Music therapy

Overview of Treatment

Music therapy is a specialized treatment that combines music with psychology and medicine to help patients improve their physical, psychological, and social functions through systematic musical activities. Its core principle is that music can directly stimulate the limbic system and autonomic nervous system, promoting the regulation of endocrine and neurotransmitter levels. This therapy is widely applied in healthcare, education, and social welfare sectors, suitable for individuals with physical and mental disabilities, chronic illnesses, and psychological trauma.

The treatment process typically includes activities such as music listening, improvisation, and song analysis, designed by professional therapists based on the patient's needs. Unlike recreational music, music therapy emphasizes professional intervention, with real-time interaction to adjust the intensity and type of music to achieve predetermined therapeutic goals.

Types and Mechanisms of Treatment

The main categories are “Active” and “Passive”:

• Active therapy: such as improvisational instrument playing and songwriting, which enhance neural plasticity through active participation
• Passive therapy: such as listening to music at specific frequencies, utilizing sound wave stimulation to improve heart rate variability and blood pressure

Its mechanisms involve increased dopamine secretion, reduced amygdala activity, and regulation of the hypothalamic-pituitary-adrenal axis.

Physiologically, the rhythm of music can synchronize brain θ and α waves, helping to alleviate pain perception; psychologically, it provides a non-verbal communication channel through melodic structures, aiding emotional expression. Recent studies also suggest that specific frequency music stimulation can promote neurogenesis in the hippocampus, potentially benefiting cognitive recovery.

Indications

Common applications include:

• Mental disorders: depression, anxiety, post-traumatic stress disorder (PTSD)
• Neurodevelopmental disorders: autism, Alzheimer’s disease, post-stroke aphasia
• Physiological conditions: managing side effects of cancer chemotherapy, chronic pain control, post-cardiac surgery rehabilitation

For children with autism, music therapy can help develop social interaction skills through rhythmic patterns.

In rehabilitation, Rhythmic Auditory Stimulation (RAS) is widely used for gait training in Parkinson’s disease patients. For epilepsy patients, specific frequency music stimulation has been shown to reduce seizure frequency.

Usage and Dosage

Standard courses usually involve 1-2 sessions per week, each lasting 30-60 minutes, with duration adjusted based on the patient's age and condition. For children, sessions may be divided into 15-20 minute units, progressing through various musical activities. Therapists will dynamically adjust the type and intensity of music based on patient responses, such as using 40-60 BPM rhythms to promote relaxation.

Dosage planning considers multiple factors:

• Physiological state: avoiding high-volume environments for cardiac patients
• Cognitive level: simplifying musical structures for cognitively impaired patients
• Cultural background: selecting familiar music types to enhance effectiveness

Treatment responses are continuously evaluated after 6-8 weeks to adjust the plan accordingly.

Benefits and Advantages

Main therapeutic effects include:

• Emotional regulation: reducing cortisol levels by an average of 15-20%
• Cognitive enhancement: improving memory test scores in Alzheimer’s patients by 10-15%
• Physiological improvements: lowering blood pressure by 5-10 mmHg and alleviating chronic pain intensity

Its non-drug nature makes it a safe option for long-term use.

Compared to traditional psychotherapy, music therapy can:

• Break through language barriers, providing non-verbal expression channels
• Simultaneously stimulate both brain hemispheres, enhancing treatment efficiency
• Create positive conditioned responses to reinforce therapeutic effects

Making it particularly effective for children and aphasic patients.

Risks and Side Effects

The vast majority of patients only experience mild discomfort, such as:

• Auditory fatigue: tinnitus or temporary increased auditory sensitivity after prolonged sessions
• Emotional fluctuations: triggering strong emotional memories in trauma patients during therapy
• Over-reliance: rare cases where patients develop irrational expectations, believing music can replace medication

Important Warning: Patients with severe mania may experience increased mood instability due to musical stimulation.

