Music therapy

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Music therapy
Louis Gallait - Power of Music - Walters 37134.jpg
Power of Music by Louis Gallait. A brother and sister resting before an old tomb. The brother is attempting to comfort his sibling by playing the violin, and she has fallen into a deep sleep, "oblivious of all grief, mental and physical".

Music therapy is the use of music to improve clients' quality of life . Music therapy is an evidence-based, clinical use of music interventions. Music Therapy consists of a process in which a music therapist uses music and all of its facets—physical, emotional, mental, social, aesthetic, and spiritual—to help clients improve their health and quality of life. Music therapists primarily help clients improve their health in several domains, such as cognitive, motor, emotional, communication, social, and educational by using both active and receptive music experiences such as improvisation, re-creation, composition, and receptive methods and discussion of music to achieve treatment goals. There is a wide qualitative and quantitative research literature base for music therapy.

Some commonly found practices include developmental work (communication, motor skills, etc.) with individuals with special needs, songwriting and listening in reminiscence/orientation work with the elderly, processing and relaxation work, and rhythmic entrainment for physical rehabilitation in stroke victims. Music therapy is also used in some medical hospitals, cancer centers, schools, alcohol and drug recovery programs, psychiatric hospitals, and correctional facilities [1]

As a former rocker-turned-neuroscientist Daniel J. Levitin is well qualified to explore the connection between music and the human brain. Levitin uses the latest research and his own knowledge to develop an argument that states our brain is affected when we listen to music. Levitin presents that music is fundamental to our species, possibly even more so than language. The author may be bias due to his former career in the music business but he now has a PhD. in cognitive psychology and is a neuroscientist. His book focuses on the wide range of music characteristic’s like melody, harmony and rhythm and how the cognitive processes are affected by them. According to Levitin, “Music may be the activity that prepared our pre-human ancestors for speech communication and for the very cognitive, representational flexibility necessary to become humans. Singing and instrumental activities might have helped our species to refine motor skills, paving the way for the development of the exquisitely fine muscle control required for vocal or signed speech” [2]

Chuang’s Music therapy is a some kind of music therapy combining Chinese and Western‘s music therapy. It cites the attack of Chinese medicine, venting therapy, and the application of psychotherapy. From the basis of the balance between yin and yang, using the resonance principle of music to introduce nerve guidance, let the body and mind well balance, is to enter Medical aids are effective in the application of body and mind areas in hospitals.

Music has been found to be an effective tool for music therapists through extensive research. It is beneficial for any individual, both physically and mentally, through improved heart rate, reduced anxiety, stimulation of the brain, and improved learning. Music therapists use their techniques to help their patients in many areas, ranging from stress relief before and after surgeries, to neuropathologies such as Alzheimer's disease. One study found that children who listened to music while having an IV inserted into their arms showed less distress and felt less pain than the children who did not listen to music while having an IV inserted.[3] Studies have been carried out on patients diagnosed different mental disorders such as anxiety, depression and schizophrenia and there has been a visible improvement in their mental health after the therapy.[4]

Approaches used in music therapy that have emerged from the field of music education include Orff-Schulwerk (Orff), Dalcroze eurhythmics, and Kodály method. Models that developed directly out of music therapy are neurologic music therapy (NMT), Nordoff-Robbins music therapy and the Bonny method of guided imagery and music.[5]:460–468

Music therapists may work with individuals who have behavioral-emotional disorders.[2][6][unreliable medical source?] To meet the needs of this population, music therapists have taken current psychological theories and used them as a basis for different types of music therapy. Different models include behavioral therapy, cognitive behavioral therapy, and psychodynamic therapy.[5]:469–473 The therapist has an ongoing responsibility to evaluate the extent to which the client is achieving the goals of therapy and whether the methods of therapy being used are helping or hindering the client.[7]

One therapy model based on neuroscience, called "neurologic music therapy" (NMT), is "based on a neuroscience model of music perception and production, and the influence of music on functional changes in non-musical brain and behavior functions".[5]:475 In other words, NMT studies how the brain is without music, how the brain is with music, measures the differences, and uses these differences to cause changes in the brain through music that will eventually affect the client non-musically. As Michael Thaut put it: "The brain that engages in music is changed by engaging in music."[5]:475 NMT trains motor responses (i.e. tapping foot or fingers, head movement, etc.) to better help clients develop motor skills that help "entrain the timing of muscle activation patterns".[8]

The two fundamental types of music therapy[edit]

There are two fundamental types of music therapy: 'receptive music therapy', and 'active music therapy', which is sometimes called 'expressive music therapy'. Active music therapy engages clients or patients in the act of making vocal or instrumental music. Receptive music therapy guides patients or clients in listening to live or recorded music.[9]


Receptive music therapy involves listening to recorded or live music selected by a therapist.[10] It can improve mood, decrease stress, pain, anxiety level, and enhance relaxation. While it doesn't affect disease, for instance, it can help with coping skills.[11]


Recipients engage in some form of music-making, whether it's singing or with instruments. Baylor, Scott, and White researchers are studying the effect of harmonica playing on patients with COPD in order to determine if they help improve lung function.[12] In a nursing home in Japan, elderly are taught to play easy-to-use instruments in order to help overcome physical difficulties.[13]



Paul Nordoff, a Juilliard School graduate and Professor of Music, was a pianist and composer who, upon seeing disabled children respond so positively to music, gave up his academic career to further investigate the possibility of music as a means for therapy. Clive Robbins, a special educator, partnered with Nordoff for over 17 years in the exploration and research of music’s effects on disabled children—first in the United Kingdom, and then in the USA in the 1950s and 60s. Their pilot projects included placements at care units for autistic children and child psychiatry departments, where they put programs in place for children with mental disorders, emotional disturbances, developmental delays, and other handicaps. Their success at establishing a means of communication and relationship with children with cognitive impairments at the University of Pennsylvania gave rise to the National Institutes of Health's first grant given of this nature, and the 5-year study "Music therapy project for psychotic children under seven at the day care unit" involved research, publication, training and treatment.[14][page needed] Several publications, including Therapy in Music for Handicapped Children, Creative Music Therapy, Music Therapy in Special Education, as well as instrumental and song books for children, were released during this time. Nordoff and Robbins's success became known globally in the mental health community, and they were invited to share their findings and offer training on an international tour that lasted several years. Funds were granted to support the founding of the Nordoff Robbins Music Therapy Centre[15] in Great Britain in 1974, where a one-year graduate program for students was implemented. In the early eighties, a center was opened in Australia, and various programs and institutes for music therapy were founded in Germany and other countries. In the United States, the Nordoff-Robbins Center for Music Therapy was established at New York University in 1989.[citation needed]

