Table 4. Characteristics and results of studies examining effects of more than one music therapy/music-based intervention session on patients with substance use disorders.
| Study | Outcome | EG | CG | Type of intervention | Frequency/ duration | Measurement tools | Population | Results |
|---|---|---|---|---|---|---|---|---|
| Albornoz[39] | Depression (self-rating/ therapist rating) |
N = 12 Whole sample: N = 24 m Age: 16–60 Addiction and depression problem |
N = 12 | MT improvisation (independent therapy) |
12 sessions, 2h per week, 3 months | BDI Hamilton Rating Scale for Depression |
Males Inpatient treatment for substance abuse Venezuela |
• Lower post- than pre-test scores for self-rated depression for EG ** and CG *, d = 0.51 across both groups (Power for comparison: 34%) • Lower post- than pre-test scores for therapist-rated depression for EG ** and CG *, d = 0.90 across both groups (Power for comparison: 78%) • Lower post-test scores for therapist-rated depression for EG compared to CG *, but not for self-rated depression |
| Cevasco et al.[43] |
Anxiety Anger Depression Stress |
N = 20 fm Age: 19–42 |
- | MT competitive games, dancing or rhythm activities |
12 sessions, 1h, twice a week each therapy 4 sessions |
State-Trait Anxiety Inventory (STAI) Novaco Anger Inventory Short Form (NAI) 10-point Likert scales |
Females Outpatient substance abuse program USA |
• No overall effects of MT methods, individual effects of MT methods • Average daily percentage of decrease a: Indicated progress for several individuals on decreased levels of depression, stress, anxiety, and anger • Mortality rate: 50%; remaining clients with lower anxiety ** and anger *** values |
| Dickerson et al.[48] |
Treatment retention and completion Substance use Problem severity Comfort and strength derived from spirituality Well-being Cognitive functioning Cultural identity Adoption of principles Physical and psychiatric symptoms |
N = 10 (50% m) Age: 19–71 (M = 52.5) |
- | MBI (drumming teacher and counselor) Drum-assisted recovery therapy for Native Americans (DARTNA) (independent therapy) |
24 sessions, 3h, twice a week | Substance Use Report Addiction Severity Index, Native American Version (ASI-NAV) Functional Assessment of Chronic Illness Therapy (FACIT): Spiritual Questions Only Expanded, Fatigue (FACIT-F) Functional Assessment of Cancer Therapy–Cognitive Functions (FACT-Cog) American Indian/ Alaska Native Cultural Identity Scale General Alcoholics Anonymous Tools of Recovery (GAATOR 2.1) BSI |
Outpatient setting Native Americans USA |
• 50% treatment completion (80% until week 6) • Improved psychiatry status * after 6 weeks, improved medical status* after 12 weeks (ASI-NAV) • Spirituality: Improved meaning/peace ** and total score ** after 12 weeks (FACIT) • Improved physical and functional well-being after 12 weeks * (FACIT-F) • No improvements in adoption of principles, physical and psychiatric symptoms or cognitive functions (GAATOR 2.1, BSI, FACT-Cog) |
| Dougherty[50] | Attendance | Age: adolescent-geriatric 100% alcohol |
- | MT music listening (structured sessions) sing along (group) |
structured sessions: 3–4 weeks, once a week sing along: 30 min, biweekly |
Percent of attendance at any given time | Inpatient rehabilitation/ Therapeutic community for alcohol dependency USA |
• 80–90% attendance |
| Gallagher & Steele[49] | Mood Participation On-task behavior |
N = 188 Age: 20–59 (M = 36) Dually diagnosed with SUD and MI |
MT music listening, group participatory music, playing instruments, relaxing, lyric analysis, drumming, songwriting, music and muscle tone/pulse rate |
45min, once a week | Roger's (1981) Happy/ Sad Faces Assessment Tool Therapist rating |
Outpatient counseling (9 month stay) USA |
