Best of Music TherapyFebruary 10, 2011 Written by JP [Font too small?]
Just because something seems simple doesn’t necessarily make it so. This is a stumbling block that I often see conventional scientists run into when discussing alternative or complementary therapies. How can everyday food possibly be as effective as a medication that’s taken millions of dollars and countless MDs and PhDs to create? Laughter is an enjoyable activity, but it can’t possibly improve cardiovascular health or survival in cancer patients. The very notion that supposedly un-serious activities such as artistic expression, listening to music or practicing generosity and kindness can alter one’s physiology is a difficult pill to swallow for many allopathically minded researchers.
Fortunately, some researchers are taking the study of mind-body medicine very seriously. One of the most intriguing examples is in the field of music therapy. A recent report from the Department of Psychology at the University of Sussex methodically elucidates how sounds can literally alter the makeup of the body and mind. According to the review, the extent to which music touches human beings is quite broad and profound. The paper describes it thusly: “music engages sensory processes, attention, memory-related processes, perception-action mediation, multi-sensory integration, activity changes in core areas of emotional processing, processing of musical syntax and musical meaning, and social cognition”. In order to illustrate how some of these concepts apply in the real world, I’ve compiled several relevant studies that have been published recently in the scientific literature. (1)
- Music Therapy for Mother and Child – A group of women suffering from labor pains and who were considered “high risk pregnancies” were provided with 30 minutes of music therapy for 3 consecutive days. A separate group of women was asked to simply rest for the same period of time. This latter group served as a comparison model. The women receiving the music therapy were documented as having lower anxiety levels and fewer physiological responses associated with labor pains. Music therapy has also recently been shown to console premature infants who suffer from “inconsolable crying” during periods when their parents or therapists aren’t present. Finally, exposing preemies to sonatas by Wolfgang Amadeus Mozart appears to help them burn fewer calories and, thereby, gain weight and become stronger. Researchers from Tel Aviv University’s Sackler School of Medicine theorized that Mozart’s highly repetitive melodies “may be affecting the organizational centers of the brain’s cortex” which makes the babies feel less agitated. (2,3,4)
- Music Therapy in Nursing Home Related Depression – An insightful study conducted at the National University of Singapore explains that “Many people over the age of 65 do not regard depression as a treatable mental disorder and find it difficult to express themselves verbally”. Therefore, a group of researchers postulated that listening to music might “facilitate the non-verbal expression of emotion and allow people’s inner feelings to be expressed without being threatened”. In order to test this hypothesis, a study involving 47 elderly residents was conducted. 23 of the participants were provided with music therapy and 24 were used as a control/comparison model. The men and women who took part in the music therapy exhibited significant reductions in blood pressure, depression scores, heart rate and respiratory rate after only 1 month of “treatment”. (5)
- Music Therapy as an Anti-Histamine – Listening to “feel-good music” may be an effective way to moderate histamine release in the body. This finding was established by having a group of young volunteers eat adverse/allergenic foods while listening to 5 minutes of happy music. Before and after salivary samples were used to quantify histamine secretion induced by the food challenges. Based on this preliminary experiment, it seems that the presence of feel-good music may have moderated the participants’ stress response, thereby decreasing histamine release. (6)
- Music Therapy Before and After Surgery – A Swedish study from July 2009 determined that relaxing music may be more effective at reducing pre-surgical anxiety than the prescription medication Midazolam. A total of 177 patients tried the music therapy and experienced a 4 point drop in State Trait Anxiety Inventory (STAI) scores. Those receiving the medication (150 patients) only found a 2 point drop in their STAI scores. The authors of the study concluded that “higher effectiveness and absence of apparent adverse effects makes pre-operative relaxing music a useful alternative to Midazolam for pre-medication”. The addition of soothing music after open heart surgery was also recently shown to increase levels of oxytocin, a hormone and neurotransmitter that promotes feelings of contentment, peace and safety. This is most likely the reason why many of the post-surgical patients reported feeling more relaxed than their music-less counterparts. The conclusion of this trial suggests that “Music intervention should be offered as an integral part of the multimodal regime administered to patients that have undergone cardiovascular surgery”. (7,8)
