The League of American Orchestras had a session titled “Getty Health and Wellness Session: Health, Wellness and Music.” The session was moderated by Jessica Balboni, Director of Learning Programs at the League. She introduced the panel: Dr. Cynthia Briggs, Director of the Music Therapy Program at Maryville University in St. Louis; Lisa Dixon, Executive Director of the Portland (Maine) Symphony; Jennifer Barnett, Director of Education and Community Engagement at the Knoxville Symphony; Maureen Byrne, Community Programs Manager, St. Louis Symphony; and Crystal Weaver, Music Therapist at the St. Louis University Cancer Center.
These orchestras all received health and wellness grants from the Getty Foundation, a program assisted by the League.
Dr. Cynthia Briggs gave an overview of the importance of music therapy.
Why is music therapeutic?
- Music is learned and stored diffusely across the entire brain from the brainstem to the frontal lobe.
- The earliest sounds we make contain the elements of music: rhythm, phrasing, accent, tonality.
- Rhythm is an organizer, and driver: it directs motor movements and organizes musical and nonmusical content.
- Music is also processed by our auditory cortex and limbic system so it connects directly to our emotions and memories.
- We associate positive affects to the music we enjoy, the same way we do with our favorite foods and people.
- We connect strong memories to music, which are embedded in our memories along with the music – when we re-experience the music we re-experience the associated memories.
Dr. Briggs quoted from a June 7, 2013 New York Times article, “Why Music Makes our Brain Sing” by Robert J. Zatorre and Valorie N. Salimpoor. She also quoted from a David Brooks New York Times op-ed piece, “Beyond the Brain” from June 17, 2013 about how people are using neurosciene to explain everything – the mind and personal experiences. What makes music powerful is that it’s so personal. We can get close to someone by knowing what music is important to them.
She defined partnerships as engaging other organizations with shared goals regarding the use of music in health and wellness programming.
- Shared interests and goals
- What does each partner hope will be the outcome of this partnership in music and health? Is it realistic/possible?
- Does each partner clearly understand what the other does and does not do?
- What does each partner need to be successful regarding their component of the partnership?
- Create shared goals for each project.
- Strengths of each partner organization and identification of needs:
- Survey the members of each partner: what are the member’s interests?
- What do partner members need to be successful?
- Educate all partner members about the project and what each partner organization does.
- Be sure the projects you create are need-driven.
- Educating the partner members through ongoing listening and ongoing dialogue:
- Initial surveys and dialogue regarding interests and needs
- become ongoing dialogue
- Listen/listen/listen! To partner members: program recipients and the community
- Post-op: reviewing regularly for evaluation and revision. This involves self-evaluation and research:
- Build in ongoing self-evaluation procedures from the start
- Structure projects, when possible, so that there can be good data collection that can later lead to sharing of results
- Evaluate and learn from all of the data you collect, no matter what the level of the data is
Lisa Dixon, Executive Director of the Portland Symphony in Maine, gave a presentation about their Music and Wellness pilot program with a partnership with the New England Rehabilitation Hospital.
The program has two arms:
- Employee programs that help employees deal with a stressful work environment, using music to help their satisfaction and stress management
- Patient Connection – the Music for Life program, where musicians are involved in movement class and guided listening
Lisa showed a video of these two programs, with musicians working with employees and with patients. Click here for a few photos of their program.
The most important part is learning about the importance of dialogue – it’s about mutually-beneficial goals for the program. The Portland Symphony’s mission is to serve the community by enriching their life through music. From the hospital point of view, they want to strengthen employee satisfaction and improve the patient experience. Their funding is tied to patient satisfaction surveys.
We are all centered on the planning team, which involves hospital people, symphony staff and musicians.
The first program for employees was in a full room. “We went through the program, gathered the surveys, and their feedback showed that the program was great but they were more stressed out by the end of the program than at the start. It turns out they were facing a window that looked out at the parking lot, and they were seeing their coworkers going to their cars out the window – they were remembering that they’d forgotten to email or call someone and were getting stressed all over again. We changed the configuration of the room and the second program was much more successful. ”
The PSO did a survey of the full orchestra to find out who is passionate about this work. They found that the musicians are really eager to get in there and make the program as strong as possible.
