Music psychotherapy, wherein the use of innovative technologies is gaining increasing significance, is becoming an important direction in contemporary education and therapeutic practice. The application of music and other auditory means is increasingly active in educational institutions, helping students to overcome various issues and achieve positive psychological and emotional outcomes [1, 2]. However, as interest in music psychotherapy grows, new challenges and questions arise concerning the effectiveness of implementing innovative technologies in this context.
In 2019, the World Health Organization published a review that found listening to and making music can help decrease stress and anxiety, as well as lower cortisol levels [3]. Like language, music has a hierarchically connected structure of smaller components– metaphors and emotions [4]. The major metaphors in classical music are associated with space, movement, and power. Music’s ability to evoke emotion is one of the main reasons why people engage with it. By playing, music performers can convey certain emotions (such as sadness, anger, happiness, and fear) to the audience and evoke an emotional response [4]. Some people are unable to derive pleasure from music. This lack of sensitivity is called musical anhedonia. The neural correlates of musical anhedonia are different from other types of anhedonic. Scholars believe music listening can help people diagnosed with clinical depression and anhedonia feel better [5].
Music therapy, music psychotherapy, and music medicine represent three distinct approaches to the application of music in the context of health and well-being. Music medicine refers to the use of music in medical or rehabilitative settings without the active engagement of the patient or direct interaction with a therapist, and it does not require the involvement of a certified music therapist [6]. For instance, listening to music through headphones during chemotherapy or prior to surgical procedures constitutes music medicine. Music therapy, in contrast, is a clinical and structured form of intervention delivered by a certified music therapist. It entails active participation from the patient—such as singing, playing instruments, songwriting, and improvisation—and is guided by clearly defined therapeutic goals, including anxiety reduction, enhancement of motor skills, and improvement in emotional regulation [7]. Music psychotherapy is a psychotherapeutic model in which music serves as the primary medium for exploring the unconscious, processing emotional experiences, and fostering personal growth [8]. It is conducted by a psychotherapist with additional training in music therapy. While the patient may sing, play instruments, or listen to music, the emphasis is placed on reflection, associative processes, and the discussion of emotional responses elicited through musical interaction. For the student population, particularly those at risk of developing depression, the integration of music therapy and music psychotherapy represents best practice.
Mental illness, such as depression, often begins with a mood disorder but could become a serious issue if left untreated. Seeking help from qualified mental health professionals can make a significant difference, as early detection improves the chances of a faster therapeutic process and recovery [9]. The cognitive theory of emotions and aesthetics in music suggests that listening to classical music is emotionally arousing and stimulates mental processes. Moreover, the theory of inhibition and psychosomatic illness suggests that revealing personal and traumatic information is beneficial and safe if it happens below the level of conscious awareness [10]. Considering the above findings, classical music and the use of innovative technologies could be a solution to reduce early depression in non-clinical students.
Literature review
Music therapy
The neural activation of guided imagery and music in negative emotional processing is associated with personal episodic memories that affect the cortical and sub-cortical structures and functions of the brain. This means that if combined with verbal content, classical music can cause negative emotions. Therapists can benefit from this effect to unblock the traumatic experience [11]. Personalized music therapy is effective against severe mental disorders, such as dementia. The prolonged listening to classical music causes agitation and apathy to decrease, even in older people with mental difficulties [12]. Moreover, music therapy can be effective in reducing anxiety and enhancing relaxation in children with exacerbated pain syndromes. In America, music therapy is an offshoot of applied psychology. It is defined as “the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed music therapist” [13]. Musical interventions are often used as an auxiliary method. Music therapies for clinical depression and generalized anxiety disorder are combined with psychological interventions that often use cognitive-behavioral therapy and/or medication [14]. Previous studies show that music (including listening, singing, and improvising) helps depressed patients reduce stigma and anxiety, enhance the perceived quality of life, and improve social relations [15]. Depending on the tempo, classical music can either increase or reduce arousal. Therefore, the therapist can use different pieces of classical music to decide how to work with patients. One way to reduce depression is to combine group music with the imagery method.
