After a traumatic and stressful week in the hospital, Siena Tompkins’ nurse asked her if she would be interested in doing a music therapy session while she was recovering. Siena jumped at the chance and soon a music therapist joined her in her room. 

        “[The session] was the first time that I really genuinely smiled and felt like everything was going to be okay since I had been moved back down from the [intensive care unit],” Siena said. 

        Every day a team of 6 certified music therapists and one intern move through the hospital visiting patients, working towards goals and spreading music and smiles through the halls of Children’s Minnesota. 

what is music therapy?

        When most people hear the word ‘therapy,’ their minds likely go to talk therapy and physical therapy. But the world of therapy is much more expansive than that. Music therapy is a way to use the profound way music impacts us to work toward achieving physical goals.

        “Everything that I do is goal driven but it's all different,” said Erinn Frees, a music therapist at Children’s. “That's why I love my job because I get to be so creative and every day I'm trying to think what would be interesting that I could do for this kid.” 

        Music therapists use the clinical properties of music to help people reach non-musical goals including things like fine and gross motor skills and reaching developmental milestones.

        “Music therapy is similar to other kinds of therapy, like speech and language, [physical therapy, occupational therapy] and even talk therapy, but we just use music as our way of supporting the patient's goals,” said Sarah Woolever, another music therapist at Children’s.

        Every day, the music therapy department works off a list of referrals from departments across the hospital for any number of reasons. 

        “Depending on the goals that we have established with them, their families and the rest of the treatment team, we come up with what music interventions we're going to use to help them reach the goals that they need to reach to heal and to cope with their hospitalization and to get out of the hospital,” Erinn said.

        For example, Erinn said if someone had some sort of lung injury or other respiratory illness, she might use a harmonica to help them regain breath support by blowing through the instrument. 

        Sarah said music therapists work closely with occupational therapists, physical therapists, speech and language pathologists while prioritizing who to see and what to do.

        Music therapists can use instruments to promote certain physical positions, like sitting or standing, that can help patients heal. For example, Sarah said if she is working with someone who they want to sit up or stand up, she can position a piano keyboard on their lap or on a table and remind them to stand up straight while playing. 

        “Sometimes I'll do therapeutic lessons where I will teach someone how to play a ukulele or a piano and it just gives kind of some direction and some meaning to the hospital stay,” Erinn said. “It can get really demoralizing just being in a hospital all day and you feel like you're not learning anything.”

        While working with each patient is different, Sara and Erinn said they are always motivated by the same thing: the goals set in collaboration with them, their families and their care teams. 

        “It really kind of depends on what their individual goals are. I have an idea when I walk in, but I'm kind of assessing the entire time and being responsive based on what they're giving me,” Sarah said.

        Sarah said she likes to bring her guitar and iPad to every session, because they are easy to transport and fit in even small hospital rooms easily. Music therapists often travel with a cart of all kinds of instruments, all carefully sanitized between uses, so they can find something that works for everyone.

        “Music therapy is for everyone, all ages across the lifespan. I have worked with every age of people from premature babies … [to] people who are like 101. And it’s for everyone in between,” Erinn said.

        Before working at Children’s, Erinn worked with Alzheimer's patients and said though the music she played with them is different from what she now plays at Children’s, the general principle of music therapy stays that same. 

        “It's very strength-based therapy and it's one that everyone can participate in. Most people are musical in some way, even if they've never played an instrument,” Erinn said. “Most people emotionally connect to music in some way so that's why it's a really motivating and effective therapy.”

        Sarah worked in a series of therapeutic preschools all designed to support families. Music therapy at those preschools was different than it is at Childrens — her work at the preschools focused on creating meaningful parent-child interaction time and helping children reach developmental milestones.

        “Music therapy was like the experiential part of this, like they would talk about how to be supportive of your child, or model or redirect and stuff and then we'd have music therapy, and then [the parents] got to try those new skills during these experiential play times,” Sarah said. 

        When the COVID-19 pandemic first started, the music therapy team at Children’s was forced to adapt, just as the rest of the world did. Suddenly instruments like harmonicas were no longer a safe option, visitors weren’t allowed in the hospital and a lot was unknown about the disease, but the music therapists continued on.  

