Developing a wellbeing program for adolescent popular music students-considerations for an initial draft. Part One-Research Portfolio Introduction and Rationale This paper will identify effective ways to support wellbeing in the Further Education (FE) college environment. It will result in the creation of a draft wellbeing program aimed at popular music students aged 16 to 19. An integrative review of the current literature offering interventions to improve musicians’ wellbeing will be carried out. The findings will be considered alongside theoretical frameworks of wellbeing and current best practice to arrive at a draft wellbeing program. A feminist social constructivist methodological lens (Wigginton & Lafrance, 2019) will be used to ensure the wellbeing program includes female musicians. In my position as the only female teacher on the music team at The Manchester College, an FE college in Greater Manchester (GM), I am conscious of gender bias in both music education (Davies, 2019) and the music industry (Raine & Strong, 2019). I will utilise my position as a feminist researcher to challenge these conditions in my working environment and enable equitable chances for success for all my students regardless of gender. Adolescent Wellbeing Whilst preparing students with the skills to meet the demands of working life (Higdon, 2018), it is also important to consider how they will cope with these demands emotionally (Mahoney et al., 2021). The wellbeing of children in GM is measured in the annual ‘BeeWell’ (2023) survey with recent results indicating a significant decline in wellbeing between year 8 and 10. Year 10 students expressed lower levels of life satisfaction and higher levels of stress (BeeWell, 2023) and life satisfaction has also been found to decrease over the course of adolescence (Reuter et al., 2022). Findings from a UK wide study concluded that one in four 17- to 19-year-olds had a probable mental health disorder (Newlove-Delgado et al., 2022). Furthermore, the Child and Adolescent Mental Health Service (CAMHS) reported a 70% rise in referrals and a 40% rise in urgent referrals in the GM region following the Covid-19 pandemic (Manchester City Council, 2022). When taken collectively these statistics suggest that the wellbeing of young people in GM is of concern, particularly in later adolescence (Newlove-Delgado et al., 2022). Public Health England and The Department for Education (2021, pp.9) describe the responsibility of colleges to ensure the wellbeing of all students with a curriculum that promotes “resilience, social support and emotional learning”. Following this directive, my college signed up to the Association of Colleges ‘Mental Health and Wellbeing Charter’ (AOC, 2019). However, the college’s focus is on general wellbeing and does not offer support specific to a career in music which I intend to address within this work. I believe we need to offer career specific wellbeing support and advice (Hofmann, Gander and Ruch, 2018). Musicians’ Wellbeing Challenges Adolescents face the uncertainty of career choices, the demands of the labour market, and how they may achieve their occupational ambitions during the later years of their schooling (Reuter et al., 2022). For those considering a career in music, this unpredictability may be even more severe due to the inherent competitiveness of the industry (Thomson, 2013). Since the introduction of music streaming, sources of income for musicians have become more diverse (Haynes & Marshall, 2018). Hesmondhalgh et al. (2021) found that just 0.4% of musicians in the UK make a manageable livelihood from streaming, suggesting that musicians must look beyond recorded music for a sustainable living. For this reason, the occupation of musician is no longer confined to the traditional activities associated with the job. A musician may write, record, and perform music, but also carry out unpaid supplementary roles such as graphic designer, content creator, promoter, social media manager and more (Haynes & Marshall, 2018). In addition to these roles a musician’s working life may involve more than one job and employer and a variety of self-employed positions including function gig performer, teacher, and session musician (Comunian et al., 2014). The term ‘portfolio career’ has become a popular way to express the different methods in which musicians earn income (Teague & Smith, 2015). The requirement for a wide base of, seemingly disparate, skills could potentially impact upon the wellbeing of musicians bringing an additional layer of pressure to the working environment (Vermeersch et al., 2023). Most professional musicians in the UK are self-employed (IPSE, 2020) giving rise to challenges including, the precarity of work (Sutherland et al., 2019), irregular working patterns (Detari et al., 2020), work-life balance (Hancock et al., 2021), lack of sick pay and the maintenance of a good reputation to ensure future employment (Stanhope et al., 2022). These conditions have been found to impact musicians’ wellbeing in several studies (Ascenso et al., 2016; Visser et al., 2021; Ong and Takenaka, 2021), however recent research into graduate musicians has found they are not well prepared for the music industry (López-Íñiguez & Bennett, 2020; Pecen et al., 2018; Perkins et al., 2017). It has been suggested that giving musicians the skills to cope with the exigencies of the vocation should be included in teaching from the earliest opportunity (European Commission, 2023; Musgrave, 2023). There is a growing call for improvements to wellbeing education for musicians with a recent think tank concluding that music educators should be trained in health and wellbeing strategies to ensure it is at the core of music education (BrittenPearsArts, 2022). Wellbeing challenges in adolescence viewed alongside wellbeing challenges experienced by musicians present a strong argument for wellbeing support in FE music studies and the creation of a specific program. Wellbeing in Music Education Currently, there is only one mention of mental health and wellbeing in the BTEC specification for the level 3 course I teach, appearing far down a list of suggested content in a section called “developing professional skills” (Pearson, 2018. pp.20.) Whilst wellbeing for musicians is well documented both in the academic world (Musgrave, 2023) and in the world of professional musicians’ organisations and bodies (BAPAM, 2023; Help Musicians, 2023; Music Mind Matters, 2023) it appears that this has yet to filter down to college level. This gap needs to be addressed so that young musicians can both survive and thrive in their future professions. This study will allow me to develop additional knowledge and resources that will influence my teaching practice both broadly across all my teaching and also in the creation of a draft wellbeing program. I plan to bring new teaching materials into the music department and my college and hope to influence the practice of my colleagues by calling attention to the wellbeing challenges our student musicians may experience now and in their future careers. Once completed, this program will be delivered at my college and shared with other 16 to 19 institutions. Feminist Research A further concern of this paper is to ensure the wellbeing program considers the experience of female adolescent musicians whom I identified in previous research as more likely to lack confidence, suffer from general and music performance anxiety, and have perfectionist tendencies (Fortune, 2023). Gender inequality in the music industry persists (Raine & Strong, 2019), with recent research identifying the lack of female performers, songwriters, and producers (Smith et al., 2021), that women get less radio airplay than men (McCormack, 2017), tend to have briefer careers (Leib, 2013) and earn less royalties (Strong and Cannizzo, 2017). Given this gender bias and the wellbeing challenges females experience in adolescence it is crucial that we provide support that empowers more females to