Individual music therapy for mental health care clients with low therapy motivation: multicentre randomised controlled trial.
BACKGROUND
Music therapy (MT) has been shown to be efficacious for mental health care clients with various disorders such as schizophrenia, depression and substance abuse. Referral to MT in clinical practice is often based on other factors than diagnosis. We aimed to examine the effectiveness of resource-oriented MT for mental health care clients with low motivation for other therapies.


METHODS
This was a pragmatic parallel trial. In specialised centres in Norway, Austria and Australia, 144 adults with non-organic mental disorders and low therapy motivation were randomised to 3 months of biweekly individual, resource-oriented MT plus treatment as usual (TAU) or TAU alone. TAU was typically intensive (71% were inpatients) and included the best combination of therapies available for each participant, excluding MT. Blinded assessments of the Scale for the Assessment of Negative Symptoms (SANS) and 15 secondary outcomes were collected before randomisation and after 1, 3 and 9 months. Changes were analysed on an intention-to-treat basis using generalised estimating equations in longitudinal linear models, controlling for diagnosis, site and time point.


RESULTS
MT was superior to TAU for total negative symptoms (SANS, d = 0.54, p < 0.001) as well as functioning, clinical global impressions, social avoidance through music, and vitality (all p < 0.01).


CONCLUSIONS
Individual MT as conducted in routine practice is an effective addition to usual care for mental health care clients with low motivation.
GAMUT, Uni Health, Uni Research, Bergen, Norway. christian.gold @ uni.no
Christian
C
Gold
Karin
K
Mössler
Denise
D
Grocke
Tor Olav
TO
Heldal
Lars
L
Tjemsland
Trond
T
Aarre
Leif Edvard
LE
Aarø
Hans
H
Rittmannsberger
Brynjulf
B
Stige
Jörg
J
Assmus
Randi
R
Rolvsjord
D000328:Adult; D005260:Female; D006801:Humans; D057194:Intention to Treat Analysis; D007398:Interpersonal Relations; D016014:Linear Models; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy*; D009042:Motivation; D009147:Music Therapy / Q000379:methods*; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D010349:Patient Compliance / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D057566:Self Report; D016037:Single-Blind Method; D016896:Treatment Outcome