Mahony Sarah E, Juncos David G, Winter Debbie
Performers College, Corringham, United Kingdom.
Voice Study Centre, East Bergholt, United Kingdom.
Front Psychol. 2022 Mar 18;13:830230. doi: 10.3389/fpsyg.2022.830230. eCollection 2022.
Treatments for students with problematic levels of music performance anxiety (MPA) commonly rely on approaches in which students are referred to psychotherapists or other clinical professionals for individual care that falls outside of their music training experience. However, a more transdisciplinary approach in which MPA treatment is effectively integrated into students' training in music/performing arts colleges by teachers who work in consultation with clinical psychologists may prove more beneficial, given the resistance students often experience toward psychotherapy. Training singing teachers, and perhaps music teachers at large, to use an evidence-based coaching strategy like Acceptance and Commitment Coaching (ACC) to directly manage students' MPA is one such approach. Building on the work of a previous study in which ACC was administered by a singing teacher to a musical theatre student with problematic MPA, we piloted the effectiveness of a six-session, group ACC course for a sample of performing arts students ( = 6) with MPA related to vocal performances, using a mixed-methods design. The coach here was also a singing teacher without a clinical background, and her training in ACC by a clinical psychologist was of a similar duration (8 h) as the previous teacher's (7 h). Similar to the musical theatre student, the students reported being significantly less fused with their MPA-related cognitions, more accepting of their MPA-related physiological symptoms, and more psychologically flexible while performing in general, and these improvements were maintained after 3 months. Furthermore, they appeared to lower their shame over having MPA and change how they thought in relation to one another. Of note, these improvements were similar to those shown by seven vocal students with MPA after they received Acceptance and Commitment Therapy from a clinical psychologist, but with larger reductions in shame and better acceptance of MPA, which suggests a non-clinical, group ACC intervention that includes supportive discussions to normalize MPA and challenges attempts to control it may be more helpful than individual psychotherapy. These results are promising and indicate a brief training in ACC (<10 h) may be sufficient for singing teachers to provide significant benefit for students with problematic MPA.
对于音乐表演焦虑（MPA）水平存在问题的学生，治疗方法通常依赖于将学生转介给心理治疗师或其他临床专业人员，接受超出其音乐训练经验的个人护理。然而，鉴于学生通常对心理治疗存在抵触情绪，一种更具跨学科性的方法可能会更有益，即在临床心理学家的咨询下，教师将MPA治疗有效地融入音乐/表演艺术学院学生的训练中。培训声乐教师，或许还有广大音乐教师，运用基于证据的指导策略，如接纳与承诺指导（ACC），直接管理学生的MPA，就是这样一种方法。基于之前一项研究的成果，在该研究中一名声乐教师对一名患有严重MPA的音乐剧学生实施了ACC，我们采用混合方法设计，对六名与声乐表演相关的MPA表演艺术学生样本，试行一个为期六节的团体ACC课程的效果。这里的指导教师也是一名没有临床背景的声乐教师，她接受临床心理学家的ACC培训时长（8小时）与前一位教师的（7小时）相近。与那名音乐剧学生类似，这些学生报告称，他们与MPA相关认知的融合程度显著降低，对MPA相关生理症状的接受度更高，总体表演时心理上更加灵活，并且这些改善在3个月后仍得以保持。此外，他们似乎减少了对患有MPA的羞耻感，并改变了彼此之间的思维方式。值得注意的是，这些改善与七名患有MPA的声乐学生在接受临床心理学家的接纳与承诺疗法后的改善情况相似，但羞耻感降低幅度更大，对MPA的接受度更高，这表明一种非临床的团体ACC干预，包括支持性讨论以使MPA正常化以及挑战控制MPA的尝试，可能比个体心理治疗更有帮助。这些结果很有前景，表明对ACC进行简短培训（<10小时）可能足以让声乐教师为患有严重MPA的学生带来显著益处。
