|
DRAFT COPY
CONFIDENTIAL
The Brain and the Power of Communal Singing
A compendium of papers regarding the practice of communal song to promote physical and psychological health
by George D. Hanus
Copyright Information
This compendium consists of summaries of studies from open access and closed–subscription journals and links to the articles. Full citations for each article can be found in the references. The editors extend gratitude to all the authors, journals, and publishers who helped make this project possible.
THE BRAIN AND THE POWER OF COMMUNAL SINGING.
Copyright © 2017.
Edited by George D. Hanus.
All rights reserved.
Printed in the United States of America.
Gravitas International Group
200 W. Madison
Chicago, Illinois 60606
ISBN 978-0-9722913-1-6 (hardcover)
ISBN 978-0-9722913-0-9 (e-book)
Table of Contents
Introduction………………………………………………………………………………………………………………………. [LINK]
An Open Letter to the Healthcare Community…………………………………………………………………… [LINK]
Communal Singing: A Closer Listen………………………………………………………………………………… [LINK]
Effects of Individual Singing and Listening……………………………………………………………………… [LINK]
The Individual Experience…………………………………………………………………………………………….. [LINK]
Part I: Physiological Effects of Group Singing……………………………………………………………………….. [LINK]
Respiration…………………………………………………………………………………………………………………. [LINK]
Dementia…………………………………………………………………………………………………………………….. [LINK]
Vascular and Neurological Conditions…………………………………………………………………………….. [LINK]
Stress, Fatigue, and Pain Tolerance………………………………………………………………………………… [LINK]
Part II: Psychological Effects of Group Singing……………………………………………………………………… [LINK]
Mental Disorders…………………………………………………………………………………………………………. [LINK]
Social Connectedness and Community Coping………………………………………………………………….. [LINK]
Learning……………………………………………………………………………………………………………………… [LINK]
Well–Being and Quality of Life………………………………………………………………………………………… [LINK]
Aging………………………………………………………………………………………………………………………….. [LINK]
Conclusion…………………………………………………………………………………………………………………………. [LINK]
References…………………………………………………………………………………………………………………………. [LINK]
Introduction
Whether you have a great voice or are not quite ready for an audience beyond your shower walls, there is one compelling reason to overcome your inhibitions: Singing with others is good for your health. Each year, billions of dollars are spent to address countless physical and psychological conditions that could be improved, literally, for a song. The pleasant feelings and connectedness experienced when singing with others make the potential tangible health benefits of group singing a logical next step.
This compendium strives to achieve three goals: to discover and gain a thorough understanding of the current scientific literature on group singing, to learn about possible future directions for implementation and impact, and to share the many therapeutic applications found in the body of research. For this project, group or communal singing is defined as any activity in which two or more people sing or perform vocal exercises together, whether in a professional, avocational, informal, or therapeutic setting, including a cappella groups, choirs, garage bands music therapy, and other hobbyist and performer groups.
In this compendium, which will be available free online for educational purposes, there are studies from various scholarly, peer-reviewed journals, containing research conducted by academics, physicians, and therapists all over the world. Each discusses the topic of communal singing as it relates to multiple aspects and measures of physiological and psychological well–being. This literature serves as a resource and inspiring call to action—for scientists, healthcare professionals, and healthcare consumers alike—to revolutionize healthcare, one note at a time. A global conversation and forum for researchers and practitioners to build on each other’s work will promote the use and expansion of communal singing as a viable and successful treatment toward bettering community health.
An Open Letter to the Healthcare Community
Any healthcare provider knows that the idea of an actual panacea is mythical. No single medicine or method can solve all ills of all patients. However, scientific studies over the last several decades have demonstrated the surprising efficacy and range of therapeutic effects of one particular activity that has been a part of ritual and amusement throughout the annals of history—communal singing. These explorations have unveiled improvements in myriad conditions, at all ages, and across multiple cultures.
However, conferences and seminars focusing on the therapeutic applications of singing are rare, and few if any publications have amalgamated or reviewed the various studies specifically on communal singing and its benefits for physical and emotional health. This compendium presents 96 studies conducted by social scientists, medical doctors, therapists, and other experts in the US, the UK, and around the world. The articles demonstrate quantifiable physiological, psychological, social, and emotional health benefits, spanning from stress reduction to improved lung function.
In a field that is too often dismissed as feel–good, these studies provide solid proof derived from empirical science. Some studies measured neuro–hormonal or immuno–genetic effects through biological data, such as TNF–alpha concentrations, secretory immunoglobulin A, prolactin, cortisol, oxytocin, and blood-oxygen levels. Others measure psychological wellness through the Visual Analog Scale, Total Mood Disturbance scores, and Profile of Mood States. Still others draw from qualitative self–reports, interviews, or video observation. These studies account for age, gender, socioeconomic status, and degree of musical involvement, from absolute amateurs to polished professionals. There are comparisons between the effects of passive listening and active singing, and between the dynamics of spoken conversations and shared lyrics.
Results show promise for improving quality of life for individuals with a wide array of conditions, including Parkinson’s, Alzheimer’s, aphasia, dysarthria, autism, Rett Syndrome, COPD, Cystic Fibrosis, and cancer. Communal singing is a tool with the potential to shift the paradigm of healthcare from an exclusive focus on expensive drugs and procedures, which are imposed on the human body and mind, to a strength and need that humans possess innately. Singing with a single partner or group is a therapy that can be procured free of charge or with relatively low staffing and equipment costs. No prescriptions. No negative side effects. No dangerous interactions with other courses of treatment. So why has the medical community not adopted communal singing as a primary rehabilitative and restorative protocol?
For years, despite dozens of studies to the contrary, the act of communal singing has been summarily dismissed as fuzzy science or relegated to ancillary and social service providers. Unfortunately, the reason there are no large medical summits on communal singing for researchers to gather data and compare notes, present their findings to one another, and enlighten practitioners is likely because there is no money in it. No one will make a fortune fighting the powerful pharmaceutical industry, complex insurance reimbursement policies, and rigid medical school curricula, but it is worth the fight. With an aging population, burgeoning mental health needs, urban isolation, and endangered Social Security and Medicare systems, people cannot afford to ignore affordable avenues to well–being.
Please share this compendium with anyone in any field who may benefit from its ideas. Collecting these studies and publishing them together may stimulate the discovery of more uses and benefits of group singing and, more importantly, catalyze their implementation across the healthcare spectrum. If patients’ well–being can be improved through inexpensive means, more individuals may be able to maintain better overall health. This is only the beginning.
Communal Singing: A Closer Listen
Music and Singing
Before seeing evidence regarding group singing, consider its building blocks. First, there is music itself, which many have called the language of the soul. This adage resonates with truth, yet it is only a small fragment of the full picture. Music speaks not only to the soul, but also to the mind and the body. Since the emergence of civilization, across all boundaries of time and geography, and through every known society and culture, humans have been hardwired for hearing and producing music. Yes, some humans have a greater talent for producing melodic sounds, but all humans benefit from trying, even if they are off–key.
Research has shown that even listening passively can improve performance on cognitive activities, enhance pain tolerance, and elevate well-being (Schellenberg, 2005; Mitchell, MacDonald, Knussen, & Serpell, 2007; Schafer, Sedlmeier, Stadtler, & Huron, 2013). Music soothes individuals from their cradles to their deathbeds. Frustration and sadness lift when music fills the air. Stress and pain fade, which experts suggest is a result of music requiring certain mental and physical activities (Mitchell, MacDonald, Knussen, & Serpell, 2007).
Next, it has been shown that the simple act of singing—anywhere, anytime—has great benefits as well. Singing contributes to the mental and physical condition of the elderly (Sakano et al., 2014), improves one’s ability to learn a foreign language (Ludke, Ferreira, & Overy, 2014), and ameliorates symptoms of diseases such as cystic fibrosis (Irons, Kenny, McElrea, & Chang, 2012)—to name just a few. It is even viewed as an exceptional form of aerobic and upper–body exercise (Sun & Buys, 2013).
Why Sing with Others?
Finally, consider the ingredient of togetherness—a sense of connection and community. Abraham Maslow’s hierarchy of needs shows that belonging is one of the most fundamental human needs (Taormina & Gao, 2013). Other social scientists agree that being a part of a group is as necessary to health as sustenance or sleep (Baumeister & Leary, 1995). Communal singing is one way of creating a sense of acceptance. This togetherness, combined with the powers of listening and singing, elevates the positive feelings that come from music.
Academicians, physicians, and therapists all over the world have taken note of the growing popularity of communal singing. Over 42 million people are estimated to belong in choruses in the United States alone. Experts have studied the effects of communal singing for decades, and it is clear that while singing alone can have health benefits, the community aspect is integral to overall well–being. Communal singing is a salve with extraordinary healing power; a song as well-known as “The Star-Spangled Banner” reverberates comfort to survivors of horrific tragedies. It can also serve as a tool for fostering community, in the case of an anthem or alma mater.
Communal singing can occur anywhere, with very little personnel or training required. Having a knowledgeable choir leader may be ideal, and competitions add enjoyment for some; still, the basic activity can be accomplished wherever there are two or more willing individuals. They may or may not share similar ailments, ages, or backgrounds. The fact that the studies presented here come from across the globe demonstrates the universality of communal singing’s positive effects, which are rooted in human physiological and psychological makeups.
When Did It Start?
The exact origin of music cannot be accurately determined, so long has it been a part of human culture. Archeologists have uncovered primitive instruments dating as far back as 7000 BCE, and it is likely that singing actually predates not just these, but spoken language itself (Wilkinson, 2015). The oldest musical notation archaeologists have found comes from Sumer, dating back to the 14th century BCE (Kolyada, 2009). Another surviving written melody was the Hurricane Hymn, discovered in Ugarit, Canaan, or modern–day Syria (2009).
Ancient liturgy from a plethora of religions contains communal chants as well. The Old Testament documents some of the oldest known examples of communal singing. When the enslaved Israelites were escaping from Egypt, the Song of the Sea transformed them from frightened and powerless slaves into the free and brave Nation of Israel. This song has been sung as part of Jewish prayer services every morning for the past 2,000 years. In fact, some scholars consider the entire Old Testament a song, and like many old songs, hearing or singing it conjures up shared memories and context that foster a sense of community. From religious chants to the national anthem, singing together continues to help commemorate events and feelings in modern times.
What Is Stopping Us?
Singing is a natural urge, and it is unmistakably beneficial when done in a group. Friends often belt out favorite familiar tunes heard on the radio. Fans in packed stadiums feel elated after singing in the seventh–inning stretch. Preschoolers’ days are punctuated—even narrated—by song, but as people grow, many are hesitant to sing in public. Perhaps they lack confidence in the face of incessant auto–tuned celebrity recordings and televised competitions, where singing is framed as a talent rather than a human tool as powerful as the spoken word. Another possibility is that communal singing has become stigmatized and has slipped from the ranks of socially acceptable activities.
Given its research–backed rehabilitative power, communal singing is a tool that you might expect to be employed across the healthcare arena—in hospitals, long–term care facilities, and rehabilitation centers—but it is not. Maybe the problem is that those who would implement such a program have little power to introduce new practices, and those with the power have less interest in or understanding of singing as a potential treatment.
