Music Therapy Protocol Research Articles

Proposal of Music Therapy Protocol for Ataxic Patients

Neurologic music therapy has been studied as an alternative methodology to stimulate neurological patients in a motor rehabilitation process. It uses music and its elements in a feedback-feedforward system, promoting an environment for neuroplasticity and re-learning of movements. Research to evaluate the use of neurologic music therapy in patients with ataxia due to Parkinson's and Stroke diseases has shown positive impacts on function rehabilitation, resulting in improvements in activities of daily living and life quality self-perception. The main goals for patients with ataxia described in available research are related to the positive impact on gait function, limb movements, speech, and postural impairment. The most commonly used techniques in neurologic music therapy research are Therapeutical Instrumental Music Performance (TIMP) and Rhythmic Auditory Stimulation (RAS). Literature indicates that both techniques are typically studied independently. Research on the application of neurologic music therapy to ataxic patients, whether due to genetic factors or acquired cerebellar damage, as well as protocols to assist music therapists in implementing these methodologies, are not available. The objective of this study is to propose a music therapy protocol for patients with ataxia from any disease or acquired, using neurologic music therapy and its techniques (TIMP and RAS), to measure the contribution in reducing impacts of ataxia in motor functions, improving patients’ autonomy in daily living activities and as a consequence higher life quality self-perception, also contributing to increasing literature availability regarding this theme. For protocol application feasibility and considering ataxia prevalence in the total population, an experimental group of 15 patients diagnosed with ataxia without impairment on auditory systems will be designed.

Preoperative anxiety management for elderly patients undergoing cataract surgery: An integrative review

BackgroundPreoperative anxiety in elderly cataract surgery patients presents challenges, demanding effective non-pharmacological interventions to ensure patient safety. MethodA comprehensive review was conducted on PubMed, CINAHL, and Embase from 2013 to 2023. Twelve experimental studies were analyzed. Interventions such as music therapy, education videos, hand massages, and non-fasting protocols were evaluated, with anxiety measured using various scales and physiological indicators. ResultOverall, the findings highlight the efficacy of these interventions in managing preoperative anxiety among elderly cataract surgery patients. Seven studies measured physiological indicators such as blood pressure or heart rate alongside anxiety scales, with four studies showing significant reductions of those indicators alongside anxiety reduction. ConclusionThese non-pharmacological interventions offer an effective alternative to pharmacological approaches, enhancing patient safety and potentially reducing healthcare costs related to polypharmacy. The international scope of the studies suggests broad applicability across diverse cultural contexts, advocating for their inclusion in hospital protocols.

Music therapy during weaning from mechanical ventilation in the intensive care unit: Study protocol for a randomised control trial

ABSTRACT Introduction People admitted to the intensive care unit (ICU) who require mechanical ventilation (MV) must complete the weaning process as soon as possible to reduce associated risk factors. Previous research suggests that music therapy may be beneficial for improving breathing capacity and relaxation, but studies related to weaning are limited. This article presents a music therapy protocol for a randomised controlled trial (RCT). Method ICU patients aged 18–80 who meet the clinical criteria for initiating weaning are eligible for this RCT with two parallel groups. Participants (n = 100) are randomly assigned to a control group (receiving standard treatment during weaning) and an intervention group (receiving daily music therapy intervention combined with standard treatment). The outcome measures are (1) duration of weaning in hours, (2) dosage of sedatives and analgesia, (3) agitation, (4) delirium, (5) perception of pain, and (6) perceived stress at 90 days follow-up. During music therapy, (7) blood pressure, heart rate, respiratory rate and oxygenation level are only measured in the intervention group. The flexible music therapy protocol addresses patient needs from a humanistic biopsychosocial perspective. It includes an assessment of individual music preferences (adapted from the Musical Life Story Questionnaire) and methods such as entrainment, clinical instrumental improvisation, songwriting, and receptive music therapy to reinforce breathing capacity and promote relaxation, stimulation, communication, and emotional regulation. Discussion The findings of this study may offer relevant implications for healthcare delivery and the application of music therapy during weaning in the ICU.

