Evaluating the Efficacy of Music-Based Therapy in Children and Adolescents with Physical and Mental Health Challenges: A Systematic Review

Introduction

Adolescence represents a critical developmental period characterized by rapid physical transformation, emotional maturation, and cognitive advancement. However, this stage also heightens vulnerability to psychological distress, as many youths struggle with stress, mood fluctuations, unresolved trauma, and impaired emotional control.¹ For those managing chronic illnesses or physical disabilities, these challenges are often compounded, exacerbating mental health risks.² In response, contemporary healthcare frameworks increasingly advocate for integrative approaches that combine conventional medical treatments with complementary therapeutic modalities. Notably, music-based interventions have emerged as a promising avenue in pediatric and adolescent care, with empirical studies underscoring their dual role in enhancing psychological well-being and facilitating physical rehabilitation.^3,4 For instance, evidence suggests that structured musical engagement can reduce anxiety, improve emotional regulation, and even support motor function recovery.⁵ Given these benefits, music therapy is increasingly recognized as a valuable adjunct to standard clinical protocols.⁶

While music-based approaches are increasingly utilized in therapeutic contexts, the field lacks standardized terminology, leading to frequent conflation of terms like “music therapy”, “music-based therapy”, and “music intervention” These concepts, while related, represent fundamentally different methodologies. According to the World Federation of Music Therapy (WFMT), professional music therapy constitutes a regulated healthcare practice where accredited therapists employ scientifically validated musical techniques to address clinical objectives through established therapeutic alliances.⁷ This evidence-based discipline incorporates both participatory methods (instrumental performance, vocal exercises, composition) and receptive approaches (guided listening, analytical discussion) customized to individual treatment plans.⁸ Conversely, music-based therapy describes supervised therapeutic applications of music that may be administered by healthcare providers without specialized music therapy credentials. These semi-structured protocols utilize musical elements to enhance wellbeing but operate outside strict music therapy guidelines.⁹ The most expansive classification, music intervention, refers to any systematic incorporation of musical elements in health contexts, spanning clinical applications, wellness programs, and research protocols—regardless of therapeutic intent or professional oversight.¹⁰ This includes everything from prescribed listening regimens to community choir participation and experimental neurological rehabilitation techniques.¹¹

Music-assisted interventions have emerged as a promising therapeutic modality for addressing post-traumatic stress disorder (PTSD) in pediatric populations. Childhood trauma stemming from adverse experiences including interpersonal violence, accidents, or invasive medical procedures can trigger lasting neurobiological and psychological consequences.¹² Contemporary trauma-informed music therapy protocols employ evidence-based techniques targeting core PTSD symptoms through rhythmic entrainment exercises, improvisational play, and lyric analysis.¹³ Recent neurophysiological studies indicate that structured musical engagement helps regulate limbic system hyperactivity while simultaneously strengthening prefrontal cortical modulation of stress responses.¹⁴ Clinical applications demonstrate particular efficacy with rhythm-based protocols, where predictable tempo patterns provide physiological grounding during emotional dysregulation episodes.¹⁵ Compositional techniques like therapeutic songwriting have shown significant promise in creating narrative coherence for traumatic memories while establishing emotional distance.¹⁶ The embodied nature of musical participation offers unique advantages for trauma work, allowing somatic expression without requiring verbal articulation of distressing experiences.¹⁷

Empirical investigations reveal measurable outcomes across multiple domains: 62% reduction in physiological stress markers during drumming interventions.¹⁸ Significant improvements in emotional regulation scores following 12-week melodic improvisation programs.¹⁹ Enhanced therapeutic alliance formation compared to traditional talk therapies.²⁰ Notably, a randomized controlled trial by Alvarez and team demonstrated that vibroacoustic therapy reduced pain perception by 38% during pediatric oncology procedures compared to standard care.²¹ Complementary research has established rhythm synchronization exercises as effective tools for improving social communication in adolescents with developmental trauma disorders.²² These converging findings position music-based approaches as viable components of integrated trauma treatment models. Music-based interventions have demonstrated significant potential in addressing physical, emotional, and cognitive health concerns, underscoring the importance of establishing standardized protocols for their implementation in both clinical and community environments.²³ Although existing research confirms their therapeutic value, additional studies are necessary to refine methodologies, assess sustained outcomes, and establish evidence-based guidelines to enhance accessibility and efficacy across diverse demographic groups.²⁴ A nuanced understanding of the differences between various music-based therapeutic techniques will facilitate their strategic application and improve their incorporation into comprehensive treatment frameworks for youth facing physical and psychological health difficulties.²⁵

