American Journal of Hospice and Palliative

Medicine
http://ajh.sagepub.com/

The Meaning of the Music: The Role of Music in Palliative Care Music Therapy as Perceived by
Bereaved Caregivers of Advanced Cancer Patients
Lucanne Magill
AM J HOSP PALLIAT CARE 2009 26: 33 originally published online 1 December 2008
DOI: 10.1177/1049909108327024

The online version of this article can be found at:

http://ajh.sagepub.com/content/26/1/33

Published by:

http://www.sagepublications.com

Additional services and information for American Journal of Hospice and Palliative Medicine can be found at:

Email Alerts: http://ajh.sagepub.com/cgi/alerts

Subscriptions: http://ajh.sagepub.com/subscriptions

Reprints: http://www.sagepub.com/journalsReprints.nav

Permissions: http://www.sagepub.com/journalsPermissions.nav

Citations: http://ajh.sagepub.com/content/26/1/33.refs.html

>> Version of Record - Feb 5, 2009

OnlineFirst Version of Record - Dec 1, 2008

What is This?

Downloaded from ajh.sagepub.com at Bobst Library, New York University on November 30, 2014

The Meaning of the Music: The Role of
Music in Palliative Care Music Therapy
as Perceived by Bereaved Caregivers of
Advanced Cancer Patients
Lucanne Magill, DA, MT-BC
In an earlier qualitative research study exploring the
meaning of preloss music therapy to bereaved caregivers
who participated in sessions through a home-based hos-
pice program, various narrative accounts revealed the sig-
nificance of music in music therapy sessions. In this
study, the role of music in palliative care music therapy
is examined and representatively summarized, followed
by a review of strategies provided by this author to home
hospice patients and their caregivers. The reported
perceptions of the meaning of music to 7 bereaved
Introduction
The impact of advanced cancer on patients and care-
givers has been an area of concern worldwide.1 Such
diagnoses often result in complex trials for all those
involved in the life and supportive care of the patient,
each of whom may contend with the challenges of
multiple life adjustments2; and there is associated
stress due to potential losses, including the death
of a loved one.3,4 These multifaceted trials can result
in an upheaval in life and living and erode overall
well being, influencing quality of life and resulting
in existential crises and grief.5 Reactions vary accord-
ing to personal factors, such as disease issues, life
stressors, sense of burden, coping mechanisms, and
spiritual concerns.6-10
Music therapy in palliative care, the use of per-
sonalized strategies by skilled and certified music
From the University of Windsor, Windsor, Ontario, Canada.
Address correspondence to: Lucanne Magill, Assistant Professor,
1671 Victoria Ave, Windsor, ON, Canada N8X 1P6; phone: (519)
560-1442; e-mail: lucannem@uwindsor.ca.
Downloaded from ajh.sagepub.com at Bobst Library, New York University on November 30, 2014
American Journal of Hospice
& Palliative Medicine1
Volume 26 Number 1
February/March 2009 33-39
# 2009 Sage Publications
10.1177/1049909108327024
http://ajhpm.sagepub.com
hosted at
http://online.sagepub.com
caregivers are presented, including a review of themes and
associated narrations that illustrated its significance. The
caregivers described these aspects of music in sessions to
have memorable and lasting effects as follows: music is a
conduit, music gets inside us, live music makes a
difference, and music is love. Findings support the
benefits of preloss music therapy for bereaved caregivers.
Keywords: music; music therapy; palliative care;
hospice; cancer; patients; caregivers; meaning
therapists to help mitigate suffering and address
issues and needs, is a health care treatment modality
commonly offered within multidisciplinary palliative
and integrative services.11 It has become widely incor-
porated into such programs around the world,12,13
and it is known to address multiple symptoms and
issues related to malignant and end-of-life disease14
while improving overall well being through suppor-
tive and ongoing measures.15
In an earlier qualitative research project exploring
the meaning of preloss music therapy to bereaved
caregivers who participated in sessions through a
home-based hospice program,16 various narrative
accounts revealed the significance of music in music
therapy sessions. In this study, the role of music in
music therapy in palliative care is examined and
representatively summarized, followed by a review
of strategies provided by this author to home hospice
patients and their caregivers. Furthermore, the
reported perceptions of the meaning of music to 7
surviving caregivers are presented, including a review
of themes and associated narrations that illustrated
its significance.
33
34 American Journal of Hospice & Palliative Medicine1 / Vol. 26, No. 1, February/March 2009
The Role of Music in Palliative Care
Music is intricately woven into the fabrics of life and
takes on deeper significance during times of loss and
