Feasibility of Music Therapy in Community Substance Misuse Treatment Services

NCT05180617 | Completed DMC

• 1 other identifier: WDPARU22
• Study Type: interventional
• Target: 15
• Locations: 1 country
• Sites: 1

Brief Summary

Music Therapy (MT) has been shown to improve several symptoms experienced by people with Substance Use Disorder (SUD), such as depressive and anxiety symptoms, as well as negative emotions. Particularly, a recent Cochrane review reported craving reduction as a main outcome for MT delivered to SUD participants. The possible mechanism(s) of therapeutic change is yet to be identified and future randomized control trials applying neuroscience research methods may help doing so. However, there is a significant lack of studies investigating those effects in a specific cohort of out-patients on prescription medicine from Community Substance Misuse Treatment Services (CSMTS). This research project aims to evaluate the acceptability and feasibility of MT and the applied test battery in CSMTS for a future Randomised Controlled Trails (RCT). Fifteen participants from a CSMTS will take part in a three-arm randomized non-blind controlled trial. 5 participants will receive 6 weekly individual music therapy sessions (IMT), 5 participants will receive 6 weekly group music therapy (GMT) sessions and 5 participants will act as a control group (CG) receiving treatment as usual (TAU). IMT and GMT participants will continue to receive TAU by the CSMTS. The CG will have the opportunity to receive MT as well, after the end of the study. Regarding the feasibility of the service implementation, the investigators will evaluate participant satisfaction and implement a focus group following the final session to collect feedback and evaluation on acceptability of the intervention from both participants and staff. Moreover, retention in treatment and completion rates will be measured after the end of the MT sessions. Furthermore, based on previous research and the theoretical basis of MT interventions, the investigators aim to explore the effects of MT on craving, substance use, symptoms of depression and anxiety, and inhibitory control in people with SUD. Changes in the brain correlates of the abovementioned symptoms will be investigated as well as how music and emotion are processed in the brain during MT. The investigators will collect subjective and objective baseline measurements and compare them against post-treatment measurements. Some variables of interest will be measured by Electroencephalography (EEG) which is a non-invasive technique to record electrical brain activity. The study will take place in a Westminster Drug Project provided community-based integrated adult substance misuse service in London. Participants will be recruited from service users receiving treatment at this service.

Conditions

Substance Use Disorders

Keywords

Addiction; Craving; music therapy; mental health; neural dynamics; EEG; Feasibility; emotion processing; drug memory

Outcome Measures

Primary Outcomes (4)

• Retention in Treatment 1 (Attendance Sheet)

  Retention in treatment will be assessed through an attendance sheet to be completed by the music therapist and the participants receiving Group Music Therapy (GMT) and Individual Music Therapy (IMT) after each session (6 sessions). In this way, participants' feedback will be taken throughout the treatment process.

  up to 6 weeks

• Acceptability of Treatment 1 (Participant Satisfaction Survey)

  Regarding the feasibility of the service implementation, the investigators will evaluate participant satisfaction and implement a focus group following the final session to collect both participants and staff feedback and evaluation. A Participant Satisfaction Survey will be conducted at week 8 (end of treatment) to the 10 participants receiving group music therapy (GMT) and individual music therapy (IMT).

  Post-Intervention Measure: at week 8

• Acceptability of treatment 2 (Focus Groups)

  Regarding the feasibility of the service implementation, the investigators will evaluate participant satisfaction and implement a focus group following the final session to collect both participants and staff feedback and evaluation. FOCUS GROUPS (FG). The feasibility of the music therapy intervention will be assessed with FG after the intervention. FG 1 will consist of individual and group music therapy members ; FG 2 will consist of 4 WDP service staff members attending a single focus group to explore staff perspectives on MT.

