The American Harp Journal - Extras - Summer 2018

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implement the harp in a therapeutic manner should consider several things: the harpist’s own talent and skill, the amount and type of therapeutic training which best fits their interests and lifestyle, as well as their desired therapeutic setting. For example, a harpist who desires to work for pay in educational, community, and medical settings, and is willing to pursue a bachelor degree or higher from an accredited music school, would do best to seek a music therapy degree. Should the harpist already hold a bachelor degree or higher from an accredited music school and be willing to take additional university classes, a music therapy equivalency program would be ideal. For a harpist who is drawn to specialize in endof-life care, particularly desiring to provide musical as well as spiritual support, pursuing credentials in musicthanatology is a suitable fit. For a harpist who seeks to implement the harp in a healthcare setting, but does not wish to pursue a university degree, enrolling in a therapeutic musicianship program may be best. For harpists desiring to share their music outside of traditional settings (recitals, ensembles, etc.), but who do not desire to address specific therapeutic goals, a volunteer position at a local nursing home or hospital waiting area would be ideal. Each harpist should consider which modality best suits their desired level of training, clinical setting, and population, and choose accordingly. Practical Recommendations Susan was in her late 60’s and was nearing end-of-life. “I’m embarrassed to admit this,” she shared with a music therapist, “but I have never liked Mozart or Haydn. I would prefer to listen to music of my favorite composers instead; maybe Bach or Brahms?” Like Susan, all individuals deserve to have their musical preferences heard and honored, particularly in times of great emotional, physical, or spiritual stress. When implementing music in a therapeutic setting, the harpist should take care to select appropriate music to ensure that the needs and preferences of the listener are being met and respected. The following section of this article addresses some practical recommendations for harpists to consider when selecting and implementing music. Individual Aspects of the Listener. Many characteristics influence a listener’s musical preference. These can include age, gender, culture, ethnicity, spiritual beliefs and identity. 23 A musician within a therapeutic setting should take care to address each of these aspects when selecting appropriate music. Failing to do so could result in awkward, ineffective, or even offensive musical selections. The musician should be especially careful to only present songs of a religious nature if the listener has requested them. For example, a harpist should not assume that “Amazing Grace” is a welcome song choice for all listeners. When in doubt, the best course of action is simply to ask the listener what his or her musical preferences are and respectfully abide by them. Additionally, providing a musical menu listing the harpist’s repertoire, categorized by decade or genre (classical, folk, Celtic, religious, pop transcriptions, show tunes, etc.), is another excellent method of ensuring that the listener has every opportunity to select his or her own preferred music, and to avoid causing offense with an inappropriate musical choice. In a volunteering situation, the harpist may wish to ask the director of volunteer services or nursing staff if there are particular types of music that tend to be preferred by patients or residents. To the extent possible, a volunteer should share music that is likely to be appreciated across many ages and cultures. Assessing a patient’s music preference contributes greatly to the effectiveness of the music intervention. This assessment may not be a one-time event, however. If the harpist is providing support over an extended period of time, the listener’s needs and preferences should be continually assessed to reflect any changes. 24 If the individual is unable to communicate musical preferences, the harpist should communicate with family or staff in an effort to gather this information. If no information on musical prefer- 23 Amin Ebneshahidi and Masood Mohseni, “The effect of Patient-Selected Music on Early Postoperative Pain, Anxiety, and Hemodynamic Profile in Cesarean Section Surgery,” The Journal of Alternative and Complementary Medicine 14 (2008), 827-831. 24 Annie Heiderscheit et al., “Music Preferences of Mechanically Ventilated Patients Participating in a Randomized Controlled Trial,” Music and Medicine 6 (2014), 29-38. 12 THE AMERICAN HARP JOURNAL – EXTRAS
