Music and Medicine Vol 14, No 5: Article Feature and Table of Contents

Published by International Association for Music and Medicine on

Featured article

A clinical pilot study on the effects of environmental music therapy on anxiety and waiting in radiation
oncology: A randomized control trial

Andrew Rossetti, Joanne Loewy, Zachary Fischer, Saarang Deshpande, Manjeet Chadha

A randomized control trial investigated perceived waiting time in patient and caregivers, and live music’s effects on anxiety levels prior to daily radiation therapy (RT). Environmental Music Therapy (EMT) is a live music intervention by music therapists meant to modify perception of potentially stressful environments through constructing dynamic soundscapes to provide enhanced comfort and safety. This study (a) rated participants’ state anxiety and distress experienced in the waiting area pre-RT, (b) determined if the EMT protocol moderated baseline treatment experience-related anxiety and (c) evaluated EMT’s affects on perceived waiting time pre-treatment, versus actual waiting time.  We hypothesized EMT would reduce state anxiety, distress, and regulate distortion of waiting time, ultimately changing overall RT perception. 160 randomized patients and caregivers were accrued- 82 receiving EMT, 78 randomized to control. Assessment pre/post intervention measured anxiety and distress with the STAI 6 and Visual Analogue Distress Scale. A time survey assessed waiting perception. Data collected and recorded by research assistants naïve to treatment conditions found EMT interventions showed significantly reduced perceived incidences of anxiety and distress, significantly shortening perceived waiting times in the EMT arm compared to controls. Reduced anxiety, distress, and temporal distortion can enhance patients’ and caregivers’ perception of hospital environments.

Can you provide an overview of the article and the topics it explores?

This study in Radiation Oncology waiting rooms is the first of its kind to address the effects of an emerging music therapy intervention – Environmental Music Therapy. (EMT) We looked at how EMT modulated anxiety and perceived waiting time-conditions common to fragile treatment area waiting rooms. Adversely affecting both constituents’ overall perception of radiation treatment itself as well as general patient satisfaction, we found not only that EMT is a highly effective intervention, but that there is a clear interactive correlation between the level of anxiety and the amount of temporal distortion. We subscribe to the idea that on a mechanistic level, EMT can change constituents’ actual perception of the waiting room environment, and that through skillful improvisation guided by the manipulation of discreet music elements, EMT can render a soundscape that leaves people with a sense of that environment feeling safer and less invasive.

What was the impetus for writing the article?

The study and subsequent article grew out of the observation that hospital waiting rooms can be a veritable crucible of state anxiety and that patients perceive the environment, such as it is, as a hostile place. This can lead to a propensity towards traumatization (medically induced or otherwise)  and a less proactive stance towards treatment. We also noticed patients reporting distinctly  different waiting times than what their actual waiting times were, and that this contributed to greater anxiety, distress and lower overall satisfaction with treatment.  We hypothesized that EMT’s ability to modulate perception of environments and peoples’ relationship  with those very environments would make it a viable and effective intervention.

 What future research or areas of exploration would benefit the field and application of what was discussed in this article ?

EMT is an understudied and underused therapeutic intervention with only a handful of clinical studies published on the topic. There is interest in environmental design in hospital contexts’ bearing on patient response and healing.  Though most of the investigation centers on physical design, study of the effects of discreet acoustic  spaces and soundscapes is gaining traction. EMT offers a cost-effective, highly efficacious dynamically interactive means of providing on-the-spot soundscape design individualized to the needs  of the space’s constituents in the moment. As such, it bears additional rigorous study to reach its full potential and applicability.

How do you think this article impacts the current understanding of music and medicine?

This article is a preliminary step (hopefully one of many) in providing the music and medicine community, amongst them medical staff,  music therapists, and hospital administrators with a viable and easily employable  clinically therapeutic option. It may open doors into recognition that the environments people are subjected to play a vital role in their response-their emotional states, and interactivity, and these are paramount to constructing vital experiences in healthcare that contribute to better compliance, behavioral health and ultimately, medical outcomes.

Andrew Rossetti PhD, MT-BC, LCAT, is a music psychotherapist, and director of Oncology Music Therapy at the Mount Sinai Healthcare System Louis Armstrong Center for Music & Medicine’s multi-site program.. His clinical practice in medical music psychotherapy extends to all areas of oncology in the hospital environ, as well as to the neonatal ICU where he specializes in Environmental Music Therapy in fragile areas, and the treatment of trauma and post traumatic stress. Dr. Rossetti is an international lecturer and has been a frequent invited and keynote speaker at conferences and universities in the US, Asia, Europe, South America, and Canada. He is an active clinical researcher whose work has been published in numerous high impact medical journals and highlighted in the New York Times. His work has also been featured on CBS, NBC, National Public Radio, and the New York Psychoanalytic Society & Institute’s Helix Center Series. Dr. Rossetti is an Editorial Board Reviewer for the International Journal of Radiation Oncology Biology and Physics, and a faculty member of Montclair State University, and the University of Barcelona.

Table of Contents


Tempora mutantur et nos mutamur in illis-or what?
Ralph Spintge, Joanne V. Loewy

Full Length Articles

Better together: Interprofessional collaborations between music educators and music therapy
Amy Clements-Cortes, Hope Pascoe, Nicholas Bridi

Use of music videos in the treatment of complex trauma
Diana Christine Hereld, Marissa Yoshizawa

Best practice recommendations for using music with children and young people with disorders of

Anna Menén Sánchez, Jonathan Pool, Janeen Bower, Valerie Paasch, Wendy Magee

Music educators’ and students’ views on participating in a music and medicine program
Roma Subramanian, Mary Perkinson

The 50-year proliferation of music medical science research: A bibliometric review
Zachary Levine, Mackenzie Campbell, Abeer Adil, Shaul Kruger, David Alter

A clinical pilot study on the effects of environmental music therapy on anxiety and waiting in radiation
oncology: A randomized control trial

Andrew Rossetti, Joanne Loewy, Zachary Fischer, Saarang Deshpande, Manjeet Chadha

Systematic literature review of the effect of music therapy on psychological outcomes in aphasia
TingYi Lu, Rachel Goff-Albritton, Alice-Ann Darrow, Elizabeth Madden

Categories: Uncategorized


Leave a Reply