Being engaged with music helps individuals to satisfy their social and emotional needs. Not only does it enable patients to recall their experiences during a therapy session, but it also evokes difficult emotions, traumatic memories, and imagery. In these cases, however, the focus is on solving the problem, which is in line with the principles of positive psychology focusing on a person’s well-being and strengths [16]. Therefore, music can serve as a means of replenishing psychological resources and handling traumatic experiences. Music therapy helps people with autism spectrum disorder. The family-oriented interventions for young children with autism suggest that parents be encouraged to actively integrate music therapy exercises into daily routines. This approach will enable the autistic child to be more motivated and more sensitive to external stimuli [17]. The ‘unhealthy’ use of music includes rumination (repetitive thinking about negative events or emotions), social isolation (cutting oneself off from other people), and avoiding thinking about or dealing with problems. It can be evaluated using the Healthy-Unhealthy Music Scale (HUMS). Previous research shows a strong correlation between ‘unhealthy’ music engagement with depression and psychological well-being [18]. Thus, music can be used as an intervention to aid the treatment of mental illness regardless of its severity.
Aspects of music’s influence on stress and anxiety
Listening to music activates numerous brain structures involved in cognitive, sensorimotor, and emotional processing. For instance, music engages sensory functions, attention, memory-related processes, perception–action mediation (including activity in the mirror neuron system), changes in the activity of key emotional processing areas, as well as the processing of musical syntax and meaning, and social cognition [7]. Listening to music during surgery under regional anesthesia, for example, has been shown to influence cortisol levels, reflecting a stress-reducing effect and decreasing the need for sedatives to achieve mild sedation [19]. Findings from another study also indicate that patients in the music therapy group exhibited lower levels of anxiety, stress, and cortisol, suggesting that music therapy was effective in reducing anxiety, stress, and the requirement for sedatives [20]. Results from a review study further support the usefulness of music-based interventions for enhancing various brain functions, including sensorimotor, auditory, communicative/language, psychological/emotional, behavioral, sleep, and memory, as well as cognitive capacities in patients diagnosed with various neuropathologies [20].
However, research conducted in Austria reported that music did not facilitate recovery following a standardized stressor, and the selection of music had no significant effect on post-stress recovery [21]. The lack of standardized protocols for the delivery of music, along with insufficient consideration of critical factors such as the cultural and musical orientation of participants and the attitudes of therapists, hinders the full therapeutic potential of music in the context of neurological disorders [22]. Therefore, despite substantial evidence supporting the beneficial effects of music on brain activity and physiological stress markers, the effectiveness of music-based interventions is largely dependent on the application context, individual characteristics of listeners, and the quality of implementation of structured therapeutic protocols.
Telecommunication technologies as a means of music psychotherapy
In the contemporary world, telecommunication technologies play a pivotal role in various spheres of life, including education and health. The field of music therapy (MT) is increasingly incorporating the use of technologies to conduct therapy sessions and improve patient outcomes [23]. Consequently, their application in music psychotherapy is becoming a highly relevant and promising area of research. Music psychotherapy, as an integral component of psychotherapeutic practice, demonstrates the potential for enhancing physical and mental health, as well as improving the quality of life [24].
Technologies offer numerous opportunities to assist individuals with physical disabilities during music therapy, as traditional musical instruments can often be too complex to use. For instance, serious games—games designed primarily for educational purposes, healthcare, etc., rather than solely for entertainment—that require responses to musical stimuli have been developed to support patients’ physical abilities and motor control, as well as to stimulate their motivation for engaging in strengthening exercises [25]. Overall, integrating technologies into music therapy for individuals with physical disabilities can enhance patient conditions, boost morale, and improve overall well-being.
