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Running Head: Music Therapy & Effects

Music Therapy and its Effects on Dementia, Brain Development, and Depression

Callie R. Donovan

Glen Allen High School

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This paper addresses research regarding the effects of music on the brain and its

application, through music therapy, on dementia, brain development, and depression. First, it

identifies physical and psychological impacts of music on the brain itself. Then, it recognizes the

two types of music therapy that researchers have distinguished, active and receptive. Under each

type, this paper discusses the many techniques identified by researchers, like lyric discussion or

free improvisation. Next, it analyzes the application of music therapy to the three conditions

listed above. Lastly, the conclusion discusses the agreements between researchers and potential

applications of the specified categories and techniques and addresses the difficulties of research

due to music therapy still being a new process.


Music therapy was fostered back in the early 1900s during World War I and II. Groups of

people would gather around the veterans, singing and playing their instruments in an attempt to

lighten the mood. Eventually doctors started noticing positive changes among the patients and

discovered musics true powers. In order to explore how music therapy helps individuals in

treating symptoms of diseases, it is important to understand the many types of music therapy and

the various techniques involved. Music therapy itself is a new, up-and-coming process therefore

researchers are still developing new ways to incorporate it into treatment plans for patients,

especially since treatment is very narrowly tailored to the individual patients themselves. Music

therapy is a complex system of forms and techniques which effectively and beneficially treat

symptoms of dementia, brain development, and depression, specifically.

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Physical Effects of Music on the Brain

Music has a positive effect on a wide variety of physical parts in the brain, broadening

the benefits of music therapy for patients experiencing a range of conditions or diseases. For

patients experiencing great amounts of pain, listening to music has been known to elevate ones

pain threshold, thus making the pain more tolerable. In Cleveland, Ohio, four studies have taken

place, from 2001 to 2010, concluding that burn patients experienced less pain during dressing

changes when they engaged in music therapy before and amid the changes (Theiss, 2011).

"You know they're going to pull and tug and scrape, so when you don't have the music,

that's all you can concentrate on, what they're doing," said Dobbs, [a previous patient].

"But when she was there, it was a huge difference. The pain, you just sing through it. It

takes you away a little. It's more endurable" (Theiss, 2011).

The pain was not only measured by the patients communication, but also by their stress

hormone levels, respiration, and heart rates (Theiss, 2011).

The same areas in the brain that are active in processing language, auditory perception,

attention, memory, executive control, and motor control are also all areas that music can reach

and affect (McIntosh & Thaut, 2010). For example, Brocas Area is used for processing a

problem in a sentence or a musical piece, like a wrong note in a melody (McIntosh & Thaut,

2010). Also, the auditory nerve in the brain is directly connected to the fight-or-flight area of the

brain, the amygdala. As a result, right when a person hears a sound or music, they immediately

become aroused or suddenly pay attention (Geist, 2015). This explains a music lovers instant

jerk when hearing the beginning tune of their favorite song on the radio. Additionally, through

the link between the auditory complex and the limbic system in the brain, music and sounds are
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processed at hyper speed to these areas that are used for long-term memory and emotions (Music

Therapy for Dementia, 2015).

It has also been discovered that music can aid in the development of reading and

language skills (Ulbricht, 2013). However, Music Therapy for Dementia (2015) declares that

music activates multiple parts of the brain at once while language activates only one side of the

brain. The combination of the two increases the chance of activating more neurological pathways

that language cannot do alone. Therefore, music gives the brain the opportunity to process in

chunks which also helps increase memorization skills (NeuroRhythm Music Therapy Services,

2017). This explains why children are taught the alphabet song and how some people find it

easier to memorize song lyrics better than anything else.

Additionally, researchers have found that learning, keeping, and creating rhythm can all

help coordinate ones motor skills (NeuroRhythm Music Therapy Services, 2017). Through the

use of fMRIs, researchers in Finland discovered that processing musical pulses recruits motor

areas in the brain thus tying music with movement (Cramer, n.d.). The Finns research would

explain why dancers are incredibly coordinated and why people who struggle with rhythm also

struggle with dancing.

Psychological Effects of Music on the Brain

Furthermore, there are several psychological effects of music on the brain as music

therapy can serve as source of non-verbal communication (NeuroRhythm Music Therapy

Services, 2017). It is observed that, by raising feel-good hormones like serotonin, music

stimulates patients to reduce negative responses, which vary depending on the condition or

disease the patient is treating. (Theiss, 2011 & NeuroRhythm Music Therapy Services, 2017).
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Instead, music activates the reward center of the brain, serving as a motivator and/or source of

encouragement (NeuroRhythm Music Therapy Services, 2017). Researchers have found many

ways to put these effects to good use, developing this new type of therapy to treat even more

conditions and diseases.

Active Music Therapy

Active music therapy or active doing is defined by patients physically interacting with

instruments, including singing (Crawford, Maratos, & Procter, 2011). Patients complete a

multitude of active therapy lessons in order to improve their motor skills as well as deepen the

connection with the therapist, opening up more room for conversation (Music Therapy for

Dementia, 2015). According to Crawford et al. (2011), there are three concepts within active

music therapy that each play a role in creating the overall experience for the patients. Those three

ideas include the aesthetic, physical, and relational properties of a single therapy session using

this method.

