Music thanatology (Chalice of Repose)

Domain VIII · Creative & expressive arts therapies · Therese Schroeder-Sheker

What it is

The Chalice of Repose Project calls music-thanatology "a contemplative practice with clinical applications": a sub-specialty of palliative medicine and a pastoral art, caring for the physical and spiritual needs of the dying through prescriptive music. One or more certified musician-clinicians…

Format

• Format. The music is played live at the bedside in hospitals, hospices, long-term care, parishes and homes. It may be played solo or by a small team, with the musicians "positioning themselves on either side of the dying patient". The 2017 abstract says patients may be of any age. A retrospective…
• How change is understood. The Project's premise is that sound organises. Live, individually shaped music can therefore calm or stir the patient's physiology and inner state. Its pages list these aims:

Who practises it, and how they are trained or regulated

• Version followed: music-thanatology as the Chalice of Repose Project (founded by Therese Schroeder-Sheker) publishes it on its own site and in the abstract of Schroeder-Sheker's 2017 Music and Medicine report, with certification standards from the Music-Thanatology Association International (MTAI) and bedside detail from training papers by Chalice of Repose and Lane Community College students, hosted by MTAI.…
• What it is. The Chalice of Repose Project calls music-thanatology "a contemplative practice with clinical applications": a sub-specialty of palliative medicine and a pastoral art, caring for the physical and spiritual needs of the dying through prescriptive music. One or more certified musician-clinicians deliver it live at the bedside, with harp and voice. MTAI describes it as a professional field within palliative…
• It is not psychotherapy and not music therapy. The 2017 abstract stresses "quiet reception rather than clinician-patient interaction". The patient listens and does nothing. Nobody makes music together, sets goals or talks the music through. In the US it is a separate occupation from board-certified music therapy (MT-BC through CBMT): it has its own certification through MTAI, no state licensure, and is usually paid…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• a sleeping patient. Do not wake them to say goodbye.
• a patient who becomes anxious in silence. Shorten it.
• under-documented adverse responses. Record these too.
• recorded wishes not to receive spiritual or musical visits.
• strings that drift with ward heating or air conditioning. Retune between patients.

Problems the guide addresses

• Patient declines, or seems to decline
• Rising agitation or no settling (the clinical equivalent of a "stuck" response)
• Silence is distressing
• Noisy or chaotic environment
• Practitioner stress, grief and ego
• Religious or cultural mismatch
• Musical trauma triggers
• Hearing safety and sensory issues
• Physical safety
• The patient dies during the vigil

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.