Many seriously ill infants admitted to neonatal intensive care units (NICU) have an uncertain future. The neonatal experience can be overwhelming and traumatic for parents and professionals caring for them. The infant may develop later psychosocial difficulties due to trauma. Services often fail to consider their cultural and religious accessibility for families. Music therapy (MT) is increasingly being considered for implementation on neonatal units to help address these challenges. However, the true acceptability of the therapy, particularly for parents with infants with uncertain futures, is unknown. Four focus groups (14 parent participants), 13 parent interviews, and 2 focus groups with 8 healthcare professionals (HCPs) were conducted to explore their lived experiences of uncertainty in the NICU and their perceptions of the use of MT in this environment. Parents experienced a prolonged period of liminality of identity as they faced multiple traumas and had minimal opportunities to connect with their infant. HCPs described the felt obligation to maintain a professional persona and an emotional disconnect to manage daily trauma. MT was considered to have the potential to support connection between baby-parent-professionals and the external world, as well as internal personal resources. Concerns about using MT included further disruption to family time in the NICU and potential disempowerment by professionalizing one of the few aspects of infant care to which parents could still contribute. Future neonatal MT approaches should ensure parents and HCPs are psychologically supported. Acknowledging family values and heritage is likely to increase feelings of acceptance and engagement.
Assessment is fundamental to music therapy, underpinning effective therapeutic planning. Despite existing tools for older adults, there remains a need for holistic, strengths-based, music and person-centered assessments that include older adults' perspectives. This article reports on phase one of a four-phase study. Phase 1 evaluated and refined the Music Therapy Assessment for Older Adults, Revision One (MTAOA-R1) as part of the development of a new assessment tool, the MT-VOICE (Music Therapy Assessment for Older Adults-Valuing Older Adults through Comprehensive Assessment). Through qualitative inquiry and a community-engaged design framework, focus groups of music therapists [MTs] (n = 14), allied health professionals [AHPs] (n = 8), and older adults [OAs] (n = 13) explored key elements of the tool and shared their perspectives on assessment with OAs to enhance relevance and person-centered focus. Data were analyzed using reflexive thematic analysis. Informed by the study's research questions, 5 predetermined categories guided deductive coding and analysis: (a) Assessment Tool Components and Structure, (b) Person-Centeredness, (c) Utility, Feasibility, and Implementation, (d) Music Within Assessment, and (e) Perspectives and Experiences of Key Partners. Findings from this analysis informed revisions to the assessment. Revisions included: broadened scope, reduced length, increased person-centered language, open-ended items and narrative spaces, and an expanded (optional) intake section. Music-based items were integrated throughout the tool, and an accompanying assessment manual was created to support training and promote consistency. With increased relevance, clarity, and feasibility, the MT-VOICE offers a comprehensive, music and person-centered tool. Study limitations and directions for subsequent phases are discussed.
Music therapy (MT) may help address the global epidemics of depression and anxiety. Tailoring of MT interventions to participants' Musical identity (MI)-an individual's emotional and physical connection to music-may substantially increase the effectiveness of MT. Therefore, we developed and tested an exploratory scale for assessing MI and determined associations between components of MI and sociodemographic and mental health outcomes. To achieve this goal, we assessed a national sample of 1512 U.S. adults aged 30-70 years in July-August 2023. We measured depression using the validated Patient Health Questionnaire (PHQ-9) and anxiety using the validated Generalized Anxiety Disorder Assessment (GAD-7). A new 12-item MI Inventory (MII) assessed MI. Principal components analysis (PCA) using Varimax rotation determined the factor structure of the MII. Cronbach's α assessed the internal consistency reliability of each resulting subscale. We examined sociodemographic and mental-health differences across MII components using χ2 analyses. PCA yielded a strong two-factor solution with MII subscales focused on musical experience and emotional connection to music. Higher scores on both subscales were associated with younger age (P < .001), greater educational attainment (P < .001), and being employed (P < .001). Anxiety was significantly associated with both subscales, while depression was significantly associated with the music experience subscale. Categorizing individuals based on MII profiles may be useful in tailoring MT modalities to optimize mental health outcomes. Younger individuals scoring higher on both subscales highlight the emerging potential for MT's relevance and effectiveness.
