These hypotheses are rationalised by the aforementioned findings, which indicate positive treatment effects of both HRVB and psychotherapeutic homework assignments in depressed clients.

In addition to this, we were interested in exploring potential interaction effects between the RFB and LH interventions, although due to insufficient literature we did not have an a priori hypothesis on the efficacy of this combination for the treatment of depression.

We conducted a 2 × 2 factorial randomised controlled trial in which all clients received IIMT Erkkilä et al. The trial was registered ISRCTN before recruitment. Conditions were derived from either the presence or absence of LH LH yes , LH no and RFB RFB yes , RFB no.

The diagnosis was made by a psychiatric nurse with an MA degree in nursing science and assessment qualification. Musical skills were not required from participants. Exclusion criteria were a known history of psychosis, bipolar disorder, personality disorder, other combined psychiatric disorders in which depression cannot be defined as primary disorder, acute and severe substance misuse, and depression severity impeding clinical measurements or verbal conversation.

After screening and diagnosis, a computerised block randomisation with randomly varying block sizes of 4 and 8 was conducted by an external person C. who had no direct contact with the patients. To ensure group allocation concealment, randomisation was conducted at another site NORCE Norwegian Research Centre.

Thus, assessor, therapists, and participants were unaware of allocation until therapy started. As this was a single-blind trial, only the outcome assessor remained blinded to allocation throughout the trial.

Outcome measures were collected by a specialist in psychiatric assessment at three measurement points: 1 baseline, i. The time point of primary interest was post-intervention. Demographic information was obtained at the beginning of the intervention.

All participants were offered 12 bi-weekly sessions of IIMT over a period of 6 weeks. Each session lasted one hour. The therapeutic approach and its additional components LH and RFB are described in the following sections.

Essential to music therapy is the client-therapist relationship, in contrast with music and medicine, where music can be used without that relationship. IIMT, developed at the Music Therapy Clinic for Research and Training University of Jyväskylä, Finland , is based on clinical improvisation, which is one of the major methods of music therapy Bruscia, IIMT is based on the interplay and alternation between free music improvisation and verbal discussion Erkkilä et al.

It was originally anchored in the psychodynamic music therapy tradition Priestley, ; Bruscia, , and later on, adopted elements from the integrative psychotherapy tradition Norcross and Goldfried, as well. The fundamental aim of IIMT is to encourage clients to engage in expressive musical interaction with the therapist.

The experiences arising from this interaction are then conceptualised and further processed in the verbal domain Erkkilä et al. In IIMT, improvising is primarily understood both as a symbolic representation of abstract mental content, and as an expressive medium able to evoke emotions, images, and memories Erkkilä et al.

We standardised the clinical setting so that every therapy process involved identical instruments and a similar arrangement of the two music therapy clinics. Two identical digital pianos placed opposite each other one for the client, another one for the therapist were used for melodic and harmonic improvisations.

Two identical djembe drums placed next to the pianos were used for non-melodic, rhythmic improvisations. No other instruments or music therapy methods were used. The improvisations were digitally recorded, which made it possible to listen back to them anytime afterwards.

Eleven qualified and clinically experienced music therapists five female, six male were responsible for conducting the therapy sessions.

The assessment followed the protocol developed by Lehrer , and consisted of two parts. First, the client was instructed in how to perform RFB abdominal breathing, inhalation through the nose and exhalation through the mouth, no holds or pauses, and breathing slower without breathing deeper.

Once the technique was sufficiently mastered, the client was asked to breathe at six different rates for 3 min each, while wearing a heart rate monitor. The breathing rates ranged from 7 to 4.

Heart rate data for each breathing segment was then analysed using Kubios HRV 3. The optimal breathing rate was defined as the rate producing the highest peak in the low frequency LF component of the power spectrum 0.

Longer exhalations are known to promote parasympathetic activation Strauss-Blasche et al. These improvisations were recorded by the therapists using Pro Tools Each client had personal access through their personal computers to all of their improvisation recordings.

