What is music therapy? How listening to music, songwriting, and more can help people cope with conditions ranging from depression to dementia

Rebecca Strong,Maya BenattarFeb 26, 2021, 11:56 IST

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Listening to music is just one of many music therapy methods.Oliver Helbig/Getty Images

Research on the many benefits of music has paved the way for the burgeoning field of music therapy.
Music therapy involves musical expression to address physical, social, and mental health goals.
Benefits include pain relief, lowered blood pressure, and chronic stress and anxiety reduction.

It's no secret that both listening to and performing music can be therapeutic - offering a powerful avenue for mental stimulation and emotional expression.

Mounting research on the benefits of music has paved the way for the burgeoning field of music therapy: A unique approach that utilizes music to address a variety of physical, social, cognitive, and emotional health goals.

Experts say that music therapy can be beneficial for people of all ages and health conditions, regardless of whether they play an instrument or have any relevant musical background or skills.

"There is no other stimulus on Earth that engages the brain as globally as music does," says Brian Harris, a board-certified music therapist. "Music has also been shown to aid in neuroplasticity, or the brain's ability to strengthen old connections and create new connections. So, when implemented by a trained clinician, music therapy becomes a powerful intervention."

Learn more about music therapy and what to expect from the practice below.

What is music therapy?

According to Jennifer Borgwardt, a board-certified hospice music therapist at the University of Pennsylvania, there are a variety of music therapy methods. A few include:

Songwriting
Performing pre-composed songs
Listening to music
Improvised instrument playing

Harris notes that the interventions used depend mainly on the client's specific goal.

For example, many cognitive interventions - or strategies that reduce the impact of issues related to memory, learning, perception, language, and reasoning - involve songwriting, playing drums, and percussion instruments. If someone is having trouble walking due to a stroke, treatment may entail walking to a specific rhythmic pattern.

Important: Music therapy is different from sound therapy, an ancient practice that leverages vibrations from the voice, instrumental gongs, Tibetan singing bowls, tuning forks, and chimes to promote relaxation.

Music therapists who successfully complete an independently administered examination by the Certification Board for Music Therapists hold the music therapist-board certified credential (MT-BC). Trained and certified music therapists work in a range of settings, such as hospitals, nursing homes, rehab facilities, outpatient clinics, community mental health centers, senior centers, halfway houses, drug and alcohol programs, and schools.

Harris adds that many music therapists also offer services in-home, at their private practices, or via teletherapy.

Types of music therapy

As the field has grown, new and different approaches to music therapy - each with its own techniques and benefits - have emerged.

According to Borgwardt, a few music therapy approaches include:

Nordoff-Robbins music therapy. This is an improvisational approach that was originally devised for those with developmental disabilities and typically entails music composition.a
Community music therapy. This is often provided to marginalized groups with the objectives of health improvement, connectedness, and social change.
The Bonny Method of Guided Imagery. The therapist uses selected sequences of classical music to stimulate the client's imagination.
Vocal psychotherapy. This is a voice-based model that encourages a musical dialogue between therapist and patient.

What conditions can be treated with music therapy?

There's an ever-growing body of research supporting the effectiveness of music therapy for managing both physical and mental health issues.

According to Harris and Borgwardt, some of the many conditions that music therapy can help with include:

Dementia
Asthma
Chronic pain
Autism
Anxiety
Depression
Stroke
Multiple Sclerosis
Parkinson's disease
Schizophrenia
Communication challenges
Alzheimer's disease

Experts say music therapy may also offer a viable alternative to talk therapy when someone is finding it difficult to express themselves verbally.

"There are so many experiences in life that, at times, feel outside of the realm of rational language-based processing," Borgwardt says. "In music therapy, we have an opportunity to utilize music experiences to help us express internal states, connect to each other in new ways, make meaning, and tap into our innate creativity, all within the context of a therapeutic relationship."

What are the benefits of music therapy?

Experts agree that music therapy can be just as effective for non-musicians as it is for instrumentalists and singers. However, Borgwardt acknowledges that an appreciation of music is generally helpful for this therapeutic work.

Here's what the research says about the health benefits of music therapy.

Physical health benefits

Relieves pain. A 2016 meta-analysis determined that music therapy has had significant effects in decreasing both acute and chronic pain. Music therapy was also found to significantly decrease the acute pain and muscle tension levels associated with daily burn care in a small 2010 study.

Improves premature babies' health. A 2013 study found that music therapy had positive effects on premature infants' cardiac and respiratory function, improved their feeding behaviors, and reduced parents' stress levels by promoting bonding.