The Nordoff-Robbins approach, based on the belief that everyone is capable of finding meaning in and benefitting from musical experience, is now practiced by hundreds of therapists internationally. It focuses on treatment through the creation of music by both therapist and client together. Various techniques are used to accommodate all capabilities so that even the most low functioning individuals are able to participate actively.[16]


Developed by Gertrude Orff at the Kindezentrum München, is another approach known as Orff Music Therapy. Both the clinical setting of social pediatrics as well as the Orff Schulwerk (schoolwork) approach in music education (developed by German composer Carl Orff) influence this method, which is used with children with developmental problems, delays and disabilities.[17] The area of social pediatrics was developed after the Second World War in Germany by Theodor Hellbrügge, who understood that medicine alone could not meet the complex needs of developmentally disabled children. He consulted psychologists, occupational therapists and other mental healthcare professionals whose knowledge and skills could aid in the diagnostics and treatment of children. Gertrude Orff was asked to develop a form of therapy based on the Orff Schulwerk approach to support the emotional development of patients. Elements found in both the music therapy and education approaches include the understanding of holistic music presentation as involving word, sound and movement; the use of both music and play improvisation as providing a creative stimulus for the child to investigate and explore; Orff instrumentation, including keyboard instruments and percussion instruments as a means of participation and interaction in a therapeutic setting; and lastly, the multisensory aspects of music used by the therapist to meet the particular needs of the child, such as both feeling and hearing sound.[17]

Corresponding with the attitudes of humanistic psychology, the developmental potential of the child- as in the acknowledgement of their strengths as well as their handicaps, and the importance of the therapist- child relationship are central factors in Orff music therapy. Theoretical foundations are also influenced by the strong emphasis on social integration and the involvement of parents in the therapeutic process found in social paediatrics. Knowledge of developmental psychology puts into perspective how developmental disabilities influence the child, as do their social and familial environments. The basis for interaction in this method is known as responsive interaction, in which the therapist meets the child at their level and responds according to their initiatives, combining both humanistic and developmental psychology philosophies. Involving the parents in this type of interaction, by having them participate directly or observe the therapist's techniques, equips the parents with ideas of how to interact appropriately with their child, thus fostering a positive parent-child relationship.[17]

Bonny method of guided imagery in music[edit]

Further information: Guided imagery

Music educator and therapist Helen Lindquist Bonny (1921 – May 25, 2010) developed an approach influenced by humanistic and transpersonal psychological views, known as the Bonny method of guided imagery in music (GIM). Guided imagery refers to a technique used in natural and alternative medicine that involves using mental imagery to help with the physiological and psychological ailments of patients.[18] The practitioner often suggests a relaxing and focusing image and through the use of imagination and discussion, aims to find constructive solutions to manage their problems. Bonny applied this psychotherapeutic method to the field of music therapy by using music as the means of guiding the patient to a higher state of consciousness where healing and constructive self- awareness can take place. Music is considered a "co-therapist" because of its importance. GIM with children can be used in one-on-one or group settings, and involves relaxation techniques, identification and sharing of personal feeling states, and improvisation to discover the self, and foster growth. The choice of music is carefully selected for the client based on their musical preferences and the goals of the session. Usually a classical piece, it must reflect the age and attentional abilities of the child in length and genre, and a full explanation of the exercises must be offered at their level of understanding.[18]

The use of guided imagery with autistic children has been found to decrease stereotypical behaviors and hyperactivity, increase attention and the ability to follow instructions, as well as increase self-initiated communication, both verbal and non-verbal.[19][page needed]

Characteristics of Music for Receptive Music Therapy[edit]

Bonny (Bonny Method of Guided Imagery and Music) writes a lot about the different features of music types in the classical genre.[20]

Classical music can be multi-layered; melodic line, harmony structure and base line. All of these aspects work together with other things to create different layers of musical sound. Classical music is written in different forms: ternary form, sonata form, theme and variations, prelude and tone poem.

Ternary form[edit]

It is associated Baroque era. It is for therapy work; it forms a stable and safe musical container, where the repetition of the open section that is recognizable before the period of change.

Sonata Form[edit]

It is associated with the Classical and Romantic era. It is composed of three parts: introduction, exposition, development and recapitulation (which may be in code).

Theme and variations[edit]

It uses different eras of music composition. The melody may be played by different instruments; played in different register (high, medium, low). It might become elongated by making each note twice is original length or shortened by making each note half the length.


It is a short piece for an orchestra that is already completed. The most receptive music therapy is Debussy's Prelude to the Afternoon of a Faun, also Ravel's Pavane for a Dead Princess.

Tone poem[edit]

This one is also from Romantic Era and also in the 20th century. Ein Heldenleben (A Hero's Life) and Enchanted Lake are great examples of this.

New Age Music[edit]

New Age Music is the type of music that allows relaxation while drawing images like landscapes enhanced by computer generated sounds. Kobialka is a type of new age music that produces large volume music that has violins playing over the background of synthesizes sounds. It's often very relaxing because the quality is seamless.

Celtic Music[edit]

This is average in character, and sometimes there are vocal selection involved in Celtic music, adding to the appeal of the song choice. An example would be the Watermark by Enya. 12 minutes maybe be able to cause deep relaxation.

Meditative Music[edit]

Meditative music has a diverse range of styles and instrumentation. Most of them have single-line melody of a wooden or pan-flute.

Trance Music[edit]

Trance Music is the type of music that many musical therapists who work with adolescent-aged clients. Trance is a style of electronic dance music that was created in 1990s, and it has a tempo of 130 and 160 bpm. Trance music enhances a feeling of calmness despite the rapid pace.

Jazz Music[edit]

Jazz Music came out in the early part of the twentieth century, and is generally known as the music of black Americans. The blues is a slow kind of jazz music that is used gentle relaxation. Jazz music is a sedative in receptive music therapy methods. Examples would be I Got Rhythm by Louie Armstrong or In a Mellotone by Duke Ellington.

