Music Therapy and Medicane

American Music Therapy Association, Inc. 8455 Colesville Road, Suite 1000, Silver Spring, MD 20910 (301) 589-3300 fax (301) 589-5175 email: [email protected] website: www.musictherapy.org

MUSIC THERAPY AND MEDICINE

I certainly think that every institution should have its music therapy and its music therapists. - Oliver Sacks, MD, Neurologist

What Is Music Therapy?

Music Therapy is the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program. It is an established health service similar to occupational therapy and physical therapy and consists of using music therapeutically to address physical, psychological, cognitive and/or social functioning for patients of all ages. Because music therapy is a powerful and non-invasive medium, unique outcomes are possible. In addition to its applications with hospital patients, music therapy is used successfully with persons of all ages and disabilities.

How Does Music Therapy Make A Difference For Medical Patients?.

Music therapy has been shown to be an efficacious and valid treatment option for medical patients with a variety of diagnoses. Music therapy can be used to address patient needs related to respiration, chronic pain, physical rehabilitation, diabetes, headaches, cardiac conditions, surgery, and obstetrics, among others. Research results and clinical experiences attest to the viability of music therapy even in those patients resistant to other treatment approaches. Music is a form of sensory stimulation, which provokes responses due to the familiarity, predictability, and feelings of security associated with it.

What Do Music Therapists Do?

Music therapists use music activities, both instrumental and vocal, designed to facilitate changes that are non-musical in nature. Music therapy programs are based on individual assessment, treatment planning, and ongoing program evaluation. Frequently functioning as members of an interdisciplinary team, music therapists implement programs with groups or individuals addressing a vast continuum of outcomes, including reduction of pain and anxiety, stress management, communication, and emotional expression.

What Can One Expect From A Music Therapist?

Music therapy utilized in a medical setting complies with the expectations and requirements inherent in the medical model of treatment. Professionally trained music therapists design and utilize individualized music experiences to assess, treat, and evaluate patients. Music therapy patient objectives are specific and relevant to medical diagnosis, course of treatment, and discharge timeline. Benefits are described in medical, and not musical, terms.

Through a planned and systematic use of music and music activities, the music therapist provides opportunities for: Anxiety and stress reduction Nonpharmacological management of pain and discomfort Positive changes in mood and emotional states Active and positive patient participation in treatment Decreased length of stay In addition, music therapy may allow for:

Emotional intimacy with families and caregivers

Relaxation for the entire family

Meaningful time spent together in a positive, creative way

Who Is Qualified As A Music Therapist?

Graduates of colleges or universities from more than 70 approved music therapy programs are eligible to take a national examination administered by the Certification Board for Music Therapists (CBMT), an independent, non-profit certifying agency fully accredited by the National Commission for Certifying Agencies. After successful completion of the CBMT examination, graduates are issued the credential necessary for professional practice, Music Therapist-Board Certified (MT-BC). In addition to the MT-BC credential, other recognized professional designations are Registered Music Therapists (RMT), Certified Music Therapists (CMT), and Advanced Certified Music Therapist (ACMT) listed with the National Music Therapy Registry. Any individual who does not have proper training and credentials is not qualified to provide music therapy services.

Where Do Music Therapists Work?

Music therapists offer services in medical hospitals, skilled and intermediate care facilities, rehabilitation hospitals, adult day care centers, senior centers, hospices, psychiatric treatment centers, drug and alcohol programs, schools and other facilities. In the medical setting, music therapists work with a variety of patient needs, and may work in many different hospital units, including ICU, NICU, Pre- and Post-Op, surgery, chronic pain management, cardiac care, obstetrics, emergency, pediatrics, physical rehabilitation, and outpatient programs. Some therapists are self-employed and work on the basis of independent contracts, while others are salaried hospital employees.

How Does Music Therapy Help Patients And Health Care Staff?

Dr. Walter Quan, Jr., Oncologist-Hematologist of St. Luke's Medical Center in Cleveland, Ohio, attests that:

"Music therapy has a wide range of applications. We see some patients whose blood pressure does come down and seems to stay down through regular use of music therapy. Another important aspect is the use in the labor and delivery room. We know that patients, who go through Lamaze training for instance, can also use music therapy to help them relax and to have pain relief in terms of labor pains." Music therapy is quantifiable and qualitative. Dr. Quan continues: "[I]n general as a physician you only use those things that you can measure or that have a number related to [them]& but there are a number of disciplines, and music therapy is one of them, where there is a qualitative effect which can give a lot of benefit for patients." Music therapists complete assessments for each patient and collect extensive data in order to write a complex patient history and develop a client-centered treatment plan. The music therapist is then able to evaluate the patient during the course of treatment. All of this contributes to the quantifiability of music therapy treatment.