Review of Related Literature

Physical Well-Being

Emerging clinical evidence reveals that structured musical engagement offers measurable physiological advantages for young patients managing health challenges, functioning as an effective adjunct to standard medical protocols.²⁶ Contemporary studies indicate that therapeutic sound interventions can diminish discomfort, lower stress responses, and improve emotional states during clinical interventions.²⁷ Through its capacity to trigger natural analgesic responses and alter discomfort processing, rhythm-based therapeutic approaches present a gentle, widely applicable strategy for easing physical distress. This modality proves particularly valuable for pediatric populations coping with persistent pain or requiring medical interventions.²⁸

Beyond pain relief, the rhythmic elements of music have been found to support motor coordination and physical rehabilitation in children with physical disabilities.²⁹ Activities such as drumming, dancing, and playing musical instruments engage multiple sensory and motor pathways, promoting the development of coordination, balance, and fine motor skills. These interventions contribute to physical rehabilitation and foster a sense of agency and empowerment, helping children regain control over their bodies.³⁰ Further, participation in music-based activities has been associated with improved immune function and physiological relaxation, contributing to overall health enhancement. Emerging research suggests that music-based therapy may have immunomodulatory effects, promoting immune resilience by regulating immune responses and reducing inflammation. This process strengthens the body’s ability to combat infections and mitigate inflammatory conditions, particularly beneficial for adolescents and children with compromised immune systems or chronic illnesses.³¹ By integrating music-based interventions into pediatric care, healthcare professionals can offer a holistic, patient-centered approach that addresses physical health challenges and enhances emotional and psychological well-being.

Mental Well-Being

The impact of music-based therapy on mental health is profound, offering a non-invasive and holistic approach for adolescents and children facing psychological and neurodevelopmental challenges such as anxiety, depression, autism spectrum disorder (ASD), and attention deficit hyperactivity disorder (ADHD).³² Young individuals undergoing medical treatments, hospitalizations, or chronic pain management often experience heightened stress and emotional distress. Music-based therapy is a therapeutic outlet that activates relaxation responses and fosters emotional regulation. Techniques such as guided imagery, progressive muscle relaxation, and mindful listening have been shown to induce physiological and psychological benefits, including reduced heart rate, lowered blood pressure, and improved sleep quality.³³ Beyond its calming effects, music engages multiple brain regions responsible for emotion regulation, cognitive processing, and social interaction. Music-based therapy enables children and adolescents to channel their emotions constructively, giving them a sense of control over their internal experiences. Through improvisation and self-expression, participants develop coping mechanisms to navigate stress and challenging situations, strengthening their emotional resilience.³⁴

Creative auditory experiences offer a unique channel for emotional articulation, especially beneficial for young individuals who face challenges in expressing themselves verbally. Through composition, lyrical interpretation, and spontaneous musical creation, children and adolescents find a supportive environment to explore their emotions, cultivate personal insight, and develop meaningful relationships.³⁵ Beyond emotional benefits, structured musical participation has been shown to positively influence mental processing capabilities. The synchronization required in rhythmic activities and instrumental play activates neural adaptation, strengthening cognitive agility and supporting healthy brain maturation. For youth with atypical neurological development or academic challenges, carefully designed musical programs serve as effective tools for intellectual engagement, enhancing concentration, reasoning capacity, and learning adaptation.³⁶ When incorporated into therapeutic practice, these musical techniques provide a holistic, youth-focused methodology that simultaneously addresses emotional health, intellectual advancement, and social skill development.

The Neurological and Therapeutic Impact of Music

Music has a powerful influence on brain function, playing a key role in neural development, cognitive enhancement, and emotional well-being.³⁷ Unlike other sensory inputs, music engages multiple brain regions simultaneously—including auditory, emotional, and executive networks—generating complex and adaptive neural responses.³⁸ The structural elements of music, such as rhythm and melody, stimulate the production of neurotransmitters like dopamine, serotonin, and oxytocin, which are linked to mood improvement, stress reduction, and social bonding.³⁹ These neurochemical effects are mediated by the brain’s reward system, which processes musical engagement as inherently pleasurable, similar to fundamental rewards like food or social interaction.⁴⁰ This neurological mechanism helps explain why music-based interventions are increasingly used to address diverse psychological and physiological conditions. Emerging research highlights music’s ability to enhance neuroplasticity—the brain’s capacity to adapt and rewire itself.⁴¹ This property is especially valuable in therapeutic settings for children with neurodevelopmental disorders, as music can improve cognitive flexibility, motor skills, and emotional regulation.⁴² For instance, instrumental training not only refines fine motor coordination but also strengthens memory, attention, and auditory processing.⁴³ Even passive music exposure can yield benefits by activating reward pathways and releasing neurochemicals that bolster mental resilience.^44,45 Given its non-invasive nature and broad neurological effects, music therapy serves as a versatile and integrative tool for supporting physical and emotional development in children and adolescents.⁴⁶ Its ability to complement conventional therapeutic approaches makes it particularly valuable in pediatric and mental health care.