Specific risks include:

• Inner ear damage: high sound pressure environments may harm auditory nerves
• Induction of arrhythmias: certain frequencies may trigger ventricular ectopy in cardiac patients
• Treatment resistance: some patients may refuse participation due to dislike of music choices

These issues require professional assessment to prevent.

Precautions and Contraindications

Absolute contraindications: Acute psychiatric episodes, severe hearing impairment, implanted electronic medical devices (e.g., pacemakers)

Relative contraindications include:

• Severe anxiety personality disorder: may trigger panic symptoms with music stimulation
• Patients with auditory hallucinations: may confuse therapeutic music with hallucinated sounds
• Recent brain surgery: specific sound waves may affect wound healing

Full auditory and psychological assessments are required before treatment.

Interactions with Other Treatments

Can be safely combined with:

• Chemotherapy: alleviating nausea and fatigue
• Physical therapy: enhancing motivation for post-stroke limb rehabilitation
• Medication: combining with antidepressants can improve treatment outcomes

However, interactions with certain neuropsychiatric drugs should be monitored.

Contraindicated combinations include:

• When used with antipsychotics, avoid sedative music that may increase drowsiness
• Electroconvulsive therapy (ECT): avoid intense stimulation music within 24 hours post-procedure
• When combined with some anxiolytics, adjust music intensity to prevent excessive relaxation and hypotension

Treatment teams should collaboratively develop plans.

Effectiveness and Evidence

Systematic reviews show:

• HbA1c levels in diabetic patients decrease by an average of 0.3-0.5%
• Pain scores (VAS) decrease by 20-30%
• Depression scores (PHQ-9) improve by an average of 4-6 points

Brain imaging studies confirm enhanced neural connections between the prefrontal cortex and cerebellum.

The 2018 Cochrane review indicates that music intervention can reduce postoperative morphine use by 15-25%. However, individual responses vary, and continuous assessment over 6-8 weeks is necessary to evaluate effectiveness. Cognitive improvements in neurodegenerative patients may take 3-6 months to manifest.

Alternatives

Non-pharmacological alternatives include:

• Art therapy: expressing emotions through painting and sculpture
• Exercise therapy: combining aerobic exercise with rhythm training
• Game therapy: interactive treatments designed for children

Selection should be based on patient characteristics for the most suitable approach.

Pharmacological options may include:

• SSRI antidepressants
• Beta-blockers to alleviate anxiety
• Cognitive Behavioral Therapy (CBT)

Careful consideration of side effects and time costs associated with psychological treatments is necessary.

 

Frequently Asked Questions

Do I need special preparations before music therapy? What should participants pay attention to?

It is recommended to communicate with the therapist about personal health conditions and music preferences before participating in music therapy. Participants should remain relaxed; if they have auditory sensitivities or specific health issues, the therapist will adjust volume or music type accordingly. The therapy environment should be free of disturbances to ensure focus on music-guided activities.

What should I do if I feel uncomfortable during music therapy?

If dizziness, emotional fluctuations, or physical discomfort occur during therapy, inform the therapist immediately to pause and adjust. The therapist may lower the volume, change the music style, or suspend the session. Severe discomfort requires further medical evaluation to rule out other health issues.

How can I cooperate with music therapy effects in daily life?

It is advisable to listen to the therapist-recommended playlist for 10-15 minutes daily and record emotional or sleep changes. Avoid mixing high-volume or unfamiliar music to maintain treatment consistency. Combining regular routines with light exercise can enhance effects.

How long should the music therapy course be? When will effects become apparent?

The number of sessions depends on individual needs; mild anxiety or stress symptoms typically require 8-12 weeks (1-2 times per week), while chronic pain management may need a longer period. Initial effects like relaxation may appear after 3-4 sessions, but sustained improvement requires ongoing participation and therapist follow-up.

Is regular follow-up necessary after treatment? How can I maintain the benefits?

It is recommended to have follow-up assessments every three months. Therapists will adjust maintenance plans based on progress. Maintaining a “music health diary,” regularly using therapeutic tracks, and observing physical and mental changes can help. Participating in music-related community activities or family music interactions can also reinforce the benefits.