enter the industry with the skills and resilience to succeed. The use of a feminist social constructivist methodological lens (Wigginton & Lafrance, 2019) to deconstruct the research around wellbeing for musicians will be utilised to ensure inclusion of female as well as male students. Project Outline This paper will begin by looking at theoretical, best practice and methodological influences, followed by an exploration of the literature review methodology and then aims and objectives will be identified. A critical reflection of the learning process is established and finally, a review of the literature is presented offering conclusive insights on the essential elements of a wellbeing program for 16 to 19-year-old popular music students. Planned Programme of Study Theoretical Influences There is no one definition of wellbeing, beyond that it is multifactorial and contains several elements (Vella et al., 2019). Whilst there is disagreement as to wellbeing’s composition, it seems that optimal human functioning is at its heart (Jarden and Roache, 2023). One accepted model of wellbeing is that of Seligman (2011) who posited that positive emotions, engagement, relationships, meaning and accomplishments (PERMA) are the main elements of wellbeing. The initial intention was to use the PERMA framework (Seligman, 2011) due to its recent use as a lens for investigating wellbeing in musicians (Ascenso et al., 2017; Ascenso et al., 2018), however, critics of PERMA suggest there may be more to wellbeing that just the five elements. In the growing study of Positive Organisational Psychology (POP; Martin-del-Rio et al., 2021) concerns over the PERMA framework and its applicability to the workplace have been raised. Donaldson et al. (2022) suggest that PERMA misses out some important elements of wellbeing when considered in relation to work and put forward PERMA +4 with the additions of physical health, mindset, working environment, and economic security. In the vocational context of this paper, these additional elements suggested by Donaldson et al. (2022) require consideration. Also relevant are models of adolescent wellbeing and how they may differ from PERMA (Seligman, 2011) and PERMA +4 (Donaldson et al, 2022). The World Health Organisation and the United Nations have worked together to create a framework (Ross et al., 2020) that defines and measures adolescent wellbeing and propose the following five domains: 1. good health and optimum nutrition, connectedness. 2. positive values and contribution to society. 3. safety and a supportive environment. 4. learning, competence, education, skills, and employability. 5. Agency and resilience (Ross et al., 2020, pp.474-475). Avedissian and Alayan (2021, pp.359) suggest the defining attributes of wellbeing for adolescents are, “autonomy, connectedness, competency and optimism”. There are many similarities in the chosen elements of wellbeing given in both PERMA (Seligman, 2011), PERMA +4 (Donaldson et al, 2022) and the two adolescent frameworks (Ross et al., 2020; Avedissian & Alayan, 2021). Bringing them altogether could result in the following: • Positive emotion/Optimism/Positive Values • Engagement/learning • Relationships/Safety/Supportive environment/ Working Environment • Meaning/Contribution to society/Connectedness • Accomplishments/Competence/Skills/Education/Employability • Mindset/Autonomy/Agency • Physical Health/Good Health/Optimum Nutrition • Economic security All but the last element on this list is present in at least two frameworks. Economic security comes from the POP research carried out by Donaldson et al. (2022) and whilst they are relevant to occupational wellbeing, there seems to be less immediate relevance for adolescents, hence its omission from the adolescent frameworks. However, economic security has been found to be of great concern to adolescents with almost half of the 16-to 24-year-olds surveyed in a recent UK study experiencing financial precarity (Strong & Webster, 2022). For this reason, I will look for evidence of economic security in the literature around musicians’ wellbeing and consider its inclusion in my wellbeing program outline. Looking further at the remaining elements; accomplishments, competence, skills, education, employability, and learning are all part of education. These elements may warrant further research elsewhere, but for the purposes of the forthcoming literature review and wellbeing program outline they have also been omitted, since the development of these areas are already occurring in FE. By combining the elements of wellbeing above, those that have been selected for consideration are: • Positive emotion • Positive values • Engagement • Relationships • Connectedness • Mindset • Agency • Economic security • Physical health. These elements will be used to categorise and analyse the research presented in the integrative review that follows and inform my wellbeing program draft. Best Practice Influences Arts and Music Organisations The Musicians’ Union (MU), instrumental in many important agreements in the industry, “is uniquely placed to provide a prism through which to view the professional lives of musicians” (Cloonan, 2014, pp. 10) and therefore an appropriate place to begin looking for best practice. The MU (2023) signposts its members to a variety of support services, which will be detailed further below, such as specialist audiologists, financial support, mental and physical health support, and emotional welfare. The British Association for Performing Arts Medicine (BAPAM, 2023) offer free clinics, advice, and training and maintains a directory of health practitioners. They also advise performing arts organisations on how to support the wellbeing of their workforce. In their ‘How to Prioritise Self Care When Working in Music’ series of online training sessions, they cover topics such as anxiety, managing stress, sleep, body image and authenticity (BAPAM, 2023). Music Mind Matters (2023) run a 24/7 helpline for musicians experiencing mental health difficulties or other concerns such as bullying and harassment. Help Musicians (2023) offers discounted audiological assessments and subsidised custom hearing protection for professional musicians and signposts to other sources of support. Tonic Rider (2023) offers bespoke training including mental health awareness in the music industry courses and free webinars centred around musicians’ wellbeing on topics such as performance anxiety, emotional resilience, and substance use awareness. All these organisations support professional musicians and those studying at undergraduate or postgraduate levels. In summary, the wellbeing support available from arts and music organisations in the UK is as follows: • Mental health support-helpline (Music Mind Matters, 2023), Online courses (BAPAM, 2023), mental health in the music industry (Tonic Rider, 2023) • Bullying and harassment in the workplace-helpline (Music Mind Matters, 2023) • Physical health-free clinics, physio, signposting to experts in performance health (BAPAM, 2023), audiologists, and subsidised hearing protection (Help Musicians, 2023). These offers of support could be in response to the help requested by organisation members and in response to research, and as they exist in the professional world it would be prudent to look seriously at including them in my wellbeing program draft. Educational Establishments Music Conservatoires have long been viewed as where elite performers go for their training (Miller and Baker, 2007) and in the QS world rankings (2022) of universities delivering performing arts courses, six of the nine UK conservatoires (see appendix 1 pp.43) appeared in the top forty with four in the top ten. For these reasons, UK conservatoires have been investigated here as best practice influences. Six music conservatoires in the UK offer Alexander Technique (AT) training to all students and all nine offer mental health support in the form of mental health practitioners or a bespoke counselling