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How Listening to Music Can Have Psychological Benefits

Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."

Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.

Listening to music can be entertaining, and some research suggests that it might even make you healthier. Music can be a source of pleasure and contentment, but there are many other psychological benefits as well. Music can relax the mind, energize the body, and even help people better manage pain.

The notion that music can influence your thoughts, feelings, and behaviors probably does not come as much of a surprise. If you've ever felt pumped up while listening to your favorite fast-paced rock anthem or been moved to tears by a tender live performance, then you easily understand the power of music to impact moods and even inspire action.

The psychological effects of music can be powerful and wide-ranging. Music therapy is an intervention sometimes used to promote emotional health, help patients cope with stress, and boost psychological well-being. Some research even suggests that your taste in music can provide insight into different aspects of your personality .

Music Can Improve Cognitive Performance

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Research suggests that background music, or music that is played while the listener is primarily focused on another activity, can improve performance on cognitive tasks in older adults. One study found that playing more upbeat music led to improvements in processing speed, while both upbeat and downbeat music led to benefits in memory.

So the next time you are working on a task, consider turning on a little music in the background if you are looking for a boost in your mental performance. Consider choosing instrumental tracks rather than those with complex lyrics, which might end up being more distracting.

Music Can Reduce Stress

It has long been suggested that music can help reduce or manage stress. Consider the trend centered on meditative music created to soothe the mind and inducing relaxation.

Fortunately, this is one trend supported by research. Listening to music can be an effective way to cope with stress.

In one 2013 study, participants took part in one of three conditions before being exposed to a stressor and then taking a psychosocial stress test. Some participants listened to relaxing music, others listened to the sound of rippling water, and the rest received no auditory stimulation.

The results suggested that listening to music had an impact on the human stress response , particularly the autonomic nervous system . Those who had listened to music tended to recover more quickly following a stressor.

Music Can Help You Eat Less

One of the most surprising psychological benefits of music is that it might be a helpful weight-loss tool. If you are trying to lose weight, listening to mellow music and dimming the lights might help you achieve your goals .

According to one study, people who ate at low-lit restaurants where soft music was played consumed 18% less food than those who ate in other restaurants.  

The researchers suggest that music and lighting help create a more relaxed setting. Since the participants were more relaxed and comfortable, they may have consumed their food more slowly and have been more aware of when they began to feel full.

You might try putting this into practice by playing soft music at home while you eat dinner. By creating a relaxing setting, you may be more likely to eat slowly and, therefore, feel fuller sooner.

Music Can Improve Your Memory

Lots of students enjoy listening to music while they study, but is that such a great idea? Some feel like listening to their favorite music as they study improves memory , while others contend that it simply serves as a pleasant distraction.

Research suggests that it may help. But it depends upon a variety of factors, including the type of music, the listener's enjoyment of that music, and even how musically well-trained the listener may be.

In one study, musically naive students learned better when listening to positive music, possibly because these songs elicited more positive emotions without interfering with memory formation.

However, musically trained students tended to perform better on learning tests when they listened to neutral music, possibly because this type of music was less distracting and easier to ignore. If you tend to find yourself distracted by music, you may be better off learning in silence or with neutral tracks playing in the background.

Another study found that participants learning a new language showed improvement in their knowledge and abilities when they practiced singing new words and phrases versus just regular speaking or rhythmic speaking.  

Music Can Help Manage Pain

Research has shown that music can be very helpful in the management of pain. One study of fibromyalgia patients found that those who listened to music for just one hour a day experienced a significant reduction in pain compared to those in a control group .  

At the end of the four-week study period, participants who had listened to music each day experienced significant reductions in feelings of pain and depression. Such results suggest that music therapy could be an important tool in the treatment of chronic pain.

A 2015 review of research on the effects of music on pain management found that patients who listened to music before, during, or even after surgery experienced less pain and anxiety than those who did not listen to music.  

While listening to music at any point in time was effective, the researchers noted that listening to music pre-surgery resulted in better outcomes. The review looked at data from more than 7,000 patients and found that music listeners also required less medication to manage their pain.

There was also a slightly greater, though not statistically significant, improvement in pain management results when patients were allowed to select their own music.

Music May Help You Sleep Better

Insomnia is a serious problem that affects people of all age groups. While there are many approaches to treating this problem, research has demonstrated that listening to relaxing classical music can be a safe, effective, and affordable remedy.​

In a study looking at college students, participants listened to classical music, an audiobook, or nothing at all at bedtime for three weeks. Researchers assessed sleep quality both before and after the intervention.

The study found that participants who had listened to music had significantly better sleep quality than those who had listened to the audiobook or received no intervention.  

Music Can Improve Motivation

There is a good reason why you find it easier to exercise while you listen to music. Researchers have found that listening to fast-paced music motivates people to work out harder.

One experiment designed to investigate this effect tasked 12 healthy male students with cycling on a stationary bike at self-paced speeds. On three different trials, the participants biked for 25 minutes at a time while listening to a playlist of six different popular songs of various tempos.

Unknown to the listeners, the researchers made subtle differences to the music and then measured performance. The music was left at a normal speed, increased by 10%, or decreased by 10%.

Speeding up the tracks resulted in increased performance in terms of distance covered, the speed of pedaling, and power exerted. Conversely, slowing down the music's tempo led to decreases in all of these variables .

So if you are trying to stick to a workout routine, consider loading up a playlist filled with fast-paced tunes that will help boost your motivation and enjoyment of your exercise regimen.

Music Can Improve Mood

Another of the science-backed benefits of music is that it just might make you happier.

In one examination of the reasons why people listen to music, researchers discovered that music played an important role in relating arousal and mood. Participants rated music's ability to help them achieve a better mood and become more self-aware as two of the most important functions of music.

Another study found that intentionally trying to boost moods by listening to positive music could have an impact within two weeks. Participants were instructed to purposefully attempt to improve their mood by listening to positive music each day for two weeks.

Other participants listened to music but were not directed to become happier intentionally. When participants were later asked to describe their own levels of happiness, those who had intentionally tried to improve their moods reported feeling happier after just two weeks.

Music May Reduce Symptoms of Depression

Researchers have also found that music therapy can be a safe and effective treatment for a variety of disorders, including depression .

One study found that music therapy was a safe, low-risk way to reduce depression and anxiety in patients suffering from neurological conditions such as dementia, stroke, and Parkinson's disease.

While music can certainly have an impact on mood, the type of music is also important. Classical and meditation music offer the greatest mood-boosting benefits, while heavy metal and techno music are ineffective and even detrimental.

Music Can Improve Endurance and Performance

Another important psychological benefit of music lies in its ability to boost performance. While people have a preferred step frequency when walking and running, scientists have discovered that the addition of a strong, rhythmic beat, such as fast-paced musical track, could inspire people to pick up the pace.  

Runners are not only able to run faster while listening to music; they also feel more motivated to stick with it and display greater endurance. The ideal tempo for workout music is somewhere between 125 and 140 beats per minute.

While research has found that synchronizing body movements to music can lead to better performance and increased stamina, the effect tends to be the most pronounced in cases of low to moderate intensity exercise. In other words, the average person is more likely to reap the rewards of listening to music more than a professional athlete might.

So why does music boost workout performance? Listening to music while working out lowers a person's perception of exertion. You're working harder, but it doesn't seem like you're putting forth more effort.

Because your attention is diverted by the music, you are less likely to notice the obvious signs of exertion such as increased respiration, sweating, and muscle soreness.

A Word From Verywell

Music can inspire and entertain, but it also has powerful psychological effects that can improve your health and well-being.

Instead of thinking of music as pure entertainment, consider some of the major mental benefits of incorporating music into your everyday life. You might find that you feel more motivated , happy, and relaxed as a result.

Gold BP, Frank MJ, Bogert B, Brattico E. Pleasurable music affects reinforcement learning according to the listener . Front Psychol . 2013;4:541. doi:10.3389/fpsyg.2013.00541

Thoma MV, La Marca R, Brönnimann R, Finkel L, Ehlert U, Nater UM. The effect of music on the human stress response . PLoS ONE . 2013;8(8):e70156. doi:https://doi.org/10.1371/journal.pone.0070156

Wansink B, van Ittersum K. Fast food restaurant lighting and music can reduce calorie intake and increase satisfaction . Psychol Rep . 2012;111(1):228-32. doi:10.2466/01.PR0.111.4.228-232

Ludke KM, Ferreira F, Overy K. Singing can facilitate foreign language learning . Mem Cognit. 2014;42(1):41-52. doi:10.3758/s13421-013-0342-5

Onieva-Zafra MD, Castro-Sánchez AM, Matarán-Peñarrocha GA, Moreno-Lorenzo C. Effect of music as nursing intervention for people diagnosed with fibromyalgia . Pain Manag Nurs. 2013;14(2):e39-46. doi:10.1016/j.pmn.2010.09.004

Hole J, Hirsch M, Ball E, Meads C. Music as an aid for postoperative recovery in adults: A systematic review and meta-analysis . Lancet . 2015;386(10004):1659-71. doi:10.1016/S0140-6736(15)60169-6

Harmat L, Takács J, Bódizs R. Music improves sleep quality in students . J Adv Nurs. 2008;62(3):327-35. doi:10.1111/j.1365-2648.2008.04602.x

Waterhouse J, Hudson P, Edwards B. Effects of music tempo upon submaximal cycling performance . Scand J Med Sci Sports. 2010;20(4):662-9. doi:10.1111/j.1600-0838.2009.00948.x

Ferguson YL, Sheldon KM. Trying to be happier really can work: Two experimental studies . J Positive Psychol . 2013;8(1):23-33. doi:10.1080/17439760.2012.747000

Raglio A, Attardo L, Gontero G, Rollino S, Groppo E, Granieri E. Effects of music and music therapy on mood in neurological patients . World J Psychiatry. 2015;5(1):68-78. doi:10.5498/wjp.v5.i1.68

Snyder KL, Snaterse M, Donelan JM. Running perturbations reveal general strategies for step frequency selection . J Appl Physiol. 2012;112(8):1239-47. doi:10.1152/japplphysiol.01156.2011

By Kendra Cherry, MSEd Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."

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Mind & Mood

Can music improve our health and quality of life?

Music boosts our mood and well-being, and music therapy may help during treatments for certain health conditions..

Times are hard. The current political climate, war, impact of global warming, continued inequities due to systemic racism, and ongoing physical and mental health challenges from COVID are taking a toll on our feelings of safety in the world and quality of life . Hopefully, each of us can find moments of ease and temporarily shift our thoughts away from the difficult daily news. For many people, music can play a role in making that shift, even incrementally.

How can music impact our quality of life?

Recently, researchers looked at the impact of music interventions on health-related quality of life, and tried to answer the question about the best way to help make that shift toward release, relaxation, and rehabilitation. This recent systematic review and meta-analysis (a study of studies) showed that the use of music interventions (listening to music, singing, and music therapy) can create significant improvements in mental health, and smaller improvements in physical health–related quality of life. While the researchers found a positive impact on the psychological quality of life, they found no one best intervention or "dose" of music that works best for all people.

Complexities of music

As complex human beings from a wide variety of cultures, with a variety of life experiences and mental and physical health needs, our connection with music is very personal. Our relationship with music can be a very beautiful, vulnerable, and often complicated dance that shifts from moment to moment based on our mood, preferences, social situation, and previous experiences. There are times where music can have a clear and immediate impact on our well-being:

• easing a transition to sleep with a soothing playlist
• finding motivation for exercise by listening to upbeat dance music
• aiding self-expression of emotions by singing
• connecting to others by attending a live musical performance.

There are other times when a board-certified music therapist can help you build that connection to music, and find the best intervention and "dose" that could positively impact your health and provide a form of healing.

How can music be used as a therapeutic tool?

Music therapy is an established health care profession that uses evidence-based music interventions to address therapeutic health care goals. Music therapy happens between a patient (and possibly their caregivers and/or family) and a board-certified music therapist who has completed an accredited undergraduate or graduate music therapy program.

Music therapists use both active (singing, instrument exploration, songwriting, movement, digital music creation, and more) and receptive (music listening, guided imagery with music, playlist creation, or music conversation and reminiscence) interventions, and create goals to improve health and well-being.

Some of those goals could include decreasing anxiety , shifting your mood, decreasing pain perception during cancer or other medical treatment, increasing expression, finding motivation, and many others. The approach to using music to achieve these kinds of goals — and to improving your quality of life in general — can shift from moment to moment, and a music therapist can help you find what works best for a particular situation.

My top music therapy tools

This intervention has been studied the most, in almost every scenario. It can be done either on your own or in music therapy. The music can be live or recorded. Listening can be done with intentional focus or as background listening. You can amplify emotions for release. You can use music to quiet the mind. Or you can utilize the " iso principle " and match music to your current energy or mood, and then slowly change feel, tempo, and complexity to help you shift. Music listening can be paired with prompts for relaxation, or to motivate you to exercise, move more, or do a task you've been putting off.

Learning or playing an Instrument

Active music-making truly engages your entire brain . This creates the most potential for distraction, pain reduction, cognition, fine and gross motor development, and expression. Some instruments are designed for easier access to free expression or learning.

A steel tongue drum , for example, set up in a pentatonic scale, has a beautiful resonant sound, has no "wrong notes," and by design allows you to just play! If you want to engage your cognitive brain a bit, try learning the ukulele. The strings are easy to push, beginner chords only need one or two fingers, and there are many great ukulele resources online. Making music with an instrument can be fun and easy.

A board-certified music therapist can help you find the most direct and success-based path to musical expression. Learning how to really master an instrument and read music takes time, patience, and practice.

This can be an amazing intervention if you have a good connection to your voice and/or have a good music therapy relationship where the therapist can help you build your connection to your instrument. There are physical benefits of singing on lung function and emotional benefits of singing lyrics that speak your truth. Finally, there is the community connection and power of being surround by strong, tight harmonies.

The bottom line

Although there is not one best intervention, magical song, or perfect genre to make all the hard things in life easier, music can be a powerful agent of change.

Need some extra help finding the best music tools for you? Here are some resources for exploring music therapy and finding certified therapists.

American Music Therapy Association Certified Board of Music Therapists American Psychological Association: Music as Medicine

About the Author

Lorrie Kubicek, MT-BC , Contributor

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Music and Mental Health: The Therapeutic Power of Sound

• Posted By: Music Crowns
• January 3, 2024

Music has consistently been revered as a global tongue, bridging cultural and linguistic divides. Its capacity to evoke emotions and memories is unparalleled, making it a powerful tool for personal expression and emotional exploration. 

Lately, there’s been an increasing fascination with exploring the deep link between music and mental well-being. Research suggests that music, whether it’s a soulful ballad or an upbeat pop song, can significantly impact our mental well-being, offering a form of solace and therapy that is both accessible and profound.

Indeed, the therapeutic power of sound extends beyond the mere enjoyment of melodies and harmonies. As we delve deeper into this article, we’ll discuss how different genres and songs can act as a catalysts for emotional healing and mental clarity. 

1. Music for Concentration and Studying

The role of music in enhancing focus and relaxation during study sessions is a topic worth exploring. Classical music, with its structured rhythms and lack of lyrics, has often been called the ideal study companion. Of course, you can also use PowerPoint presentation writing services if you need to streamline your ideas into a coherent and impactful presentation. Aside from that, music is especially beneficial during intense study sessions or when grappling with complex concepts, where the calming influence of music can reduce stress and anxiety.

It’s not just about drowning out the noise of a bustling campus or a noisy dorm room; it’s about creating a mental space where concentration can flourish. The gentle ebb and flow of a piano sonata by Beethoven or the intricate melodies of a Bach fugue can provide a soothing backdrop, fostering an environment conducive to deep focus and efficient learning.

2. The Role of Music in Boosting Mood

Certain upbeat tracks can become personal anthems, offering a sense of empowerment and confidence. Their infectious rhythms and catchy melodies can make a boring day glow. 

• Upbeat music, especially genres like pop, dance, or certain types of electronic music, can act as an instant mood enhancer.
• Songs with a fast tempo and positive lyrics can facilitate the release of feel-good hormones.
• Listening to lively music during physical activities, like working out or jogging, can increase endurance and overall enjoyment.
• Joyful music can serve as a motivational backdrop for mundane tasks, turning a boring chore into a fun activity.

The ability of upbeat music to elevate mood and bring a burst of energy is particularly beneficial for students facing the monotony of routine or the stress of academic deadlines. Just as a lively tune can invigorate a morning jog, it can also infuse a study session with positivity and dynamism, making learning more enjoyable and engaging.

3. The Calming Influence of Instrumental and Ambient Music

There is something innately comforting in instrumental and ambient music. Without the distraction of lyrics, these genres invite listeners into a world of pure sound, where the mind can wander freely or focus intently. Ambient music, with its ethereal textures and slow, unfolding patterns, is perfect for meditation or winding down after a long day. It can serve as a source of relaxation and peace.

Instrumental music, especially genres like jazz or classical, can also aid in emotional regulation. The intricate melodies and harmonies engage the brain in a way that can help soothe anxiety and foster a sense of well-being. 

4. The Reflective Power of Ballads and Acoustic Music

Ballads and acoustic music hold a special place in the hearts of many, often resonating with our deepest emotions. The raw honesty in the lyrics, combined with the simplicity of an acoustic guitar or piano, can create a powerful emotional experience. 

These genres are not just about listening; they’re about feeling. They provide a space for reflection, allowing listeners to process their emotions and find solace in the shared human experience. This music acts as a friend, offering understanding and empathy and reminding listeners that they are not alone on their journey.

5. Nature Sounds as a Remedy for Stress and Anxiety

Nature sounds are an often overlooked aspect of music therapy. The soothing effect of listening to a babbling brook or the gentle rustle of leaves can transport the listener to a place of tranquility. 

• The sounds of nature, like rain, ocean waves, or forest ambiance, can have a profoundly calming effect on the mind.
• Nature sounds can enhance concentration and productivity, especially in tasks requiring deep focus.
• Listening to the sounds of nature can reduce cortisol levels.
• Incorporating nature sounds into a relaxation routine, like meditation or yoga, can deepen the experience.
• These auditory elements can potentially enhance sleep quality, a crucial factor for sustaining sound mental health.

Whether during a study break or before bedtime, these sounds can help reset the mind, promoting a sense of peace and well-being.

6. Exploring Different Cultures Through World Music

World music presents an exploration through various cultures and traditions, offering a distinct viewpoint on the varied ways human emotions are expressed through sound. Encompassing everything from the dynamic rhythms of African drums to the deeply emotional tunes of Middle Eastern music, this genre is a tribute to cultural variety. It emphasises both learning and forming connections.

Listening to music from various cultures can broaden your musical taste and appreciation. It challenges the listener to step out of their comfort zone, exploring rhythms, scales, and unfamiliar yet intriguing instruments. 

7. Singing and Songwriting as Outlets for Emotional Expression

Singing and songwriting are powerful tools for personal expression and emotional release. Singing can be incredibly liberating, while songwriting offers a canvas for articulating thoughts and feelings, turning them into something tangible and often beautiful.

Engaging in singing or songwriting can be a therapeutic hobby. It provides an outlet for the stresses and joys of life, offering a way to process emotions creatively. Whether it’s penning down lyrics or belting out favourite tunes, these activities can provide comfort and joy, aiding in mental well-being and personal growth.

Final Thoughts 

The relationship between music and mental health is as intricate as it is profound. From the focus-enhancing rhythms of classical music to the mood-lifting beats of pop, the therapeutic power of sound is undeniable. Whether it’s through the calming echoes of nature sounds, the cultural richness of world music, or the personal expression found in singing and songwriting, music serves as a companion and healer. 

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Table of Contents

Music and mental health are intricately interconnected, with music serving as a powerful tool for emotional expression, healing, and support, it has the ability to uplift moods, alleviate stress, and provide a connection to individuals navigating mental health challenges.

Music for Mental Illness

Music has shown promising potential as a therapeutic resource 1  Clark, I. N., & Tamplin, J. (2016). How Music Can Influence the Body: Perspectives From Current Research. Voices: A World Forum for Music Therapy, 16(2). https://doi.org/10.15845/voices.v16i2.871 for individuals with mental illness, offering a means of emotional expression, comfort, and connection, while also assisting in managing symptoms, promoting relaxation, and fostering a sense of hope and resilience.

When we listen to music, it can have a deep soothing effect on our mental well-being that influence our emotions, reduce stress, and provide a comforting and relaxing feeling. Music can even act as a form of therapy 2  (PDF) Music Therapy: A Useful Therapeutic Tool for Health, Physical and Mental Growth. (n.d.). ResearchGate. Available from: https://www.researchgate.net/publication/320556617_Music_Therapy_A_Useful_Therapeutic_Tool_for_Health_Physical_and_Mental_Growth , allowing us to explore and express our emotions, and providing a supportive outlet for our struggles.

However, a survey conducted on music and mental health interventions revealed that 68.5% of 3  Kumar, N. (2016, January). The effect of listening to music on concentration and academic performance of the student: Cross-sectional study on medical undergraduate students. ResearchGate. Available from: https://www.researchgate.net/publication/311435289_The_effect_of_listening_to_music_on_concentration_and_academic_performance_of_the_student_Cross-sectional_study_on_medical_undergraduate_students these interventions had positive outcomes in addressing mental health issues. This shows the potential effectiveness of using music as a tool for improving mental well-being.

Moreover, our personal experiences and challenges 4  Ebrahim Hosseini, & Seyed Ali Hosseini. (2019, May 8). Therapeutic Effects of Music: A Review. ResearchGate; unknown. Available from: https://www.researchgate.net/publication/332934020_Therapeutic_Effects_of_Music_A_Review in mental health functioning can shape our connection with music, helping us find solace, understanding, and support through its themes and messages.

Music and Mental Health Benefits

Some positive effects 5  Rebecchini L. (2021). Music, mental health, and immunity.  Brain, behavior, & immunity – health ,  18 , 100374. https://doi.org/10.1016/j.bbih.2021.100374 of music on mental health and well-being are:

• Music has the ability to make individuals feel happier and uplift their spirits, providing a way to escape from feelings of sadness.
• It has the capacity to reduce stress and promote relaxation, with calm music being effective in helping people relax and lower their stress levels.
• Music can enhance focus, motivation, and productivity, as upbeat tunes can improve concentration and keep individuals motivated.
• Gentle and soothing music promotes better sleep quality and can assist in managing insomnia.
• It activates the brain and improves cognitive performance, stimulating cognitive abilities, including creativity.
• Music is also known to enhance memory, aiding individuals in remembering informations more effectively.
• It evokes emotional connection, making individuals feel more connected to others and fostering a sense of empathy.

Different Music for Different Mental Illness

Here are some examples 6  Ebrahim Hosseini, & Seyed Ali Hosseini. (2019, May 8). Therapeutic Effects of Music: A Review. ResearchGate; unknown. Available from: https://www.researchgate.net/publication/332934020_Therapeutic_Effects_of_Music_A_Review of positive effects of music on mental health illnesses:

1. Depression

Music can help uplift mood, provide comfort, and offer a sense of hope. Upbeat and positive music can boost spirits and provide a temporary escape from depressive thoughts.

Read More About Depression Here

2. Anxiety Disorder

Calming and soothing music can help reduce the symptoms of anxiety levels such as irritability, restlessness, etc.

Read More About Anxiety Here

3. Post-Traumatic Stress Disorder (PTSD)

Music, including techniques like rhythm-based exercises and songwriting, can help individuals process traumatic experiences, manage distressing symptoms, and promote emotional healing.

Read More About Post-Traumatic Stress Disorder (PTSD) Here

4. Attention Deficit Hyperactivity Disorder (ADHD)

Music with a steady rhythm and structure can help improve focus and attention. Instrumental music, particularly classical or ambient genres, may be helpful for enhancing concentration.

Read More About Attention Deficit Hyperactivity Disorder (ADHD) Here

5. Schizophrenia

Music can be used to help individuals with schizophrenia communicate better, become more aware of their surroundings, express their emotions and enerize them to be active.

Read More About Schizophrenia Here

6. Eating Disorders

Music can create a soothing and peaceful atmosphere during meals, which can help individuals with eating disorders feel more at ease and less focused on their body image and counting calories.

Read More About Eating Disorders Here

7. Substance Abuse Disorder

Engaging in music-making activities, such as playing instruments or songwriting, can provide a constructive outlet for emotions and serve as a distraction from the cravings for substance use.

Musicians and Mental Health Crisis

Many musicians struggle with 7  Brunt, S., & Nelligan, K. (2021). The Australian music industry’s mental health crisis: media narratives during the coronavirus pandemic.  Media International Australia ,  178 (1), 42–46. https://doi.org/10.1177/1329878X20948957 feelings of anxiety, depression, loneliness, and self-doubt, which can negatively impact their overall well-being. For example, renowned singer-songwriter Adele has openly discussed her struggles with anxiety and stage fright, leading her to take a break from performing, while singer Demi Lovato has courageously shared her journey dealing with bipolar disorder, addiction, and self-harm.

In fact, studies have shown that a significant number of independent music makers, around 73% 8  Mula, M., & Trimble, M. R. (2009). Music and madness: neuropsychiatric aspects of music.  Clinical medicine (London, England) ,  9 (1), 83–86. https://doi.org/10.7861/clinmedicine.9-1-83 , experience symptoms of mental illness. Interviews conducted with musicians reveal that 71% of them deal with anxiety and 68.5% face 9  Vaag, J., Bjerkeset, O., & Sivertsen, B. (2021). Anxiety and Depression Symptom Level and Psychotherapy Use Among Music and Art Students Compared to the General Student Population.  Frontiers in psychology ,  12 , 607927. https://doi.org/10.3389/fpsyg.2021.607927 challenges with depression.

Music for mental illness serves as a powerful tool, offering individuals a profound connection, solace, and a unique avenue for authentic self-expression. By addressing the struggles, pain, and hope associated with mental health challenges, music helps raise awareness, reduce stigma, and foster empathy and support for those navigating their mental well-being.

At A Glance

• Music and mental health benefits have a strong connection, with each being able to influence and impact the other in meaningful ways.
• Music has the ability to reduce stress, uplift mood, and improve the quality of sleep.
• Music can be beneficial for different mental health illnesses, such as depression, anxiety, ADHD, PTSD, etc.
• Many musicians struggle with feelings of anxiety, depression, loneliness, and self-doubt, which can have a negative impact on their overall well-being.
• Incorporating music into regular life can raise self-awareness, reduce stigma, and foster empathy and support for those navigating their mental well-being.

Frequently Asked Questions (FAQs)

1. what types of music are beneficial for mental health.

The type of music that is beneficial for mental health can vary depending on individual preferences and needs. Calming and soothing music is often recommended for relaxation and stress reduction.

2. Can music therapy be used as a standalone treatment for mental illness?

Yes, music therapy has been found to offer valuable assistance in various areas, including behavior disorders, mood disorders, and anxiety disorders.

3. What are the negative effects of music on mental health?

While music can have positive effects, some potential negative effects of music on mental health include triggering or intensifying negative emotions, aggression, promoting rumination, and exacerbating symptoms of anxiety or depression in certain individuals.

References:

• 1  Clark, I. N., & Tamplin, J. (2016). How Music Can Influence the Body: Perspectives From Current Research. Voices: A World Forum for Music Therapy, 16(2). https://doi.org/10.15845/voices.v16i2.871
• 2  (PDF) Music Therapy: A Useful Therapeutic Tool for Health, Physical and Mental Growth. (n.d.). ResearchGate. Available from: https://www.researchgate.net/publication/320556617_Music_Therapy_A_Useful_Therapeutic_Tool_for_Health_Physical_and_Mental_Growth
• 3  Kumar, N. (2016, January). The effect of listening to music on concentration and academic performance of the student: Cross-sectional study on medical undergraduate students. ResearchGate. Available from: https://www.researchgate.net/publication/311435289_The_effect_of_listening_to_music_on_concentration_and_academic_performance_of_the_student_Cross-sectional_study_on_medical_undergraduate_students
• 4  Ebrahim Hosseini, & Seyed Ali Hosseini. (2019, May 8). Therapeutic Effects of Music: A Review. ResearchGate; unknown. Available from: https://www.researchgate.net/publication/332934020_Therapeutic_Effects_of_Music_A_Review
• 5  Rebecchini L. (2021). Music, mental health, and immunity.  Brain, behavior, & immunity – health ,  18 , 100374. https://doi.org/10.1016/j.bbih.2021.100374
• 6  Ebrahim Hosseini, & Seyed Ali Hosseini. (2019, May 8). Therapeutic Effects of Music: A Review. ResearchGate; unknown. Available from: https://www.researchgate.net/publication/332934020_Therapeutic_Effects_of_Music_A_Review
• 7  Brunt, S., & Nelligan, K. (2021). The Australian music industry’s mental health crisis: media narratives during the coronavirus pandemic.  Media International Australia ,  178 (1), 42–46. https://doi.org/10.1177/1329878X20948957
• 8  Mula, M., & Trimble, M. R. (2009). Music and madness: neuropsychiatric aspects of music.  Clinical medicine (London, England) ,  9 (1), 83–86. https://doi.org/10.7861/clinmedicine.9-1-83
• 9  Vaag, J., Bjerkeset, O., & Sivertsen, B. (2021). Anxiety and Depression Symptom Level and Psychotherapy Use Among Music and Art Students Compared to the General Student Population.  Frontiers in psychology ,  12 , 607927. https://doi.org/10.3389/fpsyg.2021.607927

Mental Health Topics (A-Z)

• Abrasive Personality
• Academic Problems And Skills
• Actor-Observer Bias
• Addiction And The Brain
• Causes Of Addiction
• Complications Of Addiction
• Stages Of Addiction
• Types Of Addiction
• Adjustment Disorder
• Adverse Childhood Experiences
• Premature Aging
• Aging And Mental Health
• Agoraphobia
• Agreeableness
• Alcohol Use Disorder
• Alcohol Withdrawal
• Alcohol And Mental Health
• End Stage Alcoholism
• Treatment For Alcoholism
• Alienation  
• Alzheimer’s Disease
• Anger Management
• Animal Behavior
• Treatment For Anorexia Nervosa
• Anthropomorphism
• Anthropophobia
• Antidepressants
• Arachnophobia
• Art Therapy
• Causes Of Asperger’s Syndrome
• Coping With Asperger Syndrome
• Symptoms Of Asperger’s Syndrome
• Treatment For Asperger’s Syndrome
• Astraphobia
• Attachment styles
• Attachment Theory
• Attention Deficit Hyperactivity Disorder (ADHD)
• Avoidant Personality Disorder
• Bathophobia
• Behavioral Change
• Behavioral Economics
• Bereavement
• Body-Focused Repetitive Behaviors (BFRB)
• Bibliophobia
• Bibliotherapy
• Big 5 Personality Traits  
• Binge Drinking
• Binge Eating Disorder
• Binge Watching
• Causes Of Bipolar Disorder
• Treatment of Bipolar Disorder
• Birthday Depression
• Body language
• Borderline Personality Disorder (BPD)
• Causes Of Boredom
• How To Improve Brain Health
• Nutrition And Brain Health
• Brain Science
• Bulimia Nervosa
• Causes Of Burnout
• The Bystander Effect
• Caffeine Use Disorder 
• Capgras Delusion
• Caregiving  
• Character Traits 
• Child Development  
• Child Discipline 
• Christmas And Mental Health  
• Types Of Chronic Pain
• Chronomentrophobia  
• City Syndromes
• Traits Of Cluster B Personality Disorder
• Cluster B Personality Disorders Treatment 
• Coping With Codependency 
• Effectiveness Of Cognitive-Behavioral Therapy (CBT) 
• Types of Cognitive Biases
• Cognitive Decline
• Cognitive Dissonance  
• Color Psychology
• Commitment Phobia
• Communication Disorders 
• Compassion Fatigue 
• Compulsive Buying Disorder
• Conduct Disorder
• Confirmation Bias  
• Conscientiousness
• Consumer Behavior  
• Consumerism  
• Couples Therapy
• Decision-making
• Default Mode Network (DMN) And Alzheimer’s Disease
• Defense Mechanisms
• Delusional Disorder
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• Depression 
• Depression At Night
• Dermatillomania
• Discrimination
• Disruptive Mood Dysregulation Disorder (DMDD)
• Dissociative Disorders
• Treatment Of Dissociative Fugue
• Dissociative Identity Disorder
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• Domestic Violence and Mental Health
• Dopamine Deficiency
• How To Increase Dopamine
• Dream Interpretation
• Drug Abuse  
• Drunkorexia
• Coping With The Dunning-Kruger Effect
• Types of Dysgraphia 
• Dyspareunia
• Dysthymia (Persistent Depressive Disorder)
• Causes Of Eating Disorders
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• Treatment For Eating Disorders
• Ego Depletion
• Embarrassment
• Emotional Regulation
• Emotional Abuse  
• Improving Emotional Intelligence (EI)
• Empathic Accuracy
• Environmental Psychology 
• Evolutionary Psychology
• Executive Function
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• Expressive Language Disorder
• Signs Of An Extrovert
• False Memory
• Types of Family Dynamics
• Fear of Missing Out (FOMO)
• Financial Therapy  
• First Impression
• Forensic Psychology 
• Four Pillars Of Mental Health
• Free Will  
• Freudian Psychology
• Friends And Mental Health  
• Gambling Disorder
• Ganser Syndrome
• Gaslighting
• Gender Dysphoria
• Gender and Alienation 
• Gender Bias 
• Causes Of Generalized Anxiety Disorder (GAD)
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• Generalized Anxiety Disorder Treatment
• Geographical Psychology  
• Gerascophobia
• Geriatric Depression
• Group Therapy
• Growth Mindset
• How To Strengthen Your Gut Feeling
• How To Form Effective Habits
• Hakomi Therapy
• Halo Effect
•  Healing From Trauma
• Heliophobia
• Hexaco Personality Test
• Highly Sensitive Person (HSP)
• Histrionic Personality Disorder
• Hoarding Disorder
• Holiday Depression
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• Types Of Holistic Health Treatments
• Homelessness and Mental Health
• Homosexuality
• Horn Effect
• Human Trafficking And Mental Health
• Hypersomnia
• Illness Anxiety Disorder
• Imagination
• Impostor Syndrome
• Impulse Buying
• Impulse Control Disorder (ICD)
• Inspiration
• Intellectual Disability
• Internet Addiction
• Introversion
• Kleptomania
• Laughter Therapy
• Learned Helplessness
• Life Satisfaction 
• Types Of Life Skills
• Living With Someone With Mental Illness
• Locus Of Control
• How To Practice Healthy Love In Relationships
• Love Addiction
• Love And Relationships  
• Love And Mental Health
• Self Love Deficit Disorder
• Triangular Theory Of Love
• Machiavellianism
• Mageirocophobia
• Benefits Of Magical Thinking
• Magical Thinking OCD
• Causes Of Depression
• Coping With Depression
• Treatment For Depression
• Types Of Depression
• Maladaptive Daydreaming
• Manic Depression
• Manic Episode
• Mens Mental Health 
• Mental Exercises
•  Mental Health And Holidays 
• Children’s Mental Health Awareness
• Mental Health Disability
• Mental Illness 
• Mental Wellness In New Year 
• Metacognition
• Microaggression
• Microexpressions
• Midlife Crisis 
• Mindfulness
• Money and Mental Health
• Mood Disorders
• Motivated Reasoning
• Music Therapy
• Myers-Briggs Type Indicator (MBTI)
• Nature and Mental Health
• Necrophobia
• Neuroticism
• Night Eating Syndrome
• Causes Of Nightmare Disorder
• Treatment for Nightmare Disorder
• Nyctophobia
• Obsessive-Compulsive Disorder (OCD)
• Obsessive Love Disorder
• Online Counseling
• Online Therapy
• Onychophagia (Nail Biting)
• Oppositional Defiant Disorder (ODD)
• Panic Disorder
• Panic Disorder with Agoraphobia  
• Causes Of Paranoia
• Coping With Paranoia
• Helping Someone With Paranoia
• Symptoms Of Paranoia
• Treatment Of Paranoia
• Types Of Paranoia
• Paranoid Personality Disorder
• Coping With Paranoid Schizophrenia
• Helping Someone With Paranoid Schizophrenia
• Treatment of Paranoid Schizophrenia
• Parental Alienation Syndrome  
• Parkinson’s Disease
• Passive Aggression
• Pathological Jealousy
• Perfectionism
• Performance Anxiety
• Perinatal Mood And Anxiety Disorders (PMADs)
• Personality
• Personality Disorders
• Pet Therapy
• Pica Disorder
• Positive Psychology
• Causes Of PTSD
• Post-Traumatic Stress Disorder in Children
• Coping With Post-Traumatic Stress Disorder (PTSD)
• Diagnosis Of Post-Traumatic Stress Disorder (PTSD)
• Symptoms Of Post-Traumatic Stress Disorder (PTSD)
• Treatment Of Post-Traumatic Stress Disorder (PTSD)
• Treatment Of Postpartum Depression
• Postpartum Psychosis
• Premature Ejaculation
• Procrastination
• Psychoanalysis
• The Psychology Behind Smoking
• Psychotherapy
• Psychotic Depression
• Reactive Attachment Disorder
• Recovered Memory Syndrome
• Rejection Sensitive Dysphoria
• Relationships
• Reminiscence Therapy
• Repetitive Self-Mutilation
• Restless Legs Syndrome
• Retrograde Amnesia
• Rumination Disorder
• Seasonal Affective Disorder (SAD)
• Schema Therapy
• Childhood Schizophrenia
• Hebephrenia (Disorganized Schizophrenia)
• Treatment Of Schizophrenia
• Schizophrenia Spectrum Disorder 
• Selective Mutism
• Self-Actualization
• Self Care And Wellness
• Self-Control
• Self-disclosure
• Self-Esteem
• Self-Monitoring
• Self-motivation
• Self-Serving Bias
• Sensory Processing Disorder
• Separation Anxiety Disorder
• Separation Anxiety in Relationships
• Serial Killers
• Sexual Masochism Disorder
• Sexual Orientation
• Shared Psychotic Disorder
• Signs And Symptoms Of Schizophrenia
• Situational Stress
• Situationship
• Non-Rapid Eye Movement (NREM) Sleep Arousal Disorders
• Parasomnias
• Sleep Disorders
• Sleep Paralysis
• Sleeplessness
• Sleep Meditation
• Sociability
• Social Anxiety Disorder
• Social Media Addiction
• Social Media And Mental Health
• Somatic Symptom Disorder ( SSD )
• Specific Reading Comprehension Deficit
• Spirituality
• Stage Fright
• Stendhal Syndrome
• Stereotypes
• Acute Stress Disorder
• Stress Management
• Suicide And Mental Health  
• Suicide Grief 
• Teen Dating Violence
• Time Management Techniques
• 10 Helpful Time Management Tips
• Tobacco-Related Disorders
• Toxic Love Disorder 
• Transgender
• Transient Tic Disorder
• Trauma and Addiction
• Trichotillomania
• Venustraphobia
• Video Game Addiction
• Virtual Reality and Mental Health
• Voyeuristic Disorder
• Weight Watchers
• Werther Syndrome
• Good Mental Health
• Stockholm Syndrome
• Work and Mental Health 
• How To Cure Workaholism
• Workplace Bullying
• Workplace Stress
• Yoga For Mental Health
• Young Male Syndrome
• Zeigarnik Effect
• Zone of Proximal Development  

Copyright 2024

Here’s how you know

• U.S. Department of Health and Human Services
• National Institutes of Health

Music and Health: What You Need To Know

.header_greentext{color:green!important;font-size:24px!important;font-weight:500!important;}.header_bluetext{color:blue!important;font-size:18px!important;font-weight:500!important;}.header_redtext{color:red!important;font-size:28px!important;font-weight:500!important;}.header_darkred{color:#803d2f!important;font-size:28px!important;font-weight:500!important;}.header_purpletext{color:purple!important;font-size:31px!important;font-weight:500!important;}.header_yellowtext{color:yellow!important;font-size:20px!important;font-weight:500!important;}.header_blacktext{color:black!important;font-size:22px!important;font-weight:500!important;}.header_whitetext{color:white!important;font-size:22px!important;font-weight:500!important;}.header_darkred{color:#803d2f!important;}.Green_Header{color:green!important;font-size:24px!important;font-weight:500!important;}.Blue_Header{color:blue!important;font-size:18px!important;font-weight:500!important;}.Red_Header{color:red!important;font-size:28px!important;font-weight:500!important;}.Purple_Header{color:purple!important;font-size:31px!important;font-weight:500!important;}.Yellow_Header{color:yellow!important;font-size:20px!important;font-weight:500!important;}.Black_Header{color:black!important;font-size:22px!important;font-weight:500!important;}.White_Header{color:white!important;font-size:22px!important;font-weight:500!important;} Can music be good for you?