Music therapy interventions are favored for the ability to meet quality of life needs. As quality of life issues and patient choice are pushed to the forefront of the national healthcare agenda, music therapy is being increasingly recognized for its unique contribution to patient quality of life.

Music therapy can help to relieve pain and reduce stress and anxiety for the patient, resulting in physiological changes, including:

Improved respiration

Lower blood pressure

Improved cardiac output

Reduced heart rate

Relaxed muscle tension

Music therapy has been shown to have a significant effect on a patient's perceived effectiveness of treatment, self reports of pain reduction, relaxation, respiration rate, behaviorally observed and self-reported anxiety levels, and patient choice of anesthesia and amount of analgesic medication.

Why Music Therapy?

William Frohlich, President, Beth Abraham Health Services in New York, talks about music therapy as part of the total treatment modality:

"I think that the therapist plays an integral team role when you are talking about a team of physicians, a team of nurses, therapists, physical or occupational therapists and so on& included in that team needs to be a music therapist. The observations where a patient may be singing where they could not speak before or they may be walking or dancing where they could not move before - that is important for the music therapist to bring to the occupational therapist or physical therapist to become part of the total treatment modality." Dr. Walter Quan, Jr., Hematologist-Oncologist, St. Luke's Medical Center in Cleveland, Ohio, on music therapy in the treatment of cancer:

"The mind/body relationship is particularly important in terms of looking at the immune system to treat cancer. We believe that patients who are under less stress, who are in a brighter mood, appear to do better in terms of their anti-cancer therapy. I think that music therapy and imaging and immune therapy of cancer all tie together... I think it can be helpful in conjunction with biologic therapy for cancer. A study done just relatively recently on cancer patients showed that approximately three quarters of cancer patients that had their usual pain medicines but also had the additional music therapy experienced less pain then previously... Music therapy in helping patients relax could possibly be beneficial in raising the innate immune system which could have therapeutic implications for cancer."

Susan Shurin, M.D., Chief of Pediatric-Hematology, Oncology at the Ireland Cancer Center in Cleveland, Ohio, comments on the effectiveness of music therapy in treatment of neurological impairments:

"Music therapy enables people to sometimes put words together in ways that are hard for them to do otherwise. &[I]t often seems to be easier if [the patient] has the rhythm and cadence that comes along with music. Particularly with people with certain kinds of neurological deficits I think that [music therapy] can be very helpful. The music seems to get through to the patient and in many ways it enables [the patient] to get through to us which [may be] very hard to do with any other modality."

Joseph Arezzo, PhD, Vice Chair, Department of Neuroscience, Albert Einstein College of Medicine, New York, talks about music therapy's role in restorative neurology:

"[T]he degree to which function can be recovered is phenomenal and we are just tapping into the extent that we can get recovery following stroke or injury or disease. We hope that music might play a particularly important role in helping [the regeneration of] those cells, in helping the individual learn to interpret the pattern and essentially to help that person learn again."

What Is AMTA?

The American Music Therapy Association (AMTA) represents over 5,000 music therapists, corporate members, and related associations worldwide. AMTA's roots date back to organizations founded in 1950 and 1971. Those two organizations merged in 1998 to ensure the progressive development of the therapeutic use of music in rehabilitation, special education, and medical and community settings. AMTA is committed to the advancement of education, training, professional standards, and research in support of the music therapy profession. The mission of the organization is to advance public knowledge of music therapy benefits and increase access to quality music therapy services. Currently, AMTA establishes criteria for the education and clinical training of music therapists. Members of AMTA adhere to a Code of Ethics and Standards of Practice in their delivery of music therapy services.

Related Resources Available from AMTA:

Medical Music Therapy, Edited by Jayne M. Standley 2005. ISBN #1-884914-14-4

Music Therapy in Pediatric Healthcare, Edited by Sheri L. Robb 2003. ISBN #1-884914-10-1

Clinical Guide to Music Therapy in Adult Physical Rehabilitation Settings, Written by Elizabeth H. Wong 2004. ISBN #1-884914-11-X

Music Therapy with Premature Infants, Written by Jayne M. Standley 2003. ISBN #1-884914-09-8

Music Therapy & Medicine, Edited by Cheryl Dileo 1999. ISBN #1-884914-00-4

How Can You Find a Music Therapist or Get More Information?

American Music Therapy Association 8455 Colesville Road, Suite 1000 Silver Spring, MD 20910 Phone (301) 589-3300 Fax (301) 589-5175 Web: www.musictherapy.org Email: [email protected]

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