Does music therapy work? Read what Cochrane reviews found for depression, autism, dementia and cancer, the limits of the evidence and common misconceptions.
On social media we regularly come across videos with titles like "the frequency that wipes out anxiety", "the makam that helps depression" or "music that renews the brain". At the same time, we hear about music-based work in hospitals, care homes and rehabilitation centres. Caught between these two worlds, many people ask a fair question: Does music therapy work, or is it just a trend? In this article, rather than brushing the question off with a single sentence, we look at Cochrane reviews, regarded as among the most systematic summaries of scientific evidence. We explain in plain language what was found for depression, autism, dementia and cancer, how strong the evidence is, and the difference between listening to music and music therapy.
Does Music Therapy Work? First, Let's Clarify the Definition
Before answering this question, we need to be clear about what we are asking. In everyday language the term "music therapy" is used for very different things: from listening to relaxing music on headphones, to joining a choir, to playing a "healing frequency" from the internet.
Cochrane reviews define music therapy more narrowly: it is a process in which a trained practitioner engages in musical interaction with a participant within a therapeutic framework. Methods such as singing together, improvising on instruments, writing songs, or listening to music and talking about it may be used. What matters is that it unfolds within a relationship and towards a goal. Simply listening to recorded music does not fall under this definition.
This distinction matters, because the result of a study depends on which practice it examined. "Listening to music reduces anxiety" and "music therapy helps with depression" are two different claims, based on different research. We explain in detail what music therapy is in general and how it is delivered in our article on music therapy.
What Is a Cochrane Review, and Why Does It Matter?
When scientific studies are looked at one by one, they sometimes produce conflicting results. One study may find a large effect while another finds none at all. Cochrane reviews systematically gather all suitable studies on a specific question, assess their quality and combine the findings.
These reviews seek to answer not only "does it work?" but also "how far can we trust this result?". The certainty of the evidence is usually graded as high, moderate, low or very low. "Low certainty", for example, means that future research could change the result considerably.
That is why it is not enough to say a method is "helpful according to Cochrane"; we also need to say with what certainty, for which outcome and for how long the evidence holds.
Music Therapy for Depression: Short-Term Support
The Cochrane review published by Aalbers and colleagues in 2017 covers 9 studies of music therapy for depression, with a total of 421 participants. According to the findings, music therapy added to usual care may reduce depressive symptoms in the short term (up to about three months).
To read this finding correctly, three points deserve attention:
- "Added to usual care": Music therapy was added alongside existing treatment such as medication or psychotherapy, not used instead of it.
- "In the short term": There is not enough information about long-term effects.
- "Low to moderate certainty": The evidence is promising but not robust. For this reason, clinical guidelines do not yet recommend routinely adding music therapy to depression treatment.
In short, for someone living with depression, music can be a supportive element. But saying "music cures depression" is a far bigger claim than the available evidence can support. For evidence-based treatments and routes to support in depression, you can visit our depression and mood page.
Autism, Dementia and Cancer: Findings in Other Areas
Music therapy has been studied in other areas too. Here we summarise the findings of three prominent Cochrane reviews.
Autism (Geretsegger and colleagues, 2022): According to the review, music therapy probably improves the overall symptoms of autistic people by the end of treatment; this finding is of moderate certainty. Its effect on social interaction and communication, however, is unclear. Music therapy probably has no side effects; its long-term effects are unknown.
Dementia (van der Steen and colleagues): The current version of this review covers 30 studies and around 1,720 people. According to the findings, music-based interventions probably reduce depressive symptoms in people living with dementia and may improve overall behavioural problems. No marked effect is expected on agitation, aggression or cognitive function. In other words, music is not a method that brings memory back; but it can contribute to mood.
Cancer (Bradt and colleagues): The 2011 version of the review covers 30 studies with 1,891 patients with cancer. Music interventions were found to reduce anxiety and to have possible positive effects on mood, pain and quality of life; for some outcomes, however, the evidence is of low quality.
The common message of these findings is this: music-based approaches can provide supportive benefit in particular areas and for particular outcomes. In none of the reviews was music assessed as a method that replaces medical treatment or psychotherapy.
The evidence does not say that music "heals"; it says that, under suitable conditions and added to usual treatment, it can help with some symptoms.
The Limits of the Research: Why Can't We Say "Definitely"?
Music therapy research, like research on other arts-based approaches, shares some common limitations:
- Small samples: Most studies have been carried out with a small number of participants.
- No blinding: In a drug trial, a participant may not know whether they are taking the medicine or an inactive pill. In music therapy, the participant knows what they are taking part in. This can allow expectations to influence the results.
- Self-report measures: Results are mostly based on participants' own assessments.
- Short follow-up: How long the effects last is often unknown.
- Confusion over definitions: Some studies examine music therapy carried out within a therapeutic relationship, while others examine music listening alone. Mixing the two makes the results harder to interpret.
When you see a news item in a newspaper or on social media saying "it has been proven that music helps with such-and-such an illness", you can ask yourself a few questions:
- How many people took part? A twenty-person study does not carry the same weight as a review covering hundreds of people.
- Was there a comparison group? Was the group listening to music compared with a group doing nothing, or with a group doing another activity?
- What was measured? "Feeling better" is not the same as a change in the course of an illness.
- How long did the effect last? Relief straight after a session and the situation months later are different outcomes.
