For music therapists, playtime is powerful.
Sheri Robb, an Indiana University professor of supportive oncology, has been researching how young children with cancer and their parents are helped by music therapy. Through guided and interactive sessions, families process their feelings during traumatic yet lifesaving treatment.
It’s called Active Music Engagement, and Robb said the technique is grounded in more than two decades of rigorous, randomized studies.
“What's really beautiful about Active Music Engagement is that it is intended for both the parent and the child,” Robb said. “We now have evidence that it lowers distress levels for both parents and children at the same time.”
To an outsider, one of these sessions might not look too different from typical play. The therapy uses tools that are part of daily life, such as singing nursery rhymes. But therapists are constantly making clinical decisions for children and parents, Robb said.
“We want to give back choice and control to the child,” Robb said. “We want to give some structure to a situation that can feel kind of chaotic. And we also want to support that parent-child relationship so that they feel they start to connect with each other.”
Caitlin Krater, a music therapist and doctoral research fellow with IU Indianapolis, said young children often don’t have the language to express their feelings during cancer treatment. But playing gives them a way to process those feelings.
“Something we often forget is play is the work of childhood,” Krater said. “Tapping into music and tapping into play is using that avenue, using play as a way to help them organize and understand the things that they are experiencing.”
Krater said when families start music therapy, they are often overwhelmed and struggle to make choices.
“At first, they look at the instruments and the songs, and the child may not pick anything,” Krater said. “By the second and third session, that child is now running the show.”
These small changes ripple through their treatment journey, Krater said.
Robb’s research shows children experience significant reductions in anxiety, pain and fatigue. Robb said most children will survive cancer, so researchers are also focused on the long-term effects of music therapy, too.
“In the long term, longer term, we see improvements in their well-being and their mental health,” Robb said.
Parental well-being is usually tied to their children’s well-being, Robb said. Kids usually lean on their parents for support and emotional regulation, but during cancer treatment, parents are also struggling.
“All of a sudden, you have this double problem,” Robb said. “You have highly distressed parents who are doing hard work to regulate themselves and keep themselves well-regulated and calm, so that they can help their child to do that.”
Robb said music therapy can lower stress in parents. Robb said research shows parents have reduced anxiety, improved moods and less fatigue.
“And we're seeing significant reductions for some in traumatic stress symptoms,” Robb said.
Because a therapist guides the sessions, parents can enjoy the experience with their child. Robb said as parents engage in music play with their child, the way they see their child’s well-being shifts.
“They see their kid involved in something that's very normal,” Robb said. “They're allowed to see their kid beyond cancer.”
Robb’s work in Active Music Engagement focuses on children with cancer ages3 to 8, but she said this kind of therapy can be useful for many high-stress health issues.
She’s already working on a new study with six hospitals across the country.
“Although music therapy is becoming a standard of care in a lot of pediatric hospitals across the United States, it's still a limited resource,” Robb said.
Robb said clinicians now have evidence to guide screenings and referrals for music therapy. She said her team hopes to make music therapy more accessible, reaching the right family at the right time.
“If you try to touch every single family with music therapy, and you only have three or four music therapists at your institution, you run the risk that you dilute the service,” Robb said.
Krater also supports expanding music therapy. Hospital administrators have a lot of say in that expansion.
“Administration teams have a lot of power over how many music therapists work there, where they work, where funding is allocated, and things like that,” Krater said. “Research like this helps us to better understand where music therapy has a lot of impact, and stories like this are so important to be told.”
