Providing Emotional Support in Difficult Times Through Therapeutic Music

MusicTherapy blog20june19

Community Spotlight:
Sonya DiPietro, Music Therapy Intern
Anna Maria College, Class of ‘20

By Hugh Drummond, O"Neill & Associates

 

Sonya DiPietro ‘20 interns at UMass Memorial Medical Center in Worcester, MA. She’s part of the team in the Child Life Department at the Children’s Medical Center and also offering services on the adult Palliative Care team. Sonya’s is completing a 900-hour internship that is required for her to become a board certified music therapist. It’s the final requirement in her music therapy degree at Anna Maria College.

The COVID-19 pandemic transformed the work experience for many professions, but maybe none greater than for those working in healthcare. Sonya’s role as a music therapist is considered essential during the pandemic.

“The COVID-19 pandemic has brought a lot of change to everyone’s lives,” said Sonya. “In light of today’s circumstances, the support that myself, my supervisors, and fellow team members offer is needed more than ever.”

During the pandemic, patients facing chronic conditions who are accustomed to frequent clinic visits and hospitalizations now receive treatment under an additional layer of stress and fear of the unknown. Sonya and her site supervisor and Anna Maria alum Trish Jonason, MT-BC offer supportive therapeutic interventions to pediatric patients undergoing chemo treatment for cancer, recovering from severe illness or trauma, chronic illness, and those dealing with many other types of difficult conditions. Not only are they offering the typical levels of support, but now also addressing stressors caused by fear of medical complications due to virus or infection, disruption of comfortable routines, and a feeling of disconnect from their loved ones and support systems.

Staff members supporting patients who have tested positive for COVID-19 are also operating under high levels of stress. Part of the role music therapy plays in these circumstances is offering emotional support in the form of interventions addressing relaxation, self-care, coping strategies, strengthening inner resources, and recognizing their beneficial work.

For example, Palliative Care Music Therapist Mary-Carla MacDonald, MA, MT-BC offers uplifting songs and chants to staff manning entryways and working in the ICUs. She has also developed a weekly virtual platform to offer guided music and imagery to UMass employees system-wide. Sonya has had the opportunity to participate with this project and provide support and feedback as they work on ways to make therapeutic services more convenient and accessible for the busy nursing staff.blogtile sdipietro

“I often say we see a lot of folks on the ‘worst days of their lives,’” said Sonya. “Considering the emotional difficulty that comes with many of these hospital admissions. I have seen incredible hope and perseverance in parents whose children are facing life-altering diagnoses. Sometimes I think, “even though you have no idea what tomorrow will look like, you looked me in the eye, learned my name, and thanked me for my work?” Even some of my young patients going through intensive treatments have showed me the biggest smiles, most understanding temperaments, and most beautiful music.”

COVID-19 positive patients are high priorities. In pediatrics, Sonya provided music therapy services over hospital iPads to a patient recovering from the illness under strict isolation. The team is constantly trying to be creative to think of ways in which they can safely offer supportive services to those who are battling severe illness and may be experiencing a loss of connection to their support systems. For those who are not as able to recuperate, Sonya and the other music therapists at UMass have been brainstorming ways in which they can offer care. The Palliative Care team continues to try to connect COVID patients with their loved ones in times of distress. The sad truth is that many patients are isolated from their families even in the dying process. Sonya and fellow music therapists offer heartbeat recordings to families so they can create HeartSongs. This intervention provides an avenue for humanizing a chaotic situation, commemorating the unique life of the patient, providing families with a sense of connection to their loved one, and offering a means of closure and peace for staff treating the patient.

The NICU has also been touched by this pandemic. For the safety of those patients, visiting restrictions have been further locked down. In some situations, infants in critical conditions are missing the opportunity to meet one of their parents because only one is allowed at their side at a time. Parents are missing out on the opportunity to bond with their young children and offer comfort in order to reduce their risk of exposure to illness. In collaboration with a certified Child Life Specialist and a Developmental Specialist who work in the NICU, Sonya has begun to pioneer a project alongside her that enables recordings of parents’ voices to be played at bedside. She is producing sing-along tracks to be shared with parents so that they can contribute lullabies and children’s stories for NICU staff to deliver to the infant pods. This project is in the beginning stages, but will hopefully provide a way for parents to feel connected to their children, and expose infants to important auditory stimulation for bonding and development until they are able to be together again. HeartSongs are also offered to families facing poor prognoses for their children. “It provides a way for us to capture the life and beauty of that patient for the family, in the hopes that we can offer comfort,” said Sonya.

