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Music therapy interventions for stress reduction in adults with mild intellectual disabilities

Stress is increasingly being recognized as one of the main factors that is negatively affecting our health, and therefore there is a need to regulate daily stress and prevent long-term stress. This need seems particularly important for adults with mild intellectual disabilities (MID) who have been shown to have more difficulties coping with stress than adults without intellectual disabilities. Hence, the development of music therapy interventions for stress reduction, particularly within populations where needs may be greater, is becoming increasingly important. In order to gain more insight into the practice-based knowledge on how music therapists lower stress levels of their patients with MID during music therapy sessions, we conducted focus group interviews with music therapists working with adults with MID (N = 13) from different countries and clinical institutions in Europe. Results provide an overview of the most-used interventions for stress reduction within and outside of music. Data-analysis resulted in the further specification of therapeutic goals, intervention techniques, the use of musical instruments, and related therapeutic change factors. The main findings indicate that music therapists used little to no receptive (e.g., music listening) interventions for stress reduction, but preferred to use active interventions, which were mainly based on musical improvisation. Results show that three therapy goals for stress relief could be distinguished. The goal of “synchronizing” can be seen as a sub goal because it often precedes working on the other two goals of “tension release” or “direct relaxation,” which can also be seen as two ways of reaching stress reduction in adults with MID through music therapy interventions. Furthermore, the tempo and the dynamics of the music are considered as the most important musical components to reduce stress in adults with MID. Practical implications for stress-reducing music therapy interventions for adults with MID are discussed as well as recommendations for future research.

Biography, identity, improvisation, sound

Improvisation and identity

Seeing improvisation as something that really needs its place in conservatoire training and education may be more or less ‘new’. However improvisation itself is of course not at all new and has existed since as long as we can remember. I will not go into that any further, it would take not a single address but a symposium of at least two weeks.

Improvisation and identity in community music

Effects of music interventions on stress-related outcomes

Music interventions are used for stress reduction in a variety of settings because of the positive effects of music listening on both physiological arousal (e.g., heart rate, blood pressure, and hormonal levels) and psychological stress experiences (e.g., restlessness, anxiety, and nervousness). To summarize the growing body of empirical research, two multilevel meta-analyses of 104 RCTs, containing 327 effect sizes and 9,617 participants, were performed to assess the strength of the effects of music interventions on both physiological and psychological stress-related outcomes, and to test the potential moderators of the intervention effects. Results showed that music interventions had an overall significant effect on stress reduction in both physiological (d = .380) and psychological (d = .545) outcomes. Further, moderator analyses showed that the type of outcome assessment moderated the effects of music interventions on stress-related outcomes. Larger effects were found on heart rate (d = .456), compared to blood pressure (d = .343) and hormone levels (d = .349). Implications for stress-reducing music interventions are discussed.

Differential parietal and temporal contributions to music perception in improvising and score-dependent musicians, an fMRI study

Using fMRI, cerebral activations were studied in 24 classically-trained keyboard performers and 12 musically unskilled control subjects. Two groups of musicians were recruited: improvising (n=12) and score-dependent (non-improvising) musicians (n=12). While listening to both familiar and unfamiliar music, subjects either (covertly) appraised the presented music performance or imagined they were playing the music themselves. We hypothesized that improvising musicians would exhibit enhanced efficiency of audiomotor transformation reflected by stronger ventral premotor activation. Statistical Parametric Mapping revealed that, while virtually 'playing along' with the music, improvising musicians exhibited activation of a right-hemisphere distribution of cerebral areas including posterior-superior parietal and dorsal premotor cortex. Involvement of these right-hemisphere dorsal stream areas suggests that improvising musicians recruited an amodal spatial processing system subserving pitch-to-space transformations to facilitate their virtual motor performance. Score-dependent musicians recruited a primarily left-hemisphere pattern of motor areas together with the posterior part of the right superior temporal sulcus, suggesting a relationship between aural discrimination and symbolic representation. Activations in bilateral auditory cortex were significantly larger for improvising musicians than for score-dependent musicians, suggesting enhanced top-down effects on aural perception. Our results suggest that learning to play a music instrument primarily from notation predisposes musicians toward aural identification and discrimination, while learning by improvisation involves audio-spatial-motor transformations, not only during performance, but also perception.