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The Healing Power of Music

Music therapy is increasingly used to help patients cope with stress and promote healing.

By Richard Schiffman

“Focus on the sound of the instrument,” Andrew Rossetti, a licensed music therapist and researcher said as he strummed hypnotic chords on a Spanish-style classical guitar. “Close your eyes. Think of a place where you feel safe and comfortable.”

Music therapy was the last thing that Julia Justo, a graphic artist who immigrated to New York from Argentina, expected when she went to Mount Sinai Beth Israel Union Square Clinic for treatment for cancer in 2016. But it quickly calmed her fears about the radiation therapy she needed to go through, which was causing her severe anxiety.

“I felt the difference right away, I was much more relaxed,” she said.

Ms. Justo, who has been free of cancer for over four years, continued to visit the hospital every week before the onset of the pandemic to work with Mr. Rossetti, whose gentle guitar riffs and visualization exercises helped her deal with ongoing challenges, like getting a good night’s sleep. Nowadays they keep in touch mostly by email.

The healing power of music — lauded by philosophers from Aristotle and Pythagoras to Pete Seeger — is now being validated by medical research. It is used in targeted treatments for asthma, autism, depression and more, including brain disorders such as Parkinson’s disease, Alzheimer’s disease, epilepsy and stroke.

Live music has made its way into some surprising venues, including oncology waiting rooms to calm patients as they wait for radiation and chemotherapy. It also greets newborns in some neonatal intensive care units and comforts the dying in hospice.

While musical therapies are rarely stand-alone treatments, they are increasingly used as adjuncts to other forms of medical treatment. They help people cope with their stress and mobilize their body’s own capacity to heal.

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The Transformative Power of Music in Mental Well-Being

• August 01, 2023
• Healthy living for mental well-being, Patients and Families, Treatment

Music has always held a special place in our lives, forming an integral part of human culture for centuries. Whether we passively listen to our favorite songs or actively engage in music-making by singing or playing instruments, music can have a profound influence on our socio-emotional development and overall well-being.

Recent research suggests that music engagement not only shapes our personal and cultural identities but also plays a role in mood regulation. 1 A 2022 review and meta-analysis of music therapy found an overall beneficial effect on stress-related outcomes. Moreover, music can be used to help in addressing serious mental health and substance use disorders. 2 In addition to its healing potential, music can magnify the message of diversity and inclusion by introducing people to new cultures and amplifying the voice of marginalized communities, thereby enhancing our understanding and appreciation for diverse communities.

Healing Trauma and Building Resilience

Many historically excluded groups, such as racial/ethnic and sexual minorities and people with disabilities, face systemic injustices and traumatic experiences that can deeply impact their mental health. Research supports the idea that discrimination, a type of trauma, increases risk for mental health issues such as anxiety and depression. 3

Music therapy has shown promise in providing a safe and supportive environment for healing trauma and building resilience while decreasing anxiety levels and improving the functioning of depressed individuals. 4 Music therapy is an evidence-based therapeutic intervention using music to accomplish health and education goals, such as improving mental wellness, reducing stress and alleviating pain. Music therapy is offered in settings such as schools and hospitals. 1 Research supports that engaging in music-making activities, such as drumming circles, songwriting, or group singing, can facilitate emotional release, promote self-reflection, and create a sense of community. 5

Empowerment, Advocacy and Social Change

Music has a rich history of being used as a tool for social advocacy and change. Artists from marginalized communities often use music to shed light on social issues (.pdf) , challenge injustices, and inspire collective action. By addressing topics such as racial inequality, gender discrimination, and LGBTQ+ rights, music becomes a powerful medium for advocating for social justice and promoting inclusivity. Through music, individuals can express their unique experiences, struggles, and triumphs, forging connections with others who share similar backgrounds. Research has shown that exposure to diverse musical genres and artists can broaden perspectives, challenge stereotypes, and foster empathy among listeners especially when dancing together. 7

Genres such as hip-hop, reggae, jazz, blues, rhythm & blues and folk have historically served as platforms for marginalized voices, enabling them to reclaim their narratives and challenge societal norms. The impact of socially conscious music has been observed in movements such as civil rights, feminism, and LGBTQ+ rights, where songs have played a pivotal role in mobilizing communities and effecting change. Music artists who engage in activism can reach new supporters and help their fans feel more connected to issues and motivated to participate. 6

Fostering Social Connection and Support

Music can also serve as a catalyst for social connection and support, breaking down barriers and bridging divides. Emerging evidence indicates that music has the potential to enhance prosocial behavior, promote social connectedness, and develop emotional competence. 2 Communities can leverage music’s innate ability to connect people and foster a sense of belonging through music programs, choirs, and music education initiatives. These activities can create inclusive spaces where people from diverse backgrounds can come together, collaborate, and build relationships based on shared musical interests. These experiences promote social cohesion, combat loneliness, and provide a support network that can positively impact overall well-being.

Musicians and Normalizing Mental Health

Considering the healing effects of music, it may seem paradoxical that musicians may be at a higher risk of mental health disorders. 8 A recent survey of 1,500 independent musicians found that 73% have symptoms of mental illness. This could be due in part to the physical and psychological challenges of the profession. Researchers at the Max Planck Institute for Empirical Aesthetics in Germany found that musically active people have, on average, a higher genetic risk for depression and bipolar disorder.

Commendably, many artists such as Adele, Alanis Morrisette, Ariana Grande, Billie Eilish, Kendrick Lamar, Kid Cudi and Demi Lovato have spoken out about their mental health battles, from postpartum depression to suicidal ideation. Having high-profile artists and celebrities share their lived experiences has opened the conversation about the importance of mental wellness. This can help battle the stigma associated with seeking treatment and support.

Dr. Regina James (APA’s Chief of the Division of Diversity and Health Equity and Deputy Medical Director) notes “Share your story…share your song and let's help each other normalize the conversation around mental wellness through the influence of music. My go-to artist for relaxation is jazz saxophonist, “Grover Washington Jr” …what’s yours?” Submit to [email protected] to get featured!

More on Music Therapy

• Music Therapy Fact Sheets from the American Music Therapy Association
• Music Therapy Resources for Parents and Caregivers from Music Therapy Works

By Fátima Reynolds DJ and Music Producer Senior Program Manager, Division of Diversity and Health Equity American Psychiatric Association

• Gustavson, D.E., et al. Mental health and music engagement: review, framework, and guidelines for future studies. Transl Psychiatry 11, 370 (2021). https://doi.org/10.1038/s41398-021-01483-8
• Golden, T. L., et al. (2021). The use of music in the treatment and management of serious mental illness: A global scoping review of the literature. Frontiers in Psychology, 12. https://doi.org/10.3389/fpsyg.2021.649840
• Schouler-Ocak, M., et al. (2021). Racism and mental health and the role of Mental Health Professionals. European Psychiatry, 64(1). https://doi.org/10.1192/j.eurpsy.2021.2216
•  Aalbers, S., et al. (2017). Music therapy for Depression. Cochrane Database of Systematic Reviews, 2017(11). https://doi.org/10.1002/14651858.cd004517.pub3
• Dingle, G. A., et al. (2021). How do music activities affect health and well-being? A scoping review of studies examining Psychosocial Mechanisms. Frontiers in Psychology, 12. https://doi.org/10.3389/fpsyg.2021.713818
• Americans for the Arts. (n.d.). A Working Guide to the Landscape of Arts for Change. Animating Democracy. http://animatingdemocracy.org/sites/default/files/Potts%20Trend%20Paper.pdf
• Stupacher, J., Mikkelsen, J., Vuust, P. (2021). Higher empathy is associated with stronger social bonding when moving together with music. Psychology of Music, 50(5), 1511–1526. https://doi.org/10.1177/03057356211050681
• Wesseldijk, L.W., Ullén, F. & Mosing, M.A. The effects of playing music on mental health outcomes. Sci Rep 9, 12606 (2019). https://doi.org/10.1038/s41598-019-49099-9

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How Music Can Be Therapeutic

Listening to music is widely considered to be a quick way to improve your mood, but it's becoming increasingly clear that there are many more benefits to listening to music than just a quick mood boost. Research has shown that music has a profound effect on your body and psyche. In fact, there’s a growing field of healthcare known as music therapy, which uses music to heal.

People who practice music therapy are finding it can help cancer patients, children with ADD, and others. Hospitals are beginning to use music therapy to help ease pain and tension, to ward off depression, to promote movement, and to calm patients, among other benefits. Keep reading to learn more about the powerful ways music can affect the body and mind.

Therapeutic Effects of Music

The following are some of the physical effects of music that explain why music therapy can be so effective:

Brain Waves

Research has shown that music with a strong beat can stimulate brainwaves to resonate in sync with the beat, with faster beats bringing sharper concentration and more alert thinking, and slower tempos promoting a calm, meditative state.

Research has also found that music can change brainwave activity levels to enable the brain to shift speeds more easily as needed. This means music can have lasting benefits to your state of mind, even after you’ve stopped listening.

Breathing and Heart Rate

With alterations in brainwaves come changes in other bodily functions, specifically those controlled by the autonomic nervous system. This means things like breathing and heart rate can be affected by the changes music can bring. Slower breathing and a slower heart rate can help activate a relaxation response , among other things.

State of Mind

Music can also be used to bring a more p ositive state of mind , helping to keep depression and anxiety at bay. The uplifting sound of music and the positive or cathartic messages conveyed in lyrics can improve mental state as well.

Having a more positive state of mind as a baseline can help prevent the stress response from wreaking havoc on the body and can help keep creativity and optimism levels higher, which in turn bring many of their own benefits.

Other Benefits

Music has also been found to bring many other benefits, such as lowering blood pressure (which can also reduce the risk of stroke and other health problems over time), boosting immunity, easing muscle tension , and more.

With so many benefits and such profound physical effects, it’s no surprise that so many are seeing music as an important tool to help the body stay (or become) healthy.

Music Therapy

With increasing research demonstrating the benefits of music, it's no surprise music therapy is growing in popularity. Music therapists help with several other issues as well, including stress. For more information on music therapy , visit the American Music Therapy Association's website .

Using Music on Your Own to Improve Health

While music therapy is an important discipline, you can also achieve many benefits from listening to music on your own. It is likely you have been doing this since you were a teenager, but it is important to continue incorporating music into your daily life as you age. Whether it's throwing music on to dissolve the stress of a long drive or using it to keep motivated while exercising, listening to music daily can be used for relaxation, energy, and catharsis.

Mofredj A, Alaya S, Tassaioust K, Bahloul H, Mrabet A. Music therapy, a review of the potential therapeutic benefits for the critically ill . J Crit Care . 2016;35:195-199. doi:10.1016/j.jcrc.2016.05.021

Kordovan S, Preissler P, Kamphausen A, Bokemeyer C, Oechsle K. Prospective study on music therapy in terminally ill cancer patients during specialized inpatient palliative care . J Palliat Med . 2016;19(4):394-399. doi:10.1089/jpm.2015.0384

Wang W-C. A study of the type and characteristics of relaxing music for college students . Proc Mtgs Acoust . 2014;21:035001. doi:10.1121/1.4902001.

Ellis RJ, Thayer JF. Music and autonomic nervous system (dys)function .  Music Percept . 2010;27(4):317–326. doi:10.1525/mp.2010.27.4.317

De Witte M, Spruit A, Van Hooren S, Moonen X, Stams GJ. Effects of music interventions on stress-related outcomes: a systematic review and two meta-analyses . Health Psychol Rev . 2019;:1-31. doi:10.1080/17437199.2019.1627897

Aalbers S, Fusar-Poli L, Freeman RE, et al. Music therapy for depression.  Cochrane Database Syst Rev . 2017;11(11):CD004517. doi:10.1002/14651858.CD004517.pub3

Lee KS, Jeong HC, Yim JE, Jeon MY. Effects of music therapy on the cardiovascular and autonomic nervous system in stress-induced university students: a randomized controlled trial . J Altern Complement Med . 2016;22(1):59-65. doi:10.1089/acm.2015.0079

By Elizabeth Scott, PhD Elizabeth Scott, PhD is an author, workshop leader, educator, and award-winning blogger on stress management, positive psychology, relationships, and emotional wellbeing.

