Music therapy: use of music to promote healing and enhance quality of life, encourage emotional

expression, promote social interaction, relieve symptoms, and improve physical movement

Uses music to:

Develop spiritually, emotionally and personally (creative, social outlet):

Communication: listen, be listened to, tools to communicate, confidence,
build rewarding relationships
Social skills: awareness and tolerance, exploring behaviors, sharing, taking
turns, being in charge, accepting leadership
Emotional response: positive and creative manners of sharing and
expressing emotions
Personal growth: individuality, self awareness, confidence, initiative,
creativity, choices
Developmental work: auditory/tactile/visual awareness,
reaching/grasping/manipulating instruments, attention and concentration

o Tap and express emotions and allows patients to explore spirituality, family, other
relationships.
o Explore and express thoughts about disease and treatment that might otherwise
go unspoken
o Develop creativity, builds self esteem, improves self expression
o Relax and feel comfortable
o Brings people together socially, provides opportunities for socialization,
interaction and cooperation
o Decreases feelings of isolation, provides support
o Reduces stress
o Taps memories
o Social experience structure and facilitating group processes
o Auditory Environment: affects imagery, which affects memories which affects
associations and mood continuous mechanism
o Changing perception of instruments to them: attracted to instead of fearful, non-
invasive, non-threatening
o Something positive from a traumatic experience
o Normalizes hospital experience
o Resilience improved
o Family environment improved
o Others see perspectives on cancer and treatment and desires for the future
o Gain meaning in journey
o Development of musical awareness and instrumental or vocal skill is no the main
focus but it might spark

Cope with symptoms (disease and treatment):
o Improves sleep, comfort, relaxation, pain control (distraction from), mood, body
temperature, muscle tension
o Reduction of emotional distress, anxiety, nausea, heart rate, high blood pressure,
breathing rate, insomnia, depression, anxiety
o Physiologic responses (relaxation)
o
Brain can only perceive 100% of any one thing so if focus goes to music, it
can decrease by 50% the amount of pain you feel
Doesnt work all the time and depends on amount of pain

Improve learning and motor skills:
o Improves learning, enhances short and long term memory, improved motor
development or processing, stimulation/facilitation cognitive skills,
stimulation/facilitation communication (gait and speech) and language skills
o Easy tool to teach concepts, ideas, information (ABCs), mnemonic device, easier
to learn and to later recall
o Stimulates body movements
o Music improves attention skillsgrabs and holds attention

Activities include:
Music listening
Move to music
Make music with simple instruments
Singing
Write song lyrics
Discuss song lyrics
Musical entrainment
Rhythmic exercises
Group exercises
Relax with the music
Games: play activities with music (some examples shown below)
Learn through music
Therapeutic Music Video intervention: storyboarding, collecting video images, producing
videos
Sound recordings
Work with visualization, association with scents
Expressive-creative activities (drawing, dancing, modeling, moving, body expression, etc.)

More specific examples and activities
Improvising: makes up music, singing or playing whatever arises in the moment
o Freely (responding to sounds as they emerge)
o Sound portraits of feelings, events, persons, situations
Recreating: sings/plays recomposed music
o Learning how to produce vocal or instrumental sounds
o Imitating musical phrases
o Participating in sing along
o Learning to sing by repetition
Composing: write songs/lyrics, instrumental pieces, music videos, audio tapes
o Generating a melody
o Writing the lyrics of a song
o Therapist harmonizes, does the notation
Listening: reaction to live/recorded music, focus on physical, emotional, intellectual,
aesthetic, spiritual aspects
o Relaxation/meditation
o Structured/free movement
o Perceptual tasks
o Free association
o Story-telling
o Imaging
o Reminiscing
o Drawing

Cognitive domain:
o Music mnemonics
o Crossing midline (game): hitting drums oppositely to arms
Important developmental skill to create inter-hemispheric communication
as well as sensory perception
Sequencing
o Call to attention: using music to start and stop an activity

Social domain:
o Taking turns (game): one instrument between two children and after one plays,
the other responds
Pacing and cadence of conversation
o
instruments and no instruments
o Drum circle (game): everyone with instrument and leader tells them how to play
it: loud, soft, fast slow and the group decides on verbal or visual cues. Then leader
leads group in making music
Leadership skills
o Upbeat when active and transitioning to mellower music to sense the change

Listening to music as therapy

1. Choose your music: listen to music that enhances or changes your emotional state,
depending on the effect you are aiming for (happy, sad, relaxed, etc.) FIND THE MUSIC
2. Listen music that changes emotional state
3. Be purposeful with auditory environment
4. Active listen to yourself and
how you feel as you do it, breathe deeply, concentrate on breathing
Listen to each note individually, silence in between them
5. Let yourself relax
Before and during
Concentrate on breathing
6.

