Music Therapy For ADHD

Introduction

Attention deficit hyperactivity disorder (ADHD), a common neurodevelopmental condition mainly affecting children, presents lifelong challenges involving attention, impulse control and agitation.¹ 

Music therapy, a promising field that has recently gained substantial interest, is recognised as an effective approach to managing ADHD symptoms by complementing conventional treatments.¹ Music therapy helps in reducing the occurrence of maladaptive behaviours and a wide array of ADHD symptoms leading to cognitive, emotional and social improvements.^1,2 

Read on to find out more about ADHD and its challenges, music therapy, understand how it can help individuals with ADHD, and how to integrate it within the traditional ADHD treatment plan.  

Understanding ADHD

ADHD is a chronic condition affecting around 7% of children worldwide with symptoms persisting into adulthood.

Types and common symptoms

ADHD is categorised into three types, depending on the symptoms:

• The inattentive type: the main symptoms entail a lack of focus and concentration, without agitation or impulsivity. People with this type of ADHD have short attention spans, are easily distracted, tend to be forgetful, constantly lose things, have trouble following instructions, have difficulty finishing tasks, have difficulty staying focused and often make careless mistakes.   
• The hyperactive/impulsive type: the main symptoms include agitation and lack of impulse control (they act before thinking), without being inattentive. People with this type of ADHD have difficulty staying still, seem to always be on the move, often injure themselves, have trouble waiting their turn, may talk excessively, talk out of turn, and constantly interrupt other people’s discussions.
• The mixed type: people with this type of ADHD have symptoms of both types. They are inattentive, impulsive and hyperactive. 

Challenges faced by individuals with ADHD in daily life

ADHD affects many aspects of a person’s life. Children face challenges at home, at school and with their peers whereas adults with ADHD often face strained relationships, social and occupational difficulties.^1,3      

If ADHD is left untreated, communication difficulties, time management, organisational issues, impulsive and inappropriate behaviours, impulsive decision-making, and mood changes can all negatively affect a person’s life.    

Traditional treatment approaches

ADHD is best managed by a multifaceted treatment approach including medications and behavioural therapy, both of which have proven to be effective in reducing symptoms. ADHD medications include stimulants (such as methylphenidate) and non-stimulants (such as atomoxetine), with stimulants being the medications of choice.⁴

Additionally, studies have shown the benefits of incorporating alternative treatment methods, such as mindfulness, yoga, meditation, and physical activity to better manage ADHD symptoms.⁵ Recent studies have highlighted the benefits of music therapy as a complementary approach to traditional ADHD treatments.²

What is music therapy?

Music therapy is a dynamic and interactive field that can address the emotional, cognitive, developmental and social challenges faced by individuals with ADHD.¹ 

Definition and principles of music therapy

Music therapy is a form of psychotherapy that involves the use of music interventions and musical elements (melody, rhythm, sound, harmony) by a trained professional to achieve a wide variety of therapeutic goals.¹ 

It is commonly used in medicine because it is beneficial to individuals with autism spectrum disorder, Alzheimer's disease, those recovering from substance abuse and ADHD. Recently, music therapy has been extensively studied as part of the holistic management of ADHD.¹   

Types of interventions used in music therapy for ADHD

Music therapists use various therapeutic techniques, specifically personalised and tailored to the needs, preferences and challenges of each patient.² 

Throughout a session, music therapists may use active or passive interventions. During an active session, patients will actively participate in making music by either singing or playing an instrument, writing songs or moving to the music. During a passive session, patients will listen to music played by their therapist or a recording. They can also spend time discussing music and expressing their thoughts and feelings.²

Music therapy sessions can take place in various settings including hospitals, outpatient clinics, and schools, where therapists may lead one-on-one or group sessions. 

