Songwriting in Medical Music Therapy in Pediatric Palliative Care: Case-Based Clinical Insight from Music Therapy Practice

OBJECTIVE: Children receiving pediatric palliative care (PPC) have complex, multidimensional needs requiring an integrative and person-centered approach. Although songwriting (SW) within medical music therapy (MMT) has been used to support expression and communication, its role as a process-oriented intervention in PPC remains underexplored. This case-based report explores the use of SW to support emotional expression, communication, and meaning-making at the end of life. METHODS: We describe the case of a 12-year-old patient with advanced Burkitt lymphoma receiving MMT during hospitalization. SW emerged within an established therapeutic relationship grounded in receptive listening and emotional regulation. The SW process developed over approximately 30 days and was analyzed through clinical observation and musical-textual analysis. RESULTS: SW facilitated the gradual emergence of experiences related to physical suffering, hope, identity, and family relationships. The song's open structure, unstable phrasing, and vocal qualities reflected the patient's physical and emotional condition, highlighting the dynamic and nonlinear nature of lived experience. Rather than promoting emotional resolution, the process enabled the patient to remain within evolving questions, supporting a sense of meaning without closure. SW also functioned as a relational space, fostering shared meaning and emotional continuity within the family. SIGNIFICANCE OF RESULTS: This report suggests that SW in PPC can support the integration of complex experiences while sustaining meaning-making without imposing closure. It highlights the role of the music therapist in maintaining a flexible, attuned, and ethically grounded stance, offering a space in which patients can explore and inhabit their experience in a manner consistent with their condition.