The effect of therapeutic music interventions on the behavior of hospitalized children in isolation: developing a contextual support model of music therapy.

The purpose of this study was to provide preliminary data that support or negate a contextual support model of music therapy. The contextual support model of music therapy, based on Skinner and Wellborn's (1994) motivational theory of coping, argues that therapeutic music environments possess elements of structure, autonomy support, and involvement that lead children to become more actively engaged with their environment. This study examined three basic suppositions of the theory: (a) that music interventions create supportive environments, (b) that music interventions increase children's active engagement, and (c) that relationships exist between supportive environments and engaging behavior. Ten pediatric oncology patients restricted to an isolated environment participated in the study. Participants, serving as their own controls, experienced four different environmental conditions. Each condition was videotaped to facilitate collection of environmental and behavioral data. Statistical analyses of these data revealed: (a) that the music environment possessed a significantly higher frequency of environmental support elements than other activities typically experienced by hospitalized children, (b) that therapeutic music interventions elicited significantly more engaging behaviors from hospitalized children than other hospital activities, (c) that positive behavioral effects of music interventions were not maintained in hospital experiences that followed the music session, and (d) that environmental support elements were related to some positive behaviors but these behaviors were not consistent across environments.