Approaches used with adolescents[edit]

Music therapy may be used with adolescent populations to treat disorders usually diagnosed in adolescence, such as mood/anxiety disorders and eating disorders, or inappropriate behaviors, including suicide attempts, withdrawal from family, social isolation from peers, aggression, running away, and substance abuse.[21][22] Goals in treating adolescents with music therapy, especially for those at high risk, often include: increased recognition and awareness of emotions and moods, improved decision-making skills, opportunities for creative self expression, decreased anxiety, increased self-confidence, improved self-esteem, and better listening skills.[23]


Two main methods for music therapy in this age group are group meetings and individual sessions. Both methods may include listening to music, discussions concerning moods and emotions in or toward music, analyzing the meanings of specific songs, writing lyrics, composing music, performing music, and musical improvisation.[22]

Private individual sessions can provide personal attention and are most effective when the music used is preferred by the patient. Using music that an adolescent can relate to or connect with can be successful in helping adolescent patients view the therapist as a safe and trustworthy adult, and to engage in the therapeutic process with less resistance.[22] Music therapy conducted in groups affords opportunities for an adolescent individual to feel a sense of belonging, to express their opinions, learn how to socialize and verbalize appropriately with peers, improve compromising skills, and develop tolerance and empathy.[21] Group sessions emphasize cooperation and cohesion, and can be quite effective in working with adolescents.[24]

In one way or another, music plays a big part in a human’s life. From the time we are babies our mothers sing us lullabies to calm us;[25] sometimes while a baby is still in the womb a mother will expose a fetus to music. “Inside the womb, surrounded by amniotic fluid, the fetus hears sounds. It hears the heartbeat of its mother, at times speeding up, at other times slowing down. And the fetus hears music, as was recently discovered by Alexandra Lamont of Keele University in the UK. She found that, a year after they are born, children recognize and prefer music they were exposed to in the womb”[26]


Assessment includes obtaining a full medical history, musical (ability to duplicate a melody or identify changes in rhythm, etc.) and nonmusical functioning (social, physical/motor, emotional, etc.).[27][28]

In infants born prematurely[edit]

Premature infants are those born at 37 weeks or less gestational stage. They are subject to numerous health risks, such as abnormal breathing patterns, decreased body fat and muscle tissue, as well as feeding issues. The coordination for sucking and breathing is often not fully developed, making feeding a challenge. The improved developmental activity and behavioural status of premature infants when they are discharged from the NICU, is directly related to the stimulation programs and interventions they benefited from during hospitalization, such as music therapy.

Music is typically conducted by a musical therapist in the neonatal intensive care unit (NICU), with five main techniques designed to benefit premature infants:[29][page needed]

  1. Live or recorded music: Live or recorded music has been effective in promoting respiratory regularity and oxygen saturation levels, as well as decreasing signs of neonatal distress. Since premature infants have sensitive and immature sensory modalities, music is often performed in a gentle and controlled environment, either in the form of audio recordings or live vocalization, although live singing has been shown to have a greater effect. Live music also reduces the physiological responses in parents. Studies have shown that by combining live music, such as harp music, with the Kangaroo Care, maternal anxiety is reduced. This allows for parents, especially mothers, to spend important time bonding with their premature infants. Female singing voices are also more effective at soothing premature infants. Despite being born premature, infants show a preference for the sound of a female singing voice, making it more beneficial than instrumental music.[30]
  2. Promotion of healthy sucking reflex: By using a pacifier-activated lullaby device, music therapists can help promote stronger sucking reflexes, while also reducing pain perception for the infant. The Gato Box is a small rectangular instrument that stimulates a prenatal heartbeat sound in a soft and rhythmic manner that has also been effective in aiding sucking behaviours.[31][unreliable medical source?] The music therapist uses their fingers to tap on the drum, rather than using a mallet. The rhythm supports movement when feeding and promotes healthy sucking patterns. By improving sucking patterns, babies are able to coordinate the important dual mechanisms of breathing, sucking and swallowing needed to feed, thus promoting growth and weight gain. When this treatment proves effective, infants are able to leave the hospital earlier.
  3. Multimodal stimulation and music: By combining music, such as lullabies, and multimodal stimulation, premature infants were discharged from the NICU sooner, than those infants who did not receive therapy. Multimodal stimulation (MMS) includes the applications of auditory, tactile, vestibular, and visual stimulation that helps aid in premature infant development. The combination of music and MMS helps premature infants sleep and conserve vital energy required to gain weight more rapidly. Studies have shown that girls respond more positively than boys during multimodal stimulation.[32] While the voice is a popular choice for parents looking to bond with their premature infants, other effective instruments include the Remo Ocean Disk and the Gato Box. Both are used to stimulate the sounds of the womb. The Remo Ocean Disk, a round musical instrument that mimics the fluid sounds of the womb, has been shown to benefit decreased heart rate after therapeutic uses, as well as promoting healthy sleep patterns, lower respiratory rates and improve sucking behavior.[33][unreliable medical source?]
  4. Infant stimulation: This type of intervention uses musical stimulation to compensate for the lack of normal environmental sensory stimulation found in the NICU. The sound environment the NICU provides can be disruptive; however, music therapy can mask unwanted auditory stimuli and promote a calm environment that reduces the complications for high-risk or failure-to-thrive infants. Parent-infant bonding can also be affected by the noise of the NICU, which in turn can delay the interactions between parents and their premature infants. But music therapy creates a relaxed and peaceful environment for parents to speak and spend time with their babies while incubated.[34]
  5. Parent-infant bonding: Therapists work with parents so they may perform infant-directed singing techniques, as well as home care. Singing lullabies therapeutically can promote relaxation and decrease heart rate in premature infants. By calming premature babies, it allows for them to preserve their energy, which creates a stable environment for growth. Lullabies, such as "Twinkle Twinkle Little Star" or other culturally relevant lullabies, have been shown to greatly soothe babies. These techniques can also improve overall sleep quality, caloric intake and feeding behaviours, which aid in development of the baby while they are still in the NICU. Singing has also shown greater results in improving oxygen saturation levels for infants while incubated than has mothers' speech alone. This technique promoted high levels of oxygen for longer periods of time.[35]

In children[edit]

