Integrative Therapies: A patient-centered approach to symptom management Anna Eltringham, MT-BC Renée Sauter, MSW Who’s familiar with integrative therapies? Or works somewhere they are available? Today’s presentation: • Define the difference between alternative, complementary & integrative therapies • Identify common integrative therapies used in healthcare today • Highlight one hospital’s patient-reported success with the use of integrative therapies • Focus in on Music Therapy & its impact on patient well-being/recovery/etc…. • Effectiveness of Music Therapy • Music Therapy vs. Music Medicine Let’s get grounded – what’s the difference? Terms are frequently used interchangeably – but they are different! • If a non-mainstream practice is used in place of conventional medicine, it’s considered “alternative.” • If a non-mainstream practice is used together with conventional medicine, it’s considered “complementary.” So what’s integrative health/medicine? • It’s bringing conventional and complementary approaches together in a coordinated way. https://nccih.nih.gov/health/integrative-health#cvsa Common integrative therapies in healthcare • Acupuncture • Aromatherapy • Art Therapy • Energy-based therapies (Healing Touch & Reiki) • Massage Therapy • Music Therapy • Relaxation techniques (breathing exercises, guided imagery, & progressive muscle relaxation) • Yoga Why do these therapies make sense? • Helps with symptom management • Gives the patient options – when it feels like there are none • Offer comfort to family • Can engage family members too! • Distract patient from current concerns • Provides comfort unlike any other option • Helps promote rest & sleep = healing!
Transcript
Integrative Therapies:A patient-centered approach to
symptom management
Anna Eltringham, MT-BCRenée Sauter, MSW
Who’s familiar with integrative therapies?
Or works somewhere they are available?
Today’s presentation:
• Define the difference between alternative, complementary & integrative therapies
• Identify common integrative therapies used in healthcare today
• Highlight one hospital’s patient-reported success with the use of integrative therapies
• Focus in on Music Therapy & its impact on patient well-being/recovery/etc….
• Effectiveness of Music Therapy
• Music Therapy vs. Music Medicine
Let’s get grounded – what’s the difference?
Terms are frequently used interchangeably – but they are different!
• If a non-mainstream practice is used in place of conventional medicine, it’s considered “alternative.”
• If a non-mainstream practice is used together with conventional medicine, it’s considered “complementary.”
So what’s integrative health/medicine?
• It’s bringing conventional and complementary approaches
together in a coordinated way. https://nccih.nih.gov/health/integrative-health#cvsa
• Gives the patient options – when it feels like there are none
• Offer comfort to family
• Can engage family members too!
• Distract patient from current concerns
• Provides comfort unlike any other option
• Helps promote rest & sleep = healing!
This sounds nice, but does it really work?
Patients say YES, they work!
n= 3227
What do the patients say?
• “Music is better than oxycodone”
• “You made me feel human again”
• “I forgot what it felt like to be at peace until you came”
• “You gave me just what my spirit needed”
• “I have always loved music, but that was one of the first things to go when I became depressed. Thank you for reintegrating it back into my life.”
• "Wow. The music took me away, to another place - That really helped. I forgot all about my pain, depression... you name it. Very cool that they have this at Regions - I have something to look forward to with my 3 remaining surgeries now."
Integrative Therapies at Regions Hospital
Department is 10 years strong!
Staff o Massage Therapists
o Music Therapists
o Acupuncture clinical interns
o EBT volunteers; Healing Touch & Reiki practitioners
Consult System o Patients are referred by
providers, nurses, social workers, case managers, PT/OT/ST, chaplaincy, or by patients &/or family members
Reasons for Referralso Anxiety
o Pain
o Nausea
o Depression
o Insomnia
o Post-op
o Rehabilitation
o Comfort care/hospice
Music Therapy at Regions Hospital
2 full-time Music Therapists provide:✓ Individual sessions
✓ Groups sessions
See patients on:✓ Medical/Surgical
✓ ICU
✓ Oncology
✓ Burn
✓ Physical Medicine & Rehabilitation (inpatient rehab)
✓ Trauma
✓ Mental Health
Why Music?
• Music spans the lifespan o From conception on, we are exposed to music!