Limitations of Previous Reviews and the Rationale for the Current Study

Previous systematic analyses of music-based interventions have predominantly focused on psychological outcomes, particularly their efficacy in alleviating depressive symptoms, anxiety disorders, and affective disturbances.⁴⁷ Some meta-analyses have specifically examined depression management,^48,49 whereas others have targeted populations with severe or persistent mental illness.^50,51 A common methodological constraint across these reviews has been their reliance on small study samples. For example, a 2019 meta-analysis by Koenig et al assessing music therapy for psychiatric conditions incorporated just six randomized trials, raising questions about the robustness of its conclusions. Similarly, the review by Mercer et al⁵² synthesized evidence from only eight studies, providing limited insight into the multimodal effects of music interventions. Two significant gaps characterize this research landscape. First, most reviews have prioritized mental health outcomes while neglecting potential physiological benefits, despite emerging evidence of music’s impact on pain perception, motor rehabilitation, and autonomic function.^53,54 Second, the modest number of studies included in prior syntheses—typically fewer than ten—restricts the generalizability of findings. Given the exponential growth of high-quality research in this domain,^55–57 a more comprehensive evaluation is warranted.

The present systematic review addresses these limitations through three key innovations: (1) inclusion of an expanded, internationally diverse study sample nearly triple the size of previous reviews; (2) parallel assessment of both mental and physical health outcomes; and (3) critical examination of the theoretical frameworks and implementation strategies underpinning successful interventions. By adopting this multidimensional approach, our analysis provides novel insights into how music therapy can be optimized across different healthcare settings and population groups.

Methods

This evidence synthesis was conducted according to rigorous standards for systematic literature examination, adhering to established protocols for transparent research reporting.⁵⁸ To maintain the highest standards of scholarly investigation, the research team developed a detailed analytical framework through collaborative deliberation. This involved multiple rounds of consultation with specialists in both therapeutic sound applications and clinical research methodology. The selection parameters were carefully refined through an iterative process, beginning with preliminary criteria developed by the full research team and subsequently refined by the lead investigator. This refinement process ensured precise alignment with the study’s overarching aims while incorporating insights from domain experts. The principal researcher conducted a final review and validation of all inclusion parameters to guarantee methodological consistency and comprehensive coverage of relevant studies.

Eligibility Criteria

This comprehensive analysis examines the biopsychosocial effects of music therapy interventions in pediatric and adolescent populations (ages 4–18 years). The synthesis encompasses both active modalities (eg, musical composition, instrumental performance) and passive approaches (eg, guided listening, lyric analysis), evaluating their therapeutic potential across various health conditions.⁵⁸ Unlike previous reviews constrained by diagnostic specificity, this investigation adopts a transdiagnostic perspective, incorporating evidence from both mental health and somatic disorders.⁵⁹ Methodological rigor was maintained through stringent selection criteria: only quantitative studies employing randomized controlled designs (RCTs), quasi-experimental frameworks, or pre-post intervention models were included.⁶⁰ To ensure developmental relevance, studies involving participants outside the 4–18 age range were systematically excluded. The final corpus represents diverse cultural contexts and clinical settings across North America, Europe, and Asia-Pacific regions, providing cross-cultural validity to the findings.⁶¹ Quality assurance measures included: Exclusion of non-empirical research (case reports, qualitative studies); Omission of grey literature (dissertations, conference abstracts); Restriction to peer-reviewed journal articles in English; and verification of standardized intervention protocols.⁶² This approach prioritizes evidence-based conclusions while addressing previous limitations in music therapy research scope and methodology.⁵⁷

Data Sources and Search Strategies

The current investigation employed a rigorous multi-database search protocol to identify all pertinent studies evaluating music therapy efficacy in pediatric populations. Following established systematic review guidelines,⁶³ our team executed comprehensive searches across five core biomedical and psychological databases: PubMed, PsycINFO, Scopus, Web of Science, and Embase. The search encompassed all available literature through December 2024 to capture the most recent developments in this rapidly evolving field.

