Effects of Music Therapy on Change Readiness and Craving in Patients on a Detoxification Unit

Article excerpt

The purpose of this study was to determine the effect of a "rockumentary" music therapy intervention on readiness to change and craving in patients on a detoxification unit utilizing psychometric instruments in a randomized three-group design. Participants (N = 141) were randomized by group to a rockumentary music therapy intervention, verbal therapy, or recreational music therapy condition. All interventions were scripted and manualized in a posttest only design. Concerning readiness to change, results indicated there were significant between-group differences in Contemplation and Action subscales, with participants in the rockumentary and recreational music therapy conditions having higher means than participants in the verbal therapy condition. There were no differences between the two music therapy conditions concerning readiness to change variables. Although not significant, participants in both music therapy conditions tended to have lower mean craving scores than participants in the verbal therapy condition. Concerning Likert-type ratings of motivation to change, perception of helpfulness, and perception of enjoyment, participants in both music therapy conditions tended to have slightly higher mean scores than participants in the verbal therapy conditions. Participants' posttest written comments were positive, regardless of condition. Limitations of the study, suggestions for the future inquiry, and implications for clinical practice are provided.

Review of Literature

The 2008 National Survey on Drug Use and Health (NSDUH) sponsored by the U.S. Department of Health and Human Service's Substance Abuse and Mental Health Services Administration (2009) is the primary source of information regarding the use of alcohol and drugs in the non-institutionalized population of the U.S. aged 12 and older. In 2008, approximately 67,500 participants took part in the survey. Results indicated that 20.1 million (8.1%) Americans had used an illicit drug in the month prior to survey administration in 2008. This number did not change from the previous year. Approximately 1.9 million Americans used cocaine and 6.2 million (2.5%) used prescription type psychotherapeutic drugs nonmedically. More specifically, in the 50-59 year old demographic, illicit drug use has increased from 2.7% in 2002 to 4.6% in 2008.

In the same survey, over half (51.6%) of Americans reported being current alcohol drinkers. Approximately 23.3% participated in binge drinking, which was operationally defined as five or more drinks on the same occasion on at least 1 day prior to taking part in the survey. Heavy drinking, operationally defined as binge drinking on at least 5 days prior to participating in the survey, was reported by 6.9% of the sample (SAMSA, 2009). From these data, substance abuse remains a major societal concern.

While there are an abundance of potential factors that can lead to substance misuse and abuse, many people abuse substances and/ or relapse because they are craving the drug. Although ambiguous and subjective (Miller, Westerberg, Harris, & Tonigan, 1996), craving has long played a role in attempting to explain the relapse phenomenon (Marlatt, 1978). Therefore, craving is commonly included in relapse prevention efforts and considered both in physiological and psychological aspects (Roelofs & Dikkenberg, 1987). Unfortunately, craving has been difficult to assess and likely best understood through retrospective accounts of the frequency and magnitude of craving (Miller et al., 1996). Craving also is related to relapse: Heather, Stallarti and Tebbutt (1991) used an open-ended client inquiry to learn about relapse and found craving to be a principal factor. Other researchers have studied craving, continually noting its importance in treating people who are chemically dependent (Mezinskis, Honos-Webb, Rropp, & Somoza, 2001; Otto, Quinn, & Sung, 1998; Weiss, Griffin, & Hufford, 1995).

Thus, a successful detoxification process supervised by medical professionals who can help to alleviate craving can be a key component of achieving sobriety, at least temporarily. …