A Systematic Review

Music therapy (MT) and music-based interventions (MBIs) are increasingly used for the treatment of substance use disorders (SUD). Previous reviews on the efficacy of MT emphasized the dearth of research evidence for this topic, although various positive effects were identified. Therefore, we conducted a systematic search on published articles examining effects of music, MT and MBIs and found 34 quantitative and six qualitative studies. There was a clear increase in the number of randomized controlled trials (RCTs) during the past few years. We had planned for a meta-analysis, but due to the diversity of the quantitative studies, effect sizes were not computed. Beneficial effects of MT/ MBI on emotional and motivational outcomes, participation, locus of control, and perceived helpfulness were reported, but results were inconsistent across studies. Furthermore, many RCTs focused on effects of single sessions. No published longitudinal trials could be found. The analysis of the qualitative studies revealed four themes: emotional expression, group interaction, development of skills, and improvement of quality of life. Considering these issues for quantitative research, there is a need to examine social and health variables in future studies. In conclusion, due to the heterogeneity of the studies, the efficacy of MT/ MBI in SUD treatment still remains unclear

Bridging the Clinic to Community: Music Performance as Social Transformation for Military Service Members

The use of music performance in music therapy with military service members is discussed as a vehicle for social transformation and reintegration. The use of performance in music therapy is not without controversy primarily because therapy is considered a process, not a product, and confidentiality and privacy are essential components of therapy. However, others have argued that public performances can validate therapeutic changes in clients, give voice to their experiences, raise awareness of social issues within their communities, transform perceptions of injury, or illness in audience members, and may result in the clients gaining support and validation from their communities. We discuss the potential of music performances to contribute to individual development, reinforce rehabilitation, enhance function, and facilitate change at the community level to support reintegration of military service members. We illustrate this through two brief case reports of service members who received music therapy as part of their treatment for post-traumatic stress disorder, traumatic brain injury, and other psychological health concerns at the National Intrepid Center of Excellence, a Directorate of the Walter Reed National Military Medical Center, Bethesda, MD, United States. The service members wrote, learned, and refined songs over multiple music therapy sessions and created song introductions to share with audiences the meanings and benefits gained from integrating performance in music therapy. The case reports also include excerpts of interviews conducted with these service members several months after treatment about their experiences of performing and the perceived impact of their performances on the audience and greater community

Learning by Doing: Student Experiences in a Mixed Methods Research Course

Aim/Purpose The purpose of this paper is to detail the experiential learning processes of an 11-week doctoral-level intermediate mixed methods research (MMR) course in which student-researchers conceptualized and implemented an MMR study to apply theoretical and methodological learning in a practical manner. Our aim is to emphasize the value of an applied MMR course for improved student learning and curriculum planning for faculty by highlighting meaningful insights on study design, data integration, team collaboration, and the challenges and opportunities involved in project execution within a time-limited academic course. Background MMR courses are increasingly being integrated into graduate programs, yet few offer intermediate or advanced courses that go beyond introductory topics and engage students in applied learning. Furthermore, most articles on MMR courses are written from the instructor perspective and not from the student perspective. Methodology This article is organized by each week of the course curriculum, and the output of the research project, couched within reflections of the applied process, is presented. While this paper is grounded in an experiential reflection of learning, the research project itself is referred to frequently to help elucidate and capture this learning in a systematic way. The applied study employed an explanatory sequential mixed methods design to examine career satisfaction and career preference changes over time in doctoral candidates and graduates. Contribution This paper contributes to higher education by providing a student-led exemplar of applied learning in MMR pedagogy for doctoral students irrespective of discipline and research topic. It provides a sample research project, executed start to finish with a guiding blueprint that can be adapted by faculty and students in various academic departments, within a quarter or semester long course. Findings Ultimately, this course led to increased confidence and preparation to conduct interdisciplinary mixed methods research. Unique to mixed methods research, the areas in which we witnessed the most growth included developing mixed methods research questions, choosing a design based on these questions, and engaging in data integration. Recommendations for Practitioners We provide the following recommendations to instructors interested in developing intermediate- or advanced-level MMR courses: a) obtain input from students on what they are most interested in learning during course conceptualization or early on in implementation; b) consider that a great deal of time outside of the classroom may need to be dedicated to the class project, which may impact the feasibility and successful execution of an experiential course; and c) sufficient class time is dedicated to data integration from quantitative and qualitative inputs. Recommendation for Researchers Researchers interested in further examining learning and proficiency garnered from MMR and other research courses may benefit from including students as co-researchers. In addition, engaging in systematic qualitative research on student and professor experiences in learning and teaching MMR courses could highlight further areas for course refinement and topics for future research. Impact on Society Given the increasing prevalence of MMR being included in research funding announcements as a preferred methodology, it is imperative to rigorously train researchers in mixed methods research at varying levels of advancement (i.e., introductory, intermediate, and advanced). Future Research Our small explanatory sequential mixed methods study began as a class project, yet highlighted areas that could be studied further for doctoral candidates and graduates in clinically oriented fields, such as learning what types or qualities of training and mentorship may yield more career preparedness and satisfaction