Music.ALS: Clinical Perspectives on a Home-Based Music Therapy Treatment to Improve Breathing, Speech, Swallowing and Cough of Persons with ALS (MND)

Respiratory failure, malnutrition, aspiration pneumonia and dehydration contribute to mortality in ALS / MND, and loss of verbal communication impacts quality of life. There are few interventions that help with the management of these symptoms alongside pharmacological ones. Neurologic music therapy protocols, which are biomedical interventions, have been demonstrated to be effective for the treatment of human neurodegenerative disorders, but less so with ALS. Two case studies from a larger, published ALS study were selected for this new report to provide an insight into the practical aspects of music therapy treatment. The home-based protocol was designed to sustain bulbar and respiratory functions of persons with early and mid-stage onset. It was delivered to all participants twice-weekly for six weeks as a part of a 16-week ABA mixed methods study. Feasibility data (recruitment, retention, adherence, tolerability, self-motivation, personal impressions) and 34 biomedical outcome parameters for bulbar and respiratory changes were collected. The two studies highlight the differences in therapy process between participants – one with a spinal onset, slow progression ALS and another with a bulbar onset, rapid progression. In both cases, music therapy was tolerated well and perceived as pleasant, although moderately challenging. For both participants, developing the sense of agency played an essential role in the therapy process. Minor treatment protocol modifications were needed. Positive changes in the objective measures of respiration, cough, speech and swallowing were observed. Suggested individual adaptations of the experimental music therapy protocol included modifications of sitting posture, breathing technique, consonant changes in singing exercises, additional pauses and stretching, and changes to preferred song therapeutic performance. A pilot study utilising the modified protocol is called for, followed by an RCT to assess the clinical effectiveness of the innovative MT treatment.

Retinopathy of Prematurity Screening Exams, Adverse Events, and Music Therapy: A Case Series

Abstract Preterm (PT) infants are routinely screened for retinopathy of prematurity (ROP). After ROP screening exams, PT infants are at risk for adverse events (AEs), including apnea and bradycardia (ABD), respiratory decompensation, infection, and gastrointestinal complications. Music therapy (MT) has been shown to improve overall physiologic stability in PT infants in the neonatal intensive care unit (NICU). In this case series, a board-certified music therapist used a music therapy protocol during 47 ROP screening exams. The study’s purpose was to explore the potential effects of NICU MT on AEs linked to ROP screening. No infant had any respiratory decompensation, new infection, or other complications. The rate of ABD after screening exams was low. MT during ROP screening appears safe and feasible. We hypothesize that MT might prevent ABD associated with ROP screening, a theory that could be effectively studied in a randomized controlled trial.

Home-Based Music Therapy to Support Bulbar and Respiratory Functions of Persons with Early and Mid-Stage Amyotrophic Lateral Sclerosis-Protocol and Results from a Feasibility Study.

