1 Bridge Over Troubled Waters: Music Therapy Now Laura Cornelius MM, MT-BC, NICU MT Aliza Llovet Music Therapy Intern
2 Overview What is music therapy? Who is qualified to practice music therapy and where do they work? How is music therapy used within pediatric palliative care? What are the advantages of music therapy?
3 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.
4 Abbreviations to know mt- music therapy MT- Music Therapist MT-BC- Board Certified Music Therapist American Music Therapy Association CBMT- national certification board for music therapy AMTA- American Music Therapy Association
5 Where can Music Therapy be found? Senior Centers Nursing Homes Psychiatric Hospitals Rehabilitative Facilities Palliative Care/Hospice Medical Hospitals Programs Outpatient Clinics Correctional Facilities Day Care Treatment Centers Halfway Houses Community Mental Health Centers Schools Drug and Alcohol Programs Agencies Aiding Persons Private Practice with Developmental Disabilities
6 Music Therapy in Hospitals Music Therapy helps patients of all ages copes with a variety of needs: Chronic Illness/Disease Sensory Impairments Terminal Disease Chemical Dependency Neurological Disorders Labor and Delivery Developmental Disorders NICU specific needs Psychological Disorders Anxiety & Depression Grief/ Loss Issues Alzheimer's/ Dementia Emotional/ Spiritual Crisis Everyday Stress Chronic & Acute Pain
7 Music Therapy Interventions Musical Games and Live Music Stories Procedural Support Creative Music with Art Instrument Playing Song Writing Progressive Muscle Relaxation Music Video Creation Breathing Techniques Counseling
8 Live Music Music Therapists can play a variety of instruments including guitar, ukulele, piano, and more! Isn t that the same as bringing in a musician? GOALS: Procedural support, Increase relaxation, Decreasing anxiety, Normalize hospital environment
9 Benefits of Live Music One study found significant difference in anxiety, fear, fatigue, relaxation, and diastolic blood pressure when there was music therapy (Ferrer, 2007). Music therapy has been found to reduce pain, anxiety, and behavioral distress in patients and help parents/guardians and nurses feel more relaxed as well (Whitehead- Pleaux, Zebrowski, Baryza, & Sheridan, 2007).
10 Procedural Support Most pediatric interventions focus primarily on procedural support (Robb & Hanson- Abromeit, 2014). Music Therapists can provide auditory and visual distraction. Patients can be engaged in instrument playing. Procedural support can help eliminate the need for sedation.
11 Benefits of Procedural Support Music-based interventions may have a positive impact on pain, anxiety, mood disturbance, and quality of life (Archle, Bruera, & Cohen, 2013). Music therapy aids the patients in use of effective coping strategies (Barry, O Callaghan, Wheeler, 2010).
12 Instrument Playing with Patients Instrument playing can be used for distraction, increase quality of life, and promote family bonding. Instruments such as harmonicas and recorders promote proper breathing technique.
13 Benefits of Instrument Playing Interaction Music therapy has been found to have significantly increased quality of life compared to those without music therapy (Hillard, 2003).
14 NICU Music Therapy At Chris Evert Children s Hospital the Music Therapy team uses the Pacifier Activated Lullaby (PAL) for appropriate premature infants in the NICU. The PAL through the promotion of non-nutritive sucking helps to reinforce the suck/swallow/breathe coordination, to stabilize vitals, and to decrease length of stay with an average of 6 days.
15 Benefits of NICU Music Therapy Positive outcomes of NICU Music Therapy are reduced stress-related behaviors, enhanced parent-infant bonding, improved parent-child interactions, and reduced length of stay (Gooding, 2010).
16 Relaxation Techniques Through live music, we can increase relaxation and help to induce sleep. One technique that we use is progressive muscle relaxation to reduce muscle tension throughout the body.
17 Benefits of Relaxation Techniques Music listening can be used to increase relaxation and mask ambient noise (Wolfe & Waldon, 2009). Music therapy has significant effects on pain, physical discomfort, and relaxation of patients (Hillard, 2003).
18 Musical Games and Stories Musical games and stories help to normalize the hospital environment. Many familiar songs have a book counter part that can act as a visual distraction or promote academic skills.
19 Benefits of Musical Games and Stories Musical games that include the family is a great way to increase family bonding and improves parent s perception (Lindenfelser, Grocke, & McFerran, 2008).
