The Influence of Music on the Symptoms of Psychosis: A Meta-Analysis
Silverman, Michael J., Journal of Music Therapy
The purpose of this study was to analyze the existing quantitative research evaluating the influence of music upon the symptoms of psychosis. A meta-analysis was conducted on 19 studies. Results indicated that music has proven to be significantly effective in suppressing and combating the symptoms of psychosis (d = +0. 71). However, there were no differing effects between live versus recorded music and between structured music therapy groups versus passive listening. Nor were there differing effects between preferred versus therapist-selected music. Additionally, classical music did not prove as effective as nonclassical music in reducing psychotic symptoms. This supports the therapeutic potential of popular music while dispelling the theory that classical music provides the form and structure that can contribute to mental health and well-being. Further quantitative research is recommended and strongly warranted to refine unique aspects of music therapy interventions effective for those with psychotic symptoms.
Conducting any sort of research is difficult; research done particularly with clients diagnosed with schizophrenia has proven very challenging throughout the years. Millon and Diesenhaus (1972) noted that research in psychopathology has many complications such as the presence of obscure and unreliable data, choosing between scientifically safe and clinically significant problems, issues of clinical responsibility and ethics, and complications of execution.
While Emil Kraepelin's pioneering work with schizophrenia should be commended for its innovativeness, he was the product of an environment that unquestionably accepted the appropriateness of the methods and theories of his medicine and research. The problems in his methodology were never considered and he appeared to have either been unaware of or chosen to ignore the most basic principles of empirical inquiry (Boyle, 1990). A recurring problem in Kraepelin's early writings was that of knowing what data he actually collected and the manner in which he collected it. In fact, Rowe (1906) noticed his lack of reliability in the measurement of the outcome. A number of flaws have been pointed out in Kraepelin's `subjective and unquantified' accounts, including the need to present systematically gathered data, the importance of clear description so that others may attempt to replicate the observations, the importance of reliability, and the dangers of question begging (Boyle, 1990). Gardner (1931) also noted the need for further quantitative literature concerning schizophrenia in his test measuring intelligence and learning.
In current music therapy literature, there exist a great number of studies dealing with schizophrenia and/or psychosis. However, most of these studies are qualitative and provide information that may not generalize to other clients with the same diagnosis and objectives (Alexander, 1996). Today, music therapists must provide accountability for their methods and, as qualitative data does not generalize, this type of data is often times not considered as reimbursable by insurance companies (Hanser, 1999; Rogers, 1995). Methods that combine observational and self-report measures and investigate `significant events' are becoming a dominant modality (Alexander, 1996). Furthermore, quantitative methods not having some statement about the probability of the occurrence of the phenomenon due to random sources are treated judgmentally (Neufeld, 1977). Case studies and other types of qualitative data (participant observation, protocol analysis, discourse analysis, conversation analysis, voice-centered techniques, photographic analysis, diary studies, document analysis, computational modeling) do not provide the required accountability health care providers need. Qualitative research's foundation within the mental health field is still not as secure as that of quantitative research (Good & Watts, 1996). However, quantitative data are not easily attainable within the given population. …