Music Therapy
Greetings visitors. On this page you will find information about recent research and clinical work, followed by publications and links to learn more about music therapy.
WRAMTA 2022 Virtual Music Therapy: Provider Perspectives
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The global coronavirus pandemic has brought extreme hardship to nearly every corner of the world. We are grieving the loss of loved ones, and the loss of many aspects of our lives. As music therapists adapt their practices to meet the needs of those we serve, out of necessity many of us have developed new, virtual approaches to providing services. Along with Seneca Block, a music therapist and manager at University Hospitals Connor Integrative Health Network, we’ve encouraged music therapists to create a three-tiered virtual music therapy platform for their services: curated online resources, original content and telehealth. We created a video introduction summary that can be found here. Music therapists must balance meeting clinical needs with safety of their service users and themselves. Understanding how a varied approach to virtual/not-in-person services provides music therapists additional methods for service delivery that prove useful during the current global pandemic and in treatment plans of the future.
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Music Therapy in Pediatric Hospitals – Myself and a small group of music therapists working in pediatric hospitals conducted a survey study in 2017 with the aim of answering key questions about demographics, organizational structure, clinical practice and service delivery, and administrative and supervisory responsibilities. As there is very little in the literature describing the state of practice in these areas, we developed a summary article and submitted it to the Journal of Music Therapy. Our article was published in the beginning of January 2020 and described in a Medscape Medical News story about music therapy in pediatric oncology.
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In September 2018, I participated in an awake craniotomy for a young woman undergoing brain surgery. Here’s a very brief summary, please follow the link to read the hospital’s blog entry and see the cool video they made – including when she sings during the surgery! In the 15 years that I’ve been practicing music therapy at Seattle Children’s, this was my first time being involved during a brain surgery, and the first time I’ve ever encountered anyone with musicogenic epilepsy – and so thankful to be asked and able to help support her and the team.
It appeared that after years of being both musically-identified, and an active musical theater artist, she found herself having periods of suddenly being unable to sing, or keep her place the music. After consultation with the hospital’s neurosurgical team, she decided to pursue removal of the tumor, despite the risk that it might impact her ability to perceive or produce music. Fortunately for her, and for many, there is a history of conducting “cortical mapping” procedures.
It is fairly common to conduct these types of procedures to preserve functioning – typically speech. But here was a case of a young woman committed to a life using highly developed music skills. So the neurosurgical and neuropsychology teams collaborated to develop procedures that would allow them to image areas of her brain while imagining listening to music and singing, this provided a reference to tumor location. They then developed tests – an individualized mapping paradigm – that the neurosurgeon could use before removing the tumor. My role was listening while she sang during the mapping paradigm and actual removal of the tumor, to see if she was having any difficulty in hearing or producing any aspects of the music. It all went really well and Kira did an amazing job under what must have been incredibly challenging circumstances. I got to see her during her in-patient stay, and in addition to the more typical use of music to support her coping, had her sing the song she chose to sing during the tumor removal (Islands in the Sun, by Weezer), in 4 different keys, just to assess her ability to shift tonal centers. Incredible performance, especially given that it was less than 48 hours after brain surgery. Kira is home and has been recovering well. She was incredibly generous to share her experience so openly, and I’m happy to read about and see some of the opportunities she has had since her surgery.
I have been so fortunate to have been able to support young people hospitalized following brain tumor removal. I’ve known music to be deeply engaging and beneficial for myself and witnessed it in others, and have come to appreciate what we are learning about how our brains process music and how that might be useful in caring for those with injuries and illnesses impacting neural function. This case has taught me another lesson.
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In the summer of 2016, I conducted a randomized control study with typically developing 9-11 year old’s: Immediate Effects of Training with Musical Mnemonics on Verbal Memory in Children. We had 32 participants – 16 for the control group and 16 for the test group and the results showed that participants who listened to a 15 word list sung to them instead of spoken remembered 20% more words after hearing a separate “distractor” list than those that heard the list sung. Other positive effects found with musical mnemonics were that participants tended to recall the list in the order it was presented to them with more frequency than those that listened to the words sung. Visit this link to read an article co-authored with Dr. Michael Thaut.
