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

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Episodes of relationship completion through song: Case studies of music therapy research in palliative care Author: Amy Clements-Cortés VDM Verlag, 2009 ISBN 978-3-639-14542-7

Episodes ofrelationship completion through song: Case studies of music therapy research in palliative care examines how music therapy can be effective in assisting those who are dying in relationship completion. The author believes that relationship completion is part of holistic care of the dying and is necessary for improved palliation and avers music therapists are well-positioned to assist patients with such aspects of illness. She describes songwriting, lyric discussion and analysis, life review and the creation of musical gifts as beneficial techniques for assisting persons with relationships at end of life. Using four case studies with adults deemed palliative (3-6 months prognosis to live), themes of relationship completion emerged, have been collected and analyzed. This book poignantly demonstrates how the music therapy process can effectively reach into the pain and suffering of the dying person to bring resolution and wholeness.

The book has ten chapters, beginning with an introduction which includes the author's personal motivations for the research. Chapters 2 and 3 present the constructs, definitions, literature review research methodology and procedures. Chapters 4-7 are data chapters that present four case studies, an analysis of the data and emerging themes, clientcomposed song lyrics, and artistic pieces that the author crafted based on the experiences of the participants and that each one verified. Chapter 8 is a cross case chapter which includes a thematic analysis of participant experience and an examination of the process motifs arising from the progression of participant engagement in music therapy. Chapter 9 is a summary of revealed knowledge of the research study and implications for music therapists and allied health care professionals in palliative care. Chapter 10 is a personal reflection by Amy as a musician, music therapist, music educator and researcher. In addition, Amy compiled a CD called Episodes of Relationship Completion which is an artistic portrayal of the study results. The songs represent key sentiments that participants expressed to help them complete relationships they identified as significant www.notesbyamy.com.

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 ten 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).

Implicitly, a secondary question in the book is how music therapists introduce the concept of relationship completion to clients. ClementsCortés believes that the techniques employed in receptive, creative, recreative 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. …