One of the most exciting questions in music therapy research is also one of the most practical: Is it the music itself that creates change, or does the way we use music with another person make the difference?
A 2020 randomized controlled trial by Rabeyron and colleagues offers an important contribution to this conversation. The researchers compared 25 sessions of therapist-led music therapy with music listening over an eight-month period for children between 4 and 7 years old with autism spectrum disorder (ASD). In total, 37 children took part in the study.
The results were encouraging. Children who participated in music therapy showed greater overall clinical improvement than children in the music-listening condition as measured by the Clinical Global Impression scale. However, children in both groups showed improvements.There were no other areas of difference between the two groups.
Music therapy is more than listening to music
What I find interesting about this study is the inclusion of two types of music engagement. Both groups had access to music, but the experiences were not the same. The music therapy intervention involved a trained therapist using musical experiences that were interactive. Rather than simply hearing music, the children engaged in a process shaped by the therapist and the developing relationship between therapist and child.
In the comparison condition, children listened to music without the same therapist-mediated and psychotherapeutic interaction. This distinction is central to the study. The findings suggest that simply being exposed to music may not provide the same benefits as participating in a responsive therapeutic relationship that uses music intentionally.
Why this matters for music therapy research
This study is exciting because it moves beyond asking whether music therapy is helpful. It begins to sk if it’s simply the presence of music or if the way we engage with music matters.
For many music therapists, the answer has always involved the relationship. The music is important, but so are the therapist’s responsiveness, timing, flexibility, and ability to create a shared experience with the child. A song, rhythm, or musical pattern can facilitate engagement, but the therapeutic relationship is often what helps the child meet the outcomes.
The study does not prove that the relationship alone caused the improvement, and it does not tell us which specific music therapy techniques were most important. However, the comparison between music therapy and music listening is something we should be considering within the field.
A promising finding with important limits
As with any study, these results need to be interpreted thoughtfully. The sample was relatively small, and the participants were recruited from a limited number of psychiatric facilities. The study also compared two different kinds of music experiences, so factors such as therapist attention, active participation, and the therapeutic relationship may all have contributed to the differences between groups.
More research is needed with larger and more diverse samples, clearer descriptions of the music therapy process, and studies that examine exactly how therapist-child interaction contributes to change. Future research might also investigate which children benefit most, which specific musical and relational processes are involved, and whether improvements continue after therapy ends.
Even with these limitations, Rabeyron and colleagues provide a valuable reminder: music therapy is not simply music delivered to a client. It is music experienced in relationship.
Reference
Rabeyron, T., Robledo Del Canto, J. P., Carasco, E., Bisson, V., Bodeau, N., Vrait, F. X., Berna, F., & Bonnot, O. (2020). A randomized controlled trial of 25 sessions comparing music therapy and music listening for children with autism spectrum disorder. Psychiatry Research, 293, 113377. https://doi.org/10.1016/j.psychres.2020.113377