Low-Intensity Cognitive Behavioural Therapy-Based Music Groups for the Treatment of Mild to Moderate Symptoms of Mental Illness

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Trimmer, Christopher
Cognitive Behavioural Therapy , Mental Illness , Music , Depression , Anxiety , Psychosis , Community Mental Health , Music Therapy
The costs of mental illness - economic, social, and human - are immense. However, the demand for evidence-based non-pharmaceutical therapies appears to exceed the availability of these services, and when therapy is available, sustained client engagement can remain a prominent issue. Cognitive behavioural therapy (CBT) has been well-established as an effective form of psychotherapy in the treatment of mental illness. Low-intensity CBT evolved from standard CBT to address availability concerns while maintaining effectiveness, but issues of engagement remain. Music has the potential to be a popular and effective new medium for low-intensity CBT because of the positive emotional connection people have with it, the potential ease of adaptation to a low-intensity therapy format, and its non-verbal nature. The purpose of this project was to develop, and assess the feasibility of, two low-intensity CBT-based music group protocols, CBT-Music (Study 1, Chapter 2; for symptoms of depression and anxiety) and CBTp-Music (Study 2, Chapter 3; for symptoms of psychosis), for individuals in community mental health care. A randomised controlled trial (RCT - Study 1) and a pre-post trial (Study 2) were used. Measures of therapeutic acceptability (i.e. recruitment, attendance, & client feedback) and clinical effectiveness (i.e. symptomology & disability) were gathered in both studies. Development and provision of a standard CBT-based group protocol utilising music as a delivery medium was successful, as was recruitment from community mental health services. In both studies, there were high attendance rates and overall positive response from participants that showed acceptability of the group protocol. In Study 1, there was a significant decrease in measures of disability following treatment (compared to a control group), though there was no significant effect of symptom reduction. In Study 2, there was also a significant decrease in measures of disability following treatment, plus a significant reduction in the severity of delusional symptoms of psychosis. There have been no previous trials of a low-intensity CBT-based music group for mild-to-moderate symptoms of mental illness. The advantage of a CBT-based music group may be its potential for reaching a more comprehensive range of the general population, including individuals unsure about engagement with therapy. A CBT-based music group may help individuals with mild-to-moderate emotional and mental health difficulties, but also those at high risk of developing mental health problems.
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