Music therapy has been successfully employed with individuals with acquired brain injury (ABI) for rehabilitating physical needs. However, music therapy's effects on mood states for people with ABI, and their caregivers, remain underexplored, particularly in non-Western contexts. The purpose of this pilot study was to (a) examine the effects of music therapy on mood states for both adults with ABI and their caregivers in the inpatient rehabilitation unit, and (b) examine correlations of mood changes between individuals with ABI and their caregivers. Using a pre-post-test repeated measures design, 12 pairs of participants were recruited from an inpatient rehabilitation unit in a General Hospital in Taiwan (total N = 24). Each pair of participants engaged in a song-based intervention across three 30-min song-based music therapy sessions during their intensive rehabilitation program. The Visual Analogue Mood Scale (VAMS) and the Positive Aspects of Caregiving (C-PAC) were used to measure mood states and caregiving experience. There was a significant difference in pre-post scores on the VAMS energetic subscale for individuals with ABI. Statistically significant pre-post differences were also found for caregivers on the afraid, confused, sad, and happy subscales of the VAMS. Six positive correlations were found between groups for VAMS scores. There were statistically significant differences on Q8 "Enabled me to learn new skills" of the C-PAC. The findings suggest that song-based intervention may be an effective intervention to improve mood states for both individuals with ABI and their caregivers.
Collective trauma refers to psychological and emotional consequences experienced by communities exposed to large-scale traumatic events such as war. Civilians under constant threat endure instability, displacement, and loss, facing significant psychological distress. Music therapists in such contexts hold unique positions, providing therapeutic care while simultaneously experiencing the same traumatic reality as citizens. Despite extensive literature on the mental health impact of war, music therapists' lived experiences during active conflict remain underexplored. This study explored experiences of 15 music therapists (11 women, 4 men) working with war victims during the 2023 Israel-Hamas War, aiming to develop a practice-oriented model derived from their accounts. Semi-structured interviews were conducted and analyzed using inductive thematic analysis, followed by member-checking interviews. Thematic analysis revealed key themes: therapists' personal civilian experiences during war, their motivations to provide therapeutic services, and translation of these motivations into action through proactive outreach to displaced populations and adaptation of therapeutic settings. Analysis highlighted difficulties including secondary traumatization, helplessness, and lack of supervision. Alongside challenges, participants described coping resources including flexibility, mindfulness practices, and reciprocal strength gained from helping others. These findings generated the Mutual Resonance Cycle for Collective Trauma (MRC-CoT), a practice-oriented model conceptualizing the cyclical interaction between personal trauma exposure, professional motivation, therapeutic action, challenges, coping strategies, and renewal processes. The MRC-CoT builds upon established frameworks such as wounded healer and shared trauma by offering a cyclical perspective capturing the dynamic interaction of personal exposure, professional motivation, and adaptive coping strategies necessary for sustaining therapeutic presence during collective trauma.
With population aging, policies and practices that support healthy aging can be strengthened by creating accessible environments and incorporating the voices of older adults. This phenomenological study aimed to explore the lived experiences of 12 Brazilian older adults participating in a group music therapy process. Over 3 months, a music therapist facilitated 12 weekly music therapy sessions for a group of 12 older adults. Each session lasted an hour and included songs based on participants' musical preferences. Beginning with the 6th session, the group engaged in writing a song addressing the aging process and ageism, which was later recorded and publicly performed. At the end of the process, individual interviews were conducted. Data analysis, supported by the artificial intelligence tool GPT-4, revealed that the group music therapy promoted psychological well-being, facilitated new friendships and social support, retrieved autobiographical memories, and stimulated social activity. Participants considered the collective therapeutic songwriting process as an opportunity to raise awareness about aging and combat ageism. These findings suggest the potential of the music therapy process to foster meaningful social connections, enhance psychological resilience, and promote narratives related to aging and ageism.
Although music therapy can have positive impacts on motivation, treatment readiness, and craving for people with substance use disorders (SUD), most of the literature is from the objectivist paradigm and lacks the voices and lived experiences of people with addictions. A nuanced and situated understanding of music therapy that centers the experiences and voices of service users may help improve treatment. Therefore, the purpose of this study was to understand the lived experience of adults with SUD on a detoxification unit who participated in a single recovery-oriented group blues songwriting session. A board-certified music therapist facilitated 12 group single-session songwriting experiences over 6 months. Participants composed lyrics for a two-verse song identifying agency for and pathways to recovery based upon Snyder's Hope Theory. A research assistant individually interviewed 20 participants about their experiences. We used reflexive thematic analysis to analyze data, and a separate music therapy scholar provided trustworthiness to ensure the results were credible. We identified eight themes and grouped them into three categories to portray the songwriting sequence: Anticipating songwriting (Initial skepticism and doubt); Songwriting processes (An open and connected community, Composing lyrics was therapeutic, The engaging and genuine music therapist); and Songwriting products (Pride in the product, Mood changes and hope, A distinct approach, and Gratitude and recommendation). The findings offer a service user-centric understanding of the lived experience of songwriting germane to adults with SUD on a detoxification unit. Implications for clinical practice, limitations, and suggestions for future research are provided.