The mood of the session, referred to as the aesthetic, plays a key role in making the

patients feel comfortable sharing their thoughts and emotions. For example, using a low base

note can create suspense or using a harmonic progression can imply a direction (Crawford et al.,

2011). These particular actions help encourage patients to be more immersed in the session.

Additionally, the physical act of playing an instrument or singing allows patients to express

themselves in the set aesthetic. Researchers agree that most humans have a positive inclination

towards music, whether it be tapping the foot or moving with the beat. Therefore, diving deeper

into this feeling gives patients a sense of being part of something meaningful in the here-and-

now (Crawford et al., 2011). Lastly, the same researchers also imply the therapist plays a
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crucial role in facilitating aprocess of discovery by relating through music in a way

incomparable to that of talking (Crawford et al., 2011). Similarly, the co-created musical

relationship between the therapist and patient enables the latter to experience him/herself

differently (Crawford, Gold, Maratos, & Wang, 2008). While playing instruments, many times

a buzz is experienced between patients and therapists, often when they spontaneously come

together at a cadence point or even come to an end at the same moment (Crawford et al., 2011).

After the shared musical experience and trust is built, patients discuss with the therapist and

obtain a better understanding of any emotional or relational issues they may be going through

(Crawford et al., 2008).

Active Music Therapy Techniques

Researchers tend to agree on several of the techniques used to carry out active music

therapy, however the list continues to grow as new applications of instruments are discovered.

Free improvisation, a means of self-projection, allows patients to connect with emotional

memories and images (Ala-Ruona et al., 2011). According to Intveen (2007), wind instruments

instill calmness, focusing on breath and thought. Percussion instruments are more physically

focused. For instance, a drum is often used to express inner pressure and feelings (Ala-Ruona et

al., 2011). And string instruments are tied to ones heartbeat and breathing as the process of

playing a string instrument bears a resemblance to the breathing process (Intveen, 2007).

Additionally, writing songs and lyrics, as well as playing pre-composed music are also options

for active music therapy patients (Ala-Ruona et al., 2011).

Receptive Music Therapy

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Most research is consistent with recognizing that listening to music and playing music

have different effects on patients and therefore, provide different benefits, depending on the type

of symptoms being treated. Receptive music therapy is the process of listening to different types

of sounds and music, using them as a baseline for exploration and discussion of ones thoughts

and feelings. (All Psychology Careers, 2017). During a receptive session, patients take a moment

to pause and listen to the music. Some therapists choose to begin discussion while the music

plays in the background, others choose to start discussion after the song has finished (All

Psychology Careers, 2017). Researches recognize that this style of music therapy is focused on

the emotional well-being of patients, whereas active therapy provides many physical benefits as

well. Receptive techniques address thoughts, feelings, and emotions evoked by the music and

provide the opportunity for patients to reach states of deep relaxation and meditation (All

Psychology Careers, 2017). The same researchers claim that this type of music therapy

awakens creativity and provides reflections on personal relationships andpersonality (All

Psychology Careers, 2017). For example, one of Connie Tomainos (a music therapy pioneer)

Alzheimers patients who was deemed nonverbal, started speaking again in response to songs she

associated with memories (Geist, 2015).

Receptive Music Therapy Techniques

Researchers have tended to agree upon the types of techniques that fall under receptive

music therapy. These include but are not limited to: relaxation, lyric discussion, song

reminiscence, and imaginal listening. Within imaginal listening, there is the guided music

imaging method and the unguided method. Under the guided imaging method, patients are

presented with an image by the therapist and instructed to picture it while music is playing. This

process often incorporates some type of journey and the script that the therapist recites could be
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based on a place that is significant to the patient (Grocke, 2006). According to Grocke (2006),

this type of imaginal listening typically takes place when the patient is in an altered state of

consciousness. As for unguided music imaging, Grocke (2006) concludes that it fosters the

opportunity for patients to dig up images from their unconscious that could pertain to difficulties

they currently face in their life. Similarly, both Grocke (2006) and McCarthy (2016) support

song/lyric discussion, acting as a springboard for uncovering patient issues and feelings. The

patients seek out ways in which the lyrics parallel their own life and the discussion goes from


Applications of Music Therapy

Specifically, music therapy is proven effective in treating symptoms of dementia, brain

development, and depression.


Researchers have found that music therapy significantly decreases aggressive and

agitated behavior amongst dementia patients (Ulbricht, 2013). This allows for the possibility of a

greater breakthrough during therapy sessions, especially since NeuroRhythm Music Therapy

Services (2017) found that music often captures and maintains peoples attention. Likewise,

musics ties to historical events or peoples own significant experiences acts as a strong stimulus

to engage responses in dementia patients (Music Therapy for Dementia, 2015). Patients are often

observed wak[ing] up when listening to familiar songs they enjoy or did enjoy previous to

their condition (Geist, 2015).

