Music and Medicine

Published by SAGE Publications
Print ISSN: 1943-8621
We present the results of 3 focus groups conducted to assess the utility, appeal, and feasibility of the LIVE Network (LN), a 70-minute audio music program developed to educate and motivate HIV-infected persons to adhere to antiretroviral therapy (ART) and self-manage medication-related side effects. Participants included 15 African American, 2 caucasian, and 1 race unknown HIV-infected persons who had been taking ART for at least 6 months. In general, the LN was well liked, relevant, educational, and motivational. It empowered and motivated participants to be responsible for their adherence self-care. One of the more surprising findings was how freely focus group participants shared the program with family and friends as a means of education and also as a means of disclosure. Moreover, the positive reception of the LN by individuals outside of the focus groups, especially children and adolescents, speaks well for the potential broad appeal of this type of program.
Millions of women experience menopause-related hot flashes or flushes that may have a negative effect on their quality of life. Hormone therapy is an effective treatment, however, it may be contraindicated or unacceptable for some women based on previous health complications or an undesirable risk-benefit ratio. Side effects and the unacceptability of hormone therapy have created a need for behavioral interventions to reduce hot flashes. A variety of complex, multimodal behavioral, relaxation-based interventions have been studied with women (n = 88) and showed generally favorable results. However, currently extensive resource commitments reduce the translation of these interventions into standard care. Slow, deep breathing is a common component in most interventions and may be the active ingredient leading to reduced hot flashes. This article describes the content of an audio-based program designed to teach paced breathing to reduce hot flashes. Intervention content was based on skills training theory and music entrainment. The audio intervention provides an efficient way to deliver a breathing intervention that may be beneficial to other clinical populations.
Mechanical ventilation (MV) is a life-saving measure and supportive modality utilized to treat patients experiencing respiratory failure. Patients experience pain, discomfort, and anxiety as a result of being mechanically ventilated. Music listening is a non-pharmacological intervention used to manage these psychophysiological symptoms associated with mechanical ventilation. The purpose of this secondary analysis was to examine music preferences of 107 MV patients enrolled in a randomized clinical trial that implemented a patient-directed music listening protocol to help manage the psychophysiological symptom of anxiety. Music data presented includes the music genres and instrumentation patients identified as their preferred music. Genres preferred include: classical, jazz, rock, country, and oldies. Instrumentation preferred include: piano, voice, guitar, music with nature sounds, and orchestral music. Analysis of three patients' preferred music received throughout the course of the study is illustrated to demonstrate the complexity of assessing MV patients and the need for an ongoing assessment process.
Music is an ideal intervention to reduce anxiety and promote relaxation in critically ill patients receiving mechanical ventilatory support. This article reviews the basis for a music listening intervention and describes two case examples with patients utilizing a music listening intervention to illustrate the implementation and use of the music listening protocol in this dynamic environment. The case examples illustrate the importance and necessity of engaging a music therapist in not only assessing the music preferences of patients, but also for implementing a music listening protocol to manage the varied and challenging needs of patients in the critical care setting. Additionally, the case examples presented in this paper demonstrate the wide array of music patients prefer and how the ease of a music listening protocol allows mechanically ventilated patients to engage in managing their own anxiety during this distressful experience.
The Power of Music in Medicine and Health Care is the leading theme of the second International Conference of Music & Medicine to be held in Thailand, July 3-6, 2012. A dedicated group of members and associates of the International Association for Music & Medicine (IAMM) are working tirelessly to ensure a superb experience for every delegate. With 3 enticing keynote addresses, and more than 40 papers from presenters traveling from 18 countries of the globe, this promises to be an exciting event for intercultural learning, and interprofessional networking. All are welcome. See more at
Asthma prevalence in Australia is high by international standards. The disease is more common among Indigenous than non-Indigenous Australians. This article provides analyses of a music medicine intervention undertaken in 7 locations. Our team sought to evaluate whether a program of teaching didgeridoo playing and singing to Aboriginal people would be beneficial. Engaging community organizations, schools, and parents was met with challenges. While there were difficulties with retention of some participants, the overall results were positive. Spirometry indicated small improvements to lung function in a few participants; however, the overall value of the program’s capacity to improve general well-being was considered to be high by both participants and parents. Increased appreciation of traditional culture was an additional outcome. In consideration of the program’s effects and how best to sustain such health and cultural benefits to a small number of participants, its value will be weighed against the potential pragmatic problems of implementation and running costs. It is hoped that this article’s reflective stance in review of outcomes will prompt further consideration of how best to develop music and medicine, music therapy, and/or educational programs that meet unique clinical and health needs through inclusion and that also address diversity. These aspects additionally offer consideration and insight into the profound effects that culture, particularly when expressed through live and active music making, may play in the health and wellness of both individuals and families of underserved communities.
