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By 
Alejandra J. Ferrer
 and 
Ciara Reyes-Ton
 on June 21, 2023

Alejandra J. Ferrer: Music and Medicine

Music therapist Alejandra J. Ferrer uses music to help care for cancer survivors, people with memory loss, NICU babies, and adults and children with disabilities.

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Close-up of piano keys with pills and supplements on it.

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What is music therapy, and what does it look like in practice? 

It may not always be widely known, but music therapy is actually considered an allied health profession. Music therapists are board certified clinicians who undergo rigorous training. They must complete an American Music Therapy Association (AMTA)-approved bachelor’s degree in music therapy with 1200 hours of hands-on clinical training and pass a board exam by the Certification Board for Music Therapists.

Music therapists work with individuals across the lifespan. They can be found working in medical hospitals, psychiatric facilities, schools, assisted living/memory care units, hospices, addictions centers, and neurological rehabilitation facilities. Upon receiving a referral, we conduct an assessment of the client and then we develop a music-based treatment plan. We are constantly evaluating the patient’s progress, making changes as needed, and ending services when appropriate. Music therapy may involve singing, receptive music listening, instrument play, improvisation, song-writing, lyric analysis, music, and movement, or creative media projects like a musical collage accompanied by pictures and videos of the individual, their family, and friends. Importantly, music therapy is not a solo performance or passive listening experience. It is a highly interactive patient driven experience.

What drew you to the field of music therapy, and what has kept you here throughout your career?

Since I was a young child, music has been a central part of my life and an enormous part of my identity. Growing up, I remember playing instruments, performing in an orchestra, listening to music, and attending concerts. I have also always had an interest in psychology and health. When I learned about music therapy as a profession, I was immediately drawn to it. I loved the idea of using music to help others and knew that it would be my career.

I remember some of my first experiences with clients being so powerful and transformative. They were intense, painful, and challenging, but also deeply moving and life-changing. It is working with my patients and witnessing the difference that music therapy can make in their life that has kept me in my field all these years. Some of the most powerful experiences in my life have been with my patients. They have taught me so much. It has been my honor and privilege to serve so many incredible people.

My faith has also provided the inspiration and dedication needed to serve my community in a variety of ways. Christian values, including love, kindness, humility, goodness, and gentleness are present daily in both my personal and professional life. Practicing compassion and generosity towards everyone, especially those who need it most, being nurturing, and working towards making the lives of those around me better have driven much of who I am and what I have chosen to do with my life. For me, Christian service is a way of life, and I am aware of the privileged position that I am in where being of service to others is possible.

An elderly patient with dementia engaging in music therapy.

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“Working with my patients and witnessing the difference that music therapy can make in their life has kept me in my field all these years…My faith has also provided the inspiration and dedication needed to serve my community…For me, Christian service is a way of life, and I am aware of the privileged position that I am in where being of service to others is possible.”

Alejandra J. Ferrer

What is our current scientific understanding about how the body, the brain in particular, interacts with or responds to music? 

Brain imaging studies show that music activates the human brain in unique ways. The brain areas activated under various music conditions include parts for processing sound (auditory cortex), emotions (amygdala), tactile information (sensory cortex), movement (motor cortex), memory (hippocampus), vision (visual cortex),
and more.

Research has shown that overall music is inherently good for us! Exposure to music, especially our favorite music, can increase our levels of feel-good chemicals like dopamine and endorphins, boost our immune system, and even help counteract our body’s biological stress response. Music has also been shown to promote relaxation, elevate moods, reduce the perception of pain, enhance sleep, decrease fatigue, support mental alertness, and improve overall quality of life.

Exposure to music, especially our favorite music, can increase our levels of feel-good chemicals like dopamine and endorphins, boost our immune system, and even help counteract our body’s biological stress response.

