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Music therapy

 

Natural Standard Monograph, Copyright © 2013 (www.naturalstandard.com). Commercial distribution prohibited. This monograph is intended for informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified health care professional before making decisions about therapies and/or health conditions.

Related Terms

  • Active music listening, active music therapy, auditory integration training, Bonny Method of Guided Imagery and Music, "brain music" treatment, calming music therapy, contingent music, creative arts therapy, dinner music intervention, evocative music, expressive therapy, group chanting and singing, group drumming, Guided Imagery and Music (GIM), Hemi-Sync®, Heidelberg Model, improvisational music therapy, Individualized Music-Focused Auditory Therapy (IMAT), instructional music therapy, interactive music therapy, karaoke therapy, live music therapy, lullaby therapy, lyric analysis, mandalas, Medical Resonance Therapy Music (MRT-Music), medicine song, MT, muscle relaxation, music and movement, music and sign language, music-assisted progressive muscle relaxation, music-assisted reframing, music-based exercise, music-based imagery, music-based intervention, music exposure therapy, music in therapy, music intervention, music listening intervention, music stimulation, music therapy, music-reinforced therapy, music-video therapy, musical games, musical motor feedback (MMF), musical training program, musicokinetic therapy, Orff-based music therapy, rāgas (Sanskrit), recreational music-making (RMM), relaxation music, rhythmic training, self-selected music therapy, soothing music therapy, tactile music therapy, Therapeutic Application of a Musically Modulated Electromagnetic Field (TAMMEF).

Background

  • Music has been used as a tool of healing since ancient times, appearing in the writings of the Greek philosophers Pythagoras, Aristotle, and Plato. Native Americans and other indigenous groups have used music to enhance traditional healing practices for centuries. References to music for healing have appeared in ancient Native American pictographs, African petroglyphs and other ancient inscriptions. Healing songs and music have also been passed down through oral traditions worldwide. Traditional Chinese medicine (TCM) practitioners have used music for healing. Traditional rāgas ("melodic modes" used in classical music in India) have also been used to create different states of mind for healing.
  • Some scholars believe that "modern" music therapy began in the mid-1700s, when Louis Roger wrote his "A Treatise on the Effects of Music on the Human Body." Others say that the modern discipline of music therapy began early in the 20th Century to treat recovering soldiers during and after both World Wars. Patients' responses led to growth of such programs and wider scientific curiosity about the possible clinical effects of music.
  • Music has been used to influence physical, emotional, cognitive, and social well-being and improve quality of life for healthy people as well as those who are disabled or ill. Therapy may involve either listening to or performing music, with or without the presence of a music therapist.
  • Music therapists are professionally trained to design specialized applications of music according to an individual's needs using improvisation, receptive listening, song writing, lyric discussion, imagery, performance, and learning through music.
  • Sessions can be designed for individuals or groups based on the specific needs of the participants. People that support music therapy claim that infants, children, adolescents, adults, the elderly and even animals can all potentially benefit from music therapy.
  • Music therapists work in many kinds of healthcare settings including psychiatric hospitals, prisons, rehabilitative facilities, medical hospitals, outpatient clinics, day treatment centers, agencies serving developmentally disabled persons, community mental health centers, drug and alcohol programs, senior centers, nursing homes, hospice programs, correctional facilities, halfway houses, schools, and private practice.

Theory

The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious and should be evaluated by a qualified health care professional.

  • All forms of music may have therapeutic effects, although music from one's own culture may be most effective. In Chinese medical theory, the five internal organ and meridian systems are believed to have corresponding musical tones, which are used to encourage healing.
  • Types of music differ in the types of neurological stimulation they evoke. For example, classical music has been found to cause comfort and relaxation while rock music may lead to discomfort. Music may achieve its therapeutic effects in part by elevating the pain threshold.
  • Music may be used with guided imagery to produce altered states of consciousness that help uncover hidden emotional responses and stimulate creative insights. Music may also be used in the classroom to aid children in the development of reading and language skills.
  • Receptive methods involve listening to and responding to live or recorded music. Discussion of their responses is believed to help people express themselves in socially accepted ways and to examine personal issues.
  • Improvisation involves spontaneous creation of music with voice, instruments, or body sounds. This allows for creative expression, energy release, development of personal insights, and redirection of negative emotions.
  • Recreative experiences involve singing and playing pre-composed music. This is believed to help develop a sense of mastery and increased self-confidence.
  • Composition methods involve creating vocal and instrumental pieces as a means of self-expression.

Evidence

 

Uses based on scientific evidence 

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare professional.

Grade* 

Mood enhancement 

Structured music therapy programs have been found to improve mood in institutional long-term care workers facing burnout and autologous stem cell transplant patients. There is also evidence that combining music with guided imagery may lead to reduced fatigue, mood disturbance, and blood levels of cortisol (a stress hormone).

A 

Relaxation/stress/anxiety 

The relaxation response is a physiological state that speeds up many of the body's healing responses. Relaxation leads to reduced heart rate, blood pressure, and tension, as well as many other beneficial changes. Music therapy has been shown to cause relaxation.

