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Steven Brown, Eva Götell, and Sirkka-Liisa Ekman (2001)

'Music-therapeutic caregiving': The necessity of active music-making in clinical care

The Arts in Psychotherapy, 28(2):125–135.

Music’s utility in clinical and caregiving situations is well established in the research literature. Music has been used in numerous medical contexts: (a) for controlling postoperative pain (Broscious, 1999), (b) for reducing nausea and vomiting after chemotherapy (Ezzone et al., 1998), (c) in handling restrained patients (Janelli & Kanski, 1997), and (d) in decreasing anxiety during ventilatory assistance (Chlan, 1998), to name just a few. However, these studies have focused almost exclusively on the use of background music; music’s principal function in caregiving situations consists of modifying the sound environment of the patient. This is in contrast to many forms of music therapy, where active music-making comprises a significant component of the therapeutic process (e.g., Nordoff & Robbins, 1977; Bruscia, 1987; Aldridge, 1996). However, music therapy occurs outside the context of most of the clinical and caring activities mentioned above. What is crucially missing is a form of active music-making – and most especially singing – on the part of caregivers in caring contexts. This is a highly neglected area of consideration, one that has a tremendous but untapped potential to be used as an adjunct to both music therapy and background music to improve the care and functioning of patients. Despite an abundance of anecdotal evidence suggesting that singing can be an effective intervention by many types of caregivers for many types of patients, it is difficult to find any mention of this topic in the literature, a notable exception being the work of Clair (Hanser & Clair, 1995; Clair, 1996a,b; Clair & Ebberts, 1997). We introduce a new term here, music-therapeutic caregiving (MTC), to describe an active form of music-making by caregivers to and/or with patients during the course of actual caregiving activities. The goal for the patient in such a process is not the performance of music but the performance of a host of activities important for daily living and personal health. While MTC may certainly involve singing on the part of the patient, its major focus is on “receptive singing,” in other words, patient responsiveness to caregiver singing and the resultant effect this has on compliance, cognition, and emotion. We will proceed by providing a brief case study of the use of MTC in dementia care, followed by a description of its general features. MTC is an extremely straightforward technique, one that can greatly increase the quality not only of patient care but the caregiver-patient relationship as well.