Top Ten Tips Palliative Care Clinicians Should Know About Music Therapy and Art Therapy

The employment of art therapy to develop empathy and foster wellbeing for junior doctors in a palliative medicine rotation - a qualitative exploratory study on acceptability

BACKGROUND

The interdisciplinary realm of medical humanities explores narratives and experiences that can enhance medical education for physicians through perspective-taking and reflective practice. However, there is a gap in comprehension regarding its appropriateness at the postgraduate level, especially when utilising art therapists as faculty. This study aims to assess the acceptability of an innovative art therapy-focused educational initiative among junior doctors during a palliative care rotation, with the goal of cultivating empathy and promoting well-being.

METHODS

A qualitative research project was conducted at the Division of Supportive and Palliative Care (DSPC) in the National Cancer Centre Singapore (NCCS). The study involved the recruitment of junior doctors who had successfully completed a three-month palliative care rotation program, spanning from January 2020 to April 2021. In a single small-group session lasting 1.5 h, with 3 to 4 participants each time, the individuals participated in activities such as collage making, group reflection, and sharing of artistic creations. These sessions were facilitated by an accredited art therapist and a clinical psychologist, focusing on themes related to empathy and wellbeing. To assess the acceptability of the program, two individual interviews were conducted three months apart with each participant. An independent research assistant utilised a semi-structured question guide that considered affective attitude, burden, perceived effectiveness, coherence, and self-efficacy. Thematic analysis of the transcribed data was then employed to scrutinise the participants' experiences.

RESULTS

A total of 20 individual interviews were completed with 11 participants. The three themes identified were lack of pre-existing knowledge of the humanities, promotors, and barriers to program acceptability.

CONCLUSIONS

The participants have mixed perceptions of the program's acceptability. While all completed the program in its entirety, the acceptability of the program is impeded by wider systemic factors such as service and manpower needs. It is vital to address these structural limitations as failing to do so risks skewing current ambivalence towards outright rejection of future endeavours to integrate humanities programs into medical education.

Fostering Pre-Professionals and Learning Experiences in End-of-Life Care Contexts: Music Therapy Internship Supervision

Certified music therapists use music within therapeutic relationships to address human needs, health, and well-being with a variety of populations. Palliative care and music therapy are holistic and diverse fields, adapting to unique issues within end-of-life contexts. Palliative care music therapy has been formally practiced since the late 1970s and affords a variety of benefits, including pain and anxiety reduction, enhancement of quality of life, emotional expression, and relationship completion. The training of music therapists varies around the globe, but clinical supervisors play a key role in skill acquisition. Clinical supervisors support pre-professionals as they realize the application of their training, foundational competencies, and authentic therapeutic approaches in end-of-life care, while navigating the challenges and rewards of this work. This article is a narrative review which offers background information on palliative care music therapy, and reports the authors' viewpoints and reflections on supervision strategies and models employed with music therapy interns in palliative care settings based on their experiences. Approaches are shared on supporting pre-professionals as they begin working in palliative care contexts, as well as implications for supervision practices.

Developing a best-practice agenda for music therapy research to support informal carers of terminally ill patients pre- and post-death bereavement: a world café approach

BACKGROUND

Informal carers of terminally ill patients play a vital role in providing palliative care at home, which impacts on their pre- and post-death bereavement experience and presents an up to 50% greater risk for mental-health problems. However, developing and implementing effective bereavement support remains challenging. There is a need to build the evidence base for music therapy as a potentially promising bereavement support for this vulnerable population. This study aimed to co-design an international best practice agenda for research into music therapy for informal carers of patients pre- and post-death bereavement.

METHODS

Online half day workshop using a World Café approach; an innovative method for harnessing group intelligence within a group of international expert stakeholders (music therapy clinicians and academics with experience of music therapy with informal carers at end-of-life). Demographics, experience, key priorities and methodological challenges were gathered during a pre-workshop survey to inform workshop discussions. The online workshop involved four rounds of rotating, 25-minute, small group parallel discussions using Padlet. One final large group discussion involved a consensus building activity. All data were analysed thematically to identify patterns to inform priorities and recommendations.

RESULTS

Twenty-two consented and completed the pre-event survey (response rate 44%), from countries representing 10 different time zones. Sixteen participated in the workshop and developed the following best practice agenda. The effectiveness of music therapy in supporting informal carers across the bereavement continuum should be prioritised. This should be done using a mixed methods design to draw on the strengths of different methodological approaches to building the evidence base. It should involve service users throughout and should use a core outcome set to guide the choice of clinically important bereavement outcome measures in efficacy/effectiveness research.

CONCLUSIONS

Findings should inform future pre- and post-death bereavement support research for informal caregivers of terminally ill patients. This is an important step in building the evidence base for commissioners and service providers on how to incorporate more innovative approaches in palliative care bereavement services.

Music Therapy as a Topic in Medical Education: Course Concept and Student Evaluation of an Elective Course for Medical Students

OBJECTIVES

Music therapy has been proven as a safe and well-established intervention in healthcare to relieve symptoms and improve quality of life. While music therapy is already established in several settings to supplement medical care, there is a lack of integration in the field of medical education.

