A recent survey found that 1 in 5 adults have experienced a mental health issue at some point in their life. The term mental health refers to a person’s emotional, psychological, and social well-being. Mental health influences the way a person thinks, feels, acts, and relates to others. Mental health disorders are common and can be caused by a variety of factors including biological factors, life experiences, and family history. The most common mental health diagnoses are anxiety and depression. Other common mental health disorders include eating disorders, obsessive-compulsive disorder, substance use disorder, mood disorder, personality disorder, psychotic disorder, and post-traumatic stress disorder. (U.S. Department of Health and Human Services, 2019, para. 2-4).
In a mental health context, music therapy interventions are used for communication and expression. Group music therapy sessions address relationships and create healthy boundaries among clients in the session generalize to everyday life.. Common goals include exploring thoughts and feelings, addressing self-esteem, gaining personal insight, developing healthy coping skills, conflict resolution, social interaction, and giving the client an opportunity to be successful (AMTA Strategic Priority Group, 2006, p1-2). Mental health conditions are commonly a life-long battle, so treatment is not about short-term healing, but learning skills to manage and effectively cope in the future.
Educational music therapy groups are increasingly common in acute mental health care facilities. These groups use music as a tool to start conversations and reinforce concepts that are addressed in other therapies (Silverman, 2016, 390). The educational model is based on the psychoeducational approach that teaches people to “understand, be aware of, and manage their mental health conditions based on their personalized goals and values” (Silverman, 2019, 627). The educational music therapy model is a highly structured and group based approach that teaches “management of skills to promote recovery” (Silverman, 2019, 625). In a 2016 study, nurses at an acute care psychiatric facility stated that patients verbally participated more during music therapy groups than other group programming. Music therapy groups were well attended and highly motivating to patients (Silverman, 393). This information raises the question, why is it important that a music therapist facilitates the group, and what is the difference between a live music therapy session and someone playing recorded music for patients.
A 2012 study measured attendance, participation, and outcomes of active music therapy sessions versus passive music listening groups. Both groups were led by a board-certified music therapist who used a set session plan for the duration of the study. Both groups focused on communication and healthy coping or leisure skills. The study found that on average, more patients attended live music therapy sessions and participated for a longer portion of the session. Patients who attended live music therapy sessions also had a higher treatment perception rating than those who attended the group using recorded music. This study found that music therapy sessions not only improved quality of life, but also treatment outcomes. Participants were able to state what they had done in the session and how it applied to their treatment (Silverman & Leonard, 2012, 391-392).
A similar study evaluated the use of different music therapy interventions versus a control group that was discussion based. The goal of the group was not elimination of mental health problems or related symptoms, but “reclamation of a meaningful, purposeful, and valued life” despite mental illness (Silverman, 2019, 624). Patients who attended music therapy sessions participated in either a songwriting or lyric analysis intervention. In the music therapy sessions, live music was used to facilitate and guide the discussion. For example, a music therapist prepares lyric sheets and instructs patients to listen and follow along while marking any lines or phrases that stand out. After the music therapist plays and sings the song, the therapist asks patients if there was a lyric that stood out to them, why the lyric stood out, and how it related to their situation and recovery. In the control group, the therapist facilitated conversation based on prepared discussion prompts and what participants offered. The study found a higher level of participation in the music therapy sessions and patients who attended music therapy had a slightly higher recovery mean scores than those who attended the control group (Silverman, 2019, 626). An AMTA meta-analysis found live music therapy sessions in acute psychiatric facilities led to reduced muscle tension, improved self-image, increased self-esteem, decreased anxiety, decreased agitation, increased verbalization, enhanced interpersonal relationships, improved group cohesiveness, increased motivation, and successful and safe emotional release (AMTA Strategic Priority Group, 2006, p. 1-2).
These findings support the use of the educational music therapy model and the importance of a music therapist facilitating live sessions in acute psychiatric care facilities. By using the educational music therapy model, clients are encouraged to actively participate in establishing goals and managing illness. Music therapy groups based on this model teach healthy coping skills while building relationships and increasing quality of life.
-Rachel Buchheit, Music Therapy Intern
AMTA Strategic Priority Group. (2006). Fact sheet: music therapy and mental health. American Music Therapy Association. Retrieved from https://www.musictherapy.org/assets/1/7/MT_Mental_Health_2006.pdf
Silverman, M.J. (2019). Comparing Educational Music Therapy Interventions via Stages of Recovery with Adults in an Acute Care Mental Health Setting: A Cluster-Randomized Pilot Effectiveness Study. Community Mental Health Journal, 55(4), 624-630.
Silverman, M.J. (2016). Effects of Educational Music Therapy on State Hope for Recovery in Acute Care Mental Health Inpatients: A Cluster-Randomized Effectiveness Study. Frontiers in Psychology, 7.
Silverman, M.J. & Leonard, J. (2012). Effects of active music therapy interventions on attendance in people with severe mental illnesses: Two pilot studies. The Arts in Psychotherapy, 39(5), 390-396.
U.S. Department of Health and Human Services (2019). MentalHealth.gov: What is mental health. Retrieved July 25, 2019, from https://www.mentalhealth.gov/basics/what-is-mental-health