Music Therapy Effectiveness Case Study

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Music therapy and stroke patients

Why music therapy is effective in treating stroke patients and others, works cited.

Music therapy is “clinical and evidence-based use of music intervention” to achieve certain goals within a therapeutic relationship by a certified health expert who has successfully completed an approved music therapy course (American Music Therapy Association). Music therapy is a well-established medical care vocation in which highly trained and qualified healthcare experts use music to address social, emotional, cognitive, physical, and psychological needs of patients or clients (Wainapel and Avital 13).

After carefully reviewing needs of a patient, a music therapist provides the client with music therapy treatment that mostly includes playing, singing, and creating music (Whipple 123). Scholars have argued that music provides good communication avenues, which are very essential in solving problems for clients who have difficulties expressing themselves (Whipple 94).

Music therapy is also essential in facilitating treatment, increasing motivation, expressing feeling, and providing patients with emotional support necessary to promote good health (American Music Therapy Association).

Apart from providing people with entertainment, music is widely used for treatment (Whipple 94). Because of this feature, music therapy is considered as “an art and a science” (Whipple 94). In a hospital setting, clients are referred for music therapy session by other doctors after carefully assessing their condition and healthcare needs. On the other hand, clients can also choose music therapy without necessary being referred by a health expert; this is known as self-referral (American Music Therapy Association).

Music therapists are almost found everywhere especially in healthcare centers and they play a vital role in helping patients with special needs to improve communication and motor skills (Wainapel and Avital 124). Music therapists also work with elderly people and they are useful in helping them to cope with life at old age.

Music can act as stroke therapy especially when combined with other treatment techniques (Wainapel and Avital 93). In a number of cases, music therapists have assisted stroke victims to recover. Scholar and researchers around the world have proved that music has a great effect on the human brain. According to research, music is able to “affect human emotions and social interaction” (Wainapel and Avital 92).

In fact, research has proved beyond doubt that music is able to reduce stress, improve the general mood, and decrease the level of depression in human beings (American Music Therapy Association). Most recent studies have showed that music can help in reducing negative feeling hence improving clients’ motivation (Whipple 99).

Health experts have also argued that when music is combined with other traditional treatments techniques, it can facilitate faster recovery of stroke patients. This is because music has shown ability to improve emotional and motivation for patients (Wainapel and Avital 123).

A study conducted recently showed that, when music is incorporated in therapy session of a stroke patient, such a patient is likely to recover faster than when exercise is used alone for treatment (Koen 16). In addition to this, research has shown that stroke patients become more involved in therapy sessions once music is incorporated in the treatment program; this is the motivational aspect of music (Wainapel and Avital 111).

Wainapel and Avital argues that music therapy helps in clients’ social functioning therefore motivating them to participate more in the rehabilitation process (265). Different researchers have supported that when music is used together with traditional therapy, it is able to help stroke patient deal with emotional and social deficits that arise from stroke and hence speeding recovery of such patients (Koen 29).

Moreover, music has shown to improve motor skills for stroke patients. Different rhythms produced by music are responsible in stimulating the auditory nerves in the human sensory organ (Goodman 37). Once music therapy is combined with traditional therapy during patients’ rehabilitation, it improves recovery process enabling the patients to walk.

The outcomes of combining therapy session with music therapy have been studied extensively. In fact, research has shown that when stroke patient receive music therapy especially learning how to play instruments such as piano and guitar, they tend to improve motor skills within a short period (Goodman 37).

In addition, music therapy enhances communication by improving speech for stroke patients (Wainapel and Avital 102). Combination of music therapy in the rehabilitation process of stroke patients really helps in developing speech. In a study conducted by American Medical Association, stroke patients were divided into two groups.

One group received traditional therapy only while the other group received traditional therapy combined with music therapy. Under observation, the two groups continued receiving therapy for specific period. The group that received traditional therapy combined with music therapy showed quick recovery rates than the one that did not receive music therapy.

The patient receiving traditional therapy and music therapy showed great improvement in speech and communication since they were regularly singing, rapping, and chanting (Goodman 27). Such exercises (singing, chanting, and rapping) have proved to improve mouth muscle recovery for stroke patients.

I believe music is very helpful in improving health. Generally, stroke patients experience walking difficulties, communication problems, headaches, numbness, and visual problems (Goodman 42). On the other hand, music therapy has proved to facilitate muscle recovery, speech, motivational, and mood among others problems (Goodman 7). Activities such as playing guitar, piano, or a drum can facilitate muscle movements for stroke patients.

In addition to this, music that contains certain message can enhance cognitive development for patients (Wainapel and Avital 121). As such, activities such as writing lyrics and performing creative music can help stroke patients and others to improve their mental state. On the other hand, activities that allow movement of mouth muscles such as singing, rapping, and chanting can be of great help to stroke patients who have speech problems (American Music Therapy Association).

Finally, since music has the ability to affect human moods and feelings, once patients are engaged in activities that provides aesthetic qualities of music, they tend to improve their moods and motivation hence improving the general health (Goodman 23).

In conclusion, music therapy has the ability to improve the quality of life. This is because music has great effect on the human brain (Whipple 112). In fact, music has certain form of effect on emotions that in turns triggers a certain response in the human brain (Wainapel and Avital 124).

Patients who have incurred injuries in the brain or have brain problems also appear to respond to music therapy. Because of this, music therapists have continued using different music rhythms to organize the brain hence helping patients with disabilities to respond to other treatment techniques and therefore promoting fast recovery (Wainapel and Avital 124).

Because of its vital role in the healthcare sector, music therapy as a discipline is found in different settings including schools, hospitals, correctional centers, and nurseries among others (Goodman 23). When combined with other treatment models, music therapy can play a vital role in recovery of stroke patients, clients with heart problems, and epilepsy among others. As such, music therapy can greatly improve the quality of life.

American Music Therapy Association. What is Music Therapy . 2012. Web. < https://www.musictherapy.org/about/musictherapy/ >

Goodman, Doron (2011). Music Therapy Education and Training: From Theory to Practice . Illinois: Charles Thomas Press, 2011. Print.

Koen, Benjamin. The Oxford Handbook of Medical Ethnomusicology . Oxford: Oxford University Press, 2008. Print.

Wainapel, Stanley, and Avital Fast. Alternative Medicine and Rehabilitation . New York: Demos Medical Publishing, 2003. Print.

Whipple, Jennifer. Music in intervention for children and Adolescents with Autism: A Meta-Analysis. Journal of Music Therapy, 41. 2 (2004): 90–156. Print.

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Effects of music therapy on depression: A meta-analysis of randomized controlled trials

Qishou tang.

1 Bengbu Medical University, Bengbu, Anhui, China

Zhaohui Huang

2 Anhui Provincial Center for Women and Child Health, Hefei, Anhui, China

3 National Drug Clinical Trial Institution, The First Affiliated Hospital of Bengbu Medical University, Bengbu, Anhui, China

Associated Data

All relevant data are within the manuscript and its Supporting Information files.

We aimed to determine and compare the effects of music therapy and music medicine on depression, and explore the potential factors associated with the effect.

PubMed (MEDLINE), Ovid-Embase, the Cochrane Central Register of Controlled Trials, EMBASE, Web of Science, and Clinical Evidence were searched to identify studies evaluating the effectiveness of music-based intervention on depression from inception to May 2020. Standardized mean differences (SMDs) were estimated with random-effect model and fixed-effect model.

A total of 55 RCTs were included in our meta-analysis. Music therapy exhibited a significant reduction in depressive symptom (SMD = −0.66; 95% CI = -0.86 to -0.46; P <0.001) compared with the control group; while, music medicine exhibited a stronger effect in reducing depressive symptom (SMD = −1.33; 95% CI = -1.96 to -0.70; P <0.001). Among the specific music therapy methods, recreative music therapy (SMD = -1.41; 95% CI = -2.63 to -0.20; P <0.001), guided imagery and music (SMD = -1.08; 95% CI = -1.72 to -0.43; P <0.001), music-assisted relaxation (SMD = -0.81; 95% CI = -1.24 to -0.38; P <0.001), music and imagery (SMD = -0.38; 95% CI = -0.81 to 0.06; P = 0.312), improvisational music therapy (SMD = -0.27; 95% CI = -0.49 to -0.05; P = 0.001), music and discuss (SMD = -0.26; 95% CI = -1.12 to 0.60; P = 0.225) exhibited a different effect respectively. Music therapy and music medicine both exhibited a stronger effects of short and medium length compared with long intervention periods.

Conclusions

A different effect of music therapy and music medicine on depression was observed in our present meta-analysis, and the effect might be affected by the therapy process.

Introduction

Depression was reported to be a common mental disorders and affected more than 300 million people worldwide, and long-lasting depression with moderate or severe intensity may result in serious health problems [ 1 ]. Depression has become the leading causes of disability worldwide according to the recent World Health Organization (WHO) report. Even worse, depression was closely associated with suicide and became the second leading cause of death, and nearly 800 000 die of depression every year worldwide [ 1 , 2 ]. Although it is known that treatments for depression, more than 3/4 of people in low and middle-income income countries receive no treatment due to a lack of medical resources and the social stigma of mental disorders [ 3 ]. Considering the continuously increased disease burden of depression, a convenient effective therapeutic measures was needed at community level.

Music-based interventions is an important nonpharmacological intervention used in the treatment of psychiatric and behavioral disorders, and the obvious curative effect on depression has been observed. Prior meta-analyses have reported an obvious effect of music therapy on improving depression [ 4 , 5 ]. Today, it is widely accepted that the music-based interventions are divided into two major categories, namely music therapy and music medicine. According to the American Music Therapy Association (AMTA), “music therapy is the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program” [ 6 ]. Therefore, music therapy is an established health profession in which music is used within a therapeutic relationship to address physical, emotional, cognitive, and social needs of individuals, and includes the triad of music, clients and qualified music therapists. While, music medicine is defined as mainly listening to prerecorded music provided by medical personnel or rarely listening to live music. In other words, music medicine aims to use music like medicines. It is often managed by a medical professional other than a music therapist, and it doesn’t need a therapeutic relationship with the patients. Therefore, the essential difference between music therapy and music medicine is about whether a therapeutic relationship is developed between a trained music therapist and the client [ 7 – 9 ]. In the context of the clear distinction between these two major categories, it is clear that to evaluate the effects of music therapy and other music-based intervention studies on depression can be misleading. While, the distinction was not always clear in most of prior papers, and no meta-analysis comparing the effects of music therapy and music medicine was conducted. Just a few studies made a comparison of music-based interventions on psychological outcomes between music therapy and music medicine. We aimed to (1) compare the effect between music therapy and music medicine on depression; (2) compare the effect between different specific methods used in music therapy; (3) compare the effect of music-based interventions on depression among different population [ 7 , 8 ].

Materials and methods

Search strategy and selection criteria.

PubMed (MEDLINE), Ovid-Embase, the Cochrane Central Register of Controlled Trials, EMBASE, Web of Science, and Clinical Evidence were searched to identify studies assessing the effectiveness of music therapy on depression from inception to May 2020. The combination of “depress*” and “music*” was used to search potential papers from these databases. Besides searching for electronic databases, we also searched potential papers from the reference lists of included papers, relevant reviews, and previous meta-analyses. The criteria for selecting the papers were as follows:(1) randomised or quasi-randomised controlled trials; (2) music therapy at a hospital or community, whereas the control group not receiving any type of music therapy; (3) depression rating scale was used. The exclusive criteria were as follows: (1) non-human studies; (2) studies with a very small sample size (n<20); (3) studies not providing usable data (including sample size, mean, standard deviation, etc.); (4) reviews, letters, protocols, etc. Two authors independently (YPJ, HZH) searched and screened the relevant papers. EndNote X7 software was utilized to delete the duplicates. The titles and abstracts of all searched papers were checked for eligibility. The relevant papers were selected, and then the full-text papers were subsequently assessed by the same two authors. In the last, a panel meeting was convened for resolving the disagreements about the inclusion of the papers.

