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Music therapy is sound medicine
- 1. Mimi Sinclair, MM, MT-BC First Music and Medicine Conference Cincinnati, OH September 21, 2012
- 2. I’m Gonna Sing When the Spirit Says Sing I’m Gonna Sing When the Spirit Says Sing I’m Gonna Sing When the Spirit Says Sing And obey the Spirit of the Lord.
- 3. Define music therapy Identify treatment goals for music therapy Describe difference between RMM and MT Identify research-based outcomes for varied populations
- 4. Masters in Music, CCM Violin Performance Music-Therapist- Board Certified Owner & Director, Music Therapy Services, LLC Faculty, CCM Preparatory Dept. Faculty, University of Dayton Music Dept.
- 5. Completion of an American Music Therapy Association (AMTA) approved academic and clinical training program. Completion of a written objective examination demonstrating current skills in the profession of music therapy. Recertification every five years through re- examination or successful completion and documentation of 100 recertification credits
- 6. Clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program
- 7. Promote Wellness Manage Stress Alleviate Pain Express Feelings Enhance Memory Improve Communication Promote Physical Rehabilitation
- 8. supports its effectiveness in many areas such as: overall physical rehabilitation and facilitating movement increasing people's motivation to become engaged in their treatment providing emotional support for clients and their families providing an outlet for expression of feelings.
- 9. Ghetti, C.M. (2011). Active music engagement with emotional-approach coping to improve well-being in liver and kidney transplant recipients. Journal of Music Therapy, 48(4), 463- 485.
- 10. Active Musical Engagement group experienced significant decrease in pain. Emotional-Approach Coping group demonstrated significant increase in positive affect. Both groups showed significant decrease in negative affect.
- 11. Lim, H.A., Miller, K., Fabian, C. (2011). The effects of therapeutic instrumental music performance on endurance level, self-perceived fatigue level, and self-perceived exertion of inpatients in physical rehabilitation. Journal of Music Therapy, 48(2), 124-148.
- 12. Compared TIMP to Traditional Occupational Therapy treatment outcomes No significant difference in endurance Significant difference in perception of fatigue and exertion Possible long-term effects include greater motivation to take on more demanding and more frequent tasks, and increased general sense of well-being
- 13. Hunter, B.C., Oliva, R., Sahler, O.J.Z., Gaisser, D., Salipante, D.M., & Arezina, C.H. (2010). Music therapy as an adjunctive treatment in the management of stress for patients being weaned from mechanical ventilation. Journal of Music Therapy, 47(3), 198-219.
- 14. Heart rate and respiratory lowered. Staff assessment strongly agreed patient appeared less anxious. 98% patients reported feeling less anxious. No significant difference in days to wean. Patient and nurse satisfaction high. Nurses reported reduced stress in caring for patient. 100% of patients indicated they would participate in MT again.
- 15. Walworth, D. D. (2010). Effect of live music therapy for patients undergoing Magnetic Resonance Imaging. Journal of Music Therapy, 47(4), 335-350.
- 16. 26% of patients receiving live music required repeat scans. 73% of recorded music patients repeated. 2% of live music patients requested breaks. 17.6% of recorded music patients requested breaks. Less time required to complete scans with live music. Patient perception of MRI significantly better with live MT.
- 17. Andrew Rossetti with Ira Flatow, Talk of the Nation “Treating Stress, Speech Disorders with Music” December 16, 2011 www.npr.org
- 18. Cost analysis for Echocardiograms (Walworth, 2002) Without MT Staff time per Cost per Total Cost per Procedure Procedure Patient RN 2 hours $55.00 Sonographer 1 hour $23.00 Medication $9.45 $87.45 With MT Sonographer 1/3 hour $7.66 Music Therapist 1/3 hour $5.55 $13.21
- 19. Cost analysis for Echocardiograms (Walworth, 2002) Savings per patient = $74.24 Total savings for 92 patients = $6830.00 Total RN hours saved = 184 hours @27.50/hr = $5060 saved in staff cost now available for other duties Total Sonographer hours saved = 62 hours @ $23/hr = $1426
- 20. Kaplan, R.S., & Steele, A.L. (2005). An analysis of music therapy program goals and outcomes for clients with diagnoses on the autism spectrum. Journal of Music Therapy, 42(1), 2-19.
- 21. Goal areas typically addressed by music therapists include: language/communication behavioral/psychosocial cognitive, musical perceptual/motor.
- 22. Goal attainment was found to be high within one year Parents and caregivers surveyed indicated subjects generalized skills/responses acquired in music therapy to non-music therapy environments.
- 23. Hilliard, R. E. (2003) The effects of music therapy on the quality of life and length of life of people diagnosed with terminal cancer. Journal of Music Therapy, 40(2), 113-137.
