Music Therapy and Medicine
Music has a long history of aiding in the healing and wellness of individuals. Reports of healthcare providers using music in hospitals are available from the late 1940s and early 1950s. Music therapy as a profession was in large part, a response to WW II veterans’ needs while in the hospital. Currently, there are many medical populations that benefit from music therapy. Some of the most common medical uses are described below.
Jayne Standley, professor at the Florida State University, has spent a major portion of her career exploring the benefits of music therapy and music-based interventions with premature infants. In 2003, Dr. Standley and the American Music Therapy Association published a comprehensive book describing the use of music therapy with premature infants.1
Premature infants are exposed to multiple stressors because their neurological systems are not yet developed. These stressors include the noisy and unpredictable hospital environment that inhibits usual parent-child interaction and bonding. To counteract the negative effects of the hospital environment, Standley and her colleagues at Florida State University and Tallahassee Memorial Hospital have developed several music therapy interventions to improve health outcomes for premature infants including a combination of singing and massage to soothe infants, recorded music to encourage pacifier sucking (this encourages independent feeding), and parent training in music interventions.
Positive outcomes from some of these interventions include improved oxygen saturation levels, increases in weight gain and shortened hospital stay. However, while specific types of music are beneficial for preemies, Standley discourages the use of music that is too complicated and stimulating, including harp, drums, and mallet instruments such as xylophone. Neurological development in premature infants is fragile enough, that loud unpredictable sounds are not safe.
It is common for medical procedures to cause a lot of anxiety. This anxiety is due in part to the unfamiliar hospital environment and the potential findings of the procedure. Some tests are routine, but those that are not can be extremely anxiety provoking because the results may mean a serious illness. Along with anxiety, pain and discomfort are common experiences during both routine and special tests.
Music listening has been effective in decreasing anxiety and physiological arousal (heart rate, pulse, breathing rate) prior to procedures. Listening to preferred, relaxing music for 15-20 minutes can help reduce anxiety and respiration rate. Music listening with or without imagery can also help reduce anxiety and pain during unpleasant procedures. Some research suggests that people need less pain medicine or sedation when the right kind of music is used during procedures. These types of reductions can translate into lower medical costs. For example, Dr. Darcy Walworth, MT-BC examined data from music therapy procedures with children undergoing CT, ECGs, and the like.2 She was most interested in the difference in cost when a procedure included music therapy compared to what is called “usual care”. In some cases, including music therapy reduced or totally eliminated the use of sedation or anesthesia, which substantially reduced costs in terms of the number of staff members needed during the procedure, medication costs, and time to complete the procedure.
The experience of cancer can be improved by engaging in music therapy interventions. Some interventions are designed to decrease pain and the nausea that is experienced as a result of either the cancer or cancer treatment. There are some cancers that require treatment, such as bone marrow transplant, in special isolation rooms, because of the increased risk for infection. Being in isolation can increase anxiety and loneliness, leading to inactivity and depression. Music therapy interventions, both interactive and receptive, have positive benefits in terms of improving mood and decreasing pain and nausea. There are also some indications that music interventions can improve immune function, which is vitally important in recovering from some diseases.
Hospice care focuses on keeping patients and families comfortable when there is no longer a need for active treatment. Specific goals for hospice music therapy include decreasing pain and agitation, improving quality of life, family communication, and addressing spiritual concerns. Some hospice organizations provide music therapists to their patients and families to provide comfort and address spiritual issues. A very recent article examined the cost benefits of including music therapy within hospice care, which is often covered through a Medicare fixed rate. The results of this study demonstrated a significant cost savings (approximately $3000 per patient) for hospice patients who received music therapy along with usual therapies and nursing care.3
Pain is a complicated phenomenon in that only the person in pain can describe what he or she is experiencing. There are many non-physical factors that contribute to the experience of pain, such as anxiety. For instance, high levels of anxiety can increase pain perception.
There is some research that suggests listening to pleasurable music increases the body’s natural pain killers within the brain. There is other research that explains the beneficial effects of music as being a distraction from the painful stimuli. Either way, music therapy has been shown effective in decreasing pain in burn victims, cancer patients, during labor and delivery, and during recovery from surgical procedures.
1 Standley, J. M. Music Therapy with Premature Infants: Research and Developmental Interventions. Silver Spring, MD: American Music Therapy Association, 2003.
DeLoach Walworth, D. (2005). Procedural-support music therapy in the healthcare setting: a cost-effectiveness analysis. J Pediatr Nurs, 20, 276-284.
3 Romo, R., & Gifford, L. (2007). A cost-benefit analysis of music therapy in a home hospice. Nurs Econ, 25(6), 353-358.