  Post-Intervention Measure: at week 9

• Retention in Treatment 2 (Treatment Status)

  The treatment status from participants receiving Individual Music Therapy (IMT), Group Music Therapy (GMT) and Standard Treatment (ST) will be collected by WDP's case management system and will provide information about retention in treatment, treatment engagement and completion rate taken from WDP's Case management system

  1-month post-intervention: at week 11

Secondary Outcomes (15)

• The Brief Substance Craving Scale (BSCS)

  At baseline (week 1) and end of treatment (week 8)

• Craving Thermometer VAS

  up to 6 weeks

• The Treatment Outcome Profile (TOP)

  At baseline (week 1) and end of treatment (week 8)

• The Patient Health Questionnaire (PHQ-9)

  At baseline (week 1) and end of treatment (week 8)

• The Generalised Anxiety Disorder Assessment (GAD-7)

  At baseline (week 1) and end of treatment (week 8)

Study Arms (3)

Individual music therapy (IMT)

EXPERIMENTAL

After baseline measures, each Participant will receive 6 x 1 weekly hour of music therapy. During music therapy the participants will be interacting both musically and verbally with the therapist. Participants will be provided with both acoustic and electronic instruments to be able to improvise with the therapist. In addition, IMT participants will be provided with the opportunity to compose and write songs, take part in preferred music lyric analysis, sing and discuss/talk with the therapist. During session 2 and 5 EEG hyperscanning of therapist and patient will be applied. All 5 IMT participants will do the same pre-post intervention test battery.

Behavioral: Music Therapy

Group music therapy (GMT)

EXPERIMENTAL

During 6 x 1 weekly hour of GMT, 5 participants will be invited to take part in a range of group music making activities. Participants will be provided with both acoustic and electronic instruments to be able to improvise within the group setting. In addition, GMT participants will be provided with the opportunity to compose and write songs as a group, take part in preferred music lyric analysis, sing and take part in group discussions. All 5 GMT participants will do the same pre-post intervention test battery.

Behavioral: Music Therapy

Control Group

NO INTERVENTION

CG will receive standard treatment, which includes key work sessions, other group work programmes and clinical support (e.g. prescribing). All 5 CG participants will do the same pre-post intervention test battery.

Interventions

Music Therapy BEHAVIORAL

Music therapy participants will interact both musically and verbally with the therapist and will be given a range of both electronic and acoustic instruments to choose from. Music therapy sessions will be based upon music improvisation, and as such participants are not required to have any previous instrument or other music experience and be invited to improvise freely using the instruments. The music therapist will accompany participants in the improvisation. This provides participants with an opportunity to connect with emotions and feelings connected to hidden psychic material. Following improvisations, the therapist and client will identify these moments of interest which can be further explored either verbally or through further improvisation. The music created within sessions will be recorded and participants can take a copy of the recordings home and it will be used in the therapeutic monitoring and analysis of sessions.

Group music therapy (GMT); Individual music therapy (IMT)

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Service users in structured treatment for drug and/or alcohol misuse,
• Aged 18-65
• Reporting / Self-reporting symptoms of depression and/or anxiety.
• Service users will need to be deemed suitable to take part in a group / individual setting by their key workers.
• Right-handedness

You may not qualify if:

• Service users on medication for depression or anxiety,
• Services users who are currently receiving treatment as part of a Drug Rehabilitation Requirement (DRR) or Alcohol Treatment Requirement (ATR).
• Service users who are unable to provide informed consent due to a lack of mental capacity,
• Service users with little/no understanding of spoken English.
• Service users with a brain injury or history of epilepsy.
• Left-Handedness
• Mixed-Handedness
• Not registered with a General Practitioner (GP) / unable to provide GP details

Sponsors & Collaborators

• Anglia Ruskin University: lead
• Westminster Drug Project: collaborator

Study Sites (1)

Westminster Drug project

London, SW1H 9BL, United Kingdom

Location

Related Publications (13)

• Fachner, J. (2017). Retraining of Drug Reward, Music Cues and State-dependent Recall in Music Therapy. Music and Medicine, 9(1), 8-14.

  BACKGROUND

• Ridder HM and Fachner J. (2016) Objectivist case study research. Single-subject and small-n research. In: Wheeler B and Murphy K (eds) Music Therapy Research. 3 ed. Dallas: Barcelona Publishers, 291-302.

  BACKGROUND

• Albornoz, Y. (2011). The effects of group improvisational music therapy on depression in adolescents and adults with substance abuse: a randomized controlled trial. Nordic Journal of Music Therapy, 20, 208-224.

  RESULT

• Cevasco AM, Kennedy R, Generally NR. Comparison of movement-to-music, rhythm activities, and competitive games on depression, stress, anxiety, and anger of females in substance abuse rehabilitation. J Music Ther. 2005 Spring;42(1):64-80. doi: 10.1093/jmt/42.1.64.

