Music Therapy Explained

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What Is Music Therapy?

The American Music Therapy Association defines music therapy as the clinical and evidence-based use of music interventions to accomplish individualised goals within a therapeutic relationship, delivered by a credentialed professional who has completed an approved music therapy programme.[1] In practice, music therapists work with elements such as rhythm, melody and harmony to address physical, emotional, cognitive and social needs.

Methods vary. A session may involve listening, playing or creating music, singing, or discussing lyrics, chosen to suit the person and their goals. Through these activities a person may explore feelings, work on mood, develop coping and relaxation skills, and find ways of expressing themselves.

Music therapy is used particularly where spoken language is difficult, either because a person finds words hard to reach or because talking has not been a comfortable route for them. What music therapy achieves varies by person and by condition.

How Does Music Therapy Work?

Music therapy rests on a small number of working principles:

• Holistic engagement: sessions engage a person emotionally, cognitively, physically and socially rather than through talking alone.
• Nonverbal expression: for people who find it difficult to put thoughts and feelings into words, music offers an alternative to verbal communication, allowing something to be expressed without words.
• Individualised care: sessions are adapted to the person's needs, musical preferences and therapeutic goals.
• Active participation: music therapy usually asks the person to take part, by creating, playing, listening to or reflecting on music, rather than only receiving an intervention.

What to Expect From a Music Therapy Session

Sessions vary widely depending on the person's goals, the setting and the therapist's approach. Common elements include:

• Assessment: early sessions usually explore musical responses and preferences to establish needs and goals, which then guide the work.
• Musical interaction: the person takes part in music-making chosen for the goals agreed, such as playing instruments, singing or composing.
• Reflective discussion: sessions may include talking about the music-making, the feelings it raised and anything the person noticed.
• Progress review: over time the therapist and the person review how the work is going and adjust it as needs change.

Sessions are structured to create a safe and supportive setting in which a person can try things out and express themselves.

Who Can Benefit From Music Therapy?

Music therapy is offered to children, adolescents, adults and older adults, in settings including schools, hospitals, mental health services and residential care. It is commonly used with:

• People living with mental health difficulties, such as depression, anxiety and PTSD.
• People living with neurological conditions, including dementia, Alzheimer's disease and Parkinson's disease.
• Children and adults with developmental and learning disabilities.
• People undergoing medical procedures or living with chronic illness, where music is used mainly to address anxiety and pain. A Cochrane review of 26 trials with 2,051 participants found that listening to music before surgery reduced anxiety compared with standard care, although most trials were at high risk of bias and the authors advise interpreting the result with caution.[3] A separate Cochrane review of 81 trials with 5,576 participants in cancer care reported reductions in anxiety, depression, pain and fatigue, with the certainty of that evidence rated low to very low.[4]
• People looking for a non-verbal way of working on self-expression and quality of life.

Because it does not depend on talking, music therapy is sometimes taken up by people who have found more conventional talking therapies difficult. Research support differs by condition, and the strongest current evidence in this list concerns dementia.

The Pros and Cons of Music Therapy

Possible benefits

• Accessibility: music therapy does not require musical training or verbal fluency, so it can be offered across ages and cultures.
• Emotional expression: it offers a route for expressing and working through feelings, which some people find useful when dealing with trauma or grief.
• Dementia: a 2025 Cochrane review of 30 randomised trials with 1,720 participants found that at least five sessions of a music-based therapeutic intervention probably improve depressive symptoms slightly and may improve overall behavioural problems by the end of treatment. The same review found that these interventions probably do not improve agitation or aggression, found no evidence of benefit for cognition, emotional well-being, anxiety or social behaviour, and found no evidence of effects lasting four weeks or more after treatment ended. No serious adverse effects were reported.[2]
• Social contact: group sessions bring people together around a shared activity, which some find helps with isolation.
• Use alongside rehabilitation and pain management: music therapy is sometimes used as part of physical rehabilitation programmes, for example in work on movement and coordination, and as part of the management of persistent pain. A 2025 systematic review of nine randomised trials with 787 participants living with chronic pain reported lower pain and depression scores after music therapy, with no evidence of an effect on anxiety or quality of life. That is a small evidence base and the trials differed in setting and method.[5]

