Music-based Interventions or Self-care Using Music?
I have always associated music as a stress-reliever. After a long day at school, music just hits you differently. In middle and high school, the most exciting part of a boring day was leaving school on the school bus because that was when I got to put on my headphones and listen to my favorite songs. If I think about it, I was more excited to listen to music on the bus than actually going home. At home, dancing to upbeat electronic or hip-hop music always made me happier. On the other hand, soft lo-fi music is my go-to when I am having trouble falling asleep. Based on the experiences mentioned, if someone were to ask me if I think music works as a way to boost mental health, I would say yes, for sure! But what about music-based interventions like music therapy and music medicine? These interventions usually require some sort of trained professional. Does that make music-based interventions more effective than someone interacting with music on their own at home or any other place outside a clinical/medical setting?
Music-based interventions use music as a procedure in order to study the therapeutic effects of it. According to a 2017 review article by Sihvonen et al. of the University of Turku, Finland, some other forms of music-based interventions are music medicine, rhythmic auditory stimulation, music-supported therapy, and melodic intonation therapy. Each form of music-based interventions is different.
Music therapy refers to the intervention that is conducted by a trained and licensed music therapist (Sihvonen et al., 2017). An article by Tang et al. (2020) further categorizes music therapy into active and receptive music therapy. Active music therapy includes playing musical instruments, singing, and any other method where one directly engages with music in organized activities. In receptive music therapy, the participant listens to music and may do imagery-related activities such as drawing. Tang et al. (2020) also defines music therapy as a way to accomplish therapeutic goals. These are the goals of receiving therapy that the client and therapist establish together, such as finding better ways to cope with anxiety. Therefore, an individual who receives music therapy has an outcome of improving some sort of behavior.
Meanwhile, music medicine refers to treatment of patients using music by healthcare professionals who are not therapists (Sihvonen et al., 2017) and usually listening to prerecorded music (Tang et al., 2020). This would make music medicine more receptive than active as a treatment method. There is no therapeutic goal for music medicine and it can be as simple as turning on calm music for someone or yourself in bed trying to fall asleep.
Personal Use of Music to Regulate Wellbeing
Before we get into music-based interventions, it is important to understand how music as a stimulus can affect our wellbeing, which includes both physical and mental health. A research article by Granot et al. (2021) describes music as a leisure activity for many people and used to relieve stress and regulate emotions like many other leisure activities such as cooking, gardening, and reading.
Granot et al.’s (2021) study, which was conducted during the global lockdown period of the COVID-19 pandemic, found that music was particularly effective for relieving stress from social isolation. In this study, the participants had to fill out a questionnaire with questions about their goals for wellbeing such as releasing their negative emotions, enjoyment, maintaining positive moods, decreasing loneliness etc. The questionnaire also asked which of the activities mentioned helped to reach each wellbeing goal from the previous questions. Some activities listed were information seeking via the media, mindfulness activities like meditation, socializing, physical activity, etc. All questions were answered with a number rating from 0 to 4, 0 meaning “irrelevant” and 4 being “highly relevant”. The results showed that music ranked the highest for enjoyment and maintaining a positive mood. Many people actively used music for mood regulation on their own without going to a music therapy session. If music can heal us emotionally when we listen to it on our own, why seek a music-based intervention such as music therapy?
Clinical Use of Music to Treat Medical Conditions
Sihvonen et al. (2017) discusses the various uses of music-based interventions. These interventions are not limited to stress and emotional management but to various neurological diseases in order to improve a patient’s cognitive and/or motor skills. An example of a neurological disease treated with a music-based intervention mentioned in this article was stroke. Some patients with a stroke develop a neurological condition called hemiparesis which is a partial paralysis. A method called rhythmic auditory stimulation is used where a rhythmic stimulus is played by the therapist. It is shown that on average, those with hemiparesis who received rhythmic auditory stimulation improved their motor skills faster in the course of 6 weeks compared to those who received a non-music form of therapy. This improvement was observable in the patient’s posture, stride, and balance.
A study conducted by Erkkilä et al. (2021) tested the effects of music therapy on anxiety and depression. In this study, patients of working-age with depression underwent music therapy and interacted with the therapist using two digital pianos and two djembe drums, one of each instrument for the patient and the therapist. I have included a video below of how a music therapy session with djembe drums may look like, although it is not a video of the Erkkilä et al. (2021) study.
