Unlike a drug trial, it is difficult - though not impossible - to create an absolute control group (ie a group not receiving music) in music therapy trials. A control group is a group which does not obtain the treatment, for example, a drug or treatment. This is to ascertain that the independent variable (in this case, the treatment/drug) is producing an effect and not an external factor. In music therapy, there is no equivalent to a placebo pill and thus without an absolute control group(54), it is more difficult to conclude music’s efficiency in treating disease. External factors can include age or lifestyle and social interaction with the music therapist or other patients.(55) Given that it is common scientific knowledge that a suitably comparable control group is needed for an effective analysis of results, music therapy’s lack of absolute control renders its results less reliable than a drug trial, for example. This lack of control makes uncertain whether it is music eliciting a supposed therapeutic effect rather than merely the emotions produced by music listening or playing.(56) A control that could be used would be a similarly engaging activity such as reading(57), though few studies have used this as a control group. This is particularly problematic in assessing music therapy’s effectiveness with regards to dementia, where the perception of emotions is often altered(58). However, the presence of any positive result in the field of music therapy should entice researchers into further investigation, which would reduce this issue.
Many of the studies analysing music’s therapeutic potential are small in scale, with groups of twenty or fewer individuals being assessed. Whilst there are exceptions(59), a small number of patients also makes results less reliable(60), as with greater data collection standard deviation is more accurate. The reliability of typically small-scale studies involving music therapy and patients with neurological or neurodegenerative disease must be questioned, but again any evidence in this area should be promising.
Another issue with music therapy is the Outside Effect problem. The study and appreciation of music result in increased neuroplasticity.(61) Neuroplasticity or ‘brain plasticity’ is the ability of the brain to generate new neuronal cells in response to stimuli and is markedly increased in children, particularly children with intense musical training.(62) It is uncertain as to whether the plasticity derived from music practice affects the patient’s real world experiences outside of music therapy sessions and how long this effect lasts.(63) The question of what external effect music therapy produces is muddied by this difficulty in controlling for external factors, as intensified by a lack of an absolute control group.
In music therapy studies, a double-blind trial is difficult to establish.(64) A double-blind trial ensures that none of the patients know whether they are receiving the treatment or a placebo, as common in pre-clinical drug trials. Most patients are aware that they are listening to or practising music for therapeutic purposes. At the minimum, all patients are aware of when they are listening to music (the treatment) or silence. Given that patients are aware of whether they are receiving the treatment or not, this introduces the possibility of bias, which reduces the reliability of the clinical results obtained from music therapy.(65)
However, music therapy offers its own advantages which are different to a drug trial. It does not produce any side effects in patients(66), which may be harmful or even life-threatening in a drug trial. The therapy can be considered largely benign. In addition, music therapy is more cost effective than a drug trial; it does not need the high amounts of funding often associated with the development of new drugs, which may be implicated in bias related to the support of the pharmaceutical company, as discussed previously.(67)
Music therapy is easy to put into practice: all that is needed is an instrument, including the voice, and a trained therapist. This also reduces cost. Given that music therapy is shown to have a marked positive effect, it should be explored in greater depth from a clinical perspective with regards to treating patients.(68)
Through an analysis of various studies, discussions and issues related to music therapy, the current science demonstrates that there is evidence which to show that music has a significantly positive effect on certain illnesses, notably neurodegenerative conditions. Music can not only help to treat the autonomic nervous system effects of Crohn’s disease(69) but also can alleviate anxiety, stress and depression in dementia patients(70), reduce seizure frequency and intensity in epileptic patients(71), help give patients with post-traumatic stress disorder and addiction a sense of identity through community drumming(72) and help autistic people to communicate in healthy and fulfilling ways.(73)
© 2017 Nat Barrett. Published by teoria.com