Overview:
Music therapy is the evidenced-based use of music to help rebuild cognitive, motor, speech or even emotional bridges that often appear to be lost. This kind of therapy is supporting patients’ treatment plans at the subacute and long-term care departments at Sharp Coronado Hospital.
Noelle Pederson takes out a small speaker from her rolling cart, then a tambourine, some bells and other percussion instruments. She lines them up on the table, hand sanitizer close by. Finally, she props up her Taylor guitar on a stand. Her medical ensemble is ready.
Subacute
“Lord I lift your name on high / Lord, I love to sing your praises”
Pederson’s vibrato carries the worship song, reverberating off the walls in a large room at the subacute section of Sharp Coronado Hospital. The room overlooks a garden area; natural light floods through shades of green and emerald. Pederson strums the guitar with precision; she watches the patient in the room.
Some of the patients Pederson works with in this section of the hospital are experiencing disorders of consciousness. Pederson asks the patients – or the families if the patient cannot communicate – what songs mean the most to them. The hope, Pederson said, is to use their favorite music to help them reconnect pathways in the brain.
“Specifically, I’ve studied to be a neurologic music therapist which is using music to help rewire the brain for whatever rehabilitative modes that might be, whether that’s motor, speech, cognition,” Pederson says.
On this Wednesday morning, Pederson is working with a patient whose family says he loves Christian worship music.
“I’m so glad You’re in my life / I’m so glad You came to save us”
“Music is what’s called a global process,” Pederson says. “If you were to hook up your brain, and a person started singing or listening to music you like, multiple areas of the brain light up. That is why we can use music to help rehabilitate speech or movement, because it’s actually stimulating different areas of the brain.”
As she sings, she pauses occasionally to jot down a note.
“I’m trained to look at little tiny things,” Pederson says. “I’m seeing if he’ll follow a picture of his favorite musician. I’m looking to see if he starts moving any of his body. If he is looking towards me or listening to where my voice is.”
She moves from left to right, orbiting half circles around his bed. She plays music and then rings dissonant bells to see how he responds. This session is the third of four standardized assessments.
“As of this time, if you were to say his name, he wouldn’t open his eyes,” Pederson says. “Or, if you were to make a loud sound over in the corner, he probably wouldn’t jolt. We’re seeing if he is responsive to music.”
He moves his hand as the music continues.
Then, he flutters it again.
Pederson acknowledges his movement, telling him that she’s going to put a string of bells on his wrist in case he wants to interact with the music.
Those two movements were signposts in the session.
“Music therapy is not looking to be curative,” Pederson says. “It’s not like a pill that you take. It’s looking to see how we can use music to remind people of strengths they already have and to help build off of that. It’s helping them connect the dots through things they really love.”
The road to music therapy
Pederson knew she wanted to go into music therapy after reading research in high school and completing a science project about how music affects young women’s moods.
She played in the high school band and did choir. But, she had stage fright, a fear that revolved around her voice.
“Fun fact: I was terrified to sing a solo by myself until I was a senior in high school,” Pederson says. “I took operatic voice lessons from a college professor as a high school student because I knew I wanted to do [music therapy for my career]. You can’t do it if you have stage fright.”
She completed her undergraduate degree at the University of North Dakota. The music therapy program was 40% behavioral sciences, she says, and 60% music instruction. Through her classes, she became proficient in piano, guitar, percussion, voice, songwriting/arranging, clinical interventions, assessments, therapeutic practices, and more.
She said these skills make her different from a music volunteer.
“A music therapist has the counseling and verbal therapy skills. Then, I can sit and say, ‘I notice there’s some tears coming up for you. Can you share a little bit about what’s this reminding you of?’” Pederson says. “We can delve more into the therapeutic process.”
After moving to San Diego, she put her knowledge to work and completed her degree with a 1,200-hour internship. She then sat for her certification exam. That was back in 2007. She has worked since then in a variety of spaces from hospice to rehabilitation to neonatal.
“A big part of my job here is to use music for pain management, to help bring relaxation, reducing anxiety, to bring comfort,” Pederson says.
Currently, she works in oncology at Sharp Memorial, and she works with patients in long-term and subacute care at Sharp Coronado.
Between the two hospitals, she estimates she sees 60 patients a week, some in groups and others one on one.
She’s even been present to offer music therapy as families navigate the passing of a loved one.
“I’ll be playing the patients’ favorite music and trying to slow it down to help keep them calm, but then as I continue playing, I can ask the family, ‘Can you tell me a bit about your loved one since I haven’t gotten to have a conversation with them?’” Pederson says. “Getting them to start processing and working through anticipatory grief and being able to say, ‘What was their sense of humor like? What did they love most in this world?’”
She’s found that music is a “holding space” in grief.
“It’s interesting because if I stop the music, usually, people then start wiping their eyes and they’re like, ‘Okay we’re done,’” Pederson says. “But if I keep the music going then they’re more likely and apt to keep talking and to express themselves. It just makes it a safe space.”
She acknowledges that she doesn’t change a person’s world every single time she picks up the guitar, but the long-term impact is what makes it worth it.
“I truly, truly love what I do,” Pederson says.
Long term care
This is her 67th Wednesday-morning music class in long-term care at Sharp Coronado.
Five patients – Milagros Bautista, Joe Barnes, Juan Obal, Juan Gonzalez and one other – form a semi-circle around Pederson. The music class has a theme this week – honoring Labor Day.
They start off by checking in on how everyone is feeling from a scale of 1-10.
Most range from 7s to 10s. One of them says they’re a 4.
“We share everybody’s experience. The good, the bad,” a patient says.
Pederson leads them in some songs, bringing out music shakers, little drums or percussion sticks. Milagros’ smile crinkles her face as she taps along with the beat.
They also play a Labor Day game to practice social and thinking skills. They’re asked to name professions for each alphabetical letter. Phone a friend is welcome.
Barnes says what keeps him coming back to music is the engagement.
“It’s exciting and interesting,” he adds.
Obal’s favorite song is “You’ve Got a Friend.” Pederson sings some of the lyrics with him.
“When you are happy with your job, you share with others,” a patient says. “Sharing things with others is good for everyone. Happy life, good life.”
The class wraps up with music, just as it started, with everyone describing how they feel on a scale of 1-10.
The number that sticks out from the group is 5.
“I’m not saying I’m a miracle worker and leave every room better than how I found it, but that’s the goal,” Pederson says. “I try. Even if it’s an incremental, tiny, bit of change, that’s great.”
To learn more about Sharp’s music therapy program, visit https://www.sharp.com/give/arts-for-healing.