Benefits of music therapy for ADHD

Music therapy helps in reducing a wide array of ADHD symptoms including but not limited to, agitation, concentration, impulsive behaviour and decision-making, aggressiveness, disruptive behaviours, social and academic skills.^1,2 

In addition to reducing the main symptoms of ADHD, music therapy also helps control its coexisting conditions including depression, learning disorders and oppositional defiant disorder.¹⁶

Cognitive benefits

Songs, rhythms and beats provide structure, something that is lacking and highly needed in ADHD. Music elements (tempo, rhythm, beat) used during sessions help activate and promote attention and focus. Individualised interventions can improve occupational and academic performances such as reading and language skills, ^1,2 

Emotional benefits

The power of music within a session facilitates emotional regulation, reduces stress and improves the overall mood. Whether through improvisation or a structured session, music positively impacts the mood.⁶

Social benefits

Individuals with ADHD may struggle socially. Group sessions are particularly beneficial for ADHD as it fosters communication, collaboration and social skills. During a group session, therapists may follow collaborative musical activities, building teamwork, cooperation and teaching turn-taking which could be particularly challenging for some children with ADHD. By encouraging autonomy and promoting creativity, such sessions can teach children how to properly interact in a social setting.¹

Research and evidence supporting the efficacy of music therapy for ADHD

Multiple studies highlighted the positive effects of music therapy on individuals with ADHD.

One such review analysed the results of 17 studies assessing the improvements in ADHD symptoms following active and passive music therapy sessions. Results are summarised in the table below according to the type of intervention:²

In another study conducted in Korea on 60 children and adolescents with ADHD, music therapy sessions conducted twice a week over three months showed an increase in serotonin levels (a chemical that plays a role in anxiety and depression) and a consequent reduction in stress and depression. Passive music sessions promoted relaxation and helped improve emotional control and regulation. Whereas active music participation by improvisation improved the participants’ ability to cope with stress.⁶

Finally, in a survey gathered from 98 music therapists working with individuals with ADHD, results highlighted the effectiveness of music therapy in improving ADHD symptoms. Therapists perceived the sessions to be especially beneficial when combined with other ADHD treatments including medications, and behavioural and psychological therapies.^6,7

FAQs

What is the difference between music therapy and music entertainment?

Music therapy is a clinical field, led by a licensed therapist who uses music interventions to achieve specific therapeutic goals related to ADHD (reduce anxiety, depression, agitation, improve focus and emotional control). Whereas music entertainment such as concerts, performances, casual listening or music lessons, serves the purpose of leisure and pure enjoyment. 

What if I do not have previous music training?

Anyone can benefit from music therapy. There is no need for the patient to have musical abilities or previous music training. The sessions are individualised based on your treatment plan, needs and preferences.  

How many sessions are needed and at what frequency?

The duration of a session, the frequency and the total number of sessions are variable and tailored to the needs of each patient. They also depend on the therapeutic goals planned to achieve.  

How to integrate music therapy into traditional ADHD treatment protocols?

Even though a few studies highlighted the benefits of music therapy as the only treatment for ADHD, the growing body of literature stresses the greater benefits when music therapy is personalised and combined with conventional ADHD treatments (medications, behavioural, and psychological therapies).^6,7 For example, a child with ADHD who needs to work on their social skills might benefit from weekly group sessions whereas a child struggling with focus and attention may benefit more from intensive individual sessions instead.

Summary

ADHD is a chronic condition that affects many aspects of someone’s life. Music therapy is an evidence-based, personalised and dynamic tool, that complements conventional ADHD treatments. The activities conducted during a session vary depending on the needs of each patient and the goals to be achieved. Sessions, whether active or passive, one-on-one or in a group, are specifically designed and planned accordingly by a trained and certified specialist. 

By addressing the challenges faced by individuals with ADHD, music therapy becomes a valuable technique that can successfully attenuate the core symptoms (agitation, attention, impulsivity) of this disorder, and its coexisting conditions (anxiety, depression) and provide cognitive, emotional and social benefits.