The task was to improvise with these instruments. While engaging in the tasks, one group of patients’ breathing rate was controlled with a method of breathing called resonance frequency breathing, or RFB, which aims to lower heart rate by breathing in and out at a slower rate which can help alleviate symptoms of anxiety. In the other group, the sessions were recorded for the patients to listen to again at home as a way to improve the effects from therapy on the patients’ own time, which they called “listening homework”. This group did not receive RFB treatment and only interacted with the instruments with the therapist. Those who received music therapy with the RFB had a higher response rate to the musical patterns demonstrated by the therapist than those who only had listening homework. Music with a combination of breathing techniques aiming to relieve the symptoms of anxiety is more effective than passively listening to the music at home.
It seems that music is a tool that can be used to enhance already existing methods for therapy for emotional relief. In the case of the first group, it was a music intervention paired with RFB. The second group resembled more of a receptive, music medicine-like method as the patients were listening to pre-recorded music as opposed to interacting with music when they had to do the listening homework. An active music therapy can be more effective than a receptive method and that those with severe symptoms of depression and anxiety may benefit from music therapy as opposed to self-prescribing themselves with their own form of music medicine.
So… Music Therapy? Music Medicine? Or Another Intervention? Which One is the best?
It seems that music works in mood regulation whether it be at home or in a clinical setting. I had not considered receiving music therapy, but I would like to attend at least one session to experience the effects from it myself. I will continue to treat myself with the music that makes me happy, but perhaps in combination with music therapy, I can relieve my stress more effectively with the help of a professional.
If you are wondering if you would benefit from receiving a music-based intervention, it would be important to consider your goals of wellbeing. If you find the effects of music to be fulfilling when you decide to control how you interact with it, you may not need to consider going further with professional treatment. Another thing to consider can be whether or not you may have a symptom of a neurological disorder that can be treated with many kinds of treatment methods. Music may be one of those methods that may work for you. Also, if you are already seeking professional help for emotional support, music might be something you could incorporate to feel more therapeutic. You may even want to seek a licensed music therapist for a change.
One thing to keep in mind is if you are not really into music, or never thought of music being helpful for your wellbeing goals, it may be better to find another activity that works for you in terms of how healing it feels to you. There are other forms of expressive therapies like art and drama therapy. If you love music, then music-based interventions may be right for you. Ask your doctor, therapist, or any other healthcare provider whether music therapy, medicine, or other method may be right for you!
References
Erkkilä, J., Brabant, O., Hartmann, M., Mavrolampados, A., Ala-Ruona, E., Snape, N.,Saarikallio, S., & Gold, C. (2021). Music therapy for depression enhanced with listening homework and slow paced breathing: A randomised controlled trial. Frontiers in Psychology, 12. https://doi.org/10.3389/fpsyg.2021.613821
Granot, R., Spitz, D. H., Cherki, B. R., Loui, P., Timmers, R., Schaefer, R. S., Vuoskoski, J. K., Cárdenas-Soler, R.-N., Soares-Quadros, J. F., Li, S., Lega, C., La Rocca, S., Martínez, I. C., Tanco, M., Marchiano, M., Martínez-Castilla, P., Pérez-Acosta, G., Martínez-Ezquerro, J. D., Gutiérrez-Blasco, I. M., … Israel, S. (2021). “help! I need somebody”: Music as a global resource for obtaining wellbeing goals in times of crisis. Frontiers in Psychology, 12. https://doi.org/10.3389/fpsyg.2021.648013
Hollimon, N. (n.d.). What is expressive therapy? WebMD. Retrieved May 13, 2022, from https://www.webmd.com/mental-health/expressive-therapy
Sihvonen, A. J., Särkämö, T., Leo, V., Tervaniemi, M., Altenmüller, E., & Soinila, S. (2017). Music-based interventions in neurological rehabilitation. The Lancet Neurology, 16(8), 648–660. https://doi.org/10.1016/s1474-4422(17)30168-0
Tang Q., Huang Z., Zhou H., Ye P. (2020). Effects of music therapy on depression: A meta-analysis of randomized controlled trials. PLoS ONE 15(11): e0240862. https://doi.org/10.1371/journal.pone.0240862