service. The Royal College of Music (RCM) have created a compulsory first year degree module called Healthy Performer (RCM, 2020), addressing wellbeing as it pertains specifically to musicians. At The Royal Northern College of Music (RNCM, 2023), a health and wellbeing lecturer delivers sessions across all courses but there is not a specific wellbeing module like at RCM. There is little information as to the content of the Healthy Performer module at RCM or the wellbeing sessions at RNCM on their websites however, their involvement in the Conservatoires UK funded project Musical Impact (2017), comprising three studies around health and wellbeing of musicians, may have influenced their approach as the project involved two researchers from RNCM and five from RCM. Certainly, these two institutions are offering more wellbeing course content to their students than the other music conservatoires and significantly, it is part of the core content of their degrees. Collecting the wellbeing themes and activities being covered at UK music conservatoires and music colleges results in the following list: • Mindfulness. • Alexander Technique. • Physical health-preventing playing related injury. • Hearing health. It is interesting that most of the wellbeing support is centred around physical health, or at least this is the focus of the information shared online by these institutions. This begs the question of whether these institutions do not consider emotional wellbeing to be as concerning as physical wellbeing for their students or could it be that they are not sharing their wellbeing related support mechanisms for another reason, such as gatekeeping what they have created for themselves. Another possibility could be that time and resource limitations mean that decisions must be made as to how the most impact can be made for most students, and this has led to the current offerings of wellbeing support. Without further investigation it is hard to know the answers to these questions however, the choices these institutions seem to have made will influence my draft wellbeing program by offering some indicative content from the list above. When this draft program is refined during my module six project, the questions raised here will form part of the investigation into popular musicians’ wellbeing. It could be seen as predictable that where the research is taking place, in the HE environment, is where we see innovative approaches to wellbeing support for musicians such as those at RCM and RNCM. What is less predictable is how this research and new information is filtered down to younger musicians and their teachers at colleges and schools. I was unable to find evidence of wellbeing support specific to popular musicians before undergraduate study in the UK. One potential reason for this is that dissemination of research is poor (Edwards, 2015) to popular music educators in colleges. Methodological influences Joyappa and Self (1996) argue that women have historically been excluded from the academic world and so the research used to construct new knowledge is both androcentric and misrepresents the experiences of women. This could also be said for women’s experiences in the music industry; the current source of a UK government inquiry into misogyny (House of Commons, 2023). During an inquiry interview, well known DJ Annie Macmanus stated; “The music industry is a boy’s club […] the system is kinda rigged against women” (House of Commons, 2023, p.6-7). The domination of males in the industry negatively impacts the classroom with women remaining underrepresented and gendered roles practised and repeated (Davies, 2019). For this reason, it is critical that feminist research is carried out in music education and the music industry. If we are to upend the prevailing order, we must begin to address gender issues at the sources of music education (Davies, 2019). Gould (2011) asserts that using feminist methodological lenses allows for critique of research to not only consider what has been found but also what has not and what these omissions could mean. Feminist social constructivism considers there to be many and multiple truths, arguing that we create reality and, in turning to language, challenge the dominant powers to encourage resistance to oppressive systems (Wigginton & Lafrance, 2019). A researcher may consider the discourse surrounding an area of interest and how ideas are represented and constructed (Lombardo & Kantola, 2021). From this epistemological position, my research takes place. In the literature review that follows, a feminist lens will be used to allow for rhizomatic analysis (Deleuze & Guattari, 1987) with the express aim of positively impacting classroom praxis. Literature Review Methodology An integrative literature review has been chosen for part two of this paper since its form gives the opportunity to critically analyse a field of research and synthesise the literature (Elsbach & Van Knippenberg, 2020). In assessing the subject area, a researcher gathers existing knowledge to interpret it in new ways (Torraco, 2016). As the aim of this review is to bring together findings around wellbeing for musicians and wellbeing in adolescence, this collecting and interpreting of the field of research is appropriate. Callahan (2010) suggests that well-written integrative reviews should detail the search processes and inclusion and exclusion criteria to create a clear and meaningful methodology. To do this one must plan and execute the review with an organised and considered method, using tables and search maps accordingly (Torraco, 2016). Search Strategies Figure 1 details the search strategies employed including inclusion and exclusion criteria and key word searches. A period of the last five years was chosen to focus this search of peer reviewed papers. The COVID 19 pandemic negatively affected musicians’ wellbeing (Cohen and Ginsborg, 2021) and the music industry in many ways (Hu and Kim, 2022) so research closer to this period will better reflect the current wellbeing status of musicians. Following a round of exclusions based on paper titles, a more detailed assessment of the literature using the abstracts was performed and papers that did not give specific recommendations for improving the wellbeing of musicians were excluded. An evaluation of the reference sections of included articles was also carried out to ensure no relevant literature was missed. This process revealed one additional paper not found in the database searches. In total eight studies were identified for inclusion in the part two integrative literature review. All included papers were then categorised by the wellbeing elements identified in the theoretical influences section above (see appendix 2, pp.45). Figure one-Search Process Learning Outcomes Aim: To enhance the wellbeing of my students through the creation of a draft wellbeing program designed for adolescent musicians studying popular music. Secondary Aim: To ensure my female students are considered in the creation of a wellbeing program by reviewing the literature through a social constructivist feminist lens. Objectives: *To develop an understanding of the factors that impact wellbeing in adolescents and musicians by reviewing the available literature. *To identify the most appropriate content for a wellbeing program for adolescent musicians. *To create a program draft that will be used to inform further study in Module 6. Expected outcomes: * A draft wellbeing program that incorporates the relevant research and supports the development of healthy adolescent musicians. *A draft for a wellbeing program that can be further modified and reflected upon in my module 6 research project. I used a GANTT chart as an organisational tool to effectively manage my progress (Wilson, 2003) throughout the process of writing this paper (see figure 2) Figure 2-GANTT Chart Ethical Considerations There are several ethical issues which require consideration for this research paper. Firstly, it may be that