The objective of this article is to study the impact of Hindustani ragas on the cognitive functions of the right and left cerebral hemispheres, especially of the parieto-occipital lobe, in patients with cerebrovascular accident and diffuse head injury. A randomized control trial was conducted. The case group consisted of 30 patients who received both medicine and ragas, while the control group of 30 patients received only medicine. A total of 10 Hindustani ragas were taken up, and 4 follow-ups with baseline were conducted. Nahor-Benson test, a subtest of the Post Graduate Institute–Battery for Brain Dysfunction, was used at different time intervals. Univariate repeated measures analysis revealed significant differences between the 2 groups at different time intervals, confirming that listening to ragas improved visual perceptual acuity, spatial orientation, and the cognitive functions involving both right and left hemispheres of the case group patients.
Critically ill patients frequently receive sedatives in order to treat agitation in the ICU; however, adverse outcomes are linked with long-term use. The aim of this pilot study was to evaluate the effectiveness of music listening in facilitating sedation vacations. This study was conducted in neurotrauma ICUs where 50 adult critically ill patients were randomized into a music (n = 25) or no music (n = 25) group. The music group had a greater decline in heart rate (P = .042) but not in respiratory rate (P = .081) or systolic blood pressure (P = .653) when compared with the control group. There was no statistically significant change in sedation scores between groups (P = .567); however, patients in the music group were more likely to remain off sedation infusions (64% vs 52%). Music listening may be a cost-effective, nonpharmacological intervention to reduce agitation in critically ill patients.
In spite of optimized medical management, many individuals living with chronic obstructive pulmonary disease (COPD) experience distressing and disabling symptoms such as breathlessness and poor quality of life. Novel interventions, such as therapeutic singing, hold promise of ameliorating these inhibiting symptoms. This feasibility study compared the outcomes of an 8-week therapeutic singing program conducted by an accredited music therapist for 14 individuals with advanced COPD who attended a pulmonary rehabilitation program targeted to address symptoms with 5 individuals receiving usual care. While the program was enthusiastically and positively endorsed by participants, we did not find improvements in health-related quality of life, exercise capacity, or perceptions of illness for participants in the singing program compared to those receiving usual care. Further studies on optimal duration and intensity of therapeutic singing programs, as well as evaluation of psychological and quality of life specifically related to social interaction, are needed to build the evidence-based practices related to such programs.
A participant touching Q-Chord in the live music intervention. 
Patients' music preferences. 
A Comparison Between the Means of Changes in Pain and Anxiety Scores for Live Music Intervention and Listening Music Intervention During Hemodialysis. a
A Paired t Test Comparison of Mean Changes in the Pre and Post Recordings of the SBP, DBP, and Pulse Rate in Each Form of Music Intervention. a
This research focused on the use of music interventions in 54 patients receiving hemodialysis treatments at the Bangkok Metropolitan Administration hospitals. The purpose of this study was to compare the effects of live music or music listening interventions on pre- and postmeasures of patients' blood pressure, pulse rate, pain, and anxiety. The results showed significant improvements in blood pressure and pulse rate and statistically significant reductions in pain and anxiety for patients in both music interventions (P < .05). There were no significant differences in these effects between live music intervention and music listening. Both kinds of music interventions were found to significantly reduce the rate of perceived pain and anxiety. It can be summarized that both types of music interventions can be used according to patients’ need and necessity, and concern of budget, personnel, and facility within each hospital are taken into consideration.
This paper reports on the development and initial evaluation of a video-based, dynamic, sonification device used with 5 physically disabled adults, recent clients of Creative Music Therapy (CMT). Of particular interest was the extent to which the dynamic properties of the technology could assist the participants to engage in a dynamic musical interaction at the level of autonomy available to physically able people. Each participant took part in 8, half-hour sessions utilizing free interactive improvisation. During the study, several sonic algorithms were trialed and adjusted according to each participant’s movements and preferences. Informing the sonification design was the concept of dynamic orchestration developed by Paine, and real-time sound synthesis. Results indicated that video-based dynamic sonification systems may be used effectively as free improvisation tools with people who have mild physical disabilities, but that modifications may have to be made for people whose movements are more severely restricted.
Posttraumatic amnesia can be a clinically difficult phase to manage in the pediatric patient emerging from coma following severe traumatic brain injury (TBI), as agitation is a common presentation during this stage of recovery. Familiar song is offered, as a music therapy intervention, to reduce agitation for the pediatric patient; however, there is a paucity of evidence to support this. The purpose of this article is to combine interrelated knowledge from the fields of pediatric TBI recovery, music therapy, music neuropsychology, and mother–infant musicality to construct a theoretical foundation for the use of familiar song with this population.
A music intervention was performed to examine the effects of customized music programming on agitation and depression in a sample of assisted living facility residents (N = 38) with moderate-to-severe dementia. Following a 2-week no-music baseline period, music programs were streamed to the rooms of individuals assigned to a music group (N = 19) several hours per day each day for 12 weeks. Ambulatory residents assigned to the control group were incidentally exposed to the music programming in the course of daily life. Reductions in composite scores on the Cohen-Mansfield Agitation Inventory, Neuropsychiatric Inventory, and Cornell Scale for Depression in Dementia were rapid and sustained in both groups. Creating an almost omnipresent musical atmosphere directed at the musical preferences and listening histories of residents in an assisted living facility may reduce average levels of agitation and depression among the residents.
