Helping to Heal Through Music Therapy

During Child Life Month, we are spotlighting our Music Therapy program and the ways Creative Art Therapies help our patients form coping skills, explore self-expression, and illuminate feelings essential to hope and healing.

Whether writing a song with a teen patient, soothing babies and families in the Neonatal Intensive Care Unit (NICU) or leading a group jam session, board-certified music therapists Cassi Crouse and Rebekah Martin are an integral part of Lucile Packard Children’s Hospital Stanford’s patient care teams. In their research-based work, Cassi and Rebekah use clinical music therapy to reduce patients’ stress and anxiety, help them manage pain, normalize the hospital environment and encourage neurological growth. Notably, they also bring joy and comfort to patients and their families on both good and bad days.

“For children with chronic illnesses, we’re working on goals like promoting positive relationships with peers, increasing self-esteem, and coping with extensive hospitalizations and time away from ‘normal’ life,” says Martin. “Interwoven between learning cool riffs and strumming patterns are things like social skills, opportunities for independence and choice-making, or conversations about support systems and meaningful relationships.”

Collaborating with multi-disciplinary care teams, Cassi and Rebekah create individualized music interventions to promote socialization for one patient, facilitate rehabilitation in another, encourage baby-parent bonding in the NICU or, for example, support speech and motor skills development in critically or chronically ill children.

While Cassi works in the NICU and cares for infants and children in the pediatric and cardiovascular intensive care units (ICU), Rebekah works with patients in the hematology/oncology, stem cell transplantation, and outpatient dialysis units.

“With older patients, I use song writing and lyric analysis to talk about feelings and what their hospitalizations have been like,” notes Crouse.

“Although it looks like we’re jamming out or ‘just learning guitar,’ we’re really working on so much more. Music is the medium through which therapy is happening.” – Rebekah Martin, board-certified music therapist

Aria’s story – “You’ll be in my heart”

Parents Liesl and Dylan Barrett cradle their daughter Aria in the Cardiovascular Intensive Care Unit (CVICU) at Packard Children’s Hospital

One of the smallest recipients of music therapy at Packard Children’s is aptly named, Aria. And Aria, true to her namesake, loves music.

At only three months old, Aria Barrett has undergone two heart surgeries, the first when she was two days old and the second at two weeks, as well as a third surgery to correct complications arising from treatment. Aria was born with tetralogy of Fallot, a rare, complex congenital heart defect; absent pulmonary valve syndrome; and a congenital disorder of the lower spine.

Despite the more than 90 days she has spent in the ICU and her surgeries, Aria remains strong and will soon be transferred to her local hospital in Utah to prepare to go home with her family at last.

From 6 weeks old, baby Aria and her family have experienced music therapy; Crouse makes weekly visits to sing soothing lullabies and play songs, including spiritual hymns that the family requests. Crouse is always on call, says Aria’s father, Dylan Barrett—and willing to help out, whether to calm Aria for a procedure or brighten everyone’s day.

For the smallest patients, especially those in the NICU, music therapy can provide a source of relaxation that calms babies; bedside music offers emotional support for the whole family, as well. “It can be incredibly intimidating having a baby in the NICU,” says Crouse.

“I find a lot of times parents are not sure how to interact with their baby in the NICU. Music is a fantastic way to foster and promote bonding.” – Cassi Crouse, neonatal intensive care unit music therapist

Packard Children’s Hospital music therapist Cassi Crouse plays for Aria Barrett in the CVICU

Barrett recalls a challenging time in February when he was Aria’s sole parent in the hospital for two weeks. Aria’s mother, Liesl, had to return home to Utah to care for their three-year-old son, Peyton, who they thought would need a tonsillectomy. “That was hard,” says Dylan. “But I think the greatest thing we ever did was, Cassi sat down with Aria’s mom and recorded a CD that could be played for Aria.”

The CD contains a playlist of favorite songs for Aria that her mom, Liesl, a piano player, sang acapella and collaborated with Cassi to record in the hospital.

“Every time I heard the recording, it instantly reassured me that Aria’s mom would still be here,” says Dylan. “The CD has been very special for us–the nurses play it at night, too, when we can’t be here with Aria."

"Music therapy brings a calming presence in the room for everyone–parents and providers" – Dylan Barrett, father of CVICU patient Aria Barrett

“Music therapy has been such a blessing and healing tool for my sweetheart Aria,” says Liesl Barrett. “When she's feeling sad or is visibly hurting, I will often sing lullabies to calm her down. She responds with smiling or blinking her big beautiful eyes. And the nurses have said they loved playing Aria’s CD for her–it immediately soothed her whenever she was having a hard time.”