grief.17 It is an art form that is universally valued,18
and it plays a major role in cultural and spiritual life,
as it is personally linked to specific events, rituals,
and traditions.19-24
In working with patients and caregivers receiving
palliative care, music therapists strive to comprehend
the perceived meaning of illness and dying, and the
specific implication of music.23,25 Likewise, they seek
to learn prior and current relationships with music to
help participants incorporate personalized music-
based coping mechanisms into their illnesses. For
example, patients and families generally have devel-
oped affiliations with music, such as prior instrument
performance, favorite styles and recordings, or mem-
ories of selections that are intimately linked with life
events.26 During illness, they generally benefit from
accessing the music that in some way holds significance
or value for them. As a music therapist encourages the
use of their preferred music in strategies as a means for
coping,26-34 patients and caregivers are noted to find
improved quality of life through enhanced communi-
cation and greater sense of inner fulfillment.16,35
Music therapists face challenges when working with
those from diverse origins, however, as cultural val-
ues and styles are embedded in musical preferences.
They therefore recognize the need for having an
insightful, holistic understanding of cultural back-
grounds, life experiences, spiritual perspectives, and
views regarding the familiar and preferred use of
music in their lives.23 In oncologic and palliative care
music therapy, the specific role of music is generally
considered within the qualitative context of the
music therapy process and therapeutic relationship.
Although there is an abundance of literature per-
taining to the biopsychosocial effects of music36-38
and literature relating to the mediating and transcen-
dent aesthetics of music as communicator and hea-
ler39-43 as well as the role of music in the
alleviation of pain and suffering,14,26,31,38,44-48 there
is little literature describing the significance of music
in music therapy as perceived by surviving caregivers
of patients with advanced cancer who received pallia-
tive hospice care. Therefore, the aim of this study is to
review some of the caregiver themes and narrations
that emerged regarding one area of focus in a broader
qualitative study,16 specifically the perceived meaning
of music in preloss sessions.
Downloaded from ajh.sagepub.com at Bobst Library, New York University on November 30, 2014
Music Therapy Strategies Used in
Home-based Hospice Care
To help conceptually generalize the findings in this
focused study, it is important to review the music
therapy program from which the data were collected.
Therefore, the following is a description of common
strategies used by this music therapist author in
sessions. These strategies are patient centered and
are actualized within the context of a supportive
and therapeutically based patientcaregivertherapist
relationship and setting. Strategies are spontaneously
adapted and implemented according to the astute
and ongoing music therapy assessments and are
provided to address moment-to-moment patient and
caregiver needs, wishes, and emergent issues. Strate-
gies are aimed to enhance sense of control, feelings
of comfort, and sense of life meaning.
As part of the family unit of care, caregivers are
invited and encouraged to be present in sessions as
often as appropriate. They commonly assist their loved
ones in singing, selecting songs, and participating in
the lyrical and musical interactions. Through such
expressive strategies, patients and caregivers often
find resolution and relationship completion.30,49,50
Likewise, they generally find comfort in witnessing
and partaking in creative interactions that lead to
moments of intimacy and restored connectedness.16
Common strategies are as follows:
1. Use of precomposed songs: Songs are expressive
mediums that enhance interrelatedness and the
sharing of difficult-to-express thoughts, feelings,
and pertinent messages.49 Through songs, patients
and caregivers may engage in reminiscence and
life review due to the associative nature of song
content. In addition, emotionally fragile persons
tend to benefit from the structure of lyrics, as the
lyrics can serve to guide thoughts.
2. Lyric improvisation and song composition: Lyrics
within songs are often spontaneously adapted to
meet individual patient and caregiver situations.15
New songs are composed from familiar melodies
and may include participants words and life stor-
ies. Lyric improvisation is often used as a way to
personalize sessions and to assist them in articu-
lating feelings, needs, and accomplishments. Song
composition is also a technique that enhances
sense of personal value, as the lyrics are usually
selected to represent stories, attributes about self,
or messages to significant others. Participants
commonly find meaning and resolution as they
partake in life review within lyric and song

