Music soothes: Why HMH therapist says artistic approach makes difference with mental health patients

Danielle Barbera recounts meeting with a musician who struggled with a mix of depression, anxiety and alcoholism. When he sobered up, he felt that his creative drive and inspiration were amiss. It was deflating for him and his self-identity.

As she does often when someone experiencing mental health challenges has — literally and figuratively — lost their voice, Barbera politely handed over a guitar.

And, often, that’s all it takes.

Danielle Barbera.

“I said, ‘Here, play whatever comes to mind for you,’ and he responded by playing his original songs,” she said. “I heard the power in his voice as his lyrics came to life again. After he was done playing, we just sat there in silence. He became emotional and expressed how ‘weird’ but liberating it was.”

That musician went on to be discharged from Hackensack Meridian Health’s Carrier Clinic, where for this individual — and many others — a music-based patient-therapist rapport is proving to be a healing experience.

Barbera is board-certified in music therapy, a field that Hackensack Meridian Health and other local organizations are trying out as a means of managing mental health disorders and mood disturbances.

“These fields have really been booming in the region over the past 10 years, not just at hospitals, but at schools, nursing homes and veterans organizations,” Barbera said. “And it’s truly, by definition, an evidence-based therapy.”

There’s a host of evidence suggesting music therapy is effective in reducing anxiety and depression, as Barbera alluded to. Its benefits have been demonstrated across all age groups, but recent research is particularly focused on examining its efficacy in patients with dementia and conditions such as Parkinson’s disease.

Music therapy has been classified as a reimbursable service for upwards of 20 years. It’s paid for by Medicare at rehabilitation centers and hospital-based programs such as Carrier Clinic’s.

Carrier Clinic has a few different specialty programs alongside music therapy for psychiatric and rehab patients, including art and dance programs. Barbera and four other music therapy colleagues are spread throughout the hospital in different units.

Each of them takes a slightly different approach, one that differs based on patients’ past traumas and current needs, but, generally, they’re all asking patients to engage in musical improvisation or composing music to tap into their feelings.

“Patients tend to be hesitant about this in the beginning,” Barbera said. “Then, they’re surprised as to what comes out of them when they start playing and how their emotions are connected to it. Something I like to do is songwriting. What that does for a patient or client is, it helps break down what’s on the patient’s mind and how they’d like to express that through the music as we create.”

Although music therapists utilize a wide range of instruments, from simple hand instruments to pianos and guitars, Barbera said her preference is always for patients to use their voice as much as possible.

“I really want to help facilitate people finding their voice again in the music therapy process,” she explained. “The voice is so individual to who we are — and not just in textures and timbre of our voices, but in how we express ourselves, our values and morals and how we navigate through life.”

Music therapy happens in individual as well as group settings. Barbera said she’s always struck by the sighs of relief and connectivity people find in singing together and making music as a unit, even if everyone’s reasons for seeking mental health services might be totally different.

There are different modalities that music therapists, who have to pass a board-certified exam after a four-year degree program, operate under — and just as many different reasons for entering the profession to begin with.

“Growing up having some health issues myself, when I was a teen, I received music therapy services,” Barbera said. “It changed my outlook on wellness and recovery in life. And I’ve always been fascinated as a musician myself how it has been proven to be so powerful in all these modalities. So, because I’ve lived it myself, it sort of automatically became my passion.”

Barbera is thrilled with the trust Hackensack Meridian Health has in what she does, and the support it offers music therapists.

She expects many regional institutions will follow suit, if they haven’t already.

“I certainly see the field growing even more expansively throughout the country — and not just here, but throughout the world,” she said. “I truly see music therapists being in every hospital, in every nursing home and every school.”

Escaping its portrayal

Whether “electroconvulsive therapy” is a familiar concept or not, Dr. Umesh Mehta, chief of neuromodulation at Hackensack Meridian Health’s Carrier Clinic, figures there’s an image that comes to mind for a lot of people.

And, it’s probably not a positive one.

Dr. Umesh Mehta.

“‘One Flew Over the Cuckoo’s Nest’ and other bad media in the ’50s and ’60s informed peoples’ ideas about ECT treatment and led to a lot of pushback,” he said. “Later on, when there were all these patients on medications not getting better still, ECT entered the picture again.

“And that’s for good reason. Given that it’s effective 85% to 90% of the time, it has one of the highest success rates of anything in the entire field of medicine.”

As Mehta alluded to, this FDA-approved treatment was once seen as dangerous and inhumane by the public due to its portrayals. That, he said, led to a decline in the use of ECT and an increase in the use of antidepressants.

“But this is a humane treatment done through general anesthesia,” he said. “Patients are going fully out for five to seven minutes, with a muscle relaxer. When the stimulation goes into the brain, a seizure happens, but there’s no convulsion, really. There’s just a mild tremor in the body while patients are sleeping.”

ECT, which involves brief electrical stimulation delivered to the brain, is commonly used in patients with mood disorders either too severe for pharmaceutical therapies or conditions that haven’t responded to those treatments.

“A number of psychiatric disorders now are treated with ECT treatments … including Parkinson’s disease, which 50% of the time leads to depression,” Mehta said. “It’s very safe, very well-researched. It’s still a gold standard.”