Respiratory failure, malnutrition, aspiration pneumonia, and dehydration are the precursors to mortality in ALS. Loss of natural communication is considered one of the worst aspects of ALS. This first study to test the feasibility of a music therapy protocol for bulbar and respiratory rehabilitation in ALS employs a mixed-methods case study series design with repeated measures. Newly diagnosed patients meeting the inclusion criteria were invited to participate, until the desired sample size (n = 8) was achieved. The protocol was delivered to participants in their homes twice weekly for six weeks. Individualised exercise sets for independent practice were provided. Feasibility data (recruitment, retention, adherence, tolerability, self-motivation and personal impressions) were collected. Bulbar and respiratory changes were objectively measured. Results. A high recruitment rate (100%), a high retention rate (87.5%) and high mean adherence to treatment (95.4%) provide evidence for the feasibility of the study protocol. The treatment was well tolerated. Mean adherence to the suggested independent exercise routine was 53%. The outcome measurements to evaluate the therapy-induced change in bulbar and respiratory functions were defined. Findings suggest that the protocol is safe to use in early- and mid-stage ALS and that music therapy was beneficial for the participants’ bulbar and respiratory functions. Mean trends suggesting that these functions were sustained or improved during the treatment period were observed for most outcome parameters: Maximal Inspiratory Pressure, Maximal Expiratory Pressure, Peak Expiratory Flow, the Center for Neurologic Study—Bulbar Function Scale speech and swallowing subscales, Maximum Phonation Time, Maximum Repetition Rate—Alternating, Maximum Repetition Rate—Sequential, Jitter, Shimmer, NHR, Speaking rate, Speech–pause ratio, Pause frequency, hypernasality level, Time-to-Laryngeal Vestibule Closure, Maximum Pharyngeal Constriction Area, Peak Position of the Hyoid Bone, Total Pharyngeal Residue C24area. Conclusion. The suggested design and protocol are feasible for a larger study, with some modifications, including aerodynamic measure of nasalance, abbreviated voice sampling and psychological screening.

Embracing technological possibilities in the telehealth delivery of interactive music therapy

ABSTRACT Introduction Given how many music therapists have shifted their practice to telehealth in accordance with COVID-19 public safety precautions, it is essential for clinicians not only to adjust to the virtual platform, but to embrace the therapeutic potential of technological tools. Just as music is considered a therapeutic agent in music therapy sessions, the authors assert that technology may also be conceptualized and utilized as a means of enhancing therapeutic outcomes. Method Referencing an interactive music therapy protocol adapted for telehealth as part of a pain management study, the authors examine ways in which different aspects of telehealth technology can be used by music therapists to support client goals and bolster the therapeutic relationship. Generalized clinical examples drawn from virtual sessions are incorporated to demonstrate the unique therapeutic possibilities for client agency, client self-efficacy, and the client-therapist relationship afforded by the telehealth platform. Results Among the possibilities afforded by telehealth are enriched opportunities for client choice, reinforcement of learning and implementing new transferrable skills, and enhancing the therapeutic relationship through collaborative troubleshooting and adapted interactive music experiences. Discussion Specific recommendations for music therapists are included to advance the conversation around best practices regarding telehealth. The authors discuss actionable items for music therapists such as utilizing screen-sharing options to enhance musical interactions, validating and exploring clients’ use of technology for self-disclosure, and other strategies for harnessing the therapeutic potential of technology in virtual music therapy sessions.

Effects of Music Therapy on Quality of Life in Adults with Sickle Cell Disease (MUSIQOLS): A Mixed Methods Feasibility Study.

PurposeTo investigate the feasibility, acceptability, and preliminary efficacy of a 6-session music therapy protocol on self-efficacy, quality of life, and coping skills in adults with sickle cell disease (SCD).Patients and MethodsUsing a mixed-methods intervention design, adults with SCD (ages 21–57; mean age 32.33) were randomized (1:1) to either 1) a 6-session music therapy (MT) intervention (n = 12) or 2) waitlist control (WLC) (n = 12) using stratified randomization where factors were age in years (≤30 vs >30), and sex (male, female). All participants completed two weeks of daily electronic pain diary entries and self-efficacy, quality of life, and coping skills measures before and after their assigned study condition to explore preliminary efficacy. MT participants were taught music exercises accessed via smartphone and subsequently interviewed to determine feasibility and acceptability.ResultsThe enrollment rate was 89%. All study measures were completed, with high rates of electronic pain diary completion at baseline (70%) and 2-week follow-up (66%). Interviews revealed two overall themes related to MT participants’ experience: 1) participants learned new self-management skills and 2) MT improved participants’ ability to cope with pain. MT participants demonstrated 100% attendance. In preliminary analyses, MT participants demonstrated significant improvements (means ± SD) in self-efficacy (5.42 ± 5.43, p = 0.008, d = 1.20), PROMIS sleep disturbance (−1.49 ± 6.68, p = 0.023, d = −0.99), PROMIS pain interference (−2.10 ± 4.68, p = 0.016, d = −1.06), and ASCQ-Me social functioning impact scores (2.97 ± 6.91, p = 0.018, d = 1.05) compared to WLC participants.ConclusionPreliminary findings support the feasibility and acceptability of music therapy for home use in adults with SCD. While music therapy may assist adults with SCD in improving self-efficacy and quality of life, subsequent, fully-powered clinical research is needed to determine its efficacy.