Singing is not a government–reimbursable activity. It is not sanctioned by the FDA, and the pharmaceutical industry will not lobby for it. However, funding for healthcare is a source of personal struggle and political strife. Should providers not be trying out any innovative, inexpensive, low–tech, low–cost methods that can be found for improving physical and mental health? The rewards of communal singing are so widespread; it is time to actively promote the practice. What about “prescribing” communal singing in healthcare?
What If…
An older gentleman is suffering with shingles. The pain is constant and virtually unbearable. His doctor prescribes strong painkillers, which provide some relief, but the man has trouble with the consequent impairment, not to mention the side effects. What if, instead, he spent some time learning a song with his family and singing it together after dinner, or joined an amateur choral group? If there is a possibility of the pain abating enough to reduce his intake of prescription drugs, the relief could be truly profound.
A couple visits a relationship counselor after months of fighting. The counselor assigns exercises and coaching for their interactions, but what if, in addition, the couple is instructed to sing the songs that were popular when they first met? They might be transported back, past the anger, resentment, and idiosyncrasies that now annoy them, to a time when they were drawn together. Rather than starting by rehashing the negatives, counseling could begin by reigniting the original connection. With the spark relit, or at least acknowledged, the kindling toward overcoming problems has been ignited with empathy and a growing sense of togetherness and calm.
A child with cystic fibrosis is hospitalized. What if, rather than being left in her hospital bed, becoming increasingly isolated, angry, and depressed, she is brought to a group activity in the children’s ward, in which she and fellow patients sing popular music. She has an opportunity not only to socialize, but also to exercise her lungs, regulating intake and exhalation of breath. For a half hour, she can stop thinking about her illness and focus on the excitement of a favorite song and the company of others.
Next Steps
Although most books work toward a conclusion, this compendium is intended to open a discussion and promote the flourishing of an incredible alternative treatment option. These early studies show that this multidisciplinary endeavor deserves attention, as communal singing holds the promise of improving lives and even enhancing longevity. The editors envision a symposia dedicated to this endeavor, in which experts present their findings and others learn about the potential use of communal singing in their own fields.
Communal singing is organic to human nature, and it is a partial remedy for many physical and psychological ailments. Whether you work or partake in healthcare, it is time to have more discussions about the potential benefits of singing with others. By sharing research findings, direct experiences, and derived benefits with other patients and professionals, this practice can begin reaching its potential across various applications. Only with proactive efforts will the medical community at large be able to recognize the value of communal singing as an economical and effective tool that could ultimately promote the wellbeing of millions.
Effects of Individual Singing and Listening
Although this compendium was created to support and further the use of communal singing, it is important to note that decades of research have shown not only the importance of a sense of community, but also the beneficial effects of singing on physical and emotional health. Singing involves “sustaining vocal sound [which] activates the parasympathetic nervous system,” resulting in increased feelings of relaxation (J. Rook, personal communication). Certain studies, such as that by Stewart and Lonsdale in 2016, have even studied the difference between group singing, solo singing, and other group therapies to ascertain whether it is the singing, or the group activity, that is the source of observed benefits. When it comes to health, an unfortunate truth is that group singing may not always be feasible. In the case of individuals with infectious diseases or other factors preventing safe group therapy settings, it is important to note that individual singing has been found to have immense benefits as well.
Some of the studies in the following section have served as the bases for further study in group singing, while others simply illustrate the benefits of individual singing therapy for individuals who are unable to participate in group therapy. They span multiple areas of health, including patients with neurological disorders, neural plasticity, cancer, and developmental disorders. Developmental disorders in particular are a promising area for growth in music therapy. Most parents enroll children in individual therapy, but the success of singing in this setting lays the groundwork for group therapy as well.
The Individual Experience
Studies Summarized
Chapin, H., Jantzen, K., Scott Kelso, J. A., Steinberg, F., & Large, E. (2010). “Dynamic emotional and neural responses to music depend on performance expression and listener experience.”
Grape, C., Sandgren, M., Hansson, L. O., Ericson, M., & Theorell, T. (2002). “Does singing promote well–being? An empirical study of professional and amateur singers during a singing lesson.”
Groß, W., Linden, U., & Ostermann, T. (2010). “Effects of music therapy in the treatment of children with delayed speech development—results of a pilot study.”
Sakano, K., Ryo, K., Tamaki, Y., Nakayama, R., Hasaka, A., Takahashi, A., … Saito, I. (2014). “Possible benefits of singing to the mental and physical condition of the elderly.”
Schlaug, G., Marchina, S., & Norton, A. (2008). “From singing to speaking: Why singing may lead to recovery of expressive language function in patients with Broca’s aphasia.”
Tamplin, J. (2008). “A pilot study into the effect of vocal exercises and singing on dysarthric speech.”
Wan, C.Y., Bazen, L., Baars, R., Libenson, A., Zipse, L., Zuk, J., … Schlaug, G. (2011). “Auditory–motor mapping training as an intervention to facilitate speech output in non–verbal children with autism: A proof of concept study.”
Yasuhara, A., & Sugiyama, Y. (2001). “Music therapy for children with Rett syndrome.”
Zarate, J. M., Delhommeau, K., Wood, S., & Zatorre, R. J. (2010). “Vocal accuracy and neural plasticity following micromelody–discrimination training.”
“Dynamic Emotional and Neural Responses to Music
Depend on Performance Expression and Listener Experience”
In 2010, Chapin, Jantzen, Scott Kelso, Steinberg, and Large published this study comparing brain activity of people listening to music played expressively, with variations in timing and intensity, versus mechanically. Participants listened while undergoing an fMRI so that researchers could assess their emotional responses. Researchers found that in those listening to expressively played music, changes in blood flow varied significantly in brain regions associated with emotion and reward, an effect which was magnified by participants’ self–reported music experience. These findings led the researchers to conclude that evocative music produces stronger emotional responses in areas of the brain associated with movement and expectation, which has strong implications for the use of music in a therapeutic setting.
View the article here.
“Does Singing Promote Well-Being? An Empirical Study
of Professional and Amateur Singers during a Singing Lesson”
Grape, Sandgren, Hansson, Ericson, and Theorell (2002) examined how singing experience influenced the effect of singing on well–being. Multiple physiological and emotion measurements were taken before and after singing lessons in addition to interviews. Sixteen singers, half amateur and half professional, participated in the study. The results showed that professional singers were in better cardio–physiological shape, and they also had higher concentrations of TNF–alpha, which decreased in the amateurs. There were also differences by gender, as men had higher prolactin and cortisol concentrations after the lesson while women’s concentrations lowered. Both groups had increases in oxytocin and feelings of energy and relaxation, but only the amateur group reported increases on happiness measures. The interviews showed that the groups had different goals, with professionals focusing on technique and skill while amateurs focused on expressing themselves. Ultimately, the amateurs experienced increases in well-being while professionals experienced increases in arousal.
View the article here.
“Effects of Music Therapy in the Treatment of Children
with Delayed Speech Development—Results of a Pilot Study”
Groß, Linden, and Ostermann (2010) investigated effects of music therapy on the speaking abilities of children exhibiting speech development delays. Eighteen children were divided into a no–treatment control group and an experimental group, which received individual music therapy for eight weeks. The music therapy participants experienced improvement in the ability to form and understand words in addition to a few other intelligence, action, and cognitive measures, ultimately leading to the children’s developmental age approaching their actual ages. The children also improved in their communication and relationship with their therapists.
View the article here.
“Possible Benefits of Singing to the Mental
and Physical Condition of the Elderly”
In 2014, Sakano, Ryo, Tamaki, Nakayama, Hasaka, Takahashi, Ebihara, Tozuka, and Saito published this study investigating the effects of singing on a few aspects of physical and mental health, especially for pneumonia and the elderly. All 44 subjects were at least 60 years old and submitted to several oral condition tests and answered questionnaires prior to and following a four–minute or less individual singing session in doctors’ offices. The researchers found that levels of cortisol and secretory immunoglobulin A were significantly reduced after singing, indicating reduced stress and level of immune system alert. Participants also scored higher on evaluations that indicate positive mood and outlook, even those who claimed not to enjoy singing. These findings support the use of singing to improve health.
View the article here.
“From Singing to Speaking: Why Singing May Lead to Recovery of Expressive Language Function in Patients with Broca’s Aphasia”
Schlaug, Marchina, and Norton set out to test the potential effects of Melodic Intonation Therapy (MIT) on patients suffering from aphasia following a stroke (2008). Of the two participants, one was given 40 hour and a half sessions of MIT; the other received the same amount of non–musical therapy. Their speaking abilities were rated before and after the sessions, and they were also given fMRI scans while attempting to sing and speak. Both patients benefited from significant improvements, but the first patient’s improvements were greater than the patient who did not receive music therapy.
View the article here.
“A Pilot Study into the Effect of Vocal Exercises
and Singing on Dysarthric Speech”
In 2008, Tamplin published a study of music therapy on several aspects of speech in patients who experience dysarthria after experiencing a stroke or other brain injury. “Intelligibility, rate, naturalness, and pause time” of speech was assessed before, during, and after 24 music therapy sessions that took place over the course of two months (2008). The results of several speech assessments showed significant gains in intelligibility, naturalness, and pause number and length. Speech rates also improved, but not significantly. This study provided one of the foundations for Tamplin’s further research in group singing.
View the article here.
“Auditory–Motor Mapping Training as an Intervention
to Facilitate Speech Output in Non-Verbal Children
with Autism: A Proof of Concept Study”
In 2011, Wan et al. published an efficacy study to provide further proof of the success of Auditory–Motor Mapping Training (AMMT) in children with autism. This treatment combines singing, drumming, and speech instruction. Six nonverbal autistic children who had already engaged in other speech therapies for two years participated in AMMT sessions five times per week for eight weeks. Each child improved significantly and, by the end of therapy, could produce words with some reliability, even words that had not been practiced during sessions. The researchers posit that the integration of motor activities and tonal modulation engages a bilateral neural network that connects otherwise inaccessible language regions with motor functions.
View the article here.
“Music Therapy for Children with Rett Syndrome”
Yasuhara, and Sugiyama conducted this study, published in 2001, to investigate individual music therapy as an intervention for young children with Rett syndrome, which impairs motor function. The researchers found improvements in grasping as well as multiple music-related measures.
View the article here.
“Vocal Accuracy and Neural Plasticity
Following Micromelody–Discrimination Training”
Zarate, Delhommeau, Wood, and Zatorre investigated whether non–musicians would improve the accuracy of their singing after being trained on distinguishing small differences in pitch and melody (2010). Participants were all non–musicians and were split into an experimental group, which received training and brain scans while performing tasks, and a control group with no training. While there were significant improvements in auditory discrimination following training, there was no distinct improvement in vocal accuracy, which indicates that “auditory perception and vocal production” are not directly linked. The results of this study support the idea that singing has more of an impact on neural plasticity than simply listening.
View the article here.