Yes, according to a growing body of research. Listening to or making music affects the brain in ways that may help promote health and manage disease symptoms.

Performing or listening to music activates a variety of structures in the brain that are involved in thinking, sensation, movement, and emotion. These brain effects may have physical and psychological benefits. For example, music causes the release of brain chemicals (neurotransmitters and hormones) that can evoke emotional reactions, memories, and feelings and promote social bonds. Music can even affect the structure of the brain. Certain structures in the brain have been found to be larger in musicians than nonmusicians, with particularly noticeable changes in people who started their musical training at an early age.

Increasing evidence suggests that music-based interventions may be helpful for health conditions that occur during childhood, adulthood, or aging. However, because much of the research on music-based interventions is preliminary, few definite conclusions about their effects have been reached. Many reports on the potential benefits of music-based interventions come from observations of individuals or small groups of people. Evidence of this type is valuable for suggesting new ideas, but carefully designed, scientifically rigorous studies of larger numbers of people are needed to provide stronger evidence on whether music-based interventions are effective for specific purposes.

.header_greentext{color:green!important;font-size:24px!important;font-weight:500!important;}.header_bluetext{color:blue!important;font-size:18px!important;font-weight:500!important;}.header_redtext{color:red!important;font-size:28px!important;font-weight:500!important;}.header_darkred{color:#803d2f!important;font-size:28px!important;font-weight:500!important;}.header_purpletext{color:purple!important;font-size:31px!important;font-weight:500!important;}.header_yellowtext{color:yellow!important;font-size:20px!important;font-weight:500!important;}.header_blacktext{color:black!important;font-size:22px!important;font-weight:500!important;}.header_whitetext{color:white!important;font-size:22px!important;font-weight:500!important;}.header_darkred{color:#803d2f!important;}.Green_Header{color:green!important;font-size:24px!important;font-weight:500!important;}.Blue_Header{color:blue!important;font-size:18px!important;font-weight:500!important;}.Red_Header{color:red!important;font-size:28px!important;font-weight:500!important;}.Purple_Header{color:purple!important;font-size:31px!important;font-weight:500!important;}.Yellow_Header{color:yellow!important;font-size:20px!important;font-weight:500!important;}.Black_Header{color:black!important;font-size:22px!important;font-weight:500!important;}.White_Header{color:white!important;font-size:22px!important;font-weight:500!important;} What is music therapy?

Music therapy is a health profession in which music is used within a therapeutic relationship to address physical, emotional, cognitive, and social needs. The term “music therapy” is not a description of a specific type of intervention. Instead, it indicates the education, training, and credentials of the therapist who is delivering the intervention.

Music therapy may involve a variety of different activities, including music improvisation, music listening, song writing, music performance, and learning through music. Music therapists may work in many different settings, such as hospitals, outpatient clinics, nursing homes, senior centers, rehabilitation facilities, or schools.

Some of the music-based interventions described in this fact sheet fit the definition of music therapy, but others do not. For example, music-based interventions that involve listening to recorded music are often delivered by health professionals other than music therapists (such as nurses), and therefore do not fit the definition of music therapy.

You can learn more about music therapy on the website of the American Music Therapy Association .

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In general, research studies of music-based interventions do not show any negative effects. However, listening to music at too high a volume can contribute to noise-induced hearing loss. You can find out about this type of hearing loss on the National Institute on Deafness and Other Communication Disorders website .

In addition, because music can be associated with strong memories or emotional reactions, some people may be distressed by exposure to specific pieces or types of music. Extensive playing of musical instruments can lead to pain and injury. Music-based interventions that involve exercise or other types of movement could also lead to injury if appropriate safety precautions are not taken.

.header_greentext{color:green!important;font-size:24px!important;font-weight:500!important;}.header_bluetext{color:blue!important;font-size:18px!important;font-weight:500!important;}.header_redtext{color:red!important;font-size:28px!important;font-weight:500!important;}.header_darkred{color:#803d2f!important;font-size:28px!important;font-weight:500!important;}.header_purpletext{color:purple!important;font-size:31px!important;font-weight:500!important;}.header_yellowtext{color:yellow!important;font-size:20px!important;font-weight:500!important;}.header_blacktext{color:black!important;font-size:22px!important;font-weight:500!important;}.header_whitetext{color:white!important;font-size:22px!important;font-weight:500!important;}.header_darkred{color:#803d2f!important;}.Green_Header{color:green!important;font-size:24px!important;font-weight:500!important;}.Blue_Header{color:blue!important;font-size:18px!important;font-weight:500!important;}.Red_Header{color:red!important;font-size:28px!important;font-weight:500!important;}.Purple_Header{color:purple!important;font-size:31px!important;font-weight:500!important;}.Yellow_Header{color:yellow!important;font-size:20px!important;font-weight:500!important;}.Black_Header{color:black!important;font-size:22px!important;font-weight:500!important;}.White_Header{color:white!important;font-size:22px!important;font-weight:500!important;} What does research show about music-based interventions for people with health conditions?

The preliminary research that has been done so far suggests that music-based interventions may be helpful for anxiety, depressive symptoms, and pain associated with a variety of health conditions, as well as for some other symptoms associated with dementia, multiple sclerosis, Parkinson’s disease, and other conditions. 

.header_greentext{color:green!important;font-size:24px!important;font-weight:500!important;}.header_bluetext{color:blue!important;font-size:18px!important;font-weight:500!important;}.header_redtext{color:red!important;font-size:28px!important;font-weight:500!important;}.header_darkred{color:#803d2f!important;font-size:28px!important;font-weight:500!important;}.header_purpletext{color:purple!important;font-size:31px!important;font-weight:500!important;}.header_yellowtext{color:yellow!important;font-size:20px!important;font-weight:500!important;}.header_blacktext{color:black!important;font-size:22px!important;font-weight:500!important;}.header_whitetext{color:white!important;font-size:22px!important;font-weight:500!important;}.header_darkred{color:#803d2f!important;}.Green_Header{color:green!important;font-size:24px!important;font-weight:500!important;}.Blue_Header{color:blue!important;font-size:18px!important;font-weight:500!important;}.Red_Header{color:red!important;font-size:28px!important;font-weight:500!important;}.Purple_Header{color:purple!important;font-size:31px!important;font-weight:500!important;}.Yellow_Header{color:yellow!important;font-size:20px!important;font-weight:500!important;}.Black_Header{color:black!important;font-size:22px!important;font-weight:500!important;}.White_Header{color:white!important;font-size:22px!important;font-weight:500!important;} Pain

As mentioned in other sections of this fact sheet, there’s evidence that music-based interventions may help to relieve pain associated with specific health conditions. The two review articles listed below describe evidence indicating that music may be helpful for pain more generally. Newer research continues to find evidence that music may be helpful for pain from a variety of causes, but not every study has shown a beneficial effect. 

• A 2016 review looked at 97 studies (9,184 participants) of music-based interventions for acute or chronic pain associated with a variety of health problems and medical procedures. The overall evidence suggested that music-based interventions may have beneficial effects on both pain intensity and emotional distress from pain and may lead to decreased use of pain-relieving medicines.
• A 2017 review of 14 randomized trials (1,178 participants) of music-based interventions for various types of chronic pain found that the interventions reduced self-reported chronic pain and associated depressive symptoms, with a greater effect when the music was chosen by the participant rather than the researcher. The study participants had a variety of conditions that can cause chronic pain, including cancer, fibromyalgia, multiple sclerosis, or osteoarthritis, and most of the interventions involved listening to recorded music.
• Many but not all newer studies of music-based interventions for pain have had promising results. For example, in recent studies, music-based interventions were helpful for pain associated with childbirth, cancer chemotherapy, a procedure in which shock waves are used to break up kidney stones, retrieval of eggs for in vitro fertilization, treatment of nose fractures, and sickle cell disease. However, music didn’t seem to be helpful for reducing moderate pain further after use of a lidocaine spray for loop electrosurgical excision (a gynecological procedure), and the results of studies on pain during cystoscopy (a procedure in which a tube is inserted into the bladder) and pain during colonoscopy were inconsistent.

.header_greentext{color:green!important;font-size:24px!important;font-weight:500!important;}.header_bluetext{color:blue!important;font-size:18px!important;font-weight:500!important;}.header_redtext{color:red!important;font-size:28px!important;font-weight:500!important;}.header_darkred{color:#803d2f!important;font-size:28px!important;font-weight:500!important;}.header_purpletext{color:purple!important;font-size:31px!important;font-weight:500!important;}.header_yellowtext{color:yellow!important;font-size:20px!important;font-weight:500!important;}.header_blacktext{color:black!important;font-size:22px!important;font-weight:500!important;}.header_whitetext{color:white!important;font-size:22px!important;font-weight:500!important;}.header_darkred{color:#803d2f!important;}.Green_Header{color:green!important;font-size:24px!important;font-weight:500!important;}.Blue_Header{color:blue!important;font-size:18px!important;font-weight:500!important;}.Red_Header{color:red!important;font-size:28px!important;font-weight:500!important;}.Purple_Header{color:purple!important;font-size:31px!important;font-weight:500!important;}.Yellow_Header{color:yellow!important;font-size:20px!important;font-weight:500!important;}.Black_Header{color:black!important;font-size:22px!important;font-weight:500!important;}.White_Header{color:white!important;font-size:22px!important;font-weight:500!important;} Anxiety

Music-based interventions have been evaluated for their effects on anxiety in a variety of disease conditions and health care settings. Some examples are given in this section, and others are discussed in the sections on specific health conditions. Most studies have had promising results, except for studies on anxiety associated with dental care.

• A 2013 review of 26 studies (2,051 participants) showed that listening to recorded music significantly reduced anxiety in people who were waiting to have surgery. However, there was potential for bias in most of the studies because the investigators who performed the studies knew which participants had listened to music.
• A 2016 review of 17 studies (1,381 participants) that evaluated the effect of music-based interventions on anxiety in adults with cancer suggested that the interventions may have a large anxiety-reducing effect. However, there was a high risk of bias in the studies. 
• A 2015 review of 5 studies (290 participants) in people who were having dialysis treatments suggested that listening to music reduced anxiety. However, these studies have limitations because of their small size and high risk of bias.
• A 2018 review concluded that it’s unclear whether listening to music is helpful for dental anxiety. Some studies have suggested that listening to music as a distraction may not be adequate to reduce anxiety in children or highly anxious adults who are having dental care. More active types of music-based interventions (for example, a music-assisted relaxation technique that’s taught to the patient in advance) might be helpful in dental settings but have not been evaluated in formal studies.  

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It’s uncertain whether music-based interventions are helpful for people with ASD.

• A 2021 review of 22 studies (850 participants) on music therapy for children with ASD was unable to reach any definite conclusions on whether adding music therapy to their care is beneficial, although some studies had promising results. For example, some studies of educational music therapy (involving techniques such as musical games) showed possible benefits on the children’s speech, and some studies of improvisational music therapy (in which children produce music) showed possible benefits on social functioning.
• One particularly notable study of music therapy for children with ASD (which was included in the review described above) was a multinational trial involving 364 children from 9 countries. It is the largest study completed so far, and its design was especially rigorous. In this study, the severity of symptoms related to difficulties in social communication did not differ between children who received music therapy along with standard care and those who received standard care alone.

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Preliminary evidence suggests that music-based interventions may be helpful for several types of distress in people with cancer.

• A 2021 review of randomized controlled trials (studies in which participants were randomly assigned to a music-based intervention group or a control group), which included 81 trials and 5,576 participants, concluded that in adults with cancer, music interventions may have a large anxiety-reducing effect, a moderately strong beneficial effect on depression, a moderate pain-reducing effect, and a large effect on the quality of life. Most of the trials had a high risk of bias, so their results need to be interpreted with caution. Only seven of the studies included in this review involved children. Two of these studies suggested a beneficial effect on anxiety; no other conclusions could be reached from the small amount of evidence available.
• A 2021 review of 11 studies (491 participants) on music interventions for children and adolescents with cancer, which included some studies that were less rigorous than a randomized controlled trial, found evidence suggesting that music-based interventions may decrease anxiety, perceived pain, and depression symptoms and improve state of mind, self-esteem, and quality of life.

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A 2021 systematic review of 12 studies (812 participants) showed that music-based interventions were helpful for shortness of breath, anxiety, and sleep quality in adults with COPD but were not helpful for depression. Because the studies were brief (several days to 12 months) and because researchers measured effects in different ways in different studies, there is some uncertainty about the conclusions.

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Much research is being done on the potential benefits of music-based interventions for people with cognitive impairment or various types of dementia, such as Alzheimer’s disease. Limited evidence suggests that music-based interventions may improve emotional well-being, behavioral challenges, and quality of life in people with these conditions. Whether the interventions have benefits for cognitive functioning is unclear; effects might depend on the population studied or the type of intervention used.

• A 2018 review evaluated 22 studies (1,097 participants) of music-based interventions for people with dementia who were living in institutions. Some of the interventions were receptive (listening to music), some were active (singing, playing instruments, moving to music, etc.), and some were a combination of the two. The evidence from these studies indicated that music-based interventions probably reduce depressive symptoms and improve overall behavioral challenges. They may also improve emotional well-being and quality of life and reduce anxiety. However, the interventions may have little or no effect on agitation, aggression, or cognitive function.
• A 2021 review looked at 21 studies (1,472 participants) of people with either mild cognitive impairment or mild or moderate dementia; some of the people studied were living in institutions, but others were living in the community. All the music interventions were active; studies that only involved listening to music were not included. Nine of the studies (495 participants) were included in a quantitative analysis of effects on cognitive functioning; this analysis indicated that the music-based interventions had a small beneficial effect. There was also some evidence for beneficial effects on mood and quality of life.

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A 2017 review looked at 9 studies (421 participants) of music-based interventions in adults or adolescents with depression. There was moderate-quality evidence that adding music-based interventions to usual treatment improved depression symptoms when compared with usual treatment alone. Music-based interventions also helped decrease anxiety levels and improve functioning of people with depression (for example, their ability to maintain involvement in work, activities, and relationships).

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A 2020 systematic review of 7 studies (334 participants) found evidence that music-based interventions were beneficial for pain, depression, and quality of life in people with fibromyalgia. However, the amount of research was limited, and the quality of the research was low.

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A 2021 review of music-based interventions for people with multiple sclerosis (10 trials, 429 participants) found consistent evidence that the interventions were beneficial for coordination, balance, some aspects of gait and walking, emotional status, and pain, but no effect was observed for mental fatigability or memory.

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Researchers are evaluating the potential benefits of several types of music-based interventions for Parkinson’s disease symptoms. 

• Rhythmic auditory stimulation.  Rhythmic auditory stimulation uses pulsed sounds (such as those produced by a metronome) to help people synchronize their movements to the rhythm of the sounds. This technique is used to help people with Parkinson’s disease improve their ability to walk. A 2021 analysis of 5 studies (209 total participants) showed significant improvements in gait speed and stride length in people with Parkinson’s disease who participated in rhythmic auditory stimulation. However, the quality of evidence was low, and the number of studies and participants was small.
• Music-based movement therapy.  Music-based movement therapy combines physical activities such as dance or rhythmic exercises with music. Therapies that involve physical activity have been shown to be helpful for a variety of Parkinson’s disease symptoms. Adding music to the therapy might have additional benefits by providing auditory cues for movement and making the activities more enjoyable. A 2021 analysis of 17 studies (598 participants) of music-based movement therapy showed evidence of improvements in motor function, balance, freezing of gait, walking speed, and mental health but not gait cadence, stride length, or quality of life.
• Singing. The potential benefits of singing for people with Parkinson’s disease have been studied primarily in terms of effects on speech. In a 2016 review of 7 studies (102 participants), 5 studies found some evidence of a beneficial effect on speech.

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Music-based interventions are widely used in neonatal intensive care units. However, evidence for physiological benefits for newborn infants is limited. 

• In a 2020 review of 16 studies (826 infants), 12 of the studies found some evidence of benefits on physiological outcomes (such as heart rate or oxygen saturation), but several of the studies included only small numbers of infants, and the intervention methods used varied from one study to another. The reviewers concluded that the current data are insufficient to confirm physiological benefits. No harmful effects of music-based interventions were seen in the studies included in this review.

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Music-based interventions have been evaluated as adjunct treatments (additions to usual treatment) for people with schizophrenia. A 2020 review of 18 studies (1,212 participants) indicated that adjunct music-based interventions may improve a group of schizophrenia symptoms known as “negative symptoms,” such as reduced emotion and self-neglect, as well as depression symptoms and quality of life. However, music-based interventions did not reduce “positive symptoms,” such as hallucinations and delusions. The quality of the evidence was low.

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Listening to music may improve sleep quality in people with insomnia.

• A 2022 review looked at 13 studies (1,007 participants) that examined the effect of listening to recorded music in people with insomnia. The studies suggested music had no effect on insomnia severity compared to no treatment or treatment as usual. Moderate-certainty evidence did suggest, however, that listening to music has a beneficial effect on subjective sleep quality. The studies also provided low-certainty evidence that listening to music might help improve the speed of falling asleep, the length of time spent sleeping, and the amount of time a person is asleep compared to the total time spent in bed.
• It’s common for older people to have trouble sleeping. A 2021 review looked at 16 studies of music-based interventions for sleep in older adults (812 participants); 11 studies evaluated music listening, and the other 5 evaluated more complex interventions. The results were mixed, with some studies suggesting that the music interventions were helpful, while others did not.

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Music-based interventions, particularly music therapy, may be helpful for improving physical and psychological markers associated with stress, according to two related reviews.

• In a 2020 review with 104 studies (9,617 participants), investigators looked at the effects of a variety of music-based interventions on measures associated with stress, including both physical measures (heart rate, blood pressure, and levels of stress-related hormones) and psychological measures (anxiety, nervousness, restlessness, and feelings of worry). The music-based interventions had a small-to-medium sized beneficial effect on the physical measures and a medium-to-large beneficial effect on the psychological measures. 
• A second review looked at 47 studies (2,747 participants) of music therapy (excluding other music-based interventions) and found an overall medium-to-large beneficial effect on stress-related outcomes. The effects were greater than those seen in the larger review. The investigators who performed the review suggested that the opportunity for music therapists to tailor interventions to the needs of individual patients might account for the difference.

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Music-based interventions may be helpful in the rehabilitation of people who have had a stroke. A 2019 review of 27 studies (730 participants) found positive effects on physical status (upper-limb activity, various aspects of walking, balance), cognition (paying attention, communication), and mood. In particular, rhythmic auditory stimulation (which involves the use of a metronome combined with physical activities) had beneficial effects on gait and balance, and receptive music therapy (which involves listening to music while performing another task) was helpful for mood and some aspects of cognitive function.

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Tinnitus is the symptom that people often describe as “ringing in the ears,” although it can also sound like roaring, clicking, hissing, or buzzing. It can be caused by noise-induced hearing loss, blockage of the ear canal by earwax, ear or sinus infections, or other health conditions, or by starting or stopping various medications. Sometimes, tinnitus has no obvious cause.

• Sound therapies. Various types of sounds, including music, have been used to try to mask tinnitus. However, according to a 2019 review of studies conducted up to that time, the effects of these sound therapies are modest; few people achieve complete remission of tinnitus from sound therapies.
• Notched music therapy. A specific type of music therapy called “notched” music therapy has been suggested as a possible way to reduce the severity of tinnitus. Notched music therapy involves listening to music that has been modified to remove sounds close in frequency to the frequency of the tinnitus sound perceived by the patient. Two recent studies that compared notched music with conventional music did not find notched music to be more helpful in reducing the symptoms or impact of tinnitus. However, some earlier studies suggested that the loudness of tinnitus sounds could be reduced with notched music therapy.

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NIH and the John F. Kennedy Center for the Performing Arts, in association with the National Endowment for the Arts, are sponsoring an initiative called Sound Health to increase understanding of music’s effect on the brain and the potential clinical applications. The first Sound Health research projects began in 2019. Some projects are investigating music’s mechanism of action in the brain and how music may be applied to treat symptoms of disorders such as Parkinson’s disease, stroke, and chronic pain. Others are looking at the effects of music on children’s developing brains.

Topics of NCCIH-supported studies within the Sound Health initiative include:

• The effects of music-based interventions on neurodevelopment and pain response in preterm infants
• Using self-generated rhythmic cues to enhance gait in people with Parkinson’s disease
• The impact of singing interventions on markers of cardiovascular health in older people with cardiovascular disease

In collaboration with the Foundation for the NIH and the Renée Fleming Foundation, NIH has developed a toolkit for rigorous, reproducible, well-powered music-based interventions for brain disorders of aging, such as Alzheimer’s disease, Parkinson’s disease, and stroke. Three workshops were held in 2021 to gather input from experts in a variety of relevant fields, and a request for information was issued to get stakeholder feedback. The toolkit , which was released in 2023, will be pilot tested in demonstration projects. NCCIH is playing a lead role in this effort.

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Nccih clearinghouse.

The NCCIH Clearinghouse provides information on NCCIH and complementary and integrative health approaches, including publications and searches of Federal databases of scientific and medical literature. The Clearinghouse does not provide medical advice, treatment recommendations, or referrals to practitioners.

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Know the Science

NCCIH and the National Institutes of Health (NIH) provide tools to help you understand the basics and terminology of scientific research so you can make well-informed decisions about your health. Know the Science features a variety of materials, including interactive modules, quizzes, and videos, as well as links to informative content from Federal resources designed to help consumers make sense of health information.

Explaining How Research Works (NIH)

Know the Science: How To Make Sense of a Scientific Journal Article

Understanding Clinical Studies (NIH)

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• Aalbers   S, Fusar-Poli L, Freeman RE, et al.  Music therapy for depression . Cochrane Database of Systematic Reviews. 2017;(11):CD004517. Accessed at cochranelibrary.com on October 29, 2021.
• Bieleninik Ł, Geretsegger M, Mössler K, et al.  Effects of improvisational music therapy vs enhanced standard care on symptom severity among children with autism spectrum disorder. The TIME—a randomized clinical trial . JAMA. 2017;318(6):525-535.
• Bradt J, Dileo C, Magill L, et al. Music interventions for improving psychological and physical outcomes in cancer patients . Cochrane Database of Systematic Reviews. 2016;(8):CD006911. Accessed at cochranelibrary.com on October 29, 2021.
• Bradt J, Dileo C, Shim M. Music interventions for preoperative anxiety . Cochrane Database of Systematic Reviews. 2013;(6):CD006908. Accessed at cochranelibrary.com  on October 29, 2021.
• Burrai F, Apuzzo L, Zanotti R. Effectiveness of rhythmic auditory stimulation on gait in Parkinson disease: a systematic review and meta-analysis . Holistic Nursing Practice. June 11, 2021. [Epub ahead of print].
• Cheever T, Taylor A, Finkelstein R, et al. NIH/Kennedy Center workshop on music and the brain: finding harmony . Neuron. 2018;97(6):1214-1218.
• Collins FS, Fleming R. Sound health: an NIH-Kennedy Center initiative to explore music and the mind . JAMA. 2017;317(24):2470-2471.
• de Witte   M, da Silva Pinho A, Stams G-J, et al. Music therapy for stress reduction: a systematic review and meta-analysis . Health Psychology Review. 2022;16(1):134-159.
• de Witte   M, Spruit A, van Hooren S, et al. Effects of music interventions on stress-related outcomes: a systematic review and two meta-analyses . Health Psychology Review. 2020;14(2):294-324.
• Dorris   JL, Neely S, Terhorst L, et al. Effects of music participation for mild cognitive impairment and dementia: a systematic review and meta-analysis . Journal of the American Geriatrics Society.  2021;69(9):2659-2667.
• Foroushani SM, Herman CA, Wiseman CA, et al. Evaluating physiologic outcomes of music interventions in the neonatal intensive care unit: a systematic review . Journal of Perinatology. 2020;40(12):1770-1779.
• Garza-Villareal   EA, Pando V, Vuust P, et al. Music-induced analgesia in chronic pain conditions: a systematic review and meta-analysis . Pain Physician. 2017;20(7):597-610.
• Jespersen KV, Pando-Naude V, Koenig J, et al. Listening to music for insomnia in adults . Cochrane Database of Systematic Reviews. 2022;(8):CD010459. Accessed at cochranelibrary.com on September 8, 2022.
• Lee   JH. The effects of music on pain: a meta-analysis . Journal of Music Therapy. 2016;53(4):430-477.
• van der Steen   JT, Smaling HJ, van der Wouden JC, et al. Music-based therapeutic interventions for people with dementia . Cochrane Database of Systematic Reviews. 2018;(7):CD003447. Accessed at cochranelibrary.com on October 29, 2021.

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• Atipas   S, Therdphaothai J, Suvansit K, et al. A randomized, controlled trial of notched music therapy for tinnitus patients. Journal of International Advanced Otology. 2021;17(3):221-227.
• Barnish J, Atkinson RA, Barran SM, et al. Potential benefit of singing for people with Parkinson’s disease: a systematic review. Journal of Parkinson’s Disease. 2016;6(3):473-484.
• Bird HA. Overuse syndrome in musicians. Clinical Rheumatology. 2013;32(4):475-479.
• Bradt J, Teague A. Music interventions for dental anxiety. Oral Diseases. 2018;24(3):300-306.
• Brancatisano O, Baird A, Thompson WF. Why is music therapeutic for neurological disorders? The therapeutic music capacities model. Neuroscience and Biobehavioral Reviews. 2020;112:600-615.
• Buglione A, Saccone G, Mas M, et al. Effect of music on labor and delivery in nulliparous singleton pregnancies: a randomized clinical trial. Archives of Gynecology and Obstetrics.  2020;310(3):693-698.
• Burrai F, Magavern EF, Micheluzzi V, et al. Effectiveness of music to improve anxiety in hemodialysis patients. A systematic review and meta-analysis. Holistic Nursing Practice. 2020;34(6):324-333.
• Cakmak O, Cimen S, Tarhan H, et al. Listening to music during shock wave lithotripsy decreases anxiety, pain, and dissatisfaction. A randomized controlled study. Wiener Klinische Wochenscrift.  2017;129(19-20):687-691.
• Ç elebi D, Y ı lmaz E, Ş ahin ST, et al. The effect of music therapy during colonoscopy on pain, anxiety and patient comfort: a randomized controlled trial. Complementary Therapies in Clinical Practice. 2020;38:101084.
• Chantawong N, Charoenkwan K. Effects of music listening during loop electrosurgical excision procedure on pain and anxiety: a randomized trial. Journal of Lower Genital Tract Disease. 2017;21(4):307-310.
• Cheung CWC, Yee AWW, Chan PS, et al. The impact of music therapy on pain and stress reduction during oocyte retrieval—a randomized controlled trial. Reproductive Biomedicine Online. 2018;37(2):145-152.
• Çift   A, Benlioğlu C. Effect of different musical types on patient’s relaxation, anxiety and pain perception during shock wave lithotripsy: a randomized controlled study. Urology Journal. 2020;17(1):19-23.
• Gonz á lez-Mart í n-Moreno   M, Garrido-Ardila EM, Jim é nez-Palomares M, et al. Music-based interventions in paediatric and adolescents oncology patients: a systematic review. Children. 2021;8(2):73.
• Huang J, Yuan X, Zhang N, et al. Music therapy in adults with COPD. Respiratory Care. 2021;66(3):501-509.
• Jia   R, Liang D, Yu J, et al. The effectiveness of adjunct music therapy for patients with schizophrenia: a meta-analysis. Psychiatry Research. 2020;293:113464.
• Ko SY, Leung DYP, Wong EML. Effects of easy listening music intervention on satisfaction, anxiety, and pain in patients undergoing colonoscopy: a pilot randomized controlled trial. Clinical Interventions in Aging. 2019;14:977-986.
• Koelsch S. A neuroscientific perspective on music therapy. Annals of the New York Academy of Sciences. 2009;1169:374-384.
• Le Perf   G, Donguy A-L, Thebault G. Nuanced effects of music interventions on rehabilitation outcomes after stroke: a systematic review. Topics in Stroke Rehabilitation.  2019;26(6):473-484.
• Lopes   J, Keppers II. Music-based therapy in rehabilitation of people with multiple sclerosis: a systematic review of clinical trials. Arquivos de Neuro-psiquiatria.  2021;79(6):527-535.
• Mayer-Benarous   H, Benarous X, Vonthron F, et al. Music therapy for children with autistic spectrum disorder and/or other neurodevelopmental disorders: a systematic review. Frontiers in Psychiatry. 2021;12:643234.
• McClintock G, Wong E, Mancuso P, et al. Music during flexible cystoscopy for pain and anxiety – a patient-blinded randomized control trial. BJU International. 2021;128 Suppl 1:27-32. 
• Mumm J-N, Eismann L, Rodler S, et al. Listening to music during outpatient cystoscopy reduces pain and anxiety and increases satisfaction: results from a prospective randomized study. Urologia Internationalis . 2021;105(9-10):792-798. 
• Ortega   A, Gauna F, Munoz D, et al. Music therapy for pain and anxiety management in nasal bone fracture reduction: randomized controlled clinical trial. Otolaryngology—Head and Neck Surgery. 2019;161(4):613-619.
• Perković R, Dević K, Hrkać A, et al. Relationship between education of pregnant women and listening to classical music with the experience of pain in childbirth and the occurrence of psychological symptoms in puerperium. Psychiatria Danubina. 2021;33(Suppl 13):260-270.
• Petrovsky DV, Ramesh P, McPhillips MV, et al. Effects of music interventions on sleep in older adults: a systematic review. Geriatric Nursing.  2021;42(4):869-879.
• Pienkowski M. Rationale and efficacy of sound therapies for tinnitus and hyperacusis. Neuroscience. 2019;407:120-134.
• Piromchai   P, Chompunut S, Kasemsiri P, et al. A three-arm, single-blind, randomized controlled trial examining the effects of notched music therapy, conventional music therapy, and counseling on tinnitus. Otology & Neurotology. 2021;42(2):335-340.
• Robb SL, Hanson-Abromeit D, May L, et al. Reporting quality of music intervention research in healthcare: a systematic review. Complementary Therapies in Medicine. 2018;38:24-41.
• Rodgers-Melnick SN, Matthie N, Jenerette C, et al. The effects of a single electronic music improvisation session on the pain of adults with sickle cell disease: a mixed methods pilot study. Journal of Music Therapy.  2018;55(2):156-185.
• Silverman MJ, Gooding LF, Yinger O. It’s…complicated: a theoretical model of music-induced harm. Journal of Music Therapy. 2020;57(3):251-281.
• Speranza L, Pulcrano S, Perrone-Capano C, et al. Music affects functional brain connectivity and is effective in the treatment of neurological disorders. Reviews in the Neurosciences. March 24, 2022. [Epub ahead of print].
• Tang   H, Chen L, Wang Y, et al. The efficacy of music therapy to relieve pain, anxiety, and promote sleep quality, in patients with small cell lung cancer receiving platinum-based chemotherapy. Supportive Care in Cancer. 2021;29(12):7299-7306.
• Wang M, Yi G, Gao H, et al. Music-based interventions to improve fibromyalgia syndrome: a meta-analysis. Explore. 2020;16(6):357-362.
• Wolff AL, Ling DI, Casey EK, et al. Feasibility and impact of a musculoskeletal health for musicians (MHM) program for musician students: a randomized controlled pilot study. Journal of Hand Therapy. 2021:34(2):159-165.
• Zhou   Z, Zhou R, Wei W, et al. Effects of music-based movement therapy on motor function, balance, gait, mental health, and quality of life for patients with Parkinson’s disease: a systematic review and meta-analysis. Clinical Rehabilitation. 2021;35(7):937-951.

Acknowledgments

NCCIH thanks Wen Chen, Ph.D., Emmeline Edwards, Ph.D., and David Shurtleff, Ph.D., NCCIH, for their review of this fact sheet. 

This publication is not copyrighted and is in the public domain. Duplication is encouraged.

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Home › Blog › Research › Understanding the Psychology and Benefits of Music Therapy

May 3, 2022

Understanding the Psychology and Benefits of Music Therapy

By Lia Peralta

Music Therapy and Mental Health : Healing Through Music

There’s no denying that music has a strong psychological impact. Different types of music can significantly impact a person’s mood, helping them delve deeper into their consciousness to process a wide range of emotions. And it’s not just because music evokes feelings; there’s research-backed science behind the effect music and music therapy have on us.

Studies have demonstrated that music impacts numerous parts of the brain, including those involved in emotion, cognition, sensory, and movement. In fact, music therapy for mental health has been utilized as a therapeutic aid for millennia. Music therapy is successful in treating a wide range of physical and mental ailments, including depression, anxiety, and hypertension.

Doctors and clinicians began to recognize the substantial impact of music on the healing process when touring music ensembles performed for injured service members during and after both World Wars. They urged that hospitals employ professional musicians, eventually leading to the development of specialized training in the partnership of music therapy and mental health . Let’s look at where music therapy for mental health stands today and how our young people can benefit from music.

What is Music Therapy?

