research topics on music therapy

REVIEW article

The state of music therapy studies in the past 20 years: a bibliometric analysis.

• 1 School of Kinesiology, Shanghai University of Sport, Shanghai, China
• 2 Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
• 3 Department of Sport Rehabilitation Medicine, Shanghai Shangti Orthopedic Hospital, Shanghai, China

Purpose: Music therapy is increasingly being used to address physical, emotional, cognitive, and social needs of individuals. However, publications on the global trends of music therapy using bibliometric analysis are rare. The study aimed to use the CiteSpace software to provide global scientific research about music therapy from 2000 to 2019.

Methods: Publications between 2000 and 2019 related to music therapy were searched from the Web of Science (WoS) database. The CiteSpace V software was used to perform co-citation analysis about authors, and visualize the collaborations between countries or regions into a network map. Linear regression was applied to analyze the overall publication trend.

Results: In this study, a total of 1,004 studies met the inclusion criteria. These works were written by 2,531 authors from 1,219 institutions. The results revealed that music therapy publications had significant growth over time because the linear regression results revealed that the percentages had a notable increase from 2000 to 2019 ( t = 14.621, P < 0.001). The United States had the largest number of published studies (362 publications), along with the following outputs: citations on WoS (5,752), citations per study (15.89), and a high H-index value (37). The three keywords “efficacy,” “health,” and “older adults,” emphasized the research trends in terms of the strongest citation bursts.

Conclusions: The overall trend in music therapy is positive. The findings provide useful information for music therapy researchers to identify new directions related to collaborators, popular issues, and research frontiers. The development prospects of music therapy could be expected, and future scholars could pay attention to the clinical significance of music therapy to improve the quality of life of people.

Introduction

Music therapy is defined as the evidence-based use of music interventions to achieve the goals of clients with the help of music therapists who have completed a music therapy program ( Association, 2018 ). In the United States, music therapists must complete 1,200 h of clinical training and pass the certification exam by the Certification Board for Music Therapists ( Devlin et al., 2019 ). Music therapists use evidence-based music interventions to address the mental, physical, or emotional needs of an individual ( Gooding and Langston, 2019 ). Also, music therapy is used as a solo standard treatment, as well as co-treatment with other disciplines, to address the needs in cognition, language, social integration, and psychological health and family support of an individual ( Bronson et al., 2018 ). Additionally, music therapy has been used to improve various diseases in different research areas, such as rehabilitation, public health, clinical care, and psychology ( Devlin et al., 2019 ). With neurorehabilitation, music therapy has been applied to increase motor activities in people with Parkinson's disease and other movement disorders ( Bernatzky et al., 2004 ; Devlin et al., 2019 ). However, limited reviews about music therapy have utilized universal data and conducted massive retrospective studies using bibliometric techniques. Thus, this study demonstrates music therapy with a broad view and an in-depth analysis of the knowledge structure using bibliometric analysis of articles and publications.

Bibliometrics turns the major quantitative analytical tool that is used in conducting in-depth analyses of publications ( Durieux and Gevenois, 2010 ; Gonzalez-Serrano et al., 2020 ). There are three types of bibliometric indices: (a) the quantity index is used to determine the number of relevant publications, (b) the quality index is employed to explore the characteristics of a scientific topic in terms of citations, and (c) the structural index is used to show the relationships among publications ( Durieux and Gevenois, 2010 ; Gonzalez-Serrano et al., 2020 ). In this study, the three types of bibliometric indices will be applied to conduct an in-depth analysis of publications in this frontier.

While research about music therapy is extensively available worldwide, relatively limited studies use bibliometric methods to analyze the global research about this topic. The aim of this study is to use the CiteSpace software to perform a bibliometric analysis of music therapy research from 2000 to 2019. CiteSpace V is visual analytic software, which is often utilized to perform bibliometric analyses ( Falagas et al., 2008 ; Ellegaard and Wallin, 2015 ). It is also a tool applied to detect trends in global scientific research. In this study, the global music therapy research includes publication outputs, distribution and collaborations between authors/countries or regions/institutions, intense issues, hot articles, common keywords, productive authors, and connections among such authors in the field. This study also provides helpful information for researchers in their endeavor to identify gaps in the existing literature.

Materials and Methods

Search strategy.

The data used in this study were obtained from WoS, the most trusted international citation database in the world. This database, which is run by Thomson & Reuters Corporation ( Falagas et al., 2008 ; Durieux and Gevenois, 2010 ; Chen C. et al., 2012 ; Ellegaard and Wallin, 2015 ; Miao et al., 2017 ; Gonzalez-Serrano et al., 2020 ), provides high-quality journals and detailed information about publications worldwide. In this study, publications were searched from the WoS Core Collection database, which included eight indices ( Gonzalez-Serrano et al., 2020 ). This study searched the publications from two indices, namely, the Science Citation Index Expanded and the Social Sciences Citation Index. As the most updated publications about music therapy were published in the 21st century, publications from 2000 to 2019 were chosen for this study. We performed data acquisition on July 26, 2020 using the following search terms: title = (“music therapy”) and time span = 2000–2019.

Inclusion Criteria

Figure 1 presents the inclusion criteria. The title field was music therapy (TI = music therapy), and only reviews and articles were chosen as document types in the advanced search. Other document types, such as letters, editorial materials, and book reviews, were excluded. Furthermore, there were no species limitations set. This advanced search process returned 718 articles. In the end, a total of 1,004 publications were obtained and were analyzed to obtain comprehensive perspectives on the data.

Figure 1 . Flow chart of music therapy articles and reviews inclusion.

Data Extraction

Author Lin-Man Weng extracted the publications and applied the EndNote software and Microsoft Excel 2016 to conduct analysis on the downloaded publications from the WoS database. Additionally, we extracted and recorded some information of the publications, such as citation frequency, institutions, authors' countries or regions, and journals as bibliometric indicators. The H-index is utilized as a measurement of the citation frequency of the studies for academic journals or researchers ( Wang et al., 2019 ).

Analysis Methods

The objective of bibliometrics can be described as the performance of studies that contributes to advancing the knowledge domain through inferences and explanations of relevant analyses ( Castanha and Grácio, 2014 ; Merigó et al., 2019 ; Mulet-Forteza et al., 2021 ). CiteSpace V is a bibliometric software that generates information for better visualization of data. In this study, the CiteSpace V software was used to visualize six science maps about music therapy research from 2000 to 2019: the network of author co-citation, collaboration network among countries and regions, relationship of institutions interested in the field, network map of co-citation journals, network map of co-cited references, and the map (timeline view) of references with co-citation on top music therapy research. As noted, a co-citation is produced when two publications receive a citation from the same third study ( Small, 1973 ; Merigó et al., 2019 ).

In addition, a science map typically features a set of points and lines to present collaborations among publications ( Chen, 2006 ). A point is used to represent a country or region, author, institution, journal, reference, or keyword, whereas a line represents connections among them ( Zheng and Wang, 2019 ), with stronger connections indicated by wider lines. Furthermore, the science map includes nodes, which represent the citation frequencies of certain themes. A burst node in the form of a red circle in the center indicates the number of co-occurrence or citation that increases over time. A purple node represents centrality, which indicates the significant knowledge presented by the data ( Chen, 2006 ; Chen H. et al., 2012 ; Zheng and Wang, 2019 ). The science map represents the keywords and references with citation bursts. Occurrence bursts represent the frequency of a theme ( Chen, 2006 ), whereas citation bursts represent the frequency of the reference. The citation bursts of keywords and references explore the trends and indicate whether the relevant authors have gained considerable attention in the field ( Chen, 2006 ). Through this kind of map, scholars can better understand emerging trends and grasp the hot topics by burst detection analysis ( Liang et al., 2017 ; Miao et al., 2017 ).

Publication Outputs and Time Trends

A total of 1,004 articles and reviews related to music therapy research met the criteria. The details of annual publications are presented in Figure 2 . As can be seen, there were <30 annual publications between 2000 and 2006. The number of publications increased steadily between 2007 and 2015. It was 2015, which marked the first time over 80 articles or reviews were published. The significant increase in publications between 2018 and 2019 indicated that a growing number of researchers became interested in this field. Linear regression can be used to analyze the trends in publication outputs. In this study, the linear regression results revealed that the percentages had a notable increase from 2000 to 2019 ( t = 14.621, P < 0.001). Moreover, the P < 0.05, indicating statistical significance. Overall, the publication outputs increased from 2000 to 2019.

Figure 2 . Annual publication outputs of music therapy from 2000 to 2019.

Distribution by Country or Region and Institution

The 1,004 articles and reviews collected were published in 49 countries and regions. Table 1 presents the top 10 countries or regions. Figure 3 shows an intuitive comparison of the citations on WoS, citations per study, Hirsch index (H-index), and major essential science indicator (ESI) studies of the top five countries or regions. The H-index is a kind of index that is applied in measuring the wide impact of the scientific achievements of authors. The United States had the largest number of published studies (362 publications), along with the following outputs: citations on WoS (5,752), citations per study (15.89), and a high H-index value (37). Norway has the largest number of citations per study (27.18 citations). Figure 4 presents the collaboration networks among countries or regions. The collaboration network map contained 32 nodes and 38 links. The largest node can be found in the United States, which meant that the United States had the largest number of publications in the field. Meanwhile, the deepest purple circle was located in Austria, which meant that Austria is the country with the most number of collaborations with other countries or regions in this research field. A total of 1,219 institutions contributed various music therapy-related publications. Figure 5 presents the collaborations among institutions. As can be seen, the University of Melbourne is the most productive institution in terms of the number of publications (45), followed by the University of Minnesota (43), and the University of Bergen (39). The top 10 institutions featured in Table 2 contributed 28.884% of the total articles and reviews published. Among these, Aalborg University had the largest centrality (0.13). The top 10 productive institutions with details are shown in Table 2 .

Table 1 . Top 10 countries or regions of origin of study in the music therapy research field.

Figure 3 . Publications, citations on WoS (×0.01), citations per study, H-index, and ESL top study among top five countries or regions.

Figure 4 . The collaborations of countries or regions interested in the field. In this map, the node represents a country, and the link represents the cooperation relationship between two countries. A larger node represents more publications in the country. A thicker purple circle represents greater influence in this field.

Figure 5 . The relationship of institutions interested in the field. University of Melbourne, Florida State University, University of Minnesota, Aalborg University, Temple University, University of Queensland, and University of Bergen. In this map, the node represents an institution, and the link represents the cooperation relationship between two institutions. A larger node represents more publications in the institution. A thicker purple circle represents greater influence in this field.

Table 2 . Top 10 institutions that contributed to publications in the music therapy field.

Distribution by Journals

Table 3 presents the top 10 journals that published articles or reviews in the music therapy field. The publications are mostly published in these journal fields, such as Therapy, Medical, Psychology, Neuroscience, Health and Clinical Care. The impact factors (IF) of these journals ranged between 0.913 and 7.89 (average IF: 2.568). Four journals had an impact factor >2, of which Cochrane Database of Systematic Reviews had the highest IF, 2019 = 7.89. In addition, the Journal of Music Therapy (IF: 2019 = 1.206) published 177 articles or reviews (17.629%) about music therapy in the past two decades, followed by the Nordic Journal of Music Therapy (121 publications, 12.052%, IF: 2019 = 0.913), and Arts in Psychotherapy (104 publications, 10.359%, IF: 2019 = 1.322). Furthermore, the map of the co-citation journal contained 393 nodes and 759 links ( Figure 6 ). The high co-citation count identifies the journals with the greatest academic influence and key positions in the field. The Journal of Music Therapy had the maximum co-citation counts (658), followed by Cochrane Database of Systematic Reviews (281), and Arts in Psychotherapy (279). Therefore, according to the analysis of the publications and co-citation counts, the Journal of Music Therapy and Arts in Psychotherapy occupied key positions in this research field.

Table 3 . Top 10 journals that published articles in the music therapy field.

Figure 6 . Network map of co-citation journals engaged in music therapy from 2000 to 2019. Journal of Music Therapy, Arts in Psychotherapy, Nordic Journal of Music Therapy, Music Therapy Perspectives, Cochrane Database of Systematic Reviews. In this map, the node represents a journal, and the link represents the co-citation frequency between two journals. A larger node represents more publications in the journal. A thicker purple circle represents greater influence in this field.

Distribution by Authors

A total of 2,531 authors contributed to the research outputs related to music therapy. Author Silverman MJ published most of the studies (46) in terms of number of publications, followed by Gold C (41), Magee WL (19), O'Callaghan C (15), and Raglio A (15). According to co-citation counts, Bruscia KE (171 citations) was the most co-cited author, followed by Gold C (147 citations), Wigram T (121 citations), and Bradt J (117 citations), as presented in Table 4 . In Figure 7 , these nodes highlight the co-citation networks of the authors. The large-sized node represented author Bruscia KE, indicating that this author owned the most co-citations. Furthermore, the linear regression results revealed a remarkable increase in the percentages of multiple articles of authors ( t = 13.089, P < 0.001). These also indicated that cooperation among authors had increased remarkably, which can be considered an important development in music therapy research.

Table 4 . Top five authors of publications and top five authors of co-citation counts.

Figure 7 . The network of author co-citaion. In this map, the node represents an author, and the link represents the co-citation frequency between two authors. A larger node represents more publications of the author. A thicker purple circle represents greater influence in this field.

Analysis of Keywords

The results of keywords analysis indicated research hotspots and help scholars identify future research topics. Table 5 highlights 20 keywords with the most frequencies, such as “music therapy,” “anxiety,” “intervention,” “children,” and “depression.” The keyword “autism” has the highest centrality (0.42). Figure 8 shows the top 17 keywords with the strongest citation bursts. By the end of 2019, keyword bursts were led by “hospice,” which had the strongest burst (3.5071), followed by “efficacy” (3.1161), “health” (6.2109), and “older adult” (4.476).

Table 5 . Top 20 keywords with the most frequency and centrality in music therapy study.

Figure 8 . The strongest citation bursts of the top 17 keywords. The red measures indicate frequent citation of keywords, and the green measures indicate infrequent citation of keywords.

Analysis of Co-cited References

The analysis of co-cited references is a significant indicator in the bibliometric method ( Chen, 2006 ). The top five co-cited references and their main findings are listed in Table 6 . These are regarded as fundamental studies for the music therapy knowledge base. In terms of co-citation counts, “individual music therapy for depression: randomized controlled trial” was the key reference because it had the most co-citation counts. This study concludes that music therapy mixed with standard care is an effective way to treat working-age people with depression. The authors also explained that music therapy is a valuable enhancement to established treatment practices ( Erkkilä et al., 2011 ). Meanwhile, the strongest citation burst of reference is regarded as the main knowledge of the trend ( Fitzpatrick, 2005 ). Figure 9 highlights the top 71 strongest citation bursts of references from 2000 to 2019. As can be seen, by the end of 2019, the reference burst was led by author Stige B, and the strongest burst was 4.3462.

Table 6 . Top five co-cited references with co-citation counts in the study of music therapy from 2000 to 2019.

Figure 9 . The strongest citation bursts among the top 71 references. The red measures indicate frequent citation of studies, and the green measures indicate infrequent citation of studies.

Figure 10A presents the co-cited reference map containing 577 nodes and 1,331 links. The figure explains the empirical relevance of a considerable number of articles and reviews. Figure 10B presents the co-citation map (timeline view) of reference from publications on top music therapy research. The timeline view of clusters shows the research progress of music therapy in a particular period of time and the thematic concentration of each cluster. “Psychosis” was labeled as the largest cluster (#0), followed by “improvisational music therapy” (#1) and “paranesthesia anxiety” (#2). These clusters have also remained hot topics in recent years. Furthermore, the result of the modularity Q score was 0.8258. That this value exceeded 0.5 indicated that the definitions of the subdomain and characters of clusters were distinct. In addition, the mean silhouette was 0.5802, which also exceeded 0.5. The high homogeneity of individual clusters indicated high concentration in different research areas.

Figure 10. (A) The network map of co-cited references and (B) the map (timeline view) of references with co-citation on top music therapy research. In these maps, the node represents a study, and the link represents the co-citation frequency between two studies. A larger node represents more publications of the author. A thicker purple circle represents greater influence in this field. (A) The nodes in the same color belong to the same cluster. (B) The nodes on the same line belong to the same cluster.

Global Trends in Music Therapy Research

This study conducted a bibliometric analysis of music therapy research from the past two decades. The results, which reveal that music therapy studies have been conducted throughout the world, among others, can provide further research suggestions to scholars. In terms of the general analysis of the publications, the features of published articles and reviews, prolific countries or regions, and productive institutions are summarized below.

I. The distribution of publication year has been increasing in the past two decades. The annual publication outputs of music therapy from 2000 to 2019 were divided into three stages: beginning, second, and third. In the beginning stage, there were <30 annual publications from 2000 to 2006. The second stage was between 2007 and 2014. The number of publications increased steadily. It was 2007, which marked the first time 40 articles or reviews were published. The third stage was between 2015 and 2019. The year 2015 was the key turning point because it was the first time 80 articles or reviews were published. The number of publications showed a downward trend in 2016 (72), but it was still higher than the average number of the previous years. Overall, music therapy-related research has received increasing attention among scholars from 2000 to 2020.

II. The articles and reviews covered about 49 countries or regions, and the prolific countries or regions were mainly located in the North American and European continents. According to citations on WoS, citations per study, and the H-index, music therapy publications from developed countries, such as United States and Norway, have greater influence than those from other countries. In addition, China, as a model of a developing country, had published 53 studies and ranked top six among productive countries.

III. In terms of the collaboration map of institutions, the most productive universities engaged in music therapy were located in the United States, namely, University of Minnesota (43 publications), Florida State University (33 publications), Temple University (27 publications), and University of Kansas (20 publications). It indicated that institutions in the US have significant impacts in this area.

IV. According to author co-citation counts, scholars can focus on the publications of such authors as Bruscia KE, Gold C, and Wigram T. These three authors come from the United States, Norway, and Denmark, and it also reflected that these three countries are leading the research trend. Author Bruscia KE has the largest co-citation counts and is based at Temple University. He published many music therapy studies about assessment and clinical evaluation in music therapy, music therapy theories, and therapist experiences. These publications laid a foundation and facilitate the development of music therapy. In addition, in Figure 11 , the multi-authored articles between 2000 and 2003 comprised 47.56% of the sample, whereas the publications of multi-authored articles increased significantly from 2016 to 2019 (85.51%). These indicated that cooperation is an effective factor in improving the quality of publications.

Figure 11 . The percentage of single- vs. multiple-authored articles. Blue bars mean multiple-author percentage; orange bars mean single-author percentage.

Research Focus on the Research Frontier and Hot Topics

According to the science map analysis, hot music therapy topics among publications are discussed.

I. The cluster “#1 improvisational music therapy” (IMT) is the current research frontier in the music therapy research field. In general, music therapy has a long research tradition within autism spectrum disorders (ASD), and there have been more rigorous studies about it in recent years. IMT for children with autism is described as a child-centered method. Improvisational music-making may enhance social interaction and expression of emotions among children with autism, such as responding to communication acts ( Geretsegger et al., 2012 , 2015 ). In addition, IMT is an evidence-based treatment approach that may be helpful for people who abuse drugs or have cancer. A study applied improving as a primary music therapeutic practice, and the result indicated that IMT will be effective in treating depression accompanied by drug abuse among adults ( Albornoz, 2011 ). By applying the interpretative phenomenological analysis and psychological perspectives, a study explained the significant role of music therapy as an innovative psychological intervention in cancer care settings ( Pothoulaki et al., 2012 ). IMT may serve as an effective additional method for treating psychiatric disorders in the short and medium term, but it may need more studies to identify the long-term effects in clinical practice.

II. Based on the analysis of co-citation counts, the top three references all applied music therapy to improve the quality of life of clients. They highlight the fact that music therapy is an effective method that can cover a range of clinical skills, thus helping people with psychological disorders, chronic illnesses, and pain management issues. Furthermore, music therapy mixed with standard care can help individuals with schizophrenia improve their global state, mental state (including negative and general symptoms), social functioning, and quality of life ( Gold et al., 2009 ; Erkkilä et al., 2011 ; Geretsegger et al., 2017 ).

III. By understanding the keywords with the strongest citation bursts, the research frontier can be predicted. Three keywords, “efficacy,” “health,” and “older adults,” emphasized the research trends in terms of the strongest citation bursts.

a. Efficacy: This refers to measuring the effectiveness of music therapy in terms of clinical skills. Studies have found that a wide variety of psychological disorders can be effectively treated with music. In the study of Fukui, patients with Alzheimer's disease listened to music and verbally communicated with their music therapist. The results showed that problematic behaviors of the patients with Alzheimer's disease decreased ( Fukui et al., 2012 ). The aim of the study of Erkkila was to determine the efficacy of music therapy when added to standard care. The result of this study also indicated that music therapy had specific qualities for non-verbal expression and communication when patients cannot verbally describe their inner experiences ( Erkkilä et al., 2011 ). Additionally, as summarized by Ueda, music therapy reduced anxiety and depression in patients with dementia. However, his study cannot clarify what kinds of music therapy or patients have effectiveness. Thus, future studies should investigate music therapy with good methodology and evaluation methods ( Ueda et al., 2013 ).

b. Health: Music therapy is a methodical intervention in clinical practice because it uses music experiences and relationships to promote health for adults and children ( Bruscia, 1998 ). Also, music therapy is an effective means of achieving the optimal health and well-being of individuals and communities, because it can be individualized or done as a group activity. The stimulation from music therapy can lead to conversations, recollection of memories, and expression. The study of Gold indicated that solo music therapy in routine practice is an effective addition to usual care for mental health care patients with low motivation ( Gold et al., 2013 ). Porter summarized that music therapy contributes to improvement for both kids and teenagers with mental health conditions, such as depression and anxiety, and increases self-esteem in the short term ( Porter et al., 2017 ).

c. Older adults: This refers to the use of music therapy as a treatment to maintain and slow down the symptoms observed in older adults ( Mammarella et al., 2007 ; Deason et al., 2012 ). In terms of keywords with the strongest citation bursts, the most popular subjects of music therapy-related articles and reviews focused on children from 2005 to 2007. However, various researchers concentrated on older adults from 2017 to 2019. Music therapy was the treatment of choice for older adults with depression, Parkinson's disease, and Alzheimer's disorders ( Brotons and Koger, 2000 ; Bernatzky et al., 2004 ; Johnson et al., 2011 ; Deason et al., 2012 ; McDermott et al., 2013 ; Sakamoto et al., 2013 ; Benoit et al., 2014 ; Pohl et al., 2020 ). In the study of Zhao, music therapy had positive effects on the reduction of depressive symptoms for older adults when added to standard therapies. These standard therapies could be standard care, standard drug treatment, standard rehabilitation, and health education ( Zhao et al., 2016 ). The study of Shimizu demonstrated that multitask movement music therapy was an effective intervention to enhance neural activation in older adults with mild cognitive impairment ( Shimizu et al., 2018 ). However, the findings of the study of Li explained that short-term music therapy intervention cannot improve the cognitive function of older adults. He also recommended that future researchers can apply a quality methodology with a long-term research design for the care needs of older adults ( Li et al., 2015 ).

Strengths and Limitations

To the best of our knowledge, this study was the first one to analyze large-scale data of music therapy publications from the past two decades through CiteSpace V. CiteSpace could detect more comprehensive results than simply reviewing articles and studies. In addition, the bibliometric method helped us to identify the emerging trend and collaboration among authors, institutions, and countries or regions.

This study is not without limitations. First, only articles and reviews published in the WoS Science Citation Index Expanded and Social Sciences Citation Index were analyzed. Future reviews could consider other databases, such as PubMed and Scopus. The document type labeled by publishers is not always accurate. For example, some publications labeled by WoS were not actually reviews ( Harzing, 2013 ; Yeung, 2021 ). Second, the limitation may induce bias in frequency of reference. For example, some potential articles were published recently, and these studies could be not cited with frequent times. Also, in terms of obliteration by incorporation, some common knowledge or opinions become accepted that their contributors or authors are no longer cited ( Merton, 1965 ; Yeung, 2021 ). Third, this review applied the quantitative analysis approach, and only limited qualitative analysis was performed in this study. In addition, we applied the CitesSpace software to conduct this bibliometric study, but the CiteSpace software did not allow us to complicate information under both full counting and fractional counting systems. Thus, future scholars can analyze the development of music therapy in some specific journals using both quantitative and qualitative indicators.

Conclusions

This bibliometric study provides information regarding emerging trends in music therapy publications from 2000 to 2019. First, this study presents several theoretical implications related to publications that may assist future researchers to advance their research field. The results reveal that annual publications in music therapy research have significantly increased in the last two decades, and the overall trend in publications increased from 28 publications in 2000 to 111 publications in 2019. This analysis also furthers the comprehensive understanding of the global research structure in the field. Also, we have stated a high level of collaboration between different countries or regions and authors in the music therapy research. This collaboration has extremely expanded the knowledge of music therapy. Thus, future music therapy professionals can benefit from the most specialized research.

