Listen to what makes music therapeutic
Playing at the bedside of a patient is different from giving a concert. I am observing the patient while I play in order to change the music whenever necessary.
There is no set list
What I choose to play starts with what I know about the patient—their medical condition, age, the reason they were referred to me. But what I observe when I come in is what influences my choices the most. Do they appear to be in pain? Agitated? Sleepy? Whatever is happening now is where I begin.
This is a tune called “Reflection” composed by Anne Crosby Gaudet
It has a moderate tempo. There are notes on almost every beat.
Given this kind of complexity, I might start a session with this song if the patient were alert but trying to relax.
Recognizable songs might not be appropriate
Sometimes it doesn’t work to play a song that the patient knows. Sometimes it doesn’t work to play a song at all. Sometimes the patient responds best to soothing sounds without a discernible melody, or even just a single note ringing out into silence.
This is an improvisation. It has a regular rhythm, with several notes that ring out and breathe.
I might play something like this for a patient who appears agitated. The notes meet them where they’re at, and the spaces help bring them to calmer place.
Here is another example of a different kind of improvisation I might use that uses no regular rhythm which is called “arrhythmic” or “non-rhythmic”. This type of improvisation is used for general relaxation, drifting to sleep and letting go of tension, pain, or for those that are nearing death.
I might play something like this for a patient who is recovering from surgery or Pre-Op, or in Hospice. Towards the end of this improvisation, I reduced the amount of notes that I played so that there is less for the listening mind to process.
A song might need to be changed while I’m playing
One of the defining tasks of a Clinical Musician is to observe the patient while I am playing and make changes to the music if necessary. Based on their reaction to this song, should it be slower? Have fewer notes? Use a different rhythm? I watch the patient to see what works best.
I start here with “Take Me Out to the Ball Game.” It is likely a song that patients recognize.
What if the patient were not responding well to it? Perhaps they do not find familiar music to be soothing at this time.
I turn the song into something unrecognizable, keeping the same underlying structure that I started with so that only the familiar element of the music is changed.
Fewer notes are better than complexity
Playing therapeutically is a service, not a performance. It’s about supporting a healing environment, not showing off. For the most part, simpler is better.
The skill lies in selecting the right music for the patient and observing the patient throughout the session to continually meet their changing needs.
This is a Welsh Folksong called “All Through the Night”.
As the song progresses, I decrease the number of notes in the left hand. Listen to how the song gets simpler in each verse. I might play this for someone who is falling asleep.
Where can patients benefit from live music?
CCU
Oncology
Palliative care
General care
Dialysis unit
Hospice
Nursing home
Pre-op
O.R.
Post-op
ER
Obstetrics
NICU
ICU
Read some of the research that supports therapeutic music. Learn more about my training as a Clinical Musician, or see ways to contact me.