Pro Music Therapy

The Art of Choosing: Using music therapeutically to facilitate decision-making in the pediatric medical setting

While music activities such as listening, singing, dancing, or playing instruments are often utilized by music therapists to target specific behaviors, applying music therapeutically can go beyond these traditional forms to facilitate the developmentally-appropriate right to decide. This right is often quite limited for a child or adolescent who is hospitalized. However, this right is a dignified, developmental necessity which music therapy can target and fulfill. The following is a list of ideas for using music therapeutically outside of a traditional music-based activity to facilitate the opportunity for decision-making in a pediatric medical setting,

  1. Music listening to accomplish medicine-taking: Songs have form. They have a beginning and an end, and only last a certain duration. A 3-minute song can provide the structure needed to start the medicine-taking process and then complete it. The unpleasant task of taking medicine is not a choice pediatric patients are allowed to refuse. However, the method of medicine-taking, is up to them.
  2. Collaboratively creating music playlists to modify emotional or behavioral state. Music can be used intentionally to change an individual’s state. Whether the patient is creating a playlist that begins with sad songs and gradually goes to happier songs or fast (anxious) songs to slower (relaxed) songs, he or she gets to decide the music they will use to modify their current state and progressively achieve a preferred state.
  3. Arranging music on recording software to express emotions and accomplish a goal-oriented project. Patients can choose among various pre-recorded instruments and decide the beat, groove, and tempo of the song. They can record over the beat with their own instrument and voice. These tracks can be mixed together for the final product. Arranging a song gives the patient control. As the “music director,” the patient can ultimately claim the final product as his or her own.
  4. Structured song composition to express emotions. Patients can decide if the song will be fast or slow, in a major or minor key, or begin with the verse or the chorus. Melodically, the patients can choose between two melodies created by the therapist. Lyrically, the patient may choose a word that rhymes with the previous line created by the therapist and approved by the patient. All in all, the patient is empowered to make small choices among options throughout the entire process.

In conclusion, always offer choices. Choices are easier and more empowering for the patient to make than he or she trying to answer open-ended questions such as: “what do you want to do?” or “what song do you want to sing?” Always enter the session prepared with options. Being hospitalized is already overwhelming without the added pressure of having to decide from nothing. Provide activity, song, and instrument choices to allow the patient a safe and firm structure from which they can decide.