Music therapy for mental health care clients

Psychotherapy and Psychosomatics

Regular Article

Individual Music Therapy for Mental Health Care Clients with Low Therapy Motivation: Multicentre Randomised Controlled Trial

Gold C.a

Mössler K.a

Grocke D.h

Heldal T.O.a

Tjemsland L.e

Aarre T.f

Aarø L.E.b, d

Rittmannsberger H.g

Stige B.c

Assmus J.a

Rolvsjord R.c

Author affiliations

aGAMUT, Uni Health, Uni Research and bDepartment of Health Promotion and Development, cGAMUT, University of Bergen, Bergen, and dDivision of Mental Health, Norwegian Institute of Public Health, Oslo, eStavanger University Hospital, Stavanger, and fNordfjord Psychiatric Centre, Nordfjordeid, Norway; gState Psychiatric Clinic Wagner-Jauregg, Linz, Austria; hUniversity of Melbourne, Melbourne, Vic., Australia

Keywords: MotivationEffectivenessPragmatic trialResource-oriented music therapySerious mental disorders

Copyright / Drug Dosage / Disclaimer

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

Background: Music therapy (MT) has been shown to be efficacious for mental health care clients with various disorders such as schizophrenia, depression and substance abuse. Referral to MT in clinical practice is often based on other factors than diagnosis. We aimed to examine the effectiveness of resource-oriented MT for mental health care clients with low motivation for other therapies. Method: This was a pragmatic parallel trial. In specialised centres in Norway, Austria and Australia, 144 adults with non-organic mental disorders and low therapy motivation were randomised to 3 months of biweekly individual, resource-oriented MT plus treatment as usual (TAU) or TAU alone. TAU was typically intensive (71 % were inpatients) and included the best combination of therapies available for each participant, excluding MT. Blinded assessments of the Scale for the Assessment of Negative Symptoms (SANS) and 15 secondary outcomes were collected before randomisation and after 1, 3 and 9 months. Changes were analysed on an intention-to-treat basis using generalised estimating equations in longitudinal linear models, controlling for diagnosis, site and time point. Results: MT was superior to TAU for total negative symptoms (SANS, d = 0.54, p < 0.001) as well as functioning, clinical global impressions, social avoidance through music, and vitality (all p < 0.01). Conclusion: Individual MT as conducted in routine practice is an effective addition to usual care for mental health care clients with low motivation. Copyright © 2013 S. Karger AG, Basel

“Music was my refuge. I could crawl into the space between the notes and curl my back to loneliness.” – Maya Angelou

Music is all around us from the rhythm of the cars on the streets, the melody birds tend to chirp, or even the music we choose to listen to in the car, commuting to school or work, or in our homes. Maybe you even create music yourself by playing an instrument, singing, or experimenting with different music apps or programs on computers. Many people would claim that music puts them in a better mood, though are unsure why or how it has that effect. There are many articles written about mood and music, though mood is not the only factor when dealing with mental health. Our physical bodies and interpersonal relationships are also affected by our mental health, whether we are in a good place or in crisis. Music can be beneficial in aiding all of these aspects of mental health. Many people living with mental health challenges have participated in some form of therapy. However, many are unaware of the wide variety of therapies available, including those in the creative arts. This article looks at the creative art therapy of music therapy, and how it can support mental health.

What is Music Therapy?

The American Music Therapy Association (AMTA) provides a detailed definition of music therapy on their website. For this blog, we have shortened that definition as follows: Music therapy is the evidence-based practice of a board-certified music therapist using music interventions to help clients achieve non-musical goals. In music therapy, the therapy happens between the therapist and client through the music. Music therapists can work in a variety of settings such as schools, hospitals, private practice, senior centers, day programs, and hospice to name a few. A music therapist can work with a variety of different populations. A few examples include people with Autism Spectrum Disorder, seniors with dementia, adults with disabilities, hospice patients, and those living with mental health challenges. Music therapists use a variety of different music interventions to help address cognitive, physical, emotional, and social needs. Some interventions include re-creating music, song-writing, improvisation, and lyric analysis. The style of music used is dependent on the preferences and goals of each client.

5 benefits of music therapy for mental health

Now that we have an understanding of what music therapy is, we can explain how it is beneficial to those living with mental health challenges.
1. Developing useful coping strategies
When dealing with symptoms of mental illness, we hear the common expression of “using coping strategies” to help lessen symptoms. Music therapy can provide a wide variety of different coping skills including breathing techniques, rhythmic grounding, auditory grounding, relaxation, and distraction. In music therapy, these strategies are practiced, so when a crisis arises, one knows how to utilize their strategies effectively.
2. Developing positive emotional behavior
Sometimes when struggling with mental health, the hardest question to answer is “how are you?”. Many people default into saying “good”, “fine”, or “okay,” without knowledge of what those words truly mean to them in that moment. Music therapy can help with the identification and labeling of emotions in a safe environment that can transfer over into better communication of feelings and needs in other situations. Emotional behavior also includes emotional awareness and the non-verbal expression of emotions. Music therapy can be a useful tool in learning how to safely express emotions either verbally or non-verbally in order to increase emotional regulation.
3. Increasing frustration tolerance
Mental health challenges can cause frustration to increase in some situations. Many times when frustration is at its peak, that is when many mental health symptoms start to exhibit themselves and become too overwhelming to handle. Through music therapy, one can work on building frustration tolerance in a controlled environment through something creative in nature. For example, a music therapist may engage the client in a structured improvisation based on themes dealing with mental health (i.e. triggers, overcoming frustration, reflecting the emotions felt in a panic attack) to work on developing how to experience and overcome frustration. Music therapy can also help clients learn relaxation techniques to help prevent frustration from increasing.
4. Improving interpersonal relationships
Though mental health is often thought of as a personal issue, it does impact our daily relationships. This could be with family, friends, acquaintances, significant others, workplace relationships, or even strangers you happen to meet day to day. Mental health troubles can cause us to isolate, lash-out, or want to disconnect from those around us. Music therapy can provide opportunities to practice social skills that can later be transferred to daily relationships. More times in music therapy this is done in a group setting, but can also be addressed individually.
5. Improving self awareness, self-esteem, and self-image
Part of the battle with mental health is trying to understand what is happening in your mind and how it’s affecting you. Mental health challenges can take a toll on our esteem and the image that we have of ourselves as well. Music therapy can help support these and increase insight into one’s behavior and self. It is hard to be kind to yourself when you are feeling at your lowest. A music therapist can guide you through the low moments to find the good qualities within yourself that will guide you through the rough times, and help you look forward to the positive times ahead.

Author :Leandra Ward, MT-BC, NMT, Board Certified Music Therapist, Neurologic Music Therapist