The purpose of this study was to investigate the immediate and short-term effects of 3 different types of music therapy interventions on the levels of depression, anxiety, anger, and stress in clients with alcohol dependence. Thirty-six male clients participated in 30-minute music therapy sessions twice a week over a period of 6 weeks. The music therapy program was comprised of singing, music listening, and playing instruments. Each activity was conducted for 2 weeks and for 4 sessions. A repeated measures pretest–posttest design was used. An analysis of variance indicated no statistically significant differences in the effects of the 3 types of music therapy interventions on the levels of depression, anxiety, anger, and stress; however, participants’ scores in depression, anxiety, anger, and stress were significantly reduced after participating in the music therapy sessions. In the singing activity, significant differences in depression and stress levels were found between participant-selected songs and therapist-selected songs.
A unique problem faced by clinical staff who work in cancer centers is finding a way to adequately and appropriately grieve the death of patients. Engagement in rituals such as funerals and family ceremonies are usually not considered within the scope of work responsibilities. Providing appropriate and effective ways to support the needs of staff to express their grief is challenging within the fast-paced hospital environment. This article describes the development of a music therapy-multidisciplinary intervention known as the “Remembrance Ceremony,” based on Running’s 4 elements of ritual. The intervention was developed by an interdisciplinary inpatient team at a comprehensive cancer center with the aims of facilitating the processing of grief in a group setting. The intervention consisted of live reflective music, readings, a platform for expressing loss and emotion, and a ceremony to bless the healers' hands. Programmatic evaluation provides preliminary evidence supporting the face validity and acceptability of the grief intervention. This suggests that a music therapy-multidisciplinary intervention based on ritual may show promise as a grief intervention for cancer nurses and other staff.
Flow chart of eligible participants from initial contact through completion.  
Comparison of Mean Difference Between Pre-and Postintervention Measures Between the Intervention and Control Groups
Stress and anxiety are common responses to illness, hospitalization, and surgery. Increased stress and anxiety during a surgical procedure or recovery can negatively impact health outcomes, leading to longer surgical and recovery times and complications. It is believed that music implementation in the perioperative environment can reduce the stress and anxiety levels of patients. Twenty-six patients electing to have cosmetic surgery participated in this study. Fourteen were provided with preselected music during their preoperative period while 12 were not. Patients receiving the music reported 18% (P = 0.002) less anxiety after the intervention. Heart rate and blood pressure were recorded as physiological measures of stress but no significant changes were found. Results suggest that patients waiting for surgery benefit emotionally from hearing music. This low-cost, complementary therapy has the potential to improve the experience and outcomes of patients electing to have cosmetic surgery.
The purpose of this study was to determine the possible effects of an exercise program facilitated by auditory music cues on the motor function, balance, trunk flexibility, upper limb range of motion, self-perceived daily functioning, and self-perceived quality of life in persons with Parkinson diseases (PDs). Pretest and posttest measures for 7 participants resulted in significant improvements in mean Unified Parkinson’s Disease Rating scale (UPDRS) activities of daily living scores, the “Timed Up and Go” test, and trunk rotations to the right and left. It was concluded that the exercise program that includes musical cues for physical movements is feasible as an intervention to improve movement and quality of life in persons with PD. Although the study provides preliminary evidence for the feasibility of the music-facilitated exercise program, further research with a larger cohort is necessary to determine the long-term program outcomes.
A stroke results in brain damage, often causing loss or reduction in speech and language capacity. Music and music therapy can contribute to the recovery of speech and provide emotional support to individuals with aphasia. There is a diverse body of research on the links between music and language. Musical structure is related to language syntax. Singing songs from one’s culture, the emotional act of singing, the theatrics of singing, and musical improvisation can all influence speech output. The purpose of this article is to review current research on the links between language and music in brain function in order to further explore, through case study and analysis of music therapy application, how music might be employed as part of a comprehensive, multimodal approach to speech and language rehabilitation.
This article outlines research in the final phase of the Sounds of Intent project, which explores musical development in children and young people with complex needs. This has been undertaken through observation and analysis using the previously developed “Sounds of Intent” schedule, which was designed through amassing 630 observations of children’s engagement in musical activities, fused with the findings of mainstream developmental music psychology and ‘zygonic’ theory, a psychomusicological approach to understanding how music makes sense to us all and building on previous extended fieldwork in schools. The main output will be a musical development framework package of web-based technology, containing video, photographs, and descriptions of children’s musical engagement. Practitioners can use the software to assess their pupils/clients, record their attainment and progress, and download curriculum materials. The software is designed to become a user-owned constantly evolving, “wiki-based” resource, to which practitioners would contribute their own resources, ideas and views.