Data extraction

We developed a data abstraction form to extract the useful data: (1) the characteristics of papers (authors, publish year, country); (2) the characteristics of participators (sample size, mean age, sex ratio, pre-treatment diagnosis, study period); (3) study design (random allocation, allocation concealment, masking, selection process of participators, loss to follow-up); (4) music therapy process (music therapy method, music therapy period, music therapy frequency, minutes per session, and the treatment measures in the control group); (5) outcome measures (depression score). Two authors independently (TQS, ZH) abstracted the data, and disagreements were resolved by discussing with the third author (YPJ).

Assessment of risk of bias in included studies

Two authors independently (TQS, ZH) assessed the risk of bias of included studies using Cochrane Collaboration’s risk of bias assessment tool, and disagreements were resolved by discussing with the third author (YPJ) [ 10 ].

Music therapy and music medicine

Music Therapy is defined as the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program. Music medicine is defined as mainly listening to prerecorded music provided by medical personnel or rarely listening to live music. In other words, music medicine aims to use music like medicines.

Music therapy mainly divided into active music therapy and receptive music therapy. Active music therapy, including improvisational, re-creative, and compositional, is defined as playing musical instruments, singing, improvisation, and lyrics of adaptation. Receptive music therapy, including music-assisted relaxation, music and imagery, guided imagery and music, lyrics analysis, and so on, is defined as music listening, lyrics analysis, and drawing with musing. In other words, in active methods participants are making music, and in receptive music therapy participants are receiving music [ 6 , 7 , 9 , 11 – 13 ].

Evaluation of depression

Depression was evaluated by the common psychological scales, including Beck Depression Inventory (BDI), Children’s Depression Inventory (CDI), Center for Epidemiologic Studies Depression (CES-D), Cornell Scale (CS), Depression Mood Self-Report Inventory for Adolescence (DMSRIA), Geriatric Depression Scale-15 (GDS-15); Geriatric Depression Scale-30 (GDS-30), Hospital Anxiety and Depression Scale (HADS), Hamilton Rating Scale for Depression (HRSD/HAMD), Montgomery-sberg Depression Rating Scale (MADRS), Patient Reported Outcomes Measurement Information System (PROMIS), Self-Rating Depression Scale (SDS), Short Version of Profile of Mood States (SV-POMS).

Statistical analysis

The pooled effect were estimated by using the standardized mean differences (SMDs) and its 95% confidence interval (95% CI) due to the different depression rate scales were used in the included papers. Heterogeneity between studies was assessed by I-square ( I 2 ) and Q-statistic (P<0.10), and a high I 2 (>50%) was recognized as heterogeneity and a random-effect model was used [ 14 – 16 ]. We performed subgroup analyses and meta-regression analyses to study the potential heterogeneity between studies. The subgroup variables included music intervention categories (music therapy and music medicine), music therapy methods (active music therapy, receptive music therapy), specific receptive music therapy methods (music-assisted relaxation, music and imagery, and guided imagery and music (Bonny Method), specific active music therapy methods (recreative music therapy and improvisational music therapy), music therapy mode (group therapy, individual therapy), music therapy period (weeks) (2–4, 5–12, ≥13), music therapy frequency (once weekly, twice weekly, ≥3 times weekly), total music therapy sessions (1–4, 5–8, 9–12, 13–16, >16), time per session (minutes) (15–40, 41–60, >60), inpatient settings (secure [locked] unit at a mental health facility versus outpatient settings), sample size (20–50, ≥50 and <100, ≥100), female predominance(>80%) (no, yes), mean age (years) (<50, 50–65, >65), country having music therapy profession (no, yes), pre-treatment diagnosis (mental health, depression, severe mental disease/psychiatric disorder). We also performed sensitivity analyses to test the robustness of the results by re-estimating the pooled effects using fixed effect model, using trim and fill analysis, excluding the paper without information on music therapy, excluding the papers with more high biases, excluding the papers with small sample size (20< n<30), excluding the papers using an infrequently used scale, excluding the studies focused on the people with a severe mental disease. We investigated the publication biases by a funnel plot as well as Egger’s linear regression test [ 17 ]. The analyses were performed using Stata, version 11.0. All P-values were two-sided. A P-value of less than 0.05 was considered to be statistically significant.

Characteristics of the eligible studies

Fig 1 depicts the study profile, and a total of 55 RCTs were included in our meta-analysis [ 18 – 72 ]. Of the 55 studies, 10 studies from America, 22 studies from Europe, 22 studies from Asia, and 1 study from Australia. The mean age of the participators ranged from 12 to 86; the sample size ranged from 20 to 242. A total of 16 different scales were used to evaluate the depression level of the participators. A total of 25 studies were conducted in impatient setting and 28 studies were in outpatients setting; 32 used a certified music therapist, 15 not used a certified music therapist (for example researcher, nurse), and 10 not reported relevent information. A total of 16 different depression rating scales were used in the included studies, and HADS, GDS, and BDI were the most frequently used scales ( Table 1 ).

PRISMA diagram showing the different steps of systematic review, starting from literature search to study selection and exclusion. At each step, the reasons for exclusion are indicated. Doi: 10.1371/journal.pone.0052562.g001.

Note: BDI = Beck Depression Inventory; CDI = Children’s Depression Inventory; CDSS = depression scale for schizophrenia; CES-D = Center for Epidemiologic Studies Depression; CS = Cornell Scale; DMSRIA = Depression Mood Self-Report Inventory for Adolescence; EPDS = Edinburgh Postnatal Depression Scale; GDS-15 = Geriatric Depression Scale-15; GDS-30 = Geriatric Depression Scale-30; HADS = Hospital Anxiety and Depression Scale; HRSD (HAMD) = Hamilton Rating Scale for Depression; MADRS = Montgomery-sberg Depression Rating Scale; PROMIS = Patient Reported Outcomes Measurement Information System; SDS = Self-Rating Depression Scale; State-Trait Depression Questionnaire = ST/DEP; SV-POMS = short version of Profile of Mood States; NA = not available.

Of the 55 studies, only 2 studies had high risks of selection bias, and almost all of the included studies had high risks of performance bias ( Fig 2 ).

The overall effects of music therapy

Of the included 55 studies, 39 studies evaluated the music therapy, 17 evaluated the music medicine. Using a random-effects model, music therapy was associated with a significant reduction in depressive symptoms with a moderate-sized mean effect (SMD = −0.66; 95% CI = -0.86 to -0.46; P <0.001), with a high heterogeneity across studies ( I 2 = 83%, P <0.001); while, music medicine exhibited a stronger effect in reducing depressive symptom (SMD = −1.33; 95% CI = -1.96 to -0.70; P <0.001) ( Fig 3 ).

Twenty studies evaluated the active music therapy using a random-effects model, and a moderate-sized mean effect (SMD = −0.57; 95% CI = -0.90 to -0.25; P <0.001) was observed with a high heterogeneity across studies ( I 2 = 86.3%, P <0.001). Fourteen studies evaluated the receptive music therapy using a random-effects model, and a moderate-sized mean effect (SMD = −0.73; 95% CI = -1.01 to -0.44; P <0.001) was observed with a high heterogeneity across studies ( I 2 = 76.3%, P <0.001). Five studies evaluated the combined effect of active and receptive music therapy using a random-effects model, and a moderate-sized mean effect (SMD = −0.88; 95% CI = -1.32 to -0.44; P <0.001) was observed with a high heterogeneity across studies ( I 2 = 70.5%, P <0.001) ( Fig 4 ).

Among specific music therapy methods, recreative music therapy (SMD = -1.41; 95% CI = -2.63 to -0.20; P <0.001), guided imagery and music (SMD = -1.08; 95% CI = -1.72 to -0.43; P <0.001), music-assisted relaxation (SMD = -0.81; 95% CI = -1.24 to -0.38; P <0.001), music and imagery (SMD = -0.38; 95% CI = -0.81 to 0.06; P = 0.312), improvisational music therapy (SMD = -0.27; 95% CI = -0.49 to -0.05; P = 0.001), and music and discuss (SMD = -0.26; 95% CI = -1.12 to 0.60; P = 0.225) exhibited a different effect respectively ( Fig 5 ).

Sub-group analyses and meta-regression analyses

We performed sub-group analyses and meta-regression analyses to study the homogeneity. We found that music therapy yielded a superior effect on reducing depression in the studies with a small sample size (20–50), with a mean age of 50–65 years old, with medium intervention frequency (<3 times weekly), with more minutes per session (>60 minutes). We also found that music therapy exhibited a superior effect on reducing depression among people with severe mental disease /psychiatric disorder and depression compared with mental health people. While, whether the country have the music therapy profession, whether the study used group therapy or individual therapy, whether the study was in the outpatients setting or the inpatient setting, and whether the study used a certified music therapist all did not exhibit a remarkable different effect ( Table 2 ). Table 2 also presents the subgroup analysis of music medicine on reducing depression.

In the subgroup analysis by total session, music therapy and music medicine both exhibited a stronger effects of short (1–4 sessions) and medium length (5–12 sessions) compared with long intervention periods (>13sessions) ( Fig 6 ). Meta-regression demonstrated that total music intervention session was significantly associated with the homogeneity between studies ( P = 0.004) ( Table 3 ).

A, evaluating the effect of music therapy; B, evaluating the effect of music medicine.

Sensitivity analyses

We performed sensitivity analyses and found that re-estimating the pooled effects using fixed effect model, using trim and fill analysis, excluding the paper without information regarding music therapy, excluding the papers with more high biases, excluding the papers with small sample size (20< n<30), excluding the studies focused on the people with a severe mental disease, and excluding the papers using an infrequently used scale yielded the similar results, which indicated that the primary results was robust ( Table 4 ).

Evaluation of publication bias

We assessed publication bias using Egger’s linear regression test and funnel plot, and the results are presented in Fig 7 . For the main result, the observed asymmetry indicated that either the absence of papers with negative results or publication bias.

A, evaluating the publication bias of music therapy; B, evaluating the publication bias of music medicine; BDI = Beck Depression Inventory; CDI = Children’s Depression Inventory; CDSS = depression scale for schizophrenia; CES-D = Center for Epidemiologic Studies Depression; CS = Cornell Scale; DMSRIA = Depression Mood Self-Report Inventory for Adolescence; EPDS = Edinburgh Postnatal Depression Scale; GDS-15 = Geriatric Depression Scale-15; GDS-30 = Geriatric Depression Scale-30; HADS = Hospital Anxiety and Depression Scale; HRSD (HAMD) = Hamilton Rating Scale for Depression; MADRS = Montgomery-sberg Depression Rating Scale; PROMIS = Patient Reported Outcomes Measurement Information System; SDS = Self-Rating Depression Scale; State-Trait Depression Questionnaire = ST/DEP; SV-POMS = short version of Profile of Mood Stat.

Our present meta-analysis exhibited a different effect of music therapy and music medicine on reducing depression. Different music therapy methods also exhibited a different effect, and the recreative music therapy and guided imagery and music yielded a superior effect on reducing depression compared with other music therapy methods. Furthermore, music therapy and music medicine both exhibited a stronger effects of short and medium length compared with long intervention periods. The strength of this meta-analysis was the stable and high-quality result. Firstly, the sensitivity analyses performed in this meta-analysis yielded similar results, which indicated that the primary results were robust. Secondly, considering the insufficient statistical power of small sample size, we excluded studies with a very small sample size (n<20).

