QUESTIONS & ANSWERS: Music Therapy for Patients with Anorexia Nervosa

Reprinted from Eating Disorders Review
January/February Volume 27, Number 1
©2016 IAEDP

Q. One of my anorexia nervosa patients, who experiences great anxiety before and after meals, has asked me about music therapy. Is this therapy worthwhile? (T.Z., Birmingham, AL)

A. Anxiety and physical discomfort are typically high, especially early in AN treatment. Music therapy could provide distraction from negative thoughts and feelings, and diminish stress.

Results of a recent pilot study underscore the potentially helpful aspects of this therapy. Drs. Jennifer Bibb, David Castle, and Richard Newton designed a program to test the effectiveness of music therapy versus standard post-meal support in an inpatient eating disorder unit in Victoria, Australia (J Eat Disord. 2015.3:50). 

The participants were 18 inpatients with severe AN who attended a program of two 1-hour music therapy group sessions held following lunch each week. During each session, patients were encouraged to sing and to listen to songs, and to talk about and share music with other. Some patients wrote songs together. The registered music therapist who led the session also took an unconditionally positive approach instead of an instructional or directive one. Members of the group were encouraged to listen to each other and to discuss song lyrics and their own music tastes. During the remaining 3 days of the work week, the participants received standard structured post-meal support therapy, involving a 1-hour group session. During these sessions patients were encouraged to discuss their feelings, and were encouraged to focus on achieving the goals of admission and to participate in group activities such as playing games or art activities. The authors used the Subjective Units of Distress Scale before and after each condition to measure the participants’ responses to the intervention and control sessions.

The results showed that SUDS scores were lower following music therapy than was meal support (5.6 vs. 7.1). Three cautions: first, the study was non-randomized. Second, further work is needed to confirm these preliminary findings. Third, many would consider meals in AN treatment to provide nutrition—but also exposure therapy. For the latter, things that distract or divert attention might diminish distress, but may also dilute the value of the exposure. This last concern must be balanced against the possibility that therapeutic modalities such as music therapy might provide enough relief of distress to allow some patients to persist in treatment when they might otherwise not do so.