In other areas of human functioning there are examples of music therapy having positive effects on “clinical populations” (people with health conditions/disability) while not having a similar effect on comparable typically-developing, or healthy populations. While this is only one study, it’s promising to see that with musical mnemonics there is an effect with typically-developing children ages 9-11. Here’s a link to the full thesis if you want to get more of the findings: MMT RCT
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Each year the MTAW hosts a Symposium with a different theme. Last year’s event was focused on the interdisciplinary benefits of music therapy. Our music therapy service at Seattle Children’s presented on our multi-year collaboration with the rehabilitation team and pain medicine. We described how we began co-treating with members of these other services, what kinds of needs are especially suited to collaborative approaches, and then helped attendees create an action plan for initiating collaborative projects in their work settings. Turnout was good and we are encouraged that this particular aspect of our work so clearly demonstrates the core value of “Collaboration” in the new Seattle Children’s Mission, Vision and Values statement. We hope to develop this presentation to share with others.
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Music therapy is an allied health care profession with an independent certifying body.
Music therapy is used to address a broad range of needs, as well as reinforce strengths through wellness practice. Over the past 15 years, it’s role in rehabilitation has become increasingly better understood and more effectively applied. Through the advanced practice area of Neurologic Music Therapy, treatment of sensorimotor, speech-language and cognitive needs can be addressed through the design and implementation of specific music exercises. Using two methodological frameworks from Neurologic Music Therapy, this article provides a theoretical basis for proposed neurological mechanisms for music’s effects on declarative memory and includes an example from clinical practice.
Musical Mnemonics Training: Proposed Mechanisms and Case Example with Acquired Brain Injury
David Knott
Music Therapy Perspectives 2015; doi: 10.1093/mtp/miv016
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Immediate Effects of Training with Musical Mnemonics on Verbal Memory in Children – thesis of randomized control trial
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recent press:
Music therapy interview by Kate Daniels on WARM 106.9FM
KING 5 Healing the Spirit special about Seattle Children’s Therapeutic Play programs
PBS spot about Music Therapy at Seattle Children’s
Essay about Music Therapy in City Arts Magazine
Read about my cool music therapy job at Seattle Children’s
Music therapy interview by Steve Scher on KUOW 94.9FM
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For the past 15 years, I’ve been working as a music therapist at Seattle Children’s Hospital, serving in-patient units throughout the facility. I became especially interested in supporting the rehabilitation efforts of our young patients following my first fellowship training in Neurologic Music Therapy in 2007. Following is a review of an article I found useful in developing the music therapy service in this area.
Edwards, J. & Kennelly, J. (2004). Music therapy in paediatric rehabilitation: The application of modified grounded theory to identify categories of techniques used by a music therapist. Nordic Journal of Music Therapy, 13(2), 112-126.
Kennelly and Edwards present a qualitative study using Grounded Theory in order to gain insight into the area of pediatric rehabilitation. The authors worked together for four years at the Royal Children’s Hospital, and conducted the study focused on the introduction of music therapy sessions on the rehabilitation service. Acknowledging that little exists in the music therapy literature dedicated to this area, and considering Kennelly’s relatively new role on the rehabilitation team, they made a strong case for a methodology based on inductive reasoning.
Following established inclusion criteria, a convenience sample of three participants was selected: a 2 & 1/2 year old boy with a spinal cord injury, a 4 & 1/2 year old girl with a traumatic brain injury and a 13 year old girl with a traumatic brain injury. While these participants received a total duration of music therapy sessions ranging from 71 to 135 sessions, for the purposes of this study, only 3 consecutive sessions with each of the participants was videotaped. Of those nine videotaped sessions, five were extensively reviewed and coded by Edwards, following consultation with the music therapist providing the sessions (Kennelly) and sociologist Dr. Rosemary Whip, of the University of Queensland. While the authors acknowledged that music therapy techniques have previously been described in the literature, they expressed an interest in understanding the techniques used with these young patients in this setting, without reference to goals and objectives or the participants response to music therapy over time.