All improvisations created during the music therapy process were available to the client for listening throughout the therapy process. Clients were instructed to use headphones to listen, whenever they felt like doing so and as many times as they wished, to any of the available improvisations and could decide when and how many times they wanted to listen to the improvisations.

Software installation and guidance to clients on how to use the music player was performed shortly before the first music therapy session.

At the beginning of the trial, the clinicians were advised to encourage clients to listen to the improvisations after each session. In addition, the therapists were advised to recommend particular improvisations to be listened to at home when they were connected to specific, clinically important themes.

To ensure treatment fidelity, the selected clinicians were offered intensive training in the music therapy model and in the two added components. All the clinicians were qualified music therapists. Regular clinical supervision was used for monitoring and maintaining the quality of the clinical work.

The Montgomery-Åsberg Depression Rating Scale MADRS Montgomery and Åsberg, was the primary outcome of the study. At the beginning of the study, MADRS was used to determine participant eligibility. The MADRS has high joint-reliability, has been shown to be sensitive to change, and has been demonstrated to have predictive validity for major depressive disorder Rush et al.

The anxiety subscale HADS-A of the Hospital Anxiety and Depression Scale HADS Aro et al. QoL was assessed using the RAND Aalto et al. A detailed explanation of this procedure can be found in the Supplementary Material. The Global Assessment of Functioning GAF Jones et al. The measures of general functioning and QoL were chosen based on widespread use in psychological intervention studies concerning people with mental health problems.

For each condition, the selected sample size provided statistical power of 0. An intention-to-treat ITT approach was followed, using all available data regardless of whether the treatment was received as intended. Clients who left the study before completion of the intervention were considered dropouts.

Baseline, post-intervention and follow-up outcome measures served as continuous dependent variables. Repeated-measures linear mixed-effects models see Supplementary Material were used to assess RFB and LH effects for each continuous outcome.

An advantage of the utilised repeated measures design is that clients with missing data can be retained in the model, and thus all clients were used in the analysis. RFB and LH were entered as predictors and a random intercept term grouped by client was added to adjust for the dependency of repeated observations within each client.

To adjust for baseline differences between conditions, the treatment terms were removed from the model Twisk et al. Hence, the effects of RFB and LH were calculated from the interaction between each factor and time.

As an exploratory investigation to examine potential interaction effects between RFB and LH interventions, the repeated-measures linear mixed-effects models were subsequently expanded by adding an RFB x LH interaction.

Besides treatment effect post-intervention and follow-up, we obtained an overall treatment effect over time B as an estimate of the raw mean difference between presence and absence of each factor; B was calculated as the sum of the regression coefficients between each condition and time points Erkkilä et al.

To estimate effect sizes for a given outcome, its overall treatment effect over time was divided by the standard deviation of the measure across all clients at baseline.

For dichotomous variables leaving the study early, treatment response , missing data were imputed and a negative outcome was assumed for those clients left the study early, no-response for a conservative estimate.

To determine clinical significance, risk difference and number needed to treat NNT were calculated for effects that were statistically significant. Besides the crude efficacy analysis, an adjusted efficacy analysis and two sensitivity analyses were carried out.

The repeated-measures linear mixed-effects model of each continuous outcome was adjusted for prognostic covariates by adding them as random effects random slopes in the model: age group i. Two sensitivity analyses were conducted for the primary outcome: a single imputation method Last Observation Carried Forward that assumes no change for missing data, and a per-protocol approach treatment as received.

All statistical analyses were performed in Matlab b MathWorks, Natick, Massachusetts. The study was conducted at the Music Therapy Clinic for Research and Training University of Jyväskylä, Finland.

Figure 1 shows the patient flow during the trial. Recruitment started on February 1, and ended on October 31, Participants were recruited in central Finland through newspaper announcements. Of people who were initially invited for screening, 14 declined, 11 were no-shows and 7 met an exclusion criterion.

Baseline characteristics in each condition are shown in Table 1. According to the results of the treatment effect analysis, there was a significant main effect of time both post-intervention and at follow-up in the expected direction i.