Some prior reviews have evaluated the effects of music therapy for reducing depression. These reviews found a significant effectiveness of music therapy on reducing depression among older adults with depressive symptoms, people with dementia, puerpera, and people with cancers [ 4 , 5 , 73 – 76 ]. However, these reviews did not differentiate music therapy from music medicine. Another paper reviewed the effectiveness of music interventions in treating depression. The authors included 26 studies and found a signifiant reduction in depression in the music intervention group compared with the control group. The authors made a clear distinction on the definition of music therapy and music medicine; however, they did not include all relevant data from the most recent trials and did not conduct a meta-analysis [ 77 ]. A recent meta-analysis compared the effects of music therapy and music medicine for reducing depression in people with cancer with seven RCTs; the authors found a moderately strong, positive impact of music intervention on depression, but found no difference between music therapy and music medicine [ 78 ]. However, our present meta-analysis exhibited a different effect of music therapy and music medicine on reducing depression, and the music medicine yielded a superior effect on reducing depression compared with music therapy. The different effect of music therapy and music medicine might be explained by the different participators, and nine studies used music therapy to reduce the depression among people with severe mental disease /psychiatric disorder, while no study used music medicine. Furthermore, the studies evaluating music therapy used more clinical diagnostic scale for depressive symptoms.

A meta-analysis by Li et al. [ 74 ] suggested that medium-term music therapy (6–12 weeks) was significantly associated with improved depression in people with dementia, but not short-term music therapy (3 or 4 weeks). On the contrary, our present meta-analysis found a stronger effect of short-term (1–4 weeks) and medium-term (5–12 weeks) music therapy on reducing depression compared with long-term (≥13 weeks) music therapy. Consistent with the prior meta-analysis by Li et al., no significant effect on depression was observed for the follow-up of one or three months after music therapy was completed in our present meta-analysis. Only five studies analyzed the therapeutic effect for the follow-up periods after music therapy intervention therapy was completed, and the rather limited sample size may have resulted in this insignificant difference. Therefore, whether the therapeutic effect was maintained in reducing depression when music therapy was discontinued should be explored in further studies. In our present meta-analysis, meta-regression results demonstrated that no variables (including period, frequency, method, populations, and so on) were significantly associated with the effect of music therapy. Because meta-regression does not provide sufficient statistical power to detect small associations, the non-significant results do not completely exclude the potential effects of the analyzed variables. Therefore, meta-regression results should be interpreted with caution.

Our meta-analysis has limitations. First, the included studies rarely used masked methodology due to the nature of music therapy, therefore the performance bias and the detection bias was common in music intervention study. Second, a total of 13 different scales were used to evaluate the depression level of the participators, which may account for the high heterogeneity among the trials. Third, more than half of those included studies had small sample sizes (<50), therefore the result should be explicated with caution.

Our present meta-analysis of 55 RCTs revealed a different effect of music therapy and music medicine, and different music therapy methods also exhibited a different effect. The results of subgroup analyses revealed that the characters of music therapy were associated with the therapeutic effect, for example specific music therapy methods, short and medium-term therapy, and therapy with more time per session may yield stronger therapeutic effect. Therefore, our present meta-analysis could provide suggestion for clinicians and policymakers to design therapeutic schedule of appropriate lengths to reduce depression.

Supporting information

S1 checklist, funding statement.

The Key Project of University Humanities and Social Science Research in Anhui Province (SK2017A0191) was granted by Education Department of Anhui Province; the Research Project of Anhui Province Social Science Innovation Development (2018XF155) was granted by Anhui Provincial Federation of Social Sciences; the Ministry of Education Humanities and Social Sciences Research Youth fund Project (17YJC840033) was granted by Ministry of Education of the People’s Republic of China. These funders had a role in study design, text editing, interpretation of results, decision to publish and preparation of the manuscript.

Data Availability

• PLoS One. 2020; 15(11): e0240862.

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PONE-D-20-17706

Effects of music therapy on depression: a meta-analysis of randomized controlled trials

Dear Dr. Ye,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

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Additional Editor Comments:

Dear Author,

Thank you for your valuable submission. I think it would be appropriate to emphasize the main problem first. Various musical interventions are used in medical settings to improve the patient's well-being, and of course, there are many publications on this subject. However, it is important to properly differentiate between these interventions for some important reasons I have pointed out below.

The music therapy definition you made, as "Music therapy was defined as music therapy provided by a qualified music teacher, psychological therapist, or nurse" is not universally accepted specific definition for music therapy. Moreover, the specific methods used in receptive music therapy include music-assisted relaxation, music and imagery, and Guided Imagery and Music (Bonny Method). Each of these may have different levels of effects on depression. It is not clear that which receptive music therapy studies in your review have used which of these methods. So, the majority of studies that you accepted as the receptive music therapy seems to be music medicine studies indeed. Similar critiques may also be apply to some of the studies you describe as active music therapy. Today, it is widely accepted that these music-based interventions should be divided into two major categories, namely music therapy (MT) and music medicine (MM). MM mainly based on patients' pre-recorded or rarely listening to live music and the direct effects of the music they listen to. In other words, MM aims to use music like medicines. It often managed by a medical professional other than a music therapist, and not needed a therapeutic relationship with the patients. Conversely, music therapy is the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed music therapist who has completed an approved music therapy program. So, music therapy is a relational, interaction based form of therapy within a therapeutic relationship between the therapist and the client, and includes the triad of the music, the client and the music therapist. Since music therapy interventions is an evidence-based procedure using special music therapy methods of interventions and a more pragmatic approach than other music-based interventions, their effect levels and results are also different.

In the context of the above mentioned explanations, it is clear that to evaluate the effects of music therapy and other music based intervention studies together on depression can be misleading. The subjects I have mentioned so far have never been addressed in the introduction and discussion sections of your manuscript. I think that will be perceived as a major deficiency at least by the readers who are closer to the subject. In this sense, I think that an attentive revision considering the following views will be valuable and needed:

- The universally accepted definitions of music therapy (including active and receptive music therapy) and music medicine should be taken into account.

- It should be clarified that how many studies in your review did included a certified music therapist.

- Analyses, results and discussion should be submitted to the readers in accordance with all this distinctions and definitions. (The way to this seems to be to compare the effects of music medicine and music therapy on depression in parallel with the possible differences of music interventions used, and to discuss their possible implications on the results.)

- Another important point is that you did not mention nor discuss any of important reviews on same subject (for example please see: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD004517.pub3/epdf/full or https://www.frontiersin.org/articles/10.3389/fpsyg.2017.01109/full or https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD006911.pub3/full )

I am aware that such a major revision will, in a sense, be a challenging way that may require a new analysis of your data. However, I believe you would appreciate that a study aimed at shedding light on potential music-based interventions in an important public health problem such as depression should not be misleading.

Thank you for your effort in advance.

Besides, according to the statistical reviewer who only reviewed the statistical approach used in this paper, there are two caveats:

1. The authors state that they excluded studies with fewer than 20 participants in one place in the paper (page 4), but fewer than 30 participants in another place in the paper (Table 4). This needs to be corrected for consistency.

2. The authors mention stronger effects of short and medium length vs. long music therapy periods in their results but there is no accompanying figure. I think it would be beneficial to show these findings in a figure (Forest plot).

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Reviewers' comments:

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Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

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Reviewer #1: Yes

Reviewer #2: Partly

Reviewer #3: Yes

2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #2: No

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The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #2: Yes

4. Is the manuscript presented in an intelligible fashion and written in standard English?

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Reviewer #1: Thank you for conducting this research and submitting it for publication consideration.

I recognize that English may not be the primary language of the authors. There are a few instances where the language could be improved, but that is mostly a copy-editing issue. There is also a lot of passive voice in the paper. I recommend making the voice active. This will enhance the readability of the paper.

I have a few comments that I hope will improve the paper.

1. Not all countries have an established music therapy profession. I recognize that this creates challenges for the authors! I'm wondering if the authors might consider including this as a factor in the analysis? For example, if a nurse provides "music therapy" in a country that does not have music therapy as a profession, is the effect equivalent as when a qualified music therapist in a country that has music therapy as a profession provides it? This might provide some incentive for occupational regulation and establishing professional music therapy associations.

2. please fix the "short title" (oxygen)

3. Music therapy with fewer minutes might yield superior effects. This may be misleading. Is there a minimum number of minutes? How many minutes might be optimal for therapeutic outcome? I believe it does make sense that longer sessions may result in less impact - quantity/duration does not always result in enhanced outcome.

4. I believe a stronger case needs to be made for the study. There are existing meta-analyses of MT for depression (Aalbers et al., 2017 Cochrane Review). What makes the current study unique and different? What are the gaps in the literature that warrant this study? Have there been a lot of recent additions to the literature that warrant a new meta-analysis?

5. A stronger discussion of the limitation of this study. Many studies did not evaluate a group with major depression/major depressive disorder (music therapy for chronic pain is important, but the variance of the populations under study does constitute a limitation). So, this study is not exclusive to adults with a major mental health condition. Might effects be different for people who are depressed versus people who are not depressed?

6. Instead of "blinding/blinded" please use "masking/masked."

7. Is there a citation that supports your classification of active versus receptive? (I would think Bruscia would be a good place to start with that...)

8. One item that I am not seeing is group therapy versus individual therapy. Did the authors screen for that? If so, is there an optimal group size? Are effects stronger when in a group format versus an individual format? This would have serious implications for clinical practice.

9. What about inpatient settings (such as a secure [locked] unit at a mental health facility) versus outpatient settings?

10. One item that I believe is missing is the dose. Not necessarily the duration (number of minutes) of each session, but the total number of sessions a participant has received. Gold has done some work in this area. Is there is a certain number of sessions that are needed to reach a therapeutic outcome? The number of sessions/week is good, but the number of total sessions is important.

11. Table 1 has the mean age. I recommend including the SD as well.

Thank you for taking the time to consider these suggestions. While receiving critical feedback can be difficult, please understand that my intentions are to improve the paper and ensure it has maximum impact. This is an important addition to the literature and I am grateful to the authors for their scholarship. I wish you the best!

Reviewer #2: This article addresses an important topic that is of interest to music therapists, psychiatrists and teachers and metal health practitioners. The statistics look promising. However, the major concern is that the definition of music therapy is theoretically and practically incorrect and misleading:

"7 Music therapy was defined as music therapy provided by a qualified music teacher, psychological

8 therapist, or nurse. " The study is missing several research studies that I am aware of and this makes its content suspicious. Also missing is a more depth-ful analysis of what active and passive music therapy is, and if it is indeed performed by those in other professions who have no training in 'musuc therapy;'-than the contents and findings are misleading and irrelevant.

Reviewer #3: I only reviewed the statistical approach used in this paper, which appeared appropriate for the research question under study. There are two caveats:

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Reviewer #1: No

Reviewer #3: No

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Author response to Decision Letter 0

29 Sep 2020

Response to Reviewers

Dear Editors and Reviewers:

Thank you for your letter and for the reviewers’ comments concerning our manuscript entitled " Effects of music therapy on depression: a meta-analysis of randomized controlled trials (PONE-D-20-17706)".

Those comments are all valuable and very helpful for revising and improving our paper, as well as the important guiding significance to our researches. We have studied comments carefully and have made revision which we hope meet with approval. All the revised portions were marked in red font in the new document. The main corrections in the paper and the responds to the reviewer’s comments are as flowing:

Response：We have studied comments carefully and revised the manuscript extensively according to the reviewer’s comments.

Firstly, We have amended the music therapy definition mainly based on the World Federation of Music Therapy (WFMT) and The American Music Therapy Association (AMTA), WFMT defines music therapy as “the professional use of music and its elements as an intervention inmedical, educational, and everyday environments with individuals, groups, families, or communities who seek to optimize their quality of life and improve their physical, social,communicative, emotional, intellectual, and spiritual health and wellbeing”. AMTA defines music therapy as “Music Therapy is the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program”. [American Music Therapy Association (2020). Definition and Quotes about Music Therapy. Available online at: https://www.musictherapy.org/about/quotes/ (Accessed Sep 13, 2020).][van der Steen, J. T., et al. (2017). "Music-based therapeutic interventions for people with dementia." Cochrane Database Syst Rev 5: CD003477.]