specific training or skills are needed to deliver these sessions. As we have seen, it is common for Alexander Technique (AT) to be taught at music conservatoires in the UK and many have permanent, full time, AT teachers employed to work with their students (See RCM, RNCM, The Royal Birmingham Conservatoire and Leeds Conservatoire). In the FE environment where funding is significantly lower and has experienced a growing funding gap compared to Higher Education (HE) and schools since 2011 (Orr, 2020) it is highly unlikely that training current staff or employing staff with the skills to deliver this kind of intervention is possible. Therefore, ethically, it is important to question what can, and what cannot be safely delivered by a music teacher. In the case of this research paper, any wellbeing intervention that requires specific training will be considered as an optional addition to the program draft, should funding and training allow it. This will give the opportunity to share the program more widely with those who may have the skills to deliver these kinds of interventions and offer a level of ambition in the long term for a program that is not restrained by lack of funds. A second ethical issue is that of agency and power of adolescents. Children and young people have very little political voice or agency, which means that adults with power are entrusted with ensuring their wellbeing needs are met (Mastroianni, Kahn and Kass, 2019). For later adolescents, this may cause conflict as their need for agency and autonomy grow (Ross et al., 2020; Avedissian & Alayan, 2021). For this reason, an initial draft for the program is being created, following with the plan to consult adolescent music students as to their opinions of the program contents. Finally, the demands upon the students must also be considered with specific attention to whether the planned activities will be effective and if there are other, less demanding alternatives that exist (Mastroianni, Kahn and Kass, 2019). In the realms of feminist ethics of care, this would be considered part of the interdependent relational experience of caregiving (O’Riordan et al., 2023), where responsibility is both a practice and a disposition (Tronto, 2013). Critical Review The “Me, My, More, Must” (Wareing, 2017) model of reflection was chosen for this critical review because it was designed specifically for practice-based settings where this paper is situated. It is a values-based model of reflection recognising the values inherent in an organisation and individual as part of the reflective process, and it places the practitioner central to the reflective process with the first step of the model being an examination of self (Wareing, 2017). This self-examination reflects feminist social constructivist practice, in which the researcher is recognised as part of the process of knowledge construction (Wigginton & Lafrance, 2019). Me I have been a teacher of popular music at an FE college for nearly twenty years. Over that time the number of women in my department has reduced from five to one, with me being the only female teacher for the last five years. I have felt the inequity of the situation keenly, experienced unconscious bias (Ross, 2008) and noted that students are more likely to come to me to discuss their personal issues. On some level, there is a power in this position that I recognise, especially regarding my uniqueness (Bekmezci et al., 2022). However, I miss women to share the teaching experience with, and at times the extra responsibilities of care sought by my students can become overwhelming (Castelao-Huerta, 2023). I also work professionally as a musician, almost exclusively with men. This reveals the intersection within which my work as a feminist researcher, teacher and musician resides (Harcourt et al., 2022) and I must recognise that position for both its positive and negative implications. During this module, I have explored feminist methodology in more depth and found that carrying out feminist research does not mean only considering the female experience but looking at how we can create a more equitable life experience for everyone (Landman, 2006). I was forced to recognise the resentment I have for my position and that of all females in the music industry and music education, however, the research process has allowed me to explore these feelings. Employing a feminist methodology not only places my epistemological position front and centre but also gives me some form of control over the injustices I perceive (Harcourt et al., 2022). This has been an empowering experience. My I have been surprised to find my assumptions challenged particularly when it came to the wellbeing element of economic security. My initial response to this element put forward by Donaldson et al. (2022) was that this would not be a concern for 16 to 19-year-olds and I initially planned to omit it from the research. However, when I looked for reasons why this would be a good decision, I found the opposite was true and that young people have been found to not only struggle with financial precarity but also their ability to support themselves becomes more precarious as they move into young adulthood (Strong & Webster, 2022). What I found interesting in this experience was that I know there are a high number of young people in the UK living in poverty (Lee et al., 2022), and this figure is especially high in Greater Manchester (Stone, 2023), but I had naively believed that this was not something my students worry about because this is not something they discuss with me. This has highlighted to me both my ingrained class bias (Bates, 2017) as a person who grew up with financial security and who has never really struggled in this way, and my ignorance. It occurred to me that this avoidance could be because it makes me feel uncomfortable, that I have financial security and others do not. I hold a position of privilege and have a feminist responsibility to recognise this (Evans and Lépinard, 2019). To address this, I will acknowledge the influence I have in student/teacher dialogue (Skidmore, 2006) and endeavour to open more discussions (Webb, 2009) around the different circumstances we grow up in. Including economic wellbeing in my program is a positive step towards a considered dialogue on this subject. More Writing this paper has not been easy. Considering the wellbeing of others has made me question my own wellbeing and identify some shortfalls in my ability to self-care (Easton, 1993). I have recognised that some elements feel especially important to me right now, such as accomplishments and meaning (Seligman, 2011), maybe because these are areas where my wellbeing is lacking. Skovholt & Trotter-Mathison (2014) suggest those in caring professions such as teaching are highly responsive and attuned to the needs of others, often putting others' needs before their own, which can result in burnout (Chang, 2009). This learning experience has alerted me to the very real prospect that my wellbeing is at risk, just in the same way as my students, and I should attend to this more readily and effectively (Newell & Nelson-Gardell, 2014). Must In future research, it is important to me that I continue to explore feminist methodology, with a view to both deepening my understanding and challenging gender norms in education and in my organisation (Davies, 2019). I must further develop my program draft into a course of study so that I can support my students to achieve success in their studies and their future music careers. I also hope to alert my organisation's attention to the need for these sorts of industry-specific interventions (Ascenso et al., 2017). In creating a wellbeing program for my music students, I can give them the agency they need to support their own wellbeing (Ross et al., 2020; Avedissian & Alayan, 2021) and in doing so take some of the pressure off myself to fulfil those caring responsibilities that could be independently achieved by my students themselves. This