Our search methodology incorporated both controlled vocabulary (MeSH terms) and natural language keywords to optimize sensitivity and specificity. The search string combined terminology related to therapeutic modalities (“music-assisted therapy”, “rhythmic auditory stimulation”), health outcomes (“emotional regulation”, “somatic symptoms”), and target populations (“pediatrics”, “adolescents”). Boolean operators were strategically employed to create precise search combinations that balanced recall with relevance.⁶⁴ To ensure thorough coverage of the available evidence, supplementary search strategies were implemented. These included exhaustive examination of reference lists from prior meta-analyses, forward citation tracking of seminal articles, and consultation with content experts in pediatric music therapy. While maintaining rigorous inclusion standards, we also screened select gray literature sources such as conference abstracts and institutional reports to identify potentially relevant studies that might not yet appear in peer-reviewed journals.⁶⁵

The study selection process adhered to PRISMA 2020 guidelines.⁶⁶ It involved two distinct phases of evaluation. During initial screening, two independent researchers assessed all retrieved records against predetermined eligibility criteria, achieving strong inter-rater reliability (κ = 0.89). Articles passing this stage underwent full-text review by three team members, with any discrepancies resolved through consensus discussion involving a fourth senior investigator. This multi-stage review process was designed to minimize selection bias while ensuring methodological consistency throughout the study identification process. By implementing this comprehensive search and selection protocol, our systematic review provides a robust synthesis of current evidence regarding music-based interventions for youth. The inclusion of studies from diverse clinical contexts and demographic groups enhances the external validity of our findings,⁶⁷ offering important insights into both psychological and physiological treatment outcomes. This approach addresses several limitations noted in previous reviews while establishing a transparent, replicable methodology for future research in this domain.⁵⁹

Assessment of Study Methodological Rigor

The current review implemented a modified version of the Methodological Quality Rating Scale (MQRS)^67,68 to systematically evaluate the scientific merit of included investigations. This assessment tool was specifically selected for its capacity to accommodate diverse research designs, ranging from randomized controlled trials to quasi-experimental and single-group intervention studies. Unlike conventional quality appraisal instruments that focus narrowly on RCT methodology, the adapted MQRS framework provides a more inclusive approach suitable for evaluating studies with varying methodological approaches.⁶⁹

The revised MQRS incorporates 13 critical domains that collectively assess research integrity across multiple dimensions. These include but are not limited to: study design transparency, sampling procedures, intervention fidelity, outcome measurement validity, and statistical analysis appropriateness.⁷⁰ To enhance the tool’s applicability to music therapy research, several modifications were implemented to account for the unique methodological considerations inherent in this field. These adaptations better accommodate the practical constraints and innovative approaches frequently encountered in music-based intervention studies.⁷¹ The modified assessment criteria were carefully calibrated to maintain the scale’s original psychometric properties while improving its relevance to the current research synthesis. A detailed specification of the adapted MQRS parameters, including rationale for each modification. This tailored approach facilitated a more nuanced evaluation of methodological quality that respected the inherent diversity of study designs while maintaining rigorous standards of scientific appraisal.⁷² By employing this refined instrument, the review achieved a balanced assessment of research quality that appropriately recognized both conventional methodological strengths and innovative approaches characteristic of music therapy research.

Results

Study Identification and Selection Process

The systematic search across multiple academic databases initially identified 1,367 potentially relevant publications. Following the removal of 127 duplicate records through automated and manual verification processes, the research team advanced 1,222 unique citations to the preliminary screening phase.⁷³ During this initial evaluation, 961 records were excluded based on predetermined criteria regarding subject relevance and methodological appropriateness.⁷⁴ The remaining 250 publications underwent comprehensive full-text evaluation by two independent reviewers using standardized assessment protocols.⁷⁵ This rigorous examination against explicit inclusion criteria resulted in the final selection of 14 studies that fully met all requirements for methodological quality, population relevance, and intervention specificity.⁷⁶ The complete study selection workflow, including reasons for exclusion at each stage, is visually presented in Figure 1, following PRISMA 2020 reporting guidelines.⁶⁶ This transparent documentation of the selection process ensures reproducibility and methodological rigor in the current systematic review.⁷⁷ The final included studies demonstrated appropriate diversity in terms of geographic distribution, participant demographics, and intervention approaches while maintaining sufficient methodological homogeneity to permit meaningful comparative analysis.⁷⁸ This careful balance between inclusivity and scientific rigor strengthens the validity and generalizability of the review’s conclusions regarding music-based interventions for youth populations.

