“Song of Life” – Music therapy at the end of life


Each month, Professor Catherine Walshe, Editor-in-Chief of ‘Palliative Medicine’, chooses an article that readers may find particularly interesting or useful and invites the authors to draw out the key points on the EAPC blog. Focusing on research that is novel, a robust review, from a specific country or just slightly left of field, the ‘Editor’s Choice’ post aims to share experience and stimulate ideas. We hope you’ll read the longer article in ‘Palliative Medicine’.

Top row, clockwise: Friederike Koehler, Marco Warth, Martin Brehmen, Martin Weber, Hubert J Bardenheuer, Jens Kessler and Beate Ditzen.

Friederike Koehler, Marco Warth, Martin Brehmen, Martin Weber, Hubert J Bardenheuer, Beate Ditzen and Jens Kessler explain the background to their longer article selected as ‘Editor’s Choice’ in the June 2021 issue of ‘Palliative Medicine’. And it’s Open Access…   

“This is the song that my grandmother used to sing to me

when I could not fall asleep as a child…”

Patients at the end of life tend to review their lives recalling important relationships, events and phases of life. Indeed, psychosocial interventions in palliative care often work with life reviews and/or creating legacies, such as an interview transcript. Research on these techniques commonly shows beneficial effects on the patients’ quality of life and spiritual wellbeing. Since music is often deeply tied to certain memories, it may be an additional tool to support patients to come to terms with their own biography at the end of life. However, no study has yet investigated biographical music therapy, which inspired us to develop an innovative music therapy intervention for palliative care patients (“Song of Life”) that is based on a biographically meaningful song.

Consisting of three sessions, the first session contains an interview with the music therapist to identify and explore this song. In the second session, the music therapist plays the song live to the patient, which is audio recorded. The music therapist hands over the audio recording in the third session and guides the patient to reflect on the feelings and thoughts in the experience.

To evaluate the effects of this music therapy technique, we conducted a study with 104 patients on two palliative care units in Germany who participated either in three sessions of music therapy or relaxation exercises. Before and after each intervention, participants assessed their psychological and global quality of life, spiritual wellbeing, ego-integrity (a sense of acceptance and wholeness), and momentary distress. Additionally, both patients and their families rated their satisfaction with the treatment. Results of the data analysis showed no differences between the two interventions regarding psychological and global quality life. However, participants in “Song of Life” reported higher spiritual wellbeing and ego-integrity as well as lower distress compared to participants in the relaxation group. Further, both patients in music therapy and their family members were more satisfied with the treatment than patients and family members in the relaxation group. Numerous music therapy participants told us they were enormously touched by the interest and effort of the music therapist in their own life story and that the intervention was meaningful and important to them.

As the first study on biographical music therapy in palliative care, our findings add to the supply of psychosocial interventions with terminally ill patients. Especially regarding spiritual needs, biographical music therapy might facilitate an emotional processing and integration of life experiences. Practitioners and clinicians in palliative care might identify patients that are particularly afflicted with a loss of meaning and purpose in life and offer this type of music therapy as a resource to regain a sense of coherence and acceptance. As “Song of Life” also showed beneficial effects on distress, it may also provide a momentary relief of burden.

Future research might explore longer-term effects of biographical music therapy and the influence of individual characteristics, such as sex or cultural background.

Editor’s note: This post is among the Top Twenty most-viewed posts for 2021.

This post relates to the longer article, “Song of Life”: Results of a multicenter randomized trial on the effects of biographical music therapy in palliative care by Marco Warth, Friederike Koehler, Martin Brehmen, Martin Weber, Hubert J Bardenheuer, Beate Ditzen and Jens Kessler, published in Palliative Medicine Volume 35 issue: 6, page(s): 1126–1136. https://doi.org/10.1177/02692163211010394 (Open access).

More about the authors…
Marco Warth
, a post-doctoral researcher, Friederike Koehler, a doctoral researcher and Beate Ditzen, a professor and director, work at the Institute of Medical Psychology, Center for Psychosocial Medicine, Heidelberg University Hospital, Heidelberg, Germany. Martin Brehmen, a psychologist, and Martin Weber, a professor and chief physician, work at the Interdisciplinary Palliative Care Unit, III. Department of Medicine, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany. Jens Kessler, a senior physician and post-doctoral researcher, and Hubert J. Bardenheuer, a professor and chief physician, work at the Centre of Pain Therapy and Palliative Care Medicine, Department of Anesthesiology, Heidelberg University Hospital, Heidelberg, Germany.

This study received funding by the “H.W. & J. Hector Stiftung” and by “Sonnen-Blau. Gemeinnützige Morgott-Schupp-Stiftung für frühkindliche Erziehung und Palliativversorgung.”


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This entry was posted in 2021 most viewed posts, EAPC-LINKED JOURNALS, Palliative Medicine: Editor's Choice, The Arts in palliative care, Top Ten Most Viewed Posts and tagged , . Bookmark the permalink.

1 Response to “Song of Life” – Music therapy at the end of life

  1. Gold, Michelle says:

    Lucy, you might like to forward to Yinmin ________________________________

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