Table 2. Effects of music therapy with or without resonance frequency breathing or listening homework. Figures 2 , 3 show mean outcome scores across time points, separately for presence and absence of RFB and LH. An overall improvement over time for all secondary measures can be observed, regardless of condition.

Figure 2. Mean scores of continuous outcome for presence and absence of RFB across timepoints. T0: baseline; T1: post-intervention 6 weeks after the beginning of the intervention ; T2: follow-up 6 months after the beginning of the intervention.

Figure 3. Mean outcome measure scores for presence and absence of LH across timepoints. Table 2 shows the results of crude and adjusted treatment efficacy analyses post-intervention and at follow-up. The crude treatment efficacy analyses revealed significant differences between RFB yes and RFB no for all outcome measures, in all cases favouring RFB yes.

The differences between most outcome measures both post-intervention and at follow-up reached statistical significance. Regarding LH, although the results for most outcome measures favoured LH yes with the exception of HADS , none of them reached significance.

Adjusted treatment efficacy analyses yielded similar results to those obtained in the crude analyses, except that the adjusted analyses for RFB reached significance at both time points for all outcome measures.

Potential interactions between RFB and LH were examined by subsequently adding an RFB x LH interaction. This factor interaction, however, did not yield significance at any time point for any outcome measure, neither in the crude nor in the adjusted analysis.

Crude and adjusted overall treatment effect over time and resulting effect sizes are presented in Table 3. According to the crude treatment efficacy analysis, the overall effect of treatment for RFB was significant for all measures except GAF, with RFB yes clients invariably improving more than RFB no clients.

The adjusted treatment efficacy analysis yielded similar results, except for two differences. First, while the overall effect of treatment for GAF did not reach significance for RFB in the crude analysis, all outcome measures yielded significant differences for RFB in the adjusted analysis.

Second, differences between RFB yes and RFB no increased after covariate adjustment of the treatment efficacy analysis, especially for MADRS. Table 3. Effect sizes of music therapy with or without resonance frequency breathing for continuous outcomes. Montgomery-Åsberg Depression Rating Scale scores decreased in all conditions post-intervention, as shown in Figures 2 , 3.

An overall improvement in MADRS from moderate points to mild depression points can be observed for all conditions. Results for dichotomous variables are presented in Table 4.

There were fewer dropouts in RFB yes compared to RFB no but the odds ratio was not significant. A risk difference of 0. There were no significant differences between the LH factor levels in any of the dichotomous variables. Table 4. Attrition and response rates in 70 participants randomised to music therapy with or without resonance frequency breathing or listening homework.

The crude treatment efficacy analyses resulted in a significant improvement in secondary measures for RFB yes either at follow-up, post-intervention, or both time points see Table 2. HADS scores decreased in all conditions during the intervention. No significant differences were found between the LH factor levels neither at post-intervention nor follow-up; similar results regarding LH were observed for the other three secondary measures RAND MCS, RAND PSY and GAF.

Adjusted treatment effect analyses yielded comparable results, albeit of higher significance; this was also observed for the rest of the secondary outcomes. For all conditions, both RAND MCS and RAND PCS decreased during intervention. All conditions exhibited a decrease in GAF scores.

No significant differences in GAF were observed for RFB. With respect to LH, overall treatment effect analyses did not yield significant differences for any of the secondary measures. The adjusted overall treatment effect analysis yielded similar findings, although the differences between RFB yes and RFB no were larger, and GAF results reached significance.

Crude effect sizes for RFB were medium or above medium for RAND MCS and RAND PCS, and close to medium for HADS and GAF. Adjusted effect sizes for RFB were close to large for RAND MCS and above medium for HADS, RAND PCS, and GAF.

Two sensitivity analyses were conducted. The first assumed no change in MADRS scores for missing observations, thus providing a conservative estimate for dropouts. Furthermore, a per-protocol analysis reclassified three clients from LH yes to LH no , as they did not engage in any form of listening homework.

There were still no significant differences between the LH factor levels in any of the outcome measures. Reclassification of clients for the RFB factor was not needed, since they all followed protocol. Adverse events were rare, transient, and mostly unrelated to the trial interventions.

