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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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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.

Aigen KS. The Study of Music Therapy: Current Issues and Concepts . Routledge & CRC Press. New York; 2013. doi:10.4324/9781315882703

Jasemi M, Aazami S, Zabihi RE. The effects of music therapy on anxiety and depression of cancer patients . Indian J Palliat Care . 2016;22(4):455-458. doi:10.4103/0973-1075.191823

Chung J, Woods-Giscombe C. Influence of dosage and type of music therapy in symptom management and rehabilitation for individuals with schizophrenia . Issues Ment Health Nurs . 2016;37(9):631-641. doi:10.1080/01612840.2016.1181125

MacDonald R, Kreutz G, Mitchell L. Music, Health, and Wellbeing . Oxford; 2012. doi:10.1093/acprof:oso/9780199586974.001.0001

Monti E, Austin D. The dialogical self in vocal psychotherapy . Nord J Music Ther . 2018;27(2):158-169. doi:10.1080/08098131.2017.1329227

American Music Therapy Association (AMTA). Music therapy with specific populations: Fact sheets, resources & bibliographies .

Wang CF, Sun YL, Zang HX. Music therapy improves sleep quality in acute and chronic sleep disorders: A meta-analysis of 10 randomized studies . Int J Nurs Stud . 2014;51(1):51-62. doi:10.1016/j.ijnurstu.2013.03.008

Bidabadi SS, Mehryar A. Music therapy as an adjunct to standard treatment for obsessive compulsive disorder and co-morbid anxiety and depression: A randomized clinical trial . J Affect Disord . 2015;184:13-7. doi:10.1016/j.jad.2015.04.011

Kamioka H, Tsutani K, Yamada M, et al. Effectiveness of music therapy: A summary of systematic reviews based on randomized controlled trials of music interventions . Patient Prefer Adherence . 2014;8:727-754. doi:10.2147/PPA.S61340

Raglio A, Attardo L, Gontero G, Rollino S, Groppo E, Granieri E. Effects of music and music therapy on mood in neurological patients . World J Psychiatry . 2015;5(1):68-78. doi:10.5498/wjp.v5.i1.68

Altenmüller E, Schlaug G. Apollo’s gift: New aspects of neurologic music therapy . Prog Brain Res . 2015;217:237-252. doi:10.1016/bs.pbr.2014.11.029

Werner J, Wosch T, Gold C. Effectiveness of group music therapy versus recreational group singing for depressive symptoms of elderly nursing home residents: Pragmatic trial . Aging Ment Health . 2017;21(2):147-155. doi:10.1080/13607863.2015.1093599

Dunbar RIM, Kaskatis K, MacDonald I, Barra V. Performance of music elevates pain threshold and positive affect: Implications for the evolutionary function of music . Evol Psychol . 2012;10(4):147470491201000420. doi:10.1177/147470491201000403

Pavlicevic M, O'neil N, Powell H, Jones O, Sampathianaki E. Making music, making friends: Long-term music therapy with young adults with severe learning disabilities . J Intellect Disabil . 2014;18(1):5-19. doi:10.1177/1744629513511354

Chang YS, Chu H, Yang CY, et al. The efficacy of music therapy for people with dementia: A meta-analysis of randomised controlled trials . J Clin Nurs . 2015;24(23-24):3425-40. doi:10.1111/jocn.12976

Aalbers S, Fusar-Poli L, Freeman RE, et al. Music therapy for depression . Cochrane Database Syst Rev . 2017;11:CD004517. doi:10.1002/14651858.CD004517.pub3

Trimmer C, Tyo R, Naeem F. Cognitive behavioural therapy-based music (CBT-music) group for symptoms of anxiety and depression . Can J Commun Ment Health . 2016;35(2):83-87. doi:10.7870/cjcmh-2016-029

Jespersen KV, Koenig J, Jennum P, Vuust P. Music for insomnia in adults . Cochrane Database Syst Rev . 2015;(8):CD010459. doi:10.1002/14651858.CD010459.pub2

Redding J, Plaugher S, Cole J, et al. "Where's the Music?" Using music therapy for pain management . Fed Pract . 2016;33(12):46-49.

Novotney A. Music as medicine . Monitor on Psychology . 2013;44(10):46.

McCaffrey T, Cheung PS, Barry M, Punch P, Dore L. The role and outcomes of music listening for women in childbirth: An integrative review . Midwifery . 2020;83:102627. doi:10.1016/j.midw.2020.102627

Liu Y, Petrini MA. Effects of music therapy on pain, anxiety, and vital signs in patients after thoracic surgery . Complement Ther Med . 2015;23(5):714-8.doi:10.1016/j.ctim.2015.08.002

Rossetti A, Chadha M, Torres BN, et al. The impact of music therapy on anxiety in cancer patients undergoing simulation for radiation therapy . Int J Radiat Oncol Biol Phys . 2017;99(1):103-110. doi:10.1016/j.ijrobp.2017.05.003

American Music Therapy Association (AMTA). Guidance for music listening programs .

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Stanford University School of Medicine blog

Recognition of the power of music in medicine is growing

As a cellist, I have experienced firsthand the restorative powers of music. From middle school through medical school, and as a surgeon and a leader of academic medical centers, playing the cello has always brought me joy and comfort. Its benefits have been particularly important to me during the pandemic, as music has served as a source of rejuvenation and resilience.

Beyond its well-known impacts on emotion and spirit, music also has a profound ability to support physical healing. Music therapy has proven effective in helping patients recover from stroke and brain injury and in managing Alzheimer's and dementia. A 2008  study  published in  Brain: A Journal of Neurology  found that music helped people recovering from a stroke with verbal memory and maintaining focus. It also lessened depression and confusion.

Music is found in every culture, and our ability to create and interpret it is built into our anatomy. The human ear is tuned to the human voice, but its range is much greater. The frequency mothers use to communicate with their babies and the exaggerated tones and rhythms of baby talk are reflected in musical compositions.

For decades, before advances in brain imaging, the medical community saw music therapy's value purely in a support role, to foster relationships, help patients express themselves, promote emotional expression, or improve group sessions. Now, with our growing appreciation of the close link of our mental and physical health, these "softer" benefits are gaining recognition for their true importance.

Therapeutic benefits of music, dance and art

The complex and compelling concoction of melody, harmony, and rhythm activates many parts of the brain, areas that also handle language, memory, perception, cognition, and motor control functions. We use music and dance to treat patients with Parkinson's disease. The activity provides a trio of benefits: physical activity, social interaction, and mental stimulation. The profound impact of dance is the driving force behind the Stanford Neuroscience Health Center hosting a  dance class led by a professional dancer  specially trained in teaching dance for Parkinson's Disease.

Music therapists working at Stanford Children's Health see daily how their work helps patients -- and their families -- cope with anxiety and stress and manage pain. Yet it may be how the music provides comfort, on good days and bad, and even a measure of hope, that is just as important to healing.

This understanding served as a primary influence of Stanford Hospital 's design. The one-year-old facility -- filled with natural light and original works of art -- recognizes the need to heal the body, mind, and spirit. Multiple studies have shown that art can have positive impacts on blood pressure, anxiety, length of hospital stay, and other outcomes.

As a physician-scientist and a surgeon, my tendency and training send me to hard data, tests, and imaging. But I've learned over my career the importance of empathy and truly listening to understand what patients are feeling and, ultimately, the best course of action for their care.

Arts and humanities in medical education

Science teaches us the biological workings of the human body and the causes of disease, but the humanities help us make sense of illness and suffering, life and death. The arts enable us to more confidently navigate these waters and approach each patient with empathy and compassion. We must always remember that a disease is not the same as the experience of illness, and a patient is more than an ill person.

In the same vein, a doctor is much more than an expert in human anatomy. We have a number of innovative programs integrating the arts and humanities in medical education.  Medicine and the Muse , a program within the Stanford Center for Biomedical Ethics, benefits our entire Stanford Medicine community of clinicians, researchers, staff, and students by helping to restore perspective and bolster resilience in the face of intense stress.

I have particularly appreciated -- and enjoyed -- another program. Our pandemic-inspired virtual  Stuck@Home  concert series has allowed us to connect with our colleagues, share in their talents, and express ourselves in ways that would undoubtedly be more difficult during a teleconference. It has helped sustain our community. At a recent edition of this monthly concert series, I played the spiritual "Swing Low, Sweet Chariot." For me, the piece resonates so powerfully of hope, and it was my pleasure to share it with my colleagues.

Now I have a confession to make. I didn't always adore the cello. When I was 11, I wanted to play the trumpet. My parents thought otherwise. They suggested a string instrument. The school district had a cello to rent, and I've been playing ever since.

My parents were right. The cello was the better choice for me. At the time, I didn't realize how momentous that day was nor that I would be playing the cello 50 years later. In fostering in me a deep love and appreciation for music, the cello has been instrumental in creating the leader I am today.

Lloyd Minor , MD, is the Carl and Elizabeth Naumann dean of the Stanford School of Medicine and a professor of otolaryngology-head and neck surgery. This piece originally appeared on his  LinkedIn page . 

Image by  agsandrew

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What are the Benefits of Music Therapy?

After World War II, a new profession entered the arena – music therapy. With far-reaching benefits and in a variety of settings, the types and methods of music therapy have had a profound impact.

Used in conjunction with traditional therapies, positive psychology, and even as a stand-alone intervention, music therapy offers a variety of benefits. It is these benefits we will evaluate here.

Before you read on, we thought you might like to download our three Positive Psychology Exercises for free . These science-based exercises will explore fundamental aspects of positive psychology including strengths, values and self-compassion and will give you the tools to enhance the wellbeing of your clients, students or employees.

This Article Contains:

6 proven benefits of music therapy.

• What are the goals and objectives of music therapy?

What Effects Can Music Therapy Have on a Client?

What can music therapy be used for, 9 interesting facts and statistics, a look at the nordoff-robbins approach, relaxation and music therapy, 4 music therapy ideas and interventions, 12 recommended songs commonly used, 10 music therapy activities and exercises for adults, 5 group ideas and activities, technologies to support music therapy interventions, using music therapy in schools, music therapy for children, 5 ideas for kids, a take-home message.

Jillian Levy (2017) shares the six major health benefits of music therapy:

• Music therapy reduces anxiety and physical effects of stress
• It improves healing
• It can help manage Parkinson’s and Alzheimer’s disease
• Music therapy reduces depression and other symptoms in the elderly
• It helps to reduce symptoms of psychological disorders including schizophrenia
• Music therapy improves self-expression and communication

What are the Goals and Objectives of Music Therapy?

This may include, for example, improving motor function, social skills, emotions, coordination, self-expression and personal growth (Therapedia, n.d.).

Common goals in music therapy, as identified by Everyday Harmony (n.d.) are the development of:

• Communication skills (using vocal/verbal sounds and gestures)
• Social skills (making eye contact, turn-taking, initiating interaction, and self-esteem)
• Sensory skills (through touch, listening, and levels of awareness)
• Physical skills (fine and gross motor control and movement)
• Cognitive skills (concentration and attention, imitation, and sequencing)
• Emotional skills (expression of feelings non-verbally)

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Enhance wellbeing with these free, science-based exercises that draw on the latest insights from positive psychology.

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Music can affect a client’s attention, emotion, cognition, behavior, and communication (Koelsch et al., 2009). It can also help bring about relaxation and pleasure (Koelsch et al., 2009). Music also affects perception (Koelsch et al., 2009). Training in music promotes an individual’s skills in the decoding of acoustic features, such as pitch height and frequency modulation (Koelsch et al., 2009).

Music has various effects on the activity of a large range of brain structures (Koelsch et al., 2009). Functional neuroimaging studies have shown that listening to music can have effects on the core structures of emotional processing (the limbic and paralimbic structures) in both musicians and ‘non-musicians’ (Koelsch et al., 2009).

The peripheral physiological effects of listening to music and making music are still being looked into (Koelsch et al., 2009). However, given the effects of emotion on the autonomic nervous system, endocrine system, and immune system – and the fact that music has the power to evoke and modulate emotions – Koelsch and colleagues (2009) suggest that music therapy may be used to treat disorders associated with dysfunctions and imbalances within these systems.

Music therapy can be used for facilitating movement and overall physical rehabilitation and motivating clients to cope with treatment. It can provide emotional support for clients and their families, and provide an outlet for expression of feelings.

Credentialed music therapists can work with patients with an acquired brain injury (AMI). For example, music therapy helped congresswoman Gabby Giffords to regain her speech after she survived a bullet wound to her brain. Music therapy can be used to lessen the effects of dementia, reduce asthma episodes in both children and adults and help reduce pain in hospitalized patients.

Music therapy can also be used to help children with autism spectrum disorder to improve their communication capabilities. Furthermore, it can help premature infants improve sleep patterns and increase their weight gain. Finally, music therapy can be used to help individuals with Parkinson’s disease to improve motor function.

• 86% of users of the Nordoff-Robbins music therapy services said that music therapy had enabled them to develop social skills and interaction (Nordoff Robbins, n.d.)
• Your heartbeat changes to mimic the music that you listen to
• Distinguishing changes in sounds were found to be equipped in those as small as a developing fetus
• Listening to happy vs. sad music can affect the way you perceive the world around you
• An “earworm” is a song that you can’t seem to get out of your head
• A ‘brain itch’ is a need for the brain to fill in the gaps in a song’s rhythm
• Music triggers activity in the same part of the brain that releases dopamine (the ‘pleasure chemical’)
• Music triggers networks of neurons into an organized movement
• Learning a musical instrument can improve fine motor and reasoning skills

These interesting facts were sourced from Ashley Blodgett (2015).

