Music, Healing & Psychosocial Oncology:

Music Therapy at the Princess Margaret Cancer Centre

SarahRose Black, MA, MMT, MTA, RPMusic Therapist, University Health Network and Kensington Health

Wednesday July 20th, 2016

Overview and Learning Objectives

The role of music therapy in: Palliative care Inpatient oncology

Four facets

How music therapy can affect a patient’s experience

Information on how to become a music therapist

What is Music Therapy? The Canadian Association for Music Therapy defines music therapy as:

“The skillful use of music and musical elements by an accredited music therapist to promote, maintain, and restore mental, physical, emotional, and spiritual health. Music has nonverbal, creative, structural, and emotional qualities. These are used in the therapeutic relationship to facilitate contact, interaction, self-awareness, learning, self-expression, communication, and personal development.” Canadian Association for Music Therapy / Association de Musicothérapie du Canada Annual General Meeting, Vancouver, British Columbia, May 6, 1994

To summarize:Music Therapy is the use of music in a

therapeutic relationship to achieve clinical goals

What is Music Therapy in palliative care?Music therapy in cancer care is the creative

and professionally informed use of music in a therapeutic relationship with people identified as needing physical, psychosocial, or spiritual help, or with people aspiring to experience further self-awareness, enabling increased life satisfaction and quality. (O’Callaghan, 2004)

Clinical Goals of Palliative MT

Music therapy can support CURRENT goals

Music therapy can create NEW goals

Examples of MT Clinical Goals: Evidence – Based WorkPain/symptom management (Magill, 1993, O’Callaghan, 2012)

Anxiety relief (Hilliard, 2001; O‟Callaghan, 2001)

Creating legacies for family and friends (Clements-Cortes, 2009)

Relaxation (Hilliard, 2003)

Support for families (Hogan, 1999) Support (physical- breathing, emotional-

comforting) at end of life (Salmon, 2003)

Providing a positive distraction from treatment/symptoms

Providing a non-verbal space for communication

The Four FacetsClinical Improvisation

Client and therapist improvise together

Inter-Active ListeningTherapist plays and client listens

to musicSong-writing

Client and therapist write music together

Active PlayingClient and therapist play music

(often pre-composed) together

Clinical ImprovisationDefined as: the spontaneous creation of

music between therapist and client using instruments and/or voice (Lee, 2003)

Inter-Active ListeningDefined as: A music therapy methodology

that involves the therapist playing, singing, or providing music in some form while the client listens; therapist and client may interact non-verbally or verbally; further interventions may be based on potential client response. (Black, 2013)

Song-writingDefined as: the creation of a song (either

with or without lyrics) by therapist and client that may reflect the client’s experiences. Song-writing is often done as legacy work for a client’s family.

Active PlayingDefined as: client and therapist playing

(generally pre-composed music) either together or separately

The Referral Process:

Why refer?

Who refers?

Inpatient CarePain and symptom managementAnxiety relief and emotional support Psychosocial support through verbal and non-

verbal creative self-expressionFamilial support Reflection, reminiscenceProcessing of current experience Legacy work

Music Therapy CollaborationsJoint sessionsCollaborations in Care/Joint Sessions

Occupational therapy Psychiatry Nursing Pharmacy Spiritual Care

Staff wellness Physicians and nurses Pharmacists Spiritual Care Concerts

Stories from the BedsideJason’s Saxophone- active playing and

improvisation

Jason’s SaxophoneCreating meaning in

the momentEmbracing a

defining part of his life

“I want to go out with a squawk”

“I want to go out with a squawk!”

Experiential: Singing Bowl

Reflecting In what setting might this be most

appropriate? What do you think clinical goals of this

intervention might be?What did you notice in your own body?

Thoughts? Images? Sensations? How do you think this intervention could

promote health and healing?

How to become a music therapist

Undergraduate or graduate music therapy degrees

Internship MTA Status (Music Therapist Accredited) College of Registered Psychotherapists

Working in the Field Music therapists work in all kinds of settings:

Hospitals Rehabilitation centresSchoolsCorrectional facilities Academic settingsHome settingsPrivate practiceThe possibilities are endless…

Informal Use of Music at BedsideCDsRecorded musiciPods/MP3

playersPlaylists/ “Mix

Tapes”YouTubeLyric discussionsPatient

preferenceChoice is crucial

Summarizing: Creating meaningful moments through a

musical relationship incorporating clinical goals

Creating legacies Providing emotional outlets Engaging staff Supporting grief

Thank you!

Questions? Comments?

Contact: Sarahrose.black@uhn.

ca

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Hospice and Palliative Medicine, 21(4), 255–260. Clements-Cortes, A. (2009). Episodes of relationship completion through song-writing in palliative care. (Doctoral

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