Sunteți pe pagina 1din 8

Registo: 1

Using Music Techniques to Treat Adolescent Depression. By:


Hendricks, C. Bret; Robinson, Beth; Bradley, Loretta J.; Davis,
Kenneth. Journal of Humanistic Counseling, Education &
Development. Sep99, Vol. 38 Issue 1, p39. 8p. Abstract: The
authors developed a 10-week school-based therapy program
using music for teenagers who demonstrated depressive
symptoms. Pre- and posttesting indicated a significant
decrease in depressive symptoms. [ABSTRACT FROM
AUTHOR] DOI: 10.1002/j.2164-490X.1999.tb00160.x. (AN:
2366367)
Base de dados: Academic Search Complete
USING MUSIC TECHNIQUES TO TREAT ADOLESCENT DEPRESSION
The authors developed a 10-week school-based therapy program using music for teenagers who
demonstrated depressive symptoms. Pre- and posttesting indicated a significant decrease in
depressive symptoms.

Currently, depression is a significant problem for approximately 30% of the adolescent population,
and one in five individuals report a minimum of one episode of major depression by the age of 18
(Lewinsohn, Hops, Roberts, Seeley, & Andrew, 1993). Understandably, prevention and treatment of
depression in adolescence is critical to reducing the high cost of treating adults with depression (King,
1991). The increasing rates of depression among teenagers and the rising costs of mental health care
for adults who do not receive preventative and therapeutic interventions as adolescents demonstrate
the need for school-based interventions (Forrest, 1983). From among the treatment options available
in a school setting, according to McWhirter, McWhirter, and Gat (1996), a group format has the
advantages of reaching a large number of teenagers and of being adaptable to the classroom.
Although several types of group interventions have been found in school settings (McWhirter et al.,
1996), no literature that presented the use of music techniques in a group format to treat depressive
symptoms in a school setting was found.

Music techniques seem to be a potentially effective method of treating depression in adolescents


because an adolescent's life is, in many ways, centered around and heavily influenced by music. For
adolescents, listening to music will likely be a method of coping with environmental stressors (White,
1985) and loneliness (Moore & Schultz, 1983). As a result, teenagers are frequently influenced by
popular music (White, 1985). For example, adolescents who preferred heavy metal and rap music
had higher incidences of below-average school grades, school behavior problems, sexual activity,
drug and alcohol use, and arrests when compared with adolescents who preferred other types of
music (Took & Weiss, 1994). Furthermore, Martin, Clarke, and Pearce (1993) found a significant
association between an adolescent's preference for rock/heavy metal music and suicidal thoughts,
acts of deliberate self-harm, depression, delinquency, drug taking, and family dysfunction.

Similarly, the types of music adolescents listen to may be an indication of loneliness, alienation, or
conformity (White, 1985). Music is capable of producing a relaxed mood, positive stimulus for mood
change, and stress reduction (Hanser, 1985, 1988; Straseske, 1989). Stratton and Zalonowski (1994)
reported that lyrics seemed to affect mood change more than music alone among college students.
Although Ballard and Coates (1995) reported that neither the lyrical content nor the music type
affected suicidal ideation, anxiety, or self-esteem among undergraduates, they did find that nonviolent
rap songs elicited more pronounced depression than did violent rap songs. In addition, they found that
rap songs elicited significantly more angry responses than heavy metal songs. In contrast, Thaut and
Davis (1993) reported that neither the presence/absence of music nor the choice of music seemed to
affect depression among students.

The association between music and elevated or depressed mood (Straseske, 1989) suggests that
music would be an effective technique in therapeutic interventions. Music has been used as a form of
therapy in a variety of residential and adult day care centers (Gibbons, 1984, 1988; Palmer, 1989). In
addition, descriptive and experimental studies have documented the effects of music on involvement
with the environment, expression of feelings, quality of life, awareness and responsiveness, positive
associations, and socialization (Prickett, 1988; Smith, 1990; Vanderark, Newman, & Bell, 1983).
Furthermore, music may help individuals cope with pain and anxiety (Hanser & Thompson, 1994;
Linoff & West, 1982; Maranto, 1992; Standley, 1986). For example, treatment using colors, music
therapy, and counseling both separately and together seemed to be a potentially useful therapeutic
intervention in a clinically depressed university population (Neboschick, 1975). Bradford (1991) found
that using music made traditional forms of psychotherapy more effective and decreased depression
levels more effectively than therapy only. Similarly, five clients exposed to music and individual
counseling for 7 weeks demonstrated a change from levels of depression to levels of nondepression
and happiness (Mays, 1979). Hanser (1990) reported that music therapy for depressed older adults
involving eight musiclistening programs facilitated by a music therapist for use in the home
environment reduced depression.

