Effects of Live and Educational Music Therapy on Working Alliance and Trust With Patients on Detoxification Unit: A Four-group Cluster-randomized Trial


Substance Use & Misuse




BACKGROUND: Lyric analysis is a commonly utilized music therapy intervention for clients in substance abuse rehabilitation wherein participants interpret song lyrics related to their clinical objectives. For these patients, working alliance and trust in the therapist represent consequential factors that may influence outcomes. However, there is a lack of randomized controlled music therapy studies investigating working alliance and trust in the therapist within lyric analysis interventions for patients with addictions. OBJECTIVE: The purpose of this study was to quantitatively differentiate live versus recorded and educational versus recreational music therapy interventions via measures of working alliance and trust with patients on a detoxification unit. METHOD: Participants (N = 130) were cluster randomized in a single-session posttest-only design to one of four conditions: Live educational music therapy, recorded educational music therapy, education without music, or recreational music therapy. Dependent measures included working alliance and trust in the therapist. Educational music therapy interventions were scripted lyric analyses. RESULTS: There was no statistically significant between-group difference in any of the measures. Although not significant, a greater number of patients and research participants attended live educational music therapy sessions. CONCLUSIONS: Between-group descriptive data were consistently similar but attendance trends may have implications for engaging patients and billing. Implications for clinical practice, limitations of the study, and suggestions for future research are provided.

Music and Health Institute Terms

Detox Setting; Live Music Listening; Music Listening; Music Therapy; Patient Experience; Patient Satisfaction; Receptive Music Methods; Recorded Music Listening; Self-Report Measures; Song Lyric Discussion; Substance Use, Abuse and Addiction

Indexed Terms

Addiction; chemical dependency; educational music therapy; live music; recorded music; substance abuse; therapeutic alliance; trust; working alliance; Psychotherapy, Group; Substance-Related Disorders

Study Type

Quantitative Methods; Randomized Controlled Trial

PubMed ID


Document Type