Harp therapy

There is a wealth of evidence for the benefits of harp therapy within a variety of client groups, from embryo transfer to palliative care.  You can find journal articles on this page.

Harp therapy is harp music delivered by a harp therapist to illicit positive changes in physical, mental, emotional and spiritual health. Harp therapy is usually for people with disabilities, emotional difficulties or mental and health conditions. Live acoustic harp music is offered at the bedside or chair side with the intention that it can provide joy, hope, comfort and support to those who are facing challenges or uncertainties. Live acoustic therapeutic harp music is not performance, the music offered is changed to meet the needs of each individual in that moment (Ware 2013).

Using all my skills and training as an occupational therapist and harp therapist I individualise and synchronise the music according to physiological changes, breathing patterns and other observations of the client. Changes within the client can be reflected by changes to the type of music, melody, rhythm, tempo and key signature. This makes the intervention truly person centred and allows me to alter the music in line with the patients verbal and non-verbal communication, condition, mood or behaviour. This is very difficult to achieve when using recorded music.

A remarkable attribute of music is its ability to simultaneously influence the heart and the brain on a physiological and psychological level.

Rhythm and tone affect pulse and brain functions in a way that can reduce anxiety and precipitate a calming effect on the individual as well as facilitate pain control (Freeman et al 2006).

Type of music has been found to affect the degree of sedation or anxiety in humans. Slow music can have a sedative, relaxing effect.  Music with a simple, repetitive rhythm, low pitch, slow tempo and consonant harmony has been found to reduce anxiety and physiological responses. This can also lead to cognitive quietening and altered states of consciousness. Higher pitches are associated with more tension while lower pitches result in relaxation (Aragon et al 2002).

The vibration produced by music can affect different parts of the body and be used as a therapeutic intervention (Aragon et al 2002). My harps can be placed on the body and I encourage people to be mindful of the vibration they can feel while they are playing the harp.

Entrainment occurs when the rhythm of the music synchronizes to internal body rhythms like heart rate and respiratory rate. This can happen when two similarly vibrating rhythms interact and resonate at the same frequency.  The rhythm of the music can be adjusted to match that of the heart or breathing rate to try to create entrainment. The best results are accomplished when using 60 – 80 beats per minute, which is similar to the human heartbeat (Aragon et al 2002). This can lead to lower heart and respiratory rates and increased oxygen in the blood stream.

Therapeutic music is ideally delivered for at least 20 minutes since this time period is thought to be the minimum to be effective to induce relaxation (Aragon 2002).

“It is well established that fast-tempo and major-mode music tends to make listeners feel happy, whereas slow-tempo and minor-mode music makes listeners feel sad’ (Schellenberg 2012 p. 331).

A study by Franco et al (2014) with adults and children found that exposure to mood matching music improves cognitive performance and optimises cardiorespiratory regulation or respiratory sinus arrhythmia (RSA) before and after the music.  While exposure to mood mismatching music hinders cognitive performance and decreases cardiorespiratory regulation before and after the music.  Using harp therapy we can improvise for the mood we find the client in and then adapt the music as the session progresses to meet the clients mood, or to enable another feeling.

The harp has a wide pitch range which can vibrate the entire body as opposed to some instruments that have notes in the higher or low ranges. The plucking of it’s many strings can produce a wide range of vibrations and overtones (harmonics) that can resonate in a complementary way with the cell vibrations in the human body and mind. Although patients may not be hearing every tone of the harp with their ears, they are still receiving the vibrations as resonance, and this enters the body and is transmitted throughout the skin, bone, muscles, and central nervous system (CNS) (Schneider 2015).

The emerging field of harp therapy and its clinical applications

The harp has been found to make a difference in hospitals.  Music has not only been offered in all ward areas but also in waiting rooms, patient lounges and general areas. This is in addition to the hospice, intensive care unit, maternity, paediatrics and rehabilitation areas. The service provided is a complementary, non-invasive modality that has no requirement or outcome for the patient. The patient can choose to talk, lie quietly, sleep or rest. Music offered by certified practitioners can assist with anxiety, stress, pain management, grief and also provide beauty, peace and comfort.

Ware A (2013) The emerging field of harp therapy and its clinical applications. Journal of the Australasian Rehabilitation Nurses’ Association 16 (2) 15 – 17.

Clinical Trial of Therapeutic Harp Sounds for Quality of Life (QOL) Among Hospitalized Patients

The effectiveness of the harp comes from its wide range of vibrations and overtones (harmonics) that can resonate in a complementary way with the vastly complex range of cellular vibrations in the human body and mind. Although patients may not be hearing every tone of the harp with their ears, they are still receiving the vibrations as resonance, which enters the body and is transmitted throughout the skin, bone, muscles, and CNS.

