
Common Names
- Music listening
- Experiential music
- Singing therapy
- Movement music therapy
- Rhythmic drumming
- Music reminiscence
- Guided song-writing
- Music-assisted relaxation
- Lyric analysis
- Guided Imagery with Music (GIM)
For Patients & Caregivers
Tell your healthcare providers about any dietary supplements you’re taking, such as herbs, vitamins, minerals, and natural or home remedies. This will help them manage your care and keep you safe.
What Is It
Cross-cultural beliefs have long held that music has a healing effect on mind and body. Music can promote relaxation and distract from pain associated with many illnesses. It can also relieve anxiety and distress. Music therapy emerged as a formal discipline in the US in the 1940s, as methods of increased effectiveness became clearer.
Currently, there are close to 8,000 trained therapists in the US alone, with thousands more worldwide. Passive forms of therapy may be used to reduce stress before procedures or ease transition from sedation. More active forms are used for rehabilitation, enrichment, and simple enjoyment. Patients may listen to, play, and even write their own music with guidance from a professionally trained music therapist. Often this process evolves to give meaning and voice to complex emotions that patients may struggle to otherwise articulate. It can also strengthen and enhance communications and support from loved ones. Patient state, physical surroundings, instrument choices, the desire to self-select or create music, and cultural backgrounds are among the considerations that may direct therapy.
A majority of NCI-designated cancer centers now offer music therapy as part of their supportive care programs. In addition, cancer guidelines recommend music therapy for anxiety, stress reduction, depression, and mood disorders. Music therapists also work with other populations, such as specials special needs and mental health patients.
How It Works
Music therapy helps improve social, emotional, and quality of life aspects in patients with cancer, heart disease, Alzheimer’s disease, and dementia. It has also shown benefit in hospitalized children, patients undergoing difficult treatment, and those with terminal illnesses by improving symptoms of anxiety, depression, stress, fatigue, and perceived pain. Other studies have shown it can reduce blood pressure in listeners, and help improve coordination, mobility, and endurance in patients with stroke, multiple sclerosis, and Parkinson’s disease. It may also have positive effects on the nervous system and immune function.
There are many mechanisms by which these effects occur. Selecting the right music can induce either calmness or stimulation, and provide meaning and pleasure. It can offer a welcome distraction or shift perception, induce feel-good chemicals in the brain, spark positive associations and memories, or help patients process and communicate difficult emotions. The rhythm of music can help guide and improve movement coordination. Music can also impart a calming environment to reduce the stress of loved ones and caregivers.
Several forms of music therapy are also used in rehabilitation. For example, singing therapy can improve breathing and lung function. In addition, music can improve adherence to exercise regimens because it is more enjoyable, making it an important component in health-challenged populations.
Purported Uses
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Anxiety
Several clinical trials have shown that music therapy can help reduce anxiety including distress related to surgery and other procedures. Current cancer guidelines recommend music therapy for anxiety. -
Depression
Several studies have shown that music can help reduce depression. Current cancer guidelines recommend music therapy for depression and mood disorders. -
Fatigue
A large study showed that music therapy was associated with greater reduction in cancer-related fatigue and increased reporting of positive affect/emotions compared to passive music therapy. -
Pain
Several clinical trials have shown that music therapy can help reduce pain or pain perception, and possibly reduce pain medication use. However, more studies are needed. -
Stress
This use is supported by clinical trials. Current cancer guidelines recommend music therapy for stress reduction. -
Cancer-related symptoms
Cancer guidelines and a number of studies support music therapy for cancer patients to reduce anxiety, depression, and mood disturbances. -
Family and caregiver support
Music therapy can help reduce stress and enhance communications for loved ones and caregivers. -
Improving exercise adherence
Studies show that carefully selected music is integral to improving exercise adherence in health-challenged populations and in rehabilitation regimens.
Is It Safe
Music therapy is safe, but should be provided by a qualified therapist. Because music therapy is noninvasive, free of side effects, and has shown effectiveness, it is a part of standard supportive care in major cancer hospitals and other institutions. It is also recommended in cancer supportive care guidelines.
Who Can Provide this Service
A professional music therapist holds a degree in music therapy from a college or university program approved by the American Music Therapy Association (AMTA). Graduates may then apply for the national credential of Music Therapist – Board Certified (MT-BC).
Currently, close to 8,000 therapists are board-certified in the US. Therapists may also obtain post-graduate specialty certifications in Hospice and Palliative Music Therapy (HPMT), Neurologic Music Therapy (NMT), and Nordoff-Robbins Music Therapy (NRMT). Some states require additional licensure for music therapists who include psychotherapy in their scope of practice. Qualified therapists are listed in the AMTA’s National Music Therapy Registry. International organizations include the World Federation of Music Therapy and the International Society for Music Education.
