Many states are seeking legislation to insure that consumers are treated by a qualified and board certified music therapist (MT-BC). Why is that so important? Can’t anyone use music to help people? What harm is there in having someone who isn’t trained treating people using music?
First, let me say that yes, anyone can use music to help people. However, it may be important to at least consult with a music therapist to assist in how to use that music effectively and not cause harm. I worked with a fabulous physical therapist when I lived in California and she used to say that prior to working with a music therapist, she was improperly using music. But, after some training from me, she was able to use music in her treatment much more effectively. She would also tell anyone who would listen that she was able to achieve three times as much with her clients when she co-treated with a board certified music therapist (MT-BC). Collaborating and co-treating are two of my favorite professional things to do!
I’ve alluded to the fact that improper use of music can cause harm. Here is one example: I was working in a major children’s hospital when one of the PICU doctors called me in to consult on a case. There was a young teenager who ran his snowmobile into a tree and suffered a traumatic brain injury. He was in a stage of coma where he was extremely agitated. His parents consulted with someone who claimed to be a music therapist but was not. That person programmed music for them to play at their child’s bedside to help him relax. The result of that music was increased agitation, increased heart rate (to dangerous levels), and decreased oxygen saturation rates. This necessitated increased sedation medication which can have negative side effects.
Luckily, our doctors knew to call in the qualified staff (me) to consult on the case. They were playing some beautiful Mozart concerto when I came in. The child was in restraints and writhing on his bed. When I asked the mother if her son liked classical music and if that would have been his music of choice to relax to prior to the accident, she replied, “oh no. He hates classical music!” I asked them to turn the music off, but his agitation continued. I asked what music he would relax to and his parents refused to tell me because they were ashamed. Once I explained that we could deal with his poor musical taste after recovery and explained why we would be using music purposefully and cited some research, they were on board. His sister revealed that he liked to relax to gangster rap. His mother said that this was unimaginable to her, and frankly to me too, but for this child, that is what would work. So, after conducting further assessment, I set up a music listening program specifically for him. As soon as I started playing the music that would work to help him relax, he let out a huge sigh and visibly relaxed. His heart rate lowered to normal in less than three minutes and his oxygen saturation rate went from 82% to 96% and remained stable. He was able then to relax and fall asleep without further sedation medication, allowing his body and brain to focus on healing.
Having the training of a music therapist and knowing the latest research on neurological effects of music was key in assisting this teen. The person who was trying to help these parents help their child was well-meaning, but uneducated. So, yes, music can cause harm.
Here is another example, and it is actually the one possible negative side effect of utilizing music by anyone, even a music therapist: triggering negative emotional associations. While working with a seriously ill patient who was suffering from the same condition that killed her father, my intern at the time had an interesting experience. That patient had a particularly difficult week and truly deserved a break. The team thought that she also needed to refocus on those things that bring her happiness. So, the intern brought in the book and song “Sunshine on my Shoulders” by John Denver. About half way through the song, the patient broke down into uncontrollable sobbing. As it turns out, that is the song that her father used to sing to her every night. Luckily, a music therapist is trained and able to deal with instances such as this and it actually turned out for the best as she had not grieved the loss of her father. It ended up being a cathartic experience for that patient. If it had been a music volunteer or someone else with out proper training, that patient would not have been able to come to catharsis, rather they would have been left in a state of despair. Later that day, the psychologist called me thanking me for helping this patient begin her grief process.
Music is a powerful tool. It can be used to cause positive change and just as easily can be misused and cause injury, emotional and physical. Music therapists are human beings and will occasionally make mistakes. Trained and board certified music therapists will recognize when an approach is not working or even potentially dangerous and alter treatment appropriately. It is important to protect those with whom we work by providing them with professional treatment by those qualified to do so.