Telehealth-Based Music Therapy Versus Cognitive Behavioral Therapy for Anxiety in Cancer Survivors: Rationale and Protocol for a Comparative Effectiveness Trial

Background: Cancer survivors represent one of the fastest growing populations in the United States. Unfortunately, nearly 1 in 3 survivors experience anxiety symptoms as a long-term consequence of cancer and its treatment. Characterized by restlessness, muscle tension, and worry, anxiety worsens the quality of life; impairs daily functioning; and is associated with poor sleep, depressed mood, and fatigue. Although pharmacological treatment options are available, polypharmacy has become a growing concern for cancer survivors. Music therapy (MT) and cognitive behavioral therapy (CBT) are evidence-based, nonpharmacological treatments that have demonstrated effectiveness in treating anxiety symptoms in cancer populations and can be adapted for remote delivery to increase access to mental health treatments. However, the comparative effectiveness of these 2 interventions delivered via telehealth is unknown. Objective: The aims of the Music Therapy Versus Cognitive Behavioral Therapy for Cancer-related Anxiety (MELODY) study are to determine the comparative effectiveness of telehealth-based MT versus telehealth-based CBT for anxiety and comorbid symptoms in cancer survivors and to identify patient-level factors associated with greater anxiety symptom reduction for MT and CBT. Methods: The MELODY study is a 2-arm, parallel-group randomized clinical trial that aims to compare the effectiveness of MT versus CBT for anxiety and comorbid symptoms. The trial will enroll 300 English- or Spanish-speaking survivors of any cancer type or stage who have experienced anxiety symptoms for at least 1 month. Participants will receive 7 weekly sessions of MT or CBT delivered remotely via Zoom (Zoom Video Communications, Inc) over 7 weeks. Validated instruments to assess anxiety (primary outcome), comorbid symptoms (fatigue, depression, insomnia, pain, and cognitive dysfunction), and health-related quality of life will be administered at baseline and at weeks 4, 8 (end of treatment), 16, and 26. Semistructured interviews will be conducted at week 8 with a subsample of 60 participants (30 per treatment arm) to understand individual experiences with the treatment sessions and their impact. Results: The first study participant was enrolled in February 2022. As of January 2023, 151 participants have been enrolled. The trial is expected to be completed by September 2024. Conclusions: This study is the first and largest randomized clinical trial to compare the short- and long-term effectiveness of remotely delivered MT and CBT for anxiety in cancer survivors. Limitations include the lack of usual care or placebo control groups and the lack of formal diagnostic assessments for psychiatric disorders among trial participants. The study findings will help guide treatment decisions for 2 evidence-based, scalable, and accessible interventions to promote mental well-being during cancer survivorship. International registered report identifier (irrid): DERR1-10.2196/46281

The Effects of Music Entrainment on Postoperative Pain Perception in Pediatric Patients

Using a within-subjects counterbalanced design with random allocation to treatment sequences, this study examined the effects of music entrainment on postoperative pain perception and emotional state in 32 pediatric patients. Patients participated in two music entrainment conditions and one control condition over 2 consecutive days. During the music entrainment condition, live music was created by the music therapist to match the child\u27s pain. Once resonance was achieved between the pain and the music, the music progressed into music predetermined by the child as healing. During the control condition, standard care was provided. Measurements of the dependent variables were taken just prior to and immediately following each condition. The results support the effectiveness of music entrainment as a postoperative pain management technique for children and adolescents. [PUBLICATION ABSTRACT

Music Interventions for Improving Psychological and Physical Outcomes in Cancer Patients

