Author: Charles Frank

The Benefits of Music Therapy in an Addiction Treatment Setting

It should not be used in place of the advice of your physician or other qualified healthcare providers. There is research that supports the idea that music therapy provides an effective means of increasing a person’s motivation and engagement in a treatment program. It also delivers an element of emotional support and gives participants an additional outlet for expressing feelings.

1. With regards to DBP, none of the above studies reported significant differences in post-stressor DBP between their respective experimental conditions.
2. Therefore, we first fit a random-effects meta-regression model without correcting for dependencies between effect sizes.
3. In addition to being beneficial, this therapy is a proven effective therapeutic method and an evidence-based treatment for addiction recovery.
4. This meta-data can subsequently be used to obtain additional insight into the effects of music listening on stress recovery.
5. Furthermore, I did not really understand, why the number of included studies varies among these two approaches (14 vs. 17 studies).

I am not convinced that these two approaches should be studied separately, as they complement each other in a meaningful way. Also, I believe that including EMA studies would shed light on the heterogeneity as you have multiple time points and multiple contextual factors being repeatedly assessed over time. Nevertheless, I accept your choice here, but recommend to acknowledge EMA studies in the discussion (or outlook).

Music Reduces Pain

To date, research on timing differences in the context of music listening and stress recovery is scarce. Thus, future studies could further examine the influence of such timing differences to better understand their role in the relationship between music listening and stress recovery. Furthermore, multiple studies included in our review have opted to analyze continuous data by means of multivariate analyses of variance, after averaging participants’ observed stress recovery outcomes at multiple time points (e.g., pre-stress, post-stress, post-recovery). Although this approach is practical, doing so may over-simplify the complex changes that may occur during the stress response and subsequent stress recovery, such as the temporal dynamics of different physiological responses [52] and emotion regulation strategies [108]. As such, we again suggest future studies to utilize non-linear analyses of data when appropriate, particularly when investigating the effects of music listening on the recovery of autonomic activity post-stressor.

This process is thought to signal the termination of the stress response, as the binding of cortisol to low-affinity receptors inhibits further autonomic activation [24, 26]. As cortisol levels begin to decrease, slow, cortisol-mediated genomic changes are initiated, which directly oppose the rapid effects of catecholamines and the non-genomic effects of cortisol [24, 26]. Following a stressor, these genomic changes may take up to one hour to commence and may continue for several hours [24, 26]. I fully agree with the authors that, for music to exert an effect on stress, a physiological and/or psychological stress response needs to be present, from which participants may then recover. I find it therefore difficult to understand why studies which failed to induce stress (i.e., did not report a successful stress induction) were included in the meta-analysis in the first place. The fact that the successfulness of the stress induction, surprisingly, did not affect the extent of stress recovery does not really resolve my concern.

Any healthy outlet for expressing yourself is something that we support at Royal Life Centers. Knowing that musical sounds can affect your mindset, it’s easy to see how songs can be used to change your mood into a positive state of mind. Uplifting songs, and lyrics that resonate, can actually make a massive shift in mood and your level of happiness or stress. We have an in-house recording studio that is fully equipped with a variety of musical instruments for our guests to use. Royal Life Centers encourages our guests to find their passion, what brings them joy and learn to practice more uplifting activities.

For this reason, we have supplemented the quantitative synthesis of the meta-analysis with a more qualitative synthesis from a systematic review. We think this combined approach has yielded a more nuanced review, as the qualitative description of the included studies have helped provide more context to the results of our meta-analysis. Two studies looked at the presence and/or severity of depressive symptoms in order to assess whether or not music facilitated psychological recovery [19, 37].

Music is a dynamic medium that many rely on daily for inspiration and relaxation. Knowing this, it comes as no surprise that music therapy is now taking a larger role in health and healing. While there are many benefits to using music therapy for physical and mental well-being, it also can be a useful tool in addiction treatment. Research has shown that music therapy can reduce anxiety, ease withdrawal symptoms, and promote relaxation. Music therapy can also help to increase self-esteem and self-awareness, two important factors in recovery.

TRUSTED & ACCREDITED ADDICTION TREATMENT CENTERS

We agree that it is particularly important to further address the inclusion of studies with unsuccessful stress induction checks, as you and another reviewer have put forward similar concerns on the matter. The study addresses a very timely question within the growing body of research on music and stress, and is well-executed. As such, it provides a valuable and much-needed contribution to the research field. Furthermore, they provide several helpful and well-considered recommendations for future research. Six studies allowed participants to select and listen to their own ‘relaxing’ music. In four studies, participants were instructed to bring a list of ‘preferred’ relaxing music, which they would have the opportunity to listen to during the study [18, 37, 54, 66, 119].

