Effects of Group Music Intervention on Behavioral and Psychological Symptoms in Patients with Dementia: A Pilot-Controlled Trial

We investigated the effects of group music intervention on behavioral and psychological symptoms in patients with dementia. Twenty patients were nonrandomly allocated to either a music-intervention group, or an usual care group. The music-intervention group received 50 minutes of music intervention 3 times per week for 5 consecutive weeks. After 15 sessions, the music-intervention group showed significant in improvement with regard to agitation, and the total scores of both patients and caregivers were lower, compared with the control group. These findings suggest that music can improve behavioral and psychological symptoms, especially in patients with dementia and their caregivers.     

Effectiveness of music therapy for children and adolescents with psychopathology: A quasi-experimental study

Abstract

Music therapy has been found to be effective for children and adolescents with psychopathology, but its effectiveness in routine practice is unknown. The aim of this study was to examine whether individual music therapy as provided in outpatient services is an effective treatment for this group of clients and to examine potential predictors of its effectiveness. The authors assessed symptoms, competencies, and quality of life in children and adolescents with psychopathology (N=136) before and after up to 25 weekly sessions of individual music therapy or corresponding waiting time. No significant interaction effects were identified, although quality of life showed a tendency in favor of music therapy. Effect sizes were smaller than in previous experimental research. Effects on symptoms depended on the presence and severity of comorbid medical conditions. The results suggest that music therapy as provided in routine practice is effective for some but not all groups of clients.     

Music therapy in moderate and severe dementia of Alzheimer's type: a case-control study

BACKGROUND: Music therapy is a potential non-pharmacological treatment for the behavioral and psychological symptoms of dementia, but although some studies have found it to be helpful, most are small and uncontrolled. METHODS: This case-control study was carried out by qualified music therapists in two nursing homes and two psychogeriatric wards. The participants were 38 patients with moderate or severe Alzheimer's disease (AD) assigned randomly to a music therapy group and a control group. RESULTS: The study showed a significant reduction in activity disturbances in the music therapy group during a 6-week period measured with the Behavior Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD). There was also a significant reduction in the sum of scores of activity disturbances, aggressiveness and anxiety. Other symptoms rated by subscales of the BEHAVE-AD did not decrease significantly. Four weeks later the effects had mostly disappeared. CONCLUSIONS: Music therapy is a safe and effective method for treating agitation and anxiety in moderately severe and severe AD. This is in line with the results of some non-controlled studies on music therapy in dementia.     

Computer aided music therapy evaluation: Testing the Music Therapy Logbook prototype 1 system

Research indicates that music therapists are likely to make use of computer software, designed to measure changes in the way a patient and therapist make use of music in music therapy sessions. A proof of concept study investigated whether music analysis algorithms (designed to retrieve information from commercial music recordings) can be adapted to meet the needs of music therapists. Computational music analysis techniques were applied to multi-track audio recordings of simulated sessions, then to recordings of individual music therapy sessions; these were recorded by a music therapist as part of her ongoing practice with patients with acquired brain injury.The music therapist wanted to evaluate two hypotheses: one, whether changes in her tempo were affecting the tempo of a patient's play on acoustic percussion instruments, and two, whether her musical interventions were helping the patient reduce habituated, rhythmic patterning. Automatic diagrams were generated that gave a quick overview of the instrumental activity contained within each session: when, and for how long each instrument was played. From these, computational analysis was applied to musical areas of specific interest. The results of the interdisciplinary team work, audio recording tests, computer analysis tests, and music therapy field tests are presented and discussed.     

The effect of listening to light and heavy music on reducing the symptoms of depression among female students

The purpose of the research is to investigate the effect of listening to light and heavy music on reducing the symptom of depression. The participants in this study were 30 female students with depressive disorder. They were randomly assigned to three groups: (1) Experiment group receiving light music; (2) Experiment group receiving heavy music; (3) Control group. The results showed that participants in both experimental groups reported decreased levels of depression. The experiment groups, after 14 sessions, had significantly lower scores on the Beck Depression Inventory in comparison with the two other groups (p = 0.05).Music can be used therapeutically for reducing the symptoms of depressive disorder in psychiatric hospitals or individually, and it benefits the nurse.     