How music can heal our brain and heart – Kathleen M. Howland

The following information was found on the Nordoff Robbins website .

In the 1950s, 1960s, and 1970s, the Nordoff-Robbins approach was developed by Paul Nordoff (an American composer and pianist) and Clive Robbins (a teacher of children with special needs from Britain). This is not a ‘method’. It is an approach designed to harness every person’s potential for engagement in active, communicative, expressive music-making.

The Nordoff-Robbins approach began as a form of collaborative music-making used to engage vulnerable and isolated children. Nordoff and Robbins term this ‘therapy in music’.

The Nordoff-Robbins approach emphasizes the importance of music-making in developing skills, a sense of self and a capacity for satisfying social interaction. It recognizes that all people, regardless of pathology, illness, disability, trauma or social isolation have the potential to make music.

The approach is well known for its work with children and adults with learning difficulties. This is because, like all forms of music therapy, the work has a non-verbal basis.

Every music therapist using the Nordoff-Robbins approach thinks strategically. Using their musical abilities, they help people in ways that are specific to each person, each group, or each community.

While most of us would agree that music can be relaxing, how is relaxation promoted with music therapy? To begin with, music can lead to relaxation of tense muscles. When you allow your muscles to relax and loosen your body, your mind relaxes too. Music is fun, cheap, and simple. It can decrease all the tension, worries and stress you may not even have been aware of (Scott, 2018).

Listening to music can also enhance other stress-relieving activities. For example, it can aid in practicing yoga , self-hypnosis or guided imagery . In other words, music can enhance the stress-relieving properties of other relaxing activities (Scott, 2018).

Music can also help the brain reach a meditative state. This promotes relaxation. Listening to music may be a less intimidating way for a client to practice meditation (Scott, 2018).

1. Singalong

Fandom (n.d.) suggest that music therapy sessions for groups or individuals may include singing together in a way less formal than a choir.

The singalong may use a songbook of the music therapist’s repertoire, or plain copies of popular song lyrics (Fandom, n.d.). Participants could sing preferred and highly familiar songs by memory, or learn a new song by rote (Fandom, n.d.).

Singalongs encourage participation in a fun, music-making process (Fandom, n.d.). They can be used to meet various goals and objectives, including teaching breathing exercises (Fandom, n.d.).

2. ‘Blackout song-writing’ (Seibert, n.d.).

In this session, the therapist provides clients with the lyrics to 4 – 5 different choices of songs which represent recovery – such as overcoming barriers, support, or struggles. Then, clients are encouraged to take some time to read the lyrics of the song they choose, and to select words from the lyrics to make up their own song.

The idea is to ‘blackout’ the lyrics which the client does not want in the song and to use the words that they have chosen to create their own song.

3. Musical Hangman (Seibert, n.d.).

This idea is to draw a thematic picture on a board, and ask clients to guess the missing word before the picture loses its details – e.g. to try and guess the word before the tree loses all its’ leaves.

Then, choose a thematic word and find songs that start with each letter of that word. The aim is for clients to listen to the songs and try and guess the target word. For example, the word ‘happy’ may have the songs “Hey Jude”, “A Little Ray of Sunshine”, “Praying” and so on.

Each letter that is guessed correctly earns the corresponding song to play and sing. The therapist can even coordinate songs that share a thematic idea as well as matching the letter.

4. Blues Song-writing (Seibert, n.d.).

The music therapist explains the background of the blues, so that the client understands the basics – i.e. having a line A, repeating line A and a subsequent line B. Ask the client to share something that they may be feeling ‘blue’ about, and to think of a solution to the problem or a coping mechanism. Then, brainstorm ideas as to how to make the statements sound poetic in song-writing.

After each client has had a chance to write their ‘blues’, have a continuous improvisation/singalong. Sing each person’s ‘blues’ as a group, following the same melody line. This activity can be extended using an iPad: clients can improvise on the blues scale keyboard on the app ‘ GarageBand ’.

According to Rachel Rambach (2011), the following are twelve songs that every music therapist should know:

• ‘American Pie’
• ‘Amazing Grace’
• ‘Blue Suede Shoes’
• ‘Blue Skies’
• ‘Don’t Worry, Be Happy’
• ‘The Lion Sleeps Tonight’
• ‘Lean on me’
• ‘Somewhere Over the Rainbow’
• ‘Take Me to The Ballgame’
• ‘This Little Light of Mine’
• ‘You Are My Sunshine’

The following are research-based music therapy activities (interventions) for adults, found in Wigram and colleagues’ 2002 book.

• Improvisation
• Singing well-known songs
• Vibroacoustic therapy This is a receptive form of music therapy. It involves music being played through speakers which are built into a chair, mattress or bed (which the client lies in). Then, the client directly experiences the vibrations that are brought about by the music (Wigram, Pedersen & Bonde, 2002).
• Stress-reduction techniques
• Music and movement
• Folk dancing or social dancing
• Vibrotactile stimulation
• Music reminiscence
• Music stimulation
• Songwriting

For more information about any of these activities, Wigram et al. (2002) provide the scientific references associated with each activity on pages 193 – 194.

Music therapy in groups are well-known, and the following activities can help you with your next group session.

1. ‘Beach ball autonomy’ (Seibert, n.d.)

Use a blow-up beach ball and draw on a range of shapes. Inside each, write genres, styles and generic artists. Toss the ball to a client. Whichever shape their thumb lands on describes the next song selection.

The therapist encourages the client to choose a selection of appropriate songs so that the therapist can choose the preferred song for that individual. The client also gets to choose whether the group will play instruments, sing, dance, or just listen.

2. Drumming Emotions (Fandom, n.d.).

Each member of the group writes down one word to describe the emotion that they are feeling on a slip of paper. The paper is then put in a hat/bowl and group members take turns in selecting a different piece of paper. The person will then ‘perform’ (demonstrate) on the drum the emotion that is written on the paper. The rest of the group listens and tries to identify who in the group the emotion belongs to.

3. Conversation Drum Circle (Fandom, n.d.).

The group plays a beat, and in pairs take turns in a ‘musical dialogue’ exchange.

4. Name-That-Tune! (Fandom, n.d.).

The music therapist asks clients to form two or three teams and to come up with a team name. Play appropriate music and each team has a turn at earning points for stating the name of the song, the group or artist, or sharing interesting, relevant facts about the song.

It can also be fun to open up the guessing to the whole group if they are unable to identify the song. You could play “free-for-all” lightning rounds or use TV show themes, or popular movie soundtracks.

5. Music trivia (Fandom, n.d.).

This game challenges teams to answer trivia questions on music and pop-culture.

Some interventions invite active engagement, such as through dancing or playing instruments, while others require patients simply to listen to music.

Sometimes, music therapists prescribing passive interventions may choose to invite their clients to take part in these interventions outside of scheduled therapy sessions.

Many will do so with the support of technologies that allow them to design and distribute customized interventions digitally.

For example, besides in-person interventions, such as drumming or sing-alongs, a music therapist might invite their client to listen to guided imagery recordings containing music.

Using a digital psychotherapy platform such as Quenza (pictured here), these pre-recorded audio clips can be sent directly to the client’s smartphone or tablet according to a predetermined schedule.

Likewise, therapists can use platforms such as this to design and administer reflections or exercises that invite clients to explore their emotional reactions or cognitive responses to different music therapy interventions, thereby supplementing the in-person therapy experience.

This is just a couple of examples of how music therapists might adapt the functions of a blended care platform like Quenza to design holistic treatment solutions for their clients. If you’d like to learn more about designing different therapy interventions using Quenza, take a look at this dedicated psychoeducation interventions article.

Music therapy can be used with school-aged students in their school setting. Music therapy can be used at school to focus on higher level social and academic skills, including empathy, turn taking, compromise and problem-solving skills in social situations (Jacobson & Artman, 2013).

It can be used to promote academic understanding in mathematics, such as teaching math facts, telling the time, and money concepts. Music therapy can also target academic improvement in reading and writing. For example, music therapy improves phonic and sight words, and story elements (Jacobson & Artman, 2013).

In schools, music therapy can be used to improve children’s behavior and wellbeing. It can help children learn classroom rules, improving attention and focus, and promoting self-expression (Jacobson & Artman, 2013).

Finally, music therapy can be used in schools to improve social skills and communication . For example, it can help with “wh” questions (who, what, where, and when) and develop vocabulary (Jacobson & Artman, 2013).

Music therapy can also be used in Special Education settings. For example, a music therapist may work with a special needs student in the consideration of an Individual Education Program (IEP). They may work with the IEP team and the student’s family throughout the music therapy process (Jacobson & Artman, 2013).

Music therapy can be a useful way to meet the various psychosocial needs of children, through engagement in song-writing and improvisation. It can provide children with opportunities for self-expression and communication. Music therapy can also give children the opportunity to identify their strengths , providing a way for them to maintain a sense of self-esteem .

For infants and children, a music therapist can use live, familiar music in conjunction with physical, social and cognitive activities to stimulate development. This also promotes interaction and encourages participation and motivation in young children. In order to reduce irritability, pain or anxiety, the music therapist can use soothing music. This also encourages child and family bonding.

To help develop creative self-expression in infants and young children, the music therapist and child can make music together and write songs.

Adolescents can play a more active role in coming up with their own music therapy program. With a therapist, adolescents can explore a range of musical activities and select what feels right to them.

Possible activities for adolescents are song-writing, improvisation and/or singing the songs by their favorite artists or bands. Adolescents may like to use technology to produce personalized audio/visual projects. The use of live music in addition to relaxation techniques can be an effective way to help reduce pain and anxiety in adolescents.

Clinical music therapy may benefit children who are chronically ill (or are long-term hospital patients) or have a developmental delay. It can help children who have autism or are isolated or bed-bound. Music therapy can be used for children who are anxious or depressed, are physically impaired or are frequently admitted to the hospital. Finally, clinical music therapy may benefit children who have experienced trauma.

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Music Therapy and kids. Peanut butter and jelly. Try out these wonderful ideas.

1. Leader of the band (Fandom, n.d.).

The therapist can sing a little song about who’s turn it is to be the ‘leader of the band’. Demonstrate to the group appropriate directions (such as “start”, “stop”, “LOUD”, “fast”, “slooooow”) or anything that the group will understand.

You may choose a child who is cooperating and listening to directions to be the leader. Children are highly reinforced for their behavior when they get to have a turn in communicating their preferred directions to the whole group.

2. “The Hello Song” from Dragon Tales (Fandom, n.d.).

This song, based on simple chords, is a suitable ‘hello’ song for children under 8 years of age. It brings together social skills, interactive responses and allows an opportunity to greet each child individually. This activity also incorporates vocal and musical opposites such as “high” and “low” and “fast” and “slow”.

3. “Hot Potato” (Fandom, n.d.).

The group passes an object around in a circle, and when the music stops the person holding the object can – answer a question; ask a question; say something about themselves, or discuss something related to treatment.

4. ‘Music bingo’ (Fandom, n.d.)

Create bingo sheets for children that use songs instead of letters and numbers.

5. ‘Pictionary’ (Fandom, n.d.).

Prepare cue cards with song titles written on them for individuals to draw pictures of while their team attempts to guess the song.

We all can attest to the power of music, and using it to teach, calm, and encourage recovery, make it a viable therapy to consider.

We hope this article has given you an indication of some of the benefits of music therapy, and look forward to your feedback and examples where music therapy has benefited your clients.

Continue Reading: 17 Best Drama Therapy Techniques, Activities & Exercises

We hope you enjoyed reading this article. Don’t forget to download our three Positive Psychology 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/
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• 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. 2
• 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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Music therapy is one of the most important alternative therapies. Music, like any art form, is a way to find yourself. In my free time, I usually watch online streaming shows. I recently saw the Madama butterfly through Greek National Opera’s GNOTV

Thank you for informing on this. I plan on going to college to become a musical therapist.

Hi Haley, Thanks for reading. That’s brilliant — Best of luck with your career journey and studies! – Nicole | Community Manager

dear madam, thank you verymuch for giving us the knowledge about a most valuable topic.i am a researcher about music therapy.it is realy interesting to do research about music therapy.i hope you will publish more articles about music therapy,and new things about the topic.thank you again and wish you all the best.

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Reviewing the Effectiveness of Music Interventions in Treating Depression

Associated data.

Depression is a very common mood disorder, resulting in a loss of social function, reduced quality of life and increased mortality. Music interventions have been shown to be a potential alternative for depression therapy but the number of up-to-date research literature is quite limited. We present a review of original research trials which utilize music or music therapy as intervention to treat participants with depressive symptoms. Our goal was to differentiate the impact of certain therapeutic uses of music used in the various experiments. Randomized controlled study designs were preferred but also longitudinal studies were chosen to be included. 28 studies with a total number of 1,810 participants met our inclusion criteria and were finally selected. We distinguished between passive listening to music (record from a CD or live music) (79%), and active singing, playing, or improvising with instruments (46%). Within certain boundaries of variance an analysis of similar studies was attempted. Critical parameters were for example length of trial, number of sessions, participants' age, kind of music, active or passive participation and single- or group setting. In 26 studies, a statistically significant reduction in depression levels was found over time in the experimental (music intervention) group compared to a control ( n = 25) or comparison group ( n = 2). In particular, elderly participants showed impressive improvements when they listened to music or participated in music therapy projects. Researchers used group settings more often than individual sessions and our results indicated a slightly better outcome for those cases. Additional questionnaires about participants confidence, self-esteem or motivation, confirmed further improvements after music treatment. Consequently, the present review offers an extensive set of comparable data, observations about the range of treatment options these papers addressed, and thus might represent a valuable aid for future projects for the use of music-based interventions to improve symptoms of depression.

