Individual Music Therapy for Mental Health Care Clients with Low Therapy Motivation: Multicentre Randomised Controlled Trial

Abstract

Background: Music therapy (MT) has been shown to be efficacious for mental health care clients with various disorders such as schizophrenia, depression and substance abuse. Referral to MT in clinical practice is often based on other factors than diagnosis. We aimed to examine the effectiveness of resource-oriented MT for mental health care clients with low motivation for other therapies. Method: This was a pragmatic parallel trial. In specialised centres in Norway, Austria and Australia, 144 adults with non-organic mental disorders and low therapy motivation were randomised to 3 months of biweekly individual, resource-oriented MT plus treatment as usual (TAU) or TAU alone. TAU was typically intensive (71% were inpatients) and included the best combination of therapies available for each participant, excluding MT. Blinded assessments of the Scale for the Assessment of Negative Symptoms (SANS) and 15 secondary outcomes were collected before randomisation and after 1, 3 and 9 months. Changes were analysed on an intention-to-treat basis using generalised estimating equations in longitudinal linear models, controlling for diagnosis, site and time point. Results: MT was superior to TAU for total negative symptoms (SANS, d = 0.54, p < 0.001) as well as functioning, clinical global impressions, social avoidance through music, and vitality (all p < 0.01). Conclusion: Individual MT as conducted in routine practice is an effective addition to usual care for mental health care clients with low motivation.

“The Opposite of Treatment”: A qualitative study of how patients diagnosed with psychosis experience music therapy

“…Given these premises, the participants’ reports of how music therapy made them feel more vital, uplifted, joyful, hopeful, and motivated, and enabled them to become more active participants in their everyday lives, constitute an important and promising finding. Here too, we may say that the present study confirms results from outcome studies with regard to the significant effects of music therapy on negative symptoms for people with severe mental illnesses (Gold et al, 2009, 2013; Mössler et al, 2011), although in our findings such aspects were linked to experiences of well-being (that is, to an increase of positive health) rather than to a reduction of negative symptoms. In the light of the users’ experiences, we may therefore suggest that it is more appropriate to describe recovery processes in terms of the level of positive health (i.e.…”

“…Despite promising developments in medical treatment and psychosocial rehabilitation, there are growing calls for other, more effective approaches to help and support people with psychosis (Bentall, 2009; Fledderus, Bohlmeijer, Smit, & Westerhof, 2010; Herrman, Saxena, & Moodie, 2005; Slade, 2009). Within the last decade, outcome studies have documented positive effects of music therapy on symptoms and functioning for people diagnosed with schizophrenia and the wider condition of psychosis (Gold, Solli, Krüger, & Lie, 2009; Gold et al, 2013; Mössler, Chen, Heldal, & Gold, 2011). As a consequence of this emerging evidence base, music therapy is now being recommended in national treatment guidelines for people with psychosis in UK and Norway (National Collaborating Centre for Mental Health, 2010; The Norwegian Directorate of Health, 2013).…”

Effect of Social Skills Training: Friendship Clients of Social Interaction Capabilities of Social Isolation

“…The results are consistent with research concept, stating the client schizophrenia and depression decreased ability to interact, always think negative about themselves other people and the surrounding environment, pessimistic, always look down on themselves, can be enhanced by providing a social skills training which is done first by the therapist, followed by the client, given feedback, and in the evaluation of its implementation [16].…”

Concepts of context in music therapy

“…One strategy has been to develop pragmatic trials in order to ensure enough therapeutic flexibility and to capture the complexities of music therapy processes (Gold et al, 2013; Rolvsjord et al, 2005). However, it could still be argued that the term complex interventions points too much in the direction of the therapist, so that the contextual nature of the process becomes veiled.…”