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Music Therapy and Medicine
Music therapy in the medical setting serves many functions. Research has shown that it can help reduce the perception of pain, help reduce pre-operative and pre-procedural anxiety and fear, help people regain physical functioning and help people regain their ability to verbalise (Han, 1998, Daveson, 1999, Edwards, 1999, Malone, 1996, Cowen & Masse 1992, Cohen, 1994).

Music Therapy and Socialisation
Adults and children in hospital may experience isolation from home, family, work, school and friends. Group singing and music making encourages socialisation among patients and between patient and family (Davis, 1999). When people are in long term hospital care, family and friends could make a tape of music for their loved one as a way of being with them when they cannot physically come and visit. Clients could to write a song and record it for those at home (children, spouse or parents). Music therapy can provide opportunities for socialisation for both inpatients and outpatients.

Music Therapy and Emotional Expression and Support
Often when people become ill they may feel anxious, afraid, disempowered, and experience pain, depression and low self-esteem (Dileo, 1999). Music therapy can help ease these feelings by enhancing mood, motivation, self-expression (Dileo, 1999) and providing a focus away from the illness and opportunities to use existing abilities and strengths. Song writing, improvising, singing familiar songs, listening to familiar songs and preferred music are techniques employed by the music therapist to encourage emotional expression, provide stimulation, and opportunities to respond, initiate and use abilities. Opportunities for family and friends to participate in musical experiences with the client can help both the client and their loved ones feel supported. Such opportunities also allow the loved one to see the patient doing something positive and something that they are able to do.

Music Therapy and Motor Skills
Illness or diagnosis of a disorder may incur physical disability or exhaustion making physical tasks difficult. Rhythm in music can provide a steady, auditory cue, which can help with motor planning and movement. The enjoyment and fulfilment that playing music can offer can motivate clients to use their motor skills as best they can to partake in the musical experience. Han (1998) reported that a young client overcame both pain and physical impairments to play music for her mother and herself.

Music Therapy and Rehabilitation and Communication
After a stroke, people may need physical rehabilitation, speech and language therapy, occupational therapy and psychological assessment. Music can be used in physiotherapy as an enjoyable, rhythmic stimulus, which can encourage movement and reduce patient’s awareness of the negative aspects of the therapy like discomfort and boredom (Gfeller, 1999). Patients who suffer communication and speech disorders as a result of their stroke will often retain the ability to sing. ‘The singing of songs allows an avenue of expression denied them through the usual verbal means’ (Erdonmez, 1993). It can also give clients access to language when it can no longer be accessed directly. ‘This ability to sing words even if one cannot speak them, invariably gives pleasure and a sense that one is not so devastatingly disabled’ (Sacks, 1998).

Music Therapy and Pain Management
Music therapy has been found to be a useful intervention in pain management (Daveson, 1999, Edwards, 1998, Lovesky, 1991, Lowey et al, 1997, Lowey, 1999, Malone, 1996 and Gfeller et al, 1990). Pain and music appear to be processed in the same part of the brain (Han, 1998) which means that the stimulus of music can override the pain stimulus. The provision of live music can be a distraction and refocus for clients. Song writing can be used as a means of expression, which can help clients cope with their anxiety and pain.

References
Cohen, N., Masse, R. (1992). The application of singing and rhythmic instruction as a therapeutic intervention for persons with neurogenic communication disorders. Journal of Music Therapy, 30 (2), 81-89.

Cohen, N. (1994). Speech and song: Implications for therapy. Music Therapy Perspectives, 12, 8-14.

Daveson, B.A. (1999). A model of response: coping mechanisms and music therapy techniques during debridement. Music Therapy Perspectives, 17, (2), 92-98.

Dileo, C. D. (1999). Introduction to music therapy and medicine: Definitions, theoretical orientations and levels of practice. In C. D. Dileo (Ed.) Music therapy and medicine: Theoretical and clinical applications. Silverspring, MD:American Music Therapy Association.

Edwards, J. (1998). Music therapy for children with severe burn injury. Music Therapy Perspectives 16 (2) 21-26.

Erdonmez, D. (1993). Music: A mega vitamin for the brain. In M. Heal and T. Wigram (Eds.) Music therapy in health and education. London: Jessica Kingsley.

Gfeller, K., Logan, H., Walker, J. (1990). The effect of auditory distraction and suggestion on tolerance for dental restorations in adolescents and young adults. Journal of Music Therapy, 27 (1) 13-23.

Gfeller, K. (1999). Music therapy in the treatment of medical conditions. In W.B. Davis, K.E. Gfeller & M.H. Thaut (Eds.) An introduction to music therapy theory and practice. Boston: Mc-Graw-Hill College.

Han, P. (1998). The use of music in managing pain for hospitalised children. The Australian Journal of Music Therapy, 9 45-56.

Loveszy, R. (1991). The use of Latin music, puppetry and visualisation in reducing the physical and emotional pain of a child with severe burns. In K. Bruscia (Ed.) Case studies in music therapy. Philadelphia: Barcelona Publishers.

Lowey, J., MacGregor, B., Richards, K. & Rodriguez, J. (1997). Music therapy paediatric pain management: assessing and attending to the sounds of hurt, fear and anxiety. In J. Lowey (Ed.) Music therapy and paediatric pain. Cherry Hill, NJ: Jeffrey Books.

Lowey, J. (1999). The use of music psychotherapy in the treatment of paediatric pain. In C. Dileo (Ed.) Music therapy and medicine: theoretical and clinical applications. Silver Spring, MD: American Music Therapy Association.

Malone, A.B. (1996). The effects of live music on the distress of pediatric patients receiving intravenous starts, venipunctures, injections and heel sticks. Journal of Music Therapy, 33, (1), 19-33.

Sacks, O. (1998). Music and the brain. In C. Tomaino (Ed.) Clinical applications of music in neurological rehabilitation. St. Louis, USA: MMB Music Inc.