Storytelling Through Music: An Intervention to Improve Psychosocial Well-being

Carolyn Phillips

Carolyn Phillips, PhD, RN, ACNP-BC, AOCNP, Robert Wood Johnson Foundation scholar and new UT Austin alumna, is currently researching professional grief, the impact on the caregiver and care-receiver, and interventions to help health care professionals process the grief and suffering they see in their work in order to address burnout and compassion fatigue. She is a board-certified acute care nurse practitioner and an advanced oncology-certified nurse practitioner and currently working on a postdoctoral research fellowship at Dana-Farber Cancer Institute in Boston, Massachusetts.

The following is a Q&A with the busy postdoctoral fellow.

UT Austin: What got you interested in oncology nursing?

Phillips: I was immediately drawn to oncology nursing during my undergraduate studies because of the complexity of care. Medically, the care is dynamic. There is also a psychosocial complexity to the care when a person receives a diagnosis of cancer that interests me. I have had few experiences in life as vulnerable and authentic as I had while working in oncology. As a young nurse, I learned invaluable lessons while working with patients and their families as they negotiated matters of life and death. Providing care to people with cancer was a deeply meaningful and fulfilling experience.

UT Austin: Describe what Songs for the Soul is about and how it got started.

Phillips: Songs for the Soul is the name of a non-profit organization I founded in 2016. That work influenced my desire to research an intervention, which I call “Storytelling Through Music,” for my dissertation.

I have worked in oncology for 17 years as a bedside nurse, nurse practitioner, educator and leader. During that time, I observed the individual effects of compassion fatigue and burnout and also the negative impact it can have on the culture of health care and patient outcomes. In 2014, I realized that I was burned out of a profession that I loved. As I tried to understand how I got to that place, I started writing about anything and everything that came to mind about my work. While some of my first stories were about workplace dysfunction, the majority were about patients for whom I had cared and who had impacted my life, beginning from the time I worked as a nursing assistant. After writing for a period of time, I realized three things: 1. I was carrying a lot of people with me; 2. I had never been taught how to process the emotions I experienced while caring for others, and especially the effect of cumulative death; and 3. Writing these stories increased my awareness of my emotional experiences, but it did not move the dial on my emotional healing. I was numb from avoiding the emotions I had experienced in the workplace for almost two decades. I felt like I needed a bigger physical expression of my experiences to break through the numbness. For me, that meant I needed to “sing it out.”

I hired a local songwriter and began the process of creating a song so I could sing my story. The impact on my well-being was immediate. Because I’m a nurse, my next question was, “Can this help others?” In 2015, I was awarded the Innovative Ideas in Healthcare Award by SVH Support in Santa Fe, New Mexico and used part of the funding to create the program, Songs for the Soul. This program provides nurses with a safe space to tell their caregiving stories using storytelling, writing, and song to address the emotions they experienced while caring for others. I piloted the program at a community cancer clinic in Santa Fe, New Mexico. Two stories and songs from the program were recently featured at the National Academy of Medicine’s Action Collaborative on Clinician Well-being and Resilience, Expressions of Clinician Well-being Art Gallery in Washington, D.C.

In 2016, I began my PhD studies at the UT Austin School of Nursing as a Robert Wood Johnson Foundation Future of Nursing Scholar. At that time, it was not clear if this program would be something I could study for my dissertation research. Based on the immediate success of the program, I turned Songs for the Soul into a 501(c)(3) non-profit organization so that I could ensure that this experience could be made available to other caregivers. The mission of the organization is to support the well-being of society’s professional caregivers through storytelling and music and to foster a culture that celebrates and sustains compassionate care.

I had observational and anecdotal knowledge about the efficacy of this experience, but I wanted to explore whether there would be science to support it. During the first year of my PhD studies, I worked to understand the theoretical and conceptual underpinnings of the psychosocial stress experienced by health care professionals in order to connect scientific methods and research to my intervention, “Storytelling Through Music.”

My dissertation study, which exists and was funded independent of the non-profit, examined the feasibility and effects of “Storytelling Through Music,” a six-week intervention that combines storytelling, reflective writing, self-care skills, and music to address the workplace emotions related to caring for people with cancer. The results indicate that the intervention was feasible and acceptable to that group of participants. In addition, the nurses who participated in the intervention had significantly greater improvements, over time, in loneliness, insomnia, self-reflection and self-compassion when compared to those in the comparison group.

UT Austin: How did a $30,000 scholarship from the American Cancer Society help your research?

Phillips: The scholarship from the American Cancer Society was the first, crucial step to funding my intervention research. The award was $15,000 per year for two years and had very few limits on how it could be used. I would not have been able to research this intervention study without that funding. I received additional grants from the Hogg Foundation for Mental Health, Gordan and Mary Cain Excellence Fund for Nursing Research, Mary E. Walker Dissertation Award, Epsilon Theta Chapter of Sigma Theta Tau, Oncology Nursing Foundation, and the Central Texas Oncology Nursing Society.

UT Austin: What are you currently working on?

Phillips: This fall I began a postdoctoral research fellowship at Dana-Farber Cancer Institute, with a joint appointment at Harvard Medical School. It is a two-year appointment dedicated to the dissemination of my dissertation findings and the development and implementation of my next studies.

My clinical and research experiences, which cover the cancer continuum from prevention, treatment, survivorship and end-of-life care, provide the foundation for my current interest. Whether it is studying how we care for patients in the survivorship phase or how we care for the health care professionals, the ultimate goal is to improve the psychosocial well-being of people impacted by cancer.

There are numerous possibilities for research that I would like to pursue during my fellowship. From the data set I collected during my dissertation study, I want to conduct a narrative analysis of the stories and songs. Doing so  may provide additional insight into the complex psychosocial dynamic of caring for people with cancer. These insights may inform future theoretical development and by providing insight into the psychosocial stress experienced by oncology nurses. The results from my dissertation study supports continued evaluation of this intervention in a larger, randomized controlled trial with oncology nurses. During my post-doctoral fellowship, I aim to conduct a larger-scale, multicenter study with continued exploration of the intervention effect on variables measuring personal and professional well-being. Finally, I would like to pilot the “Storytelling Through Music” with a new population — cancer survivors.

UT Austin: What are your plans once you complete the fellowship?

Phillips: At this point, I am keeping my options open! I know I have more to learn and will be exploring many new opportunities in Boston. I have a passion for research and improving the psychosocial well-being of individuals through the use of storytelling and music. I believe there are many opportunities for applying my research to the clinical and educational setting.

Phillips is also a musician and part of the duo Hardened and Tempered. In 2017, they released their debut album, The Trailer Sessions. She credits music for helping her manage the stress of a three-year PhD program. Philips received a Bachelor of Science in Nursing from The Johns Hopkins University School of Nursing in 2002, a Master of Science in Nursing from the University of New Mexico College of Nursing in 2011 and a PhD in nursing from The University of Texas at Austin School of Nursing in 2019.

Sept. 20, 2019