Original Research

Patients’ voices from music therapy at a South African psychiatric hospital

Carol Lotter, Werdie van Staden
South African Journal of Psychiatry | Vol 28 | a1884 | DOI: https://doi.org/10.4102/sajpsychiatry.v28i0.1884 | © 2022 Carol Lotter, Werdie van Staden | This work is licensed under CC Attribution 4.0
Submitted: 21 February 2022 | Published: 29 July 2022

About the author(s)

Carol Lotter, Department of Music, Faculty of Humanities, University of Pretoria, Pretoria, South Africa
Werdie van Staden, Centre for Ethics and Philosophy of Health Sciences, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa


Background: In the Life Esidimeni tragedy, crucial voices of mental healthcare users and practitioners were silenced, captured in the Ombud’s report as a ‘failure to listen’. Working against this kind of failure, various therapeutic interventions listen deliberately and uncover the voice of the patient, that is, what matters from his or her subjective perspective in his or her particular circumstances. Amongst these interventions, music therapy provides for this sensitive listening by expanding the scope and means of expression from the verbal to the musical.

Aim: This article reports on a qualitative exploration of patients’ lived experiences both during and after their course of individual music therapy, expressed both verbally and in the language of active music-making.

Setting: A tertiary public psychiatric hospital in South Africa.

Methods: Audio-video recordings of 131 music therapy sessions and 15 post-therapy interviews were analysed thematically. From three sets of themes accounting for patients’ verbal contents, musical participation and verbal post-therapy reflections, 11 salient voices were identified.

Results: The 11 voices that emerged were (1) the voice of struggle, (2) the voice of disturbance, (3) the voice that feels, (4) the voice of isolation, (5) the powerless voice, (6) the voice that desires, (7) the voice of flow and connection, (8) the reflecting voice, (9) the symbolic voice, (10) the resilient voice and (11) the voice of liberation.

Conclusion: Although mental health practitioners may recognise these voices from their clinical experience, space and opportunity for hearing the voice of each patient should be generated deliberately.


music therapy; verbal expression; musical participation; patient voices; adult mental health


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