improvisation. Audio-recorded song compositions
with spoken narrations are often shared with each
other as gifts.
3. Imagery in music: This strategy is helpful when
patients are isolated or nonverbal or if they have
episodic pain, anxiety, or disturbing symptoms
such as nausea and dyspnea. With the support
of the music therapist, patients and caregivers
may select images that instill peace, security,
comfort, and pleasure. Words are accompanied
by chants or improvised melodies adapted to
meet moods and needs.
4. Music listening: Patients and caregivers often
request to listen to live music in sessions, and,
when appropriate in terms of emotional stability,
may benefit from the use of preferred songs or
instrumental pieces. Listening to familiar music
naturally stimulates association with memorable
moments. Patients tend to request to hear
specific selections to go back in time and restore
connection with transformative events in life.
During such process, the compassionate presence
of music therapist may enhance exploration and
communication within a space of trust, accep-
tance, encouragement, and creativity. Persons with
emotional fragility often benefit from improvised
music with satisfying dynamics.
Another factor involved in music listening, as well
as other strategies, is transcendence, the process of
taking one beyond the self to an enlightened focus
and interest in others and the world through which
[one is] led to a greater knowledge and capacity to
love.51 As described by Aldridge, music enables end-
of-life patients to transcend, to extend beyond the
immediate context to achieve new perspectives. . .
when they are encouraged to maintain a sense of
well-being in the face of imminent biological and
social loss.17(p107) In music therapy, it is common
for patients and caregivers to report the transporting
and inspirational effects of music, as the associative
and aesthetic qualities of music can instill calmness,
serenity, and sentiments of connectedness.52
Method
This study reviews and examines the themes pertain-
ing to caregiver perceptions regarding the particular
meaning of music in sessions, a finding that emerged
as one of the themes in an earlier qualitative research
project.16 The original study explored the meaning
of preloss music therapy to bereaved caregivers who
Downloaded from ajh.sagepub.com at Bobst Library, New York University on November 30, 2014
Role of Music in Palliative Care Music Therapy / Magill 35
had participated in preloss sessions through a home-
based hospice program and were invited by this music
therapist researcher to partake in this study as
approved by the hospice administrations Research
Review Board.16 As the purpose of the original study
was to discover and describe the meaning of the music
therapy sessions offered before the death of a loved
one,16 the method and analysis were based on natur-
alistic inquiry, an approach that involves the use of
the natural setting as source of information, as the
context it provides is fundamental to the implication
of the findings.53,54
In the original study, participant selection followed
naturalistic inquiry procedures and incorporated pur-
posive sampling to increase the scope or range of data
exposed . . . as well as the likelihood that the full array
of multiple realities will be uncovered.53(p40) Care-
givers were recruited from the hospice database of
approximately 50 caregivers who had witnessed
music therapy sessions prior to the death of their
loved one, 30 of whom had expressed reference to
the meaning of sessions. Purposive sampling
provided for the opportunity to study the research
questions and therefore gain deeper understanding
and knowledge of the topic of interest. The partici-
pants were 7 adult caregivers of 7 different patients
with advanced cancer who were followed by a home-
based hospice program and who had been present
in music therapy sessions with their loved ones
prior to death. The mode of inquiry was through
one-on-one interviews, which were audio-recorded,
transcribed, recursively analyzed, inductively coded,
and sorted into groups based on shared ideas. Data
consisted of interview transcriptions and the
researchers field notes and journal entries.
The results of the original study revealed several
themes. Caregivers conveyed the significance of
music therapy in helping to enhance feelings of
joy, empowerment, connectedness, remembrance,
and hope.55 In addition, various narrative accounts
revealed the significance of music in music therapy
sessions as a salient finding.16
This present focused study examined those
narrations that referred to the significance of the role
