Music for the ill
Paper looking at the benefits of music therapy for the ill.
INTRODUCTION
The therapeutic value of music has several positive outcomes in countless practices including: recreational, medical, psychotherapeutic, healing, and education. This paper will discuss the history, schools and the Canadian Assiciation for Music Therapy, as well as briefly describe the positive outcomes music therapy has on Child Psychosis, Dementia, and Palliative care.
METHODOLOGY
The research tools for this paper include the use of the following: Internet, Printed Textual Material, Electronic journals, and personal experience.
A BRIEF HISTORY LESSON
Music has existed in one form or another since the dawn of time. One could easily perpetuate the argument that the first use of music occurred in the animal kingdom. It is well known that whales for example, communicate through song and tone. For human being, music has played an integral part of our survival since the very beginning of our existence. We used music to communicate, exercise, train for specific tasks, and appeal to gods. As far back as 550 B.C., Pythagoras from Greece; considered music more important and beneficial than many other medical treatments (Sidorenko, 2000, p.1). The bible also documents the use of music in treating illness (Sidorenko, p. 1). The healing properties of music, according to Sidorenko are reflected in the following part of a sentence: “…effect may be best explained by the natural phenomenon of resonance between the harmony laws of the microcosm of music and the biological laws of the body” (Sidorenko, p.1). Essentially, the tone, beat and other characteristics of music, affect the human body. A point of interest though, is that sound can also be used in a negative manner. Scientists working for governmental organizations, usually military, have successfully used sound as a weapon. It has been used to deafen solders; create physical illness, nausea, vomiting, dizziness, unconsciousness, etc; destroy buildings and other structures; and even molecular disintegration. Not withstanding its possible negative implications of use, the benefits of employing sound and music as therapy are almost countless. Medical communities around the world have successfully integrated within their realm music as therapy.
In North America, the origins of music as therapy stem from Britain’s Richard Brown, who authored in 1729 a book on music and medicine called Medicina Musica (Sidorenko, 2000, p.1). In both Canada and the United States of America, music now enjoys the respect and consideration historically given to other fields of treatment such as medicine and physiotherapy. Many even consider it, just as Pythagoras did, to be more important than all other therapies. The reason for this belief is three fold. First, music as therapy is used as a supplemental treatment for illness in many disciplines. Physiotherapy, occupational therapy, speech therapy, and psychotherapy all use music therapy in conjunction with their own. As do a host of other factions within the medical community. Second, it is used as a corrective therapy in its own right. Thirdly and more importantly, is its use as a preventative measure to illness, just as physical exercise is used as a measure against sickness and disease. The implications of this three dimensional existence is exceptionally significant. As a supplemental and augmented therapy, it assists and improves the success rate of other treatments, decreases overall treatment periods for the other treatments, and reduces long-term treatment costs by being fairly inexpensive to administer. As a corrective therapy, it is very cost effective. While specialized equipment is occasionally used, the range of said equipment is quite limited, thereby keeping the price tag for treatment down. The fact that it is also a non-invasive procedure also keeps costs at a manageable level. The non-invasiveness of the procedures in music therapy also increases participation. Finally, it is used as a preventative and facilitating procedure to better health. Music therapy assists in promoting exercise in the young and old along with a list of other benefits found later in this paper. The positive effects, factors, and implications of using music therapy, along with an increased acceptance in the medical community of its importance, have created a greater than before demand for music as therapy. Additionally, it creates a demand for qualified professionals to administer music therapy as treatments. This increases the amount of people wanting to enter the field of music therapy. Universities and Colleges in Canada have created programs to meet this demand, and organizations have been formed to administer the field.
SCHOOLS AND THE CANADIAN ASSOCIATION FOR MUSIC THERAPY
Universities and Colleges in Canada understand the importance of music therapy as treatment, and have taken the opportunity to encompass music therapy programs in their course lists. The four major schools of music therapy in Canada with their phone numbers are:
- College – British Columbia Open University (604) 986-1911
- du Québec à Montréal (514) 987-3000
- Laurier University (519) 884-1970 ext. 2658
- of Windsor (519) 253-4232 ext. 2793
The preceding four schools provide students with the opportunity to earn an Honours Bachelor of Music Therapy Degree. While program, vary in complexity and depth, the following is an example of a possible four-year program in music therapy (Wilfrid Laurier University, 2001).
