I think if a music therapist is conducting their work appropriately via assessments, etc, there should be no negative effects of music therapy. Using music in a therapeutic setting (ie, NOT a music therapist) one can find negative responses, particularly if the person providing the music is unaware of previous paired experiences to specific musical stimuli. There can be agitation, self-harm, and triggers in various other ways.

I realize in different parts of the world the term "music therapy" is used to mean multiple things, as a trained music therapist, I respond from that viewpoint.

As Edwards (2011) states; it is very difficult to get negative results published. There are hardly any publication on this topic as far as I know.

I do not think that music therapy can 'never harm'. Even highly qualified music therapists might do inattentionally something incorrect, sometimes due to a lack of knowledge (on the latest research results), somethimes out of counter-transference, or because patients do not respond to the music therapy as expected.

From my own experience: I had to change texts (or delete them) if I published a 'negative' result on music therapy for certain journals. On the moment togehter with my colleague dr. Annemiek Vink we are planning to edit a book on cases of 'music therapy going wrong'; reserach going wrong is not yet easy publishable; I guess.

ref: Edwards, J.A. (2011). Music and health; Perspective on music’s perceived “good-

ness”. Nordic Journal of Music Therapy, 20(1), 90–101.

Laurien makes a valid point about the difficulty in getting negative results published. However, I believe they might be exactly what is needed in the literature as American MTs argue for the protection of our clients with state licensure. As it stands, anyone can call themselves a music therapist and not have to provide credentials (unless the facility is already knowledgeable). I think Laurien is also correct in that MTs may do something incorrect, the benefit is in the training they receive to be able to correct the issue. However, I don't believe that counter-transference or responding inappropriately to the therapy is really a result of the therapy, but rather issues with the therapist. It is difficult to separate the two, but it is an important consideration.

I agree we need more of all studies in our literature, not just those for which we find positive outcomes.

What a fascinating and timely discussion and I look forward very much to your book Laurien. I work in adult mental health and see an increased maturity in our profession about being mindful and open that some things we do could cause iatrogenic harm, especially as we tend to work with more severely ill people: eg we can increase dependency ('over-care') to meet our own needs, we might make interpretations that cause huge anxiety (and might be wrong) and reduce someone's capacity to think for themselves and to absorb helpful information from their social world ('epistemic trust' as Fonagy/Bateman describe). At my place of work we are training everyone in MBT to try to be as empirically-based as possible. Music therapists are also used to examining recordings of the work as standard within supervision.

I'm not sure whether negative results from RCTs actually mean negative results of the therapy though - e.g. MATISSE trial of group art therapy which showed no effect, was set up a bit strangely (research-participant-only groups so each group had to start from scratch) and had extremely low take up. Obviously positive results need also be interrogated in the same way....!

I'm aware this question is rather old, however I believe that it still stands to be answered. Has anyone found any articles or studies showing any negative effects or outcomes of music therapy? If so, I would be interested in reading them!

A new article was published in The Journal of Music Therapy this summer regarding the theoretical model for music-induced harm by Michael J. Silverman, Lori Gooding and Olivia Yinger.

Article It’s...Complicated: A Theoretical Model of Music-Induced Harm

Hi, The following reference pertains to art therapy but nevertheless may be helpful as it directly addresses art-related harm that occurred in therapy: '

Through the eyes of the law: What is it about art that can harm people? Springham (2008). International Journal of Art Therapy 13,2 pp 65 to 73

ublished online: 27 Nov 2008pp

A serious training of music therapists not only in music therapy but also in psychiatry, psychopathology, neurology, neuropsychology, neuropsychology of music, in-depth work on transferential processes.

- study of contraindications concerning music therapeutic processes

Most studies are not conducted by trained music therapists. The protocols in music therapy are not precise and unclear.

Studies now must necessarily also validate specific music therapy treatment , which is not yet the case. University Diploma Montpellier 3( France)

Just some thoughts in case anyone else is still thinking about this.. it would be great to hear from anyone else who has observed negative wellbeing effects from music engagement.

I haven't seen much published data but I have heard of music therapy protocols that had to be abandoned early because it was quite clear that the participants were experiencing increased distress from the specific music. The music was created by a certified music therapist, but unfortunately was too direct in terms of the way it attempted to deal with the clinical issue and inadvertently made people feel worse. It was an unforeseen adverse effect, but unfortunately the appetite for reporting on this seems to be quite low.

