Music Therapy: The Art of Psychological Treatment

by Sanjana Sankaran, December 20, 2021

Nearly 800,000 people die from suicide every year (Suicide Data). Approximately seventy percent of the American youth that struggle with depression requires treatment (The State). People with depression have a daily battle with themselves to prevent those feelings of despair and loneliness from taking over. Those living with mental health disorders may develop effective coping mechanisms to deal with their issues. Music therapy, a method of therapy and a de-stress technique for which the positive effects are not yet highly known, involves “the professional use of music and its elements as an intervention in medical, educational, and everyday environments with individuals” (Wang and Agius 595). Music therapy not only involves listening to music but also consists of thinking, analyzing, and playing it. Many people view music as a means of amusement and frivolity for those involved. Both mental health issues and the fine arts are often stigmatized in our society. In regards to mental health, several people feel the need to downplay their problems since many illnesses do not manifest with obvious physical symptoms. Hence, society issues out old cliches, suggesting that people need to learn how to ‘deal with their problems.’ In actuality, mental health can affect not only one’s mind but also one’s body and, if left untreated, can severely affect one’s quality of life. Over recent years, many have come to view the fine arts as an impractical endeavor since several jobs in this field may not lead to a stable job or income. Historically, humans have always turned to the arts to express their feelings, through music, visual arts, or the written word. Music can have a profound effect on the biochemical as well as the physiological aspects of the brain. More and more researchers today find that psychotherapeutic drugs are not as effective in treating mental health patients as they used to be, partly due to  drug tolerance. As a society, we must alter  our mindset away from  treating psychological problems exclusively through psychotherapy and drugs and must instead leverage the nontraditional method of music therapy for those  who experience daily stressors and mental health disorders.

The standard practices of mental health treatment today involve two significant methods –  psychotherapeutic drugs and psychotherapy –  both of which, given the statistics of how the rate of mental health diagnosis is accelerating, are not enough. People with mental health disorders nowadays have a lot more options as to how to treat themselves: psychotherapy, medication, case management, hospitalization, therapy groups, alternative medicine, electroconvulsive therapy, and peer support (Mental Health Treatments). In the early- to mid-1900s, methods of curing mental health ailments involved lobotomies and shock therapy. Even with all of the progress made today, a recent study shows that approximately 10 million adults in America have suicidal thoughts,  have not been able to seek treatment or have experienced both. In the past six years alone, the population of youth (ages 12-17) with depression has gone up by 4.35%, and two million kids now have major depressive episodes and need to seek treatment (The State). A team of neuroscientists from Naples, Italy found that antidepressant drug treatments are mostly ineffective for major depressive disorders. (Fornaro e. al. 494). Inefficacy can be attributed to tolerance, an anomaly that occurs when depressive symptoms reappear after previous treatment with antidepressants” with the return of depressive symptoms of MDD occurring in 9–33% of patients across published trials” (Fornaro et al. 494). Drug tolerance can build over time as the body requires higher doses of the drug  in order to have the same effect as the initial dose once did, ultimately resulting in other biological side effects. Many antidepressant drug trials tend to last shorter than 52 weeks, contributing to the  lack of understanding as to how effective these drugs will be long-term. The National Institute of Mental Health stated that 25% of 103 patients had depressive episodes. Further these patients were found to have 43 out of 171 following depressive episodes and experienced drug tolerance after a 20 year follow up (Fornaro et al. 496).   

In the book, Music Therapy in Mental Health for Illness Management and Recovery, written by Michael J. Silverman, the director of the music therapy program at the University of Minnesota, he states that “ even when medications are effective in alleviating the symptoms of mental illness, they do not necessarily facilitate psychiatric recovery as pharmacological treatments do not contribute to the development of knowledge and skills necessary for a successful transition back to the community” (Silverman 55). The state of mental health is worsening – therapies previously used for decades are now proving to be not enough in curbing  the rampant increase in prevalence of depression and other  mental health disorders. Psychiatric treatment needs to implement  a new type of therapy, like music therapy, that includes psychological interventions to analyze how people’s behavioral and thought processes have improved over  time. By seeking new methods of treatments, specifically music therapy, society will move closer towards respecting rather than ostracizing mental health patients. 

Music therapy was developed post World War I and II as a way to ease the minds of many soldiers with PTSD (Craig). Since then, this field has led to a wide range of studies, all seeking to answer the questions of how music therapy works and its purpose. If we have many different types of psychotherapy, why are neuroscientists and psychologists seeking more holistic treatments for their patients that are not guaranteed to work? Let us start with what precisely music therapy is and the basis behind it. Music therapy includes two main facets: psychoacoustics and the appreciation and hearing of music. Psychoacoustics refers to how someone perceives and comprehends music. In contrast, the brain’s mechanisms of appreciation and hearing of music is something that is developed across an entire lifespan and is influenced by many environmental factors (Craig, para. 19-20). 