Music therapy for dementia and higher cognitive dysfunction: a review

Music is known to affect the human mind and body. Music therapy utilizes the effects of music for medical purposes. The history of music therapy is quite long, but only limited evidence supports its usefulness in the treatment of higher cognitive dysfunction. As for dementia, some studies conclude that music therapy is effective for preventing cognitive deterioration and the occurrence of behavioral and psychological symptoms of dementia (BPSD). In patients receiving music therapy for the treatment of higher cognitive dysfunction, aphasia was reported as the most common symptom. Many studies have been conducted to determine whether singing can improve aphasic symptoms: singing familiar and/or unfamiliar songs did not show any positive effect on aphasia. Melodic intonation therapy (MIT) is a method that utilizes melody and rhythm to improve speech output. MIT is a method that is known to have positive effects on aphasic patients. Some studies of music therapy for patients with unilateral spatial neglect; apraxia; hemiparesis; and walking disturbances, including parkinsonian gait, are available in the literature. Studies showed that the symptoms of unilateral spatial neglect and hemiparesis significantly improved when musical instruments were played for several months as a part of the music therapy. Here, I describe my study in which mental singing showed a positive effect on parkinsonian gait. Music is interesting, and every patient can go through training without any pain. Future studies need to be conducted to establish evidence of the positive effects of music therapy on neurological and neuropsychological symptoms.     

A controlled trial investigating the effect of music therapy during an acute psychotic episode

Morgan K, Bartrop R, Telfer J, Tennant C. A controlled trial investigating the effect of music therapy during an acute psychotic episode. Objective: To investigate the effects of music therapy, as an adjunct to pharmacological therapy during an acute psychotic episode. Method: Sixty participants were quasi‐randomised into either a treatment or control group. Standardised psychological assessments [Brief Psychiatric Rating Scale (BPRS), Calgary Interview Guide for Depression, Nurses’ Observation Scale for Inpatient Evaluation (NOSIE‐30) and Depression Anxiety Stress Scale (DASS21)] were conducted before and after the sessions to determine whether there were any significant changes in outcomes. Results: Statistically significant changes in BPRS scores were seen in the treatment group (n = 25) compared with the control group (n = 24). No significant differences were seen in the results of the Calgary, NOSIE‐30 or DASS21 scores. Despite the treatment group, having a 9.3% decrease in their length of stay in hospital as opposed to the control group, this did not reach statistical significance. No significant differences were found when comparing the two groups in their doses of antipsychotic, benzodiazepine, mood stabilising or antidepressant medication or at the 1‐month follow‐up assessment. Conclusion: Most of the variables tested in our study but one did not point at any advances of adding music therapy to pharmacological treatment. The finding of improvement in Brief Psychiatric Rating Scale could be an indicator of music therapy as a useful adjunct to pharmacotherapy during an in‐patient hospital stay for the few patients amongst those suffering acute psychosis that accept to participate in music therapy.     

Effects of active music therapy interventions on attendance in people with severe mental illnesses: Two pilot studies

The purpose of these brief pilot studies was to determine if there were differences between active music therapy and passive music listening in attendance rates, durational attendance, and treatment perceptions in people with severe mental illnesses. In both studies, the researchers conducted a series of active group music therapy interventions (lyric analysis, songwriting, music game, facilitated percussion interventions, and singalong) and passive group music listening sessions (recorded music via iPod) each for five days. During the first study, a higher percentage (15.53%) of patients on the unit attended the active music therapy sessions than the passive music listening sessions. Concerning treatment perceptions, participants in the active music therapy condition tended to have slightly higher mean perceptions of enjoyment and comfort than participants in the passive music listening condition. During the second study, participants spent more time in active music therapy sessions than in passive music listening sessions. Participants in the active music therapy condition also tended to have higher perceptions of helpfulness and amount learned concerning managing their mental illnesses than participants in the passive music listening condition. Results may have implications for funding psychiatric music therapy. Limitations and suggestions for future research are provided.     

Bioenergetic exercises in inpatient treatment of Turkish immigrants with chronic somatoform disorders: a randomized, controlled study

OBJECTIVE: The aim of this study was to examine whether bioenergetic exercises (BE) significantly influence the inpatient psychotherapeutic treatment results for Turkish immigrants with chronic somatoform disorders. METHOD: In a 6-week randomized, prospective, controlled trial, we treated a sample of 128 Turkish patients: 64 were randomly assigned to BE and 64 participated in gymnastic exercises in lieu of BE. The Symptom Checklist (SCL-90-R) and State-Trait Anger Expression Inventory (STAXI) were employed. RESULTS: According to the intent-to-treat principle, the bioenergetic analysis group achieved significantly better treatment results on most of the SCL-90-R and STAXI scales. CONCLUSIONS: BE appears to improve symptoms of somatization, social insecurity, depressiveness, anxiety, and hostility in the inpatient therapy of subjects with chronic somatoform disorders. Reduction of the anger level and reduction in directing anger inwards, with a simultaneous increase of spontaneous outward emotional expression, could be expected.     

