Dear Patient,
Music therapists are valued members of the medical team. Their expertise helps patients manage physical and emotional challenges at all stages of survivorship. This handout reviews what music therapy is, how it promotes well-being, and what to expect at music therapy sessions.
What is music therapy?
Music therapy is the use of evidence-based music interventions in a therapeutic relationship. We prescribe music therapy for the same reason we prescribe physical therapy or anti-nausea medicines: to help us meet goals related to your well-being, whether physical, emotional, psychological, or social. This therapy can be provided in a hospital, clinic, or home setting (in-person or possibly as a telehealth visit).
How is a music therapist different from a musician?
While all music therapists are musicians, their training includes extensive courses in psychology and counseling, as well as hands-on experience with patients. In addition to a college degree (bachelor's, master's, doctoral), they must graduate from an approved music therapy program and pass national certification board exams. (For more, go to http://musictherapy.org)
How musical do you need to be?
Music is a universal language. As a patient, you do not need to be able to sing, play an instrument, or have any musical background.
How does music therapy work?
In a therapeutic setting, listening to or making music triggers physical and emotional changes. Ongoing clinical research has documented benefits of specific interventions using rhythms, melodies, harmonies, or lyrics. In oncology, common goals of music therapy include managing pain, nausea, muscle spasms, insomnia, depression, anxiety, anger, and feeling out of control.
Some therapies are designed to promote beneficial bodily changes. For example, blowing into a harmonica can improve lung function. Pleasant music can promote muscle relaxation that lessens certain cancer pain, or it can lower stress hormones to help decrease anxiety and improve sleep.
Other therapies are designed to improve mood, motivation, or the ability to talk about what's happening. Discussing a song's lyrics with your music therapist may lead to insights about coping with cancer. Writing lyrics may prompt conversations that you wanted and needed to have-and that help you find acceptance, hope, courage, or fortitude.
What are the different kinds of music therapy?
Some music therapy interventions can be categorized into "active" or "receptive" experiences. In active interventions, you might sing, play an instrument, write a song or lyrics, and/or improvise with your therapist. With receptive techniques, the therapist can help you use music you hear and/or your response to that music in healing ways. Examples include using music as part of guided visualization that may help with relaxing muscles, improving appetite, relieving anxiety, or recharging your batteries with an imaginary trip to a favorite place. A session may involve sharing memories stirred by a song or discussing how certain music makes you feel, conversations that often lead to useful insights about what's happening and ways to cope.
Music therapy is an advancing specialty, with many other models beyond the "active" and "receptive" categories. Some models utilize one-on-one interventions while others involve groups of patients. Some have a focus on behaviors while others take a more holistic approach.
Why should you try music therapy?
Trying it is the only way to know whether you might benefit. Minimally, enjoying your favorite music may provide needed respite from cancer. At best, you will gain insights and add valuable tools that enhance your ability to manage cancer-related challenges.
What can I expect at my first visit?
Music therapists use the first visit to become acquainted with you, your medical situation, and the challenges you are facing. The new-patient evaluation includes questions about your music preferences and past experiences with making or listening to music.
Each music therapy session may begin with the same question your doctors ask: How are you feeling today? Your answer helps your music therapist choose activities most likely to improve your well-being without overtaxing you or causing discomfort. Based on what you share, the therapist designs a personalized session to help you meet goals.
You maintain control of the pace and content of each session. You can ask the therapist to focus on the music without a single mention of cancer. That's a healing session. Other times, you may stop the music after only a few minutes, wanting and needing to spend the rest of the session talking. That's a healing session, too.
What are the downsides of music therapy?
Everything about the music therapy experience should be positive-with no downsides. Given the power of music, it is possible for an intervention to unexpectedly cause unwanted change, such as if a song makes you sad. As mentioned above, you can stop an activity immediately, anytime.
Another obstacle may be that adding another appointment to your schedule feels burdensome. Keep in mind that music therapy sessions may feel more like reprieves than treatments.
Cost may be an issue. Medicare now covers music therapy under the Partial Hospitalization Programs (PHP) if prescribed by a physician who submits the proper forms. Medicaid coverage varies from state to state. Private insurance coverage is variable, with an increasing number of policies covering it. If your insurance policy does not cover it, please ask our office managers about steps to possibly get it covered.
A potential issue is that your therapist and you don't immediately "click." As with any new relationship, things may work out well after you get to know each other. If your medical team has more than one music therapist, you can ask about switching.
What now?
Let us know if you would like to consult with a music therapist. If so, please keep us apprised of how it's going. The more we learn about patients' experiences, the better we can help future patients make informed decisions.
WENDY S. HARPHAM, MD, FACP, is an internist, cancer survivor, and author. Her books include Healing Hope-Through and Beyond Cancer, as well as Diagnosis Cancer, After Cancer, When a Parent Has Cancer, and Only 10 Seconds to Care: Help and Hope for Busy Clinicians. She lectures on "Healthy Survivorship" and "Healing Hope." As she notes on her website (http://wendyharpham.com) and her blog (http://wendyharpham.com/blog/), her mission is to help others through the synergy of science and caring.