Music has been shown to possess a profound effect on body and mind and can be applied as a therapeutic intervention to modify physiological, psychological, and mental aspects of function. The purpose of this study was to apply music components as a therapeutic tool for improving muscle strength, spasticity, lung capacity, self-esteem, and quality of life (QOL) among 39 children with physical disabilities, from Srisangwan Chiang Mai School in Thailand. The children were assigned to play therapeutic songs, parts of which were selected to match his or her instrument, physical capacity, and music capability. Therapeutic musical notes were designed to improve the children's capability by means of routine music practices. During the study, rehearsals and performances in public as part of a band ensemble were arranged for the children to promote social integration. The results of the therapeutic music program provided indicated that a music therapy could improve grip strength, increase lung capacity, reduce muscle spasticity, and increase self-esteem and QOL and did so for the study participants with physical disabilities. The increase in finger grip strength, especially the lateral pinch grip, was significant in the melodeon group. Increased self-esteem, QOL score, and lung capacity was obvious after the 18-month program. Not only did this musical intervention provide a holistic approach for the children with disabilities, but it also provided an observable spirit boost and improved self-esteem for the children involved and their caregivers during the musical performances.
This article reviews the process of designing technology to meet specific needs during rehabilitation-oriented music therapy. Individuals with acquired brain injury have unique needs, many of them involving physical rehabilitation. These needs are evaluated throughout the music therapy processes described and provide the foundational guidelines for new instrument designs. The article suggests that instruments designed with rehabilitation goals in mind may differ from traditional music instruments. Music technologies (musical instrument digital interface [MIDI] instruments and software) developed by the author to facilitate particular interventions during music therapy rehabilitation will be described. An embedded “Midi-Fly” technology that captures quantitative data related to these interventions will be explicated.
This study investigated the impact of pleasant and unpleasant classical music on experimental pain, compared to silence and to an auditory attention task. Pain measurements were assessed with the nociceptive flexion reflex (NFR), pain ratings, and the cold pressor test on 20 healthy nonmusician participants in a within-participant design. Results indicated that, in comparison to silence and to the unpleasant music, pleasant music increased pain tolerance to the cold pressor test, and decreased pain ratings associated with the NFR but did not reduce the NFR itself. Furthermore, the auditory attention task had pain-reducing effects comparable with those of pleasant music. The findings are discussed with respect to possible underlying mechanisms involving emotions and distraction elicited by music and auditory stimulations.
The interdisciplinary studies of music medicine in Austria focus on collaboration of different sciences investigating the psychological and physiological basis of music making and music listening and to translate the findings into clinical applications. This article describes the history of Austrian music research projects since 1969, when the Research Institute of the Herbert von Karajan Foundation for Experimental Psychology in Music was founded, and the former Research Network Man and Music, as well as current studies at the Institute of Ethno-Music-Therapy and the MusicMedicine Research Program. Since 2002, several (inter)national conferences with the goal of establishing interdisciplinary dialogues between the various scientific music effect research fields have been organized. In Austria, there are currently three University programs offering training for music therapists and two master programs for elemental music and dance pedagogy. The Austrian Music Therapy Law provides objective professional standards for the entire field of music therapy occupation.
We present an empirical and qualitative study testing musical empathic ability in participants with an autism spectrum disorder (ASD). Four experiments requiring an increasing level of empathy with music, from synchronization, and attuning to emotional empathy, were carried out, using kinematic devices for measuring embodied listening responses and a verbal emotion attribution task. Results suggest that people with ASD have a corporeal understanding of the affective features of music, since they are able to mirror structural and even affective features of the music into corporeal articulations. However, this corporeal understanding does not give them a straightforward access to the emotional content of the music. The participants with ASD seemed to rely on disembodied cognitive processes to attribute affects to music.
Music has been used by therapists to facilitate communicative behaviors and social engagement with individuals with autism spectrum disorder (ASD). We conducted this study to determine the effectiveness of Orff music therapy on social interaction, verbal communication, and repetitive behavior of children with autism. Five children with autism who had no previous experience in music or play therapy were recruited. Social interaction, verbal communication, and repetitive behavior of the participants were scored pre- and postintervention (Orff music therapy) using Autism Diagnostic Interview–Revised. The mean scores of social interaction were 26.60 and 14 before and after therapy, respectively (P < .001). The mean scores of verbal communication and repetitive behavior were reduced significantly (P < .05). The reduction in the scores indicated a good outcome. All participants improved significantly in their social interaction and verbal communication. The Orff music therapy also helped to decrease their repetitive behavior. Using Orff music therapy at autistic children's care centers is encouraged.
A piano concert series and jazz reception program was organized at the College of Dentistry at New York University, in 2007. An anonymous survey to assess the response of faculty, staff, and students to the concert series was conducted during 2010 to 2011. Overwhelmingly, the respondents recommend that music concerts in the dental college be continued. Support is apparent in the overall recommendation and in questions dealing with stress, productivity, music, the auditorium, and the community. Differences between groups defined by status (student, faculty, other, or unknown) and by previous music study (yes, no, or unknown) were small. Events such as a concert series organized at the College of Dentistry apparently can have positive influence on work–life balance.