Music therapy has multiple benefits which contribute to the maintenance of health and the drive toward rehabilitation for children. Advanced technology that can monitor cortical activity offers a look at how music engages and produces changes in the brain during the perception and production of musical stimuli. Music therapy, when used with other rehabilitation methods, has increased the success rate of sensorimotor, cognitive, and communicative rehabilitation.[36] Music therapy intervention programs can include an average of 18 sessions of treatment. The achievement of a physical rehabilitation goal relies on the child's existing motivation and feelings towards music and their commitment to engage in meaningful, rewarding efforts. Regaining full functioning also confides in the prognosis of recovery, the condition of the client, and the environmental resources available. Both techniques use systematic processes where the therapists assist the client by using musical experiences and connections that collaborate as a dynamic force of change toward rehabilitation.[37]

Music has many calming and soothing properties that can be used as a sedative in rehabilitation. For example, a patient with chronic pain may decrease the physiological result of stress and draw attention away from the pain by focusing on music.[38][self-published source?]

Music therapy used in child rehabilitation has had a substantial emphasis on sensorimotor development including; balance and position, locomotion, agility, mobility, range of motion, strength, laterality and directionality.[38][self-published source?] Music motivate and can be an element of distraction.[37] Rhythmic stimuli has been found to help balance training for those with a brain injury.[37]

Singing is a form of rehabilitation for neurological impairments. Neurological impairments following a brain injury can be in the form of apraxia – loss to perform purposeful movements, dysarthria, muscle control disturbances (due to damage of the central nervous system), aphasia (defect in expression causing distorted speech), or language comprehension. Singing training has been found to improve lung, speech clarity, and coordination of speech muscles, thus, accelerating rehabilitation of such neurological impairments. For example, melodic intonation therapy is the practice of communicating with others by singing to enhance speech or increase speech production by promoting socialization, and emotional expression.[37]

Music therapy is thought to be helpful with children with autism spectrum by providing repetitive stimuli which aim to "teach" the brain other possible ways to respond that might be more useful as they grow older.[39][self-published source?]

Older adults[edit]

Medical disorders[edit]

Heart disease[edit]

According to a 2013 Cochrane review, listening to music may improve heart rate, respiratory rate, and blood pressure in those with coronary heart disease (CHD).[40]


Music has proven useful in the recovery of motor skills.[41]


Alzheimer's disease and other types of dementia are among the disorders most commonly treated with music therapy. Like many of the other disorders mentioned, some of the most common significant effects are seen in social behaviors, leading to improvements in interaction, conversation, and other such skills. A meta-study of over 330 subjects showed music therapy produces highly significant improvements to social behaviors, overt behaviors like wandering and restlessness, reductions in agitated behaviors, and improvements to cognitive defects, measured with reality orientation and face recognition tests.[42] As with many studies of MT's effectiveness, these positive effects on Alzheimer's and other dementias are not homogeneous among all studies. The effectiveness of the treatment seems to be strongly dependent on the patient, the quality and length of treatment, and other similar factors.[43]

Another meta-study examined the proposed neurological mechanisms behind music therapy's effects on these patients. Many authors suspect that music has a soothing effect on the patient by affecting how noise is perceived: music renders noise familiar, or buffers the patient from overwhelming or extraneous noise in their environment. Others suggest that music serves as a sort of mediator for social interactions, providing a vessel through which to interact with others without requiring much cognitive load.[43]


Neurologist, Oliver Sacks, author of   Musicophilia: Tales of music and the Brain, has studied neurological oddities in people, trying to understand how the brain works. What he has concluded is that people with some type of frontal lobe damage often “produced not only severe difficulties with expressive language (aphasia) but a strange access of musicality, with incessant whistling and singing and a passionate interest in music. For him, this was an example of normally suppressed brain functions being released by damage to others” [44](315). Sacks had a genuine interest in trying to help people affected with neurological disorders and other phenomena associated with music and how it can provide access to otherwise unreachable emotional states, revivify neurological avenues that have been frozen, evoke memories of earlier, lost events or states of being and attempts to bring those with neurological disorders back to a time when the world was much richer for them. He was a firm believer that music has the power to heal.

Melodic intonation therapy (MIT) is a method used by music therapists and speech-language pathologists to help people with communication disorders caused by damage to the left hemisphere of the brain by engaging the singing abilities and possibly engaging language-capable regions in the undamaged right hemisphere.[45][46]

Broca’s aphasia, or non-fluent aphasia, is a language disorder caused by damage to Broca’s area and surrounding regions in the left frontal lobe. [47] Those with non-fluent aphasia are able to understand language fairly well, but they struggle with language production and syntax. [48]

While unable to speak fluently, patients with non-fluent aphasia are often able to sing words, phrases, and even sentences they cannot express otherwise. [49] MIT harnesses the singing ability of patients with non-fluent aphasia as a means to improve their communication. Although its exact nature depends on the therapist, in general MIT relies on the use of intonation (the rising and falling of the voice) and rhythm (beat/speed) to train patients to produce phrases verbally. [46] In MIT, common words and phrases are turned into melodic phrases, generally starting with two step sing-song patterns and eventually emulating typical speech intonation and rhythmic patterns.[45] A therapist will usually begin by introducing an intonation to their patient through humming. [46] They will accompany this humming with a rhythm produced by the tapping of the left hand. [46] At the same time, the therapist will introduce a visual stimuli of the written phrase to be learned. [46] The therapist then sings the phrase with the patient, and ideally the patient is eventually able to sing the phrase on their own. [46] With much repetition and through a process of “inner-rehearsal” (practicing internally hearing one’s voice singing), a patient may eventually be able to produce the phrase verbally without singing. [46] As the patient advances in therapy, the procedure can be adapted to give them more autonomy and to teach them more complex phrases. [46] Through the use of MIT, a non-fluent aphasic patient can be taught numerous phrases which aid them to communicate and function during daily life.