collective responsibility of care (Tronto, 2013), in recognition of the relational experience of wellbeing interventions, suggests individual attentiveness to our own emotional needs is an integral factor in the effective giving and receiving of care (McLeod, 2019). Part Two-Research Report Introduction This integrative literature review will provide an overview of the research on wellbeing for musicians from the last five years that met the inclusion criteria detailed earlier. It will also bring together relevant themes, and critically analyse findings. The theoretical influences described in part one of this paper; wellbeing elements from PERMA (Seligman, 2011), PERMA+4 (Donaldson et al., 2022) and the two adolescent wellbeing frameworks (Ross et al., 2020; Avedissian & Alayan, 2021) will be used as a thematic guide to deconstruct the findings. Following this, a feminist lens (Wigginton & Lafrance, 2019) will be applied to ensure the program outline actively includes female adolescent music students and collectively this will inform a draft for a wellbeing program for adolescent popular music students. Wellbeing Challenges for Musicians The next three papers (European Commission, 2023; Pecen at al., 2018; Rosset et al., 2022) assess wellbeing challenges for musicians and suggest specific interventions to improve wellbeing. The European Commission (2023) report on the health and wellbeing of professional musicians and creators sets out twenty one recommendations (See appendix…) of ways to better support music industry professionals. The recommendations cover policy making, to access to health care and sick pay and educational reforms that ensure wellbeing strategies are taught at tertiary level in music colleges and conservatoires (European Commission, 2023). The report identifies five specific risk factors around health and wellbeing: • Intrapersonal • Interpersonal • physical • work environment • societal (European Commission, 2023). The researchers note that most research into music creators’ health has been carried out with orchestral musicians and suggest that we can only have limited understanding of wellbeing issues experienced by musicians due to the lack of research participants working in diverse genres (European Commission, 2023). Consequently, the recommendations made must be viewed with some caution. The five risk factors identified could pose some influence on my program, despite the lack of genre diversity evident in the research, because they align with the some of the wellbeing framework elements discussed earlier in this paper using the same titles of working environment and physical health (Donaldson et al, 2022; Ross et al., 2020; Avedissian & Alayan, 2021; Seligman, 2011). The European Commission report (2023) does not reveal the methodology of the project or indeed how the data was dealt with to come to these risk factors and recommendations, so it is difficult to know if there is some bias or political agenda at play in the interpretation presented. However, the appropriateness of utilising these five risks in creating an outline for a wellbeing program could be confirmed as the remaining research is considered in this literature review. Pecen at al. (2018) conducted semi-structured interviews with 15 musicians at three different levels; pre elite, transitioning elite, and elite performers, to discover the wellbeing challenges they had experienced and how they dealt with them. The results found challenges to musicians’ wellbeing came under the following categories: bad teachers, environmental, professional, psychological, and physical (Pecen at al., 2018). Notably, transitions to conservatoire study were particularly difficult periods psychologically with competition, comparison and isolation frequently identified as causal factors (Pecen at al., 2018) suggesting calls for more support for musicians in this period is well warranted. Teachers that were overly controlling, negative and created co-dependent relationships were found to impact wellbeing and the conservatoire culture where environments were competitive, political and pressure filled were a source of challenge for all participants. Coping sources identified were good teachers, friends and family, self-help, humour, preparation, psychological strategies, health habits, and substances (Pecen at al., 2018). Discussion around substance use to manage wellbeing revealed that some participants had tried using drugs and alcohol in the past but were aware that they did not solve their problems and most participants were against drug and alcohol use (Pecen at al., 2018). Substance use is an important topic to discuss with adolescent music students as the working environment often means high levels of exposure to drugs and alcohol (Forsyth, Lennox and Emslie, 2016) and substance misuse in musicians is a cause for concern (Dobson, 2010; Visser et al., 2021; Miller and Quigley, 2011). Substance misuse often begins in adolescence (Kuhn, 2015) and so inclusion of substance use as a topic in the program draft is therefore appropriate. Whilst the transitioning elite and elite musicians were able to express psychological coping strategies clearly this was not as evident with the pre-elite musicians who were often unable to distinguish psychological skills from musical skills, suggesting a lack of understanding and knowledge in this area (Pecen at al., 2018). The researchers suggest interventions should be made prior to conservatoire study with an emphasis on preparing students for the transition into higher education and the wellbeing challenges this will bring (Pecen at al., 2018). Psychological skills, health, dietary advice, planning and organisations skills, objective evaluation, practice skills, goal setting, achieving positive performance experiences, and accessing social support were identified as important interventions (Pecen at al., 2018). This study was small with only 15 participants and so cannot be generalised. However, when considered alongside other research it may be that these findings can point towards a direction of travel for successful wellbeing interventions. Rosset et al. (2022) found in their longitudinal study of 62 music students’ attitudes to physical and mental health that much like Pencen et al’s (2018) participants, their first year undergraduate student participants struggled with the transition to conservatoire study and suffered psychologically. The researchers surveyed participants at the start of semester one and the close of semester two, finding that the 20 participants taking part in musicians health courses felt more confident in their knowledge of protective measures to support health in the second survey (Rosset et al., 2022). However, this knowledge was not found to result in those participants experiencing improved physical or mental health and so the researchers suggest that the embedding of taught skills into real life is of concern and should be a focus of future research (Rosset et al., 2022). This highlights an important consideration of how to foster student engagement with health and wellbeing programs and encourage the practice of healthy behaviours. To summarise, all three studies identified the need for wellbeing strategies to be taught before HE entry (European Commission, 2023; Pecen at al., 2018; Rosset et al., 2022) and collecting the wellbeing risks, factors and topics from the above studies results in the following list: • Risks-intrapersonal, interpersonal, physical, work environment and societal (European Commission, 2023). • Wellbeing factors-controlling teachers, competition, conservatoire environment, substance use and isolation (Pecen at al., 2018; Rosset et al., 2022). • Wellbeing topics- psychological skills, health, dietary advice, planning and organisations skills, objective evaluation, practice skills, goal setting, achieving positive performance experiences, self-help, accessing social support and the embedding of taught skills into real life (European