Studies into the effects of therapeutic music making in the treatment of mental illness have increased dramatically in the last decade, but there still remains a dearth of research into its effects in developing countries such as India. Of particular importance in India, where the stigma associated with mental illness is still prominent, is low self-esteem and self-efficacy in people with disorders such as schizophrenia. Using a qualitative approach, this study explored the views of the participants on the effects of musical activity, at a psychiatric treatment and rehabilitation center in India. Five main themes were interpreted from interview transcripts: therapy, motivation, mood, self-efficacy, and self-esteem, suggesting that the patients find the sessions to be therapeutic overall, including in the areas of self-esteem and self-efficacy.
In music therapy practice, it is well understood that the presence of the therapist plays an important role. Within a previous qualitative research study, 7 bereaved family caregivers of patients with advanced cancer voluntarily contributed reflections regarding memorable features of the functions of the music therapist. This article presents an overview of the strategies provided in this home-based hospice music therapy program and a focused content analysis of narrations that pertained to the caregivers' perceived roles of the therapist. Data revealed the following themes: (1) the music therapist displays calming and compassionate personal attributes; (2) the music therapist uses subtleness of approach and has person-centered therapeutic skills; (3) the music therapist maintains a supportive and interactive role; and (4) the music therapist establishes and maintains an ongoing therapeutic relationship. The findings illustrate the significance of compassion in oncologic settings and help validate the potential importance of the role of the music therapist in offering support during times of loss and grief.
Results of Repeated Multivariate ANOVAs
The present study examines psychophysiological responses to ascending melodic intervals and the specific influences of bodily movement. A total of 15 adult listeners were assessed in 2 conditions with and without voluntary bodily movements during listening to major third and major seventh intervals, while their heart rate was continuously recorded. Heart rate as well as the standard deviation of normal-to normal RR-intervals in the electrocardiogram within a given time interval (SD-NN-RR) served as dependent measures, the latter indicating parasympathetic activation. A repeated measures analysis of variance (ANOVA) revealed a significant interaction between interval and condition. Listening to the major seventh interval led to significantly higher SD-NN-RR values than listening to the major third in the condition without voluntary movement. With movement, these differences were not observed. The study extends previous findings by showing that task demands strongly influence physiological responses to isolated musical materials.
Construction and development of a conference involving music and medicine has enormous potential on many counts. This has article describes the intention of integrating medical music practices through direct event-conference thinking and through performance medium. This is a growing format that has important implications for expanding the role of the arts in health care. The Santa Fe Chamber Music Festival, the University of New Mexico Cancer Center, and Gabrielle’s Angels Foundation for Cancer Research will soon present “Music, the Brain, Medicine, and Wellness: A Scientific Dialogue.” This scientific symposium occurring from August 4 to 6, 2012, in Santa Fe, New Mexico, builds upon the knowledge of the state of the science and its impact of music on the developing brain, cognition, language, memory, and emotion. Music’s capacity to promote healing in patients with serious medical conditions including cancer, neurologic diseases, and developmental disorders as well as its influence on the well-being of individuals and their communities is critical to the expansive thinking in the integration of music and medicine.
Means and SD for Music Cognition Variables a
Advances in breast cancer treatment have resulted in improved survival rates and concomitant reports of chemotherapy-related cognitive dysfunction. Music cognition, a form of general cognition, also may be negatively affected by chemotherapy. Moreover, chemotherapy may have general ototoxic effects. The goal of this study was to explore whether breast cancer survivors (BCS) had similar hearing thresholds and music cognition abilities compared with age-matched healthy controls (HC). A total of 56 women (28 BCS and 28 HC) completed the audiometric tests and the Montreal Battery Evaluation of Amusia (MBEA). Results indicate the 2 groups have similar hearing thresholds. A comparison of music cognition variables suggests possible differences in some music cognition tasks, with HC scoring slightly, but not significantly, better in melodic perception. The BCS scored slightly better, though not significantly, on melodic memory. An adequately powered study including cognitive variables is needed for verification of findings and to establish clinical meaningfulness.
Information of Participants.
Observed and Adjusted Means for Variables at Posttest.
The purpose of this study was to examine the effect of light condition on physiological state and mood perception of music during listening. Seventy-six participants were assigned randomly to 2 experimental conditions: regular and dim light conditions. Visual analogue scales were used to indicate changes in physiological state and the perceived mood of the music. Participants assessed their physiological state between “relaxed” and “tensed” before and after the music listening. At posttest, they also indicated the perceived mood of the music on a second Visual Analog Scale. Analysis of covariance and analysis of variance were used to analyze the group differences in physiological change and perception of music, respectively. The results indicated that there was a statistical difference in physiological change between the 2 group conditions (P = .005), with greater changes present in the dimmer light condition than in the regular light condition. There was no significant difference in the music mood perception between the groups. These results indicate that brightness may be a significant paravariable in the listening experience.
