Music therapeutic emotional processing (MEP): Expression, awareness, and pain predict therapeutic outcome

Successful emotional processing is pivotal for the therapeutic change, and music can support emotional processing. However, we know little on how music-based emotional processing actually predicts clinical outcomes. This study investigated music therapeutic emotional processing (MEP) as a predictor of therapeutic outcome in treatment for depression. Data consisted of self-reports of 64 clients (age range 19-57, 74% female) from a clinical trial (12 sessions) of integrative improvisational music therapy (IIMT). A 19-item MEP questionnaire was developed for assessing clients' experiences after sessions. Emergent MEP factors were correlated with clients' perceptions of the therapeutic value of the sessions (Session Evaluation Questionnaire [SEQ]) and with recovery from depression (Montgomery-angstrom sberg Depression Rating Scale [MADRS]). MEP emerged as a constitution of three factors: expression, awareness, and pain. Expression and awareness increased across the process and correlated positively with session value and MADRS change. Pain demonstrated a more complex inverted u-shaped temporal curve and correlated with roughness of session experience. The presence of pain during the late part of the therapy predicted lower recovery. The findings support MEP factors as predictors of therapeutic outcome and provide conceptual insight into the mechanisms of change in art therapies. Knowledge on music-based emotional processing holds relevance also beyond therapy context for everyday music engagement.