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The Healing Power of Music

Music therapy is increasingly used to help patients cope with stress and promote healing.

By Richard Schiffman

“Focus on the sound of the instrument,” Andrew Rossetti, a licensed music therapist and researcher said as he strummed hypnotic chords on a Spanish-style classical guitar. “Close your eyes. Think of a place where you feel safe and comfortable.”

Music therapy was the last thing that Julia Justo, a graphic artist who immigrated to New York from Argentina, expected when she went to Mount Sinai Beth Israel Union Square Clinic for treatment for cancer in 2016. But it quickly calmed her fears about the radiation therapy she needed to go through, which was causing her severe anxiety.

“I felt the difference right away, I was much more relaxed,” she said.

Ms. Justo, who has been free of cancer for over four years, continued to visit the hospital every week before the onset of the pandemic to work with Mr. Rossetti, whose gentle guitar riffs and visualization exercises helped her deal with ongoing challenges, like getting a good night’s sleep. Nowadays they keep in touch mostly by email.

The healing power of music — lauded by philosophers from Aristotle and Pythagoras to Pete Seeger — is now being validated by medical research. It is used in targeted treatments for asthma, autism, depression and more, including brain disorders such as Parkinson’s disease, Alzheimer’s disease, epilepsy and stroke.

Live music has made its way into some surprising venues, including oncology waiting rooms to calm patients as they wait for radiation and chemotherapy. It also greets newborns in some neonatal intensive care units and comforts the dying in hospice.

While musical therapies are rarely stand-alone treatments, they are increasingly used as adjuncts to other forms of medical treatment. They help people cope with their stress and mobilize their body’s own capacity to heal.

“Patients in hospitals are always having things done to them,” Mr. Rossetti explained. “With music therapy, we are giving them resources that they can use to self-regulate, to feel grounded and calmer. We are enabling them to actively participate in their own care.”

Even in the coronavirus pandemic, Mr. Rossetti has continued to perform live music for patients. He says that he’s seen increases in acute anxiety since the onset of the pandemic, making musical interventions, if anything, even more impactful than they were before the crisis.

Mount Sinai has also recently expanded its music therapy program to include work with the medical staff, many of whom are suffering from post-traumatic stress from months of dealing with Covid, with live performances offered during their lunch hour.

It’s not just a mood booster. A growing body of research suggests that music played in a therapeutic setting has measurable medical benefits.

“Those who undergo the therapy seem to need less anxiety medicine, and sometimes surprisingly get along without it,” said Dr. Jerry T. Liu, assistant professor of radiation oncology at the Icahn School of Medicine at Mount Sinai.

A review of 400 research papers conducted by Daniel J. Levitin at McGill University in 2013 concluded that “listening to music was more effective than prescription drugs in reducing anxiety prior to surgery.”

“Music takes patients to a familiar home base within themselves. It relaxes them without side effects,” said Dr. Manjeet Chadha, the director of radiation oncology at Mount Sinai Downtown in New York.

It can also help people deal with longstanding phobias. Mr. Rossetti remembers one patient who had been pinned under concrete rubble at Ground Zero on 9/11. The woman, who years later was being treated for breast cancer, was terrified by the thermoplastic restraining device placed over her chest during radiation and which reawakened her feelings of being entrapped.

“Daily music therapy helped her to process the trauma and her huge fear of claustrophobia and successfully complete the treatment,” Mr. Rossetti recalled.

Some hospitals have introduced prerecorded programs that patients can listen to with headphones. At Mount Sinai Beth Israel, the music is generally performed live using a wide array of instruments including drums, pianos and flutes, with the performers being careful to maintain appropriate social distance.

“We modify what we play according to the patient’s breath and heart rate,” said Joanne Loewy, the founding director of the hospital’s Louis Armstrong Center for Music & Medicine. “Our goal is to anchor the person, to keep their mind connected to the body as they go through these challenging treatments.”

Dr. Loewy has pioneered techniques that use several unusual instruments like a Gato Box, which simulates the rhythms of the mother’s heartbeat, and an Ocean Disc, which mimics the whooshing sounds in the womb to help premature babies and their parents relax during their stay in noisy neonatal intensive care units.

Dr. Dave Bosanquet, a vascular surgeon at the Royal Gwent Hospital in Newport, Wales, says that music has become much more common in operating rooms in England in recent years with the spread of bluetooth speakers. Prerecorded music not only helps surgical patients relax, he says, it also helps surgeons focus on their task. He recommends classical music, which “evokes mental vigilance” and lacks distracting lyrics, but cautions that it “should only be played during low or average stress procedures” and not during complex operations, which demand a sharper focus.

Music has also been used successfully to support recovery after surgery. A study published in The Lancet in 2015 reported that music reduced postoperative pain and anxiety and lessened the need for anti-anxiety drugs. Curiously, they also found that music was effective even when patients were under general anesthesia.

None of this surprises Edie Elkan, a 75-year-old harpist who argues there are few places in the health care system that would not benefit from the addition of music. The first time she played her instrument in a hospital was for her husband when he was on life support after undergoing emergency surgery.

“The hospital said that I couldn’t go into the room with my harp, but I insisted,” she said. As she played the harp for him, his vital signs, which had been dangerously low, returned to normal. “The hospital staff swung the door open and said, ‘You need to play for everyone.’”

Ms. Elkan took these instructions to heart. After she searched for two years for a hospital that would pay for the program, the Robert Wood Johnson University Hospital in Hamilton, N.J., signed on, allowing her to set up a music school on their premises and play for patients at all stages in their hospitalization.

Ms. Elkan and her students have played for over a hundred thousand patients in 11 hospitals that have hosted them since her organization, Bedside Harp, was started in 2002.

In the months since the pandemic began, the harp players have been serenading patients at the entrance to the hospital, as well as holding special therapeutic sessions for the staff outdoors. They hope to resume playing indoors later this spring.

For some patients being greeted at the hospital door by ethereal harp music can be a shocking experience.

Recently, one woman in her mid-70s turned back questioningly to the driver when she stepped out of the van to a medley of familiar tunes like “Beauty and the Beast” and “Over the Rainbow” being played by a harpist, Susan Rosenstein. “That’s her job,” the driver responded, “to put a smile on your face.”

While Ms. Elkan says that it is hard to scientifically assess the impact — “How do you put a number on the value of someone smiling who has not smiled in six months?”— studies suggest that harp therapy helps calm stress and put both patients and hospital staff members at ease.

Ms. Elkan is quick to point out that she is not doing music therapy, whose practitioners need to complete a five-year course of study during which they are trained in psychology and aspects of medicine.

“Music therapists have specific clinical objectives,” she said. “We work intuitively — there’s no goal but to calm, soothe and give people hope.”

“When we come onto a unit, we remind people to exhale,” Ms. Elkan said. “Everyone is kind of holding their breath, especially in the E.R. and the I.C.U. When we come in, we dial down the stress level several decibels.”

Ms. Elkan’s harp can do more than just soothe emotions, says Ted Taylor, who directs pastoral care at the hospital. It can offer spiritual comfort to people who are at a uniquely vulnerable moment in their lives.

“There is something mysterious that we can’t quantify,” Mr. Taylor, a Quaker, said. “I call it soul medicine. Her harp can touch that deep place that connects all of us as human beings.”

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How Music Affects Your Mind, Mood and Body

By: Megan Hoffer MM MT-BC, Julie Avirett MM MT-BC, Kelsey Bocharski Music Therapy Intern, Joshua Da Costa Music Therapy Intern

Categories: Healthy Living

Do you find yourself tapping your foot while shopping? Or having all the feels while watching movies? No matter your race, ethnicity, age or gender, music is a common phenomenon that impacts everyone. Music can be a powerful tool with its ability to evoke strong emotional responses.

For example, music may lead to the release of dopamine, a feel-good neurotransmitter. Music is present in everyday life for most people. Here, we answer questions about how music can affect your brain and body.

Does Music Alter Moods and Relieve Stress?

The short answer is, yes! The Iso-principle is a tool that matches a music listening experience to a current mood or emotion and then gradually shifts to music that represents a desired mood or emotion. If you want to listen to a song that you pair with anger or sadness, go ahead, but don’t let it repeat too many times. Move on to music of the mood you desire. A music playlist that gradually moves from uncomfortable emotions to comfortable ones can be a healthy coping strategy and facilitate a positive mood change.

Active music-making positively affects neurotransmitters , such as dopamine and serotonin, that influence mood. Dopamine influences focus, concentration, memory, sleep, mood and motivation. Likewise, serotonin impacts mood, sleep patterns, anxiety and pain. Active music-making can involve singing , playing an instrument or creating music electronically. Making music, specifically singing in a group, helps us feel connected to other people because of the production of the hormone oxytocin. Singing synchronizes breathing patterns to promote relaxation and reduce the hormone cortisol , “the stress hormone.”

What Emotions Can Music Make You Feel?

Music can validate your current emotional state and influence your emotional destination. Again, the Iso-principle can help us experience desired emotions. It works most effectively when we first find a song that matches our current feeling or mood. In music therapy, emotional regulation is frequently addressed. Music can elicit many, if not every, emotion. Knowing yourself and which music you pair with your emotions will improve self-regulation, or “feeling your feelings.”

Music and emotions are personal, cultural and associated with prior experiences. A song will not give everybody the same feeling. That is the beauty of the diversity in music and preference across diverse cultures and time periods. Research attributes this phenomenon to the messages our cultures and experiences have assigned to sounds before listening to a song .

While culture, memories and associations influence music and emotions, Berkley found an overlap across cultures and compiled an interactive music map based on people’s responses with 13 emotional dimensions that people in China and the United States self-reported. You can check Berkley’s Interactive Music Map to find out what music makes you feel.

What Impact Does Music Have on Memory?

Music can help retain essential information despite memory loss. Music memory is stored in the hippocampus, centrally located in the brain. Therefore, music memories are less likely to be negatively impacted by age or disease .

A musical mnemonic device is a natural way to memorize and recall information. As children, we learn various academic and social concepts through songs. Similarly, these memory strategies are highly effective for adults. In fact, our brains automatically “ fill in the gaps ” when a song suddenly stops .

Music therapists often incorporate these techniques with individuals to improve memory retention or developmental learning goals. Music may activate memories and remind us of places, events or people. A familiar tune may elicit the emotions associated with those memories.

What Changes Does Music Have on Your Body?

Singing, playing instruments and even dancing can improve pain tolerance. Researchers found that the physical movement used to create music provides a synchronized activity that significantly heightens the pain threshold. Music therapists are specifically trained clinicians that use music to address goals such as pain reduction .

Because music is often an enjoyable activity, it can activate the release of endorphins, which creates a general feeling of well-being . Music therapy can successfully reduce post-operative pain, physical tension and influence heart and breathing rates. Fast music tends to increase pulse rate and blood pressure . Slow music tends to decrease pulse rate and blood pressure, as well as breathing rate .

How Does Music Affect Behavior ?

Music can affect behavior by being a motivator, a timer for completing tasks or a mood enhancer. It may also impact our shopping habits .

Music is used in advertising to encourage brand recognition and create familiarity and positive association with various products.

Younger shoppers spend more time shopping when stores play instrumental music. Older shoppers spend more time shopping when there’s music playing with lyrics. Baby boomers are likely to spend more money if classic rock is playing in a store. Generations older than baby boomers are less likely to spend money if any music is playing .

If you are buying wine for the holidays, be aware that classical music may make you feel comfortable spending a little more money than those top 40 hits .

Store associates are another group of people who are highly influenced by music. People who work in retail are more likely to engage with customers and be in a positive mood if they don’t have to listen to the same music all day .

Why Do We Enjoy Holiday Music?

Holiday music is a vehicle that communicates sacred and secular stories of the season. People may enjoy holiday music because pivotal cultural and traditional events are often intertwined. Music fosters community, remembrance and celebrations.

Known as the Festival of Lights, Hanukkah is often associated with music and dancing. Starting at nightfall in Jerusalem, you are likely to hear people singing “ Ma’oz Tzur .” In some families, singing songs while lighting the menorah candles is part of their valued traditions.

Christmas music can be associated with sacred or secular aspects of people’s lives. People decorate houses combining lights with music . Families drive down streets playing Christmas music to create memories with their children. Caroling in neighborhoods, or a similar tradition called Parrandas in Puerto Rico, includes singing to and with your communities using traditional music and instruments.

Falling directly after Christmas, Kwanzaa is a non-religious and non-political holiday originated to bring Black Americans together. Music in Kwanza includes storytelling, dancing, drumming and singing . Established in 1966, the holiday commemorates the African heritage of many Black Americans’ history, culture and traditions .

While many people have fond memories and traditions with holiday music, it is important to be mindful. Some people have equally painful memories associated with holiday music or songs.

Music Therapy

Music Therapists are trained clinical professionals that use music to accomplish physical, emotional, cognitive and social goals. There are music therapists at Tallahassee Memorial Healthcare in a variety of clinical settings and through classes . You can also search the Certification Board for Music Therapists’ website to find a music therapist in your area.

Megan Hoffer MM MT-BC, Julie Avirett MM MT-BC, Kelsey Bocharski Music Therapy Intern, Joshua Da Costa Music Therapy Intern

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What to Know About Music Therapy

Music can help improve your mood and overall mental health.

Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.

Verywell / Lara Antal

Effectiveness

Things to consider, how to get started.

Music therapy is a therapeutic approach that uses the naturally mood-lifting properties of music to help people improve their mental health and overall well-being.  It’s a goal-oriented intervention that may involve:

• Making music
• Writing songs
• Listening to music
• Discussing music  

This form of treatment may be helpful for people with depression and anxiety, and it may help improve the quality of life for people with physical health problems. Anyone can engage in music therapy; you don’t need a background in music to experience its beneficial effects.

Types of Music Therapy

Music therapy can be an active process, where clients play a role in creating music, or a passive one that involves listening or responding to music. Some therapists may use a combined approach that involves both active and passive interactions with music.

There are a variety of approaches established in music therapy, including:

• Analytical music therapy : Analytical music therapy encourages you to use an improvised, musical "dialogue" through singing or playing an instrument to express your unconscious thoughts, which you can reflect on and discuss with your therapist afterward.
• Benenzon music therapy : This format combines some concepts of psychoanalysis with the process of making music. Benenzon music therapy includes the search for your "musical sound identity," which describes the external sounds that most closely match your internal psychological state.
• Cognitive behavioral music therapy (CBMT) : This approach combines cognitive behavioral therapy (CBT) with music. In CBMT, music is used to reinforce some behaviors and modify others. This approach is structured, not improvisational, and may include listening to music, dancing, singing, or playing an instrument.
• Community music therapy : This format is focused on using music as a way to facilitate change on the community level. It’s done in a group setting and requires a high level of engagement from each member.
• Nordoff-Robbins music therapy : Also called creative music therapy, this method involves playing an instrument (often a cymbal or drum) while the therapist accompanies using another instrument. The improvisational process uses music as a way to help enable self-expression.
• The Bonny method of guided imagery and music (GIM) : This form of therapy uses classical music as a way to stimulate the imagination. In this method, you explain the feelings, sensations, memories, and imagery you experience while listening to the music.
• Vocal psychotherapy : In this format, you use various vocal exercises, natural sounds, and breathing techniques to connect with your emotions and impulses. This practice is meant to create a deeper sense of connection with yourself.

