'Well, sure, maybe just a few minutes of music."
This is the typical response I hear from patients when I offer them a music therapy session. Usually their initial hesitation leads to a visit lasting up to an hour, which may be followed by many more sessions.
As a music therapist, I work in an urban cancer centre, a residential hospice and a long-term care home. I move from inpatient units to outpatient appointments to staff support sessions lugging my keyboard, Tibetan singing bowls, an ocean drum and perhaps a fiddle and a guitar. Referred by a patient's health-care team, I provide music therapy to help manage pain, anxiety and other symptoms, to promote relaxation; to aid in the regulation of breathing, blood pressure and heart rate; to improve mood, to allow creative self-expression and to facilitate communication. I work with cancer patients at all stages of disease progression, from diagnosis and treatment to those who are receiving palliative care.
While the use of music to aid in physical, emotional and psychological well-being is an ancient concept, the formal practice of music therapy began in the 1970s. A growing body of research shows that the skillful use of music and musical elements, within a therapeutic relationship, can help promote, maintain and restore health. Music therapists now work in an increasing number of health-care settings, including hospitals, nursing homes and rehabilitation centres.
Music therapy embodies the notion that human beings are inherently musical, which is evident in the rhythms of their physiology (such as the heart beat and respiration) and melodic intonation of the voice and breath. No prior experience with music or musical instruments is required to benefit.
Music therapy can take many forms, including:
The music therapist can play familiar or improvised music, choosing based on the patient's needs and goals of care. The tempo of the music may be slowed to match the patient's respiration rate and help reduce anxiety, or may be increased to promote wakefulness. Patients can benefit even if they are not well enough to respond.
Patients and family members can play instruments, improvise with their voices or sing familiar and comforting songs, or create a rhythm on a drum. A music therapist can play in tandem, providing a musical backdrop.
Supported by a music therapist, patients can write original songs about their experiences with illness and treatment. These songs are often written as gifts or legacy pieces for family members and friends, or as opportunities for expressing oneself creatively in the midst of a difficult journey.
Lyrics can be an interesting and useful topic of conversation. They can evoke nostalgia and spark cathartic conversations and reflections in the midst of challenges and changes.
Music can be a valuable tool in difficult health-care situations alongside traditional medical interventions. When a music therapist is not available, music strategies can still be part of a treatment and support plan.
Patients can listen to music while being treated at home or in a hospital room, alone or with family and friends, providing a sense of familiarity and normalcy within a clinical setting. Playlists with meaningful or comforting songs can help elicit memories or create a calm environment. Conversations about favourite songs or styles of music can be invigorating and engaging or relaxing and soothing. Sometimes even the gentle humming of a lullaby at the bedside can provide support that transcends words.
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SarahRose Black is the music therapist at Princess Margaret Cancer Centre, University Health Network, Kensington Hospice and Kensington Gardens Long-Term Care Home. You can follow her on Twitter @sarahroseblack.