Commission, 2023; Pecen at al., 2018; Rosset et al., 2022). Wellbeing for Musicians-Intervention Studies This next collection of five studies (Matei et al., 2018; Matei and Ginsborg, 2021; Árnason et al., 2018; Baadjou et al., 2018; Lee et al., 2019) tested wellbeing interventions and evaluated the impact on participants. Matei et al. (2018) studied 104 year-one undergraduates, studying at the Royal Northern College of Music (RNCM) in the UK. Participants completed a compulsory health education course which consisted of seven lectures and five seminars related to musicians’ health and wellbeing. Content was inspired by the Health Promotion in Schools of Music project recommendations (Chesky et al., 2006), existing literature on the health problems musicians experience, and existing health promotion courses (Matei et al., 2018). The course covered: MPA, performance-related musculoskeletal disorders (PRMDs), time management and practice strategies, behaviour change techniques, cognitive tools, and lifestyle behaviour such as sleep, nutrition, and stress management. The researchers assessed the effectiveness of the course using pre and post-test questionnaires and a control group of second-year undergraduates who had not taken the course (Matei et al., 2018). Consistent with the findings of Rosset et al. (2022), results indicated that whilst the test group felt more knowledgeable when it came to health promotion this did not result in behavioural changes such as using ear protection or other healthy behaviours (Matei et al., 2018). The researchers suggest that this could be because behavioural changes tend to take longer than cognitive ones (Matei et al., 2018). Research has identified the transition to university study for musicians is particularly difficult (Rosset et al., 2022; Pecen et al., 2018). Matei et al. (2018) identified MPA, life skills and behaviour change were of greatest import to their year one undergraduate participants by tallying the topics chosen by the participants in their reflective essays. The topic choices could reflect the most pressing wellbeing issues participants were facing at the time and so this could indicate a good starting point for my program. Placing these topics at the beginning of the program (when students are in the first year of FE) could allow plenty of time for taught elements to create behaviour change (Laverack, 2017) potentially resulting in a smoother transition to university study. The conservatoire where this research took place had the advantage of team members who could deliver specialist content such as a psychologist and performing arts medicine expert. In the first instance the program I create is unlikely to be funded so needs to be appropriate for music teachers to deliver without specialist support or training. Therefore, some topics, such as avoiding PRMDs may need to be delivered in the guise of awareness-building rather than practically to avoid potential harm to students. Matei and Ginsborg (2021) gathered qualitative data by interviewing twenty of the participants from their earlier health promotion study (Matei et al., 2018), to assess impact, limitations, and perceived benefits. They found that the course encouraged participants to engage with their health and that seminar sessions allowed for active discussion on health and wellbeing themes with participants expressing the opportunity to talk and listen to other’s issues as a positive factor (Matei and Ginsborg, 2021). The lecture series was criticised for the lack of specificity to instruments with participants voicing the worth of the seminars in contrast as there was more opportunity to explore specific challenges (Matei and Ginsborg, 2021). Initially, I had planned for the program to be delivered to whole classes of up to twenty-two students, but these findings suggest there may be more engagement in topics if small group seminars were included. A further finding from this study was that participants felt empowered by the course which gave them a sense of control over their health and wellbeing (Matei and Ginsborg, 2021). Agency is an important element of adolescent wellbeing as defined by Ross et al. (2020) and Avedissian and Alayan (2021) and it would seem the very act of delivering a course to students on wellbeing could result in them feeling a sense of control and autonomy and therefore positively impact their wellbeing. Matei and Ginsborg (2021) also asked their participants how they would change the health promotion course and some interesting responses were gained. Some participants felt that elements of the course were very personal, such as discussing mental health, and they felt these topics should be optional, others felt that there was not enough focus on solutions to their wellbeing challenges (Matei and Ginsborg, 2021). There were suggestions that more information would have been welcome on the topics of effective practising, health, and relaxation strategies among others (Matei and Ginsborg, 2021). The opportunity to lead or inspire the focus of future sessions in a program may be a welcome addition and could take the form of a mid-point review of the program. Additionally, consultation with students following completion of the draft program could be beneficial. This may also improve the participants’ feeling of agency (Ross et al., 2020; Avedissian & Alayan, 2021) and potentially have a positive effect on engagement with the program (Reeve and Tseng, 2011). Árnason et al. (2018) aimed to improve the body awareness and attitudes to health of their Icelandic music conservatoire participants. This intervention study involved a small group of thirteen participants taking part in a series of twenty sessions, sixteen of which were practical (Árnason et al., 2018). The lectures looked at physiology of the performing musician and the risk factors involved with PRMDs, and the practical sessions involved body alignment activities, warm-up routines and exercises around mobility and strengthening (Árnason et al., 2018). The findings concluded that these interventions can have a positive effect on body awareness during practice and activities in daily life and the number of participants carrying out warm-up exercises before playing increased (Árnason et al., 2018). One difficulty in utilising these findings in my program draft is that this course was delivered by a physical therapist and some of the interventions would require a trained professional to deliver them safely. As a singing teacher, I have a wealth of experience and knowledge around body alignment and warm-up routines so I could confidently deliver this content to singers without additional ethical concerns, but as I am not a trained physician I would not suggest specific strength or mobility exercises or attempt to diagnose or treat. In terms of other instrumentalists, it is possible some training would need to be sought to ensure warm-up activities could be tailored to their specific needs. As my students are at the very beginning of their studies, they may not have experienced PRMDs and so the activities I can safely deliver may have a preventative effect or at least raise awareness of the potential physical challenges a musician may experience. This raising of awareness has been found in both this study (Árnason et al., 2018) and that of Matei et al (2018) and both suggest it could have a positive effect on musicians in the future. By including information on the potential for PRMDs in musicians and some body alignment and warm-up activities in my wellbeing program, my students may feel more prepared for the transition to HE studies and begin their journey towards professional musicianship with some healthy practices in place. Baadjou et al. (2018) trialled a biopsychosocial prevention course with one hundred and seventy participant music conservatoire students with around half serving as a control group who received a physical activity promotion course. Those in the test group took part in the course PRESTO-Play. This