Marko Punkanen

Individual music therapy for depression: randomised controlled trial

BACKGROUND Music therapy has previously been found to be effective in the treatment of depression but the studies have been methodologically insufficient and lacking in clarity about the clinical model employed. Aims To determine the efficacy of music therapy added to standard care compared with standard care only in the treatment of depression among working-age people. METHOD Participants (n = 79) with an ICD-10 diagnosis of depression were randomised to receive individual music therapy plus standard care (20 bi-weekly sessions) or standard care only, and followed up at baseline, at 3 months (after intervention) and at 6 months. Clinical measures included depression, anxiety, general functioning, quality of life and alexithymia. TRIAL REGISTRATION ISRCTN84185937. RESULTS Participants receiving music therapy plus standard care showed greater improvement than those receiving standard care only in depression symptoms (mean difference 4.65, 95% CI 0.59 to 8.70), anxiety symptoms (1.82, 95% CI 0.09 to 3.55) and general functioning (-4.58, 95% CI -8.93 to -0.24) at 3-month follow-up. The response rate was significantly higher for the music therapy plus standard care group than for the standard care only group (odds ratio 2.96, 95% CI 1.01 to 9.02). CONCLUSIONS Individual music therapy combined with standard care is effective for depression among working-age people with depression. The results of this study along with the previous research indicate that music therapy with its specific qualities is a valuable enhancement to established treatment practices.

The effect of improvisational music therapy on the treatment of depression: protocol for a randomised controlled trial

BackgroundMusic therapy is frequently offered to individuals suffering from depression. Despite the lack of research into the effects of music therapy on this population, anecdotal evidence suggests that the results are rather promising. The aim of this study is to examine whether improvisational, psychodynamically orientated music therapy in an individual setting helps reduce symptoms of depression and improve other health-related outcomes. In particular, attention will be given to mediator agents, such as musical expression and interaction in the sessions, as well as to the explanatory potential of EEG recordings in investigating emotion related music perception of individuals with depression.Methods85 adults (18–50 years of age) with depression (ICD-10: F 32 or F33) will be randomly assigned to an experimental or a control condition. All participants will receive standard care, but the experimental group will be offered biweekly sessions of improvisational music therapy over a period of 3 months. A blind assessor will measure outcomes before testing, after 3 months, and after 6 months.DiscussionThis study aims to fill a gap in knowledge as to whether active (improvisational) music therapy applied to people with depression improves their condition. For the first time in this context, the mediating processes, such as changes in musical expression and interaction during the course of therapy, will be objectively investigated, and it is expected that the results will provide new insights into these processes. Furthermore, the findings are expected to reveal whether music related emotional experiences, as measured by EEG, can be utilized in assessing a depressive clients improvement in the therapy. The size and the comprehensiveness of the study are sufficient for generalizing its findings to clinical practice as well as to further music therapy research.Trial registrationISRCTN84185937

Contemporary Vibroacoustic Therapy: Perspectives on Clinical Practice, Research, and Training

Vibroacoustic therapy (VAT), traditionally considered to be a physical and receptive type of music therapy intervention, uses pulsed, sinusoidal, low-frequency sound on a specially designed bed or chair. Today VAT is viewed as a multimodal approach, whereby the therapist works with the client’s physiological and psychological experiences, incorporating a mind–body approach. This article provides current knowledge in clinical practice emphasizing the systematic and documented implementations of VAT. This includes presentation and explication of the key elements of VAT, assessments, treatment plans and procedures, documen- tation, and evaluation of the treatment with recommendations for follow-up care in health and rehabilitation. Recent research is presented, and directions for future research are considered. Applicable views on clinical training and required competencies are outlined.

Biased Emotional Preferences in Depression: Decreased Liking of Angry and Energetic Music by Depressed Patients

Depression is a highly prevalent mood disorder, which has been associated with low levels of energetic arousal, delays in approach and avoidance processes, and problems expressing and regulating negative emotions such as anger. We designed a novel experiment to test the hypothesis that depressed patients’ preferences for emotional stimuli also demonstrate this tendency. To investigate how depressed patients differ in their preferences for music excerpts, both healthy (n 1⁄4 30) and depressed (n 1⁄4 79) participants were presented with 2 sets of 30 musical excerpts that represented the basic emotions (anger, sadness, and happiness), as well as different points on the 2-dimensional model of emotions (valence and energetic arousal). Depressed patients were found to dislike music that was highly energetic, arousing, or angry, which is assumed to be related to their problems with emotion regulation. The present study has practical implications for the use of music and music therapy in the treatment of depression. Keywords depression, approach and avoidance motivation, liking and preference, music, emotion