An Interpretative Investigation of the Lived Experiences and Perceptions of Autistic Adults, Parents of Children on the Autism Spectrum, and Music Therapy Clinicians on the Development of a Novel Music Therapy Social Skills Curriculum Within a Family-Centered Practice Model

Abstract

Family-centered practice within a therapeutic milieu has evolved over the last 40 years. However, few music therapy researchers have sought to understand the lived experiences and perceptions of autistic adults, parents of children on the autism spectrum (CAS), and music therapy clinicians (MTCs) regarding the development of a social skills curriculum integrated into a family-centered practice model. Therefore, the purpose of this exploratory interpretivist study was to understand autistic adults’, parents’, and music therapy clinicians’ (MTCs), perspectives, lived experiences, and recommendations regarding the development of a family-centered music therapy (FCMT) approach for social skill development in CAS. The primary research question was: What are the perspectives and recommendations of autistic adults, parents of CAS, and MTCs on social skill acquisition and a FCMT approach for social skill development? Two autistic adults, three parents of CAS, and five MT clinicians participated in separate semi-structured interviews. Using an inductive approach to thematic analysis, the author identified and established code categories and themes during repeated readings of the data. Member checks and trustworthiness were utilized. Three primary and six subthemes were identified for each of the participant groups: Autistic Adults: 1) Diagnosis influences identity (subthemes 1a: Public stigma results in internalized shame; 2a: Neurodiversity fosters positive self-concept) , 2) Family interactions (subthemes 1b: Families experience various challenges; 2b: Family participation shapes well-being), and 3) Music therapy expectations (subthemes 3a: Addressing the whole person; 3b: Varied approaches to meet individualized needs; Parents of CAS: 1) Complex caregiver roles (subthemes: 1a: A range of emotions from successes and challenges; 2a: Dynamic family relationships), 2) Roles and responsibilities of MT (subthemes: 2a: Communication and collaboration with the family; 2b: Individualized and goal-oriented approaches), and 3) Community engagement (subthemes: 3a: Connecting with other families; 3b: Exposure within greater community); MTCs: 1) Family dynamic and logistical factors (subthemes 1a: Family dynamics influence MT session logistics; 1b: General session logistics derived from non-service user factors), 2) MTC’s clinical decision-making (subthemes: 2a: Clinician’s therapeutic experiences and intuition; 2b: Treatment plans are individualized and successive), and 3) Family and MTC interactions (subthemes 3a: Family and therapist partnership develops alliance; 3b: Family member participation promotes commitment and generalization). Practicing within a neurodiversity-affirming therapy model and integrating the family into the delivery of music therapy-specific interventions can improve care receiver and family participation. Moreover, various factors influence the clinical decision-making of the MTC in a FCMT approach for social skill development. These factors can strengthen the acquisition and generalization of social skills for AC. Implications for clinical practice and suggestions for future research are provided.