The Physiological Effects of Group Singing
The idea that communal singing is good for your health is practically common sense. Recall the sense of security that suffused your consciousness when singing during a friendly gathering, whether it was an actual choir, religious service, or even a birthday party or sporting event. The part that you didn’t notice—indeed, couldn’t notice—is the effect this experience had on your lungs, hearts, and brains, with ripple effects that work like a tonic for all kinds of ailments.
Communal singing has improved the quality of life of children with cancer and seniors with heart disease (Gale, Enright, Reagon, Lewis, & van Deursen, 2012; Skingley, Martin, & Clift, 2015). When singing together, people match breath with those around them (Vickhoff et al., 2013). It leads to the release of endorphins, naturally produced opiates that soothe the synapses of frayed nerves, and oxytocin, which enhances feelings of trust and bonding, while lowering levels of cortisol, indicating decreased stress (Grape, Sandgren, Hansson, Ericson, & Theorell, 2002).
Given the wide variety of potential effects, the literature is organized into four overall categories, summarizing the open access abstracts of each. The first is respiration, where researchers focus on how the strong control of breath required for singing can improve pulmonary function and other issues. Second, studies regarding the effect of dementia are presented. One of the most common afflictions affecting elderly populations, dementia is associated with a low quality of life that communal singing has been shown to mitigate.
The next category is vascular and neurological conditions, which affect speech and movement. Studies have found that communal singing can provide an effective rehabilitative outlet for these kinds of disorders, fostering group engagement, self–expression, and social engagement. The last section is devoted to singing’s ability to improve day–to–day health, including stress, illness, and fatigue.
Together, these studies provide overwhelming evidence of group singing’s efficacy across multiple aspects of health. When the physical components of singing are considered, such as articulation, measured breath, and posture, patterns of improvement arise in connection with speech pathology, cardiovascular conditions, and blood flow. While singing alone may not reliably prevent or heal an infection, there is a definitive domino effect linking communal singing to lifting spirits, which have in turn been shown to improve immune system functioning (Kreutz et al., 2003). Singing can even directly alter chemical secretions that are associated with more robust immune system health, leading to health benefits that extend far beyond the simple pleasure of singing (Beck, Cesario, Yousefi, & Enamoto, 2000).
One of the strongest benefits of researching the effects of communal singing on health is that, infectious diseases aside, there are virtually no risks posed to patients who participate. The ramifications for post–surgical recovery, lung and cardiovascular function, and countless other medical issues could be as positive as they are far–reaching. The following compilation of research not only points directly to areas that would benefit from further investigation, but it also details multiple current health benefits and therapeutic possibilities.
Respiration
Studies Summarized
Bonilha, A. G., Onofre, F., Vieira, M. L., Prado, M. Y. A., & Martinez, J. A. B. (2009). “Effects of singing classes on pulmonary function and quality of life of COPD patients.”
Clift, S., Morrison, I., Skingley, A., Page, A., Coulton, S., Treadwell, P., … Shipton, M. (2013). “An evaluation of community singing for people with COPD.”
Gale, N. S., Enright, S., Reagon, C., Lewis, I., & van Deursen, R. (2012). “A pilot investigation of quality of life and lung function following choral singing in cancer survivors and their carers.”
Irons, J. Y., Kenny, D. T., McElrea, M., & Chang, A. (2012). “Singing therapy for young people with cystic fibrosis: A randomized controlled pilot study.”
Lord, V., Cave, P., Hume, V. J., Flude, E. J., Evans, A., Kelly, J. L., … Hopkinson, N. S. (2010). “Singing teaching as a therapy for chronic respiratory disease—a randomised controlled trial and qualitative evaluation.”
Lord, V., Hume, V. J., Kelly, J. L., Cave, P., Silver, J., Waldman, M., … Hopkinson, N. S. (2012). “Singing classes for chronic obstructive pulmonary disease: A randomized controlled trial.”
Morrison, I., Clift, S., Page, S., Salisbury, I., Shipton, M., Skingley, A., … Treadwell, P. (2013). “A UK feasibility study on the value of singing for people with chronic obstructive pulmonary disease (COPD).”
Müller V., & Lindenberger, U. (2011). “Cardiac and respiratory patterns synchronize between persons during choir singing.”
Pai, I., Lo, S., Wolf, D., & Kajieker, A. (2008). “The effect of singing on snoring and daytime somnolence.”
Skingley, A., Page, S., Clift, S., Morrison, I., Coulton, S., Treadwell, P., … Shipton, M. (2013). “ ‘Singing for Breathing’: Participant’s perceptions of a group singing programme for people with COPD.”
Tamplin, J., Baker, F. A., Grocke, D., Brazzale, D. J., Pretto, J. J., Ruehland, W. R., … Berlowitz, D. J. (2013). “Effect of singing on respiratory function, voice, and mood after quadriplegia: A randomized controlled trial.”
Vickhoff, B., Malgren, H., Åström, R., Nyberg, G., Ekström, S. R., Engwall, M., … Jörnsten, R. (2013). “Music structure determines heart rate variability of singers.”
“Effects of Singing Classes on Pulmonary Function
and Quality of Life of COPD Patients”
Bonilha, Onofre, Vieira, Prado, and Martinez measured changes in breathing quality and capacities in people with COPD to determine the effects of weekly singing classes (2009). One group of patients was given singing lessons for 24 weeks, which included breathing exercise warm–ups and Brazilian folk songs, and a control group was given lessons in handicrafts. The researchers found that immediately following a singing class, participants felt that breathing was a little more difficult, which researchers ascribed to the effort involved in singing. Over time, however, the singing group showed an improvement in maximal expiratory pressure, which is a measure of how hard a person can exhale. Over the same period, the control group dropped in this measurement, indicating that singing can help maintain and improve some aspects of breathing long term.
View the article here.
“An Evaluation of Community Singing for People with COPD”
Clift, Morrison, Skingley, Page, Coulton, Treadwell, Vella-Burrows, Salisbury, and Shipton conducted this study to evaluate the workability of weekly community singing for COPD patients and its effects on lung function, functional capacity, breathlessness, and quality of life (2013). The study was observational and uncontrolled, with researchers monitoring a weekly singing group from September 2011 to June 2012. At the beginning, middle, and end of the study, participants filled out the St. Georges Respiratory Questionnaire (SGRQ), MRC breathlessness scale, EQ-5D, and York SF-12. At the start and completion of the study, participants also had spirometry to determine a baseline lung function, which was compared to the same at the end of the study. Written feedback was qualitatively assessed for central themes, which revealed that the singing groups were seen as fun opportunities to socialize. Participants also felt that their breathing, level of activity, and overall well–being improved. Improvements were also observed in the SGRQ, FEVI, FVC, and FVC percentages. These results were highly encouraging as COPD patient health normally declines over the same period observed in the study. The researchers hope to use these results as a foundation for a controlled study in the future.
View the article here.
“A Pilot Investigation of Quality of Life and Lung Function
Following Choral Singing in Cancer Survivors and Their Carers”
Gale, Enright, Reagon, Lewis, and van Deursen (2012) worked with a group of cancer survivors and their caregivers participating in “Sing for Life,” a therapeutic choir. About 30 middle–aged subjects (40 to 70 years of age) sang in a structured setting for about 2 hours a week over 3 months. The participants were given breathing assessments and questionnaires measuring quality of life and other aspects of mental health. Participants showed statistically significant improvements in quality of life, from reduced anxiety and better mood to social functioning, vitality, and ameliorated physical pain. Although overall lung function was unaffected by the choir participation, researchers noted a trend toward increased maximal expiratory pressure, a measure of how hard a person can exhale. In patient interviews, subjects noted improvements in overall mental health, self–esteem, and outlook on the future. The researchers cite the value of engagement in a pleasurable activity with individuals sharing the same disease or life experience, which creates a sense of community and purpose, noting that it may be applicable to other chronic conditions.
View the article here.
“Singing Therapy for Young People With Cystic
Fibrosis: A Randomized Controlled Pilot Study”
Published in 2012, this study by Irons, Kenny, McElrea, and Chang investigated the effects of singing therapy on youths with cystic fibrosis. Fifty–one participants (average age 11.6 years) were divided into a singing group and a recreational group, each lasting eight sessions. Respiratory muscle strength and quality of life were measured before and after the intervention. While both groups showed improvements on the quality of life measure, only the singing group had statistically significant improvements in respiratory strength, supporting the use of singing as therapy for children with cystic fibrosis.
View the article here.
“Singing Teaching as a Therapy for Chronic Respiratory Disease—a Randomised Controlled Trial and Qualitative Evaluation”
A precursor to their 2012 study, Lord, Cave, Hume, Flude, Evans, Kelly, Polkey, and Hopkinson investigated supplementary interventions in 2010. The researchers ran a controlled experiment using singing, which they noted requires control of breathing and posture, aspects that could be beneficial to those suffering from COPD. The researchers studied 28 patients, 13 of whom received normal care, while 15 attended twice–weekly singing classes over a period of six weeks. A qualitative analysis was done based on interviews, and a quantitative analysis was done based on surveys completed by those attending singing classes. Patients who attended singing classes reported significantly higher physical component scores and significantly lower anxiety scores than the control group. While there was no demonstrated effect on breath counting or hold time, participants in the singing group did report improvements in physical sensation, well–being, social support, and feelings of achievement in their interviews. The researchers concluded that singing classes had overwhelmingly positive results with no drawbacks.
View the article here.
“Singing Classes for Chronic Obstructive Pulmonary
Disease: A Randomized Controlled Trial”
Lord, Hume, Kelly, Cave, Silver, Waldman, White, Smith, Tanner, Sanchez, Man, Polkey, and Hopkinson conducted this study, published in 2012, as a follow–up to their 2010 study to see if twice–weekly singing classes could improve shortness of breath. What distinguishes this follow–up from the prior study is the active control group: non–singers were assigned to a film club group that watched one movie per week. Patients answered health surveys, were interviewed about their experiences, were given breathing tests, and had their physical activity monitored using a sensor. Participants in both groups enjoyed the activities and reported improvements in mental health, but those in the singing group reported statistically significant improvements in their physical well–being. The sample size was quite small, but the evidence showed distinct benefits of group singing over group film viewing.
View the article here.
“A UK Feasibility Study on the Value of Singing
for People with Chronic Obstructive Pulmonary Disease (COPD)”
Published in 2013, this study by Morrison, Clift, Page, Salisbury, Shipton, Skingley, Vella–Burrows, Coulton, and Treadwell used the same research done in the previous article listed, with additional attention paid to the applicability of prior findings to the healthcare system in the UK.
View the article here.
“Cardiac and Respiratory Patterns Synchronize
between Persons during Choir Singing”
In 2011, Müller and Lindenberger published the results of their study, which analyzed the degree to which singers in a choir are synchronized on a physiological level—in particular, their breathing and heartbeats. This study was conducted to address the lack of research in between–subject synchronization, as activities which necessitate consciously coordinated efforts are usually associated with synchronization of heart and breathing patterns both within a person and between those engaged in the activity. The researchers found that synchronization occurs at higher rates when participants are singing than when resting and higher still when singing in unison. It was also discovered that the presence of a conductor has an effect on synchronization, and that the various vocalists in the chorus are distinguishable in the analysis of heart and breathing activity when represented in a graph. The researchers believe this supports a physiological foundation for coordinating interpersonal actions such as breathing.