SAMPLE PROGRAM – Honours Bachelor of Music Therapy Program
| Year I | Year II | Year III | Year IV |
| Piano | Piano | Piano | Piano |
| Theory I, II | Introduction to Music Therapy | Principles of Music Therapy | Theory of Music Therapy |
| Musical Skills I,II | Musical Skills III, IV | Practice of Music Therapy | Music Therapy Practica III, IV |
| Choir | Choir | Clinical Improvisation I | Clinical Improvisation II |
| Music History I | Theory III, IV | Music History II, III | Psychology of Music |
| Introduction to Psychology | Guitar Techniques | Psychology Research Methods | Music Therapy Research |
| Values and Society | Developmental Psychology I, II | Abnormal Psychology | Clinical Psychology |
| Motivation and Emotion | Composition I | Music of the World |
Music has profound psychological effects on people. As a result, years one, two, three and four see a strong concentration psychology. The therapist must be aware of the effects on people to properly administer care, as certain types of patients will react differently. Some patients will cry with Chopin while others will lash out violently.
The main governing body in Canada for music therapist is the Canadian Association for Music Therapy. They can be found on the Internet at “www.musictherapy.ca”. The website is very informative and includes their perspective on the history of music therapy; information about the organization; and the enlightening definition of music therapy as follows:
“Music therapy is the skillful use of music and musical elements by an accredited music therapist to promote, maintain, and restore mental, physical, emotional, and spiritual health. Music has nonverbal, creative, structural, and emotional qualities. These are used in the therapeutic relationship to facilitate contact, interaction, self-awareness, learning, self-expression, communication, and personal development”(Canadian Association for Music Therapy, 1994).
As this definition implies, music therapy can help a great deal of people. The range of people music therapists help can best be described by referring to the following list taken from the Canadian Association of music therapist website: Acquired Brain Injury, AIDS, Autism and other Pervasive Development Disabilities, Critical Care, Developmental Disabilities, Emotional, Traumas, Geriatric Care, Hearing Impairments, Mental Health, Neonatal Care, Obstetrics, Oncology, Pain Control, Palliative Care, Physical Disabilities, Speech and Language, Impairments, Substance Abuse, Teens at Risk, Victims of Abuse, Visual Impairments (Canadian Association of Music Therapist, 2001). The therapeutic value of music has several positive outcomes in each.
POSITIVE OUTCOMES
Music therapy involves using and or integrating the following delivery components into an organized treatment plan: singing, playing instruments, rhythmic movement, improvising, composing, and listening. The use of one or more of these tools helps in the treatment of countless illnesses. The following clinical conditions successfully integrate music therapy as an instrument in the healing or maintenance process: Child Psychosis, Dementia, and Palliative Care.
CHILD PSYCHOSIS
Psychosis pertaining to children is a “major mental disorder in which the person is usually detached from reality and has impaired perceptions, thinking, responses, and interpersonal relationships. Most people with psychoses require hospitalization; treatment involves the use of psychoactive drugs and psychotherapy”(Rothenberg M.D. & Chapman, 1989, p.372). As with any ailment afflicting children, child psychosis is a tragic state. One of the most prevailing problems with psychotic and autistic children is the breaching of the non-verbalization of that child with its surroundings (Benenzon M.D., 1982, p.vii). Simply, the child cannot easily communicate with others. According to Benenzon, the “inability” of the psychotic child to communicate is more a state of refusal than it is a catatonic state (Benenzon M.D., p.vii). If this is true, then one can deduct that the psychotic child is capable of certain levels of communication. By choosing not to communicate, the child is actually communicating. This of course leads to a sense of hope, and an opportunity to incorporate treatments other than drugs. As noted previously, music as therapy is a supplemental treatment of illness, and is often applied to psychotic children. The positive outcomes from the use of music therapy justify its use on such children. The practice improves a patient’s behavior in and outside a group setting; anxiety within other groups is often reduced; and there is usually an increase in self-awareness (Saroyan, 1990, p.1).