  PMID: 15839734 RESULT

• Eshaghi Farahmand, S. R., Ahadi, H., Kalhornia Golkar, M., & Sedaghat, M. (2020). Comparison of the Effectiveness of Music Therapy and Cognitive Behavioral Therapy on Quality of Life, Craving and Emotion Regulation in Patients Under Methadone Maintenance Therapy. Iranian Journal of Psychiatry and Clinical Psychology, 26(2), 170-187.

  RESULT

• Silverman, M. J. (2019). Effects of group-based educational songwriting on craving in patients on a detoxification unit: A cluster-randomized effectiveness study. Psychology of Music, 47(2), 241-254.

  RESULT

• Hohmann L, Bradt J, Stegemann T, Koelsch S. Effects of music therapy and music-based interventions in the treatment of substance use disorders: A systematic review. PLoS One. 2017 Nov 15;12(11):e0187363. doi: 10.1371/journal.pone.0187363. eCollection 2017.

  PMID: 29141012 RESULT

• Fachner JC, Maidhof C, Grocke D, Nygaard Pedersen I, Trondalen G, Tucek G, Bonde LO. "Telling me not to worry..." Hyperscanning and Neural Dynamics of Emotion Processing During Guided Imagery and Music. Front Psychol. 2019 Jul 25;10:1561. doi: 10.3389/fpsyg.2019.01561. eCollection 2019.

  PMID: 31402880 RESULT

• Kamarajan C, Porjesz B, Jones KA, Choi K, Chorlian DB, Padmanabhapillai A, Rangaswamy M, Stimus AT, Begleiter H. Alcoholism is a disinhibitory disorder: neurophysiological evidence from a Go/No-Go task. Biol Psychol. 2005 Jul;69(3):353-73. doi: 10.1016/j.biopsycho.2004.08.004. Epub 2004 Nov 21.

  PMID: 15925035 RESULT

• Huang Y, Mohan A, De Ridder D, Sunaert S, Vanneste S. The neural correlates of the unified percept of alcohol-related craving: a fMRI and EEG study. Sci Rep. 2018 Jan 17;8(1):923. doi: 10.1038/s41598-017-18471-y.

  PMID: 29343732 RESULT

• Ghetti C, Chen XJ, Brenner AK, Hakvoort LG, Lien L, Fachner J, Gold C. Music therapy for people with substance use disorders. Cochrane Database Syst Rev. 2022 May 9;5(5):CD012576. doi: 10.1002/14651858.CD012576.pub3.

  PMID: 35532044 RESULT

• Carter, T.E., Panisch, L.S. A Systematic Review of Music Therapy for Psychosocial Outcomes of Substance Use Clients. *Int J Ment Health Addiction* **19,** 1551-1568 (2021). https://doi.org/10.1007/s11469-020-00246-8

  RESULT

• Fachner J, Maidhof C, Murtagh D, De Silva D, Pasqualitto F, Fernie P, Panin F, Michell A, Muller-Rodriguez L, Odell-Miller H. Music therapy, neural processing, and craving reduction: an RCT protocol for a mixed methods feasibility study in a Community Substance Misuse Treatment Service. Addict Sci Clin Pract. 2023 May 27;18(1):36. doi: 10.1186/s13722-023-00385-y.

  PMID: 37245018 DERIVED

MeSH Terms

Conditions

Substance-Related Disorders; Behavior, Addictive; Psychological Well-Being

Interventions

Music Therapy

Condition Hierarchy (Ancestors)

Chemically-Induced Disorders; Mental Disorders; Compulsive Behavior; Impulsive Behavior; Behavior; Personal Satisfaction

Intervention Hierarchy (Ancestors)

Sensory Art Therapies; Complementary Therapies; Therapeutics; Rehabilitation; Aftercare; Continuity of Patient Care; Patient Care; Psychotherapy; Behavioral Disciplines and Activities

Study Officials

• Daniel Murtagh

  WDP

  PRINCIPAL INVESTIGATOR

• Jorg C Fachner, PhD

  Anglia Ruskin University

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: December 3, 2021
• First Posted: January 6, 2022
• Study Start: September 1, 2022
• Primary Completion: March 1, 2023
• Study Completion: June 28, 2023
• Last Updated: February 7, 2024

Record last verified: 2023-01

Data Sharing

• IPD Sharing: Will not share

Locations

GB (1)