Often, after months or even years of not speaking at all, they begin to talk again, become

more social and seem more engaged by their surroundings. Some begin to remember
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names long forgotten. Some even do what Alzheimer's patients often cannot do as their

disease worsens: They remember who they are (Geist, 2015).

In a 45-person test, the same researchers recognized that dementia patients who regularly sang

had an increase in mental acuity, meaning sharper focus, memory, and understanding. This

was measured by the Mini Mental State Examination over a four-month period (Geist, 2015).

Additionally, Geist (2015) discovered that, as soon as the majority of nursing homes in

Wisconsin began a program using personalized playlists of music during a caretakers daily

routine, the entire states use of psychotic drugs dropped. By listening to and playing music,

patients have the opportunity to remember more and even regain speech, notably due to musics

ability for the brain to process it in sections, thus making it easier to memorize (Music Therapy

for Dementia, 2015; NeuroRhythm Music Therapy Services, 2017).

Brain Development

Research has shown improvements of language, cognition, and motor control as a result

of music therapy (McIntosh & Thaut, 2010). Due to natural inflection and tone, speech naturally

has a rhythm and meter, therefore singing enhances these functions (NeuroRhythm Music

Therapy Services, 2017). Also, when patients with brain development issues learn to keep

rhythm in music, they are further improving their motor control (McIntosh & Thaut, 2010). The

act of singing relies primarily on the right side of the brain while language is primarily processed

on the left. However, the same researchers have discovered that singing has the power to bypass

injuries on the left hemisphere of the brain in order to help people produce speech (McIntosh &

Thaut, 2010). Therefore, this explains why people with lisps often sound completely clear when

singing, since the process of singing makes up for their speech impediment. Lastly, music
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therapy can activate the attention network on both hemispheres, which can help overcome

attention problems cause by a stroke or traumatic brain injury (McIntosh & Thaut, 2010).


According to Kumar & Singh (2013), music brings changes in the brain waves which in

turn create alterations in the bodily functions controlled by the autonomic nervous system. Such

functions include breathing, blood pressure, and heart rate. For patients suffering from

depression, these positive effects aid in the overall recovery process, allowing patients to turn

their focus on psychological help. Just like serotonin, music has been found to increase dopamine

levels, which influences our drive to seek awards and obtain a sense of pleasure (Kumar &

Singh, 2013). Although this research supports the use of music therapy as a form of treatment for

depression, the same researchers have found that it is most effective on patients with mild and

moderate depression rather than severe depression. Additionally, Crawford et al. (2008) found

that, as long as patients are thoroughly trained by the therapist, active music therapy can be

effectively self-administered by patients with mild depression.


Research has illustrated the complexity of music therapy as a means for treating

symptoms of various conditions. It is not a simple system, rather it can be broken down into very

specific techniques, based on the type of recovery patients require. This could range from an

improvement of motor skills to discovering the root of issues behind sadness or anxiety. Because

music therapy is narrowly tailored and personalized to fit each individuals needs, researchers

have found it difficult to conduct random, controlled trials and develop statistical evidence

(Music Therapy for Dementia, 2015). Majority of the literature appears consistent with the
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notion that music therapy can be either active or receptive and individuals needs determine the

right course of action. Overall, most techniques revolve back to the relationship between the

therapists and patients and the patients abilities to feel catharsis. As a result of these techniques,

music therapy effectively treats symptoms and effects of dementia, brain development, and

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Reference List

Ala-Ruona, E., Erkkila, J., Fachner, J., Gold, C., Pontio, I., Punkanen, M., Tervaniemi,

M., & Vanhala, M. (2011). Individual music therapy for depression: randomized

controlled trial. The British Journal of Psychiatry, 199. 132-139.

doi: 10.1192/bjp.bp.110.085431

Cramer, L. Music Therapy Enhancing Cognition. Caregiver Tips & Tools: California Central

Coast Chapter, Number 9. Retrieved from


Crawford, M., Gold, C., Maratos, A., & Wang, X. (3 Nov. 2008). Music therapy for

depression (Review). Cochrane Database of Systematic Reviews, Issue 1. Retrieved from


Crawford, M. J., Maratos, A., & Procter, S. (2011). Music Therapy for depression: It

seems to work, but how?. The British Journal of Psychiatry, 199, 92-93.

doi: 10.1192/bjp.bp.110.087494

Geist, M. E. (2015). AARP Bulletin. Retrieved from

Grocke, D. (2006). Receptive Methods in Music Therapy Techniques and Clinical Applications
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for Music Therapy Clinicians, Educators, and Students. London: Jessica Kingsley


Intveen, A. (2007). Musical Instruments in Anthroposophical Music Therapy with Reference

to Rudolf Steiners Model of the Threefold Human Being. Voices: A World Forum

For Music Therapy, 7(3). Retrieved from

Kumar, G. & Singh, B. K. (2013). To Access the Role of Music Therapy in Depression and

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Sciences and Research, Vol. 4, No. 8, 3099-3102. doi: 10.13040/IJPSR.

McCarthy, S. (2016). The Therapeutic Power of Music. Journal of the Australian Traditional-

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McIntosh, G. & Thaut, M. (2010, Mar. 24) How Music Helps to Heal the Injured Brain.

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