аÄÃÅÁùºÏ²Ê¿ª½±½á¹û2023

Adopting a knowledge-based controversy perspective, this article considers critically the 'fit' or appropriateness of the so-called 'gold standard' of assessment - the Randomised Controlled Trial. It sets the growing dominance of this method within music therapy in the contexts of medical work and the changing social relations of medical expertise, the importance of local practice in music therapy (and healthcare more widely), and the politics of representation as they apply to medical modes of accounting and measurement. I then consider what is overlooked when experimental models are used as the prime mode of perceiving the music therapeutic process and suggest that they may not provide a good or appropriate way of observing, accounting for and assessing music therapy. I suggest that they are not amenable to the observation and documentation of temporal and local craft practices and that these practices provide the active ingredients of music therapy's effectiveness. I conclude that music therapy is poised to highlight the radical performative and social features of health status and that these features have far-reaching implications for our concepts of illness and the aetiology of illness and, most importantly, for the ways in which we conceptualise and implement therapeutic procedures of all kinds.

This article is an abbreviated and slightly edited version of a review that first appeared in the Cochrane Library. The Cochrane Library (including the Cochrane Database of Systematic Reviews, CDSR, as its central product) is a database for information about the effects of a health care. While "health care" is understood in a very broad way (in fact including any type of "intervention" from surgery to intercessory prayer), the term "effects" is understood in a narrow sense. The CDSR aims at including the most "reliable" information, which in practice means systematic reviews and meta-analyses including exclusively or almost exclusively randomised controlled trials (RCTs). The authors of this review share with the Cochrane Collaboration the understanding that this type of research can, if carried out properly, in fact provide the "most reliable" information (in terms of what psychological researchers call internal validity). We also share with the more sensible proponents of the Cochrane Collaboration and understanding that internal validity is not the only criterion to be applied when appraising and evaluating research. In other words, many other types of research have their strengths as well - but these are different ones.

This article offers a simple model of generating locally relevant evidence within a study designed to suit the local context. In describing the social inclusion of older people in group music therapy and in the evaluation of a six-month pilot, it aims to show the importance of user-centred evaluation as an enabling and empowering process (Procter 2002). The successful project resulted in further funding from an inner-city social services community care section to continue and develop the work. The service-users (clients) in the study (which also involved music therapists, managers and care staff) are a multi-ethnic group of older people with physical and mental health problems, including dementia, living within the community in Supported Living Schemes and attending Day Centres. This is a conventionally socially excluded and marginalised group, who often live extremely isolated lives because of social, psychological, mental or physical difficulties (Davidson 2004). A summary of the findings, conclusions and outcome of the study demonstrates how participants have gained more control over their lives by having their voices and experience heard.

The evidence-based framework underpins the field of special education research. Many educational researchers and administrators accept this model, and expectations of research are rapidly changing as it gains prominence. This dialogue explores the impact of the evidence-based model through a debate between two researchers in the field - a special education academic with a positivist agenda and a music therapy researcher with qualitative inclinations. Through a series of questions designed to illustrate their complementary perspectives, the authors provide opinions on what constitutes evidence in special education and consider the music therapy literature from these perspectives. Ultimately, they propose a research study that pragmatically accepts the evidence-based framework as one valid approach to research. This research project is seen as one step in a series of studies that have international collaborations as their basis.