Escala de avaliação dos efeitos da musicoterapia em grupo na dependência química (MTDQ)

Abstract

Music Therapy (MT) has been a part of mental health care globally since its inception, including in Brazil where professionals were employed as music therapists before formal training programs were established. Much of the research on MT in mental health remains exploratory and qualitative, lacking evidence of its effectiveness. To demonstrate the efficacy of therapeutic treatments, evaluation instruments that assess the value of interventions can be used. Chemical dependence (DQ) is a psychopathology treated in the context of mental health care that can significantly impact users at cognitive, social, and neurological levels. Therefore, this research aims to develop an Assessment Scale of the Effects of Group Music Therapy on Chemical Dependence (MTDQ). The theoretical framework for the construction of Psychological Assessment Instruments developed by Luiz Pasquali (2010) was used in this study. This theory indicates three poles: Theoretical, Empirical, and Analytical. The theoretical procedures were based on two studies. In the first article, an Integrative Literature Review was conducted using Mesh descriptors "music therapy" and "drug abuse" to search for scientific literature that demonstrates which outcomes can be evaluated using tests in systematic MT approaches in the context of DQ. Twenty-two texts were identified, indicating a lack of standardization of the outcomes evaluated by the studies, limiting their comparability. Nevertheless, some points about the action of music therapy on psychological aspects of patients with chemical dependence could be concluded. In a second study, an approach to music therapy treatments aimed at the population with chemical dependence was presented, based on a theoretical discussion supported by the Rational Scientific Mediating Model (R-SMM) in interface with the Transtheoretical Model of Change (MTM). This study discussed the neurophysiological bases of musical processing as well as drug abuse, pointed out efficient music therapy techniques for music therapy treatment with this population, presented the MTM, and finally indicated which techniques can be more efficiently indicated for different phases of treatment. In a third study, a methodological and developmental research was carried out on the construction of the MTDQ, seeking evidence of the content validity of this measurement instrument. Procedures called Semantic Analysis and Judges Analysis were used. The MTDQ was evaluated as relevant and adequate to the population for which it is intended, with items that are theoretically connected to the domains, and all domains and items linked to it are relevant to the evaluation of MT in DQ. Studies of structural validity and reliability of the MTDQ were carried out through confirmatory factor analysis of items. The convenience sample was composed of 202 participants, 154 men (77.37%), and 45 women, with a mean age of 44.7 years (SD = 12.7, minimum = 18 and maximum = 69). Three models were tested: unidimensional, with two correlated factors, and bifactorial. The results indicate better adequacy of the bifactorial structure (CFI = 0.988; RMSEA = 0.048), composed of two specific factors (cognitive processes and behavioral processes) and a general factor. This dissertation provides initial evidence that the MTDQ is an appropriate instrument for measuring three benefits perceived by patients with chemical dependence regarding music therapy in their change processes.