of music in sessions, as there were recurring state-
ments in which they described its importance within
the context of the overall music therapy process.
Sometimes caregivers referred to the longer-term
role of music in their lives as they pondered life
stages and events. Other times they characterized
prominent attributes of music in the sessions.
36 American Journal of Hospice & Palliative Medicine1 / Vol. 26, No. 1, February/March 2009
Pertinent comments were recursively reviewed and
inductively coded according to the naturalistic inquiry
methodologies.54 As themes emerged, they were
sorted into the following 4 prominent categories.
Results and Discussion
It was so helpful to see his peace and calm. The
music brought him there . . .
it seemed to lift him and carry him.
Music is the key that can bring joy and serenity
during times when really
there would be no reason to have joy. It transported
her, and me,
to a place where we all felt happy. . .happy
words of a spouse after the death of a loved one
The following 4 themes emerged in caregiver narrative
reflections.16 The themes are presented with a sum-
marized discussion regarding the aspects of music
therapy potentially relevant to these themes, along
with the representative caregiver narrations.
Music is a Conduit
The power of music to lift, transport, and engage
attention and response, as well as to help put on a
track, was described by the caregivers as being an
important aspect of the music in sessions. The word
conduit, that is, a channel or vehicle, describes the
views of several of the participants and is an aspect
of music that embodies the process of transcen-
dence. The caregivers often referred to the role of
music in facilitating a bringing back and to in
sessions, often reawakening memories of times of
meaning, places of beauty and peace, and moments
of feeling the presence of remembered loved ones.
Caregivers also described this potential of music as it
attributed to opportunities for meaningful moments
of communication.
The music was the conduit to bring Patty [patient]
back to something sweet. When you came and sang,
she opened her eyes and she sang and her voice got
strong. . .she was there and I could sing with her.
These songs and words that are repeated over and
over during a lifetime can take someone to, and are
bringing one back to another consciousness. It is
immediately connecting to that track and Patty knew
that would take her to a beautiful place. The music
helps lead to that place . . . The words and the music
are the path to imaging.
Downloaded from ajh.sagepub.com at Bobst Library, New York University on November 30, 2014
Music Gets Inside Us
The caregivers often referred to specific attributes of
music concerning the direct influences they per-
ceived it having on them and others. Often these
comments focused on the neurophysiological effects
of music. Caregivers sometimes referred to its stimu-
lating and energizing nature, for example, during
periods of restored awareness and communication.
Likewise, they referred to this aspect of music that
reaches and helps soothe and relax during times of
distress.
It was just the sound, that is so beautiful, that it gets
into your heart, your mind, into your skin, love,
everything. Music affects us very much. It is liberat-
ing and the sounds, I think the sounds are a vibration
inside and are also soothing, helping us relax too.
And in a way, the singing is vibration as I noticed
my body was full of vibration when we sang together
with him. Music just gets inside us, into a different
part of the brain it seems. It affected him and me
in positive ways.
Live Music Makes a Difference
The caregivers referred to their thoughts concerning
the form of musical presentation. They spoke about
the use of songs and live music in sessions versus
recorded music. In particular, they commented on
the beneficial presence of live music, the use of
familiar songs, and the involvement of the voice.
When someone comes in and sings and plays the
guitar, it makes a big difference. . . with you, Mark
[patient] never said no. He loved the music. It was
our music. Knowing they [the songs] were coming
after fifty years of being just inside him, and noticing
he was also left more alive after singing. . . so the
effect was lasting also. The music always affects
me, especially when the presence of voice singing
nearby is involved. . . and we were able to adjust the
songs in the moment too. Mark sang too when we are
all using our voices around him together.
Music is Love
The caregivers referred to the tendency for music to
inspire, touch, and bring the feelings of love. This was
a salient theme and common sentiment throughout