Despite the existence of research that indicates the significance of music in the lives of teenagers and
the effectiveness of music as a therapeutic intervention for depression, little research has been done
to ascertain the effectiveness of music therapy in working with adolescents. A thorough literature
review found only one study that specifically focused on adolescent depression and music (Goldstein,
1990). Goldstein reported that suicidal or depressed adolescents who scored above the mean on the
Beck Hopelessness scale wrote more lyrics about death or metaphors for dying when they
participated in a song writing assessment, whereas those adolescents who scored below the mean
had no allusions to death in the lyrics they composed.

The lack of research concerning music interventions and adolescent depression led to the
development of this study. The purpose of this study was to examine the effectiveness of using music
techniques in a group intervention with adolescents who had been identified as exhibiting symptoms
of depression. The study used a comparative design with one group of adolescents exhibiting the
symptoms of depression being treated in a group using music techniques and the other group of
adolescents exhibiting the symptoms of depression being treated in a group using nonmusic-related
therapy. The effectiveness of music techniques was measured using a pretest and posttest
administration of the Beck Depression Scale. The hypothesis of the study was that music therapy
techniques would alleviate depressive symptoms more effectively than would nonmusic therapy
techniques.

METHOD
Participants
Participants in the study were students enrolled in a public junior high school in a middle-sized
southwestern town. Initially there were 21 participants involved in the study; however, two students
transferred to another school during the study, leaving only 19 participants. All the participants were
14 and 15 years old and had been referred to graduate students conducting the group by the school
counselors after an initial screening for depressive symptoms. All the participants were involved in
short-term individual psychotherapy in addition to participating in the group intervention. Target
complaints of the students varied widely and included anhedonia, helplessness, hopelessness,
somatic problems associated with stress, bereavement, and other difficulties. Participation in the
study was voluntary; parental consent was obtained for all the participants. Seventeen of the
participants were female and two of the participants were male. Of the participants, 15 were Angles, 3
were Hispanic, and 1 was an Asian American. None of the participants had ever participated in group
therapy before the study.

Music Therapy Techniques


The music therapy strategies used in this study were adapted from work done by Thompson, Davies,
Gallagher, and Krantz (1986) and Hanser and Thompson (1994). In the work by Hanser and
Thompson, the techniques were used with depressed older adults. The researchers presented
pleasant and potentially reinforcing music that served as stimuli for deep body relaxation, positive
imagery and mood, and clear thinking, which are all incompatible with worry. The techniques used by
Hanser and Thompson included the following:

1. Gentle exercise to familiar and energetic music.

2. Progressive muscle relaxation done with eyes open to specially designed music interspersed with
instructions from the therapist.
3. Special music used to help the individual create a structured plan for a positive action to solve a
problem or improve a mood.
4. Slow and repetitive music used at home to enhance falling asleep.

5. The use of fast rhythmic music to enhance increased energy, especially used outside group
sessions immediately before home study time.

6. Music listening in groups in conjunction with drawing.

7. Music listening in groups to pair positive experiences and memories to a particular song.

Initially participants selected the specific music selections for the group with assistance from the
facilitator. Each of the participants was interviewed separately to determine music preferences and
previous experience with music. The participants were then asked to choose a song that had special
meaning for them and share this song with the group. As the music was played, the group facilitator
observed the participant who chose the song for responses indicating relaxation. After the
composition was played, the group members were asked to report their own feelings about the songs
and the ways that listening to this song helped them feel better. The therapist then asked for
responses from other group members and assisted participants in processing these responses. The
therapist also suggested other songs similar in style to the one that was played. These other music
selections were usually listened to and followed with the same questioning regarding images and
associations experienced while listening to the music. Improvised music was also used with piano and
guitar. Initially the counselor modeled ways to improvise music and encouraged participants to begin
improvising music themselves. After some initial resistance, several participants were willing to try
improvisation.