Introduction

“If I were not a physicist, I would probably be a musician. I often think in music. I live my daydreams in music. I see my life in terms of music.” −Einstein, 1929 .

Depression is one of the most serious and frequent mental disorders worldwide. International studies predict that approximately 322 million (WHO, 2017 ) of the world's population suffer from a clinical depression. This disorder can occur from infancy to old age, with women being affected more often than men (WHO, 2017 ). Thus, depression is one of the most common chronic diseases. Depressive suffering is associated with psychological, physical, emotional, and social impairments. This can influence the whole human being in a fundamental way. Without clinical treatment, it has the tendency to recur or to take a chronic course that can lead to loneliness (Alpass and Neville, 2003 ) and an increasing social isolation (Teo, 2012 ). Depression can have many causes that range from genetic, over psychological factors (negative self-concept, pessimism, anxiety and compulsive states, etc.) to psychological trauma. In addition, substance abuse (Neighbors et al., 1992 ) or chronic diseases (Moussavi et al., 2007 ) can also trigger depression. The colloquial use of the term “depressed” has nothing to do with the depression in the clinical sense. The ICD-10 (WHO, 1992 ) and the DSM-V (APA, 2013 ) provide a classification based on symptoms, considering the patient's history and its severity, duration, course and frequency. Within the last two decades, research on the use of music medicine or music therapy to treat depression, showed a growing popularity and several publications have appeared that documented this movement (e.g., Lee, 2000 ; Loewy, 2004 ; Esfandiari and Mansouri, 2014 ; Verrusio et al., 2014 ; Chen et al., 2016 ; Fancourt et al., 2016 ). However, most researchers used a very specific experimental setup (Hillecke et al., 2005 ) and thus, for example, focused only on one music genre (i.e., classical, modern; instrumental, vocal), used a predefined experimental setup (group or individual) (e.g., Kim et al., 2006 ; Chen et al., 2016 ), or specified precisely the age range (i.e., adolescents, elderly) of participants (e.g., Koelsch et al., 2010 ; Verrusio et al., 2014 ). A recent meta-analysis (Hole et al., 2015 ) reviewed 72 randomized controlled trials and concluded that music was a notable aid for reducing postoperative symptoms of anxiety and pain.

Dementia patients showed significant cognitive and emotional benefits when they sang, or listened to familiar songs (Särkämö et al., 2008 , 2014 ). Beneficial effects were also described for CNMP (Chronic Non-Malignant Pain) patients with depression (Siedliecki and Good, 2006 ) 1 . Cardiology is an area where music interventions are commonly used for intervention purposes. Various explanations were postulated and the broad range of effects on the cardiovascular system was investigated (Trappe, 2010 ; Hanser, 2014 ). Music as a therapeutic approach was evaluated (Gold et al., 2004 ), and found to have positive effects before heart surgery (Twiss et al., 2006 ), used to increase relaxation during angiography (Bally et al., 2003 ), or decrease anxiety (Doğan and Senturan, 2012 ; Yinger and Gooding, 2015 ). A systematic review (Jespersen et al., 2015 ) concluded that music improved subjective sleep quality in adults with insomnia, verbal memory in children (Chan et al., 1998 ; Ho et al., 2003 ), and episodic long-term memory (Eschrich et al., 2008 ). Music conveyed a certain mood or atmosphere (Husain et al., 2002 ), allowed composers to trigger emotions (Bodner et al., 2007 ; Droit-Volet et al., 2013 ), based on the cultural background (Balkwill and Thompson, 1999 ), or ethnic group (Werner et al., 2009 ) someone belonged to. In contrast, the emotional state itself plays a role (Al'tman et al., 2004 ) on how music is interpreted (Al'tman et al., 2000 ), and durations are evaluated (Schäfer et al., 2013 ). Subjective impressions embedded in a composition caused physiological body reactions (Grewe et al., 2007 ; Jäncke, 2008 ) and even strengthened the immune system (McCraty et al., 1996 ; Bittman et al., 2001 ). The pace of (background) music (Oakes, 2003 ), has also been used as an essential element of many marketing concepts (North and Hargreaves, 1999 ), to create a relaxed atmosphere. An in-depth, detailed illustration described the wide variety of conscious, as well as subconscious influences music can have (Panksepp and Bernatzky, 2002 ), and endorsed future research on this subject.

Distinction between the terms “Music Therapy [MT]” and “Music Medicine [MM]”

Most of us know what kind of music or song “can cheer us up.” To treat someone else is something completely different though. Therefore, evidence-based procedures were created for a more pragmatic approach. It is important to differentiate between music therapy and the therapeutic use of music. Music used for patient treatment can be divided into two major categories, namely [MT] and [MM], although the distinction is not always that clear.

Music therapy [MT]

Term used primarily for a setting, where sessions are provided by a board-certified music therapist. Music therapy [MT] (Maratos et al., 2008 ; Bradt et al., 2015 ) stands for the “… clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program ” (AMTA) 2 . Many different fields of practice, mostly in the health care system, show an increasing amount of interest in [MT]. Mandatory is a systematic constructed therapy process that was created by a board-certified music therapist and requires an individual-specific music selection that is developed uniquely for and together with the patient in one or more sessions. Therapy settings are not limited to listening, but may also include playing, composing, or interacting with music. Presentations can be pre-recorded or live. In other cases (basic) instruments are built together. The process to create these tailor-made selections requires specific knowledge on how to select, then construct and combine the most suitable stimuli or hardware. It must also be noted that music therapy is offered as a profession-qualifying course of study.

Music medicine [MM] (i.e., functional music, music in medicine)

Carried out independently by professionals, who are not qualified music therapists, like relaxation therapists, physicians or (natural) scientists. A previous consultation, or collaboration, with a certified music therapist can be helpful (Register, 2002 ). In recent years, significant progress has been made in both the research and clinical application of music as a form of treatment. It has valuable therapeutic properties, suitable for the treatment of several diseases. The term “music medicine” is used as a term for the therapeutic use of music in medicine (Bradt et al., 2015 , 2016 ), to be able to differentiate it from “music therapy.” [MM] stands for a medical, physiological and physical evaluation of the use of music. If someone listens to his or her favorite music, this is sometimes also considered as a form of music medicine. [MM] deliberately differs from music therapy as part of psychiatric care or psychotherapy. It is important to stress out that the term “Music Therapy [MT]” should not be used for any kind of treatment involving music, although there is without doubt a relationship between [MT] and [MM]. What all of them have in common is the focus on a scientifically, artistically or clinically based approach to music.

“Seamless Transitions” between music therapy [MT] and music medicine [MM]

Activity used for treatment is ambiguous or not clearly labeled as “Music Therapy” or “Music Medicine.” It should not be forgotten that the definition of “Music Therapy” is not always clearly distinguishable from “Music Medicine.” One possible scenario would be a physician (i.e., “non-professional”), who is not officially certified by the AMTA (or comparable institutions), but still acts according to the mandatory rules. In addition, depending on one's home country, uniform standards or eligibility requirements might be substantially different. We think that every effort should be recognized and therefore postulate one definition that can describe the main principle of [MT], [MM], and everything in between, in one sentence: “ Implementation of acoustic stimuli (“music”) as a medium for the purpose of improving symptoms in a defined group of participants (patients) suffering from depression.”

Materials and methods

Literature search.

Search strategy and selection process was performed according to the recommended guidelines of the Cochrane Centre on systematic literature search (Higgins and Green, 2008 ). Our approach ( Figure 2 ) was according to their scientific relevance, supplemented by the analysis of relevant journals, conferences and workshops of recent years. We obtained 60,795 articles from various search engines as initial result. Retrieved data was collected and processed on an existing personal computer with the latest Windows operating system.

Search, collection, selection, and review strategies

We used a combination of words defining three search-categories (Music-, Treatment-, and Depression associated) as well as several words (e.g., Sound, Unhappy, and Treatment) assigned to each category as described in the collection process.below. If synonyms of those keywords were identified, they were added as well. Theme-categories 3 were created next, then related keywords identified and added into a table. “Boolean Operators 4 ” were used as logical connectives to broaden and/or narrow our search results within many databases (mostly search engines as described below).

This way the systematic variation of keyword-based queries and search terms could be performed with much more efficiency. To find the most relevant literature on the subject, keywords were entered into various scientific search engines, namely PubMed, MEDLINE, and Google Scholar. After the collection process, several different steps were used to reduce the number of retrieved results. Selection out of the collected material included to narrow down search results to a limited period of time. We decided to choose a period between 1990 and 2016 (i.e., not exceeding 26 years), because within these years several very interesting works of research were published, but often not mentioned explicitly, discussed in detail, or the main target of a comparative review. After several papers were excluded, a systematic key phrases search was conducted once more to retrieve results, limited to original research articles 5 . We also removed search results that quoted book chapters, as well as reports from international congresses and conferences. Research papers that remained were distinguished from duplicates (or miss-matches not dismissed yet). Based on our predefined criteria for in- and ex-clusion, relevant publications were then selected for an intensified review process. Our plan was to apply the following inclusion criteria: Original research article, published at time of selection, music and/or instruments were used intentionally to improve the emotional status of participants (i.e., intended or officially confirmed as music therapy). The following exclusion criteria were used: No original research, article was not published (e.g., project phase, in review), unverified data or literature was used, participants did neither receive nor interact with music. Not relevant for in- or exclusion was the kind of questionnaire used to measure depression, additional diagnostic measures for pathologies other than depression, spatial and temporal implementation of treatment, demographics (i.e., number, age, and gender) participants had, or distinctive features (like setting, duration, speakers, live version, and recorded) of stimuli. After the initial number of results, the remaining articles were manually checked for completeness and accuracy of information. Our final selection of articles included 28 research papers.

General information — (Figure ​ (Figure1 1 )

“Road-Map” Outline of the following results section (idea, concept and creation of this Figure by Leubner).

Evaluating the methodological quality of our meta-review

During the review process, we used a very strict self-monitoring procedure to ensure that the quality of scientific research was met to the best of our knowledge and stood in accordance with the standards of good scientific practice. Every effort has been made to provide the accuracy of contents as well as completeness of data published within our meta-review. Inspired by another author's meta-review (Kamioka et al., 2014 ), we evaluated our work by the AMSTAR checklist (Shea et al., 2007 ) 6 and found no reasons for objection regarding our selection of reviews. AMSTAR (acronym for “Assessment of Multiple SysTemAtic Reviews”), a questionnaire for assessing systemic reviews, is based on a rating scale with 11 items (i.e., questions). AMSTAR allows authors to determine and graduate the methodological quality of their systematic review.

Effect size

We investigated a wide variety of scholarly papers within our review. There were many different approaches and several procedures. As far as intervention approaches and procedures were concerned, we found (very) similar trends in several papers. To ensure that those different tendencies were not only based on our pure assumption as well as biased interpretation, we also calculated the effect-size correlation by using the mean scores as well as standard deviations for each of the treatment and control groups, if this setup was used by the respective researcher. Most trials showed a small difference in between the experimental and control group at baseline, what almost always turned into a large effect size regarding post-measurement.

Depression score improvement (DSI) — approach to compare questionnaires

As mentioned above, we selected 28 scholarly articles that used different questionnaires to measure symptoms of depression for experimental and control groups. According to common statistical standards we used a formula to evaluate and compare the relative standing of each mean to every other mean. To avoid confusion, we decided to refer to it as “Depression Score Improvement (DSI).” Mathematically speaking it stands for the mean difference between the pre-test and post-test results (i.e., score changes) in percent. (DSI Ind ) stands for an individual and (DSI{ Gr ) for a group setting. Please refer to the Supplementary Materials (Table: “Complete Display of Statistical Data”) 7 for additional information.

The results will review the works in terms of demographics, treatment implementation, and diagnostic measures.

Literature search results — (Figure ​ (Figure2 2 )

Overview of our Collection, Selection, and Review Process (idea, concept and creation of this Figure by Leubner). Initially, the total number of retrieved results was 118,000 as far as google-scholar was concerned. Analysis was complicated by the disproportionately high number of results from google-scholar. Therefore, we decided to narrow down this initial search query to a period from 1990 up to 2016, and reduced the results from google-scholar to 60,000 this way. Compared to the other two search engines, this process was done two steps ahead. At google-scholar we excluded patents as well as citations in the initial window for our search results. Unfortunately search options are very limited, and though we retrieved at first this overwhelming number of 118,000 results!. Some keywords (e.g., anxiety, pain, fear, violence) were deliberately excluded right from the beginning. This was done right at the start of our selection/search process, to prevent a systematic distortion of retrieved results.

Collection process – results

A large list of keywords, based on several questions we had, was created initially. They were combined into search-terms and finally put into search-categories as category-dependent keywords. In addition, we discussed several parameters and agreed on three categories (associated to music, treatment, and depression). By querying scientific databases, using the above-mentioned category-dependent keywords as input criteria, we retrieved a very large number of results. We then searched for a combination of the following words and/or phrases (e.g., “ music AND therapy AND depression”; “acoustic AND intervention AND unhappy” ), narrowed down the retrieved results according to a combination of several keywords (e.g., “ music therapy”; “acoustic intervention” ), and sorted this data according to relevance.