Clinical music therapy is the only profession that actively uses supporting evidence-based science to the creative, emotional, and energetic experiences of music for health and educational purposes. Music therapists use innovation, receptive listening, lyric discussion, imagery, performance, and learning through music to assess numerous areas of a person’s emotional well-being. They also participate in interdisciplinary treatment planning, ongoing evaluation, and follow-up.

Listening, singing, playing instruments, and producing music are examples of music therapy activities. One of the best things about music therapy is that it’s not necessary to have any musical abilities or capabilities to participate in or benefit from this form of treatment. This allows for a unique level of accessibility. Music therapy mental health sessions are generally conducted by a board-certified music therapist and can be done either one-on-one or in groups. Depending on each person’s needs, music therapy can be used in tandem with other treatments when necessary.

A music therapist works with people from many walks of life with various neurodiversities. Those with Autism Spectrum Disorder, dementia, and people with disabilities are all examples of people who can benefit from working with a music therapist. Trained professionals employ several diverse music therapy and mental health treatments for cognitive, physical, emotional, and social needs. Re-creating music, songwriting, improvisation, and lyric analysis are some of the more common treatments. Because what happens during a session will depend entirely on each person’s mental health, music therapy strategies will vary based on their specific needs.

The Psychology of Music Therapy

We all have a primordial sense of rhythm, which music taps into, creating cathartic experiences that humans have long recognized. Therefore, it’s not surprising that there’s a link between music and mental illness treatment. According to the American Music Therapy Association , modern music therapy originated after WWII. When local musicians performed for veterans in hospitals, soldiers appeared to recover faster (both physically and emotionally), encouraging institutions to bring on more professionals for the job.

Music therapy and mental health techniques are still used for hospitalized patients suffering from illness or injury. However, music therapy is used for people suffering from physical ailments due to its effect on their mental state. It can assist patients in coping with emotional stress and help them feel more confident, cheerful, and connected to the world around them. This, in turn, leads to more optimistic mindsets , which have been proven to assist in physical recovery.

Music for mental health is processed and generated in a different way than spoken language. Bypassing that channel of communication and not needing to rely on spoken words, patients can express themselves more freely, interact with loved ones on a deeper level, and have a stronger sense of their place in the world. For example, patients who have experienced trauma often have a difficult time verbalizing their feelings or describing the particular event(s). Music therapy — specifically the lyrical aspect of music — helps them express their struggles. As one music therapist said, lyrics are an “ easier gateway for expression ” than the spoken word.

There have been several musical therapy articles discussing how music therapy and mental health programs have assisted people in overcoming the challenges in their lives. In one case study , researchers tracked the effects music therapy had on the development of a 3-year-old girl diagnosed with childhood apraxia. Over the course of nine months, the young girl was seen for 24 sessions. In what has been dubbed a data-based music therapy method, the music therapy treatment included a combination of behavioral, improvisational, and artistic approaches.

The music therapists employed a range of musical, visual, and interactive aids and an engaging, entertaining discussion between the child and the clinician. The success of her music therapy treatment was undeniable. At the start of her treatment, the child’s communication techniques were virtually entirely nonverbal. By the end, she was able to pronounce syllables and create combination sounds.

The Benefits of Music Therapy

Now that we know how music therapy and mental illness interrelate, we can clarify why music can be helpful to those who struggle with their mental health.

Developing effective coping mechanisms

Certain breathing methods, rhythmic and auditory grounding, musical relaxation, and diversion are some of the coping skills that music therapy can teach people. These tactics are taught in music therapy so that when a crisis occurs, one learns how to use them effectively and cope with external influences or triggers.

Positive emotional behavior development

Music therapy can assist in identifying and naming emotions in a safe setting, which can lead to improved communication with others. Emotional awareness and nonverbal expression are also part of emotional behavior. Music therapy can help people learn to securely communicate their feelings vocally and nonverbally to improve emotional regulation.

Increasing your tolerance for frustration

Music therapy allows people to work on frustration tolerance in a controlled atmosphere while doing something creative. A music therapist, for example, might ask the patient to participate in a structured improvisation based on themes related to mental health (e.g., triggers, overcoming frustration, coping with an onslaught of emotions during a panic attack). Practicing these internal reactions is part of developing strategies for dealing with frustration and avoiding being sent “over the edge.” In tandem with learning to deal with negative emotions like frustration, music therapy can also assist clients in developing relaxation skills that can be used before, during, or after demanding situations.

Improving interpersonal communication

While mental health is often considered private, it significantly influences our interpersonal connections. Isolation or lashing out are common symptoms of a mental health struggle. These interactions can happen with family, friends, significant others, colleagues, or a stranger on the street. Music therapy for mental illness can help people practice social skills that they can then apply in their everyday lives. These sessions are usually done in a group environment in music therapy, but sessions may also be done privately.

Improving one’s self-image

Mental health issues can harm self-esteem and negatively affect our picture of ourselves. Music therapy can build self-confidence and increase awareness of one’s own behavior. When you’re at your lowest, it’s challenging to be kind to yourself. A music therapist can help people identify the positive traits that they’ve lost sight of (or, sadly, perhaps never even noticed about themselves). Not to mention, the simple act of creating music and/or engaging with others builds self-esteem in and of itself.

How Music Therapy Can Translate to Music Education

Music therapy has the potential to benefit young people in a number of ways, and there are many reasons why music is important for child development . One of the most common mental health problems that young people struggle with is anxiety. Whether it’s due to an inability to control surroundings or the discovery of the unpredictability of the world, music therapy can help. One music therapy strategy where this is particularly helpful is improvisation, as it helps young people become more comfortable with “ making things up as you go along ” in a safe setting. Music therapy can also help young people who have a hard time with interpersonal relationships. For example, students who play music in a group are provided a supportive and positive space where they can connect with others, without the need to talk.

Music education in schools is an excellent way to provide music therapy to students in a natural environment. Studies show that music programs in schools lead to higher test scores, fewer disciplinary issues, and over a 90% graduation rate. While school administrations may wish to incorporate music therapy for students exhibiting depression symptoms such as anxiety, lashing out, or difficulty concentrating, the benefits of music education can be extended to all students. Music therapy in music education may include:

– Instrument play and instruction (piano, guitar, drums, hand percussion, etc.)

– Educational concepts through music (colors, shapes, counting, etc.)

– Group sessions and/or individual sessions

– Singing or voice instruction

– Movement to music (improvisation dancing, learning choreography, etc.)

– Sung books/stories

– Lyrical writing

Music teachers are not expected to be therapists, but schools may seek music therapists to assist their music programs. Examples of supportive music therapist roles in schools include:

– Music Therapist Consultants can help design and implement musical experiences for students with disabilities.

– Direct Service Music Therapists can assist the music educator either outside or inside the classroom. These specialists can also provide personalized attention to specific students who may need assistance developing the skills to interact with their classmates.

Who Can Benefit from Music Therapy?

Everyone from children to the elderly can benefit from music therapy. It can be conducive for those with mental health needs, specifically social, developmental, and learning disabilities. Music therapy delivers a unique approach to mental health and opens avenues for healing and expression that simply aren’t available in other forms of therapy. While it can assist in the development of communicative, social, emotional, and cognitive skills for people of all ages, starting young people with music therapy early can have a huge impact on their development. It can help develop skills for autonomy and prepare young people for physical, social, and emotional changes later in life. And don’t let the word “therapy” affect you — students with special needs are not the only youngsters who can benefit from music therapy. Music therapy can assist all developing youth by providing an engaging educational opportunity that gives young people structure and meaning in their lives.

Support the Power of Music

The connections between music therapy and mental health are undeniable, particularly in young people. At Save The Music, we believe that music education is crucial for a child’s development, affecting their academic performance, social skills, and who they will become in life. We help students, schools, and communities reach their full potential through the power of making music. If you’re passionate about music in schools, check out our online music education resources or contact us about our music foundation’s impact to learn more.

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How sad music can help lift us up when we are feeling down.

By Gabriela Murza, MS, MCHES®, Professional Practice Extension Assistant Professor, Health and Wellness/HEART Initiative

Sadness as an emotion is a bit paradoxical. It is considered a basic emotion that everyone experiences, yet we may try to avoid feeling sad because of societal or personal pressures (Firestone, 2015). Sadness plays a crucial role in our lives by creating connections with others, helping us examine and work through causes, and can provide skills to help us face future situations (Lench et al., 2016).

Think back to the last time you felt sad. What caused you to feel that way? Maybe you were in an argument, received negative news (e.g., about a project, job, medical results), or maybe you have no idea what caused you to feel sad (which is OK!). Now, think about what coping strategies you used to work through your emotions. Did you talk to someone about it? Did you do something to distract yourself?

Maybe you found yourself listening to music that you perceived to be sad. If so, you are not alone! Research finds that some people are drawn to sad music for a variety of reasons when they are trying to manage sad feelings (Bodner et al., 2007; Matsumoto, 2002; Sachs et al., 2015; Van den Tol & Edwards, 2013).

• Connection : Some people report listening to music that they perceive to be sad because it helps them feel connected to the music. Some identify with the lyrics and meaning of a song, which helps them get in touch with certain emotions.
• Memories : Some songs might elicit memories about a person, place, or event with the desire to remember and feel closer to the person or event. For example, listening to a song that a loved one who passed away enjoyed listening to.
• Aesthetic value : Some people report listening to sad music because they find it beautiful or “good”. The music may distract them from negative feelings and may bring them joy.
• Positive message : Some sad songs can also share messages of positivity, hope, and empowerment, which can evoke positive feelings.
• Enhancing an emotion : Sad music can help a listener identify, express, and work through their feelings to help them feel better and move forward. However, some studies show that being diagnosed with major depressive disorder can make sad moods worse.

Listening to sad music is just one of the strategies used to manage difficult emotions like sadness. When utilized with other positive strategies, it can help someone process their emotions and situations. Next time you feel sad and feel yourself drawn to sad music, just lean into the experience and see if it’s helpful for you.

References:

• Bodner, E., Iancu, I., Gilboa, A., Sarel, A., Mazor, A., & Amir, D. (2007). Finding words for emotions: The reactions of patients with major depressive disorder towards various musical excerpts. The Arts in Psychotherapy , 32 (2), 142-150. https://doi.org/10.1016/j.aip.2006.12.002 .
• Firestone, L. (2015). The value of sadness. Psychology Today . https://www.psychologytoday.com/us/blog/compassion-matters/201507/the-value-sadness
• Lench, H., Tibbett, T., & Bench, S. (2016). Exploring the toolkit of emotion: What do saddness and anger do for us? Social and Personality Psychology Compass , 10(1), 11-25. https://doi.org/10.1111/spc3.12229
• Matsumoto, J. (2002). Why people listen to sad music: Effects of music on sad moods. Japanese Journal of Educational Psychology , 50 (1), 23-32.
• Sachs, M.E., Damasio, A., & Habibi, A. (2015). The pleasures of sad music: a systematic review. Frontiers in Human Neuroscience , 9 . https://doi.org/10.3389/fnhum.2015.00404
• Van den Tol, A.J.M. & Edwards, J. (2013). Exploring a rationale for choosing to listen to sad music when feeling sad. Psychology of Music , 41 (4), 440-465. https://doi.org/10.1177/0305735611430433

Joan Baez: I Am A Noise goes beyond adulation to uncover the artist's true, often tragic story

Joan Baez has achieved a lot in her 83 years.

She's made dozens of albums that have sold millions of copies, their commercial success belied by the cultural and artistic impact the 60s folk singer and her work had on the music world in decades to follow.

Her friendship with, and admiration for Martin Luther King Jr set the standard for her ongoing work in the civil rights and nonviolence movements, not just in the 1960s but throughout her life.

Despite this, recent documentary Joan Baez: I Am A Noise is not a self-aggrandising laundry list of the folk singer and countercultural icon's greatest moments. It's a portrait of a woman with complex struggles, and the many fractured relationships that have, in a way, shaped her life.

It begins and ends with her treatment as a child, Baez alluding to memories of childhood abuse she uncovered while under psychiatric therapy in the early 1990s. Those memories regrettably impacted her relationship with her father until his passing.

We hear about the lack of connection with her sister Mimi, who never came to terms with the alleged abuse, Joan's enormous success, nor the untimely death of her husband Dick Farina, before she died of cancer in her 50s.

She speaks openly of her infamous dalliance with Bob Dylan, a relationship that made headlines at the time, and that Baez says was "demoralising" when it ended.

Decades of distance gives her perspective on why her marriage to fellow anti-war campaigner and father to her son David Harris failed — "he was too young, and I was too crazy" — and Baez reveals a sexual awakening she had at 22 when entering a relationship with her friend Kimmie.

Perhaps saddest is the brief interjection from her son Gabriel Harris, who admits having to reconcile past issues with his mother.

"She was busy saving the world," Harris says. "No kid can understand that."

There's nowhere to hide in I Am A Noise, as Baez reveals letters, sketches, pages from diaries, and even recordings of past therapy sessions to give context to the telling of her story.

Through this material, Baez's fragile mental health sits at the forefront of this story. Her anxiety attacks, her sensitivity to the suffering of others, the racism she experienced as a child, and the abuse she repressed for many years are all clear to see.

It's a fascinating angle, given that the public image of Baez was that of a hugely successful recording artist and powerful countercultural figure. Beneath the surface, she struggled with endless mental health issues, manifesting in a regrettable addiction to quaaludes in the 1970s.

The other main takeaway from this portrait of Baez is her addiction to fame. It's never framed that way, but there are numerous moments where the singer admits that she doesn't know what it's like to walk away from adoration and adulation, because she never has.

She speaks about having to adjust her singing style as the curse of age roughens up her voice. She admits that, following the Vietnam War, she became "addicted to the activism".

There's still plenty here for music fans. The footage of a teenage Baez playing at Boston coffeehouse Club '47 in 1958 is worth the price of admission alone: her perfect voice is so singular and absorbing that it's very easy to understand why her star rose so quickly.

While footage of Dylan denying his relationship with Baez is angering, the way she speaks of her maternal connection to the young singer-songwriter makes it apparent how influential they were on one another.

"We changed each other's lives and outlooks on music and careers" she says.

For every glorious moment of Baez at her best, we see just as many regrettable moments.

She beams about the success of her brilliant 1975 album Diamonds & Rust, which put her back on the map and made her a bunch of money, while lamenting the awful front cover of 1977's Blowin' Away.

Being part of Dylan's Rolling Thunder Revue in the mid-70s helped her profile, but as we see her stagger off the bus at one stop, it seems the tour may have done her as much harm as good.

We hear her struggle while warming up for a concert on her final ever run of shows, but also see her perform stunningly for famous fans and people who's lives have been altered by her voice and her work.

Joan Baez: I Am A Noise is a staggeringly honest account of an extraordinary woman's life. It's also a reminder that, beneath the surface of even the most enviable of careers, something very dark often lingers.

Joan Baez: I Am A Noise is available to stream through DocPlay.

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• Published: 04 December 2023

Biological principles for music and mental health

• Daniel L. Bowling   ORCID: orcid.org/0000-0002-5303-5472 1 , 2  

Translational Psychiatry volume  13 , Article number:  374 ( 2023 ) Cite this article

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• Psychiatric disorders

Efforts to integrate music into healthcare systems and wellness practices are accelerating but the biological foundations supporting these initiatives remain underappreciated. As a result, music-based interventions are often sidelined in medicine. Here, I bring together advances in music research from neuroscience, psychology, and psychiatry to bridge music’s specific foundations in human biology with its specific therapeutic applications. The framework I propose organizes the neurophysiological effects of music around four core elements of human musicality: tonality, rhythm, reward, and sociality. For each, I review key concepts, biological bases, and evidence of clinical benefits. Within this framework, I outline a strategy to increase music’s impact on health based on standardizing treatments and their alignment with individual differences in responsivity to these musical elements. I propose that an integrated biological understanding of human musicality—describing each element’s functional origins, development, phylogeny, and neural bases—is critical to advancing rational applications of music in mental health and wellness.

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Introduction

Every day, hundreds of millions of people make or listen to music. This appetite is driven by music’s core effects on emotion [ 1 , 2 , 3 ], reward [ 4 ], and affiliation [ 5 ]. The value we place on these effects supports a 200 billion dollar per year industry in the US alone [ 6 ]. More and more, music’s core effects have come into focus for their alignment with core dimensions of mental health, e.g., mood, motivation, pleasure, and social functioning. Together with rapidly increasing awareness of mental health’s humanistic and financial importance, this alignment has sparked new investments in music-based interventions from government and industry [ 7 , 8 , 9 ]. This interest presents an opportunity for proponents of music’s therapeutic value to increase the specificity and rigor of its application and enhance our understanding of its clinical scope and efficacy.

Meeting this goal depends on a clear conception of music’s underlying biology as a source of principles for systematic applications towards specific clinical and subclinical goals. An awareness of such principles exists in music therapy [ 10 , 11 , 12 ], especially “neurologic” music therapies for motor rehabilitation [ 13 , 14 , 15 ], but applications in mental health remain highly variable, making it difficult to achieve a unified biologically-informed approach. Moreover, there are far too few music therapists to meet current mental health needs. In the US, for example, there are only about 10,000 board-certified music therapists, compared to about 58 million adults living with mental illness [ 16 , 17 ]. Assuming an average weekly caseload of 30 patients [ 18 ], total capacity to treat is therefore just 0.5%. Musicians represent another important source of insight, as they are ultimately the most skilled at titrating music’s neurophysiological impact. However, the inherently subjective nature of their “artistic” approach can preclude direct integration within a scientific model of health.

Given the uncertainty in defining the relationship between music and health, funders have sought to advance applications by casting a wide net. The National Institutes of Health, for example, has sponsored an extensive list of research topics involving music, including improving treatment response in cancer, stress and pain management in surgery, affect modulation in mood disorders, anxiolysis in anxiety disorders, social functioning in neurodevelopmental disorders, palliative care in advanced illness, neural rehabilitation after injury, and wellness through exercise [ 19 ]. This breadth is likely to puzzle many medical professionals and raise skepticism in more than a few. Can music really be such a panacea?

While skepticism is justified (as discussed in Section “Skepticism and need”), clear evidence of music’s effects on core mental health variables is readily apparent in our growing understanding of music’s biological foundations. Critically, these foundations provide a rational basis for standardizing and expanding music’s psychiatric applications and benefits. In this review, I outline a framework for music in human biology and describe some of its basic implications for standardized music-based interventions in mental health, with the goal of increasing biomedical integration and impact.

Developing a biological perspective

As far as we know, music has been with humans since our earliest existence. The first known evidence of human preoccupation with music comes from Stone Age flutes, carefully carved in wing bones and mammoth ivory some 40,000 years ago [ 20 ]. Over the course of recorded history, explanations of music and its power have been sought in terms of mythology, cosmology, mathematics, and physics, with many important insights along the way [ 21 , 22 ]. However, it was not until the 19th century that music came to be viewed in terms of human evolution. In 1871, based on observations of general similarity between human and animal vocalization, as well as the behavior of other “singing” mammals (like gibbons and howler monkeys), Darwin postulated a basis for music in sexual selection on social behavior. Specifically, he proposed that the vocalizations of our ancestors were likely more musical than linguistic, comprising greater regularity in pitch and time, and functioning mainly in signaling affect, attracting mates, and threatening rivals [ 23 ]. From this perspective, “music” provided the foundation for the evolution of human language, centering its underlying biology within the study of human cognition and communication more broadly [ 24 ].

Two aspects of this early account continue to shape modern biological music research or biomusicology (e.g. [ 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 ]). One is that music is, first and foremost, a form of social communication, with explicit origins in auditory-vocal interaction. The second is that singing and speaking—and thus, music and language—likely share a common origin in early hominids, as reflected by their many overlapping features, like being auditory-vocal by default, emotional expressive, and inherently social [ 25 ]. While many more specific details about the evolutionary origins of music remain under debate (cf [ 31 , 38 , 42 , 43 , 44 , 45 , 46 , 47 , 48 ]), a general view of music as rooted in social communication, with close ties to speech and language, is consistent across most theories and also central here.

Before proceeding, it is important to clarify that biomusicology chiefly concerns musicality rather than music per se. Whereas music is a cultural phenomenon of infinite variety [ 46 ], musicality is the genetically constrained and reliably developing set of neural capacities on which music production and perception rests [ 33 ]. It should be noted that this view departs significantly from common conceptions of music that center specific cultural manifestations and individual variation in preferences. Instead, a biological perspective centers music’s basic features in relation to pressures to evolve and develop neural capacities that support social communication. The following sections define this perspective with respect to four core elements of musicality—tonality, rhythm, reward, and sociality—reviewing essential concepts, biological bases, and evidence of clinical benefits, towards a framework for rational clinical translation.

Musical terms and definitions

Tones are a special class of sound stimuli that evoke a strong sense of pitch. Physically, they comprise regularly spaced pressure waves that repeat at frequencies between approximately 30–4000 Hz [ 49 ]. All musical cultures and traditions use tones [ 50 , 51 ], making neural sensitivity to tonality— defined simply as the use of tones to make music—a core element of human musicality. Tonality has primarily been considered from three perspectives. Harmony is focused on the organization of tones with respect to frequency. Melody is focused on the sequential organization of tones over time. Timbre is focused on the quality imparted to tones by their source and manner of production (e.g., a voice or a synthesizer, sounded gently or harshly, etc.) [ 52 ].

Conserved aspects of tonality

The most significant source of tones in the human auditory environment is vocal fold vibration in the larynx [ 53 , 54 ]. In speech, the frequency of vocal fold vibration fluctuates rapidly, leading to dynamic and variable tones (Fig. 1A ). In contrast, during song, these vibrations are modulated to emphasize particular frequencies and frequency relationships [ 50 , 51 , 55 ]. Beyond these “universal” features, many key aspects of harmony, melody, and timbre are widely observed across richly differentiated musical cultures and traditions.

A The same phrase spoken and sung by the same person to highlight how tones in music are related to tones in speech (based on Diana Deustch’s speech-to-song illusion). Variation in sound pressure over time (black) is overlaid with variation in the fundamental frequency of vocal fold vibration (the physical correlate of voice pitch; red). B On the left, the frequency relationships defined by the Japanese ritsu scale are presented along a vertical axis. Each relationship is calculated with respect to the lowest tone in the set (labeled “1.000”). On the right, the melody of the American gospel song “Amazing Grace” is shown using the same relationships. Conventional note letter names are listed at the right. C Timbral similarity of vocal and instrumental tones with parallel affective qualities. Top row: sound pressure waveforms with temporal envelopes shown in red. Bottom row: corresponding Fourier transforms with spectral envelopes shown in blue. These examples were selected to show similarity in temporal and spectral features of vocal and instrumental tones with parallel affective qualities.

In harmony, music almost always emphasizes a small set of tones defined by specific relationships to each other [ 51 ]. The simplest of these relationships—e.g., octaves (2:1) and fifths (3:2)—feature prominently in music worldwide [ 21 , 56 , 57 ], and particular sets of ratios called scales (or modes) are strikingly popular across cultural boundaries [ 21 , 57 , 58 ]. For example, the Western minor mode corresponds to what South Indian musicians call the Keeravani raga [ 59 ]. Similarly, the Japanese ritsu scale is also found in traditional Western folk songs like “Auld Lang Syne” and “Amazing Grace” (Fig. 1B ) [ 60 ]. In melody, tones tend to be arranged in arched or descending contours [ 21 , 51 ], traced mainly by small steps in pitch, with larger steps typically rising (Fig. 1B ) [ 61 , 62 , 63 , 64 ].

In timbre, specific temporal and spectral characteristics of tones give rise to specific perceptions of anatomical and affective source parameters, e.g., the ratio of low- to high-frequency energy in a tone is associated with size, valence, and arousal [ 65 , 66 ], rapid tone onsets signal a higher commitment of energy [ 67 ], and “rough” growl-like tones often convey anger or aggression [ 68 , 69 ] (Fig. 1C ). There is also widespread conservation in the use of tones for specific purposes. For example, lullabies typically comprise tones with relatively more low-frequency energy, sorted into simple repeating patterns [ 70 , 71 , 72 ]. Likewise, flatter contours with narrower pitch steps are favored for conveying somber affect [ 63 , 73 ]. Together, these and other broadly conserved aspects of tonality indicate a strong foundation in our shared biology.

Biological foundations of tonality

To model the biology underlying tonality, music scientists have developed vocal similarity theory (VST), the central tenet of which is that we perceive tones according to their behavioral significance in vocal communication [ 22 , 30 , 53 , 58 , 74 , 75 , 76 , 77 , 78 ]. VST is based on the fact that our experience with tones is dominated by the voice at evolutionary and individual time scales. This implies that the neurobiology of tone perception has primarily been shaped by pressure to contend with tones in the voice and their significance for adaptive behavior [ 22 , 53 , 75 ].

Phylogenetically, sensitivity to “tone of voice” is likely to have emerged very early in tetrapod evolution [ 79 ]. In mammals, auditory-vocal interaction is often central to social behavior and cognition, placing this sensitivity under intense selective pressure. Developmentally, the fetal brain begins responding to mother’s voice around the 24th week of gestation [ 80 ]. Over the ensuing weeks, these responses develop to the point that infants strongly prefer their mother’s voice at birth [ 81 ], an orientation that scaffolds the formation of our prototypical social bond, the modulation of affect through sound, and the development of communication more broadly [ 82 ]. Mechanistically, neural specialization for responding to vocal tones is evident throughout the auditory system, from enhanced representations of periodicity in the brainstems of humans and rats [ 83 , 84 ], to harmonically sensitive neurons in marmoset cortex [ 85 ], and pitch contour neurons in human cortex [ 86 ].

The culmination of this underlying biology is a brain that responds to tones reflexively by supplying percepts of meaning and intent as guides for behavior and cognition. This works because the acoustics of laryngeal vocalization are linked to source parameters at a statistical level [ 87 , 88 ]. For music, the implication of VST is that conserved aspects of tonality can be understood as consequences of the auditory system’s biological tuning to voices.

Applications of tonality in mental health

VST roots tonality in the bioacoustics of vocal affect, providing a principled basis for the assessment and manipulation of reflexive responses to musical tones, and their translation to psychiatry. For any given clinical goal related to the modulation of patient affect, VST predicts that proper applications of tonality require alignment with the statistical regularities that identify vocal expressions as conveying the emotion required to effect the desired physiological change. For example, a musical intervention aimed at relieving high anxiety and agitated negative mood should have tonal properties that align with a positive calming voice, such as extended falling pitch contours and low-frequency weighted timbres. Similarly, an intervention for depression should possess a gentle affirming tone, captured by more articulated contours that rise towards their ends. This approach naturally imbues musical tonality with a capacity to modulate listener feelings that parallels the corresponding tone of voice. However, because musical tones are (often) freed from the constraints of vocal expression—e.g., by instrumental production or release from linguistic demands—key regularities can be distilled and exaggerated to yield tones with supernormal neurophysiological effects.

Importantly, guidance derived from VST on how to use tonality to modulate affect largely corresponds with what musicians and music therapists have learned to do through subjective exploration and experience [ 76 , 89 ]. This is reflected in the effects of current musical treatments on dysregulated anxiety and mood. For example, receptive treatments (based on listening) can effectively reduce acute anxiety in chemotherapy [ 90 ], childbirth [ 91 ], and surgery [ 92 ]. A 2018 meta-analysis of 81 randomized controlled studies, involving over 6000 patients, found that music listening before, during, or after surgery significantly reduced anxiety symptoms, with an effect size equal to 69% of one standard deviation (Standard Mean Difference [SMD] = 0.69) [ 92 ]. Other meta-analyses indicate that music therapy can also be an effective anxiolytic beyond these acute medical contexts. A 2021 meta-analysis of 32 controlled studies with over 1,900 patients with anxiety showed significant anxiety reduction after an average of 7.5 music therapy sessions (SMD = 0.36). This effect was stronger in the subset of 11 studies with >12 sessions (SMD = 0.59), suggesting a dose-response effect [ 93 ]. For context, consider that estimated summary SMDs for first-line psychotherapies and pharmacotherapies lie between 0.28–0.44 and 0.33–0.45 respectively (but note that these numbers are based on much larger samples) [ 94 ].

Similarly positive effects of music therapy have been reported for affect disorders. A 2017 meta-analysis of 9 controlled studies including 411 patients diagnosed with a depressive disorder found that adding 6–12 weeks of music therapy to antidepressants and/or psychotherapy significantly reduced clinician-rated and patient-rated symptoms (SMD = 0.98 and 0.85 respectively) [ 95 ]. A 2020 meta-analysis focused specifically on receptive musical treatments found an even stronger effect when looking at depressive symptoms across patients with a wider variety of primary diagnoses, like heart disease, dementia, insomnia (SMD = 1.33, 17 controlled studies, 1,284 patients) [ 96 ]. The same paper also reports a significant effect for interactive treatment (based on making music; SMD = 0.57, 20 controlled studies, 1,368 patients) [ 96 ]. Both effects were apparent across variable depression severity levels and treatment courses (mean dosage was approximately 14 h, SD = 18, range = 0.33–126) [ 95 , 96 ]. For context, overall SMDs for psychotherapy and pharmacotherapy in depressive disorders have been estimated at 0.31 and 0.30 respectively (again, based on larger samples) [ 94 ].

While success of this kind might suggest that music therapy can do without VST, it should be noted that none of the aforementioned meta-analyses (and few of the individual studies that they cite) provide any details on the parameters of the music employed. This is largely because musical decisions are made on intuition rather than principle. Thus, while subjectivity has proven an essential guide in discovering music’s therapeutic applications, it also complicates scientific efforts to understand music’s therapeutic effects and standardize their application. VST addresses this challenge by providing objective guidelines for musical tonality based on specific therapeutic goals. This is a necessary step towards standardization, which is in turn required for expanding access to musical treatment.

Rhythm is the temporal patterning of sounds in music. The dominant feature of rhythm is temporal predictability, focused at rates ranging from approximately 0.5 to 5 Hz (30–300 beats per minute [bpm]) [ 97 , 98 , 99 ]. All musical cultures and traditions exhibit some temporal predictability in this range, making neural sensitivity to rhythm a second core element of musicality (no ranking implied) [ 50 , 51 ]. Investigations of rhythm typically identify two core components [ 100 ]. Pulse is the main cycle of rhythmic repetition perceived in music; it is generally what we synchronize to when we move in time with music. Meter refers more broadly to other rhythmic cycles perceived in music [ 101 ]. These encompass repetition rates that are both faster and slower than the pulse, defined by subdivisions of the pulse and multi-pulse cycles, respectively.

Conserved aspects of rhythm

As with tonality, key elements of rhythm are widely conserved across musical cultures and traditions. In pulse, acceptable rates (or tempos ) are highly constrained, showing a peak between approximately 1.33 and 2.67 Hz (80–160 bpm) across a variety of different musical traditions (Fig. 2A ) [ 98 , 102 ]. Intriguingly, this peak corresponds closely with dominant rates of periodicity in full-body human motion (e.g., 1.35–2.5 Hz [81–150 bpm] in walking) [ 98 ]. A second widely conserved aspect of pulse is that individual pulses tend to be isochronous or equally spaced in time [ 50 , 51 ]. There are traditions that also use unequal pulse spacing [ 103 ], but only in ways that retain predictability and thus allow interpersonal synchrony [ 104 , 105 ].

A A histogram of tempos from a sample of over 74,000 pieces of music. “DJ lists” refers to lists of song tempos used by disk jockeys to match pulse rates between tracks; “Radio” refers to songs found by randomly tuning into radio stations circa 2002; “Hits” refers to popular music from 1960–1990; and “styles” refers to a selection of music from divergent styles (e.g., renaissance polyphony and modern jazz). B One cycle from each of three rhythms with different meters, increasing in complexity from top to bottom. Circle size and shading indicate level of accenting (large/dark = strong), red stars and horizontal black brackets mark subgroups, and ellipsis denote repetition. Tin, Na , and Dhin are specific tabla drum strokes; tone, slap, bass , and touch are specific djembe drum stokes. The suku rhythm is based on section 5.3 of Polak (2010), with a timing ratio of 11:17:22 for the short-medium-long pulse patterns. C Hypothesized information flow through the network of brain areas implicated in rhythm perception. Additionally relevant brain areas include the hypothalamus, insula, and orbitofrontal cortex (see Fig. 3 ). The rhythm network is mostly bilateral despite being visualized in the left hemisphere here. Numbers refer to Brodmann areas. Insets show implicated structures in situ. Panel A is adapted from Moelants (2002) with permission from the author.

In meter, rhythmic cycles that are faster than the pulse also exhibit characteristic rates, mostly in the range of 2–8 Hz (120–480 bpm; typical of finger or wrist motion), and involving subdivisions of the pulse rate by factors of two or three [ 99 , 101 ]. Faster cycle rates are found in some traditions, e.g., 10–15 Hz [600–900 bpm] in djembe [ 103 ] or death metal [ 106 ], but this is relatively rare. For cycles at rates slower than the pulse, rhythmic patterning is almost always marked by variations in acoustic emphasis called accenting [ 100 ] (Fig. 2B ). A simple example of accenting comes from the marching rhythm “ one , two , one , two , ”, a repeating two-pulse cycle in which the first pulse is accented. Increasing in complexity, the meter of rūpak tāl in North Indian music is defined by a repeating seven-pulse cycle with multiple levels of accent set into groups of three and two [ 107 ]. More complex still are the drum patterns of Malian djembe music. For example, in suku, a repeating twelve-pulse cycle with multiple levels of accent is set into groups of three, each of which has a non-isochronous “short-medium-long” pulse pattern [ 103 ]. In sum, despite impressive diversity, rhythms from around the world are characterized by a restricted tempo range, multi-layered patterning, accenting, and predictability.

Further evidence that rhythm relies on conserved biology comes from the fact that the acoustic stimulus, taken alone, is often an insufficient basis for direct derivations of pulse and meter. Instead, these core aspects of rhythm depend on the interaction of sonic events and the brain [ 100 , 101 ]. Multiple lines of evidence indicate that humans possess specialized neural mechanisms that reflexively identify and reinforce temporal regularity in sequential auditory stimuli. These mechanisms (described in greater detail below) are specialized in that they are common to most humans but apparently rare among other animals. Individuals from many species can be trained to move in reaction to a pulse, but human movements are shifted forwards in time to anticipate, rather than lag behind, upcoming events [ 108 ]. We also synchronize flexibly, easily adjusting to tempo changes that disrupt or defeat synchrony in experiments with other species (parrots represent an interesting exception) [ 40 ].

More evidence of specialization comes from our curious tendency to spontaneously impose accenting on acoustic sequences that lack it. For example, we are apt to hear alternation or triplets in sequences of physically identical events, a perceptual imposition that can be differentiated electroencephalographically [ 109 ]. A final piece of evidence for specialized neural mechanisms in human rhythm perception is the global popularity of syncopation , especially in dance music [ 110 , 111 , 112 ]. Syncopation balances anticipation, built from sounds occurring on-the-pulse, against its systematic violation by sounds occurring off-the-pulse [ 113 ]. Perceiving syncopation thus depends on a conserved ability to form an internal model of regular temporal structure that is strong enough to withstand substantial ill-fitting sonic data [ 111 ]. Together, these and other broadly conserved aspects of rhythm indicate a strong foundation in our shared biology.

Biological foundations of rhythm

To model the biology underlying rhythm, music scientists have developed Neural Resonance Theory (NRT), the central tenet of which is that rhythm perception depends on endogenous oscillations in neural circuitry [ 97 , 114 , 115 , 116 ]. NRT holds that such oscillations spontaneously entrain to stimulus-evoked neural responses to modulate receptivity, prediction, and motor reactivity, thus providing a mechanistic basis for pulse and meter. While this “resonant” capacity is maximally engaged by music, its primary utility appears to be in processing spoken language, which, despite being less temporally regular than music, is still sufficiently regular (between 2–8 Hz [120–480 bpm] [ 102 ]) for entrained oscillations to aid in parsing phonemes, syllables, and phrases [ 117 , 118 ]. This implies that rhythm perception is intimately linked to vocal communication, just like tone perception.

A related aspect of NRT is that neural activity in auditory cortices readily couples with neural activity in parts of the brain that regulate movement, especially cortical areas and subcortical structures involved in motor planning, such as the supplementary motor and premotor cortices, the dorsal striatum, and the cerebellum [ 119 , 120 , 121 , 122 , 123 ] (Fig. 2C ). Activity in these parts of the brain increases in response to rhythm, even in the absence of movement [ 122 ], suggesting that auditory-motor interaction may be essential to rhythm perception. The link between rhythm and movement has also been explored in studies of groove , a psychological concept defined by variation in the degree to which a musical stimulus inspires movement. People generally agree about degrees of groove in music [ 124 , 125 ], with research suggesting a basis in common acoustical and structural features of rhythm, such as emphasized low-frequency energy (“bass”) [ 126 , 127 ] and moderate levels of syncopation [ 111 , 112 , 127 , 128 ]. Notably, groove is broadly associated with positive affect [ 111 , 125 , 129 , 130 ], making it directly relevant to mental health.