Participants were instructed to find some time outside group time when they could practice these
techniques without interruption; students were expected to report to the group about the experience.
The group facilitator introduced a new technique each week, and the participants were asked to test
the effects of the music whenever they experienced symptoms of depression or stress.
Treatment
Participants were randomly assigned to one of the following treatment conditions: (a) group therapy
using music techniques over 8 weeks, or (b) a control group that did not participate in group therapy
using music techniques during the 8 weeks. The treatment group had 9 participants and the control
group had 10 participants. While the treatment group participated in a group using music therapy
techniques, the control group participated in cognitive-behavioral group activities. In the control group,
the focus of discussion every week was self-concept and how depression affected self-concept. Every
week, the facilitator focused on one adjective from a list of adjectives and how it was part of the
participants' concept of who they were. Once the facilitator presented the adjective, the participants
discussed whether the adjective described them. At the end of each group session, a different
participant was placed in the "hot seat" while the rest of the group participants used positive
reinforcement to broaden the self-concept of the participant in the "hot seat."

At the end of the 8 weeks, each of the participants in the control group was given the opportunity to
participate in a group using music techniques.

Instruments
Participants in both the treatment and the control groups of the study completed the Beck Depression
Inventory (BDI; Beck, Ward, Mendelson, Mock, & Erbaugh, 1961) to monitor levels of depression. The
BDI is a self-administered questionnaire with 21 survey items. The BDI takes approximately 10 to 15
minutes to complete and responses are measured on a 4-point scale. The BDI requires a fifth-grade
reading level and is designed for individuals who are 13 years and olden In 1988, Beck, Steer, and
Garbin reviewed and conducted a meta-analysis of the reliability and validity literature for the BDI.
Beck et al. (1988) reported that internal consistency rated by Cronbach's coefficient alpha ranged
from .73 to .95. Test--retest reliability ranged from Pearson correlations of .48 to .86. Content validity
of the BDI was supported by comparing the BDI with the criteria of the Diagnostic and Statistical
Manual of Mental Disorders, fourth edition (DSM-IV; American Psychiatric Association, 1994).
Fourteen studies demonstrated fairly strong discriminate validity, although the BDI was not developed
for discriminating between populations. Regarding construct validity, the BDI correlates as predicted
with adjustment, alcoholism, suicidal behaviors, life crisis, and biological and somatological issues. In
concurrent validity studies, the mean correlation ranged from .60 to .76. All the participants in both the
treatment and the control groups completed the BDI during the 1st week and 8th week of treatment. A
t test was used to analyze the data with a significance level of .05.

RESULTS
Regarding the hypothesis that music therapy treatment would more effectively treat depression than
would nonmusic therapy, the treatment group's scores did differ significantly on the posttest. The
mean score of the control group on the BDI pretest was 32.3, whereas the mean score of the
treatment group on the BDI pretest was 39. The mean score of the control group on the BDI posttest
was 17, whereas the mean score of the treatment group on the BDI posttest was 1.34. The t test of
the variance of the group means was significant at the .05 level (F= 5.96, p = .0195). The differences
between the experimental and control groups' mean scores could be due to chance only 1.95 out of
100 times.

DISCUSSION
The issue of depression has been widely addressed in recent years. Researchers like Beck et al.
(1961), Goldstein (1990), and King (1991) have provided major insight into our understanding of
depression. Profiting from the research of others, we designed a study that focused on helping
adolescents deal with depression. We operated on the premise that what may be needed to reduce
depression in adolescents is an approach that deviates from a traditional group counseling approach.
It is from this basic premise coupled with our knowledge that music therapy techniques have been
successful in reducing depression in adults that we initiated the use of music therapy techniques with
adolescents. When we stepped into the area of therapy and used music therapy techniques with
adolescents, we soon realized adolescents were interested in music and seemed to be responding to
the techniques in the counseling sessions. The use of the music therapy techniques presented a
means whereby the adolescents could contribute something tangible to the healing process that they
were experiencing. When we analyzed that data and reviewed the significant hypotheses, our
hunches proved correct: It was clear that the music therapy techniques had made a significant
difference.

