Debra Melani, MUSICAL MEDICINE; Hospitals find that music enhances healing process. , The Washington Times, 02-20-2000, pp D1.
Music to 2-year-old Jackson McCabe is nothing but fun. The curly blond beams as his newfound friend, Ryan Judd, leads him in a guitar session. The two have been playing together for weeks, strumming their personal hits, such as "Monday Blues," and borrowing song titles, such as " Old McDonald."
Dinosaurs decorate the walls of their "recording studio," which is filled with colorful balls, mats and other props. Their audience in the pediatric rehabilitation room at Boulder Community Hospital in Boulder, Colo., generally consists of one true fan, Jackson's mom. To her, the show is much more than fun. She has been using music therapy with Jackson most of his short life.
"It really helped my son get excited about walking," Daphne McCabe says, adding that Jackson did not begin walking until he turned 2, more than a year after most children take their first steps. "There' s something about music therapy with children. The combination of music and movement works really well. It keeps it fun."
Jackson was born with water on the brain, a condition that was diagnosed only after it caused nerve damage on the left side of his body. Overcoming the challenges of his cerebral palsy requires a number of rehabilitative therapies, but Mrs. McCabe says the music version is his hands-down favorite.
Music therapy is not a new concept, but it has gained more widespread acceptance in the health care arena during the past decade. Using it for anxious surgical patients, confused seniors with Alzheimer' s disease and chemically addicted teens is becoming more commonplace. Boulder Community Hospital, for example, recently placed a full-time music therapist on staff.
When patients walk into the hospital's main lobby, they might notice something different. The rush of medical staff and urgent intercom pages is softened by the sound of classical music. A player piano sits near the couches, offering calm in place of chaos. The hospital solicits community volunteers to provide periodic live entertainment.
"There are different tiers of music therapy," says Willow Pearson, the hospital's new on-staff music therapist.
"This is music in the environment," she says of the player piano, emphasizing that it is separate from her profession. If patient feedback is positive, the hospital will consider giving the on-loan instrument a permanent home.
A player piano will be part of Longmont United Hospital's new tower, expected to open early this year, says Betty Trueblood-Smith, community relations marketing manager. "The whole premise is that music reduces the stress level," she says, adding that hospitals are moving continually toward the concept of administering to the mind as well as the body to enhance healing.
Boulder patients awaiting surgery or other anxiety-inducing procedures are offered headsets, and every hospital room in Longmont is equipped with a TV channel that solely broadcasts relaxing music and scenic images.
The Boulder hospital's pilot program with Miss Pearson and other interns from Naropa University in Boulder, where a master's degree in the field is offered, went so well, the hospital made it permanent, says Margaret Van Cleave, vice president in charge of the music program.
"We learned that not only did it address the emotional needs of, for instance, surgical patients, but there were also definite physical advantages. There were some indications that patients would come out of anesthesia more quickly and really cope better with the whole anesthesia experience," she says.
Miss Van Cleave admits those indications are all anecdotal but says the hospital plans to begin collecting hard data to help verify the program's effectiveness as it expands to other units.
Dr. Pete Sakas, a Boulder Community Hospital anesthesiologist who has been offering headsets to patients before, during and after surgery for about a year, says he has not observed physical evidence of music' s advantages.
"Does it make a difference in terms of their vital signs? I can't really say it makes a big difference," Dr. Sakas says. It does seem to set patients' minds at ease, though, he says.
"Surgery is an odd experience for people. They fear anesthesia and that loss of control maybe more than the surgery itself," Dr. Sakas says. "The theory is if there are ways to help patients handle their anxiety better with non-pharmacological means, that's good. They tend to handle the preoperative period with more of a sense of control, with less fear."
Experts in the field say they have seen effects in a vast array of patients. Jackson's mom says her son is one of them.
Jackson's cerebral palsy causes his left hand to curl up in a ball. He has trouble with balance and coordination. Before therapy, he could not jump. To get on top of a mat less than 2 inches off the ground, he had to go to his knees and crawl up.
Mr. Judd, Jackson's music therapist, uses a goal sheet from Jackson' s physical and occupational therapists at the hospital's Mapleton Center to create a routine. He improvises songs special to Jackson to capture and hold his attention and work on his physical challenges.