Applications of rhythm in mental health

So far, the clinical value of NRT has mainly been studied in the context of music therapies aimed at improving sensory and motor functions [ 131 ] (including speech [ 132 ]). However, even in these contexts, mental health benefits are often apparent. For example, in a 2021 meta-analysis of 17 randomized controlled studies testing musical interventions in Parkinson’s disease, a sub-analysis of 8 studies with mental health measures found significant benefits for mood, motivation, and emotional well-being in music conditions compared to standard care (SMD = 0.38, N  = 273 patients) [ 133 ]. Positive mental health outcomes have also been observed in response to receptive music therapy after stroke [ 134 , 135 ]. For example, one widely-cited study found that listening to music for at least one hour per day over a two-month period significantly lowered self-reported depression at 3 months post-stroke, as compared to standard medical care and rehabilitation [ 136 ]. Intriguingly, this study also reported benefits of music listening for cognitive function (memory and attention) in a well-controlled comparison to audio-book listening [ 136 ].

The capacity of rhythm to entrain activity in broad auditory-motor networks and simultaneously increase positive affect can also be hypothesized to account for a significant proportion of the benefits of musical treatments for anxiety and depression (see Section “Applications of tonality in mental health”). Specifically, engaging these networks with high-groove rhythms may provide an efficient way to disrupt maladaptive patterns of brain activity associated with negative affect and self-focused negative rumination [ 137 , 138 , 139 ]. Related to this hypothesis, there is growing evidence that groove is important for understanding the effects of music on cognition, particularly in the context of repetitive effortful work, which can often generate negative affect [ 135 , 140 , 141 , 142 , 143 , 144 , 145 ]. For example, in one recent study, listening to a high-groove drum loop for just 3 min was found to be more effective than noise at improving performance on a subsequent repetitive behavioral task measuring context-dependent response inhibition (a “Stroop” test). This effect of rhythm was specific to participants who reported enjoying the drum loop and its groove. These participants also exhibited significantly greater (dorsolateral) prefrontal cortical activity during the Stroop test in the drum-loop condition, as measured using functional Near Infra-Red Spectroscopy [ 141 ].

Experimental evidence for positive effects of rhythm on certain types of cognition accords with longstanding evidence from ethnographic literature. Specifically, rhythmic music has often been used to positively transform the experience of work otherwise experienced as negative and draining (e.g., harvesting food, military drills, and moving cargo) [ 145 , 146 ]. Similarly, musicians commonly experience “being in the groove” as a pleasant state of focus that offsets burdens associated with extended periods of high level performance (e.g., on tour) [ 125 , 129 , 147 ]. Such effects can be understood as rhythmically-driven increases in motivation and effort [ 143 ], potentially reflecting increased engagement of key cortico-basal ganglia-thalamo-cortical loop circuitry (see Fig. 2B ). They are particularly well-characterized in the context of physical exercise, where music can increase enjoyment and reduce perceived exertion [ 148 ], but such benefits may also extend to less muscular tasks (see discussion of the Mozart effect in Section “Another crest in the music and health hype cycle?”). In sum, the biological foundations of rhythm provide insight into how music can be applied to address challenges in mental health associated with mood, cognition, and motivation.

Music and brain reward circuitry

While the framework described so far is based on an analytic separation of tonality and rhythm, the health applications of several other core elements of musicality are better considered in terms of music as a whole. Perhaps the best example is our fundamental attraction to music, as reflected in its marked capacities to stimulate wanting, liking, and learning. Over the past several decades, neuroimaging studies have demonstrated that taking pleasure in music is closely associated with activity in classical brain reward circuitry [ 26 , 149 ], including the mesolimbic dopamine pathway between the ventral tegmental area (VTA) and the nucleus accumbens (NAc) [ 4 ]. Early studies used positron emission tomography with the radiolabeled dopamine D 2 receptor ligand, [ 11 C]raclopride, to show that musical frisson [ 150 ] — moments of peak neural excitement, piloerection, and “chills” that occur during music listening—are associated with surges in dopamine binding within the NAc [ 151 , 152 ]. Additional evidence that music stimulates mesolimbic reward comes from functional magnetic resonance imaging studies showing, for example, that the magnitude of an individual’s NAc response to music correlates with their subjective liking for it [ 153 ].

At the level of brain networks, functional neuroimaging studies have also found that the time-course of musically-stimulated NAc activity is tightly coupled with that of activity in the VTA and hypothalamus [ 154 ]. This has led to the proposal of a “tripartite network” at the core of musical reward, with the hypothalamic node linking desire and pleasure to autonomic and neuroendocrine effects (Fig. 3A ) [ 128 , 154 , 155 ]. Beyond this core, musical reward also engages an extended network of brain areas including the auditory, frontal, and insular cortices, as well as the amygdala and hippocampus, all of which also exhibit temporal coupling with the NAc during music listening [ 149 , 153 , 154 ]. These extended connections are presumed to situate musical reward with respect to sensory, integrative, somatic, affective, and memory-based aspects of musical responding, respectively.

A A model of the extended musical reward network including the tripartite core (red outline) and associated cortical areas and subcortical structures (gray outline). Arrows indicate significant positive temporal correlation in blood-oxygenation-level-dependent activity between the indicated areas during pleasurable music listening. Numbers refer to Brodmann areas ( B ) A close-up of the tripartite core showing dopaminergic (blue), opioideric (green), and oxytocinergic (red) circuitry hypothesized to underpin music’s capacity to stimulate social connection. In rodent models (on which this panel is based) the derivation of reward from positive social interaction requires the oxytocinergic projections from the PVN to the NAc and VTA. C Interactions within the PVN between oxytocin and CRF. Oxytocin decreases the excitability of CRF neurons in mouse hypothalamic slices, and may further inhibit CRF release by modulating CRFR1-positive neurons. Note that music may also have effects on CRF that are independent of oxytocin. ARC arcuate nucleus, CRFR1 CRF receptor type 1, NAc nucleus accumbens, POMC proopiomelanocortin, PVN paraventricular nucleus, VTA ventral tegmental area.

Lastly, as in the processing of other rewarding stimuli like food, sex, and drugs, the hedonic aspects of musical reward are partially dependent on opioidergic mechanisms. This has been shown pharmacologically, as treatment with the (predominantly μ-) opioid receptor antagonists naloxone and naltrexone significantly reduces pleasure in response to musical stimuli [ 156 , 157 ]. Thus, although the work described in this section has been carried out almost entirely with “Western” listeners, the results, taken together with the widespread enjoyment of music around the world, strongly support the sensitivity of brain reward circuitry to musical stimulation as a third core element of musicality.

Applications of musical reward in mental health

In keeping with the central importance of reward in our everyday lives, this element of musicality has extremely broad implications for mental health. Dysfunction in brain reward circuitry contributes to a wide range of psychopathology, including mood disorders, anxiety disorders, substance use disorders, eating disorders, obsessive-compulsive disorders, attention-deficit/hyperactivity disorder, autism spectrum disorders, conduct disorder, Tourette’s syndrome [ 158 ], and schizophrenia. This suggests that the benefits of many current musical treatments may be attributable to normalizing effects of tonality and rhythm on otherwise aberrant activity in brain reward circuitry. Thus, in addition to effects on core dimensions of mental health (e.g., anxiety, mood, cognition, and motivation), musical treatments have also been found efficacious in more specific cases of psychopathology that specifically feature reward dysfunction. Some examples include: substance-use disorder, where adding music therapy to standard treatment can improve motivation to rehabilitate and abstinence [ 159 ]; anorexia nervosa, where interactive music therapy can stimulate reductions in post-meal anxiety that exceed those of other treatments [ 160 ]; and Tourette’s syndrome, where music listening, performance, and even imagined performance, can be an effective tic suppressant [ 161 ].

Further evidence of music’s efficacy against reward-related dysfunction comes from treatments applied to prominent transdiagnostic symptoms, like fatigue [ 162 ], apathy [ 163 , 164 ], and anhedonia [ 165 ]. For example, in a study of nursing home residents age 60+ with mild-to-moderate dementia, a twelve-week interactive music therapy intervention significantly reduced apathy and improved communication, in comparison with a treatment-as-usual control [ 163 ]. The effect sizes were relatively small (SMD = 0.32 and 0.15 respectively), but given the central importance of apathy in dementia and other psychopathology [ 166 , 167 , 168 ], they represent an important starting point for further investigation. In sum, the capacity of music to modulate brain reward circuitry provides a strong mechanistic basis for its benefits across a wide variety of functional disorders in mental health. A better understanding of how and when music stimulates reward is thus critical to advancing music’s therapeutic benefits for mental health.

Converging evidence indicates that engaging in music with other people is an effective way to stimulate interpersonal affiliation and social connection [ 44 ]. Psychological experiments, for example, have repeatedly shown that interpersonal temporal coordination (or “synchrony”) in behavior—a defining feature of musical interaction—strengthens social bonds between participants. This has been measured in terms of increased feelings of affiliation and self-other similarity [ 169 , 170 ], trust behaviors in economic games [ 171 , 172 ], and real-world cooperation [ 173 , 174 , 175 , 176 , 177 ] (reviewed in [ 178 ]). Another line of evidence comes from physiological experiments showing that recreational forms of behavioral synchrony—e.g., in group singing, drumming, or exercise—can upregulate oxytocin secretion [ 155 , 179 , 180 , 181 , 182 ], downregulate cortisol secretion [ 155 , 181 , 183 , 184 , 185 ], modulate immune reactivity [ 182 , 184 , 185 ], and decrease pain [ 186 , 187 ].

In addition to behavioral synchrony, music almost certainly facilitates affiliation and social connection through inducing synchrony in affect. This is perhaps best illustrated by the Iso Principle for mood management in music therapy, one of a few core methods that remains consistent across diverse approaches and therapeutic goals [ 188 ]. Iso Principle is the practice of initiating treatment sessions with music that is parameterized to match the patient’s current mood, creating a basis of shared affect that can then be leveraged to shift mood through musical changes. While the neural basis of synchrony’s effects on social neurobiology has yet to be studied in detail (see [ 189 ] for leading hypotheses), at a psychological level it appears to work through empathetic processes that increase trust and promote openness to further interaction and direction [ 190 ].

A final line of evidence comes from ethnographic and historical observations indicating that music (and dance) are commonly associated with contexts involving high levels of social cohesion. Major examples include religious rituals, cooperative labor, and military drill, as well as overt expressions of group solidarity like political chants, football songs, and national anthems [ 145 , 146 ]. Taken together, these findings strongly support the sensitivity of neural mechanisms supporting affiliation and social connection to musical stimulation as a fourth core element of musicality.

Oxytocin and social reward

Although many artistic and aesthetic experiences are capable of eliciting intense pleasure, music stands out for the regularity with which it does so [ 157 ]. Research suggests that frisson, for example, are induced by music at about four times the rate that they are induced by other stimuli, including the visual arts and literature combined [ 191 ]. This begs the question of why music is so rewarding.

A potential hint comes from the fact that frisson are also induced at high rates by inspirational speech [ 191 , 192 ]. From a mechanistic perspective, this can be taken as support for the hypothesis that the reward potency of music (and speech) reflects high temporal predictability relative to other artistic stimuli [ 150 , 153 ], which is particularly well-suited to anticipatory aspects of reward processing [ 193 ]. At the same time, phylogenetic and developmental perspectives have given rise to the hypothesis that the reward potency of music reflects its basis in social communication [ 149 ]. In this non-mutually exclusive view, music’s capacity to stimulate reward processing also reflects the activity of evolved neural mechanisms that develop to afford the voice with major modulatory control over the rewards of social interaction.

Interest in the link between music and social reward has led many researchers to posit a role for the hypothalamic neuropeptide oxytocin in musicality [ 5 , 44 , 149 , 194 , 195 ], following on its essential functions in affiliative behavior and social bonding (Fig. 3B ) [ 196 , 197 , 198 , 199 , 200 ]. More specifically, music can be hypothesized to stimulate endogenous oxytocin mechanisms that upregulate dopaminergic (and related opioidergic) aspects of reward processing [ 198 ], thereby increasing sensitivity to musical rewards in social context. An important corollary of this hypothesis also addresses the anti-stress effects of music [ 201 ], as music-induced oxytocin release in the hypothalamus may also modulate local corticotropin releasing factor (CRF) circuitry to downregulate activity in the hypothalamic-pituitary-adrenal axis and the sympathetic division of the autonomic nervous system (Fig. 3C ) [ 202 , 203 , 204 , 205 , 206 ].

Applications of sociality in mental health

Social functioning—as reflected in the structure, function, and quality of an individual’s social connections—is a critical determinant of mental health in patients across prominent psychiatric disorders [ 207 , 208 ] as well as the general public [ 209 , 210 ]. This implies that effects of musical treatment of the neurobiology of social functioning may be of even broader significance than closely related effects on brain reward circuitry. However, before describing the clinical evidence supporting such effects, it should be noted that the extent to which musical treatment must involve live interaction to impact social neurobiology is presently unclear. Sound recording is only 160 years old, which implies that the vast majority of our collective experience with music has occurred in social contexts. Accordingly, there is an important sense in which listening to recorded music, even alone, may remain inherently social in neurobiological terms. Our attribution of recorded music to a person (or people) with communicative intent is essentially reflexive [ 211 ], particularly when it comprises vocals. It is also clear that recorded music is often a potent stimulus for behavioral and affective synchrony. Thus, listening to music alone may stimulate social neurobiology in many of the same ways as live musical interaction. Nevertheless, until shown otherwise, it seems reasonable to assume that live interaction is the more potent stimulus for leveraging music’s effect on sociality (e.g., see [ 212 , 213 , 214 ]).

Operationally, social functioning is targeted by interactive approaches to music therapy designed to support interpersonal responding, coordination, and synchrony [ 11 , 215 ]. A large body of evidence supports the benefits of such approaches in autism spectrum disorders [ 216 , 217 , 218 , 219 , 220 , 221 ]. Some of this evidence is summarized in a 2022 meta-analysis of 26 controlled studies including 1,165 children with diagnoses of an autism spectrum disorder (ranging from mild to severe). This analysis compared music therapy to non-musical standard care or a “placebo” therapy over an average duration of 2.5 months (SD = 2.0), with session frequency varying from daily to weekly in shorter and longer studies respectively [ 216 ]. Directly after the intervention, significant benefits associated with music therapy included improvement in clinical global impression (risk ratio=1.22, 8 studies, 583 patients), reduced total autism symptom severity (SMD = 0.83, 9 studies, 575 patients), and better quality of life for clients and/or their families (SMD = 0.28, 3 studies, 340 patients). During the intervention, music therapy was also associated with significant improvements in non-verbal communication (SMD = 1.06, 3 studies, 50 patients) and behavioral adaptation (SMD = 1.19, 4 studies, 52 patients); in the 1–5 months following the intervention, music therapy was associated with reduced total autism symptom severity (SMD = 0.93, 2 studies, 69 patients) and improved self-esteem (SMD = 0.86, 1 study, 35 patients) [ 216 ]. For context, the overall SMD for autism interventions based on Applied Behavior Analysis (a common non-musical behavioral therapy) has been estimated at 0.36 for treating general autism symptoms (based on 14 studies with 555 patients) [ 222 ].

Further evidence supporting the benefits of music therapy for social functioning comes from studies on schizophrenia [ 223 ]. A 2020 meta-analysis of 15 controlled studies involving 964 adults diagnosed with schizophrenia or a schizophrenia-like disorder highlighted significant improvements in negative symptoms (such as flat affect, poor social interactions, and apathy) when adjunct interactive and/or receptive music therapy was compared to standard care (SMD = 0.56) [ 164 ]. This aligns with an earlier 2017 meta-analysis that more specifically investigated social functioning, reporting benefits from two controlled studies involving adults with schizophrenia in which music therapy was compared to antipsychotic medication (SMD = 0.72, N  = 160 patients) [ 224 ]. For context, the SMD of antipsychotic medications for treating negative symptoms in schizophrenia has been estimated at 0.35, based on 167 studies with 28,102 patients [ 225 ].

There is also some evidence that musical interventions can impact social functioning in Alzheimer’s disease and related dementias. For example, individual studies have reported significant benefits of interactive music therapy on language functioning [ 226 ] and receptive music therapy on social engagement [ 227 ]. However, reviews and meta-analyses suggest that such social effects are mainly derivative from primary benefits that reduce agitation, anxiety, and depression [ 228 , 229 ].

Finally, outside of the clinic, musical therapy has long been valued as a non-verbal path to social connection in children with special needs [ 215 , 221 ], as well as a way to combat social isolation and loneliness, particularly in older adults living alone and/or with serious disease [ 184 , 230 ]. In sum, music’s capacity to stimulate the neurobiology of affiliation and social connection is associated with benefits in multiple major mental health disorders and across the lifespan.

Individual differences in musicality

Despite strong foundations in our shared biology, there is also substantial individual variation in neural sensitivity to the core elements of musicality. At the low end of the spectrum are individuals who cannot carry a tune or dance in time, some of whom find music irritating and actively avoid it [ 231 ]. Conversely, at the high end are individuals who find it difficult to live without music, some of whom create works of art that transcend their geographic and temporal horizons [ 232 ]. This high degree of individual variation in musical appreciation and engagement implies that there may also be substantial variation in individual capacity to benefit from musical treatment. In this section and the next I review research on understanding individual variation in musicality, outlining how its measurement may be used to increase the precision with which musical treatments are applied. Accordingly, I argue that better applications of music in mental health depend not only on aligning the neurophysiological effects of music’s core elements with specific clinical targets, but also on matching treatment content to individual differences in musicality.

Psychoacoustic testing

Tests of tone and rhythm perception have long served as the primary way to measure individual differences in musicality. Performance on the most basic of these tests—e.g., measuring sensitivity to harmony and pulse—tends to be positively skewed [ 233 ], reflecting a commonplace competency for music similar to that which we possess for language [ 41 ]. Nevertheless, there is still considerable variation in basic test scores, and this is increased for tests that probe more sophisticated musical abilities [ 234 ].

Environmental factors

Researchers have traditionally sought explanations for individual differences in musicality based on environmental factors. One of the most important environmental factors is formal training , a process by which individuals explicitly learn specific motor skills and rules for music performance and composition [ 235 ]. Formal training is particularly important for explaining sophisticated musical abilities, e.g., as assessed by Goldsmith’s Musical Sophistication Index (Gold-MSI) [ 234 ]. Another important environmental factor is musical enculturation , i.e., the process of implicitly learning the statistical properties of the music to which one is developmentally exposed. Many studies have demonstrated effects of training and enculturation on psychoacoustic tests (e.g. [ 236 , 237 ]). Though sometimes framed as evidence against biological constraints, such effects may be better considered in terms of how biological constraints manifest in the face of environmental variation [ 56 , 78 ].

Biological factors

Progress is also being made towards understanding the genetic basis of musicality [ 27 ]. Early work provided evidence that genetic factors explain surprising amounts of phenotypic variability in psychoacoustic test performance (e.g., 70–80% in tone perception [ 238 ]), as well as time spent practicing music (e.g., 40–70% [ 239 ]; see also [ 240 ]). More recently, genome-wide association (GWA) techniques have been applied to musicality [ 241 , 242 , 243 ]. The largest of these GWA studies to date has focused on rhythm perception [ 243 ]—assessed via the question “can you clap in time with a musical beat?”—in a sample of over 606,825 individuals, accessed via an academic collaboration with 23andMe, Inc. The results indicated that beat perception and synchronization depend on many genes, with variation at 69 loci spread across 20 chromosomes being significantly associated with survey responses after linkage disequilibrium pruning. Additional analyses found enriched expression of genes implicated by these loci in brain-specific regulatory elements as well as fetal brain tissue, indicating potential roles in regulating neurodevelopment. Similar analyses focused on the adult brain found enriched expression in structures implicated in rhythm and reward, including the frontal and temporal cortices, cerebellum, basal ganglia, nucleus accumbens, and hypothalamus (see Figs. 2 C and 3B ).

Although complex traits like our sensitivity to rhythm are expected to be polygenic [ 243 ], some studies have also focused on associations between musicality and individual genes. One of the best studied genes in this context is AVPR1A , which encodes the vasopressin 1A receptor, a major component of the arginine vasopressin and oxytocin signaling pathways [ 196 , 244 ]. Genetic variation in the promotor region of AVPR1A has been associated with phenotypic variation in psychoacoustic test scores [ 245 , 246 ], time spent attentively listening to music [ 247 ], and being a dancer as opposed to another type of athlete [ 248 ]. Variation in AVPRA1 has also been associated with verbal memory [ 249 ], acoustic startle [ 250 ], amygdala activity [ 251 ], prosocial behavior [ 252 ], pair-bonding [ 253 ], and autism [ 254 ]. As intriguing as these associations are, however, it should also be noted that several studies have looked and failed to find associations between musical ability/behavior and AVPR1A polymorphism [ 242 , 255 ]. Other genes of particular interest include VRK2 , FANCL , MAPT , MAPK3 , GATA2 , GBE1 , GPM6A , PCDH7, SCL64A , and UGT8 among others (see [ 27 ] and [ 243 ]).

Lastly, progress in understanding the biology underlying individual differences in musicality has also come from studies of disordered music perception. Congenital amusia [ 256 ] is an umbrella term for lifelong deficits in music perception that prevent people from singing in tune [ 257 ], dancing in time [ 258 ], or deriving pleasure from music [ 259 ]. Deficits in tone perception (or tone deafness ) is the best studied form of congenital amusia: it runs in families [ 238 , 260 ] and is associated with decreased connectivity between the auditory cortices and the inferior frontal gyrus [ 261 , 262 ], potentially reflecting abnormal frontotemporal cortical development [ 263 ]. The prevalence of tone deafness is approximately 1.5%, with as many as 4.2% of people exhibiting a lesser form of impairment [ 264 ]. Deficits in rhythms perception (or beat deafness ) appears to be at least as common [ 264 ]. Finally the prevalence of music-specific anhedonia , which, as the name implies, occurs despite otherwise normal hedonic functioning, is estimated at about 5% [ 265 ].

Hypotheses for precision medicine

Faced with questions about whether a patient is sufficiently musical to engage in treatment, many music therapists provide reassurance, as a significant part of their practice is dedicated to finding adaptive ways to leverage music’s capacities to align with individual strengths [ 266 , 267 ]. While this resource-oriented approach has the benefit of allowing music therapists to work with almost anyone, the framework proposed here can potentially offer more systematic guidelines for determining whether a patient is likely to benefit from musical treatment. Fundamentally, patients with a history of strong engagement with music and keen sensitivity to its tonal, rhythmic, rewarding, and social elements would appear to be good candidates for musical treatment, especially if neurophysiological systems influenced by one or more core elements of musicality are implicated by their symptoms. Conversely, those patients who report disliking music, find it unrewarding, or otherwise qualify for congenital amusia, would seem to have a lower likelihood of benefiting.

In between these extremes are individuals whose specific musicality profiles —conceived as a series of measurements describing sensitivity to each core element of musicality—have important potential to inform decisions about treatment content. As an example, treatment for a patient with below-average tone perception, but normal sensitivity to musical reward, rhythm, and sociality could be personalized to align with their musicality profile by focusing on the neurophysiological effects of rhythm in an affiliative interactive context in which tonal elements are minimized or omitted.

Defining musicality profiles

While measurements of underlying biology may improve assessments of individual differences in musicality in the future, current efforts must rely on psychoacoustic tests and surveys. Among the most promising for determining suitability for musical treatment is the Barcelona Music Reward Questionnaire (BMRQ) [ 265 ], a survey of 20 self-reported items that assess the degree to which an individual takes pleasure in different aspects of music. For individuals with normal scores on the BMRQ, further insight may be gained through a series of basic psychoacoustic tests, like the scale test and out-of-key test (for evaluating tone perception) and the off-beat test (for evaluating rhythm perception) from the Montreal Battery of Evaluation of Amusia (MBEA [ 233 , 268 ]; see MBEMA for testing children aged 6 to 10 [ 269 ]). If a more comprehensive assessment is desired, clinicians can deploy the Gold-MSI (for musical sophistication) [ 234 ] or the computerized beat alignment test (for rhythm) [ 270 ].

Although not explicitly focused on music, it may also be useful to assess a patient’s level of social functioning and anxiety (e.g., with the Social Responsivity Scale [SRS] [ 271 ] and Liebowitz Social Anxiety Scale [LSAS] [ 272 ] respectively), as the results could inform decisions about the extent to which a musical intervention should target social functioning. Interactive music therapy can be hypothesized to be most effective in cases where social functioning and social anxiety are both low. By contrast, in cases where social anxiety (or anxiety more generally) is high, the most effective approach may instead require limiting social interaction, at least at first. In keeping with this hypothesis, interactive approaches to music therapy in dementia (where anxiety is often high) are significantly less effective than receptive approaches at reducing agitation and behavioral problems [ 229 ]. Similarly, in music therapy for autism—which is predominantly interactive—high comorbidity with anxiety disorders may help explain some of the heterogeneity in trial results (cf [ 273 , 274 ].). Lastly, in cases where a patient is unable to complete surveys or perform perceptual tests due to developmental delay or cognitive impairment, interviewing caregivers about the patient’s history of music engagement and social functioning can offer valuable insights into their potential sensitivity to musical treatment.

Idiosyncratic preferences

Beyond tailoring musical treatments to align neurophysiological effects with clinical targets and individual musicality profiles, treatments may also be customized based on individual music preferences or “taste” [ 275 , 276 ]. In receptive music therapy, for example, it’s common for patients to nominate songs they like, with therapists providing oversight for alignment with therapeutic goals [ 89 ]. One major advantage of this approach is that listening to preferred music can be especially rewarding [ 151 , 277 ]. This is often attributed to the familiarity of preferred music, which facilitates expectations, their fulfillment, and associated memories and emotions [ 150 , 278 , 279 ]. Other potential benefits of preferred music include fostering a sense of safety, enhancing engagement, and reducing stress [ 280 , 281 , 282 ]. However, personal memories and associations can also make the therapeutic value of preferred music difficult to control, especially if not carefully reviewed [ 283 ]. This is because what a person likes is not necessarily aligned with their therapeutic goals. A prime example is that people with depression often prefer music that maintains or exacerbates their sadness [ 284 , 285 , 286 ] (but see [ 285 , 287 , 288 ]). Accordingly, despite the benefits of preferred music, using novel or unknown music is advisable in some contexts.

Having already changed how people discover new music, algorithmic music recommendation systems may also find applications in mental health. However, the issue of mismatch between what a person likes and their treatment goals remains significant here as well. For example, listening to strongly preferred or popular music while attempting to focus tends to decrease task performance [ 140 , 142 ]. In the extreme, the lifestyle associated with many forms of popular music is linked to substance abuse, risk-taking, suicide, homicide, and accidental death among practitioners [ 289 ]. This highlights the fact that engagement with music is not necessarily health-positive (cf [ 290 , 291 , 292 ].). In therapeutic contexts, though, there are still many cases in which tailoring musical interventions to idiosyncratic preferences can be beneficial. For example, in receptive music therapy for Alzheimer’s disease, listening to familiar, preferred music appears to carry benefits for self-awareness [ 293 ]. Similarly, in depression, preferred music is likely to be the most effective stimulus for normalizing brain affect and reward functions, provided that it has been properly vetted to avoid stimulating negative affect. Finally, when a patient has normal sensitivity to musical reward but only within a very restricted genre (e.g., from their youth [ 294 ]), or, reports enjoying music despite poor tone and rhythm perception [ 295 ], understanding their idiosyncratic preferences may be necessary to design effective treatment.

In sum, determining the therapeutic value of aligning musical treatment with idiosyncratic preferences is of central importance for musical applications in mental health. That said, progress in this kind of preference matching should be incorporated within a broader precision paradigm as advocated here, which aims to align the specific neurophysiological effects of musicality’s core elements with specific clinical targets and individual differences in associated responsivity.

Skepticism and need

In this final section, I address several important points of skepticism regarding the premise of the biological framework presented here, i.e., the hypothesis that music can do more for mental health.

Benefits from music to mental health are already at saturation

In addition to the effects of musical treatment described above (see Sections “Applications of tonality in mental health.”, “Applications of rhythm in mental health”, “Applications of musical reward in mental health”, & “Applications of sociality in mental health”.), there is strong evidence that people derive mental health benefits from more casual engagement with music. During the height of the COVID-19 pandemic, for example, more than half of 4,206 survey respondents reported engaging with music as a coping strategy, using it to derive reward, modulate mood, and/or reduce stress and anxiety [ 296 ]. Similar positive functions are apparent in pre-pandemic research as well (alongside more social functions) [ 2 , 297 , 298 , 299 ]. Associations between music and healing have also been found in many cultures throughout human history, suggesting a potentially ancient relationship [ 300 , 301 ]. Thus, even though music lies outside the mainstream of mental health care, many people are already using music to improve their condition.

Nonetheless, there are multiple ways in which music’s mental health benefits may be increased. First, expanding access to musical treatment is essential [ 302 ]; as stated in the introduction, music therapists in the US only have the capacity to treat 0.5% of adults with mental illness. I have argued that this necessitates standardizing and applying treatments within a biological framework. Second, the popular perception of music as entertainment needs to evolve to encompass its therapeutic benefits. Explaining musical treatments in biomedical terms and normalizing therapeutic modes of listening can facilitate this shift. Third, the balance in music education needs to pivot away from individual performance and back towards widespread attainment of basic skills (e.g., social singing and dancing, listening, reflecting, curating, etc.), with an explicit focus on developing lifelong tools for mental health and wellness [ 303 ].

Another crest in the music and health hype cycle?

Even if one accepts that music has expandable mental health benefits, the importance of music’s potential might still seem overblown, here and elsewhere. It is worth revisiting the Mozart effect in this context, as an example of music’s real effects and associated hyperbolic overinterpretation. In 1993, a study published in the journal Nature reported that 10 min of listening to a spirited Mozart sonata, versus speech-based relaxation, or silence, improved performance on a subsequent spatial reasoning task [ 144 ]. After being picked up by popular press, this finding was transformed into the notion that “listening to Mozart actually makes you smarter” [ 304 ], which was subsequently used to market books and other media for benefits purportedly backed by science [ 305 ]. Backlash from the scientific community in the form of criticism and further investigation eventually came to show that the Mozart effect amounts to a relatively small but replicable performance boost that generalizes to other types of music (and speech) which stimulate enjoyment and arousal (SMD = 0.37 in meta-analyses) [ 143 , 305 , 306 ]. Thus, while we should remain guarded against hype surrounding claims about music’s potential benefits, the example of the Mozart effect should also remind us not to counter hype with dismissal.

Low quality studies undermine claims of clinical value

The randomized double-blind placebo-controlled trial remains the gold standard for evidence in clinical medicine. However, this approach was primarily designed to test the efficacy of drug therapies, a history that creates problems for using it to test behavioral interventions, such as music therapy or psychotherapy [ 307 , 308 ]. Central problems include: difficultly blinding patients and therapists to their assigned condition (treatment or control), designing appropriate “placebo” treatments, and perceived difficulty in standardizing treatment without jeopardizing therapeutic integrity [ 308 , 309 ]. These problems are compounded in trials that rely on self- and/or clinician-reported outcomes (which is standard in much mental health research [ 309 ]). Consequently, concerns over study quality have often been cited in expressions of doubt over music’s clinical value (e.g. [ 302 , 308 ]).

A quick survey of modern clinical research in music therapy shows that such criticism has been well-received. Improvements in control conditions and blinded outcome assessments have been gradually implemented and evidence from more carefully conducted trials has begun to accumulate. Over the last decade, there has also been a surge in meta-analytic syntheses of this work, most of which explicitly assess risk-of-bias alongside their conclusions, although they do not typically take the next step of adjusting effect size estimates accordingly (cf [ 96 , 310 ].). Overall, bias assessments suggest that the certainty of evidence supporting benefits from musical treatment in mental health is moderate to low. Nonetheless, this level of certainty is consistent with many treatments in psychiatry [ 94 ]. The assertion that studies of musical treatment are especially suspect is thus poorly substantiated. Interested readers should consult bias assessments in these meta-analyses [ 93 , 95 , 96 , 133 , 164 , 216 , 224 , 229 ], and review individual studies that exemplify high-quality research on musical treatments for conditions such as anxiety [ 311 , 312 ], depression [ 313 , 314 ], autism [ 274 , 315 ], psychosis [ 316 , 317 ], and dementia [ 318 , 319 ].

Mental health needs

In concluding this section, it is useful to briefly consider musical treatment in the context of current mental health needs. In 2007, mental health disorders were estimated to account for 14% of global disease burden [ 320 ]. In 2021, an estimated 22.8% of adults in the United States had a diagnosable mental illness, with 12.7% of adolescents having serious thoughts of suicide [ 17 ]. In opposition to this growing psychopathology, first-line treatments in psychiatry are often criticized for their limited effectiveness [ 94 , 320 , 321 ]. Quantifying this point, a 2022 meta-analytic evaluation of 3,782 clinical trials examining the most common adult mental health disorders across a total sample size of 650,514 patients estimated summary effect sizes of just 0.34 SMD for psychotherapy and 0.36 SMD for pharmacotherapy [ 94 ]. In depression, SMDs <0.88 represent changes in a patient’s presentation that are typically too small to be detected by a clinician, suggesting that the effects of standard treatments for depression commonly lack clinical significance [ 94 , 322 , 323 ]. A similar SMD threshold in schizophrenia is 0.73 [ 94 , 324 ]. It is crucial to note that small summary effect sizes in meta-analyses are averages, and thus obscure the reality that a minority of patients have experienced clinically significant benefits under current treatments (due to poorly understood individual differences in treatment response). Nevertheless, the data at hand clearly indicate that new treatments are urgently needed [ 94 ].

It is in this context that advancing new standardized music-based interventions is important, not only because music affects core dimensions of mental health through the biology of tonality, rhythm, reward, and sociality, but because these avenues present an accessible, easy-entry, and low-risk approach to addressing problems for which we need solutions. Music is poorly conceived as a panacea. Instead, it has real effects on human neurobiological functions that feature prominently in mental illness, and thus has important potential in treating their disorder.

The effects of music on mental health and wellness are drawing more attention now than ever before. Efforts to better understand music’s benefits and increase their integration into medicine are complicated by their impressive diversity and a lack of clarity regarding underlying biology. This review has addressed these challenges by synthesizing progress in music research from psychology, neuroscience, and psychiatry to create a framework for defining music’s neurophysiological effects and their clinical scope in biological terms. This framework includes four core elements of human musicality: tonality , based on tone perception and the bioacoustics of vocal emotional expression, with applications targeting mood and anxiety; rhythm , based on neural resonance, anticipation, and auditory-motor entrainment, with applications targeting mood, cognition, and motivation; reward , based on engagement of classic brain reward circuitry and the reinforcement of successful communication, with broad applications in stimulating positive affect and normalizing reward function; and sociality , based on synchrony and the neurobiology of affiliation, with broad applications in treating social dysfunction and increasing social connectedness. This framework rationalizes many observed benefits of musical treatment and provides a path towards a precision approach to increasing their impact. As the world continues to change and we face new challenges to mental health and wellness, music will continue to provide real biologically mediated relief. Understanding and leveraging this fact towards better treatments and interventions in psychiatry presents an important opportunity to diversify and improve care during times of pressing need.

Koelsch S. Music-evoked emotions: principles, brain correlates, and implications for therapy. Ann N. Y Acad Sci. 2015;1337:193–201.

Article   PubMed   Google Scholar  

Lonsdale AJ, North AC. Why do we listen to music? A uses and gratifications analysis. Br J Psychol. 2011;102:108–34.

Kemper KJ, Danhauer SC. Music as therapy. South Med J 2005;98:282–8.

Zatorre RJ. Musical pleasure and reward: mechanisms and dysfunction. Ann N. Y Acad Sci. 2015;1337:202–11.

Greenberg DM, Decety J, Gordon I. The social neuroscience of music: understanding the social brain through human song. Am Psychol. 2021;76:1172–85.

The U.S. Music Industries: Jobs & Benefits, by Robert Stoner and Jéssica Dutra of Economists Incorporated, prepared for the Recording Industry Association of America (RIAA), December 2020, available at www.riaa.com .

Cheever T, Taylor A, Finkelstein R, Edwards E, Thomas L, Bradt J, et al. NIH/Kennedy Center Workshop on Music and the Brain: Finding Harmony. Neuron 2018;97:1214–8.

Article   CAS   PubMed   PubMed Central   Google Scholar  

Fitzpatrick F. Could music be a game-changer for the future of digital health? Forbes. August 25, 2021.

Edwards E, St Hillaire-Clarke D, Frankowski DW, Finkelstein R, Cheever T, Chen WG, et al. NIH music-based intervention toolkit: music-based interventions for brain disorders of aging. Neurology 2023;100:868–78.

Article   PubMed   PubMed Central   Google Scholar  

O’Kelly JW. Music therapy and neuroscience: opportunities and challenges. Voices: A World Forum Music Ther. 2016;16. https://voices.no/index.php/voices/article/view/2309 .

