Introduction to Cognitive Behavioral Music Therapy (CBMT)

A literature review on the effectiveness of Cognitive Behavioral Music Therapy (CBMT) for symptoms of anxiety and depression.

Until recently, the strongest evidence for the clinical efficacy of treatment for anxiety disorders has been the use of psychotropic medications, such as Selective Serotonin Reuptake Inhibitor’s (SSRI) (Allgulander, 2010). Examples of commonly used SSRIs for the treatment of anxiety disorders include: Citalopram, Escitalopram, Fluoxetine, and Sertraline (Mayo Clinic, 2019.)  

Over the course of several decades it became clear that medication alone was not successful in the long term treatment for symptoms of anxiety disorders (Lanouette & Stein, 2010).  

Among the more popular theories was the idea that a combination of CBT and psychotropic medication may produce a more powerful therapeutic benefit. A study in 2010 looked at the efficacy of psychosocial treatments, short-term psychotherapy, and mindfulness meditation-based cognitive therapies (Ravindran and Stein, 2009). This study was implemented with patients diagnosed with an anxiety disorder, studied the interventions both on their own and when integrated with medication (Ravindran and Stein, 2009, Lanouette & Stein, 2010).

Initially the study showed that these therapeutic approaches benefited patients, even in treatment-resistant cases (Ravindran and Stein, 2009). Upon further investigation, studies revealed that up to 50% of diagnosed patients remained symptomatic, regardless of the integration of these first line treatments (Hoge et al., 2004).

These statistics inspired a group of researchers in 2015 to conduct further studies which suggested that the integration of music therapy, both with and without medication, would result in a patient’s ability to access deeper states of preoccupation and concentration (Gutiérrez, & Camarena, 2015).

It was theorized believed that would lead to a greater likelihood of the patients’ ability to evoke positive memories, lending to a higher success rate of CBT. With guidance and repetition, new neural pathways would strengthen, allowing the patient to experience potentially negative experiences without and the ability to initiate a new perspective on how to approach them.

Researchers first administered the Beck Anxiety Inventory (BAI) and the Beck Depression Inventory (BDI) to estimate initial levels of both depression and anxiety. The study took place over the course of three months, and consisted of 12 two-hour structured sessions that were held once a week (Gutiérrez, & Camarena, 2015). The program was structured around the integration of MT to stimulate positive memories, and in turn to provide a reliable and predictable space for participants to work through negative experiences. This is a process referred to as cognitive restructuring in CBT (Dobson & Dozois, 2010).

Upon conclusion of the music therapy treatment, the BAI and BDI were re-administered and scores were compared.

The results of the study show that the mean score on the BAI pre-test (24.8), had decreased significantly when compared to the score on the post-test (8.2). Similarly, the mean score on the BDI pre-test (14.5) decreased to a post-test score of 6.2 (Gutiérrez, & Camarena, 2015).

Though this test was a pilot study, consisting of less than 200 participants, Gutiérrez & Camarena reflected that recruitment to their CBMT program was feasible, retention rates were high, and the participants reported a significant reduction in symptoms of depression and anxiety (Gutiérrez, & Camarena, 2015). The findings of this study demonstrate that CBMT was effective in reducing long term effects of anxiety and depression, showing once again the power of music to positively impact our mental health.  

Source: Alsterlind, C. (2020)

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