One IIMT had to stop therapy due to a pre-existing comorbid condition which necessitated surgery and subsequent recovery time. In line with our previous RCT Erkkilä et al.

Furthermore, our results indicate that IIMT can indeed be further enhanced, at least with RFB. More specifically, the overall effect of treatment for RFB was statistically significant for all measures except GAF, with RFB clients consistently improving more than non-RFB clients see Table 3.

We also observed significant differences in all outcome measures—either post-intervention, at follow-up, or both—favouring clients allocated to RFB see Table 2. In contrast, the LH factor did not yield significant differences in any of our analyses. However, for all outcome measures besides HADS, the observed changes did favour LH yes.

In sum, these results strongly support the hypothesis of RFB as an enhancer of therapeutic outcome and speak for its inclusion in music therapy, and possibly in other forms of psychotherapy. Interestingly, for RFB yes , the treatment effect at T2 was larger than at T1 for all outcome measures except HADS, and the mean improvement in RFB yes was monotonic i.

Although we did not monitor whether clients kept using RFB on their own after the end of therapy, it is possible that an independent practice of RFB might have contributed to maintaining and reinforcing these positive outcomes.

It is not surprising that 12 sessions of music therapy without RFB would result in a lower response rate than 20 sessions. However, the truly interesting finding is that, in terms of response rate, 12 sessions of music therapy with RFB were equivalent to 20 sessions without enhancers.

Although this is a post hoc comparison of two different trials, it suggests that integrating RBF into music therapy might allow similar results to be achieved with fewer sessions.

These results point to the existence of qualities specific to RFB and music therapy which, when combined, can create a synergy effect. As to improvisational music therapy, three of its unique characteristics are to offer a non-verbal way of expressing emotions, to provide an absorbing experience anchored in the present, and to allow the emergence of unconscious material MacDonald and Wilson, Thus, it stands to reason that combining the two methods would greatly facilitate the emergence of themes and emotions that usually remain unexpressed, while making it easier for the client to face these emotions and process them.

On a more general level, these findings highlight the benefits that can be derived from integrating RFB into an existing therapy method, instead of simply using it as an adjunct or complementary exercise, as is still largely the case when RFB or HRVB are being used.

While searching the literature, we only found a few instances where such integration took place e. Studies employing HRVB as a stand-alone intervention could serve as a baseline to determine the magnitude of possible synergy effects obtained in studies such as ours, by comparing effect sizes.

In contrast to RFB, our second added component LH did not yield any significant effect, in any of the analyses or comparisons that we performed. However, the changes observed at T1 and T2 were, nonetheless, always in favour of LH yes , except for HADS.

In other words, the clients in the LH yes condition benefited more from therapy than the clients in the LH no condition. A more detailed analysis which is beyond the present paper will address the question whether listening duration correlated with clinical change. For such an analysis it will be important to separate extended, likely intentional listening from very short listening such as in searching for a piece.

Lastly, it should be noted that our results are in line with the existing evidence presented in the Introduction, regarding the positive effect of psychotherapy on comorbid anxiety Weitz et al.

Interestingly, in this case, although the addition of RFB had a positive impact on both the physical and mental health component of QoL, the effect was more pronounced for physical health. We speculate that this was due to the nature of RFB and the regular practice thereof, which might have led to a sustained increase in autonomic flexibility and HRV, thus allowing clients to better regulate their stress levels in daily life and reduce unpleasant physical sensations.

The main limitations of this trial include limited sample size and lack of a no-treatment or placebo control group. Although the sample was large enough to detect a significant effect of breathing added to IIMT, it was not large enough to exclude a clinically meaningful effect of listening homework.

Further research with a larger sample would be required to confirm or disconfirm any effects of this component. The sample was also restricted to a single site, so that conclusions generalising to other settings or world regions cannot be drawn with confidence.

Second, the study did not use a no-treatment or placebo control group. However, robust effects of IIMT compared to standard care were already demonstrated in the previous study on which the present study was built Erkkilä et al. An issue surrounding LH is the absence of prior studies making use of this specific activity, which might have led to an incorrect estimation of the expected effect size.