View the article here.
“The Effect of Singing on Snoring and Daytime Somnolence”
This 2008 study by Pai, Lo, Wolf, and Kajieker involved observing snoring and daytime sleepiness in groups of semi–professional singers and other individuals who do not sing. All participants were healthy and of similar BMI (body mass index). Snoring was measured using the snoring scale score (SSS) as filled out by the individuals’ partners, and somnolence was measured using the Epworth Sleepiness Scale (ESS). When adjusted for age and BMI, participants who sang had significantly lower snoring rates, but no differences in daytime sleepiness compared with non-singers.
View the article here.
“ ‘Singing for Breathing’: Participant’s perceptions
of a group singing programme for people with COPD.”
ABSTRACT NEEDS TO BE WRITTEN
View the article here.
“Effect of Singing on Respiratory Function, Voice, and Mood after Quadriplegia: A Randomized Controlled Trial”
Tamplin, Baker, Grocke, Brazzale, Pretto, Ruehland, Buttifant, Brown, and Berlowitz (2013) studied the effects of thrice–weekly singing classes on people with quadriplegia. People with paralysis from spinal injuries often have respiratory trouble, so the study measured variables dealing with the strength and quality of breathing and speech. This study had a control group in which participants attended music appreciation and relaxation meetings. After twelve weeks of treatment, the experimental group showed significant improvements in projected speech intensity and maximum phonation length. The authors observed small but not statistically significant improvements in breathing and muscle strength. In both groups, researchers noted increases in mood which persisted in the control group for six months. Despite the small sample, the results and positive reports from the study’s subjects, the researchers concluded that singing lessons would be “an effective, sustainable treatment option in quadriplegia.”
View the article here.
“Music Structure Determines Heart Rate Variability of Singers.”
Vickhoff, Malgren, Åström, Nyberg, Ekström, Engwall, Snygg, Nilsson, and Jörnsten conducted this study, published in 2013, to study the effects of different kinds of songs on a phenomenon called respiratory sinus arrhythmia (RSA), which is the pairing of respiration with heart rate variability (HRV). RSA is more noticeable with deliberate, deep breathing and is considered beneficial to the cardiovascular system as it can lower blood pressure and heart rate. The study measured breathing and heart-rate in groups of 18–year–old subjects while they hummed, sang a short ‘mantra,’ as well as a hymn, each with different breathing instructions. The researchers found that musical structure influenced the relationship between heartbeat and breath. More structured music was associated with similar HRV between individuals in the group as they sang in unison, but all song structures affected HRV in individuals. In turn, RSA—the measure of beneficial breathing—was found to occur at predictable intervals during the song.
View the article here.
Dementia
Studies Summarized
Bannan, N., & Montgomery–Smith, C. (2008). “Singing for the brain: Reflections on the human capacity for music arising from a pilot study of group singing with Alzheimer’s patients.”
Camic, P. M., Williams, C. M., & Meeten, F. (2013). “Does a ‘singing together group’ improve the quality of life of people with dementia and their carers? A pilot evaluation study.”
Clements–Cortes, A. (2013) “Buddy’s Glee Club: Singing for life.”
Davidson, J., & Fedele, J. (2011). “Investigating group singing activity with people with dementia and their caregivers.”
Hessenberg, C., & Schmid, W. (2013). “Sounding bridges—An intergenerational music therapy group with persons with dementia and children and adolescents in psychiatric care.”
Millard, K. O., & Smith, J. (1989). “The influence of group singing therapy on the behavior of Alzheimer’s disease patients.”
Osman, S. E., Schneider, J., & Tischler, V. (2014). “ ‘Singing for the Brain’: A qualitative study exploring the health and well–being of singing for people with dementia and their carers.”
Ridder, H. M. O. (2003). “Singing dialogue: Music therapy with persons in advanced stages of dementia.: A case study research design.”
Sosinowicz, Belinda (2017). “An Evaluation of a Singing Group at The Healthy Living Club, Lambeth.”
Svansdottir, H.B., & Snaedal, J. (2006). “Music therapy in moderate and severe dementia of Alzheimer’s type: A case-control study.”
“Singing for the Brain: Reflections on the Human Capacity for Music Arising from a Pilot Study of Group Singing with Alzheimer’s Patients”
Bannan and Montgomery–Smith (2008) organized and documented a “Singing for the Brain” group with the aim of answering a few concrete questions through video analysis and surveys. These questions revolved around whether Alzheimer’s patients would be able to successfully join a singing group, how they might improve both in singing and enjoyment of the activity, and what caregiver responses would be. The singing instructor was not given information regarding the identity of patients versus caregivers, and in addition to filming the meetings for analysis, caregivers filled out surveys after participating. After three sessions, Bannan and Montgomery–Smith saw improvements in confidence and alertness. Instructors were able to teach a previously unknown song, and caregiver responses were positive overall.
View the article here.
“Does a ‘Singing Together Group’ Improve the Quality of Life
of People with Dementia and Their Carers?”
Camic, Williams, and Meeten studied a small group of people with dementia and their caregivers who participated in a singing group for 90 minutes once a week for 10 weeks (2013). Patients and caregivers were scored on standardized scales of well–being, quality of life, depression, stress, and anxiety. The participants were also interviewed and given surveys about their experiences. There was no control group for comparison, but the researchers observed negative progression across all measures except for quality of life and engagement, which maintained high levels over the course of the study. The researchers note that certain physical aspects of dementia cannot be addressed by singing, but more frequent singing might have a stronger effect on other aspects, such as stress and anxiety.
View the article here.
“Buddy’s Glee Club: Singing for Life.”
In 2013, Clements–Cortes studied participants in Buddy’s Glee Club as part of an investigation of factors in dementia patients’ well-being and aging. Participants attended a one hour chorus meeting every week for 16 weeks. Various well–being measures, including “general health, self–esteem, anxiety, feelings/emotions, and quality of life” were taken prior to and after the program (2013). Clements–Cortes also conducted interviews with the participants. Both the quantitative and qualitative data supported five overall themes for the benefits of participation. These were feelings of “friendship and companionship, simplicity, happiness and uplifting and positive feelings, relaxing and reduced anxiety, and fun” (2013).
View the article here.
“Investigating Group Singing Activity with
People with Dementia and their Caregivers.”
Davidson and Fedele (2011) offered group singing lessons to dementia patients and their caregivers over the course of 6 weeks. The participants were spread between two treatment centers and had varying degrees of mild to moderate dementia. The participants were scored on a variety of diagnostic, mental health, and singing-specific measures, and the singing groups were recorded to provide qualitative data. Positive outcomes were found in the singing-specific and qualitative data, as participants gained “lucidity and improved social interaction, […] enjoyment, singing engagement, and carry-over memory” (2011). These outcomes support the idea that singing program participation could improve patient–caregiver communication, even though no significant effects were found in the quantitative measures.
View the article here.
“Sounding Bridges—An Intergenerational Music Therapy Group
with Persons with Dementia and Children and
Adolescents in Psychiatric Care.”
Hessenberg and Schmid (2013) describe a longstanding and successful intergenerational music therapy program in Germany. The participants are children in a psychiatric hospital and elderly people with dementia. Participants meet once a week to sing songs, play instruments, and share their experiences. The authors describe a complementary effect, where the young people are calmed and balanced by the older people, and the elders become more attentive and lively in the presence of children. This mutual benefit of the intergenerational program makes it particularly useful therapeutically, building self–esteem for all the participants. It also provides feelings of dignity for the elderly and acceptance for the children, which are both essential feelings that are often missing in patients with dementia or psychiatric illnesses. The power of music to unite individuals, combined with intergenerational interactions, results in feelings of “social inclusion” for individuals who often feel “vulnerable or marginalized” (2013).
View the article here.
“The Influence of Group Singing Therapy
on the Behavior of Alzheimer’s Disease Patients”
This study, by Millard and Smith (1989), is an early investigation of the effects of communal singing on Alzheimer’s patients. Ten patients from an Alzheimer’s care facility participated in 30–minute singing sessions twice a week for five weeks, alternated with discussion sessions, and data was collected via observation. The researchers found a significant difference in the frequency of “physical and social behaviors” after singing sessions versus discussion sessions (1989). Patients also displayed “significantly higher vocal/verbal participation” during singing sessions, and afterwards had a significant change in behavior (1989).
View the article here.
“ ‘Singing for the Brain’: A Qualitative Study Exploring the Health and Well–Being of Singing for People with Dementia and Their Carers”
Osman, Schneider, and Tischler interviewed dementia patients and their caregivers who participated in Singing for the Brain musical activities (2014). The goal was to investigate singing as a potential non–medical therapy to assist dementia patients. Caregivers and patients who could recall the sessions reported benefits across six main themes identified by the researchers: social inclusion and support, a shared experience, impact on relationships, impact on memory, lifting the spirits, and acceptance of the diagnosis. Researchers note that music therapy benefits for dementia patients were moment–to–moment, but that it could lead to better outcomes for caregivers, who often feel isolated, anxious, and overwhelmed. The study concludes with a recommendation to expand the program.
View the article here.
“Singing Dialogue: Music Therapy with Persons
in Advanced Stages of Dementia: A Case Study Research Design”
(Unpublished doctoral thesis)
In Ridder’s doctoral thesis, she describes in detail the observed effects of music therapy on six people with advanced dementia. Patients sang recognizable songs in music therapy, and quantitative and qualitative data were collected based on recordings of the sessions and heart rate, as well as interviews with helpers involved with the process. Three main themes emerged from the data. The first is that participation, attitude, and heart rate all indicated positive effects of singing therapy on the patients. Second, patients saw improvements in communication as a result of “balanced arousal level” from the activity. Third, incidents of elevated heart rates and agitated behavior decreased in five of the six patients.
View the article here.
“An Evaluation of a Singing Group at The Healthy Living Club, Lambeth”
ABSTRACT NEEDS TO BE WRITTEN View the article here.
“Music Therapy in Moderate and Severe Dementia
of Alzheimer’s Type: A Case–Control Study”
This study, published by Svansdottir and Snaedal in 2006, set out to review music therapy as an alternative to drug–based therapy for dementia patients. Participants with moderate to severe Alzheimer’s disease came from four different care facilities and were assigned either to the experimental group, which included six weeks of music therapy in addition to their regular treatment, or the control group. Over the course of the study, participants in the music therapy group benefited from significantly fewer behavioral disturbances as well as a reduction in aggression and anxiety. These improvements did not last beyond a month after treatment.
Vascular and Neurological Conditions
Studies Summarized
Amengual, J. L., Rojo, N., Heras, M. V., Marco-Pallares, J., Grau-Sanchez, J., Schneider, S., … Rodriguez–Fornells, A. (2013). “Sensorimotor plasticity after music–supported therapy in chronic stroke patients revealed by transcranial magnetic stimulation.”
Di Benedetto, P., Cavazzon, M., Mondolo, F., Rugiu, G., Peratoner, A., & Biasutti, E. (2009). “Voice and choral singing treatment: A new approach for speech and voice disorders in Parkinson’s disease.”