METHODS

We report on the implementation and evaluation of a teaching concept for a five-day-intensive-course on music therapy. The course was offered as an elective course for medical students at the University Duisburg-Essen. At the end of the course, students filled out a free text questionnaire to assess the students' perception of the course, and additionally answered standardized questions by the structured EVALuna online evaluation tool of the University of Duisburg-Essen.

RESULTS

All students (N = 35) who participated in the music therapy course between September 2019 and March 2023 completed the questionnaires and N = 21 students filled out the EVALuna. Most students (89%) chose the course because of their interest in alternative and supportive therapy options to improve patients' well-being. About 46% had previous musical experience and passion and fun with music and 37% of the students were interested in the interdisciplinary academic subject that combined music and medicine. EVALuna online evaluation reflected high satisfaction with the course.

CONCLUSION

Due to the well-proven effectiveness and evidence of music therapy as well as the positive perception of medical students, music therapy should be further established in medical care and medical education.

Top Ten Tips Palliative Care Clinicians Should Know About Integrative Palliative Care

Integrative medicine (IM) use is widespread among individuals living with serious illness. There is a natural alignment between the fields of IM and palliative care (PC) rooted in their shared core values. Integrative palliative care (IPC) is an emerging focus within the field of PC that aims to broaden the healing toolkit available to patients with serious illness by combining standard-of-care biomedical treatments with evidence-informed integrative and complementary medicine practices with the goal of enhancing quality of life at every stage of a person's health journey. This article is an evidence-based guide to incorporating IPC practices into the care of seriously ill individuals.

Arts-based therapies, practices, and interventions in health

This collection focuses on creative art therapies, practices, and interventions in health contexts as part of the Mind-body interventions series of BMC Complementary Medicine and Therapies. The collection highlights the emerging value of the arts in complementary medicine and contributes to the expanding knowledge and integration of mind-body interventions and creative art practices.

Art Unfolds Words: Expressing Hope Through Creative Art Among Adolescents and Young Adults Who Have Advanced Cancer

Hope's role in the care of adolescents and young adults (AYAs) who have advanced cancer (AC) is not well understood. This study aimed to conceptualize the essence of hope among AYAs who have AC based on their lived experiences and illustrate hope through verbal and artistic depictions of the AYA's lived experiences. Fifteen AYAs, aged 12 to 21 years, diagnosed with AC completed two semistructured interviews to share their lived experiences of hope perspectives in the form of a descriptive narrative and a creative-art outcome. Participants who chose to draw pictures narrated the conceptual meanings based on elements of each picture. A board-certified art therapist performed a post hoc analysis of the drawings and participants' verbatim descriptions of their meanings. Five of the 15 AYA participants created drawings depicting their lived experiences of hope. The artistic process of mapping their cancer journey revealed distinct views of hope through nature landscapes and metaphors. Participants provided titles for their drawings such as "Over the Rainbow," "Growth in the Valley," and "The Light at the End of the Tunnel." The pictures embodied the AYAs' thoughts, perceptions, and lived experiences related to hope and its role during their cancer journey. Drawing is one simple art form that can facilitate an AYA's expression of well-being (including hope) beyond what may be verbally articulated. Creative art should be further researched as a screening tool to assess how AYAs with AC cope with an uncertain future and psychological and/or existential distress symptoms.

The research focus and development trend of art therapy in Chinese education since the 21st century

Since the 21st century, art therapy has made great progress and development in China's education. To find out the relationship between art therapy and special children, hundreds of related literatures were analyzed using co-word analysis software, which shows that art therapy is increasingly important in special children and their education. Expressive art therapy has a good development prospect in college students' mental health education and group counseling. The connotation of group painting therapy is constantly enriched. The theme research of mandala painting therapy is closely related, and painting art therapy focuses on the psychological counseling research of different groups, but the two are still in the marginal position in the whole research, and have not been paid attention to. Therefore, in the future research, firstly, we should continue to strengthen the research of art therapy and expressive art therapy in special education and individual mental health education; second, further broaden the depth and breadth of group painting therapy; third, strengthen the study of mandala painting therapy and painting art therapy.

Art Therapy in Advanced Cancer. A Mapping Review of the Evidence

PURPOSE OF REVIEW

The benefits of arts in improving well-being in end-of-life patients have been stated by the WHO. To inspire clinical practice and future research, we performed a mapping review of the current evidence on the effectiveness of art therapy interventions in stage III and IV cancer patients and their relatives.

RECENT FINDINGS

We identified 14 studies. Benefits reported by the authors were grouped as improved emotional and spiritual condition, symptom relief, perception of well-being, satisfaction, and helpfulness. As a body of evidence, notable limitations were observed: Only 1 study was a randomized controlled trial (RCT), and there was heterogeneity in the interventions and outcome measures. This mapping review highlights the evidence available on the effectiveness of art therapy in advanced cancer, which remains limited and presents specific challenges. It also provides a visual representation of the reported benefits, encouraging further and more rigorous investigation.