- 24. Quality of life was higher for those subjects receiving music therapy and quality of life increased over time as they received more music therapy sessions. No significant differences on length of life
- 25. Gold, C., Heldal, T.O., Dahle, T., Wigram, T. (2005). Music Therapy for Schizophrenia or Schizophrenia-like Illnesses. The Cochrane Database of Systematic Reviews, 3. Accession: 00075320-100000000-03007 PMID: 15846692
- 26. Music therapy as an addition to standard care helps people with schizophrenia to improve their global state and may also improve mental state and functioning if a sufficient number of music therapy sessions are provided.
- 27. Tallahassee Memorial Healthcare as described in Medical Music Therapy: A Model Program for Clinical Practice, Education, Training and Research. American Music Therapy Association (2005).
- 28. Multimodal stimulation for neurological development Music reinforcement of non-nutritive sucking for feeding enhancement Counseling for parents to reduce stress Lullabies in incubator to mask aversive sounds Parent training
- 29. To reduce anxiety, decrease need for sedation during CT scans/echocardiograms, IV sticks, pre-operative preparations Family assistance in dealing with special needs Training in pain management, relaxation Counseling for coping skills Normalization of physical and emotional environment To elevate mood, improve quality of life Increase fine and gross motor skills
- 30. Counseling for coping skills Pain management MT during chemotherapy For outpatient surgery to reduce use of post- operative medicine, relieve side effects of anesthesia
- 31. Stress reduction and life management Counseling for anxiety reduction Pain management
- 32. Reduce agitation Pain management Improve quality of life Counseling for coping skills Family assistance with special needs Reality orientation for confusion
- 33. Preoperative anxiety reduction Reduced length of stay Post-operative pain reduction Elevate mood, improve quality of life
- 34. Reality orientation for those with confusion Environmental stimulation Increase range of motion Memory enhancement Counseling for anxiety reduction/life management issues Increase motor skills pairing music therapy with physical activity
- 35. Cognitive stimulation Increase communication skills Increase physical activity, gait-training Increase or stabilize respiration Memory enhancement Pain management Anxiety reduction
- 36. To facilitate difficult or extended labor For childbirth education For relaxation and coping with extended hospitalization
- 37. To calm agitated mental health patients To reduce anxiety To facilitate services to children
- 38. Parkinson's Voice Program Support Groups Pediatric Rehabilitation Adult Day Services
- 39. I’ve got peace like a river. I’ve got joy like a fountain. I’ve got love like the ocean.
Notes de l'éditeur
- Activate auditory system, respiratory system. Activate motor functions and tactile sense. Activate vestibular system.
- Difference between MT and RMM are significant. Some MTs are trained in RMM. MT requires higher level of training, broader scope of practice.
- After assessing the strengths and needs of each client, the qualified music therapist provides the indicated treatment including creating, singing, moving to, and/or listening to music. Through musical involvement in the therapeutic context, clients' abilities are strengthened and transferred to other areas of their lives. Music therapy also provides avenues for communication that can be helpful to those who find it difficult to express themselves in words.
- Reviewed the last couple years of MT journals to find some interesting studies that will help define the practice of music therapy in medical settings.
- Patients experience elevated psychological distress, leads to immune dysregulation and adverse health behaviors. Emotional expression and processing may function as an approach-oriented strategy (vs. avoidance-oriented strategy). Use emotional expression, awareness, and understanding to facilitate coping with significant life stressor. Subjects N=29, ages 32-73, post-op.
- Coping self-efficacy and satisfaction with hospitalization trended toward improvements, results not significant. No significant change in ambulation willingness or length.
- Studies have shown music and rhythmic stimulation effective in gait-training, movement training, engagement and enjoyment. Subjects N=35, average age 79. Stroke, Parkinsons, hip/knee surgery.
- Demonstration of TIMP
- Patients who experience problems with ventilation describe it as one of worst experiences in their lives. Stress and anxiety play major role in preventing patients from weaning. Standard treatment in pharmacological sedation which may complicate process. Subjects N=51, age 32-96. 126 nurses surveyed.
- 45-60 minute sessions, 3x per week. Live patient-preferred music used. Two-part intervention includes playing/improv to engage, music assisted relaxation/guided imagery. MT adjusted music to match/influence pt. respiration/heart rates.
- Compared preferred recorded music with live music therapy. Many patients have difficulty undergoing MRI due to discomfort, anxiety, claustrophobia. Can cause pt. movement requiring repeated scans, early termination of scan, resulting in significant loss of $$ and vital healthcare information.
- 88 patients age 15-93 years. Both groups consulted with music therapist to choose music. Critical to decrease in anxiety for both groups.
- Play from 17:00:00-20:00:00
- Data demonstrated that MT alone is sufficient for these tests and precludes need for sedation and its subsequent need for RN supervision. Subjects were pediatric patients.
- From Medical Music Therapy: A Model Program for Clinical Practice, Education, Training and Research. Standley, et. al. AMTA monograph series.
- Every Time I Feelthe Spirit