There are two main methods of music therapy: listening and active playing. When  listening to music, therapists will put on music for the patient, recommended by medical experts who know about the patient’s specific case (Craig, para. 41-42). Some therapists will go down the more analytical route of listening to music. Therapists may ask questions that evoke personal thought analysis and insight. Some may also follow the Bonny method of guided imagery and music. Bonny methods consist of a patient listening to a song and seeing an image. This leads to the therapist asking specific guided questions that lead to the patient talking about their thoughts and emotions (Craig, para. 43-44). Music therapy can change a person’s attention, emotion, memory processing, behavior, and communication. A combination of all of these changes can result in  changes in neural processing that can  effectively change the biochemical state of depressed minds and improve their lives 

  Many studies prove that music therapy has been effective in treating people with mental disorders. In a  study done by Sergio Castillo-Pérez MD and his team, he states that “depression remains a major health problem and, despite using pharmaceutical agents, patients continue to report high levels of unrelieved depression” (Castillo-Perez et al. 390). This group of researchers decided to study a group of low to medium depressed people receiving  psychotherapy treatment compared to music therapy. A group of 79 patients between the ages of 25 to 60 years old were split into the two groups of therapy. The subjects chosen have never taken any psychotherapeutic drugs or have any other neurophysiological problems.  All subjects were asked to self-report their level of depression with a well-known survey known as  the Zung depression scale (Castillo-Perez et al. 387). The subjects self-reported how they were feeling age week for eight weeks. The music therapy itself involved a 50-minute self-administered music session, and once a week the participants would have a group session with doctors and other patients to provide a comfortable environment. The study controlled for stressful environmental variables that may occur such as sudden noises, changes in temperature, any environmental change or trigger (Castillo-Perez et al. 389). 

The psychotherapy administered in this study was standard conductive-behavioral therapy (CBT). At the end of the tests, the researchers quantitatively analyzed the patients’ progress with the Hamilton scale (another type of depression scale) based on their behaviors  and their self-reported scores of the Zung scale. The people with significant improvement meant they had to have a Hamilton scale of 0 to 7. The Hamilton scale was used after the 3rd, 5th, 7th, and 8th weeks. After only three weeks, within the music therapy group,  one person improved; however, none improved within the psychotherapy group.. By the end of the study, 29 subjects improved with music therapy, and only four did not. For psychotherapy, only 12 subjects improved with 16 people showing little to no improvement. These data from the Zung and Hamilton tests were also cross-referenced with the Friedman test, and showed to be statistically significant with a p-value as little as 0.0356 (Castillo-Perez et al. 389).  

As we can see, psychologists and neuroscientists today are doing more and more research regarding music therapy. Castillo-Perez’s study is just one of many examples in which music therapy has proven to improve the quality of life for people with depression more than psychotherapy. The three main methods of treatment for depression today are psychotherapy, antidepressants, and electroconvulsive therapy for severe cases. However, Perez and the rest of his team say, “Pharmaceutical treatments […] make no difference in the odds ratio of suicide attempts” (Castillo-Perez et al. 387). That is what needs to fundamentally change in how we treat and understand therapy for depressed patients. Pharmaceutical drugs will not influence the likelihood of someone committing suicide because there can be many sudden environmental circumstances and triggers. Musical therapy, on the other hand, aims to help depressed patients by trying to invoke the mesolimbic system, which correlates to positive and rewarding thoughts. As people living in  the 21st century, we can understand that there is something special about listening to new music by our favorite artists, or dancing and singing to a high energy song that can affect our minds positively. Songs can reflect how we feel and can heighten our current emotions, and this is something that medicine and therapy at a certain point cannot do as effectively as initially administered. 

As with many people who learn music from an early age, I found that playing a music instrument helped me relax and de-stress, especially after a long day of school and tests. After my piano lessons on Sundays and six-hour days at high school, I would hop on that leather bench and play Emile Pandolfi and feel my heartbeat slow down and my cheek muscles tense from all the grinning. Playing the theme from Harry Potter on the piano was my mode of artistic expression and relaxation. It is easily accessible, then, to imagine how music can help those who have severe emotional or mental disorders. To the parents of kids with mental health disorders, understand that music can be an outlet for kids to release their emotions and can have a tremendous effect on their functioning and behavior; to the kids who never seemed interested in playing music, that is okay. Part of music therapy merely involves passively listening to music in a relaxing setting. Society needs to alter its perspective on music from being misconstrued as a way of wasting time to a way of elevating one’s moods and taking a mental break.  