- Is what was studied really music therapy? Or was it simply music listening?
These questions help you separate exaggerated headlines from genuine findings.
These limitations do not show that music therapy is worthless. They simply remind us that larger, well-designed future studies will clarify the picture.
Common Misconceptions When Asking Whether Music Therapy Works
Many claims about music and health circulate online. Some of them are not supported by science:
- "Babies who listen to Mozart become more intelligent." This idea, popularised by an experiment in the 1990s, has not been supported by later research. It has not been shown that listening to music permanently increases intelligence.
- "432 Hz music heals." There is no reliable evidence that music at particular frequencies cures illnesses. Commercial claims of this kind are not supported by science.
- "The rast makam is good for paralysis, the hicaz makam for the kidneys." These pairings of makams (melodic modes in Turkish classical music) with illnesses appear in treatises from, or attributed to, the Ottoman period. They contradict one another from source to source and have not been scientifically tested. They are interesting as a historical belief, but they cannot be used as health advice. We discuss this in detail in our article on the effects of makams on people.
- "Music therapy can replace medication." No review has reached this conclusion. Music therapy is a supportive approach added to usual treatment.
In Turkey, music therapy is among the methods defined in the Traditional and Complementary Medicine Practices Regulation (Geleneksel ve Tamamlayıcı Tıp Uygulamaları Yönetmeliği), which came into force in 2014. Within the scope of this regulation, authority to practise rests mainly with certified physicians. A method being listed in the regulation does not mean it is effective in every situation; the regulation only sets out the framework in which it can be practised and by whom. In academia, Anadolu University offers a non-thesis master's programme in music therapy. These developments show that the field is beginning to become institutionalised in Turkey; but the answer to the question of whether music therapy works comes not from regulations or programmes but from research findings.
Music in Everyday Life: Not Therapy, but Valuable
Music therapy and listening to music in everyday life are not the same thing; but that does not mean listening to music is worthless. For many people, music is an important way to regulate their mood, shake off tiredness and ease loneliness.
Imagine a retired teacher who, after losing her husband, spends her days in a silent house. Her daughter prepares digital copies of the records she loved in her youth. Each morning, as she drinks her tea, the woman begins listening to these songs; sometimes memories of her husband come alive, sometimes her eyes fill with tears, and sometimes she hums along. This is not therapy; but it gives her a small ritual to hold on to in the midst of grief.
In Turkey, music is already woven into daily life and emotional sharing. A türkü (Turkish folk song) listened to by someone living far from home, the playlist that never leaves the headphones of a young person during exam season, songs sung together on a long journey: all of these show how people lean on music to carry their emotions. There is no need to belittle these natural habits; we simply should not expect medical results from them.
Some suggestions for drawing on music in everyday life:
- Notice your mood and choose music accordingly; "cheerful" music does not always help.
- Listening to sad music sometimes makes room for an emotion; but notice if it keeps pulling you further down.
- Singing, playing an instrument or joining a choir can offer a different experience from listening.
- Calm music before sleep can help some people; but if sleep problems have lasted a long time, an assessment is needed.
When Should You Seek Professional Support?
If music does you good, it is valuable to keep it in your life. In the following situations, however, music alone may not be enough, and it may be helpful to see a mental health professional:
- Low mood, lack of motivation or hopelessness lasting more than two weeks
- Anxiety or tension that makes daily tasks difficult
- Marked changes in sleep, appetite and energy
- Being unable to recover after a recent loss or trauma
- Thoughts of harming yourself or ending your life
If the last point applies, call 112 (emergency services) without delay or go to your nearest emergency department.
In psychological support, music can play a part according to the person's preferences: the songs a person uses to calm down, for example, can be discussed as part of their emotion regulation skills. The core work, however, is carried out with evidence-based approaches such as cognitive behavioural therapy (CBT), focusing on the person's thoughts, feelings and behaviours. Where symptoms are severe, an assessment by a psychiatrist may also be part of the process.
If you are considering music-based work for a relative, the safest course is to treat it as an option that can be added alongside their current treatment rather than replacing it, and to talk it over with the treating doctor or mental health professional. Particularly where dementia, autism or a serious illness is involved, the person's needs, resilience and preferences should be decisive in this decision.
Frequently Asked Questions
Does listening to music at home count as music therapy?
No. Music therapy is a process in which a trained practitioner engages in musical interaction with a participant within a therapeutic framework. Listening to music at home can be a valuable self-care activity, but it does not take the place of therapy.
Does music therapy completely cure depression?
According to a Cochrane review, music therapy added to usual treatment may reduce symptoms of depression in the short term. The evidence, however, is of low to moderate certainty, and there is no finding that it treats depression on its own.
Does music therapy have side effects?
The Cochrane review on autism states that music therapy probably has no side effects. Even so, music can sometimes trigger powerful memories and emotions; this is why it is important, especially for people experiencing grief or trauma, that it is carried out within a safe framework.
Do you need to know about music for music therapy?
No. Participants do not need to be able to play an instrument or read music. Here music is not a performance but a tool for communication and expression.
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Eda Erkan Alapala
Klinik Psikolog. İstanbul Kent Üniversitesi Klinik Psikoloji Tezli Yüksek Lisans mezunu; bilişsel davranışçı terapi, çocuk merkezli oyun terapisi ve çocuk-ergen psikoterapisi alanlarında eğitimlerini tamamlamıştır.
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