• 91% active participation a • 82% expression of thoughts and feelings a • 68% positive mood changes • 64% no mood changes during the session • 53% not sociable a • 46% participation in processing the session a • 60% constricted or blunted affect after the session a |
|
| Gallant et al.[44] | Client attitudes Psychosocial functioning |
N = 6 couples Age: 31–51 (Md = 43) Various drug addictions |
- | MBI (social worker) music listening, lyric analysis, relaxation |
4 sessions, 2h, over 2 weeks | 20-Item Hudson Psychosocial Screening Instrument Content analysis |
Outpatient recovery Canada |
• 5/6 patients rated MT as “very helpful“ • On average clients were less anxious, less depressed, and had fewer relationship problems. • Average Hudson Score decreased from pre to post.* Cohen’s U3 = 88%. • Content: Problem definition (55.8%), problem solving (44.2%), motivation-activation (38%), problem definition (36.6%), assessment (13.1%), goal setting (8.8%), action plan development (3.5%), cognition (68%), affective or emotive expression (32%) ○ “feeling” associated with music (55%) and “thinking” associated with lyrics (78%) more often.*** |
| Howard[42] | Depressiogenic thought frequency State immediate goals |
Sample A: N = 8 fm Age: M = 34.9 Sample B: N = 12 adolescents Age: 15–17 Chemical addictions |
Within subjects comparison (PT vs. MT) or between samples comparison | MT lyric analysis (PT also including lyric analysis) |
6 sessions (alternating music and poetry), 45min, 6 weeks | Automatic Thoughts Questionnaire (ATQ) Goal attainment form (GAF) |
2 inpatient substance abuse treatment facilities (rehab-ilitation center) USA |
• No differences in depressiogenic thought frequency and state immediate goals between groups or type of therapy for ATQ, GAF, or off-task behavior • High percentage of on-task behavior a |
| Hwang & Oh[45] | Depression Anxiety Anger Stress |
N = 42 mc Age: 31–73 (M = 50.2) 100% alcohol |
Between methods comparison |
MT singing, listening, playing instruments (therapist- or patient-selected activities) |
12 sessions (4 sessions each therapy) 0.5h, twice a week |
10-point Likert Scales | Males Inpatient alcohol treatment program South Korea |
• High pretest scores of anxiety, anger, depression, and stress for singing a • Decreased depression **, anxiety **, anger **, and stress ** in posttest • No differences between methods • No differences between patient- and therapist-selected activities at all • Significant reduction in stress and depression for therapist-chosen activities during singing * |
| James[20] Study 1 |
Locus of control |
N = 10 Whole sample: N = 20 adolescents (50% m) Age: M = 15.8 Chemical addictions |
Occupational therapy craft group (waitlist) N = 10 |
MT music listening lyric analysis |
4 sessions, 1h, one week | Abbreviated Internal External Locus of Control Scale | Adolescents Inpatient rehabilitation service for chemical dependency USA |
• Greater pre-post increase in internal locus of control for EG than CG * |
| James[20] Study 2 |
Locus of control |
N = 10 Posttest only Whole sample: N = 20 adolescents (55% m) Age: M = 16.4 Chemical addictions |
Occupational therapy craft group (waitlist) Pretest only N = 10 |
MT music listening lyric analysis |
4 sessions, 1h, one week | Abbreviated Internal External Locus of Control Scale | Adolescents Inpatient rehabilitation service for chemical dependency USA |
• Greater internal locus of control for EG than CG * |
| K. M. Murphy[38] | Motivation Depression Coping Skills |
GIM + standard program N = 9 Whole sample: N = 16 (56.3% m) Age: 19–55 M = 37.2 56.3% polydrug 37.5% alcohol 6.3% cannabis |
Standard program N = 7 |
MT GIM (relaxation, imagery focus, music imaging, drawing or journaling) |
8 sessions, 50-60min, 21 days | Importance, Confidence, Readiness Ruler (ICR) Beck Depression Inventory (BDI) Sense of Coherence Scale (SOC) |
Inpatient residential substance abuse treatment USA |