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Music Therapy vs. Sound Therapy

Music therapy and sound therapy (or sound healing ) are distinctive, and each approach has its own goals, protocols, tools, and settings: 

• Music therapy is a relatively new discipline, while sound therapy is based on ancient Tibetan cultural practices .
• Sound therapy uses tools to achieve specific sound frequencies, while music therapy focuses on addressing symptoms like stress and pain.  
• The training and certifications that exist for sound therapy are not as standardized as those for music therapists.
• Music therapists often work in hospitals, substance abuse treatment centers, or private practices, while sound therapists may offer their service as a component of complementary or alternative medicine.

When you begin working with a music therapist, you will start by identifying your goals. For example, if you’re experiencing depression, you may hope to use music to naturally improve your mood and increase your happiness . You may also want to try applying music therapy to other symptoms of depression like anxiety, insomnia, or trouble focusing.

During a music therapy session, you may listen to different genres of music , play a musical instrument, or even compose your own songs. You may be asked to sing or dance. Your therapist may encourage you to improvise, or they may have a set structure for you to follow.

You may be asked to tune in to your emotions as you perform these tasks or to allow your feelings to direct your actions. For example, if you are angry, you might play or sing loud, fast, and dissonant chords.

You may also use music to explore ways to change how you feel. If you express anger or stress, your music therapist might respond by having you listen to or create music with slow, soft, soothing tones.

Music therapy is often one-on-one, but you may also choose to participate in group sessions if they are available. Sessions with a music therapist take place wherever they practice, which might be a:

• Community health center
• Correctional facility
• Private office
• Physical therapy practice
• Rehabilitation facility

Wherever it happens to be, the room you work in together will be a calm environment with no outside distractions.

What Music Therapy Can Help With

Music therapy may be helpful for people experiencing:

• Alzheimer’s disease
• Anxiety or stress
• Cardiac conditions
• Chronic pain
• Difficulties with verbal and nonverbal communication
• Emotional dysregulation
• Feelings of low self-esteem
• Impulsivity
• Negative mood
• Post-traumatic stress disorder (PTSD)
• Problems related to childbirth
• Rehabilitation after an injury or medical procedure
• Respiration problems
• Substance use disorders
• Surgery-related issues
• Traumatic brain injury (TBI)
• Trouble with movement or coordination

Research also suggests that it can be helpful for people with:

• Obsessive-compulsive disorder (OCD)
• Schizophrenia
• Stroke and neurological disorders

Music therapy is also often used to help children and adolescents:

• Develop their identities
• Improve their communication skills
• Learn to regulate their emotions
• Recover from trauma
• Self-reflect

Benefits of Using Music as Therapy

Music therapy can be highly personalized, making it suitable for people of any age—even very young children can benefit. It’s also versatile and offers benefits for people with a variety of musical experience levels and with different mental or physical health challenges.

Engaging with music can:

• Activate regions of the brain that influence things like memory, emotions, movement, sensory relay, some involuntary functions, decision-making, and reward
• Fulfill social needs for older adults in group settings
• Lower heart rate and blood pressure
• Relax muscle tension
• Release endorphins
• Relieve stress and encourage feelings of calm
• Strengthen motor skills and improve communication for children and young adults who have developmental and/or learning disabilities

Research has also shown that music can have a powerful effect on people with dementia and other memory-related disorders.

Overall, music therapy can increase positive feelings, like:

• Confidence and empowerment
• Emotional intimacy

The uses and benefits of music therapy have been researched for decades. Key findings from clinical studies have shown that music therapy may be helpful for people with depression and anxiety, sleep disorders, and even cancer.

Depression 

Studies have shown that music therapy can be an effective component of depression treatment. According to the research cited, the use of music therapy was most beneficial to people with depression when it was combined with the usual treatments (such as antidepressants and psychotherapy). 

When used in combination with other forms of treatment, music therapy may also help reduce obsessive thoughts , depression, and anxiety in people with OCD.

In 2016, researchers conducted a feasibility study that explored how music therapy could be combined with CBT to treat depression . While additional research is needed, the initial results were promising.

Many people find that music, or even white noise, helps them fall asleep. Research has shown that music therapy may be helpful for people with sleep disorders or insomnia as a symptom of depression.

Compared to pharmaceuticals and other commonly prescribed treatments for sleep disorders, music is less invasive, more affordable, and something a person can do on their own to self-manage their condition.

Pain Management

Music has been explored as a potential strategy for acute and chronic pain management in all age groups. Research has shown that listening to music when healing from surgery or an injury, for example, may help both kids and adults cope with physical pain.

Music therapy may help reduce pain associated with:

• Chronic conditions : Music therapy can be part of a long-term plan for managing chronic pain, and it may help people recapture and focus on positive memories from a time before they had distressing long-term pain symptoms. 
• Labor and childbirth : Music therapy-assisted childbirth appears to be a positive, accessible, non-pharmacological option for pain management and anxiety reduction for laboring people.
• Surgery : When paired with standard post-operative hospital care, music therapy is an effective way to lower pain levels, anxiety, heart rate, and blood pressure in people recovering from surgery.

Coping with a cancer diagnosis and going through cancer treatment is as much an emotional experience as a physical one. People with cancer often need different sources of support to take care of their emotional and spiritual well-being.

Music therapy has been shown to help reduce anxiety in people with cancer who are starting radiation treatments. It may also help them cope with the side effects of chemotherapy, such as nausea.

Music therapy may also offer emotional benefits for people experiencing depression after receiving their cancer diagnosis, while they’re undergoing treatment, or even after remission.

On its own, music therapy may not constitute adequate treatment for medical conditions, including mental health disorders . However, when combined with medication, psychotherapy , and other interventions, it can be a valuable component of a treatment plan.

If you have difficulty hearing, wear a hearing aid, or have a hearing implant, you should talk with your audiologist before undergoing music therapy to ensure that it’s safe for you.

Similarly, music therapy that incorporates movement or dancing may not be a good fit if you’re experiencing pain, illness, injury, or a physical condition that makes it difficult to exercise.  

You'll also want to check your health insurance benefits prior to starting music therapy. Your sessions may be covered or reimbursable under your plan, but you may need a referral from your doctor.

If you’d like to explore music therapy, talk to your doctor or therapist. They can connect you with practitioners in your community. The American Music Therapy Association (AMTA) also maintains a database of board-certified, credentialed professionals that you can use to find a practicing music therapist in your area.

Depending on your goals, a typical music therapy session lasts between 30 and 50 minutes. Much like you would plan sessions with a psychotherapist, you may choose to have a set schedule for music therapy—say, once a week—or you may choose to work with a music therapist on a more casual "as-needed" basis.  

Before your first session, you may want to talk things over with your music therapist so you know what to expect and can check in with your primary care physician if needed.

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38 Music Therapy Research: Context, Methodology, and Current and Future Developments

Jane Edwards, Deakin University

• Published: 09 June 2015
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Music therapy is an evidence-based profession. Music therapy research aims to provide information about outcomes that support music therapy practice including contributing to theoretical perspectives that can explain why changes occur during treatment. Music therapy research has been conducted in a range of health, education, and community contexts throughout the world. Initially many music therapy developments in the university sector occurred through the establishment of training programmes that were developed and delivered by music therapists with professional experience in leading services in education and health care. Now many music therapy training programmes are led by people with practice experience along with research qualifications, and some universities offer music therapy doctoral pathways. Music therapy research capacity has expanded through a notable increase in PhD graduates as well as an increase in funded research in music therapy. This chapter covers: (1) traditions, (2) trends, and (3) contexts for music therapy research.

Introduction

Research is the process by which new knowledge is developed, existing knowledge is extended, and new theoretical frameworks are founded. In health care, research provides evidence for effective ways of working with patients or clients to achieve positive change; maintaining or improving optimal health and well-being. Research methods in health and education are characterized by a guiding research question or hypothesis, a theoretical or epistemological 1 orientation adopted by the researcher, a data source, and a selected method of data collection and analysis that is agreed in advance of the research commencing. All research is bound by an ethical code which is assured by approval from an Institutional Review Board, or an ethics committee. This process confirms that the processes of the research will cause no harm or discomfort to the participants, and will add value to existing knowledge.

Music therapy research is usually undertaken within the context of a university with outreach to recruit patients or students in health care or education. Initially music therapy in the university sector was built up through training programmes that were developed and delivered by people with professional experience in developing and leading music therapy services in education and health care. As higher education institutions across the world have become increasingly invested in all academic staff being research active including attaining PhDs and regularly applying for competitive research funding this has influenced the landscape of music therapy within the higher education environment. Increasingly it is unusual to find a course leader who does not either have a PhD or is working towards a PhD. Full-time permanent academic positions across the university context internationally usually require that the person has a PhD and a substantial body of work that has contributed to knowledge development in their specialist field.

Traditions of research in music therapy

In the fledgling years of music therapy research a commitment to quantitative methods within a strict positivist epistemology can be observed, especially in research publications within the USA. This was partly because of the influence of behavior modification as a technique in therapy practice ( Madsen et al. 1968 ). Modifying behavior that could be observed and measured was the goal of music therapy. Many researchers used randomized controlled trials (RCT) to examine the effects of music therapy on behaviors of clients. RCTs are studies in which participants are randomly assigned to either a music therapy treatment group, or to a control group which does not receive the treatment. The RCT is considered a gold standard within medical research ( Greenhalgh 2014 ). It is a highly effective method by which to test the effects and benefit of pharmacological medications. It can also show treatment outcomes when groups are compared where one group receives a treatment and another group, matched with the treatment group, do not (see Robb and Burns , this volume). Because of the alignment of music therapy with allied health, and the delivery of many music therapy services within medical contexts, the use of the RCT has been common in music therapy research ( Bradt 2012 ).

The most important historical development in this type of research was the introduction of randomization, where participants or subjects are randomly assigned to one of the groups, whether treatment, control, or placebo (see Robb and Burns , this volume). This random allocation to groups minimizes bias and increases the likelihood that the results of the research will be trustworthy.

In the later part of the twentieth century music therapy research reports using new methods entered the published literature, and references to new methods can be observed (for example, Aigen 1993 ; Amir 1993a , b ; Comeau 1991 ; Forinash 1992 ; Forinash and Gonzalez 1989 ; Langenberg et al. 1993 ). The early years of qualitative methods followed along the same route as other allied health research where qualitative inquiry or qualitative research became a commonly used descriptor ( Edwards 2012 ). Although qualitative is a useful description for many research methods it is not in and of itself a method. Distinctions between methods and epistemologies within qualitative traditions have not always been well defined in music therapy research reports ( Aigen 2008 ), and also in other allied health research writings ( Carter and Little 2007 ). In the maturation of music therapy research a wider range of methods and traditions have been engaged, and knowledge about different methods has become more elaborated and differentiated. It is now agreed that all methods have an underlying epistemology, and in using qualitative method research it is essential to be able to state ones position in relation to the theory of knowledge creation to which one subscribes ( Edwards 2012 ). Frequently used qualitative research methods in music therapy are grounded theory (see Daveson this volume; O’Callaghan 1996b ; 2012 ), and phenomenology ( Ghetti this volume).

An important distinction between research methods is whether they use inductive or deductive processes. Inductive refers to the way in which the researcher allows the information to be induced from the data during analysis ( O’Callaghan and McDermott 2004 ; O’Callaghan 1996a ). The researcher looks closely at the data, usually text or arts based, and reflects on the materials allowing meanings to emerge. Research which is deductive uses a pre-defined criteria to examine the data. For example, looking for particular incidences of a word in text or measuring a baseline behavior then providing treatment and following up with a further measure. Deductive might also refer to research in which the themes to be examined are decided in advance even when a qualitative method is used.

Research is published in journals following a process of anonymous peer review. A paper is submitted to just one journal and then the editor sends an anonymized version of the paper for review to at least two professionals with expertise in the area of the paper’s content. The reviewers read the paper and provide feedback to the editor about their opinion of the paper. Reviewers can recommend the paper should be published, or they can request revisions, or they can recommend that the paper be rejected. It is not unusual that articles are rejected. It can be because the editor or reviewers do not think the topic of the paper is relevant to the journal, or there can be issues of quality with the research that deem it unsuitable for publication. Many researchers make revisions to rejected papers and then submit them to another journal. It is unacceptable to submit to more than one journal at a time, and authors must sign a declaration at submission that the work has not been published elsewhere or been submitted for review to another journal.

Peer reviewed articles appear in the following English language journals of music therapy: Australian Journal of Music Therapy, British Journal of Music Therapy, Canadian Journal of Music Therapy, Journal of Music Therapy, Music Therapy Perspectives, Nordic Journal of Music Therapy , the New Zealand Journal of Music Therapy , and Voices . There are also related journals which publish music therapy research papers including: Psychology of Music, Music and Medicine , and The Arts in Psychotherapy . Music therapy research also appears in medical and therapy journals (for example, Loewy et al. 2013 , O’Callaghan et al. 2014 ). Therefore when students are researching projects or writing papers are encouraged to search the journal literature as well as reading relevant books and book chapters.

Trends in music therapy research

In this part of the chapter three trends in music therapy research will be discussed: (1) music therapy and evidence-based medicine, (2) arts-based research, and (3) mechanisms of change in music therapy.

Music therapy and evidence-based medicine

A number of music therapists have considered the ways that the profession can respond to the imperative of evidence-based medicine (EBM). EBM can be traced back to the 1960s but it more formally entered the lexicon of health care practice through the 1990s ( Smith and Rennie 2014 ). As a PhD researcher in a department of Paediatrics and Child Health in the 1990s the author observed firsthand the shift in thinking about practice and services that occurred when EBM began to be a main point of interest for researchers, not just in medicine but also through nursing and allied health departments. In order to consider the implications for music therapy she gave a series of presentations which were then worked into scholarly papers for publication. After initial rejection some of the ideas were eventually published ( Edwards 2005 , 2004 , 2002 ). Since that time others have also written about EBM and music therapy (for example Abrams 2010 , and Standley 2012 ).

Rather than relying on the outcome of a single RCT to develop new practices in health care, EBM proposed an evidence hierarchy founded on single cases (weak evidence) through to meta-analyses (strong evidence). In a meta-analysis the research findings from a number of studies with patients who have similar characteristics are analyzed statistically to show whether the changes that have occurred across all of the studies are convincing enough to warrant inclusion of the treatment in standard care. Dileo and Bradt concluded that “Overall, EBP [practice] intends to assure that patient treatment is safe, effective, and cost-effective.”(2009, p. 170)

Abrams has positioned evidence-based music therapy having multiple benefits for the profession:

The virtues of an integral understanding of evidence-based music therapy practice are numerous. It can help promote clarity of the different roles, purposes, strengths, and limits of each domain of evidence. It provides accountability to core values, standards of integrity, and standards of rigor, all internally consistent within a given perspective in any given instance. Moreover, it encourages an awareness of the applicability and relevance of evidence to clinical work in any given case. Abrams 2010 , p. 374

Earlier conceptualizations of EBM pointed out that music therapists are often referred clients or patients for whom other therapeutic supports or treatments have not been effective ( Edwards 2005 ). Therefore because of the complexity of the client’s situation and their unique needs traditional processes of matching of clients in control and treatment groups in the traditional RCT might not be possible.