Selection process – results

In step two we applied the above-mentioned approach and narrowed down our search query to a limited period of time, then systematically searched for key phrases, and excluded duplicates as well as previously overlooked miss-matches. Our inclusion criteria can be summarized as follows: Original research article, already published at time of selection, music and/or instruments were used intentionally to improve the emotional status of participants. Our exclusion criteria were: No original research, article was not published (e.g., project phase, in review), unverified data or literature was used, participants did neither receive nor interact with music.

Review process – results

Based on our predefined criteria for inclusion and exclusion, relevant publications were then selected and used for our intensified review process. After reducing the initial number of results, we obtained the remaining articles, conducted a hand-search in selected scientific journals, and manually checked for completeness as well as accuracy of the contained information. The final selection of articles, according to our selection criteria, included 28 papers.

Demographics 8

To begin with, the number of participants as well as age and gender related basic demographics were analyzed.

Participants – results

Our final selection of 28 studies included 1,810 participants, with group sizes between five and 236 persons (n av = 64.64; SD = 56.13). For experimental groups, we counted 954 individuals ( n min = 5; n max = 116; n av = 34.07; SD = 27.78), and 856 ( n min = 10; n max = 120; n av = 30.57; SD = 29.10) for the control respectively. Although three authors (Ashida, 2000 ; Guétin et al., 2009b ; Schwantes and Mckinney, 2010 ) did not use a control sample, those articles were nevertheless considered for calculating accurate and up-to-date data. Depending on each review, sample groups differed profoundly in number of participants. The smallest one had five participants (Schwantes and Mckinney, 2010 ), followed by three authors (Hendricks et al., 1999 ; Ashida, 2000 ; Guétin et al., 2009b ) who used between 10 and 20 individuals in their clinical trials. Medium sized groups of up to 100 participants were found in six articles (Gupta and Gupta, 2005 ; Castillo-Pérez et al., 2010 ; Erkkilä et al., 2011 ; Wang et al., 2011 ; Lu et al., 2013 ). Large groups with more than 100 (Koelsch et al., 2010 ; Silverman, 2011 ), or 200 (Chen et al., 2016 ) participants were the exception, and 236 participants (Chang et al., 2008 ) presented the upper end in our selection.

Age groups – results

Within our selected articles, the youngest participant was 14 (Hendricks et al., 1999 ), and the oldest 95 years of age (Guétin et al., 2009a ). We then separated relevant groups, according to their age, into three categories, namely “young,” “medium,” and “elderly.”

Participants were defined as “young,” if their mean age was below or equal to 30 years (≤30). Young individuals did show minimal better (i.e., higher) depression score improvements (DSI) (mean difference between the pre-test and post-test results was calculated in percent), if they attended group (mean DSI Gr = 53.83%) 9 , rather than individual (DSI Ind = 40.47%) music intervention sessions. These results may be due to the beneficial consequences of social interactions within groups, and thus confirm previous study results (Garber et al., 2009 ; Tartakovsky, 2015 ).

We used the term “medium” for groups of participants, whose mean ages ranged between 31 (>30) and 59 years (<60). Medium-aged participants presented much better results (i.e., higher depression score improvements), if they attended a group (mean DSI Gr = 48.37%), rather than an individual (mean DSI Ind = 24.79%) intervention setting. However, it should be stressed that our findings only show a positive trend and thus should not be evidence.

The third and final group was defined by us as “elderly” and included participants with a mean age of 60 years or above (≥60). Noticeable results were found for the age group we defined as elderly, as participants showed slightly better (i.e., higher) score improvements (mean DSI Ind = 48.96%), if they attended an individual setting. Considering the music selection that had been used for elderly participants, a strong tendency toward classical compositions was found (e.g., Chan et al., 2010 ; Han et al., 2011 ). Because a relevant number of participants came from Asian countries (e.g., China, Korea), elderly people from those research articles received, in addition to classical music, quite often Asian oriented compositions as well. Despite our extensive investigations, the influence this combination had on results, remained uncertain. Positive tendencies within those groups might be due to “traditional” and/or “culture related” factors. It is, however, also conceivable that combining Western classical with traditional Asian music is notably suited to produce better results. Concerning this matter, future research on western depression patients treated with a combination of classical Western, and traditional Asian music might be a promising concept to be further explored.

Gender – results

As far as gender was concerned, we subdivided each sample group in its female and male participants. Women and men were found in 20 study designs. This was the most frequently used constellation. Within this selection, we did not find any significant differences, and so no further analysis was done. Only women took part in two studies (Chang et al., 2008 ; Esfandiari and Mansouri, 2014 ) 10 . Interestingly the same stimuli setup was used in both cases. It consisted of instrumental music without vocals, stored on a digital record, and was presented via loudspeakers from a CD (Chang et al., 2008 ) or MP3 player (Esfandiari and Mansouri, 2014 ). Only men were seen in four research papers (Gupta and Gupta, 2005 ; Schwantes and Mckinney, 2010 ; Albornoz, 2011 ; Chen et al., 2016 ). A significant improvement of depression scores was reported for every experimental group, and once (Albornoz, 2011 ) for a corresponding control setting (received only standard and no alternative treatment). Three articles (Schwantes and Mckinney, 2010 ; Albornoz, 2011 ; Chen et al., 2016 ) shared several similarities, as percussion instruments (e.g., drums, tambourines) were part of each genre selection, all participants received music interventions in a group setting, and stimuli were actively produced within a live performance. In addition, the BDI questionnaire has also been used in three cases (Gupta and Gupta, 2005 ; Albornoz, 2011 ; Chen et al., 2016 ), and thus we were able to perform a search for similarities or tendencies. The average duration for one music intervention was 80 ( SD = 45) min and the total number of sessions was 17 ( SD = 5) in average. Two publications (Hsu and Lai, 2004 ; Wang et al., 2011 ) did not offer any information about gender related distribution of participants.

Music therapy [MT] vs. music medicine [MM] — study results

Music-therapy [mt].

Within our selection of 28 articles, six explicitly mentioned a certified music therapist (Hanser and Thompson, 1994 ; Choi et al., 2008 ; Schwantes and Mckinney, 2010 ; Erkkilä et al., 2011 ; Han et al., 2011 ; Silverman, 2011 ) 11 . For five articles with available data, a combined average depression score improvement (DSI) of 40.87% ( SD = 7.70%) was calculated for the experimental groups. As far as the relevant control groups were concerned, only twice depression scores decreased at all (Choi et al., 2008 ; Erkkilä et al., 2011 ; Table ​ Table1 1 ).

Music-Therapy interventions—music types and results.

Regarding the kind of music provided by a board-certified music therapist, we found some similarities that stood out and appeared more frequently, when compared to music medicine interventions. Percussion music (mainly drumming) was used by four researchers (Choi et al., 2008 ; Schwantes and Mckinney, 2010 ; Erkkilä et al., 2011 ; Han et al., 2011 ). One author (Choi et al., 2008 ) used music based on instruments that were selected according to participant's preferences. Included were, for example, egg shakes, base-, ocean-, and paddle-drums. Participants actively played and passively listened to instruments or sounds, complemented by singing together. Another researcher (Erkkilä et al., 2011 ) preferred the African Djembe 12 drum as well as a selection of several percussion sounds created digitally by an external MIDI ( Musical Instrument Digital Interface ) synthesizer. Percussion-oriented improvisation that included rhythmic drumming and vocal patterns was another approach one scholar (Han et al., 2011 ) used for his stimuli selection. Congas, Cabassas, Ago-Gos, and Claves was the percussion-based selection (in addition a guitar and a Piano was also available) in the fourth music-therapy article (Schwantes and Mckinney, 2010 ). Twice, music without the use of percussion instruments or drums in general, was selected for the intervention. Once (Hanser and Thompson, 1994 ) relaxing, slow and rhythmic harp-samples, played from a cassette-player, were used. In addition, each of the participants was invited to bring some samples of her or his favored music titles. The second one (Silverman, 2011 ) decided to play a “12-bar Blues” (i.e., “blues changes”) 13 progression as an introduction, followed by a Blues songwriting session. The last-mentioned music-therapy project was the only article out of six, where participants within their respective music intervention group did not present a significant reduction of depression. A very interesting “fund” was that none of the music-therapy articles neither concentrated their main music selection on classical, nor on Jazz music. When we looked for other distinctive features it turned out that stimuli were actively produced within a live performance in five articles. There was only one exception (Hanser and Thompson, 1994 ), where a passive presentation of recorded stimuli was preferred by the scholar.

Music-medicine [MM]

The remaining 22 research articles did not explicitly mention a certified music therapist. In those cases, some variant of music medicine was used for intervention. Often the expression music therapy was used, although a more detailed description or specific information was neither published nor available upon our request. With one exception (Castillo-Pérez et al., 2010 ), we could calculate the (DSI) 9 for 25 articles that used some variant of music-medicine [MM].

When we investigated the kind of music that was used, a broader selection of genres was found. Percussion based tracks and drumming appeared in five scholarly papers (Ashida, 2000 ; Albornoz, 2011 ; Lu et al., 2013 ; Chen et al., 2016 ; Fancourt et al., 2016 ). Researchers that used drums reported a significant depression score improvement for every experimental group and we calculated an average of 53.71% for those five articles. Regarding the kind of genre used in our selection of music-medicine articles, a wider range of genres was found. One of the biggest differences was that only music-medicine articles used, in addition to percussion stimuli, also classical and Jazz music for their intervention. Please note that for reasons of confusion, we do not mention the Seamless Transitions between Music Therapy [MT] and Music Medicine [MM] from the “Materials and Methods Section.”

Music genres (selection of music titles) – results

Regarding the kind of music used in our selection of research articles, a wide range of genres was found. Mainly three styles, classical 14 (9x), percussion 15 (9x), and Jazz (5x) music were used more frequently for music intervention. The evaluation took place when specific compositions showed significantly greater improvements in depression compared to other research attempts. Utilizing our comprehensive data analysis, music titles were categorized according to genre or style (e.g., classical music, Jazz), narrowed down (e.g., Jazz), sorted by magnitude of depression score improvements (DSI) 9 , and finally examined for distinctive features (like setting, duration, speakers, live version, recorded). Similarities that stood out and appeared more frequently among one selected music genre were compared with the 28 scholarly articles we selected for our meta-review.

Classical music – results

In nine articles, classical music (Classical or Baroque period) 22 was used. Several well-known composers such as W.A. Mozart (Castillo-Pérez et al., 2010 ), L. v. Beethoven (Chang et al., 2008 ; Chan et al., 2009 ) and J. S. Bach (Castillo-Pérez et al., 2010 ; Koelsch et al., 2010 ) have been among the selected samples. If classical music was used as intervention, our calculations revealed that four studies out of eight 16 were among those with depression score improvements (DSI) 31 that were above the average 17 of 39.98% ( SD = 12). When we looked for similarities between these, three of the four studies (Harmat et al., 2008 ; Chan et al., 2009 ; Guétin et al., 2009a ) used individual sessions, rather than a group setting (Koelsch et al., 2010 ). For all four articles mentioned above, we calculated an average of 11 ( SD = 10) for the total number of sessions that included classical music. The remaining five articles on the other hand, presenting results not as good as the aforementioned, showed an average of 30 ( SD = 21) music interventions. One plausible hypothesis might be “saturation effect” caused by too many interventions in total. Too little variety within the selection of music titles has probably played an important role as well. A general tendency that less intervention sessions in total would lead to better results for every case where classical compositions were included could not be confirmed for our selection.

Percussion (drumming-based) music – results

Percussion music (mainly drumming) was used by nine 18 researchers, and among those, two ways of integration were found. On the one hand, rhythmic percussion compositions were included as part of the music title selection used for intervention. On the other hand, and this was the case in nine articles, various forms of drums had been offered to those who joined the experimental groups, allowing them to “produce their own” music. Sometimes participants were accompanied by a music therapist (e.g., Albornoz, 2011 ) or professional artist (Fancourt et al., 2016 ), who gave instructions on how to use and play these instruments. When we looked for trends or distinctive features percussion music (in particular drumming) had, it turned out that, except one article (Erkkilä et al., 2011 ), all were carried out within a group, rather than an individual setting. A further search for additional similarities, leading to better outcome scores, did not deliver any new findings as far as improvement of depression was concerned. Participants in altogether 7 out of 9 percussion groups were medium aged, two authors (Ashida, 2000 ; Han et al., 2011 ) described elderly participants, whereas none of the percussion groups included young participants.

A wide and even distribution of reduced depression scores across all outcome levels became apparent, when participants received percussion (or drumming) interventions. We calculated an average depression score improvement (DSI) of 47.80% ( SD = 14). Above-average results regarding depression score improvement (DSI), were achieved in four experiments that had an average percussion session duration of 63 ( SD = 19) min. In comparison, we calculated for the remaining five articles an average of 93 ( SD = 26) min. Although a difference of 30 min showed a clear tendency, it was not enough of a difference to draw any definitive conclusions.

