Research supports therapeutic music

One of the reasons I chose to learn how to provide live harp music for patients is that beneficial results can be seen in the monitors instantly. At the bedside and the nurse’s station, we can witness the change in heart rate, respiration, blood pressure, and pulse oximetry as I'm playing, and there can be no doubt that the music is having a soothing effect…

…and we can also see if the music is not making things better. I request permission of all responsive patients before I play for them, and a responsive patient can ask me to stop at any time. If a patient cannot respond, then I watch the monitors closely to make sure the music or a particular tune is not negatively stimulating.

What can music do?

The studies cited below show that providing patients with soothing music can:

  • Reduce anxiety in general and before surgery

  • Influence heart rate and respiration

  • Reduce blood pressure

  • Lessen the perception and increase the tolerance of pain

  • Boost the immune system

  • Decrease stress hormone levels

  • Distract from negative situations

  • Aid sleep

This 2020 article➚ explores how music works to influence these outcomes. “[M]ost therapeutic outcomes arising from music-based treatments can be traced to one or more of these qualities of music” which are “that music is engaging, emotional, physical, personal, social, persuasive, and affords synchronization.” “What is unique to music is that it employs a comparatively large number of therapeutic capacities within a single package that is at once convenient, enjoyable, and universally accessible.” See reference #1.

Selected research on therapeutic music

A 2022 randomized controlled trial➚ “showed that mindfulness-based breathing and music therapy decreased stress and work-related strain (P < .05) and increased psychological well-being (P < .05)” in nurses. “The control group showed no statistically significant changes on these measures (P > .05).” The term music therapy was improperly used to describe what was actually a therapeutic music intervention: “the participant nurses listened to light piano music as background music” during the instructions on mindful breathing. See reference #2.

After receiving live therapeutic music via FaceTime, participants in a December 2021 study➚ tended to highly agree that the intervention improved their emotional state (92%); that it provided a pleasurable experience (92.4%); and that it reduced their stress and anxiety (89.5%). See reference #3.

After receiving a live therapeutic music session, participants in a September 2021 study➚ “a 44.74% reduction in perceived stress scores were observed” among healthcare workers. See reference #4.

A 2020 pilot study➚ shows live harp music being more effective than recorded harp music in reducing heart rate and blood pressure before surgery. See reference #5.

When live music was provided in a 2018 mixed qualitative and quantitative study➚, patients’ perceptions of pain, nausea, depression, anxiety, and shortness of breath decreased. Overall feelings of well-being increased. Among participants who were being treated with opioids, “there was a trending toward significant decrease in opioid use.” See reference #6.

This 2018 qualitative study➚ explores the differences between how performing musicians versus therapeutically trained musicians address therapeutic music in open areas of a hospital (lobbies, nurses’ stations). Therapeutic musicians provide a wider variety of music, which is adjusted on the fly to meet the needs of the environment in the moment. Providing music in a therapeutic setting is oriented towards the needs of the environment (such as reducing anxiety in a waiting room) as opposed to an entertainment-focused music performance. See reference #7.

A 2016 literature review➚ documents the following: “Music listening, widely used for stress release in all areas of medicine, tends to be a reliable and efficacious treatment for those critically ill patients. It can abate the stress response, decrease anxiety during mechanical ventilation, and induce an overall relaxation response without the use of medication. This relaxation response can lower cardiac workload and oxygen consumption resulting in more effective ventilation. Music may also improve sleep quality and reduce patient's pain with a subsequent decrease in sedative exposure leading to an accelerated ventilator weaning process and a speedier recovery.” The term music therapy in this paper refers to music listening, which is what a therapeutic musician provides, rather than an interactive session with a board-certified Music Therapist. See reference #8.

But is live music from a certified therapeutic musician always beneficial, all the time, for everyone? No. This small 2012 study➚ (N=20) brings up some real but addressable issues from staff experiencing live therapeutic music peripherally and directly. The staff recognizes the music as being helpful to patients, but it can be stressful for them to hear the same pieces played over and over as the months and years go by, especially pieces that they themselves don’t enjoy. Hearing music is not helpful to staff when they are engaging with emergencies or stressful cases. These concerns can be ameliorated by coordinating with staff before providing music interventions and keeping repertoire fresh. See reference #9.