Elefant, C., Baker, F., Lotan, M., Krogstie Lagesen, S., & Skeie, G. O. (2012). “The effect of group therapy on mood, speech, and singing in individuals with Parkinson’s disease—a feasibility study.”
Evans, C., Canavan, M., Foy, C., Langford, R., & Proctor, R. (2012). “Can group singing provide effective speech therapy for people with Parkinson’s disease?”
Pacchetti, C., Mancini, F., Aglieri, R., Fundaro, C., Martignoni, E., & Nappi, G. (2000). “Active music therapy in Parkinson’s disease: An integrative method for motor and emotional rehabilitation.”
Tamplin, J., Baker, F. A., Jones, B., Way, A., & Lee, S. (2013). “ ‘Stroke a chord’: The effect of singing in a community choir on mood and social engagement for people living with aphasia after a stroke.”
“Sensorimotor Plasticity after Music–Supported Therapy in Chronic Stroke Patients Revealed by Transcranial Magnetic Stimulation”
Amengual and her team of researchers tested the effects of music–supported therapy on individuals who had suffered multiple strokes, looking in particular at brain and motor function (2013). Twenty patients received transcranial magnetic stimulation and underwent a 3D movement analysis to determine motor function prior to and after receiving instruction on playing drums and keyboards. Improvements were seen in motor performance, indicating improvements in cortical plasticity and success of this form of therapy in chronic stroke patients.
View the article here.
“Voice and Choral Singing Treatment: A New Approach for
Speech and Voice Disorders in Parkinson’s Disease”
Di Benedetto, Cavazzon, Mondolo, Rugiu, Peratoner, and Biasutti (2009) ran an uncontrolled pilot study to determine the effects of group music therapy in addition to speech therapy on Parkinson’s disease patients. The therapy included two weekly one–hour speech therapy sessions for ten weeks and one weekly two-hour choir meeting for thirteen weeks. Participants underwent “neurological and otolaryngological evaluation, voice and speech acoustic analysis, auditory quality of voice analysis, and respiratory function evaluation” before and after the course of therapy (2009). Many of the measures, including lung capacity, breathing strength, and vowel phonation, improved significantly.
View the article here.
“The Effect of Group Therapy on Mood, Speech, and Singing in Individuals with Parkinson’s Disease—A Feasibility Study”
In 2012, Elefant, Baker, Lotan, Korgstie Lagesen, and Skeie conducted a study in which individuals with Parkinson’s disease received group singing therapy in order to investigate potential improvements in mood, speech, and singing ability. Ten individuals participated in the one–hour singing group once a week for 20 weeks, and at the beginning, middle, and end, their voices were analyzed by computer and their responses to a depression rating scale were collected.
Singing quality and voice range improved significantly, but speaking quality and depression symptoms did not, though they also did not decrease over the course of the music therapy. Having a control group would help determine the degree to which singing stopped further decline in speech quality and depression.
View the article here.
“Can Group Singing Provide Effective Speech Therapy
for People with Parkinson’s Disease?”
In this 2012 study, Evans, Canavan, Foy, Langford, and Proctor studied the effect of group singing lessons on voice dynamics and quality of life in Parkinson’s patients. Individuals suffering from Parkinson’s disease were specifically recruited to participate in a two–hour group lesson every two weeks for two years. A dysarthria test was administered to determine baseline and progress every six months, which revealed laryngeal improvements as well as self–reported improvements in communication. These improvements, while statistically significant, would be supported by a larger, controlled study.
View the article here.
“Active Music Therapy in Parkinson’s Disease:
An Integrative Method for Motor and Emotional Rehabilitation”
Published in 2000, this controlled study by Pacchetti, Mancini, Aglieri, Fundaro, Martignoni, and Nappi investigated the effects of group music therapy on Parkinson’s disease patients. Researchers measured disease progression, emotion, and quality of life before and after three months of music therapy, which included singing in a chorus as well as several other musical exercises. The control group engaged in a variety of physical exercises. Emotion, quality of life, and bradykinesia, a measure of how quickly patients are able to move, improved significantly for patients in the music therapy group. The researchers encourage the adoption of this form of treatment for future Parkinson’s disease sufferers.
View the article here.
“ ‘Stroke a Chord’: The Effect of Singing in a Community
Choir on Mood and Social Engagement for People Living
with Aphasia Following a Stroke.”
Tamplin, Baker, Jones, Way, and Lee (2013) studied the effects of participation in a choir on people living with speech deficits following a stroke. Thirteen people joined the choir, which was led by a music therapist. Researchers measured mood, “communication, cognition, and global functioning … and social functioning” at various intervals before and during choir participation (2013). Prior to joining the choir, participants reported worse mood and feelings of belonging compared to the population averages, which improved over the course of the choir participation. Improvements were also seen in “confidence, peer support, enhanced mood, increased motivation, and changes to communication,” supporting the idea that music therapy can help stroke patients, though small sample size and the lack of a control group present opportunities for further research (2013).
View the article here.
Stress, Fatigue, and Pain Tolerance
Studies Summarized
Bailey, B. (2006). “Perceived holistic health effects of three levels of music participation.”
Beck, R. J., Cesario, T. C., Yousefi, A., & Enamoto, H. (2000). “Choral singing, performance perception, and immune system changes in salivary immunoglobulin A and cortisol.”
Bento Allpress, R., Clift, S., & Legg, L. (2012). “Effects of Group Singing on Psychological States and Cortisol.”
Bittman, B., Berk, L., Shannon, M., Sharaf, M., Westengard, J., Guegler, K. J., & Ruff, D. W. (2005). “Recreational music–making modulates the human stress response: A preliminary individualized gene–expression strategy.”
Dunbar, R.I., Kaskatis, K., MacDonald, I., & Barra, V. (2012). “Performance of music elevates pain threshold and positive affect: Implications for the evolutionary function of music.”
Fredenburg, H. A., & Silverman, M. J. (2014). “Effects of cognitive–behavioral music therapy on fatigue in patients in a blood and marrow transplantation unit: A mixed–method pilot study.”
Kang, J., Scholp, A., Jiang, J. (2017). “A Review of the Physiological Effects and Mechanisms of Singing.”
Kenny, D. T., & Faunce, G. (2004). “The impact of group singing on mood, coping and perceived pain in chronic pain patients attending a multidisciplinary pain clinic.”
Kreutz, G., Bongard, S., Rohrmann, S., Grebe, D., Bastian, H. G., & Hodapp, V. (2003). “Does singing provide health benefits?”
Kreutz, G., Bongard, S., Rohrmann, S., Hodapp, V., & Grebe, D. (2004). “Effects of choir singing or listening on secretory immunoglobulin A, cortisol, and emotional state.”
Krout, R.E. (2001). “The effects of single–session music therapy interventions on the observed and self–reported levels of pain control, physical comfort, and relaxation of hospice patients.”
Lindblad, F., Hogmark, A., & Theorell, T. (2007). “Music intervention for 5th and 6th graders—effects on development and cortisol secretion.”
Sanal, A. M., & Gorsev, S. (2014). “Psychological and physiological effects of singing in a choir.”
“Perceived Holistic Health Effects
of Three Levels of Music Participation”
Bailey (2006) conducted this study to assess how physiological markers of stress may differ between individuals singing and listening to music. Group singing was most beneficial and group listening was least beneficial, with solo listening in the middle. Group singers reported feelings of arousal and satisfaction, with significant decreases in cortisol after practices and an increase after a performance. This group also experienced increases in secretory immunoglobulin A. Listening alone was associated with feelings of calm and relaxation. Other studies have attributed stress–relieving qualities to group listening, but those were in a controlled context. The surveyed participants may have considered group listening to be “background music,” which would offer less of a stress relief effect than the “controlled group listening” in other studies.
View the article here.
“Choral Singing, Performance Perception, and Immune System Changes in Salivary Immunoglobulin A and Cortisol”
In 2000, Beck, Cesario, Yousefi, and Enamoto published this study after working with approximately 30 members of a professional chorale and monitoring chemical markers correlated with health and stress before, during, and after two rehearsals and a performance. The researchers found a significant increase in secretory Immunoglobulin A (IgA), associated with positive emotions and a robust immune system, during rehearsals (by 150%) and performances (by 240%). Cortisol, typically associated with stress or anxiety, significantly dropped during rehearsals (by 30%) and increased during performances (by 37%). The singers were surveyed, and the researchers found that mood levels, feeling relaxed, feeling high, feeling engaged, feeling satisfied with the performance, and stress about the performance all correlated with increased levels of IgA.
View the article here.
“Effects of Group Singing on Psychological States and Cortisol”
In 2012, Bento Allpress, Clift, and Legg published this study examining the psychological states and cortisol levels of participants in a group choir activity to compare affect and stress levels between singers and individuals participating in another group activity. The results showed increases in connections and mood after both the group singing and the non-musical activity, lending support to the theory that group activities have positive effects on participants. This study does not show particular effects of singing in a group over other group activities, but it does show the positive effects of choir participation and other group activities.
View the article here.
“Recreational Music-Making Modulates the Human Stress Response:
A Preliminary Individualized Gene–Expression Strategy”
In 2005, Bittman and six colleagues conducted an experiment in which they measured biological stress indicators through blood samples in people before and after a stress–inducing exercise. Thirty–two participants were randomly assigned into one of three groups for a one–hour follow–up activity: one which went to a different room to relax, one which continued the stressful activity, and one which participated in a group music–making exercise. The researchers found that the genetic stress markers in those who participated in the music exercise decreased significantly over both the control group and the stressor group. These findings support the use of music therapy even at the biological level after a stressful event.
View the article here.
“Performance of Music Elevates Pain Threshold and Positive Affect: Implications for the Evolutionary Function of Music”
Published in 2012, this study by Dunbar, Kaskatis, MacDonald, and Barra investigated whether music’s effect on emotions is based on the endorphin system, and if so, whether it is specifically tied to hearing or performing music. Participants were separated into control and experimental groups that consisted of otherwise regular activities, such as attending a church with singing (experimental) versus silent prayer (control). After the activity, pain threshold was measured, and the researchers determined that performing music leads to a rise in endorphins, thus elevating the pain threshold significantly in the experimental group. These findings show the potential for community bonding through group singing as well as dancing and drumming.
View the article here.
“Effects of Cognitive–Behavioral Music Therapy on Fatigue
in Patients in a Blood and Marrow Transplantation Unit:
A Mixed-Method Pilot Study”
In 2014, Fredenburg and Silverman studied 11 hospitalized patients in a blood and marrow transplant unit in order to determine the effect of music therapy on fatigue. Participants were assigned to an experimental (music therapy) or control (wait–list) group and filled out a fatigue survey before and after the study period. While the authors found no differences in fatigue, themes expressed during exit interviews supported the trend of fatigue scores to rise slightly in the control group and lower slightly in the experimental group. Patients in the music group noted increases in motivation, relaxation, and a sense of receiving holistic care. The researchers urge further investigation due to small sample size and lack of statistically significant results.
View the article here.
”A Review of the Physiological Effects and Mechanisms of Singing”
ABSTRACT NEEDS TO BE WRITTEN View the article here.
