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Group music therapy for adolescents who have unhealthy relationships with music
ISRCTN ISRCTN31608830
DOI 10.1186/ISRCTN31608830
ClinicalTrials.gov identifier
EudraCT number
Public title Group music therapy for adolescents who have unhealthy relationships with music
Scientific title Effectiveness of a music therapy group to promote Healthy Uses of MuSic by adolescents
Acronym HUMS Trial
Serial number at source DP110102483
Study hypothesis 1. Does music therapy, compared to a self-guided music intervention, have an effect on adolescentsí risky and protective relationships with music?
2. Does it have an effect on the level of depression, rumination, and psychological well-being?
Lay summary Background and study aims
This study builds on the opinions shared by 40 Australian teenagers ranging from healthy to depressed. Analysis of how they described their own relationship with music revealed a number of risk and protective factors for healthy music use including isolation/bonding, rumination/processing and other coping strategies. The results of the analysis of interviews were used to create 38 questions that asked about healthy uses of music by teenagers. 187 older adolescents answered these questions as well as 10 questions that were used to measure their risk of being depressed. Analysis of how the questions were answered identified 17 questions that appear to measure healthy and unhealthy aspects of five types of musical behavior: rumination & getting stuck, mood improvement, energy and relaxation, positive identity (social and self-identity), alienation & social avoidance, avoidance of feelings, bad behaviour. These 17 questions are now compiled as the Healthy Uses of Music Scale (HUMS) and this will be used to identify adolescents who have unhealthy relationships with music for the present study.
The aim of this study is to determine whether group music therapy with younger teenagers changes their relationship with music, and if so, whether this results in significant changes in their mental health status. Studies show that music therapy has been effective for adults who have depression and young people who have psychopathology; however, preventative interventions have not been measured previously.

Who can participate?
600 students aged approximately 14-15 years in 20 schools will complete the HUMS and 20% (top scoring 6 in each school) will be recruited to the study.

What does the study involve?
The students will be randomly allocated to one of the two groups. Half of the students will participate in 8 weeks of music therapy group that focuses on improving their relationship with music. The other half will be encouraged to listen to preferred music that makes them feel better and will be provided with iTunes vouchers worth $30AUD so that they are able to purchase new music. All 120 participants will complete the HUMS again approximately 3 months from recruitment. Four different trained and registered professionals who are experienced in adolescent group work will facilitate the music therapy groups. The groups will consist of a regular structure including warm-ups, therapeutic work using music, and closure. The groups will all include establishing a therapeutic alliance between young people and therapist, empathic listening by the therapist, responsiveness to ideas contributed by young people as well as the therapist, and respect for different genres of music. The music therapy methods to be used will include group improvisation, group song writing, playlist creation and discussion of music preferences. The use of these methods is considered to be both unique and essential. Groups may also include some amount of self-disclosure, group discussion on studentís own music and assigning playlist creation homework. Individual improvisation, individual songwriting and being directive about musical choices will not be included in the music therapy groups.

What are the possible benefits and risks of participating?
Participants in the music therapy groups will have the opportunity to explore issues related to their mental health, as reflected in their uses of music. Music therapy is a professional practice requiring two years of Masters coursework training in Australia. Music therapists are able to manage the needs of participants within music therapy interventions and are ethically required to access additional support for group members if this is suitable. Within this project, the first level of additional support with be school wellbeing coordinators who have access to a range of additional professional support for students including psychologists, social workers and local doctors.
Previous research suggests that music therapy is helpful for struggling young people, based on their reports and as seen by improved mental health. Therefore participation is possibly very helpful. In addition, it is very important to understand the impact of unhealthy relationships with music since young people now have more access to a greater range of music than ever before. If the group is effective, music therapy may be recognized as an important preventative health strategy that could make a difference in the lives of many more young people.
In the recruitment for this study, young people will be asked a series of questions about their relationship with music and their mental health. A number of questionnaires will be included that measure risk of psychological distress, degree of rumination, and emotional well-being. Because many of these questions ask about the participantsí quality of mental health, it may lead participants to reflect on how they are feeling. It is possible that some young people may be saddened by their reflections. A question at the end of the survey asks students to identify if they require further support and if this box is ticked, we will ask school wellbeing officers to follow up immediately.

Where is the study run from?
The study will take place in 20 Australian schools across the state of Victoria. The government-funded schools include both inner city, outer suburban and rural locations. The socio-economic status of the schools is diverse, as will be the cultural backgrounds of participants.