Many therapeutic disciplines have increased research into using healthcare informatics for monitoring workload productivity, but informatics research in the creative arts therapies is still emerging. This paper discusses the development of a healthcare informatics tool to capture workload data within a multisite network of creative arts therapists within the military and veteran healthcare systems: art therapists, dance/movement therapists, and music therapists. In this paper, we describe the development of a workload performance measurement tool (PMT) through agile project management and a participatory evaluation approach. Developing this tool revealed that providers from the three creative arts therapies engaged in similar types of work. User testimonials also revealed the PMT provided benefits to the network beyond tracking time in multiple categories, and analyses on these themes revealed clinical creative arts therapists, administrative creative arts therapists and personnel, and noncreative arts therapists thought about the data differently. Challenges with developing the tool, solutions for the challenges, and the benefits that the tool provides are discussed.
Suicide is a significant public health concern and a leading cause of death for individuals across the lifespan. This study explored (a) what settings music therapists are working in to support individuals navigating suicidality; (b) their training and education on suicide prevention; and (c) how prepared, knowledgeable, and comfortable they feel implementing suicide-related care. Using a convergent mixed methods design, 458 credentialed music therapists working in the United States completed a survey, 19 of whom worked with people navigating suicidality and completed a qualitative interview. Survey results found 81.7% of the sample reported providing suicide-related care to therapy participants in almost all clinical settings. Most did not receive suicide prevention education in their degree program at the bachelor's (74.4%) or master's (59.6%) levels. Qualitative themes, identified via thematic analysis, on the topic of education and training highlighted minimal, missing, or inadequate training; training that occurred through workplaces, independent research, or professional development; and learning by witnessing, dialoguing, and personal experiences. Themes on areas of strength and confidence from training included conducting informal risk assessments and holding the weight of suicidal thoughts and related emotions in a nonjudgmental way. More training was desired for verbal skills (e.g., acute crisis, de-escalation, verbal processing), setting- and community-specific trainings, music therapy methods, and holistic, systemic, and contextual supports of suicide. Results highlight how critical it is for undergraduate and graduate music therapy degree programs to integrate suicide prevention education and training into their curricula to better and more ethically prepare students for clinical realities.
Music engagement is a central process of music therapy, but there remains a need for a feasible instrument to measure it. The Music Engagement Scale (MES) addresses this need with a single-item process measure of music engagement. This study evaluated the sensitivity to change and inter-rater reliability of the MES using a convenience sample of 20 clients (ages 1-69 years) receiving individual sessions in Nordoff-Robbins Music Therapy (NRMT). The majority of clients were autistic children. Three independent raters with graduate training in music therapy, but no advanced NRMT training, rated the 1st, 8th, and 15th sessions. Results showed sensitivity to change in MES scores across sessions. Inter-rater reliability was acceptable-to-strong at the 1st and 15th sessions, while reliability was lower at the study midpoint. These findings suggest that the MES may be used to measure changes in music engagement over the course of music therapy, and that inter-rater reliability may vary over the course of treatment, potentially increasing when music engagement levels are more stable. The MES may be applied in future research to test whether music engagement functions as a moderator or mediator of music therapy outcomes. Implications for clinical practice, limitations, and suggestions for future research are provided. The complete scale is included at the end of this article.
Parkinson's disease (PD) progressively affects motor functions, often resulting in hypokinetic dysarthria, characterized by reduced speech articulation and vocal intensity. Over the last few decades, singing-based interventions have demonstrated potential therapeutic benefits for treating neurological speech disorders. To review the effectiveness of singing-based interventions in treating hypokinetic dysarthria, articles were identified based on a search across MEDLINE, PubMed, Scopus, ScienceDirect, and Web of Science. After being independently screened by the authors, the information was reviewed and extracted from articles written in English and Spanish investigating the potential benefits of music interventions in people living with PD. A total of 23 studies, out of 742 screened, involving 381 participants, were included. The majority of the studies were deemed of low quality due to the risk of bias from small sample sizes, lack of randomization, absence of control groups, and heterogeneous samples resulting from the progression of the disease. Overall, the review revealed that singing-based interventions improve phonation, prosody, and respiratory control, particularly those that incorporate group singing and vocal exercises based on speech-language pathology principles and techniques, such as the Lee Silverman voice treatment (LSVT). Findings suggest that singing-based interventions, when combined with and guided by LSVT principles, may maximize therapeutic benefits on speech quality in people living with PD. Additionally, several studies reported positive effects on emotional well-being and quality of life, reinforcing their potential psychosocial benefits. However, more studies with greater methodological rigor and long-term follow-up are needed to confirm these effects and establish more standardized intervention protocols.