Effect of a Music Therapy Intervention Using Gerdner and Colleagues' Protocol for Caregivers and Elderly Patients with Dementia: A Single-Blind Randomized Controlled Study.

Music therapy (MT) is considered one of the complementary strategies to pharmacological treatment for behavioral and psychological symptoms (BPSD) of dementia. However, studies adopting MT protocols tailored for institutionalized people with dementia are limited and their usefulness for supporting caregivers is under investigated to date. Our study aimed at evaluating the effects of an MT intervention according to Gerdner and colleagues’ protocol in a sample of 60 elderly people with moderate-to-severe dementia of the Auxologico Institute (Milan, Italy) and associated caregivers, randomly assigned to an Experimental Group (EG) (n = 30) undergoing 30 min of MT two times a week for 8 weeks and to a Control Group (n = 30) (CG) receiving standard care. Before and after the intervention, residents-associated caregivers were administered the Caregiver Burden Inventory (CBI) and the Neuropsychiatric Inventory (NPI). Depression and worry were also assessed in caregivers prior to the intervention, by the Beck Depression Inventory-II and the Penn State Worry Questionnaire, respectively. A mixed model ANCOVA revealed a Time*Group effect (p = 0.006) with regard to CBI decreasing after the intervention for the EG and Time*Group effects (p = 0.001) with regard to NPI_frequencyXseverity and NPI_distress, with a greater effect for the EG than the CG. Implications for MT protocols implementations are discussed.

Standardized music therapy with and without acclimatization, to improve EEG data acquisition in young children with and without disability

IntroductionIn young children, EEG data acquisition during stimulation tasks is difficult due to anxiety, movement and behaviorally-related interruptions, especially in those with disabilities. New methodWe used standardized music therapy (MT) protocols with and without acclimatization, during and prior to time-locked EEG with a published tactile testing protocol. Our prospective study leveraged a larger trial in children with/without cerebral palsy aged 7–27 months. Group1 received no preparation, Group2 received 15-minute MT prior to the EEG session, Group3 received the same as Group2 plus a rubber cap for home practice. All groups received MT procedural support during the EEG session. Sessions were stopped/started to acquire a full dataset. Trials were reviewed using a two-step artifact detection strategy by specialists masked to group allocation. Results64 patients were included, 20 each in Groups 2 and 3, and 24 in Group1. Average age was 16.08 ± 6.33 months. All (100%) of children had data of sufficient quality and quantity for outcomes measurement without a second testing visit. There were no differences in useable trials by procedural group, disability status, age or stimulus condition. EEG recording time was shorter in Group3 vs. 1 (p = 0.02) and more patients in Group1 required repeat trials compared to Groups2 and 3 (p = 0.04 for both). Comparison with old methodOur new methods resulted in no attrition from data loss, an improvement compared to published similar studies with data loss 30–55%. Acclimatization had minimal effects. ConclusionIn children under 3, MT protocols result in high rates of EEG data acquisition, decrease behaviorally-related interruptions and session acquisition time. This method is successful for typically developing children and those with cerebral palsy.

