Mental Health, Music Therapy, and Music-Based Interventions

The American Music Therapy Association, in conjunction with the Sound Health Network is highlighting music-based interventions and related evidence from research in music therapy practice, both in the clinic and at home in the community. See below for selected references in music therapy and clinical research examining the effects of music-based interventions on outcomes for persons experiencing depression, pain, and/or anxiety. The references include studies of adults, children and youth, and mothers and infants. See also links to additional resources about music therapy and the work of the American Music Therapy Association.

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Email: findmt@musictherapy.org or info@musictherapy.org

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Selected References: Mental Health, Music Therapy, and Music-Based Interventions

The authors concluded that music therapy provides short-term beneficial effects for people with depression. When added to usual treatment music therapy interventions appear to improve depressive symptoms relative to usual care alone. Additionally, music therapy with usual treatment was not associated with more or fewer adverse events than usual treatment alone. Music therapy also revealed efficacy in decreasing anxiety and improving functioning of among depressed individuals.

Music interventions compared to standard care may have beneficial effects on anxiety, depression, hope, pain, and fatigue in adults with cancer. Evidence for music medicine alone (prerecorded music listening without a music therapist) was not found in this updated review.

This systematic review and meta-analysis examined the effects of music therapy on both physiological and psychological stress-related outcomes and included 47 independent studies (s), reporting on 76 effect sizes (k), and a total sample of N = 2.747 subjects, of which n = 1.405 subjects in the music therapy groups, and n =1.342 subjects in the comparison groups. The authors found a significant medium-to-strong effect of music therapy on stress-related outcomes in mental healthcare and medical settings. Suggestions for future research are provided and the authors discuss practical questions related to optimizing referrals to credentialed music therapists.

This chapter discusses music therapy in a psychiatric context, focusing on improvisational psychodynamic music therapy (IPMT).

Measures of depression improved with a 6-week music therapy intervention combining improvisational music therapy intervention, structured slow breathing with biofeedback (resonance frequency breathing), and homework consisting of music listening from music therapy session recordings. Active engagement with music in music therapy and during homework supports improved outcomes among adults with depression.

This systematic review examined the effects of music-based interventions in reducing internalizing symptoms (depression and anxiety) in children and adolescents. Based on the studies included in the review, the authors concluded music-based interventions may be efficient in reducing the severity of internalizing symptoms in children and adolescents.

When added to standard care, music therapy can improve the global state, mental state, social functioning, and quality of life of people with serious mental illness.

This trial examined whether Group Music Therapy (GMT) can reduce unhealthy uses of music and increase potentials for healthy uses of music, compared to self-directed music listening (SDML). Authors also were interested in the effects of GMT on depressive symptoms, psychosocial well-being, rumination, and reflection. Both interventions were well accepted and both groups tended to show small improvements over time (although not statistically significant). Younger participants benefited more from GMT, and older ones more from SDML (p = 0.018). The authors noted future studies needed to examine optimal dosing for the music interventions.

This study investigated the effect of music on maternal anxiety, before and after a non-stress test (NST), and the effect of music on the birthing process. The authors found Prenatal music intervention could be a useful and effective tool to reduce anxiety in full-term pregnant women during an NST and improve the delivery process by reducing the first stage of labor in nulliparous women.

This scoping review explores whether engaging with music is good for your mental health. The authors offer a theoretical framework theoretical model to inform future work suggesting the importance of considering music-mental health associations at multiple levels of investigation.

This study used validated scales through an online survey (N = 233) to examine whether music's use in mood regulation is influenced by coping orientations and/or demographic variables in response to the COVID lockdown. The results provide insight into how individuals engaged with music orientated coping strategies in response to the pandemic and lockdown. The authors found positive reframing and active coping (Positive Outlook) were strong predictors of music use in mood regulation amongst listener's coping strategies, as was Substance Use. Higher age indicated having a negative effect on music's use in mood regulation, while factors such as gender were not found to be significant in relation to the use of music in mood regulation within this context.