Jazz music – results

Finally, five 19 researchers used primarily Jazz 20 as music genre for their intervention. Featured performers (artists) were Vernon Duke (“April in Paris”) (Chan et al., 2009 ), M. Greger (“Up to Date”), and Louis Armstrong (“St. Louis Blues”) (Koelsch et al., 2010 ). Unfortunately, available data was quite limited, mainly since most authors did not disclose relevant information and a detailed description was rarely seen. Some interesting points were also found for research articles that used Jazz as a treatment option. All five of them were among those with good outcome scores, as far as depression reduction was concerned. Test scores ranged between a significance level of p < 0.01 (Guétin et al., 2009a ; Verrusio et al., 2014 ; Chen et al., 2016 ) and sometimes even better than p < 0.001 (e.g., Koelsch et al., 2010 ; Fancourt et al., 2016 ). Depression score improvement (DSI) had an average of 43.41% ( SD = 6). However, there was no clear trend leading toward Jazz as a more effective intervention option, when compared to other music genres. This was assumed because the two studies that showed the best 21 reduction in depression [Chan et al., 2010 (DSI = 48.78%); Koelsch et al., 2010 (DSI = 4 6.58%)] used both classical music in addition to Jazz as an intervention. Experimental groups received two types of intervention (i.e., classical music and Jazz) which eventually blurred outcome scores or prevented more accurate results. Since it was not possible to differentiate to what extent either classical music or Jazz was responsible for the positive trend in reducing symptoms of depression, further research in this field is needed.

Additional music genres – results

Numerous other music styles were used in the experiments, ranging from Indian ragas 22 played on a flute (Gupta and Gupta, 2005 ; Deshmukh et al., 2009 ), nature sound compositions (Ashida, 2000 ; Chang et al., 2008 ), meditative (Chan et al., 2010 ), or slow rhythm music (Chan et al., 2012 ), to lullabies (Chang et al., 2008 ), pop or rock (Kim et al., 2006 ; Erkkilä et al., 2011 ), Irish folk, Salsa, and Reggae (Koelsch et al., 2010 ), only to name a few. As far as we were concerned all those genres mentioned above would present interesting approaches for future research. Due to a relatively small number and simultaneously wide-ranging variety, more thorough investigations are needed, though. These should be examined independently. As far as the above-mentioned music genres, other than classical, percussion, or Jazz were concerned, no indication for a preferable combination was observed.

Experimental vs. control groups – results

Non-significant results for experimental groups ( p > 0.05).

In two (Deshmukh et al., 2009 ; Silverman, 2011 ) out of 28 studies within our selection of research papers, no significant reduction in depression scores was reported, after participants participated in music interventions. Within those two cases all relevant statistical observations differed without any obvious similarities indicating reasons for non-significant results. Although the results did not meet statistical significance for symptom improvement, both authors explicitly pointed out that positive changes in the severity of depression became obvious for the respective experimental groups. We declared one article (Guétin et al., 2009b ) as significant, although it was marked as non-significant in our complete table. This was due to the overall results of this specific research paper, with significant [HADS-D] test scores for weeks 5, 10, and 15. Only week 20 did not follow this positive trend of improvement. It is also important to mention that after music treatment every one of the additional tests [HADS-A for Anxiety; Face(-Scale) to measure mood] showed significant improvements for the experimental group.

Alternative treatment for corresponding control groups

Control groups, who received an alternative (i.e., non-music) intervention, were found in nine research articles (e.g., Guétin et al., 2009a ; Castillo-Pérez et al., 2010 ) 23 . We investigated whether there were particularly noticeable differences in outcome scores, when relevant control groups, who received an alternative treatment, were compared to those who received no additional intervention at all (or only the usual treatment) 24 . As far as these nine articles were concerned, a significant reduction ( p < 0.05) in depression scores was found in every experimental but only one control setting (Hendricks et al., 1999 ). In this case, an entirely different result became apparent, when control participants received a Cognitive-Behavioral Therapy [CBT] and a significant reduction ( p < 0.05) in depression scores was measured compared to the respective baseline score, although music still lead to better results. Another scholar (Chan et al., 2012 ) 25 , instructed participants in the control group to take a resting period, while simultaneously the experimental attendees joined their music intervention session. This alternative approach did not reduce the [GDS-15] depression score, but even increased it. Interestingly, the same author previously published (Chan et al., 2009 ) a significant ( p = 0.007) increase (i.e., worsening of depression) for the relevant control setting. To be complete, a resting period was also conducted in another case (Hsu and Lai, 2004 ), but results showed also no significant reduction in depression scores. Other attempts to provide an alternative intervention for the control group have been monomorphic tones (Koelsch et al., 2010 ) that corresponded to the experimental music samples (in pitch-, BPM-, and duration), verbal treatment sessions (Silverman, 2011 ), antidepressant drugs (Verrusio et al., 2014 ) 26 , reading sessions (Guétin et al., 2009a ) or a “conductive-behavioral” psychotherapy (Castillo-Pérez et al., 2010 ).

Significant results for control groups ( p < 0.05):

Significant reduction of depression ( p < 0.05) in corresponding control (“non-music treatment”) groups was reported twice (Hendricks et al., 1999 ; Albornoz, 2011 ) within our selection of scholarly articles. In one instance (Albornoz, 2011 ) the relevant participants received only standard care, but in the other case (Hendricks et al., 1999 ) an already above mentioned alternative treatment (i.e., “Cognitive-Behavioral Activities”) was reported.

Spatial and temporal implementation of treatment

Individual vs. group intervention – results.

As postulated by previous literature (Wheeler et al., 2003 ; Maratos et al., 2008 ), we differentiated mainly two scenarios based on the number of participants who attended music intervention sessions and referred to them as “group” or “individual.” Group sessions can awaken participants' social interactions and individual sessions often provides motivation (Wheeler et al., 2003 ). Here, a “group” scenario was specified, if two or more persons ( n ≥ 2) were treated simultaneously, whereas “individual” determined experimental settings where only one single person received music interventions individually ( n = 1). Among our article selection we could find a well-balanced distribution of 15 trials with participants who received music interventions in a group, while 13 researchers used an individual setting. First, the impact of individual compared to group treatment was evaluated. Here an almost equivalent outcome (for the significance-level of results) across all 13 individual, compared to 15 group settings was found, without any advantage to one over the other. Non-significant improvements were seen once for a group (Silverman, 2011 ) and once 27 for an individual (Deshmukh et al., 2009 ) intervention.

Single-session duration – results

The question whether groups showed different (i.e., more or less) improvements, if the duration of one single session was altered, we decided to use the intervention length as a key metric (Figure ​ (Figure3). 3 ). Except for two instances (Hendricks et al., 1999 ; Wang et al., 2011 ), 26 research papers reported the duration one single treatment had. Among those 20 min (Guétin et al., 2009a ) was the shortest, and 120 min (Albornoz, 2011 ; Han et al., 2011 ) the longest duration for one session. The average for all 26 articles was 55 min, 70 min for 13 28 group settings, and 40 min as far as the 13 individual intervention setups were concerned.

Session- and research duration–vs.–[DSI] results in dependence of treatment setting.

Entire research (=) intervention program duration – results

Continuing our review process, some interesting diversity was found for the scheduled (i.e., total) treatment duration (Figure ​ (Figure3). 3 ). It ranged from 1 day in two cases (Koelsch et al., 2010 ; Silverman, 2011 ) up to 20 (Guétin et al., 2009b ), or even 24 weeks (Verrusio et al., 2014 ). Out of 26 trials an average duration of 7 weeks was found. In two cases, the data was missing (Wang et al., 2011 ; Esfandiari and Mansouri, 2014 ). The scheduled (i.e., total) treatment duration was determined by a variety of factors. Our investigation, whether there was any relationship between the entire duration of experimental projects and relevant outcome scores, delivered the following results. For an individual (Ind) therapy setting, we isolated eight 29 research papers with above average 30 results in depression score improvement (DSI Ind > 36.50%). We then calculated for the entire project an average duration of almost 7 weeks. For the remaining five 31 articles that also used an individual approach, but had below average depression score improvements, an average duration of 6 weeks was found. A different picture became apparent when we selected those four 32 articles that presented better than average (DSI Gr > 49.09%) results in depression score improvement, after participants received music intervention in a group (Gr). Percussion music (mainly drumming) was used by three researchers (Ashida, 2000 ; Lu et al., 2013 ; Chen et al., 2016 ). In comparison, the fourth author (Hendricks et al., 1999 ) used a selection of relaxing music for treatment. For this setup, a combined duration of six ( SD = 4) weeks was calculated for the entire project length. On the other hand, a mean close to 10 ( SD = 7) weeks was found for the remaining 7 33 group intervention projects that were less successful (i.e., below average), as far as depression score reduction was concerned. Based on these results, we concluded that the length for the entire music intervention procedure might be a crucial element for successful results, and seems to be associated with the intervention type. These findings were not enough to draw further conclusions for every project though, but as far as our selection was concerned, a slightly longer intervention duration of 7 weeks led to better results if participants were treated individually. In comparison, for a group setting our calculations revealed a different picture, when we calculated the average entire duration for all relevant research projects. Here it was 6 weeks that produced the most beneficial results within groups. Drums were used for three out of the four projects that presented above average results. Once (Ashida, 2000 ) a small African drum was used for “drumming activity” at the start of every session. Each time a different participant was asked to perform with this instrument, although nobody in the experimental group was neither a professional drummer nor a musician. African drums were also used by another researcher (Chen et al., 2016 ). In addition, equipment also included one stereo, one electronic piano, two guitars, one set of hand glockenspiel, and other percussion instruments such as cymbals, tambourines, and xylophones. Finally, percussion instruments used in the third study (Lu et al., 2013 ) included hand bells, snare drums, a castanet, a tambourine, some claves, a triangle and wood blocks.

Total number of sessions – results

Continuing the analysis, we evaluated the total number of music intervention sessions. Apparently, this metric was dependent on the duration as well as frequency (“session frequency”) each intervention had. With one exception (Wang et al., 2011 ), where relevant data was missing, the number of sessions varied considerably. Only a single treatment session was used by three authors (Chan et al., 2010 ; Koelsch et al., 2010 ; Silverman, 2011 ), whereas 56 sessions (Castillo-Pérez et al., 2010 ) marked the opposite end of the scale. For 27 articles with available data, a combined average of 15 sessions was found. As far as the total number of sessions in an individual type of setting was concerned, above average results had a combined number of 13 ( SD = 5) sessions, whereas the remaining six research works had 18 ( SD = 8) interventions. The best results in a group setting showed an average of 17 sessions ( SD = 15) and they were found in 7 scholarly publications. In comparison, we calculated 14 sessions in total for the remaining 7 articles.

Session frequency (i.e., sessions per week) – results

As described previously (Wheeler et al., 2003 ), the number of sessions can produce different results. Researchers, within our selection of 28 articles, used various approaches for their experiment, as far as the “session frequency” (i.e., number of sessions within a defined duration) was concerned. Pre-defined intervals ranged from once a week up to one time a day. Once (Choi et al., 2008 ), the article did mention the total number of sessions ( n = 15) with a “frequency” of one to two times a week and a total intervention duration of 12 weeks. To be able to present an appropriate comparison of statistical data, a mean of 1.25 sessions per week was calculated. Besides two cases (Wang et al., 2011 ; Esfandiari and Mansouri, 2014 ) where no information was provided, the combined average session frequency for the remaining 26 articles was 2.89 ( SD = 2.50) interventions per week. Usually sessions were held once a week.

Session- and research duration – vs. – [DSI] results in dependence of treatment setting

We further investigated if there was an association between therapy setting (individual or group), the length of a single session, and trial duration with regard to symptom improvement. Groups (Figure ​ (Figure3) 3 ) showed better (i.e., above average) improvements in depression, if each session had an average duration of 60 min, and the mean length of treatment was 4–8 weeks.

In comparison, the two variables, session length and trial duration, had different effects for individual treatment approaches (Figure ​ (Figure3). 3 ). Above average results were found for sessions lasting 30 min combined with a treatment duration between 4 and 8 weeks.

Diagnostic measures – results of selected questionnaires

We discovered some distinctive features as well as certain similarities in our selection of 28 articles. They might be a guidance for future research projects and as such are presented in more detail in the subsections below.

Beck depression inventory [BDI]

There are three versions of the BDI. The original [BDI] (Beck et al., 1961 ), followed by its first [BDI-I/-1A] (Beck et al., 1988 ) and second [BDI-II] revision (Beck et al., 1996 ). Beck used a novel approach to develop his inventory by writing down the verbal symptom description of his patients with depression and later sorted his notes according to intensity or severity.