 Role of Music in Palliative Care Music Therapy / Magill
the interviews. Caregivers had lasting impressions of
the love-filled verbal, nonverbal, and musical com-
munications experienced in sessions. Each of the
caregivers found the quality of music as love to be
important to them as they reflected on the overall
meaning of music therapy. The spirit of this theme
was prevalent throughout each of the interviews,
often more in the context of the overall meaning of
the experiences than in verbal descriptions of music.
For example, there were many times in sessions
when the music therapist researcher witnessed
loving sentiments and compassionate expressions,
words and gestures between patients and caregivers,
and these memories resonated in caregivers as they
reminisced during interviews. Thus, music as love,
in essence, describes the overall qualitative and
contextual aspects of the music therapy sessions.
The music brought love back. I felt that love between
us when I heard the music. Music brought us love. . .
and joy. Its so beautiful, that it gets into your heart,
into love, everything. Her eyes were filled with so
much love when we sang and we could all be close
together again. At times she had seemed so far away
and it meant so much to us all to be close and to have
that love between us like that again.
Implications of the Study
Caregiver narrations indicated the potential signifi-
cance of the role of music in palliative care. Although
the presence of music in this setting has been well
documented to have multifaceted biopsychosocial
and spiritual effects,55-59 the meaning of preloss
music to caregivers, especially during times of
bereavement, has been less understood. It is evident
that music served as an aesthetic channel, inspiring
patients and family members toward cherished
moments of love and renewed communication,
memories that managed to help sustain caregivers
through the difficult days and weeks following the
death of their loved one. The relevance of these sen-
timents is profound when considered in the context
of bereavement, as caregivers are generally left with
images and thoughts reminiscent of life and living
again in lieu of suffering and remorse. It is under-
stood that supportive care administered to caregivers
prior to loss can have far-reaching and long-lasting
effects. These findings affirm the potential contribu-
tion of music therapy services to caregiver
Downloaded from ajh.sagepub.com at Bobst Library, New York University on November 30, 2014
37
populations in that therapy offered prior to death
could possibly serve to positively affect grief and
transform time in bereavement. Music therapists
may consider these findings when designing clinical
approaches for patients and caregivers in the pallia-
tive care setting. Future research could help further
explore the meaning of the more specific as well as
global elements of music with patients and caregivers
prior to loss as well as with caregivers after death.
Summary and Conclusion
The meaning of music for the caregivers represented
a range of ideas. The themes focused on the quality
of music as a conduit, a vehicle through which peo-
ple could travel to times and places of beauty, hap-
piness, life meaning, and inspiration. The caregivers
also reflected on the potential for music to get inside
us, particularly the neurophysiological attributes of
music to bring soothing vibrations that enhance
expression and relaxation. They also referred to the
format of music, specifically to the helpful features
of live music and songs. Finally, they conveyed the
unique significance of music as music is love.
Overall, music seemed to play a vital role in helping
motivate and inspire love in each of the caregivers
during the course of music therapy and during
bereavement.
Music therapy in palliative care strives to pro-
mote well being and quality of life for patients and
caregivers. Within an interactive process between
music therapist and participants, specialized and
individualized strategies are introduced to address
emergent needs and reflect personal backgrounds
and life experiences. Thus, music therapy sessions
are generally replete with moments of meaningful
explorations. Although the presence of the music
therapist is fundamental to the qualitative and
dynamic nature of sessions, the medium of music
contributes an important mobilizing and inspira-
tional dimension. Times in music therapy can
provide caregivers with moments of intimacy and
meaning, leading to memorable sentiments of love,
contentment, and healing.
References
1. Zabora J, Loscalzo M. Psychosocial consequences of adv-