From our experience, most studies on music listening published on the PubMed database reported experiments conducted within medical or therapeutic settings. Thus, when designing our search strategy, we made the decision to exclude the PubMed database from our search. Next, thank you for mentioning your concern over the inclusion of studies whose stress induction procedures were not successful. We thus agree that it is particularly important to further address the inclusion of studies with unsuccessful stress induction checks.

Triggers Positive Memories

In a post-hoc analysis, Labbé et al. [17] reported that post-stressor SC recovery was greater for the classical and self-selected music groups, compared to the heavy metal or no music groups. Collectively, three studies provide evidence for a positive effect of music listening on post-stressor SC recovery. The stress response is considered adaptive when it is short-lived and immediately followed by a period of recovery following stressor cessation. In this period, ANS- and HPA-mediated changes that have occurred in response to a stressor revert to pre-stress baselines [24, 25, 27]. Therefore, stress recovery may be conceptualized as the process of unwinding that is opposite to the neuroendocrine, physiological, and psychological activation that occurs during the stress response [4, 5].

Substance Abuse Treatment

The differential effects of these musical stimuli were difficult to account for in our meta-analysis, given the limited number of included studies. Overall, the significant heterogeneity in our meta-analytic data set suggests that our moderator analyses should be interpreted with caution. Previous research has shown that following an acute stress reaction, all elevated physiological and psychological parameters will naturally revert to pre-stress baselines within minutes (Hermans et al., 2014). As such, the most immediate proof of the effect of music listening on stress recovery would be to see whether listening to music would allow participants to reach their respective baseline levels sooner within time frame. Unfortunately, as we also point out in our Discussion, it is rare for studies to adopt a design where such changes are monitored, particularly through use of continuous measures. Instead, as you have rightly pointed out, studies either compare post-stress and post-manipulation change scores between conditions or compare post-manipulation raw group differences between music and comparable control conditions.

Three studies provide support for the beneficial role of music listening on post-stressor positive affect, and two studies provide support for the beneficial effect of music listening for negative affect. In our moderator analysis, we examined whether the effects of music listening on stress recovery differed across general (neuroendocrine, physiological, psychological) and specific outcome types. Lastly, we encourage studies to support open science research practices, and to clearly report statistical information that may be relevant for meta-syntheses (e.g., means and standard deviations per time point, per experimental condition, etc.). Additionally, based on our assessment of study quality using the RoB 2, pre-registration of analysis plans can be helpful to ensure that the conducted study is of overall high quality.

Music Encourages Physical Movement

To discern which music best promotes stress recovery, studies have contrasted the effects of classical music with other musical genres, including rock [48], jazz and pop [21], and heavy metal [17]. Music therapy has been used for years as an effective therapy for children, people with autism, dementia, psychiatric disorders, and Substance Use Disorders (SUD). It uses evidence-based musical interventions to reduce stress, open communication, enhance well-being, and distract patients from uncomfortable symptoms, among other benefits.

For example, classical music may be described as rhythmically complex, with mellow timbre and fluctuating loudness. Comparatively, though equally rhythmically complex, heavy metal possesses sharper timbre and more pronounced loudness. Investigating the differential effects of these musical features on stress recovery may provide relevant insight into the differential effects of listening to various musical genres on stress recovery. Next, the first author (KA) screened all titles and abstracts for studies examining the effects of music listening on stress recovery.

As such, there is currently no evidence to suggest that music listening is beneficial for post-stressor RR recovery. The duration of each stress induction procedure varied according to procedure category. Finally, it is also worth noting that among studies which reported successful stress induction procedures (see Table 2), the magnitude of resulting stress responses was often not reported. KA extracted means, standard deviations, and total participants per condition for each stress recovery outcome. When these statistics were not included in text, but informative graphs were provided, KA used an open-source program to extract data from the graphs [86]. The ‘141–160 bpm’, ‘unsuccessful’, ‘salivary IgA’, and ‘salivary alpha-amylase’ moderator levels were ultimately not included in the meta-analysis due to unavailable information.

In one study, participants selected ‘relaxing’ music from a list created by the experimenters (pseudo self-selection) [21]. The specific musical stimuli chosen by participants in studies allowing self-selection were often not reported. Music has a calming effect on the brain, which can help people struggling with addiction manage their emotions and reduce cravings. Studies have shown that certain types of music can reduce stress levels, increase motivation, and even improve mental clarity. Royal Life Centers offers music therapy throughout all of our addiction treatment centers. Our addiction treatment services include a variety of programs, designed to follow guests through the recovery process.