To truly get an insight on a student’s perspective of music and its effects on mental health, I interviewed a bandmate of mine from high school who has been playing trumpet since the fifth grade. Her lifelong appreciation of music started when she began taking piano lessons in the second grade. She then began taking trumpet lessons and joined the band in the 5th grade and has continued primarily with trumpet since then. When I asked her about her mental health, she said, “As someone who has depression and anxiety, a part of me is always anxious, and the daily fight is not letting it become a 100% of me, and using coping mechanisms to get out of it.” She had to move 350 miles for college and said that it was a difficult transition due to the workload and having to meet new people, making it difficult  to find time to relax. Being a part of the wind ensemble at her college allowed her to ease into the transition of a college student.  When asked how music has helped her with her mental state and journey, she stated, “playing music was definitely a double-edged sword. Although I had stress and anxiety from the responsibilities that came with being on the band e-board, the intrinsic joy I got from getting together with people I cared about and playing amazing music was amazing” (Anonymous). She found that listening to music gave her a sense of solace and tranquility. It allowed her mind to focus on just the music,  and in the process,  she forgot all of her anxieties and elevated her mood. The lyrics, instrumentation, and many other aspects of music therapy can reflect the emotions we feel and can elevate how we feel. Music can alter the state of chemical neurotransmitters in our minds and change our emotions – this is something drugs and psychotherapy cannot do as effectively.  

Due to social media today, music has become much more prevalent in students’ lives and has influenced the way college students handle stressful situations.A significant reason explaining  music therapy’s lack of usage is because there are many misconceptions about the way music therapy works. Music therapy Director of University Minnesota Dr. Silverman, discusses the ill-conceived notions of music therapy, stating that “a common misperception of music therapy is that it is used exclusively to treat musicians” ( 55). Silverman emphasizes that music therapy was always used to help treat people with a broad range of neurological and psychological issues among a variety of adults, children, and seniors. Another common misconception is  that music therapy is not as effective because it is merely the act of passive listening to pre-recorded music. However, music therapy is not just listening to music. Director Silverman says that in a study done comparing two groups of depressed patients who underwent passive music therapy and active music therapy, the active music therapy patients stayed throughout the sessions. Active music therapy involved lyric analysis, recreation music playing, and percussional music therapy (Silverman 55). All of this active participation served as psychological interventions that helped alter the person’s mood, behavior, and mindset.   

In a survey I administered to fellow Stony Brook Students and my fellow high school alumni who have taken part in music since a young age, I discovered their opinions on the use of music in a therapeutic way.  Of the 57 people who responded, 79% played an instrument, 22% of people said they listen to jazz or a variety of orchestral or classical music while studying, 80% of people listen to music when stressed out, and 73% of people found music to be therapeutic overall (“Music As Therapy”). 28% percent of the people I surveyed have mental health disorders such as anxiety, depression, and eating disorders. Even though the  majority of people surveyed did not have disorders, 80% of the people who deal with everyday environmental stressors choose to listen to music to cope. When asked on a scale of one to five (five being complete improvement in mood and one being mood unchanged), 31 people said they felt better after listening to music when they felt anxious, sad, depressed, or other negative emotions. 12 people say their mood completely changed for the better (“Music As Therapy”). Although these results are biased because many of these people have played an instrument, they show that a majority of students understand that music has therapeutic qualities and utilize it as a coping mechanism or a tool when experiencing stress, anxiety, or depressive thoughts. Music is a type of escapism that allows people to avoid focusing  on their current troubles and gives them the ability to focus all of their energy on one thing only – music.  

Having said all of the above, why do people still believe that conventional treatment methods are effective and do not want to change? Discussions of new treatment methods lack because people only know what is largely acknowledged in society. Mental health was and still is stigmatized because it affects one’s  mind and does not often manifest with physical symptoms like cancer. Only in the past few years has the topic of mental health been brought to the forefront. If many Americans do not wish to discuss their mental health problems, then how can new and more productive methods of treatment be used? Therein lies the existing problem that needs to change. Currently, in the time of self-quarantine, anxiety can run high even with people who have not been diagnosed with a  mental health disorder because we live in a time of uncertainty. In a time when the fear of virus spread is high and ‘stay at home’ orders are strict, quarantine serves as an obstacle for people who need weekly in-person therapy sessions. People need to utilize resources at home that are easily accessible to cope with their anxiety, like  music resources. If people are privileged enough to have access to the internet, there are a plethora of resources that can be used for music therapy, such as YouTube, Spotify, or an instrument if one has it. 

