Quantitative Comparison of Cognitive Behavioral Therapy and Music Therapy Research: A Methodological Best-Practices Analysis to Guide Future Investigation for Adult Psychiatric Patients
Silverman, Michael J. PhD, Mt-Bc, Journal of Music Therapy
While the music therapy profession is relatively young and small in size, it can treat a variety of clinical populations and has established a diverse research base. However, although the profession originated working with persons diagnosed with mental illnesses, there is a considerable lack of quantitative research concerning the effects of music therapy with this population. Music therapy clinicians and researchers have reported on this lack of evidence and the difficulty in conducting psychosocial research on their interventions (Choi, 1997; Silverman, 2003a). While published studies have provided suggestions for future research, no studies have provided detailed propositions for the methodology and design of meticulous high quality randomized controlled psychiatric music therapy research. How do other psychotherapies accomplish their databases and could the music therapy field borrow from their rigorous "methodological best practices" to strengthen its own literature base? Therefore, as the National Institutes of Mental Health state the treatment of choice for evidence-based psychotherapy is cognitive behavioral therapy (CBT), aspects of this psychotherapy's literature base were analyzed. The purpose of this literature analysis was to (a) analyze and identify components of high-quality quantitative CBT research for adult psychiatric consumers, (b) analyze and identify the variables and other elements of existing quantitative psychiatric music therapy research for adult consumers, and (c) compare the two data sets to identify the best methodological designs and variables for future quantitative music therapy research with the mental health population. A table analyzing randomized and thoroughly controlled studies involving the use of CBT for persons with severe mental illnesses is included to determine chief components of high-quality experimental research designs and implementation of quantitative clinical research. The table also shows the same analyzed components for existing quantitative psychiatric music therapy research with adult consumers, thus highlighting potential areas and elements for future investigations. A second table depicts a number of potential dependent measures and their sources to be evaluated in future music therapy studies. A third table providing suggestions for future research is derived from a synthesis of the tables and is included to guide researchers and encourage the advancement and expansion of the current literature base. The body of the paper is a discussion of the results of the literature analysis derived from the tables, meta-analyses, and reviews of literature. It is hoped that this report will lead to the addition of future high-quality quantitative research to the psychiatric music therapy literature base and thus provide evidence-based services to as many persons with mental illnesses as possible.
There has been a recent shift in the perception of psychological interventions in the treatment of adults with mental disorders. These interventions are now recognized as a critical component of a comprehensive treatment approach (Department of Health, NHS Executive, 1999). Although psychiatric consumers are primarily treated with medication regiments, a meta-analysis noted that the effectiveness of newer antipsychotic medications is less than previously thought (Geddes, Freemantle, Harrison, & Bebbington, 2000). While pharmacotherapy can improve symptoms of mental illness, it does not contribute to the development of skills and knowledge necessary for a successful transition back to the community or improved functioning and quality of life (Huxley, Rendali, & Sederer, 2000; Liberman, 1994). Thus, because of these factors, psychological interventions are considered a crucial component of effective and comprehensive mental health care.
Music therapy is an evidence-based profession commonly used with psychiatric consumers due to its flexibility and capacity to meet a wide variety of clinical objectives. …