Secondly, we have re-studed all included papers carefully and added the specific intervention methods of each paper in table 1 (Table 1. Characteristics of clinical trials included in this meta-analysis). Two main types of music therapy were distinguished in our present study - receptive (or passive) and active music therapy. The specific methods used in receptive music therapy in our included papers including music-assisted relaxation, music and imagery, and guided imagery and music (Bonny Method), while the specific methods used in active music therapy included recreative music therapy, improvisational music therapy, song writing, and so on.

Thirdly, we have added some contents regarding the distinction between music therapy and music medicine in introduction and discussion sections of our manuscript.

The following contents are added in introduction section, “Today, it is widely accepted that the music-based interventions should be divided into two major categories, namely music therapy and music medicine. According to the American Music Therapy Association (AMTA), “music therapy is the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program”. Therefore, music therapy is an established health profession in which music is used within a therapeutic relationship to address physical, emotional, cognitive, and social needs of individualst, and includes the triad of the music, the client and the qualified music therapist. [American Music Therapy Association (2020). Definition and Quotes about Music Therapy. Available online at: https://www.musictherapy.org/about/quotes/ (Accessed Sep 13, 2020).] While, music medicine is defined as mainly listening to prerecorded music provided by medical personnel or rarely listening to live music. In other words, music medicine aims to use music like medicines. It often managed by a medical professional other than a music therapist, and not needed a therapeutic relationship with the patients. Therefore, the essential difference of music therapy and music medicine is whether a therapeutic relationship is developed between a trained music therapist and the client.

[Bradt, J., et al. (2015). "The impact of music therapy versus music medicine on psychological outcomes and pain in cancer patients: a mixed methods study." Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer 23(5): 1261-1271.

[Yinger, O. S. and L. Gooding (2014). "Music therapy and music medicine for children and adolescents." Child and adolescent psychiatric clinics of North America 23(3): 535-553.]

【Tony Wigram．Inge Nyggard Pedersen＆Lars Ole Bonde，A Compmhensire Guide to Music Therapy．London and Philadelphia：Jessica Kingsley Publishen．2002：143．】

In the context of the clear distinction between these two major cagerories, it is clear that to evaluate the effects of music therapy and other music based intervention studies together on depression can be misleading. While, the distinction was not always clear in most of prior papers, and we found that no meta-analysis comparing the effects of music therapy and music medicine was conducted. Just a few studies made a comparison of music-based interventions on psychological outcomes between music therapy and music medicine. We aimed to (1) compare the effect between music therapy and music medicine on depression; (2) compare the effect between different specific methods used inmusic therapy on depression; (3) compare the effect of music-based interventions on depression among different population.

[Bradt, J., et al. (2015). "The impact of music therapy versus music medicine on psychological outcomes and pain in cancer patients: a mixed methods study." Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer 23(5): 1261-1271.[Yinger, O. S. and L. Gooding (2014). "Music therapy and music medicine for children and adolescents." Child and adolescent psychiatric clinics of North America 23(3): 535-553.]

The last, we have made a new analysis of our data. 1) including three new papers and re-analying of our data, 2) adding the comparison of music therapy and music medicine, 3) adding the comparison of impatient setting and outpatients setting, 4) adding the comparison of depressed people and not depressed people, 5）adding the comparison of countries have having music therapy profession and not, 6) adding the comparison of group therapy and individual therapy, 7) added the comparison of different intervention dose, and so on.

Response: (1)We have amended the of definitions of music therapy. The revised difinitons of music therapy was “Music Therapy is the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program”. [American Music Therapy Association (2020). Definition and Quotes about Music Therapy. Available online at: https://www.musictherapy.org/about/quotes/ (Accessed Sep 13, 2020).]

We have added some contents on the distinction between music therapy (MT) and music medicine (MM) in introduction and discussion sections of our manuscript.

We have added the analysis of the comparion of music therapy (MT) and music medicine (MM) in Methord and Results sections

Response: we have re-studed all included papers carefully and added a new varible (Intervenor or therapist) into table 1, and the corresponding description was addded in the results section. Of 55 studies, 32 used a certified music therapist, 15 not used a certified music therapist (for example researcher, nurse), and 10 not reported relevent information.

Response: We have divided music-based interventions into two major categories, namely music therapy and music medicine according to the difinition. With respect to specific methods used in music therapy, we also have divided music therapy into receptive (or passive) and active music therapy. The specific methods used in receptive music therapy in our included papers including music-assisted relaxation, music and imagery, and guided imagery and music (Bonny Method), and the specific methods used in active music therapy included recreative music therapy and improvisational music therapy.

We have added some sub-group analyses by different music intervention categories, different music therapy categories, and specific music therapy methords.

The the above mentioned content have been added to Intruduction Analyses, results and discussion section.

Response: we are very sorry for not mentioning these important reviews. We have studied these reviews carefully and discussed these reviews in Discussion sections.

Some prior reviews have evaluated the effects of music therapy for reducing depression. Aalbers and colleagues included nine studies in their review; they concluded that music therapy provides short-term benefificial effects for people with depression, and suggested that high-quality trials with large sample size were needed. However, this review was limited to studies of individuals with a diagnosis of depression, and did not differentiate music therapy from music medicine. Another paper reviewed the effectiveness of music interventions in treating depression. The authors included 26 studies and found a signifiant reduction in depression in the music intervention group compared with the controp group. The authors made a clear distincition on the definition of music therapy and music medicine; however, they did not include all relevant data from the most recent trials and did not conduct a meta-analysis. A recent meta-analysis compared the effects of music therapy and music medicine for reducing depression in people with cancer with seven RCTs; the authors found a moderately strong, positive impact of music intervention on depression , but found no difference between music therapy and music medicine.

【Aalbers, S., et al. (2017). "Music therapy for depression." Cochrane Database Syst Rev 11: CD004517.】

【Leubner, D. and T. Hinterberger (2017). "Reviewing the Effectiveness of Music Interventions in Treating Depression." Front Psychol 8: 1109.】

【Bradt, J., et al. (2016). "Music interventions for improving psychological and physical outcomes in cancer patients." Cochrane Database Syst Rev(8): CD006911.】

To date, many new trials focued on music therapy and depression in differnt poupulation (such as people with cancer, people with dementia, people with chronic disease, and so on ) have been performed, but they have not yet been systematically reviewed.

Response: Those comments are all valuable and very helpful for revising and improving our paper, as well as the important guiding significance to our researches. We have studied comments carefully and have made revision according to the comments.

Response: We are sorry for making this mistake. In the Methord section, we defined exclusive criteria as studies with a very small sample size (n<20),while in table 4 we performed the sensitivity analyses by excluding the papers with smale sample size ( 20< n<30). We have amended the table 4.

Response: We have added these findings with a forest plot (figure 6) according to the comment.

 1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at

Response: We have amended our manuscript according to PLOS ONE's style requirements

Please include your tables as part of your main manuscript and remove the individual files. Please note that supplementary tables (should remain/ be uploaded) as separate "supporting information" files.

Response: We have adjusted these content according to the comment.

 3. Thank you for stating the following in the Acknowledgments Section of your manuscript:

Response: We would like to update our funding statement as follows: The funders had a role in study design, text editing, interpretation of results, decision to publish and preparation of the manuscript.

4.LOS requires an ORCID iD for the corresponding author in Editorial Manager on papers submitted after December 6th, 2016. Please ensure that you have an ORCID iD and that it is validated in Editorial Manager. To do this, go to ‘Update my Information’ (in the upper left-hand corner of the main menu), and click on the Fetch/Validate link next to the ORCID field. This will take you to the ORCID site and allow you to create a new iD or authenticate a pre-existing iD in Editorial Manager. Please see the following video for instructions on linking an ORCID iD to your Editorial Manager account: https://www.youtube.com/watch?v=_xcclfuvtxQ

Response: We have created a new ORCID iD accordingly to your instructions.

Response: we are sorry for making this mistake, we have amended our list of authors on the manuscript accordingly.

Response: We have checked the refer to Figure 5 and found that the refer to figure 5 was a mistake, and we have amended it.

7. Please include captions for your Supporting Information files at the end of your manuscript, and update any in-text citations to match accordingly. Please see our Supporting Information guidelines for more information:  http://journals.plos.org/plosone/s/supporting-information .

 Response: we only have a Supporting Information files (PRISMA-2009-Checklist), and we have added the captions for this Supporting Information files accordingly. We also have updated in-text citations to match accordingly.

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Response: Thinks very much for your comment.

Response: Thinks very much for your comment. Our manuscript have been edited for proper English language, grammar, punctuation, spelling, and overall style by one qualified native English speaking editors.

Response: This suggestion is valuable and we have tried to judge if the countries in our inluded papers have an established music therapy profession by checking the author's work address, literature review, visiting the important website about music therapy, and consulting to some famous music therapist via emails. The following table showed that four countries may be not have a music therapy profession. We have added the comparison of the country having music therapy profession and not.

https://erikdalton.com/find-a-certified-therapist/

https://www.musictherapy.org/about/listserv/

Table 1. The information on the music therapy profession in the inluded papers

Country Country having music therapy profession

Korea Korean Music Therapy Association

South Korea Korean Music Therapy Association

UK British Association for Music Therapy

Australia Australian Music Therapy Association

Canada Canadian Association of Music Therapists

China Chinese Professional Music Therapist Association

Taiwan China Chinese Professional Music Therapist Association

Denmark Dansk forbund for musikterapie

Finland Finnish Society for Music Therapy

Hong Kong China Hong Kong Music Therapy and Counseling Association

Serbia Music Therapists of Serbia organize workshops

Switzerland Swiss Association of Music Therapy

USA The American Music Therapy Association

Singapore The Association for Music Therapy (Singapore)

Brazil Uniao Braileira Das Associacoes De Musicoterapia

Germany YES

Northern Ireland YES

Spanish YES

Venezuela No

2.please fix the "short title" (oxygen)

Response: We’re sorry for making this mistake, and we have corrected this mistake.

Music therapy with fewer minutes might yield superior effects. This may be misleading. Is there a minimum number of minutes? How many minutes might be optimal for therapeutic outcome? I believe it does make sense that longer sessions may result in less impact - quantity/duration does not always result in enhanced outcome.

Response: In 33 included trials, intervention time each session was different, the mimimum time was 15 minutes in only one study (Burrai et al., 2019b), followed by 20 minuters in four studies (Chirico et al., 2020; Guétin et al., 2009; Hanser et al., 1994; Sigurdardóttir et al., 2019). In our subgroup analysis by time per session (minutes), we divided time per session into three groups, namely 15-40, 41-60, >60, and this presentation might be unclear.

In order to respond this comment, we have re-divided the time per session into four groups, namely 15-40, 41-60, 61-120, to explore the optimal minuter per session for therapeutic outcome.

I believe a stronger case needs to be made for the study. There are existing meta-analyses of MT for depression (Aalbers et al., 2017 Cochrane Review). What makes the current study unique and different? What are the gaps in the literature that warrant this study? Have there been a lot of recent additions to the literature that warrant a new meta-analysis?

Response: Some prior reviews have evaluated the effects of music therapy for reducing depression. Aalbers and colleagues (Aalbers et al., 2017）included nine studies in their review; they concluded that music therapy provides short-term benefificial effects for people with depression, and suggested that high-quality trials with large sample size were needed. However, this review was limited to studies of individuals with a diagnosis of depression, and did not differentiate music therapy from music medicine.