Although the use of homework has a long history in CBT, the kind of task given in CBT is arguably not directly comparable to what was required from the clients in the present trial. Thus, it is possible that our sample size was too small to detect a significant effect for the LH factor.

Another issue with LH might have been its possible inadequacy for the client population under investigation. Indeed, in contrast to RFB, LH was unsupervised, meaning that clients were free to perform the task or not, which led to lower task adherence compared to RFB.

This raises the question of whether clients presenting with symptoms of depression should be given voluntary and unsupervised tasks in between therapy sessions, since depression typically includes a lack of initiative.

Future studies would benefit from having a larger sample size for studying LH, and being multi-centre. Furthermore, the results presented here are purely outcome-oriented, meaning it is not possible at this point to explain the results by establishing a relationship between what happened during therapy and the observed affective or behavioural changes.

Lastly, one question that remains unanswered is the extent to which the enhancement effect achieved with RFB in music therapy could be generalised to the larger field of psychotherapy. Based on our results, we presume that other forms of therapy would similarly benefit from the inclusion of RFB, especially if their approach and principles are similar to the ones used in music therapy e.

Should this be the case, it would open the door to shorter and more cost-effective forms of therapy. The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation. The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of , as revised in Written informed consent was obtained from every participant.

JE did the project leadership, contribution to the study design, development and implementation of the clinical music therapy model, writing parts of abstract, introduction, methods and discussion, and finalizing the manuscript.

OB did the contribution to the study design, development and implementation of the RFB component, and writing parts of the methods and discussion sections. MH did the development and implementation of the LH component, statistical analysis, and writing parts of the methods, results, and discussion sections.

AM did the statistical analysis, writing parts of the methods and results sections. EA-R developed and implemented the clinical music therapy model, wrote parts of the intervention, and commented the manuscript. NS did the development of LH component and implementation of the RFB component, helping to revise the methods and discussion section.

SS did the contribution to the study design, helping to draft the results section and revise the manuscript. CG did the contribution to the study design, randomisation procedure, supervision of statistical analyses and revision of the manuscript text. All authors contributed to the article and approved the submitted version.

This work was supported by funding from the Academy of Finland project numbers , , and 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.

The study team acknowledges the support from the Academy of Finland and University of Jyväskylä. The authors would like to thank Inga Pöntiö for the psychiatric assessments, Markku Pöyhönen for providing support in administrative, practical, and logistical matters, Mikko Leimu for setting up the music recording platform, Jos Twisk for statistical advice and Monika Geretsegger for her support with the study.

Aalbers, S. Music therapy for depression. Cochrane Database Systemat. doi: PubMed Abstract CrossRef Full Text Google Scholar. Aalto, A. RAND terveyteen liittyvän elämänlaadun mittarina — Mittarin luotettavuus ja suomalaiset väestöarvot.

Helsinki: STAKES National Research and Development Centre for Welfare and Health. Google Scholar. Alonso, J. Prevalence of mental disorders in Europe: results from the European Study of the Epidemiology of Mental Disorders ESEMeD project.

Acta Psychiatr. Aro, P. Validation of the translation and cross-cultural adaptation into Finnish of the Abdominal Symptom Questionnaire, the Hospital Anxiety and Depression Scale and the Complaint Score Questionnaire. Baldessarini, R.

Suicidal Risks in Reports of Long-Term Controlled Trials of Antidepressants for Major Depressive Disorder II. Brabant, O. Enhancing improvisational music therapy through the addition of resonance frequency breathing: Common findings of three single-case experimental studies.

Music Ther. CrossRef Full Text Google Scholar. Bruscia, K. Improvisational models of music therapy. Springfield: C. The dynamics of music psychotherapy. Gilsum, NH: Barcelona Publishers. Caldwell, Y. Adding HRV biofeedback to psychotherapy increases heart rate variability and improves the treatment of major depressive disorder.

Cuijpers, P. The effects of psychotherapies for major depression in adults on remission, recovery and improvement: a meta-analysis. De Maat, S. Relative efficacy of psychotherapy and pharmacotherapy in the treatment of depression: A meta-analysis.