anced cancer. In: Berger A, Portenoy R, Weissman D, eds.
38 American Journal of Hospice & Palliative Medicine1 / Vol. 26, No. 1, February/March 2009
Principles and Practice of Palliative Care and Supportive
Oncology. Philadelphia, PA: Lippincott, Williams and
Wilkins Publishers; 2002:749-761.
2. Shelby RA, Taylor KL, Kerner JF, Coleman E, Blum D.
The role of community-based and philanthropic organi-
zations in meeting cancer patient and caregiver needs.
CA Cancer J Clin. 2002;52:229-246.
3. Glajchen M. The emerging role and needs of family care-
givers in cancer care. J Support Oncol. 2004;2:145-155.
4. Holland JC. Anxiety and cancer: the patient and the fam-
ily. J Clin Psychiatry. 1989;50(suppl):20-25.
5. Schachter SR, Coyle N. Palliative home care: impact on
families. In: Holland JC, ed. Psycho-oncology. New York:
Oxford University Press; 1998:1004-1015.
6. Muir J, McDonagh A, Gooding N. Multidimensional
patient assessment. In: Berger A, Portenoy R,
Weissman D, eds. Principles and Practice of Palliative
Care and Supportive Oncology. Philadelphia, PA:
Lippincott, Williams and Wilkins Publishers; 2002:
662-660.
7. Gaston-Johannson F, Lachica EM, Fall-Dickson JM,
Kennedy MJ. Psychological distress, fatigue, burden of
care, and quality of life in primary caregivers of patients
with breast cancer undergoing autologous bone marrow
transplantation. Oncol Nurs Forum. 2004;31:1161-
1169.
8. Mystakidou K, Tsilika E, Parpa E, Galanos A, Vlahos L.
Caregivers of advanced cancer patients: feelings of
hopelessness and depression. Cancer Nurs. 2007;30:
412-418.
9. Braun M, Mikulincer M, Rydall A, Walsh A, Rodin G.
Hidden morbidity in cancer: spouse caregivers. J Clin
Oncol. 2007;25:4829-4834.
10. Edwards B, Clarke V. The psychological impact of a
cancer diagnosis on families: the influence of family
functioning and patients illness characteristics on
depression and anxiety. Psychooncology. 2004;13:562-
576.
11. Cassileth B, Vickers A, Deng G, Yeung K. PDQ
Integrative Oncology: Complementary Therapies in
Cancer Care. Philadelphia: Decker, BC; 2005.
12. Hilliard R. The effects of music therapy on the quality
and length of life of people diagnosed with terminal can-
cer. J Music Ther. 2003;40:113-137.
13. OCallaghan C. Music therapy in palliative care. In:
Hanks G, MacDonald N, Cherny N, Calman K, eds. The
Oxford Textbook of Palliative Medicine. Oxford: Oxford
University Press; 2004:1041-1046.
14. Dileo C, Bradt J. Medical Music Therapy: A Meta-
Analysis & Agenda for Future Research. Cherry Hill, NJ:
Jeffrey Books; 2005.
15. Magill L, Luzzatto P. Music therapy and art therapy. In:
Berger A, Portenoy R, Weissman D, eds. Principles and
Practice of Palliative Care and Supportive Oncology.
Downloaded from ajh.sagepub.com at Bobst Library, New York University on November 30, 2014
Philadelphia, PA: Lippincott, Williams and Wilkins Pub-
lishers; 2002:993-1006.
16. Magill L. The spiritual meaning of music therapy to sur-
viving caregivers of advanced cancer patients. Dissertation
Abstracts International 2007;68(1A):22 (Dissertations
Abstracts #3247763).
17. Aldridge D. Spirituality, hope and music therapy in pal-
liative care. Arts Psychother. 1995;22:103-109.
18. Aldridge D. Music Therapy in Palliative Care: New
Voices. London: Jessica Kingsley Publishers, Ltd; 1999.
19. Aldridge G, Aldridge D. Melody in Music Therapy: A Nar-
rative Analysis. London: Jessica Kingsley Publishers, Ltd;
2008.
20. Mount B. Whole person care: beyond psychosocial and
physical needs. Am J Hosp Palliat Care. 1993;10:28-37.
21. Negus K. Popular Music in Theory: An Introduction.
Cambridge: Polity; 1996.
22. Ruud E. Music Therapy: Improvisation, Communication
and Culture. Gilsum, NH: Barcelona Publishers; 1998.
23. Dileo C, Magill L. Multi-cultural songwriting. In:
Baker F, Wigram T, eds. Songwriting Methods, Tech-
niques and Clinical Applications for Music Therapy Clin-
icians, Educators and Students. London: Jessica Kingsley
Publishers; 2005:224-245.
24. OCallaghan C. Lullament: lullaby and lament therapeu-
tic qualities actualized through music therapy. Am J
Hosp Palliat Care. 2008;25:93-99.
25. Magill L. Spirituality and music therapy at the end-of-
life. In: Dileo C, Loewy J, eds. Music Therapy at the
End-of-life. Cherry Hill, NJ: Jeffrey Books; 2005:3-18.
26. Magill-Levreault L. Music therapy in pain and symptom
management. J Palliat Care. 1993;9:42-48.
27. Salmon D. Music and emotion in palliative care. J Palliat
Care. 1993;9:48-52.
28. Krout RE. Music therapy with imminently dying hospice
patients and their families: facilitating release near the
time of death. Am J Hosp Palliat Care. 2003;20:129-134.
29. Burns DS, Sledge PB, Fuller LA, Daggy JK,