Facilitated music listening: Music therapy in an invasive cardiac procedure

This article presents and discusses a clinical music therapy protocol for use during an invasive cardiac procedure and the theoretical rationale behind it. The protocol was developed for a specific invasive cardiac procedure performed transvenously with local anaesthesia: cardiac implantable electronic device lead extraction. The music listening intervention presented in the protocol aims to optimise stress and pain management for patients through patient involvement, communication, individualised music listening and relaxation techniques. The Music Therapist remains present throughout the peri-operative phase (in the operating theatre during the operation). The music is chosen from a limited set of prepared playlists through a process involving assessment and patient preference. Biological, psychological and social components are integrated into the protocol, which is also informed by the theory of music therapy as procedural support, the neuromatrix theory of pain and receptive music therapy techniques. The protocol was developed to be standardised for implementation into the existing medical procedure, yet flexible enough to meet individual patient needs. It is the cornerstone of the research protocol of an ongoing randomised controlled trial at the Department of Cardiology at Oslo University Hospital Ulleval. Results of the randomised controlled trial, focussing on quantitative efficacy outcomes, are expected in 2020.

A randomised controlled trial of protocolised music therapy demonstrates developmental milestone acquisition in hospitalised infants.

To compare the effectiveness of an intensive-intermittent vs. standard spaced protocolised music therapy intervention on supporting developmental milestone acquisition of infants >44weeks postmenstrual age (PMA) hospitalised in a Neonatal Intensive Care Unit (NICU). This was a comparative effectiveness study of infants 44-66weeks PMA with a projected NICU stay of at least one month from recruitment. Infants were randomised to one of two treatment groups: traditional therapy (2x/week) and intermittent-intensive (4x/week, off, 4x/week, off). Both groups received the same number of sessions over a 4-week period. Sessions at the start and end of the treatment period were video recorded. Two masked researchers reviewed and coded videos. Milestones used for video recording were adapted from the Developmental Assessment of Young Children. Twenty-four infants participated, with groups matched for birth age, PMA at start of study, race, IVH severity, and respiratory support. Total and motor composite scores were higher post-intervention (Cohen's d=0.71 and 0.97, both p<0.01), with the same degree of skill acquisition found for both intervention groups. A developmental music therapy protocol supports developmental skills acquisition of post-term infants in a NICU. Similar outcomes for both groups provide therapists with varying treatment dosing options to best support their patients.

Music therapy following cardiac surgery-is it an effective method to reduce pain and anxiety?

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: In patients undergoing cardiac surgery, is postoperative music therapy effective in reducing pain and anxiety? Altogether, 153 papers were found using the reported search method, of which 7 represented the best evidence to answer the clinical question. Six of the included studies were randomized trials, with 1 further non-randomized trial. The specific music protocols utilized widely varied, ranging from 1 short session on day 1 postoperatively to multiple sessions per day over a 72-h period. Most therapies involved music of a relaxing type, typically between 50 and 60 dB. All 7 studies reported on pain, with 4 demonstrating significant differences in pain score; however, 3 of these were not associated with reduction in analgesia requirements. Five studies reported on anxiety, with 2 demonstrating a statistically significant improvement in levels of anxiety. These results need to be contextualized by the small number of participants within each study and the heterogeneity in the therapy protocols utilized. The current best available evidence fails to support the benefits of music therapy as an effective non-pharmacological option in reducing pain and anxiety following open-heart surgery. While there is scarce evidence demonstrating efficacy, the current literature contains very small-sample-sized studies in utilizing music therapy protocols which in turn have wide range of variability in terms of duration, frequency, timing in the postoperative period and specific choice of music utilized in each protocol.

Music-Based Therapeutic Interventions for People with Dementia: A Mini-Review.

The growing population of people with dementia worldwide calls attention to the burdens associated with age-related decline that affects physiology, psychological and cognitive status, and social/emotional wellbeing. The current standards in geriatric care recommend non-pharmacological approaches to these challenges, including safe approaches to managing pain and stress, enhancing symptom relief, and fostering independent lifestyles with the highest quality of life possible. The purpose of this article is to provide definitions of music-based interventions, music therapy applications and clinician qualifications, as well as an umbrella mini-review of meta-analyses regarding music-based interventions for individuals with dementia. Our findings indicate that most descriptions of music therapy protocols in the research lack sufficient detail to enable researchers to compare and replicate studies, and clinicians to apply techniques. Definitions of music therapy and music-based interventions are inconsistent, and practitioners vary in their professional training and preparation for implementing music-based clinical strategies. We recommend that future researchers provide thorough descriptions of music therapy and music-based interventions in their protocols.

