Friday, October 23, 2009

A Pilot Study on Effectiveness of Music Therapy in Hospice in Japan.

Hisako Nakayama; Fumio Kikuta; Hidekatsu Takeda. "A Pilot Study on Effectiveness of Music Therapy in Hospice in Japan." Journal of Music Therapy. 2009: 46. 2 


Music Therapy was first introduced in Japan in 1967 and has been implemented in numerous facilities since. However, there has been a noticeable lack of music therapy programs in hospices/ palliative care facilities. This article attempts to fill some of the void in music therapy and palliative care research.

Researchers measure cortisol levels, a hormone associated with stress, as a quantitative measurement of the therapy’s effectivenes. A Mood Inventory was also used as a subjective measurement.

The 10 study participants all had terminal cancer and participated in several 40 minute group music therapy sessions. The music was selected according to the season and by the request of the patient. Interviews were conducted before and after the sessions to measure the patient’s cortisol levels and assess their overall mood. After the sessions patients showed decreased cortisol levels, increased alertness, excitement, and a slight decrease in depression and anxiety.


I have often wondered how effective music therapy is. Does it produce lasting results or only temporary relief? Is the relief psychosomatic or are conditions quantitatively improved? I thought this article would give me a good sense of the overall effectiveness of music therapy, though there are numerous forms of music therapy and it is a complex field.

I find it interesting that because of cultural differences, most music therapy sessions in Japan are group sessions. In Canada and America private sessions are common to protect the privacy of patients.

The article suggest that music can increase immunity because it increases levels of immunoglobulin A. Immunoglobulin A is responsible for the immunity of mucous membranes against bacteria and viruses. I think it is amazing that a sound, completely disconnected from the body, can cause the secretion of immunoglobulin thereby increasing our immunity. If this is true music has tremendous healing potential.

The article also includes a fairly detailed account of which hormones are secreted and where during a stressful situation. It also provides information on how palliative care is defined. All of this extra material was very useful when trying to understand the study.

I really appreciate that the researchers took great care to create a controlled experiment. Songs were carefully selected so there was an even number of minor, major, fast and slow tempi songs per session. The therapy room temperature was maintained at 26 degrees. The sessions took place at 2pm, because cortisol levels are most stable in the afternoon. Cotton swabs were used to obtain saliva samples rather than blood tests. The researchers were concerned that using blood samples would about increase the stress level of patients. Throughout the study there was an emphasis on quality on life, not just duration. The most dramatic improvement was by a 64 year old  woman with a brain tumor. She was a great music lover and researchers believe this positively impacted her results.  The second best improved was an 80 year old man who was very social, and thus experienced the positive effects of the social interaction at sessions. One woman did not show a lot of increase from the therapy, because she was bedridden and transporting her in the bed may have caused her pain.

While volunteering at a long term care facility I noticed that some of the patients were delighted to hear a concert, while others were clearly in pain after having been moved from their bedrooms. It goes to show that therapy is highly personal and each patient is unique, therapists must take an individualized approach. 


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