course covered a variety of topics, very similar to that of Matei et al. (2018), from musicians’ health information, playing without pain, strategies to alleviate MPA and stress, health, and nutrition (Baadjou et al., 2018). The control group attended the course PRESTO-Fit which gave general information about improving physical health and participants were asked to walk 10,000 steps per day (Baadjou et al., 2018). Their results indicated that PRMDs decreased for both the test and control groups. There was a high dropout rate with only fifty-two participants left at the final monitoring point two years after the start of the study and whilst this is to be expected for this type of population, the researchers suggest this may have skewed results or at least mean that interpretations should be made with caution (Baadjou et al., 2018). The fact that the test and control groups saw significant reductions in PRMDs indicates that both interventions could be effective in improving music students’ physical wellbeing and when viewed collectively with the findings of Árnason et al. (2018) the inclusion of physical work around alignment and body awareness along with warm up routines would be appropriate content for my wellbeing program. The other elements of the PRESTO-Play course not related to physical health were not found to impact significantly on participants, however, it seems in the course content those elements related to emotional wellbeing were not given as much time in the delivery plan (see appendix…), and the focus was on body posture which featured in ten of the eleven sessions (Baadjou et al., 2018). Bodily alignment, like many physical adjustments, needs time and repetition to become automatic (Ludwig et al., 2018) and this may be why the researchers chose to include it in so many of the sessions. However, a more even spread of topics across the course could have brought different results and for this reason, I have chosen to spread topics more evenly across the wellbeing program (See appendix 3) in this initial draft. Lee et al. (2019) delivered a mind-body health intervention to 34 student musicians in which participants attended a semester of sessions which included mental and improvisation training, yoga, and physical therapy exercises. The yoga sessions included breathing exercises, mindfulness, relaxation training and yoga poses and participants were asked to complete twenty to thirty minutes of yoga daily (Lee et al., 2019). Physical therapy exercises were assigned individually by a personal trainer following an extensive assessment of physical weaknesses and participants were required to complete them for twenty minutes each day (Lee et al., 2019). Mental exercises included, mindfulness approaches and mental rehearsal and improvisation sessions were focused on a free approach to playing, without judgement (Lee et al., 2019). Participants were given pre and post-course physical assessments, completed a four-stage questionnaire, and had motion capture videos of their playing taken pre and post-course (Lee et al., 2019). Results indicated improvements in strength and endurance of the neck flexor and flexibility in the left pectoral, but researchers suggest the sixteen-week intervention was not long enough to see postural corrections and aerobic improvements (Lee et al., 2019). They also found a reduction in pain in participants (Lee et al., 2019). The results of the study focus on the physical changes, but there is little discussion of how the improvisation sessions, mental training and breathing and mindfulness in the yoga sessions impacted participants (Lee et al., 2019). Whilst physical gains were made, it is not clear how each of the interventions interacted to bring about these results and so it is difficult to say how the results were gained. It is also worth noting the requirement for participants to carry out up to an hour of personal yoga and physical exercises each day as part of the study. It is not clear if the researchers looked at how many of the participants completed these personal practice sessions and if they did, what impact they had on their results. The researchers in this study (Lee et al., 2019). had the advantage of a professional yoga teacher and personal trainer to deliver parts of the course and this is not something that would be available in an FE environment due to cost implications, however, there are sports science students at another campus and there could potentially be ways to collaborate with them. This could be an avenue for further research and development of my wellbeing program in the future. The similarities between the Lee et al. (2019) study and those of Baadjou et al. (2018), and Matei et al. (2018) suggest that a holistic approach to improving wellbeing for musicians can be effective. Whilst none of the studies were able to prove which interventions were most effective, they all provided some positive responses from participants. Health promotion and knowledge brought feelings of agency and control for participants (Matei et al., 2018; Matei and Ginsborg, 2021), strength and flexibility were improved (Lee et al., 2019), health-promoting behaviours were continued following the intervention (Matei and Ginsborg, 2021) and PRMDs were reduced (Baadjou et al., 2018). To summarise here is a list of the topics and potential strategies emerging from the three intervention studies discussed above. Topics • PRMDs • Time management and practice strategies. • Body Alignment strategies • Warm-up strategies • MPA strategies to alleviate. • Life skills and behaviour change. • Health promotion-nutrition, sleep, stress management, exercise, hearing health, yoga, breathing mindfulness, and relaxation. • Improvisation Potential Strategies • Small group learning opportunities. • Instrumental group learning opportunities. • Mid-Point review with participants to guide future program content. • Optional sessions. Improving wellbeing for adolescent musicians using wellbeing frameworks and best practices. There are several elements of wellbeing not addressed within the current literature outlined above. They are connectedness, positive values, relationships, and engagement (see Appendix 1-wellbeing elements table). There is also little mention of environment or economic security. Looking at the best practice evidence from educational establishments and arts and music organisations it seems the omission of these elements in the research does not mean musicians do not require support in these areas. Connectedness, Positive Values, Relationships and Engagement Healthy Conservatoires (2023) recognise the impact of relationships, connectedness, engagement and positive values on the wellbeing of musicians by including social wellbeing in their framework, in addition to this the fact that a bullying and harassment helpline managed by Music Mind Matters has had to be created suggests a need to discuss positive relationships in the music industry, what they look like and how a musician in trouble can access support. Avedissian and Alayan (2021) suggest that positive relationships form part of the social factors that are the antecedents of adolescent wellbeing and Ross et al. (2020) agree adding that connectedness and being part of a community adds to the feeling of being valued. Anecdotally, I see my students’ wellbeing suffer when they struggle to communicate their needs and their concerns with other students and their engagement in the course can suffer as a result. When positive relationships exist in the classroom, however, and a group value is evident, I see my students thrive, and engage and a group connection is achieved (Sidelinger and Booth‐Butterfield, 2010). For these reasons, whilst there are no interventions related to relationships, connectedness, engagement, and positive values in the literature outlined earlier, it is clear from this evidence that they are important elements of adolescent and musicians’ wellbeing and must be included in a wellbeing for