ence is available, the musician should use his or her best clinical judgment to present songs that would be most appropriate. Relaxation versus Distraction. Music may be used in therapeutic settings to address a number of different goals. Common uses in medical settings include reducing physical discomfort, anxiety, or a sense of isolation. The music that a harpist offers should be carefully selected to best support each intended goal. Music chosen to promote relaxation has different musical traits from music intended to distract away from a painful or anxiety-producing stimulus. This distinction between relaxation and distraction is important, as “relaxation and distraction are two separate mechanisms encompassing distinctively different properties.” 25 Research indicates that specific aspects of music such as tempo, timbre, dynamic, rhythmic complexity, melodic complexity, pitch range, and presence or absence of sung lyrics together play a role in whether music is sedative (relaxing) or stimulating (distracting). A 2012 study found that music to promote relaxation should have “a median tempo of approximately 60 bpm, small dynamic variations, low rhythmic complexity, relatively low melodic and instrumental complexity, major mode, diatonic, with pitches centered around C5 (an octave above middle C or C4), and with no lyrics.” 26 Another study states that relaxation music has a “slow, consistent, and steady tempo, is tonal and consonant, with predictable melodic, rhythmic, textural, and harmonic features. The music has few dynamic changes, [and] is repetitive.” 27 Distraction, which involves the diversion of attention away from an aversive stimulus, is another common mechanism for pain reduction and manage- 25 Xueli Tan, “Interactionality of Trait-State Music Preference, Individual Variability, and Music Characteristics as a Multi- Axis Paradigm for Context-Specific Pain Perception and Management” (PhD Thesis, University of Iowa, 2015). 26 Xueli Tan et al., “The Interplay of Preference, Familiarity, and Psychophysical Properties in Defining Relaxation Music,” Journal of Music Therapy 49 (2012), 150-179. 27 Denise Grocke and Tony Wigram, Receptive Methods in Music Therapy: Techniques and Clinical Applications for Music Therapy Clinicians, Educators and Students (London, UK: Jessica Kingsley Publishers). Resources for Additional Research Journal Publications • The Journal of Music Therapy • Music Therapy Perspectives • Journal of the Music-Thanatology Association International • The Harp Therapy Journal Databases • National Library of Medicine: MEDLINE • National Library of Medicine: PUBMED Other Notable Publications • The Music Practitioner - E Newsletter • Music Therapy Matters Monthly • Music Therapy ENews • Imagine Magazine ment. 28 This approach is based on the “Gate Control Theory of Pain,” 29 where music “is offered as the positive and competing stimulus to divert patients’ cognitive focus from pain-evoking situations to the music.” 30 In contrast to the sedative nature of music for relaxation, music for distraction should be more stimulating: involving faster tempos, more complex melodic and harmonic components, and may or may not involve sung lyrics. Additionally, music for distraction may involve active engagement on the listener’s part; the listener may be encouraged to sing along, actively focus their attention on the music, or actively engage in music making themselves. When selecting music, the harpist has much to take into account, particularly regarding the therapeutic needs being addressed by the music, and the listener’s individual musical preferences. However, 28 Kate Gfeller, “Music Therapy, Medicine, and Well-being,” in An Introduction to Music Therapy: Theory and Practice, ed. William B. Davis et al. (Silver Spring, MD: American Music Therapy Association, 2008), 305-341. 29 “The Gate Control Theory of Pain” states that a ‘neural gate’ within the central nervous system “can be opened to varying degrees, thus modulation the incoming pain signals before they reach the brain... The extent to which the gate is open or closed depends on 1). The amount of noxious stimulation, 2). The amount of sensation in other peripheral fibers and 3). The messages that descend from the brain.” “Music Therapy, Medicine, and Well-being.” 30 “Music Therapy, Medicine, and Well-being.” 13 THE AMERICAN HARP JOURNAL – EXTRAS
Page 1 and 2: The American Harp Journal 1 THE AME
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Page 5 and 6: admired how she rocked a pair of le
Page 7 and 8: Ann Pilot, commencement address, CI
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Page 13: Table 1. Therapeutic Modalities: An
Page 17 and 18: American Music Therapy Association
Page 19 and 20: Seen at Redlands... Additional Phot
Page 21 and 22: Anne Adams Awards Recitals
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