Figure 1 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Chart showing the Process of Selection of Studies. Notes: PRISMA figure adapted from Liberati A, Altman D, Tetzlaff J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Journal of clinical epidemiology. 2009;62(10). Creative Commons.79

The systematic search process yielded an initial pool of 1,367 potentially relevant articles from academic databases, demonstrating the growing research interest in music-based interventions. Following duplicate removal, which eliminated 127 redundant publications, the research team conducted preliminary screening of 1,222 unique records. This initial evaluation excluded 961 articles that failed to meet basic relevance criteria or deviated from the review’s primary objectives, highlighting the importance of maintaining strict methodological focus in systematic reviews.⁷³ The subsequent full-text evaluation of 250 articles employed rigorous inclusion criteria to ensure methodological quality and conceptual alignment. This stringent selection process resulted in the final inclusion of 14 studies that met all predetermined standards, reflecting the current state of high-quality research in this field.⁸⁰ The complete selection methodology, documented in Figure 1, adheres to PRISMA guidelines.⁶⁶

The selected studies present a diverse yet methodologically sound representation of global research on music-based interventions. Geographically, these studies originate from 11 countries across four continents, including Ireland, Turkey, Austria, South Korea, multiple regions of China, the United States, Nigeria, and Singapore. This international distribution provides valuable insights into how cultural contexts influence both the implementation and outcomes of music therapy approaches.⁸¹ While this geographical diversity strengthens the review’s external validity, it also introduces inherent variability in study designs, participant demographics, intervention protocols, and assessment tools. The studies encompass different age groups within the pediatric population, various music therapy modalities (from passive listening to active participation), and diverse outcome measures. Such heterogeneity, while challenging for direct comparison, ultimately enriches the review by demonstrating the adaptability of music-based interventions across different healthcare systems and cultural contexts.⁷⁶

The comprehensive study characteristics presented in Table 1 reveal important patterns in current research practices. Notably, the concentration of studies from Asian regions (particularly China and South Korea) reflects growing research investment in these areas, while the inclusion of studies from Nigeria and Turkey provides crucial representation from developing healthcare systems. This global perspective is particularly valuable for understanding how socioeconomic factors and healthcare infrastructures may influence the implementation and effectiveness of music therapy programs.⁷⁸ The methodological diversity among included studies, while presenting analytical challenges, ultimately strengthens the review’s conclusions by demonstrating the robustness of music therapy effects across different research paradigms. From randomized controlled trials to longitudinal observational studies, the variety of designs provides multiple perspectives on intervention effectiveness, offering a more nuanced understanding than could be achieved through a more homogeneous selection. This comprehensive approach ensures that the review’s findings are both scientifically rigorous and clinically relevant to diverse practice settings worldwide.

Table 1 Key Characteristics of the 14 Studies Included in the Review

Characteristics and Methodological Evaluation of Included Studies

The systematic analysis of study characteristics, as detailed in Table 1, reveals notable patterns in research design and participant demographics across the selected literature. Sample sizes exhibited substantial variation, ranging from small-scale investigations (N=22) to larger cohort studies (N=450), with a majority (approximately 70%) falling within the 50–100 participant range. This clustering suggests that mid-sized samples are frequently deemed optimal for balancing statistical power with feasibility in music intervention research—a consideration particularly relevant given the specialized nature of therapeutic studies involving youth populations.⁷⁸ All studies adhered to the review’s age-based inclusion criteria, exclusively examining participants under 18 years old, though reporting of sociodemographic variables such as race and ethnicity remained inconsistent. This gap in demographic transparency underscores a broader challenge in pediatric intervention research, where cultural and contextual factors may significantly influence treatment outcomes.⁸⁹

Therapeutic focus varied across studies, with a predominant emphasis on psychological outcomes—particularly reductions in anxiety and depressive symptoms—reflecting the well-documented role of music in emotional regulation.⁹⁰ However, a subset of studies extended their scope to physical health measures, including pain perception,⁹¹ autonomic nervous system regulation,⁹² and motor function improvement.⁹³ These findings highlight the multimodal potential of music-based interventions, bridging psychological and physiological domains of well-being.⁹⁴ Recruitment strategies largely relied on convenience sampling, which, while practical, may limit generalizability. Nevertheless, several studies strengthened internal validity through randomization, reinforcing confidence in causal inferences.⁹⁵

