Music Therapy for Depression Enhanced With Listening Homework and Slow Paced Breathing: A Randomised Controlled Trial

Abstract

<b>Introduction:</b> There is evidence from earlier trials for the efficacy of music therapy in the treatment of depression among working-age people. Starting therapy sessions with relaxation and revisiting therapeutic themes outside therapy have been deemed promising for outcome enhancement. However, previous music therapy trials have not investigated this issue. <b>Objective:</b> To investigate the efficacy of two enhancers, resonance frequency breathing (RFB) and listening homework (LH), when combined with an established music therapy model (trial registration number ISRCTN11618310). <b>Methods:</b> In a 2 × 2 factorial randomised controlled trial, working-age individuals with depression were allocated into groups based on four conditions derived from either the presence or absence of two enhancers (RFB and LH). All received music therapy over 6 weeks. Outcomes were observed at 6 weeks and 6 months. The primary outcome was the Montgomery Åsberg Depression Rating Scale (MADRS) score. <b>Results:</b> There was a significant overall effect of treatment for the primary outcome favouring the breathing group (<i>d</i> = 0.50, 95% CI 0.07 to 0.93, <i>p</i> = 0.02). The effect was larger after adjustment for potential confounders (<i>d</i> = 0.62, 95% CI 0.16 to 1.08, <i>p</i> = 0.009). Treatment effects for secondary outcomes, including anxiety (anxiety scale of Hospital Anxiety and Depression Scale) and quality of life (RAND-36), were also significant, favouring the breathing group. The homework enhancer did not reach significant treatment effects. <b>Conclusion:</b> We found that the addition of RFB to a music therapy intervention resulted in enhanced therapeutic outcome for clients with depression.