Music technologies can also make music therapy more accessible for individuals with cognitive impairments, particularly those with neurodevelopmental and neurocognitive disorders. Serious games have also been designed to support cognitive functions such as memory [26]. In general, technologies can increase accessibility and inclusivity for a variety of cognitive abilities and prove especially beneficial for individuals with verbal communication difficulties.
Music technologies have also been employed to assess mental conditions through methods such as the acoustic analysis of improvised music performances [27]. When patients, who may have a wide range of psychopathologies and severity profiles, create music, their performances contain information related to the fundamental affective and communicative processes occurring during music creation.
In another study involving patients with borderline personality disorder (BPD)—individuals who face challenges in interpersonal relationships, emotional instability, and impulsive behavior—music information retrieval (MIR) methods were used to analyze improvisation sessions where the therapist and patient played a piano duet [28]. This method demonstrates distinct differences between patients with BPD and a healthy control group, opening a new avenue for assessing non-verbal interaction and cognitive processes.
To improve patients’ well-being, the use of technologies has been shown to reduce stress levels, as evidenced by participation in musical games [29]. Additionally, the application of technologies involving resonance frequency breathing during therapeutic sessions has been found to deepen and support the interpersonal and emotional processes that naturally occur in therapy, such as helping to regulate excessive arousal [30]. Recently, BCMI systems have been developed to aid listeners in self-regulating their emotions. These systems provide music and neural feedback to help listeners identify and train their emotional states, as measured by EEG [31].
However, there are certain problems and challenges associated with the use of music psychotherapy in educational settings, including the lack of proper access to specialized programs, equipment, and professionals in this field. The absence of adequate regulation and standardization in the application of music psychotherapy within educational institutions can hinder its effective implementation and the expansion of new pedagogical practices. Furthermore, there are concerns about the insufficient scientific evidence supporting the effectiveness of using telecommunication technologies in music psychotherapy in educational settings.
The relevance of this topic is underscored by the expansion of digital capabilities and their impact on contemporary education and psychotherapy methods. The motivation for writing this article stems from the need to consider and explore the potential of telecommunication technologies to enhance music psychotherapy in educational institutions. The contribution to the field lies in highlighting current issues and proposing scientific approaches for utilizing telecommunication technologies in music psychotherapy within the educational process.
Problem statement
The current literature on music-based interventions for mental illness mostly draws on specific categories of people, namely autistic individuals, people with clinical depression, elderly patients with Parkinson’s disease, those undergoing rehabilitation, etc. After the COVID-19 pandemic, cases of depression in distance learning students increased. The timely identification of students at high depression risk will enable the socio-psychological service to effectively reduce the risk of developing clinical depression. This study aims to explore the potential of utilizing telecommunication technologies in the field of music psychotherapy within educational settings to minimize the incidence of depression. Hypothetically, music will enhance the overall therapeutic effect and allow students prone to depressive episodes to normalize their psychological state. The objectives of the study are:
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Determine the level of susceptibility to depressive manifestations among students using psychometric tools.
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To develop, implement and compare the effectiveness of two group psychotherapy programs – with and without the use of a music therapy intervention based on classical music through telecommunication technologies.
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Analyze the results obtained in terms of changes in the psychological state of participants in both groups and determine whether the music therapy intervention has a statistically significant effect on reducing the symptoms of subclinical depression.
Not only does the proposed music intervention enable university students to carry on through the intense learning process, but it also opens up new opportunities for socio-psychological services at the universities. Furthermore, it is conducive to creating therapeutic programs for mental health normalization in students. The present study shows how useful group therapy is as an extracurricular activity. Interactions with mentally healthy people within a therapeutic group show the potential of using music to solve mental issues (e.g., depression, anxiety, and loneliness) caused by the social isolation resulting from the pandemic. This is especially important for China, where the psychological culture is yet to be far-reaching, even though it potentially has a positive effect on the whole society (i.e., it reduces the risk of mental disability and improves efficiency, creativity, resilience, and psychological well-being of the population).