Methodologically, self-report measures dominated outcome assessment, with instruments like the SF-MPQ and KSQ providing standardized metrics for cross-study comparison. The selective incorporation of behavioral observations in some studies added valuable objective data, mitigating potential biases inherent in self-reported outcomes.⁹⁶ To critically appraise study quality, a modified version of the MQRS was applied, incorporating 17 rigor-related criteria (see Table 2). Notably, seven RCTs within the review demonstrated particularly robust designs, aligning with gold-standard evidence-generation practices.⁹⁷ Across all studies, the use of validated instruments and explicit methodological rationales—including sample size justification and analytical transparency—enhanced the credibility of findings. Such rigor not only supports the reliability of this review’s conclusions but also sets a benchmark for future research in optimizing music-based interventions for youth health outcomes.⁶⁶ This synthesis underscores both the strengths and limitations of current literature, advocating for more standardized reporting of demographic variables and expanded investigation into music’s somatic effects. The methodological heterogeneity observed across studies, while challenging for meta-analytic approaches, ultimately enriches the field by demonstrating the adaptability of music therapy across diverse clinical and cultural settings.⁹⁸

Table 2 Methodological Quality Assessment of Included Studies (n=14)

Overview of Theoretical Approaches, Therapeutic Methods, and Contexts in Music-Centered Interventions for Youth

The analysis of 14 empirical studies reveals diverse theoretical perspectives, therapeutic techniques, and implementation settings in music-centered interventions designed to support psychological and behavioral well-being among youth. These studies demonstrate that music-based approaches can be adapted to various formats, from individualized sessions to group-based activities, each with distinct advantages. For instance, individual interventions^99–101 allow for personalized therapeutic engagement, whereas group sessions^102–104 facilitate social interaction and collective emotional expression. The duration of these programs also varied significantly, with most spanning several weeks to ensure sustained therapeutic effects. However, exceptions such as a condensed one-week intervention¹⁰⁵ and a year-long longitudinal study¹⁰⁶ highlight the flexibility of music therapy in accommodating different research and clinical objectives. Therapeutic techniques predominantly featured established music therapy practices, including vocal exercises, rhythmic engagement, instrumental play, and guided listening. Notably, Feng et al¹⁰⁷ introduced an innovative approach by incorporating robotic-assisted therapy, suggesting a promising direction for integrating technology into traditional methods. This development aligns with broader trends in digital health interventions, where artificial intelligence and interactive tools enhance therapeutic engagement. The settings of these studies further underscore the versatility of music therapy, with implementations in pediatric hospitals, schools,^108–110 and even home environments.^100,111 Such adaptability ensures accessibility, allowing interventions to be tailored to participants’ everyday contexts.

From a methodological standpoint, the studies employed varied research designs to assess efficacy. Many utilized controlled experimental frameworks with pre- and post-intervention comparisons,^{100,102,104–106,110} providing robust evidence of intervention effects. In contrast, single-group longitudinal assessments^105,106,112 offered insights into long-term behavioral changes, while qualitative observations¹⁰⁶ enriched understanding of participants’ subjective experiences. Collectively, these studies illustrate the breadth of music therapy applications, reinforcing its potential as a dynamic and inclusive therapeutic modality for diverse youth populations.

Synthesis of Key Findings and Critical Evaluation of Music-Based Interventions for Youth Well-Being

This comprehensive review examined 14 empirical studies exploring the effects of music-based interventions on the psychological and physiological health of children and adolescents. The majority of studies (12 out of 14) reported statistically significant benefits, reinforcing the potential of music therapy as an effective tool for enhancing emotional regulation, social functioning, and, in some cases, physical well-being. However, the findings were not uniformly positive, with two studies presenting limited or mixed outcomes. Gold et al,⁸³ for example, found no substantial psychological improvements despite observing enhanced interpersonal skills among participants. Similarly, Porter et al⁸² noted age-dependent effects, with adolescents experiencing increased self-esteem and reduced depressive symptoms, while younger children showed no measurable gains in social competence. These discrepancies suggest that developmental differences may play a crucial role in intervention efficacy—a factor that warrants deeper investigation, particularly since most studies did not account for variables such as age, gender, or socioeconomic background.

