Table 3.

Qualitative Findings: Treatment Benefits

Theme and definition	Categories and definitions	Example quotes
Theme 1 Self-management: VMT promotes self-management of pain, stress, and mood through the use of music listening, singing, toning, and deep breathing techniques. It furthermore stimulates an attitude of self-care.	Pain: Participants discover music as a new way to help manage pain	It just amazes me that the music has always been a part of my life but I never associated music with this part where I am dealing with pain all the time. I never thought that music could help pain. That was a great learning experience for me.
	Stress: Music helps to relax and elicits feelings of peace and safety	The humming made me feel like I was back in my mother’s womb…very safe. The music makes me feel very peaceful.
	Emotions: Group music making enhances participants’ mood, gives “voice” to suppressed emotions, and enhances positive self-expression.	So this helped me to do things kind more outwards than keeping in. It released my depression by getting out, being around people, singing…being able to laugh again.
	Self-care: VMT results in greater awareness of self and one’s needs, motivating participants to nurture and care for themselves.	The self-care, the “me” time, I didn’t really have that in my life. So coming to visit the vocal class, I love it! It helped me how to deal with me. I learned to consider my feelings and what I would like to do, what I am able to do, and what I’m not able to do with the pain.
Theme 2 Togetherness: The common experience of chronic pain coupled with creative engagement in group music making evoked a strong sense of belongings	Shared experience: Being with others affirms that one is not alone in the struggles with chronic pain.	Everyone is in there with sort of the same kind of problem and for us all to know we’re all looking for the common goal: to try to get help for the pain. So it’s cool being in there with people going through the same thing you going through.
	Social support: Creating music together and verbally processing emotions provides support and reduces isolation.	All of our spirits was coming together you know, that was the good part. Cause we are all as one unit. Working as a group, it seems to bring people out of their shell a little more and be more open.
	Joy & happiness: Singing and improvising music with others brings joy and a sense of fulfillment	Being with the group, I was happy. And I haven’t felt that way in a long time. The music therapy gave me joy so I think that was a change for me. Like I said I was shutting down and it gave me the gumption to feel better again and smile again.
Theme 3 Transformation: VMT brings about a shift in how participants perceived themselves and their being-in-the-world.	Renewed sense of self: The VMT interventions increased participants’ awareness of and appreciation for their capable selves.	She [the music therapist] seemed to bring out something that had died in you… something that you lost long time ago when you was a child or something. I didn’t hear any of that grunting and moaning. [The music therapist] brought something good out of the pain or the suffering that we do. I learned to be in more harmony with myself too
	Empowerment: The act of creating music with one’s voice acts as a metaphor for having a voice and being heard in the world.	It’s like you are not closed in or locked in. You have a voice. It was like an intervention that did me some justice, where I can live again. It gave me another choice. Sometimes when you’re in pain and you have another choice it makes you feel better […] it’s like you taking charge again
	Repositioning oneself: Making music together enabled participants to experience a new way of being in the world.	I got out of it that I can still be around people and interact. I don’t have to close myself off like I’ve been doing. Before, I was more isolated. I’ve been for about eight years that way isolating myself and I pretty much didn’t do anything, but now I can go to work. I even had a date the other day. I was getting out. Enjoying people. I wanted to be around people again.