Music therapy's positive effects on young cancer patients' coping skills, social integration

Few interventions target the unique psychosocial needs of adolescents and young adults with cancer. Joan E. Haase, PhD, RN, FAAN, and Sheri L. Robb, PhD, MT-BC, led a team that tested a music therapy intervention designed to improve resilience in such patients undergoing stem cell transplant treatments for cancer. Resilience is the process of positively adjusting to stressors, including those associated with a cancer diagnosis and treatment.

The researchers' Therapeutic Music Video intervention was designed to help adolescents and young adults explore and express thoughts and emotions about their disease and treatment that might otherwise go unspoken. Through the creative process of writing song lyrics and producing videos, a board-certified music therapist offers structure and support to help patients reflect on their experiences and identify what is important to them, such as their spirituality, family, and relationships with peers and healthcare providers. As they move through phases of the intervention -- including sound recordings, collecting video images, and storyboarding -- patients have opportunities to involve family, friends, and healthcare providers in their project, maintaining those important connections during treatment and encouraging communication. Once complete, videos can be shared through video premieres, which allow others an opportunity to gain a better understanding about the patients' perspectives on their cancer, their treatments, and their desires for the future.

For the study, 113 patients aged 11 to 24 years who were undergoing stem cell transplant treatments for cancer were randomized to be part of a Therapeutic Music Video intervention group or to be part of a control group that received audiobooks. Participants completed six sessions over three weeks.

After the intervention, the Therapeutic Music Video group reported significantly better courageous coping. One hundred days after stem cell transplant treatments, the Therapeutic Music Video group reported significantly better social integration and family environment. The investigators found that several protective factors helped adolescents and young adults to be resilient in the face of cancer treatments. These factors included spiritual beliefs and practices; having a strong family environment characterized by adaptability, cohesion, and positive communication; and feeling socially connected and supported by friends and healthcare providers. "These protective factors influence the ways adolescents and young adults cope, gain hope, and find meaning in the midst of their cancer journey," said Dr. Haase. "Adolescents and young adults who are resilient have the ability to rise above their illness, gain a sense of mastery and confidence in how they have dealt with their cancer, and demonstrate a desire to reach out and help others," she added.

When the investigators interviewed the patients' parents, they found that the videos gave parents insights into their children's cancer experiences; however, parents needed help to initiate and sustain important conversations about messages shared through their children's videos. To address this need, the study team has received funding from the National Institutes of Health and the Children's Oncology Group to examine the potential benefits of adding a parent communication component to their intervention.

The study's findings provide evidence supporting the use of a music-based intervention delivered by a music therapist to help adolescents and young adults positively cope with high-risk, high-intensity cancer treatments. "The availability of music therapy services from a board-certified music therapist in the United States has become more widespread, and through studies like this one, we hope to see increased availability and access to this important allied health service," said Dr. Robb. "One of the challenges in healthcare today is making sure that research findings from studies such as ours are used to inform healthcare practices and service delivery. One of our team's next steps is to disseminate findings, train professional music therapists on this intervention, and then conduct an implementation study to examine how the intervention may change as it moves into the standard care setting and whether, in the presence of these changes, patient benefits are maintained."