adolescent musicians’ program. Whilst it may be difficult to ‘teach’ connectedness and engagement; healthy, respectful relationships and team ethic can potentially result in these positive outcomes (Ross et al., 2020). Economic Security There are only two papers in this integrative review that mention economic security, that of Matei et al. (2018) and the European Commission report (2023). This wellbeing element does not appear in the adolescent wellbeing frameworks, so at first, it could be seen as irrelevant to my program draft. However, as discussed earlier in this document, economic security is of great concern to adolescents (Strong & Webster, 2022) and in GM young people living in poverty is extremely high at 42% (Work and Skills Strategy, 2022). If we add to this the financial precarity experienced by professional musicians (Sutherland et al., 2019), and the challenges of self-employment such as lack of sick and holiday pay (Stanhope et al., 2022), it seems that to prepare young musicians for the realities of working life addressing economic security as a topic in a wellbeing program is an essential requirement. The Feminist Lens When considering the discourse (Lombardo & Kantola, 2021) evident in the research presented several factors were identified. Firstly, both male and female participants were present in every paper considered in this integrative review, however, results were all interpreted without gender differences measured. When turning to language (Wigginton & Lafrance, 2019) we find that in all included papers participants' responses are presented without recognition of gender differences suggesting a potential underlying assumption by the researchers that gendered differences in musicians’ wellbeing and responses to interventions did not require measurement. This is particularly interesting placed against historical research that has found female musicians to experience more challenges to their wellbeing than males in the forms of PRMDs (Leaver et al. 2011; Paarup et al., 2011; Arnason et al., 2014; Kenny & Ackermann, 2015) and MPA (Dobos et al, 2019; Fishbein et al, 1988; Kenny et al, 2014; Ginsberg, 2004; Abel & Larkin, 1990; LeBlanc et al, 1997; Coşkun-Şentürk, & Çırakoğlu, 2018). If female musicians experience more challenges to their wellbeing, I propose that this suggests a need to assess wellbeing interventions regarding their efficacy for females. Considering that general anxiety is higher in female adolescents than males (Needham, 2009; Moksnes et al, 2011; Torsheim et al, 2006), there is a strong argument that female-specific strategies may be required in a wellbeing program aimed at adolescent music students. What those specific strategies would be remains to be seen, although physical health (Lee et al., 2019), body alignment (Árnason et al., 2018) and strategies to reduce MPA (Matei et al., 2018) could be good starting points. The measurement of gender differences in intervention studies would improve our understanding and allow researchers to investigate both male and female viewpoints and experiences. As a focus of feminist research is to engender “human equity” (Merriam & Simpson, 1995. P135.), we have a responsibility to not only recognise the differences between genders but also ensure equal opportunities. If female musicians experience more challenges to their wellbeing, we should not only recognise that but try to mitigate it, so that achieving and maintaining a successful music career is just as achievable as for male musicians. One potential idea is for female-only wellbeing sessions to be offered so that female students can share and discuss in a ‘safe space’ (Lewis et al., 2015), however, this could then result in male students’ awareness of the issues relating to female wellbeing in the music industry being reduced, rather than discussed openly and made an issue for both male and female musicians to be responsible for. The problem of gender bias in the music industry is not just a problem for women (Davies, 2019) so opening the discussion around gender differences in the context of musicians’ wellbeing could be a good way to raise awareness among all music students. Gould (2011. P130) describes “shared decision-making and negotiation, increased student collaboration and independence” as some of the ways in which feminist pedagogy is enacted in the classroom. If we are to encourage these practices then we must open the discussion with our students (Isaeva et al., 2020) and ask them, what help they need to improve their wellbeing, what are the challenges they are experiencing and even more importantly, how would you like to be helped. This dialogue would not only support the development of curricula and the sharing of information but would also allow students agency as to how they wish to be supported, which has been identified as an important element of adolescent wellbeing (Avedissian & Alayan, 2021; Ross et al., 2020). Wellbeing Activities and Topics-Inclusion/Exclusion Decisions Wellbeing topics and activities evident in the literature are gathered in the table below. Inclusion/exclusion decisions are evident and reflect the findings of this study. Conclusion This study has resulted in a draft wellbeing program for 16 to 19-year-old popular music students (see Appendix 3) but it is in no way a finished article. By reviewing the available literature, theoretical and best practice influences a program draft and a list of appropriate topics for inclusion were created (See Appendix 4). Strategies around delivery were revealed, such as small group work, optional female-only sessions, instrumental group sessions and a mid-point review. To develop this outline into a full program there is still much work to be done. Topics have been chosen, but how these topics will be delivered to music students still needs to be decided and what content would be appropriate for each topic is still in question. Subsequently, it has become clear that the aim of improving wellbeing for adolescent popular music students is a much longer term endeavour than could be achieved in the scope of this module of study afforded. However, the result of this study is a starting point for the creation of a wellbeing program and has raised several questions about how we can better support female students’ wellbeing, involve our students in the process of program design so that have agency (Avedissian & Alayan, 2021; Ross et al., 2020) and can feel connected to their studies, and better understand how research can inform practice. Two areas of concern remain, the first is in creating a wellbeing program that is tailored to popular music students. No recent research includes popular musicians, so all the findings discussed here relate to the classical musicians’ experience. To truly create a program that meets the needs of popular musicians, research into their experiences of wellbeing needs to be carried out and the European Commission’s (2023) calls for more genre-diverse research should be taken seriously. The same can be said for ensuring the inclusion of female musicians in this wellbeing program. Whilst tentative suggestions have been made, without research that measures the female response to wellbeing interventions it is difficult to make any conclusive recommendations. The next step would be to refine the wellbeing program draft. This could be done by carrying out a review of the program draft and suggested topics with adolescent popular music students. Further research could look beyond the binary male, and female and consider how those in non-binary and trans+ communities may respond to wellbeing interventions for musicians and if their needs are being catered to effectively. Additionally, interviewing present, recent and past students to discuss their wellbeing now and how it has changed over time may bring new insights that can further clarify the wellbeing program contents and structure. I plan to carry out these interviews in a qualitative research project for my module six study.