Second, this research represents several practical implications. IMT is the current research frontier in the field. IMT usually serves as an effective music therapy method for the health of people in clinical practice. Identifying the emerging trends in this field will help researchers prepare their studies on recent research issues ( Mulet-Forteza et al., 2021 ). Likewise, it also indicates future studies to address these issues and update the existing literature. In terms of the strongest citation bursts, the three keywords, “efficacy,” “health,” and “older adults,” highlight the fact that music therapy is an effective invention, and it can benefit the health of people. The development prospects of music therapy could be expected, and future scholars could pay attention to the clinical significance of music therapy to the health of people.

Finally, multiple researchers have indicated several health benefits of music therapy, and the music therapy mechanism perspective is necessary for future research to advance the field. Also, music therapy can benefit a wide range of individuals, such as those with autism spectrum, traumatic brain injury, or some physical disorders. Future researchers can develop music therapy standards to measure clinical practice.

Author Contributions

KL and LW: conceptualization, methodology, formal analysis, investigation, resources, writing—review, and editing. LW: software and data curation. KL: validation and writing—original draft preparation. XW: visualization, supervision, project administration, and funding acquisition. All authors contributed to the article and approved the submitted version.

This study was supported by the Fok Ying-Tong Education Foundation of China (161092), the scientific and technological research program of the Shanghai Science and Technology Committee (19080503100), and the Shanghai Key Lab of Human Performance (Shanghai University of Sport) (11DZ2261100).

Conflict of Interest

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.

Abbreviations

WoS, Web of Science; ESI, essential science indicators; IF, impact factor; IMT, improvisational music therapy; ASD, autism spectrum disorder.

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Keywords: music therapy, aged, bibliometrics, health, web of science

Citation: Li K, Weng L and Wang X (2021) The State of Music Therapy Studies in the Past 20 Years: A Bibliometric Analysis. Front. Psychol. 12:697726. doi: 10.3389/fpsyg.2021.697726

Received: 20 April 2021; Accepted: 12 May 2021; Published: 10 June 2021.

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Copyright © 2021 Li, Weng and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Xueqiang Wang, wangxueqiang@sus.edu.cn

† These authors have contributed equally to this work and share first authorship

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• Published: 04 December 2023

Biological principles for music and mental health

• Daniel L. Bowling   ORCID: orcid.org/0000-0002-5303-5472 1 , 2  

Translational Psychiatry volume  13 , Article number:  374 ( 2023 ) Cite this article

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• Human behaviour
• Neuroscience
• Psychiatric disorders

Efforts to integrate music into healthcare systems and wellness practices are accelerating but the biological foundations supporting these initiatives remain underappreciated. As a result, music-based interventions are often sidelined in medicine. Here, I bring together advances in music research from neuroscience, psychology, and psychiatry to bridge music’s specific foundations in human biology with its specific therapeutic applications. The framework I propose organizes the neurophysiological effects of music around four core elements of human musicality: tonality, rhythm, reward, and sociality. For each, I review key concepts, biological bases, and evidence of clinical benefits. Within this framework, I outline a strategy to increase music’s impact on health based on standardizing treatments and their alignment with individual differences in responsivity to these musical elements. I propose that an integrated biological understanding of human musicality—describing each element’s functional origins, development, phylogeny, and neural bases—is critical to advancing rational applications of music in mental health and wellness.

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Introduction

Every day, hundreds of millions of people make or listen to music. This appetite is driven by music’s core effects on emotion [ 1 , 2 , 3 ], reward [ 4 ], and affiliation [ 5 ]. The value we place on these effects supports a 200 billion dollar per year industry in the US alone [ 6 ]. More and more, music’s core effects have come into focus for their alignment with core dimensions of mental health, e.g., mood, motivation, pleasure, and social functioning. Together with rapidly increasing awareness of mental health’s humanistic and financial importance, this alignment has sparked new investments in music-based interventions from government and industry [ 7 , 8 , 9 ]. This interest presents an opportunity for proponents of music’s therapeutic value to increase the specificity and rigor of its application and enhance our understanding of its clinical scope and efficacy.

Meeting this goal depends on a clear conception of music’s underlying biology as a source of principles for systematic applications towards specific clinical and subclinical goals. An awareness of such principles exists in music therapy [ 10 , 11 , 12 ], especially “neurologic” music therapies for motor rehabilitation [ 13 , 14 , 15 ], but applications in mental health remain highly variable, making it difficult to achieve a unified biologically-informed approach. Moreover, there are far too few music therapists to meet current mental health needs. In the US, for example, there are only about 10,000 board-certified music therapists, compared to about 58 million adults living with mental illness [ 16 , 17 ]. Assuming an average weekly caseload of 30 patients [ 18 ], total capacity to treat is therefore just 0.5%. Musicians represent another important source of insight, as they are ultimately the most skilled at titrating music’s neurophysiological impact. However, the inherently subjective nature of their “artistic” approach can preclude direct integration within a scientific model of health.

Given the uncertainty in defining the relationship between music and health, funders have sought to advance applications by casting a wide net. The National Institutes of Health, for example, has sponsored an extensive list of research topics involving music, including improving treatment response in cancer, stress and pain management in surgery, affect modulation in mood disorders, anxiolysis in anxiety disorders, social functioning in neurodevelopmental disorders, palliative care in advanced illness, neural rehabilitation after injury, and wellness through exercise [ 19 ]. This breadth is likely to puzzle many medical professionals and raise skepticism in more than a few. Can music really be such a panacea?

While skepticism is justified (as discussed in Section “Skepticism and need”), clear evidence of music’s effects on core mental health variables is readily apparent in our growing understanding of music’s biological foundations. Critically, these foundations provide a rational basis for standardizing and expanding music’s psychiatric applications and benefits. In this review, I outline a framework for music in human biology and describe some of its basic implications for standardized music-based interventions in mental health, with the goal of increasing biomedical integration and impact.

Developing a biological perspective

As far as we know, music has been with humans since our earliest existence. The first known evidence of human preoccupation with music comes from Stone Age flutes, carefully carved in wing bones and mammoth ivory some 40,000 years ago [ 20 ]. Over the course of recorded history, explanations of music and its power have been sought in terms of mythology, cosmology, mathematics, and physics, with many important insights along the way [ 21 , 22 ]. However, it was not until the 19th century that music came to be viewed in terms of human evolution. In 1871, based on observations of general similarity between human and animal vocalization, as well as the behavior of other “singing” mammals (like gibbons and howler monkeys), Darwin postulated a basis for music in sexual selection on social behavior. Specifically, he proposed that the vocalizations of our ancestors were likely more musical than linguistic, comprising greater regularity in pitch and time, and functioning mainly in signaling affect, attracting mates, and threatening rivals [ 23 ]. From this perspective, “music” provided the foundation for the evolution of human language, centering its underlying biology within the study of human cognition and communication more broadly [ 24 ].

Two aspects of this early account continue to shape modern biological music research or biomusicology (e.g. [ 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 ]). One is that music is, first and foremost, a form of social communication, with explicit origins in auditory-vocal interaction. The second is that singing and speaking—and thus, music and language—likely share a common origin in early hominids, as reflected by their many overlapping features, like being auditory-vocal by default, emotional expressive, and inherently social [ 25 ]. While many more specific details about the evolutionary origins of music remain under debate (cf [ 31 , 38 , 42 , 43 , 44 , 45 , 46 , 47 , 48 ]), a general view of music as rooted in social communication, with close ties to speech and language, is consistent across most theories and also central here.

Before proceeding, it is important to clarify that biomusicology chiefly concerns musicality rather than music per se. Whereas music is a cultural phenomenon of infinite variety [ 46 ], musicality is the genetically constrained and reliably developing set of neural capacities on which music production and perception rests [ 33 ]. It should be noted that this view departs significantly from common conceptions of music that center specific cultural manifestations and individual variation in preferences. Instead, a biological perspective centers music’s basic features in relation to pressures to evolve and develop neural capacities that support social communication. The following sections define this perspective with respect to four core elements of musicality—tonality, rhythm, reward, and sociality—reviewing essential concepts, biological bases, and evidence of clinical benefits, towards a framework for rational clinical translation.

Musical terms and definitions

Tones are a special class of sound stimuli that evoke a strong sense of pitch. Physically, they comprise regularly spaced pressure waves that repeat at frequencies between approximately 30–4000 Hz [ 49 ]. All musical cultures and traditions use tones [ 50 , 51 ], making neural sensitivity to tonality— defined simply as the use of tones to make music—a core element of human musicality. Tonality has primarily been considered from three perspectives. Harmony is focused on the organization of tones with respect to frequency. Melody is focused on the sequential organization of tones over time. Timbre is focused on the quality imparted to tones by their source and manner of production (e.g., a voice or a synthesizer, sounded gently or harshly, etc.) [ 52 ].

Conserved aspects of tonality

The most significant source of tones in the human auditory environment is vocal fold vibration in the larynx [ 53 , 54 ]. In speech, the frequency of vocal fold vibration fluctuates rapidly, leading to dynamic and variable tones (Fig. 1A ). In contrast, during song, these vibrations are modulated to emphasize particular frequencies and frequency relationships [ 50 , 51 , 55 ]. Beyond these “universal” features, many key aspects of harmony, melody, and timbre are widely observed across richly differentiated musical cultures and traditions.

A The same phrase spoken and sung by the same person to highlight how tones in music are related to tones in speech (based on Diana Deustch’s speech-to-song illusion). Variation in sound pressure over time (black) is overlaid with variation in the fundamental frequency of vocal fold vibration (the physical correlate of voice pitch; red). B On the left, the frequency relationships defined by the Japanese ritsu scale are presented along a vertical axis. Each relationship is calculated with respect to the lowest tone in the set (labeled “1.000”). On the right, the melody of the American gospel song “Amazing Grace” is shown using the same relationships. Conventional note letter names are listed at the right. C Timbral similarity of vocal and instrumental tones with parallel affective qualities. Top row: sound pressure waveforms with temporal envelopes shown in red. Bottom row: corresponding Fourier transforms with spectral envelopes shown in blue. These examples were selected to show similarity in temporal and spectral features of vocal and instrumental tones with parallel affective qualities.

In harmony, music almost always emphasizes a small set of tones defined by specific relationships to each other [ 51 ]. The simplest of these relationships—e.g., octaves (2:1) and fifths (3:2)—feature prominently in music worldwide [ 21 , 56 , 57 ], and particular sets of ratios called scales (or modes) are strikingly popular across cultural boundaries [ 21 , 57 , 58 ]. For example, the Western minor mode corresponds to what South Indian musicians call the Keeravani raga [ 59 ]. Similarly, the Japanese ritsu scale is also found in traditional Western folk songs like “Auld Lang Syne” and “Amazing Grace” (Fig. 1B ) [ 60 ]. In melody, tones tend to be arranged in arched or descending contours [ 21 , 51 ], traced mainly by small steps in pitch, with larger steps typically rising (Fig. 1B ) [ 61 , 62 , 63 , 64 ].

In timbre, specific temporal and spectral characteristics of tones give rise to specific perceptions of anatomical and affective source parameters, e.g., the ratio of low- to high-frequency energy in a tone is associated with size, valence, and arousal [ 65 , 66 ], rapid tone onsets signal a higher commitment of energy [ 67 ], and “rough” growl-like tones often convey anger or aggression [ 68 , 69 ] (Fig. 1C ). There is also widespread conservation in the use of tones for specific purposes. For example, lullabies typically comprise tones with relatively more low-frequency energy, sorted into simple repeating patterns [ 70 , 71 , 72 ]. Likewise, flatter contours with narrower pitch steps are favored for conveying somber affect [ 63 , 73 ]. Together, these and other broadly conserved aspects of tonality indicate a strong foundation in our shared biology.

Biological foundations of tonality

To model the biology underlying tonality, music scientists have developed vocal similarity theory (VST), the central tenet of which is that we perceive tones according to their behavioral significance in vocal communication [ 22 , 30 , 53 , 58 , 74 , 75 , 76 , 77 , 78 ]. VST is based on the fact that our experience with tones is dominated by the voice at evolutionary and individual time scales. This implies that the neurobiology of tone perception has primarily been shaped by pressure to contend with tones in the voice and their significance for adaptive behavior [ 22 , 53 , 75 ].

Phylogenetically, sensitivity to “tone of voice” is likely to have emerged very early in tetrapod evolution [ 79 ]. In mammals, auditory-vocal interaction is often central to social behavior and cognition, placing this sensitivity under intense selective pressure. Developmentally, the fetal brain begins responding to mother’s voice around the 24th week of gestation [ 80 ]. Over the ensuing weeks, these responses develop to the point that infants strongly prefer their mother’s voice at birth [ 81 ], an orientation that scaffolds the formation of our prototypical social bond, the modulation of affect through sound, and the development of communication more broadly [ 82 ]. Mechanistically, neural specialization for responding to vocal tones is evident throughout the auditory system, from enhanced representations of periodicity in the brainstems of humans and rats [ 83 , 84 ], to harmonically sensitive neurons in marmoset cortex [ 85 ], and pitch contour neurons in human cortex [ 86 ].

The culmination of this underlying biology is a brain that responds to tones reflexively by supplying percepts of meaning and intent as guides for behavior and cognition. This works because the acoustics of laryngeal vocalization are linked to source parameters at a statistical level [ 87 , 88 ]. For music, the implication of VST is that conserved aspects of tonality can be understood as consequences of the auditory system’s biological tuning to voices.

Applications of tonality in mental health

VST roots tonality in the bioacoustics of vocal affect, providing a principled basis for the assessment and manipulation of reflexive responses to musical tones, and their translation to psychiatry. For any given clinical goal related to the modulation of patient affect, VST predicts that proper applications of tonality require alignment with the statistical regularities that identify vocal expressions as conveying the emotion required to effect the desired physiological change. For example, a musical intervention aimed at relieving high anxiety and agitated negative mood should have tonal properties that align with a positive calming voice, such as extended falling pitch contours and low-frequency weighted timbres. Similarly, an intervention for depression should possess a gentle affirming tone, captured by more articulated contours that rise towards their ends. This approach naturally imbues musical tonality with a capacity to modulate listener feelings that parallels the corresponding tone of voice. However, because musical tones are (often) freed from the constraints of vocal expression—e.g., by instrumental production or release from linguistic demands—key regularities can be distilled and exaggerated to yield tones with supernormal neurophysiological effects.

Importantly, guidance derived from VST on how to use tonality to modulate affect largely corresponds with what musicians and music therapists have learned to do through subjective exploration and experience [ 76 , 89 ]. This is reflected in the effects of current musical treatments on dysregulated anxiety and mood. For example, receptive treatments (based on listening) can effectively reduce acute anxiety in chemotherapy [ 90 ], childbirth [ 91 ], and surgery [ 92 ]. A 2018 meta-analysis of 81 randomized controlled studies, involving over 6000 patients, found that music listening before, during, or after surgery significantly reduced anxiety symptoms, with an effect size equal to 69% of one standard deviation (Standard Mean Difference [SMD] = 0.69) [ 92 ]. Other meta-analyses indicate that music therapy can also be an effective anxiolytic beyond these acute medical contexts. A 2021 meta-analysis of 32 controlled studies with over 1,900 patients with anxiety showed significant anxiety reduction after an average of 7.5 music therapy sessions (SMD = 0.36). This effect was stronger in the subset of 11 studies with >12 sessions (SMD = 0.59), suggesting a dose-response effect [ 93 ]. For context, consider that estimated summary SMDs for first-line psychotherapies and pharmacotherapies lie between 0.28–0.44 and 0.33–0.45 respectively (but note that these numbers are based on much larger samples) [ 94 ].

Similarly positive effects of music therapy have been reported for affect disorders. A 2017 meta-analysis of 9 controlled studies including 411 patients diagnosed with a depressive disorder found that adding 6–12 weeks of music therapy to antidepressants and/or psychotherapy significantly reduced clinician-rated and patient-rated symptoms (SMD = 0.98 and 0.85 respectively) [ 95 ]. A 2020 meta-analysis focused specifically on receptive musical treatments found an even stronger effect when looking at depressive symptoms across patients with a wider variety of primary diagnoses, like heart disease, dementia, insomnia (SMD = 1.33, 17 controlled studies, 1,284 patients) [ 96 ]. The same paper also reports a significant effect for interactive treatment (based on making music; SMD = 0.57, 20 controlled studies, 1,368 patients) [ 96 ]. Both effects were apparent across variable depression severity levels and treatment courses (mean dosage was approximately 14 h, SD = 18, range = 0.33–126) [ 95 , 96 ]. For context, overall SMDs for psychotherapy and pharmacotherapy in depressive disorders have been estimated at 0.31 and 0.30 respectively (again, based on larger samples) [ 94 ].

While success of this kind might suggest that music therapy can do without VST, it should be noted that none of the aforementioned meta-analyses (and few of the individual studies that they cite) provide any details on the parameters of the music employed. This is largely because musical decisions are made on intuition rather than principle. Thus, while subjectivity has proven an essential guide in discovering music’s therapeutic applications, it also complicates scientific efforts to understand music’s therapeutic effects and standardize their application. VST addresses this challenge by providing objective guidelines for musical tonality based on specific therapeutic goals. This is a necessary step towards standardization, which is in turn required for expanding access to musical treatment.

Rhythm is the temporal patterning of sounds in music. The dominant feature of rhythm is temporal predictability, focused at rates ranging from approximately 0.5 to 5 Hz (30–300 beats per minute [bpm]) [ 97 , 98 , 99 ]. All musical cultures and traditions exhibit some temporal predictability in this range, making neural sensitivity to rhythm a second core element of musicality (no ranking implied) [ 50 , 51 ]. Investigations of rhythm typically identify two core components [ 100 ]. Pulse is the main cycle of rhythmic repetition perceived in music; it is generally what we synchronize to when we move in time with music. Meter refers more broadly to other rhythmic cycles perceived in music [ 101 ]. These encompass repetition rates that are both faster and slower than the pulse, defined by subdivisions of the pulse and multi-pulse cycles, respectively.

Conserved aspects of rhythm

As with tonality, key elements of rhythm are widely conserved across musical cultures and traditions. In pulse, acceptable rates (or tempos ) are highly constrained, showing a peak between approximately 1.33 and 2.67 Hz (80–160 bpm) across a variety of different musical traditions (Fig. 2A ) [ 98 , 102 ]. Intriguingly, this peak corresponds closely with dominant rates of periodicity in full-body human motion (e.g., 1.35–2.5 Hz [81–150 bpm] in walking) [ 98 ]. A second widely conserved aspect of pulse is that individual pulses tend to be isochronous or equally spaced in time [ 50 , 51 ]. There are traditions that also use unequal pulse spacing [ 103 ], but only in ways that retain predictability and thus allow interpersonal synchrony [ 104 , 105 ].

A A histogram of tempos from a sample of over 74,000 pieces of music. “DJ lists” refers to lists of song tempos used by disk jockeys to match pulse rates between tracks; “Radio” refers to songs found by randomly tuning into radio stations circa 2002; “Hits” refers to popular music from 1960–1990; and “styles” refers to a selection of music from divergent styles (e.g., renaissance polyphony and modern jazz). B One cycle from each of three rhythms with different meters, increasing in complexity from top to bottom. Circle size and shading indicate level of accenting (large/dark = strong), red stars and horizontal black brackets mark subgroups, and ellipsis denote repetition. Tin, Na , and Dhin are specific tabla drum strokes; tone, slap, bass , and touch are specific djembe drum stokes. The suku rhythm is based on section 5.3 of Polak (2010), with a timing ratio of 11:17:22 for the short-medium-long pulse patterns. C Hypothesized information flow through the network of brain areas implicated in rhythm perception. Additionally relevant brain areas include the hypothalamus, insula, and orbitofrontal cortex (see Fig. 3 ). The rhythm network is mostly bilateral despite being visualized in the left hemisphere here. Numbers refer to Brodmann areas. Insets show implicated structures in situ. Panel A is adapted from Moelants (2002) with permission from the author.

In meter, rhythmic cycles that are faster than the pulse also exhibit characteristic rates, mostly in the range of 2–8 Hz (120–480 bpm; typical of finger or wrist motion), and involving subdivisions of the pulse rate by factors of two or three [ 99 , 101 ]. Faster cycle rates are found in some traditions, e.g., 10–15 Hz [600–900 bpm] in djembe [ 103 ] or death metal [ 106 ], but this is relatively rare. For cycles at rates slower than the pulse, rhythmic patterning is almost always marked by variations in acoustic emphasis called accenting [ 100 ] (Fig. 2B ). A simple example of accenting comes from the marching rhythm “ one , two , one , two , ”, a repeating two-pulse cycle in which the first pulse is accented. Increasing in complexity, the meter of rūpak tāl in North Indian music is defined by a repeating seven-pulse cycle with multiple levels of accent set into groups of three and two [ 107 ]. More complex still are the drum patterns of Malian djembe music. For example, in suku, a repeating twelve-pulse cycle with multiple levels of accent is set into groups of three, each of which has a non-isochronous “short-medium-long” pulse pattern [ 103 ]. In sum, despite impressive diversity, rhythms from around the world are characterized by a restricted tempo range, multi-layered patterning, accenting, and predictability.

Further evidence that rhythm relies on conserved biology comes from the fact that the acoustic stimulus, taken alone, is often an insufficient basis for direct derivations of pulse and meter. Instead, these core aspects of rhythm depend on the interaction of sonic events and the brain [ 100 , 101 ]. Multiple lines of evidence indicate that humans possess specialized neural mechanisms that reflexively identify and reinforce temporal regularity in sequential auditory stimuli. These mechanisms (described in greater detail below) are specialized in that they are common to most humans but apparently rare among other animals. Individuals from many species can be trained to move in reaction to a pulse, but human movements are shifted forwards in time to anticipate, rather than lag behind, upcoming events [ 108 ]. We also synchronize flexibly, easily adjusting to tempo changes that disrupt or defeat synchrony in experiments with other species (parrots represent an interesting exception) [ 40 ].

More evidence of specialization comes from our curious tendency to spontaneously impose accenting on acoustic sequences that lack it. For example, we are apt to hear alternation or triplets in sequences of physically identical events, a perceptual imposition that can be differentiated electroencephalographically [ 109 ]. A final piece of evidence for specialized neural mechanisms in human rhythm perception is the global popularity of syncopation , especially in dance music [ 110 , 111 , 112 ]. Syncopation balances anticipation, built from sounds occurring on-the-pulse, against its systematic violation by sounds occurring off-the-pulse [ 113 ]. Perceiving syncopation thus depends on a conserved ability to form an internal model of regular temporal structure that is strong enough to withstand substantial ill-fitting sonic data [ 111 ]. Together, these and other broadly conserved aspects of rhythm indicate a strong foundation in our shared biology.

Biological foundations of rhythm

To model the biology underlying rhythm, music scientists have developed Neural Resonance Theory (NRT), the central tenet of which is that rhythm perception depends on endogenous oscillations in neural circuitry [ 97 , 114 , 115 , 116 ]. NRT holds that such oscillations spontaneously entrain to stimulus-evoked neural responses to modulate receptivity, prediction, and motor reactivity, thus providing a mechanistic basis for pulse and meter. While this “resonant” capacity is maximally engaged by music, its primary utility appears to be in processing spoken language, which, despite being less temporally regular than music, is still sufficiently regular (between 2–8 Hz [120–480 bpm] [ 102 ]) for entrained oscillations to aid in parsing phonemes, syllables, and phrases [ 117 , 118 ]. This implies that rhythm perception is intimately linked to vocal communication, just like tone perception.

A related aspect of NRT is that neural activity in auditory cortices readily couples with neural activity in parts of the brain that regulate movement, especially cortical areas and subcortical structures involved in motor planning, such as the supplementary motor and premotor cortices, the dorsal striatum, and the cerebellum [ 119 , 120 , 121 , 122 , 123 ] (Fig. 2C ). Activity in these parts of the brain increases in response to rhythm, even in the absence of movement [ 122 ], suggesting that auditory-motor interaction may be essential to rhythm perception. The link between rhythm and movement has also been explored in studies of groove , a psychological concept defined by variation in the degree to which a musical stimulus inspires movement. People generally agree about degrees of groove in music [ 124 , 125 ], with research suggesting a basis in common acoustical and structural features of rhythm, such as emphasized low-frequency energy (“bass”) [ 126 , 127 ] and moderate levels of syncopation [ 111 , 112 , 127 , 128 ]. Notably, groove is broadly associated with positive affect [ 111 , 125 , 129 , 130 ], making it directly relevant to mental health.

Applications of rhythm in mental health

So far, the clinical value of NRT has mainly been studied in the context of music therapies aimed at improving sensory and motor functions [ 131 ] (including speech [ 132 ]). However, even in these contexts, mental health benefits are often apparent. For example, in a 2021 meta-analysis of 17 randomized controlled studies testing musical interventions in Parkinson’s disease, a sub-analysis of 8 studies with mental health measures found significant benefits for mood, motivation, and emotional well-being in music conditions compared to standard care (SMD = 0.38, N  = 273 patients) [ 133 ]. Positive mental health outcomes have also been observed in response to receptive music therapy after stroke [ 134 , 135 ]. For example, one widely-cited study found that listening to music for at least one hour per day over a two-month period significantly lowered self-reported depression at 3 months post-stroke, as compared to standard medical care and rehabilitation [ 136 ]. Intriguingly, this study also reported benefits of music listening for cognitive function (memory and attention) in a well-controlled comparison to audio-book listening [ 136 ].