Silverman MJ. Music therapy in mental health for illness management and recovery. Oxford, UK: Oxford University Press; 2015.

Book   Google Scholar  

Lin ST, Yang P, Lai CY, Su YY, Yeh YC, Huang MF, et al. Mental health implications of music: insight from neuroscientific and clinical studies. Harv Rev Psychiatry. 2011;19:34–46.

Thaut MH, Francisco G, Hoemberg V. The clinical neuroscience of music: evidence based approaches and neurologic music therapy. Front Neurosci. 2021;15:1–2.

Article   Google Scholar  

Altenmüller E, Schlaug G. Neurobiological aspects of neurologic music therapy. Music Med. 2013;5:210–6.

Tomaino CM. Auditory cueing of pre-learned skills and role of subcortical information processing to maximize rehabilitative outcomes bridging science and music-based interventions. Healthcare 2022;10:2207.

The American Music Therapy Association Workforce Analysis: A Descriptive Statistical Profile of the 2021 AMTA Membership and Music Therapy Community. Available at www.musictherapy.org .

Substance Abuse and Mental Health Services Administration. Key substance use and mental health indicators in the United States: results from the 2021 national survey on drug use and health (HHS Publication No. PEP22-07-01-005, NSDUH Series H-57). Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/data/report/2021-nsduh-annual-national-report . 2022.

Jackson T. Caseloads of professional music therapists: a descriptive analysis [Master’s Thesis]. Saint Mary-of-the-Woods College, Saint Mary-of-the-woods, IN; 2016.

National Institutes of Health. Music and health: understanding and developing music medicine. (2021). Available at: https://grants.nih.gov/grants/guide/pa-files/par-21-100.html .

Conard NJ, Malina M, Münzel SC. New flutes document the earliest musical tradition in southwestern Germany. Nature 2009;460:737–40.

Article   CAS   PubMed   Google Scholar  

Reck D. Music of the whole earth. New York, NY: Charles Scribner’s Sons; 1977.

Google Scholar  

Bowling DL, Purves D. A biological rationale for musical consonance. Proc Natl Acad Sci. 2015;112:11155–60.

Darwin C. The descent of man and selection in relation to sex. London, UK: John Murray; 1871.

Fitch WT. Musical protolanguage: Darwin’s theory of language evolution revisited. In: Bolhuis JJ, Everaert M, editors. Birdsong, speech, and language: exploring the evolution of the mind and brain. Cambridge, MA: MIT Press; 2013. p. 489–504.

Chapter   Google Scholar  

Fitch WT. The biology and evolution of music: a comparative perspective. Cognition 2006;100:173–215.

Koelsch S. Brain correlates of music-evoked emotions. Nat Rev Neurosci. 2014;15:170–80.

Gingras B, Honing H, Peretz I, Trainor LJ, Fisher SE. Defining the biological bases of individual differences in musicality. Philos Trans R Soc B Biol Sci 2015;370:20140092.

Albouy P, Mehr SA, Hoyer RS, Ginzburg J, Zatorre RJ. Spectro-temporal acoustical markers differentiate speech from song across cultures (preprint). bioRxiv. 2023.01.29.526133.

Haiduk F, Fitch WT. Understanding design features of music and language: the choric/dialogic distinction. Front Psychol. 2022;13:786899.

Bowling DL, Purves D, Gill KZ. Vocal similarity predicts the relative attraction of musical chords. Proc Natl Acad Sci. 2018;115:216–21.

Panksepp J. The emotional antecedents to the evolution of music and language. Music Sci. 2009;13:229–59.

Wallin NL. Biomusicology: neurophysiological, neuropsychological, and evoluitonary perspectives on the orgins and purposes of music. Pendragon Press, Maestag, UK; 1991.

Honing H. Musicality as an updeat to music: introduction and research agenda. In: Honing H, editor. Origins of Musicality. Cambridge, MA: MIT Press; 2019. p. 3–20.

Patel A. Music, language, and the brain. Oxford, UK: Oxford University Press; 2008.

Dissanayake E. Antecedents of the temporal arts in early mother-infant interaction. In: Wallin NL, Merker B, Brown S, editors. The origins of music. Cambridge, MA: The MIT Press; 2000. p. 389–410.

Brown S. The ‘musilanguage’ model of music evolution. In: Wallin NL, Merker B, Brown S, editors. The origins of music. Cambridge, MA: MIT Press; 2001. p. 271–300.

Thompson WF, Marin MM, Stewart L. Reduced sensitivity to emotional prosody in congenital amusia rekindles the musical protolanguage hypothesis. Proc Natl Acad Sci USA. 2012;109:19027–32.

Mithen S. The singing neaderthals: the origins of music, language, mind, and body. Cambridge, MA: Harvard University Press; 2007.

Hoeschele M, Merchant H, Kikuchi Y, Hattori Y, ten Cate C. Searching for the origins of musicality across species. Philos Trans R Soc B Biol Sci. 2015;370:20140094–20140094.

Patel AD. Vocal learning as a preadaptation for the evolution of human beat perception and synchronization. Philos Trans R Soc B Biol Sci 2021;376:20200326.

Article   CAS   Google Scholar  

Trehub S. The developmental origins of musicality. Nat Neurosci. 2003;6:669–73.

Miller G. Evolution of human music through sexual selection. In: Brown S, Merker B, Wallin C, editors. The origins of music. Cambridge, MA: The MIT Press; 2000. p. 329–60.

Merker B, Morley I, Zuidema W. Five fundamental constraints on theories of the origins of music. Philos Trans R Soc B Biol Sci. 2015;370:20140095.

Savage PE, et al. Music as a coevolved system for social bonding. Behav Brain Sci. 2021;44:E59.

Mehr SA, Krasnow MM, Bryant GA, Hagen EH. Origins of music in credible signaling. Behav Brain Sci. 2021;44:E60.

Cross I. Music, cognition, culture and evoution. Ann N. Y Acad Sci. 2001;930:28–42.

Huron D. Is music an evolutionary adaptation? Ann N. Y Acad Sci. 2001;930:43–61.

Trainor LJ. The origins of music: auditory scene analysis, evolution, and culture in musical creation. In: Honing H, editor. Origins of Musicality. MIT Press; 2019. p. 81–112.

Rossing TD, Moore FR, Wheeler PA. The science of sound. Addison Wesley; 2002.

Brown S, Jordania J. Universals in the world’s musics. Psychol Music. 2013;41:229–48.

Savage PE, Brown S, Sakai E, Currie TE. Statistical universals reveal the structures and functions of human music. Proc Natl Acad Sci USA. 2015;112:8987–92.

McAdams S. Musical timbre perception. In: Deutsch D, editor. The Psychology of Music. 3rd ed. London, UK: Academic Press; 2013. p. 35–67.

Schwartz DA, Howe CQ, Purves D. The statistical structure of human speech sounds predicts musical universals. J Neurosci. 2003;23:7160–8.

Negus VE. The comparative anatomy and physiology of the larynx. Hafner publishing company; 1949.

Ozaki Y, et al. Globally songs are slower, higher, and use more stable pitches than speech [Stage 2 Registered Report]. Peer Community Regist. Reports https://doi.org/10.31234/osf.io/jr9x7 .

Bowling DL, Hoeschele M, Gill KZ, Fitch WT. The nature and nurture of musical consonance. Music Percept. 2017;35:118–21.

McBride J, Tlusty T. Cross-cultural data shows musical scales evolved to maximise imperfect fifths. 2020. https://doi.org/10.48550/arXiv:1906.06171v2 .

Gill KZ, Purves D. A biological rationale for musical scales. PLoS One. 2009;4:e8144.

Prasad VKK. Ragas in Indian music. Nagercoil, IN: CBH Publications; 2008. p. 304.

Tokita AM. Mode and scale, modulation and tuning in Japanese Shamisen music: the case of Kiyomoto narrative. Ethnomusicology. 1996;40:1.

Vos PG, Troost JM. Ascending and descending melodic intervals: statistical findings and their perceptual relevance. Music Percept. 1989;6:383–96.

Bowling DL, Gill K, Choi JD, Prinz J, Purves D. Major and minor music compared to excited and subdued speech. J Acoust Soc Am. 2010;127:491–503.

Bowling DL, Sundararajan J, Han S, Purves D. Expression of emotion in eastern and western music mirrors vocalization. PLoS One. 2012;7:e31942.

Von Hippel P, Huron D. Why do skips precede reversals? the effect of tessitura on melodic structure. Music Percept. 2000;18:59–85.

Bowling DL, et al. Body size and vocalization in primates and carnivores. Sci Rep. 2017;7:41070.

Banse R, Scherer KR. Acoustic profiles in vocal emotion expression. J Pers Soc Psychol. 1996;70:614–36.

Eerola T, Ferrer R, Alluri V. Timbre and affect dimensions: evidence from affect and similarity ratings and acoustic correlates of isolated instrument sounds. Music Percept. 2012;30:49–70.

Arnal LH, Flinker A, Kleinschmidt A, Giraud AL, Poeppel D. Human screams occupy a privileged niche in the communication soundscape. Curr Biol. 2015;25:2051–6.

Tsai C, et al. Aggressiveness of the growl-like timbre: acoustic characterisctis, musical implications, and biomechanical mechanism. Music Percept. 2010;27:209–22.

Trehub SE, Unyk AM, Trainor LJ. Adults identify infant-directed music across cultures. Infant Behav Dev. 1993;16:193–211.

Mehr SA, Singh M, York H, Glowacki L, Krasnow MM. Form and function in human song. Curr. Biol. 2018;1–13.

Unyk AM, Trehub SE, Trainor LJ, Schellenberg EG. Lullabies and simplicity: a cross-cultural perspective. Psychol Music. 1992;20:15–28.

Huron D. A comparison of average pitch height and interval size in major-and minor-key themes: evidence consistent with affect-related pitch prosody. Empir Musicol Rev. 2008;3:59–63.

Bowling DL. Harmonicity and roughness in the biology of tonal aesthetics. Music Percept. 2021;38:331–4.

Terhardt E. The concept of musical consonance: a link between music and psychoacoustics. Music Percept. 1984;1:276–95.

Juslin PN, Laukka P. Communication of emotions in vocal expression and music performance: different channels, same code? Psychol Bull. 2003;129:770–814.

Juslin PN. Communicating emotion in music performance: a review and theoretical framework. In: Juslin PN, Slobada JA, editors. Music and emotion: theory and research. Oxford, UK: Oxford University Press; 2001. p. 309–37.

Bowling DL. Vocal similarity theory and the biology of musical tonality. Phys Life Rev. 2023;46:46–51.

Filippi P, Congdon J, Hoang J, Bowling DL, Reber SA, Pašukonis A, et al. Humans recognize emotional arousal in vocalizations across all classes of terrestrial vertebrates: evidence for acoustic universals. Proc R Soc B Biol Sci 2017;284:20170990.

Gerhardt KJ, Abrams RM. Fetal exposures to sound and vibroacoustic stimulation. J Perinatol. 2000;20:S21–30.

DeCasper J, Fifer WP. Of human bonding: newborns prefer their mothers’ voices. Science 1980;208:1174–6.

Trevarthen C. Musicality and the intrinsic motive pulse: evidence from human psychobiology and infant communication. Music Sci. 1999;3:155–215.

Langner G. Periodicity coding in the auditory system. Hear Res. 1992;60:115–42.

Bidelman GM, Krishnan A. Neural correlates of consonance, dissonance, and the hierarchy of musical pitch in the human brainstem. J Neurosci. 2009;29:13165–71.

Feng L, Wang X. Harmonic template neurons in primate auditory cortex underlying complex sound processing. Proc Natl Acad Sci USA. 2017;114:E840–8.

Tang C, Hamilton LS, Chang EF. Intonational speech prosody encoding in the human auditory cortex. Science 2017;357:797–801.

Pisanski K, Bryant GA. The evolution of voice perception. In: Eidsheim NS, Meizel K, editors. The Oxford Handbook of Voice Studies. Oxford University Press; 2019. p. 268–300.

Elfenbein HA, Laukka P, Althoff J, Chui W, Iraki FK, Rockstuhl T, et al. What do we hear in the voice? An open-ended judgment study of emotional speech prosody. Personal Soc Psychol Bull. 2022;48:1087–104.

Grocke D, Wigram T. Receptive methods in music therapy: techniques and clinical applications for music therapy clinicians, educators, and students. London, UK: Jessica Kingsley Publishers; 2006. p. 45–60.

Lin MF, Hsieh YJ, Hsu YY, Fetzer S, Hsu MC. A randomised controlled trial of the effect of music therapy and verbal relaxation on chemotherapy-induced anxiety. J Clin Nurs. 2011;20:988–99.

Lin HH, Chang YC, Chou HH, Chang CP, Huang MY, Liu SJ, et al. Effect of music interventions on anxiety during labor: a systematic review and meta-analysis of randomized controlled trials. PeerJ 2019;2019:1–20.

Kühlmann AYR, de Rooij A, Kroese LF, van Dijk M, Hunink MGM, Jeekel J. Meta-analysis evaluating music interventions for anxiety and pain in surgery. Br J Surg. 2018;105:773–83.

Lu G, Jia R, Liang D, Yu J, Wu Z, Chen C. Effects of music therapy on anxiety: a meta-analysis of randomized controlled trials. Psychiatry Res. 2021;304:114137.

Leichsenring F, Steinert C, Rabung S, Ioannidis JPA. The efficacy of psychotherapies and pharmacotherapies for mental disorders in adults: an umbrella review and meta-analytic evaluation of recent meta-analyses. World Psychiatry. 2022;21:133–45.

Aalbers S, Fusar-Poli L, Freeman RE, Spreen M, Ket JCF, Vink AC, et al. Music therapy for depression (review). Cochrane Database Syst Rev. 2017. https://doi.org/10.1002/14651858.cd004517 .

Tang Q, Huang Z, Zhou H, Ye P. Effects of music therapy on depression: a meta-analysis of randomized controlled trials. PLoS One. 2020;15:e0240862.

van Noorden L, Moelants D. Resonance in the perception of musical pulse. J N. Music Res. 1999;28:43–66.

Moelants D. Preferred tempo reconsidered. Proc. 7th Int. Conf. Music Percept. Cogn. 2002. p. 580–3.

Bruno H. Sensorimotor synchronization: a review of the tapping literature. Psychon Bull Rev. 2005;12:969–92.

Fitch W. Rhythmic cognition in humans and animals: distinguishing meter and pulse perception. Front Syst Neurosci. 2013;7:68.

London J. Hearing in Time. Oxford, UK: Oxford University Press; 2012.

Ding N, Patel A, Chen L, Butler H, Luo C, Poeppel D. Temporal modulations in speech and music. Neurosci Biobehav Rev. 2017;81:181–7.

Polak R. Rhythmic feel as meter: non-isochronous beat subdivision in jembe music from mali. Music Theory Online. 2010;16:1–26.

Polak R, London J, Jacoby N. Both isochronous and non-isochronous metrical subdivision afford precise and stable ensemble entrainment: a corpus study of malian jembe drumming. Front Neurosci. 2016;10:1–11.

Polak R. Non-isochronous meter is not irregular, a review of theory and evidence. In: Gegliederte Zeit: 15. Jahreskongress def Gesellschaft für Musiktheorie 2020, GMTH, Olms, DE; p. 365–79.

Roddy D. The evolution of blast beats. Pembroke Pines, FL: World Music 4all Publications; 2007. p. 10.

Clayton M. Theory and practice of long-form non-isochronous meters, the case of the North Indian rupak tal. Music Theory Online. 2020;24:1–24.

Patel A. The evolutionary biology of musical rhythm: was Darwin wrong? PLoS Biol. 2014;12:e1001821.

Iversen JR, Repp BH, Patel AD. Top-down control of rhythm perception modulates early auditory responses. Ann N. Y Acad Sci. 2009;1169:58–73.

Snoman R. Dance music manual: tools, toys, and techniques. Focal Press; 2019.

Witek MAG, Clarke EF, Wallentin M, Kringelbach ML, Vuust P. Syncopation, body-movement and pleasure in groove music. PLoS One. 2014;9:e94446.

Witek MAG, et al. A critical cross-cultural study of sensorimotor and groove responses to syncopation among Ghanaian and American university students and staff. Music Percept. 2020;37:278–97.

Longuet-Higgins HC, Lee CS. The rhythmic interpretation of monophonic music. Music Percept Interdiscip J 1984;1:424–41.

Giraud AL, Poeppel D. Cortical oscillations and speech processing: emerging computational principles and operations. Nat Neurosci. 2012;15:511–7.

Doelling KB, Florencia Assaneo M, Bevilacqua D, Pesaran B, Poeppel D. An oscillator model better predicts cortical entrainment to music. Proc Natl Acad Sci USA. 2019;116:10113–21.

Large EW, Snyder JS. Pulse and meter as neural resonance. Ann N. Y Acad Sci. 2009;1169:46–57.

Poeppel D, Assaneo MF. Speech rhythms and their neural foundations. Nat Rev Neurosci. 2020;21:322–34.

Ding N, Melloni L, Zhang H, Tian X, Poeppel D. Cortical tracking of hierarchical linguistic structures in connected speech. Nat Neurosci. 2015;19:158–64.

Grahn JA, Brett M. Rhythm and beat perception in motor areas of the brain. J Cogn Neurosci. 2007;19:893–906.

Grahn JA, Rowe JB. Feeling the beat: premotor and striatal interactions in musicians and nonmusicians during beat perception. J Neurosci. 2009;29:7540–8.

Chen JL, Zatorre RJ, Penhune VB. Interactions between auditory and dorsal premotor cortex during synchronization to musical rhythms. Neuroimage 2006;32:1771–81.

Chen JL, Penhune VB, Zatorre RJ. Listening to musical rhythms recruits motor regions of the brain. Cereb Cortex. 2008;18:2844–54.

Kotz SA, Brown RM, Schwartze M. Cortico-striatal circuits and the timing of action and perception. Curr Opin. Behav Sci. 2016;8:42–45.

Madison GS. Experiencing groove induced by music: consistency and phenomenology. Music Percept. 2006;24:201–8.

Janata P, Tomic ST, Haberman JM. Sensorimotor coupling in music and the psychology of the groove. J Exp Psychol Gen. 2012;141:54–75.

Hove MJ, Marie C, Bruce IC, Trainor LJ. Superior time perception for lower musical pitch explains why bass-ranged instruments lay down musical rhythms. Proc Natl Acad Sci. 2014;111:10383–8.

Stupacher J, Hove MJ, Janata P. Audio features underlying perceived groove and sensorimotor synchronization in music. Music Percept Interdiscip J 2016;33:571–89.

Bowling DL, Graf Ancochea P, Hove MJ, Fitch WT. Pupillometry of groove: evidence for noradrenergic arousal in the link between music and movement. Front Neurosci. 2019;12:1–12.

Berliner PF. Thinking in jazz: the infinite art of improvisation. Chicago, IL: The University of Chicago Press; 1994. p. 349–52.

Matthews TE, Witek MAG, Lund T, Vuust P, Penhune VB. The sensation of groove engages motor and reward networks. Neuroimage 2020;214:116768.

Dalla Bella S. The use of rhythm in rehabilitation for patients with movement disorders. Music Aging Brain 2020;383–406.

Tomaino CM. Effective music therapy techniques in the treatment of nonfluent aphasia. Ann N. Y Acad Sci. 2012;1252:312–7.

Zhou Z, Zhou R, Wei W, Luan R, Li K. Effects of music-based movement therapy on motor function, balance, gait, mental health, and quality of life for patients with Parkinson’s disease: a systematic review and meta-analysis. Clin Rehabil. 2021;35:937–51.

Yoo GE, Kim SJ. Rhythmic auditory cueing in motor rehabilitation for stroke patients: systematic review and meta-analysis. J Music Ther. 2016;53:149–77.

Sihvonen AJ, et al. Music-based interventions in neurological rehabilitation. Lancet Neurol. 2017;16:648–60.

Särkämö T, et al. Music listening enhances cognitive recovery and mood after middle cerebral artery stroke. Brain 2008;131:866–76.

Hamilton JP, Farmer M, Fogelman P, Gotlib IH. Depressive rumination, the default-mode network, and the dark matter of clinical neuroscience. Biol Psychiatry. 2015;78:224–30.

Moberly NJ, Watkins ER. Ruminative self-focus and negative affect: an experience sampling study. J Abnorm Psychol. 2008;117:314–23.

Boehme S, Miltner WHR, Straube T. Neural correlates of self-focused attention in social anxiety. Soc Cogn Affect Neurosci. 2014;10:856–62.

Orpella J, Bowling DL, Tomaino C, Ripollés P. Affectively parameterized music improves mood and attention (preprint). PsychiArXiv. 2023. https://doi.org/10.31234/osf.io/yauxt

Fukuie T, et al. Groove rhythm stimulates prefrontal cortex function in groove enjoyers. Sci Rep. 2022;12:1–14.

Huang RH, Shih YN. Effects of background music on concentration of workers. Work 2011;38:383–7.

Thompson WF, Schellenberg EG, Husain G. Arousal, mood, and the Mozart effect. Psychol Sci. 2001;12:248–51.

Rauscher FH, Shaw GL, Ky KN. Music and spatial task performance. Nature 1993;365:611.

Gioia T. Work songs. Durham, NC: Duke University Press; 2006.

McNeill W. Keeping together in time. Cambridge, MA: Harvard University Press; 1995.

Dietrich A. Neurocognitive mechanisms underlying the experience of flow. Conscious Cogn. 2004;13:746–61.

Schaffert N, Janzen TB, Mattes K, Thaut MH. A review on the relationship between sound and movement in sports and rehabilitation. Front Psychol. 2019;10:1–20.

Koelsch S. A coordinate-based meta-analysis of music-evoked emotions. Neuroimage 2020;223:117350.

Huron D, Margulis EH. Musical expectancy and thrills. In: Juslin PN, Sloboda JA, editors. Handbook of music and emotion: theory, research, applications. Oxford University Press; 2010. p. 575–604.

Salimpoor VN, Benovoy M, Larcher K, Dagher A, Zatorre RJ. Anatomically distinct dopamine release during anticipation and experience of peak emotion to music. Nat Neurosci. 2011;14:257–62.

Blood AJ, Zatorre RJ. Intensely pleasurable responses to music correlate with activity in brain regions implicated in reward and emotion. Proc Natl Acad Sci USA. 2001;98:11818–23.

Salimpoor VN, et al. Interactions between the nucleus accumbens and auditory cortices predict music reward value. Science 2013;340:216–9.

Menon V, Levitin DJ. The rewards of music listening: response and physiological connectivity of the mesolimbic system. Neuroimage 2005;28:175–84.

Bowling DL, et al. Endogenous oxytocin, cortisol, and testosterone in response to group singing. Horm Behav. 2022;139:105105.

Mallik A, Chanda ML, Levitin DJ. Anhedonia to music and mu-opioids: evidence from the administration of naltrexone. Sci Rep. 2017;7:1–8.

Goldstein A. Thrills in response to music and other stimuli. Physiol Psychol. 1980;8:126–9.

Dichter GS, Damiano CA, Allen JA. Reward circuitry dysfunction in psychiatric and neurodevelopmental disorders and genetic syndromes: animal models and clinical findings. J Neurodev Disord. 2012;4:1–43.

Wu Q, et al. Effectiveness of music therapy on improving treatment motivation and emotion in female patients with methamphetamine use disorder: a randomized controlled trial. Subst Abus. 2020;41:493–500.

Bibb J, Castle D, Newton R. The role of music therapy in reducing post meal related anxiety for patients with anorexia nervosa. J Eat Disord. 2015;3:1–6.

Bodeck S, Lappe C, Evers S. Tic-reducing effects of music in patients with Tourette’s syndrome: self-reported and objective analysis. J Neurol Sci. 2015;352:41–47.

Atkinson TM, et al. Association between music therapy techniques and patient-reported moderate to severe fatigue in hospitalized adults with cancer. JCO Oncol Pr. 2020;16:e1553–7.

Tang Q, et al. Effect of music intervention on apathy in nursing home residents with dementia. Geriatr Nurs. 2018;39:471–6.

Jia R, et al. The effectiveness of adjunct music therapy for patients with schizophrenia: a meta‐analysis. Psychiatry Res. 2020;293:113464.

Janzen TB, Al Shirawi MI, Rotzinger S, Kennedy SH, Bartel L. A pilot study investigating the effect of music-based intervention on depression and anhedonia. Front Psychol. 2019;10:1–13.

Skorvanek M, et al. The associations between fatigue, apathy, and depression in Parkinson’s disease. Acta Neurol Scand. 2015;131:80–7.

Bortolon C, Macgregor A, Capdevielle D, Raffard S. Apathy in schizophrenia: a review of neuropsychological and neuroanatomical studies. Neuropsychologia 2018;118:22–33.

Lechowski L, et al. Persistent apathy in Alzheimer’s disease as an independent factor of rapid functional decline: the REAL longitudinal cohort study. Int J Geriatr Psychiatry. 2009;24:341–6.

Hove MJ, Risen JL. It’s all in the timing: interpersonal synchrony increases affiliation. Soc Cogn. 2009;27:949–61.

Reddish P, Fischer R, Bulbulia J. Let’s dance together: synchrony, shared intentionality and cooperation. PLoS One. 2013;8:e71182.

Anshel A, Kipper DA. The influence of group singing on trust and cooperation. J Music Ther. 1988;25:145–55.

Wiltermuth SS, Heath C. Synchrony and cooperation. Psychol Sci. 2009;20:1–5.

Valdesolo P, Desteno D. Synchrony and the social tuning of compassion. Emotion 2011;11:262–6.

Kokal I, Engel A, Kirschner S, Keysers C. Synchronized drumming enhances activity in the caudate and facilitates prosocial commitment-if the rhythm comes easily. PLoS One. 2011;6:e27272.

Cirelli L, Einarson K, Trainor L. Interpersonal synchrony increases prosocial behavior in infants. Dev Sci. 2014;17:1003–11.

Cirelli L, Wan S, Trainor L. Fourteen-month-old infants use interpersonal synchrony as a cue to direct helpfulness. Philos Trans R Soc Lond B Biol Sci. 2014;369:20130400.

Kirschner S, Tomasello M. Joint music making promotes prosocial behavior in 4-year-old children. Evol Hum Behav. 2010;31:354–64.

Rennung M, Göritz AS. Prosocial consequences of interpersonal synchrony: a meta-analysis. Z Psychol. 2016;224:168–89.

PubMed   PubMed Central   Google Scholar  

Keeler JR, Roth EA, Neuser BL, Spitsbergen JM, Waters DJM, Vianney J. The neurochemistry and social flow of singing: bonding and oxytocin. Front Hum Neurosci. 2015;9:518.

Kreutz G. Does singing facilitate social bonding? Music Med. 2014;6:51–60.

Good A, Russo FA. Changes in mood, oxytocin, and cortisol following group and individual singing: A pilot study. Psychol Music. 2021. https://doi.org/10.1177/03057356211042668 .

Grape C, Sandgren M, Hansson L, Ericson M, Theorell T. Does singing promote well-being?: An empirical study of professional and amateur singers during a singing lesson. Integr Physiol Behav Sci. 2003;38:65–74.

Schladt TM, Normann GC, Emilius R, Kudielka BM, de Jong TR, Neumann ID. Choir versus solo singing: effects on mood, and salivary oxytocin and cortisol concentrations. Front Hum Neurosci. 2017;11:1–9.

Fancourt D, et al. Singing modulates mood, stress, cortisol, cytokine and neuropeptide activity in cancer patients and carers. Ecancermedicalscience 2016;10:1–13.

Fancourt D, Perkins R, Ascenso S, Atkins L, Kilfeather S, Carvalho L, et al. Group drumming modulates cytokine response in mental health services users: a preliminary study. Psychother Psychosom. 2016;85:53–55.

Fritz TH, Bowling DL, Contier O, Grant J, Villringer A. Musical agency during physical exercise decreases pain. Front Psychol. 2018;8:2312.

Cohen E, Ejsmond-Frey R, Knight N, Dunbar R. Rowers’ high: behavioural synchrony is correlated with elevated pain thresholds. Biol Lett. 2010;6:106–8.

Davis WB. Ira Maximilian Altshuler: psychiatrist and pioneer music therapist. J Music Ther. 2003;40:247–63.

Bonini L, Rotunno C, Arcuri E, Gallese V. Mirror neurons 30 years later: implications and applications. Trends Cogn Sci. 2022;26:767–81.

Watson JC, Greenberg LS. Empathic resonance: a neuroscience perspective. In: Decety J, Ickes W, editors. The social neuroscience of empathy. Cambridge, MA: The MIT Press; 2009. p. 125–38.

Schurtz DR, Blincoe S, Smith RH, Powell CAJ, Combs DJY, Kim SH. Exploring the social aspects of goose bumps and their role in awe and envy. Motiv Emot. 2012;36:205–17.

Benedek M, Kaernbach C. Physiological correlates and emotional specificity of human piloerection. Biol Psychol. 2011;86:320–9.

Schultz W, Tremblay L, Hollerman JR. Reward processing in primate orbitofrontal cortex and basal ganglia. Cereb Cortex. 2000;10:272–83.

Freeman W. A neurobiological role of music in social bonding. In: Wallin NL, Merker B, Brown S, editors. The origins of music. Cambridge, MA: MIT Press; 2000. p. 411–24.

Harvey AR. Links between the neurobiology of oxytocin and human musicality. Front Hum Neurosci. 2020;14:1–19.

Insel TR. The challenge of translation in social neuroscience: a review of oxytocin, vasopressin, and affiliative behavior. Neuron 2010;65:768–79.

Dölen G, Darvishzadeh A, Huang KW, Malenka RC. Social reward requires coordinated activity of nucleus accumbens oxytocin and serotonin. Nature 2013;501:179–84.

Itskovitch E, Bowling DL, Garner JP, Parker KJ. Oxytocin and the social facilitation of placebo effects. Mol Psychiatry. 2022;27:2640–9.

Ross HE, Young LJ. Oxytocin and the neural mechanisms regulating social cognition and affiliative behavior. Front Neuroendocrinol. 2009;30:534–47.

Hung LW, Neuner S, Polepalli JS, Beier KT, Wright M, Walsh JJ, et al. Gating of social reward by oxytocin in the ventral tegmental area. Science 2017;357:1406–11.

Linnemann A, Ditzen B, Strahler J, Doerr JM, Nater UM. Music listening as a means of stress reduction in daily life. Psychoneuroendocrinology 2015;60:82–90.

Jamieson BB, Nair BB, Iremonger KJ. Regulation of hypothalamic corticotropin-releasing hormone neurone excitability by oxytocin. J Neuroendocrinol. 2017;29:1–10.

Winter J, Jurek B. The interplay between oxytocin and the CRF system: regulation of the stress response. Cell Tissue Res. 2019;375:85–91.

Jiang Z, Rajamanickam S, Justice NJ. Local corticotropin-releasing factor signaling in the hypothalamic paraventricular nucleus. J Neurosci. 2018;38:1874–90.

Rajamanickam S, Justice NJ. Hypothamalic corticotropin-releasing factor neurons modulate behavior, endocrine, and autonomic stress responses via direct synpatic projections. Curr Opin Endocr Metab Res. 2022;100400. https://doi.org/10.1016/j.coemr.2022.100400 .

Deussing JM, Chen A. The corticotropin-releasing factor family: physiology of the stress response. Physiol Rev. 2018;98:2225–86.

Porcelli S, Kasper S, Zohar J, Souery D, Montgomery S, Ferentinos P, et al. Social dysfunction in mood disorders and schizophrenia: clinical modulators in four independent samples. Prog Neuro-Psychopharmacol Biol Psychiatry. 2020;99:109835.

Hedley D, Uljarević M, Foley KR, Richdale A, Trollor J. Risk and protective factors underlying depression and suicidal ideation in Autism Spectrum Disorder. Depress Anxiety. 2018;35:648–57.

Holt-Lunstad J, Smith TB, Layton JB. Social relationships and mortality risk: A meta-analytic review. PLoS Med. 2010;7:e1000316.

Hakulinen C, Pulkki-Råback L, Virtanen M, Jokela M, Kivimäki M, Elovainio M. Social isolation and loneliness as risk factors for myocardial infarction, stroke and mortality: UK Biobank cohort study of 479 054 men and women. Heart 2018;104:1536–42.

Launay J. Musical sounds, motor resonance, and detectable agency. Empir Musicol Rev. 2015;10:30.

Kragness HE, Eitel MJ, Anantharajan F, Gaudette-LeBlanc A, Barazowska B, Cirelli L. An itsy bitsy audience: live performance facilitates infants’ attention and heart rate synchronization. Psychol Aesthet Creat Arts. 2015. https://doi.org/10.1037/aca0000597

Onderdijk KE, Swarbrick D, van Kerrebroeck B, Mantei M, Vuoskoski JK, Maes PJ, et al. Livestream experiments: the role of COVID-19, agency, presence, and social context in facilitating social connectedness. Front Psychol. 2021;12:1–25.

Swarbrick D, Seibt B, Grinspun N, Vuoskoski JK. Corona Concerts: The Effect of Virtual Concert Characteristics on Social Connection and Kama Muta. Front Psychol. 2021;12:1–21.

Nordoff P, Robbin C. Therapy in music for handicapped children. New York, NY: St Martin’s Press; 1971.

Geretsegger M, Fusar-Poli L, Elefant C, Mössler KA, Vitale G, Gold C. Music Therapy for Autistic People. Cochrane Database Syst. Rev. 2022;CD004381. https://doi.org/10.1002/14651858.CD004381.pub4 .

Alvin J, Warwick A. Music therapy for the autistic child. Oxford, UK: Oxford University Press; 1991.

Berger DS. Music therapy, sensory integration, and the autistic child. London, UK: Jessica Kingsley Publishers; 2002.

Whipple J. Music in intervention for children and adolescents with autism: a meta-analysis. J Music Ther. 2004;41:90–106.

Thompson GA, Mcferran KS, Gold C. Family-centred music therapy to promote social engagement in young children with severe autism spectrum disorder: a randomized controlled study. Child Care Health Dev. 2014;40:840–52.

Mayer-Benarous H, Benarous X, Vonthron F, Cohen D. Music therapy for children with autistic spectrum disorder and/or other neurodevelopmental disorders: a systematic review. Front Psychiatry. 2021;12:643234.

Yu Q, Li E, Li L, Liang W. Efficacy of interventions based on applied behavior analysis for autism spectrum disorder: a meta-analysis. Psychiatry Investig. 2020;17:432–43.

Gold C, Solli HP, Krüger V, Lie SA. Dose-response relationship in music therapy for people with serious mental disorders: systematic review and meta-analysis. Clin Psychol Rev. 2009;29:193–207.

Geretsegger M, Mössler KA, Bieleninik L, Chen XJ, Heldal TO, Gold C. Music therapy for people with schizophrenia and schizophrenia-like disorders. Cochrane Database Syst Rev. 2017;2017:CD004025.

PubMed Central   Google Scholar  

Leucht S, Leucht C, Huhn M, Chaimani A, Mavridis D, Helfer B, et al. Sixty years of placebo-controlled antipsychotic drug trials in acute schizophrenia: Systematic review, Bayesian meta-analysis, and meta-regression of efficacy predictors. Am J Psychiatry. 2017;174:927–42.

Brotons M, Koger SM. The impact of music therapy on language functioning in dementia. J Music Ther. 2000;37:183–95.

Lord TR, Garner JE. Effects of music on Alzheimer patients. Percept Mot Skills. 1993;76:451–5.

Hanser SB. The effectiveness of music-based interventions for dementia: An umbrella review. Music Med. 2021;13:156–61.

Tsoi KKF, Chan JYC, Ng YM, Lee MMY, Kwok TCY, Wong SYS. Receptive music therapy is more effective than interactive music therapy to relieve behavioral and psychological symptoms of dementia: a systematic review and meta-analysis. J Am Med Dir Assoc. 2018;19(568):e3.

Good A, Kreutz G, Choma B, Fiocco A, Russo F. The SingWell project protocol: the road to understanding the benefits of group singing in older adults. Public Heal Panor. 2020;6:141–6.

McDonald C, Stewart L. Uses and functions of music in congenital amusia. Music Percept. 2008;25:345–55.

Gladwell M, Headlam B. Miracle and wonder: conversations with Paul Simon [Audiobook]. New York, NY: Pushkin Industries; 2021. Prologue, 00:00-01:00.

Peretz I, Champod AS, Hyde K. Varieties of musical disorders. Ann N. Y Acad Sci. 2003;999:58–75.

Müllensiefen D, Gingras B, Musil J, Stewart L. The musicality of non-musicians: an index for assessing musical sophistication in the general population. PLoS One. 2014;9:0089642.

Hannon EE, Trainor LJ. Music acquisition: effects of enculturation and formal training on development. Trends Cogn Sci. 2007;11:466–72.

