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Typically, editorials are straightforward, written with relative ease as they function to summarize and frame the articles you will find within a particular issue. Somewhat more conceptually elegant are editorials which are shaped by a common theme, which allows for a process of creatively weaving together a shared thematic thread that runs throughout the various articles submitted. There are other times when an editorial must weave into its structure a pressing current concern or event relevant to its readers. My initial aim was to do just that. As I first sat down to write this editorial, which was back in the middle of May, the world was undergoing a catastrophic pandemic, a devastating death toll caused by COVID-19.

To date, millions of people around the world have contracted the virus and hundreds of thousands of people have died. And though we are all experiencing this pandemic, it is differentially impacting different communities, such as Black, Indigenous, and Brown communities, due to long-term disparities in health and access to nutritious food and affordable healthcare. We must take notice of the devastating impact on poor and under-resourced Asian and white communities for the same reasons. This global crisis is highlighting and magnifying these disparities. In fact, given the disproportionate impact COVID-19 has had on Black communities in the US, at the end of March, the guest editors of the next special issue for Voices- which will be a multidisciplinary issue on Black aesthetics and the arts therapies co-edited by Marisol Norris, Leah Gipson, and Britton Williams-requested that we postpone the next special issue precisely due to the impact that the pandemic was having on the authors for their special issue. For more about this, see their commentary in this issue.

So, in mid-May, I had crafted an editorial in my mind around issues the readership was facing, how this was experienced differently depending on sociocultural and geographical location, and I had tied this into themes that are found in the articles in this issue. I considered how a sense of being, belonging, and becoming, experienced by Autistic adults in a singing group, as described by Laurel Young in this issue, is being challenged for music therapists in this pandemic; how the theme of continual "becomings" of something new, as described by Maevon Gumble in this issue, is something we are forced to consider in terms of our roles as music therapists in this pandemic; how, like music therapists, refugees, in seeking a new becoming, turn to music performance as a primary source for healing trauma as Bernard Austin Kigunda Muriithi demonstrates in this issue; how COVID-19 may be influencing the perceived impact of music therapy, which could be examined using Giorgos Tsiris, Neta Spiro, Owen Coggins, and Ania Zubala approach outlined in this issue as a guide; how what we unintentionally learn in moments like this is sometimes more significant than what we expected to learn, as described in the work conducted by Jim Hiller in this issue; and, how not only understanding the intersubjective experiences of profoundly disabled people, as described by Jiří Kantor in this issue, but also the complexities of telehealth, pose strong barriers for the development of a therapeutic relationship.

And then on May 24 th I woke up to an email from co-editor-in-chief, Brynjulf Stige, that was sent to Kat McFerran and me as the other co-editors-in-chief, in which he was informing us that he had decided to end his tenure at Voices in July of this year. I sat staring at my screen. While Brynjulf had been preparing us for a few years for this, it was suddenly very real. It took a while for it to sink in. It was 21 years ago that Brynjulf and Carolyn Kenny conceived Voices. For Brynjulf to leave Voices is a monumental change, as it was in 2013 when Carolyn stepped down. And this change is one of a string of changes this year in our Voices team. For example, at the beginning of the year, Melody Schwantes let us know that she would be stepping down as copyeditor after the July issue, then Kat McFerran let us know that she would be stepping down as co-editor-in-chief once we could find a replacement, and also we have just been informed that our new production editor, Hilde Kjerland, is being moved into another role and will be being replaced. As Brynjulf's email header aptly noted, "The Times They Are A 'Changing"!

Given all of this, I knew that the focus of the editorial would need to shift to reflect these changes. But how? I kept hearing Nina Simone, "Everything Must Change," as I was taking in the effects of COVID-19 and all that was about to change at Voices.

everything must change

nothing stays the same

everyone will change

no one, no one stays the same

the young become the old

and mysteries do unfold

for that's the way of time

no one, and nothing goes unchanged

there are not many things in life one can be sure of

except rain comes from the clouds

sun lights up the sky

hummingbirds fly

As I listened to her powerfully wise and instructive voice, I wondered what things in life we can ever be sure of, and more specifically in music therapy and in Voices. Yet, I was reassured of the power of music to transform us and to comfort us and to express our pains and our joys and our complexities. I was reassured that there is a community of people around the world who are committed to deepening our discussions on music, health, and social change. I felt appreciative of the great editorial team and reviewers we have who donate so much of their time and energy to maintaining a dialogical space at Voices. And I acknowledged that while everything must change, there are a few things in life we can be sure of, and one of these is our enduring relationships with music and our interconnectedness with each other, which COVID-19 has highlighted in so many ways.

I could barely sit with all of this, when a day later, on May 25 th another African American, George Floyd, was brutally murdered by police here in the US. As I watched this unfold on video for 8 minutes and 46 seconds, I felt physically sick and shaken, emotionally shaken to my core, and spiritually shaken. As I grieved for this Black man, his family, his community, and my community, I was reminded about how in the US and around the world Black people are, to so many people, ungrievable. Judith Butler ( 2016) wrote:

One way of posing the question of who "we" are in these times of war is by asking whose lives are considered valuable, whose lives are mourned, and whose lives are considered ungrievable. We might think of war as dividing populations into those who are grievable and those who are not. An ungrievable life is one that cannot be mourned because it has never lived, that is, it has never counted as a life at all. We can see the division of the globe into grievable and ungrievable lives from the perspective of those who wage war in order to defend the lives of certain communities, and to defend them against the lives of others-even if it means taking those latter lives. (p. 38)

Here was another one of the "things in life we can be sure of," and yet this one was so far from the comforting ones in Nina Simone's song. This was a reminder that Black life is all too often not "counted as life at all." Hearing George Floyd pleading and uttering multiple times "I can't breathe" was eerily familiar. It is the exact same phrase repeated 11 times in the last moments of Eric Garner's life in Statton Island, New York, in 2014; 12 times in the last moments of David Dungay's life as he was murdered by prison officers in New South Wales, Australia, in 2015; in the final moment of Eric Harris' life in Tulsa, Oklahoma, in 2015 (where the response from the police officer was "Fuck your breath"); and in the final moment of Manuel Ellis' life in Tacoma, Washington, in 2020. "I can't breathe" has become a rallying cry in the Black Lives Matter movements around the world to represent how Black and Brown people are restricted in their mobilities, denied possibilities, as well as literally having their breath denied them. As Bryant Keith Alexander wrote:

I am thinking about breathing in relation to our need to learn collective breathing in relation to that now notorious message, statement, and cry, "I Can't Breathe"-often posted as white letters on a black t-shirt or on the forever reimagined hoodie of Trayvon Martin-now as emblematic of the construction of restrictive mobilities, unquestioned intentions, and denied possibilities not only as an indictment but as an opportunity to meditate on the realities of breathing and the potential consequences of not breathing. ( Alexander et al., 2018, p. 2)

At this moment, I urge you to take a moment to remember all of the countless deaths of Black, Indigenous, and other People of Color (BIPOC) as a result of white supremacist policies and practices throughout our communities, while listening to and watching NYC Cellist Yves Dharamraj perform a five-cello arrangement of "When I am laid in earth" (Dido's Lament) from Henry Purcell's Dido and Aeneas as a protest for Black Lives Matter and artistic tribute to George Floyd.

As the news of George Floyd's death began to spread, the differences in felt responses was palpable. Many "good" white people responded with disbelief and outrage that this murder could have happened. Most Black people felt the trauma of yet another person's name to add to a long list, the repetition of racist lynchings of thousands of Black people in the US for decades. And yet while acknowledging these very real differences in response, there has been widespread protests where people of all races, from a wide range of geographical spaces (almost every continent), have come together, risking their health and lives during the most devastating pandemic of our lifetime, demanding change. The widespread prolonged nature of the current protests feels different from anything many of us have ever experienced. While I continue to feel quite pessimistic, there is a glimmer of hope that this could be an important inflection point. For a moment, Sam Cook's voice enters into my consciousness, "it's been a long, a long time coming, but I know a change is gonna come. "

So, for the past two weeks I have been unable to come up with a way to write this editorial. I have sat here at my computer with complete writers' block. I wanted to find the right words to say at this time, to speak to what is, by any measure, a profoundly tragic time. But absolutely none were coming to me. There was just too much that felt too weighty to tie together into a coherent editorial statement. For those who know me, I am not usually at a loss for words. But here I was with none that were forthcoming. So, instead I decided to share the above to express the sheer difficulty I was having as I tried to find the words to express during this incredibly significant moment in our collectively shared history.

I have mentioned all of this without even touching on what is happening in Hong Kong, or Palestine, or so many other places that are also experiencing significant social injustices and human rights violations. I have said nothing about the continued climate crisis and the impact that will have on future pandemics.

And this all brings me back to Brynjulf Stige, co-founder of Voices, who reminds us of our complicity in systems of injustice, noting that we either "contribute to social control or to social and cultural change" ( Stige, 2002, p. 278). In other words, when we are not actively working towards social and cultural change, we are not bystanders, but we are actively contributing to social control. It is not enough to express outrage at what others have done or are doing, but we must open ourselves up to learn how we are contributing to social injustices and how we can actively work for social justice. We need to free ourselves from the tenacity with which we try to assure ourselves that we are the "good ones." Such hubris and tenacity only conceal the very unjust practices that we must change. We need to challenge and move from our understanding of ourselves as neoliberal subjects, and instead acknowledge our interconnectedness, that all that we do and don't do touches / impacts others in ways we often don't even imagine or even want to imagine. We often think about how this happens in positive ways, yet we must pay close attention to the negative impacts. It is our responsibility to humanity, our commitment to community, our obligation to ourselves.

