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Music Therapy

An Overview of the effects and applications of music therapy

  • A substantial body of literature exists to support the effectiveness of music therapy.
  • Healthy individuals can use music for stress reduction via active music making, as well as passive listening for relaxation. Music is often a vital support for physical exercise. Music therapy may be used to facilitate labor and delivery. Effects of music for stress reduction have been documented in physiological (e.g. heart rate, blood pressure, hormonal levels), neurological (e.g. EEG readings) and psychological (e.g. self-report, the Spielberger State-Trait Anxiety Inventory) domains.
  • Music is used in hospitals to alleviate pain in conjunction with anesthesia or pain medication: elevate patients1 mood and coun¬teract depression; promote movement for physical rehabilitation; calm or sedate, often to induce sleep; counteract apprehension or fear; and lessen muscle tension for the purpose of relaxation.
  • Anxiety and stress reduction is one of the primary outcomes in¬vestigated in music medicine and music therapy research with medical patients.
  • The effects of both music and music therapy interventions have been documented in a range of medical patients, for example, pre-surgical, oncology, pediatric, and pre-procedural patients.

How does Music Influence Health?

  • Five factors contribute to the effects of music therapy
    • Attention modulation
    • Emotion modulation
    • Cognition modulation
    • Behavior modulation
    • Communication modulation
  • These processes can have beneficial effects on psychological & physiological health.
  • Music can evoke strong emotions & reliably affecting mood.
  • Music-evoked emotions can modulate activity in all limbic & paralimbic brain structures
  • Functional magnetic resonance imaging shows that listening to music modulates activity in a network of mesolimbic structures of the brain, including the nucleus accumbens, ventral tegmental area, hypothalamus & insula, which regulate autonomic & physiological responses to rewarding & emotional stimuli.
  • It is well known that the hypothalamus exerts control over sev¬eral vital bodily functions through the hypothalamic-pituitary-adrenal axis & the autonomic nervous system. Therefore, hypothalamic activation induced by music is of special interest.

Therapeutic Significance of Musical Characteristics and Genre

  • There is no particular style of music that is more therapeutic than the rest.
  • Regardless of subjective factors, there are some sound charac¬teristics which move us in certain emotional, physical or psychological directions.
  • Certain sound patterns motivate us, while others tend to evoke peace or relaxation.
  • Musical elements that affect a listener include rhythm, volume, complexity, variation in pitch, repetition within the tune, & the type of music.
  • Although researchers have extensively investigated the effects of specific musical characteristics such as tempo, melody, harmony and timbre, on emotional responses in non-medical populations, such research is still needed with medical patients.
  • More controlled trials are needed with medical patients to further examine which specific musical characteristics enhance the psychological and physiological benefits of music.

Music Therapy and Music Medicine

  • Music therapy is the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program. It is an established health service similar to occupational therapy and physical therapy and consists of using music therapeutically to address physical, psychological, cognitive and/or social func¬tioning for patients of all ages.
  • Music therapy requires no prior musical knowledge - such as the ability to play an instrument - on the part of the patient.
  • Interventions are categorized as "music medicine' when passive listening to pre-recorded music is offered as an ancillary therapy, by medical personnel who are not necessarily specialized in the field of music therapy.
  • In contrast, music therapy requires the implementation of a mu¬sic intervention by a trained/qualified music therapist
  • In active music therapy, the patient makes music either alone, with a therapist or within a group.
  • Typical intervention techniques include singing, playing with rhythm, improvisation, and the composition of music or songs,2 In receptive music therapy, therapeutic goals are pursued exclusively by listening to recorded or live music.

Complementary/alternative medicine & mind-body medicine

  • The term "mind refers to the totality of mental functions related to consciousness, thought, mood, and behavior, derived from ac¬tivities within the brain.
  • Mental health is a key determinant of overall health.
  • The Influence of the mind on the body and the effect of psychological factors in health and disease are well known
  • Complementary and alternative Medicine (CAM) refers to the various disease-treating or disease-preventing practices whose methods and efficacy differ from traditional or conventional bio-medical treatment.
  • Some of these CAM approaches can be used in conjunction with allopathic medicine.
  • Mind-body medicine is a domain within CAM that focuses on the interactions between mind and body, and the ways in which emo¬tional and behavioral factors can directly affect health.4 Mind-body practices use the mind to affect physical functioning and promote health,4
  • Music therapy is classified as a mind-body intervention, along with yoga, meditation, biofeedback etc.

Musical preference of the Patient / Client

  • An individual's musical preference is highly subjective.
  • Music that feels soothing to one may feel unpleasant to others.
  • Some factors that influence musical preference & taste1
    • Age & gender
    • Familiarity with the music
    • Culture, community & peer influences
    • Intelligence & education
    • Socioeconomic status
    • Musical training
    • Mood & personality
    • Current situation & circumstances
  • An important prerequisite for effective music therapy is that the patient enjoys what he or she is hearing.
  • The individual's preferences, circumstances and need for treat¬ment, arid the client or patient's goals help to determine the types of music a therapist may use.
  • Further research is required to clarify the differential effects of therapjst / researcher-selected versus patient-selected music.

Music in Clinical Setting: Major Reviews of Research

  • A systematic review of 42 randomized controlled trials showed that music intervention reduced perioperative anxiety and pain, in approximately half of the reviewed studies.
  • A Cochrane review of 51 studies on the effect of music on pain concluded that listening to music reduces pain intensity levels and opioid requirements.
  • A Cochrane review of 23 randomized controlled trials concluded that music listening may have a beneficial effect on blood pres¬sure, heart rate, respiratory rate, anxiety, and pain in persons with coronary heart disease.
  • A meta-analysis of 8 randomized controlled trials concluded that music improves patients1 overall experience with colonoscopy.4 A Cochrane review stated that 4 of the 5 studies reviewed re¬ported greater reduction in symptoms of depression among those randomized to music therapy than to those in standard care conditions.
  • A Cochrane review of 4 randomized controlled trials of music therapy for schizophrenia concluded that music therapy as an addition to standard care may improve symptoms.
  • A review of 13 studies observed that music therapy reduced agi¬tation in patients with dementia, in a majority of the studies.

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