Listen to what makes music therapeutic

Playing at the bedside of a patient is different from giving a concert. I am observing the patient while I play in order to change the music whenever necessary. 

There is no set list

What I choose to play starts with what I know about the patient—their medical condition, age, the reason they were referred to me. But what I observe when I come in is what influences my choices the most. Do they appear to be in pain? Agitated? Sleepy? Whatever is happening now is where I begin.

This is the beginning of “If I Were A Blackbird.” 

It has a moderate tempo. 

There are notes on almost every beat. 

The chords change from minor (more sad) to major (more happy). 

Given this kind of complexity, I might start a session with this song if the patient were alert but trying to relax.

Recognizable songs might not be appropriate

Sometimes it doesn’t work to play a song that the patient knows. Sometimes it doesn’t work to play a song at all. Sometimes the patient responds best to soothing sounds without a discernible melody, or even just a single note ringing out into silence.

This is an improvisation.

It is based on a scale that is very light and airy.

It has a regular rhythm, with several notes that ring out and breathe.

I might play something like this for a patient who appears agitated. The notes meet them where they’re at, and the spaces help bring them to  calmer place.

A song might need to be changed while I’m playing

One of the defining tasks of a Certified Music Practitioner is to observe the patient while I am playing and make changes to the music if necessary. Based on their reaction to this song, should it be slower? Have fewer notes? Use a different rhythm? I watch the patient to see what works best.

I start here with “You Are My Sunshine.” It is likely a song that patients recognize.

What if the patient were not responding well to it? Perhaps they do not find familiar music to be soothing at this time.

I turn the song into something unrecognizable, keeping the same underlying structure that I started with so that only the familiar element of the music is changed.

Fewer notes are better than complexity

Playing therapeutically is a service, not a performance. It’s about supporting a healing environment, not showing off. For the most part, simpler is better. 

The skill lies in selecting the right music for the patient and observing the patient throughout the session to continually meet their changing needs.

This is part of a lullaby called “Éiníní.”

As the song progresses, I decrease the number of notes in the left hand. Listen to how the song gets simpler in each phrase.

(To keep this video brief, I make these changes more quickly than I would in a real session.)

I might play this for someone who is falling asleep.

Where can patients benefit from live music?

  • CCU

  • Oncology

  • Palliative care

  • General care

  • Dialysis unit

  • Hospice

  • Nursing home

  • Pre-op

  • O.R.

  • Post-op

  • ER

  • Obstetrics

  • NICU

  • ICU