        “[COVID-19] kind of changed everything and nothing. Our work is still the same at the core, but we have had to adapt in so many ways,” Erinn said. “Since only parents can be in the hospital, I've had to do a lot of sessions like where the siblings are on FaceTime or like grandma's on FaceTime or grandma's on zoom on the computer, trying to participate from afar.”

        Music therapy investigates the scientific reasoning behind the connection humans have to music in order to use it as a healing tool.

        “With music therapy, the research goes deeper into the why of that, like ‘why is it that music makes us want to move our body? Why do we want to run to or dance to the beat? Why is that?’” Sarah said. “It just engages our brains in different ways than language does.”

how do you become a music therapist?

        Erinn didn’t grow up wanting to be a music therapist, rather, a combination of working at a nursing home and her mom suggesting she look into the field eventually led her to working as a music therapist.

        “My grandfather got Alzheimer's and he was in a nursing home and so I would go visit him and while I was visiting him the executive director of the place, happened to come talk to me and … she was like, ‘oh, like, do you want to do you want a job here?,’” Erinn said. “I did work there for years and I loved it and that was kind of when it clicked for me like that I wanted to be in this helping profession and I wanted to use music.”

        Though a music therapy major is not commonplace — around 70 schools in the United States offer it — it is not the only path to becoming a certified music therapist. 

        “The way that I did my degree, because I wasn't at a school that had a music therapy degree, is I just did an undergraduate double major in music and psychology and then I went on to a master's program that had that equivalency afterwards,” Erinn said. 

        Sarah went to a school that had its own music therapy program and then, after working in the field for a few years, went back to school to get her masters degree. 

        “I was always active with music but I didn't want to be a music teacher. I definitely knew that and I didn't think I wanted to be a performer,” Sarah said. “I was looking towards the social work, therapy fields anyway, so then when I got that flyer [from Berklee School of Music], I was like, ‘Oh, this would be really cool.’”

        Certified music therapy programs, like the one Sarah did at the University of Iowa, feature a core curriculum about music therapy, many music foundations classes like theory and composition classes and science classes like psychology and anatomy. 

        “When you train to be a music therapist you can work with any population, any age, so it's not like a different or specialized degree depending on what you're interested in,” Erinn said. “I just know I loved both age groups and learned so much from everybody I've worked with.”

        Before becoming a certified music therapist, people must complete a series of requirements, including an American Music Therapy Association approved internship, which lasts six months and is supervised clinical work. 

        “We always look for people who have volunteered at their local hospital or at a nursing home or a camp for children with different abilities. …  just showing that they're out there in the community, getting involved with the populations that they want to work with,” Erinn said.

        Children’s is a national roster certified program and gets interns from across the country and Erinn said the hospital has had 13 interns so far. 

        “Every day I just tell our interns like ‘how lucky are we that music is our tool in this way,’ because it really just is such a natural and comforting way to work with people and it's a really positive thing that's happening at the hospital,” Sarah said.  

        Erinn said anyone interested in the field should start learning guitar and piano and working on their singing skills. 

        “I would recommend this job to anyone who loves music and who loves helping people and it's super rewarding, it's so flexible, you can work in so many settings,” Erinn said. “People always say like ‘oh you can't make a living doing music or whatever unless you're a professional’ which is so few people … but this is a way that I get to play music pretty much all day every day, that's pretty awesome.”

        Nationally, the American Music Therapy Association is the place to look for more information about music therapy and for Minnesota specifically there is the Music Therapy Association of Minnesota.

        “There's so so so many ways to use music that are beneficial, but to actually be music therapy it has to be provided by a music therapist,” Erinn said. “Anyone can use music in a therapeutic way and anybody can use music to improve and benefit their life, but music therapists do have a lot of training, and a lot of clinical internship hours.

how can it help?

        At any given time the referral list the music therapists work off of at Children’s has 50 to 60 patients on it, Erinn said, and they are referred for all kinds of things. 

        Siena was referred after a particularly traumatic week at Children’s during which she had had an adverse reaction to anesthesia. 