Another paper reviewed the effectiveness of music interventions in treating depression. The authors (Leubner D., 2017) included 26 studies and found a signifiant reduction in depression in the music intervention group compared with the controp group. The authors made a clear distincition on the definition of music therapy and music medicine; however, they did not include all relevant data from the most recent trials and did not conduct a meta-analysis. A recent meta-analysis (Bradt et al., 2016) compared the effects of music therapy and music medicine for reducing depression with seven RCTs; the authors found a moderately strong, positive impact of music intervention on depression , but found no difference between music therapy and music medicine. However, this review was limited to studies of individuals with a diagnosis of cancer.

Figure 1 presents the number of published paper ( search from Pubmed) focued on music therapy and depression from 1983 to 2020, the published paper was in the rapidly growing stage during the past five years. While, the above mentioned reviews all included papers published before 2017. To date, many new trials focued on music therapy and depression in differnt poupulation (such as people with cancer, people with dementia, people with chronic disease, and so on ) have been performed, but they have not yet been systematically reviewed.

While, no meta-analysis compared the the difference of music therapy on depression in differnt poupulation (such as people with depression, people with dementia, people with chronic disease, health people, and so on ) have been performed.

Figure 1 The pubished papers from 1983 to 2020 focused on music therapy and depression (searched from Pubmed)

In our persent meta-analysis, we aimed to (1) compare the effect between music therapy and music medicine on depression; (2) compare the effect between different specific methods used inmusic therapy on depression; (3) compare the effect of music-based interventions on depression among different population.

We have added the above content to Intruduction and Dissussion sections.

5.A stronger discussion of the limitation of this study. Many studies did not evaluate a group with major depression/major depressive disorder (music therapy for chronic pain is important, but the variance of the populations under study does constitute a limitation). So, this study is not exclusive to adults with a major mental health condition. Might effects be different for people who are depressed versus people who are not depressed?

Response: This is a very important comment. According to this comment, we have made some revision.

Firstly, we have added a sensitivity analysis by excluding the studes focused on the people with a major mental health condition.

Secondly, we have re-grouped the populations into three groups, namely mental health, severe mental disease /psychiatric disorder, and depression and we have added the subgroup analysis (table 2 in revised manuscript)..

Thirdly, we have added the analysis of the difference between people who are depressed versus people who are not depressed accordingly (table 2 in revised manuscript).

6.Instead of "blinding/blinded" please use "masking/masked."

Response: We have replaced "blinding/blinded" with "masking/masked" according to this comment.

Response: In active methods (improvisational, re-creative, compositional), participants are ‘making music’ , and in receptive music therapy (music-assisted relaxation, music and imagery, guided imagery and music, lyrics analysis ), participants are ‘receiving’ (e.g. listening to) music (Bruscia 2014; Wheeler 2015).

We have amended the difinition and added the citation to the Result section according to this commment.

[Bruscia KE. Defining Music Therapy. 3rd Edition.University Park, Illinois, USA: Barcelona Publishers, 2014.]

[Wheeler BL. Music Therapy Handbook. New York, New York, USA: Guilford Publications, 2015.]

Response: Of the 55 studies, 38 used group therapy, 17 used individual therapy, and 2 not reported. We have added the comparison of group therapy versus individual therapy according to this comment (table 2 in revised manuscript).

Response: Of 55 studies, a total of 25 studies were conducted in impatient setting,28 studies were in outpatients setting setting, and 2 studies not repoted the setting. We have added the subgroup analysis by inpatient settings (secure [locked] unit at a mental health facility versus outpatient settings) according to this comment (table 2 in revised manuscript).

Response: We have added the subgroup analysis by total sessions a participant has received according to this comment.

Response: We have added the SD in table 1

Response: Thanks very much for your important comments, these comments are all valuable and very helpful for revising and improving our paper, as well as the important guiding significance to our researches.

Response: (1) We have amendded the difinition of music therapy. According to the American Music Therapy Association (AMTA), “music therapy is the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program”.. [American Music Therapy Association (2020). Definition and Quotes about Music Therapy. Available online at: https://www.musictherapy.org/about/quotes/ (Accessed Sep 13, 2020).]

(2)We are very sorry for missing several research studies in our present meta-analysis. According to this comment, we have performed more extensive electronic search using the following terms: depression or mood disorders or affective disorders and music. We also performed manual search for the reference of all relevent reviews. In order to ensure the study quality of included papers, we excluded the studies with a very small sample size (n<20), we also excluded the non-english papers due to our language barrier. We included 23 new papers and deleted 1 old paper, in the last a total of 55 paper were included in our present analysis. The following are the new included papers and some excluded papers:

New-included papers

1)Albornoz Y. The effects of group improvisational music therapy on depression in adolescents and adults with substance abuse: a randomised controlled trial. Nordic Journal of Music Therapy 2011;20(3):208–24.

2)Hendricks CB, Robinson B, Bradley B, Davis K. Using music techniques to treat adolescent depression. Journal of Humanistic Counseling, Education and Development 1999; 38:39–46. （unavaliable）

3)Hendricks CB. A study of the use of music therapy techniques in a group for the treatment of adolescent depression. Dissertation Abstracts International 2001;62(2-A):472.

4)Radulovic R. The using of music therapy in treatment of depressive disorders. Summary of Master Thesis. Belgrade: Faculty of Medicine University of Belgrade, 1996.

5)Zerhusen JD, Boyle K, Wilson W. Out of the darkness: group cognitive therapy for depressed elderly. Journal of Military Nursing Research 1995;1:28–32. PUBMED: 1941727]

6)Chen SC, Yeh ML, Chang HJ, Lin MF. Music, heart rate variability, and symptom clusters: a comparative study. Support Care Cancer. 2020;28(1):351-360. doi:10.1007/s00520-019-04817-x

7)Chang, M. Y., Chen, C. H., and Huang, K. F. (2008). Effects of music therapy on psychological health of women during pregnancy. J. Clin. Nurs. 17, 2580–2587. doi: 10.1111/j.1365-2702.2007.02064.x

8)Chen XJ, Hannibal N, Gold C. Randomized Trial of Group Music Therapy With Chinese Prisoners: Impact on Anxiety, Depression, and Self-Esteem. Int J Offender Ther Comp Criminol. 2016;60(9):1064-1081. doi:10.1177/0306624X15572795

9)Esfandiari, N., and Mansouri, S. (2014). The effect of listening to light and heavy music on reducing the symptoms of depression among female students. Arts Psychother. 41, 211–213. doi: 0.1016/j.aip.2014.02.001

10)Fancourt, D., Perkins, R., Ascenso, S., Carvalho, L. A., Steptoe, A., and 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. doi: 10.1371/journal.pone.0151136

11)Giovagnoli AR, Manfredi V, Parente A, Schifano L, Oliveri S, Avanzini G. Cognitive training in Alzheimer's disease: a controlled randomized study. Neurol Sci. 2017;38(8):1485-1493. doi:10.1007/s10072-017-3003-9

12)Harmat, L., Takács, J., and Bodizs, R. (2008). Music improves sleep quality in students. J. Adv. Nurs. 62, 327–335. doi: 10.1111/j.1365-2648.2008.04602.x

13)Liao J, Wu Y, Zhao Y, et al. Progressive Muscle Relaxation Combined with Chinese Medicine Five-Element Music on Depression for Cancer Patients: A Randomized Controlled Trial. Chin J Integr Med. 2018;24(5):343-347. doi:10.1007/s11655-017-2956-0

14)Lu, S. F., Lo, C. H. K., Sung, H. C., Hsieh, T. C., Yu, S. C., and Chang, S. C. (2013). Effects of group music intervention on psychiatric symptoms and depression in patient with schizophrenia. Complement. Ther. Med. 21, 682–688. doi: 10.1016/j.ctim.2013.09.002

15)Mahendran R, Gandhi M, Moorakonda RB, et al. Art therapy is associated with sustained improvement in cognitive function in the elderly with mild neurocognitive disorder: findings from a pilot randomized controlled trial for art therapy and music reminiscence activity versus usual care. Trials. 2018;19(1):615. Published 2018 Nov 9. doi:10.1186/s13063-018-2988-6

16)Nwebube C, Glover V, Stewart L. Prenatal listening to songs composed for pregnancy and symptoms of anxiety and depression: a pilot study. BMC Complement Altern Med. 2017;17(1):256. Published 2017 May 8. doi:10.1186/s12906-017-1759-3

17)Porter S, McConnell T, McLaughlin K, et al. Music therapy for children and adolescents with behavioural and emotional problems: a randomised controlled trial. J Child Psychol Psychiatry. 2017;58(5):586-594. doi:10.1111/jcpp.12656

18)Raglio A, Giovanazzi E, Pain D, et al. Active music therapy approach in amyotrophic lateral sclerosis: a randomized-controlled trial. Int J Rehabil Res. 2016;39(4):365-367. doi:10.1097/MRR.0000000000000187

19)Torres E, Pedersen IN, Pérez-Fernández JI. Randomized Trial of a Group Music and Imagery Method (GrpMI) for Women with Fibromyalgia. J Music Ther. 2018;55(2):186-220. doi:10.1093/jmt/thy005

20)Verrusio, W., Andreozzi, P., Marigliano, B., Renzi, A., Gianturco, V., Pecci, M. T., et al. (2014). Exercise training and music therapy in elderly with depressive syndrome: a pilot study. Complement. Ther. Med. 22, 614–620. doi: 10.1016/j.ctim.2014.05.012

21)Wang, J. , Wang, H. and Zhang, D. (2011) Impact of group music therapy on the depression mood of college students. Health, 3, 151-155

22)Yap AF, Kwan YH, Tan CS, Ibrahim S, Ang SB. Rhythm-centred music making in community living elderly: a randomized pilot study. BMC Complement Altern Med. 2017 Jun 14;17(1):311. doi: 10.1186/s12906-017-1825-x. PMID: 28615007; PMCID: PMC5470187.

23)Koelsch, S., Offermanns, K., and Franzke, P. (2010). Music in the treatment of affective disorders: an exploratory investigation of a new method for music-therapeutic research. Music Percept. Interdisc. J. 27, 307–316. doi: 10.1525/mp.2010.27.4.307

Excluded papers：

24)Bally, K., Campbell, D., Chesnick, K., and Tranmer, J. E. (2003). Effects of patient controlled music therapy during coronary angiography on procedural pain and anxiety distress syndrome. Crit. Care Nurse 23, 50–58. （not provide useable data）

25)Atiwannapat P, Thaipisuttikul P, Poopityastaporn P, Katekaew W. Active versus receptive group music therapy for major depressive disorder - a pilot study. Complementary Therapies in Medicine 2016;26:141–5. (sample size<20)

26)Garrido S, Stevens CJ, Chang E, Dunne L, Perz J. Music and Dementia: Individual Differences in Response to Personalized Playlists. J Alzheimers Dis. 2018;64(3):933-941. doi:10.3233/JAD-180084 （not randomised or quasi-randomised controlled trials）

27)Sánchez A, Maseda A, Marante-Moar MP, de Labra C, Lorenzo-López L, Millán-Calenti JC. Comparing the Effects of Multisensory Stimulation and Individualized Music Sessions on Elderly People with Severe Dementia: A Randomized Controlled Trial. J Alzheimers Dis. 2016;52(1):303-315. doi:10.3233/JAD-151150 （the control group also received music intervention）

28)Mondanaro JF, Homel P, Lonner B, Shepp J, Lichtensztein M, Loewy JV. Music Therapy Increases Comfort and Reduces Pain in Patients Recovering From Spine Surgery. Am J Orthop (Belle Mead NJ). 2017;46(1):E13-E22. (No full text available)

29)Castillo-Pérez, S., Gómez-Pérez, V., Velasco, M. C., Pérez-Campos, E., and Mayoral, M. A. (2010). Effects of music therapy on depression compared with psychotherapy. Arts Psychother. 37, 387–390. doi: 0.1016/j.aip.2010.07.001 （not provide useable data)

30)Alcântara-Silva TR, de Freitas-Junior R, Freitas NMA, et al. Music Therapy Reduces Radiotherapy-Induced Fatigue in Patients With Breast or Gynecological Cancer: A Randomized Trial. Integr Cancer Ther. 2018;17(3):628-635. doi:10.1177/1534735418757349（not provide useable data)

31)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. Reprod Biomed Online. 2018;37(2):145-152. doi:10.1016/j.rbmo.2018.04.049（not provide useable data)

32)Pezzin LE, Larson ER, Lorber W, McGinley EL, Dillingham TR. Music-instruction intervention for treatment of post-traumatic stress disorder: a randomized pilot study. BMC Psychol. 2018;6(1):60. Published 2018 Dec 19. doi:10.1186/s40359-018-0274-8 (the control group also received music intervention)

33)Silverman, M. J. (2011). Effects of music therapy on change and depression on clients in detoxification. J. Addict. Nurs. 22, 185–192. doi: 10.3109/10884602.2011.616606 （the control group also received music intervention）

34)Särkämö T, Laitinen S, Numminen A, Kurki M, Johnson JK, Rantanen P. Clinical and Demographic Factors Associated with the Cognitive and Emotional Efficacy of Regular Musical Activities in Dementia. J Alzheimers Dis. 2016;49(3):767-81. doi: 10.3233/JAD-150453. PMID: 26519435.

