Music therapy as procedural support for invasive medical procedures: toward the development of music therapy theory

Abstract

In partial response to the demand for evidence-based practice, there is an increasing interest in the use of music therapy as procedural support for both invasive and non-invasive medical procedures. Clinicians and researchers are attempting to define how music therapy functions as procedural support in order to advance clinical practice and research, but concepts remain inadequately specified in the literature. The current philosophical inquiry used qualitative document analysis to critically examine the extant literature in music therapy as procedural support during invasive medical procedures. The aims of the analysis were to identify key concepts, provide definitions of those concepts, and begin to explicate the interrelationships among concepts related to music therapy as procedural support. A total of 19 clinical practice articles, clinical practice book chapters, and research articles met the criteria for inclusion in the analysis. Data analysis and synthesis resulted in a working model of music therapy as procedural support, in which the music therapist engages in a reflexive process of continually assessing the patient's responses in order to refocus the intervention lens (e.g., altering aspects of the music, of focus of attention, and of patient/therapist interaction) to positively influence outcomes. It is hoped that the working model of music therapy as procedural support may stimulate clinical dialogue and serve as an initial systematic step toward theory construction in this area.

Music interventions for dental anxiety

“…For patients with special needs, several visits with a music therapist may be needed to build a trust relationship and to have multiple opportunities for practice of the music‐based skills. On the day of the treatment, it is recommended that the music therapist works with the patient prior to the dental procedure and continue to offer a calming or engaging experience upon arrival of the dental practitioner to prevent escalation of anxiety at the start of treatment (Ghetti, ).…”

Facilitated music listening: Music therapy in an invasive cardiac procedure

“…She also underlines the importance of individualised treatment, which has to be reflected in the development of intervention protocols. 2 In turn, Ghetti's (2012) article about music therapy as support in invasive medical procedures is also influenced by the neuromatrix model. Ghetti presents and summarises key concepts in a theoretical transaction model ( Figure 2).…”

“…Implementation of the music therapy intervention, consisting of therapist + music + patient responses, adds another three lenses to the experience through which biological, psychological and/or social positive influences can be viewed. Ghetti (2012) points to three primary approaches of music therapy as procedural support: music alternate engagement (refocusing), integration and music-assisted relaxation. The current protocol focusses on musicassisted relaxation within the framework of short-term treatment, thus operating at an augmentative or supportive level (Bruscia, 2014;Dileo, 2015Dileo, , 2016.…”

Receptive Music Therapy

“…The Gate Control Theory of pain (Melzack and Wall 1965) proposes that an auditory stimulus, such as music, acts to divert attention away from the experience of pain, by activating different areas of the brain required for processing auditory information. In a review of research studies of music therapy as procedural support for invasive medical procedures, Ghetti (2012) found that the Gate Control theory was the most commonly mentioned theory in these studies, although Melzack and Katz' (2004) theory of the body-self neuromatrix goes further to address the inter-related areas of the brain that are involved in pain perception and pain behavior. Ghetti (2012) stated that:…”

“…In a review of research studies of music therapy as procedural support for invasive medical procedures, Ghetti (2012) found that the Gate Control theory was the most commonly mentioned theory in these studies, although Melzack and Katz' (2004) theory of the body-self neuromatrix goes further to address the inter-related areas of the brain that are involved in pain perception and pain behavior. Ghetti (2012) stated that:…”