CareSearch Blog: Palliative Perspectives

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The Role of Music Therapy in Addressing Anxiety in Palliative Care – Part Two

A guest blog post by Andrea Bryk, Registered Music Therapist, Peninsula Home Hospice

  • 25 August 2017
  • Author: CareSearch
  • Number of views: 7227
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Image of music lyrics on pad with penThe use of music based relaxation to assist in reducing anxiety
Whilst there seems to be numerous barriers to overcoming anxiety, palliative clients, predictably, often have a vivid imagination and astute focus. The paradox is that some of the traits that can cause suffering can be used very productively on the other end of the spectrum to create a great sense of calm and well-being. Changing the focus from imagining what the future holds to noticing comfort in the present moment and redirecting attention to a space of safety and comfort is usually the key to decreasing anxiety [1]. Music therapy interventions, specifically the use of music based relaxation programs, can provide an anxious person the opportunity to experience peace in the moment [2].

After completing an assessment session, the client usually agrees to a live music relaxation trial. At this point I have ascertained the issues, problems, patterns and needs. Generally, I have identified the purpose for relaxation (e.g. to encourage sleep, to increase energy/vitality, clarity). The length of the intervention is discussed and noted.

The intervention begins by asking a person to find an ideal place for relaxation. This can be in a quiet room and in a comfortable chair or bed with support for the body. While it is important to point out that distractions might occur (as they often do in life), we are trying to set up an ideal space for quiet to encourage focus. Working with somebody at home offers the ability to prepare a therapeutic space ideal for relaxation at any time.

The selection of appropriate recorded music for the relaxation reflects client needs. I tend to use unfamiliar, recorded music selections so I can focus on the induction (the verbal script used in a relaxation process) and notice the person's response to the process as we go. Before we begin the process, we agree on the placement of the speaker and test the volume of the music. During the induction, I note the client's ability to focus and respond to the instructions as well as their reaction to the music selected. 

After relaxation, the therapeutic conversation evolves around the response to the experience, refining the aspects of that or answering questions related to the process. The client is able to debrief to reflect on learning that occurred within that short intervention and is encouraged to continue to practice. 

The most common components of music relaxation programs used in the palliative care setting include, but are not limited or defined, to using: 
  • introduction to settle the body
  • focus on the breath
  • body scan
  • imagery
  • affirmation/mantra
  • an 'outro' (ending) reintroducing them back to an awake and alert presence.
I advise that in the early live sessions the music may be "choppy" as I try to introduce as many different pieces for the client to experience. With client feedback, a seamless and refined relaxation track is given to the client in an accessible audio format. That track is used until the current needs resolve. Often, after anxiety issues are resolved, further music therapy sessions featuring different intervention methods are offered for continued support. 

References
  1. Tolle, E. The Power of Now: A guide to Spiritual Enlightenment.  Sydney, NSW:  Hodder; 1999.
  2. Groke, D &Wigram, T.  Receptive Methods in Music Therapy.  Philadelphia, PA: Jessica Kingsley Pub; 2007.
Please see attachment (491KB pdf) to access the full blog. 

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Andrea Bryk (RMT, MMus) is a music therapist at Peninsula Home Hospice providing community palliative care services for the Mornington Peninsula area of Victoria
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Tags: palliative care CareSearch music palliative perspectives music therapy anxiety psychological interventions relaxation

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