Society needs to acknowledge that music therapy is a method that has proven to be successful amongst a wide range of people with varying disorders and varying levels of depression. Well known music therapist Dr. Dany Bouchard eloquently describes how to handle anxiety during the time of COVID: “Music has a connection with memory, brings us emotions, all kinds of stuff. It is how you use it now in order to make it a music prescription” (Rowat, para. 15). Music can help with COVID-related anxiety by serving as a focusing tool that allows our mind to target what is going on now rather than worrying about an uncertain future (Rowat, para. 18). Being open to trying new modes of therapy can  be much more effective for anyone. As time goes on, some people with mental health disorders may have to increase their drug dosage due to drug tolerance that inevitably develops. At times, people who go to therapy may feel that it is not working, and can  revert to unhealthy habits and coping mechanisms. Mental health overall is something that affects people every day through their actions and their emotions. Treatment of mental health disorders is an important aspect of healthcare that needs to be improved;  it is a series of actions and behaviors one takes in order to see an actual result. Music can alter the state of someone’s mood and change someone’s behavior after prolonged daily music sessions. Additionally, the collaborative nature of music therapy allows people with mental disorders to have a massive support system on their path to recovery. Music therapy moves away from the idea persisting in mental health recovery that it is up to the person to improve themselves, and it is a solitary journey. Take 10 or maybe even 20 minutes per day to actively take part in something that involves music, whether it’s through such as playing, writing, singing, or listening.  People with mental health problems are in a daily battle  with their minds to prevent feelings of depression and anxiety from overcoming their thoughts. While psychotherapeutic drugs and therapy are helpful to an extent, music therapy can provide long term positive effects.


Works Cited

Anonymous. Personal interview. 15 April, 2020.

Castillo-Perez, Sergio, et al. “Effects of Music Therapy on Depression Compared with Psychotherapy.” The Arts in Psychotherapy, vol. 37, no. 5, Nov. 2010, pp. 387-90. ScienceDirect, doi:10.1016/j.aip.2010.07.001. Accessed 15 Apr. 2020.

Craig, Heather. “What Is Music Therapy and How Does It Work?” Positive Psychology, 18 Mar. 2020: par 1-101, positivepsychology.com/music-therapy/. Accessed 15 Apr. 2020.

Fornaro, Michele, et al. “The Emergence of Loss of Efficacy during Antidepressant Drug Treatment for Major Depressive Disorder: An Integrative Review of Evidence, Mechanisms, and Clinical Implications.” Pharmacological Research, vol. 139, Jan. 2019, pp. 494-502. ScienceDirect, doi:10.1016/j.phrs.2018.10.025. Accessed 15 Apr. 2020.

“Mental Health Treatments.” Mental Health America National, Mental Health America: par 1-10, http://www.mhanational.org/mental-health-treatments. Accessed 15 Apr. 2020.

Rowat, Robert. “We Asked a Music Therapist How to Relieve Anxiety Caused by Social Distancing.” CBC Music, 20 Mar. 2020, p. 1. CBC: par 1-23, http://www.cbc.ca/music/we-asked-a-music-therapist-how-to-relieve-anxiety-caused-by-social-distancing-1.5504973. Accessed 15 Apr. 2020.

Sankaran, Sanjana. “Music As Therapy.” Survey. 15 April. 2020.

Silverman, Michael J. “An Overview of Music Therapy as a Psychosocial Intervention for Psychiatric Consumers.” Music Therapy in Mental Health for Illness Management and Recovery, Oxford UP, 2015, pp. 60-67. doi:10.1093/acprof:oso/9780198735366.001.0001.

“The State of Mental Health in America.” Mental Health America National, Mental Health America, 2017, http://www.mhanational.org/issues/state-mental-health-america. Accessed 15 Apr. 2020.

“Suicide Data.” World Health Organization, 27 Sept. 2019, http://www.who.int/mental_health/prevention/suicide/suicideprevent/en/. Accessed 15 Apr. 2020.

Wang, Shentong, and Mark Agius. “The Use of Music Therapy in the Treatment of Mental Illness and the Enhancement of Societal Wellbeing.” Psychiatria Danubina, vol. 30, 30 Nov. 2018, pp. 595-600, http://www.psychiatria-danubina.com/UserDocsImages/pdf/dnb_vol30_noSuppl%207/dnb_vol30_noSuppl%207_595.pdf. Accessed 15 Apr. 2020.

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