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Typically, editorials are straightforward, written with relative ease as they function to summarize and frame the articles you will find within a particular issue. Somewhat more conceptually elegant are editorials which are shaped by a common theme, which allows for a process of creatively weaving together a shared thematic thread that runs throughout the various articles submitted.

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By Leah Ra’chel ,Britton Williams, and Marisol Norris

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By Leah Ra’chel ,Britton Williams, and Marisol Norris

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We write this commentary as co-editors of the forthcoming special multidisciplinary issue of Voices on Black aesthetics and the arts therapies. In March, the apparent toll of the coronavirus pandemic on Black communities informed our decision to request the delay of our special issue. We made this request with historical and contemporary inequities in mind, knowing that Black contributors to the special issue would need to find solutions to problems, likely with fewer resources or greater demands for physical, psychological, economic, and spiritual soundness at the height of COVID-19. Our intuition was haunting. In the weeks following our initial request, widespread protest erupted across the globe to demand justice for the modern-day lynchings of George Floyd, Breonna Taylor, Ahmaud Arbery, Sean Reed, Tony McDade, Nina Pop and Iyonna Dior. As we write these few names, we also recognize that there are far more people left unnamed whose deaths are at the intersections of racialized violence. It is the horrifying fact that unjust Black death in the U.S. is so recurrent and underreported that even the names of those that are missing from our list could not contain the immenseness of our loss. We offer this commentary in the interim of our special issue to underscore the basic and foundational realities of racism that must clearly be reemphasized here as this moment of growing white allyship reveals that there are many who have yet to learn them. But mainly, we offer our voices to directly acknowledge our Black colleagues who are experiencing grief and pain, while absorbing the impact of this current moment. Each co-editor has chosen to write their own reflection of this present time and its reverberations of the past.

Leah Gipson: Say Her Name

The surveillance video of King County psychiatric hospital waiting room in New York City shows Esmin Green slowly collapsing from her chair; her head leans forward and collides into another chair before her body reaches the ground. Esmin struggles on her hands and knees beneath her hospital gown, but her body gives in to pain. She lies on the waiting room floor with her arms bent between chairs and her exposed legs sprawled into the center of the room. A hospital security staff casually stands hand-on-hip at the corner of the room, staring at Esmin's body. Esmin, a Jamaican woman who had immigrated to the U.S., worked as a housekeeper, and an elder and child care provider to support her children in Jamaica. She lived with depression, which eventually worsened following her unemployment. In 2008, she was involuntarily admitted to the emergency room for psychiatric treatment. Because there were no available beds in the facility, Esmin sat in the waiting room for 24 hours before she collapsed. She was checked by medical staff after lying on the floor, unattended for an hour. She was already dead.

Black communities have been painfully aware of the many life-threatening forms of racialized neglect and terror that require unending emotional labor and everyday solutions for survival. State violence threatens Black life across the lifespan. Emerald Black was in Oakland, California, when police forced her out of her car and stomped on her visibly pregnant body during a traffic stop. Emerald miscarried. Aiyana Stanley Jones, age 7 of Detroit, MI, Bettie Jones, age 55 of Chicago, IL, Atatiana Jefferson, age 28 of Fort Worth, TX, and Breonna Taylor, age 26 of Louisville, KY were shot and killed by police who invaded their homes. In this moment of visibility around racism and protest, Black girls' and women's narratives of violence flood my thoughts. I consciously remember Esmin Green, the way she was involuntarily hospitalized by the state, and left to wait and to die as a spectacle. This violence has its historical roots in Black women's pain and resistance, a legacy known today through the narratives of Harriet Jacobs, Celia, Anarcha Wescott, Betsey Harris, Lucy Zimmerman, Henrietta Lacks, and Recy Taylor. COVID-19 has raised social anxieties and uncertainties in possibly every aspect of life. Due to COVID-19, more people around the world face inadequate medical systems, loss of income and housing, sudden illness, death, and loss of loved ones without the opportunity to share goodbyes. Black communities, including children, trans and gender non-binary persons, disabled people, and cis women and men routinely navigate such realities, which are magnified due to the coronavirus pandemic. The United States' cultural benchmarks for health, safety, and social progress have never been measured by the lives of Black people, particularly those among the working class. From tuberculosis (TB), to HIV, sickle cell anemia, reproductive health, heart disease and asthma, to mental illness and racial trauma, the sense of urgency around health crises is deeply felt within Black communities. But the already unbearable conditions of racial capitalism have not been enough to mobilize creative arts therapists along with other mental health professionals to create a normative culture of resistance against the anti-Black racism that enables the mental health industrial complex. If Esmin Green had survived the hospital waiting room, she might have met an art therapist during her in-patient treatment. Seemingly, therapists advocate for people who can manage to reach their offices. Whose responsibility is to advocate for those who are unlikely to ever make it to a session?

When reports began to confirm that COVID-19 was disproportionately impacting Black communities, a friend had cautioned, "Black people are already tired." And she was right. Black women have shared our fatigue as an act of refusal when high-pressure conditions in our lives have outlasted all reasonable expectations of patience before any relief or change. As a womanist, I believe that doing the work of care helps to sustain a political desire for healing - expanding the available options for survival and liberation. Being "sick and tired of being sick and tired" is simultaneously a breaking point and a breakthrough. How should Black creative arts therapists continue to call for justice and develop multidisciplinary organizing strategies for change?

Britton Williams: A Devastating Loop, A Never Ending Cycle

State-sanctioned violence against Black people is as certain in the US (and across the globe) as the rising of the sun. Black people individually and collectively experience perpetual and compounded racial oppression. When COVID-19 emerged, the U.S. was already in the grips of the unattended crisis of racism. Anti-Black racism is largely left untreated and even denied, which results in a vicious and viral cycle. Billie Holiday and Nina Simone sang about lynchings, "Southern trees bearing strange fruit/ Blood on the leaves and blood at the roots/ Black bodies swinging in the southern breeze/ Strange fruit hanging from the poplar trees." Blood now stains the steaming concrete of city sidewalks and streets. When Eric Garner was murdered in 2014, his last words were "I can't breathe. I can't breathe. I can't breathe." In 2020, we heard those same last words from Manuel Ellis and George Floyd who were murdered by the police. This brutal loop of Black death goes ignored by our so-called justice system, and it plays on repeat. What does healing look like in a cycle like this? There is so much blood; there are too many bones.

Mary Turner. Eric Garner. Michelle Cusseaux. Steven Demarco Taylor. Tamir Rice. Atatiana Jefferson. Ahmaud Arbery. Sandra Bland. Sean Reed. Walter Scott. Tanisha Anderson. Ariane McCree. Emmett Till. Pamela Turner. Miles Hal. Korryn Gaine. Terrance Franklin. Trayvon Martin. Yvette Smith. Amadou Diallo. Anthony Hill. Shelley Frey. Emantic "EJ" Fitzgerald Bradford Jr. Michael Brown. Tanisha Anderson. Michael Griffith. Aura Rosser. Yusef Hawkins. Meagan Hockaday. Rekiah Boyd. Laquan McDonald. Pierre Loury. Ronald "RonnieMan" Johnson.

Racialized violence and multi-contextual disparities are not new; however, they are swelled and this swelling has led to the current eruption of uprising. It is important to acknowledge that though we are currently at a crossroads, folx are getting lost in the intersections. While the deaths of Black men are the current media focus, there are others in the Black community being lost to Anti-Black violence. Breonna Taylor, a Black woman, and an essential worker during the COVID-19 pandemic lay sleeping in her bed only to be riddled with bullets shot by police. Risking her life every day to care for others in the midst of the pandemic, and yet there was no care for her life. Black trans people too are being (and have been) murdered at alarming rates while the media attention and public outcry and outrage are resoundingly quiet. On May 27, 2020, the police killed Tony McDade, a Black trans man, and yet there has been no widespread outcry for him. Nina Pop, a trans-Black woman, was brutally murdered and found in her apartment. Yet, where is the outrage for her? Black people at the intersection of poverty and disability have long been systematically and societally neglected. Black death is far too common. Black death is far too accepted.

This reflection cannot hold all those who have been lost to racialized violence or underscore every intersection and variation of compounding oppressions that Black people endure. One lifetime cannot contain the pain and rage that results from centuries of racialized erasure, violence and bloodshed. As a Black woman, my body holds the weight of all these assaults and losses-known and unknown, the present and the historical. The racialized violence that we are presently facing is rooted in historical frameworks. We must recognize that the here and now is steeped in the there and then. And there and then is manifest in the here and now.

We have never reckoned with our history of chattel slavery or how slavery exists, legally, still today. How can we expect justice from a prison system that is our contemporary version of state-sanctioned slavery as outlined in the 13 th amendment? The answer is, we can't. We must recognize that the prison, education, and healthcare systems are not separate; they are interlocked and foundationally oppressive. As creative arts therapists, we work within a system that is not removed or exempt from these truths. Individually and collectively, we must reckon with how and where Anti-Blackness sits within us and/or bears its weight on top of us. As a Black woman, I do not have the luxury of ignoring racism or being patient with slow-moving change. This is urgent. This is an everyday struggle and so it must be an everyday fight. Let us take care of the most marginalized among us and recognize that if they are well, all will be well. Black lives matter, inclusive of all identity intersections.

Every. Black. Life. Matters.