“The Impact of Group Singing on Mood, Coping and Perceived Pain in Chronic Pain Patients Attending a Multidisciplinary Pain Clinic”
Kenny and Faunce studied how group singing could help people suffering from chronic pain with “mood, coping, and perceived pain” (2004). They integrated their experiment into the routine at a pain center, where patients underwent a three–week program consisting either of half–hour singing groups or exercise while listening to music. The subjects were rated on a variety of scales before and after therapy. Researchers found that both groups saw significant improvements, with the singing participants only showing a distinct advantage in the variable of “active coping” (2004). It is possible that the efficacy of the music therapy was clouded by the other treatments available to patients, which they continued while engaging in the study.
View the article here.
“Does Singing Provide Health Benefits?”
This 2003 study by Kreutz, Bongard, Rohrmann, Grebe, Bastian, and Hodapp looked for changes in chemical markers in saliva before and after singing and listening sessions. The two markers were secretory immunoglobulin A (sIgA), involved with immune response, and cortisol, associated with stress levels. A group of 31 amateur adult choristers of mixed gender and age sang excerpts from Beethoven’s Requiem, and their saliva was sampled before and after singing. The next week, instead of practice, they listened to the same excerpts and a lecture on choral tradition. The researchers found that after singing, people had a significantly higher level of sIgA, indicating immune health benefits. Cortisol decreases were not statistically significant, but singers did report better mood. After the listening activity, sIgA was not significantly changed, but listeners had reduced cortisol levels and increased negative affect, indicating that listening lowered stress but worsened mood. The researchers attributed the mood changes to frustration at having to sit and listen instead of singing as usual routine. They conclude that communal singing appears to be an affordable and impactful option to promote well–being with little to no risks.
View the article here.
“Effects of Choir Singing or Listening on
Secretory Immunoglobulin A, Cortisol, and Emotional State”
Kreutz, Bongard, Rohrmann, Hodapp, and Grebe set out to determine how choir music effects certain physiological and emotional markers (2004). The experimental group sang in an amateur choir, and the control group listened to choir music. Before and after the two sessions, researchers collected saliva and self–reported data regarding mood. The researchers found that participants in the choir singing group had significant increases in mood and secretory immunoglobulin A, supporting the idea that group singing has a positive effect on one’s immune system and emotional state. The listening group subjectively reported a significant increase in negative emotions, but the physiological data showed significantly lower cortisol levels. This seeming contradiction warrants further research.
View the article here.
“The Effects of Single–Session Music Therapy Interventions on the Observed and Self–Reported Levels of Pain Control, Physical Comfort, and Relaxation of Hospice Patients”
Krout (2001) studied how one session, out of ongoing music therapy, affected hospice patients’ pain, comfort, and relaxation. Eighty subjects participated by self–reporting data or being observed prior to and following therapy, which consisted of both creating and listening to music. Immediately following a music therapy session, patients and observers both reported statistically significant improvements over all three parameters, indicating that in the short term, music therapy has a positive impact on the lives of the terminally ill.
View the article here.
“Music Intervention for 5th and 6th Graders—Effects
on Development and Cortisol Secretion”
Lindblad, Hogmark, and Theorell (2007) assessed the self-esteem, social anxiety, social phobia, and potential for psychopathology of fifth and sixth graders in order to determine if music education had an impact on these measures. The experimental group received an extra hour of music education, while the control group received an extra hour of education that was in line with their regular coursework. The researchers found that students in the music group had significantly decreased cortisol levels, but there were no significant differences on the mental health questionnaires from the beginning of the year to the end or between the groups of students. Still, the biological measures support the use of music education as an intervention for stress levels.
View the article here.
“Psychological and Physiological Effects of Singing in a Choir”
Sanal and Gorsey (2014) examined the relationship between choral participation and anxiety and other emotions. They used multiple biological and psychological measures but did not find differences in their initial analysis. The researchers then split choir participants into two smaller groups, with one having an hour of free time while the other spent an additional hour singing. Mood surveys and saliva samples were taken before and after the hour. The researchers found that the singing rehearsal had a significant decrease in negative mood indicators and a small but not statistically significant increase in positive affect. The control group showed an increase in negative mood indicators. No physiological effects were found, but the findings still present promising effects of group singing on mood.
Psychological Effects of Group Singing
Humans feel a great sense of belonging, acceptance, and lifted spirits when singing with others. The existing body of research has shown that communal singing is a potential antidote to modern social isolation, helping individuals engage, build social skills, and identify with others (Teater & Baldwin, 2012). Many could rationalize how singing can help with depression, but group singing has even effected improvements in patients with mood disorders and schizophrenia (Tavormina, Tavormina, & Nemoianni, 2014; Khalaf–Beigi, Akbarfahimi, Ashayeri, Dorood, & Doostdar, 2012).
Singing instills values such as empathy, coöperation, and acceptance, encouraging teamwork and the building of cross-cultural bonds (Southcott and Joseph, 2010; Anshel and Kipper, 1988). It also serves as a cognitive stimulus, promoting learning and combatting depression, stress, aggression, and anxiety (Slater, Strait, Skoe, O’Connell, & Thompson, 2014; Lord et al., 2012). These effects have been found across all ages, economic backgrounds, and cultures.
The following summaries of open access abstracts have been organized into categories illustrating the areas in which communal singing has been found to have positive psychological effects. The first category is devoted to studies which have found considerable benefits in the realm of mental health, which can be not only difficult to treat but also traumatic and isolating for those afflicted. Second, research regarding social connectedness and community coping are presented. People’s sense of community engagement strongly affects their mental, emotional, and physical health, and singing has been found to help individuals come together, especially in healing after a tragedy.
Next, studies which have focused on learning are presented. Singing uses several different parts of the brain and has been found to help people learn new skills at an accelerated rate, even into adulthood. For instance, the activity naturally involves multitasking, as participants must listen, recall, form words, and regulate pitch at once. The final category is a compilation of research regarding the effects of group singing on well–being and quality of life. Communal singing has been repeatedly shown to have positive effects on these measures, especially in isolated or marginalized groups.
The research clearly demonstrates the potential for group singing to improve various aspects of mental and emotional well–being. Aside from the potential for self–consciousness, which tends to be overcome when the practice is considered mainstream, the feelings associated with singing are so positive that research isn’t even necessary to convince anyone of the potential benefits. Still, if the effects are both anecdotally and scientifically agreed upon, the question remains as to why group singing is not being more widely used as an intervention. Many individuals suffering from a variety of psychological issues have their troubles compounded by feelings of helplessness that could be mitigated by the introduction of a new therapy. Those whose condition result in feelings of isolation would by definition find a positive oulet by joining an activity where they can find acceptance in a group of peers.
The studies in the coming sections introduce multiple potential areas for application, from hurricane relief to reduced anxiety in hospice. It is widely accepted that the mental well-being benefits reported here could have a direct link to physical health benefits as well, thanks to the link between positive feelings and immune health (Kreutz et al., 2003). With virtually no risks or cost and huge potential benefits, society literally cannot afford to let these opportunities to positively affect community mental health pass by.
Mental Disorders
Studies Summarized
Baines, S. (2003). “A consumer–directed and partnered community mental health music therapy program: Program development and evaluation.”
Clift, S., Page, S., Daykin, N., & Peasgood, E. (2016). “The perceived effects of singing on the health and well–being of wives and partners of members of the British Armed Forces: a cross–sectional survey.”
Clift, S., Manship, S., & Stephens, L. (2017). “Further evidence that singing fosters mental health and wellbeing: the West Kent and Medway project.”
Gardstrom, S. C., & Diestelkamp, W. S. (2013). “Women with addictions report reduced anxiety after group music therapy: A quasi–experimental study.”
Grocke, D., Bloch, S., & Castle, D. (2009). “The effect of group music therapy on quality of life for participants living with a severe and enduring mental illness.”
Khalaf–Beigi, M., Akbarfahimi, M., Ashayeri, H., Dorood, N., & Doostdar, H. (2012). “The effect of music on attention in schizophrenia.”
Pavlakou, M. (2009). “Benefits of group singing for people with eating disorders: Preliminary findings from a non–clinical study.”
Petchkovsky, L., Robertson–Gillam, K., Kropotov, J., & Petchkovsky, M. (2014). “Using QEEG parameters (asymmetry, coherence, and P3a Novelty response) to track improvement in depression after choir therapy.”
Rumball, K. (2010). “The effects of group musical activity on psychiatric patients in India.”
Tang, W., Yao, X., & Zheng, Z. (1994). “Rehabilitative effect of music therapy for residual schizophrenia: A one–month randomised controlled trial in Shanghai.”
Tavormina, M.G., Tavormina, R., & Nemoianni, E. (2014). “The singing–group: A new therapeutic rehabilitation for mood disorders.”
Ulrich, G., Houtmans, T., & Gold, C. (2007). “The additional therapeutic effect of group music therapy for schizophrenic patients: A randomized study.”
“A Consumer–Directed and Partnered Community Mental Health
Music Therapy Program: Program Development and Evaluation”
Baines (2003) reviewed a group music therapy program in Canada in order to determine if it was an effective psychosocial intervention for individuals with severe, persistent mental illness. The group collaborated to fulfill their many needs, which included “energetic discharge, sensory gratification, comfort and sustenance, a supportive place for grief work, opportunity for creativity, validation, familiarity and togetherness, and personal and group expression” (2003). Afterwards, participants, staff, and visitors noted a “positive shift in the atmosphere” and felt these would have persistent carry–over effects (2003). After a few years of offering music therapy classes, participants still found music therapy sessions to be relaxing, social, and fun. They took pleasure in the sense of belonging and developing their skills. The author emphasizes that music is a positive resource for persons living with mental illness, but the benefits of group music–making cannot be accessed by solitary music–making.
View the article here.
“The Perceived Effects of Singing on the Health
and Well-Being of Wives and Partners of Members
of the British Armed Forces: A Cross-Sectional Survey”
ABSTRACT NEEDS TO BE WRITTEN View the article here.
“Further Evidence That Singing Fosters Mental Health
and Wellbeing: The West Kent and Medway Project”
ABSTRACT NEEDS TO BE WRITTEN View the article here.
“Women with Addictions Report Reduced Anxiety
after Group Music Therapy: A Quasi-Experimental Study”
In 2013, Gardstrom and Diestelkamp published a study intended to further the research on music therapy specific to women suffering from addiction. The researchers aimed to determine the rate of anxiety prior to group music therapy and how many of those suffering anxiety would have lower anxiety levels after therapy. Participants attended the music therapy group twice a week for nine weeks and engaged in singing, writing, and listening to music. Of the 53 volunteers, 73.6% self-reported anxiety prior to therapy, and 84.6% of those reported decreased anxiety after therapy. Without a control group, the researchers could not determine causality, but the data lead them to strongly support group music therapy as a therapeutic tool for women with addiction.
View the article here.