Selected reports on therapeutic music

A 2019 WHO report➚ aggregates studies that show how patients with a wide range of illnesses and conditions can benefit from receiving music, from mental illness to surgery to general inpatient care. The report includes these benefits for staff: “Music has been found to improve mood and reduce stress while working, as well as improving levels of concentration, efficiency, enthusiasm and ordered working.” See reference #10.

This 2012 article➚ discusses how unwanted noise in healthcare settings contributes to staff errors, longer hospital stays, and decreased HCAHPS scores. “Noise-induced stress is contagious, impacting family members who eventually wind up at the nurses' station complaining about a variety of issues worsened by the extraneous noise… [T]he distraction, interruption, stress, confusion, and challenge to clear communication caused by noise…leads directly to safety issues.” See reference #11.

This 2014 article➚ seeks to remove some of the mystery behind choosing music for patients: “To elicit a specific clinical response…one must approach the process through specificity and systematic guidelines. First, through detailed assessment, to determine preferences, culturally, physiologically and cognitively, and to meld these with specific individualized goals. Second, by means of equally detailed analysis of music elements in patient preferred music to provide effective music stimuli.” Although Certified Music Practitioners use live music, and our intentions are to assist in transition or to support overall healing rather than “specific individualized goals,” CMPs use a similar method to alter the elements of music to match the needs of the patient in the moment. See reference #12.

Links to research referenced above

  1. Why is Music Therapeutic for Neurological Disorders? The Therapeutic Music Capacities Model➚. Brancatisano O, Baird A, Forde Thompson W. Neuroscience & Biobehavioral Reviews 2020

  2. The effect of mindfulness-based breathing and music therapy* practice on nurses' stress, work-related strain, and psychological well-being during the COVID-19 pandemic➚. Yıldırım D corresponding author and Yıldız CC. Holistic Nursing Practice 2022.

  3. Neurology telemusic program at the time of the COVID-19 pandemic: Turning hospital time into aesthetic time during crisis➚. Bonakdarpour B, McFadden A, Zlotkowski S, Huang D, Shaker M, Shibata B, Haben W, Brashear C, Sandoval A, Breitenbach C, Rodriguez C, Viamille J, Porter M, Galic K, Schaeve M, Thatcher D, Takarabe C. Frontiers in Neurology 2021.

  4. Impact of live therapeutic music on stress levels among healthcare workers in COVID-19 critical care units➚. Bittel CL, Beckman C, Carrega J. Interprofessional Journal of Healthcare and Research 2021.

  5. Efficacy of live versus recorded harp music in reducing preoperative stress and fear related to minor surgery: A pilot study➚. Gelatti F, Viganò C, Borsani S, Conistabile L, Bonetti L. Alternative Therapies 2020.

  6. Music intervention as a tool in improving patient experience in palliative care➚. Peng CS, Baxter K, Lally KM. American Journal of Hospice and Palliative Medicine 2018.

  7. Environmental music in a hospital setting: Considerations of music therapists* and performing musicians➚. Zhang JW, Doherty MA, Mahoney JF. Music & Medicine 2018.

  8. Music therapy*, a review of the potential therapeutic benefits for the critically ill➚. Mofredj A, Alaya S, Tassaioust K, Bahloul H, Mrabet A. Journal of Critical Care 2016.

  9. The incidental impact of music on hospital staff: An Italian case study➚. Preti C, Welch GF. Arts & Health 2012.

  10. What is the evidence on the role of the arts in improving health and well-being? A scoping review➚. Fancourt D, Finn S. WHO Regional Office for Europe 2019.

  11. Creating a culture of safety: Reducing hospital noise➚. Mazer SE. Biomedical Instrumentation Technology 2012.

  12. Towards prescribed music in clinical contexts: More than words➚. Rossetti A. Music & Medicine 2014.

* Some studies use the term music therapy to refer to a patient passively listening to music. I have only cited studies that use music therapy in this passive sense. Studies about active music therapy do not reflect what I do as a therapeutic musician. Read more about the difference between music therapy and therapeutic music, or see ways to contact me.