When is the study starting and how long is it expected to run for?
Data collection for the study will take place between August 2013 and July 2014.

Who is funding the study?
The research has been funded by the Australian Research Council, which is the major government funding agency for studies in the Humanities and Social Sciences.

Who is the main contact?
Associate Professor Katrina Skewes McFerran
k.mcferran@unimelb.edu.au
Ethics approval 1. Department of Education and Early Childhood Development (2012_001839) 18th January, 2013
2. The University of Melbourne, Human Research Ethics Committee (HREC) # 1238526.2, 27th May, 2013
Study design Multicentre parallel cluster-randomised controlled trial
Countries of recruitment Australia
Disease/condition/study domain Unhealthy relationships with music, which may indicate risk of mood disorder
Participants - inclusion criteria Students in Years 8 and 9 (aged approx. 14-15) in government-funded secondary schools in the state of Victoria, Australia, who have unhealthy relationships with music, as identified by a high HUMS score. Following a survey using the Healthy Uses of Music Scale (HUMS), those six with the highest scores in each school will be eligible to participate.
Participants - exclusion criteria Does not meet inclusion criteria
Anticipated start date 01/08/2013
Anticipated end date 31/07/2014
Status of trial Ongoing
Patient information material Not available in web format, please use the contact details below to request a patient information sheet
Target number of participants 120 (in 20 clusters of 6)
Interventions 1. Group music therapy: Half of the students will participate in 8 weeks of group music therapy that focuses on improving their relationship with music. Four trained and registered professionals who are experienced in adolescent group work will facilitate the music therapy groups. The groups will consist of a regular structure including warm-ups, therapeutic work using music, and closure. The groups will all include establishing a therapeutic alliance between young people and therapist, empathic listening by the therapist, responsiveness to ideas contributed by young people as well as therapist, and respect for different genres of music. The music therapy methods to be used will include group improvisation, group song writing, playlist creation and discussion of music preferences. The use of these methods is considered to be both unique and essential. Groups may also include some amount of self-disclosure, group discussion on studentís own music and assigning playlist creation homework. Individual improvisation, individual songwriting and being directive about musical choices will not be included in the music therapy groups.
2. Self-directed music listening: The other half will be encouraged to listen to preferred music that they choose because it makes them feel better and will be provided with iTunes vouchers worth $30AUD so that they are able to purchase new musical material.
Duration of follow-up in all groups: 3 months.
Primary outcome measure(s) Total score of the Healthy Uses of Music Scale (HUMS; McFerran, Saarikallio & Gold, in preparation). This is a self-report scale assessing healthy and unhealthy uses of music that may be associated with risk for developing mental health problems. It consists of 17 Likert-scaled items. Reliability and validity have been tested and confirmed in a separate sample.
Secondary outcome measure(s) 1. Depression, as measured with the Kessler 10 Depression scale (a 10-item self-report scale; Kessler et al., 2002, Psychol Med).
2. Rumination, as measured with the respective subscale of the Reflection-Rumination Questionnaire (RRQ; a self-report with 12 items for this subscale; Trapnell & Campbell, 1999, J Pers Soc Psychol)
3. Reflection, as measured with the respective subscale of the RRQ (12 items for this subscale)
4. Psychological wellbeing, as measured by the Keyes well-being scale (a 14-item self-report scale; Keyes et al, 2006, Adolescent & Family Health).
5. A Ten-item Personality Inventory (TIPI) based on the Big-Five dimensions (Gosling, Rentfrow & Swann, 2003).
Sources of funding Australian Research Council (project no. DP110102483) (Australia)
Trial website
Publications
Contact name Prof  Katrina  McFerran
  Address 151 Barry Street
Melbourne Conservatorium of Music
  City/town University of Melbourne
  Zip/Postcode 3010
  Country Australia
  Email k.mcferran@unimelb.edu.au
Sponsor University of Melbourne (Australia)
  Address c/o A/Professor Katrina Skewes McFerran
151 Barry Street
Melbourne Conservatorium of Music
  City/town Melbourne
  Zip/Postcode 3010
  Country Australia
  Email k.mcferran@unimelb.edu.au
  Sponsor website: http://www.unimelb.edu.au/
Date applied 23/07/2013
Last edited 05/08/2013
Date ISRCTN assigned 05/08/2013
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