Concepts used in evidence are now turning towards music therapy participants’ views to be a better accessed and utilized form of evidence (for example, Ansdell and Meehan 2010 ). Although initially this author’s concerns about EBM focused on inappropriate application by managers to limit innovation and cut services, in practice EBM has some but not complete influence on service leaders’ decisions to support or close programmes. At the same time it has produced an outstanding number of music therapy meta-analyses published in the most important medical evidence database in the world, the Cochrane Library (for example Mössler et al. 2011 ).

Arts-based research

The arts are increasingly being used in health care and related research to learn about the experiences of care workers and recipients, to gain access to marginalized voices, and to communicate research findings to a wider audience. Ledger and Edwards 2011 , p. 313

Arts-based research is a movement that has developed internationally with minimal input from creative arts therapists. Ledger and Edwards (2011) provided a number of examples in which music therapists appeared reluctant to describe their research methods as arts based . This reluctance was hypothesized as emerging from anxiety about seeming scientific enough, especially when conducting research in health and medical contexts.

As artistic processes within music are central to music therapy practice, the use of music making or other creative arts processes could be considered compatible with the goals of music therapy inquiry. It is therefore puzzling why arts based processes are not more widely used in music therapy research.

Arts-based research was included in the main research textbook to date in music therapy ( Wheeler 2005 ). Dianne Austin and Michele Forinash make a distinction between arts based research and the studies that have analyzed music created in music therapy sessions. They have shown that the arts can be used at every step in the research process to develop rich and expressive findings. Arts-based research is explained as offering a valuable way to gain insights that might not otherwise be discoverable ( Austin and Forinash 2005 ).

Mechanisms of change in music therapy

Research contributes to knowledge about change, but researchers also have a responsibility to theorize why the change occurs. Research relevant to music therapy from the fields of psychology and neuroscience are key to understanding the mechanisms of change in music therapy. For example, music therapy relies on the evocative potentials of music to develop a way of relating between the therapist and the client that is helpful in meeting the client’s needs and contributing to their well-being. Some of these evocative capacities include the ability of music to influence affect. In order to be able to interact and support clients in a way that is helpful and informed, understanding how music influences emotional states is key. Music therapists have extensive experience and expertise in observation of musical responses. As an experienced music therapy practitioner the following mechanism as to how emotional response to music might occur makes sense to the author. Julin and Västfjäll have proposed that when humans listen to music all of the following psychological processes happen, not separately but concurrently, and this is why an emotional response occurs:

(1) brain stem reflexes, (2) evaluative conditioning, (3) emotional contagion, (4) visual imagery, (5) episodic memory, and (6) musical expectancy. Juslin and Västfjäll 2008 , p. 563

Their proposition is interesting for music therapy practitioners to engage in order to understand the instantaneous aspects of response over which an individual has no control, and to confirm that there is no one piece of music that has the same effect on every listener. However, many psychological theories such as these that are relevant to music therapy are silent on the core interpersonal and relational aspects of music therapy. Therefore neuropsychological and physiological theories need to be accessed in order to further understanding of music therapy as a relational practice.

Developing theories about brain growth indicate that infant brains develop in collaboration and interaction with other brains ( Schore 2010 ). Loving, predictable responsiveness from the adult care giver is essential for an infant’s healthy start in life. The failure of the infant-parental bond to coalesce and attachment to be formed is disastrous for the child’s ongoing development. This can occur because of maltreatment and/or neglect, or because of demands on the carer’s own resources result in them being unavailable to the infant’s needs. This has lifelong consequences on development, particularly the skills needed for social interaction with others, and the resilience to deal with stressful experiences and events. Neurosequential modelling proposes that the infant brain develops in stages.

The brain is organized in a hierarchical fashion with four main anatomically distinct regions: brainstem, diencephalon, limbic system, and cortex. During development the brain organizes itself from the bottom up, from the least (brainstem) to the most complex (limbic, cortical) areas. While significantly interconnected, each of these regions mediates distinct functions, with the lower, structurally simpler areas mediating basic regulatory functions and the highest, most complex structures (cortical) mediating the most complex functions. Each of these main regions develops, organizes, and becomes fully functional at different times during childhood… Perry 2009 , p. 243

This theory is important for music therapy because it provides information to explain why children who have not developed self-regulatory processes due to severe early relational trauma, for example what Perry described as the “overanxious, impulsive, dysregulated child” (p. 243), might behave differently in the regulating holding environment of music therapy where predictable structure can contain and support the child’s actions and spontaneity (for relevant case examples, see Drake 2011 ).

The therapeutic opportunities in music therapy lie not only in the client’s responses to music but equally and sometimes more importantly in the therapist-client relating. Porges’ Polyvagal Theory is so named because it associates two physiological systems with feelings of safety and security and explains how these function in interpersonal relating. These are:

(a) the commonly known fight-or-flight system that is associated with activation of the sympathetic nervous system… and (b) a less-known system of immobilization and dissociation that is associated with activation of a phylogenetically more ancient vagal pathway. Geller and Porges 2014 , p. 180

Using the Polyvagal Theory ( Porges 2011 ) Geller and Porges (2014) have illuminated therapeutic presence as a salient factor reliant on neurophysiological processes by which safety, security, and trust are experienced in the therapeutic relationship. Given that many people who seek or are referred to psychological services have experienced a breakdown of their capacity to cope, or to relate successfully with others, the ability to provide safety and security in the interpersonal space is crucial to providing opportunities for capacity building towards growth and change.

Expert therapists have reported that the experience of therapeutic presence involves concurrently (a) being grounded and in contact with one’s integrated and healthy self; (b) being open, receptive to, and immersed in what is poignant in the moment; and (c) having a larger sense of spaciousness and expansion of awareness and perception. This grounded, immersed, and expanded awareness also occurs with (d) the intention of being with and for the client in service of their healing process. By being grounded, immersed, and spacious, with the intention of being with and for the other, the therapist invites the client into a deeper and shared state of relational therapeutic presence. Geller and Porges 2014 , p. 180

Polyvagal theory has contributed to the development of new ways of working as well as supporting existing practices in music therapy. As Loewy (2011) noted:

… [Polyvagal Theory] contributes to the theoretical justification for the role that music therapy can play in activating neural circuits that regulate reactivity. Porges’ rationale for and description of feeding and rocking as primal attachment behaviors which influence vagal afferent pathways is an essential contributor to the current thinking about the importance of the quality of care in the first stage of life. Music therapy practices that activate somatomotor components which trigger visceral change influence attachment practices which are critically important in the early years. Loewy 2011 , p. 182

The relational dimensions of music therapy practice are underpinned by multiple psychobiological principles including those encapsulated in communicative musicality initially developed by Stephen Malloch in his postdoctoral work at Edinburgh University, which was then further elaborated ( Malloch and Trevarthen 2009 ). Malloch and Trevarthen (2009) documented how the development of the theory and observation of the presence of communicative musicality occurred through many decades of research in the last century. Importantly multiple theorists and researchers from a range of fields, whether during field observations or in laboratory based experimental work, noted the expressive, dance and song like interactions between infants and the adults who share loving relationships with them. These multiple perspectives result in the conclusion that:

… we are evolved to know, think, communicate, create new things and care for one another in movement—through a sense of being in rhythmic time with motives and in tune with feelings to share the energy and harmony of meaning and of relating. Malloch and Trevarthen 2009 , p. 8

Contexts for research

All research conducted with service users in music therapy involves a context. This may be a single site such as a school or a hospital (see Colwell , this volume), or multiple sites. It may involve a service such as an oncology department, or additionally it may involve participants who access multiple services, for example children with cerebral palsy. Each context differs as to how service users or students can be approached to be involved in the research, and who will act as formal or informal gate-keepers. Researchers planning projects need to factor in how the people who will contribute to managing the data collection of the project will be sorced, and how these potential gate-keepers will assist in managing the recruitment and involvement of service users. Often people who are crucial to the research such as gate-keepers receive little acknowledgement either in research reports, or in international publications. This can make it difficult for novice researchers to understand how crucial they are to conducting research which relies on data collection from service users or students ( Porter et al. 2014 ).

Clinicians working within a service are often the referring point for participation in a music therapy project. The clinician can decide whether a person who meets the criteria for the project is able to manage the requirements of the project participation, and would potentially benefit from being a research participant. Clinicians are protective of their clients or patients. Therefore the researcher must take care to ensure that the clinician has confidence in the researcher and the research processes, that participants will not be taxed or made demands of in any problematic way. The gatekeeper may also be encoraged to note that the client may end up receiving music therapy, and that this participation may be highly enjoyable and potentially therapeutically beneficial.

One contextual dimension that has received limited attention in the literature is the role of the researcher and how this differs from the role of music therapist. Ledger (2010a) has reflected on her experiences as a music therapy researcher undertaking an ethnographic research project in a hospital that was developing a new music therapy service. She wrote:

Returning to the familiar setting of a hospital brought to the fore a set of previously held positions and behaviors. I needed to manage not only the boundary between researcher and music therapist but also the boundaries between researcher and colleague, researcher and friend, and experienced music therapist and student. These boundaries needed to be negotiated and renegotiated throughout the duration of my ethnography. There were times when it was helpful to cross boundaries in order to build rapport and to show appreciation to the staff who contributed to my research. However, there were also times when I needed to establish clear boundaries and to reiterate my research intentions. Ledger 2010a , p. 300

Ledger’s further reflection reveals some of the dilemmas that can arise when conducting qualitative methods research ( Ledger 2010b ). Unlike other types of research where one might collect data through testing or questionnaires, ethnography involves participation and observation. Being aware of the need to manage and negotiate role identity is an important part of undertaking this work.

The future of music therapy research

As music therapy matures and grows as a field of practice it is developing its depth and breadth of research engagement. Contemporary research is immensely inspiring, especially for increasingly sounding the voices of service users ( Ansdell and Meehan 2010 ; Solli et al. 2013 ), and the careful development of research procedures which ensure the complexity of musical experiences are not lost in the need for research rigor ( Erkkilä et al. 2011 ). The development of greater sophistication in mixed methods research (see Erkkilä , this volume) will ensure that the outcomes of psychological testing or observation of the therapist will not be privileged over the lived experience of participants. The increasing harnessing of the capacities of technology in conducting systematic evaluation of music therapy services show promising developments ( Streeter et al. 2012 ). More robust theoretical engagement with neuroscience and psychophysiology (for example Loewy 2011 ) and social theories ( Baines 2013 ) will ensure that music therapy has strong theoretical bones upon which the flesh and sinew of competent practice can continue to grow.

Epistemology refers to theory of knowledge. All research has an epistemological foundation whether or not it is made explicit. For further information see Edwards (2012) .

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What is Music Therapy and How Does It Work?

Perhaps the music leaves you feeling calmer. Or happy. Or, let’s face it, downright sad. I am sure all of us can attest to the power of music.

Did you know, however, that music therapy is in itself an evidence-based therapy? Keep reading to learn more about the profession of music therapy.

Before you continue, we thought you might like to download our three Positive CBT Exercises for free . These science-based exercises will provide you with detailed insight into Positive CBT and give you the tools to apply it in your therapy or coaching.

This Article Contains:

A look at the psychology, a brief history of music therapy, research and studies, the different types and methods of music therapy, a list of music therapy techniques, what does a music therapist do, the best instruments to use in music therapy, available music therapy apps, voices: a world forum for music therapy, what is music therapy perspectives.

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Bruscia (1991) defined music therapy as ‘ an interpersonal process in which the therapist uses music and all of its facets to help patients to improve, restore or maintain health ’ (Maratos, Gold, Wang & Crawford, 2008).

A little later, in 1998, Bruscia suggested another alternative definition of music therapy as ‘ a systematic process of intervention wherein the therapist helps the client to promote health, using musical experiences and the relationships that develop through them as dynamic forces of change ’ (Geretsegger, Elefant, Mössler & Gold, 2014).

Does music therapy simply consist of music used therapeutically? As Bruscia’s definitions demonstrate, music therapy is much more complex. It shouldn’t be confused with ‘music medicine’ – which is music interventions delivered by medical or healthcare professionals (Bradt & Dileo, 2010).

Music therapy, on the other hand, is administered by trained music therapists (Bradt & Dileo, 2010).

How does music therapy work? Well, it is claimed that five factors contribute to the effects of music therapy (Koelsch, 2009).

Modulation of Attention

The first aspect is the modulation of attention. Music grabs our attention and distracts us from stimuli that may lead to negative experiences (such as worry, pain, anxiety and so on). This may also explain the anxiety and pain-reducing effects of listening to music during medical procedures (Koelsch, 2009).

Modulation of Emotion

The second way music therapy work is through modulation of emotion . Studies have shown that music can regulate the activity of brain regions that are involved in the initiation, generation, maintenance, termination, and modulation of emotions (Koelsch, 2009).

Modulation of Cognition

Music also modulates cognition. Music is related to memory processes (including the encoding, storage, and decoding of musical information and events related to musical experiences) (Koelsch, 2009). It is also involved in the analysis of musical syntax and musical meaning (Koelsch, 2009).

Modulation of Behavior

Music therapy also works through modulating behavior. Music evokes and conditions behaviors such as the movement patterns involved in walking, speaking and grasping (Koelsch, 2009).

Modulation of Communication

Music also affects communication. In fact, music is a means of communication. Therefore, music can play a significant role in relationships, as alluded to in the definition of music therapy (Koelsch, 2009).

• Musical interaction in music therapy, especially musical improvisation, serves as a non-verbal and pre-verbal language (Geretsegger et al., 2014).
• It allows people who are verbal to gain access to pre-verbal experiences (Geretsegger et al., 2014).
• It also gives non-verbal people the chance to communicate with others without words (Geretsegger et al., 2014).
• It allows all people to interact on a more emotional, relationship-oriented way than may be possible relying on verbal language (Geretsegger et al., 2014).

Interaction also takes place with listening to music by a process that generally includes choosing music that has meaning for the person, such as the music reflecting an issue that the person is currently occupied with (Geretsegger et al., 2014).

Wherever possible, individuals are encouraged to reflect on personal issues that relate to the music, or, associations that the music brings up. For individuals who have verbal abilities, another important part of music therapy is to reflect verbally on the musical processes (Geretsegger et al., 2014).

Looking at a psychological theory of music therapy is extremely challenging, given the fact that there are multiple ideas regarding the mechanisms of music used as a therapeutic means (Hillecke, Nickel & Volker Bolay, 2005).

The psychology of music is a relatively new area of study (Wigram, Pedersen & Bonde, 2002). Music therapy is a multi-disciplinary field, and the area of music psychology is an innovative interdisciplinary science drawing from the fields of musicology, psychology, acoustics, sociology, anthropology, and neurology (Hillecke et al., 2005; Wigram et al., 2002).

Psychologists use experiments and diagnostics such as questionnaires, and the paradigm of cognition, to analyze what happens in music therapy (Hillecke et al., 2005).

Important topics in the psychology of music are:

• The function of music in the life and history of mankind
• The function of music in the life and identity of a person
• Auditory perception and musical memory
• Auditory imagery
• The brain’s processing of musical inputs
• The origin of musical abilities and the development of musical skills
• The meaning of music and musical preferences for the forming of identity
• The psychology of music performance and composition (Wigram et al., pp 45 – 46).