Marisol Norris: I Can't Sing If I Can't Breathe

Yesterday, as my sister, Monique, and I prepared for a protest to demand justice for Black lives, she stated, "I can't sing if I can't breathe." I was drawn to the paradox of Black people across the African diaspora who have done the impossible. For centuries Black people have voiced pain, struggle, joy, resistance, and liberation through song amidst bondage, enslavement, and violence, even unto death. In so doing, we've dually demonstrated how our expression has been linked to our humanity that allows the creative reimaging of freedom. Yet Monique's words contended any proposed singularity of condition; rather, they amplify the interconnectedness of physical death and social death as existing on a continuum of oppression that has also demanded Black people to sing or die.

The realities of COVID-19, having a wide impact, have amplified the numerous social and economic inequities and health disparities experienced by disenfranchised peoples across the globe. While at this time all peoples have undoubtedly considered the existential crisis of life and death and the necessity of breath, the calls of justice for George Floyd's last breath ripple throughout protest-filled streets. At a time when our global community must meet the demand for the preservation of life, we unearth the paradox of the vast devaluation of Black life to the point of torture and execution. The cries from the streets, "I can't breathe" reiterate George Floyd's last words as he gasped for air choked from his body beneath U.S. police officer Derek Chauvin's pinned knee for almost nine consecutive minutes. George Floyd's lifeless body made public display is invariably tethered to the last words of Eric Garner who too was asphyxiated through excessive force by U.S. police. Both laid cold on a city street, tethered to a countless number of Black people whose deaths are a part of the history of police brutality, anti-Black violence, and white supremacy. Protests echo justice for Breonna Taylor. Tony McDade. Sean Reed. Steven Demarco Taylor. Manuel Ellis. Ahmaud Arbery. Ariane McCree. Atatiana Jefferson. Pamela Taylor. Miles Hall. Botham Jean. Stephon Clark. Jordan Edwards. Korryn Gaines. Sandra Bland. Kalief Browder. Yvette Smith. Freddie Gray. Walter Scott. Megan Hockaday. Tamir Rice. Tanisha Anderson. Aura Rosser. Michelle Cusseaux. Mike Brown. Renisha McBride. Jonathan Ferrell. Trayvon Martin. Amadou Diallo. James Byrd, Jr. Emmett Till. Mary Turner. Names Unspoken.

I often grapple with the idea of death recognizing the multiple ways music therapy is linked to the social death of Black people. The continued contention of Black clients within music therapy spaces represents points of resilience but also a common displacement of Black narratives and the inherent struggle to survive. Furthermore, occupying less than 2% of the U.S. professional body, Black music therapists often navigate a barren disciplinary landscape with little to no scholarly distinction of the socio-political, socio-cultural, and socio-structural realities that mark both therapists' and clients' Black existence. At the risk of centering whiteness to the point of our own erasure, Black music therapy communities are tasked to practice, teach, and integrate disparate knowledge from disciplines outside of music therapy to affirm Black personhood. As a Black music therapist, I'm compelled to ask: When we sing, who do we sing for? And for the growing white mass that would declare allyship, I ask, must we sing for you, too?

The physical and metaphorical knees at the necks of Black people index the singular white lens that pervades arts therapies discourse. These spaces often allude to the nature of the arts and artistic processes as a phenomenon that circumvents Black culture. Arts therapists explore Black clients with the aims of conforming them to dominant norms, and fail to consider the ways that various micro and macro systems impact the aesthetic experience of Black personhood. These realities remain unnamed and unacknowledged in the field, meanwhile, white supremacy aims to perpetuate our devaluation and assault a Black sense of self. During the COVID-19 pandemic, as people experience an expanded focus on life and death, a radical centering of Black lives is needed. And until that radical imagining is actualized, the protest continues.

Conclusion

Our collective experience necessitates that we tend to the variation and fluidity of our responses in the vastness of this moment. Focusing on the virus without looking at the social determinants of health would lead to the false conclusion that the racial disparities in COVID-19 hospitalizations and deaths are a result of the virus. International protests against racism are not only indicators of police violence, but the rampant abuses of power that permeate a U.S. way of life that guarantees fewer or eliminated resources for those who have been systematically othered. As people living in the U.S. are witnessing another collective articulation of the political and economic system that devalues Black life, creative arts therapists must answer to the truth of having previously known this violence as fact. What has intensified this awareness during the chaos of COVID-19? The coronavirus only amplified the issues that have been embedded within well-established norms. As healthcare and cultural workers, what does this history mean for how creative arts therapists understand their fields and longstanding practices, and how these practices determine accepted roles in society?

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Three Black Women's Reflections on COVID-19 and Creative Arts Therapies:

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We write this commentary as co-editors of the forthcoming special multidisciplinary issue of Voices on Black aesthetics and the arts therapies. In March, the apparent toll of the coronavirus pandemic on Black communities informed our decision to request the delay of our special issue.

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Ethical Approval

Prior to initiation of recruitment or data collection procedures, this study received ethical approval from Concordia University's Human Research Ethics Committee (protocol #30000163) and Comité d'éthique de la recherche conjoint destiné aux CRDITED (CÉRC-0143).

Participants

A convenience approach to sampling was employed. Participants had to be at least 18 years of age, English speaking, have a diagnosis of high-functioning autism or Asperger's Syndrome, and have the legal capacity to provide their own informed consent. Eligible participants were informed about this study via recruitment procedures initiated by two social services organizations. Twelve potential participants contacted the researcher by telephone or e-mail to inquire about the project. Eight of these individuals (2 females, 6 males; 21-38 years old [ M = 26.88, SD = 5.77]) decided to participate for various reasons (see Table 1).

Table 1

All participants identified as Canadian though some indicated other cultural connections including South American, Peruvian, Russian, Chinese, German, Italian, and Ukrainian. Six participants did not indicate having a religious affiliation. One identified as a born again Christian and another identified as a Pagan (e.g., observed holidays on the Pagan calendar). Participants were not explicit about their sexual orientations, although one participant spoke openly about involvement in gay pride events and another male participant spoke about having a date with a female. Although all participants had support systems in place, four participants lived independently whereas four lived with one or more family members. The participants also had diverse musical backgrounds, preferences, and dislikes; some had sound sensitivities or other hearing issues. See Table 2 for an overview of this information.

Table 2

Participant*

Music Background

Music Preferences

Music Dislikes

Hearing/Sound Issues

Design

This exploratory study employed a mixed methods concurrent transformative design, which is "useful for giving voice to alternative perspectives, advocating for research participants, and better understanding a phenomenon that may be changing as a result of being studied" ( Hanson, Creswell, Plano Clark, Petska, & Creswell, 2005, p. 229). Theoretically, this aligned well with the purpose of this research (presented above). Qualitative data were collected throughout all phases of the research process and quantitative self-report type data were collected via individual meetings that happened before and after the singing group period (see procedures below). The use of open and closed questions, conversation, and Likert-type scale questions provided participants with different options through which they could express their perspectives. Given the small sample size, the explicit advocacy lens (i.e., neurodiversity and CoMT), and the exploratory nature of the research, priority was given to the qualitative data. Descriptive statistics were embedded into the qualitative results, which helped to verify, challenge, and elucidate some of the qualitative interpretations. This could also be considered as a component of trustworthiness (i.e., validity).

Data Collection Procedures

Prior to initiating the singing group sessions, I met privately with each participant to discuss the project and gather preliminary data. Each individual completed a form (with support from me as needed), that gathered information on: demographics, motivations for participating in the singing group; and music background, preferences, dislikes, and hearing/sound issues. These interviews were audio recorded to gather information that emerged in conversation and not captured via the form. In addition to gathering demographic and background information, Likert type questions (5-point scales) were used to capture participants' attitudes on the importance of music in their daily lives, how they felt about their singing voices, their level of comfort with social situations, their mood and level of anxiety in their daily lives, and how they felt in general about themselves (i.e., their self-esteem) in their daily lives. They were also asked to indicate what they liked most and least about their lives.

All of this information helped me and three graduate research assistants (certified music therapists enrolled in advanced music therapy training) to create a flexible singing group format that was adapted as needed to accommodate individuals' implicit and explicit needs, potentials, and goals as they manifested within a particular session and over the duration of the group. This format included: a brief verbal check-in, breathing, vocal, and body warm ups (incorporated improvisatory components); one or more opening songs (chosen by the music therapist facilitators; varied according to participants' overall mood, level of energy, anxiety, etc.; often incorporated improvisatory components; sung a cappella or accompanied by a music therapist facilitator on guitar or piano); singing participants' song requests and practicing selected songs arranged for a group CD project (this project was not preplanned and emerged as part of the group process); a closing song (participants voted based on 2-3 songs suggested by music therapist facilitators; suggestions varied according to participants' need for relaxation, energy, and review or closure of issues that arose during the session; accompanied by a music therapist facilitator on guitar or piano; one participant (Nancy) sometimes played a drum).

Twelve, 1.5-hour, group singing sessions were held over a 10-week period. Two of the graduate research assistants and I took turns leading the various group singing experiences. When not leading, we each provided musical and personal support for participants. The third research assistant monitored the video and audio equipment used to record the sessions (for analysis purposes) and also provided personal support to participants as needed.

Approximately four weeks after the singing group sessions ended, I again met privately with each participant. I began by presenting each individual with their copy of the CD project (described in the Results section) and asked them to choose a selection that we could listen to together. After listening, we chatted about their chosen selection--why they chose it, what they liked or did not like about it, and what they were thinking as they listened to it. Each individual then completed a form (with support from me as needed), that gathered information on: what they liked and disliked about the singing group, things that made them feel comfortable/uncomfortable, what they learned (if anything), if they would choose to participate again (if given the opportunity), and any other feedback/questions they had. These interviews were audio recorded to gather information that emerged in conversation and not captured via the form. As was the case in the pre-singing group interviews, Likert-type questions (5-point scales) were used to capture participants' attitudes on various issues (outlined previously). Four more Likert-type questions were added to help understand participants' level of comfort with the social aspect of the singing group; what they generally perceived their mood and anxiety levels to be during the singing group; and how they felt about themselves as a person (i.e., their self-esteem) during the singing group. Again, participants were asked to indicate what they liked most and least about their lives.