Jennifer Barnett of the Knoxville Symphony talked about their partnership with the University of Tennessee Medical Center. The program started in 2003, when they had 16 performances in assisted-living facilities. In 2012 they gave 88 performances, reaching 6,000 people in the region. They now have four partners, including the University of Tennessee Medical Center, Parkwest Hospital, Covenant Healthcare Facilities, and the Fort Sanders Regional Hospital Cancer Support Community.
The musicians play as soloists or in a quartet. The UT Medical Center Cancer Institute is their primary partner – they play in the oncology and main waiting areas, with solo musicians playing for the patients receiving chemotherapy treatment. One violinist played in the neo-natal intensive care unit for an infant. When he moved to the side of the crib, the patient turned her head to the right, tracking the music. She had had reconstructive surgery on her neck, and had never turned her head to the right since surgery. It was a break-through in her recovery. In contrast, what they do now is send in a soloist along with a therapist. After a few minutes of entrainment work – matching the rhythm of the music to the rhythm of something in the patient’s body – they can note that heart rates have decreased from the 170s to the 140s, and oxygen level percentages have increased form 89% to 98%. They now have actual documented measurements, rather than just anecdotal evidence.
The most exciting recent development is that they’ve added a board-certified music therapist to the KSO staff – the need for a music therapist came out of a needs assessment project. There were no music therapists working in East Tennessee, so this program is pioneering this activity for the region. Her salary is funded by the KSO, UT Cancer Center provides clinical space, and the Cancer Support program provides benefits. Her role is to provide individual and group therapy, and she works with the musicians in the program.
Jennifer showed a video of KSO musicians working with patients, who commented at the end of the session, “I played with the Knoxville Symphony!”
This year the KSO started professional development for their musicians with Getty funding. The music therapist has discussed interactions and interpersonal skills, appropriate decibel levels in the hospital, making the shift from performer to provider, and how to organize repertoire for different areas of the hospital. Also caring for caregiver, given that the musicians are sometimes in tense situations.
The musicians are enrolled in the Music for Healing and Transition Program, a five-module program at the end of which they will become Certified Music Practitioners. They’ve already completed module 1, which covers patient assessment and general guidelines when entering a patient’s room. The program also includes a 45 hour internship for the musicians to work with patients
One of their great challenges over the last year has been to decide what repertoire is appropriate. What’s the best kind of music? Is classical music the best? The difficult answer is it so much depends on the patient’s preferences and background.
They’ve identified several overarching questions that our industry must answer while doing this work:
- How do orchestras integrate professional musicians into healthcare settings in conjunction with a music therapist? The music therapist has years of academic training in their field – they provide the musical intervention in a patient’s room. How do we take orchestral musicians who’ve not had this training and put them into these situations with musical therapists? What does that relationship look like? Where are the boundaries?
- How do musicians and organizations justify providing music that benefits patients, visitors and staff in healthcare settings with artistic goals? Musicians are constantly evaluated on the quality of their playing – the music played here is not always cohesive with that goal. How do we make the shift from performers to providers?
Maureen Byrne, Director of Community Programs at St. Louis Symphony, discussed the SLS’s programs. They’re involved in three healthcare programs. Two just went through their pilot year and the third is in its second year.
The local NPR station did a great story about the collaboration with the St. Louis Cancer Center, featuring cellists Anne Faberburg and Bjorn Ranheim.
The key to the program is partner commitment. The SLU Cancer Center hired a full-time board-certified music therapist, and they implemented a comprehensive music therapy program that helped define and direct the St. Louis Symphony’s musician involvement.
They know how many musicians are interested in Monday morning performances in infusion rooms. How many ask to be part of it? They were recruiting in the pilot year, and last year they had more musicians who wanted to be part of the program than they had spaces for.
Chrystal Weaver does professional development with the musicians – she sets both their expectations, and the patients’ expectations. She’s also produced a handbook with suggestions on repertoire and logistics at the cancer center – it takes a lot of the stress out of making this visit.
The St. Louis Symphony decided on musician duos, because it’s too stressful for one musician but there’s not enough room for three.
Crystal does a clinical assessment. She feels that is a really good experience for both musicians and patients when you partner with a music therapist, who has training both with cancer patients and with musicians. One of the best benefits is the symphony’s ability to incorporate formal research when presenting the results of the program to healthcare organizations.
Tempo really does affect someone’s physical state. It’s not one style for everyone – SLS musicians have a lot more creative control and freedom – when they play from 66 to 72 beats, the pulse and heartbeat, and respiration of the patient begins to entrain with the tempo of music.
The American Music Therapy website has lots of additional information.