Soothing sound of music (Music therapy)

The following articel is from the Mind Your Body of the Straits Times dated Jul 1, 2010 by April Chong.
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Its therapeutic effects are gradually being acknowledged. Music is now also used to alleviate pain and as a form of treatment for dementia patients and the terminally ill
By April Chong

When music therapy was introduced here in the 1980s, it was used mainly to help children with special needs.

In the last few years, this form of therapy has diversified and is used, for instance, in pain management, for geriatrics and end-of-life care as well.

In countries such as the United States and Australia, where music therapy is more established, it has been used to soothe violent criminals, calm women in labour and awaken the comatose.

Music therapy, regarded as a science, has to be administered by a trained therapist who will assess what the client needs and then tailor the sessions to suit him, said Ms Ng Wang Feng, the president of the Association for Music Therapy here.

The Singapore association was formed in 2007 and there are now 12 therapists based here. However, music therapy certification is not available here and most therapists received their training in the US or Australia.

This form of therapy is still mainly employed in special schools. However, it is also used in medical institutions such as the Singapore General Hospital, KK Women's and Children's Hospital and Dover Park Hospice.

The kind of instrument or music used is not chosen randomly. Patients or clients are assessed on their physical, cognitive and social abilities. The intervention is then planned according to their needs and musical preferences.

Some programmes may run over a number of years - such as when therapists are working with special needs children - while patients in acute care may need only a few sessions.

For those with dementia

For patients with dementia or Alzheimer's disease, this therapy targets their cognition and social skills, said

Ms Ng. For example, if the person is confused or disoriented, the therapist will use an instrument, such as a guitar, to engage him in a 'hello' song.

In the song, the therapist will help the patient orientate himself with questions like 'What day is it today?'.

Music can also help jog the memories of those with dementia, said music therapist Melanie Kwan, who works with various medical institutions. These include Alexandra Hospital, where she works with dementia patients, and Dover Park Hospice, where she works with the terminally ill.
'Music helps them reminisce and retain their dignity even when they have lost their independence,' she said.

When the therapist plays the chords of part of a song the patient likes, it can help him recall the rest of the song and this may motivate him, she added.

In pain management, music is not just a distraction from the pain. It is used also to regulate the patient's breathing and to help him relax.

For social interaction

As music can be enjoyed without the use of language, it works on people who are not able to articulate themselves, said Ms Charissa Tan, a music therapist based at the Leukemia and Lymphoma Foundation. For example, music can be used to engage autistic children and give them a chance to express themselves through singing or playing an instrument.

Patients can be very isolated and music can help them interact with people. The sense of achievement patients feel from learning to play an instrument draws them out of their shell and helps them interact with others. This also helps to boost their self-esteem, she explained.

To boost motor skills

Examples of the other uses of music therapy include getting uncooperative patients to comply with treatment and maintaining the motor skills of muscular dystrophy patients by getting them to play instruments.

Some of the instruments used are specially built for therapy. The reverie harp, for example, always sounds harmonious no matter how it is strummed.

Dr Adrian Wang, a consultant psychiatrist at Gleneagles Medical Centre, said that researchers believe that musical memory may be better preserved for those with cognitive and learning disorders. In reawakening these connections and memories in the brain, other parts of the brain may also be stimulated, he said.

The calming effect

Linking music to learning is helpful because music can be calming and allows one to focus better. One example is how people often whistle or hum a tune as they work. This can help a person coordinate and perform better at his task, he added.

To alleviate pain or anxiety, music can stimulate a neurotransmitter response in the brain although the mechanism is not fully understood, he said.

For example, a 1999 study published in the journal Alternative Therapies In Health And Medicine found that music therapy increases the level of melatonin in the body.

The hormone melatonin is believed to have helped put the patients in the study in a relaxed and calm mood.

Melatonin is also believed to help in memory and learning. Another study done in 1997 and published in the journal Neuroscience found that it prevents the death of the nervous cells in the brain when a person has Alzheimer's disease.

While there is wide acceptance of the profession of music therapy overseas, it is still a relatively small field here. Some are sceptical about its efficacy and doubt if it is an exact science.

Ms Tan said the evidence would be in the behaviour changes in the patient after the session. She also hopes that more local research will be done to encourage the use of music therapy here.

For the comatose

Another potential use of music therapy is in coma awakening in which the comatose are made to be more aware of their environment. This may help them emerge from their coma.

While the effects of music therapy may vary, there is at least one sure thing. 'It can stimulate positive emotions and enhance recovery. Most people do enjoy music to some extent,' said Dr Wang.