Data Analysis Procedures

One of the graduate research assistants and I reviewed the audio-video recordings of the group singing sessions and created concise summary descriptions of what happened before, during, and after each singing experience--she completed five summary descriptions and I completed seven. I then reviewed all of the videos, highlighting salient points, quotes, and occurrences on the summary descriptions. I listened back to the pre and post singing group interviews, reviewed my session notes as well as qualitative data from the interview forms, and extracted relevant data (i.e., related to participants' needs, potentials, quality of life) from these sources. Using all of this material, I conducted a directed qualitative content analysis using a pre-determined coding framework wherein I gradually pared the material down to create concise descriptions of how quality of life variables appeared to manifest for participants in this singing group context. Sample quotes from participants were incorporated into these descriptions, which contained both objective observations and subjective interpretations. The coding framework was based on domain and sub-domain headings contained within a Quality of Life (QoL) Model conceptual framework developed by researchers at the University of Toronto ( Raphael, Brown, & Renwick, 1999; The Quality of Life Model, n.d.). These domain and subdomain headings were a good fit for the present study as they were developed from a holistic biopsychosocial perspective (defined above) and could be conceptualized specifically in accordance with participants' needs and potentials, as they emerged or were revealed within the singing group context. I also added three musical sub-domain headings to this framework based upon the CoMT concept of health musicking, which suggests that there are multiple ways in which a music practice (i.e., group singing) may serve as a contextually situated health resource ( Stige, 2012). See Table 3 which outlines the predetermined coding framework. As an overarching concept, QoL was defined as the ways in which participants expressed, enjoyed, and found meaning through realization of their individual and collective potentials.

Table 3

QoL variables conceptualized within this framework were considered as components and potential determinants of participants' health and wellbeing within the singing group context and in their everyday lives. Research suggests that enhancing various QoL domains rather than an exclusive emphasis on symptom-focused interventions will lead to better life outcomes for Autistic persons ( Jennes-Coussens, Magill-Evans & Koning, 2006; Renty, & Roeyers, 2006).

Quantitative self-report data gathered in the pre and post singing group individual interviews were analyzed using descriptive statistics and paired samples t- tests. Notable results (including relevant examples of individual participants' scores) were integrated into the descriptive framework, which helped to verify, broaden, and elucidate some of the qualitative results and interpretations.

Trustworthiness

This study demonstrated credibility through the use of triangulation (i.e., multiple sources of data such as pre and post interviews and audio-visual recordings). Although member checking was not used per se (addressed further in the Discussion section), participants did have the opportunity to provide additional perspectives in the post singing group session interviews. They were also sent a summary of preliminary results via e-mail or post (according to their stated preference) and invited to respond; none did. This study contains elements of transferability via the use of thick descriptions thus potentially helping music therapists or others to readily adapt components of the singing group format, process, and results to suit other singing group contexts for Autistic adults. Dependability and confirmability were addressed through: triangulation (described above), debriefing meetings held with the three graduate music therapy research assistants and me where we discussed our collective observations about the group; I referred to session plans and notes to help audit my interpretations; and I continuously reflected upon my beliefs, values, perspectives, and assumptions (through analytic memos, professional supervision, etc.) some of which were summarized at the beginning of this paper.

Table 4

Likert-Type Scale Questions

Pre Singing Group M(SD)

Post Singing Group M(SD)

Paired Samples t tests

How important is music to you in your daily life?

3.50(1.07)

3.75(.71)

How do you feel about your singing voice?

3.38(.74)

3.63(.74)

Overall, in your daily life, how do you feel about yourself as a person?

4.13(.83)

4.00(.53)

Table 5

Overall, how comfortable do you feel in social situations?

3.00(1.31)
See a.

Overall, after the first few sessions, how comfortable did you feel about being with others during the singing group?

3.38(.52)

Overall, in your daily life, would you say that:
I am not anxious...I am extremely anxious

2.13(.64)

Overall, during the singing group would you say that: I was not anxious...I was extremely anxious

1.50(.76)

Overall, in your daily life, would you say that your mood is not at all good...very good

4.00(.53)

Overall, during the singing group, did you feel that your mood was not at all good...very good

4.38(.74)

Overall, in your daily life, how do you feel about yourself as a person?

4.00(.53)

Overall, during the singing group, how did you feel about yourself?

4.25(.71)

How Quality of Life Domains and Subdomains Manifested in this Context

Although the Quality of Life Domains and Subdomains framework was predetermined (see Table 3 and rationale outlined above), the data analysis process was inductive in that each Subdomain was conceptualized specifically in accordance with participants' needs and potentials, as they emerged or were revealed within the singing group context.

Domain I: Being (expressing who one is)

Subdomain Ia: Physical Being. During body, breath, and vocal warm ups, all participants demonstrated intentional body awareness (e.g., placing hands on diaphragm/ribcage when vocalizing/deep breathing, participation in facial massage, etc.) as well as improved posture (sitting and standing) immediately before and during singing experiences (with verbal and gestural prompts from the music therapists). Participants used a wide variety of hand gestures and body movements to express themselves before, during, and after singing experiences. These included: spontaneous dancing/moving to music, fist pumps, pointing, jazz hands, clapping, thumbs up sign, whistling, body rocking, swaying while singing (standing position), hand flapping, and emotive hand gestures. Ted explained to the group that gesturing while singing "helps you get into the role. It's like method acting." Participants enjoyed action songs/warm ups that contained pre-determined/modelled movements (e.g., YMCA) and creative body and breathe warm ups (e.g., picking apples, hula hooping, hissing like a snake). While singing, they often spontaneously initiated actions/gestures that reflected song lyrics/stylistic components (e.g., the "Monsignore" vocal warm up, "The Twist," "Leaving on a Jet Plane", Sean hugged himself when the group sang I just need somebody to love ). For some participants, body movements and gestures may have eased their anxiety and helped them to self-regulate. Participants exhibited enhanced physical coordination by clapping, foot tapping/stomping, patting their laps, finger snapping, and hand drumming, in time with the music, a skill that improved and was expressed more liberally over time. Some noted that the group helped them to feel good (e.g., Gabriel: "Even after a long day, the singing group made me feel relaxed").

Subdomain Ib: Psychological Being. Participants indicated that they felt good about/proud of their individual vocal contributions. After rehearsing his solo part in "Hit Me with Your Best Shot", River exclaimed: "I feel like that was my best!" When listening back to recordings of their vocal solos, Dylan said: "I smiled all the way through!" Ted nodded his head, smiled, and commented: "It wasn't perfect but it wasn't embarrassingly bad." After the first successful completion of her French vocal solo in "Beauty and the Beast," Clare gave one of the music therapists a high five and a huge smile. Participants also expressed a sense of accomplishment after group performances. Following a rousing rendition of "We Will Rock You", River announced: "We are in the zone!" After working together to learn the intricacies of various parts of "The Twist" and then recording a formidable rendition of the arrangement, both Ted and Sean exclaimed: "Good job everyone!" Between singing experiences, participants also had opportunities to share knowledge, opinions, or advice (e.g., song preferences, music and other trivia, input into how a song should be performed, personal experiences/beliefs, etc.).

These experiences and opportunities may have enhanced aspects of individuals' psychological well-being during the singing group, specifically in terms of self-esteem, mood, and level of anxiety. It is interesting to note that two individuals (Clare and River) indicated on the post singing group Likert-type scale questions (see Table 5) that they felt better about themselves during the group--5 (very good) as compared to their daily lives 4 (good). There were no differences between these two measures for other participants, although Ted stated in the post singing group interview that "the group helped my self-esteem."

Nancy, River, and Harold indicated on the post singing group Likert-type scale questions (see Table 5) that their overall mood in everyday life was 4 (good) and that their overall mood during the singing group was 5 (very good). Ted indicated that his overall mood in everyday life was 3 (okay) and that his overall mood during the group was 5 (very good). In the post singing group interview he said:

I would definitely participate in this group again if I had the opportunity because it gave me the chance to express myself which I was unable to do during my teenage years, which were pretty dark. The group gave me a chance to feel better and to feel more alive.

Gabriel and Dylan both rated their overall mood in everyday life as 4 (good) and 5 (very good), (respectively) and their overall mood during the group as 3 (okay) and 4 (good), (respectively). There are no clear explanations for this finding but important to note nonetheless. Although River rated his mood as 4 (good) in both contexts, he also stated that after singing the song "Unforgettable" he was able to "release a long day's work and negativity that nobody needs."

The statistical analysis revealed that the group mean level of anxiety experienced during the singing group was significantly lower than the group mean level of anxiety experienced in their daily lives (see Table 5). This finding is further supported by Harold's statement: "I wasn't really anxious at all in the group. I do get anxious sometimes but not here." Two participants' individual scores however, contradicted the overall group result. Sean indicated that he was 1 (not anxious) in either context. Clare indicated that she felt 2 (slightly anxious) in her daily life whereas she felt 3 (moderately anxious) during the singing group. In the post singing group interview, Clare indicated that she is more comfortable when she is "in charge and giving the orders", which may help to explain this individual result.