- Music Therapy and Stroke Recovery – A German study published in the July 2009 edition of the Annals of the New York Academy of Sciences examined the effects of “music-supported therapy” in a group of 32 stroke patients. 15 music therapy sessions were provided over a 3 week period along with standard care. The patients involved all suffered from moderate impairment of motor function and had not previously received music treatment. 30 other patients received a similar therapeutic program minus the music and were used as a comparison group. The stroke patients who received the standard care + music intervention demonstrated statistically greater improvements in “fine as well as gross motor skills” involving precision, smoothness and speed of movement. While the control group reported virtually no improvement, the music group further illustrated “electrophysiological changes indicative of better cortical connectivity and improved activation of the motor cortex”. The music, in conjunction with rehabilitation therapy, was literally allowing the brain to reorganize and compensate for the damage caused by the stroke. (9)
There’s still a lot to learn about how exactly to best utilize music in the healing arts. A recent Chinese study set out to prove that happy melodies would reduce pain more efficiently than sad music. The only problem is that the results of the trial didn’t support the original hypothesis! What the researchers determined instead is that the valence or perceived attractiveness of the music was the determining factor in pain relieving potential. This could conceivably open the door for doctors and psychiatrists to prescribe music much like they would medications – based on an individual’s personal needs and preferences. (10)
I’m certain that there’s going to be a multitude of new research on music therapy in the years to come. But what’s equally important to consider is how music is perceived by those who are being exposed to it. One of the finest things about music therapy is that it is generally welcomed by those who need it most. A recent report in the journal Complementary Therapies in Medicine asked “17 wheelchair bound elderly residents” about their impression of group music therapy. The men and women collectively stated that music provided them with added strength and enhanced their quality of life. They went on to remark that the inclusion of music inspired them to exercise and learn more and, perhaps as importantly, added variety and greater satisfaction to their lives. These are the type of statements that are rarely uttered with regard to conventional medical care. My hope is that the modern medical paradigm will soon incorporate more music into its institutes of healing. When they do, I believe that more actual healing of the body and mind will occur. (11)
Update: February 2011 – Scientists the world over have embraced the concept of using music as a viable therapy. This fact is evidenced by the sheer number of current publications appearing in the medical literature. Here’s a brief description of five new studies that illustrate the potential health benefits of arranging, listening to and/or performing music. 1) Daily exposure to a specific sonata by Mozart (K.448) for 6 months reduced the frequency of seizures in children with refractory epilepsy. 2) Children who created and used a music therapy CD while undergoing cancer treatment (radiation therapy) were found to cope with treatment significantly better than those in a “control” group. Success was measured by a reduced tendency to withdraw socially as a coping mechanism. 3) A new trial conducted in Turkey reports that the use of pain-relieving medication during pregnancy can be decreased if music therapy is administered staring one-hour after delivery/surgery. 4) According to researchers from Singapore, elderly patients with dementia demonstrated profound improvements in quality of life when they engage in a “weekly structured music therapy and activity program” as assessed by two scales: Apparent Emotion Scale (AES) and Revised Memory and Behavioral Problems Checklist (RMBPC). 5) The addition of relaxing music before bedtime effectively and safely improves emotional measures (reduced depression and “situational anxiety”) and sleep quality in patients with schizophrenia. This collection of data clearly indicates that many seemingly disparate medical conditions can be improved with the implementation of music therapy. (12,13,14,15,16)
Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!
Tags: Allergies, Depression, Surgery
Posted in Alternative Therapies, Mental Health, Women's Health
February 11th, 2011 at 9:46 am
The music fraternity I was in, in college – SAI –
They do music therapy for hospice patients.
And the effect is awesome, of course.
A gift at the beside that the families will never forget.
February 11th, 2011 at 11:45 am
Very interesting article JP.
Music can not only be soothing but for most people can make us recall happy memories. Many will recall the music at their wedding or other memorable family occasion. Music scores have enhanced both the mood and emotions in many memorable films.
Personally I find humming ‘Singing in the Rain’lifts my spirit when feeling down, which reminds me that there is a BBC Prom concert celebrating 75 years of MGM musicals on youtube for anybody interested.
Ah,those were the days!
February 11th, 2011 at 12:54 pm
You’ve lived such an interesting life. I’m amazed and impressed by the many ways you work to help people. My hat’s off to you!
February 11th, 2011 at 12:57 pm
I couldn’t agree more. I really do hope that one day we’ll all use things like comedy, music and time in nature and with pets as part of our regular wellness plan. These are gifts and tools that ought to be applied and respected at least as much as many medications.
Will check out that link now!
February 12th, 2011 at 5:25 am
Music therapy is quite useful and do wonder. I remember some years back when my mother went into the coma, and doctors and physicians were unable to treat her and bring her out of it, it was suggested to apply musical therapy. I did it . At last along with some other medical changes it worked out well and she came out of coma.