35)Tuinmann G, Preissler P, Böhmer H, Suling A, Bokemeyer C. The effects of music therapy in patients with high-dose chemotherapy and stem cell support: a randomized pilot study. Psychooncology. 2017 Mar;26(3):377-384. doi: 10.1002/pon.4142. Epub 2016 May 5. PMID: 27146798.（not provide useable data)

36)Hsu, W. C., and Lai, H. L. (2004). Effects of music on major depression in psychiatric inpatients. Arch. Psychiat. Nurs. 18, 193–199. doi: 10.1016/j.apnu.2004.07.007（not provide useable data)

（3）We have added some new analyses of our data. 1) including three new papers and re-analying of our data, 2) adding the comparison of music therapy and music medicine (figure 3 in revised manuscript) , 3) adding some subgroup analyses by country having music therapy profession, intervention settings, therapy mode, specific music therapy methord, intervenor /therapist, and total intervention session (table 2 in revised manuscript) .

Response: We are sorry for making this mistake. In the Methord section, we defined exclusive criteria as studies with a very small sample size (n<20),while in table4 we performed the sensitivity analyses by excluding the papers with smale sample size ( 20< n<30). We have amended the table 4.

Response: We have added these findings with a forest plot (figure 6 in revised manuscript) according to the comment.

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How Music Helps People Heal: The Therapeutic Power of Music

• June 19, 2024

Music has the power to touch our souls, lift our spirits and heal. But can music actually act as medicine ?

Whether it’s used in hospitals or hospices, music can provide comfort for those who are ill and help them cope with their illness. Music helps people heal on a physical level by providing transformative relaxation that reduce stress levels and improve cognitive function. It also provides emotional healing by helping us express feelings of grief, fear or sadness which often accompany hospital stays or end-of-life situations.

Let’s explore how healing music can be an invaluable tool in times of need , as well as discuss live musical visits specifically designed to bring joy into the lives of patients and families during difficult times.

Table of Contents:

• Music as a Source of Comfort
• Benefits of Music Therapy

How Music Can Help Heal Emotional Wounds

Memory improvement.

• Concentration &amp; Focus

Stress Reduction

• The Power of Music in Hospitals &amp; Hospices
• Live Musical Visits for Patients &amp; Families

Music Has Healing Power

Music has long been used as a source of comfort and solace in times of distress. It can provide a sense of connection, support, and understanding during difficult moments. The history of music in healthcare has shown that music can reduce stress, anxiety, depression, and even chronic physical pain. Listening to calming music can help people relax and focus on the present moment.

Studies by scientists have also found that listening to music helps release endorphins – hormones associated with pleasure (and reducing pain) – which further reduces stress levels and may even aid in the healing process .

Music is often used in therapy sessions for this reason; it helps create an atmosphere and an emotion conducive to stress relief and healing emotional wounds . In addition to reducing stress levels, music can also be used as a form of self-expression or communication when words fail us.

Listening to uplifting songs or singing along with them can help boost our moods by increasing serotonin levels in the brain – the neurotransmitter responsible for regulating our emotions and feelings of happiness or sadness.

Research has shown that listening to music can increase the release of dopamine , a neurotransmitter associated with pleasure and reward. This release can lead to feelings of happiness and enjoyment, which are often accompanied by the release of endorphins. The study cited above by McGill University found that dopamine levels were higher when participants listened to music they enjoyed, indicating a strong link between music and the brain’s reward system .

Research in the science of musical therapies has also suggested that certain types of music may improve cognitive function by stimulating areas in the brain related to memory recall and learning new skills faster than usual. Studies have shown that music can enhance connectivity between the auditory and emotional regions of the brain , which can facilitate memory encoding and recall.

Music is a powerful tool that can have a positive impact, bringing solace and joy to those facing difficult times.

The therapeutic benefits of music should not be overlooked.

Benefits of Music As Therapy

Music therapy is an evidence-based practice that uses music to address physical, emotional, cognitive, and social needs of individuals. It has been found to be beneficial in a variety of settings including hospitals and hospices. Music therapy can help reduce pain levels, promote relaxation, improve communication skills, and provide comfort during difficult times.

One way music therapy can be used to reduce pain is through the use of rhythmical breathing techniques. These techniques involve the person focusing on a steady beat while taking slow deep breaths which helps relax the body and mind. This type of intervention has been shown to decrease anxiety levels as well as lower heart rate and blood pressure which can lead to reduced pain levels overall.

Another benefit of music therapy is its ability to promote a state of relaxation by providing a distraction from stressful thoughts or feelings.

Listening to calming music can help create a sense of peace and tranquility which may allow for more effective coping strategies when dealing with difficult emotions or situations such as those experienced in hospital or hospice settings. Additionally, some research suggests that certain types of musical interventions may even have an analgesic effect due to their ability to activate endorphins in the brain which are natural pain relievers. For instance, a study published in  Frontiers in Human Neuroscience  found that music interventions promote high endorphin secretion, which contributes to pain relief by lowering blood pressure, heart rate, respiratory rate, oxygen consumption, and plasma lactate levels

Music also provides opportunities for improved communication between patients and healthcare providers or family members who may not otherwise be able to communicate effectively due to language barriers or other issues related to illness or injury.

For example, singing familiar songs together allows for shared experiences that build connections between people regardless of their similar backgrounds. Similarly, playing instruments together creates moments where both parties feel heard without verbalizing their thoughts.

Finally, music provides comfort during difficult times by allowing us to access our innermost feelings in ways words cannot express. Listening to favorite songs can provide inspiration and bring back memories associated with them; it’s like visiting old friends we haven’t seen in a while but still hold dear in our hearts. Music for hospice patients can be the difference between despair and delight.

The power these memories bring often leads us feeling connected to others around us despite any physical distance that might exist between them at the time. In this way, music serves as a bridge connecting two worlds – one filled with joy and sorrow – making it possible to heal emotional wounds no matter how deep they run.

Music therapy has been proven beneficial for physical, mental, and emotional health. As such, it is an invaluable tool in helping people heal from various ailments. Next we will explore how music can help heal emotional wounds.

It can provide comfort and solace during times of distress, allowing us to express our feelings without having to put them into words. Music can also be used as a tool for self-reflection, helping us gain insight into our own experiences and find meaning in difficult situations.

Music has been found to be particularly beneficial for those who are grieving or suffering from trauma or PTSD (post-traumatic stress disorder).

Listening to certain types of music can evoke memories of happier times, providing a sense of hope and optimism even when faced with difficult circumstances. This kind of emotional healing is often accompanied by physical healing; studies have found that people who listen regularly experience improved sleep quality, lower blood pressure, reduced pain levels, and increased immune system functioning.

For those struggling with mental health issues such as depression or anxiety, music therapy may offer an effective form of treatment. A trained therapist will use musical activities such as singing or playing instruments in order to facilitate communication between patient and therapist while encouraging self-expression through sound exploration techniques like improvisation or songwriting exercises.

By exploring emotions through music rather than talking about them directly, it becomes easier for patients to open up about their feelings without feeling judged or overwhelmed by negative thoughts or memories associated with the issue at hand.

Music can be a powerful tool for healing emotional wounds and a positive influence for restoring hope. By exploring how music can also help improve cognitive function, we may uncover even more benefits of its therapeutic effects.

How Music Can Help Improve Cognitive Function

Music has been used as a form of therapy for centuries, and its healing power is still being studied today. Music can help improve cognitive function in many ways, from improving memory to increasing concentration.

Listening to music can help stimulate the brain and improve memory recall. Studies have shown that people who listen to classical music while studying are more likely to remember what they learned than those who don’t listen to any music at all. This is because listening to certain types of music helps activate parts of the brain associated with learning and memorization. Listening to familiar songs can also trigger memories from past experiences, which may be beneficial for those suffering from dementia or Alzheimer’s disease.

Concentration & Focus

The rhythm and melody of certain pieces of music can help focus attention on tasks that require concentration, such as reading or writing an essay. Instrumental tracks without lyrics are often best for this purpose since they won’t distract you with words or singing voices like vocal-based songs might do. Classical works by composers such as Mozart, Beethoven, and Bach are particularly effective when it comes to aiding concentration due to their structured patterns and melodic progressions, which encourage mental clarity and focus on the task at hand rather than allowing your mind to wander off into daydreaming mode.

Music has long been known for its calming effects on both body and mind, making it an ideal choice when trying to reduce stress levels in high-pressure situations such as exams or job interviews where nerves could get the better of you. Listening to soothing sounds before taking part in these activities will not only relax your muscles but also clear away distracting thoughts so that you can stay focused on achieving success in whatever challenge lies ahead.

Music can be a powerful tool to help improve cognitive function and provide comfort, which is why it has been used in hospitals and hospices for many years. Let’s explore the power of music in these environments further.

The Power of Music in Hospitals & Hospices

Music has been found to have powerful effects on the mental and physical health of patients in hospitals and hospices. Studies show that music can reduce stress levels, improve moods, increase energy levels, reduce pain levels, and even speed up recovery time from illness or injury.

For example, one study conducted at a hospital in England showed that playing classical music for cardiac surgery patients significantly reduced their anxiety levels compared to those who did not listen to music. Another study found that listening to relaxing music before undergoing an MRI scan helped patients remain calm during the procedure.

Research suggests that listening to calming music can reduce stress and anxiety levels and help with pain management. A study conducted at a hospice facility in California showed that playing soothing instrumental pieces for end-of-life care patients resulted in decreased pain intensity ratings compared with those who did not listen to any type of musical intervention.

The power of music is further evidenced by its ability to help improve cognitive function among hospitalized individuals.

Music therapy sessions have been shown to assist in improving memory recall and language comprehension skills among elderly stroke victims receiving rehabilitation services in a hospital setting.

Additionally, studies suggest that singing along with familiar songs may help people suffering from dementia remember words better than if they were simply asked questions about them without any accompanying melody or rhythm present.

Live musical visits are becoming increasingly popular for providing comfort and solace to both hospitalized patients and their families. Live musicians offer an opportunity for meaningful connection through song, which can provide much-needed emotional support during difficult times spent away from home due to medical treatments or end-of-life care services being provided elsewhere.

Services like Harmony & Healing can also provide music-based healing modalities. Harmony & Healing’s live Zoom musical visits by professional musicians serves as a way for patients to access some of their most cherished memories. Harmony & Healing’s “Musical Memory Healing” is a powerful adjunct to traditional music therapy.

This form of entertainment helps break up long days spent inside hospital rooms while simultaneously bringing joy into otherwise stressful situations faced by many families visiting loved ones who are ill or nearing death’s doorsteps.

Music is a powerful tool for healing, providing comfort and joy to patients, families and loved ones in hospitals and hospices. By offering live musical visits via Zoom, we can bring these benefits directly into the homes of those who need it most.