Subdomain Ic: Spiritual/Cultural Being. Participants spoke about ways in which the singing group experiences helped them to express and connect with their spirituality. Ted: "I really felt like I was expressing myself when I sang Hail to the Hammer and connected to my spiritual beliefs. It was elevating and grounding at the same time." River: "Singing is a way to feel alive. Music is like religion; a set of beliefs. I was certainly invested in this. It's like trying to get in tune with yourself and seeing where it leads". On one occasion, Ted explained to the group that "when you get goosebumps, it means you are feeling the music in your soul."

Although the group facilitators had begun to consider the concept of making a group CD, the idea was actually put forth to the group in the third session by Sean: "It would be fun to do a recording of ourselves." Participants agreed that this was a good idea. In the coming weeks, musical selections for this project were chosen and arranged in collaboration with participants to reflect individuals' beliefs, values, personal qualities, skills, and preferences. See Table 6 which illustrates how these various components were realized. The CD project as a whole is being considered as a unique musical cultural mosaic (i.e., an arts-based research outcome) that emerged out of this singing group context.

Table 6

Selections

Key Features/Participants' Contributions*

Selected vocal warm-ups/traditional rounds.

Examples selected from sessions. All unfamiliar material learned by participants in the singing group.

Hail to the Hammer (2002, Tyr).
Folk heavy metal.
Inspired by Tyr's original recording.

Aligned with Ted's musical preferences and Pagan beliefs. He was the vocal soloist with support provided by the group via a repetitive drone type vocal ostinato. The whole group also sang the bridge and the last line.

Beauty and the Beast/ La Belle et la Bête.
(1991, Celine Dion and Peabo Bryson).

Aligned with Clare's preference for Disney music. She sang two solo parts in French (at her request) while the group sang a supportive background part on ooh. The whole group sang remaining lyrics in English. Sean indicated that he liked both the movie and musical; offered to wear his "Beauty and the Beast" t-shirt to the group. Nancy played cymbal with brushes throughout and ended the song with a gentle glissando on the hanging chimes.

In the Summertime (1970, Ray Dorset).
Inspired by Mungo Jerry's performance.

Requested by Dylan because "It's a happy song" and it aligned with his preference for "old pop." He was the vocal soloist with support provided by the group via a continuous rhythmic ostinato using nonsense syllables (Chh chh-chh uh). The whole group sang the bridge section.

Subdomain Id: Musical/Vocal Being. Individuals' musical contributions to the CD project (see Table 6) may also be considered as unique expressions of their musical/vocal being. The singing group context provided each participant with the possibility to discover and express their own authentic voice and develop a positive and unique musical/vocal identity. River said:

I felt comfortable in the singing group because I was allowed to express all of my vocal range, starting from the low and going to the high. That [Monsignore vocal warm up] was my favourite; how high can I go?

River often held the last note of a song much longer (and louder) than the rest of the group, especially if it ended on a high note. "That's just me. I can't help it."

In both the pre and post singing group interviews, participants were asked to complete a Likert-type scale question that asked how they felt about their singing voice (see Table 4). It is interesting to note that three individuals' scores changed on this measure. Most notably, Sean's score increased from 3 (okay) to 5 (very good). Although one cannot be certain as to why this occurred, he indicated that he had been told prior to the group that he sings "off key." During the group, he sometimes had trouble matching pitch. However, the music therapist facilitators did not correct him but rather encouraged him to develop and express his own unique vocal sound. Over time, his level of active singing participation increased and he even sang a solo in "The Banana Boat Song (Day-O)" where the group provided background vocal support. In the post singing group interview he stated: "What I liked least about the group is that it ended because I want to sing more, more, more!"On this same measure, Dylan's score increased from 3 (okay) to 4 (good), perhaps due at least in part to having a positive experience when rehearsing and recording his vocal solo for the CD project ("In the Summertime"). Conversely, River's score decreased from 5 (very good) to 4 (good). This may have been due to the fact that he was quite taken aback by what he heard when listening to a recording of his voice in session 11. When asked in the post singing group interview what he liked least about the group he replied: "Hearing my voice on recording. It's a work in progress, not the end." Potential implications of this finding are addressed in the Discussion section.

Domain II: Belonging (connections)

Subdomain IIa: Physical Environment. Due to a lack of available space at the university, the singing group was held in a room that was in somewhat of a state of disrepair. Just prior to the first session, the building had flooded and our room had an ongoing ceiling leak under which a large blue plastic recycling bin had been placed. Participants acclimatized to and even claimed ownership of this space by jokingly referring to this set up as our Tranquility Fountain. Participants sat in a semi-circle, facing the facilitators and a piano with the fountain behind them, looking back periodically to check and comment upon the rate of flow. It remained as a permanent, jokingly admired fixture for the duration of the group.

Subdomain IIb: Social Belonging. In both the pre and post singing group interviews, individual participants were asked to indicate on a Likert-type scale question how comfortable they felt in social situations in general (see Table 4). It is interesting to note that three participants' scores decreased slightly on this measure. Sean and Harold moved from 4 (very comfortable) to 3 (moderately comfortable) and Dylan moved from 5 (extremely comfortable) to 4 (very comfortable). Conversely, Clare and Nancy's scores increased from 3 (moderately comfortable) to 4 (very comfortable). Gabriel and River's scores remained stable at 3 (moderately comfortable). Ted was unable to answer this question as he felt that the social situation needed to be contextualized. Other participants raised similar concerns prior to answering this question, which suggests that results on this measure should be interpreted with caution.

In this singing group context, all of the participants developed positive, trusting relationships with one or more of the group facilitators and some (Ted, River, and Clare) explicitly indicated that this contributed to their level of comfort in the group. Relationships with the music therapists often helped to enable successful participation and increase constructive interactions among group members, which reinforced a sense of belonging. For example, one of the RA music therapists sat by Clare whenever she sang her French solo in "Beauty and the Beast." Clare clearly stated that she did not want anyone else to sing the solo part with her but while singing, she would look at the RA music therapist for reassurance (a nod or a smile) and upon finishing her part, would seek validation from her that she had done a good job (e.g., ask her, put up her hand for a high five). The first time Clare made it through the entire song without having to stop, the group erupted into a spontaneous and enthusiastic round of applause.

Some participants (Nancy, Sean, Harold, and Clare) indicated that they previously knew some of the group members and that this helped them to feel more comfortable in the group. Participants expressed concern when one of the participants (River) was uncharacteristically late and when one of the RA music therapists missed the group because she was ill. Between singing experiences, participants often offered compliments and advice to one another. For example, Ted told River after an enthusiastic song performance that: "You're really good at diffusing energy. You managed to help my anxiety." River raised his arms and responded with an enthusiastic "Wahoo!" When Gabriel and Harold were telling Nancy how she should play the chimes in a particular selection, Ted politely interjected and said "let her do it the way she wants to."

In the post singing group interviews, participants were presented with their personal copy of the group CD and asked to choose one selection that we could listen to together. Nancy and Gabriel indicated that they wanted to hear specific participants' vocal solos (River in "Hit Me with your Best Shot" and Clare in "Beauty and the Beast," respectively). When asked why they chose these selections Nancy answered: "Because I like River's singing;" Gabriel answered: "I wanted to hear which of the versions had Clare's French parts." Perhaps they each felt a special connection with that person. Some participants also commented on the constructive social (i.e., extramusical) interactions of the group as a whole. Sean: "I liked that we got along so well." Harold: "It helped that no one member tried to be the boss and tell us how a song should go." Nancy indicated that she would participate in this group again if given the opportunity because "it was fun and I enjoyed being with others."

Finally, in the post singing group interviews, participants completed a Likert-type scale question that asked how comfortable they felt being with others in the singing group after the first few sessions. This measure was compared with the group's post session interview mean score on how comfortable they felt in social situations in general (see Table 5). It is interesting to note that Nancy and Dylan's scores indicated that they were 3 (moderately comfortable) being with others in the singing group as compared to 4 (very comfortable) in social situations in general. Conversely, Sean and Harold's scores indicated the exact opposite result. All other participants' scores were stable across these two measures with the exception of Ted who was able to answer that he felt 3 (moderately comfortable) in this singing group context. As noted above, some participants had difficulty answering questions about decontextualized social situations at large, and these results should again be interpreted with caution.

Subdomain IIc: Community Belonging. This singing group did not engage directly with the community at large. It is important to note however, that it occurred in a university setting that hosts various public events, which made it feel more like a community group rather than a clinical initiative. During informal discussions (before and after the group) as well as between songs (participants sometimes started talking during transitions between singing experiences) participants shared information with each other about various community events, including those related to autism awareness, implying that some participants felt a sense of connection with the larger Autistic community. For example in session ten, when the music therapists were changing the recording set up between two songs, Sean asked the group: "Did you guys know that there's an Asperger's walk this weekend? ... On Saturday." When asked during the post singing group interview if he would like to participate in another singing group should the opportunity arise, Sean indicated: "I would like to learn how to use the sound system and do a broadcast about Asperger's." Sean and River also expressed/implied interest in sharing the group's music with the public or participating in public singing performances (e.g., Sean asked if he could contact a local radio station about the CD project; River requested that we take pictures of him posing with a microphone as if performing for an audience). Additional ways in which future reiterations of this singing group might work to enhance reciprocal engagement between participants' and their communities are presented in the discussion section.