Genre

Classical
Jazz
Folk
Rock
Country
Western
Easy listening
New age
Big band
Spanish
Religious

However, genre isnt as important as volume, rhythm, preference of the patient and
especially the goal of the individual child
Classical music (especially Beethoven and Mozart) is very recommended because it
can be used for various purposes. For instance: relaxation, stimulation, energy

Types of activities and purposes

Improvisation -- structure and freedom: developing spontaneity, creativity, freedom of
expression, communication, organizing thoughts and ideas in a meaningful way
Recreation -- self expression and compliance with score: develop senso-motor skills, learn
adaptive behaviors, maintain reality orientation, identify with feelings of others, work
cooperatively towards common goals
Playing instruments: gross, fine motor coordination
Reading notation: auditory, visual motor integration
Composing music -- spontaneity and planned decision-making: make decisions and
commitments, working economically and with certain limitations
Songwriting: expressing, understanding fears
Listening -- active/physical and passive/intellectual: activated, soothed physically,
emotionally, intellectually, spiritually (relaxing, reducing stress, managing pain, regulation
body functions-heart rate, breathing-, arousing, energizing, reassuring), access ideas and
thoughts that need to be discussed, ideas that need to be shared, stimulate images,
fantasies, associations, memories, structured reminiscence, review life, spiritual highs,
peak experiences (hope, courage, beauty of life)
Singing: vocabulary, linguistic composition
Group exercises: motor functions, interpersonal relationships
Rhythmic exercises: coordination, physical endurance

Why it works

Music is a core function in brain primed early to respond to and process music
o Physiologically and neurologically: music is processed in the entire brain
Our bodies entrain to rhythm our motor systems match to a rhythmic beat
o Musical input enters control nervous system through auditory nerve, most goes to
brain for processing but some goes strait to motor nerves through spinal cord
(tapping foot, walking to a beat without thinking)
Shared neural circuits as speech
Music and language use similar mechanisms in the brain, making it an ideal way to teach
language and communication (association with colors, shapes, letters, words, numbers)
Music activates and uses important, core structures in our brains
Predictable, structured, organized brains like it
Everyone, because of the human development, is prepared to be a music-maker and
music-lover
o Basic capacity for musical expression and appreciation, no talent or training
needed
o Sing, play simple instruments, move to music, react to the elements of music,
perceive relationships between sounds, remember music, image to music, ascribe
meaning to musical experience

Proof:
Listening to Mozart produces short-term improvement in tasks that use spatial abilities
Studies of brain circulation show that people listening to Mozart have more activity in
certain parts of the brain Mozart Effect
When they get to choose their mus
CancerTurkish study (2013): 40 people with anxiety, vomiting and nausea. Anxiety levels
greatly reduced and less frequent and reduced nausea and vomiting
Cancer2003: 69 patients with music therapy fewer mood changes (distress and
anxiety)
Radiotherapy
those who listened to music more often
Physical & psychological 30 trial of 1891 participantsreduced anxiety and positive
impact on mood, pain-reducing effect, small reductions in heart rate, respiratory rate,
blood pressure but no evidence of improvement on depression or physical status or
fatigue
Painreduced pain and need for strong painkillers
ChildrenVietnam study (lumbar puncture): less pain and fear and lower heart and
breathing rates during and after the procedure
Relationship with musicAustralia (2011): music made difficult experiences easier to cope
with, improved family and social relationships, promoted resilience and development,
reduced distress, supported families and home life as well
According to CANCER (peer-reviewed journal of the American Cancer Society), MT can
provide essential psychological support to help young patients adjust to cancer
Dopamine levels, the chemical substance that produces an effect of pleasure on the
human body, are up to 9% higher when hearing something that is pleasing
Listening to music that is happier favors good cardiovascular health. Studies have proven
that when we listen to something that we like, our veins and arteries dilate 26%.