The mechanisms of this success are yet to be fully understood. It is commonly agreed that while speech is lateralized mostly to the left hemisphere (for right-handed and most left-handed individuals), some speech functionality is also distributed in the right hemisphere. [50] MIT is thought to stimulate these right language areas through the activation of music processing areas also in the right hemisphere [51] Similarly, the rhythmic tapping of the left hand stimulates the right sensorimotor cortex in order to further engage the right hemisphere in language production. [52] Overall, by stimulating the right hemisphere during language tasks, therapists hope to decrease dependence on the left hemisphere for language production.[46]

While results are somewhat contradictory, studies have in fact found increased right hemispheric activation in non-fluent aphasic patients after MIT.[53] This change in activation has been interpreted as evidence of decreased dependence on the left hemisphere.[54] There is debate, however, if changes in right hemispheric activation are part of the therapeutic process during/after MIT, or are simply a side effect of non-fluent aphasia.[55] In hopes of making MIT more effective, researchers are continually studying the mechanisms of MIT and non-fluent aphasia.

Neurological researchers Sparks, Helm, and Albert developed MIT in 1973.[45][56]

Psychiatric disorders[edit]

A 2016 meta-analysis-analysis on the use of music therapy in the treatment of schizophrenia found that the treatment effect was significantly better in the patients who received adjunct music therapy than in those who did not, in negative symptoms, mood symptoms, and also positive symptoms.[57]

A 2017 Cochrane review found that moderate- to low-quality evidence suggests that music therapy as an addition to standard care improves the global state, mental state (including negative and general symptoms), social functioning, and quality of life of people with schizophrenia or schizophrenia-like disorders. However, effects were inconsistent across studies and depended on the number of music therapy sessions as well as the quality of the music therapy provided.[58]

A 2017 review of studies of music therapy for children and adolescents with major depressive or anxiety disorders found that music-based interventions may be efficient in reducing the severity of internalizing symptoms in children and adolescents.[59] There is moderate-quality evidence that music therapy added to treatment as usual is more effective than treatment as usual alone in people with depression.[60]

Michael J. Silverton (Ph.D., MT-BC, and Full Professor) is the Director of the Music Therapy Program and a Professor at the University of Minnesota. Silverman is published extensively in peer-reviewed journals and is the author of scholarly texts as well. He works in musical therapy, special education rehabilitation and research. The purpose of this work is to discuss the need for additional research in the field of controlled psychiatric music therapy. This paper discusses cognitive behavioral therapy and the analytical dynamics of music and the psychotherapy field. The paper was written for those in the mental health field. It may be too scientific to be used for this topic but there could be some information pertinent to the layman. The article refers to data sheets and tables. The paper is written from research data and fact based scientific research data. [61]

A 2017 theoretical review on the use of music therapy in post-traumatic stress disorder suggests that music therapy may be a useful therapeutic tool to reduce symptoms and improve functioning among individuals with trauma exposure and PTSD, though more rigorous empirical study is required.[62]

Brain Injuries[edit]

Susan Gaidos is a science, news journalist and correspondent with degrees in journalism and biology. Gaidos has received awards in medicine and science writing from the Council for Advancement and Support of Education and writes scientific articles for several publications. Topics she writes about range from nanotechnology to brain biology. This article discusses stimulation of the brain by music and the possibility of using music as a therapeutic treatment for emotional disorders and brain injuries. This article is intended for people involved in the neuroscience or scientific research community. The article is a good match for my topic which is how music affects the brain. The article is written using fact based information and seems to be written from an impartial, unbiased point of view as well as the authors own personal experience with music. Gaidos quotes musicians as well as physicians in this article.[63]

Cultural Aspects[edit]

Music has been looked upon for centuries as an accompaniment to rituals and cultural traditions. Michael B Bakan, author of the book World Music: Traditions and Transformations states that “Music is a mode of cultural production and can reveal much about how the culture works” [64] Music and cultures are evolving over time and people are becoming more accepting of each other and each other’s cultures and customs. Just recently Mariah Carey was the first woman to perform on stage in Saudi Arabia and her hair was not covered. She performed despite activists (Saudi women) calling for the cancellation of the show. [65]Carey showed respect by wearing a more sedate and demure costume than she usually wears when performing. The Saudi women have started driving and Mariah Carey was allowed to perform in front of a huge crowd, where at one time a woman would have been killed for doing what just comes naturally to her. This change of attitude on the part of the Saudis proves that music must in some way affect the brain and the emotions or Mariah Carey would never have been allowed to do what she did. In this case, hopefully, it is building a bridge between our nations that promotes peace.

Usage by region[edit]


In 1999, the first program for music therapy in Africa opened in Pretoria, South Africa. Research has shown that in Tanzania patients can receive palliative care for life-threatening illnesses directly after the diagnosis of these illnesses. This is different from many Western countries, because they reserve palliative care for patients who have an incurable illness. Music is also viewed differently between Africa and Western countries. In Western countries and a majority of other countries throughout the world, music is traditionally seen as entertainment whereas in many African cultures, music is used in recounting stories, celebrating life events, or sending messages.[66][page needed]


One of the first groups known to heal with sound were the aboriginal people of Australia. The modern name of their healing tool is the didgeridoo, but it was originally called the yidaki. The yidaki produced sounds that are similar to the sound healing techniques used in modern day. For at least 40,000 years, the healing tool was believed to assist in healing "broken bones, muscle tears and illnesses of every kind".[67] However, here are no reliable sources stating the didgeridoo's exact age. Archaeological studies of rock art in Northern Australia suggest that the people of the Kakadu region of the Northern Territory have been using the didgeridoo for less than 1,000 years, based on the dating of paintings on cave walls and shelters from this period. A clear rock painting in Ginga Wardelirrhmeng, on the northern edge of the Arnhem Land plateau, from the freshwater period[68] (that had begun 1500 years ago)[69] shows a didgeridoo player and two songmen participating in an Ubarr Ceremony.[70] Australia in 1949, music therapy (not clinical music therapy as understood today) was started through concerts organized by the Australian Red Cross along with a Red Cross Music Therapy Committee. The key Australian body, the Australian Music Therapy Association (AMTA), was founded in 1975.


In 1956, Fran Herman, one of Canada's music therapy pioneers, began a 'remedial music' program at the Home For Incurable Children, now known as the Holland Bloorview Kids Rehabilitation Hospital, in Toronto. Her group 'The Wheelchair Players' continued until 1964, and is considered to be the first music therapy group project in Canada.[71] Its production "The Emperor's Nightingale" was the subject of a documentary film.