• No differences in coping skills, depression, and motivation between EG and CG in pre- and posttest • Depression a: CG 46% decrease, EG 75% decrease • Retention rate a: CG 50%, EG 75% |
| Oklan & Henderson[40] | Depression Psychiatric symptoms Coping skills |
Case study N = 1 m Age: 14 |
- | MBI (unclear) Recorded Music Expressive Arts (RMEA) therapy with songwriting and production (independent therapy) |
16 sessions, 75min, 16 weeks | BDI-II Symptom Checklist 90-R (SC-90-R) Adolescent Coping Orientation to Problems Experienced (A-COPE) |
Adolescent Outpatient psychological treatment, inhalant abuse, case study USA |
• Depression: Reduced SC-90-R Depression score, no reduction in BDI-II after 10 weeks (normal range) b • Reduction in obsessive-compulsive, depressive, psychotic, anxiety, and overall symptoms c • Increased seeking spiritual support, positive imagery, self-reliance c • Decreased physical diversion, humor c |
| Ross et al.[15] | Problem Severity General functioning Motivation Physical and psychiatric symptoms Medication adherence Attitudes towards MT and therapist MT characteristics |
N = 80 (80% m) Age: 20–57 (M = 39.7) Dually diagnosed with MI and SUD 50% alcohol 37% cocaine 20% cannabis 19% polydrug 14% opiates |
- | MBI (unclear) music and imagery (listening), drumming, improvisation |
1h, one to more than 6 sessions | Addiction Severity Index Clinical Global Impression Severity Scale (CGI), Global Assessment of Function Scale (GAF) SOCRATES BSI MT Questionnaire Number of sessions |
Inpatient dual diagnosis unit USA |
• Pretest variables unrelated to MT characteristics and MT Questionnaire • 100% medication adherence a • 71% appeared at outpatient aftercare treatment a • Number of sessions positively associated with aftercare appointment*** Pre- vs. posttest: • Relationship between MT appreciation and changes in CGI ** • Relationship between therapist appreciation and changes in CGI **, GAF *, and Taking Steps * • Relationship between MT appreciation and attitudes towards the therapist *** Cross-sectional analyses at discharge • Relationship between MT appreciation and Taking Steps * Relationship between therapist appreciation and Ambivalence *, Taking Steps* |
| Silverman[47] | Perceived effectiveness and enjoyment Intervention assessment compared to other groups |
N = 8 fm Age: 19–65 100% chemical dependency |
- | MT music games, relaxation training, lyric analysis, songwriting |
8 sessions, once a week | 25-point analogue scales | Females Inpatient chemically dependency treatment USA |
• No differences between the interventions regarding enjoyment and effectiveness • Mean scores for enjoyment/ effectiveness nearly at maximum a • 50% reported MT as more effective and enjoyable than other groups a |
| Yun & Gallant[41] | Forgiveness and grief Depression |
N = 21 fm Age: 28–64 (M = 48) SUD due to forgiveness/grief issues |
MBI (counselor) listening, lyric analysis Individual setting |
12 sessions per client, 1h, biweekly, 6 month | Forgiveness Grief Perspectives Scale (FGPS) BDI |
Females Outpatient rehabilitation center, Canada |
• Decrease in forgiveness and grief from pre- to posttest (d = 1.95) *** • Decrease in depression from pre- to posttest (d = 2.42) *** • Positive correlation between forgiveness/grief and depression in pretest (r = .54) ***, and posttest (r = .58) *** |
Effect sizes are only listed when reported in the articles. For music-based intervention (MBI) studies, conducting persons are listed in brackets. BDI = Beck Depression Inventory; BSI = Brief Symptom Inventory; CG = control group; EG = experimental group; fm = female; m = male; MBI = music-based intervention; MI = Mental illness; MT = music therapy; pd = prescription drugs; SUD = substance use disorders
a Frequency counts.
b Results based on a criterion of clinical significance, i.e., changes by at least one standard deviation of the mean.
c Results based on scores from 36 participants.
*p < .05.
** p < .01.
*** p < .001