Medicine with a melody:
Music therapy allows patients to
tune out their illnesses and focus on healing
By Kawanza L. Griffin
With the strum of a guitar, the melodious whisper of a flute or the mere power of her voice, Miriam Larsen can use the soothing sounds of music to enlighten her clients about ways to handle stressful situations. And though she doesn't teach them how to sing or play instruments, she does help them use music to experience the unique psychological and neurological benefits it offers to patients with cognitive limitations.
"With music they can deal with what they're going through," said Larsen, who works with clients at the Milwaukee Center for Independence. "They're able to interact more verbally and to think more critically about life and what they feel good or bad about." Larsen is one of more than 3,200 certified music therapists in the Unted States who now draw upon their love and understanding of music to help patients cope with health or educational problems. According to a recent membership survey by the American Music Therapy Association, music therapists work in 35 countries and are employed either full-time or by independent contractual positions in several settings, including hospitals, nursing homes, schools and psychiatric facilities.
Enrollment in music therapy programs at colleges and universities also has been on the rise, increasing 11% during the 1999-2000 academic year compared with 1998-99 enrollment figures. The number of students who entered graduate programs for music therapy increased as well during this time.
New Research
Although the idea of using music to ease feelings of pain or discomfort is not new, its effectiveness compared to traditional medical care has not been readily known. However, more and more studies published in medical and musical journals - including the Journal of the American Medical Association (JAMA), Lancet and the Journal of Music Therapy - are finding that music can reduce blood pressure, improve immune function and decrease the length of hospital stays for both children and adults.
So the medical community is becoming increasingly aware of not only the popularity of music therapy, but the many ways that it can complement traditional medical treatment. "As a discipline, we are doing a better job communicating to the medical community what we're doing," said John Hartman, music therapy director for the Milwaukee Center for Independence. "Before we were just saying 'it's music, it's good, it works', but didn't have the research to back it up." But now there are results that show "it's not just a fluke, but it's real and it's helping," he said. Here are some of the ways.
Mental Health
Music therapy has been shown to be an effective treatment for people with psychosocial, cognitive and communicative disorders. Studies have found that music helps patients improve personal expression, self-esteem and social interaction by providing a creative way for them to transform feelings of frustration, anger, or aggression into something that is fun and purposeful.
A study published in the journal Adolescence found that music decreased the pattern of brain signals associated with feelings of depression. "Music provides a way of getting people in touch with things within themselves that they can't express otherwise," said Anthony Meyer, medical director of Milwaukee Psychiatric Hospital in Wauwatosa. "It's something that we hear everyday and take for granted, but it can be an avenue for self-expression added to our other methods of patient understanding and care." Meyer said that he has patients that use music therapy and that the changes he's seen in their behavior, mood and mentality show that "it really, really works."
For Lisa, a client at the Center for Independence, music therapy sessions have helped her improve her ability to communicate and work with her peers. Although she has no major problems expressing herself, she often would rudely interrupt others during conversation and had difficulty following directions and working with others. But since enrolling in music, Lisa, whose last name the center requested not be printed, has become more mild-mannered and is now able to socialize with anyone around her. She likes music, she says, because "I can get my feelings in there . . . . After my feelings are done then I can talk." And because she sees changes in herself, she looks forward to coming to class each week. "My goal is to use my conversation skills," she said after a recent session during which she sang, played an instrument called a tone bar, and beat a drum. "I did it today, but I want to do it more."
Cancer Pain and Anxiety
Music encourages positive changes in mood and emotional state and gives people a sense of control over their lives, said Deforia Lane, director of music therapy at University Hospitals of Cleveland, Ireland Cancer Center and Rainbow Babies & Children's Hospital in Ohio. "The music is always to entrain the heart rate, blood pressure and respiration of the person in order to help calm them," she said. "It's more than shaking bells or strumming a guitar, it has a purpose and the therapist is always working to achieve a certain goal."
Entrainment means synchronization of the beats of music with natural body function or processes, she said. Lane, also a spokeswoman for the American Cancer Society, says that music - both instrumental and vocal - helps to decrease feelings of pain and anxiety for cancer patients and that she sometimes will follow patients throughout the entire surgical procedure to help keep them relaxed. In addition to cancer, studies have found that music improves well-being and relaxation for stroke and cardiac patients and those with traumatic brain injury. It also works for people who are terminally ill or who have chronic pain.