Diest, I. Biofeedback 39, — Erkkilä, J. Hargreaves, D. Miell, and R. MacDonald New York: Oxford University Press , — Enhancing the efficacy of integrative improvisational music therapy in the treatment of depression: study protocol for a randomised controlled trial.

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Gevirtz, R. Evidence was not sufficient to determine differences between music therapy and standard care or between different types of music therapy for either primary or secondary outcomes. The studies in the meta-analysis were quite different from one another. Depression was diagnosed using a variety of rating scales and criteria from the Diagnostic and Statistical Manual of Mental Disorders , 5th ed.

The music therapy interventions were heterogeneous in terms of duration and number of sessions, individual vs. group therapy, and type of therapy. Five of the studies recruited participants from mental health service locations, two studies involved geriatric patients, and two others involved high school students.

Although only one study reported negative outcomes, it did not demonstrate a difference in adverse events between patients who received therapy and those who did not.

Current guidelines do not recommend routinely adding music therapy to standard treatment for depressive disorders. Further studies are needed to better characterize aspects of music therapy interventions and determine long-term effects on depression and related conditions.

However, this Cochrane review provides low- to moderate-quality evidence that music therapy is a low-cost and low-risk intervention that may be worth adding to standard care for patients with depressive disorders.

Aalbers S, Fusar-Poli L, Freeman RE, et al. Music therapy for depression. Cochrane Database Syst Rev. National Institute of Mental Health. Major depression. Accessed July 30, World Health Organization. Updated December 4, Ribeiro MKA, Alcântara-Silva TRM, Oliveira JCM, et al.

Music therapy intervention in cardiac autonomic modulation, anxiety, and depression in mothers of preterms: randomized controlled trial. BMC Psychol. Diagnostic and Statistical Manual of Mental Disorders.

American Psychiatric Association; This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference.

At the end of the study, patients who received music therapy had a significantly higher improvement in their depression symptoms than control patients who only received standard depression treatments.

Researchers also looked at changes in anxiety symptoms. Anxiety is a common comorbidity with depression, meaning that depressed patients often have anxiety as well. They found that over the course of the study, patients who received music therapy had significantly fewer anxiety symptoms compared to those who did not.

While this study was not designed to look specifically at Anxiety Disorders, other studies have found music therapy to be an effective treatment for anxiety when used alongside standard therapies.

One of the most important takeaways from this study is that music therapy can make a significant impact for many depressed patients when used alongside standard therapies. Consistent with previous research, patients in this study were significantly more likely to at least partly recover from depression when they received music therapy.

While the study only looked at one type of music therapy, it would be interesting to see if music in general, both listening and playing, has any impact on depression.

One possible weakness of this study was that the control patients did not receive the same amount of therapy as music therapy patients. From this study design, we do not know whether it was the "music" that led to the improvements seen, or whether these improvements came from having more therapy overall.

All in all, this study provides good support for what looks like a great therapeutic option for depressed patients. The pandemic has magnified environmental and personality-based risk factors for Researchers are discovering associations between mental disorders and cancer.

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Mental health is an important part of our total health. Certain mental health conditions, specifically anxiety and depression, are two common conditions that continue to grow in prevalence year after year.

Even the World Health Organization WHO is concerned since these conditions affect around million people around the world. Anxiety and depression can both be debilitating and create issues in daily life for people struggling with them, such as interference in school, work, and relationships.

Fortunately, emerging treatments, such as music therapy, can provide non-invasive and cost-effective options for individuals with these disorders. This article aims at providing some insights into the value of music therapy in mental health, including the mechanism of action and how this therapy is implemented as music can be a hopeful treatment choice.

Anxiety is a feeling of unease, fear, and apprehension. It can cause various symptoms, such as sweating, rapid heart rate, hyperventilation, feeling weak or tired, nervousness, and difficulty concentrating. Depression is another mental health condition affecting how someone feels and thinks.

For example, it can affect their life activities such as personal relationships, work, and even enjoying different parts of life. This medical condition is characterized by a persistent loss of interest in daily activities and decreased mood, significantly impacting overall everyday life.