“The Effect of Group Music Therapy on Quality of Life
for Participants Living with a Severe and Enduring Mental Illness”
In 2009 Grocke, Bloch, and Castle, published this study to investigate the effects of music therapy on mentally ill patients. The participants attended one–hour therapy sessions once a week for ten weeks, filled out surveys regarding quality of life and social anxiety, and gave interviews. Researchers also made qualitative assessments of the songs written by participants during the sessions. The data showed significantly higher quality of life, independent of any changes in patients’ symptoms during participation, as well as multiple positive feedback themes from focus groups. The main trends from the song lyrics involved the challenges of mental illness and sources of enjoyment or support, which included “working as a team” (2009). These findings provide staunch support of group music therapy as an intervention for patients with mental illness.
View the article here.
“The Effect of Music on Attention in Schizophrenia”
Khalaf–Beigi, Akbarfahimi, Ashayeri, Dorood, and Doostdar (2012) studied potential benefits of music therapy on patients with schizophrenia, specifically related to their attention. A total of 55 people diagnosed with schizophrenia were randomly assigned into an experimental group or a control group. The experimental group engaged in music therapy sessions together while having their attention measured through various tests, such as the Stroop and Lezak tests. The researchers found that participants in the experimental group had improved processing speeds compared to the control group, but not enough to reach statistical significance.
View the article here.
“Benefits of Group Singing for People with Eating Disorders:
Preliminary Findings from a Non–Clinical Study”
In this dissertation, published in 2009, Pavlakou studied eight women with different eating disorders participating in communal singing set up by the researcher. Pavlakou established the singing workshop for the purpose of studying the effects on the women’s self–esteem and emotional states outside of a clinical setting, as these are considered underlying issues of disordered eating. Participant interviews revealed benefits of the activity that could be attributed to the singing itself, the rehearsals, being in a group, and from sources outside of the workshop. Overall, participants experienced decreases in stress and increases in empowerment and self–esteem. Rumball concluded that group music therapy is especially beneficial for those suffering from eating disorders, as it addresses some of the underlying issues.
View the article here.
“Using QEEG Parameters (Asymmetry, Coherence, and P3a Novelty Response) to Track Improvement in Depression after Choir Therapy”
Petchkovsky, Robertson–Gillam, Kropotov, and Petchkovsky worked with nine depression patients to determine the effect of their 8–week chorus program on quantitative electroencephalography (QEEG), a measure of brain function (2014). QEEGs can map brain activities that indicate multiple conditions, including depressive symptoms. Participants underwent a QEEG prior to and after participating in the group singing therapy, and the data showed multiple improvements in areas that are considered indicators of depression. The findings provide quantitative, biological support for the use of group singing to treat symptoms of depression.
View the article here.
“The Effects of Group Musical Activity on Psychiatric Patients in India”
Published in 2010, this study by Rumball explored the effects of music therapy on psychiatric patients. Seven music therapy sessions were conducted at a hospital in India, and participants, who included both patients and staff, were observed, surveyed, and interviewed. The data showed significant increases in “mood, energy, and attention levels” as well as increased “interaction, learning, and confidence” (2010). Rumball concluded that the effects of the music specifically were distinct from those that could be attributed to the group setting.
View the article here.
“Rehabilitative Effect of Music Therapy for Residual Schizophrenia:
A One-Month Randomised Controlled Trial in Shanghai”
This study, conducted by Tang, Yao, and Zheng, was published in 1994. It assessed 76 schizophrenia patients who continued to receive their regular treatment while the experimental group engaged in music therapy for one month. Participants were assessed using a negative symptom scale translated into Chinese as well as a disability scale from the World Health Organization. The researchers found that participants in the experimental group had significant decreases in negative symptoms and social isolation and significant increases in “ability to converse with others” and “level of interest in external events” (1994). This early study acknowledged that there are virtually no side efects of this treatment and encouraged further research to expand the use of music therapy.
View the article here.
“The Singing–Group: A New Therapeutic Rehabilitation
for Mood Disorders”
Tavormina, Tavormina, and Nemoianni (2014) conducted this study in order to determine the effects of choral singing on several aspects of rehabilitation for mentally ill patients. The researchers saw improvements in how patients took care of and felt about themselves, managed their emotions, engaged more in their interests, and experienced “integration and socialization” (2014). Participants suffering from mood disorders experienced the most improvements. Researchers conclude that group singing, combined with the patients’ ongoing cognitive and pharmaceutical therapies, is an effective intervention not only for individual therapy, but also for reintegration to the patients’ everyday lives.
View the article here.
“The Additional Therapeutic Effect of Group Music Therapy for Schizophrenic Patients: A Randomized Study”
Ulrich, Houtmans, and Gold (2007) conducted a controlled study of the effects of music therapy on hospitalized schizophrenia patients. The experimental group consisted of 21 patients who continued their regular treatment while participating in a group music therapy program. The control group continued with their regular treatment, and patients in both groups submitted data through self–evaluation in addition to caretaker feedback before and after the five–week intervention. The researchers found significant improvements in “psychosocial orientation” and decreases in “negative symptoms” in self reports, but these were not corroborated by nurse ratings (2007). Despite the different perceptions, the researchers concluded that musical activity has positive benefits, including helping patients adapt post-hospitalization.
View the article here.
Social Connectedness and Community Coping
Studies Summarized
Anshel, A., & Kipper, D. A. (1988). “The influence of group singing on trust and coöperation.”
Cohen, M. (2007). “Explorations of inmate and volunteer choral experiences in a prison–based choir.”
Chorus America (2009). “The Chorus Impact Study.”
Dingle, G. A., Brander, C., Ballantyne, J., & Baker, F. A. (2013). “To be heard: The social and mental health benefits of choir singing for disadvantaged adults.”
Harvey, R., Smith, M., Abraham, N., Hood, S., & Tannenbaum, D. (2007). “The hurricane choir: Remote mental health monitoring of participants in a community–based intervention in the post–Katrina period.”
Liebowitz, M., Tucker M. S., Frontz M., & Mulholland S. (2015). “Participatory choral music as a means of engagement in a veterans’ mental health and addiction treatment setting.”
Pearce, E., Launay, J., & Dunbar, R. (2015). “The ice–breaker effect: singing mediates fast social bonding.”
Pearce, E., Launay, J., van Duijn, M., Rotkirch, A., David-Barrett, T., & Dunbar, R. (2016). “Singing together or apart: the effect of competitive and coöperative singing on social bonding within and between sub–groups of a university fraternity.”
Repar, P. A., & Reid, S. (2014). “Creatively caring: Effects of arts–based encounters on hospice caregivers in South Africa.”
Roma, C. (2010). “Re–sounding: Refuge and reprise in a prison choral community.”
Southcott, J., & Joseph, D. (2010). “Sharing community through singing: The Bosnian Behar Choir in Victoria, Australia.”
Weinstein, D., Launay, J., Pearce, E., Dunbar, R., & Stewart, L. (2015). “Singing and social bonding: changes in connectivity and pain threshold as a function of group size.”
“The Influence of Group Singing on Trust and Coöperation”
In 1988, Anshel and Kipper published this foundational study of the effects of group singing on interpersonal trust and coöperation. Participants were divided into 4 groups: singing, listening to music, reading poetry together, and watching a movie. After doing one of the four activities for an hour, the men were paired off randomly. They rated the personality of their partners and played a game which measures coöperation through the score. The researchers found that singing together influenced how participants rated their partners, and that both active groups—singing and reading together—had a significant effect on increasing coöoperation.
View the article here.
“Explorations of Inmate and Volunteer
Choral Experiences in a Prison–Based Choir”
This study by Cohen (2007) took a closer look at the well–being of inmates who participated in a choir consisting of both inmates and volunteers. Twenty prisoners and 24 volunteers joined the choir and filled out the Friedman Well–Being Scale. The results showed that participating in the choir gave individuals an escape from stress and a sense of accomplishment. Prisoners felt these improvements to a higher degree than volunteers, but volunteers felt they were able to pick out off–key singing more than prisoners. The results of the study provide a promising foundation for choir singing as a positive influence on inmates.
View the article here.
“The Chorus Impact Study”
ABSTRACT NEEDS TO BE WRITTEN View the article here.
“To Be Heard: The Social and Mental Health Benefits
of Choir Singing for Disadvantaged Adults”
This study, conducted by Dingle, Brander, Ballantyne, and Baker, investigated how participation in a choir affected the well–being of 21 adults experiencing mental, physical, or intellectual health issues (2013). Participants were interviewed at the beginning, six–month, and one–year mark of their involvement with the choir. Findings revolved around a number of perceived benefits to choir singing for disadvantaged adults. Singers felt good personally and could better regulate their emotions; they also experienced increased social functioning and feelings of connectedness as well as gains in functional outcomes, such as overall health and employability. These results led the researchers to conclude that group singing presented a great supplemental therapy for adults with various health problems.
View the article here.
“The Hurricane Choir: Remote Mental Health Monitoring of Participants in a Community–Based Intervention in the Post–Katrina Period”
This article by Harvey and Smith reviewed the effects of a community choir for displaced victims after Hurricane Katrina, who were experiencing a variety of negative symptoms, such as stress, anxiety, and depression (2007). Participants also filled out surveys and consulted with Australian therapists online. After a 12 week period of choir participation, the researchers found improvements in mood, community, and coping. This paper illustrates how choirs can become groups that serve their members in ways that go beyond music, functioning as key organizational structures with the ability to shepherd suffering people toward support and treatment.
View the article here.
“Participatory Choral Music as a Means of Engagement in a Veterans’ Mental Health and Addiction Treatment Setting”
Liebowitz, Tucker, Frontz, and Mulholland (2015) studied the effects of a choral group on feelings of engagement among at-risk veterans living in a care facility. Data was collected through interviews and showed that participants felt more engaged after choir participation for three main reasons: 1) interacting with people by way of a mutual interest; 2) interpersonal connections that carried over from choir into other areas; and 3) the opportunity to take one’s mind off stressors and ease the adjustment period. While there was no control group, the themes expressed in these interviews support the use of choral singing as an intervention for at–risk veterans as well as other groups experiencing stressful transitions.
View the article here.
“The Ice–Breaker Effect: Singing Mediates Fast Social Bonding”
ABSTRACT NEEDS TO BE WRITTEN View the article here.
“Singing Together or Apart: The Effect of Competitive and Coöperative Singing on Social Bonding Within and Between Sub-Groups
of a University Fraternity.”
ABSTRACT NEEDS TO BE WRITTEN View the article here.
“Creatively Caring: Effects of Arts–Based Encounters
on Hospice Caregivers in South Africa”
In this study, Repar and Reid set out to determine if music therapy could be as useful in an area with less access to resources, such as South Africa (2014). For three months, a therapist engaged in music and other therapies with primarily Zulu caregivers in a hospice facility. The researchers compiled qualitative data from interviews, observations, and recordings and determined that the “creative activities” of the meetings were the most effective in eliciting the most positive feelings and stress relief among the caregivers. The fact that arts–based therapies do not require many resources, especially financial, makes them a great fit for any environment.
View the article here.
“Re–sounding: Refuge and Reprise in a Prison Choral Community”
This study by Roma investigated the effects of a men’s chorus on imprisoned individuals’ “self–perception, intra–group relationships, and external connections” (2010). The choir recorded and sold CDs to the public, with profits going to different charities selected by the prisoners. This aspect was included in order to promote external relationships with the community. Roma sought to determine how inmates’ self–perception was affected by their participation and how inmates’ relationships with each other and the external community were affected by their performances.