Where Can I Get Treatment
Many major hospitals offer some form of music therapy for rehabilitation and supportive care. In addition, a majority of NCI-designated cancer centers now offer music therapy as part of their supportive care programs. Therapists are skilled at employing evidence-based techniques for symptom management in clinical, intensive care, and hospice settings.
The Integrative Medicine Service at MSK offers music therapy and other mind-body modalities in a new online program, Integrative Medicine at Home, to help support the recovery and well-being of cancer patients everywhere.
For Healthcare Professionals
Clinical Summary
Cross-cultural beliefs have long held that music has a healing effect on mind and body. Music can promote relaxation, distract from pain associated with many illnesses, and relieve distress. Music therapy emerged as a formal discipline in the United States in the 1940s, as methods of increased effectiveness became clearer. Currently, close to 8,000 trained music therapists work in clinical settings in the US alone, with thousands more worldwide. Patients passively or actively listen to music, or engage in playing or even writing their own music, with guidance from a professionally trained therapist.
Goals of therapy can include reducing stress before procedures or easing transition from sedation, reducing feelings of isolation, or bringing pleasure into what can often be a sterile setting. This process may evolve to give meaning and voice to complex emotions that patients might struggle to otherwise articulate. It can also strengthen and enrich communications and support from loved ones. Patient demeanor, physical surroundings, instrument availability, the desire to self-select or write music, applied interpretations, and cultural backgrounds are among the considerations that may direct therapy.
Studies have shown that music can reduce perioperative anxiety, pain, and stress (1) (2) (3) (4) (5) (6), and a meta-analysis indicates it can help reduce opioid and sedative medication requirements (10). Both active and passive distraction-based music therapy were effective for pediatric patients undergoing procedures and their caregivers (7) (64). Music was superior to standard care for anxiety among intensive care unit patients receiving acute ventilatory support (8). In addition, it enhanced pulmonary rehabilitation (9) and improved respiratory function in patients with asthma (10). In hemodialysis patients, self-selected music was effective for fistula puncture-related pain (11) and preliminary findings suggest benefits of vocal music therapy in managing chronic pain (65). Music therapy also decreased pain and anxiety during colonoscopy (66).
Music helps improve social and emotional aspects in patients with Alzheimer’s disease (12) (13) (14) and quality of life in patients with dementia (15) (67), stroke (16), and schizophrenia (68). Positive effects of group music therapy were experienced by elderly individuals with mild to moderate dementia (17). Music interventions also reduced anxiety among older adults in an urban emergency department (18), in full-term pregnant women (19), and in women with fibromyalgia (20). However, improvisational music therapy did not reduce symptoms in children with autism spectrum disorder (21) (22).
Music therapy helps to alleviate symptoms associated with cancer and its treatments as well. Data suggest it helps reduce breathing problems and improves quality of life in terminal cancer patients (23) (24) (25). In those undergoing radiation therapy simulation, music therapy lowered anxiety and distress (26). For autologous stem cell transplantation (ASCT) recipients, it reduced narcotic medication use (27) and pain perception (28), and improved mood, coping, and social integration (29) (30). Another study among ASCT patients found acute rather than long-term benefits (31). In patients with malignant lymphomas undergoing chemotherapy, patient-preferred live music decreased anxiety (69). In a retrospective study comparing a single first-time session of either music therapy or massage therapy for adult cancer inpatients, both interventions reduced depressive symptoms, although music therapy was associated with greater reductions (76). In addition, a meta-analysis indicates music therapy can help reduce depressive symptoms, including in cancer patients (71).
In a large study involving patients with different cancer types, active music therapy was associated with greater reduction in cancer-related fatigue and increased reporting of positive affect/emotions compared to passive music therapy (63). Among cancer inpatients, active music therapy was found to be stimulating, and provided opportunities for joyous social interaction not centered on diagnosis, while passive recipients experienced calming therapeutic effects (72). Reductions in pain and/or anxiety have also been demonstrated in pediatric (32) (33) and breast (34) (35) cancer patients, women undergoing colposcopy (36) (37), and those receiving chemotherapy (38) and radiation therapy (39). Conclusions from systematic reviews however, question the clinical significance of music therapy for treating pain (40) and also point to poor methodology in trials (41).
Music also enhances the effects of exercise (42) (43) and may enhance cellular immunity (44). For specific health-challenged populations, careful music selection rather than just exercise performance is an important consideration to improve recovery and long-term adherence to lifestyle changes and physical activity guidelines (43) (45) (46) (47) (48) (49).
