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UK HealthCare expert discusses what you should know about music therapy

September 21, 2021 / in Cancer, Integrative medicine / by UK HealthCare

September is Pain Awareness Month.

Established in 2001 by the American Chronic Pain Association, the goal of Pain Awareness Month is to foster widespread understanding of chronic pain in an effort to reduce the stigma attached to the condition and aid the effort to effectively treat it.

We recently spoke with Cheryl H. Benze, MME, MT-BC, NICU-MT, UK HealthCare Creative Arts Therapies Clinical Coordinator in the department of Integrative Medicine and Health, about music therapy and how it can help with pain management.

Music therapy can be an effective non-pharmacologic pain management option. Pain management is a vital part of what medical music therapists do, but it is not the only thing.

An experienced clinician, Benze has provided music therapy to a wide variety of patients, from those needing early intervention to those needing hospice care. Her experience includes work with Duke University Medical Center Heart and Cancer Centers, Duke Hospice, Habersham Medical Center, and Warren Memorial Hospital. Benze has presented in workshops for music therapy conferences, professional and medical organizations, caregiver and community organizations. She also served as President of the Southeast Region of the American Music Therapy Association and currently sits on the AMTA  Assembly of Delegates.

Broadly speaking, what is music therapy?

Music therapy is a clinical discipline that incorporates the use of evidence-based music interventions within a therapeutic relationship to address patient goals.

Board Certified music therapists (MT-BC) systematically effect non-musical outcomes in psychological/emotional, physical, cognitive, spiritual and/or social domains. Because music therapy is a powerful and non-invasive medium, unique outcomes are possible when it is used to reduce pain, anxiety and/or depression.  Research results and clinical experiences have proven its effectiveness. 

Where do music therapists work and how do they identify people who could benefit from the practice?

Music therapists work in a large variety of areas, including medical hospitals, psychiatric hospitals, day treatment centers, substance abuse programs, community mental health centers, public schools, special education, rehab centers, nursing homes, senior centers, hospice programs, prisons, wellness centers, and in private practice. Clients are referred by primary care physicians, psychologists, teachers, social workers, and other care providers. Many patients also self-refer.  People who may benefit from music therapy are children, adolescents, adults, and the elderly with mental health needs, developmental and learning disabilities, Alzheimer's disease and other aging-related conditions, substance abuse problems, brain injuries, physical disabilities, and acute and chronic pain.

At UK HealthCare, music therapy is available throughout Chandler Hospital and Kentucky Children’s Hospital with a physician/provider order, similar to physical therapy and occupational therapy.  We may provide treatment for patients of all ages, from birth to end of life. Infants in the NICU receive specialized protocols for developmental needs. Cancer patients participate in music therapy to manage anxiety and cope with illness and treatment. Music therapy provides comfort and respite for end-of-life patients and their families. Providers order the discipline for pain management, stress and anxiety, to Improve mood and enhance coping skills for improved clinical outcomes, to Increase relaxation, for rehab goals, and for self-expression. We can also provide support for families and caregivers who share the difficulty of hospitalization. No musical background or experience is necessary for music therapy to be effective.

What does music therapy do?

Music therapy has been shown to be an effective treatment for people of all ages and conditions. Research suggests that music can reduce anxiety, decrease the perception of pain and improve quality of life. It can provide motivation for movement and participation in treatment. Music therapy can help patients with confusion, delirium and/or memory problems by accessing all areas of the brain. Music alone is the therapy in many instances, such as a hymn providing spiritual comfort, favorite songs as distraction from pain or to calm agitation. Music is also used in other ways within therapy — such as discussing or identifying with song lyrics, reminiscing about memories elicited by songs or playing an instrument to enhance physical rehabilitation. In most cases, music functions both ways in any session, as the music and the therapist work together to meet the patient’s needs.

Can you walk us through what might happen in a typical music therapy session?

