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Making her 30 years of work for the UK music therapy profession, Denize Christophers is interviewed by Helen Tyler

When children with Autistic Spectrum Disorder (ASD) are assessed in music therapy, significant strengths, potentials and resources emerge that may remain hidden in other, more formalised assessments. Therefore, it is becoming more necessary to develop a systematic method of describing this responsiveness, in order to define the expectations of therapy. Music therapy is a particularly important intervention for children with ASD to engage and nurture their capacity for flexibility, creativity, variability and tolerance of change, in order to balance the more structured and behaviourally driven education that is currently popular. The potential of treatment can be defined within the context of meeting healthcare needs. A case study will illustrate a model for defining 'expectations of therapy', by drawing on one child's awakened capacity for interaction through shared, improvised music-making. This article includes a long appendix providing an evidence-based review and recommendations regarding assessment and referral criteria based on current research and clinical evidence.

The Evidence Based Medicine (EBM) framework has been incorporated into the field of healthcare practice over the past decade. Whatever our stance as to its benefits and disadvantages, more and more music therapists in health departments and related clinical posts will be asked to account for their work using this approach to the documentation of clinical effectiveness. It is important that music therapist working within clinical service guidelines understand the framework of EBM and are aware of ways in which they can include its precepts in their justifications for practice and posts. The levels of evidence in an EBM approach and presented and discussed and the issues particular to the application for music therapy research findings are explored. Given the author's experience in paediatric medical settings, some of the examples in this paper will refer to the children's hospital context in particular.

Peak emotional experiences can be triggered inter alia by music (Maslow 1962). 74 college staff members, from a population previously surveyed for incidences of such experiences, listed to music selections under controlled conditions and recorded the timings of any peak events that might have occurred. An attempt was then made to identify and analyse points in the music that had triggered high incidents of peaks, such as changes in harmony, key or loudness. Although there were individual differences, at the macro level the recorded peaks during 25 to 30 minutes of gentle music revealed an alternating high-low response pattern between different pieces, but such a trend was less obvious with upbeat items. Some reasons for these findings are suggested. The results may have value for those who use music for healing purposes, especially music therapists, and for composers or compilers of music programmes who need to anticipate listener reaction.

The information contained in this article has been derived from a series of interviews conducted by the author with selected specialists in music therapy group improvisation. Although the music therapy literature barely addresses the musical material created in group improvisations, it is not true to say that there is no expertise in this area. Rather, it is likely that the difficulties in communicating these musical processes via the written word or transcribed score have discouraged researchers and clinicians from publishing current theories and understandings. For this reason, selected specialist were approached to take part in in-depth interviews aimed to solicit their current understandings of music therapy group improvisations. The results in this article are make up solely of the information shared in these interviews in response to a series of open-ended questions posed by the author.