A pendulum between trauma and life: Group music therapy with post-traumatized soldiers

This study suggests a model for group music therapy with post-traumatized soldiers. Six soldiers who had been diagnosed as suffering from combat or terror-related posttraumatic stress disorder participated in a series of 90-min weekly sessions of music therapy. Data were gathered by filming the sessions with digital cameras and by means of open-ended in-depth interviews. A mixed method analysis of musical and verbal contents revealed two waves of group engagement in trauma and non-trauma matters. As a whole, this process decreased reflections of traumatic emotions and increased expressions of non-traumatic feelings. The findings are discussed in light of Levine's (1997) “pendulation” therapy model. Practical implications for music therapy are suggested.     

The additional therapeutic effect of group music therapy for schizophrenic patients: a randomized study

OBJECTIVE: Schizophrenia is one of the most serious mental disorders. Music therapy has only recently been introduced as a form of treatment. The aim of this study was to examine the effect of music therapy for schizophrenic in-patients needing acute care. METHOD: Thirty-seven patients with psychotic disorders were randomly assigned to an experimental group and a control group. Both groups received medication and treatment indicated for their disorder. Additionally, the experimental group (n = 21) underwent group music therapy. RESULTS: Significant effects of music therapy are found in patients' self-evaluation of their psychosocial orientation and for negative symptoms. No differences were found in the quality of life. CONCLUSION: Musical activity diminishes negative symptoms and improves interpersonal contact. These positive effects of music therapy could increase the patient's abilities to adapt to the social environment in the community after discharge from the hospital.     

Psychiatric symptoms in patients with chronic hepatitis C receiving interferon alfa-2b therapy

BACKGROUND: Psychiatric side effects of interferon alfa are frequently observed in the therapy of patients with chronic hepatitis C infection. The goal of the present study was to assess prospectively the incidence, spectrum, and extent of psychiatric symptoms of patients receiving interferon alfa therapy as compared with an untreated reference group. METHOD: 104 patients with chronic hepatitis C were consecutively enrolled in a prospective longitudinal study. The treatment group (N = 84) received interferon alfa-2b for up to 12 months, and the reference group (N = 20) received no treatment. Patients who began treatment between November 1996 and August 1998 (N = 44) received interferon alfa-2b, 5 million units 3 times per week. Patients who began treatment in September 1998 or later (N = 40) received a combination of interferon alfa-2b, 3 to 5 million units 3 times per week, and ribavirin, 1000-1200 mg/day. Diagnostic scores for depression and anxiety were obtained by means of the psychometric instrument Hospital Anxiety and Depression Scale, and scores for anger/hostility were obtained with the Symptom Checklist-90 Revised. RESULTS: In contrast to the untreated reference group, we found significantly increased scores for depression (p <.001) and anger/hostility (p <.001) during interferon alfa therapy in the treatment group. Even before therapy, scores of those in the treatment group were above the respective cutoff values for clinically relevant symptoms of depression in 15.5% of the patients, anxiety in 13.1% of the patients, and anger/hostility in 11.3% of the patients. These proportions rose to 35.0% (depression), 25.6% (anxiety), and 24.5% (anger/hostility). The cumulative frequency of clinically relevant emotional distress (depression, anxiety, or anger/hostility) during interferon alfa therapy was 57.7%, as compared with 22.5% before therapy. However, interferon alfa therapy had to be stopped prematurely because of untreatable psychiatric symptoms in only 8.3% of patients. CONCLUSION: In view of the high frequency and extent of psychiatric symptoms with interferon alfa therapy, we recommend a close follow-up of patients receiving this therapy with respect to potential limiting mood changes.     

