The World within the Walls: A Music Therapy Group for Patients in Long-Term Segregation at the National High Secure Service for Women in the UK

Abstract

This article describes work undertaken at a high secure service for women in the UK. It provides an account of an on-ward, time-limited music therapy group for individuals detained in long-term segregation in the intensive care unit of the hospital. The high level of risk patients pose to themselves and others means mixing with their peers requires close supervision, and also results in long periods of isolation. The group was initiated with the primary focus being to help develop relationships between the women. Often the whole ward team participated, with staff members taking the role of participant-observer during the session. A background to the work, including the nature of the forensic setting, is provided. Group music therapy in this setting is then described, with consideration given to the impact of institutional dynamics on the process. The relationship between the culture of the NHS and the high-secure setting, with the inevitable struggle to maintain authentic therapeutic relationships, is also explored.