Background: Having cancer may result in extensive emotional, physical and social suffering. Music interventions have been used to alleviate symptoms and treatment side effects in cancer patients.; Objectives: To assess and compare the effects of music therapy and music medicine interventions for psychological and physical outcomes in people with cancer.; Selection Criteria: We included all randomized and quasi-randomized controlled trials of music interventions for improving psychological and physical outcomes in adult and pediatric patients with cancer. We excluded participants undergoing biopsy and aspiration for diagnostic purposes.; Data Collection and Analysis: Two review authors independently extracted the data and assessed the risk of bias. Where possible, we presented results in meta-analyses using mean differences and standardized mean differences. We used post-test scores. In cases of significant baseline difference, we used change scores.; Main Results: We identified 22 new trials for inclusion in this update. In total, the evidence of this review rests on 52 trials with a total of 3731 participants. We included music therapy interventions offered by trained music therapists, as well as music medicine interventions, which are defined as listening to pre-recorded music, offered by medical staff. We categorized 23 trials as music therapy trials and 29 as music medicine trials. The results suggest that music interventions may have a beneficial effect on anxiety in people with cancer, with a reported average anxiety reduction of 8.54 units (95% confidence interval (CI) −12.04 to −5.05, P \u3c 0.0001) on the Spielberger State Anxiety Inventory - State Anxiety (STAI-S) scale (range 20 to 80) and −0.71 standardized units (13 studies, 1028 participants; 95% CI −0.98 to −0.43, P \u3c 0.00001; low quality evidence) on other anxiety scales, a moderate to strong effect. Results also suggested a moderately strong, positive impact on depression (7 studies, 723 participants; standardized mean difference (SMD): −0.40, 95% CI −0.74 to −0.06, P = 0.02; very low quality evidence), but because of the very low quality of the evidence for this outcome, this result needs to be interpreted with caution. We found no support for an effect of music interventions on mood or distress. Music interventions may lead to small reductions in heart rate, respiratory rate and blood pressure but do not appear to impact oxygen saturation level. We found a large pain-reducing effect (7 studies, 528 participants; SMD: −0.91, 95% CI −1.46 to −0.36, P = 0.001, low quality evidence). In addition, music interventions had a small to moderate treatment effect on fatigue (6 studies, 253 participants; SMD: −0.38, 95% CI −0.72 to −0.04, P = 0.03; low quality evidence), but we did not find strong evidence for improvement in physical functioning. The results suggest a large effect of music interventions on patients\u27 quality of life (QoL), but the results were highly inconsistent across studies, and the pooled effect size for the music medicine and music therapy studies was accompanied by a large confidence interval (SMD: 0.98, 95% CI −0.36 to 2.33, P = 0.15, low quality evidence). A comparison between music therapy and music medicine interventions suggests a moderate effect of music therapy interventions for patients\u27 quality of life (QoL) (3 studies, 132 participants; SMD: 0.42, 95% CI 0.06 to 0.78, P = 0.02; very low quality evidence), but we found no evidence of an effect for music medicine interventions. A comparison between music therapy and music medicine studies was also possible for anxiety, depression and mood, but we found no difference between the two types of interventions for these outcomes. The results of single studies suggest that music listening may reduce the need for anesthetics and analgesics as well as decrease recovery time and duration of hospitalization, but more research is needed for these outcomes. [See Full Text for entire Abstract]; Authors\u27 Conclusions: This systematic review indicates that music inter entions may have beneficial effects on anxiety, pain, fatigue and QoL in people with cancer. Furthermore, music may have a small effect on heart rate, respiratory rate and blood pressure. Most trials were at high risk of bias and, therefore, these results need to be interpreted with caution

Effects of music therapy and music-based interventions in the treatment of substance use disorders: A systematic review.

Music therapy (MT) and music-based interventions (MBIs) are increasingly used for the treatment of substance use disorders (SUD). Previous reviews on the efficacy of MT emphasized the dearth of research evidence for this topic, although various positive effects were identified. Therefore, we conducted a systematic search on published articles examining effects of music, MT and MBIs and found 34 quantitative and six qualitative studies. There was a clear increase in the number of randomized controlled trials (RCTs) during the past few years. We had planned for a meta-analysis, but due to the diversity of the quantitative studies, effect sizes were not computed. Beneficial effects of MT/ MBI on emotional and motivational outcomes, participation, locus of control, and perceived helpfulness were reported, but results were inconsistent across studies. Furthermore, many RCTs focused on effects of single sessions. No published longitudinal trials could be found. The analysis of the qualitative studies revealed four themes: emotional expression, group interaction, development of skills, and improvement of quality of life. Considering these issues for quantitative research, there is a need to examine social and health variables in future studies. In conclusion, due to the heterogeneity of the studies, the efficacy of MT/ MBI in SUD treatment still remains unclear

Vocal Music Therapy for Chronic Pain Management in Inner-city African Americans: A Mixed Methods Feasibility Study

To date, research on music for pain management has focused primarily on listening to prerecorded music for acute pain. Research is needed on the impact of active music therapy interventions on chronic pain management. [PUBLICATION ABSTRACT