The capacity of rhythm to entrain activity in broad auditory-motor networks and simultaneously increase positive affect can also be hypothesized to account for a significant proportion of the benefits of musical treatments for anxiety and depression (see Section “Applications of tonality in mental health”). Specifically, engaging these networks with high-groove rhythms may provide an efficient way to disrupt maladaptive patterns of brain activity associated with negative affect and self-focused negative rumination [ 137 , 138 , 139 ]. Related to this hypothesis, there is growing evidence that groove is important for understanding the effects of music on cognition, particularly in the context of repetitive effortful work, which can often generate negative affect [ 135 , 140 , 141 , 142 , 143 , 144 , 145 ]. For example, in one recent study, listening to a high-groove drum loop for just 3 min was found to be more effective than noise at improving performance on a subsequent repetitive behavioral task measuring context-dependent response inhibition (a “Stroop” test). This effect of rhythm was specific to participants who reported enjoying the drum loop and its groove. These participants also exhibited significantly greater (dorsolateral) prefrontal cortical activity during the Stroop test in the drum-loop condition, as measured using functional Near Infra-Red Spectroscopy [ 141 ].

Experimental evidence for positive effects of rhythm on certain types of cognition accords with longstanding evidence from ethnographic literature. Specifically, rhythmic music has often been used to positively transform the experience of work otherwise experienced as negative and draining (e.g., harvesting food, military drills, and moving cargo) [ 145 , 146 ]. Similarly, musicians commonly experience “being in the groove” as a pleasant state of focus that offsets burdens associated with extended periods of high level performance (e.g., on tour) [ 125 , 129 , 147 ]. Such effects can be understood as rhythmically-driven increases in motivation and effort [ 143 ], potentially reflecting increased engagement of key cortico-basal ganglia-thalamo-cortical loop circuitry (see Fig. 2B ). They are particularly well-characterized in the context of physical exercise, where music can increase enjoyment and reduce perceived exertion [ 148 ], but such benefits may also extend to less muscular tasks (see discussion of the Mozart effect in Section “Another crest in the music and health hype cycle?”). In sum, the biological foundations of rhythm provide insight into how music can be applied to address challenges in mental health associated with mood, cognition, and motivation.

Music and brain reward circuitry

While the framework described so far is based on an analytic separation of tonality and rhythm, the health applications of several other core elements of musicality are better considered in terms of music as a whole. Perhaps the best example is our fundamental attraction to music, as reflected in its marked capacities to stimulate wanting, liking, and learning. Over the past several decades, neuroimaging studies have demonstrated that taking pleasure in music is closely associated with activity in classical brain reward circuitry [ 26 , 149 ], including the mesolimbic dopamine pathway between the ventral tegmental area (VTA) and the nucleus accumbens (NAc) [ 4 ]. Early studies used positron emission tomography with the radiolabeled dopamine D 2 receptor ligand, [ 11 C]raclopride, to show that musical frisson [ 150 ] — moments of peak neural excitement, piloerection, and “chills” that occur during music listening—are associated with surges in dopamine binding within the NAc [ 151 , 152 ]. Additional evidence that music stimulates mesolimbic reward comes from functional magnetic resonance imaging studies showing, for example, that the magnitude of an individual’s NAc response to music correlates with their subjective liking for it [ 153 ].

At the level of brain networks, functional neuroimaging studies have also found that the time-course of musically-stimulated NAc activity is tightly coupled with that of activity in the VTA and hypothalamus [ 154 ]. This has led to the proposal of a “tripartite network” at the core of musical reward, with the hypothalamic node linking desire and pleasure to autonomic and neuroendocrine effects (Fig. 3A ) [ 128 , 154 , 155 ]. Beyond this core, musical reward also engages an extended network of brain areas including the auditory, frontal, and insular cortices, as well as the amygdala and hippocampus, all of which also exhibit temporal coupling with the NAc during music listening [ 149 , 153 , 154 ]. These extended connections are presumed to situate musical reward with respect to sensory, integrative, somatic, affective, and memory-based aspects of musical responding, respectively.

A A model of the extended musical reward network including the tripartite core (red outline) and associated cortical areas and subcortical structures (gray outline). Arrows indicate significant positive temporal correlation in blood-oxygenation-level-dependent activity between the indicated areas during pleasurable music listening. Numbers refer to Brodmann areas ( B ) A close-up of the tripartite core showing dopaminergic (blue), opioideric (green), and oxytocinergic (red) circuitry hypothesized to underpin music’s capacity to stimulate social connection. In rodent models (on which this panel is based) the derivation of reward from positive social interaction requires the oxytocinergic projections from the PVN to the NAc and VTA. C Interactions within the PVN between oxytocin and CRF. Oxytocin decreases the excitability of CRF neurons in mouse hypothalamic slices, and may further inhibit CRF release by modulating CRFR1-positive neurons. Note that music may also have effects on CRF that are independent of oxytocin. ARC arcuate nucleus, CRFR1 CRF receptor type 1, NAc nucleus accumbens, POMC proopiomelanocortin, PVN paraventricular nucleus, VTA ventral tegmental area.

Lastly, as in the processing of other rewarding stimuli like food, sex, and drugs, the hedonic aspects of musical reward are partially dependent on opioidergic mechanisms. This has been shown pharmacologically, as treatment with the (predominantly μ-) opioid receptor antagonists naloxone and naltrexone significantly reduces pleasure in response to musical stimuli [ 156 , 157 ]. Thus, although the work described in this section has been carried out almost entirely with “Western” listeners, the results, taken together with the widespread enjoyment of music around the world, strongly support the sensitivity of brain reward circuitry to musical stimulation as a third core element of musicality.

Applications of musical reward in mental health

In keeping with the central importance of reward in our everyday lives, this element of musicality has extremely broad implications for mental health. Dysfunction in brain reward circuitry contributes to a wide range of psychopathology, including mood disorders, anxiety disorders, substance use disorders, eating disorders, obsessive-compulsive disorders, attention-deficit/hyperactivity disorder, autism spectrum disorders, conduct disorder, Tourette’s syndrome [ 158 ], and schizophrenia. This suggests that the benefits of many current musical treatments may be attributable to normalizing effects of tonality and rhythm on otherwise aberrant activity in brain reward circuitry. Thus, in addition to effects on core dimensions of mental health (e.g., anxiety, mood, cognition, and motivation), musical treatments have also been found efficacious in more specific cases of psychopathology that specifically feature reward dysfunction. Some examples include: substance-use disorder, where adding music therapy to standard treatment can improve motivation to rehabilitate and abstinence [ 159 ]; anorexia nervosa, where interactive music therapy can stimulate reductions in post-meal anxiety that exceed those of other treatments [ 160 ]; and Tourette’s syndrome, where music listening, performance, and even imagined performance, can be an effective tic suppressant [ 161 ].

Further evidence of music’s efficacy against reward-related dysfunction comes from treatments applied to prominent transdiagnostic symptoms, like fatigue [ 162 ], apathy [ 163 , 164 ], and anhedonia [ 165 ]. For example, in a study of nursing home residents age 60+ with mild-to-moderate dementia, a twelve-week interactive music therapy intervention significantly reduced apathy and improved communication, in comparison with a treatment-as-usual control [ 163 ]. The effect sizes were relatively small (SMD = 0.32 and 0.15 respectively), but given the central importance of apathy in dementia and other psychopathology [ 166 , 167 , 168 ], they represent an important starting point for further investigation. In sum, the capacity of music to modulate brain reward circuitry provides a strong mechanistic basis for its benefits across a wide variety of functional disorders in mental health. A better understanding of how and when music stimulates reward is thus critical to advancing music’s therapeutic benefits for mental health.

Converging evidence indicates that engaging in music with other people is an effective way to stimulate interpersonal affiliation and social connection [ 44 ]. Psychological experiments, for example, have repeatedly shown that interpersonal temporal coordination (or “synchrony”) in behavior—a defining feature of musical interaction—strengthens social bonds between participants. This has been measured in terms of increased feelings of affiliation and self-other similarity [ 169 , 170 ], trust behaviors in economic games [ 171 , 172 ], and real-world cooperation [ 173 , 174 , 175 , 176 , 177 ] (reviewed in [ 178 ]). Another line of evidence comes from physiological experiments showing that recreational forms of behavioral synchrony—e.g., in group singing, drumming, or exercise—can upregulate oxytocin secretion [ 155 , 179 , 180 , 181 , 182 ], downregulate cortisol secretion [ 155 , 181 , 183 , 184 , 185 ], modulate immune reactivity [ 182 , 184 , 185 ], and decrease pain [ 186 , 187 ].

In addition to behavioral synchrony, music almost certainly facilitates affiliation and social connection through inducing synchrony in affect. This is perhaps best illustrated by the Iso Principle for mood management in music therapy, one of a few core methods that remains consistent across diverse approaches and therapeutic goals [ 188 ]. Iso Principle is the practice of initiating treatment sessions with music that is parameterized to match the patient’s current mood, creating a basis of shared affect that can then be leveraged to shift mood through musical changes. While the neural basis of synchrony’s effects on social neurobiology has yet to be studied in detail (see [ 189 ] for leading hypotheses), at a psychological level it appears to work through empathetic processes that increase trust and promote openness to further interaction and direction [ 190 ].

A final line of evidence comes from ethnographic and historical observations indicating that music (and dance) are commonly associated with contexts involving high levels of social cohesion. Major examples include religious rituals, cooperative labor, and military drill, as well as overt expressions of group solidarity like political chants, football songs, and national anthems [ 145 , 146 ]. Taken together, these findings strongly support the sensitivity of neural mechanisms supporting affiliation and social connection to musical stimulation as a fourth core element of musicality.

Oxytocin and social reward

Although many artistic and aesthetic experiences are capable of eliciting intense pleasure, music stands out for the regularity with which it does so [ 157 ]. Research suggests that frisson, for example, are induced by music at about four times the rate that they are induced by other stimuli, including the visual arts and literature combined [ 191 ]. This begs the question of why music is so rewarding.

A potential hint comes from the fact that frisson are also induced at high rates by inspirational speech [ 191 , 192 ]. From a mechanistic perspective, this can be taken as support for the hypothesis that the reward potency of music (and speech) reflects high temporal predictability relative to other artistic stimuli [ 150 , 153 ], which is particularly well-suited to anticipatory aspects of reward processing [ 193 ]. At the same time, phylogenetic and developmental perspectives have given rise to the hypothesis that the reward potency of music reflects its basis in social communication [ 149 ]. In this non-mutually exclusive view, music’s capacity to stimulate reward processing also reflects the activity of evolved neural mechanisms that develop to afford the voice with major modulatory control over the rewards of social interaction.

Interest in the link between music and social reward has led many researchers to posit a role for the hypothalamic neuropeptide oxytocin in musicality [ 5 , 44 , 149 , 194 , 195 ], following on its essential functions in affiliative behavior and social bonding (Fig. 3B ) [ 196 , 197 , 198 , 199 , 200 ]. More specifically, music can be hypothesized to stimulate endogenous oxytocin mechanisms that upregulate dopaminergic (and related opioidergic) aspects of reward processing [ 198 ], thereby increasing sensitivity to musical rewards in social context. An important corollary of this hypothesis also addresses the anti-stress effects of music [ 201 ], as music-induced oxytocin release in the hypothalamus may also modulate local corticotropin releasing factor (CRF) circuitry to downregulate activity in the hypothalamic-pituitary-adrenal axis and the sympathetic division of the autonomic nervous system (Fig. 3C ) [ 202 , 203 , 204 , 205 , 206 ].

Applications of sociality in mental health

Social functioning—as reflected in the structure, function, and quality of an individual’s social connections—is a critical determinant of mental health in patients across prominent psychiatric disorders [ 207 , 208 ] as well as the general public [ 209 , 210 ]. This implies that effects of musical treatment of the neurobiology of social functioning may be of even broader significance than closely related effects on brain reward circuitry. However, before describing the clinical evidence supporting such effects, it should be noted that the extent to which musical treatment must involve live interaction to impact social neurobiology is presently unclear. Sound recording is only 160 years old, which implies that the vast majority of our collective experience with music has occurred in social contexts. Accordingly, there is an important sense in which listening to recorded music, even alone, may remain inherently social in neurobiological terms. Our attribution of recorded music to a person (or people) with communicative intent is essentially reflexive [ 211 ], particularly when it comprises vocals. It is also clear that recorded music is often a potent stimulus for behavioral and affective synchrony. Thus, listening to music alone may stimulate social neurobiology in many of the same ways as live musical interaction. Nevertheless, until shown otherwise, it seems reasonable to assume that live interaction is the more potent stimulus for leveraging music’s effect on sociality (e.g., see [ 212 , 213 , 214 ]).

Operationally, social functioning is targeted by interactive approaches to music therapy designed to support interpersonal responding, coordination, and synchrony [ 11 , 215 ]. A large body of evidence supports the benefits of such approaches in autism spectrum disorders [ 216 , 217 , 218 , 219 , 220 , 221 ]. Some of this evidence is summarized in a 2022 meta-analysis of 26 controlled studies including 1,165 children with diagnoses of an autism spectrum disorder (ranging from mild to severe). This analysis compared music therapy to non-musical standard care or a “placebo” therapy over an average duration of 2.5 months (SD = 2.0), with session frequency varying from daily to weekly in shorter and longer studies respectively [ 216 ]. Directly after the intervention, significant benefits associated with music therapy included improvement in clinical global impression (risk ratio=1.22, 8 studies, 583 patients), reduced total autism symptom severity (SMD = 0.83, 9 studies, 575 patients), and better quality of life for clients and/or their families (SMD = 0.28, 3 studies, 340 patients). During the intervention, music therapy was also associated with significant improvements in non-verbal communication (SMD = 1.06, 3 studies, 50 patients) and behavioral adaptation (SMD = 1.19, 4 studies, 52 patients); in the 1–5 months following the intervention, music therapy was associated with reduced total autism symptom severity (SMD = 0.93, 2 studies, 69 patients) and improved self-esteem (SMD = 0.86, 1 study, 35 patients) [ 216 ]. For context, the overall SMD for autism interventions based on Applied Behavior Analysis (a common non-musical behavioral therapy) has been estimated at 0.36 for treating general autism symptoms (based on 14 studies with 555 patients) [ 222 ].

Further evidence supporting the benefits of music therapy for social functioning comes from studies on schizophrenia [ 223 ]. A 2020 meta-analysis of 15 controlled studies involving 964 adults diagnosed with schizophrenia or a schizophrenia-like disorder highlighted significant improvements in negative symptoms (such as flat affect, poor social interactions, and apathy) when adjunct interactive and/or receptive music therapy was compared to standard care (SMD = 0.56) [ 164 ]. This aligns with an earlier 2017 meta-analysis that more specifically investigated social functioning, reporting benefits from two controlled studies involving adults with schizophrenia in which music therapy was compared to antipsychotic medication (SMD = 0.72, N  = 160 patients) [ 224 ]. For context, the SMD of antipsychotic medications for treating negative symptoms in schizophrenia has been estimated at 0.35, based on 167 studies with 28,102 patients [ 225 ].

There is also some evidence that musical interventions can impact social functioning in Alzheimer’s disease and related dementias. For example, individual studies have reported significant benefits of interactive music therapy on language functioning [ 226 ] and receptive music therapy on social engagement [ 227 ]. However, reviews and meta-analyses suggest that such social effects are mainly derivative from primary benefits that reduce agitation, anxiety, and depression [ 228 , 229 ].

Finally, outside of the clinic, musical therapy has long been valued as a non-verbal path to social connection in children with special needs [ 215 , 221 ], as well as a way to combat social isolation and loneliness, particularly in older adults living alone and/or with serious disease [ 184 , 230 ]. In sum, music’s capacity to stimulate the neurobiology of affiliation and social connection is associated with benefits in multiple major mental health disorders and across the lifespan.

Individual differences in musicality

Despite strong foundations in our shared biology, there is also substantial individual variation in neural sensitivity to the core elements of musicality. At the low end of the spectrum are individuals who cannot carry a tune or dance in time, some of whom find music irritating and actively avoid it [ 231 ]. Conversely, at the high end are individuals who find it difficult to live without music, some of whom create works of art that transcend their geographic and temporal horizons [ 232 ]. This high degree of individual variation in musical appreciation and engagement implies that there may also be substantial variation in individual capacity to benefit from musical treatment. In this section and the next I review research on understanding individual variation in musicality, outlining how its measurement may be used to increase the precision with which musical treatments are applied. Accordingly, I argue that better applications of music in mental health depend not only on aligning the neurophysiological effects of music’s core elements with specific clinical targets, but also on matching treatment content to individual differences in musicality.

Psychoacoustic testing

Tests of tone and rhythm perception have long served as the primary way to measure individual differences in musicality. Performance on the most basic of these tests—e.g., measuring sensitivity to harmony and pulse—tends to be positively skewed [ 233 ], reflecting a commonplace competency for music similar to that which we possess for language [ 41 ]. Nevertheless, there is still considerable variation in basic test scores, and this is increased for tests that probe more sophisticated musical abilities [ 234 ].

Environmental factors

Researchers have traditionally sought explanations for individual differences in musicality based on environmental factors. One of the most important environmental factors is formal training , a process by which individuals explicitly learn specific motor skills and rules for music performance and composition [ 235 ]. Formal training is particularly important for explaining sophisticated musical abilities, e.g., as assessed by Goldsmith’s Musical Sophistication Index (Gold-MSI) [ 234 ]. Another important environmental factor is musical enculturation , i.e., the process of implicitly learning the statistical properties of the music to which one is developmentally exposed. Many studies have demonstrated effects of training and enculturation on psychoacoustic tests (e.g. [ 236 , 237 ]). Though sometimes framed as evidence against biological constraints, such effects may be better considered in terms of how biological constraints manifest in the face of environmental variation [ 56 , 78 ].

Biological factors

Progress is also being made towards understanding the genetic basis of musicality [ 27 ]. Early work provided evidence that genetic factors explain surprising amounts of phenotypic variability in psychoacoustic test performance (e.g., 70–80% in tone perception [ 238 ]), as well as time spent practicing music (e.g., 40–70% [ 239 ]; see also [ 240 ]). More recently, genome-wide association (GWA) techniques have been applied to musicality [ 241 , 242 , 243 ]. The largest of these GWA studies to date has focused on rhythm perception [ 243 ]—assessed via the question “can you clap in time with a musical beat?”—in a sample of over 606,825 individuals, accessed via an academic collaboration with 23andMe, Inc. The results indicated that beat perception and synchronization depend on many genes, with variation at 69 loci spread across 20 chromosomes being significantly associated with survey responses after linkage disequilibrium pruning. Additional analyses found enriched expression of genes implicated by these loci in brain-specific regulatory elements as well as fetal brain tissue, indicating potential roles in regulating neurodevelopment. Similar analyses focused on the adult brain found enriched expression in structures implicated in rhythm and reward, including the frontal and temporal cortices, cerebellum, basal ganglia, nucleus accumbens, and hypothalamus (see Figs. 2 C and 3B ).

Although complex traits like our sensitivity to rhythm are expected to be polygenic [ 243 ], some studies have also focused on associations between musicality and individual genes. One of the best studied genes in this context is AVPR1A , which encodes the vasopressin 1A receptor, a major component of the arginine vasopressin and oxytocin signaling pathways [ 196 , 244 ]. Genetic variation in the promotor region of AVPR1A has been associated with phenotypic variation in psychoacoustic test scores [ 245 , 246 ], time spent attentively listening to music [ 247 ], and being a dancer as opposed to another type of athlete [ 248 ]. Variation in AVPRA1 has also been associated with verbal memory [ 249 ], acoustic startle [ 250 ], amygdala activity [ 251 ], prosocial behavior [ 252 ], pair-bonding [ 253 ], and autism [ 254 ]. As intriguing as these associations are, however, it should also be noted that several studies have looked and failed to find associations between musical ability/behavior and AVPR1A polymorphism [ 242 , 255 ]. Other genes of particular interest include VRK2 , FANCL , MAPT , MAPK3 , GATA2 , GBE1 , GPM6A , PCDH7, SCL64A , and UGT8 among others (see [ 27 ] and [ 243 ]).

Lastly, progress in understanding the biology underlying individual differences in musicality has also come from studies of disordered music perception. Congenital amusia [ 256 ] is an umbrella term for lifelong deficits in music perception that prevent people from singing in tune [ 257 ], dancing in time [ 258 ], or deriving pleasure from music [ 259 ]. Deficits in tone perception (or tone deafness ) is the best studied form of congenital amusia: it runs in families [ 238 , 260 ] and is associated with decreased connectivity between the auditory cortices and the inferior frontal gyrus [ 261 , 262 ], potentially reflecting abnormal frontotemporal cortical development [ 263 ]. The prevalence of tone deafness is approximately 1.5%, with as many as 4.2% of people exhibiting a lesser form of impairment [ 264 ]. Deficits in rhythms perception (or beat deafness ) appears to be at least as common [ 264 ]. Finally the prevalence of music-specific anhedonia , which, as the name implies, occurs despite otherwise normal hedonic functioning, is estimated at about 5% [ 265 ].

Hypotheses for precision medicine

Faced with questions about whether a patient is sufficiently musical to engage in treatment, many music therapists provide reassurance, as a significant part of their practice is dedicated to finding adaptive ways to leverage music’s capacities to align with individual strengths [ 266 , 267 ]. While this resource-oriented approach has the benefit of allowing music therapists to work with almost anyone, the framework proposed here can potentially offer more systematic guidelines for determining whether a patient is likely to benefit from musical treatment. Fundamentally, patients with a history of strong engagement with music and keen sensitivity to its tonal, rhythmic, rewarding, and social elements would appear to be good candidates for musical treatment, especially if neurophysiological systems influenced by one or more core elements of musicality are implicated by their symptoms. Conversely, those patients who report disliking music, find it unrewarding, or otherwise qualify for congenital amusia, would seem to have a lower likelihood of benefiting.

In between these extremes are individuals whose specific musicality profiles —conceived as a series of measurements describing sensitivity to each core element of musicality—have important potential to inform decisions about treatment content. As an example, treatment for a patient with below-average tone perception, but normal sensitivity to musical reward, rhythm, and sociality could be personalized to align with their musicality profile by focusing on the neurophysiological effects of rhythm in an affiliative interactive context in which tonal elements are minimized or omitted.

Defining musicality profiles

While measurements of underlying biology may improve assessments of individual differences in musicality in the future, current efforts must rely on psychoacoustic tests and surveys. Among the most promising for determining suitability for musical treatment is the Barcelona Music Reward Questionnaire (BMRQ) [ 265 ], a survey of 20 self-reported items that assess the degree to which an individual takes pleasure in different aspects of music. For individuals with normal scores on the BMRQ, further insight may be gained through a series of basic psychoacoustic tests, like the scale test and out-of-key test (for evaluating tone perception) and the off-beat test (for evaluating rhythm perception) from the Montreal Battery of Evaluation of Amusia (MBEA [ 233 , 268 ]; see MBEMA for testing children aged 6 to 10 [ 269 ]). If a more comprehensive assessment is desired, clinicians can deploy the Gold-MSI (for musical sophistication) [ 234 ] or the computerized beat alignment test (for rhythm) [ 270 ].

Although not explicitly focused on music, it may also be useful to assess a patient’s level of social functioning and anxiety (e.g., with the Social Responsivity Scale [SRS] [ 271 ] and Liebowitz Social Anxiety Scale [LSAS] [ 272 ] respectively), as the results could inform decisions about the extent to which a musical intervention should target social functioning. Interactive music therapy can be hypothesized to be most effective in cases where social functioning and social anxiety are both low. By contrast, in cases where social anxiety (or anxiety more generally) is high, the most effective approach may instead require limiting social interaction, at least at first. In keeping with this hypothesis, interactive approaches to music therapy in dementia (where anxiety is often high) are significantly less effective than receptive approaches at reducing agitation and behavioral problems [ 229 ]. Similarly, in music therapy for autism—which is predominantly interactive—high comorbidity with anxiety disorders may help explain some of the heterogeneity in trial results (cf [ 273 , 274 ].). Lastly, in cases where a patient is unable to complete surveys or perform perceptual tests due to developmental delay or cognitive impairment, interviewing caregivers about the patient’s history of music engagement and social functioning can offer valuable insights into their potential sensitivity to musical treatment.

