Guided Imagery and Music (GIM) with adults on sick leave suffering from work-related stress – a mixed methods experimental study

A mixed methods study in Guided Music and Imagery as a treatment method for adults on long-term stress-related sick leave has combined a randomized clinical trial and a hermeneutic phenomenological analysis of themes and therapy cases. Stress has been studied within a biopsychosocial model of health. A number of 20 subjects from different professions with a mean age of 44.5 and a majority of women (16 out of 20) were randomized into two groups. There was a high degree of compliance (no protocol violations, all data were collected at nine weeks' followup and only one dropped out (5%). The treatment condition included six sessions of GIM plus standard care versus standard care alone. Significant effects of GIM compared to standard care were found after nine weeks in the psychological variables Mood, Sleep Quality, Anxiety, Well-being and Physical Symptoms with effect sizes ranging from 0.73 to 1.37. The analysis of stress-related hormones in saliva indicated a significant decrease of Cortisol, a decrease of Melatonin and an increase of Testosterone. The standard care control group received GIM after waiting, and the analysis of the effect of early intervention versus late intervention was carried out. Significant effects in Perceived Stress, Mood, Depression and Anxiety were found with effect sizes from 0.80 to 1.11. Job return did not significantly improve in the early intervention group compared to late intervention, but the odds of being on sick leave at 6 months' followup were 4.08. In the whole group of subjects 83% of the participants were no longer at sick leave six months after the end of therapy. Early intervention thus has significant implications for the degree of improvement from work-related chronic stress. The clinical trial was combined with a hermeneutic inquiry on the music therapeutic processes of embodiment and coping. Themes in the therapies were identified to relate equally to work stress and life stress. The participants found new coping strategies, new ways of being, increased contact with their bodies, reduced pain experience and enhanced creativity and hope through the music journeys. Bodily experiences and emotions were found to be closely connected to the processes of coping. Unresolved traumatic work episodes were identified as a part of the chronic stress and were renegotiated in music therapy leading to new social competencies. The music was experienced as a supportive space for self-regulative body processes, emotional expression, reconnection to self-esteem and competency, processes of existential life issues and contact with creativity. A result generated from the convergence of qualitative and quantitative results is that GIM decreased bodily stress symptoms, increased energy and well-being, enhanced coping with inner and outer conflicts, helped to overcome traumatic work experiences, provided new relational competencies, improved mood and gave access to hope for the future work life. The results of this study seen in relation to previous research indicate that Guided Music and Imagery is a valuable and effective short-term treatment that can be an alternative to established treatment practices for work-related chronic stress. Further research with a larger sample is needed.