Tag: Medical music therapy

Music Therapists & Volunteer Musicians: What’s the Difference?

A question we often address as Music Therapists is that of what we do and how it makes us different from a volunteer musician. Music therapists and volunteer musicians may often seem like they are doing similar work. This is a common misconception. There are significant differences in training, repertoire, goals, and patient connection between music therapists and volunteers. It is also important in recognizing what music therapists do and the value they bring as a healthcare service. This will help differentiate which service one might be receiving.

Music therapist: Credentialed healthcare professional who has completed an approved music therapy program and uses clinical and evidence-based music interventions to accomplish individualized goals within a therapeutic relationship.

Musician volunteer: May offer music in any healthcare setting on a volunteer basis. Refers to any non-certified, non-music therapist individual offering music.

While many healthcare facilities benefit from volunteer musicians, a certified music therapist is trained and qualified to provide many more services. Depending on the setting, some of the interventions and services we provide may seem simply musical. For example, singing with a patient in a nursing home, or playing relaxing guitar melodies for someone who is in the hospital. Each of these scenarios can seem simple at first glance, but in reality, there is much thought and preparation put into even the simplest of musical interventions. When providing music therapy in any setting there are steps taken before music-based services are ever provided. A music therapist must have a referral, assessment, and documentation leading up to any music intervention. After carefully planning a session to meet specific needs/goals of the client, a music therapist will provide music-based interventions that meet those specific needs. Here are some examples of how we do this: 

Referral & Assessment 

The first step in music therapy process of determining needs of the patient. Some common symptoms that benefit from music therapy are anxiety, depression, drowsiness, restlessness, pain management, cognitive stimulation, spiritual support, family support, and more. 

Documentation 

This is important to track observed and measurable data for each patient. Without data, a music therapist has no evidence of progress in a patient’s areas of need. Goals have objectives to be measured during each session. These objectives should be met in order for clients to progress or maintain in a physical and/or psychological domain. 

Why do we use this process? 

It can be assumed that music is never harmful. Can’t any music be enjoyed? Won’t they be thankful to have a visitor entertain them? You don’t need to be trained to provide therapeutic music for people…etc. 

While not all assumptions are wrong, it is still important to point out that music provided without proper knowledge or considerations can be harmful. It can be overstimulating, agitating, too sad, too happy, or completely meaningless/inappropriate to someone’s situation. Yes, there is power in music alone, but when it is paired with the proper considerations for the listener it is SO much more meaningful. This is great advice for any musician volunteering in a healthcare setting. Be mindful of your audience and what their sensitivities may be! 

Music therapist are trained to provide a therapeutic experience using music as the tool based off of previous medical and personal knowledge of the patient. Music Volunteers perform their instrument and use their talent to engage the listener in hopes of providing a meaningful musical experience. Both of these are important. Music therapists encourage live music and informed volunteers in settings that we serve. We do not however encourage facilities to feel that they are meeting therapeutic needs without a music therapist. Volunteers do not replace music therapy, but they can certainly add to the many services a facility provides. 

See the below list for comparisons: 

Service Offered Music Therapist Volunteer Musician
Provides live music for patients  XX
Improves patient quality of life and wellbeing XX
Can enhance patient and family relationships with care team XX
Medically non-invasive XX
Primary focus is recreation, entertainment, & diversion  X
Allied health profession recognized by NHPCOX 
Education, clinical training, and board certification required to practice X 
Conducts a comprehensive clinical assessment X 
Develops, implements, and documents patient treatment goals X 
Competent with all genres and multiple instruments X 
Consistently utilizes patient-preferred music X 
Addresses goals in Psychological, Psychosocial, and Spiritual domains X 
Non-pharmoligical intervention for symptom management X 
Measures and responds appropriately to adverse responses to musicX 
Overseen by National Organizations X 
Adheres to best practice and evidence-based treatmentsX 
Research demonstrated cost-effectiveness in health settings X 

Sensory Processing

The Out-of-Sync Child: Recognizing and Coping with Sensory Processing Disorder
Kranowitz, C.S. (2005). The Out-of-Sync Child: Recognizing and Coping with Sensory Processing Disorder. New York, NY. The Penguin Group.