Idiosyncratic preferences

Beyond tailoring musical treatments to align neurophysiological effects with clinical targets and individual musicality profiles, treatments may also be customized based on individual music preferences or “taste” [ 275 , 276 ]. In receptive music therapy, for example, it’s common for patients to nominate songs they like, with therapists providing oversight for alignment with therapeutic goals [ 89 ]. One major advantage of this approach is that listening to preferred music can be especially rewarding [ 151 , 277 ]. This is often attributed to the familiarity of preferred music, which facilitates expectations, their fulfillment, and associated memories and emotions [ 150 , 278 , 279 ]. Other potential benefits of preferred music include fostering a sense of safety, enhancing engagement, and reducing stress [ 280 , 281 , 282 ]. However, personal memories and associations can also make the therapeutic value of preferred music difficult to control, especially if not carefully reviewed [ 283 ]. This is because what a person likes is not necessarily aligned with their therapeutic goals. A prime example is that people with depression often prefer music that maintains or exacerbates their sadness [ 284 , 285 , 286 ] (but see [ 285 , 287 , 288 ]). Accordingly, despite the benefits of preferred music, using novel or unknown music is advisable in some contexts.

Having already changed how people discover new music, algorithmic music recommendation systems may also find applications in mental health. However, the issue of mismatch between what a person likes and their treatment goals remains significant here as well. For example, listening to strongly preferred or popular music while attempting to focus tends to decrease task performance [ 140 , 142 ]. In the extreme, the lifestyle associated with many forms of popular music is linked to substance abuse, risk-taking, suicide, homicide, and accidental death among practitioners [ 289 ]. This highlights the fact that engagement with music is not necessarily health-positive (cf [ 290 , 291 , 292 ].). In therapeutic contexts, though, there are still many cases in which tailoring musical interventions to idiosyncratic preferences can be beneficial. For example, in receptive music therapy for Alzheimer’s disease, listening to familiar, preferred music appears to carry benefits for self-awareness [ 293 ]. Similarly, in depression, preferred music is likely to be the most effective stimulus for normalizing brain affect and reward functions, provided that it has been properly vetted to avoid stimulating negative affect. Finally, when a patient has normal sensitivity to musical reward but only within a very restricted genre (e.g., from their youth [ 294 ]), or, reports enjoying music despite poor tone and rhythm perception [ 295 ], understanding their idiosyncratic preferences may be necessary to design effective treatment.

In sum, determining the therapeutic value of aligning musical treatment with idiosyncratic preferences is of central importance for musical applications in mental health. That said, progress in this kind of preference matching should be incorporated within a broader precision paradigm as advocated here, which aims to align the specific neurophysiological effects of musicality’s core elements with specific clinical targets and individual differences in associated responsivity.

Skepticism and need

In this final section, I address several important points of skepticism regarding the premise of the biological framework presented here, i.e., the hypothesis that music can do more for mental health.

Benefits from music to mental health are already at saturation

In addition to the effects of musical treatment described above (see Sections “Applications of tonality in mental health.”, “Applications of rhythm in mental health”, “Applications of musical reward in mental health”, & “Applications of sociality in mental health”.), there is strong evidence that people derive mental health benefits from more casual engagement with music. During the height of the COVID-19 pandemic, for example, more than half of 4,206 survey respondents reported engaging with music as a coping strategy, using it to derive reward, modulate mood, and/or reduce stress and anxiety [ 296 ]. Similar positive functions are apparent in pre-pandemic research as well (alongside more social functions) [ 2 , 297 , 298 , 299 ]. Associations between music and healing have also been found in many cultures throughout human history, suggesting a potentially ancient relationship [ 300 , 301 ]. Thus, even though music lies outside the mainstream of mental health care, many people are already using music to improve their condition.

Nonetheless, there are multiple ways in which music’s mental health benefits may be increased. First, expanding access to musical treatment is essential [ 302 ]; as stated in the introduction, music therapists in the US only have the capacity to treat 0.5% of adults with mental illness. I have argued that this necessitates standardizing and applying treatments within a biological framework. Second, the popular perception of music as entertainment needs to evolve to encompass its therapeutic benefits. Explaining musical treatments in biomedical terms and normalizing therapeutic modes of listening can facilitate this shift. Third, the balance in music education needs to pivot away from individual performance and back towards widespread attainment of basic skills (e.g., social singing and dancing, listening, reflecting, curating, etc.), with an explicit focus on developing lifelong tools for mental health and wellness [ 303 ].

Another crest in the music and health hype cycle?

Even if one accepts that music has expandable mental health benefits, the importance of music’s potential might still seem overblown, here and elsewhere. It is worth revisiting the Mozart effect in this context, as an example of music’s real effects and associated hyperbolic overinterpretation. In 1993, a study published in the journal Nature reported that 10 min of listening to a spirited Mozart sonata, versus speech-based relaxation, or silence, improved performance on a subsequent spatial reasoning task [ 144 ]. After being picked up by popular press, this finding was transformed into the notion that “listening to Mozart actually makes you smarter” [ 304 ], which was subsequently used to market books and other media for benefits purportedly backed by science [ 305 ]. Backlash from the scientific community in the form of criticism and further investigation eventually came to show that the Mozart effect amounts to a relatively small but replicable performance boost that generalizes to other types of music (and speech) which stimulate enjoyment and arousal (SMD = 0.37 in meta-analyses) [ 143 , 305 , 306 ]. Thus, while we should remain guarded against hype surrounding claims about music’s potential benefits, the example of the Mozart effect should also remind us not to counter hype with dismissal.

Low quality studies undermine claims of clinical value

The randomized double-blind placebo-controlled trial remains the gold standard for evidence in clinical medicine. However, this approach was primarily designed to test the efficacy of drug therapies, a history that creates problems for using it to test behavioral interventions, such as music therapy or psychotherapy [ 307 , 308 ]. Central problems include: difficultly blinding patients and therapists to their assigned condition (treatment or control), designing appropriate “placebo” treatments, and perceived difficulty in standardizing treatment without jeopardizing therapeutic integrity [ 308 , 309 ]. These problems are compounded in trials that rely on self- and/or clinician-reported outcomes (which is standard in much mental health research [ 309 ]). Consequently, concerns over study quality have often been cited in expressions of doubt over music’s clinical value (e.g. [ 302 , 308 ]).

A quick survey of modern clinical research in music therapy shows that such criticism has been well-received. Improvements in control conditions and blinded outcome assessments have been gradually implemented and evidence from more carefully conducted trials has begun to accumulate. Over the last decade, there has also been a surge in meta-analytic syntheses of this work, most of which explicitly assess risk-of-bias alongside their conclusions, although they do not typically take the next step of adjusting effect size estimates accordingly (cf [ 96 , 310 ].). Overall, bias assessments suggest that the certainty of evidence supporting benefits from musical treatment in mental health is moderate to low. Nonetheless, this level of certainty is consistent with many treatments in psychiatry [ 94 ]. The assertion that studies of musical treatment are especially suspect is thus poorly substantiated. Interested readers should consult bias assessments in these meta-analyses [ 93 , 95 , 96 , 133 , 164 , 216 , 224 , 229 ], and review individual studies that exemplify high-quality research on musical treatments for conditions such as anxiety [ 311 , 312 ], depression [ 313 , 314 ], autism [ 274 , 315 ], psychosis [ 316 , 317 ], and dementia [ 318 , 319 ].

Mental health needs

In concluding this section, it is useful to briefly consider musical treatment in the context of current mental health needs. In 2007, mental health disorders were estimated to account for 14% of global disease burden [ 320 ]. In 2021, an estimated 22.8% of adults in the United States had a diagnosable mental illness, with 12.7% of adolescents having serious thoughts of suicide [ 17 ]. In opposition to this growing psychopathology, first-line treatments in psychiatry are often criticized for their limited effectiveness [ 94 , 320 , 321 ]. Quantifying this point, a 2022 meta-analytic evaluation of 3,782 clinical trials examining the most common adult mental health disorders across a total sample size of 650,514 patients estimated summary effect sizes of just 0.34 SMD for psychotherapy and 0.36 SMD for pharmacotherapy [ 94 ]. In depression, SMDs <0.88 represent changes in a patient’s presentation that are typically too small to be detected by a clinician, suggesting that the effects of standard treatments for depression commonly lack clinical significance [ 94 , 322 , 323 ]. A similar SMD threshold in schizophrenia is 0.73 [ 94 , 324 ]. It is crucial to note that small summary effect sizes in meta-analyses are averages, and thus obscure the reality that a minority of patients have experienced clinically significant benefits under current treatments (due to poorly understood individual differences in treatment response). Nevertheless, the data at hand clearly indicate that new treatments are urgently needed [ 94 ].

It is in this context that advancing new standardized music-based interventions is important, not only because music affects core dimensions of mental health through the biology of tonality, rhythm, reward, and sociality, but because these avenues present an accessible, easy-entry, and low-risk approach to addressing problems for which we need solutions. Music is poorly conceived as a panacea. Instead, it has real effects on human neurobiological functions that feature prominently in mental illness, and thus has important potential in treating their disorder.

The effects of music on mental health and wellness are drawing more attention now than ever before. Efforts to better understand music’s benefits and increase their integration into medicine are complicated by their impressive diversity and a lack of clarity regarding underlying biology. This review has addressed these challenges by synthesizing progress in music research from psychology, neuroscience, and psychiatry to create a framework for defining music’s neurophysiological effects and their clinical scope in biological terms. This framework includes four core elements of human musicality: tonality , based on tone perception and the bioacoustics of vocal emotional expression, with applications targeting mood and anxiety; rhythm , based on neural resonance, anticipation, and auditory-motor entrainment, with applications targeting mood, cognition, and motivation; reward , based on engagement of classic brain reward circuitry and the reinforcement of successful communication, with broad applications in stimulating positive affect and normalizing reward function; and sociality , based on synchrony and the neurobiology of affiliation, with broad applications in treating social dysfunction and increasing social connectedness. This framework rationalizes many observed benefits of musical treatment and provides a path towards a precision approach to increasing their impact. As the world continues to change and we face new challenges to mental health and wellness, music will continue to provide real biologically mediated relief. Understanding and leveraging this fact towards better treatments and interventions in psychiatry presents an important opportunity to diversify and improve care during times of pressing need.

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The author would like to thank Drs. Dale Purves, Concetta Tomaino, and Karen Parker for comments on drafts of this manuscript, as well as Drs. Daniel Levitin, Patrick Savage, and two anonymous reviewers for constructive feedback during peer review. This work was supported by NIMH grant K01MH122730.

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Daniel L. Bowling

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Bowling, D.L. Biological principles for music and mental health. Transl Psychiatry 13 , 374 (2023). https://doi.org/10.1038/s41398-023-02671-4

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38 Music Therapy Research: Context, Methodology, and Current and Future Developments

Jane Edwards, Deakin University

• Published: 09 June 2015
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Music therapy is an evidence-based profession. Music therapy research aims to provide information about outcomes that support music therapy practice including contributing to theoretical perspectives that can explain why changes occur during treatment. Music therapy research has been conducted in a range of health, education, and community contexts throughout the world. Initially many music therapy developments in the university sector occurred through the establishment of training programmes that were developed and delivered by music therapists with professional experience in leading services in education and health care. Now many music therapy training programmes are led by people with practice experience along with research qualifications, and some universities offer music therapy doctoral pathways. Music therapy research capacity has expanded through a notable increase in PhD graduates as well as an increase in funded research in music therapy. This chapter covers: (1) traditions, (2) trends, and (3) contexts for music therapy research.

Introduction

Research is the process by which new knowledge is developed, existing knowledge is extended, and new theoretical frameworks are founded. In health care, research provides evidence for effective ways of working with patients or clients to achieve positive change; maintaining or improving optimal health and well-being. Research methods in health and education are characterized by a guiding research question or hypothesis, a theoretical or epistemological 1 orientation adopted by the researcher, a data source, and a selected method of data collection and analysis that is agreed in advance of the research commencing. All research is bound by an ethical code which is assured by approval from an Institutional Review Board, or an ethics committee. This process confirms that the processes of the research will cause no harm or discomfort to the participants, and will add value to existing knowledge.

Music therapy research is usually undertaken within the context of a university with outreach to recruit patients or students in health care or education. Initially music therapy in the university sector was built up through training programmes that were developed and delivered by people with professional experience in developing and leading music therapy services in education and health care. As higher education institutions across the world have become increasingly invested in all academic staff being research active including attaining PhDs and regularly applying for competitive research funding this has influenced the landscape of music therapy within the higher education environment. Increasingly it is unusual to find a course leader who does not either have a PhD or is working towards a PhD. Full-time permanent academic positions across the university context internationally usually require that the person has a PhD and a substantial body of work that has contributed to knowledge development in their specialist field.

Traditions of research in music therapy

In the fledgling years of music therapy research a commitment to quantitative methods within a strict positivist epistemology can be observed, especially in research publications within the USA. This was partly because of the influence of behavior modification as a technique in therapy practice ( Madsen et al. 1968 ). Modifying behavior that could be observed and measured was the goal of music therapy. Many researchers used randomized controlled trials (RCT) to examine the effects of music therapy on behaviors of clients. RCTs are studies in which participants are randomly assigned to either a music therapy treatment group, or to a control group which does not receive the treatment. The RCT is considered a gold standard within medical research ( Greenhalgh 2014 ). It is a highly effective method by which to test the effects and benefit of pharmacological medications. It can also show treatment outcomes when groups are compared where one group receives a treatment and another group, matched with the treatment group, do not (see Robb and Burns , this volume). Because of the alignment of music therapy with allied health, and the delivery of many music therapy services within medical contexts, the use of the RCT has been common in music therapy research ( Bradt 2012 ).

The most important historical development in this type of research was the introduction of randomization, where participants or subjects are randomly assigned to one of the groups, whether treatment, control, or placebo (see Robb and Burns , this volume). This random allocation to groups minimizes bias and increases the likelihood that the results of the research will be trustworthy.

In the later part of the twentieth century music therapy research reports using new methods entered the published literature, and references to new methods can be observed (for example, Aigen 1993 ; Amir 1993a , b ; Comeau 1991 ; Forinash 1992 ; Forinash and Gonzalez 1989 ; Langenberg et al. 1993 ). The early years of qualitative methods followed along the same route as other allied health research where qualitative inquiry or qualitative research became a commonly used descriptor ( Edwards 2012 ). Although qualitative is a useful description for many research methods it is not in and of itself a method. Distinctions between methods and epistemologies within qualitative traditions have not always been well defined in music therapy research reports ( Aigen 2008 ), and also in other allied health research writings ( Carter and Little 2007 ). In the maturation of music therapy research a wider range of methods and traditions have been engaged, and knowledge about different methods has become more elaborated and differentiated. It is now agreed that all methods have an underlying epistemology, and in using qualitative method research it is essential to be able to state ones position in relation to the theory of knowledge creation to which one subscribes ( Edwards 2012 ). Frequently used qualitative research methods in music therapy are grounded theory (see Daveson this volume; O’Callaghan 1996b ; 2012 ), and phenomenology ( Ghetti this volume).

An important distinction between research methods is whether they use inductive or deductive processes. Inductive refers to the way in which the researcher allows the information to be induced from the data during analysis ( O’Callaghan and McDermott 2004 ; O’Callaghan 1996a ). The researcher looks closely at the data, usually text or arts based, and reflects on the materials allowing meanings to emerge. Research which is deductive uses a pre-defined criteria to examine the data. For example, looking for particular incidences of a word in text or measuring a baseline behavior then providing treatment and following up with a further measure. Deductive might also refer to research in which the themes to be examined are decided in advance even when a qualitative method is used.

Research is published in journals following a process of anonymous peer review. A paper is submitted to just one journal and then the editor sends an anonymized version of the paper for review to at least two professionals with expertise in the area of the paper’s content. The reviewers read the paper and provide feedback to the editor about their opinion of the paper. Reviewers can recommend the paper should be published, or they can request revisions, or they can recommend that the paper be rejected. It is not unusual that articles are rejected. It can be because the editor or reviewers do not think the topic of the paper is relevant to the journal, or there can be issues of quality with the research that deem it unsuitable for publication. Many researchers make revisions to rejected papers and then submit them to another journal. It is unacceptable to submit to more than one journal at a time, and authors must sign a declaration at submission that the work has not been published elsewhere or been submitted for review to another journal.

Peer reviewed articles appear in the following English language journals of music therapy: Australian Journal of Music Therapy, British Journal of Music Therapy, Canadian Journal of Music Therapy, Journal of Music Therapy, Music Therapy Perspectives, Nordic Journal of Music Therapy , the New Zealand Journal of Music Therapy , and Voices . There are also related journals which publish music therapy research papers including: Psychology of Music, Music and Medicine , and The Arts in Psychotherapy . Music therapy research also appears in medical and therapy journals (for example, Loewy et al. 2013 , O’Callaghan et al. 2014 ). Therefore when students are researching projects or writing papers are encouraged to search the journal literature as well as reading relevant books and book chapters.

Trends in music therapy research

In this part of the chapter three trends in music therapy research will be discussed: (1) music therapy and evidence-based medicine, (2) arts-based research, and (3) mechanisms of change in music therapy.

Music therapy and evidence-based medicine

A number of music therapists have considered the ways that the profession can respond to the imperative of evidence-based medicine (EBM). EBM can be traced back to the 1960s but it more formally entered the lexicon of health care practice through the 1990s ( Smith and Rennie 2014 ). As a PhD researcher in a department of Paediatrics and Child Health in the 1990s the author observed firsthand the shift in thinking about practice and services that occurred when EBM began to be a main point of interest for researchers, not just in medicine but also through nursing and allied health departments. In order to consider the implications for music therapy she gave a series of presentations which were then worked into scholarly papers for publication. After initial rejection some of the ideas were eventually published ( Edwards 2005 , 2004 , 2002 ). Since that time others have also written about EBM and music therapy (for example Abrams 2010 , and Standley 2012 ).

Rather than relying on the outcome of a single RCT to develop new practices in health care, EBM proposed an evidence hierarchy founded on single cases (weak evidence) through to meta-analyses (strong evidence). In a meta-analysis the research findings from a number of studies with patients who have similar characteristics are analyzed statistically to show whether the changes that have occurred across all of the studies are convincing enough to warrant inclusion of the treatment in standard care. Dileo and Bradt concluded that “Overall, EBP [practice] intends to assure that patient treatment is safe, effective, and cost-effective.”(2009, p. 170)

Abrams has positioned evidence-based music therapy having multiple benefits for the profession:

The virtues of an integral understanding of evidence-based music therapy practice are numerous. It can help promote clarity of the different roles, purposes, strengths, and limits of each domain of evidence. It provides accountability to core values, standards of integrity, and standards of rigor, all internally consistent within a given perspective in any given instance. Moreover, it encourages an awareness of the applicability and relevance of evidence to clinical work in any given case. Abrams 2010 , p. 374

Earlier conceptualizations of EBM pointed out that music therapists are often referred clients or patients for whom other therapeutic supports or treatments have not been effective ( Edwards 2005 ). Therefore because of the complexity of the client’s situation and their unique needs traditional processes of matching of clients in control and treatment groups in the traditional RCT might not be possible.

Concepts used in evidence are now turning towards music therapy participants’ views to be a better accessed and utilized form of evidence (for example, Ansdell and Meehan 2010 ). Although initially this author’s concerns about EBM focused on inappropriate application by managers to limit innovation and cut services, in practice EBM has some but not complete influence on service leaders’ decisions to support or close programmes. At the same time it has produced an outstanding number of music therapy meta-analyses published in the most important medical evidence database in the world, the Cochrane Library (for example Mössler et al. 2011 ).

Arts-based research

The arts are increasingly being used in health care and related research to learn about the experiences of care workers and recipients, to gain access to marginalized voices, and to communicate research findings to a wider audience. Ledger and Edwards 2011 , p. 313

Arts-based research is a movement that has developed internationally with minimal input from creative arts therapists. Ledger and Edwards (2011) provided a number of examples in which music therapists appeared reluctant to describe their research methods as arts based . This reluctance was hypothesized as emerging from anxiety about seeming scientific enough, especially when conducting research in health and medical contexts.

As artistic processes within music are central to music therapy practice, the use of music making or other creative arts processes could be considered compatible with the goals of music therapy inquiry. It is therefore puzzling why arts based processes are not more widely used in music therapy research.

Arts-based research was included in the main research textbook to date in music therapy ( Wheeler 2005 ). Dianne Austin and Michele Forinash make a distinction between arts based research and the studies that have analyzed music created in music therapy sessions. They have shown that the arts can be used at every step in the research process to develop rich and expressive findings. Arts-based research is explained as offering a valuable way to gain insights that might not otherwise be discoverable ( Austin and Forinash 2005 ).

Mechanisms of change in music therapy

Research contributes to knowledge about change, but researchers also have a responsibility to theorize why the change occurs. Research relevant to music therapy from the fields of psychology and neuroscience are key to understanding the mechanisms of change in music therapy. For example, music therapy relies on the evocative potentials of music to develop a way of relating between the therapist and the client that is helpful in meeting the client’s needs and contributing to their well-being. Some of these evocative capacities include the ability of music to influence affect. In order to be able to interact and support clients in a way that is helpful and informed, understanding how music influences emotional states is key. Music therapists have extensive experience and expertise in observation of musical responses. As an experienced music therapy practitioner the following mechanism as to how emotional response to music might occur makes sense to the author. Julin and Västfjäll have proposed that when humans listen to music all of the following psychological processes happen, not separately but concurrently, and this is why an emotional response occurs:

(1) brain stem reflexes, (2) evaluative conditioning, (3) emotional contagion, (4) visual imagery, (5) episodic memory, and (6) musical expectancy. Juslin and Västfjäll 2008 , p. 563

Their proposition is interesting for music therapy practitioners to engage in order to understand the instantaneous aspects of response over which an individual has no control, and to confirm that there is no one piece of music that has the same effect on every listener. However, many psychological theories such as these that are relevant to music therapy are silent on the core interpersonal and relational aspects of music therapy. Therefore neuropsychological and physiological theories need to be accessed in order to further understanding of music therapy as a relational practice.

Developing theories about brain growth indicate that infant brains develop in collaboration and interaction with other brains ( Schore 2010 ). Loving, predictable responsiveness from the adult care giver is essential for an infant’s healthy start in life. The failure of the infant-parental bond to coalesce and attachment to be formed is disastrous for the child’s ongoing development. This can occur because of maltreatment and/or neglect, or because of demands on the carer’s own resources result in them being unavailable to the infant’s needs. This has lifelong consequences on development, particularly the skills needed for social interaction with others, and the resilience to deal with stressful experiences and events. Neurosequential modelling proposes that the infant brain develops in stages.

The brain is organized in a hierarchical fashion with four main anatomically distinct regions: brainstem, diencephalon, limbic system, and cortex. During development the brain organizes itself from the bottom up, from the least (brainstem) to the most complex (limbic, cortical) areas. While significantly interconnected, each of these regions mediates distinct functions, with the lower, structurally simpler areas mediating basic regulatory functions and the highest, most complex structures (cortical) mediating the most complex functions. Each of these main regions develops, organizes, and becomes fully functional at different times during childhood… Perry 2009 , p. 243

This theory is important for music therapy because it provides information to explain why children who have not developed self-regulatory processes due to severe early relational trauma, for example what Perry described as the “overanxious, impulsive, dysregulated child” (p. 243), might behave differently in the regulating holding environment of music therapy where predictable structure can contain and support the child’s actions and spontaneity (for relevant case examples, see Drake 2011 ).

The therapeutic opportunities in music therapy lie not only in the client’s responses to music but equally and sometimes more importantly in the therapist-client relating. Porges’ Polyvagal Theory is so named because it associates two physiological systems with feelings of safety and security and explains how these function in interpersonal relating. These are:

(a) the commonly known fight-or-flight system that is associated with activation of the sympathetic nervous system… and (b) a less-known system of immobilization and dissociation that is associated with activation of a phylogenetically more ancient vagal pathway. Geller and Porges 2014 , p. 180

Using the Polyvagal Theory ( Porges 2011 ) Geller and Porges (2014) have illuminated therapeutic presence as a salient factor reliant on neurophysiological processes by which safety, security, and trust are experienced in the therapeutic relationship. Given that many people who seek or are referred to psychological services have experienced a breakdown of their capacity to cope, or to relate successfully with others, the ability to provide safety and security in the interpersonal space is crucial to providing opportunities for capacity building towards growth and change.