February 13th, 2011 at 9:14 pm
Music therapy is wonderful for people with Alzheimer’s disease…Songs and words seem to be etched in their minds…
This is wonderful and so exciting to see in Alsheimer’s units.
This is not something that is forgotten easily.
Thanks JP this article is an inspiration to read.
February 15th, 2011 at 1:52 pm
Agreed. And, thank you, Cyndi! 🙂
March 3rd, 2015 at 11:05 pm
Update: Classical music my promote healthier surgical recovery …
Pediatr Rep. 2014 Sep 29;6(3):5534.
Music benefits on postoperative distress and pain in pediatric day care surgery.
Postoperative effect of music listening has not been established in pediatric age. Response on postoperative distress and pain in pediatric day care surgery has been evaluated. Forty-two children were enrolled. Patients were randomly assigned to the music-group (music intervention during awakening period) or the non-music group (standard postoperative care). Slow and fast classical music and pauses were recorded and played via ambient speakers. Heart rate, blood pressure, oxygen saturation, glucose and cortisol levels, faces pain scale and Face, Legs, Activity, Cry, Consolability (FLACC) Pain Scale were considered as indicators of response to stress and pain experience. Music during awakening induced lower increase of systolic and diastolic blood pressure levels. The non-music group showed progressive increasing values of glycemia; in music-group the curve of glycemia presented a plateau pattern (P<0.001). Positive impact on reactions to pain was noted using the FLACC scale. Music improves cardiovascular parameters, stress-induced hyperglycemia. Amelioration on pain perception is more evident in older children. Positive effects seems to be achieved by the alternation of fast, slow rhythms and pauses even in pediatric age.
June 13th, 2015 at 4:49 pm
J Affect Disord. 2015 Apr 11;184:13-17.
Music therapy as an adjunct to standard treatment for obsessive compulsive disorder and co-morbid anxiety and depression: A randomized clinical trial.
BACKGROUND: Previous studies have highlighted the potential therapeutic benefits of music therapy as an adjunct to standard care, in a variety of psychiatric ailments including mood and anxiety disorders. However, the role of music in the treatment of obsessive-compulsive disorder (OCD) have not been investigated to date.
METHODS: In a single-center, parallel-group, randomized clinical trial (NCT02314195) 30 patients with OCD were randomly assigned to standard treatment (pharmacotherapy and cognitive-behavior therapy) plus 12 sessions of individual music therapy (n=15) or standard treatment only (n=15) for one month. Maudsley Obsessive-Compulsive Inventory, Beck Anxiety Inventory, and Beck Depression Inventory-Short Form were administered baseline and after one month.
RESULTS: Thirty patients completed the study. Music therapy resulted in a greater decrease in total obsessive score (post-intervention score: music therapy+standard treatment: 12.4±1.9 vs standard treatment only: 15.1±1.7, p<0.001, effect size=56.7%). For subtypes, significant between-group differences were identified for checking (p=0.004), and slowness (p=0.019), but not for washing or responsibility. Music therapy was significantly more effective in reducing anxiety (post-intervention score: music therapy+standard treatment: 16.9±7.4 vs standard treatment only: 22.9±4.6, p<0.001, effect size=47.0%), and depressive symptoms (post-intervention score: music therapy+standard treatment: 10.8±3.8 vs standard treatment: 17.1±3.7, p<0.001, effect size=47.0%).
LIMITATIONS: Inclusion of a small sample size, lack of blinding due to the nature of the intervention, short duration of follow-up.
CONCLUSION: In patients with OCD, music therapy, as an adjunct to standard care, seems to be effective in reducing obsessions, as well as co-morbid anxiety and depressive symptoms.
August 8th, 2015 at 4:05 pm
Clin Rheumatol. 2015 Aug 6.
Effects of music on pain in patients with fibromyalgia.
Fibromyalgia syndrome (FMS) is a chronic syndrome characterized by diffuse musculoskeletal system pain and painful tender points in certain areas of the body. The aim of the investigation was to determine the effects of music on pain in fibromyalgia patients. This randomized clinical trial was carried out with 37 fibromyalgia outpatients as an experimental group (n = 21) and control group (n = 16) at a University Hospital Internal Medicine and Rheumatology Clinic between 1 June and 1 December 2014. The research instruments used were descriptive characteristics questionnaire, Visual Analogue Scale (VAS), music CD which includes water and wave sounds recommended by the Turkish Psychological Association for psychological relaxation, and pain evaluation form. According to the findings, the average age of patients was 43.59 years ± 10.30, 94.6 % were women and 81.1 % were married. The fibromyalgia patients had the disease ranged from 1 month to 20 years, the average of disease duration was 23.6 ± 45.5 months, and the average of pain intensity was 6.89 ± 1.64 on the VAS. Average pain was reported in the experimental group in VAS on day 1 (5.45 ± 2.73), day 7 (4.57 ± 2.71), and day 14 (4.14 ± 2.45), and significant reduction in pain in the listening music group was seen (p = 0.026). A repeated measure analysis of variance controlling for differences between days demonstrated a significant decrease in pain between day 1 and day 14 (p = 0.022). There was no significant decrease in pain among control group participants. The effect of music has been found to control pain in fibromyalgia patients. Music therapy should be suggested in pain management for fibromyalgia patients as an non-pharmacologic nursing intervention.