Composer/pianist Alfred Rosé, a professor at the University of Western Ontario, also pioneered the use of music therapy in London, Ontario at Westminster Hospital in 1952 and at the London Psychiatric Hospital in 1956.[72]

Two other music therapy programs were initiated during the 1950s; one by Norma Sharpe at St. Thomas Psychiatric Hospital in St. Thomas, Ontario, and the other by Thérèse Pageau at the Hôpital St-Jean-de-Dieu (now Hôpital Louis-Hippolyte Lafontaine) in Montreal.

A conference in August 1974, organized by Norma Sharpe and six other music therapists, led to the founding of the Canadian Music Therapy Association, which was later renamed the Canadian Association for Music Therapy (CAMT).[73] As of 2009, the organization had over 500 members.

Canada's first music therapy training program was founded in 1976, at Capilano College (now Capilano University) in North Vancouver, by Nancy McMaster and Carolyn Kenny.[74]


Norway is widely[peacock term] recognised as an important country for music therapy research. Its two major research centres are the Center for Music and Health[75] with the Norwegian Academy of Music in Oslo, and the Grieg Academy Centre for Music Therapy (GAMUT),[76] at University of Bergen. The former was mostly developed by professor Even Ruud, while professor Brynjulf Stige is largely responsible for cultivating the latter. The centre in Bergen has 18 staff, including 2 professors and 4 associate professors, as well as lecturers and PhD students. Two of the field's major international research journals are based in Bergen: Nordic Journal for Music Therapy[77] and Voices: A World Forum for Music Therapy.[78] Norway's main contribution to the field is mostly in the area of "community music therapy", which tends to be as much oriented toward social work as individual psychotherapy, and music therapy research from this country uses a wide variety of methods to examine diverse methods across an array of social contexts, including community centres, medical clinics, retirement homes, and prisons.

United States[edit]

Music therapy has existed in its current form in the United States since 1944 when the first undergraduate degree program in the world was begun at Michigan State University and the first graduate degree program was established at the University of Kansas. The American Music Therapy Association (AMTA) was founded in 1998 as a merger between the National Association for Music Therapy (NAMT, founded in 1950) and the American Association for Music Therapy (AAMT, founded in 1971). Numerous other national organizations exist, such as the Institute for Music and Neurologic Function, Nordoff-Robbins Center For Music Therapy, and the Association for Music and Imagery. Music therapists use ideas from different disciplines such as speech and language, physical therapy, medicine, nursing, and education.

A music therapy degree candidate can earn an undergraduate, master's or doctoral degree in music therapy. Many AMTA approved programs offer equivalency and certificate degrees in music therapy for students that have completed a degree in a related field. Some practicing music therapists have held PhDs in fields other than, but usually related to, music therapy. Recently, Temple University established a PhD program in music therapy. A music therapist typically incorporates music therapy techniques with broader clinical practices such as psychotherapy, rehabilitation, and other practices depending on client needs. Music therapy services rendered within the context of a social service, educational, or health care agency are often reimbursable by insurance and sources of funding for individuals with certain needs. Music therapy services have been identified as reimbursable under Medicaid, Medicare, private insurance plans and federal and state government programs.

A degree in music therapy requires proficiency in guitar, piano, voice, music theory, music history, reading music, improvisation, as well as varying levels of skill in assessment, documentation, and other counseling and health care skills depending on the focus of the particular university's program. A music therapist may hold the designations CMT (Certified Music Therapist), ACMT (Advanced Certified Music Therapist), or RMT (Registered Music Therapist) – credentials previously conferred by the former national organizations AAMT and NAMT ; these credentials remain in force through 2020 and have not been available since 1998. The current credential available is MT-BC. To become board certified, a music therapist must complete a music therapy degree from an accredited AMTA program at a college or university, successfully complete a music therapy internship, and pass the Board Certification Examination in Music Therapy, administered through The Certification Board for Music Therapists. To maintain the credential, either 100 units of continuing education must be completed every five years, or the board exam must be retaken near the end of the five-year cycle. The units claimed for credit fall under the purview of the Certification Board for Music Therapists. North Dakota, Nevada and Georgia have established licenses for music therapists. In the State of New York, the License for Creative Arts Therapies (LCAT) incorporates the music therapy credentials within their licensure.


In 2006, Hamda Farhat introduced music therapy to Lebanon, developing and inventing therapeutic methods such as the triple method to treat hyperactivity, depression, anxiety, addiction, and post traumatic stress disorder. She has met with great success in working with many international organizations, and in the training of therapists, educators, and doctors.[citation needed]

United Kingdom[edit]

Live music was used in hospitals after both World Wars as part of the treatment program for recovering soldiers. Clinical music therapy in Britain as it is understood today was pioneered in the 1960s and 1970s by French cellist Juliette Alvin whose influence on the current generation of British music therapy lecturers remains strong. Mary Priestley, one of Juliette Alvin's students, created "analytical music therapy". The Nordoff-Robbins approach to music therapy developed from the work of Paul Nordoff and Clive Robbins in the 1950/60s.

Practitioners are registered with the Health Professions Council and, starting from 2007, new registrants must normally hold a master's degree in music therapy. There are master's level programs in music therapy in Manchester, Bristol, Cambridge, South Wales, Edinburgh and London, and there are therapists throughout the UK. The professional body in the UK is the British Association for Music Therapy[79] In 2002, the World Congress of Music Therapy, coordinated and promoted by the World Federation of Music Therapy, was held in Oxford on the theme of Dialogue and Debate.[80] In November 2006, Dr. Michael J. Crawford and his colleagues again found that music therapy helped the outcomes of schizophrenic patients.[81][82]


The roots of musical therapy in India, can be traced back to ancient Hindu mythology, Vedic texts, and local folk traditions.[83] It is very possible that music therapy has been used for hundreds of years in the Indian culture.