It can present in various persistent symptoms such as sleep disturbances, appetite changes, chronic fatigue, and difficulty concentrating. It can also lead to increased thoughts of self-harm. There are an estimated 25 million adults and teens in the US that have this disorder annually.

Music therapy , as defined by AMTA American Music Therapy Association , uses evidence-based music interventions in the clinical setting. These interventions should be completed by an approved credentialed professional.

The elements of their therapy include establishing a therapeutic relationship with individuals and accomplishing their specific goals.

This therapy can be applied to the mental health setting and impact emotions through promoting wellness, managing stress, improving memory and communication, and expressing feelings. A meta-analysis of studies indicated that music therapy can be used to reduce anxiety symptoms and depression in adults.

This analysis revealed that music therapy helped with physical and mental relaxation, promoting overall well-being. This therapy allows patients to get in touch with their emotions and encourages interpersonal relationships with their therapists.

It can provide distraction and improve communication to overcome barriers and limitations, making music therapy effective in managing anxiety. A meta-analysis of music therapy and depression revealed that music can be beneficial in alleviating depressive symptoms.

Music therapy was a valuable tool in conjunction with treatment as usual TAS in modulating moods and emotions. It also showed that it effectively improved functioning and anxiety levels in people with depression.

In a cancer study , music therapy demonstrated a reduction in depression and anxiety as a non-invasive method. Medications are often used in cancer patients with depression. However, they can come with many side effects on the patient's mind and can create drug dependence.

Therefore, music therapy shows promising benefits as a non-drug method in cancer patients to alleviate symptoms of depression. There is increasing evidence that the use of clinical musical therapy can have beneficial effects on the brain.

The neurological and physiological impact includes engaging the brain centers involved in emotion, motivation, cognition, and motor functions.

This therapy can improve socialization, emotional and neuromotor functioning. Music therapy can activate the limbic system, the reward and pleasure centers of the brain, thus positively impacting mood and promoting social cohesion, communication, and relationships.

This therapy can improve the psychosocial aspects of people struggling with mental health disorders and effects their overall emotional well-being by activating these various brain processes. Qualified music therapists will utilize various effective techniques in their sessions with people with anxiety and depression.

Firstly, they must assess each individual's needs and strengths, including discussing their emotional well-being, physical health, social functioning, communication abilities, cognition, trauma history, and physiological responses.

They may also discuss whether the patients have musical backgrounds and preferences. After this assessment, the therapist will collaborate with the patient on goals and then create the appropriate music therapy.

These sessions can be done in schools, hospitals, nursing homes, mental health centers, clinics, and patients' homes. They can be done individually or in groups and can involve creating music, singing favorite pieces of music, or listening and moving to music.

They may also discuss the lyrics in music or use instruments. Regarding depression, music therapy may also be combined with other therapies, including psychological or pharmacological.

These techniques all depend on the individual's preferences and abilities. That is why the prior assessment is essential in determining the proper musical therapy program.

As the research suggests, music therapy can be a beneficial option in treating conditions such as anxiety and depression, emphasizing its importance in continued research and increased usage. The AMTA is leading the way in the future direction of research in music therapy and expanding its use in various conditions.

The future direction focuses on consumer impact and their collaboration, clinician involvement that includes a team of clinician scholars, diverse methodologies, further developing the theory, growing research, and expanding partnerships.

Ultimately, the future of music therapy is to integrate research into the essential functions and increase access to the quality of music therapy services that benefit the clients and families who need it.

Anxiety and depression can often be debilitating for people when it occurs chronically, resulting in decreased daily function and enjoyment in life. Thankfully, there are many effective interventions for improving these conditions. One such intervention is music therapy.

This intervention done in a clinical setting can support psychological, emotional, physical, social, and cognitive functions leading to decreased anxiety and depression.

Music therapy holds promise as an effective stand-alone or adjunctive treatment for mental health, allowing individuals with these conditions to thrive. Documents Tab. Redesigned Patient Portal. Simplify blood panel ordering with Rupa's Panel Builder.