Psychology of Music: Music therapy of depression - Research Paper Example

? PSYCOLOGY OF MUSIC MUSIC THERAPY OF DEPRESSION CHAPTER I: INTRODUCTION The purpose of this literature based study is to explore published methods of music therapy as possible treatment options for depressive and dysphoric symptoms in adolescents with chronic medical conditions. This thesis reviewed literature about current treatments such as verbal therapy and pharmacological options for this population, as well as literature addressing the difficulties that can arise when treating these adolescents. It also attended to varying music therapy treatment options. Recommendations were then made from the results. Adolescents with chronic medical conditions have a higher risk for depressive symptoms than their healthy peers (Siegel, Golden, Gough, Lashley, & Sacker, 1990). These symptoms affect the quality of life of these adolescents (Bhatia, 2007) and negatively impact the medical condition (Bennett, 1994). This thesis addressed this problem by researching music therapy treatment options for these adolescents. This research has the potential to help this population by showing how music therapy can address the unique needs of the adolescents both in inpatient and outpatient settings. The results of this research can be recommended to both music therapists and other medical professionals as an effective approach for treating adolescents with chronic conditions and co-morbid depressive symptoms. Pharmacological treatments have been shown to increase suicidal symptoms and attempts in 4% of the child and adolescent aged population (United States Food and Drug Administration, 2009). Data also exists showing that there is no statistical difference in suicide rate among patients in studies assigned to antidepressants or placebos (Khan,Khan, Kolts, & Brown, 2003). The most commonly reported form of treatment, cognitive-behavior therapy (CBT), has shown some promise among this population, but it has been researched and used primarily with adult populations (Koplewicz, 2002). This treatment is also used mainly for moderate to severe forms of depression (Paxton & Leventhal, 2006). Interpersonal psychotherapy (IPT) has been deemed equivalent to CBT, but challenges have arisen with difficulty forming the therapeutic alliance and adolescent egocentrism (Chan, 2005). Existing treatment options are limited and under-researched, thus creating the need for a treatment approach that is both effective and meets the adolescent where they are. There also arises the issue of compliance of treatment in adolescents with chronic conditions (Kyngas, Kroll, & Duffy, 2000). Through music therapy, a supportive environment is created from the natural structure of the music. Music offers the adolescent a form of expression that can affect their emotions deeper than words alone (Tervo, 2001). Adolescents can use music to relieve and dispel negative emotions, as well as for identity formation (Arnett, 1995). The question then that this thesis will attempt to address is “In what ways can music therapy by used to treat adolescents who have chronic medical conditions and related depressive symptoms?” The research objective is that types of music therapy can be used as an effective treatment option to help alleviate depressive symptoms in adolescents who also have chronic medical conditions. One delimitation that was imposed on this study was limiting the age of the population being studied to adolescence, which in this study was defined as ages 12 through 21. Another delimitation was that while many adolescents suffer from depression, this study was limited to adolescents who also have a coexisting chronic medical condition. The current limitations of the study are that the results will not be generalizable to every adolescent with a chronic medical condition. Another limitation is that because no human subjects are being studied, actual results could differ from what is inferred from the research. It is expected that the findings of this thesis can be applied in the clinical setting, in both inpatient and outpatient situations. By utilizing the creativity that can be facilitated through music therapy (Robertson, 1992), depressive symptoms in adolescents could be alleviated. CHAPTER II: LITERATURE REVIEW OVERVIEW In the first section of this chapter, the author will provide basic information on adolescent development that may relate to the effects that a chronic condition can have on that development. Coping and treatment adherence during adolescence are also covered. Comorbid depression in adolescents with chronic conditions is looked at, followed in the second section by current treatment options for adolescent depression including psychopharmacologic, psychotherapeutic, and creative arts therapy options. Although music therapy does fall into the creative arts therapy category, for this literature review it will be defined and examined within its own section. 2.1. Specific Information on Adolescents 2.1.1.Characteristics of Development Adolescence is a time of great change physically, psychosocially, and cognitively. For the purposes of this literature review, psychosocial and cognitive changes in adolescence will be the primary focus. Rice, a family psychologist, and Dolgin, a child development psychologist, state that Freud described adolescence as a time of “sexual excitement, anxiety, and sometimes personality disturbance” (Rice & Dolgin, 2005, p. 25). His psychoanalytic theory describes adolescence as a time when individuation occurs, a period when a child separates from his or her parents to create their own feeling and thoughts. They also state that Anna Freud viewed adolescence in a similar manner as her father, describing it as a “period of internal conflict, psychic disequilibrium, and erratic behavior” (p.27). In addition to this perspective, the authors cite Erikson’s view of adolescence as a time of identity vs. diffusion. It is during this stage of personality that the adolescent must develop a sense of one’s current and future self or a lack of commitment and instability will ensue. Rice and Dolgin add that cognitively, adolescents are moving through Piaget’s Formal Operational Stage. It is in this stage that adolescents start to think in “more logical, abstract terms” (p.31). It is in this stage that adolescents develop the ability to think into the future. However, this stage is takes time to complete, and can last into the mid twenties because the frontal cortex of the brain is not completely developed (p.152). Havighurst (1953) presented his own theory of personality development, outlining nine tasks that adolescents must accomplish before moving forward into adulthood. These tasks include: achieving new and mature relations with age mates of both sexes, achieving masculine or feminine social role, accepting one’s physique and using the body effectively, achieving emotional independence from parents and other adults, achieving assurance of economic independence and selecting and preparing for occupation, preparing for marriage and family life, developing intellectual skills and concepts necessary for civic competence, desiring and achieving socially responsible behavior, and acquiring a set of values and an ethical system as a guide to behavior. Working with adolescents presents different challenges than working with children. British and Australian pediatricians Payne, Martin, Viner, and Skinner (2005) provide suggestions for adolescent treatment within the pediatric medical practice. The two main points of their approach include communicating with the adolescents by developing a rapport and establishing confidentiality. Pamela Burnard, a British professor with research on musical creativity and development, lists the main four musical developmental milestones of creativity theories (Burnard, 2006). Gardner’s theory only follows creative development through age 7 BACKGROUND Music 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. METHODS Eighty-five 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. DISCUSSION This 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 client's 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. BACKGROUND Depression is a highly prevalent disorder associated with reduced social functioning, impaired quality of life, and increased mortality. Music therapy has been used in the treatment of a variety of mental illnesses. REFERENCES MUSIC THERAPY AND DEPRESSION BMC Psychiatry. 2008 Jun 28;8:50. The effect of improvisational music therapy on the treatment of depression: protocol for a randomised controlled trial. Erkkila J, Gold C, Fachner J, Ala-Ruona E, Punkanen M, Vanhala M. University of Jyvaskyla, Finnish Centre of Excellence in Interdisciplinary Music Research, Department of Music, P,O Box 35, FI-40014, University of Jyvaskyla, Finland Maratos AS, Gold C, Wang X, Crawford MJ. Central and Northwest London Foundation NHS Trust, Arts Therapies, Greater London House, Hampstead Road, London, UK, NW1 7QY Read More