"Music Therapy, COVID-19 and Change"

[Scene: Music Therapist walking into hospital]

Step one: SANITIZE SANITIZE SANITIZE

Step two: Greet (and be greeted by) the temperature checker! 

“Good morning to you!  In the last 48 hours, have you experienced any of the following symptoms: fever, cough, shortness of breath, loss of taste or smell?”

Step three: Have temperature checked. 

“... and don’t forget your screening sticker!”

This is now a pretty normal experience for any healthcare professional entering the hospital for a new day of work and is just one of the many changes we’ve had to adapt to over the past year.  Luckily for us music therapists, adaptability is our middle name (no, not really)!  Even so, this year has brought about new policies, procedures and restrictions that have changed what music therapy looks like for our patients and ourselves - possibly forever.

Many music therapists are accustomed to working with at-risk populations, including people that are now at high risk for the COVID-19 virus.  So, what exactly does medical music therapy in the time of COVID-19 look like?  Let me share with you my experience.

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First up - the logistics.  

I currently work in three different hospitals, with mostly adult patients in various settings including physical and neurologic rehabilitation and an infusion center for those receiving chemotherapy and other regular infusions.

In addition to our new hospital entry process, we are required to utilize all personal protective equipment required for the patient we are working with - typically this looks like eye protection (goggles or glasses) and, of course, a mask.  I have reduced instrument use with patients and now only use instruments if they are required to meet a certain goal - motor/movement or cognitive based goals are the most common instances.  This was a big change for me as we often picture music therapy sessions as utilizing guitar, piano, and all kinds of instruments.  These days, I sometimes utilize only my voice, if that is required during sessions.  There has also been an increase in tele-health or video visit sessions, to reduce the amount of in person contacts our patients and clients have on a daily basis.

In addition to changes in policy, there has also been a change in the type of patient care I provide and the type of support our patients need in the hospital.  At my physical rehabilitation site, I have noted an increased need to focus on the social and emotional wellbeing of my patients as opposed to only their “rehab” goals (typically motor, speech or cognition based).  Patients who are hospitalized during this time are experiencing increased stress and anxiety, due to the pandemic, our current nationwide environment and everything else that 2020 sent our way. I have noticed in myself, my patients and other hospital staff, a decreased emotional bandwidth for coping with everything going on in our world. Most hospitals have also had to increase visitor restrictions due to the pandemic, so many hospitalized patients are experiencing isolation from their friends & family during their recovery and decreased opportunities for social interactions. Even group sessions that would have been happening pre-pandemic, have been cancelled or required adaptations such as: decreased group members and increased social distancing.

But with all of these limitations and challenges, we are still able to make a positive impact and difference in the lives of our patients and the staff that work with them.  How?  Though music.

So what can music do for you? For us?

Music can be a great tool for helping us feel “better” and for increasing feelings of relaxation and calm. One of the greatest things about music (in my humble opinion), is that you do not have to be “musically inclined” in order to benefit from the use of music in your life. Music has a way of impacting our brain and body in a way that no other sense does. When we listen to music, the body releases endorphins into our system, as well as dopamine and serotonin hormones, which can help elevate our mood and help us feel better. When we sing, the brain also releases oxytocin, a hormone that can help relieve stress and anxiety.  And the best part?  You don’t have to be a “great” singer to sing - you have the instrument built in!

Beyond the chemical impact it has on the brain, music is a great motivator and unifier.  As a music therapist, I’m able to utilize music as a way to connect instantly with someone I’ve met for the first time.  I’m able to utilize the emotional connection and enjoyment someone has to music and provide comfort and connection to a patient who has been hospitalized and isolated for several weeks. Music allows us to build relationships with others like you would a mutual friend, building on that immediate rapport with patients to give them that deeper level of support and care they need in these uncertain and downright frightening times.

Several weeks ago, I was working with a patient who was recovering from a spinal cord injury sustained after falling while working outside on his home.  It was smack in the middle of the holiday season and every patient I had worked with was feeling the heaviness of being in the hospital at this time of the year.  For George*, this would be his first time that he was unable to spend Christmas with his kids and his newest grandchild, born earlier in November (after his accident).  George had several sessions with me to increase his fine motor skills & sensation in his hands and fingers, but also utilized the connection we had through music to process how difficult this recovery process was for him.  During our last session, George shared “The work has been hard and it’s been difficult being away from my family. This has really made a big difference for me here; just being able to make music, work on my goals and talk with you has helped me feel so much better.”

As music therapists, we are able to use music to positively impact our patients and help them cope with the many changes our world is going through. The times may be a’changing, the way music therapy looks may be a’changing, but the impact that music has on all of us will continue to promote healing, connection and overall wellness.  That will never change.