Challenges and considerations

• Individual preferences and reactions: musical taste is personal, and particular genres or songs can carry difficult associations. Working within a person's preferences is necessary, and it also narrows what the therapist can draw on.
• Misconceptions about its seriousness: music therapy is sometimes assumed to be a recreational activity rather than a structured clinical intervention, which can affect whether it is offered or taken up.
• Finding a qualified therapist: music therapists hold specific credentials, and availability is limited in many areas. Check the registration and qualifications of any therapist you are considering. In the United States, the Certification Board for Music Therapists holds the register of board-certified (MT-BC) practitioners and lets you search it. Elsewhere, the World Federation of Music Therapy lists the national associations that hold the equivalent register for their country. You can also start from the TherapyRoute directory.
• Place within wider care: music therapy is often one part of a broader treatment plan, particularly where difficulties are complex or severe, and usually works best in coordination with the person's other clinicians.
• Limits of the evidence: the research base is uneven. It is stronger for some conditions than others, many trials are small, and long-term effects are poorly established.

Is Music Therapy Right for You?

Several things are worth weighing up:

• Your relationship with music: music therapy works through your own engagement with music. It may help to consider what place music already has in your life.
• Your goals: consider whether what you are hoping for matches what music therapy sets out to do. It suits people looking for an expressive, non-verbal way of working.
• Willingness to take part: the work asks you to play, listen and reflect, and then to talk about what came up. Consider whether that appeals to you at the moment.
• Group or individual sessions: some people prefer the contact of a group, others the focus of individual work.

If music therapy does not seem like the right fit, you can look at other forms of therapy to find an approach that suits you better.

Consulting a professional

A consultation with a credentialed music therapist is a useful next step. Worth discussing:

• Your goals and concerns: what you hope to work on, and anything you are unsure about.
• The therapist's approach: their methods, their experience with situations similar to yours, and how they understand music as therapy.
• Logistics: session frequency, duration and cost, what is expected of you, and how progress will be reviewed.

An open conversation at the outset makes it easier to judge whether the work is likely to suit you, and to adjust it as you go.

Conclusion

Music therapy uses musical activity, within a therapeutic relationship, to work on physical, emotional, cognitive and social needs. Sessions are built around the person's own preferences and may involve listening, singing or playing instruments. It is offered to a wide range of people, from those living with mental health difficulties to those coping with medical conditions. What it achieves varies by person and by condition, the research base is uneven, and finding a properly qualified therapist matters.

Key Takeaways

• Music therapy is a structured clinical intervention delivered by a credentialed therapist, not a recreational music activity.
• It offers a way of working that does not depend on talking, which suits some people who find verbal therapy difficult.
• Evidence differs by condition. In dementia, a 2025 Cochrane review found probable small improvement in depressive symptoms and no evidence of lasting effects after treatment ended.
• It is often used alongside other treatments rather than on its own.
• Sessions are adapted to the person's musical preferences and goals.

FAQ

Does music therapy require musical skills?

No, musical training or ability is not needed. The work is about the therapeutic process, not musical performance.

How does music therapy work online?

Online sessions are offered over video platforms and tend to rely on listening exercises, discussion and digital music-making. How well this substitutes for in-person work is not well established, and it is worth discussing with the therapist.

Can I choose the music used in therapy?

Yes. Music therapists usually select music together with the person, so that the material used means something to them.

Are there different types or approaches to music therapy?

Yes. Approaches differ in how much weight they give to improvisation, listening, songwriting or discussion.

Is music therapy covered by medical insurance?

Coverage varies by country, scheme and plan. Check with your medical scheme or insurer before starting.

References and Further Reading

• [1] American Music Therapy Association. What is Music Therapy?
• [2] van der Steen JT, van der Wouden JC, Methley AM, Smaling HJA, Vink AC, Bruinsma MS. Music-based therapeutic interventions for people with dementia. Cochrane Database of Systematic Reviews, 2025.
• [3] Bradt J, Dileo C, Shim M. Music interventions for preoperative anxiety. Cochrane Database of Systematic Reviews, 2013.
• [4] Bradt J, Dileo C, Myers-Coffman K, Biondo J. Music interventions for improving psychological and physical outcomes in people with cancer. Cochrane Database of Systematic Reviews, 2021.
• [5] Chen S, Yuan Q, Wang C, Ye J, Yang L. The effect of music therapy for patients with chronic pain: systematic review and meta-analysis. BMC Psychology, 2025.
• Certification Board for Music Therapists. cbmt.org
• World Federation of Music Therapy. wfmt.info