No between-group difference but tendencies for patient support: A pilot study of a resilience-focused music therapy protocol for adults on a medical oncology/hematology unit

During hospitalization for cancer treatment, patients can experience adversities that negatively impact quality of life and hinder recovery. Thus, it is important for patients to develop resilience to help them adapt, cope, and potentially overcome stressors within hospital and home environments. The purpose of this study was to determine if and how a two-day resilience-focused music therapy (RFMT) support program would impact resilience of adults on a medical oncology/hematology unit. Participants (N=15) were randomly assigned to RFMT or a waitlist control condition. Participants in the RFMT condition received a two-day music therapy intervention: Resilience-themed patient-preferred live music (PPLM) on day one and RFMT through resilience-themed PPLM on day two. Experimental participants completed an individual semi-structured interview after the intervention. Quantitative results indicated no between-group difference at posttest. However, experimental participants tended to have slightly more favorable resilience and pain mean scores than control participants at posttest. Thematic analysis of patient feedback during interviews indicated that music therapy tended to (a) improve the therapeutic relationship, (b) highlight positive perceptions of music, (c) provide a positive distraction and improved mood, and (d) improve inner strength and hope. Although quantitative results were not significant, results from post-intervention interviews tended to provide initial support for the protocol. Limitations, implications for clinical practice, and suggestions for future research are provided.

The Development of a Music Therapy Protocol: A Music 4 Life® Case Report of a Veteran with PTSD

A music therapist-directed protocol designed to assist in resolving unsettled moods and bringing emotional balance is explicated through a case report of a 36 year old Army veteran. Upon completing a protocol, increased motivation, decreased stress, and a reported sense of feeling more “complete” following four years of medical disability and significant social phobias was noted. Posttests completed at marked intervals during the 10 week treatment period showed significant shifts in emotional states with reduced anxiety and depression. Physician directed cessation of anti-anxiety, depression, and pain medications subsequently led to increased reengagement with previously enjoyed activities and a reported enhanced quality of life.

Choral singing therapy following stroke or Parkinson’s disease: an exploration of participants’ experiences

Purpose: People with stroke or Parkinson’s disease (PD) live with reduced mood, social participation and quality of life (QOL). Communication difficulties affect 90% of people with PD (dysarthria) and over 33% of people with stroke (aphasia). These consequences are disabling in many ways. However, as singing is typically still possible, its therapeutic use is of increasing interest. This article explores the experiences of and factors influencing participation in choral singing therapy (CST) by people with stroke or PD and their significant others. Method: Participants (eight people with stroke, six with PD) were recruited from a community music therapy choir running CST. Significant others (seven for stroke, two for PD) were also recruited. Supported communication methods were used as needed to undertake semi-structured interviews (total N = 23). Results: Thematic analysis indicated participants had many unmet needs associated with their condition, which motivated them to explore self-management options. CST participation was described as an enjoyable social activity, and participation was perceived as improving mood, language, breathing and voice. Conclusions: Choral singing was perceived by people with stroke and PD to help them self-manage some of the consequences of their condition, including social isolation, low mood and communication difficulties.Implications for RehabilitationChoral singing therapy (CST) is sought out by people with stroke and PD to help self-manage symptoms of their condition.Participation is perceived as an enjoyable activity which improves mood, voice and language symptoms.CST may enable access to specialist music therapy and speech language therapy protocols within community frameworks.

Coping-Infused Dialogue through Patient-Preferred Live Music: A Medical Music Therapy Protocol and Randomized Pilot Study for Hospitalized Organ Transplant Patients.