Family caregivers of people with cancer may struggle as they observe the effects of the illnesses and experience the demands of caregiving amid potential loss. In order to provide beneficial support, health care professionals need to understand factors that promote caregivers' resilience. This research explored the role of music. Twelve caregivers were recruited and data were collected through questionnaires and semi-structured interviews. Data analysis was informed by grounded theory. Six thematic findings emerged: caregivers' music backgrounds affect their cancer experiences; caregivers' use or nonuse of music is associated with how they cope with the patients' illnesses; music can help improve biopsychosocial and spiritual well-being; music can be used in caring; music may intrude; and music is recommended. Recommendations are that health care organizations providing supportive cancer care might consider offering music-based care and that health professionals may consider inquiring about caregivers' musical lives to increase their understanding about caregivers' resilience or vulnerability.
Change in interbeat interval. Error bar (mean + SEM) profile of interbeat interval fluctuations within a treatment session for PMR (left) and monochord (right) group. Results were pooled across participants and sessions (pre and post). SEM indicates standard error of mean; PMR, progressive muscle relaxation.  
Change in LF power, HF power, and LF:HF ratio within the pre session. Spectral parameters—LF power (a), HF power (c), and LF:HF ratio (e)—of heartbeat interval variability for PMR group during the begin (filled bar) and the end (open) phase within the second chemotherapy (pre) session. (b), (d), (f) are the same but for the monochord group. Error bars denote SEM. SEM indicates standard error of mean; LF, low frequency; HF, high frequency; PMR, progressive muscle relaxation.  
Change in mean, standard deviation, and skew within the pre session. Time domain parameters-(a) mean, (c) standard deviation, and (e) skew for the PMR group during the begin (filled bar) and the end (open) phase within the second chemothearpy session (pre) session. (b), (d), (f) are the same but for the monochord group. Error bars denote SEM. SEM indicates standard error of mean; LF, low frequency; HF, high frequency; PMR, progressive muscle relaxation.
Change in mean, standard deviation, and skew within the post session. See Figure 4 for other details.  
This study investigated the impact of monochord (MC) sounds, a type of archaic sound used in music therapy, on the heart rate variability (HRV) in patients with cancer undergoing chemotherapy. The HRV of patients was recorded during the first and last sessions of relaxation treatments. The time series of HRV was analyzed using methods based on the time and frequency domains. During MC-induced relaxation, low-frequency power and the ratio of low and high frequency were increased over sessions. However, changes in low and high frequency lay in different directions during relaxation caused by progressive muscle relaxation (PMR) in each session. Different activities of the parasympathetic and sympathetic nervous systems were shown during relaxation caused by either listening to MC sounds or exercising PMR. It is necessary to further investigate the relationship between the physical and psychological states induced by certain relaxation methods and specific activity of HRV.
When I was diagnosed with stage 4 non-Hodgkin lymphoma, it plunged me into a crisis. Unexpectedly, I found myself with a desire to sing, not knowing why. I started by searching for a singing teacher but wound up in music therapy, a journey unlike anything I had experienced. Improvising in music therapy made it possible for me to face the desolation and dread of cancer and to express my deepest lament. I found new wellsprings of life in myself, while my cancer went into temporary, spontaneous remission.
In recent decades, the fields of palliative care and music therapy have undergone rapid formal and global development, to be practiced in many countries and cultures. Simultaneous with the global development of palliative care and music therapy has been the world-wide movement of migrants and refugees1 which has “resulted in many…societies…becoming increasingly ethnically and culturally diverse.” This has led to a growing awareness of the richly diverse cultural experiences and traditions that both clinicians and clients bring to end-of-life care and music therapy. This paper maps the discussion of cultural issues in palliative care and music therapy. The literature will be examined, key issues identified, and the impact of these on the provision of culturally appropriate palliative care and music therapy services explored, and a framework offered for considering the cultural landscape of palliative music therapy practice.
Improved childhood cancer survival rates are associated with increasing numbers of patients with neurocognitive impairment. Detrimental cancer treatment effects include declines in IQ, attention, executive function, processing speed, memory, visuospatial, and visuomotor skills, reducing patients’ quality of life and the potential to achieve key life milestones. Music training can improve intelligence, attention, and memory as well as provide a medium for interaction, coping, stress reduction, and improved self-esteem. Given the crossover between the domains impaired by childhood cancer treatment, and improved through music training, there is potential for music-based interventions to minimize detrimental treatment effects. This article reviews the neurocognitive effects of childhood cancer and its treatment, provides a theoretical rationale for offering children with cancer music-based interventions, and suggests strategies that carers may use to extend their intellectual potential and quality of life.
This is a reflective article, based on the author’s 20 years of experience working as a music therapist in the field of pediatric cancer care at the Royal Children’s Hospital, Melbourne, Australia. During this time, the music therapy program has evolved from a 5-hour a week consultation into a successful, integrated service comprising 45 hours per week. Reflections include details of how the program has developed over time, reflections of what has influenced this, and some significant aspects of music therapy service delivery identified by the author. These reflections may be useful to others providing similar services in the field of pediatric cancer care, and will offer recommendations for starting out in this field, by expanding the way we envision working within the field.