McDermott JH, Schultz AF, Undurraga EA, Godoy RA. Indifference to dissonance in native Amazonians reveals cultural variation in music perception. Nature 2016;25:21–25.

Smit EA, Milne AJ, Sarvasy HS, Dean RT. Emotional responses in Papua New Guinea show negligible evidence for a universal effect of major versus minor music. PLoS One. 2022;17:14–20.

Drayna D, Manichaikul A, De Lange M, Snieder H, Spector T. Genetic correlates of musical pitch recognition in humans. Science 2001;291:1969–72.

Mosing MA, Madison G, Pedersen NL, Kuja-Halkola R, Ullén F. Practice does not make perfect: no causal effect of music practice on music ability. Psychol Sci. 2014;25:1795–803.

Seesjärvi E, Särkämö T, Vuoksimaa E, Tervaniemi M, Peretz I, Kaprio J. The nature and nurture of melody: a twin study of musical pitch and rhythm perception. Behav Genet. 2016;46:506–15.

Pulli K, Karma K, Norio R, Sistonen P, Göring HHH, Järvelä I. Genome-wide linkage scan for loci of musical aptitude in Finnish families: Evidence for a major locus at 4q22. J Med Genet. 2008;45:451–6.

Oikkonen J, Huang Y, Onkamo P, Ukkolva-Vuoti L, Raijas P, Karma K, et al. A genome-wide linkage and association study of musical aptitude identifies loci containing genes related to inner ear development and neurocognitive functions. Mol Psychiatry. 2015;20:275–82.

Niarchou M, Gustavson J, Sathirapongsasuti JF, Angelda-Tort M, Eising E, Bell E, et al. Genome-wide association study of musical beat synchronization demonstrates high polygenicity. Nat Hum Behav. 2022;6:1292–309.

Song Z, Albers HE. Cross-talk among oxytocin and arginine-vasopressin receptors: relevance for basic and clinical studies of the brain and periphery. Front Neuroendocrinol. 2018;51:14–24.

Ukkola LT, Onkamo P, Raijas P, Karma K, Järvelä I. Musical aptitude Is associated with AVPR1A-haplotypes. PLoS One. 2009;4:e5534.

Granot RY, Frankel Y, Gritsenko V, Lerer E, Gritsenko I, Bachner-Melman R, et al. Provisional evidence that the arginine vasopressin 1a receptor gene is associated with musical memory. Evol Hum Behav. 2007;28:313–8.

Ukkola-Vuoti L, Oikkonen J, Onkamo P, Karma K, Raijas P, Järvelä I, et al. Association of the arginine vasopressin receptor 1A (AVPR1A) haplotypes with listening to music. J Hum Genet. 2011;56:324–9.

Bachner-Melman R, Dina C, Zohar AH, Constantini N, Lerer E, Hoch S, et al. AVPR1a and SLC6A4 gene polymorphisms are associated with creative dance performance. PLoS Genet. 2005;1:394–403.

Zhang Y, Zhu D, Zeng P, Le W, Qin W, Liu F, et al. Neural mechanisms of AVPR1A RS3-RS1 haplotypes that impact verbal learning and memory. Neuroimage 2020;222:117283.

Levin R, Heresco-Levy U, Bachner-Melman R, Israel S, Shalev I, Epstien RP, et al. Association between arginine vasopressin 1a receptor (AVPR1a) promoter region polymorphisms and prepulse inhibition. Psychoneuroendocrinology 2009;34:901–8.

Meyer-Lindenberg A, Kolachana B, Gold B, Olsh A, Nikodemus KK, Mattay V, et al. Genetic variants in AVPR1A linked to autism predict amygdala activation and personality traits in healthy humans. Mol Psychiatry. 2009;14:968–75.

Knafo A, Israel S, Darvasi A, Bachner-Melman R, Uzefovsky F, Cohen L, et al. Individual differences in allocation of funds in the dictator game associated with length of the arginine vasopressin 1a receptor RS3 promoter region and correlation between RS3 length and hippocampal mRNA. Genes, Brain Behav. 2008;7:266–75.

Walum H, Westberg L, Henningsson S, Neiderhiser JM, Reiss D, Igl W, et al. Genetic variation in the vasopressin receptor 1a gene (AVPR1A) associates with pair-bonding behavior in humans. Proc Natl Acad Sci USA. 2008;105:14153–6.

Francis SM, Kim SJ, Kistner-Griffin E, Guter S, Cook EH, Jacob S. ASD and genetic associations with receptors for oxytocin and vasopressin-AVPR1A, AVPR1B, and OXTR. Front Neurosci. 2016;10:1–10.

Morley AP, Narayanan M, Mines R, Molokhia A, Baxter S, Craig G, et al. AVPR1A and SLC6A4 polymorphisms in choral singers and non-musicians: a gene association study. PLoS One. 2012;7:2–8.

Ayotte J, Peretz I, Hyde K. Congenital amusia: a group study of adults afflicted with a music-specific disorder. Brain 2002;125:238–51.

Grant Allen I. Note deafness. Mind 1878;3:157–67.

Phillips-Silver J, Toiviainen P, Gosselin N, Piché O, Nozaradan S, Palmer C, et al. Born to dance but beat deaf: a new form of congenital amusia. Neuropsychologia 2011;49:961–9.

Mas-Herrero E, Zatorre RJ, Rodriguez-Fornells A, Marco-Pallarés J. Dissociation between musical and monetary reward responses in specific musical anhedonia. Curr Biol. 2014;24:699–704.

Peretz I, Cummings S, Dubé M-P. The genetics of congenital amusia (tone deafness): a family-aggregation study. Am J Hum Genet. 2007;81:582–8.

Loui P, Alsop D, Schlaug G. Tone deafness: a new disconnection syndrome? J Neurosci. 2009;29:10215–20.

Hyde KL, Zatorre RJ, Peretz I. Functional MRI evidence of an abnormal neural network for pitch processing in congenital amusia. Cereb Cortex. 2011;21:292–9.

Peretz I. Neurobiology of congenital amusia. Trends Cogn Sci. 2016;20:857–67.

Peretz I, Vuvan DT. Prevalence of congenital amusia. Eur J Hum Genet. 2017;25:625–30.

Mas-Herrero E, Maarco-Pallares J, Lorenzo-Seva U, Zatorre RJ, Rodriguez-Fornells A. Individual differences in music reward experiences. Music Percept. 2013;31:118–39.

Edwards J. Conceptualizing music therapy: five areas that frame the field. In: Edwards J, editor. The Oxford handbook of music therapy. Oxford, UK: Oxford University Press; 2016. p. 1–13.

Rolvsjord R. Resource-oriented perspectives in music therapy. In: Edwards J, editor. The Oxford handbook of music therapy. Oxford, UK: Oxford University Press; 2016. p. 557–76.

Vuvan DT, Paquette S, Mignault Goulet G, Royal I, Felezeu M, Peretz I. The Montreal protocol for identification of amusia. Behav Res Methods. 2018;50:662–72.

Peretz I, Gosselin N, Nan Y, Caron-Caplette E, Trehub SE, Beland R. A novel tool for evaluating children’s musical abilities across age and culture. Front Syst Neurosci. 2013;7:1–10.

Harrison PMC, Müllensiefen D. Development and validation of the computerised adaptive beat alignment test (CA-BAT). Sci Rep. 2018;8:1–19.

Constantino JN, Davis SA, Todd RD, Schindler MK, Gross MM, Brophy SL, et al. Validation of a brief quantitative measure of autistic traits: Comparison of the social responsiveness scale with the Autism Diagnostic Interview-Revised. J Autism Dev Disord. 2003;33:427–33.

Liebowitz MR. Social phobia. Mod Probl Pharmacopsychiatry. 1987;22:141–73.

Bieleninik GeretseggerM, Mössler K, Assmus J, Thompson G, Gattino G, et al. Effects of improvisational music therapy vs enhanced standard care on symptom severity among children with autism spectrum disorder: the TIME-A randomized clinical trial. JAMA - J Am Med Assoc. 2017;318:525–35.

Sharda M, Tuerk C, Chowdhury R, Jamey K, Foster N, Custo-Blanch M, et al. Music improves social communication and auditory–motor connectivity in children with autism. Transl Psychiatry. 2018;8:231.

Greenberg DM, Kosinski M, Stillwell DJ, Montiero BL, Levitin D, Rentfrow PJ, et al. The song is you: preferences for musical attribute dimensions reflect personality. Soc Psychol Personal. Sci 2016;7:597–605.

Schedl M. Deep learning in music recommendation systems. Front Appl Math Stat. 2019;5:1–9.

Pereira CS, Teixeira J, Figueiredo P, Xaiver J, Castro SL, Brattico E, et al. Music and emotions in the brain: familiarity matters. PLoS One. 2011;6:e27241.

van den Bosch I, Salimpoor VN, Zatorre RJ. Familiarity mediates the relationship between emotional arousal and pleasure during music listening. Front Hum Neurosci. 2013;7:1–10.

Freitas C, Manzato E, Burini A, Taylor MJ, Lerch JP, Anagnostou E. Neural correlates of familiarity in music listening: a systematic review and a neuroimaging meta-analysis. Front Neurosci. 2018;12:1–14.

Silverman MJ, Letwin L, Nuehring L. Patient preferred live music with adult medical patients: a systematic review to determine implications for clinical practice and future research. Arts Psychother. 2016;49:1–7.

Hilliard RE. A post-hoc analysis of music therapy services for residents in nursing homes receiving hospice care. J Music Ther. 2004;41:266–81.

Jiang J, Rickson D, Jiang C. The mechanism of music for reducing psychological stress: music preference as a mediator. Arts Psychother. 2016;48:62–68.

Sakka LS, Saarikallio S. Spontaneous music-evoked autobiographical memories in individuals experiencing depression. Music Sci. 2020;3:1–15.

Garrido S, Schubert E. Moody melodies: do they cheer us up? A study of the effect of sad music on mood. Psychol Music. 2015;43:244–61.

Yoon S, Verona E, Schlauch R, Schneider S, Rottenberg J. Why do depressed people prefer sad music? Emotion 2019;20:613–24.

Millgram Y, Joormann J, Huppert JD, Tamir M. Sad as a matter of choice? Emotion-regulation goals in depression. Psychol Sci. 2015;26:1216–28.

Huron D, Vuoskoski JK. On the enjoyment of sad music: pleasurable compassion theory and the role of trait empathy. Front Psychol. 2020;11:1–16.

Sachs ME, Damasio A, Habibi A. The pleasures of sad music: a systematic review. Front Hum Neurosci. 2015;9:1–12.

Kenny DT, Asher A. Life expectancy and cause of death in popular musicians: is the popular musician lifestyle the road to ruin? Med Probl Perform Art. 2016;31:37–44.

Anderson CA, Berkowitz L, Donnerstein E, Huessmann LR, Johnson JD, Linz D, et al. The influence of media violence on youth. Psychol Sci Public Interes. 2003;4:81–110.

Thompson WF, Geeves AM, Olsen KN. Who enjoys listening to violent music and why? Psychol Pop Media Cult. 2019;8:218–32.

Depasquale J. A fly over the fringes: depressive suicide black metal, past, present, and beyond. Invisible Oranges. 2018. https://www.invisibleoranges.com/depressive-black-metal/ .

Arroyo-Anlló EM, Díaz JP, Gil R. Familiar music as an enhancer of self-consciousness in patients with Alzheimer’s disease. Biomed Res Int 2013;2013:752965.

Smith TW. Generational differences in musical preferences. Pop Music Soc. 1994;18:45–59.

Omigie D, Müllensiefen D, Stewart L. The experience of music in congenital amusia. Music Percept. 2012;30:1–18.

Fink LK, Warrenburg L, Howlin C, Randall WM, Hansen NC, Wald-Fuhrmann M. Viral tunes: changes in musical behaviours and interest in coronamusic predict socio-emotional coping during COVID-19 lockdown. Humanit Soc. Sci Commun. 2021;8:1–11.

North AC, Hargreaves DJ, O’Neill SA. The importance of music to adolescents. Br J Educ Psychol. 2000;70:255–72.

Tarrant M, North AC, Hargreaves DJEnglish. and American adolescents’ reasons for listening to music. Psychol Music. 2000;28:166–73.

Boer D, Fischer R, Tekman HG, Abubakar A, Njenga J, Zenger M. Young people’s topography of musical functions: personal, social and cultural experiences with music across genders and six societies. Int J Psychol. 2012;47:355–69.

West M. Music Therapy in Antiquity. In: Horden P, editor. Music as medicine: the history of music therapy since antiquity. Aldershot, UK: Ashgate Publishing Limited; 2000. p. 51–68.

Singh M. The cultural evolution of shamanism. Behav. Brain Sci. 2017;1–83.

Golden TL, Tetreault L, Ray CE, Kuge MN, Tiedemann A, Magsamen S. The state of music-based interventions for mental illness: thought leaders on barriers, opportunities, and the value of interdisciplinarity. Community Ment Health J. 2022;58:487–98.

Gaston ET. Music education for health. Music Educ J 1945;31:24–25.

Ross A. Classical view; Listening to prozac…Er, Mozart. The New York Times . August 28, 1994, Section 2, Page 23.

Pietschnig J, Voracek M, Formann AK. Mozart effect-shmozart effect: a meta-analysis. Intelligence 2010;38:314–23.

Nantais KM, Schellenberg EG. The mozart effect: an artifact of preference. Psychol Sci. 1999;10:370–3.

Kirsch I. Placebo psychotherapy: synonym or oxymoron? J Clin Psychol. 2005;61:791–803.

Rolvsjord R, Gold C, Stige B. Research rigour and therapeutic flexibility: Rationale for a therapy manual developed for a randomised controlled trial. Nord J Music Ther. 2005;14:15–32.

Bradt J. Randomized controlled trials in music therapy: guidelines for design and implementation. J Music Ther. 2012;49:120–49.

Cuijpers P, Karyotaki E, Reijnders M, Ebert DD. Was Eysenck right after all? A reassessment of the effects of psychotherapy for adult depression. Epidemiol Psychiatr Sci 2019;28:21–30.

Kim YK, Kim SM, Myoung H. Musical intervention reduces patients’ anxiety in surgical extraction of an impacted mandibular third molar. J Oral Maxillofac Surg. 2011;69:1036–45.

Bringman H, Giesecke K, Thörne A, Bringman S. Relaxing music as pre-medication before surgery: a randomised controlled trial. Acta Anaesthesiol Scand. 2009;53:759–64.

Ribeiro MKA, Alcântara-Silva TRM, Oliverira JCM, Paula TC, Dutra JBR, Pedrino GR, et al. Music therapy intervention in cardiac autonomic modulation, anxiety, and depression in mothers of preterms: randomized controlled trial. BMC Psychol. 2018;6:1–10.

Erkkilä J, Punkanen M, Fachner J, Ala-Ruona E, Pöntiö I, Tervaniemi M, et al. Individual music therapy for depression: randomised controlled trial. Br J Psychiatry. 2011;199:132–9.

Rabeyron T, Robledo del Canto JP, Carasco E, Bisson V, Bodeau M, Vrait FX, et al. A randomized controlled trial of 25 sessions comparing music therapy and music listening for children with autism spectrum disorder. Psychiatry Res. 2020;293:113377.

Volpe U, Gianoglio C, Autiero L, Marino ML, Facchini D, Mucci A, et al. Acute effects of music therapy in subjects with psychosis during inpatient treatment. Psychiatry Interpers Biol. Process 2018;81:218–27.

Gold C, Mössler K, Grocke D, Heldal TO, Tjemsland L, Aarre T, et al. Individual music therapy for mental health care clients with low therapy motivation: multicentre randomised controlled trial. Psychother Psychosom. 2013;82:319–31.

Gerdner LA. Effects of individualized versus classical ‘relaxation’ music on the frequency of agitation in elderly persons with Alzheimer’s disease and related disorders. Int Psychogeriatr. 2000;12:49–65.

Raglio A, Bellelli G, Traficante D, Gianotti M, Ubezio MC, Villani D, et al. Efficacy of music therapy in the treatment of behavioral and psychiatric symptoms of dementia. Alzheimer Dis Assoc Disord. 2008;22:158–62.

Prince M, Patel V, Saxena S, Maj M, Maselko J, Phillips MR, et al. No health without mental health. Lancet 2007;370:859–77.

Czeisler MÉ, Wiley J, Facer-Childs ER, Robbins R, Weaver MD, Howard ME, et al. Mental health, substance use, and suicidal ideation during a prolonged COVID-19-related lockdown in a region with low SARS-CoV-2 prevalence. J Psychiatr Res. 2021;140:533–44.

Moncrieff J, Kirsch I. Empirically derived criteria cast doubt on the clinical significance of antidepressant-placebo differences. Contemp Clin Trials. 2015;43:60–62.

Hengartner MP, Plöder M. Statistically significant antidepressant-placebo differences on subjective symptom-rating scales do not prove that the drugs work: effect size and method bias matter! Front Psychiatry. 2018;9:517.

Leucht S, Kane J, Etschel E, Kissling W, Haman J, Engel RR. Linking the PANSS, BPRS, and CGI: Clinical implications. Neuropsychopharmacology 2006;31:2318–25.

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Acknowledgements

The author would like to thank Drs. Dale Purves, Concetta Tomaino, and Karen Parker for comments on drafts of this manuscript, as well as Drs. Daniel Levitin, Patrick Savage, and two anonymous reviewers for constructive feedback during peer review. This work was supported by NIMH grant K01MH122730.

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Bowling, D.L. Biological principles for music and mental health. Transl Psychiatry 13 , 374 (2023). https://doi.org/10.1038/s41398-023-02671-4

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Portland Artist Kyleen King Wants to Bring Mental Health Support to the Forefront of the Local Music Scene

“it’s almost an expectation that you’re supposed to be suffering horribly or on something in order to create. i highly disagree,” king says..

Kyleen King may be a world-class musician, but she’s also, as she readily admits, a drag at the after-party.

“I just want to talk about childhood trauma on a Friday night,” she says, laughing. “And people are, like, ‘We’re drinking here. We’re having a good time. Shut up about your problems.’ I don’t belong in a touring environment for that reason.”

Being on the road, however, is one way King has been able to sustain a career as a musician since moving to the Northwest from Nashville in the early ‘00s. The 43-year-old plays violin in Grammy winner Brandi Carlile’s live band and was a member of roots-rockers the Heartless Bastards during their tour in support of 2015′s Restless Ones . Though satisfying creatively, the business side of the music business left King feeling jaded, even before COVID shut it all down for a while.

“The pandemic allowed me time to understand what my identity was outside of music,” she says, enjoying a spot of spring weather at The Fresh Pot on North Mississippi. “I decided mental health was the path for me and it’s going to intersect with music. I didn’t know how, but they’re going to work together.”

It didn’t take long for her to connect her two interests. As she started working her way toward an undergraduate degree in social work at Portland State University, King was approached last November by Musicians Union Local 99 to help head up its newly formed mental health committee. Since then it’s been meeting once a month to brainstorm ideas on how to aid local musicians, including partnering with trade association MusicPortland, to put together a comprehensive directory of mental health care providers in the city.

King is also helping to facilitate, with Thriving Roots Counseling owner Sabrina Sheehy, a support group for musicians, to be held over Zoom starting April 11. “I want this to be an opportunity for people to talk about the hard stuff in a safe environment as a trial for me and [Sabrina],” King says. “Does this work? Is it helpful? What support do you need? Let’s talk about your stuff and let’s find you some support.”

Though the stigma regarding being open about one’s mental health issues has been slowly disappearing from Western culture, there can still be some discomfort in opening up about such matters. For the people King wants to support, it doesn’t help that the public perception is either that they must be doing OK because of the positive effects that music can have on the brain or that musicians have to be fucked up to make great art.

“The profession romanticizes hardship,” King says. “It’s almost an expectation that you’re supposed to be suffering horribly or on something in order to create. I highly disagree. I know what issues we’re coming up against. What we’re turning to to numb out and try to avoid all the hardships. I think I can help address the specifics.”

King has also been witness to some welcome developments, like Live Nation providing counseling services for musicians and members of the road crew at festivals and arena shows. While the underpinning of offering such help is purely economic—conflict between band members or roadies struggling with anxiety can have a not insignificant impact on profits—it is a step in the right direction for a greater wave of support for even those artists who rarely venture out of their local scene.

“It’s a start,” King says of such mental health services. But she knows it’s not nearly enough, especially when it comes to artists who might not get the chance to play at a Live Nation venue like The Gorge or the Hayden Homes Amphitheater in Bend.

“I’m mostly interested in providing this for people who don’t have the resources to afford it,” she continues. “The people on the small-club level are working just as hard. Marginalized communities need a lot of support in fighting the uphill battle of oppression. There’s an opportunity to get a Taylor Swift or Dolly Parton or somebody like that to fund an organization or something to help these smaller-level artists get mental health support that’s accessible and relevant to their experience. There’s totally a way to do this.”

GO: Musicians Support Group online. 2–3:30 pm Thursdays, April 11–May 2. To participate, email Kyleen King at [email protected] .

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The Use of Music in the Treatment and Management of Serious Mental Illness: A Global Scoping Review of the Literature

Tasha l. golden.

1 Johns Hopkins Medicine, Baltimore, MD, United States

Stacey Springs

2 Department of Health Services, Policy and Practice, Brown University, Providence, RI, United States

Hannah J. Kimmel

3 Medical School, University of Michigan, Ann Arbor, MI, United States

Sonakshi Gupta

4 Department of Pharmacy, Birla Institute of Technology and Science, Pilani, India

Alyssa Tiedemann

Clara c. sandu, susan magsamen, associated data.

The original contributions presented in the study are included in the article/ Supplementary Material , further inquiries can be directed to the corresponding author/s.

Mental and substance use disorders have been identified as the leading cause of global disability, and the global burden of mental illness is concentrated among those experiencing disability due to serious mental illness (SMI). Music has been studied as a support for SMIs for decades, with promising results; however, a lack of synthesized evidence has precluded increased uptake of and access to music-based approaches. The purpose of this scoping review was to identify the types and quantity of research at intersections of music and SMIs, document evidentiary gaps and opportunities, and generate recommendations for improving research and practice. Studies were included if they reported on music's utilization in treating or mitigating symptoms related to five SMIs: schizophrenia, bipolar disorder, generalized anxiety disorder, major depressive disorder, or post-traumatic stress disorder. Eight databases were searched; screening resulted in 349 included studies for data extraction. Schizophrenia was the most studied SMI, with bipolar disorder studied the least. Demographics, settings, and activity details were found to be inconsistently and insufficiently reported; however, listening to recorded music emerged as the most common musical activity, and activity details appeared to have been affected by the conditions under study. RCTs were the predominant study design, and 271 unique measures were utilized across 289 primary studies. Over two-thirds of primary studies (68.5%) reported positive results, with 2.8% reporting worse results than the comparator, and 12% producing indeterminate results. A key finding is that evidence synthesis is precluded by insufficient reporting, widely varied outcomes and measures, and intervention complexity; as a result, widespread changes are necessary to reduce heterogeneity (as feasible), increase replicability and transferability, and improve understandings of mechanisms and causal pathways. To that end, five detailed recommendations are offered to support the sharing and development of information across disciplines.

Introduction

Mental and substance use disorders have been identified as “the leading cause of disability globally” (Whiteford et al., 2016 , n.p.), affecting one in every three to five individuals throughout their lives (see Steel et al., 2014 ; Vigo et al., 2016 ). Despite the high prevalence of these disorders, resources and effective treatment remain inconsistently available, with funders and policy makers “fail[ing] to prioritize treatment and care of people with mental illness” (Vigo et al., 2016 ). Indeed, according to Steel et al. ( 2014 ), “substantial evidence indicates the majority of people with mental disorder do not receive specialized services and that global resources allocated to the management of mental disorders is substantially lower than for other chronic health conditions” (p. 490) 1 . In response, health researchers and practitioners have increasingly called for policy changes and additional research to improve treatment, noting that the burden of mental illness will not be reduced without the identification of “more effective ways to provide sustainable mental health services, especially in resource constrained environments” (Whiteford et al., 2013 ).

In 2020, the need for improved treatment and access skyrocketed as a result of the COVID-19 pandemic. Psychological well-being was undermined by diagnoses and fear of infection (Duan and Zhu, 2020 ), the necessity of social isolation (Armitage and Nellums, 2020 ; Brooks et al., 2020 ), and job loss and subsequent economic hardship (Murthy et al., 2020 ; Panchal et al., 2020 ). Health care workers have experienced increased post-traumatic stress disorder (PTSD), stress, insomnia, and depressive symptoms as a result of their work and lack of adequate support (Choudhury et al., 2020 ; Greenberg, 2020 ; Spoorthy, 2020 ). In addition, COVID-19 has disproportionately affected low-income communities and communities of color (Farquharson and Thornton, 2020 ; Laurencin and McClinton, 2020 ), exacerbated by the fact that such communities have historically been excluded from access to—and the benefits of—adequate health resources. When combined with the disproportionate prevalence of mental health concerns in these same communities (Coleman et al., 2016 , Kilbourne et al., 2018 ), the current crises make clear that the provision of quality mental health care—as well as policy changes, funding, and innovation to increase access and effectiveness—is an urgent priority for health and health equity.

Given this increasing urgency, it is imperative that mental health researchers and funders prioritize the study of innovative strategies that show promise not only of reducing or eliminating symptoms of mental illness, but also of preventing illness and supporting thriving and resilience. Notably, research and innovation in mental health should be targeted toward SMIs (serious mental illnesses), as “the burden of mental illness is…concentrated among those who experience disability due to SMI” (National Institute of Mental Health, 2019 , n.p.). SMIs are defined as “mental, behavioral, or emotional disorder[s] resulting in serious functional impairment, which substantially interferes with or limits one or more major life activities” (National Institute of Mental Health, 2019 , n.p.).

To support efforts toward improved and expanded options for addressing SMIs, this scoping review gathers and maps evidence regarding uses of music to treat or mitigate symptoms related to SMI. In doing so, it maps the current research landscape, answering the questions: What has been researched? How, and with what results? And what barriers and opportunities exist moving forward?

Music and Mental Health

For many decades, music has been utilized and studied as a support for mental health—with applications ranging from general mood elevation and stress reduction to clinical interventions designed to treat SMIs. Research indicates that music-based approaches to mental health care can increase patients' likelihood of accessing care 2 (Schroeder, 2018 ; Fancourt and Finn, 2019 ) while reducing its costs (Aalbers et al., 2017 ). Studies also suggest that mental health treatments that incorporate music may advance health by delivering benefits long associated with arts exposure and participation, such as increased social connectivity (Kreutz, 2014 ; Welch et al., 2014 ; Fancourt et al., 2016 ), additional health-enhancing behaviors (Theorell and Kreutz, 2012 ; Løkken et al., 2018 ), and the promotion of identity and resilience (Boggan et al., 2017 ; Zarobe and Bungay, 2017 ). Taking place in both clinical and community settings, studies of music's effects on mental health have been conducted within disciplines including psychology (McFerran et al., 2018 ; Pezzin et al., 2018 ); neurology (Ventouras et al., 2015 ; Tan et al., 2016 ); music therapy (Moe, 2002 ; Gold et al., 2006 ); nursing (McCaffrey and Locsin, 2002 ; Pölkki et al., 2012 ), dance therapy (Meekums et al., 2015 ; Campbell, 2020 ); and psychiatry (Grocke et al., 2008 ; Grasser et al., 2019 ), among others.

As one might expect, the many disciplines involved in this work vary widely in how they describe, conduct, and report their studies and practices. As a result, mental health researchers and practitioners have found it difficult to coordinate and synthesize relevant evidence; this has hindered efforts to establish best practices and clinical practice guidelines, develop standardized prescription and treatment models, and promote responsive policies. These limitations have posed ongoing barriers to the testing and scaling of promising strategies that could improve outcomes and access to mental health care.

Scoping Review

To address these barriers, a scoping review was conducted of the literature regarding uses of music in treatment and symptom mitigation related to SMIs 3 . The purpose of the review was threefold:

• to outline the many practices, interventions, and research processes being undertaken at the intersection(s) of music and SMIs, from all published works;
• to identify evidentiary gaps and opportunities; and
• to offer initial recommendations to support evidence synthesis, improve research practices, and ultimately increase treatment effectiveness and access over time.

This review was conducted utilizing the methodological framework detailed by the Joanna Briggs Institute's (JBI) Methodology for JBI Scoping Reviews (Peters et al., 2020 ). According to the The Joanna Briggs Institute ( 2015 ), the purpose of a scoping review is “to map the key concepts underpinning a research area as well as to clarify working definitions, and/or the conceptual boundaries of a topic” (p. 6). Scoping reviews involve a systematic process of literature searching, screening, and data analysis; the result is a detailed overview of the topic—including who and what have been studied, when and how frequently, research strategies utilized, and preliminary findings. Unlike systematic reviews, scoping reviews do not include a quality assessment of included studies, nor do they generate meta-analyses. Instead, scoping reviews are undertaken regarding emerging topics or knowledge areas, when it is not yet clear what particular questions could or should be addressed via future systematic reviews. Their purpose is to provide a sense of the field's landscape, identifying existing gaps and densities in the evidence.

Over the past decade, heightened interest in researching the mechanistic features of music's effects on mental health has led to an increase in studies; as a result, a scoping review at this point in time advances understanding of the uptake and dissemination of music across disciplines addressing SMIs. Thus, in December 2019, this review's research team searched for similar reviews or protocols using PROSPERO: International Prospective Register of Systematic Reviews, Cochrane Database of Systematic Reviews, BioMed Central Systematic Reviews, and JBI Database of Systematic Reviews and Implementation Reports. None of the resulting reviews had examined ways in which music—including but not limited to “music therapy”—was being utilized in interventions for multiple SMIs.

Protocol Registration and Reporting

A protocol for this review was developed following the JBI scoping review protocol guidelines (Peters et al., 2020 ); it was registered in January 2020 with both JBI and the Open Science Foundation (OSF) under the title, “Uses of music in the treatment of serious mental illness: A scoping review.” Reporting of this scoping review was completed in accordance with the PRISMA-ScR Reporting Guidelines.

Definitions and Classifications

In categorizing music-based interventions represented in included studies, researchers extracted details regarding the musical elements of each intervention—referring to these as the interventions' music-based “activities.” Throughout this article, the term “activities” refers specifically to the music-based elements of the intervention of which they are a part.

Activities were further characterized as “passive,” “active,” or “both.” While levels of felt engagement are likely to vary from participant to participant, these terms allowed the research team to calculate how many activities involved direct/active engagement such as singing or playing an instrument, vs. comparatively passive experiences such as listening to music or watching a performance. This distinction is important, as previous studies have indicated that passive and active engagement in music and other alternative therapies generate varied changes via differing mechanisms (Cosio and Lin, 2018 ; McPherson et al., 2019 ; Prakash, 2019 ).

Activities were additionally categorized as “individual” (involving a single participant either on their own or one-on-one with a facilitator), “group” (involving multiple participants), or “both”—the latter indicating interventions that, for example, alternated between individual and group sessions. Studies regarding the health benefits of social connection suggest that group activities may moderate or mediate effects of music engagement (Holt-Lunstad et al., 2010 ; Umberson and Karas Montez, 2010 ; Eisenberger and Cole, 2012 ), rendering this distinction important.

Finally, most activities involved a therapist, researcher, or other leader who directed or facilitated music-based activities; throughout this article, these individuals are referred to as “facilitator(s).”

Inclusion and Exclusion Criteria

Because its goal was to illuminate all published research at intersections of music and SMIs, this review did not limit results by date or geographic location. Inclusion criteria were identified using the following PICOS framework:

• Population (P): Humans of all ages being treated for—or assisted in the alleviation of symptoms related to—serious mental illness (SMI), as defined for the purposes of this review by: (1) a diagnosis or suspected diagnosis (verified or self-reported) of schizophrenia, bipolar disorder, MDD, GAD, or PTSD; or (2) inclusion in the experimental group in a study of interventions designed to treat or mitigate symptoms related to these illnesses 4 .
• Intervention (I): Any uses of music when incorporated specifically in the context of a SMI for the purpose of treating or mitigating symptoms related to the SMI. To accomplish the task of mapping all uses of music in this context, the current review drew upon an intentionally broad conceptualization of music-based activities, as differentially conceptualized by varying fields and practitioners. Thus, interventions may involve (but were not limited to) listening to music, playing musical instruments, singing, attending a music-based performance, performing music, dancing 5 , songwriting, or analyzing songs or song lyrics. Uses of music for the promotion of general mental well-being were not included, as these were not pertinent to the SMI classification.
• Comparator (C): Studies comparing music interventions to standard treatments (or treatment as usual (TAU)), studies comparing music interventions to no treatment, and studies comparing music interventions to other non-standard treatments. Studies without a comparator were also eligible for inclusion.
• Outcome (O): All outcomes related to the treatment of SMIs were eligible, such as changes in symptoms, affect, quality of life, functional assessments, academic achievement, social or emotional functioning, delivery of care, and more. Because this review focused on treatment or symptom mitigation related to SMIs, uses of music to research SMIs (i.e., outcomes not directly related to changes in symptoms, function, etc.) were excluded.
• Study design (S). All study designs were eligible, including RCTs, pre/post-test designs, qualitative studies, case reports, systematic reviews with and without meta-analyses, etc .

Studies that were not available in English ( n = 24) were excluded from this scoping review. In addition, library closures caused by the COVID-19 pandemic resulted in lack of access to some texts. Great effort was taken by multiple research team members to access all missing texts, using InterLibrary Loan (ILL) requests at multiple research institutions and extensive hand-searches online. Dozens of texts were ultimately located using this strategy; however, 88 studies remained inaccessible, and were ultimately excluded.

Literature Search

Comprehensive literature searches were conducted by an experienced health sciences librarian in PubMed, the Cochrane Library, PsychINFO, CINAHL, Embase, SCOPUS, RILM, and The Music Periodicals Database. The search strategy was peer-reviewed by an external expert advisor; after recommended modifications were made, it was again peer-reviewed by a second health sciences librarian using the PRESS (Peer Review of Electronic Search Strategies) Checklist (McGowan et al., 2016 ). Once searches were conducted, librarians exported results from each database into EndNote, de-duplicated them, and uploaded them into the Covidence platform ( https://www.covidence.org/home ) for screening by the research team.

Data Collection and Analysis

Title and abstract screening was conducted in Covidence by blinded pairs of research team members. Full-text screening was conducted by the research team, with data extraction completed in a shared Google Sheets file.

Critical Appraisal

As noted above, scoping reviews differ from systematic reviews in that their objective is to provide “an overview of existing evidence regardless of methodological quality or risk of bias” (Tricco et al., 2018 ). In keeping with the aims of this scoping review, included sources were not critically appraised.

Numerical Summary

This scoping review's literature search identified 11,967 studies for potential inclusion. Following title/abstract screening and full-text screening, 349 articles were found to meet the inclusion criteria; they have been included in the following analysis. See Data Sheet 1 for a complete list of articles.

Data were analyzed by diagnosis, population, musical activity, study design, variables or outcomes measured, and findings. Studies indicated considerable variations in purposes, intervention strategies, populations, settings, facilitator identities/roles, measurements, outcomes, and reported details. Because secondary studies incorporated multiple primary studies, some of which appeared separately in this scoping review, secondary studies were excluded from analyses that sought frequency counts of factors such as demographics, setting, facilitator details, etc . This prevented duplicative reporting.

Sample Size and Populations

Of the 289 primary studies, 10 (3.4%) did not record a study sample size. Among the remaining studies, sample size ranged from one to 1,000 participants, with a mean sample size of 48.8 and a median of 20.

Demographic reporting varied widely. Of the 289 primary studies, 19 (6.6%) did not report on gender. Of the remaining studies, 50 (17.3%) involved female participants, and 40 (13.8%) involved male participants. One hundred seventy-nine studies (61.9%) were “mixed group,” meaning that multiple genders were included (breakdown was not consistently reported).

Race and ethnicity were inconsistently reported, with 221 primary studies (76.5%) failing to report race or ethnicity at all. Of those reporting this variable, the majority included multiple races, although the breakdown was inconsistently reported.

Age was also inconsistently reported, with 124 primary studies (42.9%) failing to report minimum participant age, and 131 (45.3%) failing to report maximum age. Thirty-one primary studies (10.7%) reported the numeric age of a single participant. Across all studies, a range in age from 3 to 100 is represented, with apparent density between the ages of 18 and 60.

Apart from demographics, data extraction included populations/groups under study, such as “veterans” (Wilbur et al., 2015 ), “inpatients with schizophrenia” (He et al., 2018 ), and survivors of domestic violence (Hernández-Ruiz, 2005 ). Such groups were initially documented verbatim, and later coded by researchers according to the list in Table 1 , selecting the most specific population group discernible from the full text 6 . Given the complexity of research at the intersections of music and SMIs, it is likely that targeted interventions (for particular groups, settings) would support the development and synthesis of evidence and best practices.