• We are all musical beings • Physiologically
• Behaviorally
• Socially
• Emotionally
• Spiritually
“Music can lift us out of depression or move us to tears – it is a remedy, a tonic, orange juice for the ear. But for many of my neurological patients, music is even more – it can provide
access, even when no medication can, to movement, to speech, to life. For them, music
is not a luxury but a necessity” - Dr. Oliver Sacks
What is Music Therapy?
An established healthcare profession
Board Certified Music Therapist
Carefully selected music interventions
Within the therapeutic relationship
Address medical, physical, emotional, cognitive, spiritual, and social needs
With patients of all ages and abilities
Why is Music Therapy Effective?
• Music is processed in all areas of the brain and has the ability to stimulate areas that may not be accessible through other modalities
• Music elicits physiological responses such as blood pressure, heart rate, respiration rate, and pain perception
• When pleasurable music is heard the brain releases dopamine, a neurotransmitter that plays an important role in movement, memory, behavior, cognition, attention, sleep, mood, and learning
• Music coordinates movement, facilitating more organized and controlled movements
Why is Music Therapy Effective?
• Music captivates and maintains attention, enhancing executive function and creating an optimal environment for the learning of new skills
• Music stimulates the motivation and reward centers of the brain, and acts as a natural motivator and stimulator for desired responses
• Speech and singing are closely related in function and proximity in the brain, and Neurologic Music Therapy techniques can be used to elicit functional speech responses after a brain injury
• Music is processed in the emotion centers of the brain and elicits emotional responses that can be expressed and processed in a safe therapeutic relationship
MT’s utilize clinical expertise in order to address:
• Pain• Anxiety• Nausea• Depression• Motor functioning• Speech and language
goals• Insomnia• Agitation• End of life needs• Emotional regulation
• Socialization• Reality orientation• Thought processing• Coping skill
development
Common Music Therapy Interventions
• Live music listening
• Directed imagery + music
• Guided relaxation
• Improvisation
• Instrument playing
• Therapeutic singing
• Songwriting
• Drumming
• Lyric analysis
• Neurologic Music Therapy
Our patients rate it as being VERY effective!
Music Therapy & The Patient and Family-Centered Model • When family members are present, they become part of the
therapeutic process
o Individualized Music Therapy interventions provide the space for patients and family members to:o Connect
o Find hope and meaning
o Support one another
Music Therapy vs. Music Medicine
• Music Medicine: “The use of music by medical professionals in order to reduce the stress of the medical condition, hospitalization and/or medical procedures, while optimizing physiological functioning such as heart rate, blood pressure, and respiratory rate”
What does the research say?Music Therapy and Music Medicine have positive benefits within the following goal areas:
• ↓ of pain, anxiety, stress, chemotherapy-related nausea
• ↑ in motor ability and joint ability
• Shortened labor
• ↑ in capacity and strength in respiration ability
• ↓ in fear or trauma
• Assistance in acceptance of death or disability
• Assistance in symptom management
• Stimulation or elicitation of responses from those in isolation
• ↑ in short and long-term memory
• ↑ in awareness, self-control, and monitoring of physiological responses
• ↓in depression/isolation
• ↑in feeling of well-being
• ↓in medication request
What does a Music Medicine Program Look Like?
It is highly recommended to consult with a Music Therapist on these items:
• Individualized music listening devices and/or music in common areas
✓ iPods vs. CD Players
✓ Spotify subscription is recommended
• Develop a music assessment tool to ensure music is helping rather than hurting
✓ It is common for individuals to have negative associations with certain music
✓ Consider psychophysical properties of relaxation music
• Include a variety of playlists that consider various cultures and preferences ✓ Patient preferred music is key!
• Develop guided relaxation scripts
Using Music for Self Care
• Self care is a priority and a necessity!– Unmanaged stress leads to emotional
exhaustion, lack of work satisfaction, and decrease in work performance
– Healthcare professionals have a high risk of burnout
• Music is a simple yet effective tool to use for emotional, mental, physical, and spiritual self care
“Self-care is not selfish. You cannot serve from an empty vessel.” –Eleanor Brownn
Using Music for Self Care
• Bring music into your self-care routine: listening to music releases endorphins, slows heart rate, and relaxes our bodies and minds
• App Recommendations:
• Relaxation Techniques to Use With Music:• Visualization Exercises
• Progressive Muscle Relaxation
• Autogenic Relaxation
• Focused breathing using musical phrases as a guide
