Therapy Group
The investigator, a professional music therapist, informed the patient of his or her assignment to the music therapy group and then proceeded with the intervention. After placing a “Do Not Disturb” sign on the door and preparing the patient and the environment (adjusting the lights, offering a blanket, turning off cell phones, and so on), the therapist briefly played the ocean drum to give the patient the choice of whether or not to include it in the intervention because some patients express aversion for it and find that it inhibits their ability to relax. The therapist then facilitated a single 20-minute music therapy intervention directed at lowering pain. The intervention, a standard protocol for all participants, began with verbal instructions for autogenic relaxation. The music therapist asked the patient to pay attention to breathing for approximately one minute. Then the therapist led the patient in autogenic muscle relaxation by asking the patient to pay attention to the scalp muscles and allow them to release, and moving down with similar focus on specific muscle groups, ending with the feet. Next, the patient was invited to imagine a safe place of his or her own choosing. The therapist asked the patient to imagine what he or she saw, smelled, heard, tasted, and felt on the skin at the safe place. Then the music therapist informed the patient that she would begin to play first the ocean drum, if chosen, and then the harp to support his or her exploration of the safe place. The therapist played the same harp pieces for every patient. The pieces for the present protocol were chosen based on the therapist's clinical experience in which patients had described them as soothing, peaceful, and calming. All pieces were played at a soft volume in a slow tempo and are described as follows: 1) an improvisation in the mode of G Mixolydian with a duple meter, 2) four precomposed pieces in the key of C Major that can be described as “light classical” and are unfamiliar to most listeners: “Andante” by Waddington in duple meter, “Passing By” and “Reverie” by Grandjany in duple meter, and “Barcarolle” by Grandjany in triple meter. At the conclusion of the music, the therapist gently invited the participant to leave his or her imagined safe place and re-enter the hospital room, realizing that the safe place is a resource to which he or she can return at any time. Then the music therapist left the room and notified the same CNS to return to the patient to reassess pain using the same three measures: the NRS, the FLACC Scale, and the FPS. After completion of the post-tests, the therapist re-entered the patient's room to verbally process the music therapy intervention and offer follow-up treatment. She gave each study participant a CD of the intervention for future use and provided a CD player on request. Interested readers may contact the investigator to request a recording of the intervention.