Subdomain IId: Musical/Vocal Belonging. Adapted song structures, vocal, breath, and body warm ups; and the CD recording process (which inherently motivated participants to execute uninterrupted song performances) served as well-delineated yet flexible frameworks that enabled constructive musical/vocal collaboration. Transitions between singing experiences were often chaotic, with many participants wanting to speak at the same time. At a certain point River interjected: "I don't want to be rude but could we get back to the music please?" In the video recordings, one can see and hear how a sense of group coherence was most salient and consistently maintained during the singing experiences; perhaps because it was possible for everyone to sing and listen to each other at the same time. Some participants commented on how the group, as a musical/vocal entity, came together. Sean: "I didn't think our voices would fit but they did. I like that we sounded so good together." Harold said:

I think that everyone enjoyed themselves and people put their best efforts into all of the songs. It helped that the skill levels of the singers were similar. I didn't feel like I was sticking out [or have to] worry about others being better singers.

In the post singing group interview, when listening back to "Unforgettable," River indicated that what he liked most about the recording was "voices coming together" and that he did not like places where "voices weren't together."

The CD project provided the group with a shared musical purpose. Participants provided musical/vocal support to each other and also had opportunities to feel supported in this way. Dylan: "I liked [having] the ch ch ch [vocal sounds] in the background while I sang." Clare noticed when the group did not sing their background part as loudly as she would have liked to support her vocal solo: "What happened to my oohhs everyone? What am I, chopped liver?" When Dylan realized that he had a scheduling conflict and would not be able to attend the last session, he sought out reassurance from me that his vocal solo would still be included on the CD. As noted above, in the post singing group interviews, participants were presented with their copy of the CD and asked to choose one song that we could listen to together. Ted and Harold each chose a particular song stating that they wanted to hear the whole group singing together ("We will Rock You" and "Unforgettable," respectively). The CD itself provided concrete evidence (i.e., a memento) that participants had belonged to this singing group and had contributed to this collaborative musical outcome. Sean felt that this project provided the group with a "clear purpose" and that this helped him to feel more comfortable/at ease.

Domain III: Becoming (Ways of achieving personal goals, hopes, and aspirations)

Subdomain IIIa: Addressing Practical Issues. Participants demonstrated commitment and motivation through consistent attendance and willingness to participate. Ted indicated that he sometimes attended even when he did not feel like it because he knew it would be good for him. Harold appreciated the fact that we always started on time. Participants took care to keep hydrated during the group (we set up a water station in the room) and eat dinner before they arrived. They were interested in understanding the practical applications of the various vocal, breathing, and body warm ups. Practical supports such as ear plugs (Gabriel), leaving the room and "tuning out" for a bit (Ted), and sitting with a facilitator (Clare) appeared to ease these participants' anxiety and help them to self-regulate, which in turn enabled them to realize their potentials in the group.

Subdomain IIIb: Leisure. All participants indicated that they "enjoyed" or "had fun" in the group. Every session contained a great deal of laughter and humor--especially during the improvisatory components of the vocal, breath, and body warm ups and opening songs. For example, after a call and response exercise where I played with the timbre, tempo, and volume of my voice, Gabriel held his sides saying "I can't take it," laughing so hard that he had to sit down, which caused everyone else to laugh with him. Ted said: "The group was fun. I could express myself and feel better. It helped me to feel more alive." As we were wrapping up the final singing group session Harold said:

It's been fun. It [time] flew. We'll do it again. In the post singing group interview he reiterated: I enjoyed singing with people. It was fun and a change of routine. It was a relaxed atmosphere and I didn't feel like I was under the gun or anything.

Seven out of eight individuals indicated that they would participate again if given the opportunity; Gabriel indicated that it would depend upon his schedule.

Subdomain IIIc: Personal Growth. Participants' realized personal (extramusical) potentials in various ways. Those who had vocal solos on the CD created personalized ways of assuming their leadership roles. While trying out various poses at the microphone River said: "In this kind of pose I feel like I'm on top of the world." Dylan unexpectedly donned his sunglasses just prior to a recording session of "In the Summertime." On a few occasions he said: "Watch out American Idol. Here I come!" Gabriel (somewhat uncharacteristically) assumed a role of responsibility by agreeing to count the group in to help set the tempo for "We Will Rock You." He also appeared to become slightly more tolerant of change and spontaneity. Early on, he was quite upset when one of the RA music therapists introduced one of his song requests to the group because her acoustic version of "What Makes You Beautiful" by One Direction did not sound like their recorded version. "You got the lyrics and the whole song wrong!" Although we did not push the issue with this song, we reiterated to everyone that the point of our group was to create our own versions of songs that highlighted our unique talents. Over time, Gabriel got used to (and perhaps even liked) the group's versions of songs; as evidenced by his voluntary participation in these arrangements. He also came to really enjoy warm up songs (e.g., "Monsignore," "Boom Chicka Boom," "Ya Gotta Sing When the Spirit Says Sing"), where he would spontaneously suggest lyrics or actions and facilitator would also insert musical surprises (change of volume, tempo, vocal timbre, etc.). These songs varied from week to week and were never presented in exactly the same way.

In both the pre and post singing group interviews, individual participants were asked to indicate on a Likert-type scale question how they felt about themselves as a person in their daily lives (see Table 4). It is interesting to note that Ted showed an increase on this measure moving from 3 (okay) to 4 (good), while Nancy and Harold showed a decrease on the measure moving from 5 (very good) to 4 (good). Although participants exhibited personal growth in the singing group context, the extent to which this affected their perceptions of themselves outside of the group is difficult to say. However, when I asked River, if there was anything that he learned from the group that he would bring into his daily life, he responded: "Don't be afraid of change...Try something you've never tried before."

Subdomain IIId: Musical/Vocal Growth. All participants did sing but some more than others. In reviewing the video, it appeared that the level of active singing participation notably increased for Nancy, Sean, and Clare, who sang very little/sporadically in the initial sessions. Nancy also sang quite softly for the duration of the singing group period. As previously noted, the Likert-type scale questions indicated that Nancy and Clare did not feel any differently about their voices after the singing group ( 3 [okay] and 4 [good] respectively). However, Sean's score increased from 3 (okay) to 5 (very good) which seems relevant to consider (as previously discussed). In both the pre and post singing group interviews, individual participants were asked to indicate on a Likert-type scale question how important music was in their daily lives (see Table 4). It is interesting to note that two participants (Harold and Clare) showed a slight increase on this measure, both going from 2 (not important) to 3 (moderately important. Given that both of these individuals indicated that they would participate in this group again (if given the opportunity), the amount of positive verbal feedback given by Harold (several examples throughout this paper), and the fact that both indicated in their pre-singing group interviews that they "rarely listened to music" (see Table 2), this finding seems quite pertinent.

Participants may also have experienced a heightened sense of musical/vocal competency through the development of intuitive and concrete knowledge and skills. With support from the facilitators, participants demonstrated a growing ability to match pitch and sing harmonies (3-part chords and memorized rounds); follow diverse conducting cues, and maintain a rhythmic ostinato with drums ("We Will Rock You") and voice ("Hail to the Hammer" used a repetitive drone type vocal ostinato). They asked questions about music. River: "Does anyone know what an ostinato is?" Dylan: "Is there a word for silly words [in a song] that don't mean anything?" Gabriel: "What key is that song in?" Clare: "Are the notes the same for both [piano and guitar]? I'm just curious." They offered constructive critiques, suggestions, or requests which indicated that they were listening. After accompanying Ted's solo with a drum Nancy indicated: "Me and him weren't together." After doing a run through of "Hail to the Hammer" Ted suggested: "It's a little slower than I'm used to. Let's speed it up a little." On another occasion he said: the end of the fourth line is a little higher and then proceeded to sing it for me so I could provide better musical support to him and the others as I conducted from the piano. As sessions progressed, Gabriel began to request changes to musical components of the warm ups: "Can we do it ["Monsignore" vocal exercise] staccato?" Then, after we fulfilled his request: "Let's do it with deep, loud voices." In the post singing group session interview, Clare requested: "If we have another group, I'd like to do another solo in French or Italian. Let me know if something comes up."

Active participation in diverse vocal experiences revealed potential for expansion of personal music preferences. Participants learned new songs (familiar and unfamiliar) and also learned (and appeared to enjoy singing) songs that did not align with their stated music preferences. In our post singing group interview, Harold said:

At first, I didn't think we would be able to do a song like Hail to the Hammer properly. It's also not the kind of music I like. I got used to it and when I listened to it on YouTube, we did a better job than I thought we could. I learned that not all heavy metal is bad.

Finally, in the post group singing session interviews, some participants indicated potential for change in how they viewed the act of singing and the use singing in their daily lives. Dylan: "When I get nervous, I am going to try singing and breathing exercises." Nancy: "I hope to sing more." Ted: "I will use music more to help with my mood." In addition to having selected vocal warm ups on the CD, participants were given a handout containing descriptions of various exercises that we used in the singing group in the event that they wanted to try these on their own.

Benefits of Group Singing

Prior to the present study, no research had been conducted on the potential benefits of group singing for Autistic adults. The process and results of the present inquiry indicate that these participants realized a range of QoL benefits, some of which are similar to those previously identified for the general adult population at large. These included observed and reported instances of: enhanced posture and voice quality ( Clift & Hancox, 2001; Subdomains I a., d., & III d.); reduced feelings of stress/anxiety ( Judd & Pooley, 2014; Linnemann, Schnersch, & Nater, 2017; Subdomain I b.); increased feelings of relaxation and heightened feelings of energy ( Livesay et al., 2012; Mellor, 2013; Vaillancourt et al., 2018; Subdomains I a. & b.); new learning ( Livesay et al. 2012; Subdomains III c. & d.); enhanced self-awareness ( Mellor, 2013; Subdomains I a., b., c., & d.); meaningful social and musical connections made with others ( Faulkner & Davidson, 2006; Stewart & Lonsdale, 2016; Vaillancourt et al., 2018; Subdomains II b. & d.); feelings of belonging ( Judd & Pooley, 2014; Livesay et al., 2012; Mellor, 2013; Stewart & Lonsdale, 2016; Subdomains II b., c., & d.); enhanced feelings of self-confidence, self-esteem, personal growth, and accomplishment ( Busch & Gick, 2012; Livesay et al., 2012; Vaillancourt et al., 2018; Subdomains I b., III c., & d.). Additionally, participants expressed pleasure and excitement when they felt that they sounded good (Subdomains I b., d., III. b., and d.).