In understanding how people hear and perceive musical sounds, a part of music psychology is psychoacoustics – one’s perception of music. Another important facet of the psychology of music is an understanding of the human ear, and also the way the brain is involved in the appreciation and performance of music (Wigram et al., 2002).

Lifespan music psychology refers to an individual’s relationship to music as a lifelong developmental process (Wigram et al., 2002).

The earliest reference to music therapy was a paper called “Musically Physically Considered”, that was published in a Columbian magazine (Greenberg, 2017).

Even long before that, Pythagoras (c.570 – c. 495 BC), the Greek philosopher and mathematician prescribed a variety of musical scales and modes in order to cure an array of physical and psychological conditions (Greenberg, 2017).

However, perhaps the earliest account of the healing properties of music appear in the Jewish bible. In it, the story was that David, a skilled musician, could cure King Saul’s depression through music (Greenberg, 2017).

This was told in Chapter 16 in Prophets:

“And it happened that whenever the spirit of melancholy from God was upon Saul, David would take the lyre (harp) and play it. Saul would then feel relieved and the spirit of melancholy would depart from him”

(1 Samuel, 16:23).

There may even be earlier accounts of music therapy. Whether such religious texts are historically accurate or not, music was conceived as a therapeutic modality when such texts were written (Greenberg, 2017).

Music therapy emerged as a profession in the 20th century after World War I and World War II. Both amateur and professional musicians attended veterans’ hospitals to play for the veterans who had suffered physical and emotional trauma (The American Music Therapy Association, n.d.).

The impact of the music on the patients’ physical and emotional responses saw the doctors and nurses requesting to hire the musicians. It became apparent that the hospital musicians required training before starting, and thus ensued the beginning of music therapy education (The American Music Therapy Association, n.d.).

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To begin this discussion into musical therapy research, I will share a couple of Cochrane Reviews. Cochrane Reviews are systematic reviews that are internationally recognized as the highest standard in evidence-based health care.

A Cochrane Review of 5 studies examining music used in different ways as a part of the psychological treatment of people with depression found that reporting of the studies was poor. It did, however, find that most of the studies that made up the review did show positive effects in reducing depressive symptoms (Maratos et al., 2008). Therefore, the authors suggested that further research in this area is necessary.

Another Cochrane Review looked at 10 studies (a total of 165 participants) that assessed the effect of music therapy interventions that were conducted with children with autism spectrum disorder (ASD) over periods ranging from one week to seven months (Geretsegger et al., 2014).

Individuals with ASD experience impairments in social interaction and communication. Music therapy provides a means of communication and expression through musical experiences and the relationships that develop through them (Geretsegger et al., 2014).

Geretsegger and colleagues (2014) found that in terms of social interaction within the context of therapy, music therapy was associated with improvements in the non-verbal communicative skills, verbal communication skills, initiating behavior and social emotional reciprocity of individuals with ASD. However, there was no statistically significant difference in non-verbal communication skills outside the context of the therapy (Geretsegger et al., 2014).

In terms of secondary outcomes, music therapy was found to be superior to ‘placebo’ therapy or standard care in promoting social adaptation and quality of the parent-child relationships (Geretsegger et al., 2014).

In a Cochrane Review, authors found that a limited range of studies suggest that music therapy may be beneficial on improving quality of life in end-of-life care (Bradt & Dileo, 2010). However, the results are derived from studies that have a high risk of bias. Bradt and Dileo (2010) therefore concluded that more research into this particular area is needed.

In other studies, Klassen and colleagues (2008) looked at 19 randomized controlled trials and found that music therapy significantly reduced anxiety and pain in children undergoing medical and dental procedures.

The study also showed that rather than the use of music alone, use of music as a part of a multifaceted intervention may be more effective (Klassen, Liang, Tjosfold, Klassen & Hartling, 2008). The music is used to distract the patient from painful or anxiety-provoking stimuli, and this can also reduce the amount of medication required (Klassen et al., 2008).

Gerdner and Swanson (1993) examined the effects of individualized music in five elderly patients diagnosed with Dementia of Alzheimer’s Type. The patients resided in a long-term care facility and were confused and agitated.

Results from the study, both the immediate effects and the residual effects one hour after the intervention, suggest that individualized music is an alternate approach to management of agitation in confused elderly patients (Gerdner & Swanson, 1993).

Forsblom and colleagues (2009) conducted two parallel interview studies of stroke patients and professional nurses to ascertain the therapeutic role of listening to music in stroke rehabilitation.

They found music listening could be used to help patients relax , improve their mood and afford both mental and physical activation during the early stages of stroke recovery. Music listening was described as a ‘participative rehabilitation tool’ (Forsblom, et al. 2009).

The final study I will review, by Blood and Zatorre (2001) showed that music modulated amygdala activity. Using brain imaging techniques, the researchers played participants a piece of their own favorite music to induce an extremely pleasurable experience – described as “chills”.

In the control condition, participants listened to another participant’s favorite music. The intensity of the ‘chills’ experienced by participants correlated with increases in regional cerebral blood flow in brain areas believe to be involved in reward and emotion. This study supports the argument that music can induce ‘real’ emotions, as the brain regions for emotional processing were modulated by music (Blood & Zatorre, 2001).

Music-based therapy is based on two fundamental methods – the ‘receptive’ listening based method, and the ‘active’ method based on playing musical instruments (Guetin et al., 2009).

There are two receptive methods. The first of these, receptive ‘relaxation’ music therapy is often used in the treatment of anxiety, depression and cognitive disorders . Receptive ‘analytical’ music therapy is used as the medium for ‘analytic’ psychotherapy (Guetin et al., 2009). ‘Music medicine’ generally involves passive listening to pre-recorded music provided by medical personnel (Bradt & Dileo, 2010).

In terms of other types of music therapy, there is the Bonny Method of Guided Imagery and Music . This was developed by Helen Lindquist Bonny (Smith, 2018). The approach involves guided imagery with music.

With music added, the patient focuses on an image which is used as a starting point to think about and discuss any related problems. Music plays an integral role in the therapy and may be called a ‘co-therapist’. Individual patient needs and goals influence the music that is selected for the session (Smith, 2018).

The Dalcroze Eurythmics is a method used to teach music to students, which can also be used as a form of therapy. Developed by Èmile Jaques-Dalcroze, this method focuses on rhythm, structure, and expression of movement in the learning process. Because this method is apt for improving physical awareness, it helps those patients who have motor difficulties immensely (Smith, 2018).

The therapist may also ‘prescribe’ music medicine or guided imagery recordings containing music for the client to listen to outside the therapy room by making use of a digital psychotherapy platform such as Quenza (pictured here).

Therapists can use modern platforms such as these to send pre-recorded audio clips directly to the client’s smartphone or tablet according to a predetermined schedule.

Likewise, the therapist can track clients’ progress through these audio activities via their own computer or handheld device.

It is thought that Zoltàn Kodàly was the inspiration for the development of the Kodaly philosophy of music therapy (Smith, 2018). It involves using rhythm, notation, sequence, and movement to help the patient learn and heal.

This method has been found to improve intonation, rhythm and music literacy. It also has a positive impact on perceptual function, concept formation, motor skills and learning performance in a therapeutic setting (Smith, 2018).

Neurologic Music Therapy (NMT) is based on neuroscience. It was developed considering the perception and production of music and its influence on the function of the brain and behaviors (Smith, 2018).

NMT uses the variation within the brain both with and without music and manipulates this in order to evoke brain changes which affect the patient. It has been claimed that this type of music therapy changes and develops the brain by engaging with music. This has implications for training motor responses, such as tapping the foot to music. NMT can be used to develop motor skills (Smith, 2018).

Orff-Schulwerk is a music therapy approach developed by Gertrude Orff. When she realized that medicine alone was not sufficient for children with developmental delays and disabilities, Orff formed this model (Smith, 2018).

“Schulwerk”, or ‘school work’ in German, reflects this approach’s emphasis on education. It uses music to help children improve their learning ability. This method also highlights the importance of humanistic psychology and uses music as a way to improve the interaction between the patient and other people (Smith, 2018).

• Listening to live or recorded music
• Learning music-assisted relaxation techniques, such as progressive muscle relaxation or deep breathing
• Singing of familiar songs with live or recorded accompaniment
• Playing instruments, such as hand percussion
• Improvising music on instruments of voice
• Writing song lyrics
• Writing the music for new songs
• Learning to play an instrument, such as piano or guitar
• Creating art with music
• Dancing or moving to live or recorded music
• Writing choreography for music
• Discussing one’s emotional reaction or meaning attached to a particular song or improvisation

This information about what music therapists do was found on the ‘Your Free Career Test’ (n.d.) website.

Music therapists work in a variety of settings, including schools, hospitals, mental health service locations, and nursing homes. They help a variety of different patients/clients.

A music therapist evaluates each clients’ unique needs. They ascertain a client’s musical preferences and devises a treatment plan that is customized for the individual.

Music therapists are part of a multi-disciplinary team, working with other professionals to ensure treatment also works for the client to achieve their goals. For example, if a person is working on strengthening and movement in order to address physical limitations, a music therapist could introduce dance into their treatment plan.

Therapists are advised to follow their own preferences, and as explained by Rachel Rambach (2016) a board-certified music therapist – instruments are the tools of a music therapist and should be specifically chosen based on the needs and goals of clients.

Some instruments are, however, more popular.

Muzique (a company promoting creative art experiences) has listed three instruments that have been proven most effective.

The first of these is the Djembe , or hand drum. Given that this single drum does not have a central melodic component, the client is free to express and connect with the musical rhythms without fear of playing a ‘wrong note’. The use of a small drum also facilitates a connection between the therapist and client by allowing them to be in close proximity.

They can play together at the same time, which may not be possible with a piano or guitar.

The guitar , according to Muzique (n.d.) is generally the top instrument used by music therapists. Again, a guitar can be used in close proximity to a client. The music therapist can also maintain melodic or harmonic control whilst allowing the client to play. The guitar can help maintain control in a group setting, but it can also be soothing and relaxing.

Muzique (n.d.) suggests that the piano is probably the instrument of choice when working with large groups. As the sound of a guitar can be drowned out by other instruments being played by clients, the piano can be more steady and holding background.

The music therapist should be mindful, however, of the apparent physical barrier between themselves and the client, and if possible, have the client sit next to the piano.

When Working With Children

Rachel Rambach (2016) concedes that there are certain instruments that she tends to utilize more often than others in her work with children. These include the 8 note hand bell set , which consists of a group of bells that each have their own color, number and letter of the medical alphabet (which can be ordered by pitch) and the mini guitar (which is very child-friendly and portable).

Another instrument Rambach (2016) likes is the frog guiro , which can be used in various ways – such as a guiro making a croaking sound, like a frog, or as a wood block. Castanets make a fun sound, and also help children acquire a pincer grip.

Rambach (2016) favors fruit shakers , which although they don’t make a unique sound, have a very realistic appearance and thus appeal to children. The cabasa does, on the other hand, make a unique sound and also brings in a tactile element to music therapy.

The cabasa is good for targeting fine and gross motor skills. The ‘lollipop’ drum is light, and not too loud so these are often preferred by Rambach (2016) over bigger paddle drums.

Rambach (2016) thinks every music therapist should have a ukulele . Their sound is sweet and inviting, and the ukulele makes the perfect alternative to a guitar.

They can be used as an accompanying instrument, but also for adapted lessons. Finally, the gathering drum encourages group cohesion in group settings or classes. They encourage children, or adult clients, to work together – sharing, and interacting with others (Rambach, 2016).

Anytune – slow down music BPM

Get it from the App Store .

Get it from Google Play .

Garage Band

This app provides a great tool for song-writing or improvisation. The individual can create literally hundreds of realistic, high-quality sounds (Fandom, n.d.).

Guitarist’s Reference

The app provides guitar triads, arpeggios, a reverse chord finder tool, alternate guitar tunings, chords scale relationships and a guitar chord quiz (Fandom, n.d.).

Magic Piano

The app can also be switched to where you have to hit the right spot (or the note will sound out of tune if not) or just tap the screen with the rhythm. It has 4 different difficulty settings: easy, medium, hard and auto mode that senses the person’s ability after a few songs (Fandom, n.d.).

Real Guitar Free

It has a vast range of options and is perfect for both beginners and experienced guitarists (Sena, 2012).

The following information was found on the ‘ Voices ’ website.

This is an open-access peer-reviewed journal. It welcomes dialogue and discussion across disciplines about music, health, and social change. The journal promotes inclusiveness and socio-cultural awareness. It features a focus on cultural issues and social justice.

‘Voices’ is published by the University of Bergen and NORCE Norwegian Research Centre through GAMUT – The Grieg Academy Music Therapy Research Centre. The vision statement of ‘Voices’ is:

“ Voices: A World Forum for Music Therapy seeks to nurture the profile of music therapy as a global enterprise that is inclusive and has a broad range of influences in the International arena. The forum is particularly interested in encouraging the growth of music therapy in developing countries and intends to foster an exchange between Western and Eastern as well as Northern and Southern approaches to the art and science of music therapy ”.

An official publication of the American Music Therapy Association aim, is to inform readers from both within and outside the music therapy profession.

By disseminating scholarly work, this journal sets out to promote the development of music therapy clinical practice, with a particular focus on clinical benefits.

Music Therapy Perspective seeks to be a resource and forum for music therapists, music therapy students, and educators as well as others from related professions.

The Journal of Music Therapy

The Journal of Music Therapy disseminates research (edited by A. Blythe LaGasse) that advances the science and practice of music therapy. It also provides a forum for current music therapy research and theory, including music therapy tools , book reviews, and guest editorials.

“ Its mission is to promote scholarly activity in music therapy and to foster the development and understanding of music therapy and music-based interventions…The journal strives to present a variety of research approaches and topics, to promote clinical inquiry, and to serve as a resource and forum for researchers, educators, and clinicians in music therapy and related professions ”.

The 5 Best Books on the Topic (Incl. The Music Therapy Handbook)

There is such a lovely selection of books on music therapy, but to be concise, we only reflect on five.

1. Music Therapy Handbook – Barbara Wheeler

This book is a key resource for music therapists and also demonstrates how music therapy can be used by other mental health and medical professionals.

It provides case material and an extensive look at music therapy, including both the basic concepts as well as the emerging clinical approaches. It contains a comprehensive section on clinical applications.

Find the book on Amazon .

2. The New Music Therapist’s Handbook – Suzanne Hanser

This is a revised, updated version of Hanser’s 1987 book. It reflects recent developments in the field of music therapy.

This book serves as a ‘go-to’ resource for both students and professionals. It contains an introduction to music therapy as a profession, provides guidelines for setting up a practice, and describes new clinical applications as well as relevant case studies.

3. Case Studies in Music Therapy – Kenneth Bruscia

This book is suitable as a reference, a textbook for students, or simply to provide an introduction to the field of music therapy.

It is made up of 42 case-histories of children, adolescents and adults receiving group and individual therapy in a range of different settings, in order to demonstrate the process of music therapy from beginning to end.

The book describes various approaches and techniques in music therapy, and captures moving stories of people worldwide who have benefitted from music therapy and the relationships developed with music therapists.