Population.

Studies Over Time

Data extraction for this scoping review dated each study according to publication date. The earliest study identified in this literature search was published in 1946 (Rubin and Katz, 1946 ); studies began increasing in frequency in 2005, and this trend continues. Study frequency over time can be seen in Figure 1 (interactive version available at https://www.aerodatalab.org/livingreviews/onemind ).

Studies Over Time.

Study Locations

Study locations were documented by country. When the study country could not be determined, locations were documented according to the corresponding author's country. Results are recorded in Table 2 .

In addition to geographic area, the settings of included studies varied widely. The majority (247, 85.4%) were conducted in clinical settings; other settings are documented in Table 3 .

Study Designs

This scoping review collected data from 349 studies, inclusive of all study designs as well as secondary studies—including systematic reviews with or without meta-analyses ( n = 60). When documenting study designs, the research team utilized the study design terminology identified by the study authors. If the study design was not identified by the authors, the research team assigned a design type based on their reading.

The study design for each study was coded according to the list in Table 4 . Randomized Controlled Trials (RCTs) comprised the largest percentage of studies (23.2%), followed by Pre/Post Tests (21.8%) and Case Reports (18.3%).

Design type.

SMIs Studied

Of the five SMIs included in this scoping review, schizophrenia was the most studied, followed by MDD and PTSD. The majority of included studies (69.2%) addressed only one SMI. Ninty studies (30.7%) addressed multiple diagnoses; notably, only one study focused strictly on bipolar disorder. Frequency counts by SMIs are documented in Table 5 .

Frequency counts by SMI.

Interventions

Music activities.

The music-based activities engaged by each study were documented verbatim for the first 210 studies. Researchers utilized this data to generate a standard list, with which activities in all 349 studies were ultimately coded. Activity types for all primary studies are documented in Table 6 .

Activity types.

Activities were later disaggregated by SMIs to illuminate whether condition/diagnosis appears to have had a bearing on choice of activity. Results are shown in Figure 2 .

Music-Based Activities Per SMI.

Activity Details

As noted earlier, each music activity was categorized as passive, active, or both. One hundred thirty-five primary studies (46.7%) involved active elements, while 79 (27.2%) involved passive elements; 52 studies (18%) involved both. The remaining 23 studies (8%) did not provide enough information to allow categorization.

The music activities in each study were also categorized as individual, group, or both. One hundred and nine primary studies (37.7%) involved individual interventions; 139 (48.1%) involved group interventions and 21 (7.3%) involved both. Participation categories were disaggregated by SMIs to illuminate disparities among SMIs. Results are shown in Figure 3 .

Group vs. Individual Activities Per SMI.

Facilitators

Two hundred and thirty-five primary studies (81.3%) reported information regarding the identities of those facilitating the interventions. Of these, Music Therapists working alone was the most represented identity or credential (29.4%), followed by Researcher/Investigator (10.4%). Remaining facilitator identities are documented in Table 7 .

Facilitators of music-based activities.

Outcomes in each of the included studies varied widely. To allow for analysis, outcomes were first documented verbatim, then later coded by researchers utilizing Dodd et al.' (2018) taxonomy of outcome domains. As expected given a focus on SMIs, the majority of studies (199, 57.0%) measured psychiatric outcomes—which “relate to mental health conditions and associated behaviors (e.g., addictions and behavioral problems)” (Dodd et al., 2018 ). For example, Zarate ( 2016 ) and Gutiérrez and Camarena ( 2015 ) examined whether music therapy reduced anxiety symptoms, and Pylvänäinen et al. ( 2015 ) investigated effects of dance movement therapy (DMT) on symptoms of depression. Other studies examined effects of music engagement on PTSD symptoms (e.g., Esparza, 2016 ; Macfarlane et al., 2019 ), symptoms of schizophrenia (e.g., He et al., 2018 ), stress levels (Wilbur et al., 2015 ; Steinberg-Oren et al., 2016 ), and similar.

Emotional Functioning/Well-Being was the second most prominent outcome domain ( n = 130, 37.3%), addressing such factors as “impact of disease/condition on emotions or overall well-being (e.g., ability to cope, worry, frustration, confidence, perceptions regarding body image and appearance, psychological status, stigma, life satisfaction, meaning and purpose, positive affect, self-esteem, self-perception and self-efficacy” (Dodd et al., 2018 ). For example, Hovey ( 2013 ) and Silverman ( 2019 ) conducted studies of the effects of music therapy on self-efficacy among acute care mental health inpatients and patients with schizophrenia, respectively. Papadopoulos and Röhricht ( 2014 ) and Pylvänäinen and Lappalainen ( 2018 ) investigated effects of dance movement therapy on body image.

Social Functioning followed ( n = 91, 26.1%); this domain encompasses ways in which one's condition affects “ability to socialize, behavior within society, communication, companionship, psychosocial development, aggression, recidivism, participation” (Dodd et al., 2018 ). For example, Solli and Rolvsjord ( 2015 ) studied whether making music in a group could improve participants' ability to take “an important first social step” (p. 76). Much earlier, Lehrer-Carle ( 1971 ) studied how group music therapy affected the ability of adolescents with schizophrenia to communicate with others and generate socially-valuable skills.

Physical functioning was the fourth most prominent domain ( n = 30, 8.6%), with studies examining effects of music interventions on pain (e.g., Gosselin et al., 2019 ) and sleep (e.g., Guétin et al., 2009 ; Blanaru et al., 2012 ). Global Quality of Life followed ( n = 35, 10.0%), often included as a second or third outcome. This domain “includes only implicit composite outcomes measuring global quality of life;” e.g., Zidani et al. ( 2017 ) utilized the Quality of Life Systematic Inquiry (QLSI) in their study of the effects of music listening on anxiety, and Deatrich et al. ( 2016 ) measured effects of group music therapy on the quality of life among inpatients at a psychiatric hospital. Role Functioning ( n = 12, 3.4%) was also typically included as a second or third outcome, and involved such factors as ability to care for one's children (Tornek et al., 2003 ) or ability to follow therapy instructions (Strauss et al., 2016 ).

Cognitive Functioning outcomes ( n = 22, 6.3%) involved such factors as cognition/memory testing (e.g., Glicksohn and Cohen, 2000 ; Tan et al., 2016 ) and attention/concentration (e.g., Shagan et al., 2018 ; Macfarlane et al., 2019 ). Delivery of Care 7 was addressed by 12 studies (3.44%); e.g., Trimmer et al. ( 2018 ) examined whether integrating music with CBT group therapy increased effectiveness and retention. Preyde et al. ( 2017 ) investigated the feasibility and acceptability of group music therapy among youth in a hospital's Child and Adolescent Mental Health unit. All outcome domains identified by this scoping review are documented with frequency counts in Table 8 .

Count of outcome subdomains.

Comparators

Like outcomes, the comparators in included studies varied widely; see Table 9 . Note that while most study designs involve varying comparators, Pre/Post tests—which accounted for over a quarter of all study designs—always utilize the same comparator: a participant's status previous to the intervention. As a result, this “comparator” (documented as “Before/After”) was the most common across studies ( n = 128, 44.3%). The second most prominent comparator was treatment as usual (TAU), utilized by 26 studies (9%).

Count of comparator types.

Across the 289 included primary studies in this review, 271 distinct measures were reported ( Data Sheet 2 ). Most studies utilized more than one measure, and reporting regarding their use varied considerably. To determine measures used, all measures were documented verbatim during data extraction. Then, to accommodate their scope and variety, verbatim measures were standardized 8 and subsequently coded as Biomarkers, Custom Questionnaires, Physical/Performance Tests/Tasks, Qualitative Measures, or Standardized Questionnaires. These categories are documented in Table 10 . All included measures are listed in Data Sheet 2 .

Measures/Instruments.

Study Findings

Due to the wide variety of outcomes and measures included, findings for each primary study were coded simplistically according to whether the music intervention had performed better, worse, or equal to the comparator, or whether results had been indeterminable ( Table 11 ).

Study results.

This scoping review found that hundreds of studies related to music-based interventions for SMIs have been conducted worldwide over several decades, with significant increases in study frequency since 2005. Studies have primarily involved mixed-gender groups with more than one race or ethnicity represented; however, demographic reporting was inconsistent and routinely inadequate. This limits researchers' and practitioners' ability to note disparities in results, and to ascertain who may be most helped by music-based activities and experiences.

As noted, schizophrenia was the most studied SMI, followed by MDD, PTSD, GAD, and bipolar disorder. While bipolar disorder was included in 30 studies, only one study focused singularly on this illness; similarly, only 14 studies addressed GAD alone 9 . Further research is warranted to determine causes for frequency disparities among the included SMIs; e.g., do theories of change indicate less potential for music-based interventions for bipolar disorder and GAD patients, or have studies regarding these illnesses simply been limited by lack of funding, researcher interest, and other concerns?

Many systematic reviews related to music and health have been unable to aggregate and synthesize evidence from studies; as a result, they have often recommended further study and greater rigor (see van Westrhenen and Fritz, 2014 ; Petrovsky et al., 2015 ; Williams et al., 2018 ). This need for rigor is often interpreted as a need for greater utilization of RCTs; however, this scoping review yields that RCTs emerged as the predominant study design. In other words, a lack of rigor—along with other obstacles to evidence synthesis—should not be simplistically linked to a failure to utilize a particular study design. Indeed, while some systematic review authors do highlight the value of randomized controlled trials (Yang et al., 2019 ), others note that rigor would be improved by longer-term studies (Veerman et al., 2017 ), as well as improved use of rigorous qualitative strategies such as data triangulation, structured clinical observations, and far more detailed descriptions of study participants, their behaviors, and musical activities (van Westrhenen and Fritz, 2014 ).

Of course, although RCTs were the predominant study design in this scoping review, it should be noted that controls varied widely—including treatment as usual (TAU), delayed treatment, other genres of music, other forms of art therapy, and more. As a result, the findings of the included RCTs had quite disparate applications. In addition, given that scoping reviews are not designed to assess data quality, the authors cannot speak to the rigor and quality of the studies included, regardless of design. In the absence of quality assessments, it can be tempting to use study design as a proxy for study quality (e.g., assuming that an RCT is of higher evidential quality than a case study); however, such assumptions are inadvisable, as quality varies widely across study designs (see Ryan et al., 2013 ; Chambers, 2017 ; Higgins and Thomas, 2020 ).

A wide range of activities were represented in this scoping review, with the most prominent being listening to recorded music (15.3%). Notably, 47 studies (8.1%) did not report the type of musical activity experienced by study participants. Active engagement in music-based interventions was considerably more common in the review's findings than passive engagement (46.7 vs. 27.2%), and group interventions were more common than individual (48.1 vs. 37.7%). Notably, the SMI being addressed appears to have affected activity facets. For example, bipolar disorder studies involved more “recording music” activities than other SMIs, while GAD and PTSD studies involved more playing of instruments. Group interventions were utilized for MDD more often than for PTSD (48 vs. 40%).

Just as the details of activities themselves were inconsistently reported, the rationale behind detail selection is inconsistently provided. As a result, it is often unclear to what extent activity facets—such as passive vs. active engagement, group-based vs. individual approaches, genres, etc.—were selected based upon factors such as availability, convenience, or facilitator expertise, vs. factors such as prior research or formalized theories of change related to particular participant groups or conditions. Considering that outcomes are highly likely to be affected by activity details, further research is needed to determine which types of engagement reliably generate particular results—and for whom. This would allow selection of activity details based on diagnoses, symptoms, participant factors, outcomes, and more. To this end, it is critical that future researchers document the rationale behind each decision related to interventions and their many facets (see Recommendation I).

Facilitators ranged in discipline and background; while music therapists comprised the largest percentage (29.4%), those identified simply as a researcher/investigator (often including an author of the study) made up over 16% of the facilitators. The frequency with which researchers facilitated music interventions raises two questions: First, did researchers receive musical (or music-facilitation) training before initiating programs or studies; and second, was their training decision based on science/evidence? (For example if researchers did not receive training, was this based on evidence that such training was not essential/beneficial?).

One in six primary studies (16.6%) involved multidisciplinary teams as facilitators, or facilitators who had multidisciplinary backgrounds—underscoring the interdisciplinary nature of the music and SMI intersection. Unfortunately, almost as many (16.3%) failed to report or specify facilitator details at all. This prevents assessment regarding the role of facilitators—including their discipline, training, relationship with study participants, etc .—in an intervention and its outcomes. Inconsistencies in reporting, combined with the variety of facilitators involved, highlight the need for continued research regarding whether and to what extent facilitator characteristics and backgrounds affect results. In the future, evidence synthesis will be supported by the careful reporting of facilitator details including credentials, training (or lack thereof), and relationships with study participants (see Recommendation I).

Reported Findings

Over two-thirds of all primary studies (68.5%) reported positive findings (“music > comp”), while 12 percent ( n = 35) produced indeterminate results. Only eight studies (2.8%) indicated that the music-based intervention had produced worse results than the comparator. A scoping review does not offer assessments of study quality or risk of bias; as a result, practice and policy guidelines cannot be generated based on existing data. However, these data indicate the potential promise of music-based activities in treatment or symptom management of SMIs, and they underscore the value of continued research—with the implementation of robust study and reporting protocols.

Evidence Synthesis

Overall, the findings in this scoping review suggest that inconsistent reporting practices, a lack of core outcomes or outcome measures, and the sheer complexity of interventions combine to render difficult the synthesis of existing evidence for the purposes of further developing or scaling music-based interventions. Reporting practices and core outcome sets are discussed under Recommendation IV, below. Regarding intervention complexity, the many variables involved in each musical activity generate the potential for effects on studied outcomes. For example, “listening to music,” though often documented as a straightforward activity, can take place while participants lay down or while they move about; it can also take place via the use of headphones, small speakers, large speakers, or the presence of a live musician. The music to which participants listen may be selected by study participants themselves, or by facilitators; it could be of high quality and played at an ideal volume; it could also be of low quality, or too quiet/loud for a given participant. Activity complexity expands significantly when one adds the potential effects of: setting (e.g., clinic vs. home vs. community center vs. prison); facilitators' relationships with participants; group interactions (including how well group members know one another); how long a given participant has lived with an SMI; how many other treatments or options a study participant has previously tried; levels of autonomy in the activity (who selects music, volume, instruments, dose/duration, etc.); and more.

Unfortunately, this scoping review found that such variables were insufficiently and inconsistently reported—precluding readers' ability to discern precisely what type of activity/component delivered (or failed to deliver) results. For example, it was impossible in some cases to ascertain the identity of the activity facilitator at all, let alone the nature of the facilitator's relationship with study participants. Similarly, basic demographic data were inconsistently available, let alone details regarding participants' diagnoses (were these volunteered/self-reported?) or participants' prior experience(s) with mental health treatments.

Meticulous documentation is necessary for identifying mechanisms, causal patterns, and replicable strategies. Replicability is critical to the development of robust evidence bases and practice guidelines for integrating music into intervention and treatment plans. When researchers or health practitioners read a peer-reviewed article and cannot identify precisely what was done in the reported study or intervention, it becomes impossible for them to replicate the process with other populations, in other settings, or with larger sample sizes.

Of course, studies that cannot produce generalizable results (due to study designs or small sample sizes) may yet generate valuable, transferable findings; however, a lack of detail impedes this benefit as well. In other words, although scalability is not an aim of every music-based intervention for SMIs, improved reporting is nevertheless critical for enhancing understanding of the music-SMI intersection across disciplines. Consistent, rigorous detail in reporting will support the sharing of information among mental health practitioners, individuals with lived experience with SMIs, artists and arts-program facilitators, and others, while also improving research and scalability when appropriate.

Music's complex, wide-ranging nature—as observed in this review—should be understood as a promising asset; it suggests that music-based strategies offer adaptability, flexibility, and customize-ability as SMI interventions. Nevertheless, the sheer breadth of activities falling under the heading of “music”—and the extent to which each of these can vary from setting to setting—present impediments to synthesizing evidence and advancing the field. To navigate these difficulties, five recommendations are offered below.

Recommendations

While existing systematic reviews have demonstrated the potential for music interventions to support mental health (e.g., music therapy for depression; Aalbers et al., 2017 ), many have also asserted that there are issues with the quality of evidence and relevance of outcome measures (Aalbers et al., 2017 ; Geretsegger et al., 2017 ; Clift, 2020 ). Results of the current scoping review comport with these assertions. As noted, scoping reviews are not designed to analyze existing research for the purpose of making practice recommendations; however, they are designed to document the state of the science and identify gaps and future directions for research. The below recommendations are intended to support ongoing and future research to improve the evidence base and promote translation of evidence into practice.

Recommendation I: Standardize Reporting Practices by Adopting Existing Reporting Guidelines to Clearly and Consistently Document Studies

A limitation to the current body of research—and a hindrance to translating existing evidence into practice—is a lack of consistent and sufficient documentation with regard to key study information necessary to understand: (1) the populations and conditions studied; (2) specific details of each intervention studied; and (3) the specificity and relevance of outcomes measured, along with details required for an assessment of the quality of the research.

Underreporting of key information in research is not a phenomenon unique to music-based studies. An analysis of completeness of the intervention description in trials and reviews found that studies of non-pharmacological interventions provided adequate documentation of the intervention only 29% of the time, as compared to 67% for pharmacological interventions (Glasziou et al., 2008 ). In addition, a comprehensive study of adherence to reporting guidelines over a 20-years span (January 1996 to September 2016) for clinical trials, systematic reviews, observational studies, meta-analysis, diagnostic accuracy, economic evaluations, and preclinical animal studies demonstrated that 87.9% of the included studies reported suboptimal adherence to reporting guidelines (Jin et al., 2018 ). Inadequate reporting of intervention studies limits opportunities for clinicians and patients to utilize research studies to support medical decision making and precludes future researchers from building on existing research. By contrast, standardizing reporting practices for all studies—including those involving music-based interventions for SMIs—will support translation into policy and practice and improve future research.

Sharp et al. ( 2019 ) observed that across disciplines, “[r]eporting guideline endorsement rates are low; information is vague and scattered” (n.p); similarly, Jin et al. ( 2018 ) confirmed “the need for further emphasis in the scientific community to encourage the use of reporting guidelines” (n.p.). Building on their findings, we recommend that future research incorporate and promote the use of reporting guidelines. Reporting guidelines inform researchers which elements of a study must be documented in order to support the transparency, interpretation, synthesis, replication, and reproducibility of research. A number of reporting guidelines are available to researchers working at the nexus of music and mental health, and they help document each key aspect of a study, including:

• Conditions/populations of interest; e.g., PTSD (Kaloupek et al., 2010 );
• Study designs employed; e.g., CONSORT for RCTs, STROBE for observational studies;
• Types of data collected; e.g., eMOOD (Faurholt-Jepsen et al., 2019 ), fMRI (Poldrack et al., 2008 ); and
• Intervention details; e.g., TIDieR (Hoffmann et al., 2014 ) and CReDECI 2 (Möhler et al., 2015 ).

Notably, while reporting guidelines focus on optimizing the translation of research findings into practice, much of the valuable work regarding art's impacts on health is not necessarily occurring in the context of formal academic research. Therefore, the authors suggest that artists, practitioners, and facilitators also utilize these reporting guidelines when evaluating and documenting arts-based programming and activities—regardless of the level of researcher involvement. This enables consistency in communicating the work across the spectrum of disciplines and audiences.

Recommendation II: Utilize the Current Scoping Review as a Basis on Which to Investigate the Utility of a Reporting Guideline or Reporting Guideline Extension for Music Interventions

Studies of music interventions in mental health may be sufficiently unique as to warrant a new guideline for reporting these studies. Indeed, a 2017 workshop about “music and the brain,” hosted by the National Institutes of Health (NIH), generated recommendations to promote “more rigorous reporting of interventions, methodologies and results” at the intersection of music and brain health, and to “establish standardized and/or personalized outcome measures” (Ambler et al., 2020 ). A proposal for a reporting guideline for music and health was suggested by Robb and colleagues ( 2011 ); however, this guideline does not appear to have been formalized or taken up by the field.

A first step toward the development of any reporting guideline is an evidence synthesis of the body of evidence in the relevant field, such as the current scoping review. The data in this review, combined with existing guidelines, suggests an opportunity to generate a new tool for researchers working at the nexus of music and mental health. If taken up by researchers in the field, a reporting guideline specific to music in mental health research could facilitate better documentation—ultimately improving evidence synthesis and the translation of research into practice. Such a guideline could also support the design of new music-based interventions, and support funding agencies in structuring their grant reporting and calls for proposals (CFPs).

If undertaken, the development of a new reporting guideline should take a comprehensive, stakeholder-engaged approach that yields insights into how clinicians, artists, content experts, patients, caregivers, researchers, and other key stakeholders imagine the research process. Diverse perspectives and iterative development processes help ensure the guideline accounts for the many ways in which music impacts on mental health. The guideline should additionally support transparent documentation for all who will be looking to evidence to inform their decision making.

Meanwhile, the authors of the current scoping review have identified key elements for reporting, which may be considered in any guideline for music interventions in mental health research. These are offered in Data Sheets 3 and 4 .

Recommendation III: Accommodate the Complexity of Music Interventions

Simple interventions typically feature a linear pathway whereby outcomes and interventions are linked; by contrast, complex interventions include non-linear causal pathways and multiple, interacting components (Petticrew, 2011 ). In fact, even “simple” interventions are often influenced by complex interplays of individual characteristics, social determinants, the health care delivery system, and the interventions themselves (Guise et al., 2017 ). Like most non-pharmacological interventions, music interventions are complex, consisting of several components that work independently or interdependently of each other and can be tailored to fit a specific setting (Craig et al., 2008 ). This non-standardization of music interventions complicates how we study them.

For example, the fact that music could be delivered through headphones to patients in a therapist's private office, vs. delivered through speakers to patients in clinical waiting rooms, generates so-called intervention complexity (Guise et al., 2017 ). In addition, music has unique neurobiological and psychological impacts (Boso et al., 2006 ) that can interact with other clinically important outcomes in healthcare—generating so-called pathway complexity (Guise et al., 2017 ) 10 . In short, music-based approaches to SMI care must be understood and studied as complex interventions.

Working with complex interventions requires solid theoretical understanding of how a given intervention causes change. Theories of change undergird the development of intervention protocols; they also allow weak links in the causal chain to be identified and strengthened. Of course, researchers should balance the need for protocol fidelity with the utility of adaptation when important for the local setting; however, departures from protocols should be documented with care and transparency (see “Modifications,” Data Sheet 4 ). In addition, when studying complex interventions, researchers should be cautious about interpreting findings—as a lack of impact may not signal a lack of efficacy, but rather a failure of implementation. Lastly, research teams working with music and SMIs should consider study designs capable of yielding better evidence for complex interventions; e.g., cluster-randomized trials, N-of-1 designs, and step-wedge designs (Craig et al., 2008 ).

As stated, transparent reporting of study elements is critical; to that end, the Criteria for Reporting the Development and Evaluation of Complex Interventions in Healthcare: Revised Guideline (CReDECI 2) provides specific guidance on documenting the components of complex interventions (Möhler et al., 2015 ). It emphasizes the importance of documenting:

• Theoretical underpinnings of an intervention.
• Selection of outcomes and modes of evaluation.
• All intervention components, including reasons for their selection, their essential functions, and any intended interaction between components.
• Strategy for delivering the intervention within the study context.
• All materials and tools used in the delivery of the intervention.
• Fidelity of the delivery process compared to the study protocol.

Recommendation IV: Consider Developing Core Outcome Sets and Core Measures for Studies of Music's Use in Supporting Mental Health

This scoping review demonstrates broad uptake of music as an intervention to support those with SMI and their caregivers across a continuum of outcomes—including clinical, humanistic, and economic outcomes that matter to patients, providers, and policy-makers. Nevertheless, it remains a rare occurrence for systematic reviews of music-based interventions to yield a strong recommendation for clinical translation into practice. As stated above, this is not necessarily a result of insufficiently rigorous study methods (e.g., RCTs), but rather of clinical heterogeneity—defined as a “…variation in study population characteristics, coexisting conditions, cointerventions, and outcomes evaluated across studies included in an SR [systematic review] or CER [comparative effectiveness research] that may influence or modify the magnitude of the intervention measure of effect” (West et al., 2010 ). In other words, the selection of unique, often incomparable, heterogenous outcomes—in terms of outcome domains (what is measured) and selection of measurement tools/instruments (how the outcome is measured)—often limits the combination and comparison of results of individual studies. An additional consequence of inconsistent outcome selection is the risk that outcomes are being selected without having determined their importance or relevance to patients and caregivers living with the studied conditions.

This issue of outcome heterogeneity is not specific to research related to music and mental health; it actually affects the conclusion of a substantial proportion of Cochrane Collaborative systematic reviews (Kirkham et al., 2010 ), and outcome reporting bias is an important problem in randomized trials (Dwan et al., 2008 ). Of relevance to the current scoping review, these issues also occur in a great deal of general SMI research. A meta-analysis of 198 trials of psychotherapeutic interventions for MDD identified 33 unique outcome measurement tools (Barth et al., 2013 ). The current scoping review confirms this trend with regard to music and SMIs, demonstrating extensive heterogeneity in outcomes and outcome measures (see Tables 8 , ​ ,10 10 ).

One approach to mitigating the effects of outcome heterogeneity is the adoption of core outcome sets . A core outcome set (COS) establishes a minimum standardized collection of outcomes, identified by key stakeholders through robust consensus methods 11 . Utilizing a minimum COS would improve comparative effectiveness of interventions and ensure that the outcomes that are important to communities requiring evidence for decision-making (e.g., patients, caregivers) are represented in the study design process, even if not directly engaged by the study team.

Implementing a COS does not restrict researchers to only those minimum outcomes; rather, it sets an expectation that COS will always be collected while researchers continue to explore additional outcomes. If it is decided that a measure within a COS should be excluded from a given study, the research team is expected to explain the exclusion, as well as the relevance and importance of other (additional) selected outcomes (Williamson et al., 2012 ).

Notably, the process of engaging stakeholders to identify a COS can itself yield important findings that advance health. For example, a recent study to identify outcome domains and outcome measures of importance to people living with MDD identified 80 outcome domains related to the benefits of treatments, derived from the lived experience of depression (Chevance et al., 2020 ). The study revealed that several outcome domains frequently mentioned by participants were not measured by the seven most-used depression scales in MDD research. It also identified 57 additional outcome domains that were unrelated to the direct benefits of treatment (e.g., treatment safety, health-care organization, social representation of depression), and which at present remain understudied (Chevance et al., 2020 ).

For the above reasons, the authors recommend the uptake and implementation of existing COS for each SMI. Teams studying music-based interventions for SMIs should first identify whether a COS exists for the population and condition of interest, and (if so) implement that COS by reviewing the literature and consulting the COMET Database. In addition, the development and implementation of a specific COS for the study of music-based interventions for SMIs may be an important step in this field, to promote the translation of evidence into practice.

Recommendation V: Consider Developing a Taxonomy to Better Organize and Define “Music” and “Music Engagement”

Distinct activities included under the general umbrella-term of “music” are likely to affect health via multiple, distinct mechanisms. For example, vigorous group drumming outdoors can be expected to generate different physiological and psychological effects than listening to music on headphones while lying in a hospital bed. While both are music-based activities, the expectation that they share outcomes or measures may strain the definition or category of music beyond its utility in health research and practice. To be clear, improved reporting of all music-based interventions is both urgent and fully feasible, as is the increased standardization of many research aspects and processes. However, expecting distinct activities to utilize similar outcomes or measures merely because they can both be described as “music(al)” may actually minimize the effects of music-inclusive interventions by obscuring or eliding their scope and variety.

The general category of “music” is highly useful in terms of developing research and practice networks, supporting advocacy, raising funds, and advancing patient and public awareness of the value of music as an aspect of health and well-being. However, grouping disparate activities together in research, particularly apart from specific protocols, may perpetuate the heterogeneity that has precluded adequate synthesis to date. Notably, this scoping review was able to identify the difficulties of this heterogeneity in part because it too was broadly inclusive. To meet its goal of illuminating all uses of music in the treatment or mitigation of symptoms related to SMIs, this review was required to include studies involving myriad activities that, while related to music, are likely to effect change in disparate ways.

As researchers and practitioners consider developing formal reporting guidelines and core outcome sets, they might also consider developing taxonomies of music-based or music-inclusive activities—perhaps grouping them iteratively (e.g., by types of movement involved, potential mechanisms, where they range from prescriptive to improvisational/expressive, etc.). Such taxonomies would help generate shared vocabularies for use by practitioners, artists, and the research community, and support development of best practices related to specific forms of music engagement. Taxonomies may be operationalized by journals and research databases to index studies—enabling better identification of similar studies, in turn supporting meaningful aggregation and synthesis of studies for the purposes of systematic review.

Limitations

The extraction and coding of data across this collection of studies involved adapting studies to the extraction tool, typically in collaboration with multiple research team members. It is possible that, provided with the same data, other research teams may have made alternative selections. However, these would be highly unlikely to result in changes to the review's overarching findings or recommendations.

Interruptions to library access caused by the COVID-19 pandemic limited the research team's access to studies that may otherwise have been available. While many of these would likely have been excluded regardless, it is possible that current findings exclude data from applicable studies. That said, the sample size of the review generates a high level of confidence regarding its findings; again, it is unlikely that the addition of inaccessible texts would result in changes to overarching findings or recommendations.

Finally, the large number of studies included in this scoping review resulted in a focus on frequency counts and standardized coding practices, with the aim of illuminating a general landscape and identifying research densities and gaps. Future researchers may wish to disaggregate studies by various factors, allowing more in-depth looks into particular practices, populations, or study designs.

This scoping review sought to support the improvement and expansion of options for addressing SMIs by gathering and coordinating evidence regarding music-based interventions for MDD, PTSD, bipolar disorder, GAD, and schizophrenia. To our knowledge, it is the first scoping review to examine intersections of music and SMIs at this scale. Having documented details regarding 349 studies, this review illuminates the volume and variety of research occurring at intersections of music and SMIs. It additionally underlines the promise of music in supporting mental health, as most studies indicated positive results. Findings indicate that music-based interventions are currently constrained not by a lack of research, but by an ongoing inability to synthesize the extensive research being generated. Despite accumulating studies since 1946, synthesis continues to be precluded by a wide variety of outcomes and outcome measures, a lack of quality reporting, and the inherent complexity of music-based interventions. Findings suggest that the extensive time, funds, and expertise being invested in this field will continue to see limited returns until widespread changes occur to reduce heterogeneity (as feasible), increase replicability and transferability, and improve understandings of mechanisms and causal pathways.

To support these efforts, this review offered five key recommendations, with an emphasis on the immediate action step of improving reporting practices. While the review's illumination of extensive heterogeneity and complexity have indicated urgent obstacles, the creativity, innovation, and attentiveness to patient experience that are apparent in included studies also figure as assets to the mental health field's overarching efforts to advance care, access, and equity over the long term.

Data Availability Statement

Author contributions.

TG led the scoping review study as well as the writing of this article. SS co-authored the discussion and recommendations, and contributed multiple revisions throughout. HK, SG, AT, and CS contributed data analyses. SG contributed to the manuscript's introduction. SM helped conceive of the project and oversees IAM Lab's research output. All authors contributed to the article and approved the submitted version.

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

1 See also Vigo et al. ( 2019 ), who indicated that a “striking imbalance exists between government spending on mental health and the related disease burden in the Americas” (n.p.).

2 For example, by reducing stigma associated with care, or by rendering care less intimidating or more culturally responsive.

3 This scoping review was part of a larger initiative which included a transdisciplinary gathering of thought leaders, who were asked to review and respond to early scoping-review findings. This group then generated recommendations to advance opportunities at the intersection of music and SMIs. Their responses, informed by professional expertise as well as lived experience with SMIs, will be published separately.

4 This scoping review excluded (a) studies that were inexplicit regarding the type of mental illness treated (such as the five diagnoses here named); and (b) studies that examined effects of relevant interventions on one or more of the five diagnoses here listed, but included these among other illnesses or diagnoses while failing to disaggregate outcomes.

5 The authors acknowledge that the inclusion of dance will be seen by some disciplines as problematic; however, many cultures, disciplines, patients, and practitioners do not formally separate these activities (Besson and Schön, 2001 ; Thompson, 2014 ; Leman and Maes, 2015 ; Levitin et al., 2018 ). Because dance interventions utilize music (with rare exceptions), excluding dance would have resulted in the exclusion of many interventions in which music played a role—thereby compromising the scoping review's goal of generating of a broad, inclusive landscape of all uses of music in SMI interventions.

6 For example, if a study indicated that study participants had been veterans and clinical patients, the “Veterans and/or Military Personnel” category would be selected over “patients,” due to increased specificity.

7 According to Dodd et al. ( 2018 ), this outcome domain refers to outcomes related to “adherence/compliance; patient preference; tolerability/acceptability of intervention; withdrawal from intervention (e.g., time to treatment failure, reason for stopping therapy); appropriateness of intervention; accessibility, quality and adequacy of intervention; patient/career satisfaction (emotional rather than financial burden); process, implementation, and service outcomes (e.g., overall health system performance and the impact of service provision on the users of services)”.

8 For example, “heart rate” and “pulse” were combined, “EEG” and “electroencephalogram” were combined, etc.

9 By comparison, 43 studies addressed PTSD alone, 55 addressed MDD alone, and 87 addressed schizophrenia alone.

10 Recognizing that complex interventions require deeper consideration and different tools to design, implement, replicate, and critically review associated studies, the Medical Research Council updated their guidance in 2019. Their document articulates key implications for the study of complex interventions, and provides recommendations for researchers studying complex interventions (Craig, 2019 ).

11 These consensus methods should themselves be measured and consistently reported in all trials for a specific clinical area (Williamson et al., 2012 ).

Funding. Partial funding for this study was provided by One Mind.

