Music therapy: An Essential Instrument in the Healing Process
Willow is bouncing up and down on her bed at Phoenix Children’s Hospital, and wriggling to the music. Her eyes are brighter and her small, chunky body moves with the beat. In some ways, she looks like a typical one-year-old, the apple of her mom’s eye.
Except, most one-year-olds aren’t fighting cancer. To most, it appears that Willow is enjoying the music, which can distract her from pain and fatigue, even if she can’t verbalize her responses yet. But there’s something more complex going on.
The music is tapping into the part of her brain – the “control tower” that tells the rest of her body what to do. In this case, slow down her heartrate, reduce toxins that cause stress, and begin the process of healing. And also, promote her continued development, despite spending so many hours confined to the hospital room.
Today, the guitar playing and singing she’s listening to is her “prescription” — a dose of music therapy.
“Music therapy is an allied health profession that uses music to accomplish non-musical goals in the hospital setting.” That’s how Julie Renato, a board-certified Music Therapist at Phoenix Children’s Hospital, helps us understand her proud profession.
“We don’t work on music – we use music to work on other skills.” Her work takes her to every corner of the Hospital, from Rehabilitation to the Cancer Center to the Newborn Intensive Care Unit (NICU). No two days are the same, because music therapy has countless applications depending on the patient’s age, temperament, diagnosis, preferences and mood. And she likes it that way.
“Each session varies so widely; I work with kids from the first day of life to early adulthood with varied diagnoses and needs. Sometimes, if a patient’s in pain, I play the guitar at bedside to help them calm down so they can sleep with a reduced need for medications. I can hum a lullaby to help an agitated infant receive treatment. Sometimes a session is an engaging one where we can use drums or shakers; sometimes with older kids, we work on songwriting to help them express their feelings. I can also support family bonding too; maybe just for a moment, a mom can hold her child while I sing, and feel a little more normal.”
The brain on music
Most of Julie’s professional peers have a 4-year degree in music therapy, participate in 6-month internships, and some, like her, earn Masters degrees in Music Therapy. She says every single day is different, because each patient in the Hospital needs something different from her. It’s rewarding too, she says, to see how music therapy spurs healing and development.
“I was working with a boy who was 2-years-old in rehabilitation; he wasn’t speaking or walking, and through the use of music, he spoke his first word while I was singing Twinkle, twinkle. Also, the music cued his brain’s sub cortex to move his feet. So while it’s easy to see how music can affect the mood, I’ve gotten to see firsthand how music can help re-grow the brain pathways and improve neuroplasticity [the brain’s ability to reorganize itself, particularly after injury or disease]. When it works and it clicks, it’s exciting to see the joy in the patients’ and parents’ responses.”
Julie’s role is an integral one along with the multi-disciplinary team approach practiced at Phoenix Children’s. She’s part of the Child Life team of professionals that work to make procedures and hospitals stays more comfortable for children. The team also works closely with clinicians and varied team members to consider the needs of the whole patient, and how they can work together to achieve better patient experiences and outcomes.
“We might be making up a song, and when I can see that something works, and the lyrics or cadence inspire them to move, I might record that song and share it with the physical therapy team so they can continue to work with it, too,” says Julie, for example. She says it helps especially to stay very present in the moment, and to change things up if a patient isn’t feeling well enough to participate, or isn’t in the mood to do the usual therapy.
Which brings us back to Willow. “Willow is a very special and adorable 1-year-old I’ve been working at for a while now; she’s been in and out of the hospital, and I try to see her a couple times a week. With Willow, we’re working especially hard to help her achieve her developmental milestones. While she’s enjoying the music, she can also reach for the instruments and move around. She’s engaging; she loves to dance and sing and she’s made a lot of progress. But sometimes if she’s just too tired, I’ll change things up in the middle of a session to try what works that day. Maybe instead of getting her to participate, I’ll sing to her instead.”
“There is no right or wrong way to respond to music,” she says. “That’s the beautiful thing about it.”
The key to music therapy: Staying present in the moment
Julie loves working for Phoenix Children’s, and says she’s grateful for the donors who support this critical program, which is funded solely through philanthropy.
Music has always played an important role in Julie’s life; she loved singing and being on-stage when she was just 3 years old in preschool. “I performed all through high school. I started to pursue a degree in Music Theatre, but I realized it wasn’t for me — what I really wanted to do was help people. Music therapy combines my passion for music and helping others.”
Working in a pediatric setting pulls on the heartstrings, Julie says. Sometimes clinicians will ask for the presence of a music therapist when withdrawing life support care, or when a patient is moving toward the end of life.
“I’m able to be present with that patient and family in that moment, but then I have to move on to connect and empathize with other patients. You have to be aware of your emotions because it’s not your story – you’re helping facilitate something for the family.”
Willow flashes Julie a gummy smile, curls next to her and coos her affection. Her laugh is music to her mother’s ears.
Imagine you’re 6 years old. After a terrifying accident, you were pried from a car, whisked into an ambulance and rushed to the trauma center at Phoenix Children’s Hospital. All you can see are glaring lights and the faces of people you don’t know. Doctors are urgently giving orders. Nurses are putting a mask over your face and needles in your arm. You can‘t breathe; you’re disoriented, and no one knows your name yet. Your tears spill over and you begin to panic. Then, a Child Life Specialist enters the room. Everything changes.