To cope with the negative impact of stress, millions of people around the world use tranquilizing medication. However, these can have all sorts of harmful side effects. ‘This demonstrates the urgent need for development of and research into innovative and non-pharmacological interventions for stress reduction – especially for patient groups that are known to be more vulnerable to stress and for which psychological interventions are less appropriate, such as people with mild intellectual disabilities’, says Martina de Witte.

Given the known fact that listening to and making music can reduce stress, music interventions are increasingly used in medical and mental health care. ‘Moreover, the experience- and action-oriented approach of music interventions makes them particularly suitable for people with intellectual disabilities’, says De Witte.

In addition to analysing their effects, she and her team conducted research into the exact use of different types of music interventions, and into which aspects of these interventions are important in treating stress-related complaints. ‘In practice, we see that two types of music interventions are used in particular: 1) “music medicine” interventions, in which the aim is to relax by listening to specific relaxing music, and 2) music therapy interventions, which are used to treat stress and tension. The latter are goal-oriented and methodical interventions, offered by a qualified music therapist, that involve listening to music and making music together, such as songwriting, singing together, or musical improvisation.’

High-grade evidence that music interventions can be effective

In a first study, De Witte and colleagues analysed over 100 studies with a total of almost 10,000 participants, of whom 4,838 took part in a music intervention group (musical activities or music therapy). The interventions took place in clinical, medical and work or study-related settings. The remaining 4,779 participants formed the control group. This first study showed that music interventions have small to medium-sized positive effects on both physiological stress-related arousal (increased blood pressure, heart rate, hormone levels) and experiences of stress (anxiety, restlessness or nervousness).

• Music appears to be able to reduce the physiological effects associated with stress, such as increased heart rate, blood pressure and respiratory rate.
• Music has positive effects on the subjective experiences of stress, such as the feeling of not being able to cope, worrying and nervousness.

‘This study provides high-grade evidence that music interventions can be effective in reducing stress and thus justifies the increasing use of music interventions in both medical and mental health practice’, argues De Witte.

Music therapy appears to be especially effective in reducing stress

In a second study, De Witte and colleagues made a systematic analysis of studies into the stress-reducing effects of music therapy interventions in particular. The result was an overview of 47 studies in total, with a control group of 2,747 subjects.

The researchers concluded that music therapy has a medium-sized to large effect on stress-related outcomes. ‘We found that music therapy in particular is effective in reducing stress. This can possibly be explained by the personalised, tailor-made approach of the music therapist, who is specifically trained to tailor the music to the needs of the patient’, concludes De Witte. According to De Witte, these results justify the increasing use of music therapy by a qualified music therapist in both mental health and medical practice. Given the added value that qualified music therapists provide, De Witte recommends that careful consideration be given to whether music therapy is necessary or music listening interventions, as already offered by many care providers, are sufficient.

‘Overall, we may conclude that music interventions, in the form of both music listening and music therapy, delivered by specifically educated and trained therapists, can be of great benefit to patients in both medical and mental health settings’, concludes De Witte.

In addition to these two studies, De Witte also looked at music therapists’ practical knowledge of stress reduction in people with intellectual disabilities, the validity and reliability of self-reported stress measurement instruments and their suitability for people with mild intellectual disabilities, and the development of a music therapy micro-intervention for stress reduction.

Doctoral research details

Martina de Witte, ‘Music Interventions for Stress Reduction’, supervisors: Prof. G.J.J.M. Stams and Prof. X.M.H. Moonen, co-supervisor: Prof. S.A.H. van Hooren

Time and location

Friday, 29 October, 11:00, Aula (Lutheran Church), Amsterdam.

About Martina de Witte

Martina de Witte is a lecturer and researcher at HAN University of Applied Sciences’ School of Health Studies, the University of Amsterdam and the national research group KenVaK. In addition, she has years of practical experience as a music therapist at Stevig, where she treats people with mild intellectual disabilities and psychiatric problems (both forensic and non-forensic). She presents her research results at both national and international conferences and symposia, and cooperates at the international level with various researchers in order to conduct even more in-depth research into the effects and applicability of innovative and experience-oriented interventions, such as music interventions.