Reflections on supporting older couples in a long-term music therapy group when one partner has dementia

Introduction Facilitating any ageing group, that may include couples in which one partner lives with dementia, presents a unique challenge. This article reflects on the complex dynamics between the individual and the dyad relationships observed in a long-term music therapy group.Method This article draws on twenty years of clinical work with an ageing group, comprising over one thousand sessions. It is informed by ongoing clinical practice and reflective analysis of therapeutic encounters within a humanistic approach. Key moments in interactions between participants, couples, and the therapist were identified through clinical writing after music therapy sessions, integrating observations, therapist experience, and participant feedback. These reflections were revisited through extensive clinical notes, enabling identification of recurring relational patterns in couples and their development through practice-oriented writing.Results The group maintained strong consistency with the same music therapist and setting, creating a stable environment that supported the person with dementia in preserving a sense of continuity and integration. However, a paradox emerged: while participation benefits the person with dementia, it could trigger feelings of affiliate stigma in the spouse, negatively affecting well-being. Therefore, the therapist’s role is essential in managing these complex challenges.Discussion These reflections underscore the importance of a humanistic, reflexive clinical stance in managing dyadic needs in a group setting. This paper emphasizes that music therapy interventions must balance collective support for the person living with dementia with specific clinical attention to alleviating potential affiliate stigma in the partner.