Monahan PO. Cancer patients interest and preferences
for music therapy. J Music Ther. 2005;42:185-199.
30. Dileo C, Parker C. Final moments: the use of song in
relationship completion. In: Dileo C, Loewy J, eds.
Music Therapy at the End-of-life. Cherry Hill, NJ: Jeffrey
Books; 2005:43-56.
31. Magill L. The use of music therapy to address the suffering
in advanced cancer pain. J Palliat Care. 2001;17:167-172.
32. OCallaghan C. Bringing music to life: a study of music
therapy and palliative care experiences within a cancer
hospital. J Palliat Care. 2001;17:155-160.
33. Hilliard R. The use of music therapy in meeting the
multidimensional needs of hospice patients and families.
J Palliat Care. 2001;17:161-166.
34. Daveson BA. Music therapy and childhood cancer: goals,
methods, patient choice and control during diagnosis,
 Role of Music in Palliative Care Music Therapy / Magill
intensive treatment, transplant, and palliative care.
Music Ther Perspect. 2001;19:114-120.
35. Hilliard R. The effects of music therapy on the quality
and length of life of people diagnosed with terminal can-
cer. J Music Ther. 2003;40:113-137.
36. Spintge R, Droh R. MusicMedicine. St Louis, MO: MMB
Music, Inc; 1989.
37. Hodges DA. Handbook of Music Psychology. 2nd ed. San
Antonio: IMR Press; 1999.
38. Maranto C. Music Therapy and Medicine: Theoretical and
Clinical Applications. Silver Spring, MD: AMTA; 1999.
39. Aldridge D. Music therapy and spirituality: a transcen-
dental understanding of suffering. In: Aldridge D,
Fachner J, eds. Music and Altered States: Consciousness,
Transcendence, and Addiction. London: Jessica Kingsley
Publishers; 2006:155-171.
40. Shepherd J, Wicke P. Music and Cultural Theory.
Cambridge: Polity; 1997.
41. Kleinman A. Everything that really matters: social suffer-
ing, subjectivity and the remaking of human experience.
Theol Rev. 1997;90:315-335.
42. Gfeller K. The function of aesthetic stimuli in the thera-
peutic process. In: Unkefer RF, ed. Music Therapy in the
Treatment of Adults With Mental Disorders: Theoretical
Bases and Clinical Interventions. New York: Schirmer;
1990.
43. Feld S. Communication, music and speech about music.
In: Keil C, Feld S, eds. Music Grooves. Chicago, IL:
University of Chicago Press; 1994.
44. OCallaghan C, Sexton M, Wheeler G. Music therapy
as a non-pharmacological anxiolytic for paediatric
radiotherapy patients. Australas Radiol. 2007;51:159-
162.
45. OCallaghan C. Therapeutic opportunities associated
with music when using song writing in palliative care.
Music ther perspect. 1997;15:32-38.
46. Aldridge D. Music Therapy Research and Practice in
Medicine: From Out of the Silence. London: Jessica
Kingsley Publishers, Ltd; 1996.
Downloaded from ajh.sagepub.com at Bobst Library, New York University on November 30, 2014
39
47. Edwards J. Developing pain management approaches in
music therapy with hospitalized children. In: Dileo C,
Loewy J, eds. Music Therapy at the End-of-life. Cherry
Hill, NJ: Jeffrey Books; 2005:57-64.
48. Loewy J. ed. Music Therapy and Pediatric Pain. Cherry
Hill, NJ: Jeffrey Books; 1997.
49. Bailey LM. The use of songs in music therapy with
cancer patients and their families. Music Ther. 1984;4:
5-17.
50. Dileo C. Songs for living. In: Dileo C, ed. Music Therapy
and Medicine: Theoretical and Clinical Applications.
Silver Spring, MD: AMTA; 1999.
51. Aldridge D. Spirituality, Healing and Medicine: Return to
the Silence. London: Jessica Kingsley Publishers, Ltd;
2000:38.
52. Magill L. Music therapy and spirituality and the chal-
lenges of end-stage illness. In: Aldridge D, Fachner J,
eds. Music and Altered States: Consciousness, Transcen-
dence, and Addiction. London: Jessica Kingsley
Publishers; 2006:172-283.
53. Lincoln Y, Guba E. Naturalistic Inquiry. Thousand Oaks,
CA: Sage Publications; 1985.
54. Aigen K. Naturalistic inquiry. In: Wheeler B, ed. Music
Therapy Research: Quantitative and Qualitative Perspec-
tives. 2nd ed. Phoenixville, PA: Barcelona; 2005:352-364.
55. Magill L. The spiritual meaning of pre-loss music ther-
apy to bereaved caregivers of advanced cancer patients.
J Palliat Support Care. 2008 IN PRESS.
56. Hilliard RE. Music therapy in hospice and palliative
care: a review of the empirical data. Evid Based Comple-
ment Alternat Med. 2005;2:173-178.
57. Wlodarczyk N. The effect of music therapy on the spiri-
tuality of persons in an patient hospice unit as measured
by self-report. J Music Ther. 2007;44:113-122.
58. Gallagher LM, Huston MJ, Nelson KA, Walsh D,
Steele AL. Music therapy in palliative medicine. Support
Care Cancer. 2001;9:156-161.
59. Dileo C, Bradt J. Medical Music Therapy: A Meta-
analysis. Cherry Hill, NJ: Jeffrey Books; 2005.