I have also come across instances where music can trigger negative sensations for people with spinal cord injuries or damaged nerves. They can become physiologically over-sensitised to music and other sounds to the degree that it actually triggers painful sensations. Given that this is a physiological response it would occur regardless of whether the music was delivered by musicians or a music therapist. Typically individuals seem quite aware of the phenomenon themselves and often quickly decline from music intervention studies. This seems to be relatively rare, I have only seen it in clinical contexts, but have not seen systematic clinical evaluations on this. Nonetheless for this reason I always do safety checks now when I'm recruiting for music intervention studies and recommend that people discontinue listening if they feel any increases in discomfort.

I've also collected some data that indicates that people with musical anhedonia (people who do not experience pleasure as a result of music listening) do not appear to benefit to the same degree from music interventions as people who enjoy music. This would undermine the therapeutic benefits of music interventions, and should be considered and potentially controlled for in future research.

We, Avi Gilboa and me, hope to publish the book in June 202; Making meaning of mistakes in music therapy'. Containing case material, discussion material, qualitative research from information gathered during national and international conferences on negative outcomes of music therapy on many different levels. Beside Silverman et al, very happy with the articles of Isenberg (2011) of Murakami (2021) as well!.

Isenberg, C. (2012). PRIMUM NIL NOCERE (ABOVE ALL, DO NO HARM): A Direction for the Development of Music Therapy. Canadian Journal of Music Therapy, 18(1), 62-78.

Murakami, B. (2021). The music therapy and harm model (MTHM). ECOS-Revista Científica de Musicoterapia y Disciplinas Afines, 6(1), 003-003.

he musical treatment must be carried out by a qualified music therapist.

A clinical interview is essential to evaluate the relationship that the patient has with music to carry out evaluations to target the devices to be set up in connection with the therapeutic objectives.

On the other hand, it is necessary to know perfectly the patient's pathology, counter indications can be indicated on a type of music therapy, it is necessary to carry out a review of the literature to know the relevance of the care.

A validated study makes it possible to evaluate the impact of music on the reward circuits Barcelona Music Reward Questionnaire

Mas-Herrero, E., Marco-Pallares, J., Lorenzo-Seva, U., Zatorre, R. J., & Rodriguez-Fornells, A. (2013).

I am researching the effects of pentatonic music on dental anxiety in children. I'll measure levels of some inflammation markers.. I will share the results with you.

it would be pleasure

Please let me know your first results thanks a laot we keep in touch

Of course, thank you.

I have a conference presentation coming up in the Nordic Music Therapy Conference in April on negative experiences of music therapy in people living with chronic pain. There's also a mention of it in a paper currently under review on music therapy for people with chronic pain. We observed that those with Fibromyalgia were more susceptible to exhaustion in active music therapy. One client had to take days off work following a performance (in 1:1 session) of a song they had written on the topic of their illness. It wasn't the writing of the song that was draining but rather the singing of it. Another found improvisation to be exhausting.

A methodology is necessary for the care of people suffering from chronic pain:

Clinical interview to assess motivation to engage in music therapy sessions.

To elaborate a personalized therapeutic project, it is necessary to focus on the comorbidities associated with the pathology, often these people have a depressive tone and anxiety states that increase the perception of pain.

The objectives are most of the time to respond effectively to the reduction of pain by acting on the reduction of anxiety.

Relaxation under musical induction is recommended and then the patient is invited to active music therapy to regulate emotions.

It is important to take into account the fatigue and cognitive faculties of the person. It seems to me that when we notice that music therapy can have negative effects, it is because the therapeutic objective has been poorly set and that the means are not relevant to achieve this objective.

Thanks a lot

Pierre-Luc Bensoussan

Bensoussan pierre-luc Thanks for your thoughts on the topic Pierre-Luc. I would be agreement with your thoughts above. In the two trials we have done thus far, consideration of comorbid mental health issues has been at the fore. In the context of the aforementioned cases, a person-centred approach was taken and the choice of musical intervention led by the client. It would have been both client's first experience of songwriting and improvisation. Each session always began with relaxation or mindfulness with music to gently bring the client into the musical and therapeutic space.

You might be interested in following my current work. I am undertaking a PhD in music therapy for chronic pain (individual, group and online interventions). We have three articles under review at the moment. I would be very interested in reading anything you have written on the topic or any studies that you have found useful.

Best wishes,

Katie.

yes ,sure I'm interessed by your current work, I think you have to focus the effect of music or music therapy on anxiety , pain, regulation of emotions and not only fibromyalgie.

We keep in touch

Thanks a lot

Have you read ...

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