Given the significant finding, what does it mean? First it means that we must pay more attention to the
unique context of the adolescent's environment. How else can counselors establish a working alliance
with adolescents but by understanding the beliefs and feelings that guide their actions? Second,
counselors and other mental health workers need to listen and respond to the needs of adolescents.
This means counselors must be willing to reshape counseling sessions to meet individual as well as
group needs rather than attempt to continue with a set of traditional programs and services. Third,
one could easily be tempted to conclude that if adolescents are experiencing depression, then the
counselor should place the adolescent in a group and use music techniques. In fact, nothing could be
further from the truth. In considering therapy techniques, the counselor must always consider what is
best for the adolescent. In some instances, group counseling will be more effective and in other
cases, individual counseling is the preferred mode. In other instances, some adolescents may not
respond to therapy involving any aspect of music. Basically, techniques must be tailored to meet the
needs of the client.

We acknowledge that despite the significant findings this research has limitations. One limitation was
the small sample of participants. Although we concede the merits of a larger sample size, the study
nevertheless substantiates the clinical observations reported by music therapists and research
indicating that music techniques used in counseling may be effective in the therapy of depressed
individuals (Hahser, 1988). This study also presents significant findings indicating not only that
depression decreased in the treatment group but, in addition, in a follow-up 6 months later, the
reduction in depression continued with participants indicating they were continuing to use music
techniques in group counseling. Other limitations included the screening of the participants, lack of
consistent curriculum between the control and the treatment groups, and geographic location.

Despite many efforts as researchers to design and implement this study, we must acknowledge that
there is no clear template using music therapy techniques. Instead, we recommend that future
researchers seek not one model but a set of techniques that could be used in a variety of ways, yet
be sensitive to the individual needs of the members of the group. To assist with this task, we offer the
following recommendations:

1. Replicate this study using a larger participant size.

2. Improve this study by having a more structured curriculum.

3. Extend this study by selecting participants from a wider geographic area.

4. Expand this study to assess the effects across age, gender, racial/ethnic groups.

5. Design a study that assesses the impact of the treatment over 6 months, 1 year, and 3 years to see
if the treatment's effect continues.
REFERENCES
American Psychiatric Association. (1999). Diagnostic and statistical manual of mental disorders (4th
ed.). Washington, DC: Author.

Ballard, M. E., & Coates, S. (1995). The immediate effects of homicidal, suicidal, and nonviolent
heavy metal and rap songs on the moods of college students. Youth & Society, 27, 148-168.

Beck, A. T., Steer, R. A., & Garbin, M. G. (1988). Psychometric properties of the Beck Depression
Inventory: Twenty-five years of evaluation. Clinical Psychology Review, 8, 77-100.

Beck, A. T., Ward, C., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring
depression, Archives of General Psychiatry, 4, 561-571.

Bradford, D. L. (1991). Music as an adjunctive therapeutic mode in the treatment of depression.


Dissertation Abstracts International, 51(10-B), 5020-5021.

Forrest, D. V. (1983). Depression: Information and interventions for school counselors. The School
Counselor, 30, 269-279.

Gibbons, A. C. (1984). Music development in the elderly: What are the chances? Design for Arts in
Education, 13, 44-49.

Gibbons, A. C. (1988). A review of literature for music development and education. Music Therapy
Perspectives, 5, 33-40.

Goldstein, S. L. (1990). A songwriting assessment for hopelessness in depressed adolescents: A


review of the literature and a pilot study. Arts in Psychotherapy, 17, 117-124.

Hanser, S. B. (1985). Music therapy and stress reduction research. Journal of Music Therapy, 22,
193-201.

Hanser, S. B. (1988). Controversy in music listening stress reduction research. The Arts in
Psychotherapy, 15, 211-217.

Hanser, S. B. (1990). A music therapy strategy for depressed older adults in the community. Journal
of Applied Gerontology, 9, 283-298.

Hahser, S. B., & Thompson, L. W. (1994). Effects of music therapy strategy on depressed older
adults. Journal of Gerontology, 49, 265-269.

King, S. R. (1991). Recognizing and responding to adolescent depression. Journal of Health Care for
the Poor and Underserved, 2, 122-129.