From my experience as a music therapist, I’ve witnessed that musical memory is powerful, especially the music that we loved and emotionally connected to during our teen and early adulthood years. There is a strong link between music and memories. I have worked with many older adults with advanced dementia. They may have minimal to no orientation to people, place, and time, feel anxious and agitated, and be socially withdrawn. Without fail, these same patients experience a cognitive awakening when I present them with their favorite music from their teen years/early adulthood. We might observe them smiling, laughing, singing, and moving to the music including clapping, foot tapping, and dancing. We may also see more attentive behaviors like better eye contact, engaged physical posture, and more interested facial expressions. This results in an immediate increase in social interaction and a greater level of awareness. Patients in earlier stages of dementia can often reminisce and recount lived experiences with great accuracy when prompted by music.

In your work you’ve used music to help cancer survivors, treat mental illness and substance abuse disorders, help care for people with memory loss and individuals in assisted living, and help NICU babies and adults and children with developmental disabilities. In what ways have you personally observed music to be a healing balm or form of “medicine” to these diverse populations you have served?

It is important to acknowledge that music is intrinsically powerful, but that its benefits are not left up to chance. Rather, from the moment the therapist and client meet, the interactions (musical and non-musical), occur in a systematic process. All aspects of the interaction are intentional, methodical, and follow evidence-based guidelines of what constitutes good therapy. It is the interaction between the client, therapist, and music that results in the positive outcomes that we see. 

Here are a couple special moments from my clinical experience that I love sharing:

  • Cancer patients: I remember walking into a patient’s room a couple of days following their surgery. The surgery had taken a huge physical and emotional toll on this patient, who had been battling stage IV cancer for several years. I had been working with this patient through those years and knew them and their family very well. Walking into the room and seeing them in such a state was very difficult. We talked a little bit about the surgery and how he was feeling. Afterwards, I started singing some of the patient’s favorite songs in a slow, quiet, gentle, somewhat sober manner. Musically, I was trying to match his emotional state as a way of reflecting and validating his experience. I intentionally left out lines or verses of certain songs that I felt were not congruent with the patient’s emotional state and experience in that moment. The patient took notice of this, pointed it out, and it led to a deep, meaningful discussion, where lots of thoughts and emotions were expressed. When I left the room, the patient appeared a little brighter. He was smiling, appreciative, and even made a few jokes regarding the situation.
  • Older adults: One of my most favorite memories is of a patient with advanced dementia. I would see this patient twice a week in a group setting on a memory care unit. This patient was minimally responsive until one day when I played a great song called, “I’m Forever Blowing Bubbles,” a popular song during the 1920s. In addition to the song, I blew soap bubbles, many of the patients played instruments, and I encouraged them to reach for the bubbles. It was a fun, rich, sensory experience that the patients loved. All of a sudden, the patient smiled as joyfully as I had ever seen her. She was mouthing the lyrics and extending her arms in the air, visually tracking the bubbles, and trying to catch as many as possible. She even tried standing up! I had never seen such a response from her. The music resulted in a cognitive awakening. The patient was fully present and actively engaged in the group for several moments. She enjoyed herself immensely and it’s truly one of the most beautiful moments I’ve ever witnessed.
Older brother watching Baby brother in NICU

Photo by Gabriel Tovar on Unsplash

In my work I have helped treat babies with Neonatal Abstinence Syndrome, a condition caused when a baby has withdrawal symptoms from exposure to drugs before birth. In these clinical settings I often use infant directed singing in the form of lullabies to soothe an agitated baby. It is such a beautiful thing to witness a very upset baby transition to a calm state!

Alejandra J. Ferrer

You’ve collaborated with a jazz ensemble on your campus to record lullabies for babies. How does music help NICU babies recover? Is there a particular type of music that helps them? 

Lullabies or any song made to sound like a lullaby are the preferred choice of music when it comes to treating NICU babies. Lullabies have been used universally for thousands of years to soothe a fussy baby. Research has shown that the most effective music for helping NICU babies is soothing, constant, and stable. It is also in the low decibel range of sound, with melodies in higher vocal ranges sung by a female. Normally developing fetuses hear in the womb and develop a preference for women’s voices. We also typically use music with words, in the child’s native language to promote language development.