History
Ancient Greek philosophers believed music could heal both body and soul
Native Americans have used singing and chanting as part of their healing rituals for
millennia
WWII: US Veterans Administration hospitals using music to help treat soldiers suffering
from shell shock
1944: Michigan State University launched the first Music Therapy degree program in the
world
Spain has been the world leader in the development of music therapy and the study and
application of music to improve health:
o Spain is constantly developing studies and experimental tests
o The founded the first Association of Music Therapy in the world (founded by
Professor Abimael Guzman)
Argentina was the first Hispano-American country that incorporated a Music Therapy
career in 1967
However, many of the important findings are made by American and Canadian universities
such as McGill (Montreal, Canada), North Eastern (USA) and University of Maryland (USA).
70+ colleges have degree programs in MT

What music therapists do

Preparing, conducting, evaluating, documenting sessions
Before first meeting: gather as much info as possible about strengths and needs
First session: assess, collect and analyze patients (through observation and discussion
with patients and family and in relation to their lives):
Emotional well-being
Physical health
Physiological responses
Perceptual/motor skills
Social functioning
Communication abilities
Cognitive skills
How patient makes, responds to, relates to music
Formulates goals input from patient, family, professionals, clinicians (SMART goals)
o Patients musical background and musical preferences identified and taken into
consideration as therapist designs goals and interventions used within sessions to
meet patients needs
Treatment plan: strategies and musical experiences
Periodic evaluations (which methods are effective, progress in relation to goals,
adjustments to methods and goals)
Weekly documentation of clients engagement
Regular reports summarizing engagement, aims, objectives keeping in mind the initial
evaluation and always coming back to the objectives set at the beginning of the therapy
Intermittent audio visual progress presentations to staff and family (when consent given)
VERBAL DISCUSSIONS: talk about music, reactions, thoughts, images, feelings, expression
through drawing, painting, dance, drama, poetry
REFLECTION (what is important?)
Every session involves a musical experience of some kind
End: prepares patient for leaving, closure
Evaluating:
o Musical improvement: the stages of the improvement are evaluated based on the
sonic gesture that the child demonstrates
o Emotional improvement: observation is key (not only from myself but also from
others). The information and results collected are qualitative, not quantitative.
o Physical improvement: evaluation based on the results of the childs basic vital
signs and exams. Success of the program is measured when the results at the end
of the therapy are compared to those before it.
Extra:
o Develop listening programs
o Produce shows/various kinds of musical events with patients
o Arrange for patients to attend concerts in community


Qualities of music therapists

Love and talent to help others
Interest in music/psychology/medicine
Musicianship
In-depth understanding of the power of musicability to reach others through singing
and instruments
Emphasis on piano, guitar, voice
Depth of musical knowledge and ability
Good mental and physical health and motivation, stamina, maturity
Sensitive and caring understanding of differences
Self awareness and emotional stability to help others

Logistics

Usually 30-60 minutes sessions
Listening between sessions
Regular therapy
Private or group
Being comfortable with therapist -- trusting relationship because there are important
emotional/developmental themes to be explored
Regular feedback
Client-centered: everyone exploring in their own way
Support of expression of individuality
Largely improvised
Covers wide range of styles
No musical training needed for the patients
Patients preferences: type of musical activities, style of music, medium of expression
Involving loved ones in the process, encouraging connections and communication
o Parents need to have conversations about it with kids
Its important to be monitored by a music therapist or a professional
o Music therapist (main specialist) -- music therapists graduate on a career on music
therapy
o Other professionals that could be consulted/interviewed: psychiatrists, doctors,
psychologists and teachers in special education

Caution
No side effects
Careful with loud music or particular kinds of sounds which could make some people
uncomfortable or irritated
Musical intervention by untrained people can be ineffective and cause stress/discomfort
Relying only on this treatment and avoiding/delaying conventional medical care can have
serious health consequences
Cannot cure, treat, prevent any type of disease
Time to implement the therapy: Any time within the course of the illness is fine as long as
it isnt an obligation for the child, or something that he is not enjoying
If his health is being compromised, then the program should be discontinued
In relation to age: it has been said that music stimulates children early on, but in reality, it
helps children of all ages combat their diseases and improve their activity