Tuesday, June 3, 2014

Songwriting With Patients

Songwriting is an intervention used by music therapists in many different settings. In hospice, songwriting can be a beneficial tool to address a vareity of patient needs. This intervention can be shaped and changed to be successful for many patients, regardless of their cognitive abilities or their willingness to be open and expressive.

For patients whose cognition is compromised, a music therapist may use songwriting as a success-oriented intervention to increase interaction and reminiscence. For example:

"This train is bound for (location), this train.
This train is bound for (location), this train.
This train is bound for (location), and (patient's name) is going to bring (item).
This train is bound for (location), this train."

In this example, the music therapist would encourage the patient to choose a location to which they would like to travel, or have enjoyed traveling in the past. The patient would then identify some items (favorite book, favorite drink, favorite snack) or even a special person to bring on the make-believe trip. This intervention can continue as long as the patient can still come up with ideas for a trip and things to bring along.

When working with a patient who is higher functioning, but has difficulty expressing themselves, a fill-in-the-blank songwriting experience can be very useful for eliciting expression, reminiscence and interaction. A music therapist may omit words from an existing song, such as "lean on me" or "sometimes in our lives."

"We _______________________________________
We ________________________________________
But if we ____________________________________
We know that _________________________________"

In this example, a patient can benefit from the structure of a pre-existing song to develop their own thoughts and feelings. This, like the previous example, is very success-oriented to help the patient have a sense of accomplishment and enjoyment.

Finally, occasionally, a patient may enjoy talking about a certain subject during every visit. Discussing this topic may bring this patient a sense of joy, pride or contentment. In this case, the patient demonstrates facility with self-expression and may benefit from a less structured form of songwriting. In this case, the music therapist would work with the patient to devise original song lyrics, and possibly even a chord structure, rhythm and overall style of song. This song would be a unique product of the patient, and a great source of pride and accomplishment.

Songwriting can be a useful intervention with hospice patients. For patients who wish to leave a legacy or a gift for their families, a unique and original song may be a treasured item after the passing of the patient. Additionally, music is a powerful tool to elicit socialization and reminiscence, increasing the quality of life of the patient with whom the music therapist is working.

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