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Music Therapy at UAB Medicine

UAB’s Medical Music Therapy Program, part of Rehabilitation Therapy Services, has been serving patients since 1999. Music therapist Amelia Lane, MT-BC, NICU-MT, joined the program in 2012. In this interview Lane shares some key points about the importance and role of music therapy at UAB.

What is music therapy, and how is it used in patient care and rehabilitation?

The simplest definition is the use of music to achieve goals unrelated to music. We use music and music activities to reach specific goals in a medical setting. Those goals may include decreasing depression, improving vital signs, pain management, reducing anxiety, making positive changes in mood to enhance patients’ coping skills, and even enhancing neurological development. It’s important to note that we are not entertainers; we are not volunteer musicians. There is a tremendous depth to the benefits of music therapy. We also know that there are long term benefits, as we can see how far people have come with this therapy.

 

Is this a new treatment?

It’s new compared to traditional forms of health care, but the history of music therapy goes back as far as the end of WWII, when wounded or injured veterans returning from duty were comforted by volunteer musicians at VA hospitals. The medical staff began to notice results, and very early they were saying ‘Look, this seems to help our patients. We need more training and research that will determine if this is actually effective based on scientific evidence.’  The establishment of the National Association for Music Therapy, in 1950, [now the American Music Therapy Association] formalized music therapy as a field of study and brought it to the national level.  So now everything we do is evidence based. The association sponsors Journal of Music Therapy and Music Therapy Perspectives, which provide outlets for scholarly work and resources for therapists and researchers.

How many therapists are in the program?

We have seven music therapists, and we always have one intern in training. We all have at least a bachelor’s degree in music therapy and are board certified by the Certification Board for Music Therapists. Each of us has a role in providing care to our patients, but also to work with various staff to explain the importance of music therapy and how it works in different settings.

Describe a typical day for you and your team.

Well, we work in so many places, I’m not sure there’s ever a typical day. Any one of us could be at intensive care units, the bone marrow transplant unit, heart/lung transplant, palliative care, adolescent and adult psychiatric units, with the general inpatient units, or the acute neonatal nursery.  But, for example, if I’m in any of the acute care areas, I will begin by looking for any referrals from our Impact system. We can get referrals from any member of a care team, or chaplains, social workers, anyone who sees that there is a need. We will do a chart review to determine what the treatment goals are. Then we will meet with the patient to get an assessment, to learn what the most immediate issue is that we can address. We find out what their music tastes are, what kind of coping methods they may already have in place, what level of family support they have, and then we tailor our treatment based on all of that data.  We will have a guitar with us; our research shows that patient preferred music is most effective.

Why is live music so effective?

There are several factors, but the main reason a live performance works so well is because we can control the energy and manipulate the elements of that music. We can adjust lyrics accordingly. It’s all a matter of being alert to, and responding to, the patient’s physiological responses. An emotional connection to a certain song, or the response to a memory associated with it, are elements we have to be sensitive to. That’s not possible in real time with recorded music played on a device.

You mentioned that one benefit of music therapy is associated with neurological growth. How does that work?

Our infants that are born pre-term are not ready, neurologically, to be outside of the womb. There is a lot of sensory stimulation that can overwhelm them at that stage. Music therapy is good at masking some of that, but it’s also soothing, nurturing stimulation. Because music is organized auditory stimulation, and not just random sounds, we see that infants learn to tolerate it far better than they will respond to noise. We play very simple melody lines for these babies. It’s calm and consistent, which provides auditory stimulation that soothes, so an infant’s vital signs improve when they are able to relax. We also teach parents how to sing lullabies appropriately.

Why do you sometimes focus on the content of songs used in music therapy?

We have a therapeutic process called Lyric Analysis. Song may have lyrics that pertain to what a patient is going through. We use this in psychiatric settings, palliative care, and sometimes acute care. It’s a way for people to connect with songs and then with each other, because the lyrics can offer a new insight into what’s going on, or describe a situation a patient relates to. This connection provides avenues for analysis and therapeutic conversation. Memories associated with certain songs can initiate conversations as well. You could say lyric analysis is a way to build rapport between patient and care giver to sort of jumpstart the therapy.

Do you recall any especially memorable cases in your experience at UAB?

A patient in palliative care wanted to renew his marriage vows. We got the chaplain involved. We did a life review, by which we identify certain songs that were important to this patient at various points in his life and in the life of this couple. I found out the song that was played at their wedding, and learned it so I could play it during their renewal of vows. That entire experience was very touching.