The definition of music therapy is to design interventions of benefit to achieve non-musical goals to meet a client’s needs. Determining what the goals should be for the client is a really important part of the music therapy standards of practice, and it takes a lot of practice to know what goals are appropriate for each client. Goals are determined after the client is assessed. Assessment occurs after a client has been referred by someone (doctor, teacher, self). In hospice, music therapy can be referred by the doctor, nurse, or social worker.
In assessment, the music therapist (MT) will engage with the patient and/or the family. She will find out the patient’s preferred music and any significant songs or artists they really love. She may ask what the patient is looking forward to or hopeful for, and what’s most important to them. Usually, the MT will have had an opportunity to look at the patient’s chart to find his/her primary and secondary diagnoses (what the terminal illness is) and from that alone we can get an idea of what goals would be appropriate. For example, if the patient’s diagnosis is dementia, the goals will most likely be decreased isolation and depression (because a lot of times they can’t remember that people visit them) and improving quality of life. Here is a list of the most common goals for hospice music therapy patients:
- improve quality of life
- life review
- decrease isolation
- decrease loneliness
- decrease anxiety
- decrease depression
- family connection
- spiritual support
- emotional support
- interpersonal support
- self expression
- anticipatory grief
Goals can also be set for the family or caregiver. Sometimes the patient is in a comatose state or unresponsive, but the spouse or other family members are having difficulty with their grief. In those cases, music therapy can still be prescribed to support the family. Goals in these instances are usually family connection, spiritual and emotional support, and anticipatory grief.
So how can music help achieve these goals? Some of them are self-explanatory. The presence of the music therapist and the music itself can be comforting and can also help with goals of decreasing isolation and loneliness. Spiritual and emotional support occurs when music is selected that is meaningful to the patient and/or in which the lyrics have significant meaning to the situation (yesterday the daughters of a patient told us how he remarked he was ready to go home, so I sang the song “Going Home”).
It’s easy to come to the conclusion that anybody with a guitar and a nice singing voice could do this job…and I guess they could pretty well. But music therapists are trained not only to know songs and be able to pick out the right ones, but we’re trained to determine the most effective goals for the patient. We’re also educated in the diseases we come across and how music affects the physiology of the patient (breathing, heart rate, etc.) I compare it to someone who wants physical therapy, so they just hire someone who is athletic and knows how to stretch. Yeah, stretching is good, but there’s more to physical therapy than just moving limbs back and forth. The same is true for music therapy: there’s more to it than just singing pretty songs.
Just look at our documentation!