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Family, Friends, Music – Oh My!

By Seika Bishton, MusicWorx Intern

Hospitals across the country are easing visitor restrictions and hospital staff are seeing more families and loved ones of patients throughout the day. For the past 3 months as a music therapy intern, I learned seeing visitors in a patient’s room was never a good sign. Recently, with fewer restrictions, I learned to view seeing families as a good sign and embrace interacting with them. As visitors are being allowed in hospitals again, I am going to showcase how music therapists, family members, and patients all work together to achieve therapeutic goals benefiting everyone involved.

What is family music therapy?

Family music therapy, in a hospital setting, is when a music therapist provides social/emotional and general support to patients and their family through music and music interventions. A music therapist uses music to promote relaxation, assist with emotional release and regulation, decrease pain, and assist with the grieving process. Family music therapy sessions are not a “one size fits all” and look a little different. Here are some examples of what a family music therapy session may look like from personal experience.

Scenario 1: Family Support

In a situation where the patient is unresponsive, asleep or intubated, the music therapist has a unique opportunity to focus on the family members present in the room. Oftentimes, family members have difficulties coping with their loved one being in the hospital. Imagine being in a hospital where nothing makes sense, your loved one is not improving and everyone who comes to visit has no new updates. Imagine all of that, plus being in a global pandemic where there are various restrictions on visitors depending on where you live. Lack of control and fear of the unknown can cause feelings of anger, anxiety, stress, fear and helplessness.

Music therapists use music to connect with family members and provide a space that promotes emotional expression and release of any frustration. Music serves as a comforting blanket that is calming and familiar to most people. The presence of music creates a safe space for family members to just listen and breathe even if it’s just for a moment. Music therapists may assist in verbal processing if that is what the family needs at the moment. The main goal is to provide general support to the family members when a patient is unresponsive, intubated or asleep.

Scenario 2: Family and Patient Support

In this scenario, a music therapist sees a patient who is awake and whose family is present. The plan of care naturally now extends to include the family. This session presents its own unique beauties and challenges for a music therapist. 

Music therapy with a family is a beautiful experience to facilitate. The music serves as an unseen string that ties everybody together in harmony. Patients and their family members connect in a new way through music. Sometimes, families learn more about each other through experiencing music therapy. Others bond over a shared favorite song that brings back memories. Music has the power to elicit unexpected emotions, whether they be happy or sad. Sometimes, music has the power to silence a room that was once buzzing with sound. The true beauty of family music therapy sessions in a hospital setting is that a music therapist will never know what to expect from a session. The possibilities are endless and music therapists must be ready to adapt to any situation. Personally, no two sessions with family are the same; just like the clients we serve, each session is unique.

On the flip side, not all family music therapy sessions are rainbows and butterflies. These sessions present their own challenges as well. Some examples from personal experience are:

  1. Family decline. Family members may choose to decline music therapy services for their loved one, even if the patient could benefit from a visit. Music therapists must respect the family’s choice despite feeling strongly about how the patient could benefit from music therapy.
  2. Conflicting needs. The family’s needs can be completely different from the patient’s needs. For example, family members may have more energy than the patient and want to ask questions and request to hear preferred music. However, the patient may be over stimulated and needs music to promote relaxation and lower their heart rate. The challenge for the music therapist is to address both in a way that ultimately benefits the patient without completely excluding the family from the situation. 

In the end, the music therapist’s job is to provide support to the patient and their family to the best of their abilities.The patient and family choose what they get out of a session and the music therapist has no control over that. What music therapists can control is providing the best care and experience to meet the needs of the patient and loved ones.

Scenario 3: Active Passing/End of Life

In the event where a loved one passes away or the prognosis does not look good, loved ones are left vulnerable with many emotions taking over at once. Music therapists acknowledge the presence of music is overwhelming for some and helpful or comforting for others. When a loved one passes or is actively passing, forming words becomes impossible. In the patient’s room or hospital room, a music therapist will play background instrumental music to fill the silence and provide an unseen blanket of comfort. Sometimes the presence of music is all it takes to allow for a release of emotions family members didn’t know they were hanging on to. In these cases, I had the privilege of witnessing the true power of music. Music moves people so easily and unexpectedly families are often caught off guard by their own emotions and physiological reactions to music during such a vulnerable time. Some families need their space, and music and the presence of a complete stranger during such a vulnerable time is too much to handle and the music therapist must respect that. 

I want to point out that although restrictions have been eased, the country is not back to normal. Restrictions may vary from each hospital on how many visitors are allowed, how many times a day they are allowed for and for how long. Social isolation and yearning to be with loved ones makes situations in the hospital more sensitive these days. Emotions such as fear, guilt, anger, frustration and sadness are all common among family members and patients. Music therapists are there in hospitals to provide emotional support to patients, loved ones and family. 

In the end, every family session a music therapist has the opportunity to facilitate is different. Sometimes they are planned, sometimes they are spontaneous. Sometimes a family member approaches you and requests music therapy services, other times the music therapist does some convincing. Whatever the situation may be, providing the best care possible for the patient and their family remains the ultimate goal for the music therapist. Music has yet to fail me and consistently surprises me during the family music therapy sessions I have been a part of. Music has a huge impact on everyone involved in ways I can’t even begin to understand. Each person’s connection with music is vastly different and as well as music’s effect on everyone. This beautiful unknown and softness of music leaves each session unpredictable. For me, that is the true beauty of music therapy.

Moving Forward

MusicWorx has a resource titled Six-Month Chrysalis that has more stories and experiences from past interns. If you enjoyed reading about my experiences with family music therapy, you can purchase this book on Amazon to read more stories and experiences. For further reading, other MusicWorx interns have written blog posts similar to the topic of family music therapy and COVID-19. The Circle of Grief and Coping with Mass Trauma are two blog posts written by former interns that relate to loss and stress during the COVID-19 pandemic.

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