Continuing education is important to enhance the efficacy and effectiveness of music therapy practice. Literature on continuing education needs of music therapists in developing country contexts in particular, is needed. This article reports a cross-sectional survey of music therapists' perspectives from select developing countries to explore their continuing education needs. Music therapists (N = 331) were recruited from six developing countries. One online questionnaire was used with open-ended questions on what they seek in terms of on-the-job professional development and continuing education. Respondents suggested the need for continuing education programs on cultural reflexivity, improvisations, and new methods and techniques. In particular, they needed refresher training on ways of taking into account cultural and contextual factors in practice and ways to engage with indigenous or native and ethnic music. Therapists' gender and core practice expertise or main clientele with whom they practiced contributed to variations in continuing education needs. This survey adds to the growing domain of research on regional differences in music and music-making, and how that would impact music therapists' continuing education requirements. Evolving new theoretical approaches through culturally-reflexive music therapy practice, improvisations through the use of indigenous or native art forms, and building organic music therapy models using indigenous music, may be the focus of investing in continuing education of developing country practitioners.
The 2025 Global Music Therapy Survey offers a long-term examination on the profession's evolution, a decade after the inaugural 2016/2017 study. Designed to track developments in demographic characteristics, professional practice and processes as well as emerging trends, the survey gathered responses from 1,183 current practitioners (67.6% response rate) across 8 World Federation of Music Therapy regions. Quantitative and qualitative analyses provide insight into both consolidation and transformation within the field. The profession remains predominantly female, though gender plurality is rising, and educational attainment remains high. Since 2016, entrepreneurial role creation has more than doubled, reflecting professional adaptation to persistent gaps in regulation and systemic support. Practice patterns reveal a shift toward healthcare and private practice alongside sustained work in education and community programs. Music therapists serve clients across the lifespan, with developmental disabilities, mental health, and neurological conditions most frequently addressed. In-person delivery continues to dominate, yet telepractice and digital tools-largely absent a decade ago-have emerged as supplemental models, offering expanded access but also professional ambivalence regarding their integration. Respondents emphasized music therapy's contributions to resilience, social connection, prevention, and global health, yet identified enduring barriers of insufficient policy recognition, inequitable compensation, and fragile infrastructures that constrain sustainability. Overall, the survey portrays a profession that is increasingly confident, globally relevant, yet structurally vulnerable. Advancing its potential as a vital contributor to international health agendas, the field must now progress through coordinated policy advocacy, accessible education, equitable labor protections, ethical use of technology, and sustained research to strengthen legitimacy, and global impact.
People with neurodevelopmental and acquired conditions affecting cognition (NACAC) who learn to play a musical instrument or learn to sing may benefit from unconventional musical notations (UMN). Unconventional musical notations are mostly used in the education and music therapy of people with dyslexia and developmental disabilities. The objectives of this study were (1) to identify existing UMN for people with NACAC, (2) to analyze how the UMN represent different features of musical material, and (3) to summarize the available research evidence. This scoping review was conducted following the JBI (formerly Joanna Briggs Institute) methodology. Out of the 1,527 documents, 50 complied with the eligibility criteria. Unconventional musical notations found in these relevant documents were classified into visually adapted conventional notation, UMN based on different types of coding, standardized UMN, and multisensory/computer-based notations. The results of this review were used to create a comprehensive framework for understanding the applications of diverse types of UMN across music education and music therapy. This framework may help practitioners to identify an appropriate notation for people with NACAC.