Expert therapists have reported that the experience of therapeutic presence involves concurrently (a) being grounded and in contact with one’s integrated and healthy self; (b) being open, receptive to, and immersed in what is poignant in the moment; and (c) having a larger sense of spaciousness and expansion of awareness and perception. This grounded, immersed, and expanded awareness also occurs with (d) the intention of being with and for the client in service of their healing process. By being grounded, immersed, and spacious, with the intention of being with and for the other, the therapist invites the client into a deeper and shared state of relational therapeutic presence. Geller and Porges 2014 , p. 180

Polyvagal theory has contributed to the development of new ways of working as well as supporting existing practices in music therapy. As Loewy (2011) noted:

… [Polyvagal Theory] contributes to the theoretical justification for the role that music therapy can play in activating neural circuits that regulate reactivity. Porges’ rationale for and description of feeding and rocking as primal attachment behaviors which influence vagal afferent pathways is an essential contributor to the current thinking about the importance of the quality of care in the first stage of life. Music therapy practices that activate somatomotor components which trigger visceral change influence attachment practices which are critically important in the early years. Loewy 2011 , p. 182

The relational dimensions of music therapy practice are underpinned by multiple psychobiological principles including those encapsulated in communicative musicality initially developed by Stephen Malloch in his postdoctoral work at Edinburgh University, which was then further elaborated ( Malloch and Trevarthen 2009 ). Malloch and Trevarthen (2009) documented how the development of the theory and observation of the presence of communicative musicality occurred through many decades of research in the last century. Importantly multiple theorists and researchers from a range of fields, whether during field observations or in laboratory based experimental work, noted the expressive, dance and song like interactions between infants and the adults who share loving relationships with them. These multiple perspectives result in the conclusion that:

… we are evolved to know, think, communicate, create new things and care for one another in movement—through a sense of being in rhythmic time with motives and in tune with feelings to share the energy and harmony of meaning and of relating. Malloch and Trevarthen 2009 , p. 8

Contexts for research

All research conducted with service users in music therapy involves a context. This may be a single site such as a school or a hospital (see Colwell , this volume), or multiple sites. It may involve a service such as an oncology department, or additionally it may involve participants who access multiple services, for example children with cerebral palsy. Each context differs as to how service users or students can be approached to be involved in the research, and who will act as formal or informal gate-keepers. Researchers planning projects need to factor in how the people who will contribute to managing the data collection of the project will be sorced, and how these potential gate-keepers will assist in managing the recruitment and involvement of service users. Often people who are crucial to the research such as gate-keepers receive little acknowledgement either in research reports, or in international publications. This can make it difficult for novice researchers to understand how crucial they are to conducting research which relies on data collection from service users or students ( Porter et al. 2014 ).

Clinicians working within a service are often the referring point for participation in a music therapy project. The clinician can decide whether a person who meets the criteria for the project is able to manage the requirements of the project participation, and would potentially benefit from being a research participant. Clinicians are protective of their clients or patients. Therefore the researcher must take care to ensure that the clinician has confidence in the researcher and the research processes, that participants will not be taxed or made demands of in any problematic way. The gatekeeper may also be encoraged to note that the client may end up receiving music therapy, and that this participation may be highly enjoyable and potentially therapeutically beneficial.

One contextual dimension that has received limited attention in the literature is the role of the researcher and how this differs from the role of music therapist. Ledger (2010a) has reflected on her experiences as a music therapy researcher undertaking an ethnographic research project in a hospital that was developing a new music therapy service. She wrote:

Returning to the familiar setting of a hospital brought to the fore a set of previously held positions and behaviors. I needed to manage not only the boundary between researcher and music therapist but also the boundaries between researcher and colleague, researcher and friend, and experienced music therapist and student. These boundaries needed to be negotiated and renegotiated throughout the duration of my ethnography. There were times when it was helpful to cross boundaries in order to build rapport and to show appreciation to the staff who contributed to my research. However, there were also times when I needed to establish clear boundaries and to reiterate my research intentions. Ledger 2010a , p. 300

Ledger’s further reflection reveals some of the dilemmas that can arise when conducting qualitative methods research ( Ledger 2010b ). Unlike other types of research where one might collect data through testing or questionnaires, ethnography involves participation and observation. Being aware of the need to manage and negotiate role identity is an important part of undertaking this work.

The future of music therapy research

As music therapy matures and grows as a field of practice it is developing its depth and breadth of research engagement. Contemporary research is immensely inspiring, especially for increasingly sounding the voices of service users ( Ansdell and Meehan 2010 ; Solli et al. 2013 ), and the careful development of research procedures which ensure the complexity of musical experiences are not lost in the need for research rigor ( Erkkilä et al. 2011 ). The development of greater sophistication in mixed methods research (see Erkkilä , this volume) will ensure that the outcomes of psychological testing or observation of the therapist will not be privileged over the lived experience of participants. The increasing harnessing of the capacities of technology in conducting systematic evaluation of music therapy services show promising developments ( Streeter et al. 2012 ). More robust theoretical engagement with neuroscience and psychophysiology (for example Loewy 2011 ) and social theories ( Baines 2013 ) will ensure that music therapy has strong theoretical bones upon which the flesh and sinew of competent practice can continue to grow.

Epistemology refers to theory of knowledge. All research has an epistemological foundation whether or not it is made explicit. For further information see Edwards (2012) .

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Articles on Music therapy

Displaying 1 - 20 of 26 articles.

Music therapy could help manage the pain of bereavement

Lisa Graham-Wisener , Queen's University Belfast and Tracey McConnell , Queen's University Belfast

How music heals us, even when it’s sad – by a neuroscientist leading a new study of musical therapy

Leigh Riby , Northumbria University, Newcastle

How music therapy can help rebuild the lives of refugees

Elizabeth Coombes , University of South Wales

Drawing, making music and writing poetry can support healing and bring more humanity to health care in US hospitals

Marlaine Figueroa Gray , University of Washington

How an African church choir made a difference to care home life in Greater Manchester

Kayonda Hubert Ngamaba , University of York and Cheyann Heap , University of York

What’s your school closures playlist? Why music should be part of parents’ pandemic survival strategy

Ala Krivov , Western University

Anxiety: a playlist to calm the mind from a music therapist

High-tech concert hall measures brain waves and heart rates during performances

Laurel Trainor , McMaster University and Dan J. Bosnyak , McMaster University

Curious Kids: is it OK to listen to music while studying?

Timothy Byron , University of Wollongong

How music therapy can help anxious children

Music therapy improves the health of premature babies and boosts parental bonding

Creative arts therapies can help people with dementia socialise and express their grief

Joanna Jaaniste , Western Sydney University

Groovy findings: Researching how and why music moves you

Tomas Matthews , Concordia University

Singing death: why music and grief go hand in hand

Helen Maree Hickey , The University of Melbourne and Helen Dell , The University of Melbourne

The healing power of hip hop

Alexander Crooke , The University of Melbourne and Raphael Travis Jr. , Texas State University

Understanding the NDIS: how does the scheme view music therapy?

Katrina McFerran , The University of Melbourne

Ageing in harmony: why the third act of life should be musical

Jennifer MacRitchie , Western Sydney University

Songwriting as solace: ‘I live in the same body but it can’t talk to me any more’

Felicity Anne Baker , The University of Melbourne

Questions to ask your teenager about music and mental health

How music can help relieve chronic pain

Don Knox , Glasgow Caledonian University

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Senior Lecturer in Music Therapy, University of South Wales

Professor and Head of Music Therapy, The University of Melbourne

Senior Research Fellow, Music Therapy, The University of Melbourne

PhD Candidate, Music and Public Health, Griffith University

Professor of Music Therapy, Berklee College of Music

Senior research fellow in health and wellbeing, University of Sheffield

Reader in health technology assessment, Brunel University London

Senior audio lecturer, Glasgow Caledonian University

Postdoctoral Research Fellow in Music Therapy, The University of Melbourne

Researcher in the Australian Research Council for the History of Emotions, The University of Melbourne

Professor of Social Work, Texas State University

Honorary Research Fellow in the School of Culture and Communication, University of Melbourne, The University of Melbourne

Research Fellow, Social Policy & Social Work, School for Business and Society, University of York

PhD Candidate, Concordia University

Career Development Fellow, Western Sydney University

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Music and Health: What the Science Says

Clinical Guidelines, Scientific Literature, Info for Patients:  Music and Health

.header_greentext{color:green!important;font-size:24px!important;font-weight:500!important;}.header_bluetext{color:blue!important;font-size:18px!important;font-weight:500!important;}.header_redtext{color:red!important;font-size:28px!important;font-weight:500!important;}.header_darkred{color:#803d2f!important;font-size:28px!important;font-weight:500!important;}.header_purpletext{color:purple!important;font-size:31px!important;font-weight:500!important;}.header_yellowtext{color:yellow!important;font-size:20px!important;font-weight:500!important;}.header_blacktext{color:black!important;font-size:22px!important;font-weight:500!important;}.header_whitetext{color:white!important;font-size:22px!important;font-weight:500!important;}.header_darkred{color:#803d2f!important;}.Green_Header{color:green!important;font-size:24px!important;font-weight:500!important;}.Blue_Header{color:blue!important;font-size:18px!important;font-weight:500!important;}.Red_Header{color:red!important;font-size:28px!important;font-weight:500!important;}.Purple_Header{color:purple!important;font-size:31px!important;font-weight:500!important;}.Yellow_Header{color:yellow!important;font-size:20px!important;font-weight:500!important;}.Black_Header{color:black!important;font-size:22px!important;font-weight:500!important;}.White_Header{color:white!important;font-size:22px!important;font-weight:500!important;} Pain

There is some evidence that music-based interventions may help to relieve pain associated with specific health conditions.

.header_greentext{color:green!important;font-size:24px!important;font-weight:500!important;}.header_bluetext{color:blue!important;font-size:18px!important;font-weight:500!important;}.header_redtext{color:red!important;font-size:28px!important;font-weight:500!important;}.header_darkred{color:#803d2f!important;font-size:28px!important;font-weight:500!important;}.header_purpletext{color:purple!important;font-size:31px!important;font-weight:500!important;}.header_yellowtext{color:yellow!important;font-size:20px!important;font-weight:500!important;}.header_blacktext{color:black!important;font-size:22px!important;font-weight:500!important;}.header_whitetext{color:white!important;font-size:22px!important;font-weight:500!important;}.header_darkred{color:#803d2f!important;}.Green_Header{color:green!important;font-size:24px!important;font-weight:500!important;}.Blue_Header{color:blue!important;font-size:18px!important;font-weight:500!important;}.Red_Header{color:red!important;font-size:28px!important;font-weight:500!important;}.Purple_Header{color:purple!important;font-size:31px!important;font-weight:500!important;}.Yellow_Header{color:yellow!important;font-size:20px!important;font-weight:500!important;}.Black_Header{color:black!important;font-size:22px!important;font-weight:500!important;}.White_Header{color:white!important;font-size:22px!important;font-weight:500!important;} What Does the Research Show?

• A 2016 meta-analysis of 97 randomized controlled trials involving a total of 9,184 participants examined music-based interventions for acute or chronic pain associated with a variety of health problems and medical procedures. The overall evidence suggested that music-based interventions may have beneficial effects on both pain intensity and emotional distress from pain and may lead to decreased use of pain-relieving medicines.  
• A 2017 systematic review and meta-analysis of 14 randomized trials (1,178 participants) examined music-based interventions for various types of chronic pain and found that the interventions reduced self-reported chronic pain and associated depressive symptoms, with a greater effect when the music was chosen by the participant rather than the researcher. The study participants had a variety of conditions that can cause chronic pain, including cancer, fibromyalgia, multiple sclerosis, or osteoarthritis, and most of the interventions involved listening to recorded music.   Overall, the data suggested that as an adjuvant therapy, music reduces self-reported pain and common comorbidities associated with chronic pain.
• In recent studies, music-based interventions were helpful for pain associated with childbirth, platinum-based chemotherapy, shock wave lithotripsy, oocyte retrieval for in vitro fertilization, treatment of nose fractures, and sickle cell disease.   However, music didn’t seem to be helpful for pain associated with loop electrosurgical excision, and the results of studies on pain during cystoscopy and pain during colonoscopy were inconsistent.

.header_greentext{color:green!important;font-size:24px!important;font-weight:500!important;}.header_bluetext{color:blue!important;font-size:18px!important;font-weight:500!important;}.header_redtext{color:red!important;font-size:28px!important;font-weight:500!important;}.header_darkred{color:#803d2f!important;font-size:28px!important;font-weight:500!important;}.header_purpletext{color:purple!important;font-size:31px!important;font-weight:500!important;}.header_yellowtext{color:yellow!important;font-size:20px!important;font-weight:500!important;}.header_blacktext{color:black!important;font-size:22px!important;font-weight:500!important;}.header_whitetext{color:white!important;font-size:22px!important;font-weight:500!important;}.header_darkred{color:#803d2f!important;}.Green_Header{color:green!important;font-size:24px!important;font-weight:500!important;}.Blue_Header{color:blue!important;font-size:18px!important;font-weight:500!important;}.Red_Header{color:red!important;font-size:28px!important;font-weight:500!important;}.Purple_Header{color:purple!important;font-size:31px!important;font-weight:500!important;}.Yellow_Header{color:yellow!important;font-size:20px!important;font-weight:500!important;}.Black_Header{color:black!important;font-size:22px!important;font-weight:500!important;}.White_Header{color:white!important;font-size:22px!important;font-weight:500!important;} Anxiety

Music-based interventions have been evaluated for their effects on anxiety in a variety of disease conditions and health care settings. Most studies have had promising results.

• A 2013 Cochrane systematic review of 26 studies involving a total of 2,051 participants found that listening to recorded music significantly reduced anxiety in people who were waiting to have surgery. However, there was potential for bias in most of the studies because the investigators who performed the studies knew which participants had listened to music. 
• A 2016 Cochrane systematic review of 17 studies involving a total of 1,381 participants evaluated the effect of music-based interventions on anxiety in adults with cancer. The findings from the review suggested that music-based interventions may have a large anxiety-reducing effect as well as beneficial effects on pain, fatigue, and quality of life in people with cancer. However, there was a high risk of bias in the studies. 
• A 2015 systematic review and meta-analysis of 5 studies (290 participants) in people who were receiving incenter maintenance hemodialysis suggested that listening to music reduced anxiety. However, the studies included in the review have limitations because of their small size and high risk of bias.

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It’s uncertain whether music-based interventions are helpful for people with ASD.

• A 2021 systematic review of 22 studies (850 participants) on music therapy for children with ASD was unable to reach any definite conclusions on whether adding music therapy to their care was beneficial, although some studies had promising results. For example, some studies of educational music therapy (involving techniques such as musical games) showed possible benefits on the children’s speech, and some studies of improvisational music therapy (in which children produce music) showed possible benefits on social functioning.
• A 2017 randomized controlled trial of improvisational music therapy for children with ASD (which was included in the review described above) was a multinational trial involving 364 children from 9 countries. It is the largest study completed so far, and its design was especially rigorous. In this study, the severity of symptoms related to difficulties in social communication did not differ between children who received improvisational music therapy along with standard care and those who received standard care alone.  

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There is some limited evidence that music-based interventions may be helpful for shortness of breath, anxiety, and sleep quality in adults with COPD.

• A 2021 systematic review of 12 studies (812 participants) showed that music-based interventions (i.e., listening to music or a combination of listening and singing) were helpful for shortness of breath, anxiety, and sleep quality in adults with COPD but were not helpful for depression. Because the studies were brief (several days to 12 months) and because researchers measured effects in different ways in different studies, there is some uncertainty about the conclusions.

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Much research is being done on the potential benefits of music-based interventions for people with cognitive impairment or various types of dementia, such as Alzheimer’s disease. Limited evidence suggests that music-based interventions may improve emotional well-being, behavioral challenges, and quality of life in people with these conditions. Whether the interventions have benefits for cognitive functioning is unclear; effects might depend on the population studied or the type of intervention used.

• A 2018 Cochrane systematic review evaluated 22 studies (1,097 participants) of music-based interventions for people with dementia who were living in institutions. Some of the interventions were receptive (listening to music), some were active (singing, playing instruments, moving to music, etc.), and some were a combination of the two. The evidence from these studies indicated that music-based interventions probably reduce depressive symptoms and improve overall behavioral problems, but effects differ for different behavior problems. They may also improve emotional well-being and quality of life and reduce anxiety. However, the interventions may have little or no effect on agitation, aggression, or cognitive function. 
• A 2021 systematic review and meta-analysis analyzed 21 studies involving 1,472 participants with either mild cognitive impairment or mild or moderate dementia for potential effect sizes and intervention activities. Nine of the studies (495 participants) were included in a quantitative analysis of effects on cognitive functioning This analysis indicated that the music-based interventions had a small beneficial effect on cognitive functioning for older adults with probable mild cognitive impairment or dementia. There was also some evidence for beneficial effects on mood and quality of life.

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There is some evidence that adding music-based interventions to usual treatment may improve depressive symptoms when compared with usual treatment alone. There is also some evidence that music-based interventions may help decrease anxiety levels and improve functioning in people with depression.

• A 2017 Cochrane systematic review looked at 9 studies (421 participants) of music-based interventions in adults or adolescents with depression. There was moderate-quality evidence that adding music-based interventions to usual treatment saw improvement based on clinician‐rated and patient‐reported measures of depression when compared with usual treatment alone. Music-based interventions also helped decrease anxiety levels and improve functioning of people with depression (for example, their ability to maintain involvement in work, activities, and relationships).

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Findings from several studies suggest that music-based interventions may be beneficial for coordination, balance, some aspects of gait and walking, emotional status, and pain in people with MS.

• A 2021 systematic review of music-based interventions for people with multiple sclerosis (10 trials, 429 participants) found consistent evidence overall that the music-based therapies were better than conventional care or no intervention for fatigue level, fatigability, coordination, balance, some aspects of gait and walking, emotional status, and pain, but no effect was observed for mental fatigability or memory.  The music-based therapy came from one of four different modalities: (1) Rhythmic auditory; (2) Playing musical instruments; (3) Dance strategy; and (4) Neurological music therapy.   

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There is some limited evidence that rhythmic auditory stimulation may significantly improve gait speed and stride length in people with PD. There is some evidence that music-based movement therapy may improve motor function, balance, freezing of gait, walking speed, and mental health. In addition, a few studies have found some evidence that singing may have a beneficial effect on speech in people with PD.

• Rhythmic auditory stimulation. A 2021 systematic review and meta-analysis of 5 studies (209 total participants) showed significant improvements in gait speed and stride length in people with PD who participated in rhythmic auditory stimulation. However, the quality of evidence was low, and the number of studies and participants was small.
• Music-based movement therapy.  A 2021 systematic review and meta-analysis of 17 studies (598 participants) of music-based movement therapy showed evidence of improvements in motor function, balance, freezing of gait, walking speed, and mental health but not gait cadence, stride length, or quality of life in people with PD.
• Singing. The potential benefits of singing for people with PD have been studied primarily in terms of effects on speech. In a 2016 systematic review of 7 studies (102 participants), 5 studies found some evidence of a beneficial effect on speech.

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Results of studies have been mixed as to whether music-based interventions can be helpful for sleep problems.

• A 2021 systematic review of 16 studies involving 812 older adults with sleep problems found mixed results; some studies suggested that the music interventions were helpful, while others did not.
• 2015 Cochrane systematic review of 6 studies involving a total of 314 participants with insomnia found that music-based interventions may be effective for improving subjective sleep quality in adults with insomnia.

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Music-based interventions, particularly music therapy, may be helpful for improving physical and psychological markers associated with stress, according to two related reviews.

• A 2020 systematic review and two meta-analyses of 104 studies (9,617 participants), analyzed the effects of a variety of music-based interventions on measures associated with stress, including both physiological measures (heart rate, blood pressure, and levels of stress-related hormones) and psychological measures (anxiety, nervousness, restlessness, and feelings of worry). The music-based interventions had a small-to-medium sized beneficial effect on the physiological measures and a medium-to-large beneficial effect on the psychological measures. 
• A 2022 systematic review and meta-analysis of 47 studies (2,747 participants) of music therapy (excluding other music-based interventions) found an overall medium-to-large beneficial effect on stress-related outcomes. The effects were greater than those seen in the larger review. The investigators who performed the review suggested that the opportunity for music therapists to tailor interventions to the needs of individual patients might account for the difference.

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There is evidence that music-based interventions may be helpful in the rehabilitation of people who have had a stroke.

• A 2019 systematic review of 27 studies (730 participants) found positive effects on physical status (upper-limb activity, various aspects of walking, balance), cognition (paying attention, communication), and mood in people who had a stroke. In particular, rhythmic auditory stimulation had beneficial effects on gait and balance, and receptive music therapy was helpful for mood and some aspects of cognitive function (i.e., verbal memory, focused attention).

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• In general, research studies of music-based interventions do not show any negative effects. However, listening to music at too high a volume can contribute to noise-induced hearing loss. You can find out about this type of hearing loss on the National Institute on Deafness and Other Communication Disorders website . 
• Because music can be associated with strong memories or emotional reactions, some people may be distressed by exposure to specific pieces or types of music. 
• Music-based interventions that involve exercise or other types of movement could lead to injury if appropriate safety precautions are not taken.

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• Music and the Brain: Report on an NIH/Kennedy Center Workshop  

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• v.18; 2021 Dec

Music, mental health, and immunity

Music is a crucial element of everyday life and plays a central role in all human cultures: it is omnipresent and is listened to and played by persons of all ages, races, and ethnic backgrounds. But music is not simply entertainment: scientific research has shown that it can influence physiological processes that enhance physical and mental wellbeing. Consequently, it can have critical adaptive functions. Studies on patients diagnosed with mental disorders have shown a visible improvement in their mental health after interventions using music as primary tool. Other studies have demonstrated the benefits of music, including improved heart rate, motor skills, brain stimulation, and immune system enhancement. Mental and physical illnesses can be costly in terms of medications and psychological care, and music can offer a less expansive addition to an individual's treatment regimen. Interventions using music offers music-based activities in both a therapeutic environment (Music therapy) with the support of a trained professional, and non-therapeutic setting, providing an atmosphere that is positive, supportive, and proactive while learning non-invasive techniques to treat symptoms associated with various disorders – and possibly modulate the immune system.

1. Introduction

Music can play a crucial role to support people at all stages of life: from helping new-born babies develop healthy bonds with their parents to offering vital, sensitive, and compassionate palliative care at the end of life. Singing to new-borns, a widespread activity practised worldwide, has been demonstrated to have valuable benefits such as improving mother-infant interaction and reducing infant distress ( Vlismas et al., 2013 ; Mualem and Klein, 2013a ). In the same way, music has been reported as an aid in the reduction of anxiety and agitation in older adults with senile dementia ( Sung et al., 2012 ).

The clinical and evidence-informed use of music interventions to accomplish individualised goals within a therapeutic relationship is defined as Music therapy ( Press Release on Mus, 2014 ). Established as a profession after World War II, Music therapy has become an important part of internationally therapeutic and healthcare settings ( Greenberg and Rentfrow, 2017 ). Even long before that, Pythagoras (c.570 – c.495 BC), the Ancient Greek philosopher and mathematician, prescribed various musical scales and modes to cure an array of physical and psychological conditions ( Greenberg and Rentfrow, 2017 ). Music therapy is part of the Creative Arts Therapies ( Mind [Internet]. [cited 2, 2021 ), in which arts-based activities are used in a therapeutic environment, with the support of a trained professional. Creative Arts Therapies are particularly effective for people who face barriers in expressing themselves with spoken languages, such as individuals with communication deficits or people with mental health difficulties who find it difficult to talk about their experiences and feelings in words. These therapies provide a safe and supportive environment to enable and encourage the patients to express themselves in whatever way possible, encouraging self-expression and development supported by the therapeutic relationship ( Ahessy, 2013 ). Music therapy interventions involve a therapeutic process developed between the patient (or client) and therapist through the use of personally tailored music experiences ( de Witte et al., 2019 ).

This distinguishes Music therapy from other music interventions, offered mainly by medical or healthcare professionals ( de Witte et al., 2019 ; Agres et al., 2021 ). In fact, music can be utilized not only through a setting lead by a professional Music therapist, but also with individuals and groups in a variety of settings. A wide range of musical styles and instruments can be used, including the voice, enabling people to create their unique musical language to explore and connect with the world and express themselves. Bringing out emotions and thoughts through methods of verbal and nonverbal expression and exploration - such as dance and body movement, music, art ( Havsteen-Franklin ), and expressive writing ( Pennebaker and Chung, 2007 ; Rebecchini, 2019 ) - may deactivate the avoidance mechanism and enable the elaboration of emotions and distress. As Juslin and Vastfjall (2008) , and Levitin ( British Association for M, 2021 ) have underlined, music has evolved from emotional communication, and the musical components of speech provide honest communication about emotions. Because musical participation and response do not depend solely on the ability to speak, music is particularly effective for people who have difficulty communicating verbally ( British Association for M, 2021 ). Hence, working with music can be life-changing for people affected by disability, injury, or mental disorders.

The potential of music to affect mood, cognition, and behavior has been demonstrated in several studies. On a negative side, some studies have shown that men who were exposed to music with misogynistic lyrics displayed higher levels of aggressive behavior than did those who were exposed to neutral music, especially when the aggressive behavior was directed at a female target person. Men also recalled more negative attributes of women after exposure to misogynistic music ( Barongan, Hall ). And when the music contained men-hating lyrics, women recalled more negative than positive attributes about men ( Fischer and Greitemeyer, 2006 ). Furthermore, playing loud music incessantly to prisoners has been reported as a form of “music torture” designed to cause extreme discomfort. In fact, it's been a practice against which the legal charity Reprieve set up its “zero-dB” campaign ( zero, 2021 ) the 60th anniversary of the Universal Declaration of Human Rights in December 2008.