Lewinsohn, P.M., Hops, H., Roberts, R., Seeley, J. R., &Andrew, J. (1993). Adolescent
psychopathology: I. Prevalence and incidence of depression and other DSM-III-R disorders in high
school students. Journal of Abnormal Psychology, 102, 183-204.

Linoff, R. C., & West, C. M. (1982). Relaxation training systematically combined with music.
International Journal of Behavioral Geriatrics, I, 11-18.
Maranto, C. D. (Ed.). (1992). Music and medicine. Silver spring, MD: National Association for Music
Therapy.

Martin, G., Clarke, M., & Pearce, C. (1993). Adolescent suicide: Music preference as an indictor of
vulnerability. Journal of the American Academy of Child & Adolescent Psychiatry, 32, 530-535.

Mays, R. (1979). The use of music as a counseling aid in the treatment of depression. Dissertation
Abstracts international, 40(4-A), 1878-1879.

McWhirter, B. T., McWhirter, J. J., & Gat, I. (1996). Depression in childhood and adolescence:
Working to prevent despair. In D. Capuzzi & D. R. Gross (Eds.), Youth at risk.' A prevention resource
for counselors, teachers, and parents (pp. 105-128). Alexandria, VA: American Counseling
Association.

Moore, D., & Schultz, N. R. (1983). Loneliness at adolescence: Correlates, attributions, and coping.
Journal of Youth and Adolescence, 12, 95-100.

Neboschick, M. R. (1975). A treatment of the psychopathology of depression through inducement of


appropriate changes by a combination of music and comparable colors with complementary
counseling. Dissertation Abstracts International, 35(10-B), 5088.

Palmer, M.D. (1989). Music therapy in gerontology: A review and a projection. Music Therapy
Perspectives, 6, 52-59.

Prickett, C. A. (1988). Effectiveness of music therapy procedures: Documentation of research and


clinical practice. Washington: National Association for Music Therapy.

Smith, D. S. (1990). Therapeutic treatment effectiveness: Implications for music therapy. Music
Therapy Perspectives, 8, 32-40.

Standley, J. M. (1986). Music research in medical/dental treatment: Meta-analysis and clinical


applications. Journal of Music Therapy, 23, 56-122.

Straseske, C. A. (1989). Musically induced moods: Effects on judgments of self-efficacy. Dissertation


Abstracts International, 50(l-B), 355.

Stratton, V. N., & Zalanowski, A. H. (1994). Affective impact of music vs. lyrics. Empirical Studies of
the Arts, 12, 173-184.

Thaut, M. H., & Davis, W. B. (1993). The influence of subject-selected versus experimenter-chosen
music on affect, anxiety, and relaxation. Journal of Music Therapy, 30, 210-223.

Thompson, L. W., Davies, R., Gallagher, D., & Krantz, S. (1986). Cognitive therapy with older adults.
In T. Brink (Ed.), Clinical gerontology: A guide to assessment and intervention (pp. 245-279). New
York: Haworth.

Took, K. J., & Weiss, D. S. (1994). The relationship between heavy metal and rap music and
adolescent turmoil: Real or abstract? Adolescence, 29, 613-623.

Vanderark, S., Newman, K., & Bell, S. (1983). The effects of music therapy on quality of life. Music
Therapy, 3, 71-81.
White, A. (1985). Meaning and effects of listening to popular music: Implications for counseling.
Journal of Counseling and Development, 64, 65-69.

~~~~~~~~
By C. Bret Hendricks; Beth Robinson; Loretta J. Bradley and Kenneth Davis

C. Bret Hendricks is a doctoral candidate at Texas Tech University and clinical director at the
Children's Home of Lubbock, Lubbock, Texas. Beth Robinson is an assistant professor in the
Department of Behavioral Sciences at Lubbock Christian University in Lubbock. Loretta J. Bradley is
chair of the Division of Educational Psychology and Leadership at Texas Tech University. Kenneth
Davis is chair of Choral Activities at Texas Tech University Correspondence regarding this article
should be sent to C. Bret Hendricks, Children's Home of Lubbock, PO Box 2824, Lubbock, TX 79408.

Copyright of Journal of Humanistic Counseling, Education & Development is the property of Wiley-
Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without
the copyright holder's express written permission. However, users may print, download, or email
articles for individual use.

S-ar putea să vă placă și