A collaborative multisite study has found that teens and young adults undergoing stem cell transplantation as part of cancer treatment gain coping skills and resilience-related outcomes when participating with a board-certified music therapist in a therapeutic music protocol that includes writing song lyrics and producing videos. The study’s findings were published recently in Cancer and provide evidence supporting the use of a music-based intervention delivered by music therapists to help patients with cancer cope with challenging treatments.1
SMART Study
Sheri L. Robb, PhD, MT-BC and Joan E. Haase, PhD, RN, FAAN, of Indiana University led the research team. The SMART study, “Stories and Music for Adolescent and Young Adult Resilience During Transplant,” involved 11 sites with 49 board-certified music therapists supporting the protocol. The study included 113 patients aged 11 to 24 years who were undergoing stem cell transplant treatments for cancer. Patients were randomly assigned 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 3 weeks. The music therapists’ role included helping patients identify and write about what was important to them through writing song lyrics, while also supporting their efforts to connect with health-care providers, peers, and family through the process of creating their music video. While the intervention tested in this study requires delivery from a credentialed music therapist, it fosters involvement from patients’ entire team.
Outcomes Were Positive
After the intervention, the Therapeutic Music Video group reported significantly better courageous coping. One hundred days after stem cell transplant 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.
Parent Communication Component a Next Step
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.
Next Steps
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 authors and the American Music Therapy Association advocate that nurses and other interdisciplinary team members collaborate with music therapists to identify patients/families who might benefit from this specific intervention, and use opportunities for involvement in the intervention to connect with their patients.
“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. She added that one challenge in health care is “making sure that research findings from studies such as ours are used to inform health-care 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.”
For more information about music therapy for patients with cancer, visit the American Music Therapy Association at info@musictherapy.org. ■
Reference
1. Robb SL, Burns DS, Haase J, et al: Randomized clinical trial of therapeutic music video intervention for resilience outcomes in adolescents/young adults undergoing hematopoietic stem cell transplant: A report from the Children’s Oncology Group. Cancer. January 27, 2014 (early release online).
