Amid the pain, worry and trauma of serious illness, people can become downcast and trapped within their own thoughts. A music therapist explains how she empowers them to come to terms with their predicament through self-expression. Willa Wu reports.

In a temporary consulting room partitioned off with screens, there was Chan, a man dying of cancer and pouring out his grief. "I know the hope is dim, but I should try to be tough for my family," he said

Cheung Kit-yang, sitting next to him, said firmly, "Yes, we should be tough and be positive. Why don't we write a song together, for your family?"

Cheung is a UK-registered music therapist. "Just jot down whatever you would like to say to your family," Cheung told him. The man wrote four lines, dedicated mainly to his wife: "I want to say sorry. I didn't care enough about you before. Now you are tired from taking care of me. I wish I could give you a better life. I will hang in there, for you and our daughter."

Cheung took her master's degree in Britain, and she believes her work performs magic. "In my work, I see how music connects and changes a person's deeper thoughts. I am amazed by the big impact of music. And my job shows me what makes humans different from each other - the emotions they contain," she said.

Cheung has worked with children with special needs, parents expecting babies and patients with cancer.

Chan is in his early 50s. The cancer was already in an advanced stage when it was discovered. Now he's getting chemotherapy at Queen Mary Hospital.

Seeding thoughts

A social worker in the hospital suggested Chan meet Cheung. When he walked into Cheung's temporary consulting room, his face contained no expression. But soon, after they sang a song which was chosen by Chan, his emotions welled up when Cheung asked him which lyrics struck him the most.

He rubbed his forehead, took a deep breath, pointed at the lyric sheet, and read the lyrics out with a trembling voice: "Set your goal and let it guide you ahead."

"Singing a song together is the first step. It opens the door to trust. Patients are more likely to talk if the therapist can sing songs they are familiar with or love," Cheung said.

"Observation and evaluation of the lyrics the patients write gives the therapist a clearer insight into the patient's mind. Chan subconsciously revealed the thoughts haunting him, by constantly rubbing his forehead. The lyrics he composed reveal he hadn't given up. He was holding on for his family," Cheung added.

Once the bond of trust was established, Cheung introduced the music composition element of the therapy. She improvised the melody to Chan's lyrics.

When the two finished their composition, Chan grinned and offered a gentle applause, while holding the paper on which he had composed his lyrics close to his chest.

"I never tell my clients what they should be doing. I often seed their thoughts. I hope to guide them to make their own choices, to think, to realize," Cheung said.

Cheung vividly remembers when she was struck by the concept of music therapy. She was taking a summer course in music at Berklee College of Music in Boston, United States, in 2010. She saw a poster showing a man dressed as a doctor, holding a violin. The poster invited applications for a master's degree in music therapy.

"Doctors pay more attention to patients' physical conditions, leaving little time to attend to their mental wellbeing. So there is a gap for mental health workers to intervene, to fill the gap. The music therapist is one such gap-filling worker," Cheung said.

There is no fixed duration of treatment. "It really depends on the patient's mental status. Some treatments last for no more than 20 minutes while some may continue for one to two years," Cheung explained.

Each patient is an individual. "It is not about playing lively songs to the introverted or smooth ones to the hyperactive. Music therapists pick an existing or improvised melody based on their observation and analysis on the patients' response, verbal and non-verbal," Cheung said.

A grueling gig

After returning to Hong Kong in 2012, Cheung opened her own studio in Prince Edward. She needs to work extremely hard to find clients due to the extraordinary nature of her work. Consequently, she says she can feel defeated from time to time. "I feel like I'm fighting the battle alone," she said.

"Working freelance means you have to do the entire job yourself with little guidance. Apart from looking for clients, I also find myself engaging in promotional work, introducing the concept to the public and convincing them of the power of music therapy." she said.

Hong Kong has neither local master's degree courses in music therapy nor a registry for professionals. Aspirants must go overseas to obtain their degree and certification.

Paul Pang Ka-wa, the first licensed music therapist in Hong Kong and a co-founder of the Hong Kong Music Therapy Association, said there are about 70 registered music therapists working in Hong Kong. Among them only five to six are employed full-time, with three to four having their own centers. The rest provide services on a contract basis, relying on funding from government or non-governmental organizations.

"A local registry will better guide therapists not just in the clinical sense but also socially in promoting the concept. Meanwhile the public as well as the funding organizations would get to know more about the therapy and learn that results cannot be achieved in a short time. It's easier to open the door of emotion than close it. Twenty minutes is really a short time," Cheung said.

Despite feeling hopeless every now and then, Cheung is positive about her profession. She cited her services at Queen Mary Hospital, which started three years ago, as an example. "From the beginning, I was allowed to provide the therapy in focused groups for outpatients. Then I was asked to do it at the bedsides of patients in wards. And now the hospital has built a temporary consulting room for me to meet patients in a one-on-one process. The progress illustrates that awareness of the therapy is developing," she said.

And it seems the government is working on it. In the 2016 Policy Address, the government promised to "gradually implement regulatory proposals including launching a voluntary accredited registers scheme for supplementary healthcare professions". In addition, the Department of Health plans to launch a pilot scheme at the end of 2016 that will establish regulatory bodies for 15 professions, including clinical psychologists, educational psychologists and speech therapists.

"Let's hope music therapy will be included in the list in the future," Cheung said

Contact the writer at

willa@chinadailyhk.com

(HK Edition 10/27/2016 page9)