Beck depression inventory [BDI] – results

The BDI 34 (Beck et al., 1961 , 1996 ) was the most widely used screening tool in our scholarly selection. It was used in eight trials, but we only selected 7 35 studies for evaluating pre-post BDI scores. Once (Harmat et al., 2008 ), results were only provided for the experimental group, although an experimental control setting was described by the author. Twice (Harmat et al., 2008 ; Esfandiari and Mansouri, 2014 ) two experimental groups and one control group were reported. In one case (Esfandiari and Mansouri, 2014 ) two different music genres were used (“Light Pop & Heavy Rock”), and in another incident (Harmat et al., 2008 ) the second experimental group listened to an audiobook (“Music & Audiobook”). BDI baseline scores, that indicated a minimal 36 to mild 37 depression, were found in two articles (Gupta and Gupta, 2005 ; Harmat et al., 2008 ). Both authors reported for their experimental group a significant improvement of (BDI) depression scores. We calculated an overall average reduction of 2.72 ( SD = 0.03). Moderate 38 signs of depression, with BDI baseline scores that ranged from 18.66 (Albornoz, 2011 ) to 24.72 (Chen et al., 2016 ), were found twice. Music intervention improved BDI scores significantly, with an overall average reduction of 10.65 ( SD = 3.63) for both articles mentioned above. For the respective control groups one author (Chen et al., 2016 ) reported non-significant pre-post changes, whereas the other researcher (Albornoz, 2011 ) described a significant 39 reduction in the standard treatment group as well. The remaining three scholarly papers (Hendricks et al., 1999 ; Choi et al., 2008 ; Esfandiari and Mansouri, 2014 ) described participants with a severe 40 depression, as confirmed by the initial (baseline) BDI results. One article (Esfandiari and Mansouri, 2014 ), of the three mentioned above, used one control and two experimental groups, who were treated with either “light” or “heavy” music. To be able to compare this work with the other studies one single baseline (31.75), post treatment (12.50), and pre-post difference score of 19.25 ( SD = 2.47) 41 was calculated (according to common statistical standards) for both experimental settings. Interestingly, the corresponding control sample showed a three-point increased BDI score ( p > 0.05) and no decrease at any time. Continuing with the remaining articles, even bigger initial baseline BDI scores of 39.00 ( SD = n/a) (Hendricks et al., 1999 ) and 49.30 ( SD = 3.10) (Choi et al., 2008 ) were found. In addition, both authors reported a significant pre-post BDI score reduction 42 for their experimental groups. Based on the published data it became evident that BDI scores improved significantly in each of the cases and this time an overall average reduction of 26.90 ( SD = 9.59) was calculated. Once (Hendricks et al., 1999 ) a significantly reduced BDI pre-post score was also reported for the control setting, where participants received a cognitive-behavioral activities program as an alternative (non-music) intervention.

We compared all research projects that used the BDI questionnaire (Table ​ (Table2). 2 ). Higher baseline scores almost always led to comparatively bigger score reductions in those experimental groups, who received music intervention. Except for two articles (Hendricks et al., 1999 ; Albornoz, 2011 ), no significant improvements were found for control samples. For one of the above-mentioned exceptions (Hendricks et al., 1999 ) an alternative treatment (“ Cognitive-Behavioral” activities ) was provided, which might be a plausible explanation why those relatively young participants (all 14 or 15 years old) showed such reductions in BDI values. Nevertheless, it is also important to mention that the relevant experimental group improved to a greater extent (BDI PRE − BDI POST = 37.66) after treatment. As far as the other case (Albornoz, 2011 ) was concerned, no alternatives (i.e., other than basic or usual care) were offered, and thus no explanation had been established as to how the results could be explained.

Comparison of BDI results.

Geriatric depression scale [GDS-15/-30]

The original Geriatric Depression Scale [GDS-30] (Yesavage et al., 1983 ) includes 30 questions (Hanser and Thompson, 1994 ; Chan et al., 2009 ; Guétin et al., 2009a ) and its shorter equivalent [GDS-15] (Yesavage and Sheikh, 1986 ) contains 15 items (Chan et al., 2010 , 2012 ; Verrusio et al., 2014 ).

Geriatric depression scale [GDS-15/-30] – results

A more precise analysis of results was also done for the Geriatric Depression Scale (GDS-15/-30) scores. As already suggested by its name, all 223 participants were elderly. Because both GDS versions are based on the same questionnaire, we combined scores of the long (i.e., GDS-30) with the short (i.e., GDS-15) test version and found a total of 223 participants in six articles (e.g., Chan et al., 2009 ; Verrusio et al., 2014 ). A possible bias could be prevented because tests were evenly distributed in number, and with respect to higher GDS-30 as well as lower GDS-15 scores, calculations were adapted accordingly. Taking a closer look at the GDS-15/-30 results (Table ​ (Table3), 3 ), some similarities could be found for the most successful (all p ≤ 0.01) four research articles (Chan et al., 2009 , 2010 ; Guétin et al., 2009a ; Verrusio et al., 2014 ). All of them used and mainly focused on classical compositions as far as their music title selection was concerned. The average reduction in depression as measured by the GDS-15/-30 depression scores was 43% (−42.62%; SD = 6.24%). In comparison, every one of the remaining four research projects (Hanser and Thompson, 1994 ; Ashida, 2000 ; Han et al., 2011 ; Chan et al., 2012 ) also presented significant results, albeit not as good as the above-mentioned (all p ≤ 0.05). Interestingly, as far as music genres were concerned, the focus of these less successful projects was rhythmic drumming in two cases (Ashida, 2000 ; Han et al., 2011 ). For the remaining two (Hanser and Thompson, 1994 ; Chan et al., 2012 ) primarily relaxing, slow paced titles 43 were selected as intervention.

Comparison of GDS-15/-30 Results ( * )GDS-15, ( ** )GDS-30.

Other diagnostic measures for depression 44 – results 45

Several times, additional questionnaires were used to measure changes in the severity of depression.

Researchers performed those surveys (Table ​ (Table4) 4 ) in addition to their “main” depression questionnaire. Please refer to our Supplementary Material for a more comprehensive test description.

Additional tests, conducted by researchers within our article selection for investigating changes in depression.

Diagnostic measures for pathologies other than depression – results

In many instances, additional questionnaires were used (Table ​ (Table5 5 ) 49 to measure symptoms other than depression (e.g., Anxiety is known to be one of the most common depression comorbidities, Sartorius et al., 1996 ; Bradt et al., 2013 ; Tiller, 2013 ). Eight 46 researchers concentrated their investigation entirely on depression, and thus only performed questionnaires related to this pathology. In comparison, most of the remaining studies measured additional pathologies, with some of them known to be often associated comorbidities with depressive symptoms. However, because these topics were not the focus of this review, we won't discuss them here in detail. A much more detailed representation is available in the Supplementary Table. Please refer to the original studies for a more comprehensive test description.

Additional tests, conducted by researchers within our selection for investigating changes in other pathologies.

Discussion, conclusion and further thoughts

Depression often reduces participation in social activities. It also has an impact on reliability or stamina at daily work and may even result in a greater susceptibility to diseases. Music can be considered an emerging treatment option for mood disorders that has not yet been explored to its full potential. To the best of our knowledge, there were only very few meta-analyses, or systematic reviews of randomized controlled trials available that generated the amount of statistical data, which we presented here.

Certain individual-specific attributes of music are recognizable, when the medium of music is decomposed (Durkin, 2014 ) 47 into its components. Numerous researchers reported the beneficial effects of music, such as strengthening awareness and sensitiveness for positive emotions (Croom, 2012 ), or improvement of psychiatric symptoms (Nizamie and Tikka, 2014 ). Group drumming, for example, helped soldiers to deal with their traumatic experiences, while they were in the process of recovery (Bensimon et al., 2008 ). However, we have concentrated our focus of interest on patients diagnosed with clinical depression, one of the most serious and frequent mental disorders worldwide.

In this review we examined whether, and to what extent, music intervention could significantly affect the emotional state of people living with depression. Our primary objective was to accurately identify, select, and analyze up-to-date research literature, which utilized music as intervention to treat participants with depressive symptoms. After a multi-stage review process, a total of 1.810 participants in 28 scholarly papers met our inclusion criteria and were finally selected for further investigations about the effectiveness music had to treat their depression. Both, quantitative as well as qualitative empirical approaches were performed to interpret the data obtained from those original research papers. To consider the different methods researchers used, we presented a detailed illustration of approaches and evaluated them during our investigation process.

Interventions included, for example, various instrumental or vocal versions of classical compositions, Jazz, world music, and meditative songs to name just a few genres. Classical music (Classical or Baroque period) for treatment was used in nine articles. Notable composers were W.A. Mozart, L. v. Beethoven and J. S. Bach. Jazz was used five times for intervention. Vernon Duke (Title: “April in Paris”), M. Greger (Title: “Up to Date”), or Louis Armstrong (Title: “St. Louis Blues”) are some of the featured artists. The third major genre researchers used for their experimental groups was percussion and drumming-based music.

Significant criteria were complete trial duration, amount of intervention sessions, age distribution within participants, and individual or group setting. We compared passive listening to recorded music (e.g., CD), with active experiencing of live music (e.g., singing, improvising with instruments). Furthermore, the analysis of similar studies has enhanced and complemented our work. Previous studies indicated positive effects of music on emotions and anxiety, what we tried to confirm in more detail. The length of an entire music treatment procedure was suspected to be an important element for reducing symptoms of depression. A longer treatment duration of 7 weeks for an individual, compared to nearly 6 weeks in a group setting led to better (i.e., above average) outcomes. Although a difference was discovered, 1 week was not enough to draw further conclusions for each and every project. As far as intervals between sessions were concerned, we found no differences between those research articles that were among the best, compared to the remaining experimental designs. Consequently no trend was becoming apparent, favoring one over the others. We further investigated if there was any association between an individual or a group setting, if the length of a single session and trial duration were compared with regard to symptom improvement. Groups showed better improvements in depression, if each session had an average duration of 60 min, and a treatment between 4 and 8 weeks long. In comparison, the two variables, session length and trial duration, had different effects for individual treatment approaches. Above average results were found for sessions lasting 30 min combined with a treatment duration between 4 and 8 weeks. Furthermore, results were compared according to age groups (“young,” “medium,” and “elderly”). Overall, elderly people benefitted in particular from this kind of non-invasive treatment. During, but mainly after completion of music-driven interventions, positive effects became apparent. Those included primarily social aspects of life (e.g., an increased motivation to participate in life again), as well as concerned participants' psychological status (e.g., a strengthened self-confidence, an improved resilience to withstand stress).

We described similarities, the integration of different music intervention approaches had on participants in experimental vs. control groups, who received an alternative, or no additional treatment at all. Additional questionnaires confirmed further improvements regarding confidence, self-esteem and motivation. Trends in the improvement of frequently occurring comorbidities (e.g., anxiety, sleeping disorders, confidence and self-esteem) 48 , associated with depression, were also discussed briefly, and showed promising outcomes after intervention as well. Particularly anxiety (Sartorius et al., 1996 ; Tiller, 2013 ) is known to be a common burden, many patients with mood disorders are additionally affected with. Interpreted as manifestation of fear, anxiety is a basic feeling in situations that are regarded as threatening. Triggers can be expected threats such as physical integrity, self-esteem or self-image. Unfortunately, researchers merely distinguished between “anxiety disorder” (i.e., mildly exceeded anxiety) and the physiological reaction. Also, the question should be raised if the response to music differs if patients are suffering from both, depression and anxiety. Sleep quality in combination with symptoms of depression (Mayers and Baldwin, 2006 ) raised the question, whether sleep disturbances lead to depression or, vice versa, depression was responsible for a reduced quantity of sleep instead. Most studies used questionnaires that were based on self-assessment. However, it is unclear whether this approach is sufficiently valid and reliable enough to diagnose changes regarding to symptom improvement. Future approaches should not solely rely on questionnaires, but rather add measurements of physiological body reactions (e.g., skin conductance, heart and respiratory rate, or AEP's via an EEG) for more objectivity.

The way auditory stimuli were presented, also raised some additional questions. We found that for individual intervention most of the times headphones were used. For a group setting speakers were the number one choice instead. For elderly participants, a different sensitivity for music perception was a concern, when music was presented directly through headphones. Headphones add at least some isolation from background noises (i.e., able to reduce noise disturbances and surround-soundings). Another concern was that most of the time a certified hearing test was not used. Although, a tendency toward a reduction in the ability to hear higher frequencies is quite common with an increased age, there might still be substantial differences between participants.

Two authors (Deshmukh et al., 2009 ; Silverman, 2011 ) reported that participants within their respective music intervention group, did not present a significant reduction of depression. Those two had almost nothing in common 49 and were not investigated further.

Control groups, who received an alternative (“non-music”) intervention, were found in nine research articles. Significant reduction of depression in corresponding control (“non-music intervention”) groups was reported by two authors (Hendricks et al., 1999 ; Albornoz, 2011 ). In one instance (Albornoz, 2011 ) the relevant participants received only standard care, but in the other case (Hendricks et al., 1999 ) an alternative treatment (Cognitive-Behavioral activities) was reported. Medical conceptions are in a constant state of change. To achieve improvements in areas of disease prevention and treatment, psychology is increasingly associated with clinical medicine and general practitioners. Under the guidance of an experienced music therapist, the patient receives a multimodal and very structured treatment approach. That is the reason why we can find specialists for music therapy in fields other than psychosomatics or psychiatry today. Examples are internal medicine departments and almost all rehabilitation centers. The acoustic and musical environment literally opens a portal to our unconscious mind. Music therapy often comes into play when other forms of treatment are not effective enough or fail completely.

Music connects us to the time when we only had preverbal communication skills (Hwang and Hughes, 2000 ; Graham, 2004 ; i.e., communication before a fully functioning language is developed; e.g., infants or children with autism spectrum disorder), without being dependent on language. Although board-certified music therapy is undeniable the most regulated, developed and professional variant, this should not hinder health professionals and researchers from other areas in the execution of their own projects using music-based interventions. The only thing they should be very precise about, is the way they define their work. Within our selection of articles the expression music therapy was used sometimes, although a more detailed description or specific information was neither published nor available upon our request. In those cases, the term “music therapy” should not be used, but instead music medicine or some of the alternatives mentioned in this manuscript (e.g., therapy with music, music for treatment). This way many obstacles as well as misunderstandings can be prevented in the first place, but high-quality research is still produced. Also, it is very important that researchers contemplate and report the details of the music intervention that they use. For example, they should report whether the music is researcher-selected or participant-selected, the specific tracks they used, the delivery method (speakers, headphones), and any other relevant details.

