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Music Therapy... does it actually work?

While this blog post on music therapy FAQs endeavoured to offer answers to the most commonly asked questions that my community of music therapists could think of, there is more scope to explore one of the questions raised in a bit more detail.

Music therapy… does it actually work?

The implication being, what’s the evidence? How do we know this is actually doing something? Can we quantify exactly what’s going on during music therapy and show how it’s helping? Can we compare it to other potential interventions and work out which one is right for the person we’re working with?

In short: yes we can.

The music therapy charity Nordoff-Robbins have collated the most comprehensive body of evidence available for music therapy in the UK and beyond, and have made it free to access on the internet. You can find their evidence bank here.

But that’s not the whole story. There are two important caveats that we need to consider, and we need to consider seriously, because it affects the future of music therapy, and the service North London Music Therapy and others provide.

It’s really pretty difficult to evidence well.

Quantity is all well and good when it comes to research, but what each methodologist is really after is what’s called the “gold standard”, which often means a type of study called a Randomised Control Trial.

The NICE guidelines, the framework used by the NHS, define this as: “A study in which a number of similar people are randomly assigned to 2 (or more) groups to test a specific [...] intervention.

“One group has the intervention being tested, the other has an alternative intervention, a dummy intervention (placebo) or no intervention at all.

“The groups are followed up to see how effective the experimental intervention was.”

Cochrane Reports for music therapy (which collate all gold standard research papers) exist for music therapy with dementia, autism, depression, schizophrenia and cancer. All include some valid papers, and all conclude that music therapy may help reduce some symptoms in those with all of the above conditions, but request more studies with standardised methodologies in order to corroborate existing results more accurately.

One of the highest standard reports comes from a related profession to music therapy, the Tavistock Adult Depression Study (TADS), which produced some pretty solid results:

44% of the patients who were given 18 months of weekly psychoanalytic psychotherapy no longer had major depressive disorder when followed up two years after therapy had ended (for those receiving the NHS treatments currently provided the figure was only 10%), and, after two years of follow-up, depressive symptoms had partially remitted in 30% of those receiving psychoanalytic therapy; in the control condition this figure was only 4%.

The problem? It took 10 years to complete the study. Long-term work means long-term research.

Lots of existing outcome measures don’t necessarily measure outcomes.

Music therapists often find that lots of time is spent explaining what exactly it is we do. This is fine, and often necessary. What becomes more tricky is when that spills over into our outcome measures.

Lots of existing measures look at the process of a session, what’s going on during a session. What parents, professionals and people holding the purse strings are interested in, though, are the outcomes of a session: what’s changed for the person receiving music therapy (hopefully positively), and how.

Some outcome measures designed for use in music therapy do this really well: a couple of examples are the Music Therapy Outcome Star and the Music in Dementia Assessment Scales (MiDAS). It’s not straightforward to create these measures (MiDAS was the result of a whole PhD) - but even allowing for that, let’s have some more, and let’s work hard to use the ones we already have as effectively as possible.

The challenge for longer-term work, like the music therapy offered by North London Music Therapy, is to be able to evidence its efficacy as effectively as possible. It’s a difficult task, but worth continuing to consider in order to be able to show the effectiveness of a trusting therapeutic and musical relationship built steadily over time.

See how North London Music Therapy could benefit you or someone you know: click here for more information.

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