20 Creative Music with Art and Child Life Mixing music therapy activities and art is a great way for the music therapist to collaborate with the child life specialist. Having music and art opportunities gives the children multiple ways to express themselves.
21 Benefits of Creative Music with Art Art activities and music activities are a good way to promote the expression of griefrelated thoughts and feelings (Roberts & McFerran, 2013).
22 Song Writing Song writing can be taking a known song and changing the lyrics or creating an entirely new song. Music therapist can facilitate a song writing session to allow creative expression and reflection, develop a new coping skill, and can be used for bereavement support.
23 Twinkle, Twinkle, Beautiful Child
24 Benefits of Song Writing Song writing helps individuals cope by them being able to express themselves and their feelings (Roberts & McFerran, 2013). Song writing can aid patient s in their physical, psychosocial, and spiritual needs (O Callaghan, 1996). Music therapy improved the parent s perception of their child s medical state.
25 Music Video Creation Music video project can an individual or group project. Patients can be a part of each step of the project: choosing song, how they want to participate, recording, and editing. The Music Therapy team have also made picture videos for the families at end of life as a part of legacy building.
27 Picture Video 1
28 Picture Video 2
29 Benefits of Music Video Creation Music video creation significantly increases coping skills, facilitates social integration, and improves family environment (Robb, S.L., Burns, D.S., Stegenga, K.A., Haut, P.R., Monahan, P.O., Meza, J., Haase, J.E., 2014).
30 Counseling As part of the Music Therapy curriculum, students have to take a series of psychology courses. Music therapy counseling can be facilitated through song writing, lyric analysis, and group or family music therapy sessions.
31 Benefits of Counseling Music therapy counseling has been found to have significant reduction of anxiety (Archie, Bruera, & Cohen, 2013). Music therapy has been found to significantly lower mood disturbance and has an increased affect over time (Cassileth, Vickers, & Magill, 2003).
32 Support for the Team Music therapy is part of the Child Life department and acts as support for the medical staff. The Music Therapy team leads music therapy demonstrations during presentations to the staff. Staff is always welcome to join music therapy group activities like in this conga line.
33 References Archie, P., Bruera, E., & Cohen, L., (2013). Music-based interventions in palliative cancer care: a review of quantitative studies and neurobiological literature. Support Care Cancer, 21, Barry, P., O Callaghan, C., Wheeler, G., & Grocke, D., (2010). Music therapy cd creation for initial pediatric radiation therapy: a mixed methods analysis. Journal of Music Therapy, 48(3), Burns, D.S., (2012). Theoretical rationale for music selection in oncology intervention research: an integrative review. Journal of Music Therapy, 49(1), Casslleth, B.R., Vickers, A.J., & Magill, L.A., (2003). Music therapy for mood disturbance during hospitalization for autologous stem cell transplantation. Cancer, 98(12), Ferrer, A.J., (2007). The effect of live music on decreasing anxiety in patients undergoing chemotherapy treatment. Journal of Music Therapy, 44(3), Hilliard, R.E., (2003). The effects of music therapy on the quality and length of life of people diagnosed with terminal cancer. Journal of Music Therapy, 40(2), Lindenfelser, K.J., Grocke, D., & McFerran, K., (2008). Bereaved parents experiences of music therapy with their terminally ill child. Journal of Music Therapy, 45(3),
34 References Continued O Callaghan, C.C., (1996). Lyrical themes in songs written by palliative care patients. Journal of Music Therapy, 33(2), Robb, S.L., Burns, D.S., Stegenga, K.A., Haut, P.R., Monahan, P.O., Meza, J., Haase, J.E., (2014). Randomized clinical trial of therapeutic music video intervention for resilience outcomes in adolescents/young adults undergoing hematopoietic stem cell transplant. Cancer, 120(6), Robb, S.L., & Hanson-Abromeit, D., (2014). A review of supportive care interventions to manage distress in young children with cancer and parents. Cancer Nursing, 37(4). Roberts, M., & McFerran, K., (2013). A mixed methods analysis of songs written by bereaved preadolescents in individual music therapy. Journal of Music Therapy, 50(1), Whitehead-Pleaux, A.M., Zebrowski, N., Baryza, M.J., & Sheridan, R.L., (2007). Exploring the effects of music therapy on pediatric pain: phase 1. Journal of Music Therapy, 44(3),