Ninety-two eligible patients participated in the clinical trial. All the QOL variables had significantly higher percentages of patients with improvements during the harp treatment than during standard care. The five symptoms of fatigue, anxiety, sadness, relaxation, and pain were significantly improved following therapeutic harp treatment. Approximately 30% to 50% of patients showed a significant increase in the QOL measures after harp treatment, providing evidence of strong positive effects on the QOL of hospitalized patients who received therapeutic harp sound treatment along with standard care.

Schneider, D. M. et al (2015) Application of Therapeutic Harp Sounds for Quality of Life Among Hospitalized Patients. Journal of Pain and Symptom Management Vol 49 No 5 836-845.

Impact of healing touch with healing harp on inpatient acute care pain a retrospective analysis

Healing Touch and healing harp can significantly reduced moderate to severe pain and anxiety in postoperative patients. Patients received healing touch and healing harp at the same time for a session lasting 20 – 30 minutes with the focus to help minimise pain, reduce nausea and decrease anxiety.

Lincoln, V. et al (2014) Impact of healing touch with healing harp on inpatient acute care pain a retrospective analysis. Holistic Nursing Practice 28 (3) 164 – 170.

The Effect of Live Spontaneous Harp Music on Patients in the Intensive Care Unit.

Spontaneous harp music significantly decreased patient perception of pain by 27% but did not significantly affect heart rate, respiratory rate, oxygen saturation, blood pressure, or heart rate variability. Trends emerged, although not statistically significant, that systolic blood pressure increased while heart rate variability decreased. These findings may invoke patient engagement, as opposed to relaxation, as the underlying mechanism of the decrease in the patients’ pain and of the healing benefit that arises from the relationship between healer, healing modality, and patient. The reduction in patient’s perception of pain supports the introduction of live harp music into the ICU as a non-invasive means to reduce patient pain.

Chiasson et al (2013) The Effect of Live Spontaneous Harp Music on Patients in the Intensive Care Unit. Evidence-Based Complementary and Alternative Medicine. Published online.

The Effects of Harp Music in Vascular and Thoracic Surgical Patients.

The study involved a single 20-minute session of live harp playing administered to 17 vascular and thoracic post-surgical patients, while being physically monitored for heart rate and other measurable functions. Live music was chosen because of the harp therapist’s ability to observe the patients’ reactions and then tailor the intervention to their specific needs. Results indicated that listening to live harp music had a positive effect on patient perception of anxiety, pain, and satisfaction, and produced statistically significant differences in physiological measures of systolic blood pressure and oxygen saturation.

Aragon D et al (2002) The Effects of Harp Music in Vascular and Thoracic Surgical Patients. Alternative Therapies in Health and Medicine 8 (5):52 – 60.

Effect of specific music on psychoneuroimmunological responses

The research team analysed the effect of specific harp music on cancer patients undergoing chemotherapy treatment. Results indicated a reduction of high beta waves which is an indicator of reduced stress. Although the sample size was small, this study points to a possible adjunct treatment for cancer patients experiencing chemo brain symptoms and stress. The decrease in high beta waves and decrease in slow wave activity correlates to a decrease in stress. Subjective reports found all participants feeling better eight out of the ten days, and three participants reporting increased concentration and focus immediately after listening to the harp music,

Waheed et al (2018) Effect of specific music on psychoneuroimmunological responses. International Journal of Ocology Reserach 1(2)

Integrating complementary and alternative medicine (CAM) into standard hospice and palliative care.

At a San Diego Hospice harp playing sessions using the essential elements of music as defined by the International Harp Therapy Programme (drone tone, rhythm, harmonics, harmony, repetition, melody, instrumental colours, form and intent) were delivered to patients and families. 77% of patients and families felt harp music was of great benefit, and 23% felt it had some benefit. Specific symptoms that were relieved with harp music were: anxiety in 84% of patients, fear in 70%, dyspnea (difficult / laboured breathing) in 71%, nausea in 92% and pain in 63%.

Lewis, C. R. et al (2003) Integrating complementary and alternative medicine (CAM) into standard hospice and palliative care. American Journal of Hospice and Palliative Care 20 (3) 221 – 228.

Using the Harp for Healing

A study at a San Diego Hospice based on 300 participants found that live harp music supports 71% of patients to breathe more easily and reduce anxiety levels in 84% of patients. In addition 63% of patients reported a reduction in pain when listening to live harp music.

Tourin C (2007) Using the Harp for Healing Positive Health May 2007 9 – 12.