Effets bénéfiques de la musique préférée sur les capacités cognitives des patients en état de conscience minimale

Several studies have shown that music can boost cognitive functions in normal and brain-damaged subjects. A few studies have suggested a beneficial effect of music in patients with a disorder of consciousness but it is difficult to conclude since they did not use quantified measures and a control condition/group. The aim of the present study was to compare the effect of music to that of a continuous sound on the relational behavior of patients in a minimally conscious state (MCS). Behavioral responses of six MCS patients were evaluated using items from the Coma Recovery Scale-Revised. Weekly evaluation sessions were carried out, over four weeks, under two conditions: following the presentation of either the patient's preferred music, or following a continuous sound (control condition). Qualitative and quantitative analyses showed that twelve of the eighteen sessions (66.6%) showed a better result for the music condition than for the control condition. This new protocol suggests that preferred music has a beneficial effect on the cognitive abilities of MCS patients. The results further suggest that cerebral plasticity may be enhanced in autobiographical (emotional and familiar) contexts. These findings should now be further extended with an increased number of patients to further validate the hypothesis of the beneficial effect of music on cognitive recovery.     

Eye movement desensitization and reprocessing therapy in subsyndromal bipolar patients with a history of traumatic events: A randomized,controlled pilot-study

Traumatic events are frequent in bipolar patients and can worsen the course of the disease. Psychotherapeutic interventions for these events have not been studied so far. Twenty DSM-IV bipolar I and II patients with subsyndromal mood symptoms and a history of traumatic events were randomly assigned to Eye Movement Desensitization and Reprocessing therapy (n=10) or treatment as usual (n=10). The treatment group received between 14 and 18 Eye Movement Desensitization and Reprocessing sessions during 12 weeks. Evaluations of affective symptoms, symptoms of trauma and trauma impact were carried out by a blind rater at baseline, 2 weeks, 5 weeks, 8 weeks, 12 weeks and at 24 weeks follow-up. Patients in the treatment group showed a statistically significant improvement in depressive and hypomanic symptoms, symptoms of trauma and trauma impact compared to the treatment as usual group after intervention. This effect was only partly maintained in trauma impact at the 24 weeks follow-up visit. One patient dropped from Eye Movement Desensitization and Reprocessing group whereas four from the treatment as usual group. This pilot study suggests that Eye Movement Desensitization and Reprocessing therapy may be an effective and safe intervention to treat subsyndromal mood and trauma symptoms in traumatized bipolar patients.     

‘Naming the unnameable and communicating the unknowable’: Reflections on a combined music therapy/social work program

Spinal cord injury (SCI) is the sudden onset of a traumatic disabling condition. It impacts on people with SCI physiologically, psychologically and socially. People face major life changes and the lifelong challenges of disabilities that affect every aspect of their lives. This paper is a reflection on the impact of individual music therapy sessions and combined social work and music therapy group sessions, the music therapy program (MTP), on adjustment to SCI. Reflections focused on data drawn from group discussions, semi-structured satisfaction interviews of 13 men with SCI, who had undergone primary rehabilitation in the Royal Talbot Rehabilitation Centre, Melbourne, Australia; findings from an independent evaluation of MTP; and practitioner perceptions. Three themes were identified during this reflection. These were: Music as a conduit; Music and the body; and Music as a connector. Reflections identify a number of benefits of incorporating the MTP in rehabilitation programs for men with SCI.     

Effects of music therapy on depression compared with psychotherapy

This paper reports a study testing the effects of music on depression and compares them with the effects of psychotherapy. There are mainly three conventional treatments for depression: psychotherapy, pharmaceutical treatments, and electroconvulsive therapy. Because conventional treatment has proven to be poorly successful, new means of treatment must be found that might improve depression when used together with other therapies. A randomized controlled clinical trial was performed with a convenience sample of 79 patients aged 25–60 years with low- and medium-grade depression. The Zung Depression Scale was employed for selection purposes. Patients were randomly assigned to the music-therapy group (classical and baroque music) (n = 41), or the psychotherapy group based on conductive-behavioral therapy (n = 38). The music therapy was applied for 50 min a day, every day, for eight weeks. At the end, the music-therapy group had less depressive symptoms than the psychotherapy group, and this was proven to be statistically significant with the Friedman test. We propose that patients with low- and medium-grade depression can use music to enhance the effects of psychological support.     