Although needs of Autistic adults are unique to their circumstances and context and keeping the neurodiversity stance of this paper in mind, it is important to note that benefits of group singing experienced by the participants in this study overlapped with some benefits experienced by other adult cohorts who may face similar challenges (e.g., anxiety, social isolation, social stigma, etc.) albeit for different reasons. For example, previous research ( Dassa & Amir, 2014; Lesta & Petocz, 2006) indicates that group singing in music therapy contexts has helped persons living with dementia to experience: feelings of accomplishment (Subdomains I b., III c., & d.) and belonging (Subdomains II b. & d.); enhanced social and musical interactions (Subdomains II b. & d.); reduced feelings of anxiety (Subdomain I b.); and enhanced feelings self-esteem and improved mood (Subdomain I b.). It is beyond the scope of this paper to compare and contrast the results of the present study with all studies that examine the benefits of group singing in clinical or CoMT contexts for the wide range of implicated adult cohorts. However, future studies could make these types of detailed comparisons which in turn, could aid in the formulation of population and context specific singing, health, and well-being best practice guidelines. A model of voicework in music therapy proposed by Baker and Uhlig (2011), does not explicitly include a CoMT philosophical orientation, and these guidelines could also contribute to further development of that model. Best practice guidelines on how to facilitate CoMT singing groups for Autistic adults (developed through further research) could also partially address the identified need for more training in music therapy service provision for these individuals ( Kern, Rivera, Chandler, & Humpal, 2013).

Group singing appeared to have multiple benefits for the participants in this study that fulfilled and went beyond their original motivations for joining the singing group (see Table 2). Some participants also asked questions about how they could improve their singing skills and seemed to appreciate vocal tips. Although we did incorporate some aspects of vocal improvisation into the group (in the warm ups and opening songs), it would be interesting to explore in subsequent research how participants' unique vocal expressions might be further developed within a wider range of improvisatory and compositional frameworks, and better understand what the associated benefits or contraindications might be.

In future reiterations of this singing group, individualized vocal coaching sessions and a broader spectrum of singing experiences might help some participants to further realize their unique vocal potentials (in traditional and non-traditional ways), which in turn could contribute to the overall creative energy and musical aesthetic of the group. From both practical (Subdomain III a.) and intrapersonal (Subdomain I b.) perspectives, literature suggests that increased vocal strength and flexibility has potential to enhance one's feelings of control and sense of identity ( Warnlock, 2011). It should also be noted however, that increased awareness of how one's own voice actually sounds can be quite surprising or even upsetting, as was the case for River when he heard a recording of his vocal solo (which incidentally, sounded fine to the music therapists). Although we were able to work through this issue, this potential sensitivity must be kept in mind when doing voicework with individuals whose sense of self may be somewhat fragile due to life experiences (previous and ongoing) of feeling unaccepted or like they do not belong.

Considerations Pertaining to Singing and Performance

There are additional factors pertaining to singing and performance that must be considered. Given the exploratory nature of the research and the short duration of the singing group, this project did not include a public performance component, which within a CoMT approach, may serve as a platform for promoting equal rights and social justice ( Vaillancourt, 2012). Public performance as a vehicle for self-advocacy, empowerment, creative self-expression, community connection, and public education is a central component of the Sensory Friendly Concerts (SFCs) initiative (described previously and discussed further below; Shiloh & Lagasse, 2014). Brandalise ( 2015) illustrated how incorporating theatre performance into a CoMT approach helped to meet the psychological, cultural, and social needs of a group of young Autistic adults (aligns with Subdomains I b., c., & II b., respectively). Some participants in the present study (River and Sean) expressed a desire to perform and future singing groups for Autistic adults could consider this option. However, having been involved in various types of CoMT singing groups ( e.g., Young, 2009; Young & Pringle, 2018), it has been my experience that some individuals benefit first and foremost from participation in the group singing experience in and of itself and do not necessarily want to perform in a public forum. These individuals need access to group singing contexts where participation in performance is not required. Additionally, there are situations where vocal performance may be contraindicated (e.g., the amount of anxiety elicited negates potential benefits; Young & Nicol, 2011). Finally, in a study that examined negative experiences of amateur choral society members, Kreutz & Brünger( 2012) found that perceived demands of public performance lead some individuals to form negative associations with choral singing. This is an important finding to consider, especially if the fundamental purpose of a singing group is to promote feelings of well-being.

In the present study, the CD project recording process could be considered as a type of performance, wherein participants worked together to achieve uniquely tailored renditions of each selection, which they could later share with family and friends if they chose to do so (Subdomains II b. & c.). This type of project (which emerged out of the group process and was not pre-planned) could serve as a viable alternative for or adjunct to community/public performance depending upon the individual and collective needs or goals of a particular singing group.

Community Music Therapy and Neurodiversity

This research was motivated in part by my belief that a singing group conceptualized within a CoMT approach could provide Autistic adults with a creative and supportive forum wherein individual neurodiverse participants could realize their unique potentials. As this belief aligns with the philosophy of Sensory Friendly Concerts (SFCs; Musical Autist/About, 2018; Shiloh & Lagasse, 2014), it is relevant to highlight similarities and distinctions between these two initiatives. It is also important to note that the identified distinctions are not contradictions but rather different ways in which the subdomains contained in the present study's QoL framework may be realized and supported.

Like SFCs, we made accommodations to support the sensory needs of our participants (see Table 3; also aligns with Subdomain III a.). Although we did not have access to noise cancelling headphones/ear buds (which I would definitely use in the future), our participants did have access to foam ear plugs, which one participant (Gabriel) used regularly. If anyone became overwhelmed or overly anxious, it was understood that they could leave the room and sit quietly in an adjacent room until they felt ready to return (SFCs have a designated sensory calm room). One of our group facilitators would accompany that person and check on them as needed; and provide musical and personal support when they returned. For very valid reasons (e.g., auditory processing disorders/sensitivities, loud, startling sounds; disconcerting effects of surround sound, etc.), SFCs do not use a house Public Address (PA) system. However, in this research project, we did use a microphone attached to a speaker (via a soundboard) for individuals who performed solos or other special parts on the group CD project. For some, singing into and holding a microphone appeared to be an empowering experience (as evidenced by body stance, gestures, facial expressions, comments, etc.; Subdomains I a., b., c., & d .), and it was very helpful for participants with soft voices who wanted to sing and record a solo part (Subdomain III a.). It also enhanced group awareness (i.e., group members watched and listened to the soloist more intently; Subdomains II b. & d.) and clarified musical roles (i.e., created an inherent structure wherein soloists and backup singers naturally assumed these roles; Subdomains I d. & II d.). The music therapist leading particular rehearsal/recording activities sometimes wore a headset microphone to provide vocal support/direction as needed for both group and solo parts. We did have one incident where feedback from our amplification system greatly startled Clare who was rehearsing a vocal solo for the CD recording. Although the group members demonstrated notably enhanced musical and personal support (Subdomains II b. & d.) toward her as a result of this incident (their previous interactions with her had been somewhat limited/strained), it also clearly demonstrated potential contraindications for use of amplification. I recommend considering this issue with great care and caution, taking the needs of each group and individual as well as the particularities of each singing group context into account. It is also very important that the intricacies of the equipment be well understood, if it is to be used.

Like the SFCs initiative, this research singing group context also provided "a safe and understanding environment where different responses to music [were] respected" ( Shiloh & Lagasse, 2014, p. 118). Behaviours such as hand flapping, rocking, or spontaneous vocalizations were not discouraged. Improvised dancing, moving to music, or walking around were considered as natural forms of musical and self-expression (Subdomains I a., b., c., & d.). Songs for the CD project were arranged to showcase the unique musical, personal, and cultural expressions, strengths, and preferences of individual participants (also see Tables 2 & 6).

Unlike SFCs, we did not integrate community musicians into our group. The four certified music therapists involved in the project (three certified music therapist graduate research assistants and I) provided both musical and personal support. Musically, we brought a range of clinical and performance skills (including vocal knowledge and experience) to the project which helped us to accommodate traditional and non-traditional aesthetic needs and potentials of participants. Our therapy training and experience helped us to understand and navigate complex group processes and individual challenges that emerged as well as provide individualized support to help promote the realization of unique personal resources. However, this does not preclude the inclusion of community musicians in future reiterations of singing groups for Autistic adults. This could potentially expand the scope of music experiences offered (i.e., unique genres, instruments, vocal approaches, languages, etc.; aligns with Subdomains I c., d., & III d.), enhance individuals' understandings about autism, and strengthen reciprocal connections between community members and Autistic culture (Subdomains II c. & d.)