There is a vast body of evidence demonstrating that Music therapy is beneficial both physically and mentally. Recently the attention has also focused on whether general music activities, not led by therapists, can enhance the mental health and wellbeing of service users ( de Witte et al., 2019 ; Fancourt et al., 2016 ). Studies on patients diagnosed with mental disorders such as anxiety, depression, and schizophrenia have shown a visible improvement in their mental health after general music and Music therapy interventions ( Fancourt et al., 2016 ; McCaffrey et al., 2011 ; Mössler et al., 2011 ; Erkkilä et al., 2011 ). Moreover, studies have demonstrated other benefits of music and Music therapy, including improved heart rate, motor skills, stimulation of the brain ( Bradt et al., 2013 ; Magee et al., 2017 ; Norton et al., 2009 ) and enhancement of the immune system ( Taylor, 1997 ; Fancourt et al., 2014 ; Li et al., 2021 ).

Although music might have initially evolved as a pure art expression with entertainment scopes, it is now clear that music can affect physiological processes, improving physical and mental wellbeing. Consequently, it can have critical adaptive functions.

1.1. The role of music since first interactions

The use of the voice through singing is a unique form of interaction and expression. Singing is closely linked to the first forms of interaction between a mother and her infant. The body of research on parent-infant communication has shown that humans' earliest contact has many musical qualities ( Trevarthen and Malloch, 2000 ; Stern, 2010 ). As Dissanayake suggested ( Dissanayake, 2000 ), a mother's use of rhythmical movement appears to be an essential component for the expression communicated while singing with her infant.

Evidence has underlined that a mother's touch and rhythmical movements, co-created with her infant during musical interactions, are central to the infant's feelings of pleasure ( Longhi, 2008 ) and a healthy mother-infant relationship ( Hatch and Maietta, 1991 ). As a mother emotionally engages with her infant, her sensitivity and affection are communicated through her voice ( Fernald, 1989 , 1992 ; Rock et al., 1999 ), touch and facial expressions ( Papoušek and Papoušek, 1987 ; Stack and Muir, 1992 ), and rhythmical movements ( Hatch and Maietta, 1991 ). This co-created communicative interaction has been demonstrating a ‘communicative musicality’ due to its intrinsic music and dance-like qualities of the regularity of pulse and sensitive exchange of gestural narratives ( Malloch and Trevarthen, 2009 ). The positive emotional arousal and synchronisation between a mother and her child could be the root of a positive mother-infant relationship, thus essential for future child development ( Hodges, 1980 ; Mualem and Klein, 2013b ).

A study conducted by Vlismas et al. (2013) on the effect of music and movement on mother-infant interactions showed that maternal engagement in a music and movement programme resulted in changes to both mothers' and infants' behavior. Specifically, it showed that the effect of the programme increased the mothers' self-reported use of music and enjoyment of interactions with their infants; the mothers' self-reported attachment to their infants; the dyadic reciprocity between mother and infant; and the attentional and affective aspects of mothers' speech.

2. Music, music therapy and mental health

Utilising music as a structured intervention in treating mental illnesses such as anxiety, depression and schizophrenia has been reported as beneficial in relieving symptoms ( Mössler et al., 2011 ; Erkkilä et al., 2011 ), while improving mood and social interactions ( Edwards, 2006 ). Some people with mental disorders may be too disturbed to use verbal language alone efficiently as a therapeutic medium. Thus, the musical interaction might support and provide musical resources and competencies very beneficial for patient's everyday life. Music can have unique motivating, relationship-building, and emotionally expressive qualities ( Solli, 2008 ; Rolvsjord, 2001 ).

Numerous studies have focused on the effect of music interventions on individuals in clinical settings. Many of these studies concluded that music interventions positively impact mood and anxious or depressive symptoms in both children ( Kim and Stegemann, 2016 ; Yinger and Gooding, 2015 ; Kemper and Danhauer, 2005 ) and adults ( Carr et al., 2013 ; van der Wal-Huisman et al., 2018 ). Reviews of the evidence have suggested that Music therapy may improve mental health in children and adolescents and communication in children with autistic spectrum disorder ( Gold et al., 2007 ; Whipple, 2004 ). In the same way, clinical reports and pre-experimental studies have suggested that Music therapy may be an effective intervention for adult patients with mental health problems across the world. A recent review which aimed to identify, summarise, and synthesise different experimental studies addressing the effects of Music therapy alone or Music therapy added to standard care on mental health ( Lee and Thyer, 2013 ) has shown the therapy alone or added to standard care to have significantly better effects than psychotherapy ( Castillo-Pérez et al., 2010 ), verbal relaxation ( Lin et al., 2011 ), standard care ( Erkkilä et al., 2011 ; Lin et al., 2011 ; Yang et al., 2009 ) and no treatment ( Mohammadi et al., 2011 ; Siedliecki and Good, 2006 ).

Mental health diseases such as depression and anxiety can have devastating consequences both for patients and their families. Symptoms can be severe and debilitating, leaving individuals alone and isolated. Relationships among family and friends may suffer, and individuals may not receive the support needed to manage their disease. Music can improve symptoms associated with mental illness, but it can also provide an environment for social interaction. As Choi, Lee, and Lim described ( Choi et al., 2008 ), Music therapy helps the individual to express emotions while producing a state of mental relaxation, and consequently it can be beneficial in decreasing symptoms of depression and anxiety, while enhancing interpersonal relationships.

Other music interventions - not lead by a professional music therapist - such as group drumming have been very effective, leading to the enhancement of psychological states, specifically fewer depressive symptoms and greater social resilience ( Fancourt et al., 2016 ): there is a growing body of evidence demonstrating the effects of community group on mental health ( Estevao et al., 2021 ; Clift and Morrison, 2011 ; Coulton et al., 2015 ). For example, a study conducted with mothers suffering from postnatal depression found that mothers with moderate-severe depressive symptoms who participated in 10 weeks of music and singing classes with their babies had a significantly faster improvement in symptoms than mothers who participated in usual care groups ( Fancourt and Perkins, 2018 ).

In the same way, using Music therapy to decrease psychological stress during pregnancy has been reported as an appropriate alternative therapy for pregnant women suffering from mental health problems attempting to avoid the side effects associated with medication. A study conducted in 2007 with the aim of examining the effects of Music therapy on reducing psychological stress during pregnancy reported that listening to music for at least 30 minutes daily substantially reduced psychological stress, anxiety, and depression ( Chang et al., 2008 ). Hence, listening to music daily during pregnancy can generate considerable health benefits.

These experimental results indicate that music promotes psychological health both during pregnancy, and the entire lifetime; it can be easily used in many environments, and it can also be tailored to personal preferences to enhance mental health.

2.1. Music and immune system

The immune system, composed by molecular and cellular components, is a complex system of structures and processes that have evolved to protect us from disease. The function of these components is divided up into nonspecific mechanisms, those which are innate to an organism, and responsive responses, which are adaptive to specific pathogens. The innate immune system represents the first line of defense against infection and includes cells and proteins that are nonspecific to particular antigens. The adaptive immune system provides a secondary, antigen-specific response during which cells with a memory for specific pathogens are created. The adaptive immune system has the capacity to recognize and respond to virtually any protein or carbohydrate imaginable; yet, without the innate immune system to instruct it—in effect, telling it whether, when, how, and where to respond—it is powerless ( Clark and Kupper, 2005 ). As the literature shows, the immune system is strongly associated with mood, psychological condition, and hormonal balance ( Segerstrom and Miller, 2004 ). Thus, as a result of negative mood, psychological stress affects the immune system and may cause dysregulation leads to a change in the humoral and cellular immunity and increases health risks.

Psychological stress can have detrimental effects on both immune system responses, leading to a weakening of defenses against new pathogens and increasing in systemic inflammation ( Chanda and Levitin, 2013a ; Maddock and Pariante, 2001 ). While inflammation is a local, protective response to microbial invasion or injury, it must be fine-tuned and regulated precisely, because deficiencies or excesses of the inflammatory response cause morbidity and shorten lifespan ( Tracey, 2002 ; Bassi et al., 2018 ). Because stress can be a predisposing factor to diseases associated with immunologic responses ( Maddock and Pariante, 2001 ), increased exposure to stressful situations expands the risk of mental and physical disorders ( Hazelgrove et al., 2021 ). Acute stress can affect basal sensitivity, increasing or decreasing pain threshold in acute and chronic pain processes. For the fact that acute and chronic pain are potent stressors, they can alter the body homeostasis: pain can be an activator of the hypothalamic-pituitary-adrenal axis (HPA axis), the major system responsible for stress responses, which may be hypoactive or hyperactive under chronic or persistent stress conditions ( Timmers et al., 2019 ). In turn, the HPA axis modulation directly affects the release levels of glucocorticoids, ‘hormones of stress’, which induce anti-inflammatory and immunosuppressive effects at pharmacological doses, whereas at physiological levels they play an essential regulatory role in the immune system ( Pariante and Miller, 2001 ). Thus, stress can negatively affect the cardiovascular, neuroendocrine, and immune systems, which, consequently, may impair recovery, increase the risk for adverse effects, and delay hospital discharge ( Biondi and Zannino, 1997 ).

Although psychological stress cannot be eliminated, there are ways in which the perception of stress and ability to adapt to stressors can be altered: music has been adapted as a form of stress management and studies have confirmed the effect of music on the reduction of stress responses in the cardiovascular and endocrine system ( Taylor, 1997 ; Mojtabavi et al., 2020 ). Specifically, music has been shown to modify heart rate, respiration rate, perspiration, and other autonomic systems ( Blood et al., 1999 ), supporting reports that many people use music to achieve physical and psychological balance. Lifestyle choices that reduce stress are thought to be highly protective against diseases ( Dimsdale, 2008 ), and music may be among these ( Dileo et al., 2007 ; Nilsson, 2008 ).

The human's biological stress response is highly adaptive in the short term: it is an elegant choreography ( Chanda and Levitin, 2013b ) of neuroendocrine, autonomic, metabolic, and immune system activity that involves multiple feedback loops at the level of the central and peripheral nervous systems ( Landgraf and Neumann, 2004 ). Together these systems trigger short term adaptive behaviours, including arousal, vigilance, focused attention, and temporarily inhibit functions that are nonessential during a crisis, such as eating, digestion, growth, and sex drive. At the same time, cardiovascular changes such as elevated heart rate and rapid breathing are helpful to increase oxygenation and glucose supply to the brain and skeletal muscles.

However, as already mentioned, the prolonged activation of these systems has devastating consequences for health. Continuous and elevated circulating levels of glucocorticoids (e.g., cortisol) act as neurotoxins, weakening the ability of neurons and other cells to resist injury and making them more vulnerable to the effects of toxins and the normal attrition process ( Landgraf and Neumann, 2004 ). Furthermore, although glucocorticoids act as an immunosuppressant under acute stress conditions, they may promote a state of chronic low-grade inflammation in the long term ( Gouin et al., 2008 ). These neurotoxic and pro-inflammatory effects of chronic stress have been linked to a host of adverse health outcomes such as susceptibility to infectious diseases, anxiety and depression ( Pitharouli et al., 2021 ), and cardiovascular diseases ( Chrousos, 2009 ; Lupien et al., 2009 ).

As many studies have demonstrated, neuroinflammation is the cause of several mental diseases such as depression and anxiety ( Zheng et al., 2021 ; Troubat et al., 2021 ). Hence, attention has increasingly focused on the effect of music as a possible anti-inflammatory mechanism in these central inflammatory conditions. A recent work conducted by Dasy Fancourt (2014) - the first systematic review that aimed to assess published studies dealing with psychoneuroimmunological effects of music - showed that music can have effects on various neurotransmitters, cytokines, and hormones ( Fancourt et al., 2014 ). Specifically, fifty-six of the sixty-three studies included in the author's systematic review linked psychoneuroimmunological effects of music to the stress response.

Salivary Immunoglobulin A (s-IgA), a first-line in the defence against bacterial and viral infections ( Woof and Kerr, 2006 ) and a reliable marker of the functional status of the entire mucosal immune system ( Hucklebridge et al., 2000 ), has been revealed to be particularly responsive to music, increasing following exposure to a range of styles of music including both relaxing and stimulating music, as well as for both active involvements and simply listening to recorded music ( Fancourt et al., 2014 ). Strong patterns have also been noticed concerning cortisol, which repeatedly decreased in response to relaxing recorded music ( Fancourt et al., 2014 ). There also appeared to be patterns in the response of epinephrine and norepinephrine, which have been shown to decrease in response to relaxing recorded music ( Leardi et al., 2007 ).

Another study conducted to determine if (i) musical activity could produce a significant change in the immune system measured by s-IgA, and if (ii) active participation in musical activity had a different effect on the immune system than passive participation showed that S-IgA levels of the active group (playing music and singing) had more significant increase than those of the passive group (listening only) ( Kuhn, 2002 ). This result suggested that active participation in musical activity produces a more significant effect on the immune system than passive participation.

Overall, changes have been observed across various immune response biomarkers, including leukocytes, cytokines, immunoglobulins, and hormones and neurotransmitters associated with immune response ( Fancourt et al., 2014 ). Music has begun to be taken seriously in healthcare settings as research findings have started to link the beneficial effects of music on stress to a broader impact on health ( Haake, 2011 ). If music can mediate anti-inflammatory effects, evidenced by decreased levels of inflammatory biomarkers (see Table 1 ), there may be biological plausibility for its use in the care of ill patients. The results of these studies provide further confirmation that the immune system can be enhanced by music and, as Daisy Fancourt has underlined, the trend towards positive findings of the effect of music on psychoneuroimmunological response strongly supports further investigation in this field ( Fancourt et al., 2014 ).

Table 1

Markers of inflammation and immune response influenced by music .

2.1.1. Other biological effects

In the last decade, there has been growing interest in music's chemical and biological effects ( Table 1 ) ( Khan et al., 2018 ). Some studies have focused on whether music can affect the same neurochemical reward systems as other reinforcing stimuli. Does music have the earmarks of a rewarding stimulus, including the ability to motivate an individual to learn and engage in goal-directed behavior to obtain a pleasurable feeling ( Chanda and Levitin, 2013b )? As Salimpoor et al. have underlined ( Salimpoor et al., 2015 ), dopamine activity can explain why an individual would be motivated to keep listening to a piece of music, or to seek out that music in the future. However, it cannot alone explain the experience of pleasure when listening to music. Berridge and colleagues described ‘hedonic hotspots’ in the nucleus accumbens (NAc) and ventral pallidum that are explicitly linked to the display of pleasure and are triggered by opioid signalling ( Berridge and Kringelbach, 2013 ). Thus, there are crucial interactions between the dopamine and opioid systems. A rapid increase in dopamine release in humans induces euphoria, with the level of euphoria correlating with the level of ventral striatal dopamine release, which also leads to robust increases of endorphin release in the NAc ( Drevets et al., 2001 ). On the other hand, opioid antagonists block the subjective ‘high’ caused by strong dopamine release ( Jayaram-Lindström et al., 2004 ). Consequently, it seems reasonable to hypothesize that a strong induction of dopamine release caused by music can trigger opioid stimulation of so-called hedonic hotspots. In the other direction, the opioid system robustly modulates dopamine release in to the NAc ( Hjelmstad et al., 2013 ). This likely provides a mechanism through which music that is experienced as pleasing can enhance dopamine-mediated positive prediction error signaling and reinforcement learning. Thus, the association of dopamine release and NAc activation during peak musical pleasure may be a direct manifestation of this opioid–dopamine interaction ( Salimpoor et al., 2015 ).

There is an increasing body of evidence demonstrating the functional activation ( Blood and Zatorre, 2001 ; Brown et al., 2004 ; Jeffries et al., 2003 ; Koelsch et al., 2006 ), network connectivity ( Menon and Levitin, 2005 ), and central dopamine release ( Salimpoor et al., 2011 ) during the perception of pleasurable music. A review conducted by Chanda and Levitin (2013b) showed that studies that used positron emission tomography (PET) to investigate regional cerebral blood flow (rCBF) during experienced musical pleasure ( Blood and Zatorre, 2001 ; Brown et al., 2004 ; Jeffries et al., 2003 ) suggested that music reward involve the activation of the NAc, as well as opioid-rich midbrain nuclei known to regulate morphine analgesia and descending inhibition of pain ( Jeffries et al., 2003 ). NAc activation was also reported during listening to unfamiliar pleasant music compared to rest ( Brown et al., 2004 ) and during singing compared to speech ( Jeffries et al., 2003 ). On the other hand, listening to techno-music induced changes in neurotransmitters, peptides and hormonal reactions, related to mental state and emotional involvement: techno music increased plasma cortisol, adrenocorticotropic hormone, prolactin, growth hormone and norepinephrine levels ( Gerra et al., 1998 ). The neuroendocrine pattern induced by this fast music (techno music) turned out to be similar to the biological reaction to psychological stress ( Henry, 1992 ).

Other studies that used higher resolution functional magnetic resonance imaging (fMRI) to investigate the neural correlates of music pleasure ( Koelsch et al., 2006 ; Menon and Levitin, 2005 ; Salimpoor et al., 2011 ; Janata, 2009 ) showed that musical reward is dependent on dopaminergic neurotransmission within a similar neural network as other reinforcing stimuli: pleasant (consonant – positive emotional valence) and unpleasant (dissonant – negative emotional valence) music were contrasted, and the results confirmed activation of the ventral striatum and Rolandi operculum during pleasurable music listening, while strong deactivations were observed in the amygdala, hippocampus, parahippocampal gyrus, and the temporal poles in response to pleasant music ( Koelsch et al., 2006 ). Activation of the anterior superior insula in response to pleasant music has also been observed: a significant finding because of the insula's connectivity to the NAc and its role in the activation of the emotional circuitry and reward system ( Pavuluri et al., 2017 ) which, in turn, increases the innate and adaptive immune system ( Ben-Shaanan et al., 2016 ). All these structures have previously been implicated in the emotional processing of stimuli with (negative) emotional valence ( Heinzel et al., 2005 ; Siegle et al., 2002 ). The results of the studies mentioned above indicate that these structures respond to auditory information with emotional valence, and that listening to music has the capacity to up-as well as down-regulate neuronal activity in these structures.

3. Conclusion and limitations

The increasing evidence of the benefits of music activities and Music therapy provided by the literature is a driving force for developing music-based therapies services in the health care sector. By promoting physical and psychological health, music can be an effective treatment option suitable for every environment and people of every age, race, and ethnic background.

Since music is a complex topic, there are some aspects that this mini review has not fully addressed, such as the role of the autonomic nervous system involved in musical activities; the involvement of music as a possible component of an “enriched environment” ( Kempermann, 2019 ); and, finally, the beneficial effects of rhythmical movements and physical musical activities, and their contribution to the preference for treatment options.

Figure 1. Lavinia Rebecchini is an Italian psychologist currently doing a Ph.D at the Department of Psychological Medicine at the Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London. She graduated from Università Cattolica del Sacro Cuore of Milan and, after completing her Master of Science in Developmental Psychology with full marks, she decided to move to London to broaden her horizons. She started as an intern at the Perinatal Psychiatry section of the Stress, Psychiatry, and Immunology Laboratory (SPI Lab) at the IoPPN and, after being hired as a Research Assistant, she then decided to further cultivate her strong interest in the perinatal mental health field with a PhD. She has always been interested in perinatal psychiatry and the relationship between mothers and their children. Her Ph.D at the SPI Lab is concentrating on mother-infant interaction with mothers suffering from perinatal depression. With her Ph.D project, she focuses on which implications perinatal depression may carry for the developing mother-infant relationship. She looks at whether an intervention of music and singing sessions can help mothers develop compensatory skills to interact with their children appropriately so to better respond to their infants' needs. In addition to her academic experiences, during her free time, she has always volunteered to help children and families in need. She is determined and enthusiastic, and her eight years' experience in alpine skiing competitions has allowed her to build strong determination in achieving her goals.

Declaration of competing interest

The author Lavinia Rebecchini declares that there are no conflicts of interest.

Acknowledgements

Dr Rebecchini is supported by a kind gift from Michael Samuel through King's College London & King's Health Partners, by the UK National Institute for Health Research (NIHR) Biomedical Research Centre at the South London and Maudsley NHS Foundation Trust, and by the Wellcome Trust SHAPER programme (Scaling-up Health-Arts Programme to scale up arts intervention; award reference 219425/Z/19/Z).

Dr. Lavinia Rebecchini.

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Researchers provide recommendations for understanding music therapy's impact on chronic pain

by University Hospitals Cleveland Medical Center

A recent article from a multi-institutional group of researchers provides recommendations for music therapy practice and research among individuals with chronic pain using sickle cell disease as an exemplar condition.

While several studies have demonstrated the benefits of music therapy for addressing acute pain intensity (e.g., pain rated on a 0 to 10 scale), few studies have examined its impact on more meaningful outcomes, such as how much pain interferes with day-to-day life and individuals' ability to participate in social activities despite chronic pain .

The article, entitled "Recommendations for patient-reported outcome use in music therapy practice and research within chronic pain and sickle cell disease populations," provides guidance on how to address these gaps and improve the evidence base for music therapy within this population.

Rather than focusing on outcomes like pain intensity, which fails to speak to the impact of pain on individuals' daily lives or individuals' perceived ability to cope despite the pain, the authors recommend measuring more meaningful outcomes, including pain interference, self-efficacy, pain catastrophizing, and physical, emotional, and social functioning.

The authors provide specific recommendations for which measures to use, how to ensure measures are appropriate to specific chronic pain populations, and how to streamline data collection processes with technology. For example, the authors state that regardless of which measures are used, music therapists and researchers should ensure that measures are (1) relevant to the population's specific needs; (2) appropriate to individuals' developmental and health literacy levels, (3) appropriate to individuals' culture, environment, and socio-economic status; and (4) not overly burdensome.

"Music therapists can play an important role in the effective management of chronic pain because they are able to address multiple factors known to exacerbate pain, such as stress, depressed mood, and loneliness. In addition, music therapists teach people music-based strategies for pain management, and this helps people to feel more in control over their pain," said Joke Bradt, Ph.D., MT-BC, Professor and Director of the Ph.D. Program in Creative Arts Therapies in the Department of Creative Arts Therapies at Drexel University and co-author of the study.

Bradt said, "My research on music therapy for chronic pain management has shown that music therapy is particularly helpful in improving people's pain-related self-efficacy. Self-efficacy is well recognized to play an essential role in effective management of chronic pain."

Much of the article focuses on the implications of music therapy practice and research for people with sickle cell disease. Unlike other chronic pain conditions, chronic pain in sickle cell disease often emerges in adolescence due to the cumulative impact of vaso-occlusion on bones, blood vessels, and brain function.

Samuel Rodgers-Melnick, MPH, MT-BC, a music therapy researcher at University Hospitals Connor Whole Health and lead author of the manuscript added, "with the support of the Kulas Foundation, over the past decade, our research has demonstrated the benefits of music therapy for not only addressing acute pain in the hospital , but also helping people with sickle cell disease better cope with daily pain and have greater confidence in their ability to manage their symptoms ."

Rodgers-Melnick said, "To further understand the role of music therapy for people with chronic pain, music therapists and researchers will need to collect data that speak to the impact our work can have on helping these individuals achieve meaningful outcomes."

The paper is published in the Nordic Journal of Music Therapy .

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Good Research Topics about Music Therapy

• Active Music Therapy for Parkinson’s Disease
• Effectiveness of Music Therapy for Survivors of Abuse
• Music Therapy Effectiveness for Treatment of Alzheimer’s Disease
• The Link between Ancestral Hormones and Music Therapy
• Analysis of the Effectiveness of Art and Music Therapy
• Music Therapy Usefulness for Cancer Patients
• Music Therapy Impact on Students with Emotional and Behavioral Disorders
• Healing Chronic Pain with Music Therapy
• Music Therapy Effect on the Wellness and Mood of Adolescents
• Comparing Cognitive Behavioral Therapy and Music Therapy
• Constructing Optimal Experience for the Hospitalized Newborn Through Neuro-Based Music Therapy
• Music Therapy: Considerations for the Clinical Environment
• Music Therapy for Children with Autism Spectrum Disorder
• Discussing Music Therapy: Reducing Stress, Health, and Social Care
• Music Therapy for Delinquency Involved Juveniles through Tripartite Collaboration
• Heidelberg Neuro Music Therapy Enhances Task-Negative Activity in Tinnitus Patients
• Music Therapy for Post-Traumatic Stress Disorder

Interesting Topics to Write about Music Therapy

• How Does Music Therapy Promote Positive Mental Health?
• The Relationships between Learning and Music Therapy
• Music Therapy for Sexually Abused Children
• Managing Sickle Cell Pain with Music Therapy
• Music Therapy: How Does Music Impact Our Emotions?
• Dealing with Depression with the Help of Music Therapy
• Effectiveness of Music Therapy and Drug Therapy for Children with Autism
• The Link between Music Therapy and Personality Theory Psychology
• How Music Therapy Improves Depression Among Older Adults
• Music Therapy: The Best Way to Help Children with Mental Illness
• Interventions of Music Therapy for Stress Reduction
• Neurologic Music Therapy Training for Mobility and Stability Rehabilitation
• Nursing Theory for Music Therapy Quality Improvement Program
• The Help of Music Therapy in Pain Management
• Relationship between Hypertension and Music Therapy
• Yoga and Music Therapy as Effective Methods of Stress Management

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Current Research Initiatives

Improving access and quality: music therapy research 2025, november 13, 2015.