Traumatic brain injury (TBI) is caused by an external force to the head, which disrupts brain functioning and is associated with psychiatric and neurobehavioral issues, engendering a need for rehabilitative care. Recent literature has discussed the effectiveness of applying music therapy (MT) and music-based interventions (MBIs) for a range of psychopathologies, noting the capacity for music to induce feelings of pleasure and its relationship to brain reward circuitry. However, whether music can be used to effectively mitigate the social, emotional, and behavioral difficulties of TBI is currently unclear. This systematic review investigates the impact of MBIs (including MT) on psychiatric and psychological outcomes of TBI. We conducted a search for studies examining the effect of MBIs on psychological symptoms, mental health disorders, and behavior in individuals with a TBI history. Eight studies were included. Outcomes consisted of stress, mood, anxiety, depression, social interaction, agitation, inertia, and sleep quality. Included articles were evaluated using Cochrane Risk of Bias tools. The studies included in this review have implications that MBIs may improve agitation, stress, and depression in adult TBI patients. MT studies reported improvements in mood and inertia, and more often used active music engagement. Music-based intervention studies reported increased social interaction and sleep quality. Our risk of bias assessment suggests that design limitations limit strong conclusions about MBI efficacy in TBI. Increasing the methodological rigor in future studies is necessary to reduce the risk of bias and support evidence-based MBI approaches for TBI rehabilitation.
Challenges in social responsiveness and social communicative behaviors are often observed in autistic children. It is imperative to develop effective treatment methods to enhance social communication and reciprocity in autistic children. This study examines the efficacy of two particular treatment methods to improve social communication including Reciprocal Communication Training (RCT) and Reciprocal Communication Training through Music (RCTM). Ten autistic children participated in this study and engaged in musical and nonmusical interventions that addressed greeting, receptive communication, imitation, initiation, and emotional congruence with facial expression, emotion identification, and emotional attunement. To analyze the impact of these interventions, the study included dependent samples t-tests to explore the differences in reciprocal communicative behaviors of autistic children between RCT and RCTM. A paired t-test analysis indicated that there were significant differences between RCT and RCTM on greeting, imitating behavior, initiating behavior, and emotional (happy vs. sad) congruence. The results indicated that participants who underwent RCTM demonstrated enhanced reciprocal communicative skills, particularly evident in the participants' improved greeting and imitation behaviors. This improvement was observed across both early and late intervention stages. Moreover, the study suggests that RCTM had a positive influence on various aspects of reciprocal and affective communication, optimizing the effects of music to create a sensory-rich environment for enhanced engagement. RCTM emerges as a promising method for fostering social communication skills in autistic children, offering potential benefits for their educational and therapeutic outcomes.
This meta-synthesis investigates the concept of pleasure in music therapy, responding to Stige's (2006) call for a deeper understanding of its role in therapeutic processes. Drawing on qualitative research studies published between 2010 and 2024, the study analyzes consumer perspectives on pleasurable experiences in music therapy within adult mental health and adolescent mental wellbeing contexts. The research employs an interpretivist approach, utilizing pleasure as a sensitizing concept to guide data extraction and analysis. The methodology involves a systematic review of 26 qualitative studies, focusing on participant interviews that reference pleasurable aspects of music therapy. Data analysis incorporates elements of discourse analysis, thematic categorization, and arts-based interpretation. Findings reveal multifaceted dimensions of pleasure in music therapy, including sensorial experiences, emotional activation, and shared affective states. The analysis distinguishes between experiences of individuals with severe mental illness and those in recovery or with milder psychological distress. The study also explores differences in pleasure descriptions between group and individual therapy settings.
The significance of time in music therapy has been discussed by a few researchers (e.g., Abrams, 2011; Aigen, 2013; Hadar & Amir, 2021; Robbins & Forinash, 1991; Ruud, 2008); however, it has mostly been overlooked in the field. The current study focused on unpacking Nordoff and Robbins's (NR) uses of music's temporality in their clinical improvisations with the children they worked with. Embedded in a grounded theory approach, the first author coded the recordings of full-length courses of therapy with 7 children who met with NR for regular music therapy treatment, and 3 additional courses of therapy that were only partially analyzed. The analysis revealed NR's extensive use of temporality to engage a child musically and achieve various therapy goals. The integration of all temporal techniques gave rise to a four-position time model for understanding clinical improvisation, including (a) Augmented Time Frame (e.g., moments when NR were expanding the musical form with musical rests); (b) Playing in Synchronization (e.g., moments when NR were inviting the clients to play simultaneously within a pre-determined tempo); (c) Emotional Time (e.g., moments when NR were inviting the client for a time-free exploration of their inner selves); and (d) Synchronization Discrepancies (e.g., moments when NR were enabling a free negotiation over the improvisation's tempo). The authors also make theoretical links between temporal positions and therapy goals, and practical recommendations are provided.