Music therapy can result in beneficial outcomes on emotion, motivation, participation, locus of control, and perceived helpfulness for adults with substance use disorders. Single music therapy sessions can be as effective as single verbal therapy sessions for various psychological outcomes with higher music therapy scores for comfort, therapist-rated working alliance, and change readiness for adults with substance use conditions.

This integrative review conducted by nurses found consistent and significant evidence that music can reduce anxiety in hospitalized children before and during procedures. Results with respect to pain and vital signs, often viewed as the physiologic analogs to pain, were mixed in this review. The authors concluded music-based interventions are safe for hospitalized children.

Music interventions show pain reducing effects and may reduce analgesic use, including opioid and non-opioid intake. Children as well as adults benefit from music interventions for pain although children appear to benefit more.

Authors found a vocal music therapy intervention in adults with chronic pain resulted in large treatment effects for self-efficacy, depression, and ability to participate in social activities. Medium effects were found for pain intensity, anxiety, positive effect, and well-being, and small effects for pain interference and satisfaction with social roles. On average, participants felt moderately better after completion of the vocal music therapy program. Qualitative findings suggested that the intervention protocol resulted in better self-management of pain, enhanced psychological well-being, and stronger social and spiritual connections.

The author offers an update to the music therapy research literature in the area of addictions treatment noting common music therapy method include lyric analysis, music and imagery methods, and songwriting. Recommendations for future research are suggested. N.B.: It’s important to note that this literature is relevant to mental health and well-being since there are a strong associations between addictions, coping and mental health, and pain.

251 youth (8-16 yrs.) with social, emotional, behavioral, and developmental difficulties and parent dyads were randomized to 12 weekly sessions of MT plus usual care or usual care alone. The primary outcome focused on communication (Social Skills Improvement System Rating Scales) (SSIS) and secondary outcomes included social functioning, self-esteem, depression and family functioning. Significant results were found for children aged 13-16 yrs. Overall, self-esteem was significantly improved and depression scores were significantly lower at week 13.

The authors describe the “Therapeutic Function of Music (TFM), a theory-based description of the structural characteristics for a music-based stimulus to musically facilitate developmentally appropriate high arousal and low arousal in-the-moment emotion regulation experiences. The TFM analysis is based on a review of the music theory, music neuroscience, and music development literature and provides a preliminary model of the structural characteristics of the music” to guide intervention design.

“Emotion regulation (ER) describes the goal-directed ability to manage and shape the dynamics and timing of one's emotional experiences and expressions, an ability that develops early in life.” Maladaptive ER skills can significantly impact development. This mixed methods study examined feasibility and preliminary efficacy of the Musical Contour Regulation Facilitation (MCRF) intervention, a multi-session strategy for promoting ER development in young children.

The aim of this meta-analysis was to determine and compare the effects of music therapy and music medicine on depression, and explore the potential factors associated with the effect. Among the specific music therapy methods, recreative music therapy, guided imagery and music, music-assisted relaxation, music and imagery, improvisational music therapy, music and discussion exhibited a different effect, respectively. Music therapy and music medicine both exhibited stronger effects of short and medium length compared with long intervention periods. The authors conclude a different effect of music therapy and music medicine on depression was observed and the effect might be affected by the therapy process. N.B. The authors, therefore, suggest the effect of the credentialed therapist as part of the intervention process and favorably influencing outcomes.

This study investigated whether a prenatal music and singing intervention can improve maternal well-being as well as mother-infant bonding. Promising effects of music were noted and singing, in particular, had a positive effect on maternal well-being and perceived closeness during pregnancy. Prenatal music and singing interventions can be an easily implemented and and effective addition to improve mood and well-being of the expectant mother and support mother-infant bonding.

Music therapy, an established health care profession, uses music within a therapeutic relationship with a music therapist to accomplish nonmusic goals. Research in wellbeing and mental health of children and adolescents is relatively sparse; however, neuroimaging research indicates that listening to preferred music activates reward circuitry in the brain and active musical participation engages more areas of the brain than passive listening. The authors note, emerging research indicates promising effectiveness for specific approaches to music therapy with children and adolescent mental health consumers.