The American Music Therapy Association (AMTA) releases proceedings from the historic and innovative research symposium, “IMPROVING ACCESS AND QUALITY: MUSIC THERAPY RESEARCH 2025” (MTR2025). This visionary special event was designed to recommend guidance for future research in music therapy and was made possible by a generous donation from David’s Fund and Tom and Lucy Ott.

The symposium proceedings, unveiled as part of the AMTA annual conference State of the Association address, are available as a pdf file free of charge online at the AMTA website ( www.musictherapy.org ). 

Click here to download

25 individuals contributed to written content contained in the proceedings and the document contains some 42 recommendations representing the collective input of all symposium attendees. The proceedings are of high interest to all music therapy professionals, interns, and students - both graduate and undergraduate -  since the document's intent is to help guide future research in music therapy and, ultimately, improve access and quality of music therapy services. All attendees of the 2015 AMTA annual conference received a copy of the Executive Summary as part of their meeting packet materials.

Individuals may locate the Executive Summary and full document under the Research/Strategic Priority on Research/ website page [insert URL link]. Printed copies of the proceedings may be purchased during the AMTA 2015 conference taking place Nov. 12-15, 2015 in Kansas City, MO and through the AMTA online store beginning the week of November 15.

For more information, contact Barbara Else, MTR Coordinator and Senior Research Consultant [email protected] ; 520-245-7717, cell

Improving Access and Quality: Music Therapy Research 2025 Executive Summary and Conclusions

- october 7, 2015.

The American Music Therapy Association (AMTA) convened an historic and innovative research symposium, “Improving Access and Quality: Music Therapy Research 2025” (MTR2025), July 16-18, 2015. This visionary symposium was designed to recommend guidance for future research in music therapy and was made possible by a generous donation from David’s Fund and Tom and Lucy Ott. MTR2025 is tied to AMTA’s long-standing Strategic Priority on Research. The symposium represents an important event and is part of a larger and ongoing initiative to grow access to and quality of research in music therapy.

MTR2025 was structured to foster dialogue and to embrace diversity in thinking, approaches to practice, and methodologies. See Appendix A for the Symposium Agenda. AMTA was proud to sponsor this unique opportunity to bring the myriad members of the music therapy community together to collaboratively explore our research future. At the opening keynote panel, the Editors of AMTA’s peer-reviewed journals, Drs. Meadows and Robb aptly noted:

When viewed as a whole, music therapy research has moved through several important stages of development, characterized by differentiation and integration of philosophies and perspectives that parallel changes occurring in the broader national health research community, including an emphasis on diverse methodologies.  Central to advancing the science and practice of music therapy is finding ways to develop and integrate this knowledge across these research cultures, while meeting both internal and external demands for research that demonstrates improvements in quality and access to care.

The Keynote topics and speakers included:

• “Importance of Research for Improving Access and Quality,” Pamela Hinds, RN, PhD, FAAN, Associate Center Director, Center for Translational Science, Children’s Research Institute; Director, Nursing Research and Quality Outcomes, Children’s National™
• “Cultures of Inquiry in Music Therapy and Research and the Changing Landscape of Knowledge Generation and Implementation,” Sheri Robb, PhD, MT-BC and Tony Meadows, PhD, MT-BC.

The Symposium agenda benefitted from input garnered through a broad and diverse group of dedicated and enthusiastic individuals including clinicians, educators, students, and researchers. Four panel presentations helped set the tone and provided background context for the participant and small group discussions, and working groups.

• Panel One. Music Therapy Research Needs: In advance of the symposium informal surveys/interviews were conducted with clinicians and educators. A summary of findings was followed by exploration of how the research process grows and evolves in music therapy practice. Panelists highlighted the important questions, potential impact, and interplay of theories, methods, and approaches.
• Panel Two. Policy Imperatives: This panel discussed the impact of research on Music Therapy recognition, access, and funding. AMTA’s government relations perspective was represented regarding future music therapy research as it informs policy imperatives. The presentation summarized input from a variety of colleagues outside of music therapy regarding the role and use of research in policy-making and advocacy at the federal, state, and local levels.
• Panel Three. Considerations for Future Research in Selected Clinical Topics: Autism Spectrum Disorder, Alzheimer’s and Related Dementias, and Acquired Brain Injury (ABI) were selected to highlight opportunities for future research. These topics involve large segments of practicing music therapists and have been identified by policy-makers and funders as areas where research findings impact policy and funding. Each topic leader outlined considerations for future research in music therapy, drawing from the literature and knowledge of trends in current music therapy practice. Respondents added commentary and supplemental remarks.
• Panel Four. Research Capacity Building: Infrastructure, Education, and Training: Panelists offered conceptual ideas and factors for consideration regarding research capacity building for two major topics: a) research infrastructure and b) music therapy education and training. In addition to the perspectives of educators, the perspectives of clinicians and intern supervisors were presented because of their importance to the dialogue and to the unique set of challenges and needs of practicing clinician-scholars.

Recommendations by Topic

Six breakout groups convened in which participants discussed topics related to Panels Two, Three, and Four, responded to a set of questions, and generated 42 recommendations.

Policy Imperatives [11 recommendations]

• Define and describe the intervention using accepted standards of specification in published research and as part of research planning. When planning a research study, the music therapy intervention needs to be identified and specified by intervention and not just by the term “music therapy.”
• Conduct music therapy studies that focus on specific interventions for specific diagnoses/conditions. Numerous past published studies have commingled populations and conditions, especially in group music therapy settings. In order to prepare to ask for Medicare coverage of specific interventions/procedures, future research needs to examine (isolate) the research for one particular intervention for one particular diagnosis.
• List the ICD-10 diagnosis of the research participants to help link the benefit of a particular intervention to a particular diagnosis.
• Present a research briefing on Capitol Hill and include a famous spokesperson to headline to attract key legislators and staff to attend.
• Partner with the health sciences field to conduct research, encourage team science, and secure lines of funding.
• Recommend the creation and addition of a policy section to Music Therapy Perspectives .
• Commission white papers on all populations for which there is a substantial body of research evidence. White papers could be written by population work groups with teams of clinicians and researchers.
• Recommend research prioritizing the following clinical areas: Autism Spectrum Disorder, Dementia, TBI and ABI
• Create a research document for each population for the purpose of advocacy. This is envisioned as a fairly simple document that is specifically geared toward legislators and policy makers.
• A study in dementia to examine the potential effect (reduction/change) on use of psychotropic drugs associated with the use of music therapy interventions. 
• A study exploring the potential impact (reduction/change) in institutionalization (e.g., admissions, readmissions, and LOS) related to MT-BCs training caregivers in music-based techniques. 
• Approach private insurers for coverage of NICU interventions.

Clinical Population—Autism Spectrum Disorder [9 recommendations]

• Focus research in music therapy and autism spectrum disorder (ASD) on the following target domains/areas: Motor/sensory, Cognition, Mental health, Comorbidity, Pain perception, Musical development
• What is the role of music in the intervention?
• What is the role of the clinician?
• How do music therapists (MTs) set goals?
• How do MTs determine the rate, frequency, dose, and length of treatment?
• What brings consumers to music therapy (MT)?
• What are the consumers’ desired outcomes?
• What does MT mean for consumers?
• Conduct comparison studies in music therapy and ASD. This recommendation includes consideration of comparison research studies between outcome domains (inter-domain), among approaches (within MT practice), cost-effectiveness analyses, and between disciplines (outside MT profession). 
• Incorporate family/peer-supported services in MT with persons with ASD. This recommendation includes research regarding the role and impact of MT services mediated by parents, peers, or siblings.
• Conduct research regarding MT services across the lifespan among persons with ASD. This recommendation includes research in the following areas: Effectiveness of MT for adults, Community music-making, Accommodations for success in the community.
• Ensure research includes cultural considerations including investigation of MT as vehicle for social change, acknowledging the culture of clients, and neurodiversity.
• Move toward standardization of music therapy assessments in MT practice with persons with ASD.
• Focus research on the following settings: Medical, School, Home, Clinic, Community

Clinical Population—Alzheimer’s & Dementias/Older Adults & Aging* [5 recommendations]

• Expand research applications with new publications.
• Create partnerships and collaborations with Centers on Aging, community agencies, researchers, etc., in order to improve quality of research, evaluation, training, access, etc.
• Improve research methodology to design decision tree analysis for MT interventions and include data that would contribute to cost effectiveness studies in research, when possible.
• Disseminate research to improve clinician access to MT and research on related disciplines to a) ensure high quality clinical care and b) establish AMTA as the centralized source of information on state-of-the-art music therapy for persons who are aging.
• Increase visibility of music therapy research nationally and internationally in established advocacy and policymaking bodies (e.g., Alzheimer’s Association NAPA, AARP, Trial Match).

*This workgroup recommended that the scope of the workgroup topic should expand to include older adults and aging populations in addition to persons with Alzheimer’s and related dementias.

Clinical Population—Acquired Brain Injury (ABI) & Comorbidities [6 recommendations]

• Identify and disseminate evidence that MT is effective in treating ABI and co-morbidities.
• Demonstrate the relative cost-effectiveness of MT interventions in this clinical population.
• Utilize expert clinical opinion as a form of evidence and to help drive research agendas.
• Include the voices of patients with ABI in MT research (service-user led research).
• Generate clinical data sets that can be shared to support lines of MT research in this clinical topic.
• Incorporate research frameworks to develop lines of research that speak to colleagues in other disciplines.

Building Research Capacity: Research Infrastructure [5 recommendations]

• Create a portrait of the current music therapy research infrastructure with case studies of best practices, including examples from universities, clinical research faculty positions, and research fellowships.
• Increase meaningful engagement of clinicians in research, including as Principal Investigators.
• Increase research-active scholars among persons with doctoral level training to support their regular and active involvement in research programs and to support development of lines of research.
• Increase postdoctoral opportunities through raising awareness of research career paths and through PhD faculty mentors.
• Include the voice of the consumers (as partners and collaborators) in music therapy research.

Building Research Capacity: Research Infrastructure – Education, Continuing Education, and Training [6 recommendations]

• Explore best practices in the education of evidence-based and evidence-informed MT practice.
• Expand methodologies to include clients’ and clinicians’ voices in the MT body of research.
• Develop opportunities for post-doctoral training and education in MT practice and research scholarship.
• Develop and conduct focus groups to identify continuing education needs unique to each of the following roles: educators, clinicians, internship directors, and researchers (online, regional, state, national).
• Explore ways to make research relevant to clinical practice, e.g., engage clinicians and researchers in responding to publications.
• Create mechanisms to disseminate information on available grants, mentorships, fellowships, and post-doctoral opportunities.

Conclusions

MTR2025 is an initiative of AMTA geared towards stimulating conversation about building research capacity and growing the production and usage of high quality research in music therapy.

Multiple cross-cutting themes emerged at MTR2025 symposium. Here is a selection:

• Consumer Impact. The critical importance of the consumers’ voices in music therapy research, planning, and implementation
• Clinician Involvement. The essential role of the practicing music therapist in accessing and using published research and in participating in research as clinician-scholars and as part of team science
• Diverse Methodologies. The value of embracing diverse, complex, and integrated research methodologies
• Theory. The need to further develop, integrate, describe, and link theory and theoretical models in music therapy research with well articulated and defined music therapy interventions
• Research Capacity Building. The need to grow research capacity among music therapists with attention to both research infrastructure as well as education, training, and continuing education
• Economic Analyses. The importance of including, where appropriate, cost and economic analyses as part of music therapy research including building research partnerships with individuals skilled in cost analyses and economic research
• Expanding Partnerships. The value of expanding and growing collaborations, partnerships, and networks (including interdisciplinary team science) for efficient and productive work in important lines of research

The recommendations developed by symposium participants represent only a fraction of the important dialogue and exchange occurring before, during, and continuing after the symposium. As we rocket towards the year 2025, it is important that each individual consider one’s role and contribution in growing and sustaining a legacy of research to inform practice and, ultimately, benefit our clients and their families.

This symposium was just the beginning. Following the July, 2015, symposium, AMTA continues MTR2025 by way of an array of discussions, activities, and processes to infuse, embed, and integrate research as a cross-cutting and essential feature of clinical and association functions designed to increase access to and quality of music therapy services.

MTR2025 Progress Report

Progress report of historic music therapy research symposium - mtr2025: a productive and engaging meeting.

The American Music Therapy Association (AMTA) convened an historic and innovative research symposium, “IMPROVING ACCESS AND QUALITY: MUSIC THERAPY RESEARCH 2025” (MTR2025), July 16-18, 2015. This visionary special event was designed to recommend guidance for future research in music therapy and was made possible by a generous donation from David’s Fund and Tom and Lucy Ott.

The Editors of AMTA’s peer reviewed journals, Drs. Meadows and Robb noted that,

“when viewed as a whole, music therapy research has moved through several important stages of development, characterized by differentiation and integration of philosophies and perspectives that parallel changes occurring in the broader national health research community, including an emphasis on diverse methodologies.  Central to advancing the science and practice of music therapy is finding ways to develop and integrate this knowledge across these research cultures, while meeting both internal and external demands for research that demonstrates improvements in quality and access to care.” 

The opening night keynotes addressed these points and others.

Keynotes included:

• Importance of Research for Improving Access and Quality by Pamela Hinds, RN, PhD, FAAN, Associate Center Director, Center for Translational Science, Children’s Research Institute; Director, Nursing Research and Quality Outcomes, Children’s National™
• Cultures of Inquiry in Music Therapy and Research and the Changing Landscape of Knowledge Generation and Implementation by Sheri Robb, PhD, MT-BC and Tony Meadows, PhD, MT-BC. 

The Symposium agenda facilitated input from a broad and diverse group of professional music therapists including clinicians, educators, students, and researchers. 

• Panel One: Music Therapy Research Needs: a summary of surveys/interviews with clinicians and educators was followed by exploration of how the research process grows and evolves in music therapy practice and highlights the important questions, potential impact, and interplay of theories, methods, and approaches.
• Panel Two: Policy Imperatives: discussed the impact of research on Music Therapy recognition, access, and funding.   AMTA Government Relations Director, Judy Simpson, shared her thoughts regarding future music therapy research as it informs policy imperatives. Judy summarized input from a variety of colleagues regarding the role and use of research in policy-making and advocacy at the federal, state, and local levels.
• Panel Three: Considerations for Future Research in Selected Clinical Topics: Autism Spectrum Disorder, Alzheimer’s and Related Dementias, and Acquired Brain Injury (ABI) were selected to highlight opportunities for future research. These topics involve large segments of practicing music therapists and have been identified by policy-makers and funders as areas where research findings impact policy and funding. Each topic leader outlined considerations for future research in music therapy, drawing from the literature and knowledge of trends in current music therapy practice. Respondents added commentary and supplemental remarks.
• Panel Four: Research Capacity Building: Infrastructure, Education, and Training: panelists offered conceptual ideas and factors for consideration regarding research capacity building for two major topics: a) research infrastructure and b) music therapy education and training. In addition to the perspectives of educators, the perspectives of practicing clinicians and intern supervisors were presented because of their importance to the dialogue, and the unique set of challenges and needs of practicing clinician/scholars.

Six breakout groups convened in which participants discussed topics related to Panels Two, Three and Four, responded to a set of questions, and prioritized 42 recommendations.  The results will be summarized, consolidated, and shared in the fall through the AMTA website and at the annual conference.  AMTA is proud to sponsor this unique opportunity to bring the many myriad members of the music therapy community together to collaboratively explore our research future.

For more information contact: AMTA Communications; 301-589-3300.

Music therapy highlights: nih-sponsored third national summit on military & arts, - march 4, 2015.

AMTA proudly headed a delegation of more than 25 music therapy professionals, representing AMTA’s two scholarly journals; NIH-funded music therapy researchers; music therapists’ research and practice at Veterans Health Administration facilities; and music therapists in private practice, in hospitals, in the community, at military health facilities, and at academic centers nationwide. AMTA provided outreach information at the meeting and distributed copies of the AMTA white paper on military and music therapy ( http://www.musictherapy.org/amta_releases_white_paper_on_music_therapy__military/ )

AMTA staff and members successfully advocated for the unique value of board certified music therapists to numerous NIH, NEA, NEH, and VA officials as well as to other administrators and gatekeepers.

A report and recommendations based on the Summit is expected to follow in the coming months.

Information online regarding the Americans for the Arts and the “National Initiative for Arts & Health in the Military” can be found at http://www.americansforthearts.org/by-program/reports-and-data/legislation-policy/the-national-initiative-for-arts-health-in-the-military

Improving Quality and Access: Music Therapy Research 2025 (MTR2025)

Embarking on a Journey Improving Quality and Access: Music Therapy Research 2025 (MTR2025)

- Originally published in Music Therapy Matters , September 2014

Thanks to funding by Tom and Lucy Ott and David’s Fund, AMTA has the extraordinary opportunity to focus over the next year on guidance for future generations of scholarship in music therapy.  Once funding was awarded, an Advisory Team was appointed by the Board of AMTA.  Serving on the team are Annette Whitehead-Pleaux (Speaker of Assembly), Judy Simpson (Director, Government Relations), with Drs. Debra Burns (Chair, Research Committee), Sheri Robb (Editor in Chief, JMT), Tony Meadows (Editor in Chief, MTP), Alicia Clair (AMTA Board Representative), Andi Farbman (Executive Director), and Linda Demlo (Retired, USPHS/CDC and AHRQ). Dr. Joke Bradt, was unable to attend the meeting due to previous international travel plans, but she offered input in advance. Barbara Else serves as Project Coordinator in her role as a consultant and Senior Advisor/Special Projects Coordinator.

Albert Einstein was quoted as saying that he believed intuition, inspiration, and imagination are key factors in pursuing scientific research. Our pre-planning meeting was productive and very inspiring, due to the imagination and dedication of team.  

Improving Quality and Access: Music Therapy Research 2025 MTR2025 Launches at the AMTA Annual Conference

- originally published in music therapy matters , december 2014.

Improving Quality and Access: Music Therapy Research 2025, or simply “MTR2025,” is an AMTA initiative, which is part of the Strategic Priority on Research. MTR2025 is visionary in nature with the ultimate goal being to advance the state of music therapy research. MTR2025 aims to take a forward looking perspective to offer guidance on the many important areas of music therapy research and to prepare documents and products for a variety of audiences, both internal and external to the profession.  External audiences include policy makers and funders. Offering stakeholders a concise document with recommendations on future research in music therapy based on the input and review of highly qualified music therapy professionals and researchers will be an historic and significant contribution.  

As reported in the September 2014 newsletter, the advisory team met in the summer of 2014 to outline the initiative.  During the November Annual Conference, AMTA Senior consultant, Barbara Else, invited conference attendees to be involved: “You are a part of this initiative and you need to offer your ideas and input regarding future research and questions important to music therapy practice and the profession. Music therapy professionals are encouraged to consider what we know—based upon the best available research evidence; and, consider what we don’t know—based upon your important open questions, gaps in knowledge, and unmet research needs. In thinking about your practice area and these needs, what would you recommend to guide the next several generations of researchers? In 2025, and beyond, what burning questions and research areas need to be addressed? What research infrastructure is needed to support these important questions?”

Over the next year, AMTA will be gathering input from music therapy professionals, researchers, and interested stakeholders regarding opportunities and needs for future research in music therapy. On the evening of July 16 through the morning of July 18, a face-to-face meeting to discuss future research opportunities and needs is planned and will take place near the Baltimore-Washington International airport. This research meeting is funded through a grant from Tom and Lucy Ott and “David’s Fund.” AMTA is extremely grateful for this grant and the opportunity to move the discussion forward. We are exploring efficient and convenient ways to disseminate the July 2015 meeting discussions to the members knowing that the face-to-face meeting will be limited in space and capacity.

What happened during the Louisville Conference?

MTR2025 was announced through a series of briefings at the AMTA Annual Conference in Louisville, Kentucky. During the annual meeting, briefings on MTR2025 were provided to the following groups:

• AMTA Board of Directors: General update and briefing provided. 
• Regional Presidents and Presidents-Elect meeting: Each region will be nominating one key participant and two alternates for the July 2015 face-to-face research meeting. The alternates will be back-up in the event the nominee is unavailable. 
• AMTA Assembly of Delegates: Assembly delegates were updated on the initiative. There was a focus on participation, noting input into MTR2025 is encouraged via multiple channels, including a dedicated email address and the July, 2015 face-to-face meeting. 
• General conference session: This was a well-attended general session held on Friday evening of the conference. The session, facilitated by Barb Else, provided an introduction to the initiative with audience discussion and comments. Following the general session, AMTA President Amy Furman noted, “if this group is indicative of the enthusiasm and appetite for guidance and resources for future research in music therapy, then the future is bright!”

Any take-aways from these briefings? 

Music therapists were clear in stating a desire to embrace research that considers all music therapy approaches and practice perspectives. Research questions should also consider and embrace all appropriate methods. During the general session, practicing clinicians expressed a strong desire to grow their skills in reviewing published research in order to translate findings/evidence into practice.  Clinicians also expressed a desire to contribute to research projects and collaborate with investigators.

What is the timeline and what's next?

• Regional Presidents will be receiving a memo in January to solicit nominations for qualified participants at the July 2015 meeting.
• A small number of issue briefs summarizing a series of key research subtopics will be commissioned in advance of the July 2015 meeting to help stimulate discussion.  
• AMTA’s website pages on research will be updated on the initiative.

How can I share my thoughts and ideas on future research in music therapy? 

We welcome dialogue and discussions. In order to track your input and ideas, AMTA has set up an email address.  We want to hear your thoughts and we will be soliciting input across a couple of phases. We begin with an open-ended call for comment and input from music therapists regarding your thoughts on future research guidance in music therapy.  This comment period begins now and ends February 1, 2015. When sending your input, please let us know:

• Your name 
• Indicate your preferred contact method and contact information (in case we need to seek clarification of your input)
• Identify your professional practice area(s) and/or practice setting(s) 
• Indicate your primary professional role(s) – e.g., intern supervisor, private practice, educator, staff music therapist, etc. 
• Provide your comment, suggestion for future research, and/or input. Concise comments are appreciated and not to exceed a couple of paragraphs.
• Send via email to: [email protected]   Emails go to AMTA and are logged on an input tracking spreadsheet. All input will be shared with the Advisory Team and summarized as a whole in advance of the July 2015 meeting.

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80 Music Therapy Essay Topic Ideas & Examples

🏆 best music therapy topic ideas & essay examples, 📌 good research topics about music therapy, 🔍 interesting topics to write about music therapy, ❓ music therapy research questions.