Alzheimer's Disease and Dementia
Music can be used to trigger memory and emotions in patients with Alzheimer's disease, said Connie Chestnut, multicultural outreach coordinator for the Alzheimer's Association of Southeastern Wisconsin. "It lifts their spirits," she said. "They feel that they're in touch and involved in things around them." The Alzheimer's Association uses music therapy, art therapy and pet therapy as complementary treatments for their patients because they help improve their quality of life and because the therapies help assess their patients and aid in determining the best methods for treatment, Chestnut said. Patients with Alzheimer's disease or other dementia sometimes experience depression, withdrawal, anxiety and confusion, and may become traumatized by changes in their life that result from their condition. Studies have found that music therapy helps ease the transition to long-term health care facilities, if needed, and helps to ease some of the speech and behavioral problems triggered by the disease. According to the Alzheimer's Association, most effective music therapy treatments use music familiar and enjoyable to the patient and link it with other reminiscent activities, such as questions or photographs to help stir memories. The sessions also encourage movements such as hand clapping or dancing.
Children
"Music is a part of our growth and development," Lane said. "Before they are even born, babies are perceiving heartbeat, water and blood sounds and hearing their mother's voice, (so) sound and vibrations are already a part of you." For this reason, music therapists can use verbal and instrumental music to encourage development of speech, sensory motor skills, socialization, in children of all ages, she said. In premature babies, music therapy was associated with faster weight gain, according to an article in JAMA. Nancy Dexter-Schabow, a private-practice therapist with Music Therapy Services LLC, of Waukesha County, said she uses the therapy for children with autism, visual, learning or language impairments and that she has done so with children as young as 6 months. She said that a music therapist often works in collaboration with other health care professionals such as physicians, speech, physical and occupational therapists to help get the best results from a child.
At the Center for Blind and Visually Impaired Children, music therapy is a part of each child's daily schedule. "Music gives us another opportunity to teach children skills," said Linda Bell, executive director of the center. "And since we're talking about children without vision, it helps to stimulate them to use other senses." Bell said that with music, she's seen children become motivated to crawl, sit for longer periods, and use parts of their body that were usually too stiff for motion. "The overall goal is to increase attention to what we're doing, increase interaction with their instructor, therapist and peers, and to increase their expressive communication," Dexter-Schabow said. She said that sessions can either be done individually or in group sessions, with or without parental participation, but that they must never overstimulate children, because that will negate whatever the therapist is trying to do.
Assessing its Value
So how do you know if a music therapist can help you?
Music therapy has been shown to work in all ages and for both healthy individuals and those dealing with sickness or pain, so it's really up to you to decide if the treatment is right for you. But Diane Knight, a professor of music therapy at Alverno College, warns that care must be taken in choosing the right therapist. "It takes a highly skilled professional, because it's not a matter of going in and playing music to feel better," she said. "A music therapist must first and foremost be a musician - because that's your tool. The musician must then manipulate music to meet client need."
Training includes a four-year undergraduate degree, a six-month clinical and a national board certification, she said. All sessions are individualized based upon an overall assessment client's health and may use songwriting, instrument playing, discussion or listening to help clients reduce stress, resolve conflict and take control of their lives. "That's the beauty of music therapy and also one of its difficulties," Hartman said. "If they like jazz, we use jazz. If they like pop rock, we use pop rock, because if people hear music and don't like it, they won't respond and the therapy won't be successful."
Although the cost varies depending on length of session, training of the therapist, and whether the session is for a group or individual, average cost for the region is $50 for a one-hour session, said Mary Ellen Wylie, president of the Great Lakes region of the American Music Therapy Association.
"Some people see results very quickly, while others take longer because of the time it takes to establish relationships with the instructor," she said. "But the big common denominator (for music therapy) is the brain and how it processes music." She said music stimulates the entire brain and often can be used to retrain parts of the brain to do new functions. "Medicine is bringing us so far, but it doesn't provide all the ways (for treatment)," she said. "As we learn more about the human organism and people learn about treatment with music, more people will be seeking it out."
MORE INFORMATION
Kawanza Griffin is a staff journalist for Milwaukee Journal Sentinel. The Sentinel's website is www.jsonline.com
Music without words means leaving behind the mind. And leaving behind the mind is meditation.
Meditation returns you to the source. And the source of all is sound. — Kabir
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