A cross-cultural randomized pilot trial of western-based and five elements music therapy for psychological well-being

Explore (NY). 2023 Jul-Aug;19(4):571-577. doi: 10.1016/j.explore.2022.11.001. Epub 2022 Nov 9.

Abstract

Background: Music therapy and culture are interconnected. It is unclear whether the therapeutic effects of music can be exerted in diverse cultural contexts. Both Western-based and Chinese Five elements music therapy (FEMT) have shown effectiveness in improving the perception of stress, anxiety and depression in their respective cultures. FEMT is a commonly used traditional Chinese Medicine approach; however, it has not been investigated with non-Chinese participants.

Purpose: To investigate the impact of FEMT and of Western-based music therapy on stress and related outcomes and explore cross-cultural comparisons in participants from Chinese and Canadian contexts.

Methods: This pre-post randomized controlled study was conducted with 35 participants, 23 from Canada and 12 from China. Participants from the two cultural groups were randomly divided into two groups: a FEMT group (n = 20), a western art music therapy (WAMT) group (n = 15). The main outcome was self-rated stress, evaluated by a 10-point numeric rating question. Secondary outcomes included anxiety/depression (Hospital Anxiety and Depression Scale (HADS), pulse rate and qualitative comments. Cross-sectional, pre-post and longitudinal comparisons were pursued.

Results: We observed comparable effects of FEMT and WAMT in both the Chinese and Canadian samples. There was a statistically significant decrease in self-rated stress over time, especially after the conclusion of the four-week music therapy intervention (p = 0.001), regardless of type of music therapy, and in both cultural contexts. We observed a statistically significant decrease in anxiety and depression scores in the FEMT group only (p<0.001), but no effect on pulse rate.

Conclusion: This is the first study to report evidence of feasibility, acceptability and effectiveness of FEMT in non-Chinese participants. Further investigation of the observed differences is warranted.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Anxiety / psychology
  • Anxiety / therapy
  • Canada
  • Cross-Cultural Comparison
  • Cross-Sectional Studies
  • Depression / therapy
  • Humans
  • Music Therapy*
  • Music* / psychology
  • Pilot Projects
  • Psychological Well-Being