A team of music therapy researchers at IU Indianapolis is partnering with Hoosier communities to help residents recover from chronic opioid use. The team is, from left, SJ Stuckenchneider, undergraduate research assistant; Kate Myers-Coffman, principal investigator; Caitlin Krater, co-investigator and study music therapist; and Shelby Schuller-Hsu, study project manager. Photo by Liz Kaye, Indiana University

A team of music therapy researchers at Indiana University Indianapolis is partnering with Hoosier communities to help residents recover from chronic opioid use. The team was recently awarded $310,000 through a State Opioid Response Grant from the Indiana Division of Mental Health and Addictions. The funds will help the program expand, demonstrating IU’s leadership in finding innovative, effective solutions for addiction recovery and mental health across the Hoosier state.

In Marion County, the team led by Kate Myers-Coffman, visiting assistant professor of music therapy in the Herron School of Art and Design, has been building a music therapy protocol through a partnership with the Indianapolis Comprehensive Treatment Center, a state-funded outpatient opioid treatment facility.

The sessions are designed to train the brain to restore impulse control and reconnect with healthy sources of pleasure, like music and meditation, instead of relying on opioids. The Herron team’s research is the first in the U.S. to focus on how music therapy, paired with medication-assisted recovery, can help people who engage with recovery via outpatient clinics.

IU researcher Caitlin Krater plays the guitar during a music therapy session. Photo by Liz Kaye, Indiana University

Supporting Indiana communities

During the pilot phase of the study, 19 participants attended drop-in music therapy sessions at the Indianapolis Comprehensive Treatment Center over two eight-week periods. They later reported significant improvements in calmness, self-kindness, hopefulness and readiness to cope with stress.

“It gives me the opportunity to relax and focus on what I’m trying to do in my day,” said Ed Robinson, an Indianapolis resident who has regularly attended the center’s music therapy sessions for the past year and a half. “I never thought about music being a way for me to do that until now.”

Caitlin Krater leads a music therapy session at the Indianapolis Comprehensive Treatment Center, which specializes in outpatient opioid recovery. Photo by Liz Kaye, Indiana University

The new funding will help the current program expand, offering three 90-minute sessions per week rather than one 60-minute session. It will also help the program build relationships with additional clinics in high-need Indiana communities, including Kokomo and Charlestown, and pilot a program for Dove Recovery House, a residential recovery center for women.

“We partner with community clinics to find out how we could uniquely support the needs of the people who go there for care, and then we develop programming that’s tailored to them,” Myers-Coffman said.

Caitlin Krater, a board-certified music therapist and Ph.D. student, has been working on the research team since the study began. Krater is developing a separate protocol designed for pregnant or postpartum women in recovery, in addition to leading the music therapy sessions at the Indianapolis Comprehensive Treatment Center.

“There has historically been very limited research on music therapy embedded in outpatient opioid treatment programs, particularly in methadone clinic settings,” Krater said. “Most of the existing literature focuses on in-patient or residential contexts, so we are helping to fill an important gap.”

Participants improvise music during a music therapy session. Each instrument is tuned to allows everyone to play without worrying about the notes. Photo by Liz Kaye, Indiana University

Medication assisted recovery is often necessary for chronic opioid users since they must wean themselves off of their body’s chemical dependence. Krater said medication assisted treatment is evidence-based and lifesaving, and for many people it is an essential part of stability, not a failure of recovery.

“This year, the state of Indiana passed legislation that increases access to medication assisted recovery,” Krater said. “Indiana has really been targeting the opioid epidemic, and the numbers are improving.”

Staying engaged in recovery is highly important for those struggling with opioid dependence. Krater said that finding coping mechanisms and systems of support outside of a clinical setting are essential for helping people stay engaged, which is what the team strives to provide.

Finding peace, practicing patience

“I find peace when I’m here,” Robinson said of the music therapy sessions. “I didn’t know what to expect, but this is one of the things that has kept me coming back, and it’s helped me not feel so ashamed.”

Robinson is a mechanic who recently took a leave of absence to undergo heart surgery. He said one of his favorite parts of music therapy is when Krater plays the monochord, an ancient string instrument that, when played in person, produces a deep, resonant tone that vibrates throughout the body.

Caitlin Krater, a music therapy researcher at IU Indianapolis, plays a monochord, an ancient string instrument. Photo by Liz Kaye, Indiana University

Robinson said he has even started meditating in the mornings when he’s at home, humming or playing music to replicate the effects of the monochord.

After the hypnotic monochord session, Krater asks participants to choose from an assortment of instruments, including small tin drums, tambourines, maracas and wooden xylophones. Together, they play improvisationally as Krater strums a guitar. Each instrument is tuned to the C pentatonic scale, which allows everyone to play without worrying they will hit a “wrong” note.

Sometimes Krater will ask the group to share a word to guide their improvisational music session.

“It gives me the opportunity to relax and focus on what I’m trying to do in my day,” said Ed Robinson of Indianapolis, who has attended music therapy sessions for the past year and a half. Photo by Liz Kaye, Indiana University

“I heard patience,” Krater said during one session. “That’s a great one. Let’s start a little slow to be patient and then build it up.”

Several of the participants gathered to talk about patience after they played their instruments. They agreed that practicing patience is important for recovery, since opioid use hijacks the brain, diminishing impulse control. They said taking time to pause and reflect can often be the difference between using and not using opioids.

“For me, it gave me an opportunity to look inside and ask myself some questions because in the hustle and bustle of life, you don’t always get a chance to do that, and that’s how I found myself in this situation in the first place,” Robinson said.

He said he hopes that music therapy of this nature will become more widely available to those in recovery because it has helped him a great deal.

“I’ve never once felt judged coming to this whole entire program, but especially this music aspect,” Robinson said. “It’s made a big difference for me, and I appreciate it. I’d like to see it go on forever.”