A 

Autism 

People with autism spectrum disorders often show a heightened interest and response to music. This may aid in the teaching of verbal and nonverbal communication skills and in establishing normal developmental processes.

B 

Dementia 

In older adults with Alzheimer's, dementia, and other mental disorders, music therapy has been found to reduce aggressive or agitated behavior, reduce symptoms of dementia, improve mood, and improve cooperation with daily tasks, such as bathing. Music therapy may also decrease the risk of heart or brain diseases in elderly dementia patients.

B 

Depression 

There is evidence that music therapy may increase responsiveness to antidepressant medications. In elderly adults with depression, a home-based program of music therapy may have long-lasting effects. In depressed adult women, music therapy may lead to reductions in heart rate, respiratory rate, blood pressure, and depressed mood. Music therapy may also be beneficial in depression following total knee replacement surgery or in patients undergoing hemodialysis.

B 

Infant development / neonatal care 

There is evidence that music played to the womb during late pregnancy may lead to children being more responsive to music after birth. Soothing music may help newborns be more relaxed and less agitated. Pre-term newborns exposed to music may have increased feeding rates, reduced days to discharge, increased weight gain, and increased tolerance of stimulation. They may also have reduced heart rates and a deeper sleep after therapy.

B 

Pain (adjunct) 

Music therapy helps in a wide range of pain conditions, primarily by its ability to improve mood, encourage relaxation, and increase pain threshold. Most research has shown positive results. However, studies, especially those that involved severe pain, have not found benefits.

B 

Parkinson's disease 

Parkinson's patients have shown modest improvement in symptoms including in some aspects of motor coordination, speech intelligibility and vocal intensity, bradykinesia (slow movement), emotional functions, activities of daily living, and quality of life.

B 

Quality of life 

Quality of life is a broad concept comprising morale, mood, self-esteem, daily functioning, pain, general well-being, life satisfaction, and related issues. Music therapy has been associated with improved quality of life in a variety of populations, usually based on regular group sessions over several weeks. Benefits to quality of life from such an approach have been seen in cancer patients, seniors with emphysema, elders in long-term care, terminal/hospice patients, and multiple sclerosis.

B 

Schizophrenia 

Music therapy that includes either chorus or karaoke may improve interpersonal functioning in people with schizophrenia. Music therapy may also help reduce symptoms of schizophrenia, including psychosis. Non-classical music was found to be more effective than classical music. Also, it does not seem to make a difference if the music is live or recorded or if therapy is structured or not structured.

B 

Sleep quality 

In older adults, music may result in significantly better sleep quality as well as longer sleep duration, greater sleep efficiency, shorter time needed to fall asleep, less sleep disturbance, and less daytime dysfunction. There is also evidence of benefit in elementary-age children or stable preterm infants. Music therapy may also be as effective as chloral hydrate in inducing sleep or sedation in children undergoing EEG testing.

B 

Attention deficit hyperactivity disorder (ADHD) 

More study is needed in this area before a strong recommendation can be made.

C 

Cardiac conditions 

Music therapy may reduce pain and anxiety in adults undergoing heart surgery, although it does not appear to improve heart rate or blood pressure. In children, music therapy may improve heart rate and breathing rate, as well as reduce pain.

C 

Communication skills 

Based on early research, music therapy may help children learning English as a second language, although more studies are needed to confirm this finding. Music therapy has also been studied as a possible way to improve learning and communication skills in patients with Rett syndrome or pseudo-Parkinsonian vascular disease.

C 

Cystic fibrosis 

Routine chest physiotherapy (CPT) is a component of prophylactic therapy in children with cystic fibrosis (CF) and requires significant time and energy. There is some evidence that children's tolerance and enjoyment of physiotherapy may benefit from music therapy.

C 

Grief (children) 

Grieving children may benefit from a group music therapy program in terms of both improved mood and reduced problematic behavior in school.

C 

Mental performance 

Music therapy may help maintain mental functioning in elderly adults undergoing surgical procedures, reduce postoperative confusion and delirium, and increase energy levels.

C 

Nausea/vomiting 

Music therapy may reduce levels of nausea and episodes of vomiting in bone marrow transplant patients during the preparatory period when they are receiving high-dose cyclophosphamide.

C 

Ringing in the ears 

A specially designed music therapy may help improve symptoms of ringing in the ears. More research is needed.

C 

Sedation 

Music can have a calming or sedating effect. There is evidence of this in studies of patients undergoing gastrointestinal endoscopic procedures, including evidence that colonoscopy patients who used music intervention may have a higher rate of completed colonoscopies and shorter examination time. Other work suggests that patients undergoing spinal anesthesia may have less need for sedative medication during and after surgery.

C 

 

*Key to grades: 

A: Strong scientific evidence for this use;
B: Good scientific evidence for this use;
C: Unclear scientific evidence for this use;
D: Fair scientific evidence against this use (it may not work);
F: Strong scientific evidence against this use (it likely does not work).