After coding and analysis of the sessions, eight categories of techniques emerged: cueing, synchrony, choices, orientation, preparation, feedback, incorporation and humor. Cueing included such actions as counting “1, 2, 3, go” or taking a breath right before the participant was expected to sing. Incorporation included actions such as taking a bit of off-topic information that a participant brought up during the session and utilizing it musically, or as a prompt to redirect attention and facilitate participation.
This article has been useful in two primary ways: by providing detailed information relevant to the MT-BC standard of practice area of implementation and by articulating a role for music therapy in pediatric rehabilitation.
Strategies for improving implementation skills
The techniques that emerged from this study, while not specifically music therapy techniques, offer music therapy practitioners guidance in arguably the most challenging area of practice – implementation. Especially when dealing with young patients who are struggling, managing pain, discomfort and fatigue, and frequently dealing with cognitive and emotional states that are new, challenging and dynamic, reading about the techniques and the authors’ descriptions provide insight into simple but essential aspects of conducting a session: attracting and maintaining attention, collaborating with other team members and honoring the often and seemingly non-sequitur contributions of our young patients while gently redirecting them to the objectives of the session, among others.
A role for music therapy in pediatric rehabilitation
In the background/rationale for the study, I found similarities with my experiences, such as how the music therapy service could be involved in the early stages of medical stabilization, even before a young patient was ready for intensive therapy to begin. The flexibility of the service, and ability to form relationships with patients and family members before the hard work of rehabilitation begins can be a strong asset to the team. Acknowledging the sparsity of literature in this area and describing Kennelly’s new role with the rehabilitation service offered further encouragement to develop the music therapy service’s support to our in-patient rehabilitation department.
In addition to the techniques described from this grounded theory study, what also comes through in the article is a picture of a music therapy service that is founded in listening and responding to the emergent needs of the participant, being a collaborative team member and utilizing the underlying power of our modality in service of the rehabilitative needs of young patients. This article has been a valuable resource for me and contributes to the development of music therapy in pediatric rehabilitation.
David Knott, MT-BC | Music Therapist-Board Certified; Fellow, Academy for Neurologic Music Therapy
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A video has circulated recently that demonstrates how metronomes will synchronize their rhythm if placed on a surface that conducts the energy from their movement:
Besides being a fascinating physical demonstration of the concept of entrainment in oscillating matter, it can help music therapists to understand the process that is involved neurally when using Rhythmic Auditory Stimulation to facilitate motor movements. Fortunately, the process happens much more efficiently in humans, as auditory motor neurons synchronize with the external rhythm resulting in smoother and more predictable movement patterns. Ever catch yourself tapping your foot when music is playing? Congratulations – you can entrain to an external rhythm!
What I find very interesting about all this is that it happens before we are even conscious of it. Dr. Michael Thaut and his team at Colorado State University, in a study in 1998, were looking at subjects finger tapping ability to match changes in tempo. What they found was that subjects changed their tapping to correctly match changes in the rhythm before they were conscious of the change. This was investigated further by a team led by Franca Tecchio in 2000. To learn more about how we entrain to external rhythms, try wading into literature on sensorimotor synchronization. While it doesn’t get at the pre-conscious element in all this, it’s fun and helpful for me to see demonstrations like the one above from the Ikeguchi Laboratory, where the concept of entrainment can be better understood through direct observation.
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Music affects us, music changes us. We work out with stimulating, fast tempo music and relax with slower rhythms and softer timbres. Melodic and harmonic elements, and lyrics can influence our emotions. Musical play can be as elemental as a childlike free improvisation or as sophisticated as a symphony orchestra. It involves us socially, influences our identity, shapes us behaviorally and may even be changing the structure and functioning of our brains.
Everyone who interacts with music has an experience of being changed by that interaction, from lifelong musician to casual listener. Our direct experiences with music and knowledge gained from that helps us to better understand our selves and each other, our motivations and where we find meaning; it helps us to relate to one another.
Researchers and clinicians seek to understand how we are affected by our experiences with music and utilize models of inquiry with varied subjective and objective methods. Understanding music’s true effect, interpreting the mechanisms of action into predictable dose, response and frequency schedules that realize the maximal benefit of it’s therapeutic value in order to generalize across populations, remains a beacon for many.