I am a huge advocate for medical music therapy and have been accustomed to seeing a diverse approach in all settings throughout my career.  Many people that receive music therapy services have neurological related diagnoses. Some of these diagnoses are Attention Deficit Disorder, Autism Spectrum Disorder, and Cerebral Palsy. Although each case is very different, some clients tend to show needs and deficits in similar areas, one of these areas being sensory needs. The Out-of -Sync Child is my go-to book when I need to refresh my understanding of the brain and sensory related disorders. Many music therapy clients have sensory needs and this book gives an in-depth overview of what makes up Sensory Processing Disorders (SPD). I would highly recommend it to any parent or caregiver. 

What is a sensory disorder?

Kranowitz briefly defines SPD as the inability to use information received through the senses to function smoothly in daily life. Think with me for a moment about the five senses. Sight, smell, hearing, taste and touch. There is never a moment in our lives where we are not using all of these. But we are able to regulate, ignore, and organize the way we perceive the messages each sense sends to our brain at any given time. I can make myself aware of the way the air feels on my skin when I am sitting in a room, but that takes more conscious effort. I may never notice the feeling of the air on my skin if I wasn’t trying. The same goes for all the other senses. But what if it was the opposite? What if I suddenly couldn’t stand the way every small movement I made changed the way my skin felt against the air around me. It would be annoying and distracting. That is SPD on a small scale. 

Before reading this book I had a very basic understanding of Sensory Processing Disorder (SPD). I knew that many clients I worked with and observed in the past had specific sensory preferences. I was not aware of the depth or anatomical specifics as to why each individual might behave or seek out certain sensory stimuli. This book answered all of my questions and more. 

SPD involves more than just the five senses!

 Kranowitz begins by breaking down SPD into two main dimensions, external and internal. External would be our five senses. Internal senses are the vestibular sense (inner ear), proprioception (muscles, joints), and introspection (internal organs). Since SPD is the neurological procedure of organizing the information we take in from the outside around us for daily use, it makes sense that our internal senses are included. Many times you may notice a child with autism that rocks back and forth repeatedly when seated. This is one instance in which SPD can be explained in the vestibular sense. Our inner ear is what sustains our since of balance. When the central nervous system is not smoothly signaling to the rest of our body then disorganization happens. The rocking we sometimes notice is stimulating the vestibular sense and helps the child know where their body is in space. 

The central nervous system is explained in more detail in an interesting and relatable way. This is one of the reasons this book was such an enjoyable read. The author gives research facts on top of medical data to support findings. All of which are backed up by multiple scenarios and real life testimonies of parents, teacher, therapists, and individuals that deal with SPD. 

What are proprioceptive senses? 

Personally chapter five was one of the most eye opening for me. The chapter concentrated on the elements that make up the proprioceptive senses. In short, the proprioceptive is what tells our body where it is in space. This includes muscles, skin, and the central nervous system. The sense of touch informs the receptors in the body of so much. Without a normally operating proprioceptive sense, an individual can struggle with motor planning, body awareness, and motor control in general. I learned that a deficit in processing of this sense is usually accompanied by issues in other areas as well; the two most common being the tactile and vestibular. 

I want to conclude by fast forwarding to the last few chapters in Part 2. It is true that knowledge changes perception and I feel strongly about what the last few chapters discuss regarding daily life with SPD, coping with SPD, school life, and parenting. Therefore all of the information prefacing these chapters is extremely important in understanding why such things as a “sensory diet” are necessary in the life of any child growing up with SPD. But before any advice can be taken, caretakers must recognize issues and seek out professional opinions. SPD can present itself alone, but often times coexist amongst other common diagnosis. This is yet another reason why this book is great resource for parents who see early signs of  “out-of-sync” tendencies in their child’s life. 

How are their primary needs being met and what adaptions need to be made?

For me, understanding, empathizing, and advocating for individuals with SPD boils down to first realizing primary needs. This is where a sensory integration is implemented. This is also where learning to cope is imperative to making productive changes at home. Acceptance can be challenging for parents, something we all observe from time to time. Comparing what we have and don’t have. What works and doesn’t work normally… This book speaks encouragingly and realistically to the parent dealing with a child with multiple disabilities, including SPD. 

Overall I was impressed with this book and would highly recommend it to professionals, parents, and peers. It is educational and a great resource for anyone seeking knowledge on SPD or related disorders!