The "Indian Association of Music Therapy" was established in 2010 by Dr. Dinesh C. Sharma with a motto "to use pleasant sounds in a specific manner like drug in due course of time as green medicine"[84] He also publish a journal "International Journal of Music Therapy (ISSN 2249-8664) to popularize and promote music therapy research on international platform[85]

Suvarna Nalapat has studied music therapy in the Indian context. Her books Nadalayasindhu-Ragachikilsamrutam (2008), Music Therapy in Management Education and Administration (2008) and Ragachikitsa (2008) are accepted textbooks on music therapy and Indian arts.[86][87][88][89][90]

The "Music Therapy Trust of India" is yet another venture in the country. It was started by Margaret Lobo[91] She is the founder and director of the Otakar Kraus Music Trust and her work began in 2004.[92]


According to Evan Andrews, reporting for the History channel, ancient flutes, carved from ivory and bone, were found by archaeologist's, that were determined to be from as far back as 43,000 years ago. He also states that “The earliest fragment of musical notation is found on a 4,000-year-old Sumerian clay tablet, which includes instructions and tuning for a hymn honoring the ruler Lipit-Ishtar. But for the title of oldest extant song, most historians point to “Hurrian Hymn No. 6”[93] an ode to the goddess Nikkal that was composed in cuneiform by the ancient Hurrian’s sometime around the 14th century B.C.”. [94] These historic artifacts suggest that perhaps music did play a part in mankind’s advancement’s. The find, of the oldest known melody, Hurrian Hymn No. 6, proves that humans were composing music as far back as 3,400 years ago and leads me to believe that there was, more than likely, some form of music much farther in the past than we know. Scientific research shows that humans have been evolving over a period of millions of years.[95]

Music has been used as a healing implement for centuries.[96] Apollo is the ancient Greek god of music and of medicine. Aesculapius was said to cure diseases of the mind by using song and music, and music therapy was used in Egyptian temples. Plato said that music affected the emotions and could influence the character of an individual. Aristotle taught that music affects the soul and described music as a force that purified the emotions. Aulus Cornelius Celsus advocated the sound of cymbals and running water for the treatment of mental disorders. Music therapy was practiced in the Bible when David played the harp to rid King Saul of a bad spirit (1 Sam 16:23).[97][page needed] As early as 400 B.C., Hippocrates played music for mental patients. In the thirteenth century, Arab hospitals contained music-rooms for the benefit of the patients.[98] In the United States, Native American medicine men often employed chants and dances as a method of healing patients.[99] The Turco-Persian psychologist and music theorist al-Farabi (872–950), known as Alpharabius in Europe, dealt with music therapy in his treatise Meanings of the Intellect, in which he discussed the therapeutic effects of music on the soul.[100] In his De vita libri tres published in 1489, Platonist Marsilio Ficino gives a lengthy account of how music and songs can be used to draw celestial benefits for staying healthy.[101] Robert Burton wrote in the 17th century in his classic work, The Anatomy of Melancholy, that music and dance were critical in treating mental illness, especially melancholia.[102][103][104]

The rise of an understanding of the body and mind in terms of the nervous system led to the emergence of a new wave of music therapy in the eighteenth century. Earlier works on the subject, such as Athanasius Kircher's Musurgia universalis of 1650 and even early eighteenth-century books such as Michael Ernst Ettmüller's 1714 Disputatio effectus musicae in hominem (Disputation on the Effect of Music on Man) or Friedrich Erhardt Niedten's 1717 Veritophili, still tended to discuss the medical effects of music in terms of bringing the soul and body into harmony. But from the mid-eighteenth century works on the subject such as Richard Brocklesby's 1749 Reflections of Antient and Modern Musick, the 1737 Memoires of the French Academy of Sciences, or Ernst Anton Nicolai's 1745 Die Verbindung der Musik mit der Arzneygelahrheit (The Connection of Music to Medicine), stressed the power of music over the nerves.[105]

After 1800 books on music therapy often drew on the Brunonian system of medicine, arguing that the stimulation of the nerves caused by music could directly improve health. For example, Peter Lichtenthal's influential 1807 book Der musikalische Arzt (The Musical Doctor) was also explicitly Brunonian in its treatment of the effects of music on the body. Lichtenthal, a musician, composer and physician with links to the Mozart family, was mostly positive about music, talking of 'doses of music', which should be determined by someone who knows the "Brunonian scale".[106]

Music therapy as we know it began in the aftermath of World Wars I and II, when, particularly in the United Kingdom, musicians would travel to hospitals and play music for soldiers suffering from war-related emotional and physical trauma.[107]

Even as recent as 2017, music therapy has shown the ability to provide emotional relief to the members of our society. With Logic's "1-800-273-8255", suicide prevention calls experienced a 33% growth in relation to their number of calls received in the previous year.[108]


A music therapist from a "Blues in the Schools" program plays harmonica with a US Navy sailor at a Naval Therapy Center.


Music therapy finds its roots in the military. The United States Department of War issued Technical Bulletin 187 in 1945, which described the use of music in the recuperation of military service members in Army hospitals.[109] The use of music therapy in military settings started to flourish and develop following World War II and research and endorsements from both the United States Army and the Surgeon General of the United States. Although these endorsements helped music therapy develop, there was still a recognized need to assess the true viability and value of music as a medically-based therapy. Walter Reed Army Medical Center and the Office of the Surgeon General worked together to lead one of the earliest assessments of a music therapy program. The goal of the study was to understand whether “music presented according to a specific plan” influenced recovery among service members with mental and emotional disorders.[110] Eventually, case reports in reference to this study relayed not only the importance but also the impact of music therapy services in the recovery of military service personnel.

The first university sponsored music therapy course was taught by Margaret Anderton in 1919 at Columbia University.[111] Anderton's clinical specialty was working with wounded Canadian soldiers during World War II, using music-based services to aid in their recovery process.

Today, Operation Enduring Freedom and Operation Iraqi Freedom have both presented an array of injuries; however, the two signature injuries are Post-Traumatic Stress Disorder (PTSD) and Traumatic Brain Injury (TBI). These two signature injuries are increasingly common among millennial military service members and in music therapy programs.

A person diagnosed with PTSD can associate a memory or experience with a song they have heard. This can result in either good or bad experiences. If it's a bad experience, the song's rhythm or lyrics can bring out the person's anxiety or fear response. If it's a good experience, the song can bring feelings of happiness or peace which could bring back positive emotions. Either way, music can be used as a tool to bring emotions forward and help the person cope with them.


