Music Therapy in a Paediatric Hospital: Everything, Everywhere, All at once

Our main role is providing Music and Art Therapy to children and their families: where thoughts and feelings are too difficult to be expressed in words alone; where there are barriers to attachment and bonding; with young people who have barriers to communication; in end of life care and neuro-rehabilitation.

The referral criteria for the Clinical Health Psychology Team is: to support children, young people and their families where the difficulties faced are as a result of a physical health condition. This is obviously not as clear as it sounds - we're a service of 1.5 full time staff plus trainees within a hospital of 310 Paediatric inpatient beds and thousands of outpatients. We face challenges about priority and scope of service. Our team decisions align with the criteria above and also identifies clinical areas which the 15+ years of Music Therapy service have shown particular need such as Palliative Care, Oncology, PICU/High Dependency and Neuro-rehab.

Music Therapists do not only support patients and families, but are an integrated member of the team around the child, having a wider impact on patient care. This can be really challenging. For example, a patient admitted with an eating disorder's care will fall under Eating Disorders or CAMHS rather than under our team. It means tough decisions when, on a human level, you just want to meet the young person and offer support.

From a governance point of view we are not able to offer therapy to young people under different hospital teams which includes our CAMHS team. One thing I've learned is that we can never meet all of the needs and until services and funding catch up, we will remain unable to offer support to everyone who needs it.

Where our service model differs from Music Therapy in other hospital settings is the stance of the Clinical Health Psychology Team. For our patients and families, their distress does not fade when they are discharged and the ongoing need for support can be significant. This in combination with the unpredictability of inpatient admissions and discharges means the model of support is dictated by patient need whether they are admitted or not, rather than their current location. This way we can have continuity of therapy, more predictable endings and feels more therapeutic.

• Firstly, there would be funding for more Music, Art and Dramatherapists
• These services would be embedded within Psychology and/or AHP services and a standard part of psychological care
• Funding would increasingly be "core" NHS funding
• Research into psychological difficulties faced by Paediatric patients will increase and will continue to map our creative approaches to therapy onto a wider evidence base
• All Music Therapists in Paediatrics will be recognised as Allied Health Professionals and Psychological Therapists

From a professional practice viewpoint, the job of a Music Therapist in a Paediatric setting is somewhat of a "jack of all trades" situation. We must be experts in everything from trauma to disorders of consciousness; from family therapy to end of life care and from neuro-disability to bereavement. The question "What is Paediatric Music Therapy?" is impossible to answer, but rather than having to put in boundaries to protect ourselves and our patients, wouldn't it be amazing to have a Creative Therapies team who all have expertise in fields in which they are passionate; contribute specialist knowledge and skills; and can provide best practice for patients and their families.

Everything, everywhere, all at once.

CATT Training

EMDR Association UK