Advances in neural imaging and more detailed modeling of neurochemical processes are converging with the evolution (and awareness) of music therapy methods and approaches, leading to a better understanding of how musical engagement affects us and how we can best facilitate those effects with those that may benefit from them.
Two recent articles lead these trends: Mona Lisa Chanda and Daniel Levitin’s Neurochemistry of Music and Joanne Loewy, et al.’s The Effects of Music Therapy on Vital Signs, Feeding, and Sleep in Premature Infants
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In the spirit of inquiry into music therapy, won’t you join us on May 4th for:
Music Therapy Infusion: New Strategies, Techniques, and Procedures to Infuse Your Music Therapy Practice!
Seattle Pacific University
3469 3rd Avenue West Seattle, WA 98119
Saturday, May 4, 2013 from 9:30 AM to 5:00 PM (PDT)
8:45am: Registration, Poster session and Resource table open
(at the poster session, we’ll have Adaptive Use Musical Instruments set up to try)
9:30am-11am:
Panel Discussion: Infusing the Community with Music Therapy
This panel discussion will address how we define needs, make connections with the community, access funding and develop partnerships and programs that can be sustained overtime.
Panel participants include:
Kymla J. Eubanks, MT-BC, director of Higher Octave Healing in Tempe, AZ.
Patti Catalano, MMT, MT-BC, a Neurologic Music Therapy Fellow and the Regional Project Manager for the Wilson Trust Music Therapy Project, a project of the American Music Therapy Association.
Lillieth Grand, MS, MT-BC, Executive Director Milestone Music Therapy, Portland, OR. Lillieth has been a music therapist for over 20 years specializing in working with children who have neurological impairment, traumatic brain injury, autism, developmental disabilities, and chronic health conditions. She is passionate about the field and holds several regional and national positions with AMTA and WRAMTA.
Curtis Romjue, founder of JUBILEE, the first 501(c)(3) non-profit rock band in the United States, using their live performances and CD sales to fight human trafficking.
Concurrent sessions
11:15am-12:30pm: Session 1
12:30pm-1:30pm: Student Union “Gazebo.” Box Lunches provided
1:45pm-3pm: Session 2
3:15pm-4:30pm: Session 3
4:30pm: MTAW General meeting and resource table open
Presenters: Wendy Woolsey, MA, MT-BC and Elizabeth Shain, MME, MT-BC
“Music Therapy Nuts and Bolts” .
Abstract: Goals and Objectives are basic aspects of our work as music therapists. Music therapists must be familiar and comfortable with determining, writing and implementing these essential components. Through demonstration and experiential learning, participants will actively practice these competencies and discuss and participate in possible clinical applications.
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Presenter: Julie Flanagan
“Build an Orchestra In An Hour”
Abstract: Participants will learn how to arrange music with very simple parts that anyone can play on any instrument, and organize musicians and non-musicians of all ages and skill levels into an orchestra. Orchestra members are promoted to more difficult parts as their skill levels improve.
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Presenter: Wendy Zieve
“Providing Continuing Education for Music Educators”
Abstract: Providing continuing education opportunities for music educators is a much needed service that music therapists can provide. Models for providing this service and content suggestions will be presented. Content suggestions such as to how to best use paraprofessionals, how to adapt materials and instruction, how to use visual schedules and social scripts will be shared.
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Presenter: Emily Murer, MS, MT-BC Neurologic Music Therapist
“Think Globally, Act Locally: Developing a Private Practice in the Pacific Northwest”
Abstract: Participants will assess their current professional strengths and weaknesses; professional goals related to private practice will be developed. Special attention will be paid to consulting business professionals, researching the local market, developing collegial relationships with other MT-BCs, establishing a business plan, and making a budget.
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Presenters: Barbara Jurgensmeier and Kirsten Hutchison
“Music Therapy Pilot Project with At-Risk Youth in Seattle”
Abstract: The use and research of music therapy techniques with at-risk youth has been limited. This presentation will discuss the efficacy of two pilot programs initiated in downtown Seattle. Presenters will analyze challenges, observations, and recommendations for future music therapy involvement in the treatment of homeless and at-risk youth.
