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Tuning In: The Role of Music Therapy in Mental Health and Addiction Treatment

Kirsten Davis, a music therapist at Homewood Ravensview, a private inpatient facility for mental health and addiction recovery in British Columbia, sits in front of a piano with her patient. The woman is terrified, her body tense, her fingers reluctant to so much as touch the keys. Gradually, Davis encourages her to play a chord. Then another. And another. What happened next is a testament to the extraordinary healing power of music.

“She started to relax,” Davis recalls. “Together, we played, and she started to laugh and do silly things on the piano, like playing it with her elbows.”

Goofing off at the piano may not seem like much of breakthrough, but Davis’s patient was a residential school survivor who was struck by the nuns who taught her every time she played the wrong note. Traumatized, she had not touched a piano since. But at Ravensview, she was finally ready to face her fears and find her voice. 

“At the end of the session, she discovered that the piano was not this scary monster anymore,” says Davis. “It was something that could be fun and joyful.” 

The healing power of music

Humans have instinctually recognized the power of music for centuries. In ancient Greece, music’s effect on the mind and body was considered so intense that some believed it should be controlled. In ancient Egypt, physicians used music to help patients recover from illness. And in many Aboriginal cultures, music is viewed as a powerful healing tool.

Today, music is globally recognized as a therapeutic intervention in a wide variety of clinical contexts. To date, more than 1,000 scientific studies have been published on the topic of music therapy and its impact on everything from asthma management to autism to pre-term infant care to palliative pain relief. Music therapy has also become a vital component in mental health and addiction treatment options for conditions such as anxiety, depression, dementia, stress, PTSD, and addiction to alcohol, drugs, or prescription medications.

In this article, we’ll look at how music is being integrated into holistic treatment programs in Canada to help people identify, explore, and regulate their emotions to discover new resilience, confidence, and authenticity.

What is music therapy?

Music therapy uses music as a therapeutic tool to address emotional, cognitive, social, and physical needs of individuals. It is delivered by a trained and licensed therapist who uses music to help people achieve therapeutic goals, such as improving communication and expressive skills, managing stress, and enhancing overall well-being.

Music therapy can involve a wide array of activities, including group drumming sessions, learning to play an instrument such as the guitar or piano, singing and breathwork, sharing and analyzing songs, creating new music, lyrics, or soundscapes individually or as a group, or simply listening to music for relaxation or emotional discovery.

Davis believes that music therapy provides an important outlet.

“There’s so much work that we do in treatment that’s based on talking,” she says. “If we can provide ways for people to express themselves without using words, that’s really important.”

Priya Shah, who provides music therapy at Homewood Health Centre, an inpatient treatment facility in Guelph, Ontario, sees music as a way to explore difficult emotions or experiences safely.

“Music can act as a form of symbolic distance,” she explains. “Someone can say they relate to a specific song or lyrics without actually saying, ‘This is what happened to me,’ or ‘This is how I’m feeling.’”

Who benefits from music therapy?

As part of mental health and addiction treatment services, music therapy benefits a wide range of individuals as part of a holistic treatment approach. At Homewood Health facilities, music therapists collaborate with other expressive arts therapists (art, creative writing, and horticulture), cognitive behavioural and dialectical behavioural therapists, physicians, and nurses to develop programs for:

  • People with acute or life-threatening psychiatric conditions or addictions
  • People who have been diagnosed with depression, bipolar disorder, or anxiety disorders such as generalized anxiety disorder, social anxiety disorder, panic disorder, or agoraphobia
  • First responders, including firefighters, paramedics, law enforcement, military personnel, and veterans, who have post-traumatic stress disorder (PTSD) or occupational stress disorder (OSI)
  • People with neurocognitive impairment or forms of dementia including Alzheimer’s
  • Youth in their teens to early 20s with mental health or addiction issues or a history of trauma and secondary diagnoses such as eating disorders or self-harm

How music therapy supports recovery

Shah and Davis both describe music as a versatile medium that can promote the emotional wellbeing of people undergoing mental health and addiction treatment by helping them to connect with, understand, and share their emotions in a safe and creative environment.

Connecting with emotion

Shah says that people often come to music therapy with a certain emotion in mind that they’d like to evoke through music. With the help of a trained music therapist, they can get in touch with those sometimes-overwhelming emotions in a safe space.

