Kayla Shafer tells her favorite story this way:
She was playing guitar before a group of folks with memory issues. Her playlist featured songs about travel and faraway places, and she invited the group to sing along. Near the end of the program she suggested that while traveling can be enjoyable, it's also nice to come back from vacations. She began singing, "Show Me the Way to Go Home."
Suddenly, an elderly woman in the audience who had been slumped over and unresponsive "sat up straight and sang the whole song with me," and the woman's adult daughter started crying at the transformation.
Shafer, co-founder of Keynote Music Therapy in the Twin Cities, is a former music teacher who five years ago joined a growing number of more than 3,800 music therapists nationwide.
Stories, books and videos about the impact of music on people with health issues tend to resonate even with nonmusicians. One book, Waking the Spirit: A Musician's Journey Healing Body, Mind and Soul, by Andrew Schulman, is a page-turning account of his near-death experience in a New York hospital. His revival from the brink turned on his wife's inspiration to play a recording of Schulman's favorite music — Bach's St. Matthew Passion.
Many people treasure a piece of music because it helps them relax. Or they perform a lively composition that revs them up. Or they compile a personal playlist of recordings that trigger poignant memories of people and events.
Minnesota Public Radio and American Public Media provide online streaming of specialized music playlists, from lullabies and choral music to classical favorites chosen by the network's staff. Music director Ryan Lohr said such specialized offerings are based on research into audience needs and desires. Listeners expressed their enthusiasm for such pieces as Dvorak's Ninth Symphony, Beethoven's Fifth and Jules Massenet's Meditation from the opera Thais.
"The decisions we make support things that are doing well," based on how often listeners tune in and how long they listen, he said. "A lot of it is trial and error."
Such musical connections might feel therapeutic to listeners at the time. But they're not necessarily music therapy. Neither is the work of a guitar player in a hospital ward that aims to trigger smiles, not necessarily to lower blood pressure.
In contrast, music therapy is a growing discipline that centers on the use of music, scientific research and clinical experience by a certified therapist to help achieve a nonmusical outcome. It's not just entertainment, although a skilled practitioner will play guitar or piano, earn board certification and be able to adjust to the needs of individual patients or clients.
Melissa Wenszell, who heads music therapy at the MacPhail Center for Music in Minneapolis, said scientific research "is catching up to what people have known for years and years" about music's healing abilities. Neurology, psychology and anatomy all play a role in music therapy's repertoire.
But one musical prescription might not fit every client. Shafer has not found that "Show Me the Way to Go Home" sparks a response in anyone else so far. And a person with memory issues might respond dramatically to a particular music therapy approach only "until the veil comes back over; we see that time and time again."
Even so, Wenszell said, music therapists use rhythms and melodies to help relax or energize clients, rejuvenate speaking abilities for stroke victims and accelerate restoration of a person's impaired motor movements. Sometimes, she added, "our job is for the family or staff [of a care facility]. It gives their day some pep" when they see music therapy spark a response. Some research tries to trace people's responses to certain sounds, rhythms and frequencies back to sensations that babies experience in the womb. But such responses might not be universal. Wenszell said teens might respond more to rhythms in music rather than to words, while older people might light up after hearing lyrics they learned decades earlier during impressionable parts of their lives.
That helps explain why skilled therapists try to tune into each patient's particular needs — extending even the places where treatments occur. If patients and therapist meet in a dark, gloomy room, for example, "I would not start [a session] with the 'Beer Barrel Polka,'" Shafer said, but rather with low-key songs that give way gradually to more upbeat tunes.
Wenszell said music can help reinforce mental skills, maintain cognitive ability and jumpstart physical rehabilitation — "anything to get a person's system to operate at its best."
While neuroscience research can help explain "why what we do works," Shafer said, it takes training and skill to make it work well.
When Shafer hires music therapists for her counseling service — four, so far — "I'm looking for excellent communication skills and people who are likable, relatable, someone I can trust and who has fantastic music skills." She values creativity and flexibility because therapy's impact can hinge adapting treatment in the moment — perhaps rewriting lyrics to reflect a client's experience or memories.
Shafer began taking piano lessons at 6 and later added clarinet and guitar. She earned her undergraduate degree in music education at the University of Minnesota before pursuing a master's equivalency program with classes in abnormal psychology, anatomy and developing a counseling style. She spent weekly sessions shadowing a music therapist and in six months fulfilled a 1,000-hour internship. Then she passed an exam that presented hypothetical cases requiring her responses from a music therapy perspective. Only then did she earn the Music Therapist-Board Certified credential.
Therapists say it's been a struggle so far to have insurance pay the costs of music therapy, despite evidence that it can relieve stress and symptoms of Parkinson's and Alzheimer's diseases.
Keynote's web site says music therapists typically charge $35 to $80 per session. Shafer said she hopes the insurance issue can be resolved, because large numbers of the baby boom generation are entering old age, meaning more will face memory issues and the costs that care requires. Music therapy, by helping maintain cognitive functions, can help "get ahead of this explosion," she said, "before it's too late."
Dan Wascoe is a retired Minneapolis Star Tribune reporter and columnist. As a musician, he is a volunteer bell player at Minneapolis City Hall and, with vocalist Baibi Vegners, performs as Nuance/a duo.