        “I love music. And music has been a huge part of coping with a lot of my admissions and surgeries and procedures and things like that, so I was pretty excited,” said 16-year-old Siena.

        Siena has struggled for years with her health, starting with a pulmonary embolism diagnosis that kicked off a series of other diagnoses including POTS, chronic migraines, endometriosis and EDS (hypermobility type). You can read more about Siena’s journey in our feature story about her here.

        For Siena, her time with a music therapist was a mix of active participation and passive listening, just letting the music wash over her. One song she played with the therapist was “I And Love And You” by The Avett Brothers. She picked it because it is one of her moms favorite songs and she was missing her mom. 

        “She pulled up the easiest version of music on the iPad, and showed me the chords that I would need,” Siena said. “She had a ukulele and I had a ukulele, and we just started playing and we got to sing. My singing voice is not fantastic, but it didn't really matter because it was genuinely so therapeutic.”

        Before the pandemic therapists at Children’s frequently ran group sessions that brought patients in remarkably different situations together to unite over music.

        “Many of us have that shared experience of how music can help us wake up in the morning, and can make us cry, can make us finish our exercise at the gym, or whatever,” Sarah said. “I think we have that common understanding of how music is really powerful.”

        In a session Sarah recalled, the group involved kids ranging from six months old to 13 years, with a whole host of medical needs and four different languages. Even without an interpreter, Sarah was able to use music to get the older kids helping the younger kids and feeling successful, the younger kids feeling cool because they were hanging out with the older kids and everyone making music together.

        “I can walk into a room of strangers, and we can create a shared experience with music,” Sarah said. “We don't need a common language to have that gathering and that cohesive feeling and for it to be supportive for the patient and the family. That's really one thing that I love.”

        When Siena did music therapy at Children’s her dad recorded parts of the session. Siena said these videos are now very special to her because she got to share the experience with her mom and now she has them forever to help her remember it. 

        “It wasn't just like she walked in and was like, ‘Okay, here's this guitar, I'm gonna play some songs and then leave,’ it was like, ‘No, let me interact with you. Let me get you involved in the music. Let me show you how to play these chords you can follow along with the music and the lyrics,’” Siena said. “It was really, really special for me.”

        Music therapy isn’t just special for patients though, Erinn said it's really special to be a part of the breakthrough moments the therapy can bring for patients.

        “I think that my favorite part of my job is when I see a light bulb moment happen that I know would not have happened without music, just this firsthand witness to the power of music,” Erinn said. 

        Erinn said she remembers working with one patient in particular, who had been on a serious level of care for a long time. During their session, Erin witnessed a breakthrough moment for her after singing with her.

        “She was singing for the first time in months, and then after she was done she said ‘I love you, mom’ and those were like the first things that she'd spoken since months ago,” Erinn said. “I witness those kind of miraculous feeling moments and it's just amazing to be like wow, music therapy had a hand in this moment happening.”

        For Siena, music therapy came at the perfect time, after a traumatizing week, and helped her see past the situation she was in at that moment. 

        “I was able to choose songs and music that had a meaning to me. … I just kind of got to tune out all of the IV pumps and the vitals and my nurse coming in and out and checking all these things,” Siena said. “I just got to tune out the hospital while we played and listened to these songs that were really special to me. It felt like not necessarily being at home, but just being in my happy place.”

        Siena said she appreciated the music therapist's willingness to try some of her more confusing requests, specifically a song from a summer camp which takes the words from “Amazing Grace” and puts them to the tune of “The House of the Rising Sun.”

        “Knowing that there were so many people with so many different roles that are so ready and willing and excited to help with emotional support … It makes me so happy,” Siena said. 

        Music therapy provided a much needed respite from the chaos and burdens of the hospital for Siena. Singing the song from camp helped brighten the winter day, playing her mom’s favorite song helped her feel connected and close to her when she wasn’t able to visit and relaxing listening to her favorite Disney song helped take her mind off of the week she had had. 

        “It was really fun,” Siena said. “You don't say that often about things when you are in the hospital, but any moment that you can get to feel a little bit less like the sick kid and a little bit more like just a kid or like just a teenager you will take it.”