Music thanatology: Prescriptive harp music as palliative care for the dying patient.

Hearing, often outlasting both sight and speech, is the sensory ability that usually functions until the end of life. Therefore, a person who can no longer see or speak can usually still listen and respond to music.

The results of this study suggest that harp vigils could have a positive influence on both the agitation and wakefulness of the patients. The patients’ wakefulness levels decreased by the end of the vigil, potentially indicating a more calm and restful state. The agitation levels also decreased even if they were initially experiencing pain. Changes in several facets of the patients’ respiration were also examined. Most patients in this study maintained a regular respiration rate, both at the start and at the completion of the vigil. On the other hand, patients took deeper breaths with less effort by the time the vigil ended compared to a more shallow, yet more laboured breathing pattern when the vigil began. Also noteworthy was that the average respiration rate of the patient decreased by at least one breath per minute during the music vigil. These changes are consistent with other reports suggesting the calming physiological effects of music on individuals.

Freeman, L. et al (2006) Music thanatology: Prescriptive harp music as palliative care for the dying patient.American Journal of Hospice and Palliative Medicine 23 (2) 100 – 104.

Family members’ views on the benefits of harp music vigils for terminally-ill or dying loved ones

Family members perceived that the vigils resulted in modest improvement in the patients’ breathing, relaxation, comfort, and ability to sleep, with fewer positive effects on pain, and almost no negative effects. Open ended comments focused on the positive benefit in increasing calm, relaxation, comfort. Comments on the positive effects for the family were almost as common as comments on the positive results for the patient.

The use of music vigils in palliative care should be investigated more extensively as this study supports that this intervention has benefits, almost no risk, minimal cost, and may improve patient-family experience of the dying process.

Ganzini L. et al (2015) Family members’ views on the benefits of harp music vigils for terminally-ill or dying loved ones. Palliative and Supportive Care 13, 41 – 44.

Combining Kangaroo Care and Live Harp Music Therapy in the Neonatal Intensive Care Unit Setting

Kangeroo Care (KC) (skin-to-skin contact)and live harp music therapy had a significantly beneficial effect on maternal anxiety score. Infants’ physiological responses and behaviour did not differ significantly. KC combined with live harp music therapy is more beneficial in reducing maternal anxiety than KC alone. This combined therapy had no apparent effect on the tested infants’ physiological responses or behavioural state.

Schlez, A. et al (2011) Combining Kangaroo Care and Live Harp Music Therapy in the Neonatal Intensive Care Unit Setting. Israel MedicalAssociationJournal 13 354 – 358.

Live Harp Music Reduces Activity and Increases Weight Gain in Stable Premature Infants.

Live harp music was found to enhance weight gain in premature infants on fixed feeding regimes, measuring salivary cortisol and heart rate variability and activity. Infants heard harp music for 45 minutes for three days. Live harp music was thought to enhance weight gain by decreasing activity and caloric expenditure.

Kemper K, Hamilton C, (2008) Live Harp Music Reduces Activity and Increases Weight Gain in Stable Premature Infants. Journal of Alternative Complement Medicine 14 (10): 1185 – 1186.

Randomized Trial of Harp Therapy During In Vitro Fertilization–Embryo Transfer

This study evaluated whether harp therapy reduces levels of stress and improves clinical outcomes in patients undergoing embryo transfer. This prospective randomized trial enrolled 181 women undergoing embryo transfer, who were randomized to harp therapy during embryo transfer or standard treatment. Patients underwent standardized psychological testing and physiologic assessment of stress. Setting: The study was conducted in a reproductive medicine practice. Results: No statistically significant differences were found in the heart and respiratory rates, nor was there a significant difference in event- based anxiety at baseline. Harp therapy had a significantly larger decrease in state anxiety from pre– to post– embryo transfer.

Harp therapy decreases state, or event-based, anxiety, significantly lowering state scores post transfer and having a positive effect on acute levels of stress. Larger sample sizes are needed to evaluate the effect of  harp therapy on pregnancy rate.

Murphy, E. M. et al (2014) Randomized Trial of Harp Therapy During In Vitro Fertilization–Embryo Transfer. Journal of Evidence-Based Complementary & Alternative Medicine Vol 19 (2) 93 – 98

Additional references:

Schellenberg, E. G. (2012). Cognitive performance after listening to music: A review of the Mozart effect. In R. MacDonald, G. Kreutz, & L. Mitchell (Eds.), Music, health, and wellbeing (pp. 324–338). Oxford, UK: Oxford University Press.  

Franco, F. et al (2014) Affect-matching music improves cognitive performance in adults and young children for both positive and negative emotions.  Psychology of Music 42(6) 869 – 887.