Implementing music therapy through telehealth: considerations for military populations

Abstract

Purpose: Telehealth provides psychotherapeutic interventions and psychoeducation for remote populations with limited access to in-person behavioural health and/or rehabilitation treatment. The United States Department of D efense and the Veterans Health Administration use telehealth to deliver primary care, medication management, and services including physical, occupational, and speech-language therapies for service members, veterans, and eligible dependents. While creative arts therapies are included in telehealth programming, the existing evidence base focuses on art therapy and dance/movement therapy, with a paucity of information on music therapy. Methods: Discussion of didactic and applied music experiences, clinical, ethical, and technological considerations, and research pertaining to music therapy telehealth addresses this gap through presentation of three case examples. These programmes highlight music therapy telehealth with military-connected populations on a continuum of clinical and community engagement: 1) collaboration between Berklee College of Music in Boston, MA and the Acoke Rural Development Initiative in Lira, Uganda; 2) the Semper Sound Cyber Health programme in San Diego, CA; and 3) the integration of music therapy telehealth into Creative ForcesV R , an initiative of the National Endowment for the Arts. Results: These examples illustrate that participants were found to positively respond to music therapy and community music engagement through telehealth, and reported decrease in pain, anxiety, and depression; they endorsed that telehealth was not a deterrent to continued music engagement, requested continued music therapy telehealth sessions, and recommended it to their peers. Conclusions: Knowledge gaps and evolving models of creative arts therapies telehealth for military-connected populations are elucidated, with emphasis on clinical and ethical considerations. ä IMPLICATIONS FOR REHABILITATION Music therapy intervention can be successfully adapted to accommodate remote facilitation. Music therapy telehealth has yielded positive participant responses including decrease in pain, anxiety, and depression. Telehealth facilitation is not a deterrent to continued music engagement. Distance delivery of music through digital platforms can support participants on a clinic to community continuum.

Neurologic Music Therapy via Telehealth: A Survey of Clinician Experiences, Trends, and Recommendations During the COVID-19 Pandemic

“…The disproportionate geographical distribution of health-care professionals can be viewed as a dominant factor for limited access to health-care, especially in less developed countries (Schneider and Biglan, 2017). Telehealth, telemedicine, and telerehabilitation transgress geographical location boundaries and thus are an important future frontier for health care services such as NMT even after the pandemic has run its course (Vaudreuil et al, 2020). Data from the present study indicates that participants believed certain clients may benefit particularly from a telehealth modality more than from in-person therapy.…”

“…Data from the present study indicates that participants believed certain clients may benefit particularly from a telehealth modality more than from in-person therapy. Previous studies suggested that some autistic clients may benefit from an online format more than an in-person format (Baker and Krout, 2009;Vaudreuil et al, 2020). Open-ended question responses regarding benefits of telehealth referred to the benefit of an online modality to clients with autism who normally struggled with attention, persons with aphasia, and individuals with mental health struggles.…”

“…Music therapy students and supervisors at the Berklee School of Music delivered music therapy services to a school for child soldiers in Lira, Uganda. Various forms of music making were used, including singing, dancing, call-and-response drumming, and improvised music (Vaudreuil et al, 2020). A case-study by Lightstone et al (2015) reported that telehealth music therapy (led by a music therapist together with a clinical psychologist) was effective in addressing post-traumatic stress disorder and major depressive disorder in a veteran, evidenced by the client's retrospective self-report.…”

“…Interventions reported by Lightstone et al (2015) involved musical improvisation of various emotions to improve the client's ability to tolerate, express, and avoid dissociation related to different emotions, followed by discussion of these improvisations with the clinical psychologist. Vaudreuil et al (2020) reviewed several published and unpublished examples of music therapy and telehealth, relating to sessions with veterans. They reported that music therapy and other creative arts therapies can be promising avenues of holistic treatment for veterans whose physical location made it difficult for them to access in-person services.…”

“…They observed that family tele-intervention provided a high level of parent-child interaction, and parent skill development. These case studies and single-project studies are compelling, as they provide preliminary evidence that telehealth music therapy may be as beneficial as in-person therapy in certain situations (Baker and Krout, 2009); that telehealth may reach clients who would not ordinarily be able to access services (Lightstone et al, 2015;Vaudreuil et al, 2020); or that telehealth may help to address client needs in a more robust manner by involving caregivers in sessions (Fuller and McLeod, 2019). However, in addition to the limitations of case studies, generalizability is also limited due to variability of music therapy techniques.…”