Music therapy for good health

Deborah C. Escalante

Overview

What is music therapy?

Music therapy is the clinical use of music to accomplish individualized goals such as reducing stress, improving mood and self-expression. It is an evidence-based therapy well-established in the health community. Music therapy experiences may include listening, singing, playing instruments, or composing music. Musical skills or talents are not required to participate.

Music therapy may help you psychologically, emotionally, physically, spiritually, cognitively and socially. A short list of benefits includes:

  • Lowering blood pressure.
  • Improving memory.
  • Enhanced communication and social skills through experiencing music with others.
  • Self-reflection. Observing your thoughts and emotions.
  • Reducing muscle tension.
  • Self-regulation. Developing healthy coping skills to manage your thoughts and emotions.
  • Increasing motivation.
  • Managing pain.
  • Increasing joy.

Formal music therapy was defined and first used by the United States War Department in 1945. It helped military service members recovering in Army hospitals with occupational therapy, education, recreation and physical reconditioning.

Who do music therapists work with?

People of all backgrounds, ages and cultures can respond to music, and to music therapy. Notable groups music therapists have helped include:

  • Military service members and veterans. Music therapy helps you cope with trauma.
  • People with Autism Spectrum Disorder (ASD). Individuals on the spectrum learn best when there is familiarity, structure, predictability and consistency.
  • Individuals with Alzheimer’s disease. Music therapy may help with memory and stimulate your mind because of predictability, familiarity and feelings of security.
  • People in correctional settings. If you’re incarcerated, in a mental health facility, half-way house or group home, music therapy may help with problem-solving, communication skills, relaxation and decreasing impulsivity.
  • Victims of trauma and crisis. If you’ve experienced trauma and crisis, you might have anxiety, stress and pain. Music therapy can help you with decreasing those three experiences, improving your mood, feeling confident and in control and providing a non-verbal outlet for emotions.
  • Those who are physically ill. The list includes, but is not limited to people with chronic pain, diabetes, cardiac conditions, cancer, headaches, recent surgery and people in rehab.
  • Individuals with mental health disorders. If you’re dealing with a mental health disorder, music therapy can help you with communication and expression, help you explore your thoughts and feelings, improve your mood and concentration and develop coping skills.
  • People with chronic pain. Music therapy can help decrease your pain, anxiety, fatigue and depression.
  • Substance abusers. Music therapy may help if you have a substance abuse disorder. Research has shown that it can increase motivation and self-esteem, reduce muscle tension, decrease anxiety, improve self-awareness and strengthen coping skills.

Where does music therapy take place?

The most common settings are hospitals, schools, nursing homes, outpatient clinics, mental health centers and residences for individuals with developmental disabilities. Music therapists also go to juvenile detention facilities, schools and private practices.

Is music therapy outpatient or inpatient?

Whether the music therapy is delivered outpatient or inpatient depends on the individual program. You may be able to come in for sessions during the day (just like a counseling appointment), or a music therapist may come to you while you’re admitted into the hospital or at school. Sometimes music therapy is held in groups.

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Do music therapists work with children and adolescents?

Yes. Music therapy may help with the following:

  • Behavior disorders.
  • Mood and anxiety disorders.
  • Attention deficit/Hyperactivity disorder (ADHD).
  • Autism spectrum disorders (ASD).
  • Trauma.
  • Substance abuse disorders.

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
  • Singing
  • Dancing
  • 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.

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.
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Techniques

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:

  • Clinic
  • Community health center
  • Correctional facility
  • Hospital
  • 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:

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

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:

  • Calmness
  • Euphoria
  • Confidence and empowerment
  • Emotional intimacy

Effectiveness

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). 

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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.

Insomnia 

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.

Cancer 

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.

Things to Consider

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.

How to Get Started

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

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

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

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