Encouraged by the promising potential of music as an intervention (Kemper and Danhauer, 2005 ), we pursued our ambitious goal to contribute knowledge that provides help for the affected individuals, both the patients themselves as well as their nearest relatives. Furthermore, we wanted to provide detailed information about each randomized controlled study, and therefore made all our data available, so others may benefit for their potential upcoming research project. The overall outcome of our analysis, with all significant effects considered, produced highly convincing results that music is a potential treatment option, to improve depression symptoms and quality of life across many age groups. We hope that our results provide some support for future concepts.

Author contributions

DL (Substantial contributor who meets all four authorship criteria): (1) Project idea, article concept and design, as well as planning the timeline, substantially involved in the data, material, and article acquisition, (2) mainly responsible for drafting, writing, and revising the review article, (3) responsible for selecting and final approving of the scholarly publication, (4) agreed and is accountable for all aspects connected to the work. TH (Substantial contributor who meets all four authorship criteria): (1) Substantial help with the concept and design, substantially contributed to the article and material acquisition, (2) substantially contributed to the project by drafting and revising the review article, (3) responsible for final approval of the scholarly publication, (4) agreed and is accountable for all aspects connected to the work.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

1 Participants in the two music groups (standard or patterning music) showed an increased belief in their personal power as well as a reduction in pain, depression and disability, compared to the relevant control group. The two experimental groups listened to 1 h of music each day for 7 days in a row.

2 Official definition of the American Music Therapy Association [AMTA] http://www.musictherapy.org/about/quotes/

3 Clinical speciality areas; Diagnostic, Treatment, and Therapeutic procedures, approaches, tools; Disorders; Age groups; Scientific; Country-specific; Musical Aspects; Recording hardware and equipment; Literature Genre; Publication type or medium; Year of publication; Number of authors.

4 Boolean Operators for searching databases: Concept explained by the Massachusetts Institute of Technology [MIT] .

5 Our preference was an experimental-control setting, but unfortunately three authors (Ashida, 2000 ; Guétin et al., 2009b ; Schwantes and Mckinney, 2010 ) did not use a control sample.

6 AMSTAR (Shea et al., 2007 )–Further Info & AMSTAR online calculator: https://amstar.ca/Amstar_Checklist.php ; National Collaborating Centre for Methods and Tools (NCCMT): http://www.nccmt.ca/resources/search/97 Questions included in the AMSTAR-Checklist (Shea et al., 2007 ) are: (I) Was an “a priori” design provided? (II) Was there duplicate study selection and data extraction? (III) Was a comprehensive literature search performed? (IV) Was the status of publication (i.e. gray literature) used as an inclusion criterion? (V) Was a list of studies (included and excluded) provided? (VI) Were the characteristics of the included studies provided? (VII) Was the scientific quality of the included studies assessed and documented? (VIII) Was the scientific quality of the included studies used appropriately in formulating conclusions? (IX) Were the methods used to combine the findings of studies appropriate? (X) Was the likelihood of publication bias assessed? (XI) Was any conflict of interest included?

7 In our Supplementary Table (“Complete Display of Statistical Data”), DSI was referred to as “Change [%].”

8 A much More Detailed Representation of Demographics is Available in the Supplementary Table ( Appendix-B ).

9 9DSI: Depression Score Improvement stands for the mean difference between the pre-test and post-test results (i.e., score changes) in percent. Please refer to the supplementary materials for additional information.

10 Music interventions: Individual setting (Chang et al., 2008 ); Group setting (Esfandiari and Mansouri, 2014 ).

11 One [MT] music-therapy article (Silverman, 2011 ) was not used for comparison and calculations because the relevant data was unavailable.

12 Djembe is based on the expression “anke djé, anke bé” which roughly translates as “everyone should come together in peace and harmony.”

13 12-bar Blues: Traditional Blues pattern that is 12 measures long. This chord progression is also used for many other music genres and quite popular in pop-music.

14 Ambiguity of the term “classical” music: In our review, this term refers to “Western Art Music” and thus includes, but is not limited to the “Classical” music period. Most of the time we used this term for music from the Baroque (1600–1750), Classical (1750–1820), and Romantic (1804–1910) period.

15 Within percussion groups various types of drums presented the instrument of choice most of the time.

16 Eight out of nine articles because in on case (Castillo-Pérez et al., 2010 ) scores were missing. The remaining were: Hsu and Lai, 2004 ; Chang et al., 2008 ; Harmat et al., 2008 ; Chan et al., 2009 , 2010 ; Guétin et al., 2009a ; Koelsch et al., 2010 ; Verrusio et al., 2014 .

17 Average: Arithmetic mean of all score-changes in [%] for a defined selection (e.g., classical music). Example: We calculated the score-change in [%] for each of the eight experimental groups that received classical music as intervention. In this case the arithmetic mean (DSI Clas ) was 39.98% (i.e., average). Then every individual score can be compared to this average. If it was above, we called it “above average”.

18 Percussion music (drumming): Ashida, 2000 ; Choi et al., 2008 ; Schwantes and Mckinney, 2010 ; Albornoz, 2011 ; Erkkilä et al., 2011 ; Han et al., 2011 ; Lu et al., 2013 ; Chen et al., 2016 ; Fancourt et al., 2016 .

19 Jazz: Chan et al., 2009 , 2010 ; Guétin et al., 2009a ; Koelsch et al., 2010 ; Verrusio et al., 2014 .

20 In most cases there was no further categorization between different musical sub-genres of Jazz.

21 Greatest: Best in terms of depression score improvement (DSI) (i.e., pre-post score reduction in percent) with Jazz as intervention.

22 Raga: Classification system for music that originated during the eleventh century in Asia (mainly India).

23 Setting was always: Experimental group received music as intervention, and the corresponding control group received an (non-music) alternative.

24 For example, if elderly people lived in a retirement home, a standard daily routine or common everyday activities were seen as usual or regular treatment. If, on the other hand, a resting period (e.g., Chan et al., 2012 ) was carried out simultaneously, this was interpreted as an (“non-music”) alternative.

25 In all three of his articles within our selection (Chan et al., 2009 , 2010 , 2012 ) participants were instructed to rest.

26 Pharmacotherapy treatment included SSRI (Paroxetine 20mg/die), NaSSA (Mirtazapine 30 mg/die), and Benzodiazepine (Alprazolam).

27 As already described above, the other individual setting (Guétin Soua, et al., 2009) with pre-post results of p > 0.05 was still counted as significant.

28 Information regarding the duration for one group session was unavailable in two articles (Hendricks et al., 1999 ; Wang et al., 2011 ).

29 Hanser and Thompson, 1994 ; Hsu and Lai, 2004 ; Harmat et al., 2008 ; Chan et al., 2009 , 2010 , 2012 ; Guétin et al., 2009a ; Erkkilä et al., 2011 .

30 Average DSI for all 13 articles that used an individual ( * Ind) treatment as intervention was 36.50%.

31 Gupta and Gupta, 2005 ; Kim et al., 2006 ; Chang et al., 2008 ; Deshmukh et al., 2009 ; Guétin et al., 2009b .

32 Once (Esfandiari and Mansouri, 2014 ) the relevant score was unavailable.

33 Once (Wang et al., 2011 ) the relevant score was unavailable.

34 BDI: Original BDI from1961; (1st) Revision (=) BDI-I or BDI-1A from 1978; (2nd) Revision (=) BDI-II from 1996.

35 BDI-scores were measured only once (Silverman, 2011 ), either at the end (experimental group), or at the beginning (control group) and thus was excluded for this calculation.

36 Minimal depression: BDI-I (= BDI-1A) score (=) 00–09; BDI-II score (=) 00–13.

37 Mild depression: BDI-I (= BDI-1A) score (=) 10–18; BDI-II score (=) 14–19.

38 Moderate depression: BDI-I (= BDI-1A) score (=) 19–29; BDI-II score (=) 20–28.

39 Albornoz ( 2011 ) found in both groups a significant reduction for BDI scores albeit to a significantly greater extent in the experimental (−8.08; p < 0.01) than in the control (−2.25; p < 0.05) setting.

40 Severe depression: BDI-I (=BDI-1A) score (=) 30–63; BDI-II score (=) 29–63.

41 Pre-post difference: experimental (1) “light” music (=) 17.50; experimental (2) “heavy” music (=) 21.00 (both p < 0.05 within groups) (Esfandiari and Mansouri, 2014 ).

42 Average pre-post BDI reduction of −30.73 ( SD = 9.80) combined (Hendricks et al., 1999 ; Choi et al., 2008 ).

43 One author (Chan et al., 2012 ) limited his selection to slow music (60–80 beats per minute). The other researcher (Hanser and Thompson, 1994 ) also used some “energetic” or “empowering” titles, but mainly concentrated on relaxing compositions.

44 for a reference “intervention review” about music therapy for depression see: maratos et al. ( 2008 ).

45 Every available test-result (Pre-/Post-Scores for experimental/control) can be found in our Supplementary Table 12.

46 Hendricks et al., 1999 ; Ashida, 2000 ; Hsu and Lai, 2004 ; Kim et al., 2006 ; Chan et al., 2009 , 2012 ; Castillo-Pérez et al., 2010 ; Albornoz, 2011 .

47 We used the metaphor “decomposed” based on the inspiring book by Andrew Durkin (“Decomposition: A Music Manifesto”), who refers to it “as a way…to demythologize music without demeaning it” (Review by Madison Heying).

48 A complete list, with all results we could extract, can be found in the Supplementary Table.

49 Music Therapy; Duration 90min./session; Session Frequency 7x/week; Raagas Music (Deshmukh et al., 2009 ).

Supplementary material

The Supplementary Material for this article can be found online at: http://journal.frontiersin.org/article/10.3389/fpsyg.2017.01109/full#supplementary-material

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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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The Role of Music Therapy as Alternative Treatment Term Paper

Introduction.

Music therapy is the use of music interventions to achieve individualized goals of healing the body, mind, and spirit. It involves skilled music therapists, who act as mediators to interact with patients, assesses their physical, emotional, and mental needs, and offer them with the necessary healing through music. Music therapy integrates various musical elements and certain therapeutic protocols to achieve certain objectives (Bruscia, 2000). Many people obtain some kind of healing whenever they have emotional, cognitive, or social issues through music. People living with disabilities or certain illnesses have often found music to offer a soothing environment that facilitates the healing process. Music uses creative, emotional and a non-verbal language to enable users to gain self-awareness and self-expression. In many cases, people have found music to be more powerful than plain words, as it offers a unique channel of communication and expression. Essentially, people suffering from autism and Alzheimer’s disease, and those having developmental disabilities can always become beneficiaries of music therapy. This paper will give a brief history of music therapy, and its role as an alternative treatment for autism and Alzheimer’s disease. Thereafter, the paper will give a brief discussion on the politic of making music therapy a real treatment.

History of music therapy

Music therapy traces its history back in the times of Aristotle and Plato. The writers wrote great articles describing the effect of music on health and personal behavior. After the First and Second World War, musicians felt that the only way to show gratitude to the war veterans was to visit them in the hospitals and soothe them with nice music. Surprisingly, the veterans responded positively to music, as their rate of recovery from physical and emotional trauma increased significantly. Their response triggered the doctors to confirm that music had some miraculous healing power. The doctors and nurses went ahead and ordered the hiring of musicians to help in relieving trauma in patients. Within no time, the demand for trained music therapists rose significantly, and Michigan State university began offering training in music therapy. Its first group of students graduated in 1944, and the society was impressed with the existence of the remarkable course. Thereafter, several developments occurred in the field of music therapy, and the ringleaders founded the American Music Therapy Association in 1998.

In today’s world, music therapists are imperative in hospitals, schools, rehabilitation centers, and nursing homes among other places. Some medical practitioners have backed up sociologists in approving the power that music has in reducing stress, easing anxiety, and bringing a relaxation mode to patients (Lisa, 2009). Indeed, music plays a great role in promoting the emotional, physical, and mental well being for patients suffering from the autism spectrum disorder and Alzheimer’s disease among many other diseases.

Role of music therapy as an alternative treatment for Autism and Alzheimer’s disease

Autism is a condition that is common in children and adolescents while Alzheimer’s disease is common in the elderly; however, the two conditions affect the brain. Autism is a developmental disorder that affects children’s verbal and non-verbal ability before they attain the age of three years. The commonest condition is the child’s inability to communicate and interact with other people. On the other hand, Alzheimer’s disease occurs when neuronotoxic proteins develop in the brain and lead to the damage and death of brain cells. Patients suffering from the Alzheimer disease loose memory, they develop mood swings, and they often become confused while doing their chores. However, music has a special way of calming down the psychiatric patients, and it acts as an alternative treatment to the illnesses as discussed below.