• Music Therapy: Where Words Cease In spite of the fact that, as a rule, one indulges into art to find the shelter from the reality, the author of the book called The Soloist explores quite a different issue of the […]
• Music Therapy Throughout the Soloist Globally, classical music in its sense has always been known to adjoin the listener to some transcendent understanding of the world order, the feeling of integrity with the Universe and enormous delight rising up from […] We will write a custom essay specifically for you by our professional experts 808 writers online Learn More
• Sound as an Element of Music Therapy This is one of the reasons why in the Abrams study the participants explained that they preferred the sound of rain, ocean waves and the soft strumming of a guitar as compared to the work […]
• Music Therapy Effectiveness In addition to this, research has shown that stroke patients become more involved in therapy sessions once music is incorporated in the treatment program; this is the motivational aspect of music.
• The Role of Music Therapy as Alternative Treatment Music therapy is the use of music interventions to achieve individualized goals of healing the body, mind, and spirit. Thereafter, several developments occurred in the field of music therapy, and the ringleaders founded the American […]
• Music Therapy as a Social Work Intervention One of such interventions is music therapy which is aimed at helping people in a sensitive way accurately adjusting the possibilities this therapy may offer to the requirements of a particular client of a group […]
• Music Therapy: Alternative to Traditional Pain Medicine The sources underline that therapists should pay attention to the subjects of music and their impact on the health of clients.
• Music Therapy: The Impact on Older Adults There is therefore the need to focus more energy to aid more understating on the role of music therapy on older residents.”The recent qualitative review of literature in the area of music and music therapy […]
• Substance Use Disorder: Possibility of Using Music Therapy In their study, Bourdaghs and Silverman address the possibility of using music therapy as the tool for promoting the socialization of people with a substance use disorder.
• Music Therapy as a Related Service for Students With Disabilities From a neuroscientific perspective, how would music intervention improve classroom behaviors and academic outcomes of students with ADHD as a way to inform policy-makers of the importance of music therapy as a related service?
• Music Therapy for Children With Learning Disabilities This review includes the evidence supporting music therapy as an effective strategy for promoting auditory, communication, and socio-emotional progression in children with ASD.
• Music Therapy in Healthcare Therefore, the article suggests that music can be used for relaxation, as well as managing the health issues that may arise due to the lack of relaxation.
• Art and Music Therapy Coverage by Health Insurance However, I do believe that creative sessions should be available for all patients, and I am going to prove to you that music and art are highly beneficial for human health.
• Music Therapy for Schizophrenic Patients’ Quality of Life Consequently, the purpose of the project will be to review the existing literature and prepare a document with recommendations regarding MT in the discussed population, including psychiatric nurses’ acceptable role in delivering such interventions.
• Music Therapy as Experiential Activity For this reason, a technique was applied to the 10-year-old child with developmental delays to transform the lyrics of the favorite sad melody into a more positively inspiring and uplifting one.
• Active Music Therapy for Parkinson’s Disease
• Effectiveness of Music Therapy for Survivors of Abuse
• Music Therapy Effectiveness of Treatment of Alzheimer’s Disease
• The Link Between Ancestral Hormones and Music Therapy
• Analysis of the Effectiveness of Art and Music Therapy
• Music Therapy Usefulness for Cancer Patients
• Music Therapy Impact on Students With Emotional and Behavioral Disorders
• How Music Therapy Can Be Used to Reduce Pre-Operative Anxiety
• Healing Chronic Pain With Music Therapy
• Music Therapy Effect on the Wellness and Mood of Adolescents
• Comparing Cognitive Behavioral Therapy and Music Therapy
• Constructing Optimal Experience for the Hospitalized Newborn Through Neuro-Based Music Therapy
• Music Therapy: Considerations for the Clinical Environment
• “Dementia and the Power of Music Therapy” by Steve Matthews Analysis
• Music Therapy for Children With Autism Spectrum Disorder
• Discussing Music Therapy Reducing Stress Health and Social Care
• Does Music Therapy Help Children With Special Needs?
• Music Therapy for Delinquency Involved Juveniles Through Tripartite Collaboration
• Heidelberg Neuro-Music Therapy Enhances Task-Negative Activity in Tinnitus Patients
• Music Therapy for Post Traumatic Stress Disorder
• How Does Music Therapy Promote Positive Mental Health?
• Music Therapy and Its Positive Effects on the Brain
• The Relationships Between Learning and Music Therapy
• Music Therapy for Sexually Abused Children
• Managing Sickle Cell Pain With Music Therapy
• Music Therapy: How Does Music Impact Our Emotions
• Dealing With Depression With the Help of Music Therapy
• Effectiveness of Music Therapy and Drug Therapy for Children With Autism
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• The Link Between Music Therapy and Personality Theory Psychology
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• Music Therapy: The Best Way to Help Children With Mental Illness
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• Does Music Therapy Actually Work?
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500+ Music Research Topics

Music is a universal language that has the power to evoke emotions, bring people together, and express complex ideas and feelings. As a result, it has been the subject of extensive research and analysis across a wide range of fields, from psychology and neuroscience to sociology and cultural studies. Whether you are a music student, researcher , or simply a curious enthusiast, there are countless fascinating and important topics to explore within the realm of music research. From the history and evolution of different musical genres to the impact of music on human behavior and cognition, the possibilities for investigation and discovery are virtually endless. In this post, we will highlight some of the most interesting and relevant music research topics that you can explore in your own studies or simply as a way to deepen your appreciation and understanding of this rich and diverse art form.

Music Research Topics

Music Research Topics are as follows:

• The impact of music on memory retention.
• The evolution of hip-hop music and its influence on popular culture.
• The relationship between music and emotions.
• The role of music in religious and spiritual practices.
• The effects of music on mental health.
• The impact of music on athletic performance.
• The role of music in therapy and rehabilitation.
• The evolution of classical music through the ages.
• The impact of technology on music creation and distribution.
• The relationship between music and language acquisition.
• The cultural significance of music in different parts of the world.
• The influence of popular music on politics and social issues.
• The impact of music on academic performance.
• The role of music in film and television.
• The use of music in advertising and marketing.
• The psychology of musical preferences.
• The effects of music on sleep patterns and quality.
• The impact of music on creativity and productivity.
• The influence of music on fashion and style.
• The impact of music education on childhood development.
• The role of music in memory recall and nostalgia.
• The effects of music on physical health.
• The relationship between music and brain development.
• The impact of music on the immune system.
• The influence of music on social behavior.
• The evolution of jazz music and its impact on society.
• The role of music in cultural preservation and identity.
• The effects of music on stress levels and anxiety.
• The relationship between music and social movements.
• The impact of music on language learning and pronunciation.
• The effects of music on learning and cognition.
• The influence of music on political ideologies and movements.
• The impact of music on academic achievement.
• The relationship between music and cultural assimilation.
• The role of music in international diplomacy.
• The effects of music on physical performance and endurance.
• The impact of music on memory consolidation and recall.
• The influence of music on fashion trends and subcultures.
• The role of music in socialization and identity formation.
• The effects of music on perception and attention.
• The impact of music on decision making and judgment.
• The relationship between music and romantic attraction.
• The role of music in social justice movements.
• The effects of music on motor skills and coordination.
• The influence of music on cultural exchange and globalization.
• The impact of music on language and cultural barriers.
• The relationship between music and cultural appropriation.
• The role of music in community building and activism.
• The effects of music on motivation and goal setting.
• The influence of music on fashion advertising and marketing.
• The impact of music on social inequality and discrimination.
• The relationship between music and cultural hegemony.
• The role of music in political propaganda and manipulation.
• The effects of music on physical therapy and rehabilitation.
• The influence of music on cultural diplomacy and international relations.
• The impact of music on the environment and sustainability.
• The relationship between music and social hierarchies.
• The role of music in cultural exchange and intercultural communication.
• The effects of music on creative thinking and problem solving.
• The influence of music on consumer behavior and product preferences.
• The impact of music on social mobility and economic inequality.
• The relationship between music and cultural diversity.
• The role of music in intergenerational communication and conflict resolution.
• The effects of music on mood and emotional regulation.
• The influence of music on cultural authenticity and representation.
• The impact of music on memory in patients with Alzheimer’s disease.
• The impact of music on recovery and rehabilitation in individuals with physical injuries.
• The role of music in promoting cultural exchange and understanding in international education.
• The role of music in promoting cultural sensitivity and understanding in international relations.
• The role of music in promoting cultural sensitivity and understanding in international human rights.
• The effects of music on cognitive functioning and mental health in individuals with ADHD.
• The relationship between music and cultural representation in the food and beverage industry.
• The influence of music on cultural identity and mental health in individuals with mixed-sexual orientations.
• The impact of music on job satisfaction and retention in the finance industry.
• The role of music in promoting cultural diversity and understanding in international development.
• The effects of music on emotional regulation and depression in individuals with post-traumatic stress disorder.
• The relationship between music and cultural representation in the transportation industry.
• The influence of music on cultural identity and mental health in individuals with mixed-abilities.
• The impact of music on academic performance and motivation in college students.
• The role of music in promoting cross-cultural understanding and acceptance in international cooperation.
• The effects of music on social skills and behavior in individuals with autism spectrum disorder.
• The relationship between music and cultural representation in the entertainment industry.
• The influence of music on cultural identity and mental health in individuals with mixed-language backgrounds.
• The impact of music on creativity and innovation in the tech startup industry.
• The role of music in promoting cultural sensitivity and understanding in international peacekeeping.
• The effects of music on cognitive functioning and mental health in individuals with traumatic brain injury.
• The relationship between music and cultural representation in the travel industry.
• The influence of music on cultural identity and mental health in individuals with mixed-socioeconomic backgrounds.
• The impact of music on job satisfaction and productivity in the education industry.
• The role of music in promoting cultural diversity and understanding in international cooperation.
• The effects of music on emotional regulation and anxiety in individuals with generalized anxiety disorder.
• The relationship between music and cultural representation in the home appliance industry.
• The influence of music on cultural identity and mental health in individuals with mixed-culture backgrounds.
• The impact of music on academic performance and motivation in graduate students.
• The role of music in promoting cross-cultural understanding and acceptance in international diplomacy.
• The effects of music on social skills and behavior in individuals with attention deficit disorder.
• The relationship between music and cultural representation in the construction industry.
• The influence of music on cultural identity and mental health in individuals with mixed-spiritual backgrounds.
• The impact of music on creativity and productivity in the healthcare industry.
• The role of music in promoting cultural sensitivity and understanding in international justice.
• The effects of music on cognitive functioning and mental health in individuals with Parkinson’s disease.
• The relationship between music and cultural representation in the hospitality industry.
• The influence of music on cultural identity and mental health in individuals with mixed-political backgrounds.
• The impact of music on job satisfaction and retention in the automotive industry.
• The role of music in promoting cultural diversity and understanding in international diplomacy.
• The effects of music on emotional regulation and depression in individuals with major depressive disorder.
• The relationship between music and cultural representation in the telecommunications industry.
• The influence of music on cultural identity and mental health in individuals with mixed-ethnic and racial backgrounds.
• The impact of music on academic performance and motivation in high school students with disabilities.
• The role of music in promoting cross-cultural understanding and acceptance in international trade.
• The effects of music on social skills and behavior in individuals with borderline personality disorder.
• The relationship between music and cultural representation in the fashion industry.
• The influence of music on cultural identity and mental health in individuals with mixed-heritage backgrounds.
• The effects of music on cognitive functioning and mental health in individuals with schizophrenia.
• The relationship between music and cultural representation in the technology industry.
• The influence of music on cultural identity and mental health in individuals with mixed-race identities.
• The impact of music on job satisfaction and retention in the hospitality industry.
• The role of music in promoting cultural diversity and understanding in global development.
• The effects of music on emotional regulation and anxiety in individuals with social phobia.
• The relationship between music and cultural representation in the toy industry.
• The influence of music on cultural identity and mental health in individuals with mixed-faith backgrounds.
• The impact of music on academic performance and motivation in high school students.
• The effects of music on social skills and behavior in individuals with oppositional defiant disorder.
• The relationship between music and cultural representation in the beauty industry.
• The influence of music on cultural identity and mental health in individuals with mixed-ethnicity backgrounds.
• The impact of music on creativity and productivity in the fashion industry.
• The role of music in promoting cultural sensitivity and understanding in international aid.
• The effects of music on cognitive functioning and mental health in individuals with dementia.
• The relationship between music and cultural representation in the fitness industry.
• The influence of music on cultural identity and mental health in individuals with mixed-gender identities.
• The impact of music on job satisfaction and productivity in the technology industry.
• The role of music in promoting cultural diversity and understanding in international tourism.
• The effects of music on emotional regulation and depression in individuals with anxiety disorders.
• The relationship between music and cultural representation in the pet industry.
• The influence of music on cultural identity and mental health in individuals with mixed-education backgrounds.
• The impact of music on academic performance and motivation in middle school students.
• The effects of music on social skills and behavior in individuals with obsessive-compulsive disorder.
• The relationship between music and cultural representation in the home decor industry.
• The influence of music on cultural identity and mental health in individuals with mixed-sex identities.
• The impact of music on creativity and innovation in the gaming industry.
• The role of music in promoting cultural sensitivity and understanding in international conflict resolution.
• The effects of music on cognitive functioning and mental health in individuals with bipolar disorder.
• The relationship between music and cultural representation in the sports industry.
• The influence of music on cultural identity and mental health in individuals with mixed-nationality and mixed-linguistic backgrounds.
• The impact of music on job satisfaction and retention in the retail industry.
• The role of music in promoting cultural diversity and understanding in global governance.
• The effects of music on emotional regulation and anxiety in individuals with panic disorder.
• The relationship between music and cultural representation in the electronics industry.
• The influence of music on cultural identity and mental health in individuals with mixed-citizenship backgrounds.
• The impact of music on academic performance and motivation in elementary school students.
• The role of music in promoting cross-cultural understanding and acceptance in international security.
• The effects of music on social skills and behavior in individuals with conduct disorder.
• The relationship between music and cultural representation in the agriculture industry.
• The influence of music on cultural identity and mental health in individuals with mixed-religious backgrounds.
• The effects of music on cognitive functioning and mental health in individuals with traumatic brain injuries.
• The influence of music on cultural identity and mental health in individuals with disability identities.
• The role of music in promoting cross-cultural understanding and acceptance in the healthcare industry.
• The effects of music on emotional regulation and anxiety in individuals with post-traumatic stress disorder (PTSD).
• The influence of music on cultural identity and mental health in individuals with LGBTQ+ identities.
• The impact of music on job satisfaction and productivity in the gig economy.
• The role of music in promoting cultural sensitivity and understanding in education policy.
• The effects of music on social skills and behavior in individuals with autism spectrum disorder (ASD).
• The influence of music on cultural identity and mental health in individuals with mixed-age identities.
• The impact of music on creativity and innovation in the advertising industry.
• The role of music in promoting cultural diversity and understanding in urban planning.
• The effects of music on cognitive functioning and mental health in individuals with attention deficit hyperactivity disorder (ADHD).
• The relationship between music and cultural representation in the food industry.
• The impact of music on job satisfaction and retention in the nonprofit sector.
• The role of music in promoting cultural understanding and acceptance in international business.
• The effects of music on emotional regulation and depression in individuals with chronic pain.
• The relationship between music and cultural representation in the gaming industry.
• The influence of music on cultural identity and mental health in individuals with mixed-sexual orientation identities.
• The role of music in promoting cross-cultural communication and understanding in foreign policy.
• The effects of music on social skills and behavior in individuals with social anxiety disorder.
• The relationship between music and cultural representation in the craft industry.
• The influence of music on cultural identity and mental health in individuals with mixed-disability identities.
• The impact of music on creativity and productivity in the media industry.
• The role of music in promoting cultural sensitivity and understanding in corporate social responsibility.
• The effects of music on cognitive functioning and mental health in individuals with substance use disorders.
• The relationship between music and cultural representation in the automotive industry.
• The impact of music on job satisfaction and productivity in the education sector.
• The role of music in promoting cultural diversity and understanding in international law.
• The relationship between music and cultural representation in the wellness industry.
• The influence of music on cultural identity and mental health in individuals with mixed-nationality backgrounds.
• The impact of music on academic performance and motivation in adult learners.
• The role of music in promoting cultural understanding and acceptance in global governance.
• The relationship between music and cultural representation in the furniture industry.
• The influence of music on cultural identity and mental health in individuals with mixed-generational backgrounds.
• The impact of music on creativity and innovation in the film industry.
• The role of music in promoting cultural integration and social cohesion in diverse communities.
• The effects of music on cognitive functioning and mental health in individuals with multiple sclerosis.
• The relationship between music and cultural representation in the tech industry.
• The influence of music on cultural identity and mental health in second-generation immigrants.
• The role of music in promoting cross-cultural communication and understanding in diplomacy.
• The effects of music on emotional regulation and self-esteem in individuals with eating disorders.
• The relationship between music and cultural representation in the publishing industry.
• The influence of music on cultural identity and mental health in biracial and multiracial families.
• The impact of music on creativity and innovation in the workplace.
• The role of music in promoting cultural awareness and sensitivity in the criminal justice system.
• The effects of music on social skills and behavior in individuals with schizophrenia.
• The influence of music on cultural identity and mental health in individuals with refugee backgrounds.
• The role of music in promoting cultural understanding and acceptance in global marketing.
• The effects of music on emotional regulation and anxiety in individuals with obsessive-compulsive disorder (OCD).
• The influence of music on cultural identity and mental health in individuals with mixed religious backgrounds.
• The impact of music on academic achievement and retention in community college students.
• The role of music in promoting cultural exchange and understanding in international development.
• The effects of music on social skills and behavior in individuals with bipolar disorder.
• The relationship between music and cultural representation in the luxury goods industry.
• The influence of music on cultural identity and mental health in individuals with immigrant parents.
• The impact of music on creativity and productivity in the tech industry.
• The role of music in promoting cultural sensitivity and understanding in journalism.
• The effects of music on emotional regulation and depression in individuals with chronic fatigue syndrome.
• The relationship between music and cultural representation in the wine industry.
• The influence of music on cultural identity and mental health in individuals with non-binary gender identities.
• The impact of music on job satisfaction and productivity in remote workers.
• The role of music in promoting cultural diversity and understanding in international relations.
• The role of music in promoting cultural awareness and sensitivity in diplomacy.
• The effects of music on emotional regulation and self-esteem in individuals with body dysmorphia.
• The influence of music on cultural identity and mental health in individuals with immigrant grandparents.
• The role of music in promoting cultural understanding and acceptance in global advertising.
• The effects of music on social skills and behavior in individuals with borderline intellectual functioning.
• The relationship between music and cultural representation in the fragrance industry.
• The influence of music on cultural identity and mental health in individuals with mixed-citizenship status.
• The impact of music on creativity and productivity in the creative industries
• The relationship between music and social cohesion in diverse communities.
• The role of music in social justice movements and protests.
• The effects of music on pain management and perception.
• The influence of music on cultural hybridity and globalization.
• The impact of music on social identity and self-esteem.
• The relationship between music and cultural imperialism.
• The role of music in therapeutic settings for children and adolescents.
• The effects of music on language development in bilingual children.
• The influence of music on cultural representation in the media.
• The impact of music on interpersonal relationships and communication.
• The relationship between music and cultural hegemony in the digital age.
• The role of music in community-based initiatives for social change.
• The effects of music on mental health in marginalized communities.
• The influence of music on cultural identity and self-expression.
• The impact of music on academic engagement and success in at-risk students.
• The relationship between music and cultural appropriation in popular culture.
• The role of music in cultural diplomacy and international relations in the 21st century.
• The effects of music on cognitive processing in individuals with attention-deficit/hyperactivity disorder (ADHD).
• The influence of music on cultural hybridity and transnationalism.
• The impact of music on social justice advocacy and awareness-raising.
• The relationship between music and cultural resistance in marginalized communities.
• The role of music in the negotiation of cultural identities in the diaspora.
• The effects of music on language processing and learning in second language acquisition.
• The influence of music on cultural exchange and intercultural communication in the digital age.
• The impact of music on academic achievement in students with disabilities.
• The relationship between music and cultural hegemony in the music industry.
• The role of music in the socialization and empowerment of girls and women.
• The effects of music on physical health in individuals with chronic pain.
• The influence of music on cultural authenticity and representation in the tourism industry.
• The impact of music on the construction of gender and sexuality in popular culture.
• The relationship between music and cultural appropriation in the fashion industry.
• The role of music in promoting cross-cultural understanding and empathy.

About the author

Muhammad Hassan

Researcher, Academic Writer, Web developer

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Student project: Music therapy can help people overcome the struggles of mental health

Music has been able to help people in a myriad of ways, which is what makes it an effective medium in therapeutic sessions.

Music therapy is a therapeutic method that allows music to reach people and give them a chance to grow both emotionally and psychologically. 

Eunice Verrilli had been looking for a music therapist who could help her nonverbal son, Eli, since the COVID-19 pandemic hit Ohio in March 2020.

She was connected to a local music therapist Kimberly Haffey, owner of Dynamic Music Therapy Services LLC in Worthington. Verilli said Eli has made progress in staying focused, developing motor skills and expressing himself more effectively.

The music therapy has helped Eli develop his communication skills with others, Verilli said.

Verilli has noticed that Eli's sessions with Haffey have helped him become more calm and relaxed. He hasn't had as many outbursts since he began music therapy. She said she's seen that music therapy has been very effective in helping her son progress emotionally and mentally, and believes there should be more attention to the impact it has on people’s lives.

Music therapists typically draw on a client’s current connection to music to build a therapeutic rapport with them, said Andrew Holbrook , assistant professor of instruction in music therapy at Ohio University.

There are different models of music therapy, and which model is used depends on the patient a therapist is working with. Holbrook was also trained in using music therapy to help unpack and recover a person’s trauma, allowing them to work through it and heal from it.

Music can activate all parts of the brain and help a patient with relearning certain functions and skills that they may have lost due to a stroke or other physical complications, Holbrook said. Rhythm is also a major aspect of the field and can help build coordination and improve a person’s ability to walk.

Ryan Vorvornator is a student at Columbus Alternative High School. This piece was created for Columbus Journalists in Training, a program sponsored by the Columbus Dispatch and Society of Professional Journalists Central Ohio Pro-Chapter for Columbus City Schools students. Ryan was a member of team CRFC News.

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A noninvasive treatment for “chemo brain”

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Patients undergoing chemotherapy often experience cognitive effects such as memory impairment and difficulty concentrating — a condition commonly known as “chemo brain.”

MIT researchers have now shown that a noninvasive treatment that stimulates gamma frequency brain waves may hold promise for treating chemo brain. In a study of mice, they found that daily exposure to light and sound with a frequency of 40 hertz protected brain cells from chemotherapy-induced damage. The treatment also helped to prevent memory loss and impairment of other cognitive functions.

This treatment, which was originally developed as a way to treat Alzheimer’s disease, appears to have widespread effects that could help with a variety of neurological disorders, the researchers say.

“The treatment can reduce DNA damage, reduce inflammation, and increase the number of oligodendrocytes, which are the cells that produce myelin surrounding the axons,” says Li-Huei Tsai, director of MIT’s Picower Institute for Learning and Memory and the Picower Professor in the MIT Department of Brain and Cognitive Sciences. “We also found that this treatment improved learning and memory, and enhanced executive function in the animals.”

Tsai is the senior author of the new study, which appears today in Science Translational Medicine . The paper’s lead author is TaeHyun Kim, an MIT postdoc.

Protective brain waves

Several years ago, Tsai and her colleagues began exploring the use of light flickering at 40 hertz (cycles per second) as a way to improve the cognitive symptoms of Alzheimer’s disease. Previous work had suggested that Alzheimer’s patients have impaired gamma oscillations — brain waves that range from 25 to 80 hertz (cycles per second) and are believed to contribute to brain functions such as attention, perception, and memory.

Tsai’s studies in mice have found that exposure to light flickering at 40 hertz or sounds with a pitch of 40 hertz can stimulate gamma waves in the brain, which has many protective effects, including preventing the formation of amyloid beta plaques. Using light and sound together provides even more significant protection. The treatment also appears promising in humans: Phase 1 clinical trials in people with early-stage Alzheimer’s disease have found the treatment is safe and does offer some neurological and behavioral benefits.

In the new study, the researchers set out to see whether this treatment could also counteract the cognitive effects of chemotherapy treatment. Research has shown that these drugs can induce inflammation in the brain, as well as other detrimental effects such as loss of white matter — the networks of nerve fibers that help different parts of the brain communicate with each other. Chemotherapy drugs also promote loss of myelin, the protective fatty coating that allows neurons to propagate electrical signals. Many of these effects are also seen in the brains of people with Alzheimer’s.

“Chemo brain caught our attention because it is extremely common, and there is quite a lot of research on what the brain is like following chemotherapy treatment,” Tsai says. “From our previous work, we know that this gamma sensory stimulation has anti-inflammatory effects, so we decided to use the chemo brain model to test whether sensory gamma stimulation can be beneficial.”

As an experimental model, the researchers used mice that were given cisplatin, a chemotherapy drug often used to treat testicular, ovarian, and other cancers. The mice were given cisplatin for five days, then taken off of it for five days, then on again for five days. One group received chemotherapy only, while another group was also given 40-hertz light and sound therapy every day.

After three weeks, mice that received cisplatin but not gamma therapy showed many of the expected effects of chemotherapy: brain volume shrinkage, DNA damage, demyelination, and inflammation. These mice also had reduced populations of oligodendrocytes, the brain cells responsible for producing myelin.

However, mice that received gamma therapy along with cisplatin treatment showed significant reductions in all of those symptoms. The gamma therapy also had beneficial effects on behavior: Mice that received the therapy performed much better on tests designed to measure memory and executive function.

“A fundamental mechanism”

Using single-cell RNA sequencing, the researchers analyzed the gene expression changes that occurred in mice that received the gamma treatment. They found that in those mice, inflammation-linked genes and genes that trigger cell death were suppressed, especially in oligodendrocytes, the cells responsible for producing myelin.

In mice that received gamma treatment along with cisplatin, some of the beneficial effects could still be seen up to four months later. However, the gamma treatment was much less effective if it was started three months after the chemotherapy ended.

The researchers also showed that the gamma treatment improved the signs of chemo brain in mice that received a different chemotherapy drug, methotrexate, which is used to treat breast, lung, and other types of cancer.

“I think this is a very fundamental mechanism to improve myelination and to promote the integrity of oligodendrocytes. It seems that it’s not specific to the agent that induces demyelination, be it chemotherapy or another source of demyelination,” Tsai says.

Because of its widespread effects, Tsai’s lab is also testing gamma treatment in mouse models of other neurological diseases, including Parkinson’s disease and multiple sclerosis. Cognito Therapeutics, a company founded by Tsai and MIT Professor Edward Boyden, has finished a phase 2 trial of gamma therapy in Alzheimer’s patients, and plans to begin a phase 3 trial this year.

“My lab’s major focus now, in terms of clinical application, is Alzheimer’s; but hopefully we can test this approach for a few other indications, too,” Tsai says.

The research was funded by the JPB Foundation, the Ko Hahn Seed Fund, and the National Institutes of Health.

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MIT scientists have found that a potential treatment for Alzheimer’s disease involving flickering lights and low-pitched sound could also help prevent cognitive problems after cancer treatment, reports Clare Wilson for  New Scientist . The treatment is aimed at stimulating 40 Hz brainwaves, which are linked to memory processing. The results suggest targeting such “brainwaves may result in broader benefits for the brain, including increasing the activity of immune cells and, most recently, boosting its drainage system, which could help clear a toxic protein called beta-amyloid.”  

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• Department of Brain and Cognitive Sciences

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