A Synerdisciplinary Music Therapy Treatment Team Approach for Hospice and Palliative Care
The role of the clinician on the multi-dimensional palliative care treatment team continues to evolve, expand, and be re-defined as patients and families are successfully served in and by music therapy. The terms interdisciplinary, multidisciplinary, and transdisciplinary are often used to describe such inclusive treatment teams. A new term, synerdisciplinary, is offered, which builds and expands on previous terms. The stimulus for using this new term comes from the author's personal and professional experiences working as a clinician in hospice and palliative care. The related term synergetic is also considered as it relates to music therapy teams themselves within hospice and palliative care organizations. In this case, it refers to music therapists working together as a department with differing but complementary treatment approaches, philosophies, and orientations to their work in palliative and hospice music therapy.
Key Words: music therapy; hospice; palliative; treatment team
The provision of services by a multi-faceted treatment team for the patient with a life-limiting illness or condition is a fundamental tenet of hospice and palliative care (Saunders, 1990). The inclusion of music therapy in complementing this treatment team has been increasingly accepted and progressively embraced in recent years in the United States, Canada, Great Britain, Australia, Europe, and New Zealand (Aldridge, 1987,2003; Brooks & O'Rourke, 2002; Croxson & Krout, 2002; Haghighi & Pansch, 2000; Hilliard, 1995,2001,2003; Hogan, 2002; Krout, 2000, 2001,2002,2003; Lucchese & Krout, 2000; Mandel, 1993; O'Callaghan, 2003; O'Kelly, 2002; Porchet-Munro, 1998). In her landmark book, Munro
(1984) described such team work, stating "a music therapist could not function in the ways described in this book unless he or she were part of a multidisciplinary team, sharing in the complex care of the terminally ill person" (p. 62).
There are several terms that are frequently used to describe these treatment teams. I began researching this area five years after beginning my work as a music therapist as a member of such teams in palliative and hospice settings, concluding that the existing terms may not be entirely adequate. It is my own experiences and a review of the literature which have stimulated me to propose new terms. First I will examine the descriptors in current use in the literature.
The Multidisciplinary, Interdisciplinary, and Transdisciplinary Treatment Team
Teams are often described as being multidisciplinary when professionals from different disciplines provide their own treatments for the common good of the patient without necessarily meeting together to plan or discuss their needs and progress. The disciplines involved in the team may be diverse and include physicians, nurses and nurse assistants, social workers, physiotherapists, pastoral counsellors, and volunteers. Areas such as music, art, and drama therapy, massage, acupuncture, aromatherapy, Reiki, and others may complement these treatments. Determining the composition of the treatment team is an essential aspect of providing quality services to the patient and family. An example of an extended care team which includes complementary disciplines can be seen in Figure 1 (It should be noted that the placement of the various disciplines in Figure 1 does not suggest their relational value).
[FIGURE 1 OMITTED]
In the interdisciplinary team, members work more closely together in both the planning and providing of services. West (1990) outlined several criteria for a successful team:
The interdisciplinary team is formed from a group of individuals who will undoubtedly have been drawn to this work for a variety of reasons. Most care-givers have personal reasons for needing to care, and a wish to understand and be involved in the dynamics of patient and family as well as in team work is a good beginning. …