HISTORY OF MUSIC THERAPY USE IN HEALTHCARE PRACTICE

The use of music has helped humans become more socially interactive beings. The idea of music being utilized as a healing influence is as old as the writings of Aristotle and Plato and in some cultures, long before that. Ancient civilizations from India, Arab and Greece, also utilized music for therapeutic purposes. The notion of music as therapy is based on ancient cross-cultural beliefs that music can have a "healing" effect on mind and body.

In India, it was started in the form of Raga Chikitsa [2] where different ragas were used to promote emotional well-being. In the United States, music therapy formally began after World War I and World War II when community musicians of all types, both amateur and professional, went to Veterans hospitals to play for the thousands of veterans suffering both physical and emotional trauma from the wars [3]. The patients' notable physical and emotional responses to music led the doctors and nurses to request the hiring of musicians by the hospitals. Thayer Gaston, known as the “father of music therapy,” was instrumental in moving the profession forward in terms of an organizational and educational point of view [4].

Dr. Paul Nordoff, an esteemed composer, a graduate of the Philadelphia Conservatory of Music and the Juilliard Graduate School, and Dr. Clive Robbins, a special education teacher, identified new ways to teach special needs children and develop their cognitive processes [5]. The collective findings, from all these early pioneers of music therapy, seems to have been that music when used with intention, increased engagement levels that unlocked hidden potential and developed new strengths. In France, music therapist and doctor of clinical psychology, Stéphane Guétin, developed a methodology to use music prescriptively to control pain and anxiety before coronary angiography using a smartphone-based application [6]. Patients reported a significant reduction in anxiety scores after listening to the music during the procedure. The selection of music differed widely with majority of them selecting Andean instrumental music, Indian music or instrumental jazz music.

In 2011, Andy Tubman, a music therapist in California, co-founded a program called SINGFIT, which uses a technology-based app to prescribe singing for residents of senior living communities to improve cognition, social interaction and help patients with dementia [7].

APPLICATIONS OF MUSIC THERAPY IN HEALTHCARE SECTOR

The expanding role of music in healthcare has suddenly seen an exponential rise in the last twenty years. Music therapy is the use of evidence based musical interventions in the form of playing and instrumental, engaging in vocal and body percussion or receptive listening, song writing or meditative music. Non-pharmacological methods such as music therapy (receptive or active engagement) may be of immense benefit when appropriately and scientifically utilized in patient care. In order to improve patient well-being and reduce anxiety, music therapy is an easy and acceptable tool that can be applied to our clinical practice.

As physicians, we have a set of specific goals and objectives towards our patients, similarly music therapy has certain goals and objectives for each patient. Music therapists constitute a small group compared to other better-known healthcare professionals, but they can be utilized to fill necessary gaps in patient care in the areas of well-being, mood, motivation, and memory domains in the hospital setting. The requirement of an integrated music therapy department is therefore the need of the hour. The planned and sustained use of music care domains have been observed within healthcare organizations by individuals, training institutions, and professional organizations, and may be accredited by a third party.

MY EXPERIENCE AS A MUSIC THERAPIST

As a music therapist, I have used music therapy interventions through workshops to help workforces (teachers, students, office workers) inculcate much needed life skills such as building empathy and resilience, stress management, problem solving, develop active listening and improve their communication.

As a practicing anesthesiologist, I am slowing trying to increase the use of music therapy in hospital-based settings. I realized during the pandemic as Covid intensivist, the importance of preventing post-traumatic stress due to the social isolation from family and the ICU stay. I am presently using music in my anesthesia practice to reduce the stress of surgery, provide sedation for awake procedures, reduce intraoperative awareness, improve hemodynamics in ventilated patients and for post-operative pain management.

I recently conducted a short survey on physicians from across the world, where I collected their most loved forms of organized sounds (Table 1). Sounds that are pleasant to hear are being used in the form of various meditative applications on smartphones to improve sleep, and for their meditative affects [8]. Mindfulness based music therapy is an unexplored specialty of medicine that may be used to improve a patient’s wellbeing by incorporating it in receptive music therapy techniques for patients.

Table 1. Most loved organized sounds by physicians across the globe.

MUSIC THERAPY SCOPE IN THE INDIAN HEALTHCARE SCENARIO

In India, tertiary care hospitals and other healthcare institutions such as rehabilitation centers, mental health institutions, special schools, need to be made aware about this form of integrated therapy. The goal of music care is the integration of music into caring relationships, care tasks, personal care plans, and within caring communities. By exploring its scope and drawing on a combination of clinical assessment, creative art, empathetic interventions and innovation, we as physicians can provide the best possible care to our patients. Indian ragas have an untapped potential thereby utilizing the science behind the ragas, and implementing raga-based music therapy methods into healthcare settings could play a key role in improving patient outcomes with wider medical applications.