A key limitation across the literature is the scarcity of long-term follow-up assessments. While most studies documented immediate or short-term benefits, only Wong et al¹⁰⁶ adopted a longitudinal approach, tracking outcomes over a full year to evaluate sustained effects. The lack of extended monitoring in other studies raises questions about the durability of observed improvements, leaving a gap in understanding whether music-based interventions offer lasting psychological or behavioral change. This oversight is particularly significant given that mental and emotional well-being—the primary focus of most included research—often requires ongoing support rather than transient interventions. Studies such as Cheung et al,¹⁰⁰ Kwok,¹⁰² and Chen et al¹⁰³ provided compelling evidence that structured music therapy can alleviate anxiety, enhance mood, and foster social connectedness. In contrast, physical health outcomes received less attention, though preliminary findings from Feng et al¹⁰⁷ and Bulut et al⁸³ suggest that rhythmic and movement-based musical activities may also contribute to motor coordination and physiological relaxation, pointing to an underexplored but promising research direction.

Therapeutic methodology further influenced outcomes, with active, participatory approaches—such as collaborative music creation, instrumental performance, and improvisational exercises—consistently outperforming passive listening-based interventions.^100,102 This distinction underscores the importance of engagement and creativity in therapeutic settings, where direct involvement may amplify emotional and cognitive benefits. Despite these encouraging results, critical gaps remain. Future research should prioritize longitudinal designs to assess the persistence of therapeutic effects, incorporate stratified analyses to examine demographic influences, and expand investigations into the somatic benefits of music therapy. By addressing these limitations, subsequent studies can refine intervention frameworks and strengthen the empirical foundation supporting music-based therapies for diverse youth populations.

Discussion

This critical analysis examines the multifaceted effects of music-centered interventions on both mental and physical health outcomes, synthesizing evidence from diverse international and clinical settings. By moving beyond conventional focus areas in existing literature, this review makes a substantive contribution to the field through its dual emphasis on psychological benefits and often-overlooked physiological impacts. The inclusion of physical health outcomes represents a particularly valuable expansion of current knowledge, offering new perspectives on how rhythmic and melodic interventions may contribute to comprehensive wellness. Furthermore, by systematically analyzing the theoretical frameworks and delivery methods employed across studies, this review provides crucial insights into the mechanisms through which musical engagement produces therapeutic effects.

The accumulated evidence strongly suggests that structured musical interventions can induce meaningful improvements across multiple health domains. Psychologically, participants demonstrated measurable reductions in anxiety and depressive symptoms, alongside enhanced capacities for emotional articulation and social connection. Physiologically, emerging data points to benefits including refined motor skills, improved neuromuscular coordination, increased relaxation responses, and greater facility in collaborative physical activities – all of which hold particular relevance for developing children. While these findings resonate with previous meta-analyses,^84,85 the current review extends prior work by incorporating a broader spectrum of therapeutic environments and assessment methodologies, thereby capturing the full diversity of music therapy applications.

However, the analysis also reveals important limitations in intervention efficacy. The most robust psychological benefits emerged for mood regulation and social functioning, whereas more complex medical conditions – particularly acute somatic symptoms like treatment-related nausea – showed limited responsiveness to musical interventions. This pattern suggests that music therapy may function most effectively as an adjunctive treatment within broader rehabilitation protocols rather than as a standalone clinical intervention. The review also identifies significant variation in outcomes based on therapeutic approach, with active participation modalities (eg, instrumental performance, collaborative composition) consistently outperforming passive reception methods. These observations align with Malchiodi’s⁸⁶ theoretical framework positing that embodied musical engagement facilitates deeper neurocognitive and emotional integration. Methodological constraints across the reviewed studies present notable challenges for evidence interpretation. The near-universal absence of longitudinal follow-up precludes definitive conclusions about the persistence of therapeutic gains, while the frequent lack of participant blinding introduces potential expectancy biases that may inflate reported outcomes. These limitations underscore the necessity for more rigorous research designs incorporating extended observation periods and controlled assessment protocols. Future investigations should prioritize examination of demographic moderators, durability of effects, and standardized implementation frameworks to advance both theoretical understanding and clinical application. While affirming the therapeutic value of music-based approaches, this review ultimately calls for more sophisticated research paradigms to fully elucidate their role in contemporary healthcare and wellness initiatives.

The synthesis ultimately positions music therapy as a promising but not yet fully optimized intervention modality, with particular strengths in psychosocial domains and emerging potential for physical health applications. Its value appears most pronounced when integrated within comprehensive treatment plans and when employing active, participatory methodologies. The path forward requires both refinement of therapeutic protocols and expansion of research methodologies to establish music’s precise role in holistic health promotion across developmental stages and clinical populations.

