Supporting continuing bonds for parents with infants with uncertain futures on neonatal units in the United Kingdom: co-designing a culturally sensitive music therapy intervention.

Introduction: Neonatal intensive care is a traumatic environment for parents, infants and staff. Services need to collaborate with their users to develop acceptable and sustainable support. Music therapy can have positive impacts on physiological and psychological outcomes for infants and has the potential to help create a supportive service environment. This study aimed to co-design a culturally sensitive music therapy intervention to support the development of continuing bonds for parents with infants with uncertain futures on neonatal units. Methods: An Experience-based Co-design approach was implemented to identify areas of challenge within neonatal units before designing solutions informed by a music therapy approach. Across four co-design meetings, six parents, five staff and three charity representatives worked collaboratively and co-analysed qualitative data to develop a culturally sensitive music therapy intervention. Results: Three themes were identified from the data: trauma, identity and staff-parent relationships. A logic model was constructed which guided the intervention development, leading to a trauma-informed intervention comprising a) a musical gift created by external family and friends supported by a music therapist b) parent and staff playlists c) a journal to guide use of music and encourage self-reflection and d) 'ask me' staff badges to start staff-parent conversations. Discussion: This is the first co-designed neonatal music therapy intervention. Through increasing social connections and promoting individuals' strengths, it has the potential to increase psychological safety for both parents and staff.