Behavioural treatment of non-compliance in adolescents with newly acquired spinal cord injuries

Purpose: To demonstrate the efficacy of using differential reinforcement to treat non-compliance in adolescents with spinal cord injury. Method: A case series design was used to examine three adolescents (aged 14–16 years) with tetraplegia who received multi-disciplinary rehabilitation treatment and a behavioural contract programme during an in-patient hospital admission. Assessment included collecting data on each patient's weekly percentage of compliance with all rehabilitation goals, weekly percentage of negative affect observed in therapy sessions and scores on a measure of mobility in physical therapy. Results: Compliance with rehabilitation demands improved from a baseline of 20–65% to 80% or greater after the patients received differential reinforcement for participating in the rehabilitation regimen. Patients exhibited less anger, sadness and frustration during therapy sessions once contracts were started. Conclusions: The adolescents demonstrated greater compliance after the implementation of a behavioural contract. Future studies should identify the specific variables that affect psychological adjustment and predict ‘readiness’ to participate in rehabilitation.     

Effect of a combined dance/movement and music therapy on young adults diagnosed with severe autism

Current literature is scarce on the potential effects of combined dance/movement and music therapy on adults diagnosed with severe autism, particularly in distinguishing these effects on different areas of psychopathological disorders. We set two goals: first, to assess the effectiveness based on the score the participants obtained from the Revised Clinical Scale for the Evaluation of Autistic Behavior (ECA-R) after a series of dance/movement and music therapeutic procedures on adults with severe autism; second, to contrast the differences in effectiveness in concrete areas defined by subscales of the ECA-R, especially in its defined 2 factors and 12 functions. An overall of 36 one-hour sessions were carried out during 17 weeks on a sample of 8 participants with severe autism (approximately 2 sessions per week). During the treatment 8 measurements were taken (1 every 3 weeks) from this sample and from a control sample, which was also comprised of 8 subjects who were equally monitored at the same care center by two independent psychologists. Our experimental study seems to suggest that combined dance/movement and music therapy could be effective if used regularly for the improvement of autistic symptoms in adults diagnosed with severe autism.     

Effects of music therapy on positive and negative affect and pain with hospitalized patients recovering from a blood and marrow transplant: A randomized effectiveness study

Due to the extensive procedures surrounding treatment, cancer patients often experience a variety of physical and psychological symptoms and side effects that negatively impact their quality of life and ability to cope with and manage an illness. Providing a choice of music during a receptive music therapy session may not only distract the patient from negative affective states, but also may provide a sense of autonomy and control over a patient's immediate environment. The purpose of the study was to determine whether receptive music therapy can improve two general dimensions of emotional experience and pain in a single session for hospitalized patients recovering from a blood and marrow transplantation (BMT) procedure. The guiding research question was: Will participants experience improved positive and negative affect and pain immediately following a patient-preferred live music therapy session? Participants (N = 32) were randomly assigned to experimental or wait-list control conditions and completed the Positive and Negative Affect Schedule (Watson, Clark, & Tellegen, 1988) Short Form version and a Likert-type Pain Scale as a pre- and posttest within a single-session design. In an attempt to provide support, autonomy, and distraction, patient-preferred live music was used in receptive music therapy sessions as previous music therapy researchers indicated patient-selected live music is preferred and can be effective. There were no between-group differences at pretest. Concerning posttest analyses, there were significant between-group differences in positive and negative affect and pain, with experimental participants having more favorable scores than control participants. From the results of this randomized effectiveness study, it seems that a single receptive music therapy session can be an effective intervention concerning positive and negative affect and pain for hospitalized BMT patients. As higher levels of patient engagement may result in stronger treatment effects, future research encouraging hospitalized BMT patients to engage in different types of active music therapy interventions is warranted. Limitations of the study, implications for clinical practice, and suggestions for future research are provided.     

Re-discovering voice: Korean immigrant women in group music therapy

This article discusses group music therapy work with six older Korean immigrant women residing in New York. The women received weekly group music therapy sessions for a 6-month period. With each client belonging to four major subculture groups (Korean, immigrant, older adults, and women), attention was paid to the impact of subculture on group dynamics and the therapeutic process. Particular focus was placed on the influence of clients’ cultural adjustments, their gender role, the types of gender issues which emerged in sessions, and the clients’ use of music as a medium to increase their awareness of and to work through social–political oppression experienced during their cultural adjustment phase. The effective management of acculturative stress using music was also discussed. Music therapists are advised to take into account specific cultural considerations and the gender roles of their clients to better serve them. Clinical recommendations are further discussed in the article.