4. Defining Music Therapy – Kenneth Bruscia

Bruscia’s book examines the unique difficulties of defining music within a therapeutic context and, conversely, defining therapy within a music context. It compares and examines more than 40 definitions of music therapy and provides a new definition.

Bruscia discusses each component of this new definition and by doing so suggests boundaries for what music therapy IS versus what it IS NOT.

5. Musicophilia: Tales of Music and The Brain – Oliver Sacks

This book is slightly different to the others. It examines the place music occupies in the brain, and how music affects the human condition.

Sacks explores cases of what he terms “musical malalignment”.

He explains why music is irresistible and can be both healing and unforgettable.

Bunt, L., & Pavlicevic, M. (2001). Music and emotion: Perspectives from music therapy. In P.N. Justin & J.A. Sloboda (Eds), series in affective science. Music and emotion: Theory and Research (pp. 181 – 201). New York, NY, US: Oxford University Press

Stultz, D. L., Lineweaver, T. T., Brimmer, T., Cairns, A.C., Halcomb, D. J., Juett, J. et al. (2018). “Music first”: An alternative or adjunct to psychotropic medications for the behavioral and psychological symptoms of dementia. GeroPsych: The Journal of Gerontopsychology & Geriatric Psychiatry, 31, 17 – 30. http://dx.doi.org/10.1024/1662-9647/a000180

Landis-Shack, N., Heinz, A. J., & Bonn-Miller, M. O. (2017). Music therapy for posttraumatic stress in adults: A theoretical review. Psychomusicology: Music, Mind, and Brain, 27, 334 – 342. http://dx.doi.org/10.1037/pmu0000192

Bell, T. P., McIntyre, K. A., & Hadley, R. (2016). Listening to classical music results in a positive correlation between spatial reasoning and mindfulness. Psychomusicology: Music, Mind, and Brain, 26, 226 – 235. http://dx.doi.org/10.1037/pmu0000139

Barrett, F. J., Grimm, K. J., Robins, R. W., Wildschut, T., Sedikides, C., & Janata, P. (2010). Music-evoked nostalgia: Affect, memory, and personality. Emotion, 10, 390-403. http://dx.doi.org/10.1037/a0019006

Ladviig, O., & Schellenberg, E. G. (2012). Liking unfamiliar music: Effects of felt emotion and individual differences. Psychology of Aesthetics, Creativity and The Arts, 6, 146 – 154. http://dx.doi.org/10.1037/a0024671

17 Science-Based Ways To Apply Positive CBT

These 17 Positive CBT & Cognitive Therapy Exercises [PDF] include our top-rated, ready-made templates for helping others develop more helpful thoughts and behaviors in response to challenges, while broadening the scope of traditional CBT.

Created by Experts. 100% Science-based.

Some of these heart-warming videos are perfect to illustrate the benefits of Music Therapy.

What is Music Therapy?

This video features a board-certified musical therapist, Ryan Judd. He answers the questions “What is music therapy?” and “how do I find a music therapist?”

Music Therapy: Healing Music Sound Therapy for Relax, Chakra Balancing, and Well-being.

From the Meditation Relax Club .

Suitable for use in relaxation exercises or meditation, this video features peaceful, calming music set against a tranquil video.

My Job: Music Therapist

Trish, a music therapist, explains her role. She also explains how music therapy can help clients to meet both medical and emotional needs.

What a Music Therapy Session Looks Like

By sharing a description of working with a child with autism spectrum disorder, this board-certified music therapist explains what happens in a music therapy session. This video gives a brief snapshot of what music therapy looks like.

Music Therapy

This video shows the music therapy department at the Children’s Hospital of Pittsburgh of UPMC. It explains how board-certified music therapists assist patients to cope with procedures, pain and anxiety.

The power of music has been evident since the earliest days of humankind. However, after the world wars of the 20th century, music therapy heralded the beginning of a powerful new profession.

Since then, various types and methods of music therapy have been developed, and music therapy has been practiced in a variety of settings with far-reaching benefits.

Hopefully, this article has provided you with a helpful overview of the music therapy profession. What are your experiences with music therapy? What do you think it offers clients in conjunction with traditional therapies? Or, have you had experience of music therapy as a stand-alone intervention? Please feel free to share your thoughts and ideas.

We hope you enjoyed reading this article. For more information, don’t forget to download our three Positive CBT Exercises for free .

• Blodgett, Ashley (2015). These 12 facts about music, and how they affect your brain, will astound you! Retrieved from https://www.unbelievable-facts.com/2015/04/facts-about-music.html/2
• Blood, A., & Zatorre, R. J. (2001). Intensely pleasurable responses to music correlate with activity in brain regions implicated in reward and emotion. National Academy of Sciences, 98 , 11818 – 11823.
• Bradt, J., & Dileo, C. (2010). Music therapy for end-of-life care. Cochrane Database of Systematic Reviews, 1, Art. No: CD007169.
• Children’s Health Queensland Hospital and Health Service (n.d.). Music Therapy. Retrieved from https://www.childrens.health.qld.gov.au/fact-sheet-music-therapy/
• Everyday Harmony (n.d.). What is Music Therapy? Retrieved from www.everydayharmony.org/what-is-music-therapy/
• Fandom (n.d.). Music therapy activities wiki. Retrieved from https://musictherapyactivities.fandom.com/wiki/Music_Therapy_Activities_Wiki
• Forsblom, A., Lantinen, S., Särkämö, T., & Tervaniemi, M. (2009). Therapeutic role of music listening in stroke rehabilitation. The Neurosciences and Music III-Disorders & Plasticity: Annals of the New York Academy of Science, 1169 , 426 – 430.
• Gerdner, L. A., & Swanson, E. A. (1993). Effects of individualized music on confused and agitated elderly patients. Archives of Psychiatric Nursing, 7 , 284 – 291.
• Geretsegger, M., Elefant, C., Mössler, K. A., & Gold, C. (2014). Music therapy for people with autism spectrum disorder. Cochrane Review of Systematic Reviews, 6, Art. No: CD004381.
• Gold, C., Voracek, M., & Wigram, T. (2004). Effects of music therapy for children and adolescents with psychopathology: A meta-analysis. Journal of Child Psychology and Psychiatry, 45 , 1054 – 1063.
• Greenberg, D. M. (2017). The World’s First Music Therapist. Retrieved from https://www.psychologytoday.com/au/blog/the-power-music/201704/the-world-s-first-music-therapist
• Guetin, S., Portet, F., Picot, M. C., Pommie, C., Messgoudi, M., Djabelkir, L. et al. (2009). Effect of music therapy on anxiety and depression in patients with Alzheimer’s type dementia: Randomised, controlled study. Dementia & Geriatric Cognitive Disorders, 28 , 36 – 46.
• Hillecke, T., Nickel, A., & Volker Bolay, H. (2005). Scientific perspectives on music therapy. Annals of the New York Academy of Sciences, 1060 , 1 – 12.
• Jacobson, V., & Artman, J. (2013). Music therapy in a school setting. Retrieved from https://williams-syndrome.org/sites/williams-syndrome.org/files/MusicTherapyTearSheet2013.pdf
• Klassen, J. A., Liang, Y., Tjosvold, L., Klassen, T. P., & Hartling, L. (2008). Music for pain and anxiety in children undergoing medical procedures: A systematic review of randomized controlled trials. Ambulatory Pediatrics, 8 , 117 – 128.
• Koelsch, S. (2009). A Neuroscientific perspective on music therapy. Annals of the New York Academy of Science, 1169 , 374 – 384.
• Levy, Jillian (2017). Music therapy: Benefits and uses for anxiety, depression and more. Retrieved from https://draxe.com/music-therapy-benefits
• Maratos, A., Gold, C., Wang, X., & Crawford, M. (2008). Music therapy for depression. Cochrane Database of Systematic Reviews, Issue 1, Art. No: CD004517.
• Muzique (n.d.). Top 3 instruments to use in a music therapy session. Retrieved from https://www.muzique.org/muziqueblog/top-3-instruments-to-use-in-a-music-therapy-session
• Nordoff Robbins (n.d.). What is music therapy? Retrieved from https://www.nordoff-robbins.org.uk/what-is-music-therapy
• Rambach, Rachel (2011). 12 songs every music therapist should know. Retrieved from https://listenlearnmusic.com/2011/03/12-songs-every-music-therapist-should-know.html
• Rambach, Rachel (2016). My top 10 music therapy instruments. Retrieved from https://listenlearnmusic.com/2016/02/my-top-10-music-therapy-instruments.html
• Scott, Elizabeth (2018). Music relaxation: A healthy stress management tool. Retrieved from https://www.verywellmind.com/music-as-a-health-and-relaxation-aid-3145191
• Seibert, Erin (n.d.). Mental health session ideas. Retrieved from https://musictherapytime.com/2015/12/24/mental-health-session-ideas/
• Sena, Kimberley (2012). Guest Post: Essential iPad apps for music therapists. Retrieved from www.musictherapymaven.com/guest-post-essential-ipad-apps-for-music-therapists/
• Smith, Yolanda (2018). Types of Music Therapy. Retrieved from https://www.news-medical.net/health/Types-of-Music-Therapy.aspx
• Soundscape Music Therapy (n.d.). Music Therapy Methods. Retrieved from https://soundscapemusictherapy.com/music-therapy-methods/
• The American Music Therapy Association (n.d.). Retrieved from https://www.musictherapy.org/
• Therapedia (n.d.). Music Therapy. Retrieved from https://www.theravive/therapedia/music-therapy
• Wigram, T., Pedersen, I. N., & Bonde, L. O. (2002). A Comprehensive Guide to Music Therapy: Theory, Clinical Practice, Research and Training . London: Jessica Kingsley Publishers
• Wong, H. L., C., Lopez-Nahas, V., & Molassiotis, A. (2001). Effects of music therapy on anxiety in ventilator-dependent patients. Heart and Lung: The Journal of Acute and Critical Care, 30 , 376 – 387.
• Your Free Career Test (n.d.). What does a music therapist do? Retrieved from https://www.yourfreecareertest.com/what-does-a-music-therapist-do/

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That was a great article .Thank you

So informative

Wonderful Post, simple, clear, direct, Very Informative…..Great Job Heather!!!…BRAVO,….Am musician, composer & arranger and I’m actually working on a Research Proposal for an MPhil by Research will be exploring in the field of Music Therapy. All the Best to You Heather

Thanks for sharing, great article.

This was very helpful. It helped in my understanding of the connection between music and wellness.

This article is so good. I got all the information I need. Thanks for sharing.

That’s really nice post. I appreciate, Thanks for sharing.

Thank you Heather. I am researching music and the therapeutic effects it has on those of us with brain injuries, to put together a small book on How To Recover From. A Brain Injury. Interestingly enough, my sister played music for me, while I was in a coma. I then went through a post injury (10 years later) phase of recovery where I loved live music. I would like to contribute this idea, although I am sure you are aware of it yourself, and that is the ability of music to bring you into the moment so fully, that all the deficits and disabilities fall away. I found my whole being enveloped in the music being performed, and forgot all about who I was. It was fabulously wonderful to feel so lifted up from a world of always working on improving yourself.

Great book Heather with so much information, I am researching for a uni essay and this has been most helpful,

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Home — Essay Samples — Nursing & Health — Music Therapy — Informative On Music Therapy

Informative on Music Therapy

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Published: Mar 19, 2024

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Introduction, the history of music therapy, the benefits of music therapy, the role of music therapy in contemporary healthcare.

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Music Therapy: Review

Introduction, forms of music therapy, effectiveness of passive music therapy, singing benefits, institutions, works cited.

Music therapy is the controlled use of music in treatment, rehabilitation, and a means of optimizing creativeness and pedagogical work. Behavioral therapists widely adopt music to treat depressive conditions. Since the mechanism of the effect is not always clear, music therapy sometimes seems like a kind of miracle, giving a melody a magical meaning. A significant part of scientists considers music therapy an auxiliary means of psychotherapy to prepare patients with sophisticated therapeutic methods. It is increasingly asserted in the status of a universal educational system that optimizes the process of development of a person in social life. The methods of music therapy have gained wide popularity. Many specialists have been studying how to use music to treat patients with specific psychological or somatic problems.

Music affects the human body in the physical realm. At the beginning of the 20th century, it was experimentally proved that musical sounds make every cell of the human body vibrate (Gilroy and Lee 163). Electromagnetic waves alter blood pressure, heart rate, rhythm, and depth of breath (Gilroy and Lee 163). Music has proven to be effective in sports medicine, actively influencing the improvement of sports performance. It is no accident that in modern medical science, music therapy is gaining increasingly more popularity along with herbal medicine and art therapy.

The following forms of music therapy are distinguished: receptive, active, and integrative. Receptive or so-called passive music therapy means that the patient does not actively participate in the music therapy session, taking the position of a listener (Gilroy and Lee 109). He or she is offered to listen to various musical compositions or sounds that correspond to the state of his or her mental health and treatment stage. Passive listening aims at relaxing the nervous system. Active methods of music therapy are based on the work with musical material: instruments playing and singing. Being engaged in singing, according to a unique program, the patient experiences two healing effects at once. On the one hand, singing strengthens the respiratory and cardiac systems, and on the other, it positively affects the nervous system (Gilroy and Lee 110). Integrative music therapy takes advantage of other forms of art, organically integrating with them. For example, there are different approaches such as drawing to a tune, music-moving games, plastic dramatization to music, creating poems to a musical theme, and other creative forms (Gilroy and Lee 115). Artistic therapeutic methods are selected, as a rule, individually.

There are several main therapeutic effects of music therapy. The first benefit is emotional activation during verbal psychotherapy. Furthermore, it stimulates the development of interpersonal skills, for example, communicative functions and abilities (Sundar 248). Listening to music together creates an atmosphere of mutual trust between the doctor and the patient (Sundar 248). Finally, music affects psycho-vegetative processes and increases the aesthetic needs of a person.

The mechanisms of the therapeutic effect of music therapy are emotional discharge, regulation of the emotional state, and reducing frustration with life problems. It increases social activity, acquiring new means of emotional expression and facilitating the building of new social relationships. Sudan claims that correctly selected melodies, works, and improvisations are convenient to work with in the subconscious mind (250). Music structures the processes of reflecting and recalling a memory. Sounds interact with associative structures, bringing them to the surface into the current state of mind. Even unpleasant dissonances can affect remembrance and consciousness, and, consequently, have a beneficial effect on the general mental condition.

With regard to the mental impact on a person, different musical genres have various outcomes. Gregorian chants use rhythms of natural breathing, which allows patients to achieve a sense of spatial relaxation (Gilroy and Lee 235). These melodies are well-suited for quiet exercises and meditation, reducing the level of stress. Slow Baroque music, for instance, compositions of Bach, Handel, Vivaldi, gives a sense of stability, order, security, and creates a spiritually productive ambiance that is suitable for the work process (Gilroy and Lee 235). Classical music, like that of Haydn and Mozart, is distinguished by clarity, elegance, and transparency. It can enhance concentration, improve memory, and spatial perception (Gilroy and Lee 235). The music of romanticism of composers such as Schubert, Schumann, Tchaikovsky, Chopin, and Liszt emphasizes expressiveness and sensuality, and often awakens individualism. It is better to use it to activate feelings and emotions that usually tend to diminish or are hidden.

