Music Therapy in the Psychosocial Care of Pediatric Patients with Epilepsy

ABSTRACT: Presented here is a working model of music therapy as an invaluable component to the psychosocial care of pediatric patients admitted for the diagnostic testing and treatment of epilepsy. Central to this model is the implementation of music therapy across three domains: psychoeducation to increase patient understanding and awareness, procedural support to maximize coping and compliance, and psychotherapeutic support to facilitate the expression and processing of feelings pertinent to the experience of living with epilepsy. Data collected over a four-year period in which 835 patients successfully underwent Video Electroencephalogram (diagnostic testing for epilepsy) without the use of sedation or medical controls reflect the efficacy of the model and may also suggest certain cost effectiveness as well. "Doctors treat the body but music therapy treats and cures the soul's spirit, and keep it up from one day to another . . . from one week to another. I listen to the music therapist play music that quietly sooths my son's worries. I listen when music played loudly makes my son feel so strong, carefree of all worries and pain. His spirit floats to a different world of beauty." Parent of a pediatric patient Epilepsy affects an estimated 10.5 million children worldwide (Guerrini, 2006), implicating it as one of the most widely diagnosed illnesses among pediatric patients. Central to the diagnosis of epilepsy, is the Video-Electroencephalogram (VEEG), which measures the electrical activity in the brain while simultaneously recording correlative clinical (visible) data on the patient being tested. The VEEG, which involves the topical placement of twenty-six electrodes onto the patient's scalp, is not a painful procedure but it is invasive on a sensory level. This often leads to a high degree of patient resistance and non-compliance during the procedure, especially in those patients who are tactile sensitive to any degree. Many EEG laboratories regularly implement medical controls (defined as any method of physically restricting a person's freedom of movement, physical activity, or normal access to his or her body by way of papoosing or through the use of commercially manufactured devices such as vest and belt restraints, mittens, and soft limb restraints) to ease the process of electrode application. The questionable morality and humanity of restraining any child against his or her will regardless of age, is substantiated in a growing body of research (Minnick, Mion, Leipzig, Lamb, & Palmer, 1998; Mohr, Mahon, & Noone, 1998; Pridham, Adelson & Hansen, 1987), and provides impetus for this report. Additionally, the use of general anesthesia or chloral hydrate to achieve conscious sedation may be sought by the ill-prepared unit in order to ensure the successful completion of the procedure. While such interventions are made under the guise of being in the best interest of the child undergoing the procedure, this practice actually translates into a tremendously inefficient use of hospital staff and resources. The reported expense of various forms of sedation and anesthesia (Lee, Vann, & Roberts, 2001; Nelson, Hoagland, & Kunkel, 2000), as well as studies on the possible adverse effects of such intervention (Cote, Karl, Notterman, Weinberg, & McCloskey, 2000; Bluemke & Breiter, 2000; Heistein et al. 2005; Lang & Rosen 2002; Lee et al. 2002; Mascia, Koch, & Medicis, 2000; Meiser & Laubenthal, 2005; Nelson, Hoagland & Kunkel, 2000; Pershad, Palmisano, & Nichols, 1999), should generate genuine interest at the administrative level of the health industry to seek alternative means of reinforcing patient coping and compliance during minor procedures such as this one. Music therapy within the context of Child Life philosophy (American Academy of Pediatrics [AAP], 1993; Orland, 1965; Plank, 1965) is routinely implemented as both a time- and cost-effective alternative to sedation and restraining within the epilepsy-monitoring unit (EMU) of a large medical center operating in the New York metropolitan area. …