This article outlines a unique collaborative project designed to increase palliative care patient access to music therapy services by tapping into multiple university-community resources—resources of an undergraduate university music therapy program, of a professional symphony orchestra, and of funding available for university-community partnerships. Music therapy interventions were provided to palliative care patients within single sessions by 2-person music therapy teams (each comprised of one student music therapist and one symphony orchestra musician). Student music therapists served as team leaders and symphony musicians served as co-facilitators. The project was evaluated over a 3-year period in terms of student music therapy intervention effectiveness on the pain relief, relaxation, positive mood, and quality of life of 371 adult palliative care patients. Results indicated that there was a significant difference at the P < .0001 level in the pretest/posttest measures on all 4 variables. Study limitations and directions for future research are identified.
Objectivist and constructivist music therapy research in oncology and palliative care since 1983 is detailed, and the meaningfulness of evidence gathered is considered. Objectivist approaches are informed by positivism and commonly use experimental, hypothetically driven methodologies incorporating researcher-designed measures. Constructivist approaches are informed by varied theoretical frameworks (e.g., postmodernism, phenomenology) and commonly aim to understand participants' subjective experiences. Methodologies include grounded theory, ethnography, and discourse analysis. Both research approaches have uncovered varied and evolutionary understandings about how music therapy can help people deal with loss and maintain life quality when affected by life-threatening and end-stage illnesses. Furthermore, constructivism and palliative care are compatible in that both focus on understanding individualized and multiple interpretations of experience. It is contended that objectivist and constructivist research will never be able to capture an absolute “truth” about music therapy’s effectiveness; however, findings from both approaches can be conceptually generalized to comparable clinical contexts.
Total Observations of Children (n ¼ 162) and Caregivers (n ¼ 146) Children and Caregivers Observed
This research looks at the impact of live music on children and their caregivers in a pediatric hospital in Italy. Observations were carried out over a period of 4 weeks involving 162 children and 146 caregivers. In addition, interviews were conducted with 14 children and 22 caregivers. Subsequently, thematic analysis and content analysis were performed on 4 modes of data (observations, videos, interviews, field notes) with the support of Atlas.ti software. Results suggest that, in this context, there is evidence of the musical intervention helping the children and their families to focus their attention on something that is external to the illness. Through the familiarity of the repertoire, children’s perceptions of the hospital environment turns into something more familiar and less threatening. Consequently, the music constitutes for children and their family a psychosocial space where they can interact without the anxiety and stress elicited by diagnosis-feared perception as well as illness.
Verbal and Nonverbal Interaction ScaleÀCare Recipient Version: Sample Items Care-recipient behavior Verbal-positive Uses coherent communication The CR verbal and/or nonverbal behavior can be understood by the CG
Verbal and Nonverbal Interaction During Baseline and Intervention Observations During Morning Care Observations During Morning Care Baseline Intervention
Music Therapeutic Caregiving (MTC), when a caregiver sings for or together with a resident with dementia, has been used to enhance communication between caregivers and residents. This single case study measured communication in a resident with dementia during “usual” and MTC morning care. Video observations of 8 weekly sessions, consisting of 4 recordings of usual morning care and 4 recordings of morning care with MTC intervention provided the data. The Verbal and Nonverbal Interaction scale was used for analysis. Under the MTC condition, the resident’s positive verbal and nonverbal communication increased by 23%. Furthermore, negative verbal and nonverbal communication, decreased by 80%, compared to the “usual” morning care sessions. Under the MTC condition, the resident was able to remember words to songs and singing with the caregiver occurred in 39 of the 40 observed minutes. The findings indicate that MTC could be an effective nursing intervention in dementia care.
A number of recent studies have pointed to the prevalence of performance-related disorders experienced by college-age music students in the United States (Barton et al., 2008; Chesky, Dawson, & Manchester, 2006; Chesky & Hipple, 1997; Fehm & Schmidt, 2004; Manchester, 1988; Manchester & Lustik, 1989; Smith, 1992). These disorders include overuse injuries, chronic pain, debilitating stage fright, depression, and substance abuse. This article addresses the underlying causes of performance-related disorders in college-age musicians and offers a clinically tested curriculum for prevention, treatment, and empowerment. The integrative curriculum draws from clinically proven techniques from the disciplines of music therapy, behavioral medicine, and yoga science. Performance Wellness training recommendations are included for educators, counselors, and health professionals who work with college-age music students.
This commentary addresses the inclusion of a new class of digital hand-held music devices in clinical music therapy work. The discussion includes the conditions required to create productive, therapeutic methods with hand-held music devices in contemporary medical practice. Recommended solutions include the creation and development of applications that allow for rhythmic organization with autocorrection, memory enhancement and revitalization, vocal empowerment, mobility with fluidity that provide data sets that are diagnostic, prescriptive, interactive, and demonstrate patient progress toward specific goal attainment. The recommended methods should also incorporate the vocabulary, structure, and architecture of digital hand-held music devices into a system of clinical methods that are derived from best practices and clinical trials. The proposed methods include the use of open source, materials to move the discussion forward toward the creation of standardized clinical interventions using digital handheld music-making devices.