Supplementary Material

The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fpsyg.2021.649840/full#supplementary-material

• Aalbers S., Fusar-Poli L., Freeman R. E., Spreen M., Ket J. C., Vink A. C., et al.. (2017). Music therapy for depression . Cochrane Database Syst. Rev. 11 :Cd004517. 10.1002/14651858.CD004517.pub3 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Ambler M., Springs S., Garcia D., Born C. (2020, August 19 ). “Heterogeneity of Outcomes for Intraoperative Music Interventions: A Scoping Review and Evidence Map,” in BMJ Evidence-Based Medicine (BMJ Publishing Group) . 10.1136/bmjebm-2020-111382 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Armitage R., Nellums L. B. (2020). COVID-19 and the consequences of isolating the elderly . Lancet Public Health 5 :e256. 10.1016/S2468-2667(20)30061-X [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Barth J., Munder T., Gerger H., Nüesch E., Trelle S., Znoj H., Jüni P., Cuijpers P. (2013). Comparative efficacy of seven psychotherapeutic interventions for patients with depression: a network meta-analysis . PLoS Med . 10 :e1001454. 10.1371/journal.pmed.1001454 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Besson M., Schön D. (2001). Comparison between language and music . Ann. N. Y. Acad. Sci. 930 , 232–258. 10.1111/j.1749-6632.2001.tb05736.x [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Blanaru M., Bloch B., Vadas L., Arnon Z., Ziv N., Kremer I., Haimov I. (2012). The effects of music relaxation and muscle relaxation techniques on sleep quality and emotional measures among individuals with posttraumatic stress disorder . Mental Illness . 4 , 59–65. 10.4081/mi.2012.e13 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Boggan C. E., Grzanka P. R., Bain C. L. (2017). Perspectives on queer music therapy: a qualitative analysis of music therapists' reactions to radically inclusive practice , in Journal of Music Therapy ( Vol. 54 ) (American Music Therapy Association; ), 375–404. 10.1093/jmt/thx016 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Boso P., Barale F., Enzo E., Politi M. (2006). Neurophysiology and neurobiology of the musical experience . Funct. Neurol . 21 , 187–191. [ PubMed ] [ Google Scholar ]
• Brooks S. K., Webster R. K., Smith L. E., Woodland L., Wessely S., Greenberg N., Rubin G. J. (2020). The psychological impact of quarantine and how to reduce it: rapid review of the evidence , in The Lancet ( Vol. 395 ) (Lancet Publishing Group; ), 912–920. 10.1016/S0140-6736(20)30460-8 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Campbell B. (2020). Correction to: past, present, future: a program development project exploring post traumatic slave syndrome (PTSS) using experiential education and dance/movement therapy informed approaches , in American Journal of Dance Therapy ( Vol. 42 ) (Springer; ), 145–146. 10.1007/s10465-020-09330-x [ CrossRef ] [ Google Scholar ]
• Chambers C. (2017). The Seven Deadly Sins of Psychology: A Manifesto for Reforming the Culture of Scientific Practice by Chris Chambers . Princeton, NJ: Princeton University Press. Retrieved from: https://www.goodreads.com/book/show/32025411-the-seven-deadly-sins-of-psychology [ Google Scholar ]
• Chevance A., Ravaud P., Tomlinson A., Le Berre C., Teufer B., Touboul S., et al.. (2020). Identifying outcomes for depression that matter to patients, informal caregivers, and health-care professionals: qualitative content analysis of a large international online survey . Lancet Psychiatry 7 , 692–702. 10.1016/S2215-0366(20)30191-7 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Choudhury T., Debski M., Wiper A., Abdelrahman A., Wild S., Chalil S., et al.. (2020). COVID-19 pandemic: looking after the mental health of our healthcare workers . J. Occupat. Environ. Med . 62 , e373–e376. 10.1097/JOM.0000000000001907 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Clift S. (2020). Fancourt, D. and Finn, S. (2019). What is the evidence on the role of the arts in improving health and well-being? A scoping review . Nordic J. Arts Cult. Health 2 , 77–83. 10.18261/issn.2535-7913-2020-01-08 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Coleman K. J., Stewart C., Waitzfelder B. E., Zeber J. E., Morales L. S., Ahmed A. T., et al.. (2016). Racial-ethnic differences in psychiatric diagnoses and treatment across 11 health care systems in the mental health research network . Psychiatr. Serv . 67 , 749–757. 10.1176/appi.ps.201500217 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Cosio D., Lin E. (2018). Role of active vs. passive complementary and integrative health approaches in pain management . Global Adv. Health Med . 7 :216495611876849. 10.1177/2164956118768492 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Craig P. (2019). Developing and Evaluating Complex Interventions . London. Retrieved from: www.mrc.ac.uk/complexinterventionsguidance [ Google Scholar ]
• Craig P., Dieppe P., Macintyre S., Michie S., Nazareth I., Petticrew M. (2008). Developing and evaluating complex interventions: the new Medical Research Council guidance . BMJ 337 :1–39. 10.1136/bmj.a1655 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Deatrich K. G., Prout M. F., Boyer B. A., Yoder S. E. (2016). Effectiveness of group music therapy in a psychiatric hospital: a randomized pilot study of treatment outcome . Int. J. Group Psychother . 66 , 592–617. 10.1080/00207284.2016.1190239 [ CrossRef ] [ Google Scholar ]
• Dodd S., Clarke M., Becker L., Mavergames C., Fish R., Williamson P. R. (2018). A taxonomy has been developed for outcomes in medical research to help improve knowledge discovery . J. Clin. Epidemiol . 96 , 84–92. 10.1016/j.jclinepi.2017.12.020 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Duan L., Zhu G. (2020). Psychological interventions for people affected by the COVID-19 epidemic , in The Lancet Psychiatry ( Vol. 7 ) (Elsevier Ltd; ), 300–302. 10.1016/S2215-0366(20)30073-0 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Dwan K., Altman D. G., Arnaiz J. A., Bloom J., Chan A. W., Cronin E., et al.. (2008). Systematic review of the empirical evidence of study publication bias and outcome reporting bias . PLoS ONE 3 :e3081. 10.1371/journal.pone.0003081 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Eisenberger N., Cole S. W. (2012). Social neuroscience and health: neurophysiological mechanisms linking social ties with physical health . Nat. Neurosci . 15 :6690674. 10.1038/nn.3086 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Esparza J. (2016). Using Person-Centered Expressive Arts Group Therapy With Combat-Related PTSD Veterans . ProQuest Information & Learning. Retrieved from: http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2016-31155-090&site=ehost-live&scope=siteNS~-
• Fancourt D., Finn S. (2019). What is the evidence on the role of the arts in improving health and well-being? A scoping review. WHO Regional Office Europe . Available onlien at: http://www.euro.who.int/en/publications/abstracts/what-is-the-evidence-on-the-role-of-the-arts-in-improving-health-and-well-being-a-scoping-review-2019 [ PubMed ]
• Fancourt D., Perkins R., Ascenso S., Carvalho L. A., Steptoe A., Williamon A. (2016). Effects of group drumming interventions on anxiety, depression, social resilience and inflammatory immune response among mental health service users . PLoS ONE . 11 :e0151136. 10.1371/journal.pone.0151136 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Farquharson W. H., Thornton C. J. (2020). Debate: Exposing the most serious infirmity – racism's impact on health in the era of COVID-19 . Child Adolesc. Ment. Health . 25 , 182–183. 10.1111/camh.12407 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Faurholt-Jepsen M., Geddes J. R., Goodwin G. M., Bauer M., Duffy A., Vedel Kessing L., Saunders K. (2019). Reporting guidelines on remotely collected electronic mood data in mood disorder (eMOOD)—recommendations . Transl. Psychiatry . 9 :162. 10.1038/s41398-019-0484-8 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Geretsegger M., Mössler K. A., Bieleninik Ł., Chen X.-J., Heldal T. O., Gold C. (2017). Music therapy for people with schizophrenia and schizophrenia-like disorders . Cochr. Database System. Rev . 5 :CD004025. 10.1002/14651858.CD004025.pub4 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Glasziou P., Meats E., Heneghan C., Shepperd S. (2008). What is missing from descriptions of treatment in trials and reviews? BMJ 336 , 1472–1474. 10.1136/bmj.39590.732037.47 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Glicksohn J., Cohen Y. (2000). Can music alleviate cognitive dysfunction in schizophrenia? Psychopathology 33 , 43–47. 10.1159/000029118 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Gold C., Wigram T., Elefant C. (2006). Music therapy for autistic spectrum disorder , in Cochrane Database of Systematic Reviews (John Wiley & Sons, Ltd; ). 10.1002/14651858.CD004381.pub2 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Gosselin E., Gélinas C., Bourgault P., Lavoie S. (2019). Intervention for Patients Intubated and Conscious to decrease Peritraumatic Distress (IPIC-PTD) – Acceptability and Feasibility . 10.31770/2561-7516.1019 [ CrossRef ] [ Google Scholar ]
• Grasser L. R., Al-Saghir H., Wanna C., Spinei J., Javanbakht A. (2019). Moving through the trauma: dance/movement therapy as a somatic-based intervention for addressing trauma and stress among syrian refugee children , in Journal of the American Academy of Child and Adolescent Psychiatry ( Vol. 58 ) (Elsevier Inc.), 1124–1126. 10.1016/j.jaac.2019.07.007 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Greenberg N. (2020, August 1). Mental Health of Health-Care Workers in the COVID-19 Era. Nature Reviews Nephrology . Nature Research. 10.1038/s41581-020-0314-5 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Grocke D., Bloch S., Castle D. (2008). Is there a role for music therapy in the care of the severely mentally ill? Austral. Psychiatry 16 , 442–445. 10.1080/10398560802366171 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Guétin S., Soua B., Voiriot G., Picot M. C., Hérisson C. (2009). The effect of music therapy on mood and anxiety-depression: an observational study in institutionalised patients with traumatic brain injury . Ann. Phys. Rehabil. Med . 52 , 30–40. 10.1016/j.annrmp.2008.08.009 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Guise J.-M., Chang C., Butler M., Viswanathan M., Tugwell P. (2017). AHRQ series on complex intervention systematic reviews—paper 1: an introduction to a series of articles that provide guidance and tools for reviews of complex interventions . J. Clin. Epidemiol . 90 , 6–10. 10.1016/j.jclinepi.2017.06.011 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Gutiérrez E. O. F., Camarena V. A. T. (2015). Music therapy in generalized anxiety disorder . Arts Psychother . 44 , 19–24. 10.1016/j.aip.2015.02.003 [ CrossRef ] [ Google Scholar ]
• He H., Yang M., Duan M., Chen X., Lai Y., Xia Y., et al.. (2018). Music intervention leads to increased insular connectivity and improved clinical symptoms in schizophrenia. Front. Neurosci . 11 :744. 10.3389/fnins.2017.00744 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Hernández-Ruiz E. (2005). Effect of music therapy on the anxiety levels and sleep patterns of abused women in shelters , in Journal of Music Therapy ( Vol. 42 ) (American Music Therapy Association; ), 140–158. 10.1093/jmt/42.2.140 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Higgins J., Thomas J. (2020). Cochrane Handbook for Systematic Reviews of Interventions | Cochrane Training . Available online at: https://training.cochrane.org/handbook/current (accessed November 25, 2020).
• Hoffmann T. C., Glasziou P. P., Boutron I., Milne R., Perera R., Moher D., et al.. (2014). Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide . BMJ 348 , 348–1687. 10.1136/bmj.g1687 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Holt-Lunstad J., Smith T. B., Layton J. B. (2010). Social relationships and mortality risk: a meta-analytic review . PLoS Med . 7 :e1000316. 10.1371/journal.pmed.1000316 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Hovey S. A. (2013). The effects of musical activity on the self-esteem and self-efficacy of patients with schizophrenia: a cultural study in west bengal, india . Music Med. 5 , NP1–NP4. 10.1177/1943862112467465 [ CrossRef ] [ Google Scholar ]
• Jin Y., Sanger N., Shams I., Luo C., Shahid H., Li G., et al.. (2018). Does the medical literature remain inadequately described despite having reporting guidelines for 21 years? – A systematic review of reviews: an update . J. Multidiscip. Healthc . 11 , 495–510. 10.2147/JMDH.S155103 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Kaloupek D. G., Chard K. M., Freed M. C., Peterson A. L., Riggs D. S., Stein M. B., et al.. (2010). Common data elements for posttraumatic stress disorder research . Kamioka Am. Congress Rehabil. Med . 91 , 1684–1691. 10.1016/j.apmr.2010.06.032 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Kilbourne A. M., Beck K., Spaeth-Rublee B., Ramanuj P., O'Brien R. W., Tomoyasu N., Pincus H. A. (2018). Measuring and improving the quality of mental health care: a global perspective . World Psychiatry . 17 , 30–38. 10.1002/wps.20482 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Kirkham J. J., Dwan K. M., Altman D. G., Gamble C., Dodd S., Smyth R., et al.. (2010). The impact of outcome reporting bias in randomised controlled trials on a cohort of systematic reviews . BMJ 340 , 637–640. 10.1136/bmj.c365 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Kreutz G. (2014). Does singing facilitate social bonding? Music Med . 6 :51. 10.47513/mmd.v6i2.180 [ CrossRef ] [ Google Scholar ]
• Laurencin C. T., McClinton A. (2020). The COVID-19 pandemic: a call to action to identify and address racial and ethnic disparities . J. Rac. Ethnic Health Dispar . 7 , 398–402. 10.1007/s40615-020-00756-0 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Lehrer-Carle I. (1971). Group dynamics as applied to the use of music with schizophrenic adolescents . J. Contemp. Psychother . 3 , 111–116. 10.1007/BF02110244 [ CrossRef ] [ Google Scholar ]
• Leman M., Maes P. J. (2015). The role of embodiment in the perception of music . Empir. Music. Rev. 9 , 236–246. 10.18061/emr.v9i3-4.4498 [ CrossRef ] [ Google Scholar ]
• Levitin D. J., Grahn J. A., London J. (2018). The psychology of music: rhythm and movement . Annu. Rev. Psychol . 69 , 51–75. 10.1146/annurev-psych-122216-011740 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Løkken B. I., Rangul V., Merom D., Ekholm O., Krokstad S., Sund E. R. (2018). Are playing instruments, singing or participating in theatre good for population health? Associations with self-rated health and all-cause mortality in the HUNT3 study (2006-2008), Norway , in Music and Public Health: A Nordic Perspective (Springer International Publishing; ), 33–54. 10.1007/978-3-319-76240-1_3 [ CrossRef ] [ Google Scholar ]
• Macfarlane C., Masthoff E., Hakvoort L. (2019). Short-Term music therapy attention and arousal regulation treatment (SMAART) for prisoners with posttraumatic stress disorder: a feasibility study . J. Foren. Psychol. Res. Practice 19 , 376–392. 10.1080/24732850.2019.1670023 [ CrossRef ] [ Google Scholar ]
• McCaffrey R., Locsin R. C. (2002). Music listening as a nursing intervention: a symphony of practice . Holistic Nurs. Pract. 16 , 70–77. 10.1097/00004650-200204000-00012 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• McFerran K. S., Hense C., Koike A., Rickwood D. (2018). Intentional music use to reduce psychological distress in adolescents accessing primary mental health care . Clin. Child Psychol. Psychiatry 23 , 567–581. 10.1177/1359104518767231 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• McGowan J., Sampson M., Salzwedel D. M., Cogo E., Foerster V., Lefebvre C. (2016). PRESS Peer review of electronic search strategies: 2015 guideline statement . J. Clin. Epidemiol . 75 , 40–46. 10.1016/j.jclinepi.2016.01.021 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• McPherson T., Berger D., Alagapan S., Fröhlich F. (2019). Active and passive rhythmic music therapy interventions differentially modulate sympathetic autonomic nervous system activity . J. Music Ther . 56 , 240–264. 10.1093/jmt/thz007 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Meekums B., Karkou V., Nelson E. A. (2015). Dance movement therapy for depression , in Cochrane Database of Systematic Reviews ( Vol. 2015 ) (John Wiley and Sons Ltd; ). 10.1002/14651858.CD009895.pub2 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Moe T. (2002). Restitutional factors in receptive group music therapy inspired by GIM . Nord. J. Music Ther . 11 , 152–166. 10.1080/08098130209478057 [ CrossRef ] [ Google Scholar ]
• Möhler R., Köpke S., Meyer G. (2015). Criteria for reporting the development and evaluation of complex interventions in healthcare: revised guideline (CReDECI 2) . Trials 16 :204. 10.1186/s13063-015-0709-y [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Murthy S., Gomersall C. D., Fowler R. A. (2020). Care for “Critically Ill Patients with COVID-19 , in JAMA - Journal of the American Medical Association ( Vol. 323 ) (American Medical Association; ), 1499–1500. 10.1001/jama.2020.3633 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• National Institute of Mental Health. (2019). Mental Illness . Available online at: https://www.nimh.nih.gov/health/statistics/mental-illness.shtml (accessed August 31, 2020).
• Osborne N. (2012). Neuroscience and “real world” practice: Music as a therapeutic resource for children in zones of conflict . Annals N. Y. Acad. Sci. 1252 , 69–76. 10.1111/j.1749-6632.2012.06473.x [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Panchal N., Kamal R., Orgera K., Cox C., Garfield R., Hamel L., et al.. (2020, August 21). The Implications of COVID-19 for Mental Health and Substance Use | KFF . Retrieved from: https://www.kff.org/coronavirus-covid-19/issue-brief/the-implications-of-covid-19-for-mental-health-and-substance-use/ (accessed August 31, 2020).
• Papadopoulos N. L. R., Röhricht F. (2014). An investigation into the application and processes of manualised group body psychotherapy for depressive disorder in a clinical trial . Body Mov. Dance Psychother . 9 , 167–180. 10.1080/17432979.2013.847499 [ CrossRef ] [ Google Scholar ]
• Peters M., Godfrey C., McInerney P., Munn Z., Trico A., Khalil H. (2020). Chapter 11: scoping reviews , in JBI Manual for Evidence Synthesis (JBI; ). 10.46658/JBIMES-20-12 [ CrossRef ] [ Google Scholar ]
• Petrovsky D., Cacchione P. Z., George M. (2015). Review of the effect of music interventions on symptoms of anxiety and depression in older adults with mild dementia , in International Psychogeriatrics ( Vol. 27 ) (Cambridge University Press; ), 1661–1670. 10.1017/S1041610215000393 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Petticrew M. (2011). When are complex interventions “complex”? When are simple interventions “simple”? Europ. J. Public Health 21 , 397–398. 10.1093/eurpub/ckr084 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Pezzin L. E., Larson E. R., Lorber W., McGinley E. L., Dillingham T. R. (2018). Music-instruction intervention for treatment of post-traumatic stress disorder: A randomized pilot study . BMC Psychol. 6 :60. 10.1186/s40359-018-0274-8 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Poldrack R. A., Fletcher P. C., Henson R. N., Worsley K. J., Brett M., Nichols T. E. (2008). Guidelines for reporting an fMRI study . NeuroImage 40 , 409–414. 10.1016/j.neuroimage.2007.11.048 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Pölkki T., Korhonen A., Laukkala H. (2012). Nurses' expectations of using music for premature infants in neonatal intensive care unit . J. Pediatr. Nurs . 27 , e29–e37. 10.1016/j.pedn.2011.06.001 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Prakash R. (2019). Passive and Active Music Therapy . Retrieved from: https://sites.duke.edu/voicestogether/series-the-potential-power-of-music-therapy-within-the-autism-community/passive-and-active-music-therapy/ (accessed November 19, 2020)
• Preyde M., Berends A., Parehk S., Heintzman J. (2017). Adolescents' evaluation of music therapy in an inpatient psychiatric unit: a quality improvement project . Music Ther. Persp . 35 , 58–62. 10.1093/mtp/miv008 [ CrossRef ] [ Google Scholar ]
• Pylvänäinen P., Lappalainen R. (2018). Change in body image among depressed adult outpatients after a dance movement therapy group treatment . Arts Psychother . 59 , 34–45. 10.1016/j.aip.2017.10.006 [ CrossRef ] [ Google Scholar ]
• Pylvänäinen P. M., Muotka J. S., Lappalainen R. (2015). A dance movement therapy group for depressed adult patients in a psychiatric outpatient clinic: effects of the treatment . Front. Psychol . 6 :980. 10.3389/fpsyg.2015.00980 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Robb S. L., Carpenter J. S., Burns D. S. (2011). Reporting guidelines for music-based interventions , in Journal of Health Psychology (SAGE Publications Ltd.) 10.1177/1359105310374781 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Rubin H. E., Katz E. (1946). Auroratone films for the treatment of psychotic depressions in an army general hospital . J. Clin. Psychol . 2 , 333–340. 10.1002/1097-4679(194610)2:4<333::AID-JCLP2270020405>3.0.CO;2-P [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Ryan R., Hill S., Prictor M., McKenzie Last J. (2013). Cochrane Study Quality Guide . Retrieved from: https://cccrg.cochrane.org/sites/cccrg.cochrane.org/files/public/uploads/StudyQualityGuide_May%202013.pdf
• Schroeder M. O. (2018, May). Accessing the Mental Health Benefits of Music Therapy. U.S. News & World Report. [ Google Scholar ]
• Shagan S., Shagan D., Shagan B., Fiszdon J. M., Thime W., Haber L. C., Pearlson G. D., Choi J. (2018). How music impacts visual attention training in schizophrenia: a pilot study . J. Nerv. Mental Dis . 206 , 968–970. 10.1097/NMD.0000000000000911 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Sharp M. K., Bertizzolo L., Rius R., Wager E., Gómez G., Hren D. (2019). Using the STROBE statement: survey findings emphasized the role of journals in enforcing reporting guidelines . J. Clin. Epidemiol. 116 , 26–35. 10.1016/j.jclinepi.2019.07.019 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Silverman M. J. (2019). Music therapy for coping self-efficacy in an acute mental health setting: a randomized pilot study . Commun. Ment. Health J . 55 , 615–623. 10.1007/s10597-018-0319-8 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Solli H. P., Rolvsjord R. (2015). The Opposite of Treatment”: a qualitative study of how patients diagnosed with psychosis experience music therapy . Nord. J. Music Ther . 24 , 67–92. 10.1080/08098131.2014.890639 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Spoorthy M. S. (2020). Mental health problems faced by healthcare workers due to the COVID-19 pandemic–A review , in Asian Journal of Psychiatry ( Vol. 51 ) (Elsevier B.V; ), 102119. 10.1016/j.ajp.2020.102119 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Steel Z., Marnane C., Iranpour C., Chey T., Jackson J. W., Patel V., et al.. (2014). The global prevalence of common mental disorders: a systematic review and meta-analysis 1980-2013 . Int. J. Epidemiol . 43 , 476–493. 10.1093/ije/dyu038 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Steinberg-Oren S. L., Krasnova M., Krasnov I. S., Baker M. R., Ames D. (2016). Let's dance: a holistic approach to treating veterans with posttraumatic stress disorder , in Federal Practitioner ( Vol. 33 ) (Frontline Medical Communications; ). Available online at: www.fedprac.comProgramProfile [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Strauss M., van Heerden S. M., Joubert G. (2016). Occupational therapy and the use of music tempo in the treatment of the mental health care user with psychosis . South Afric. J. Occup. Ther . 46 , 21–26. 10.17159/2310-3833/2016/v46n1a6 [ CrossRef ] [ Google Scholar ]
• Tan S., Zou Y., Wykes T., Reeder C., Zhu X., Yang F., et al.. (2016). Group cognitive remediation therapy for chronic schizophrenia: a randomized controlled trial . Neurosci. Lett . 626 , 106–111. 10.1016/j.neulet.2015.08.036 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• The Joanna Briggs Institute. (2015). The Joanna Briggs Institute Reviewers' Manual 2015: Methodology for JBI Scoping Reviews . Retrieved from: https://nursing.lsuhsc.edu/JBI/docs/ReviewersManuals/Scoping-.pdf
• Theorell T., Kreutz G. (2012). Epidemiological studies of the relationship between musical experiences and public health , in Music, Health, and Wellbeing (Oxford University Press; ). 10.1093/acprof:oso/9780199586974.003.0028 [ CrossRef ] [ Google Scholar ]
• Thompson W. (2014). Music in the social and behavioral sciences: an encyclopedia , in Music in the Social and Behavioral Sciences: An Encyclopedia. 10.4135/9781452283012 [ CrossRef ] [ Google Scholar ]
• Tornek A., Field T., Hernandez-Reif M., Diego M., Jones N. (2003). Music Effects on EEG in intrusive and withdrawn mothers with depressive symptoms . Psychiatry 66 , 234–243. 10.1521/psyc.66.3.234.25157 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Tricco A. C., Lillie E., Zarin W., O'Brien K. K., Colquhoun H., Levac D., et al.. (2018, October 2). PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and explanation. Annals of Internal Medicine. American College of Physicians. 10.7326/M18-0850 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Trimmer C., Tyo R., Pikard J., McKenna C., Naeem F. (2018). Low-intensity cognitive behavioural therapy-based music group (CBT-music) for the treatment of symptoms of anxiety and depression: a feasibility study . Behav. Cogn. Psychother . 46 , 168–181. 10.1017/S1352465817000480 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Umberson D., Karas Montez J. (2010). Social relationships and health: a flashpoint for health policy . J. Health Soc. Behav . 51 , S54–S66. 10.1177/0022146510383501 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• van Westrhenen N., Fritz E. (2014). Creative Arts Therapy as treatment for child trauma: an overview . Arts Psychothe . 41 , 527–534. 10.1016/j.aip.2014.10.004 [ CrossRef ] [ Google Scholar ]
• Veerman S. R. T., Schulte P. F. J., de Haan L. (2017). Treatment for negative symptoms in schizophrenia: a comprehensive review , in Drugs ( Vol. 77 ) (Springer International Publishing; ), 1423–1459. 10.1007/s40265-017-0789-y [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Ventouras E. C., Margariti A., Chondraki P., Kalatzis I., Economou N. T., Tsekou H., et al.. (2015). EEG-based investigation of brain connectivity changes in psychotic patients undergoing the primitive expression form of dance therapy: a methodological pilot study . Cogn. Neurodyn . 9 , 231–248. 10.1007/s11571-014-9319-8 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Vigo D., Thornicroft G., Atun R. (2016, February 1). Estimating the true global burden of mental illness , in The Lancet Psychiatry (Elsevier Ltd; ). 10.1016/S2215-0366(15)00505-2 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Vigo D. V., Kestel D., Pendakur K., Thornicroft G., Atun R. (2019). Disease burden and government spending on mental, neurological, and substance use disorders, and self-harm: cross-sectional, ecological study of health system response in the Americas . Lancet Public Health . 4 , e89–e96. 10.1016/S2468-2667(18)30203-2 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Wang S., Agius M. (2018). The use of music therapy in the treatment of mental illness and the enhancement of societal wellbeing , in Psychiatria Danubina ( Vol. 30 ) (Medicinska Naklada Zagreb; ), S595–S600. [ PubMed ] [ Google Scholar ]
• Welch G. F., Himonides E., Saunders J., Papageorgi I., Sarazin M. (2014). Singing and social inclusion . Front. Psychol . 5 :803. 10.3389/fpsyg.2014.00803 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• West S. L., Gartlehner G., Mansfield A. J., Poole C., Tant E., Lenfestey N., et al.. (2010). Comparative Effectiveness Review Methods: Clinical Heterogeneity . Available online at: https://www.ncbi.nlm.nih.gov/books/NBK53310/ [ PubMed ]
• Whiteford H., Ferrari A., Degenhardt L. (2016). Global burden of disease studies: Implications for mental and substance use disorders . Health Aff . 35 , 1114–1120. 10.1377/hlthaff.2016.0082 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Whiteford H. A., Degenhardt L., Rehm J., Baxter A. J., Ferrari A. J., Erskine H. E., et al.. (2013). Global burden of disease attributable to mental and substance use disorders: findings from the global burden of disease study 2010 . Lancet 382 , 1575–1586. 10.1016/S0140-6736(13)61611-6 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Wilbur S., Meyer H. B., Baker M. R., Smiarowski K., Suarez C. A., Ames D., Rubin R. T. (2015). Dance for veterans: a complementary health program for veterans with serious mental illness . Arts and Health . 7 , 96–108. 10.1080/17533015.2015.1019701 [ CrossRef ] [ Google Scholar ]
• Williams E., Dingle G. A., Clift S. (2018). A systematic review of mental health and wellbeing outcomes of group singing for adults with a mental health condition . Eur. J. Public Health . 28 , 1035–1042. 10.1093/eurpub/cky115 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Williamson P. R., Altman D. G., Blazeby J. M., Devane D., Gargon E., Tugwell P. (2012). Developing core outcome sets for clinical trials: issues to consider . Trials 13 :132. 10.1186/1745-6215-13-132 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Yang W., jiao Bai Y., mei Qin L., Xu X., lan Bao K., fang Xiao J., et al.. (2019). The effectiveness of music therapy for postpartum depression: a systematic review and meta-analysis , in Complementary Therapies in Clinical Practice ( Vol. 37 ) (Churchill Livingstone; ), 93–101. 10.1016/j.ctcp.2019.09.002 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Zarate R. (2016). Clinical Improvisation and its effect on anxiety: a multiple single subject design . Arts Psychother . 48 , 46–53. 10.1016/j.aip.2015.11.005 [ CrossRef ] [ Google Scholar ]
• Zarobe L., Bungay H. (2017, November 1). The role of arts activities in developing resilience and mental wellbeing in children and young people a rapid review of the literature , in Perspectives in Public Health (SAGE Publications Ltd; ). 10.1177/1757913917712283 [ PubMed ] [ CrossRef ] [ Google Scholar ]
• Zidani M., Audet J. S., Borgeat F., Aardema F., O'Connor K. P., Khazaal Y. (2017). Augmentation of psychotherapy through alternative preconscious priming: a case series exploring effects on residual symptoms. Front. Psychiatry 8 :8. 10.3389/fpsyt.2017.00008 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]

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Chelsea Cutler Opens Up About Her ‘Yellowstone’ Themed Album ‘Stellaria,’ Mental Health & More

The 27-year-old rising star released her third studio album in October.

By Rania Aniftos

Rania Aniftos

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For Stellaria , Cutler knew that she wanted a Western aesthetic to go along with the project. “I knew I wanted the content to be kind of Yellowstone inspired, so we ended up going out there and that word ‘stellaria’ kept coming up,” she recalled. “There was a Stellaria Lane and a Stellaria Creek. Me being a Latin nerd, I saw that and I was like, ‘That’s a fascinating word.’ I fell in love with it, it means ‘starlight,’ and it just felt like such a great representation for the world that I wanted to make.”

Cutler is also no stranger to being open about her mental health, and she says that her vulnerability goes hand-in-hand with her creativity. “I feel so selfish, because writing music and being honest in my music is so for me and it’s such an awesome byproduct that the vulnerability translates into a greater narrative around being open with my mental health,” she said. “I think it’s cool that when I sit down to make music, it’s just an outlet for all of these big feelings that I’m having and I feel no shame around sharing that at all. It led to so many amazing conversations surrounding mental health.”

Watch Billboard ‘s full interview with Chelsea Cutler above.

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20 Self-Care Ideas to Boost Your Mental Health

Posted: July 29, 2023 | Last updated: July 29, 2023

Meditation has been proven to reduce stress and anxiety while increasing feelings of well-being. It's recommended to set aside some time each day to meditate and quiet your mind.

Susan Albers, PsyD, a psychologist at Cleveland Clinic, spoke about the benefits of meditation. "Clinical research indicates that meditation is great for both the body and the mind. Studies have shown that it helps to decrease stress, increase your ability to cope with anxiety, chronic health issues, and pain, improve sleep, and reduce blood pressure," she told Newsroom.

Reduce caffeine intake

Too much caffeine can increase feelings of anxiety and stress. Try reducing your caffeine intake or switch to decaf. Some experts argue that caffeine can be addictive.

Lisa Axelrad, a nutritionist in Los Angeles, spoke to Esquire about the addictive effects of caffeine. "Coffee leads to an afternoon crash and stains our teeth, and that's from just one cup a day. If you're drinking more, you are likely to suffer from headaches, disrupted sleep, irritability, high blood pressure, jitters, insulin resistance, and hormone disruption," Axelrad said.

Seek professional help

If you are struggling with your mental health, it is important to seek professional help. Talk to your doctor or a mental health professional.

According to the US National Institute of Mental Health, talking therapies, such as cognitive-behavioral therapy, interpersonal therapy, and psychodynamic therapy, can be helpful for treating a range of mental health conditions, including depression, anxiety, post-traumatic stress disorder, and obsessive-compulsive disorder, among others.

Eat a healthy diet

Eating a healthy diet can help improve your mood and reduce stress. Focus on consuming whole foods and avoiding processed foods. According to registered dietitian Garrett Swisher, better nutrition equals better mental health.

"The way we eat those foods is important. Eating a well-balanced diet, including foods from all food groups, focusing on more whole, unprocessed, less refined foods, and eating regularly. The brain and the gut are interconnected. Foods that make us feel bad are going to make us miserable and not enjoyable to be around," Swisher explained to WTHR.

Regular exercise is beneficial not only for physical health but also for reducing stress and improving mood. It's crucial for both the body, in terms of fitness and longevity, and mental health.

In fact, researchers from the University of South Australia found that physical activity is 1.5 times more effective than therapy or leading medications for reducing symptoms of depression, anxiety, and distress. "Exercise is often overlooked as a potential treatment for anxiety or depression. Exercise and physical activity can be effective in treating depression," said Dr. Scott Krakower, DO, a psychiatrist with Northwell Health, in an interview with Parade.

Connect with friends and family

Make time for regular social activities as spending time with loved ones can help reduce stress and improve mood.

Dr. Raymond Hobbs, a physician consultant at Blue Cross Blue Shield of Michigan, emphasized the importance of socializing for our mental and physical health. "We know that social isolation is a serious threat to health. Strengthen relationships with family members, such as siblings, children, nephews, nieces, and cousins," Hobbs explained to Healthline.

Get outside

Spending time outside has been shown to reduce stress and improve mood. Take a walk or sit in the sun for a few minutes each day.

Fitness expert Denise Austin spoke to Prevention about the importance of walking. "It has tremendous benefits, from supporting a healthy immune system to boosting your metabolism to strengthening your joints, muscles, and bones — not to mention it's amazing for stress relief and enjoying a little 'me time,'" Austin said.

Practice mindfulness

Mindfulness is the practice of being present and fully engaged in the moment. It has been shown to reduce stress and improve mental well-being.

Lalah Delia, a wellness educator, discussed the benefits of mindfulness with USA Today. "Mindfulness helps us be present in the world, aware of our energy and aware of the energy around us. It involves actively exploring our thoughts and surroundings to understand how they impact our mental and emotional well-being. This is different from traditional meditation," she explained.

Writing in a journal can be a great way to reflect on your feelings and emotions. It can also help you to identify patterns and triggers that may be affecting your mental health.

"Journaling also improves mental health and allows for stress relief, because it can provide a safe space to unload your pent-up thoughts and feelings," says Dr. Carla Manly, a clinical psychologist based in Sonoma County, California. "In general, whether it's after a therapy session or just after a long day, it is a safe space to put everything out there and close it up," she told TODAY.

Practice gratitude

It's important to take time each day to reflect on the things you're grateful for. Focusing on the positive can help to reduce stress and improve mood.

According to Dani Moye, Ph.D, a licensed marriage and family therapist, being grateful can have a positive impact on our mental health. "When we focus on the good in our lives, the things that make us feel sad or worried are minimized. This shift in perspective can give us emotional freedom and serenity, no matter what we're facing," Moye explained to Forbes Health.

Try a new hobby

Trying something new can be a great way to reduce stress and improve mental well-being. Pick up a new hobby or learn a new skill. "Hobbies have so many positive benefits on mental wellness," said Dr. Tom MacLaren, consultant psychiatrist at Re:Cognition Health, to Irish News.

"They help lift mood, reduce stress, and promote happiness and contentment. To get the full mental health benefit, it's important to find something meaningful and enjoyable, whether it be creative, musical, athletic, academic, involving collecting, or something unique or personal," he added.

Be kind to yourself

Remember to be kind and understanding to yourself. Practice patience and celebrate your accomplishments, no matter how small they may seem.

Dr. Kelli Harding, an assistant clinical professor of psychiatry, discussed the positive effects of kindness on our mental health with EverydayHealth. "Kindness can lower cortisol and blood pressure, reduce pain, anxiety, and depression, and boost our immune system, thus mitigating stress on an individual level," Dr. Harding stated.

Spend time in nature

Spending time in nature has been proven to reduce stress and improve mood. Going for a walk in the park or hiking in the woods are great ways to do this.

Ernesto Lira de la Rosa, PhD, a licensed psychologist and media advisor for the Hope for Depression Research Foundation, explained to Real Simple that our physical and mental health benefit when we connect with nature. "When we spend time in nature, we can literally disconnect from everyday stressors, technology, and social interactions. Nature can help us ground and recharge our bodies and minds, especially if we take time to observe our surroundings," he added.

Listen to music

Listening to music has been shown to reduce stress and improve mood. Put on your favorite music and enjoy.

Trish Glynn, who is a licensed mental health counselor and the owner of The Carey Center, has explained the benefits of listening to music. "Music is known to lower your heart rate while also reducing levels of cortisol, which is known as the stress hormone," Glynn has told Insider.

Practice deep breathing

Deep breathing can be an effective way to reduce stress and improve mental well-being. Try taking a few deep breaths in through your nose and out through your mouth.

According to a study published in the journal Cell Reports Medicine, breathing techniques like cyclic breathing have been shown to be more effective in improving mood than mindfulness meditation and other breathwork techniques.

Read a book

Reading is an excellent way to unwind and escape from the stresses of daily life. Set aside time each day to read a book that interests you.

Furthermore, reading can help keep your mind sharp and prevent cognitive decline. "Various activities, including reading, that are seen as cognitively engaging are definitely associated with better brain health," said Jonathan King, Ph.D., senior scientific advisor in the division of behavioral and social research at the National Institute on Aging, in an interview with TODAY.com.

Take a bath

Taking a warm bath can be a fantastic way to unwind and reduce stress. Get in the water, lay back, and relax. You can also enhance the experience by playing some music or lighting candles.

According to family medicine provider Amy Zack, MD, taking a bath could have a significant positive impact on your mental health. "Baths also create a peaceful environment for meditation, introspection, and escape from everyday stressors. Promoting relaxation helps you let go of things that can keep you awake as you try to wind down," Zack explained to HealthEssentials.

Practice self-compassion

Be kind and understanding to yourself. Remember that it's okay to make mistakes because you're only human.

According to Kristin Neff, Ph.D., "A lot of research shows that people who score high on self-compassion eat better, exercise more, and keep doctor appointments. It's an attitude of genuine consideration, one that a good parent would have toward a child who wants to have ice cream for dinner every night. The loving and compassionate decision is to say no, to balance the short-term pleasure with the long-term benefit because you value the person," as told to Shape magazine.

Take breaks

It's important to take breaks throughout the day to rest and recharge. Taking a walk, stretching, or simply taking a few deep breaths can be helpful.

Jennifer Bramen, PhD, a senior research scientist, spoke to Healthline about the importance of taking short breaks, especially during work. "In general, the closer you are to taking a 10-minute break, the better you will perform. However, even shorter breaks can still be beneficial," said Bramen.

Get enough sleep

Getting a good night's sleep is crucial for maintaining good mental health. It's recommended to aim for at least 7-8 hours of sleep every night. According to Casey Kelley, MD, ABoIM, founder and medical director of Case Integrative Health, sleep is essential for the body to function properly, just like food, water, and oxygen.

"Sleep is a vital, yet often underappreciated, aspect of overall body health and longevity," Kelley told Real Simple. "While you're asleep, your immune system releases proteins called cytokines that protect against inflammation or infection," she added.

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