Voice and Music in Psychotherapy (StimMusTher)

Pilot project 1996 – 1999

Project Management
Sabine Rittner

Project team members
Dipl.-Psych. Michael Wolfart, Department for Voice and Speech Disorders; Dr. sc. hum. Dipl.-Music Therapist Henrik Jungaberle; Christine Klaar (M.A.), doctoral student; Simone Kühn, doctoral student; Ulrike Seifert, doctoral student.

Cooperation partner
Department of Voice and Speech Disorders and Pedaudiology at the University Hospital Heidelberg (Prof. Dr. Ute Pröschel); Institute for Music Therapy at the University of Witten/Herdecke (Prof. Dr. David Aldridge)

Duration of the patient groups
September 1997 to December 1998

Duration of the project
November 1996 to December 1999

“Voice is living biography” (Gundermann)

The voice is a phenomenon which, as the primary expressive form of the human being, links the logical-rational content of speech to the emotional meaning. Like a prism, it crystallizes both manifold personality aspects and temporary moods. Beyond the interpersonal aspect of non-verbal communication, singing in particular can bring about complex psychophysiological and emotional change processes within the individual. The aim of this pilot study was to identify factors in which the importance of vocal expression in the therapeutic relationship (previously underestimated in psychotherapy research) is condensed.

Three functional levels of the voice were considered in this research project:

The voice as an indicator for therapeutic change processes. Here we investigated whether pre-, peri- and post-therapeutic differences in the phonation of patients can be scientifically proven.

The voice as a symptom. For acute or chronic voice patients we offered group psychotherapy on a music-therapeutic and systemic basis after thorough phoniatric, logopaedic and psychological preliminary examination. Based on a psychosomatic basic understanding of the existing voice symptoms, we examined the efficiency of our integrative therapeutic approach with regard to a future differential indication.

The Voice goes beyond as a language-free medium of communication,
as a way to train perception, to promote expression and to process unconscious conflict material for use (resource-oriented concept).

Three short-term group psychotherapies were carried out with a total of 32 patients over twelve sessions of three hours each. Two of these groups were aimed at psychotherapy patients with psychosomatic symptoms, one of the groups was offered specifically for patients with functional and psychogenic voice disorders. The evaluation was carried out with a standardised, quantitative set of measuring instruments as well as with various qualitative examination methods. In addition, imaging methods of voice analysis were used. Furthermore, in the context of a doctoral thesis, questions of metaphorical communication in the therapist-patient relationship were addressed. The study was financed from internal departmental funds of the Institute for Medical Psychology at the University Hospital of Heidelberg (headed by Prof. Dr. Rolf Verres).

Project related publications

Rittner, Sabine (2008)
The voice as a factor in psychotherapy / music therapy
In: Music Therapeutic Review, Theme Booklet “The Voice in Therapeutic Dialogue”, Vol. 29, 3/2008, pp. 201-220 Göttingen: Vandenhoeck & Rupprecht.

Rittner, Sabine (1998)
The research project “Voice and Music in Psychotherapy” (StimMusTher) at the University Hospital of Heidelberg
In: Studiengruppe Musiktherapie Ulm (Ed.): Lecture collection on the “10th Ulm Workshop for Music Therapeutic Basic Research”.
University Hospital Ulm, Dept. of Psychotherapy and Psychosomatic Medicine.

Rittner, Sabine and Jungaberle, Henrik (1998)
Development and objective of the research project “Voice in music therapy” (StimMusTher) – Investigation of a music therapy group with the focus voice (repertory grid technique)
In: Studiengruppe Musiktherapie Ulm (Ed.): Lecture collection on the “10th Ulm Workshop for Music Therapeutic Basic Research”.
University Hospital Ulm, Dept. of Psychotherapy and Psychosomatic Medicine.

Rittner, Sabine and Jungaberle, Henrik (2002)
Sounding systems – Different Approaches to the Evaluation of Music Psychotherapy Groups
In: Aldridge,D. and Fachner,J.(eds.):Info CD-Rom iv. University of Witten Herdecke: Witten. (S. 1514-1543).

Jungaberle Henrik (2000)
Contributions to the theory and evaluation of a music therapy group treatment.
Music and metaphor
Dissertation on Dr. sc. hum., University of Heidelberg.

Jungaberle Henrik (2001)
New steps in musical meaning – metaphor as an organizing principle
In: Nordic Journal of Music Therapy 10(1): p. 4-16.

Jungaberle, Henrik (2007)
Evaluation of the metaphor analysis of a music therapy group treatment.
Music and Metaphors. Psychotherapy in transition. On the theory and evaluation of music as a therapeutic medium.
Berlin: Pro Business.

Veit, Ulrike (2004)
Change processes in patients with functional voice disorders under music psychotherapeutic treatment
Dissertation on Dr. med., University Hospital Heidelberg.

Klaar, Christine (1999)
Health education in transition
Analysis of the pedagogical relevance of health education using selected case studies from the research project “StimMusTher” at the Department of Medical Psychology of the Psychosomatic University Hospital Heidelberg.
Master’s thesis in Educational Science, University of Heidelberg.

Kraus, Wolfgang (1996)
The voice in the music therapeutic relationship – a resonance phenomenon.
Diploma thesis music therapy, University of Applied Sciences for Music Therapy Heidelberg.