Concerning rock songs and pop music, the latter provoke rhythmic movements and create a feeling of well-being. Rock music performed by artists can awaken deep senses, stimulate active changes, and relieve nervous tension. It might ease the pain and reduce the unpleasant effect of loud and sharp sounds in case they are in the environment (Landis-Shack et al. 334). Meanwhile, it is necessary to maintain a nuanced approach to treating patients with this genre since rock music can create nervous tension, causing a dissonance of emotions. Sometimes it can be the reason for a stressful state or adverse mental conditions.

Moreover, these days, musical therapy is used not only in behavioral treatment but also in domains that can be considered far from music, for example, in surgery or dentistry. The practice of medicine has shown that some musical works have an anesthetic effect; consequently, it can reduce the fear of pain. An important role in postoperative rehabilitation is played by the patient’s mental state before, during, and after surgery. A review of medical studies shows that preoperative anxiety is associated with more pain, even with equal doses of analgesics (Martin-Saavedra et al. 87). For reducing stress and, as a result, improving the patient’s physical well-being after an operation, various methods are used: among them, there is music therapy. However, one neuropsychologist, according to Martin-Saavedra et al., admitted that music should accompany medical treatment, but not replace it (88). Not every disease can be cured with jazz or hip-hop. For instance, in the case of a broken leg, it is difficult, but regarding bacterial infection, music can stimulate the immune system. Musical programs for the immunostimulating effects have already been developed in some medical organizations.

Singing has a particularly beneficial effect on a person’s health. It is a unique respiratory gymnastics that helps to establish regular breathing. The correct breathing setting leads to an apparent increase in all the reserve capabilities of the human body. Chanting acts as a breathing training massage of the larynx, during which breathing muscles and diaphragmatic breathing are trained, bronchial drainage is improved, and lung capacity is increased (Irons et al. 80) When a person sings, vibration occurs in his or her internal organs, especially in the academic manner of singing (Irons et al. 75). Studies have confirmed that singing not only develops the lungs and pectoral muscles but also strengthens the cardiac muscle (Irons et al. 80). Singing helps to cure bronchial asthma, other broncho-pulmonary diseases, and sinusitis (Irons et al. 80). As a result, it has a beneficial effect on the kidneys, endocrine glands, and thyroid gland. All these facts put singing next to physical education.

The purposeful therapeutic use of music called music therapy or music treatment has stood out in an independent direction, which has occupied its niche at the intersection of science and art. Since 1969 in Sweden, there has been a music therapeutic society (Gilroy and Lee 34). It became known to the whole world that the sounds of bells containing resonant ultrasonic radiation kill typhoid bacilli, pathogens of jaundice, and influenza viruses in seconds (Gilroy and Lee, 34). Since 1998, the American Association of Music Therapy has existed in the United States (Gilroy and Lee 34). Its goal is to support the therapeutic use of music in hospitals, educational centers, and communication facilities, training and certification of music therapists, and conferences. Through its journal Music Therapy and other publications, information is exchanged among the members of the association about new research, clinical trials of methods, and equipment for music therapy (Gilroy and Lee 35). Two 2700 musicians are certified as music therapists and music therapy is carried out according to individual repertoire plans.

One can argue in favor of using music therapy, including vocal exercises, in the treatment of various diseases. In general, people should not underestimate the role of this new direction in the development of modern medical science. Music therapy can treat neurotic disorders, various phobias, stresses, and other psycho-emotional abnormalities. It allows a person to reduce the dose of drugs, prolong the therapeutic effect, and improve the overall quality of life. There is no optimal musical direction or a specific melody for the treatment of a particular disease. Positive influence can be achieved through rhythm and harmony.

Gilroy, Andrea, and Colin Lee, eds. Art and Music: Therapy and Research. Routledge, 2019.

Irons, J. Yoon, et al. “A Systematic Review on the Effects of Group Singing on Persistent Pain in People with Long‐Term Health Conditions.” European Journal of Pain, vol. 24, no. 1, 2020, pp. 71-90.

Landis-Shack, Nora, et al. “Music Therapy for Posttraumatic Stress in Adults: A Theoretical Review.” Psychomusicology: Music, Mind, and Brain, vol. 27, no. 4, 2017, p. 334.

Martin-Saavedra, Juan Sebastian, et al. “Standardizing Music Characteristics for the Management of Pain: A Systematic Review and Meta-Analysis of Clinical Trials.” Complementary Therapies in Medicine, vol. 41, 2018, pp. 81-89.

Sundar, Sumathy. “Role of Music in Therapeutic Communication.” Effective Medical Communication , edited by Subhash Chandra Parija and Balachandra V. Adkoli Springer, 2020, pp. 247-256.

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80 Music Therapy Essay Topic Ideas & Examples

🏆 best music therapy topic ideas & essay examples, 📌 good research topics about music therapy, 🔍 interesting topics to write about music therapy, ❓ music therapy research questions.

• Music Therapy as a Social Work Intervention One of such interventions is music therapy which is aimed at helping people in a sensitive way accurately adjusting the possibilities this therapy may offer to the requirements of a particular client of a group […]
• Music Therapy for Schizophrenic Patients’ Quality of Life Consequently, the purpose of the project will be to review the existing literature and prepare a document with recommendations regarding MT in the discussed population, including psychiatric nurses’ acceptable role in delivering such interventions.
• Art and Music Therapy Coverage by Health Insurance However, I do believe that creative sessions should be available for all patients, and I am going to prove to you that music and art are highly beneficial for human health.
• Music Therapy in Healthcare Therefore, the article suggests that music can be used for relaxation, as well as managing the health issues that may arise due to the lack of relaxation.
• Music Therapy for Children With Learning Disabilities This review includes the evidence supporting music therapy as an effective strategy for promoting auditory, communication, and socio-emotional progression in children with ASD.
• Music Therapy as a Related Service for Students With Disabilities From a neuroscientific perspective, how would music intervention improve classroom behaviors and academic outcomes of students with ADHD as a way to inform policy-makers of the importance of music therapy as a related service?
• Substance Use Disorder: Possibility of Using Music Therapy In their study, Bourdaghs and Silverman address the possibility of using music therapy as the tool for promoting the socialization of people with a substance use disorder.
• Music Therapy: The Impact on Older Adults There is therefore the need to focus more energy to aid more understating on the role of music therapy on older residents.”The recent qualitative review of literature in the area of music and music therapy […]
• Music Therapy: Alternative to Traditional Pain Medicine The sources underline that therapists should pay attention to the subjects of music and their impact on the health of clients.
• The Role of Music Therapy as Alternative Treatment Music therapy is the use of music interventions to achieve individualized goals of healing the body, mind, and spirit. Thereafter, several developments occurred in the field of music therapy, and the ringleaders founded the American […]
• Music Therapy Effectiveness In addition to this, research has shown that stroke patients become more involved in therapy sessions once music is incorporated in the treatment program; this is the motivational aspect of music.
• Sound as an Element of Music Therapy This is one of the reasons why in the Abrams study the participants explained that they preferred the sound of rain, ocean waves and the soft strumming of a guitar as compared to the work […]
• Music Therapy Throughout the Soloist Globally, classical music in its sense has always been known to adjoin the listener to some transcendent understanding of the world order, the feeling of integrity with the Universe and enormous delight rising up from […]
• Music Therapy: Where Words Cease In spite of the fact that, as a rule, one indulges into art to find the shelter from the reality, the author of the book called The Soloist explores quite a different issue of the […]
• Active Music Therapy for Parkinson’s Disease
• Effectiveness of Music Therapy for Survivors of Abuse
• Music Therapy Effectiveness of Treatment of Alzheimer’s Disease
• The Link Between Ancestral Hormones and Music Therapy
• Analysis of the Effectiveness of Art and Music Therapy
• Music Therapy Usefulness for Cancer Patients
• Music Therapy Impact on Students With Emotional and Behavioral Disorders
• How Music Therapy Can Be Used to Reduce Pre-Operative Anxiety
• Healing Chronic Pain With Music Therapy
• Music Therapy Effect on the Wellness and Mood of Adolescents
• Comparing Cognitive Behavioral Therapy and Music Therapy
• Constructing Optimal Experience for the Hospitalized Newborn Through Neuro-Based Music Therapy
• Music Therapy: Considerations for the Clinical Environment
• “Dementia and the Power of Music Therapy” by Steve Matthews Analysis
• Music Therapy for Children With Autism Spectrum Disorder
• Discussing Music Therapy Reducing Stress Health and Social Care
• Does Music Therapy Help Children With Special Needs?
• Music Therapy for Delinquency Involved Juveniles Through Tripartite Collaboration
• Heidelberg Neuro-Music Therapy Enhances Task-Negative Activity in Tinnitus Patients
• Music Therapy for Post Traumatic Stress Disorder
• How Does Music Therapy Promote Positive Mental Health?
• Music Therapy and Its Positive Effects on the Brain
• The Relationships Between Learning and Music Therapy
• Music Therapy for Sexually Abused Children
• Managing Sickle Cell Pain With Music Therapy
• Music Therapy: How Does Music Impact Our Emotions
• Dealing With Depression With the Help of Music Therapy
• Effectiveness of Music Therapy and Drug Therapy for Children With Autism
• Music Therapy and Its Effect on the Levels of Anxiety
• The Link Between Music Therapy and Personality Theory Psychology
• How Music Therapy Improves Depression Among Older Adults
• Music Therapy: The Best Way to Help Children With Mental Illness
• Interventions of Music Therapy for Stress Reduction
• The Real Science Behind the Theory of Music Therapy
• Music Therapy Should Not Be Considered a Therapy
• Neurologic Music Therapy Training for Mobility and Stability Rehabilitation
• Nursing Theory for Music Therapy Quality Improvement Program
• The Help of Music Therapy in Pain Management
• Relationship Between Hypertension and Music Therapy
• Yoga and Music Therapy as Effective Methods of Stress Management
• What Is Music Therapy Used For?
• What Are Some Examples of Music Therapy?
• What Kind of Music Is Used in Music Therapy?
• What Are the Side Effects of Music Therapy?
• What Mental Illnesses Does Music Therapy Help?
• Can Music Therapy Help With Anxiety?
• What Type of Music Therapy Helps Depression?
• Does Music Therapy Actually Work?
• Do Psychiatrists Use Music Therapy?
• Do Doctors Recommend Music Therapy?
• How Long Does Music Therapy Last?
• Why Is Music Therapy Not Used?
• What Is a Typical Music Therapy Session Like?
• What Are the Two Main Benefits of Music Therapy?
• How Can Music Therapy Be Done at Home?
• What Does Music Therapy Do to the Brain?
• Is Music Therapy Good for Stress?
• Can Music Therapy Help With Trauma?
• What Ages Benefit From Music Therapy?
• What Is the First Step of Music Therapy?
• Does Music Therapy Include Talking?
• What Instruments Are Used for Music Therapy?
• What Is the Difference Between Sound Therapy and Music Therapy?
• Can You Do Music Therapy Without a Degree?
• Why Is Music Therapy Better Than Medicine?
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The neuroscience of singing: How choirs help our brains and bodies recover from burnout

For some, the sensation feels like fireworks exploding out of their brain into the night sky.

For others, there’s a kind of buzz — electricity or vibration. Goosebumps cover their whole body.

"A bit like a warm hug." A moment of "collective happiness", "clarity", and feeling totally grounded. Entering some kind of "flow state".

This is what it's like to sing in harmony as part of a community choir.

Humans have come together in song for — at least —  tens of thousands of years. Through ancient songlines and sacred hymns, in times of celebration and in grief.

And if you ask any of those who dedicate a window of their everyday lives to this practice, they'll tell you just how good it feels.

Many say it's a form of therapy, and that without it, they're not sure they would survive.

Scientists have been singing the praises   of choirs for decades. These musical gatherings seem to support social and emotional wellbeing for all sorts of groups — among small or large crowds, those with established connections and those who are just getting to know each other, and across cultures.

Researchers have established how group singing can support and even facilitate recovery in patients with Parkinson's disease , post-natal depression and some types of cancer — and they say they've only just begun to scratch the surface on the cognitive possibilities.

A safe place to recover and reconnect

Emily Fleming went in search of a choir as part of her recovery from chronic illnesses that worsened after an episode of severe burnout.

In her mid-20s, Emily was diagnosed with myalgic encephalomyelitis, also known as chronic fatigue syndrome or ME/CFS. She became so unwell she was unable to leave her house for about a year, feeling isolated, disconnected, and confused about the road to recovery.

"Most health professionals would say, 'this is something you'll have forever, you won't ever be able to run again, you won't be able to go out and do the things you used to do', which is just devastating. And so I guess in the back of my mind, I'd always thought that recovery for me looks like getting back into the community," she says.

When Emily eventually became well enough to venture out into the world again, she set her sights on a community choir run by Brisbane musician Emma Dean.

"I had wanted to join a choir for so long because I loved music at school, it was a big part of my life. And then as an adult, I felt like there was a part of me missing … I thought, I'm just gonna do it. Because I think it's what my soul is longing for."

It's a common refrain at Cheep Trill. Every week, choristers gather in community halls — one on Brisbane’s north side and one on the south — to sing together. Manager Corinne Buzianczuk and musical assistant Tony Dean lead the choir in a physical and vocal warm-up before Emma takes the reins to work on the one of the arrangements she's been teaching the group for their end-of-term performance.

Section by section, sopranos, altos, tenors and basses practise their do-dos and woah-ohs, listening intently and frequently bursting into applause when their fellow singers nail a phrase — or a kind giggle when someone flubs a lyric.

There's a break for tea and biccies before switching to a fresh song for the second half of rehearsals. A hum of friendly chatter fills the hall once more as people stack and pack away the chairs, wash up the mugs and wander back out into the night.

From her first rehearsal, Emily says she felt an instant connection with her fellow singers.

"Choir people are just the best, because it's so inclusive …  I didn't get to connect with people for such a long time and so I do miss having that kind of connection with people of different ages. That for me has been what Cheep Trill has given me — intergenerational friendships," she says.

"To have this community of people that are from different walks of life, and in different stages of life, and to really understand that we're kind of going through the same thing."

This sense of community is more than just a hunch — there's an extensive volume of research that shows how singing as part of a group can alleviate feelings of loneliness and isolation, and increase self-efficacy and self-esteem.

Researchers led by Genevieve Dingle, director of clinical psychology programs at the University of Queensland, have found choirs are particularly powerful for people experiencing chronic ill health or significant social disadvantages .

Rockelle Duffy, who joined Cheep Trill in 2023, says it has been a lifeline — a safe space in a particularly dark period.

She had been struggling with what she now understands is functional neurological disorder and fibromyalgia on top of a major depressive disorder and anxiety. Like Emily, Rockelle became unable to work or leave her home.

"I found that I was really reclusive. I had incredibly terrifying dark thoughts constantly running in my brain, screaming at me … I became fearful of going out. So while that's going on in one part of my mind, this little creative spark kept trying to light up and grab my attention," Rockelle says.

She decided to join Cheep Trill after accompanying a friend and long-term member, David Truong .

"I remember going the first night of that term … I just was turned into this blubbering mess. I was streaming tears, my nose was full of snot, my body was shaking … I felt really safe just to sit there and go through whatever was going on for me,” Rockelle says.

