Episodes of Relationship Completion through Song: Case Studies of Music Therapy Research in Palliative Care

Article excerpt

Clements-Cortes, A. (2009). Episodes of relationship completion through song: Case studies of music therapy research in palliative care. VDM Verlag, 356 pages, ISBN 978-3-639-14542-7. $106.00

Canadian music therapist Amy Clements-Cortes offers the reader engaging and beautiful narratives of case studies in palliative care based on the model of relationship completion as outlined by Dileo & Dneaster (2005). This model includes three levels of practice: supportive (palliative endof-life symptoms like pain, comfort, quality of life); communicative/expressive (i.e., launching and reflective techniques, musical autobiographies, improvisation); transformative (i.e., life review, resolve conflicts and feelings, address spiritual issues). Through the detailed presentation and deconstruction of four poignant case studies (the accompanying CD, Episodes of Relationship Completion, can be purchased through her website, notesbyamy.com), one can readily see the effectiveness of music therapy facilitated relationship completion. The author believes that relationship completion is part of holistic care of the dying. Clements-Cortes describes songwriting, lyric discussion and analysis, life review and the creation of musical gifts as beneficial techniques for assisting persons with relationship completion at end of life. Anchoring her approach in Dileo & Dneaster's model gives the music therapist a tool to address end-of-life opportunities for relationship completion.

Relationships in this study involve "any relationship that the dying person has a desire to complete that is of an intrapersonal (with oneself), interpersonal (with other people), and/or transpersonal nature (with God, pets, nature etc.) (pp. 22-27) The literature shows that relationship, whether intrapersonal, interpersonal or transpersonal, are highly valued in terminally ill people. According to Byock, there are 1 0 tasks for the end-of-life. He defines them as:

...sense of completion with worldly affairs, sense of completion in relationships with the community; sense of meaning about one's individual life; experienced love of self; experienced love of others; sense of completion in relationships with family and friends; acceptance of the finality of life and of one's existence as an individual; sense of a new self beyond personal loss; sense of meaning about life in general; and surrender to the transcendent and the unknown (p. 3).

Understanding how music therapy can assist in relationship completion, one of these landmark tasks, is the central inquiry of the book. According to Byock, there are five sentiments that permit relationship to reach completion once they are expressed. These are:

"I love you," "Thank you," "Forgive me," "I forgive you," and "Goodbye" (p. 15).

A secondary question in the book is how music therapists introduce the concept of relationship completion to clients. Clements-Cortes believes that the techniques employed in receptive, creative, re-creative, and combined approaches of music therapy are useful with respect to relationship completion in potentially three ways: a) to bring focus or clear thinking to set the work of relationship completion in motion b) to serve as launching points or reflections about relationships, and/or c) to become vehicles or tools for expression of the various sentiments that permit relationships to close. …