For full grading rationale, click here.

Uses based on tradition or theory 

The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified health care professional

Abuse, addiction, adjunct in surgery (reduced stress during extra corporeal membrane oxygenation), aggression, alcoholism, anger, antisocial behavior, asthma, balance, bipolar disorder, brain injuries, breathing difficulties, cardiac conditions, childbirth, cognitive performance enhancement (problem solving), concentration enhancement, chronic pulmonary obstructive disease (COPD), coping skills, diabetes, dyspnea, eating disorders, epilepsy, headaches, hallucinations (auditory), high blood pressure, impulsivity, increasing agility, irritability, joint mobility, melatonin deficiency (in people with Alzhemier's), migraine (children), motion sickness, multiple sclerosis, muscle tension, neurodermatitis, neurological trauma, post-operative recovery, post-stroke rehabilitation, prevention of pregnancy complications, psoriasis, psychological disorders (low therapy motivation), pulmonary conditions (respiration rate, respiratory muscle strength), rehabilitation, restlessness, spinal cord injury, strength, stroke, well-being (hopelessness).

Safety

Many complementary techniques are practiced by healthcare professionals with formal training, in accordance with the standards of national organizations. However, this is not universally the case, and adverse effects are possible. Due to limited research, in some cases only limited safety information is available.

  • Just as certain music can help induce relaxation and peaceful states, other music may cause agitation.
  • There is evidence that music that reflects the listener's personal preference is more likely to have desired effects.
  • It is possible that music through headphones during medical procedures could interfere with the patient's cooperation with the procedures. Also, listening to music at high volumes may damage the ears and lead to hearing loss.
  • Music should not be used as the sole treatment for potentially dangerous medical or psychiatric conditions.
  • Use is not recommended in those who do not like music therapy as this may result in agitation or stress.

Authors

  • This information is based on a professional level monograph edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Selected References

Natural Standard developed the above evidence-based information based on a systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

  1. Boso, M., Emanuele, E., Minazzi, V., Abbamonte, M., and Politi, P. Effect of long-term interactive music therapy on behavior profile and musical skills in young adults with severe autism. J Altern Complement Med 2007;13(7):709-712.
  2. Bruer, R. A., Spitznagel, E., and Cloninger, C. R. The temporal limits of cognitive change from music therapy in elderly persons with dementia or dementia-like cognitive impairment: a randomized controlled trial. J Music.Ther 2007;44(4):308-328.
  3. Hatem TP, Lira PI, Mattos SS. The therapeutic effects of music in children following cardiac surgery. J Pediatr (Rio J) 2006 May-Jun;82(3):186-92.
  4. Hilliard RE. The effects of orff-based music therapy and social work groups on childhood grief symptoms and behaviors. J Music Ther 2007 Summer;44(2):123-38.
  5. Holmes C, Knights A, Dean C, et al. Keep music live: music and the alleviation of apathy in dementia subjects. Int Psychogeriatr 2006 Dec;18(4):623-30.
  6. Jaber S, Bahloul H, Guetin S, et al. [Effects of music therapy in intensive care unit without sedation in weaning patients versus non-ventilated patients]. Ann Fr Anesth Reanim 2007 Jan;26(1):30-8.
  7. Kern P, Aldridge D. Using embedded music therapy interventions to support outdoor play of young children with autism in an inclusive community-based child care program. J Music Ther 2006 Winter;43(4):270-94.
  8. Kwon IS, Kim J, Park KM. Effects of music therapy on pain, discomfort, and depression for patients with leg fractures. Taehan Kanho Hakhoe Chi 2006 Jun;36(4):630-6.
  9. Leardi S, Pietroletti R, Angeloni G, et al. Randomized clinical trial examining the effect of music therapy in stress response to day surgery. Br J Surg 2007 Aug;94(8):943-7.
  10. Liu RW, Mehta P, Fortuna S, et al. A randomized prospective study of music therapy for reducing anxiety during cast room procedures. J Pediatr Orthop 2007 Oct-Nov;27(7):831-3.
  11. Ostermann T, Schmid W. Music therapy in the treatment of multiple sclerosis: a comprehensive literature review. Expert Rev Neurother 2006 Apr;6(4):469-77.
  12. Rudin D, Kiss A, Wetz RV, et al. Music in the endoscopy suite: a meta-analysis of randomized controlled studies. Endoscopy 2007 Jun;39(6):507-10.
  13. Sendelbach SE, Halm MA, Doran KA, et al. Effects of music therapy on physiological and psychological outcomes for patients undergoing cardiac surgery. J Cardiovasc Nurs 2006 May-Jun;21(3):194-200.
  14. Silverman MJ. The influence of music on the symptoms of psychosis: a meta-analysis. J Music Ther 2003 Spring;40(1):27-40.
  15. Talwar N, Crawford MJ, Maratos A, et al. Music therapy for in-patients with schizophrenia: exploratory randomised controlled trial. Br J Psychiatry 2006 Nov;189:405-9.
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