Enhancing the patients’ lives : The best thing that one can do to people with incurable conditions is enhancing their lives and making them happy. Music enhances the feeling of well-being, and it enables the patients to fight against stress and ill health. Music therapy has proven to be very effective in enabling patients with autism and Alzheimer’s disease to communicate. Although the patients are unable to express themselves by talking, music therapy enables them to express their innermost feelings. Music has a supernatural way of stimulating the sensory organs and enhancing the physical, psychological, and cognitive processes of the patients. The therapy promotes stress management, and it enhances the memory, which would otherwise be impossible under normal biomedical treatments.

Calming psychiatric patients: One of the commonest characteristic of people with brain disorders is the display of violent behaviors. People suffering from autism and Alzheimer’s disease have a tendency of experiencing mood swings, they feel sad, and their frustrations increase on a daily process. However, music therapy does the magic, as the patients’ violent behaviors decreases significantly in response to music. In fact, music calms down the patients better than the psychotropic drugs do. It is worth noting that patients suffering from autism and Alzheimer’s disease tend to display their violent behaviors when isolated in dark and quite rooms. In the presence of music, the agitation that some of the patients have reduces significantly.

Increasing social companionship : In many cases, physicians isolate patients with mental conditions to avoid the potential problems that may arise if they begin acting violently. The patients feel isolated, and their actions aim at obtaining attention from other people. However, music therapy plays a great role in reducing the social isolation experience that psychiatric patients encounter. The patients liken music sessions to storytelling sessions that console, relax, and offer them with the best time of their life. Medical caregivers will always have an easy time dealing with the patients, who experience some form of social companionship with music. Music enables the patients to recollect activities of past events, which arouses their spirits. Essentially, music therapy plays a great role in enhancing social interaction, stimulating speech, and in improving the mood of the patients.

Sociological aspects of music therapy

Their increasing role in medical practice.

Although biomedical healthcare is predominant in most countries globally, music therapy has proved to have an increasing role in the medical field in countries in the west. Other than offering physical healing to the affected patients, music therapy offers mental healing. Music therapy has proved to promote the healing process of post-surgery patients. It is worth noting that in spite of the fact that singing does not have a direct effect on healing the wound, it enhances the sense of well-being and the feeling of social connectedness. Moreover, music therapy has played a great role in rehabilitation centers by helping patients to quit their addiction. Although not scientifically proven, drug addicts obtain some form of relieve while drumming and playing loud music. Moreover, most nations in the west have utilized music therapy in special education schools to help in achieving social, emotional, behavioral, and psychological needs of the people living with disabilities. It is evident that music therapy has an increasing role in the medical field, and the nations that still disregard it will soon embrace music therapy because of its endless rewards.

The politic of making music therapy a real treatment

Music therapy has encountered various views in the medical field, as it is just a complementary or alternative treatment. While some countries strongly believe that music therapy is an essential treatment for psychiatric illnesses, other countries have marginalized music therapy as a form of treatment. Essentially, the politic of making music therapy a real treatment mainly involves the medical practitioners and sociologists.

It is evident that many people believe in superior treatment methods that fit into the biomedical field. The strongest believe in biomedical treatments lies in the fact that every treatment is predictable and controllable. Medical practitioners mainly focus on the disease, and they would rather treat psychiatric patients using medicine rather than using the music therapy approach, which would be ineffective at other times. Believers of biomedical treatments have confidence in the evidence-based approach to deal with diseases. If need be, the practitioners set up control groups to determine the suitability of a certain drug. Therefore, from a rational point of view, medical practitioners disqualify music therapy because it is not evidence based, as the music therapists might find it difficult to have control groups to carry out randomized trials (Plum, 2011, 2012).

On the other hand, some sociologists strongly back up complementary and alternative treatments like music therapy, as the therapies have little or no side effects. According to them, music therapy is a non-biomedical treatment that uses a holistic approach to address medical conditions and promote health. Moreover, music therapy has the power to provide social, emotional, behavioral, psychological, and physical healing concurrently unlike the biomedical treatments. The power of music therapy lies in its ability to make the best out of ordinary activities like dancing, singing, and listening to music. The sociologists disregard biomedical treatments because of their inability to fulfill the social, moral, spiritual, and scientific needs of the society and the patients.

From the discussions, it is evident that medical practitioners and sociologists have reasons to support their schools of thought; therefore, the politic of making music therapy a real treatment is not about to end. However, it is factual that music therapy has the capability to act as an alternative treatment to patients suffering from autism and Alzheimer’s disease among other diseases. However, medical practitioners and music therapists should work together and base their treatment on certain objectives that may vary from one patient to another. While some patients need some sensory stimulation, others need some speech simulation or mood improvement. It is noteworthy that autism is a spectrum disorder that affects patients differently, thus, the level of illness varies from one patient to another. While other patients may have difficulties in their common senses of smell, taste, hearing, touch, and sight, others may have learning difficulties. Therefore, they need different treatments. The same thing applies to patients suffering from Alzheimer’s disease, as they may have different impairments that require different therapies. Overall, in spite of the existing politic in making music therapy a real treatment, it is evident that it is indeed playing a major role in advancing the healing process of patients living with mental disabilities.

Bruscia, K. (2000). The nature of meaning in music therapy. Nordic Journal of Music Therapy, 9 (2), 37-43.

Lisa, B. (2009). Alzheimer’s disease: The role of music therapy in symptom palliation. Web.

Plum, C. B. (2011). Sociology of medicine: How music therapy is affected by the dominant position of the biomedical model pt 1 . Web.

Plum, C. B. (2012). Opposition to music therapy: How music therapy is affected by the dominant position of the biomedical model pt 2. Web.

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IvyPanda. (2020, June 18). The Role of Music Therapy as Alternative Treatment. https://ivypanda.com/essays/the-role-of-music-therapy-as-alternative-treatment/

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Bibliography

IvyPanda . "The Role of Music Therapy as Alternative Treatment." June 18, 2020. https://ivypanda.com/essays/the-role-of-music-therapy-as-alternative-treatment/.

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Essay on Music Therapy

Students are often asked to write an essay on Music Therapy in their schools and colleges. And if you’re also looking for the same, we have created 100-word, 250-word, and 500-word essays on the topic.

Let’s take a look…

100 Words Essay on Music Therapy

Introduction.

Music therapy is a therapeutic technique that uses music to improve health. It’s used by certified professionals to promote emotional, cognitive and social well-being.

Types of Music Therapy

There are two types: active and receptive. In active therapy, individuals make music using instruments. In receptive therapy, individuals listen to music and discuss feelings.

Benefits of Music Therapy

Music therapy helps reduce stress and anxiety. It can also improve mood, concentration, and communication skills. It’s beneficial for all, especially those with mental health conditions.

Music therapy is a powerful tool for healing. It’s a unique way to express emotions and improve overall health.

250 Words Essay on Music Therapy

Music therapy is an evidence-based, clinical use of musical interventions to improve clients’ quality of life. Therapists are professionals trained in psychology and music, using the transformative power of music to enhance health and wellbeing in various settings.

Music Therapy: A Multifaceted Approach

Music therapy is not a one-size-fits-all approach. It can be passive, where individuals listen to music, or active, involving music creation. Techniques are tailored to individual needs, whether it’s to improve cognitive functioning, motor skills, emotional development, or social skills.

Neurological Underpinnings

Music therapy’s effectiveness is rooted in neurology. Music stimulates both hemispheres of the brain, promoting neural plasticity and aiding in recovery from neurological damage. The “Mozart Effect”, a theory suggesting that listening to Mozart’s music can increase IQ, exemplifies the potential neurological benefits of music.

Therapeutic Applications

Music therapy is used in diverse settings like hospitals, schools, and rehabilitation centers. It has proven beneficial for a range of conditions, from autism and dementia to depression and PTSD. The non-verbal, creative, and emotional qualities of music provide unique avenues for therapy.

The power of music therapy lies in its ability to tap into the fundamental human connection to music. This innovative therapy approach has the potential to revolutionize healthcare, offering a holistic, patient-centered method to enhance quality of life. As research continues, it’s clear that the therapeutic power of music is only beginning to be understood.

500 Words Essay on Music Therapy

Introduction to music therapy.

Music therapy, a rapidly evolving field in the realm of health and wellness, is the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional. It is an intersection of music, psychology, and healthcare, aiming to improve the quality of life for individuals.

The Mechanism of Music Therapy

Music therapy operates on the principle that our brains process music in a unique way. It stimulates both hemispheres of the brain, making it a holistic treatment approach. Music can evoke emotions and memories, stimulate the release of endorphins, and alter our mood. These effects can be harnessed for therapeutic purposes, helping individuals express feelings they might struggle to put into words.

Applications of Music Therapy

Music therapy has a broad range of applications. It can be used in mental health treatment, aiding in managing stress, anxiety, and depression. It’s also employed in the field of neurology, where it helps patients with Parkinson’s disease, Alzheimer’s, and other cognitive disorders improve motor function and memory recall. In palliative care, music therapy can provide comfort and pain relief. Moreover, in educational settings, it can enhance learning and development in children with special needs.

Evidence Supporting Music Therapy

Empirical evidence validates the effectiveness of music therapy. A meta-analysis published in the Cochrane Library showed that music therapy improves social interaction, verbal communication, and initiating behavior in autistic children. Another study published in the Journal of Music Therapy demonstrated that music therapy can reduce anxiety levels in patients undergoing invasive procedures.

Challenges and Future Directions

Despite its potential, music therapy faces several challenges. The lack of standardized protocols, limited understanding of its mechanisms, and skepticism about its efficacy are some of the hurdles. However, with ongoing research and increasing acceptance in mainstream healthcare, the future of music therapy looks promising.

More research is needed to develop standardized treatment protocols and to understand the neurobiological mechanisms underpinning music therapy. Furthermore, interdisciplinary collaboration between music therapists, neuroscientists, psychologists, and healthcare professionals can foster a more comprehensive understanding of this field.

Music therapy is a potent tool in the arsenal of healthcare, offering a unique approach to treatment. It transcends traditional boundaries of therapy, harnessing the universal language of music to heal and uplift. As we continue to explore its potential, we can expect to see music therapy become an integral part of holistic healthcare, enhancing the quality of life for countless individuals.

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The Role of Art and Music Therapies in Mental Health and Beyond

Prescribing art therapy , yoga, and music lessons is truly a breakthrough for mental health treatment . I want to be completely clear here, this is a breakthrough, but not a breakthrough therapy per se. It is a huge step forward, on the level of readjusting our mental health system, it is really a systems course correction at the root of it. Art therapy, music, etc., all are tested modalities for improving mental health conditions; almost all of them. For chronic, highly disordered and severely dysfunctional patients, this is not a miracle cure. These are, at best, supplementary, tandem, and co-functioning treatment methods to mitigate the severity and intensity of symptoms.

I am not knocking or trying to minimise the importance of this breakthrough. These are not only important modalities in and of themselves, but also support the creativity , independence, and freedom of patients to not only choose their own method of care but also nourish their capacity to carry on treatment more autonomously without being under direct supervision . 

Even more importantly, the system is broken, in total if not complete disarray, and needs to be revised urgently if we are to advance treatment at the speed it requires to meet the mental health crisis where it’s at. These new prescribed modalities will not only serve to add ‘person-centredness’ to the paradigm but also new flexibility within the limits of the system.

Even highly disordered patients are extremely creative during their darkest hour. Art therapy, music, and all of these modalities which draw upon creativity and promote purposeful free-flowing ideas are as self-soothing as they are productive in reducing the negative impact of active symptoms.

I can tell you that I have benefited from a music or art group on an inpatient unit in the hospital many times. Some of my fondest memories from experiencing first-episode psychosis in the hospital were singing and dancing to Stevie Nicks , at my request, when I could barely speak from word salad symptoms and was just a few moments away from being transferred to a higher level of inpatient care for unresolved psychosis. But I danced and laughed like the floor was on fire.

Art, music, yoga, all of these modalities are terribly inaccessible to most patients living off state benefits, who are consigned to a life shut-in and isolated in their homes. Aside from ‘getting out more’, these patients simply don’t have the resources to pay for and maintain a connection to art therapists and other more non-traditional treatment in the community. Unless you are connected to a special service or have the best insurance, these modalities simply aren’t an option for most service users and people with a severe mental health condition.

I truly applaud this shift in the systems paradigm that for so long was all about medication and traditional psychotherapy. We really need more of this in countries supposedly promoting better mental health treatment.

I also want to suggest that therapists who practice traditional talk therapy , straight CBT (cognitive behavioural therapy) can continue to add new self-soothing and proven techniques to their toolkit. I am always encouraging my student therapists to do artwork, let their children dance in therapy. Yes, you read this right, just dance, when the time is right and fits the course of treatment.

We need to get out of this traditional black and white thinking of what therapy is and is not . Therapy is what people need in the moment, to feel and behave in a manner that better suits their goals, chosen lifestyle, and needs. So with this said, why not let a child who is struggling to adjust to a new foster parent, dance in session when he can’t play at home. Sure, not for every session and for the duration of every patient contact, but sometimes, when it will benefit the patient, you just have to do it. 

Yes, this is truly a breakthrough in thinking among us practitioners and the higher-ups in our discipline who say what’s what in mental health treatment. It signals that we need to be dynamic, and shift our thinking as practitioners, peers, and anyone charged with providing therapeutic intervention . It is high time we see more of it, from government-sponsored care and any system which is charged with the care of people with a psychiatric disability, or who needs therapeutic intervention to find relief from whatever problem in their life is causing them distress.

Max E. Guttman, LCSW  is a psychotherapist and owner of Recovery Now, a mental health private practice in New York City.

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