December 17th, 2015 at 11:49 pm
J Altern Complement Med. 2015 Dec 15.
Effects of Music Therapy on the Cardiovascular and Autonomic Nervous System in Stress-Induced University Students: A Randomized Controlled Trial.
OBJECTIVE: Stress is caused when a particular relationship between the individual and the environment emerges. Specifically, stress occurs when an individual’s abilities are challenged or when one’s well-being is threatened by excessive environmental demands. The aim of this study was to measure the effects of music therapy on stress in university students.
DESIGN: Randomized controlled trial.
PARTICIPANTS: Sixty-four students were randomly assigned to the experimental group (n = 33) or the control group (n = 31).
INTERVENTION: Music therapy.
OUTCOME MEASURES: Initial measurement included cardiovascular indicators (blood pressure and pulse), autonomic nervous activity (standard deviation of the normal-to-normal intervals [SDNN], normalized low frequency, normalized high frequency, low/high frequency), and subjective stress. After the first measurement, participants in both groups were exposed to a series of stressful tasks, and then a second measurement was conducted. The experimental group then listened to music for 20 minutes and the control group rested for 20 minutes. A third and final measurement was then taken.
RESULTS: There were no significant differences between the two groups in the first or second measurement. However, after music therapy, the experimental group and the control group showed significant differences in all variables, including systolic blood pressure (p = .026), diastolic blood pressure (p = .037), pulse (p < .001), SDNN (p = .003), normalized low frequency (p < .001), normalized high frequency (p = .010), and subjective stress (p = .026). CONCLUSION: Classical music tends to relax the body and may stimulate the parasympathetic nervous system. These results suggest music therapy as an intervention for stress reduction. Be well! JP
January 1st, 2016 at 9:35 pm
J Eat Disord. 2015 Dec 30;3:50.
The role of music therapy in reducing post meal related anxiety for patients with anorexia nervosa.
BACKGROUND: It is well known that mealtime is anxiety provoking for patients with Anorexia Nervosa. However, there is little research into effective interventions for reducing meal related anxiety in an inpatient setting.
METHODS: This study compared the levels of distress and anxiety of patients with Anorexia Nervosa pre and post music therapy, in comparison to standard post meal support therapy. Data was collected using the Subjective Units of Distress (SUDS) scale which was administered pre and post each condition.
RESULTS: A total of 89 intervention and 84 control sessions were recorded. Results from an unpaired t-test analysis indicated statistically significant differences between the music therapy and supported meal conditions.
CONCLUSIONS: Results indicated that participation in music therapy significantly decreases post meal related anxiety and distress in comparison to standard post meal support therapy. This research provides support for the use of music therapy in this setting as an effective clinical intervention in reducing meal related anxiety.
June 1st, 2016 at 12:32 pm
The Journal of Alternative and Complementary Medicine
The Effects of Music Intervention on Sleep Quality in Community-Dwelling Elderly
Objectives: To examine the effects of music intervention on sleep quality in community-dwelling elderly people.
Design: Two-armed randomized controlled trial.
Settings: Four urban communities in Xi`an, China.
Participants: People aged 60 years or older with poor sleep quality (Pittsburgh Sleep Quality Index [PSQI] score >7).
Interventions: All participants received one sleep hygiene education session and biweekly telephone calls. Each participant in the intervention group received an MP3 player with a music database. The participants selected the preferred music and listened for 30–45 minutes per night for 3 months.
Outcome measures: Sleep quality, the main study outcome, was measured by PSQI at baseline, 1 month, 2 months, and 3 months.