“My husband and I love music and truly believe music has healing powers. We're so grateful for the Packard Children’s music therapy program." – Liesl Barrett, mother of Aria Barrett

Kayano’s story – “Perfect”

Fifteen-year-old Kayano Lizardo-Bristow has grown up in a musical family. Since he can remember, Kayano has loved listening to his grandfather play classic rock on his guitar or jamming alongside him and other professional musicians during carefree afternoons. It was natural that Kayano would turn to music to express himself when his chronic kidney disease forced him and his mom to relocate to Palo Alto last summer to receive regular dialysis treatment while awaiting a kidney transplant; leaving behind his father, younger brother Koda, and grandfather in Yuba City.

Kayano Lizardo-Bristow. Photo courtesy Lizardo-Bristow family.

The road to this moment has been a long one. When Kayano was no more than six months old his mom, April Bristow, noticed he could not tolerate food well, he would vomit often and was unable to gain weight. Tests indicated kidney disease and the family was referred to Packard Children’s Hospital. Kayano’s family knew early on that he would need a kidney transplant by the age of 7 or 8. But Kayano defied the odds–his health remained stable until age 13.

Now as he prepares for kidney transplant, Kayano receives dialysis three times a week, for nearly 4 hours at a time. In late 2018 music therapist Rebekah Martin started working with Kayano, using music to offer him a sense of control over his environment. Control has felt fleeting to Kayano; twice in the past few months it appeared he could be getting his new kidney, but the potential donor organ failed to match. Rebekah believes that music therapy, their guitar lessons and weekly sessions together have played a large part in helping Kayano keep up a positive outlook.

“I’ve seen him become more motivated to overcome challenges, engage with peers more easily and display increased independence,” says Martin.

Bristow says it has been a long, rough journey for Kayano’s entire life. Now–as they await a donor organ–living for the past eight months at the Ronald McDonald House at Stanford, Kayano has had to overcome new challenges.

“It's tough on a 15-year-old boy to be so limited in extracurricular activities, visits with others and access to fun things,” says Bristow. Although Kayano is able to go home some weekends and his dad and brother visit, she admits, “We have been feeling extra homesick, more than ever lately.”

During their music therapy sessions, Martin and Kayano focus on one song, playing the tricky parts over and over again until the music starts to flow more smoothly. Martin says his talent is obvious.

Patient Kayano Lizardo-Bristow, music therapist Rebekah Martin and mom April Bristow laugh together during music therapy while Kayano undergoes kidney dialysis at Packard Children’s Hospital

Kayano enjoys the music of Coldplay, Lynyrd Skynyrd, and Dire Straits, but his favorite musician by far is Ed Sheeran. He and Martin have been working on a Sheeran ballad, Perfect, breaking down chord progressions, harmonizing together and getting closer to mastering the melody. Having never had his own guitar–he always played his grandfather’s or mother’s–Kayano was recently surprised by an extraordinary gift from one of his nurses. Colin James, RN, won a guitar signed by Ed Sheeran through a holiday toy drive benefitting the hospital. James learned of Kayano’s love for Sheeran’s music and, along with Martin and the Lucile Packard Foundation for Children's Health, devised the surprise.

“I was sitting in dialysis with Mom, Dad,. and Rebekah, playing the [Ed Sheeran] song Thinking Out Loud,” Kayano described. “Rebekah said, ‘I think we need a new guitar for this part.’ Then a few people walked in, Colin was carrying a guitar case. I was in shock, I was about to have a heart attack! I had a very emotional reaction. Everyone was tearing up. I played a song on the new guitar, I finished while I was still crying.”

The guitar is inscribed with the words “Play! Don’t display! Ed Sheeran.”

When asked how playing music makes him feel, Kayano has a simple answer: “Happy.”

“He has wanted his own guitar for a long time, but we couldn't afford it,” said Bristow. “Kayano has been learning over the years, but actually, never had a nice guitar of his own. He’s always talked about having his own. This is a great boost of inspiration and energy that we could both use right now!”

Patient Kayano Lizardo-Bristow displays his new guitar, inscribed by musician Ed Sheeran, following a kidney dialysis session at Lucile Packard Children’s Hospital Stanford.