TY - JOUR
T1 - Process-outcome relations in music therapy versus music listening for people with schizophrenia viewed through a mediational model
T2 - the role of the therapeutic alliance
AU - Hannibal, Niels
AU - Pedersen, Inge Nygaard
AU - Bertelsen, Lars Rye
AU - Nielsen, René Ernst
AU - Gold, Christian
N1 - Funding Information:
This study owes thanks to the TRYG Foundation (ID110977) and the Obel Family Foundation for the funding of the study. We would also like to acknowledge Aalborg University, Department of Communication and Psychology and Aalborg University Hospital, Department of Psychiatry for joint financial support in the original study.
Publisher Copyright:
Copyright © 2023 Hannibal, Pedersen, Bertelsen, Nielsen and Gold.
PY - 2023/5/2
Y1 - 2023/5/2
N2 - Objectives: Examine whether change in clinical outcomes for patients with schizophrenia and negative symptoms randomized to either Music Therapy (MT) or Music Listening (ML) is associated to moderators and mediators, with focus on alliance, attendance and dropout. Method: An exploratory post-hoc analysis of data from an original randomized controlled trial (RCT) investigating the effect of MT vs. ML for people with schizophrenia and negative symptoms. Inclusion to the study was implemented through screening of referred patients for symptoms of schizophrenia and negative symptoms. A total of 57 patients were randomly assigned, 28 to MT and 29 to ML. Session logs and notes were included in this study. Statistical analysis investigated moderator and mediator relation to outcome variables: Negative symptoms, functioning, quality of life, and retention to treatment. Results: On average, participants in MT attended 18.86 sessions (SD = 7.17), whereas those in ML attended 12.26 (SD = 9.52), a statistically significant difference (p = 0.0078). Dropout at 25 weeks was predicted by intervention, with dropout being 2.65 (SE = 1.01) times more likely in ML than in music therapy (p = 0.009). Helping alliance score at weeks was explained by intervention, with mean score being 0.68 (SE = 0.32) points lower in ML than in MT (p = 0.042). The number of sessions attended was also explained by intervention, with participants in ML attending on average 6.17 (SE = 2.24) fewer sessions than those randomized to MT (p = 0.008). Though both groups improved significantly, improvements in negative symptoms, depression, and functioning tended to be higher in ML, whereas improvements in alliance and quality of life tended to be higher in MT. Conclusion: The analysis could not detect a direct link between helping alliance score and outcome variables. However, the analysis documented a stronger alliance developed in the MT group, a lower dropout rate, as well as higher attendance in treatment. Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT02942459.
AB - Objectives: Examine whether change in clinical outcomes for patients with schizophrenia and negative symptoms randomized to either Music Therapy (MT) or Music Listening (ML) is associated to moderators and mediators, with focus on alliance, attendance and dropout. Method: An exploratory post-hoc analysis of data from an original randomized controlled trial (RCT) investigating the effect of MT vs. ML for people with schizophrenia and negative symptoms. Inclusion to the study was implemented through screening of referred patients for symptoms of schizophrenia and negative symptoms. A total of 57 patients were randomly assigned, 28 to MT and 29 to ML. Session logs and notes were included in this study. Statistical analysis investigated moderator and mediator relation to outcome variables: Negative symptoms, functioning, quality of life, and retention to treatment. Results: On average, participants in MT attended 18.86 sessions (SD = 7.17), whereas those in ML attended 12.26 (SD = 9.52), a statistically significant difference (p = 0.0078). Dropout at 25 weeks was predicted by intervention, with dropout being 2.65 (SE = 1.01) times more likely in ML than in music therapy (p = 0.009). Helping alliance score at weeks was explained by intervention, with mean score being 0.68 (SE = 0.32) points lower in ML than in MT (p = 0.042). The number of sessions attended was also explained by intervention, with participants in ML attending on average 6.17 (SE = 2.24) fewer sessions than those randomized to MT (p = 0.008). Though both groups improved significantly, improvements in negative symptoms, depression, and functioning tended to be higher in ML, whereas improvements in alliance and quality of life tended to be higher in MT. Conclusion: The analysis could not detect a direct link between helping alliance score and outcome variables. However, the analysis documented a stronger alliance developed in the MT group, a lower dropout rate, as well as higher attendance in treatment. Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT02942459.
KW - assessor- and patient- blinded study
KW - attendance
KW - drop out
KW - music listening
KW - music therapy
KW - negative symptoms
KW - schizophrenia
UR - http://www.scopus.com/inward/record.url?scp=85159343856&partnerID=8YFLogxK
U2 - 10.3389/fpsyt.2023.1120003
DO - 10.3389/fpsyt.2023.1120003
M3 - Article
AN - SCOPUS:85159343856
SN - 1664-0640
VL - 14
JO - Frontiers in Psychiatry
JF - Frontiers in Psychiatry
M1 - 1120003
ER -
