The Effect of Lyric Analysis on Treatment Eagerness and Working Alliance in Consumers Who Are in Detoxification: A Randomized Clinical Effectiveness Study

ABSTRACT: Substance abuse and dependency continues to be a solemn problem in the United States and around the world. The purpose of this study was to evaluate the effects of a single music therapy session on clients who are in detoxification using psychometric instruments measuring readiness to change and working alliance during a randomized and controlled clinical trial. Participants took part in a scripted and manualized intervention facilitated by a Board-Certified Music Therapist. The experimental group (n = 29) participated in a group lyric analysis intervention focusing on relapse prevention while the control group (n=37) participated in a group verbal therapy session also focusing on relapse prevention. There was a significant between group difference in measures of therapist perceived working alliance (p Substance abuse continues to constitute a major social concern in the United States and worldwide. The National Survey on Drug Use and Health (NSDUH) is an annual survey sponsored by the Substance Abuse and Mental Health Services Administration. It is considered the primary information source on the use of alcohol and drugs in the United States for people aged 12 and older (Department of Health and Human Services, 2006). In 2005, an estimated 19.7 million Americans aged 12 and older were considered current illicit drug users. This estimate constituted 8.1 percent of the population in this age range. Approximately 2.4 million used cocaine and 6.4 million used prescription-type drugs in a nonmedical manner in the last month. More than half (51.8 percent) of Americans in this age bracket reported being current drinkers of alcohol (Department of Health and Human Services, 2006). Recent research has evaluated the effects of music therapy on clients who are in substance abuse rehabilitation. Single sessions of music therapy were found to facilitate positive emotions in participants (Baker, Gleadhill, & Dingle, 2007). In a related study, music therapy treatment resulted in high levels of motivation and enjoyment (Dingle, Gleadhill, & Baker, 2008). Silverman (2003) found no differences between intervention types but positive perceptions of therapeutic benefit and enjoyment with women in long-term chemical dependence treatment. Jones (2005) studied the effects of lyric analysis and songwriting interventions on consumers who were in treatment for substance abuse. Results indicated positive emotional mood changes but no differences between interventions. Cevasco, Kennedy, and Generally (2005) compared the effects of music therapy interventions on depression, stress, anxiety, and anger. Similar to the results of Jones (2005) and Silverman (2003), positive changes were noted but no differences were found between interventions. To date, however, no music therapy studies concerning substance abuse have employed the use of a control group while few have used established psychometric instruments. Motivation for alcoholism and drug change has been traditionally judged in two ways: a person is unmotivated and in denial or is motivated to change (Clancy, 1964; DiCicco, Unterberger, & Mack, 1978). Motivation for change in drug/ drinking use is an important variable (Miller, 1985; Miller, Benefield, & Tonigan, 1993) and has been construed as a fluctuation between pros and cons of a behavior (Janis & Mann, 1 977). Past research has found that the therapist's style, as well as environmental characteristics, influence the consumer's motivation for change. Although it is theorized that music therapy can enhance treatment motivation with other populations, presently, no studies have investigated the effect of music therapy on motivation to change in persons who are chemically dependent. …