Because music therapy treatment and music preferences are so individualized, it is difficult to describe a “typical” session. However, we here UK HealthCare primarily use live music (we play guitar and sing) to offer patients their preferred music genre. Research shows that people respond more favorably when they can choose their own musical preferences than when music is chosen for them. This also means that some people may relax to Metallica songs and others to Enya songs. Physical pain and emotional suffering are also individualized, and music therapy can improve pain management by directing attention away from the pain, increasing breathing and relaxation techniques (which reduce the perception of pain), teaching these techniques for autonomy and control, and improving sleep. In addition to live music, music therapists may use techniques like song writing, lyric analysis, instrument playing or patient singing. It all depends on what the patient needs at the time. A session can be 20 minutes or it may be 50 minutes. At UKHC, it will occur in the patient’s room and can involve the family and caregivers as well.
 

Can you give us some examples of how music therapy has helped people with pain, and/or statistics to quantify its success in treating patients?

There are copious amounts of research literature that provide evidence for music therapy’s efficacy. A recent meta-analysis of the music therapy and pain literature looked at a large number of studies with numerous music therapy interventions. PET scans can show how music is processed throughout the brain. 

Just to make it more personal, let me give an example of a recent session where the patient was in excruciating pain, drawing up and clinging to their knees. They gave 10-plus as a pain score. After determining preferences, the music therapist played music that rhythmically matched the patient’s movements and engaged the patient’s attention. As the music proceeded, the patient listened more intently to the lyrics, singing along softly. The music therapist would change lyrics to see if the patient would listen and catch changes. The music therapist facilitated the patient’s choice of music, but gradually slowed the tempo and rhythm to encourage relaxation. The patient lay back in the bed and closed their eyes and were shortly asleep, breathing regularly and calmly. In later sessions, the music therapist instructed the patient on music-assisted relaxation techniques so the patient could utilize them on their own when needed, giving control and reducing the need for medication.

Music therapists frequently assist with needle sticks, IV insertions and other painful procedures for adults and children. A nurse was about to insert a particularly difficult IV in a frightened elderly patient and there were multiple anxious family members at bedside. The music therapist provided age appropriate music, engaging the patient and the family in a pleasant singing-and-reminiscing activity while the nurse quickly completed the procedure. The patient and family were surprised when they realized the procedure was over. Afterward, the nurse commented to the music therapist that it was the fastest and smoothest IV insertion they had done. 

What sort of music therapy options does UK HealthCare provide?

Music therapy is available Monday through Friday, 8:30 a.m. to 5 p.m. throughout Chandler Hospital for inpatients with a physician order, including Markey Cancer Center, stroke, trauma, cardiology and other patients. Music therapy is also available at the same times in Kentucky Children’s Hospital, including the NICU, NACU, PICU and inpatient units. Music therapy is included in the non-pharmacologic pain resources. In addition, we provide some services to the Hospice Inpatient Unit. Due to the COVID situation, we are restricted from providing service to some units, but we hope to return to full service as soon as it is safe to do so.  We also have an excellent, nationally recognized, in-demand music therapy clinical training program that provides advanced students with the supervised clinical hours required for certification in the profession.

Is there anything else you'd like people to know about music therapy?

There are three things: First; music therapy is NOT entertainment. While music therapy may be enjoyable, the music is chosen and applied for specific reasons after assessment of the patient’s needs, preferences and circumstances. Entertainment is not goal directed, not person-specific, and doesn’t necessarily engage the recipient. Music therapy does all that and more.

Second; while listening to music is usually pleasant, application of the wrong music can be harmful with someone who does not know how to help recipients process. Music preference is extremely personal and music may elicit memories and associations that are upsetting. Music therapists assess this prior to providing treatment but, as trained therapists, they can help patients identify, work through, cope with and/or resolve strong emotions and reactions.

Third; everyone can benefit from music therapy in some way. You do not have to have musical training, musical ability or a musical background to benefit. You don’t really even have to enjoy music, but it does help! 

To learn more about UK HealthCare’s music therapy programs, email our Creative Arts Therapies Department (musictherapy@uky.edu), or call 859-323-4325.


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