"Jackson's tapping his sticks, Jackson's tapping his sticks, Jackson' s drumming his sticks on the floor," Mr. Judd sings, as he plays the guitar. "Now reach up high, reach up high." The pair focus on reaching games to help stretch Jackson's muscles, which the cerebral palsy causes to retract. They do jumping games, and Jackson is just beginning to get off the ground. They spin on the mat, which Jackson now can step up on. Each game, at Jackson's insistence, is followed by a dual guitar session.
"Almost every night and several times a day, Jackson will pull out his guitar, singing songs that Ryan taught him," Mrs. McCabe says.
The guitar is an integral part of Jackson's therapy, as he must use his left hand to strum, forcing the hand to open up. His love for the instrument makes home therapy easy, Mrs. McCabe says.
"I'll sing with him. And he likes to do concerts for me," she adds. Jackson is making great strides. Special-needs children have trouble maintaining focus when trying to overcome their physical barriers, and music changes that, she says.
"There's sort of an automatic focus that occurs that helps them bring all their senses together. It makes it more natural."
It makes it more fun, as well, she says. "If you just tell a child to jump, you aren't going to get very far. But if you make a song about jumping and then jump, it's effective."
In the Washington area, similar music-therapy exercises are used at the Ivy Mount School in Rockville. The special-needs school incorporates music into the the curriculum for preschoolers through young adults, says music therapist Ruthlee Adler.
"Music has a huge influence when children have communications differences, " she says. "It has helped the children at our school with sensory integration, social interaction and cognitive skills. The kids think it is just fun, but they are learning to listen, and the ability to listen carries over into everything."
Mrs. Adler uses a song board to illustrate emotions, as in the song "If You're Happy and You Know it." Children have to match pictures of faces illustrating the appropriate emotion.
At the high school level, Ivy Mount students write, sing and act in their own musical.
"Working on that is a way for students to express themselves and make choices," Mrs. Adler says.
Miss Van Cleave says many pediatric patients have had success with the intern music program, provided free to rehabilitative patients through spring 2000.
"I think all of us react to music," she says. "It strikes an emotional chord with us. You can, if you will, lose yourself in music to a more calm state. So when you're in a time of great stress, it gives you a place to retreat."
That retreat is key to all music-therapy patients, whether their problem is physical or psychological, says Naropa's Laurie Rugenstein, director of the music-therapy program, who also has worked with Boulder County Hospice for seven years.
Naropa graduates who choose music therapy must also complete the degree program in transpersonal counseling psychology. Much music-therapy work has been done with patients who have mental disorders such as autism, Alzheimer's disease or attention deficit hyperactivity disorder. As in Miss Rugenstein's case, therapists also work with those who are dying.
Mrs. Adler, who also sees patients in a private practice, says music therapy can be a valuable relaxation and stress-management technique for cancer patients. She also has seen Alzheimer's patients show amazing clarity when presented with music.
"Music can be an important link to the here and now," she says. " It was [songwriter] Irving Berlin's birthday, so I brought in a song book of Irving Berlin music. After I played a couple of lines of the song, a woman who rarely spoke started singing all the melodies."
Miss Rugenstein goes into people's homes, offering her musical talents to help the terminally ill cope. She says she always tries to get the family involved, sometimes finding relatives to play other instruments. She says she believes in live music and improvisation.
"I'm able to read a patient and create music that meets them where they are," Miss Rugenstein says. She also plays music to take them back, songs they choose with meaning in their lives.
"It's important for people to review their lives. Many of the people I work with are couples. It's a way for them to go back and remember things and events in their lives together and begin the process of letting go," she says.
Songs allow clients to say things they cannot put into words, Miss Rugenstein says. Often they cry, she says. "I usually don't stop. That's what many of them want to do, is experience those feelings in a container where they can be held. The music provides that container for them."
The music is what makes the therapy more powerful than other forms of counseling, says Miss Pearson, who also works with dying patients or those who have suffered a great loss, such as a limb.
"I would say that music has the capability to reach people where other means of communication may not. It can be a noninvasive way of communication with people and a direct inroad to their physical, emotional and spiritual well-being."
Many music therapists are musicians who perform outside of work. But their psychological training is just as important as their musical talents, Miss Pearson says, noting that with a suicidal patient, for instance, a therapist would have to know where not to go.
The field is becoming more recognized, with programs in some 50 general hospitals, 70 children's hospitals and 120 rehabilitative clinics in the United States. Sixty-nine colleges and universities, including Howard University in the District, have accredited music-therapy majors.
Family Times staff writer Karen Goldberg Goff contributed to this article.
Copyright © 2000 News World Communications, Inc.