This study was one of the 8 case studies conducted on an acute unit of a psychiatric hospital as part of a research project focused on listening to participant-selected music with patients who were in the early stages of psychosis. The central research question was to explore whether listening to music with patients could help facilitate their emotional containment and expression. What the case study illustrated was that the participant case musical selections expressed her identity and aspirations and gave form to emotional expressions that she otherwise might have had trouble assigning directly through verbal expression. Music as a meta-communication tool helped this participant articulate and contain unbearable feelings. By listening to music with the participant, the researcher was allowed brief and meaningful access and attunement to the participant’s inner world. This case study provides background information about the participant, describes highlights from 10- to 30-minute listening sessions, and offers analysis of the participant’s musical choices and responses to music. It is hoped that the methodology and findings of this in-depth case report might provide a means for processing, analysing, and reporting for those who practice music psychotherapy and music medicine. This may serve as particularly useful with patients who have psychiatric diagnoses or psychotic episodes.
Music Therapy Techniques Utilized in End-of-Life Care 
Gloria and Jack's theme chart.  
This article describes a study that investigated the experience of 4 dying persons and their significant relationships, as they engaged in music therapy sessions designed with the goal of facilitating relationship completion. Multiple data sources informed the case studies and the themes that emerged for each case are presented. A cross-case analysis was performed, which incorporated a thematic analysis of participants' experiences where 6 global themes were identified including love, loss, gratitude, growth/transformation, courage/strength, and good-bye. Results indicate that life review, song dedications, and the creation of musical gifts were a core part of each participant’s process. The article concludes with a summary, discussion, and implications for future research.
The purpose of this study was to isolate the effects of melodic complexity with and without rhythm on working memory as measured by sequential monosyllabic digit recall performance. The recall of information paired with 6 different melodies was tested on 60 university students. Melodies were built upon 3, 5, and 7 notes, and each level contained a rhythmic sequence and a nonrhythmic sequence. Results indicated that there was no significant difference between recall of music majors and nonmusic majors, although music majors tended to outperform nonmusic majors. There was a significant difference in the within-subject variable of rhythm: The mean recall of information paired with a rhythmic component was higher than recall of information not paired with a rhythmic component. Congruent with existing research, participants recalled information in serial positions of primacy and recency most accurately. Suggestions for future research and implications for clinical practice are provided.
Key elements of vibroacoustic therapy 
Vibroacoustic therapy (VAT), traditionally considered to be a physical and receptive type of music therapy intervention, uses pulsed, sinusoidal, low-frequency sound on a specially designed bed or chair. Today VAT is viewed as a multimodal approach, whereby the therapist works with the client’s physiological and psychological experiences, incorporating a mind–body approach. This article provides current knowledge in clinical practice emphasizing the systematic and documented implementations of VAT. This includes presentation and explication of the key elements of VAT, assessments, treatment plans and procedures, documentation, and evaluation of the treatment with recommendations for follow-up care in health and rehabilitation. Recent research is presented, and directions for future research are considered. Applicable views on clinical training and required competencies are outlined.
A qualitative thematic approach was used to exploremusicians' views and experiences of delivering a music intervention and its efficacy for people with dementia in long-term care.Two musicians who delivered the intervention in a randomized controlled trial were interviewed using a semistructured schedule. The data were sorted, categorized, and thematically analyzed. Two themes emerged: design of the protocol and efficacy of the program. Musicians felt that the intervention was appropriately designed, particularly in terms of repertoire selection, session length, incorporation of live and prerecorded music, and use of 2 musicians. They reported seeing improvements in mood, memory, general well-being, and quality of life for persons with dementia, both during and after the session. The findings support a music protocol structure that can be used for randomized controlled trials. They also highlight how standardized assessment tools used in randomized controlled trials can be complemented with qualitative, reflective evidence. Yes Yes
Singing is not merely a vocal expression but also a physical activity involving the lungs and respiratory muscles. The purpose of this study was to evaluate singing as an adjunct therapy for young people with cystic fibrosis (CF). In a randomized controlled study, 51 hospitalized children (mean age = 11.6 years, 35% male) participated in either 8 singing or 8 recreational sessions. Respiratory muscle strength using maximal inspiratory and expiratory pressure (MIP and MEP, respectively), spirometry, and quality of life (QoL) were assessed at baseline (T1), postintervention (T2), and follow-up (T3). The singing group demonstrated statistically significant increases in MIP and MEP at T2 and T3, while no statistically significant changes were evident in the control group. In the QoL measurements, both groups showed improvement in some domains. The results indicate that singing has the potential to improve the respiratory status and QoL of young people with CF.
Top-cited authors
Gunter Kreutz
  • Carl von Ossietzky Universität Oldenburg
Debra S Burns
  • Indiana University-Purdue University Indianapolis
Janet S Carpenter
Wendy L Magee
  • Temple University
Amy Clements-Cortes
  • University of Toronto