Results: Sixty-four elderly people with a mean age of 69.38 ± 5.46 years were randomly assigned to the control group (n = 32) or the intervention group (n = 32). All participants completed the study, and none reported discomfort related to the music intervention. The intervention group demonstrated continuous improvements in sleep quality, with a global PSQI score of 13.53 at baseline, 9.28 at 1 month, 8.28 at 2 months, and 7.28 at 3 months. Although the global PSQI score in the control group also decreased from 12.26 at baseline to 8.72 at 3 months, the intervention group achieved greater improvements at each measurement (all p < 0.05). Repeated-measures analysis of variance revealed significant group-by-time interaction effects in global PSQI score and three component scores: sleep latency, sleep efficiency, and daytime dysfunction (all p < 0.05). Conclusion: Music is a safe and effective nonpharmacological intervention for improving the sleep quality of community-dwelling elderly people, especially in improving sleep latency, sleep efficiency, and daytime dysfunction. Be well! JP
February 1st, 2017 at 1:17 pm
Neurol Sci. 2017 Jan 30.
Active music therapy approach for stroke patients in the post-acute rehabilitation.
Guidelines in stroke rehabilitation recommend the use of a multidisciplinary approach. Different approaches and techniques with music are used in the stroke rehabilitation to improve motor and cognitive functions but also psychological outcomes. In this randomized controlled pilot trial, relational active music therapy approaches were tested in the post-acute phase of disease. Thirty-eight hospitalized patients with ischemic and hemorrhagic stroke were recruited and allocated in two groups. The experimental group underwent the standard of care (physiotherapy and occupational therapy daily sessions) and relational active music therapy treatments. The control group underwent the standard of care only. Motor functions and psychological aspects were assessed before and after treatments. Music therapy process was also evaluated using a specific rating scale. All groups showed a positive trend in quality of life, functional and disability levels, and gross mobility. The experimental group showed a decrease of anxiety and, in particular, of depression (p = 0.016). In addition, the strength of non-dominant hand (grip) significantly increased in the experimental group (p = 0.041). Music therapy assessment showed a significant improvement over time of non-verbal and sonorous-music relationships. Future studies, including a greater number of patients and follow-up evaluations, are needed to confirm promising results of this study.
August 5th, 2017 at 9:54 pm
The Journal of Alternative and Complementary Medicine. July 2017
Does Music Therapy Improve Anxiety and Depression in Alzheimer’s Patients?
Objective: To evaluate the effectiveness of the implementation of a short protocol of music therapy as a tool to reduce stress and improve the emotional state in patients with mild Alzheimer’s disease.
Methods: A sample of 25 patients with mild Alzheimer’s received therapy based on the application of a music therapy session lasting 60 min. Before and after the therapy, patient saliva was collected to quantify the level of salivary cortisol using the Enzyme-Linked ImmunoSorbent Assay (ELISA) immunoassay technique and a questionnaire was completed to measure anxiety and depression (Hospital Anxiety and Depression Scale).
Results: The results show that the application of this therapy lowers the level of stress and decreases significantly depression and anxiety, establishing a linear correlation between the variation of these variables and the variation of cortisol.
Conclusions: A short protocol of music therapy can be an alternative medicine to improve emotional variables in Alzheimer patients.
July 12th, 2018 at 1:28 pm
J Alzheimers Dis. 2018 Jul 6.
The Effects of Music Therapy on Cognition, Psychiatric Symptoms, and Activities of Daily Living in Patients with Alzheimer’s Disease.
BACKGROUND: Alzheimer’s disease (AD) is the most common type of dementia, affecting millions of older people worldwide. However, pharmacological therapies have not achieved desirable clinical efficacy in the past decades. Non-pharmacological therapies have been receiving increased attention to treat dementia in recent years.
OBJECTIVE: This study explores the effects of music therapy on cognitive function and mental wellbeing of patients with AD.
METHODS: A total number of 298 AD patients with mild, moderate, or severe dementia participated in the study. The participants with each grade of severity were randomly divided into three groups, which were a singing group, a lyric reading group, and a control group. These three groups received different interventions for three months. All participants underwent a series of tests on cognitive functions, neuropsychological symptoms, and activities of daily living at baseline, three months, and six months.
RESULTS: The analysis shows that music therapy is more effective for improving verbal fluency and for alleviating the psychiatric symptoms and caregiver distress than lyrics reading in patients with AD. Stratified analysis shows that music therapy is effective for enhancing memory and language ability in patients with mild AD and reducing the psychiatric symptoms and caregiver distress in patients with moderate or severe AD. However, no significant effect was found for activities of daily living in patients with mild, moderate, or severe AD.
CONCLUSION: This study suggests that music therapy is effective in enhancing cognitive function and mental wellbeing and can be recommended as an alternative approach to manage AD associated symptoms.