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Presenter: Barbara Dunn, PhD, LICSW, MT-BC
“Music Therapy and End-of-Life Care”
Abstract: This workshop will address music therapy and it’s support of end-of-life issues and care. Music therapy techniques highlighted will include uses of singing, songwriting, instrument playing and recorded music. We will also explore our own feelings surrounding issues of death and dying and self-care tools.
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Music Therapy: Emerging Trends in Research and Clinical Practice
On May 4 and 5, 2012 the Music Therapy Association of Washington hosted an exciting two-day event at Seattle Pacific University for music therapists, expressive arts therapists, healthcare workers, and the public. From 12-4pm on May 4, Dr. James Gardiner facilitated his “BrainTuning” wellness playshop (see below) and on May 5 offered a keynote speech followed by afternoon break out sessions led on a variety of topics by local professional music therapists.
Visit the Symposium page on the Music Therapy Association of Washington website for more information.
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Music therapy on Weekday
KUOW FM 94.9 Seattle February 24, 2011
People with neurological disorders that prevent talking or moving, are often able to sing or dance. Doctors and therapists have been harnessing this power of music for many years. Music therapy has also helped lessen the pain of cancer patients, and calm behaviorally challenged adolescents or those with autism. KUOW’s Steve Scher talks with music therapists Dr. Deforia Lane, Patti Catalano and David Knott about their profession today.
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When we play and listen to music, we are profoundly effected in many ways. Music calms us, motivates us, inspires us; it establishes and recalls memories, can help us learn, even marks important points in our lives and draws us together in shared experience. How and why music effects us has been examined from many different theoretical perspectives and research methodologies.
Recent advances in brain imaging technology are influencing how music therapists understand these effects on the brain and plan interventions to meet clinical needs and in some cases facilitate new neural pathways where others are damaged.
Resources to learn more about music neuroscience:
Canadian Geographic magazine article with visual representations of brain regions engaged by specific musical tasks.
University of Washington’s Eric Chudler put together some neuroscience resources for kids, his “The Musical Brain” is most excellent and suitable for all ages.
The Brain Injury Association of Sudbury & District’s brain map with corresponding descriptions of function.
Map the brain using MRI: PBS Nova Interactive page allows you to highlight specific brain structures and view the architecture of a brain by successively viewing the “slices” – scan images taken from MRI.
_______________________________For more about music therapy, please visit:
American Music Therapy Association: http://www.musictherapy.org
Certification Board for Music Therapists: http://www.cbmt.org
Academy of Neurologic Music Therapy and Center for Biomedical Research in Music: http://www.colostate.edu/dept/cbrm/
Music Therapy Voices, World Forum for Music Therapy: http://www.voices.no/
Music Therapy Research Blog: http://www.musictherapyresearchblog.com/
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Recent Article:
11th International Conference of Music Perception and Cognition
David Knott, MT-BC, NMT is a board-certified music therapist, fellow in the Academy of Neurologic Music Therapy, instrument maker, improvisor and composer living and working in Seattle. He specializes in using musical improvisation to engage and facilitate therapeutic change with critically ill infants, children, adolescents and their families at Seattle Children’s Hospital.
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Music Therapy in the News
Read a press release about availability of Dr. Jayne Standley’s Pacifier Activated Lullaby system to improve non-nutritive sucking skills in hospitalized premature infants.
A Bangkok Post article illustrating the use of the therapeutic instrument music performance technique facilitating range of motion exercises with a young person with cerebral palsy. Music therapy is happening in Thailand.
Wounded warriors in San Diego participate in 8 week Neurologic Music Therapy groups to work on pain and stress management and improved motor function, memory and speech articulation skills.
Recent article in the UK’s Telegraph about how Representative Gabrielle Giffords engagement in music therapy is aiding her recovery from a gunshot wound to the head. Good Morning America article with more information about how music therapy is being used with Rep. Giffords. Excellent context for the effectiveness of music therapy provided in this article informed by Dorita Berger and Connie Tomaino.
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The Music Never Stopped
A new movie telling the story of Dr. Connie Tomaino’s work with a young man with a brain tumor and how music therapy provides a bridge for communication between him and his estranged family. Click here for info about the movie and screenings in your area.
Press Release at the San Francisco Chronicle
Marshall Fine’s Huffington Post review of The Music Never Stopped.