“During the course of that term, one of the few things that would get me out of the house aside from attending to the multitude of medical appointments and so forth was choir."

Through the choir, Rockelle has been able to connect with her creativity, process difficult emotions and explore new opportunities — she's started singing in a rock band and writing her own music.

But she says the biggest change has been regaining her self-worth and learning to show up for herself day after day.

What's happening to our bodies when we sing together?

It perhaps goes without saying that in a room full of self-confessed musical theatre nerds, there's a lot of talk about feelings. But the benefits of group singing go beyond the mushy stuff.

Professor Sarah Wilson, a clinical psychologist credited with pioneering music neuroscience research in Australia, explains it as "an internal therapy tool" that engages several parts of the brain at once.

That "singing network", as Professor Wilson calls it, includes areas that control complex motor activity, auditory processing, language, emotion and memory.

Vocal motor control networks activate and coordinate the right muscles to project our voice and manage our airflow. Auditory and language networks help us to pitch our notes correctly, adjust our volume and sing the right lyrics.

Professor Wilson explains that in choir singing, higher level executive functions are also involved, "making sure we come in at the right time, on the right note, and that hold note in our mind … timing it and coordinating relative to the music and the other singers".

Long-term, engaging in musical activities has been shown to support neuroplasticity — that is, the ability to heal and adapt, creating new pathways over time — in healthy ageing brains.

Some of Professor Wilson's work has focused on using singing, through Melodic Intonation Therapy, to help rehabilitate speech in patients recovering from severe strokes .

"We're watching their brain rewire itself, in real time, and switching back on parts of the language network to support their rehabilitation and brain plasticity," she says.

"So it's a really powerful, innate tool … both for our brain plasticity and cognitive health, but also our mental health."

There are also physiological factors at play — our heartbeats and breathing sync up when we sing together .

Both Emily and Rockelle say they've noticed the regular practice has helped in other ways, too.

“I first thought that it would be purely for my mental health … What I wasn't expecting was how much of a physical difference [choir] has made for me," Emily says.

"With the conditions that I have, standing up for a long period of time is really challenging. With choir, for two hours a week [I'm] standing up and down, and just sort of practising those movements. So that has really improved my standing tolerance."

Rockelle says singing has become part of her "self-deigned therapy program" in managing her FND and chronic pain.

"When my body doesn't want to behave the way we think it should, when the signals aren't working properly, I tune into music. I get out the choir [guide tracks], and I look at the [sheet music] … and I'll sway and I'll dance on the spot. It gets that cognitive conversation happening … to get me moving again," she says.

Rockelle says learning about how to engage and switch between her chest voice and head voice has been helpful for regulating her breathing during bouts of extreme anxiety or panic attacks.

The academic jury is still out on exactly how singing in a group affects our levels of oxytocin — that warm, fuzzy feel-good brain chemical.

Professor Wilson says we know singing directly activates the brain's reward network, and there is evidence to suggest choir practice can reduce cortisol levels — an indicator of stress — and even boost immune function.

In two recent studies that measured hormone response in choir singers — one from the University of Regensburg in 2017 , and a smaller pilot study from the University of Toronto in Canada in 2021 — researchers found that positive effects of singing were more pronounced after group singing compared with solo singing.

In addition, Professor Wilson explains that choir singing engages the mirror neuron system, which plays a powerful part in social bonding.

"When we have a verbal conversation, we can't do it together, we have to take turns — otherwise, it's impossible, we're just talking over each other. Whereas singing is this one chance where we get to use our voices in unison," she says.

"Our brain activity is mirroring each other. That activates our own circuitry, and it helps us put ourselves in their shoes. And that facilitates that bonding that we experience when we're singing in a choir."

Cultivating a community around creativity

Cheep Trill is just one of the hundreds — possibly thousands — of community choirs in Australia that focus on bringing amateur singers together in a non-auditioned and non-competitive format.

The purpose of these groups is as much about connection as it is about crafting perfect harmonies.

That people feel supported, welcomed, and held in this space is no coincidence. It's a culture that every single one of the dozen or so 'Trillers' who spoke to the ABC puts down — at least in part — to their musical director, Emma Dean.

In 2014, Emma had been slogging it out to make a name in New York, working as a kids' entertainer and performing late-night opening sets for off-Broadway drag and cabaret artists, making very little money and careening towards total burnout.

With her marriage falling apart and a deep depression setting in, Emma says she had reached rock bottom when a friend suggested that she should start a choir. 

And so she returned to Brisbane and started singing with a small group of musical mates on a friend's verandah. Something clicked into place — watching other people shine gave Emma a new purpose.

“This choir, this strange little group of people who gathered on this verandah, saved me. Really genuinely saved my life," she says.

"They saved my love of music, because I kind of felt like music had betrayed me at some point. I knew that that wasn't completely the truth, but I knew I had to reignite the spark I felt for music."

In the 10 years since, the choir has evolved into a buzzing community of singers from all walks of life, welcoming fresh faces and expanding their repertoire each term.

It's seen new friendships blossom, family ties strengthen, and set the backdrop for at least one marriage proposal.

There are practical and intentional decisions that have allowed Cheep Trill to grow — finding a space that wheelchair users and singers with assistance dogs can navigate seamlessly, making sure there are vegan and gluten-free snacks available during the break, crafting arrangements that share melodies equally between parts, and working on creative solutions for singers with particular sensory needs.

Many community choirs have found ways to offer concessions on term fees or open up sponsored spots for choristers to pay it forward for singers who don’t have the financial means to join.

Emma says above all, she tries to conduct and teach in a way that "creates a space that is safe for people to explore their voice, to explore their creativity", without fear of judgement.

"We're not doing brain surgery. We're just singing a song. I actually quite like mistakes. They're fabulous," she says.

"It's also about facilitating a meeting place where people who have never come across other sorts of people are kind of forced to listen to each other."

Whatever the reasons behind it, there's just something magical that happens when people sing together.

What does it feel like to sing together in a choir?

On an almost-chilly Saturday morning earlier this month, the hundred-or-so Cheep Trillers gathered to share that magic with crowds wandering through the West End markets.

Diligently dressed in their brightest colours, the northside and southside chapters came together to perform four pieces for a small crowd under the shade of a mighty fig tree on the banks of the Brisbane River.

After 10 weeks spent working towards their creative debut, it was a big moment.

Rockelle noticed the feelings in her body, like "a ray of sunshine" penetrating from head to toe.

"My ears are soothed, my tummy settles and my heart swells with love," she says. "I feel light, I feel bright. I feel like I'm worthy. And that there's something here for me — let's keep going."

For Emily, it was a feeling of pure clarity. "Like that is the only thing that I'm thinking of in that moment. I'm not even thinking of the fact that I'm singing and remembering the words, I'm just thinking about how it sounds together, how we're blending our voices together."

There's a synchrony, too, in the way these singers talk about working creatively towards a common goal.

"That's the power of a choir. It's supportive, like you're an instrument in an orchestra, and everyone's voice is part of that," says Piet, who adds Cheep Trill has become like "a second family".

Liz Bremer joined this term as part of a challenge to herself after her father's death to do something each year that scares her.

"When it clicks, everybody starts to sound like one voice and you sort of don't even hear yourself. And that's when as soon as the song's finished, you just feel elated. It's really energising," she says.

"It feels electric," adds her new friend Lucy, another alto-slash-tenor who's new to Cheep Trill. "There's something beautiful about doing something where you can mess up and maybe embarrass yourself in public, but then you don't ... even if you sing off-key or you accidentally sing the wrong lyric, it is such a safe place."

Lucy passes the mic back to Liz: "It reminds you that you're not alone."

Professor Wilson calls it kama muta, a Sanskrit phrase that roughly translates to "being moved by love".

"It's that real sense of being moved by music … and being part of maybe something that's bigger, a communal sense, a higher connection," she says.

In fact, this suspected link between music and feelings of nostalgia or kama muta is currently under investigation by one of Professor Wilson's PhD students at the University of Melbourne. That research is still underway, but Professor Wilson says the hypothesis is that this overwhelming communal feeling is an important evolutionary function of music.

On a basic level, Emma says there is "this great joy, and a great relief that comes from being a part of something bigger than yourself".

"Singing solo is a very different experience to singing in a group … you feel lifted, you feel supported by so many other people around you," she says.

"You are creating something so special, that is not only making the people in the choir happy, but also the people listening to it. You're giving this incredible gift to people witnessing this magic."

Again, the science supports that sentiment. Another study from Professor Dingle and her fellow UQ researchers in 2023  found that watching a choir performance "can foster admiration, respect and positive regard toward choristers" among members of the audience.

The crowd watching Cheep Trill seemed to agree. Uplifting, engaging, playful, a little bit whimsical — a good vibe all round, was how some enjoying the performance put it afterwards.

They did notice, however, one singer standing towards the back who became a bit teary during a moving rendition of REM's Nightswimming. Overcome with emotion, perhaps. The choir sang on while she gathered herself — it's a safe space, after all.

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Music and Health: What You Need To Know

.header_greentext{color:green!important;font-size:24px!important;font-weight:500!important;}.header_bluetext{color:blue!important;font-size:18px!important;font-weight:500!important;}.header_redtext{color:red!important;font-size:28px!important;font-weight:500!important;}.header_darkred{color:#803d2f!important;font-size:28px!important;font-weight:500!important;}.header_purpletext{color:purple!important;font-size:31px!important;font-weight:500!important;}.header_yellowtext{color:yellow!important;font-size:20px!important;font-weight:500!important;}.header_blacktext{color:black!important;font-size:22px!important;font-weight:500!important;}.header_whitetext{color:white!important;font-size:22px!important;font-weight:500!important;}.header_darkred{color:#803d2f!important;}.Green_Header{color:green!important;font-size:24px!important;font-weight:500!important;}.Blue_Header{color:blue!important;font-size:18px!important;font-weight:500!important;}.Red_Header{color:red!important;font-size:28px!important;font-weight:500!important;}.Purple_Header{color:purple!important;font-size:31px!important;font-weight:500!important;}.Yellow_Header{color:yellow!important;font-size:20px!important;font-weight:500!important;}.Black_Header{color:black!important;font-size:22px!important;font-weight:500!important;}.White_Header{color:white!important;font-size:22px!important;font-weight:500!important;} Can music be good for you?

Yes, according to a growing body of research. Listening to or making music affects the brain in ways that may help promote health and manage disease symptoms.

Performing or listening to music activates a variety of structures in the brain that are involved in thinking, sensation, movement, and emotion. These brain effects may have physical and psychological benefits. For example, music causes the release of brain chemicals (neurotransmitters and hormones) that can evoke emotional reactions, memories, and feelings and promote social bonds. Music can even affect the structure of the brain. Certain structures in the brain have been found to be larger in musicians than nonmusicians, with particularly noticeable changes in people who started their musical training at an early age.

Increasing evidence suggests that music-based interventions may be helpful for health conditions that occur during childhood, adulthood, or aging. However, because much of the research on music-based interventions is preliminary, few definite conclusions about their effects have been reached. Many reports on the potential benefits of music-based interventions come from observations of individuals or small groups of people. Evidence of this type is valuable for suggesting new ideas, but carefully designed, scientifically rigorous studies of larger numbers of people are needed to provide stronger evidence on whether music-based interventions are effective for specific purposes.

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Music therapy is a health profession in which music is used within a therapeutic relationship to address physical, emotional, cognitive, and social needs. The term “music therapy” is not a description of a specific type of intervention. Instead, it indicates the education, training, and credentials of the therapist who is delivering the intervention.

Music therapy may involve a variety of different activities, including music improvisation, music listening, song writing, music performance, and learning through music. Music therapists may work in many different settings, such as hospitals, outpatient clinics, nursing homes, senior centers, rehabilitation facilities, or schools.

Some of the music-based interventions described in this fact sheet fit the definition of music therapy, but others do not. For example, music-based interventions that involve listening to recorded music are often delivered by health professionals other than music therapists (such as nurses), and therefore do not fit the definition of music therapy.

You can learn more about music therapy on the website of the American Music Therapy Association .

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In general, research studies of music-based interventions do not show any negative effects. However, listening to music at too high a volume can contribute to noise-induced hearing loss. You can find out about this type of hearing loss on the National Institute on Deafness and Other Communication Disorders website .

In addition, because music can be associated with strong memories or emotional reactions, some people may be distressed by exposure to specific pieces or types of music. Extensive playing of musical instruments can lead to pain and injury. Music-based interventions that involve exercise or other types of movement could also lead to injury if appropriate safety precautions are not taken.

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The preliminary research that has been done so far suggests that music-based interventions may be helpful for anxiety, depressive symptoms, and pain associated with a variety of health conditions, as well as for some other symptoms associated with dementia, multiple sclerosis, Parkinson’s disease, and other conditions. 

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As mentioned in other sections of this fact sheet, there’s evidence that music-based interventions may help to relieve pain associated with specific health conditions. The two review articles listed below describe evidence indicating that music may be helpful for pain more generally. Newer research continues to find evidence that music may be helpful for pain from a variety of causes, but not every study has shown a beneficial effect. 

• A 2016 review looked at 97 studies (9,184 participants) of music-based interventions for acute or chronic pain associated with a variety of health problems and medical procedures. The overall evidence suggested that music-based interventions may have beneficial effects on both pain intensity and emotional distress from pain and may lead to decreased use of pain-relieving medicines.
• A 2017 review of 14 randomized trials (1,178 participants) of music-based interventions for various types of chronic pain found that the interventions reduced self-reported chronic pain and associated depressive symptoms, with a greater effect when the music was chosen by the participant rather than the researcher. The study participants had a variety of conditions that can cause chronic pain, including cancer, fibromyalgia, multiple sclerosis, or osteoarthritis, and most of the interventions involved listening to recorded music.
• Many but not all newer studies of music-based interventions for pain have had promising results. For example, in recent studies, music-based interventions were helpful for pain associated with childbirth, cancer chemotherapy, a procedure in which shock waves are used to break up kidney stones, retrieval of eggs for in vitro fertilization, treatment of nose fractures, and sickle cell disease. However, music didn’t seem to be helpful for reducing moderate pain further after use of a lidocaine spray for loop electrosurgical excision (a gynecological procedure), and the results of studies on pain during cystoscopy (a procedure in which a tube is inserted into the bladder) and pain during colonoscopy were inconsistent.

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Music-based interventions have been evaluated for their effects on anxiety in a variety of disease conditions and health care settings. Some examples are given in this section, and others are discussed in the sections on specific health conditions. Most studies have had promising results, except for studies on anxiety associated with dental care.

• A 2013 review of 26 studies (2,051 participants) showed that listening to recorded music significantly reduced anxiety in people who were waiting to have surgery. However, there was potential for bias in most of the studies because the investigators who performed the studies knew which participants had listened to music.
• A 2016 review of 17 studies (1,381 participants) that evaluated the effect of music-based interventions on anxiety in adults with cancer suggested that the interventions may have a large anxiety-reducing effect. However, there was a high risk of bias in the studies. 
• A 2015 review of 5 studies (290 participants) in people who were having dialysis treatments suggested that listening to music reduced anxiety. However, these studies have limitations because of their small size and high risk of bias.
• A 2018 review concluded that it’s unclear whether listening to music is helpful for dental anxiety. Some studies have suggested that listening to music as a distraction may not be adequate to reduce anxiety in children or highly anxious adults who are having dental care. More active types of music-based interventions (for example, a music-assisted relaxation technique that’s taught to the patient in advance) might be helpful in dental settings but have not been evaluated in formal studies.  