Current oncology societies recommend music therapy for anxiety, stress reduction, depression and mood disorders (50) (51). Because it is noninvasive, free of side effects, and has shown effectiveness, music therapy is integrated into standard supportive care at major cancer hospitals.
Virtual mind-body programs that include music therapy have been positively received to more easily access supportive care that enhances coping, motivation, social connections, and adherence to health behaviors (73) (74) (75). The Integrative Medicine Service at MSK offers music therapy and other mind-body modalities in a new online program, Integrative Medicine at Home, to help support the recovery and well-being of cancer patients everywhere.
Mechanism of Action
The effects of music on mood disorders have in part been attributed to the therapeutic framework and interaction that offers patients opportunities for new aesthetic, physical, and relational experiences (52). This can be particularly important as patients who are hospitalized or undergoing treatment may experience increased isolation and limited communication.
Music selection and delivery method are important considerations in periprocedural settings to induce relaxation and decrease anxiety. For example, slow-rhythm music for women undergoing colposcopy reduced anxiety and pain perception (36) (37).
In other therapeutic settings, the intimate nature of music that is written or offered translates to a deeply personal and transporting experience. Listening to preferential music appears to shift the autonomic balance towards parasympathetic activity (53). Background, experiences, and traditions that have meaning to the patient as well as cherished songs or intriguing sounds can engage the brain’s reward circuitry (54), and guide therapy to energize someone who feels lethargic, evoke pleasant sensations and autobiographical memory (55), or calm agitation and distressed mood.
The principle of entrainment, a method used with live music, has been shown to be effective among agitated patients (56). It seeks to musically emulate an existing pattern of body processes to meet a person where they are, effectively offering a bridge by which one can organically move into a less distressed state. In rehabilitation, mechanisms for neurobiological and cognitive effects of singing therapy include neuroplastic reorganization, mirror neuron system activation, multimodal integration, and both shared and distinct features fundamental to music and language (57). Among studies of singing lessons for lung conditions, Parkinson’s disease, and multiple sclerosis, participants had improved breathing, breath control, physical functioning, and mood, and also described it as fun and good exercise (58). Rhythmic movements with a percussion intervention was shown to activate the prefrontal cortex in older adults with mild cognitive impairment (59).
During high-intensity exercise, music promotes ergogenic and psychological benefits but may not reduce perceptions of exertion beyond the anaerobic threshold (42). Animal studies suggest music exposure enhances lymphocyte function in the brain to reverse stress-induced immune suppression (60). In humans, drumming has also been shown to enhance cellular immunity by increasing lymphocyte activated natural killer cell activity (44).
Adverse Reactions
Music therapy is safe, but should be provided by a qualified therapist. Because music therapy is noninvasive, free of side effects, and has shown effectiveness, it is a part of standard supportive care in major cancer hospitals and other institutions. It is also recommended in cancer supportive care guidelines.
Practitioners and Treatments
Music therapist practitioners employ evidence-based techniques for symptom management in clinical, intensive care, and hospice settings. A professional music therapist holds a degree in music therapy from a college or university program approved by the American Music Therapy Association (AMTA). Graduates may then apply for the national credential of Music Therapist – Board Certified (MT-BC).
Currently, close to 8,000 therapists are board-certified in the US. Therapists may also obtain post-graduate specialty certifications in Hospice and Palliative Music Therapy (HPMT), Neurologic Music Therapy (NMT), and Nordoff-Robbins Music Therapy (NRMT). Some states require additional licensure for music therapists who include psychotherapy in their scope of practice. Qualified therapists are listed in the AMTA’s National Music Therapy Registry. International organizations include the World Federation of Music Therapy and the International Society for Music Education.
A skilled music therapist is integral to achieving patient-centered therapeutic directions, offer and assess options for engagement, and encourage patient confidence in expression. For example, a therapist may help a patient write their own music to enjoy experimentation and discovery, take them to a place of understanding about themselves, or provide a means by which they may more easily communicate with loved ones and caregivers.
Many major hospitals offer some form of music therapy for rehabilitation and supportive care. In addition, a majority of NCI-designated cancer centers now offer music therapy as part of their supportive care programs (61). A recent report suggests variable access to music therapy in hospice settings (62). Music therapists also work with other populations, such as specials needs and mental health patients.
The Integrative Medicine Service at MSK offers music therapy and other mind-body modalities in a new online program, Integrative Medicine at Home, to help support the recovery and well-being of cancer patients everywhere.