Solid organ transplant patients often experience a variety of psychosocial stressors that can lead to distress and may hinder successful recovery. Using coping-infused dialogue (CID) through patient- preferred live music (PPLM) music therapy sessions may improve mood and decrease pain while also imparting psychoeducational knowledge concerning the identification of local and global problems and coping skills. The purpose of this pilot study was to develop a coping-based medical music therapy protocol that combines coping-infused dialogue (CID) with patient-preferred live music (PPLM) and measure the effects of the resulting CID-PPLM protocol on mood (positive and negative affect) and pain in hospitalized transplant patients. Our study used a pre-/posttest single-session wait-list control design. Participants (N=25) were randomly assigned to experimental (CID-PPLM) or control (usual care) conditions. Participants in the CID-PPLM condition received a single 30-minute session that integrated stressor identification and knowledge of coping skills (CID) with patient-preferred live music (PPLM). Results indicated no between-group differences at pretest and significant correlations between pre- and posttest measures. Concerning posttest ANCOVA analyses, there were significant between-group differences in positive affect, negative affect, and pain, with experimental participants having more favorable posttest scores than control participants. Effect sizes were in the medium-to-large range for positive affect (η2=.198), negative affect (η2=.422), and pain (η2=.303). CID through receptive PPLM may be an effective protocol for improving mood and decreasing pain in organ transplant recipients. MT interventions can be an important tool to develop rapport and enhance outcomes with patients. As greater engagement during interventions may have stronger treatment effects, we recommend future research examining patient engagement as a potential mediator of intervention effects, as well as the number of sessions required to maximize clinical outcomes.

The effect of musical attention control training (MACT) on attention skills of adolescents with neurodevelopmental delays: a pilot study.

Given the effect of musical training on the rate and accuracy of processing auditory information, therapeutic uses of music may potentially have remedial benefits for individuals with neurodevelopmental deficits. However, additional studies are needed to establish efficacy of music therapy interventions for attention skills in children/adolescents with neurodevelopmental disabilities including those with Autism Spectrum Disorders (ASD). To establish feasibility and preliminary efficacy of a group music therapy protocol to improve attention skills (sustained, selective, attentional control/switching) in adolescents diagnosed with autism and/or developmental delays. This single group pretest/posttest study took place in a private school for high functioning adolescents with neurodevelopmental delays. Nine students (4 males, 5 females), ages 13 to 20, participated in the study. Autism severity was assessed using the CARS2-HF and indicated the following distribution for study participants: severe (n = 3), mild (n = 4), or minimal/no (n = 2) symptoms. We assessed feasibility of implementing a 45-min Musical Attention Control Training (MACT) intervention delivered by a board-certified music therapist eight times over 6 weeks in a school setting. We also examined preliminary efficacy of the MACT to improve attention skills using the Test of Everyday Attention for Children (TEA-Ch). Parental consent rate was 100%. All nine participants successfully completed testing measures and 6 weeks of the intervention. Average participation rate was 97%. Data analysis showed positive trends and improvements on measures of attentional control/switching and selective attention. The results showed that the intervention and testing measures were feasible to implement and acceptable to the participants who all completed the protocol. Data analysis demonstrated positive trends indicating that more research on the use of music therapy attention training in high-functioning adolescents with neurodevelopmental disabilities is warranted.

Harmony of the Heart: Music Therapy

This article presents a research agenda that began with the development of a clinical music therapy protocol, including music-assisted relaxation and imagery (MARI), for individuals with heart conditions who are referred for cardiac rehabilitation. Health-related outcomes of this program were investigated in a randomized controlled trial, finding significant changes in blood pressure over time, and short-term changes in stress and anxiety. A mixed methods study then examined process and outcomes more thoroughly in a small sample of patients. In a more recent trial, this approach was applied to individuals who have diabetes. Coming full circle, the research investigations informed an adaptation of the original music therapy protocol for clinical use in cardiac rehabilitation. Underlying mechanisms in the autonomic nervous system and future research directions are also discussed.