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It’s uncertain whether music-based interventions are helpful for people with ASD.

• A 2021 review of 22 studies (850 participants) on music therapy for children with ASD was unable to reach any definite conclusions on whether adding music therapy to their care is beneficial, although some studies had promising results. For example, some studies of educational music therapy (involving techniques such as musical games) showed possible benefits on the children’s speech, and some studies of improvisational music therapy (in which children produce music) showed possible benefits on social functioning.
• One particularly notable study of music therapy for children with ASD (which was included in the review described above) was a multinational trial involving 364 children from 9 countries. It is the largest study completed so far, and its design was especially rigorous. In this study, the severity of symptoms related to difficulties in social communication did not differ between children who received music therapy along with standard care and those who received standard care alone.

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Preliminary evidence suggests that music-based interventions may be helpful for several types of distress in people with cancer.

• A 2021 review of randomized controlled trials (studies in which participants were randomly assigned to a music-based intervention group or a control group), which included 81 trials and 5,576 participants, concluded that in adults with cancer, music interventions may have a large anxiety-reducing effect, a moderately strong beneficial effect on depression, a moderate pain-reducing effect, and a large effect on the quality of life. Most of the trials had a high risk of bias, so their results need to be interpreted with caution. Only seven of the studies included in this review involved children. Two of these studies suggested a beneficial effect on anxiety; no other conclusions could be reached from the small amount of evidence available.
• A 2021 review of 11 studies (491 participants) on music interventions for children and adolescents with cancer, which included some studies that were less rigorous than a randomized controlled trial, found evidence suggesting that music-based interventions may decrease anxiety, perceived pain, and depression symptoms and improve state of mind, self-esteem, and quality of life.

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A 2021 systematic review of 12 studies (812 participants) showed that music-based interventions were helpful for shortness of breath, anxiety, and sleep quality in adults with COPD but were not helpful for depression. Because the studies were brief (several days to 12 months) and because researchers measured effects in different ways in different studies, there is some uncertainty about the conclusions.

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Much research is being done on the potential benefits of music-based interventions for people with cognitive impairment or various types of dementia, such as Alzheimer’s disease. Limited evidence suggests that music-based interventions may improve emotional well-being, behavioral challenges, and quality of life in people with these conditions. Whether the interventions have benefits for cognitive functioning is unclear; effects might depend on the population studied or the type of intervention used.

• A 2018 review evaluated 22 studies (1,097 participants) of music-based interventions for people with dementia who were living in institutions. Some of the interventions were receptive (listening to music), some were active (singing, playing instruments, moving to music, etc.), and some were a combination of the two. The evidence from these studies indicated that music-based interventions probably reduce depressive symptoms and improve overall behavioral challenges. They may also improve emotional well-being and quality of life and reduce anxiety. However, the interventions may have little or no effect on agitation, aggression, or cognitive function.
• A 2021 review looked at 21 studies (1,472 participants) of people with either mild cognitive impairment or mild or moderate dementia; some of the people studied were living in institutions, but others were living in the community. All the music interventions were active; studies that only involved listening to music were not included. Nine of the studies (495 participants) were included in a quantitative analysis of effects on cognitive functioning; this analysis indicated that the music-based interventions had a small beneficial effect. There was also some evidence for beneficial effects on mood and quality of life.

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A 2017 review looked at 9 studies (421 participants) of music-based interventions in adults or adolescents with depression. There was moderate-quality evidence that adding music-based interventions to usual treatment improved depression symptoms when compared with usual treatment alone. Music-based interventions also helped decrease anxiety levels and improve functioning of people with depression (for example, their ability to maintain involvement in work, activities, and relationships).

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A 2020 systematic review of 7 studies (334 participants) found evidence that music-based interventions were beneficial for pain, depression, and quality of life in people with fibromyalgia. However, the amount of research was limited, and the quality of the research was low.

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A 2021 review of music-based interventions for people with multiple sclerosis (10 trials, 429 participants) found consistent evidence that the interventions were beneficial for coordination, balance, some aspects of gait and walking, emotional status, and pain, but no effect was observed for mental fatigability or memory.

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Researchers are evaluating the potential benefits of several types of music-based interventions for Parkinson’s disease symptoms. 

• Rhythmic auditory stimulation.  Rhythmic auditory stimulation uses pulsed sounds (such as those produced by a metronome) to help people synchronize their movements to the rhythm of the sounds. This technique is used to help people with Parkinson’s disease improve their ability to walk. A 2021 analysis of 5 studies (209 total participants) showed significant improvements in gait speed and stride length in people with Parkinson’s disease who participated in rhythmic auditory stimulation. However, the quality of evidence was low, and the number of studies and participants was small.
• Music-based movement therapy.  Music-based movement therapy combines physical activities such as dance or rhythmic exercises with music. Therapies that involve physical activity have been shown to be helpful for a variety of Parkinson’s disease symptoms. Adding music to the therapy might have additional benefits by providing auditory cues for movement and making the activities more enjoyable. A 2021 analysis of 17 studies (598 participants) of music-based movement therapy showed evidence of improvements in motor function, balance, freezing of gait, walking speed, and mental health but not gait cadence, stride length, or quality of life.
• Singing. The potential benefits of singing for people with Parkinson’s disease have been studied primarily in terms of effects on speech. In a 2016 review of 7 studies (102 participants), 5 studies found some evidence of a beneficial effect on speech.

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Music-based interventions are widely used in neonatal intensive care units. However, evidence for physiological benefits for newborn infants is limited. 

• In a 2020 review of 16 studies (826 infants), 12 of the studies found some evidence of benefits on physiological outcomes (such as heart rate or oxygen saturation), but several of the studies included only small numbers of infants, and the intervention methods used varied from one study to another. The reviewers concluded that the current data are insufficient to confirm physiological benefits. No harmful effects of music-based interventions were seen in the studies included in this review.

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Music-based interventions have been evaluated as adjunct treatments (additions to usual treatment) for people with schizophrenia. A 2020 review of 18 studies (1,212 participants) indicated that adjunct music-based interventions may improve a group of schizophrenia symptoms known as “negative symptoms,” such as reduced emotion and self-neglect, as well as depression symptoms and quality of life. However, music-based interventions did not reduce “positive symptoms,” such as hallucinations and delusions. The quality of the evidence was low.

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Listening to music may improve sleep quality in people with insomnia.

• A 2022 review looked at 13 studies (1,007 participants) that examined the effect of listening to recorded music in people with insomnia. The studies suggested music had no effect on insomnia severity compared to no treatment or treatment as usual. Moderate-certainty evidence did suggest, however, that listening to music has a beneficial effect on subjective sleep quality. The studies also provided low-certainty evidence that listening to music might help improve the speed of falling asleep, the length of time spent sleeping, and the amount of time a person is asleep compared to the total time spent in bed.
• It’s common for older people to have trouble sleeping. A 2021 review looked at 16 studies of music-based interventions for sleep in older adults (812 participants); 11 studies evaluated music listening, and the other 5 evaluated more complex interventions. The results were mixed, with some studies suggesting that the music interventions were helpful, while others did not.

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Music-based interventions, particularly music therapy, may be helpful for improving physical and psychological markers associated with stress, according to two related reviews.

• In a 2020 review with 104 studies (9,617 participants), investigators looked at the effects of a variety of music-based interventions on measures associated with stress, including both physical measures (heart rate, blood pressure, and levels of stress-related hormones) and psychological measures (anxiety, nervousness, restlessness, and feelings of worry). The music-based interventions had a small-to-medium sized beneficial effect on the physical measures and a medium-to-large beneficial effect on the psychological measures. 
• A second review looked at 47 studies (2,747 participants) of music therapy (excluding other music-based interventions) and found an overall medium-to-large beneficial effect on stress-related outcomes. The effects were greater than those seen in the larger review. The investigators who performed the review suggested that the opportunity for music therapists to tailor interventions to the needs of individual patients might account for the difference.

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Music-based interventions may be helpful in the rehabilitation of people who have had a stroke. A 2019 review of 27 studies (730 participants) found positive effects on physical status (upper-limb activity, various aspects of walking, balance), cognition (paying attention, communication), and mood. In particular, rhythmic auditory stimulation (which involves the use of a metronome combined with physical activities) had beneficial effects on gait and balance, and receptive music therapy (which involves listening to music while performing another task) was helpful for mood and some aspects of cognitive function.

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Tinnitus is the symptom that people often describe as “ringing in the ears,” although it can also sound like roaring, clicking, hissing, or buzzing. It can be caused by noise-induced hearing loss, blockage of the ear canal by earwax, ear or sinus infections, or other health conditions, or by starting or stopping various medications. Sometimes, tinnitus has no obvious cause.

• Sound therapies. Various types of sounds, including music, have been used to try to mask tinnitus. However, according to a 2019 review of studies conducted up to that time, the effects of these sound therapies are modest; few people achieve complete remission of tinnitus from sound therapies.
• Notched music therapy. A specific type of music therapy called “notched” music therapy has been suggested as a possible way to reduce the severity of tinnitus. Notched music therapy involves listening to music that has been modified to remove sounds close in frequency to the frequency of the tinnitus sound perceived by the patient. Two recent studies that compared notched music with conventional music did not find notched music to be more helpful in reducing the symptoms or impact of tinnitus. However, some earlier studies suggested that the loudness of tinnitus sounds could be reduced with notched music therapy.

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NIH and the John F. Kennedy Center for the Performing Arts, in association with the National Endowment for the Arts, are sponsoring an initiative called Sound Health to increase understanding of music’s effect on the brain and the potential clinical applications. The first Sound Health research projects began in 2019. Some projects are investigating music’s mechanism of action in the brain and how music may be applied to treat symptoms of disorders such as Parkinson’s disease, stroke, and chronic pain. Others are looking at the effects of music on children’s developing brains.

Topics of NCCIH-supported studies within the Sound Health initiative include:

• The effects of music-based interventions on neurodevelopment and pain response in preterm infants
• Using self-generated rhythmic cues to enhance gait in people with Parkinson’s disease
• The impact of singing interventions on markers of cardiovascular health in older people with cardiovascular disease

In collaboration with the Foundation for the NIH and the Renée Fleming Foundation, NIH has developed a toolkit for rigorous, reproducible, well-powered music-based interventions for brain disorders of aging, such as Alzheimer’s disease, Parkinson’s disease, and stroke. Three workshops were held in 2021 to gather input from experts in a variety of relevant fields, and a request for information was issued to get stakeholder feedback. The toolkit , which was released in 2023, will be pilot tested in demonstration projects. NCCIH is playing a lead role in this effort.

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Nccih clearinghouse.

The NCCIH Clearinghouse provides information on NCCIH and complementary and integrative health approaches, including publications and searches of Federal databases of scientific and medical literature. The Clearinghouse does not provide medical advice, treatment recommendations, or referrals to practitioners.

Toll-free in the U.S.: 1-888-644-6226

Telecommunications relay service (TRS): 7-1-1

Website: https://www.nccih.nih.gov

Email: [email protected] (link sends email)

Know the Science

NCCIH and the National Institutes of Health (NIH) provide tools to help you understand the basics and terminology of scientific research so you can make well-informed decisions about your health. Know the Science features a variety of materials, including interactive modules, quizzes, and videos, as well as links to informative content from Federal resources designed to help consumers make sense of health information.

Explaining How Research Works (NIH)

Know the Science: How To Make Sense of a Scientific Journal Article

Understanding Clinical Studies (NIH)

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• Aalbers   S, Fusar-Poli L, Freeman RE, et al.  Music therapy for depression . Cochrane Database of Systematic Reviews. 2017;(11):CD004517. Accessed at cochranelibrary.com on October 29, 2021.
• Bieleninik Ł, Geretsegger M, Mössler K, et al.  Effects of improvisational music therapy vs enhanced standard care on symptom severity among children with autism spectrum disorder. The TIME—a randomized clinical trial . JAMA. 2017;318(6):525-535.
• Bradt J, Dileo C, Magill L, et al. Music interventions for improving psychological and physical outcomes in cancer patients . Cochrane Database of Systematic Reviews. 2016;(8):CD006911. Accessed at cochranelibrary.com on October 29, 2021.
• Bradt J, Dileo C, Shim M. Music interventions for preoperative anxiety . Cochrane Database of Systematic Reviews. 2013;(6):CD006908. Accessed at cochranelibrary.com  on October 29, 2021.
• Burrai F, Apuzzo L, Zanotti R. Effectiveness of rhythmic auditory stimulation on gait in Parkinson disease: a systematic review and meta-analysis . Holistic Nursing Practice. June 11, 2021. [Epub ahead of print].
• Cheever T, Taylor A, Finkelstein R, et al. NIH/Kennedy Center workshop on music and the brain: finding harmony . Neuron. 2018;97(6):1214-1218.
• Collins FS, Fleming R. Sound health: an NIH-Kennedy Center initiative to explore music and the mind . JAMA. 2017;317(24):2470-2471.
• de Witte   M, da Silva Pinho A, Stams G-J, et al. Music therapy for stress reduction: a systematic review and meta-analysis . Health Psychology Review. 2022;16(1):134-159.
• de Witte   M, Spruit A, van Hooren S, et al. Effects of music interventions on stress-related outcomes: a systematic review and two meta-analyses . Health Psychology Review. 2020;14(2):294-324.
• Dorris   JL, Neely S, Terhorst L, et al. Effects of music participation for mild cognitive impairment and dementia: a systematic review and meta-analysis . Journal of the American Geriatrics Society.  2021;69(9):2659-2667.
• Foroushani SM, Herman CA, Wiseman CA, et al. Evaluating physiologic outcomes of music interventions in the neonatal intensive care unit: a systematic review . Journal of Perinatology. 2020;40(12):1770-1779.
• Garza-Villareal   EA, Pando V, Vuust P, et al. Music-induced analgesia in chronic pain conditions: a systematic review and meta-analysis . Pain Physician. 2017;20(7):597-610.
• Jespersen KV, Pando-Naude V, Koenig J, et al. Listening to music for insomnia in adults . Cochrane Database of Systematic Reviews. 2022;(8):CD010459. Accessed at cochranelibrary.com on September 8, 2022.
• Lee   JH. The effects of music on pain: a meta-analysis . Journal of Music Therapy. 2016;53(4):430-477.
• van der Steen   JT, Smaling HJ, van der Wouden JC, et al. Music-based therapeutic interventions for people with dementia . Cochrane Database of Systematic Reviews. 2018;(7):CD003447. Accessed at cochranelibrary.com on October 29, 2021.

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Acknowledgments

NCCIH thanks Wen Chen, Ph.D., Emmeline Edwards, Ph.D., and David Shurtleff, Ph.D., NCCIH, for their review of this fact sheet. 

This publication is not copyrighted and is in the public domain. Duplication is encouraged.

NCCIH has provided this material for your information. It is not intended to substitute for the medical expertise and advice of your health care provider(s). We encourage you to discuss any decisions about treatment or care with your health care provider. The mention of any product, service, or therapy is not an endorsement by NCCIH.

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