chan, R. C. K. (2022). The important role of motivation and pleasure deficits on social functioning in patients with schizophrenia: A network analysis. Schizophrenia Bulletin, 48(4), 860-870.
  9. Jia, R., Liang, D., Yu, J., Lu, G., Wang, Z., Wu, Z., ... Chen, C. (2020). The effectiveness of adjunct music therapy for patients with schizophrenia: A meta-analysis. Psychiatry Research, 293, 113464.
  10. Lam, L., Chang, W. C., & Grimmer, K. (2023). Treatment effects of adjunct group music therapy in patients with chronic schizophrenia: A systematic review. Frontiers in Psychiatry, 14, 1215578.
  11. Lee, J. M., & Park, H. S. (2017). Development and validation of the Self-Awareness Scale (SAS). Korean Journal of Counseling, 18(5), 21-40.
  12. Magee, W. L., & Stewart, L. (2015). The challenges and benefits of a genuine partnership between music therapy and neuroscience: A dialog between scientist and therapist. Frontiers in Human Neuroscience, 9, 223.
  13. Mossler, K., Gold, C., Asmus, J., Schumacher, K., Calvet, C., Reimer, S., ... Schmid, W. (2019). The therapeutic relationship as predictor of change in music therapy with young children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 49(7), 2795-2809.
  14. Ryan, R. M. (1982). Control and information in the intrapersonal sphere: An extension of cognitive evaluation theory. Journal of Personality and Social Psychology, 43(3), 450-461.
  15. Ryan, R. M., & Deci, E. L. (2000). Intrinsic and extrinsic motivations: Classic definitions and new directions. Contemporary Educational Psychology, 25(1), 54-67.
  16. Silverman, M. J. (2022). Music therapy in mental health for illness management and recovery (2nd ed.). Oxford, UK: Oxford University Press.
  17. Stewart, J., Garrido, S., Hense, C., & McFerran, K. (2019). Music use for mood regulation: Self-awareness and conscious listening choices in young people with tendencies to depression. Frontiers in Psychology, 10, 1199.
  18. Strauss, G. P., Esfahlani, F. Z., Kirkpatrick, B., Allen, D. N., Gold, J. M., Visser, K. F., & Sayama, H. (2019). Network analysis reveals which negative symptom domains are most central in schizophrenia vs bipolar disorder. Schizophrenia Bulletin, 45(6), 1319-1330.
  19. Thaut, M. H., & Gardiner, J. C. (2016). Neurologic music therapy in mental health and rehabilitation. In B. Wheeler (Ed.), Music Therapy Handbook (pp. 232-245). New York, NY: The Guilford Press.
  20. Tobe, M., Nemoto, T., Tsujino, N., Yamaguchi, T., Katagiri, N., Fujii, C., & Mizuno, M. (2016). Characteristics of motivation and their impacts on the functional outcomes in patients with schizophrenia. Comprehensive Psychiatry, 65, 103-109.