The idea for HeartSongs at UMass started with a music therapist working in Ohio, who began to think of creative ways to use the recording of a patient’s heartbeat in clinical work. Brian Schreck, MA, MT-BC is a music therapist at Cincinnati Children’s Hospital Medical Center. He came up with a way to record heartbeats by inserting a lapel mic into the tubing of a stethoscope, and began mixing those recordings with live music to create “HeartSongs.” Trish Jonason, MT-BC, noticed his sudden boom on social media and reached out to ask for advice as to how to bring this to patients at UMass. Schreck responded with helpful support and feedback that allowed Jonason to adapt a similar technological process at the Children’s Medical Center in Worcester.

The basic process of a HeartSong involves the following steps. First, the family and/or patient is consulted on the idea. If they are receptive, the patient’s heartbeat is recorded at bedside with a recordable stethoscope. This only takes about a minute or so. Then, the music therapist imports the audio to editing software and cleans up the sound to produce an audible heart sound. The heartbeat is trimmed and looped, creating some sort of metronome or “percussion.” The music therapist then records a requested or generally appropriate song live along with the heartbeat and mixes the two together. In some cases, they mix pre-recorded music with the heartbeat if that is more appropriate for the music selection made by the family. The finished song is then shared with the family by mailing a CD or presenting them with a postcard that has a QR code linking them to their file. Sometimes the song is also played at staff meetings for members of the team who have cared for the patient, if they have passed. This gives the care providers room to process grief and appreciate the connection they had with that person.

Over the course of her internship, Sonya’s had the opportunity to produce many HeartSongs and due to the rising demand of technical support and clinical application of HeartSongs, Sonya’s site supervisor and academic advisor Lisa Summer, PhD, LMHC, MT-BC helped her pioneer a HeartSong “class” to present to the rising class of junior music therapy majors at Anna Maria College. Sonya presented a unit on the “Clinical Considerations and Technical Tutorial” involved in HeartSongs to this class in collaboration with their professor for “Introduction to MIDI.” They presented them with a de-identified recording of a NICU patient’s heartbeat, and have walked them through the process of creating something beautiful for their family. Sonya’s aim in this project was not only to share her learning with upcoming students so that they can develop these skills for their own clinical work, but also to enlist more support from folks who are willing to help us produce this content on a larger scale.

Tension is high at the hospital, and staff is facing a great deal of additional stress and exhaustion. Sonya often feels a sense of pressure to provide meaningful intervention to every patient experiencing some form of isolation as a result of this pandemic. As this is physically impossible, she’s appreciated the collaborative efforts of her two teams on site and their creative ideas.

Sonya’s music therapy education at Anna Maria College helped her to develop a clinical perspective that made this work possible. Dr. Summer’s guidance in preparing Sonya’s class for her internships was incredibly helpful. As music therapy seniors, they also received a lot of focused training on self-care. This is vital to the development of a healthy therapist working in a “typical” environment, but especially to one facing disruption as a result of a pandemic.

“Anna Maria students shouldn’t be afraid to speak up and ask about the things that interest you! I was able to be a part of all these beautiful experiences because I spoke up about my passion and expertise for using music technology,” said Sonya. “As you go through your studies, be patient. Early on some of music classes are designed to be general but you will be surprised what aspects of those classes will come back to you in your clinical work. For example, my Ear Training, Clinical Guitar, and MIDI classes offered me a lot of tools for my tool box that enabled me to produce HeartSongs that were minimally time consuming and of high quality.”

In closing, Sonya reminded students and practitioners alike to take care of themselves. “Your health and wellness is important, and will only help you be a better clinician at the end of the day.”

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