Implications for Practice and Future Directions in Music-Based Therapeutic Interventions

The findings from this comprehensive analysis yield significant implications for clinical implementation, research advancement, and health policy formulation, particularly concerning therapeutic approaches for children and adolescents experiencing psychological distress or physical health challenges. The accumulated evidence demonstrates that properly structured music-based interventions can produce clinically relevant improvements in both mental and physical well-being. However, the effectiveness of these interventions is mediated by several critical variables, including the clinical setting, participant demographics, and specific intervention design. Importantly, while music therapy demonstrates considerable therapeutic potential, it should be conceptualized as an adjunctive rather than primary treatment modality – one that works optimally when integrated into comprehensive care models alongside conventional medical and psychological interventions. Clinicians should adopt a personalized approach when implementing these therapies, carefully considering each individual’s developmental stage, health condition, and cultural context to maximize therapeutic relevance and effectiveness.

A key revelation emerging from this synthesis concerns the marked variability in outcomes based on intervention methodology. The data consistently reveal that active engagement techniques – including musical composition, vocal performance, and instrumental interaction – produce substantially greater therapeutic gains compared to passive listening-based approaches. This finding carries important practical implications, suggesting that clinicians should prioritize experientially rich, participatory activities when designing therapeutic programs. Such dynamic modalities appear particularly potent for enhancing emotional self-regulation, building psychological coping mechanisms, and developing interpersonal competencies. Looking ahead, the field requires focused investigation into how these active engagement strategies can be optimally adapted across different treatment environments and customized for specific clinical populations. There exists a pressing need to establish standardized clinical guidelines that define evidence-based protocols, outline measurable therapeutic objectives, and ensure proper professional training in music therapy techniques. The advancement of this therapeutic domain would benefit significantly from enhanced interdisciplinary collaboration. Strategic partnerships between music therapists, psychologists, physicians, and rehabilitation specialists could yield more nuanced and effective treatment paradigms, particularly for pediatric populations requiring coordinated care across multiple health domains. From a research perspective, a conspicuous gap exists in our understanding of the temporal persistence of therapeutic benefits. The current literature predominantly captures immediate or short-term outcomes, leaving critical questions unanswered about the durability of improvements over extended periods. Future investigations should prioritize longitudinal study designs to assess sustained effects and examine how music-based interventions might be incorporated into ongoing treatment regimens. Addressing these knowledge gaps will enable music therapy to assume a more defined and impactful role within integrated healthcare systems, ultimately enhancing outcomes for young individuals navigating complex health challenges.

This analysis ultimately positions music-based interventions as a valuable but under-optimized component of contemporary therapeutic practice. While demonstrating particular efficacy in psychosocial domains, their implementation requires careful consideration of methodological factors and individual differences. The path forward demands both refinement of therapeutic protocols and expansion of empirical evidence to fully realize music’s potential as a complementary therapeutic tool in pediatric healthcare. By establishing more robust clinical guidelines and fostering cross-disciplinary cooperation, healthcare systems can better harness the unique benefits of music therapy while maintaining rigorous standards of evidence-based practice.

Limitations and Direction for Future Studies

While this systematic review offers a comprehensive synthesis of existing research on music-based interventions, it is important to recognize certain constraints that may affect the generalizability and depth of its findings. A key limitation lies in the lack of detailed demographic stratification in the analyzed studies. Many of the included investigations do not account for critical variables such as participant age, gender, socioeconomic status, or cultural background, which may significantly influence the efficacy of music therapy. Since individual responses to therapeutic interventions can vary based on these factors, the absence of subgroup analyses restricts the ability to determine whether certain populations benefit more than others. Moving forward, researchers should place greater emphasis on examining these demographic distinctions to facilitate more tailored and effective intervention strategies.

Further, the scope of this review was confined to peer-reviewed journal articles, omitting potentially valuable insights from grey literature, clinical case reports, and practitioner observations. This exclusion is noteworthy because many music therapy professionals apply these interventions in real-world clinical settings, where practical adaptations and nuanced understandings of patient needs often emerge. However, such experiential knowledge is frequently undocumented in formal academic literature, creating a disconnect between research and practice. To address this gap, future studies should actively seek out practitioner perspectives through qualitative methodologies, such as interviews or mixed-methods research. By integrating empirical evidence with the lived expertise of clinicians, the field can develop more robust and adaptable guidelines that enhance the application of music-based therapies across diverse healthcare environments and patient demographics.