Key Takeaway: Music for healing has a powerful effect on physical and mental health. Studies show that it can reduce stress, improve moods, increase energy levels, decrease pain intensity ratings and even help with cognitive function. Live musical visits are becoming increasingly popular for providing comfort to both patients and their families during difficult times spent away from home due to medical treatments or end-of-life care services.

Live Music for Patients & Families

Live musical visitations for patients & families.

Music has the power to bring joy and comfort to those who are struggling with illness or grief. Harmony & Healing’s live musical Zoom visits offer an opportunity for patients and families to connect through music in a safe environment. These visits provide an uplifting experience that can help brighten up even the darkest of days.

What Is Involved?

A live musical visit typically involves a musician visiting a patient’s room or family member’s home via Zoom, Skype, or other video conferencing platforms. During this time, they will play songs that have been requested by the patient or their loved ones, as well as any original compositions they may have written specifically for them. This is also an opportunity for them to share stories about how music has impacted their lives and answer any questions that may arise during the visit.

Benefits of Live Music for Patients

Live musical visits can be beneficial in many ways:

• They provide emotional support – Music can be used as a form of therapy, helping people cope with difficult emotions such as sadness, fear, anger, and anxiety. It can also help lift spirits when feeling down or overwhelmed by life’s challenges.

• They foster connection – Music helps create connections between people on both physical and emotional levels, which is especially important when dealing with illness or grief-related issues where communication can be challenging at times.

• They encourage creativity – Playing music together encourages creative expression, which allows individuals to express themselves in unique ways while connecting with others around them in meaningful ways too!

• They promote healing – Research shows that listening to music reduces stress hormones such as cortisol which helps promote relaxation and overall well-being – something we could all use more of these days!

Overall, live musical visits are a great way for patients and families alike to enjoy some quality time together while being reminded of the immense power that music holds.

Key Takeaway: Live musical visits offer an uplifting experience that can help bring joy and comfort to those who are struggling with illness or grief. These visits provide emotional support, foster connection, encourage creativity, and promote healing – all of which can be beneficial in many ways.

Music Offers Healing Effects

Whether it is used as a form of therapy or simply enjoyed for its beauty, music helps people heal by providing emotional support and improving cognitive function. Live musical healing visits offer an opportunity for hospital and hospice patients, families and loved ones to connect with one another through the healing power of music. Music truly does have the ability to help us all heal from physical, mental and emotional wounds.

We invite you to join us in creating moments of harmony and healing for hospital and hospice patients, families, and loved ones. Through live musical visits via Zoom, we aim to bring joy into the lives of those affected by illness or injury.

Together, let’s work towards improving quality of life through the music that soothes the soul.

To arrange a musical Zoom visit for a loved one or friend, please contact Harmony & Healing today!

Request A Musical Visit Today

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Essay about music therapy – Research essay

In my essay I research music therapy and its effects. I discover what music therapy is and consider various resources to find if it actually has any medical benefits.

Music therapy is the practice of using music to heal people. It is used by companies around the world. Their aim is to either heal people or make them feel better about their condition.

Music therapy is not free. The aim of the companies that give and conduct music therapy may be to help people heal or feel better about their condition, but all of them charge money to do it. This means that their reasons for doing what they do must be motivated by money at least to a partial degree. It makes them no more noble or correct than the people that rub apples on their customer’s skin in order to help them heal.

There has never been any evidence to prove that music therapy works. This makes it a pseudo-medical practice as it has no proven effects. The people that claim to have felt the effects are either delusional, were not really ill, or have experienced the placebo effect.

Music therapy is no different to hydrotherapy in its effects. There has also never been any evidence to show that hydrotherapy works in any way to heal or help people, which makes it very similar to music therapy.

Practitioners of music therapy claim that there are certain sounds that activate healing in the body. They play those sounds via musical mediums. The practitioners say that as time goes by the user will heal and feel better because of the music. It is then customary to tell the customer that he or she is looking better after each session. When a customer asks for a progress report for all the treatments, the practitioner will say that the music therapy has helped and is improving the customer, but that the customer must keep coming back for more therapy if he or she wants to heal correctly.

It seems that all the practitioners I interviewed were saying the same thing, and all they could offer were poor excuses as to why people should try their therapy. They showed no real evidence of its effectiveness and each one has created his or her own version of the truth about music therapy and how it works. If you ask a doctor how diagnosing the Flu goes, then all doctors will tell you the same thing. Ask a music therapist about how any of their processes work and they will all say different things.

My research led me to the same place again and again, and that place is the conclusion that music therapy is a very nasty con that is practiced by monstrous people that exploit ill, vulnerable and dumb people. The practitioners are people that are very good at acting as if they are professional and is if they care, when in fact they are money grabbing fiends that enjoy having control over their victims. My research also showed that music therapy has no benefits whatsoever.

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Music Therapy Essay

Stroke patients who get music therapy not only have more motivation and better moods, but an mprovement in their movement recovery. The sensory and intellectual stimulation of music can help maintain a person’s quality of life. Moreover, music therapy may benefit children and adults with developmental disabilities and adults with Alzheimer’s disease. Because music therapy is closely linked to other forms of stress reduction, it might also be helpful for depression, anxiety disorders and memory enhancement. Haltzman)

“American Music Therapy Association”)Music therapy is based on the principle that the body responds to passive music listening, active music roduction and sharing the experience of music with others. The brain, experts theorize, is programmed to respond music’s regular beat and rhythm. Slower beats can slow down brain waves down and induce relaxation; faster beats can stimulate the brain. (Haltzman) While researchers haven’t completely tested out these theories, we do know that the part of the brain involved in musical awareness is closely linked to the part that controls emotions.

It’s also a generally accepted medical truth that reducing stress can help people control the symptoms of illnesses. (Haltzman) There are thousands of scientific studies on he research of music therapy that i have come across. I have listed just a few that I feel have significant value to validate that research supports that music therapy is a legitimate alternative therapy, and that it does work. In 1983, Hanser, Larson, and O’Connell studied the use of music to enhance relaxation and decrease pain responses in mothers during childbirth.

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Informative on Music Therapy

• Categories: Music Therapy

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Words: 770 |

Published: Mar 19, 2024

Words: 770 | Pages: 2 | 4 min read

Table of contents

Introduction, the history of music therapy, the benefits of music therapy, the role of music therapy in contemporary healthcare.

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58 Music Therapy Essay Topics

🏆 best essay topics on music therapy, 👍 good music therapy research topics & essay examples, 🎓 most interesting music therapy research titles, 💡 simple music therapy essay ideas.

• Why Health Insurance Should Cover Art and Music Therapy?
• Music Therapy: Review
• Effects of Music Therapy on the Behavioral and Psychological Symptoms of Dementia
• Brain Music System: Standardized Brain Music Therapy
• The Effect of Music Therapy on the Elderly
• Effects of Music Therapy on Depressed Elderly People
• The Effect of Music Therapy on Depression
• Music Therapy as ASD Individuals Alternative Treatment Within recent decades the chances of a child being diagnosed with autism spectrum disorder have increased dramatically.
• Mindfulness-Based Music Therapy & Chemotherapy Musical stimuli also seem to have a positive effect on the patients’ mood, helping alleviate negative feelings and help reach a state of peace and emotional stability.
• Music Therapy and Its Positive Psychological Impact Music therapy is defined as an evidence-based and clinical use of interventions related to the musical experience.
• Music Therapy as an Additional Means of Psychotherapy Music therapy is a complementary means in psychotherapy and helps prepare patients for complex therapies and interventions.
• Mindfulness-Based Music Therapy and Cancer Treatment Music therapy is currently viewed as one of the tools for managing the stress that women undergoing cancer treatment are experiencing.
• Mindfulness-Based Music Therapy and Mental Health In her research, Lesiuk pays attention to specific mental health problems of adult women with breast cancer who are having chemotherapy.
• Music Therapy Effects for Breast Cancer Patients The research question for this study is whether mindfulness-based music therapy influences attention and mood in women who receive adjuvant chemotherapy for breast cancer.
• Music Therapy in Nurse’s Work Although music does not have a direct influence on physical condition, it is able to make people feel healthier by influencing their mental condition and giving them a feeling of inner harmony.
• Mindfulness-Based Music Therapy in Cancer Patients The paper reviews Lesiuk’s study “The effect of mindfulness-based music therapy on attention and mood in women receiving adjuvant chemotherapy for breast cancer”.
• Music Therapy and Pain Management The control group will not have intervention whereas musical group will listen for 30 minutes pre-recorded sedative music without lyrics of 60-80 beats.
• Effects of Music Therapy for Adolescents with Autism Music Therapy is the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional.
• The Systematic Review as a Research Process in Music Therapy
• Harnessing the Power of Music Therapy in Recovery
• Levels of Therapy: The Classification of Music Therapy Goals
• Music Therapy for Alzheimer’s Disease Management
• The Aesthetics and Politics of Music Therapy in the Clinic
• Music Therapy as a Potential Intervention for Sleep Improvement
• Understanding the Technological Practices and Needs of Music Therapists
• Multilevel, Holistic Music Therapy Process in Emotional Skills
• Healing Power of Music: Benefits of Music Therapy
• Analysing Change in Music Therapy Interactions of Children With Communication Difficulties
• Music Therapy for Gait and Speech Deficits in Parkinson’s Disease
• Using Electronic Music Technologies in Music Therapy
• Music Therapy: More Than Just Entertainment
• Probe Into the Role of Music Therapy in Workplace Health Management
• Music Therapy and Its Benefits for Patients With ADHD
• The Role of Music Therapy in Mental Health and Addiction Treatment
• View of Developing Music Therapy Goals and Objectives
• Processes of Music Therapy: Clinical and Scientific Rationales and Models
• Digital Technologies Applied to Music Therapy in the Information-Semantic Approach
• The Evolution of the Iso Principle in Music Therapy and Music Listening
• Neurologic Music Therapy in Neurorehabilitation
• Verbal Processing Within the Music Therapy Relationship
• Exploring the Benefits and Different Techniques of Music Therapy
• The Unexpected Benefits of Music Therapy for Dementia Patients
• Music Therapy Techniques for Wellness
• Understanding Human-AI Collaboration in Music Therapy Through Co-Design With Therapists
• The Attachment of Music Therapy and Spiritual Care
• A Process-Compositional Approach in Music Therapy to Empower Creative Potential
• Improving Health and Wellbeing Through Music Therapy
• Effect of Music Therapy on Pain and Quality of Life Among Cancer Survivors
• Using Music Therapy Techniques to Treat Teacher Burnout
• Cultural Intersections in Music Therapy: Music, Health, and the Person
• Exploring the Types of Music Therapy and How They Differ
• The Four Types of Interventions in Music Therapy
• Compositional Music Therapy: A Systematic Review of Clinical Trials
• Music Therapy and Other Music-Based Interventions in Pediatric Health Care
• Development of a Music Therapy Micro-Intervention for Stress Reduction
• Music Therapy for Adults With Mental Health and Substance Use Conditions
• Effectiveness of Music Therapy in Children With Autism Spectrum Disorder
• Music Therapy for Health Workers to Reduce Stress, Mental Workload and Anxiety

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StudyCorgi. (2024, August 21). 58 Music Therapy Essay Topics. https://studycorgi.com/ideas/music-therapy-essay-topics/

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StudyCorgi . "58 Music Therapy Essay Topics." August 21, 2024. https://studycorgi.com/ideas/music-therapy-essay-topics/.

StudyCorgi . 2024. "58 Music Therapy Essay Topics." August 21, 2024. https://studycorgi.com/ideas/music-therapy-essay-topics/.

These essay examples and topics on Music Therapy were carefully selected by the StudyCorgi editorial team. They meet our highest standards in terms of grammar, punctuation, style, and fact accuracy. Please ensure you properly reference the materials if you’re using them to write your assignment.

This essay topic collection was updated on September 5, 2024 .