Although I did have a few brief interactions with parents/other caregivers (via phone, e-mail, or in person) they did not observe sessions nor were they invited to be part of the singing group as they are at SFC gatherings. Initially, this decision was made for two reasons: (a) to have a clearly defined group of research participants (i.e., include verbal Autistic adults only), and (b) an identified lack of programming that catered specifically to the needs of Autistic adults. Research has indicated that difficult transitions from supportive youth services to limited or no services for adults has left young Autistic adults and their families feeling concerned about their potential to live a meaningful life ( Milen & Nicholas, 2017). This small singing group consisted of eight diverse individuals who had experienced social isolation and stigma because of their autism, even though (and sometimes because) they had caregivers who had tried to protect them. Throughout the research process, participants implicitly and explicitly indicated their desire to live their own lives and find their own way (Subdomains III a., b., c., & d.). For this particular age cohort (and perhaps for older Autistic adults), this type of delimited singing group format may serve as an empowering forum or transitional space where Autistic individuals can discover, accept, and celebrate unique aspects of themselves. The inclusion of caregivers (and others) as part of a singing group format would potentially have other benefits. For example, parents and caregivers who participate in the SFCs initiative experience an environment where autistic behaviours are accepted as the norm, they learn about neurodiversity, and they are able relax and enjoy the music at whatever level they desire to participate ( Shiloh & Lagasse, 2014). Possible benefits of singing groups that include parents/caregivers/others as well as the potential for adaptation/modification of relevant components of existing inclusive community chorus models ( e.g., Carpenter, 2015) should be further explored in future research.

As previously noted, research suggests that enhancing various QoL domains rather than an exclusive emphasis on symptom-focused interventions will lead to better life outcomes for Autistic persons ( Jennes-Coussens, Magill-Evans & Koning, 2006; Renty, & Roeyers, 2006). The research process and results of the present study further reinforce this position and also indicate that a singing group conceptualized within a CoMT philosophical approach may serve as a forum for empowerment and self-actualization on individual and collective levels. However, more research is needed to understand various ways in which singing groups might be conceptualized for Autistic adults and what the contextually specific complexities and benefits might be. For example, aging well is becoming an increasingly popular concept in society yet there is limited research and knowledge on what this means for Autistic adults. In a qualitative interview study conducted with 15 Autistic adults and 9 carers of Autistic adults that explored this concept, Hwang, Foley, and Trollor ( 2017) found that being autistic was not viewed as a hindrance (i.e., aligned with a strengths-based, neurodiversity perspective) but that participants identified social and relational issues (Subdomain II b.) as well as societal attitudes (Subdomains II c.) as unique and key factors to aging well. Future inquiries could explore how these (and other) issues might be addressed via a CoMT singing group context for aging Autistic adults.

Autistic self-advocates do not support the traditional biomedical cure research agenda for autism and instead believe that research priorities should focus on areas that have the most potential to improve the daily lives of Autistic people ( ASAN, 2018a). Music therapist researchers (in collaboration with a range of relevant stakeholders) need to find ways to legitimate QoL music therapy practices and produce accessible and practical findings without utilizing research methodologies that contribute to the disempowerment of participants ( Metell, 2014). Throughout this research process, I became more consciously aware of how aspects of the biomedical model were subtly influencing what I considered to be my humanistic client/music centered therapy approach. Both music therapy students and professionals need to develop skills and understanding on how to navigate the current systemic realties of employment contexts without inadvertently contributing to the disempowerment and over-pathologization of their clients. This issue could be more consistently and directly addressed within the context of music therapy training programs, continuing education, and professional advocacy initiatives.

Limitations

This study has limitations that must be acknowledged. All of the participants were verbal and highly capable in various aspects of their lives. Therefore, the research process, results, and implications may have limited applicability to Autistic persons who are non-verbal and whose challenges and strengths manifest in other ways. Additional research that explores how various individuals on the autism spectrum might realize their potential for wellbeing through musical self-expression (vocally or otherwise) is warranted.

Although I am able to share audio recordings of the group within presentation contexts, I unfortunately did not obtain participants' consent to include audio excerpts in any related publications. In some instances, one can hear how particular subdomains contained within the overarching QoL domains are reflected in various singing experiences. These audio excerpts would have served to further validate the findings and well as provide concrete, practical, and thought-provoking examples for readers. Whenever possible, researchers should try and obtain permission to include audio examples in future similar research publications.

Some may view my dual role as researcher and lead group facilitator as problematic. Given the exploratory nature of this study, I felt that I needed to directly interact and develop relationships with the participants in order to identify and set aside my assumptions and make my best attempt to truly understand how QoL variables might be realized for this group in context. In the post singing group interviews (as compared to the pre singing group interviews), participants were generally more comfortable in sharing their perspectives (i.e., they talked more and were more forthcoming with their answers) because they had gotten to know me, which I believe ultimately enhanced the quality (i.e., authenticity) of the post session data.

I also decided not to use member checking. It took a long time to transcribe and analyze the data, and the passage of time may have affected participants' perspectives in such a way that could have convoluted rather than clarified the results ( McConnell-Henry, Chapman, & Francis, 2011). Furthermore, in getting to know the participants, I came to believe that a member checking process could evoke unnecessary anxiety for some individuals. In future studies, it may be more useful and appropriate to include [some or all] participants and other Autistic individuals as part of the research team to ensure that key stakeholder perspectives are an integral part of the process at every stage (i.e., use a participatory action research methodology). A current study being conducted on "Music in Everyday Autistic Life" (funded by the American Music Therapy Association Fultz Award) is utilizing a 6-member, neurodiverse research team for this very reason (K. Aigen, personal communication, February 13, 2018).

Finally, the Likert-type scale questions provided concrete choices for answers and this seemed helpful for some participants (i.e., less anxiety provoking than open ended questions or conversation). Additionally, examining individual participants' quantitative data sometimes provided important information that either elucidated or validated some of the individual and group qualitative interpretations. However, some individuals expressed anxiety at having to choose an answer (that felt like it could be wrong) and felt that more context was needed (e.g., I am highly anxious in some social situations and not in others). Although the quantitative results have some potentially meaningful implications, they should be interpreted with caution. In future research studies, the inclusion of Likert-type scales may be most useful for the unique reasons outlined here, and their value as a measure of the general attitudes of a group of Autistic adults may be limited.

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Prior to initiation of recruitment or data collection procedures, this study received ethical approval from Concordia University's Human Research Ethics Committee (protocol #30000163) and Comité d'éthique de la recherche conjoint destiné aux CRDITED (CÉRC-0143). A convenience approach to sampling was employed.

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By Giorgos Tsiris, Neta Spiro, Owen Coggins, Ania Zubala

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By Giorgos Tsiris, Neta Spiro, Owen Coggins, Ania Zubala

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Resources from Leah, Britton, Marisol

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The mission of the BIPOC Student Fund by Black Arts Therapies Educators is to provide access and support for Black, Indigenous, and People of Color in creative arts therapies education programs. As many colleges move to remote-learning and online platforms during the COVID-19 pandemic, BIPOC students are required to purchase laptops, tablets, art supplies, instruments, and books, while covering the costs of basic necessities during their undergraduate or graduate coursework.

Marisol Norris, MT-BC, Britton Williams, LCAT, RDT/BCT and Leah Gipson, LCPC, ATR-BC, recognized that BIPOC students are increasingly likely to delay their studies due to illness, economic hardship, lack of a supportive network, loss and trauma. In addition to the hardships that many college students endure, BIPOC students experience racism at academic institutions, professional associations, and internships. Each of these factors can negatively impact students' motivation and mental health, and ultimately lead to fewer BIPOC mental health professionals, in particular those who specialize in using art in psychotherapy.

The BIPOC Student Fund will provide immediate need-based-aid and build more resources for students. We affirm and support all BIPOC students, including those who identify as trans, disabled, queer, have marginalized religious identities, or share lived experiences as first generation college students. Award eligibility is inclusive of students across BIPOC diasporas and can be used for creative arts therapies education in any country. We are a grassroots initiative and welcome contributions from individuals, small groups, larger organizations, and institutions.

On July 7, 2020, we launched a $20,000 campaign. In just one day, donations reached our first fundraising benchmark of $2,500, an amount we have set aside for an emergency fund. This first application cycle will award small grants to students from each discipline, dance-movement therapy, drama therapy, music therapy, art therapy, and expressive arts therapy during the Fall 2020 academic term.

The BIPOC Student Fund aims to provide four types of grants during the academic year, based on available funds:

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The mission of the BIPOC Student Fund by Black Arts Therapies Educators is to provide access and support for Black, Indigenous, and People of Color in creative arts therapies education programs. As many colleges move to remote-learning and online platforms during the COVID-19 pandemic, BIPOC students are required to purchase laptops, tablets, art supplies, instruments, and books, while covering the costs of basic necessities during their undergraduate or graduate coursework.

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For more about Maevon's work visit their website below.

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For more about Maevon's work visit their website below.

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A small music therapy business in the Greater Pittsburgh Area (owned by Maevon Gumble, MMT, MT-BC) which offers a variety of music therapy services.

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Live interview with Bernard with special guests 

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Live interview with Bernard with special guests 

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Music as the Medicine of Trauma among Refugees in Arizona

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Live interview with Maevon and special guests

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Live interview with Maevon and special guests

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Voices Live with Maevon Gumble and Special Guests

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Voices: World Forum for Music Therapy Interview with Dr. James Hiller

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Interview with Dr. Laurel Young on her article.

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Interview with Dr. Laurel Young on her article.

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Voices: A World Forum for Music Therapy Interview with Dr  Laurel Young

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Voices Interview with Dr. Giorgos Tsiris 

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Voices Interview with Dr. Giorgos Tsiris 

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Voices Interview with Dr. Giorgos Tsiris