'Goes beyond words': UNC Health incorporates music in health care

Content Warning: This article contains mentions of mental health.

At UNC Health, music is a space for emotional and physical support and remains an important strategy for improving and humanizing patient care during times of crisis, music therapists Maryrose Nelson and Joyu Lee said.

Starting in 2018, music therapists joined UNC Health to help achieve clinical therapeutic goals – including treating pain and physiological injuries, promoting mental health outcomes and providing end-of-life care. Therapies are managed by licensed professionals who have graduated with a degree in music therapy, completed an internship experience and passed a national exam supervised by the Certification Board for Music Therapists. 

With recent events such as the COVID-19 pandemic and the Aug. 28 on-campus shooting still impacting students at the University, Nelson, who works for UNC Health, said the music therapy program is something that is both hopeful and creative for students.

“We want to engage in the issues that are affecting people,” Nelson said. “My hope is that we can raise awareness, and we can also within our fields do better work that is more honest and culturally responsive to people's lived experiences and needs.”

Ashley Taul, a UNC Health music therapist who works at the Youth Behavioral Health Hospital, said many of her patients often experience depression, anxiety and suicidal ideation. To perform a music therapy evaluation, she said she often has to learn about the patient on a deeper level.

“We are learning their likes, their dislikes, a little bit about their diagnoses, their journey, where they’ve been and what they've been through,” Taul said. “Then, what we do as music therapists is we actually identify goals to work on.”

Taul said some positive interventions include engaging her youth patients in group music therapy sessions with peers to foster social interactions and “Post-it Note songwriting," where patients contribute ideas and work together to write a song.

Lee, a senior therapist, said active music-making is one major part of music therapy.

Activities like singing or playing an instrument can allow music therapists to help patients find their voice, Lee said, while allowing patients to explore building habits and give them a chance to work through therapeutic problems.

Receptive music therapy is another major aspect of treatment, where patients listen to music and consider personal feelings and connections. Lee said one exercise she works with is music breathing, which uses guided imagery and music to connect to current issues or problems with patients.

“I would choose music that can either support that intensity or support the person to find ways to release some of that stress or find some ways to allow that stress to move through,” Lee said. “It's like storytelling and using that information to reconnect what's going on in your life.”

Amanda Reid, associate professor at the Hussman School of Journalism and Media, is researching interactions between copyright law and the usage of music therapy. She said during therapy, copyright law may put some limitations on how works can be used without a license.

Nevertheless, Reid said there are various therapeutic benefits from music therapy. She said music can trigger pleasure centers within the brain and reduce stress.

“When they do brain scans of people listening to music, that music, especially our preferred music, activates certain reward centers of the brain,” Reid said. “When those get activated, it releases the 'feel good' chemicals that make us happy.”

Music is something essential to the human experience because it is something deeply personal and interwoven within individuals’ lives, regardless of one’s musical background, Nelson said. Music goes beyond words and diagnosis contexts.

“There is so much that goes beyond words and diagnosis contexts that music gets at,” Nelson said. “In the setting that I work in mental health, primarily in the Emergency Department here, it's really about offering care in a really hard time in somebody's life.”

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