DEMENTIA
The clinical application of music therapy on patients with demented illnesses has demonstrated positive effects on self-esteem, memory recall, and depression (Bright, 1988, p.22). The term dementia refers to an ongoing mental degeneration, including judgment, memory, possibly disorientation, stupor and disintegration of personality (Rothenberg M.D. & Chapman, 1989, p. 119-120). A demented state is most often a result of another illness or condition such as Alzheimer’s, Parkinson’s, or brain injury. The condition not only affects the patient, but also family members and the often-overlooked caregiver. Music therapy can play a very important role in the lives of these people. As mentioned earlier, improvements in self-esteem levels and the lessening of depression are key benefits of music therapy for a person with dementia (Bright, p.22). But the same treatment is also beneficial for the family and the caregiver. It is beneficial to the client because he or she often cannot communicate. It is also relatively easy and cost effective to administer. It is however, crucial that the therapist take into account the patients pathology, previous life history, and preferences (Bright, p.22). It is of great value if the patient can express his or her desires regarding music choice. Often in the early stages of dementia, this is still a strong possibility, especially if cues are given. Cues have been shown to help in memory retrieval (Bright, p.23). The chosen music also increases the opportunity for the patient to retrieve information about him or herself (Larkin, 2001, p.1). Being able to communicate at any level with some ability to recall, aids in the lessening of depression. Another positive outcome of music therapy in the dementias is the increased readiness of a patient to spend more time at the dinner table. A study conducted by a clinical nursing research group in Sweden, has shown a causal link between the playing of music, particularly soothing music, and a patient’s ability to spend longer periods of time at the dinner table (Ragneskog & Kihlgren, 1996, p.5-6). These combinations of benefits and positive outcomes are crucial in the maintenance of the body, and the retardation of physical and mental degeneration.
PALLIATIVE CARE
Music therapy can improve the life of many patients under palliative care. Palliative care arises from the need to care for people who have a terminal ailment or disease. The underlying task of palliative care unit is to bring as much relief as possible to the suffering patient that will soon pass on. With this in mind, it is not only important to help the patient, but the family as well. Music therapy as an indispensable tool, and helps the easing of this final transition. According to the music therapy Association of British Columbia, “music therapy can improve the quality of life by addressing the emotional, spiritual, and physical needs that may arise during this time” (Music Therapy Association of British Columbia, 2000, p.1). In addition, the MTABC notes that music has significant impacts on pain management, relaxation, anxiety, agitation, and insomnia (Music Therapy Association of British Columbia, p.1).
While music assists the terminally ill patient during his or last weeks or months, it is also very applicable to the final moment of passing. The positive outcomes of using music therapy with patients whom are about to pass on can best be summarized by the following paragraph taken from the Canada Medical Association Journal:
“Sometimes, adds Salmon, music helps patients let go and die more peacefully. ‘When a patient is close to death, music can help create a sense of calm in the room. Sometimes I’ll sing or play in rhythm with a patient’s laboured breathing, gradually modifying the music to a more regular or slower rhythm. In many cases, the patient’s respirations seem to follow the music, becoming slower and relaxed’” (Hamilton, 1998, p.1).
CONCLUSIONS
Music therapy should be incorporated in all clinical areas. While music therapy is now at a stage in which it receives more accolades than at any other time in its history, it is still occasionally “perceived” as a superfluous treatment that receives too much attention and resources. The fact is that music therapy is an incredibly flexible treatment device makes it very attractive. Not even the person / patient that is completely deaf is immune to the efficiencies of music therapy. Its relatively low cost and numerous positive outcomes, should make it be a sought after augmented treatment by medical communities everywhere. With increased public awareness and funding, the future of music therapy is very promising. Without it, the extent to which a patient will suffer will remain higher than need be, without cause.
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