December 13, 2018

Music therapy adds extra component of care for critically ill children

Sitting cross-legged on her twin bed, Lupita, 9, hunches over an electronic keyboard during a music lesson. Her teacher, Vanya Green, watches the young girl carefully plunk out the notes to “Happy Birthday.”

As she does so, a nurse quietly enters the room. Lupita, a patient at Mattel Children’s Hospital UCLA, has childhood leukemia and is due for an IV change.

It’s not a typical music lesson, but Green is not a typical music teacher. With a master’s degree from New York University and several decades of performance under her belt, Green is a licensed music therapist who operates a recent addition to the world-renowned hospital: the music-therapy cart.

Stocked with an array of instruments — including a keyboard, guitar and drums — the cart was donated to the hospital by the Children’s Cancer Association and began operation in September 2009. The cart is fully portable and can be maneuvered easily down the hospital’s winding hallways.

“Kids are generally motivated to be engaged in music,” Green said. “We can deal with emotions through play and through music, and music can help to lower anxiety, heart rate, help them breathe more calmly.”

Green became interested in music therapy while studying Jewish music on a Fulbright scholarship in Israel. Watching Sephardic and flamenco performers in Spain, she said she noticed that they “entered into this state of deep connection with their emotions, called duende. When a person has duende, it’s similar to our idea of soul.”

At UCLA, Green spends most of her time with children who are in extended stays at the hospital. Through music, she says, she can help them address their feelings and feel less alone.

“We’ll start with whatever brings them in, and we’ll go from there,” she said. “Hopefully [music] will help them relax, express themselves creatively, have a sense of autonomy, have fun and feel at home.”

The goal, Green adds, is not to have patients become better musicians — although she can help them do that if they want — but for music therapy to complement their medical care, from relaxing after a surgical procedure to helping a patient learn how to speak through song after the removal of a brain lesion.

According to Raffi Tachdjian, assistant clinical professor at the UCLA David Geffen School of Medicine, the physical effects of music therapy are still “in the baby stages of being studied,” but early research has shown that music has significant impact on the brain.

Scientific studies of MRI scans of the brain, along with others that look at saliva samples, have shown that pleasurable music decreases the chemical cortisol, which is linked to stress, and increases “feel-good” hormones like oxytocin, serotonin and dopamine.

Some researchers even believe that the use of music therapy can mimic the effects of sedation during minimally invasive procedures like inserting an IV.

“It refocuses the attention,” Tachdjian said. “You’re turning the mind on something they have control over.”

And, of course, there’s the added benefit of time and cost: According to Tachdjian, sedation lasts four to six hours and can cost a minimum of $1,000 to $2,000. Music therapy, on the other hand, only lasts as long as is necessary to get the IV in and costs about $50 an hour.

In order for music therapy to work properly, the patient must be actively engaged.

“The definition of music therapy is that the patient plays,” Tachdjian said. “That’s the engaging part; you’re part of it.”

The notion is supported by research. A study published in 2002 in the Journal of Psycho-Oncology looked at the effects of interactive music therapy on children hospitalized with cancer. Researchers found that, among children who participated in the study, after several sessions of music therapy, respondents and their parents reported that their moods were significantly improved.

At UCLA, an interactive approach might mean encouraging a toddler to sing along with a guitar, or helping teenagers make and record songs using the cart’s “GarageBand” software.

Lupita makes it all the way through her dogged rendition of “Happy Birthday,” which she plans to sing for her two brothers on their upcoming birthdays. But the music is good for her, too, and like many other children, she doesn’t need anyone to explain why. “When you play hard,” she said, “it tells your emotions.”