Music and Health: What Interventions for What Results?

OPINION ARTICLE published: 02 March 2015 doi: 10.3389/fpsyg.2015.00230 Music and health: what interventions for what results? Alfredo Raglio 1* and Osmano Oasi 2 1 Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy 2 Department of Psychology, Catholic University of Milan, Milan, Italy *Correspondence: [email protected] Edited by: Gian Mauro Manzoni, eCampus University, Italy Reviewed by: Gianni Nuti, Aosta Valley University, Italy Keywords: music, music therapy, evidence-based approach, health For several decades, music has been used and even to one’s social attitude (Chanda Music therapy interventions in the sci- more and more frequently and consciously and Levitin, 2013). entific culture of the discipline are charac- as a mean of care to reduce or stabi- The purposes of this article are to define terized by a relational component, which lize symptoms and/or complications aris- the basic characteristics that therapeutic is considered essential, and by the pres- ing therefrom. This has been the case interventions with music have in common ence of a qualified music therapist. In these with several diseases, including chronic and to categorize the types of interven- cases, the treatment is therefore mediated and degenerative ones (in psychiatry, child tion based on the use of music. This is of by the presence of a therapist that uses neuropsychiatry, neurology, oncology, pal- paramount importance to identify thera- applicative models based on psychologi- liative care, etc.) (Gold et al., 2004; peutic interventions with music as distin- cal and/or neuroscientific theories. In the Särkämö et al., 2008; Bradt et al., 2011; guished from a general practice or fruition first case the reference is to the active Erkkilä et al., 2011; Mössler et al., 2011; of it (Raglio, 2011). The latter, while pro- techniques (which are based on a direct Raglio et al., 2012; Bradt and Dileo, 2014) ducing beneficial effects on the individual, interactions with the patient/client using andincontextsinwhichthesymptomsare it does not possess the characteristics that chiefly musical improvisation) and recep- just momentary (e.g., in hospitals before define a therapeutic intervention. In many tive ones (which involve listening to music surgical interventions in order to reduce contexts in which the therapeutic use of in order to verbally elaborate the emo- anxiety and stress, or to reduce the per- music is put into practice, we can observe tional content emerging from it) that aim ception of pain during invasive medical a considerable heterogeneity of interven- at reducing psychological symptoms or procedures) (Bradt et al., 2013; Cepeda tions (Gold, 2009), a low level of defi- complications arising therefrom, and at et al., 2013). Indeed, music also gives plea- nition of the therapeutic proposals and increasing relational and communication sure, promotes well-being, facilitates the some methodological weaknesses in the skills (Gold et al., 2009). Neuroscientific expression and regulation of emotions and evaluation of the effectiveness of such models are mainly based on the use of improves communication and relation- interventions. active techniques, such as music exercises ships between individuals (Hillecke et al., There are some basic conditions that (withafrequentuseofrhythm),thatcon- 2005). Numerous systematic reviews of characterize a therapeutic intervention stitute an effective motor, cognitive and the literature (including many Cochrane such as the presence of a qualified profes- sensory rehabilitation tool (the most com- Reviews), randomized controlled or con- sional, a reference model that defines the mon example in the literature is given by trolled clinical trials and qualitative stud- theoretical and practical details which sup- Neurologic Music Therapy) (Thaut, 2005). ies, all show the significant results that port the intervention (the therapy ratio- Applications that involve listening to come with the therapeutic use of music. nale), the presence of a therapeutic setting, music can be divided into those where The basis underlying the therapeutic and also the ability to define targets and the patient listens to his favorite music potential of music are to be considered therapeutic strategies of intervention with (individualized music listening) (Särkämö in relation to the extensive action which adequate awareness and the possibility to et al., 2008; Gerdner, 2012), and those that music itself exerts on the brain at the cor- verify the therapeutic results achieved. go under the name of “music medicine” tical level but also at the limbic and par- From a careful analysis of the scien- approach (in relation to the possibility alimbic ones (Koelsch, 2009; Levitin and tific literature different applications that of acting on specific symptoms or dis- Tirovolas, 2009). Music and sound also make use of music can be identified: eases) (Haas and Brandes, 2009). Listening affect vital signs and neurochemical sys- music therapy interventions (following to music is different from music ther- tems (such as those of dopamine, opioid, relational or rehabilitative models), music apy techniques mainly in that it does not serotonin, cortisol, oxytocin, etc.) which listening (individualized music listening imply a relational component between the are related to the perception of pleasure, or listening to music based on “music patient/client and the therapist. A thera- reward and motivation, but also to stress medicine” approach) and general music- peutic value is therefore attributed to the and arousal level, to the immune system based interventions. mere action of music. In this case, the role www.frontiersin.org March2015|Volume6|Article230| 1 Raglio and Oasi Music therapy and health of the music therapist is to lay down a pro- disturbances. In the case of music lis- proper music therapy setting in the place gram of music listening. This task can be tening based on the “music medicine” where the treatment is performed (e.g., in carried out either according to the choices approach, pieces are identified on the hospitals). made by the patient/client, or according to basis of the structural characteristics of The generic music-based interventions the structural characteristics of music and music and their parameters, depending can be considered a non-specific use its parameters in relation to the objective on the objective of the treatment. Tracks of music. In these, a professional with of the treatment. In the case of individ- are then proposed that, because of their music skills organizes activities aimed ualized music listening, a trained music nature, can act on the patient/client by at increasing the person’s well-being. In therapist prepares a play-list containing adjusting its physiological and psycholog- particular, the objective is to improve pieces that are emotionally relevant for the ical parameters passing from one phase the person’s mood and motivation, pro- patient/client, or pieces that meet his taste. of resonance to one of gradual change mote socialization and stimulate sensory, Thus, the tracks are selected on the basis and adaptation that goes in the oppo- motor and cognitive aspects in general. of indications given by the patient/client site direction to that of the pathology. These are activities that lack a thera- himself and through an anamnestic work Sometimes “music medicine” approach peutic rationale, they are usually per- involving formal or informal caregivers. is aimed at reducing symptoms, some- formed in groups, where there is neither Music listening based on the selection of times momentarily, and therefore at hav- a real therapeutic setting nor intervention favorite music, as documented in the lit- ing an immediate impact on the person. strategies aimed at achieving specific tar- erature, is aimed at people with a disease, Frequently listening to music is used when gets. The proposed activities are generally often chronic or degenerative, in order the condition of the patient/client does structured and consist of musical interac- to stimulate the patient/client cognitively not allow a direct interaction, or when tion (e.g., rhythmic accompaniment of a and to reduce psychological or behavioral logistical issues do not allow to set up a song, singing, movements associated with Table 1 | Types of intervention with music in clinical settings and their characteristics. Music therapy approaches Listening to music approaches Music-based approaches Relational music therapy Rehabilitative Individualized music Listening to music General music-based music therapy listening based on music approaches medicine approach - Trained music therapist - Trained music therapist - Trained music therapist - A staff with - Absence of a music - Therapeutic Setting -Rehabilitative setting helps patient/client to medical/therapeutic therapist - Psychological models -Neuroscientific models create a playlist including background (sometimes - Absence of a specific - Relationship as the core of - Motor, cognitive and music that meets his/her supported by a music therapeutic setting intervention sensory rehabilitation as taste therapist) creates - Absence of a specific - Specific techniques: active the core of intervention - Absence of a specific specific music listening intervention model approaches (in particular - Specific techniques: therapeutic setting programs for - Making music sonorous-musical active approaches; - Neuroscientific and patient/client (structured musical improvisation) or receptive exercises using psychological

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