Sheri Robb talks about the fascinating and growing field of Music Therapy
On June 3, Sheri Robb and Ben Folds will team up for Breakthroughs with Music Therapy: Recovery, Resilience & Quality of Life as a part of Sound Health: Music and the Mind. Robb took some time ahead of that session to talk about her field and research.
First things first: Music can be therapeutic. That is a quality that has inspired philosophers dating back to Aristotle and countless composers and artists. However, the term “music therapy” refers to an organized profession of trained therapists who use music as a tool with patients for positive health outcomes.
“Music therapy as an organized profession really started gaining momentum around the time of World War I and II,” explained Dr. Sheri Robb. “There was an organized movement of musicians going into VA hospitals and working with veterans. Hospitalizations were very long back then, often months. They noticed that there were responses and benefits, and eventually decided it would be important to have an organized profession with training to guide the work that was being done.”
In the 1940s, the first degree programs were established, which Robb said is often seen as the official beginning of music therapy as a profession. Robb, a music therapist and behavioral intervention researcher, is on faculty at Indiana University School of Nursing. Her research focuses on development and testing of music therapy interventions to manage distress and improve health outcomes for children and adolescents with cancer and their families.
Robb said a cornerstone of the profession since its inception has been research. It is one thing to observe a positive benefit from music (say a patient with dementia reacting to a song from his or her childhood), but music therapy researchers seek to understand how and why those responses occur — then use that information to create a targeted and repeatable treatment.
Robb said that it is equally important is identify and understand adverse effects from music. The assumption is that music can do no harm, but music can have averse effects for certain people. For individuals with neurologic disorders or vulnerable patients with compromised communication, it’s especially important to be knowledgeable about music’s potential to overstimulate, disorganize, or evoke traumatic memories. As Daniel J. Levitin wrote recently for the Daily Beast, this is one of the reasons it’s important that music therapist be trained properly and certified.
Early music therapy research was grounded primarily in the social, psychological, and behavioral sciences. This research, Robb said, is still very important, but developments in brain imaging and neuroscience, along with advances in music perception research present a great opportunity.
“What I find most exciting [about advances in neuroscience] is that it means we have this opportunity to create even more targeted and focused interventions,” Robb said. “By establishing the efficacy of music therapy interventions through rigorous trials, we hope to see increased access to music therapy services. Perhaps even more exciting is that through research partnerships with neuroscientists, healthcare providers, and families who receive our care, we have the opportunity to really dig in and understand how and for whom a specific intervention works — which is consistent with advancements in personalized medicine.”
More robust science and research means that music therapists can be even more effective in delivering individualized care, and it makes the case to health providers or insurance companies to make music therapy more available. Robb said it is an exciting time for the profession as they are starting to see music therapy become a standard of care.
Music therapy can take many forms and has varied applications. It has been used with those who have Alzheimer’s to lessen the effects of dementia, or rhythm-based interventions have helped people with Parkinson’s to show improved motor control. Recently, a music therapist worked with Congresswoman Gabrielle Giffords to help her regain her ability to speak.
One music therapy intervention developed by Robb is a Therapeutic Music Video (TMV) intervention for adolescents and young adults undergoing high-risk cancer treatment.
During the TMV, board-certified music therapists work with adolescents going through cancer treatment to write song lyrics and create visuals that represent what is most important to them. “We know that many times it is difficult for adolescents and young adults to communicate with family or friends about their cancer experience,” Robb said. “They may avoid these conversations in an effort to protect others and sometimes themselves from difficult, emotional conversations. So a big part of the intervention is focused on giving them a way to express things to other people about what they’re going through without having to tell their story over and over.”
The intervention helps adolescents/young adults develop positive coping strategies, maintain social relationships, and improve family communication during high-risk cancer treatment. Robb’s colleague, Dr. Joan Haase, developed a Resilience in Illness Model, which specifies risk and protective factors related to resilience. They used Joan’s model to guide evaluation of the TMV that focuses on strengthening protective factors (like family communication and coping), and that lead to improved resilience.
The music therapist is able to structure the experience so adolescents can successfully engage in the project, even when very ill. This allows them to reflect on, express, and talk about their experiences. Robb said, “Through the creative process of writing lyrics and creating a music video, adolescents identify their own strengths, re-connect with family, friends, and healthcare providers, and developing positive ways to cope.”
“Findings from our multi-site efficacy trial indicate that adolescents who received the therapeutic music video intervention had significant benefits in terms of increased use of positive forms of coping, improved peer and family relationships, and communication which are associated with better long-term health outcomes” said Robb.