Lowers blood pressure. A 2016 meta-analysis determined that music therapy may be effective for improving or lowering systolic blood pressure in patients with hypertension.

Positively affects those with traumatic brain injuries. A 2021 meta-analysis revealed that music therapy may have positive effects for patients with traumatic brain injuries, including improved stride length when they walk and improved executive function - mental skills that are involved in working memory, focus and attention, and multitasking.

Positively affects stroke rehabilitation treatment. A 2020 study found that when stroke patients participated in music therapy sessions for two full years alongside existing stroke rehabilitation treatment, they experienced physical benefits such as better arm function and gait.

Reduces chronic stress. A 2018 systematic review and two meta-analyses concluded that music therapy interventions can have a significant effect on stress reduction, with particularly noteworthy effects on reducing heart rate.

Reduces instances of hospitalization for pediatric asthma. In a 2019 study, children who participated in music therapy experienced fewer asthma-related hospitalizations compared to those who didn't engage in music therapy sessions.

Improves symptoms of Parkinson's disease. A 2015 study revealed that rhythm-related techniques can improve gait (speed, frequency, and step length), coordination of limbs, posture, and balance in those with Parkinson's.

Likewise, a 2019 study also found that rhythmic auditory stimulation, a type of music therapy, significantly reduced the number of falls in Parkinson's disease while leading to faster walking and longer strides.

Improves instances of aphasia. A 2019 systematic review and meta-analyses concluded that music therapy can moderately improve language rehabilitation in people with post-stroke aphasia.

This condition caused by brain damage from a stroke or other head trauma can result in difficulties communicating both verbally and in writing. Interestingly, though, stroke patients with speech and language disorders are often able to sing entire pieces of text that they can't speak.

Mental health benefits

Schizophrenia. According to a 2011 review, music therapy coupled with standard care helps people with schizophrenia to improve their overall mental state, social functioning, and some aspects of their behavior and cognitive functioning.

Autism. School-aged children who underwent eight to 12 weeks of music therapy intervention improved their parent-reported social communication and their functional brain activity related to communication in a small 2018 study.

Dementia. According to a small 2008 study, music therapy is an effective approach for reducing behavioral and psychological symptoms of dementia such as delusions, agitation, anxiety, apathy, and irritability, and night-time disturbances.

Another 2010 study found that group music activities can reduce physically and verbally aggressive behavior in elderly people with dementia.

Depression. A 2017 review concluded that music therapy can reduce both clinical and patient-reported depression and may also reduce anxiety levels and improve overall functioning in depressed individuals.

Anxiety. One 2016 study revealed that music therapy can help to reduce anxiety and fatigue in cancer patients, while another small 2002 study found that undergraduates experienced lower anxiety and stress after 20 hours of music therapy - and those benefits were sustained at a two-month follow-up.

Post-Traumatic Stress Disorder (PTSD). A 2017 review states that music therapy may address and reduce symptoms of PTSD, including thoughts that make it difficult to manage your emotions, as well as avoidance and negative moods.

Improved spiritual well-being. In a small 2007 study, just four 30-minute music therapy sessions resulted in a significant increase in spiritual well-being - such as a greater acceptance of mortality, feelings of purpose, fulfillment and enjoyment in life, and optimism about the future - among hospice patients.

Insider's takeaway

Music therapy can provide a creative, non-verbal outlet as well as neurological stimulation, resulting in far-reaching mental, physical, and emotional benefits.

Music therapy is considered a reimbursable service under benefits for partial hospitalization programs if it's specified in the physician's treatment plan, and a few U.S. states allow payment for music therapy services via Medicaid waivers.

What's the cost: Music therapy fees are dependent upon the care setting and not widely covered by insurance. However, master's level music therapists are often eligible for licensure as psychotherapists in certain states, in addition to their MT-BC, and this can allow for more insurance coverage reimbursement. According to Borgwardt, many hospice (also hospitals, day programs, nursing homes, and more) programs have music therapists on staff who provide services for free, and therapists with private practices often offer sliding scales based on the patient's income The American Music Therapy Association estimates that 20% of music therapists receive reimbursement from private insurance for their services.

When seeking out services, it's important to look for a board-certified therapist (MT-BC) to ensure they have the proper training and credentials to provide adequate services. Credentials such as registered music therapist (RMT), certified music therapist (CMT), or advanced certified music therapist (ACMT) are no longer recognized by the National Music Therapy Registry.

For more information on music therapy, experts recommend such resources as the Certification Board for Music Therapists, the Academy of Neurologic Music Therapy, and the American Music Therapy Association - which offers a directory you can search to find a qualified music therapist in your area.

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