Music therapists work with active duty military personnel, veterans, service members in transition, and their families. Music therapists strive to engage clients in music experiences that foster trust and complete participation over the course of their treatment process. Music therapists use an array of music-centered tools, techniques, and activities when working with military-associated clients, many of which are similar to the techniques used in other music therapy settings. These methods include, but are not limited to: group drumming, listening, singing, and songwriting. Songwriting is a particularly effective tool with military veterans struggling with PTSD and TBI as it creates a safe space to, "... work through traumatic experiences, and transform traumatic memories into healthier associations".[112]


Music therapy in the military is seen in programs on military bases, VA healthcare facilities, military treatment facilities, and military communities. Music therapy programs have a large outreach because they exist for all phases of military life: pre-mobilization, deployment, post-deployment, recovery (in the case of injury), and among families of fallen military service personnel.[113]

Resounding Joy, Inc., a San Diego, California-based music therapy program, is a pioneer for the use of music therapy in the military. Its Semper Sound program specializes in providing music therapy services to active duty military service members and veterans diagnosed with PTSD, TBI, substance abuse, and other trauma-related diagnoses. It features different programs such as The Semper Sound Band, based in San Diego, California, and the GI Jams Band, based in Chelsea, Massachusetts.[114]

Walter Reed Army Medical Center located in Bethesda, Maryland, is another pioneer for the use of music therapy in the military. All patients at the medical center are eligible to receive music therapy services; therefore, the range of clients is wide: TBI, stroke, psychological diagnoses (anxiety, depression, PTSD), autism spectrum disorder, and more.[113]

The Exceptional Family Member Program (EFMP) also exists to provide music therapy services to active duty military families who have a family member with a developmental, physical, emotional, or intellectual disorder. Currently, programs at the Davis-Monthan Air Force Base, Resounding Joy, Inc., and the Music Institute of Chicago partner with EFMP services to provide music therapy services to eligible military family members.[113]

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“Music Therapy” Izabel Chuang Published Psychoco Ltd, company May,2004 ISBN:978-957-702-675-0

“Elders Groups Of music Therapy “ Izabel Chuang Aug.2016 ISBN:978-957-43-3890-0

Further reading[edit]

  • Aldridge, David, Music Therapy in Dementia Care, London: Jessica Kingsley Publishers, November 2000. ISBN 1-85302-776-6
  • Boso M, Politi P, Barale F, Enzo E (2006). "Neurophysiology and neurobiology of the musical experience". Functional Neurology. 21 (4): 187–91. PMID 17367577.
  • Boynton, Dori, compiler (1991). Lady Boynton's "New Age" Dossiers: a Serendipitous Digest of News and Articles on Trends in Modern Day Mysticism and Decadence. New Port Richey, Flor.: Lady D. Boynton. 2 vol. N.B.: Anthology of reprinted articles, pamphlets, etc. on New Age aspects of speculation in psychology, philosophy, music (especially music therapy), religion, sexuality, etc. (Without ISBN.)
  • Bruscia, Kenneth E. "Frequently Asked Questions About Music Therapy". Boyer College of Music and Dance, Music Therapy Program, Temple University, 1993. July 6, 2009.
  • Bunt, Leslie – Stige, Brynjulf: Music Therapy: An Art Beyond Words. (Second edition.) London: Routledge, 2014. ISBN 978-0-415-45068-3.
  • Davis, William B., Kate E. Gfeller, and Michael H. Thaut. An Introduction to Music Therapy: Theory and Practice. Third ed. Silver Spring: American Music Therapy Association, 2008. ISBN 978-1-884914-20-1
  • Erlmann, Veit (ed.) Hearing Cultures. Essays on Sound, Listening, and Modernity, New York: Berg Publishers, 2004. Cf. especially Chapter 5, "Raising Spirits and Restoring Souls".
  • Gold, C., Heldal, T.O., Dahle, T., Wigram, T. (2006) "Music therapy for schizophrenia or schizophrenia-like illnesses", Cochrane Database of Systematic Reviews, Issue 4.
  • Goodman, K.D. (2011). Music Therapy Education and Training: From Theory to Practice. Springfield, Illinois: Charles C. Thomas. ISBN 978-0-398-08609-1.
  • Hart, Hugh. (March 23, 2008) The New York Times "A Season of Song, Dance and Autism". Section: AR; page 20.
  • La Musicothérapie: thémathèque. Montréal, Bibliothèque du personnel, Hôpital Rivière-des-Prairies, 1978.
  • Levinge, Alison: The Music of Being: Music Therapy, Winnicott and the School of Object Relations. London: Jessica Kingsley Publishers, 2015. ISBN 978-1-84905-576-5.
  • Marcello Sorce Keller, "Some Ethnomusicological Considerations about Magic and the Therapeutic Uses of Music", International Journal of Music Education, 8/2(1986), 13–16.
  • Pellizzari, Patricia y colaboradores: Flavia Kinisberg, Germán Tuñon, Candela Brusco, Diego Patles, Vanesa Menendez, Julieta Villegas, y Emmanuel Barrenechea. "Crear Salud", aportes de la Musicoterapia preventiva-comunitaria. Patricia Pellizzari Ediciones. Buenos Aires, 2011.
  • Owens, Melissa (December 2014). "Remembering through Music: Music Therapy and Dementia". Age in Action. 29 (3): 1–5.
  • Tuet, R.W.K.; Lam, L.C.W. (September 2006) "A preliminary study of the effects of music therapy on agitation in Chinese patients with dementia", Hong Kong Journal of Psychiatry, Volume 16, Number 3
  • Wheeler, Barbara L. (2015). Music Therapy Research: Quantitative And Qualitative Perspectives. Barcelona: Barcelona Publishers(NH). ISBN 978-1891278266.
  • Whipple J (July 2004). "Music in intervention for children and adolescents with autism: a meta-analysis". Journal of Music Therapy. 41 (2): 90–106. doi:10.1093/jmt/41.2.90. PMID 15307805.
  • Wigram, Tony (2000). "A Method of Music Therapy Assessment for the Diagnosis of Autism and Communication Disorders in Children". Music Therapy Perspectives. 18 (1): 13–22. doi:10.1093/mtp/18.1.13.
  • Vladimir Simosko. Is Rock Music Harmful? Winnipeg: The Author, 1987.
  • Vladimir Simosko. Jung, Music, and Music Therapy: Prepared on the Occasion of the "C.G. Jung and the Humanities" Colloquium, 1987 . Winnipeg: The Author, 1987.
  • Vomberg, Elizabeth. Music for the Physically Disabled Child: a Bibliography. Toronto: The Author, 1978.

External links[edit]