In my work I have helped treat babies with Neonatal Abstinence Syndrome, a condition caused when a baby has withdrawal symptoms from exposure to drugs before birth. In these clinical settings I often use infant directed singing in the form of lullabies to soothe an agitated baby. It is such a beautiful thing to witness a very upset baby transition to a calm state!

Interventions commonly used with NICU infants may include receptive music listening for soothing and comfort, using music to stabilize and synchronize breathing and heart rate to a normal rhythm, and using a Pacifier Activated Lullaby System, which helps premature babies develop the skills they need to feed by associating pacifier sucking with soothing music. These interventions used in the NICU help support the premature infant in multiple ways ultimately providing comfort that can help them sleep better, reduce stress, meet developmental milestones, and enhance their bond with their care-giver.

Worship particularly through music is an important part of many Christian traditions. Does your background as a music therapist and as someone who has studied music affect how you experience worship?

This is a tricky question to ask me! I am Catholic and grew up in Venezuela, experiencing very traditional mass and daily practice. Music for worship was not something that I was ever really exposed to, so I don’t identify with it in that way per se. Worship for me is very quiet, very private, and involves lots of set prayers! However, I do love singing hymns, spirituals, and gospel songs to my patients. I understand, value, and recognize the great meaning that they hold and offer the listener. It just isn’t something that I would spontaneously do for myself.

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About the authors

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Alejandra J. Ferrer

Alejandra J. Ferrer, PhD, MT-BC, is Associate Professor of Music and Coordinator of Music Therapy at Belmont University in Nashville, TN. Dr. Ferrer holds a BM in music therapy from The Florida State University (2004), an MM in music therapy from The Florida State University (2005), and a PhD in music education from The Ohio State University (2012). Prior to joining Belmont, Dr. Ferrer worked as an adjunct professor at Ohio University and The Ohio State University, where she taught music therapy and music education courses. Concurrently, she practiced music therapy at Nationwide Children’s Hospital, specifically working with infants and toddlers in the Neonatal Intensive Care Unit. During this time, she supervised undergraduate and graduate practicum students and interns, participated in interdisciplinary research efforts, and engaged in outpatient program development. Dr. Ferrer developed the first music therapy program at the Arthur G. James Cancer Hospital and Richard J. Solove Research Institute. During her tenure at The James, she established a strong outpatient music therapy program that supported the psychosocial needs of adult cancer survivors. Dr. Ferrer has also served adults with mental illness and substance abuse disorders in both acute care and forensic units, older adults in memory care and assisted living settings, and children and adults with developmental disabilities. Dr. Ferrer is a regular presenter at regional and national music therapy conferences on topics pertaining to college student mental health, accessibility in music therapy education, and professional issues. She has authored multiple book chapters and her work has been published in the Journal of Music Therapy, Music Therapy Perspectives, and Imagine. In the past, Dr. Ferrer served on the American Music Therapy Association’s (AMTA) Academic and Program Approval Committee and the Diversity, Equity and Inclusion Committee. Currently, Dr. Ferrer serves on the AMTA’s Board of Directors as Council Coordinator for Education and Clinical Training.
Ciara Reyes-Ton

Ciara Reyes-Ton

Ciara Reyes-Ton is a biologist, science writer and editor who is passionate about science communication to faith communities. She has a Ph.D. in Cell & Molecular Biology from the University of Michigan. She has served as Managing Editor for the American Scientific Affiliation’s God & Nature Magazine, and previously taught Biology at Belmont University and Nashville State Community College. She is currently the Digital Content Editor for BioLogos and an Adjunct Professor at Lipscomb University. Outside science, she enjoys singing as part of her band Mount Carmell and being a mom. She recently released a new single "To Become Human," a song that explores the biology and theology of what it means to be human. She is also the author of "Look Closely," a science and faith devotional that explores the life of Christ by bringing scripture in conversation with science, from water walking lizards to dividing cells and resurrecting corals.

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