“Sometimes patients come to a group saying, ‘I want to release some anger,’ or, ‘I want to cry,’” says Shah. “There can be moments that feel uncomfortable, messy, and chaotic, but music can act as a form of symbolic distance. In individual or group sessions, we practice using music to build distress tolerance.”

Understanding emotion

Being able to name, understand, and accept the emotions they feel also plays an important role in a person’s recovery, and it’s a skill many people in recovery have difficulty with.

“Music can help people identify and express emotions,” Davis says. “We’ll sometimes listen to a song and pull it apart to understand what mood it’s expressing and why people are connecting with that.”

Sharing emotion

Music can also be used to bring people together and help them understand and accept one another and themselves. By sharing a favourite song or lyric with a group, or by creating music and sounds that express their feelings and experiences, people can learn to connect with others and build relationships of trust.

“A lot of the benefit comes from relating to peers and connecting with people who have had similar experiences,” Davis explains. “People find such comfort in realizing they’re not alone, that there are other people who have had those kinds of experiences.”

Creating a safe space

People receiving treatment for mental health and addiction issues face intense psychological challenges, and the emotions and experiences that music evokes can be overwhelming if they are not explored with the help of a trained therapist.

To help their patients safely explore and gain control over the intense emotions that can come up during a therapy session, Shah and Davis ensure that every session is personalized, structured, and nonjudgmental.

Personalized

Shah never sets a routine or schedule. Instead, she checks in with the individual or group to assess what’s needed in the moment and that sets the direction for the session. Activities can include listening to music, singing, playing instruments, creating music or soundscapes, writing lyrics, analyzing or talking about a piece of music, or even dancing.

Davis also takes care to customize the music selection to reflect participants’ tastes. For example, for the “My Path” mental health treatment program for youth at Ravensview, the music selection leans toward hip-hop, rap, and pop.

“For young people, research shows that music is very connected to identity development,” says Davis. “It can help them get in touch with their angst and anger at a safe distance and sharing that music with peers can really validate their experience.”

Structured

Despite being flexible in her approach, Shah believes in carefully structuring therapy sessions so that participants can be playful and experiment, but also have a framework to guide them if they need it.

“Creating sound isn’t always harmonic or pretty. Building comfort with those messy parts of music is an important part of the process,” Shah says. “There can be a lot of perfectionism and fear of getting things wrong. Having something structured can give people something to hold on to, some comfort and instruction. Part of my job is knowing when to challenge and when to let music be a safe place.”

Nonjudgmental

Davis and Shah both agree that one of the most crucial elements of music therapy is its ability to help people overcome negative thoughts and self-image, and both therapists actively create affirmative, accepting spaces.

“People come in with a lot of expectations of themselves,” says Davis. “And they come in thinking that this is about performance, or accuracy, or talent. People will say, ‘I’m tone deaf. I can’t carry a tune in a bucket.’ And we have to break through that, because music is genetically programmed into everybody.”

The impact of music therapy

The effect of music on patients in a therapeutic setting has been researched extensively. Over the past 20 years, more than 1,000 studies have been published on the topic, and there is considerable evidence that music therapy is an effective treatment adjunct for a wide range of mental health and addiction treatments.

Music therapy and trauma

There is evidence that music therapy is a useful therapeutic tool for reducing symptoms and improving functioning among individuals with trauma exposure and PTSD.

Music therapy and schizophrenia

Music therapy helps people with schizophrenia improve their mental state, social functioning, and quality of life.

 Music therapy and dementia

People with Alzheimer’s disease and dementia saw improved non-verbal expression, reduce anxiety and depression.

 Music therapy and addiction

A study of 53 women found that those who experience situational or chronic anxiety related to their addictive disorder saw a significant decrease in anxiety with music therapy.

Music therapy and youth mental health

A meta-analysis of nine papers suggested that for children and teenagers with conditions such as depression and anxiety, music therapy had the potential to improve communication, reduce depression, and increase self-esteem.

Writing a new song

Music can play a critical role in the journey toward recovery by helping people with mental health and addiction issues to safely explore, reconnect with, and regulate powerful and sometimes destructive emotions. By exploring rhythm, melody, sound, and lyrics, they can reconnect with and replenish their inner stores of joy, courage, and creativity on the way to recovering and rediscovering their authentic selves.

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Homewood Health Centre is a fully accredited, physician-led, medically-based inpatient treatment facility offering several specialized programs and extensive services to treat a wide range of mental health issues including trauma, addiction, anxiety, depression as well as co-occurring mental health and addiction issues.
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