View the article here.
“Sharing Community through Singing:
The Bosnian Behar Choir in Victoria, Australia”
This 2010 study by Southcott and Joseph involved interviewing refugees participating in a Bosnian community choir in Australia. The singers were mostly older and had left the turmoil of Eastern Europe but maintained their culture by participating in this weekly choir that combined Bosnian folk music with modern music from Australia. The three areas identified as having been positively affected by choir participation were well–being, sense of community, and cultural diversity. Many participants agreed that the act of singing itself offers benefits above other group activities and that the experience of a shared performance is so much more than a group outing.
View the article here.
“Singing and Social Bonding: Changes in Connectivity
and Pain Threshold as a Function of Group Size”
ABSTRACT NEEDS TO BE WRITTEN View the article here.
Learning
Studies Summarized
Brown, S., Martinez, M. J., Hodges, D. A., Fox, P. T., & Parsons, L. M. (2004). “The song system of the human brain.”
Cogo–Moreira, H., de Ávila, C. R. B., Ploubidis, G. B., & Mari, J. dJ. (2013). “Effectiveness of music education for the improvement of reading skills and academic achievement in young poor readers: A pragmatic cluster–randomized, controlled clinical trial.”
Eerola, P. S., & Eerola, T. (2013). “Extended music education enhances the quality of school life.”
Freudenhammer, W., & Kreutz, G. (2009). “Development of vocal performance in 5th grade children: A longitudinal study of choral class singing.”
Moreno, S., Bialystok, E., Barac, R., Schellenberg, E.G., Cepeda, N.J., & Chau, T. (2011). “Short–term music training enhances verbal intelligence and executive function.”
Slater, J., Strait, D.L., Skoe, E., O’Connell, S., Thompson, E., & Kraus, N. (2014). “Longitudinal effects of group music instruction on literacy skills in low–income children.”
“The Song System of the Human Brain”
This study by Brown, Martinez, Hodges, Fox, and Parsons involved participants undergoing PET scans to measure brain activity during vocal tasks (2004). Participants were all trained singers, and their brain scans were compared in order to determine areas of common activity for the different vocal tasks. While some of the regions, such as those associated with listening and mouth movement, were in line with expectations, the researchers were surprised to find that part of Brodmann’s Area, associated with clear speech production, was activated during tasks involving repeating and harmonizing with a melody. This finding indicates a neural underpinning for the hypothesis that song-training may help people who are struggling with language acquisition.
View the article here.
“Effectiveness of Music Education for the Improvement of Reading Skills and Academic Achievement in Young Poor Readers:
A Pragmatic Cluster–Randomized, Controlled Clinical Trial”
Cogo–Moreira, de Ávila, Ploubidis, and Mari (2013) conducted this study in Brazil to determine if group music instruction had any effect on reading level and general academic success of students already experiencing difficulties with reading. A total of 235 children participated, with 114 randomly selected to receive the music education. Analysis revealed marginal improvements in reading, language, math, and overall academic success, and the researchers, while encouraged, recommend further research in this area.
View the article here.
“Extended Music Education Enhances the Quality of School Life”
This study, published in 2013, set out to determine if music classes could lead to increases in “quality of school life” (Eerola & Eerola). A total of 735 students were surveyed and split into an experimental group with music classes and a control group without music classes. The researchers found that quality of school life was improved in students taking the music classes, especially when it came to feelings of satisfaction, achievement, and opportunity. As a follow–up, the researchers executed the same study with non–music courses, and the same effects were not seen, indicating that music education in particular positively affects students’ sense of quality of school life.
View the article here.
“Development of Vocal Performance in Fifth–Grade Children:
A Longitudinal Study of Choral Class Singing”
Freudenhammer and Kreutz (2009) compared two groups of fifth graders to determine whether attending a chorus class improved their vocal range and quality. Vocal quality was measured using the Dysphonia Severity Index, which can be used to assess progress in patients receiving therapy for abnormal vocal function. The two conditions included a chorus singing class accompanied by half–hour small–group vocal training and a regular music class (which did include some singing) accompanied by playtime. The results for the children in the chorus class, who did not differ significantly from the regular music class at the beginning of the year, showed significant improvement in vocal range and quality. These findings support the use of choral instruction to have effects on vocal plasticity.
View the article here.
“Short-Term Music Training Enhances Verbal Intelligence
and Executive Function”
In this 2011 study, Moreno, Bialystok, Barac, Schellenberg, Cepeda, and Chau attempted to find proof of the transfer of skills developed in a training setting to unrelated activities. Two groups of students received training in music and visual arts, respectively. Twenty days later, the students in the music group showed significantly better vocabulary and verbal skills as well as improved performance on a higher–level task. These findings support the ability of music education programs to lead to increased cognition in other areas in children.
View the article here.
“Longitudinal Effects of Group Music Instruction on
Literacy Skillsin Low–Income Children”
Slater, Strait, Skoe, O’Connell, Thompson, and Kraus (2014) compared the reading skills of two groups of Spanish–English bilingual children in Los Angeles. One group received two extra–curricular music lessons a week for a year; the other did not. At the end of the year, the students in the music program were considered on–track for their age–normed level of reading performance, while the control group’s level did not keep pace with the age–normed level. The degree of difference was not large, but it does show that music programs hold value for helping to promote reading development in students from low socioeconomic backgrounds.
View the article here.
Well–Being and Quality of Life
Studies Summarized
Bailey, B., & Davidson, J. (2001). “Emotional, social, and cognitive enrichment through participation in group singing: interviews with members of a choir for homeless men.”
Bailey, B., & Davidson, J. (2005) “Effects of group singing and performance for marginalized and middle–class singers.”
Bonde, L. O. (2011). “Health musicing—music therapy or music and health? A model, empirical examples and personal reflections.”
Clift, S. M., & Hancox, G. (2001). “The perceived benefits of singing: Findings from preliminary surveys of a university college choral society.”
Clift, S., & Hancox, G. (2010). “The significance of choral singing for sustaining psychological well–being: Findings from a survey of choristers in England, Australia and Germany.”
Clift, S., & Morrison, I. (2011). “Group singing fosters mental health and well–being: Findings from the East Kent ‘Singing for Health’ Network Project.”
Judd, M., & Pooley, J. A. (2014). “The psychological benefits of participating in group singing for members of the general public.”
Mellor, L. (2013). “An investigation of singing, health and well–being as a group process.”
Robb, S. L. (2000). “The effect of therapeutic music interventions on the behavior of hospitalized children in isolation: Developing a contextual support model of music therapy.”
Romito, F., Lagatolla, F., Costanzo, C., Giotta, F., & Mattioli, V. (2013). “Music therapy and emotional expression during chemotherapy. How do breast cancer patients feel?”
Ruud, E. (2013). “Can music serve as a ‘cultural immunogen’? An explorative study.”
Sandgren, M. (2009). “Evidence for strong immediate well–being effects of choral singing—with more enjoyment for women than men.”
Stewart, N. A. J., & Lonsdale, A. J. (2016). “It’s better together: The psychological benefits of singing in a choir.”
Unwin, M., Kenny, D. T., & Davis, P. (2002). “The effects of group singing on mood.”
Vaag, J., Saksvik, P. O., Theorell, T., Skillingstad, T., & Bjerkeset, O. (2013). “Sound of well–being—choir singing as an intervention to improve well–being among employees in two Norwegian county hospitals.”
Von Lob, G., Camic, P., & Clift, S. (2010). “The use of singing–in–a–group as a response to adverse life events.”
“Emotional, Social, and Cognitive Enrichment Through Participation in Group Singing: Interviews with Members of a Choir for Homeless Men”
In this exploratory study, Bailey and Davidson interviewed seven members of a group choir, all of whom were middle–aged men who had experienced periods of homelessness and substance abuse, poverty, mental illness, and other issues (2001). The choir was not formally therapeutic, but participants felt that it was a form of therapy. It had wide–ranging benefits, including connection with society, interpersonal interactions, and an opportunity to focus on higher–order tasks. This last benefit to the participants’ cognition suggests that singing can be a positive interruption to the negative “flow” homeless individuals often experience (2001).
View the article here.
“Effects of Group Singing and Performance
for Marginalized and Middle–Class Singers”
In 2005, this study by Bailey and Davidson was published, shedding light on how participation in a choir for homeless men with no musical background can have significant benefits emotionally, socially, and cognitively. As a comparison, Bailey and Davidson also interviewed middle–class singers with a variety of music experience. The researchers found that regardless of background or musical experience, participation in a choir has similar positive emotional effects. However, on an interpersonal and cognitive level, middle–class singers were less likely to “embrace all aspects” of the choir (2005). The researchers believe this may be due to certain social expectations leading to inhibitions among those in the middle class.
View the article here.
“Health Musicing—Music Therapy or Music and Health?
A Model, Empirical Examples and Personal Reflections”
Bonde (2011) proposed a four quadrant “map” showing how music therapy affects individuals on a Mind/Body axis and on a Social/Individual axis in order to help determine the effectiveness of the therapy at achieving four overall goals. Community singing largely falls into the quadrant of social activities meant to improve mental health and overall well–being, though there are physical benefits as well. Bonde notes that though the field of music therapy has been professionalized, all areas of music therapy are open to participation by all seeking to further the practice and promote the health benefits of music therapy.
View the article here.
“The Perceived Benefits of Singing: Findings
from Preliminary Surveys of a University College Choral Society”
Clift and Hancox review two studies regarding the effects of being in a chorus (2001). One study involved 84 university choristers filling out a survey about perceived benefits of choir membership and found significant social, emotional, physical, and spiritual benefits. In the other study, 91 members of the same choir filled out a questionnaire that was developed based on the responses from the first study, including new social experiences, lung capacity and breath control, mood and stress regulation, and more. The researchers found six overall themes from the data, which were “benefits for well–being and relaxation, benefits for breathing and posture, social benefits, spiritual benefits, emotional benefits, and benefits for heart and immune system” (2001). There were small variations by gender, age, and religious background.
View the article here.
“The Significance of Choral Singing for Sustaining
Psychological Well–Being: Findings from a Survey of Choristers in England, Australia and Germany”
Clift and Hancox (2010) surveyed 1,124 experienced choir members in Australia, England, and Germany about their feelings about choral singing. Using the WHO Quality of Life scale and a short survey regarding the choir participation specifically, the authors found that women were more likely to endorse choral singing and that there was a direct correlation between their participation and quality of life. Though men were generally enthusiastic about singing, there was no significant correlation between this activity and their overall quality of life. When looking at a subgroup of participants who reported life challenges (relationship problems, physical problems, recent deaths) the authors found that “positive affect, focused attention, deep breathing, social support, cognitive stimulation, and regular commitment” were potentially influential aspects of choir participation that could help with coping (2010).
View the article here.
“Group Singing Fosters Mental Health and Well–Being:
Findings from the East Kent ‘Singing for Health’ Network Project”
Clift and Morrison (2011) conducted an assessment of 42 choir participants to determine the effect of participation on mental health state. A total of seven choirs with 137 singers were set up in the UK for this purpose. Using the CORE survey, the researchers found significant decreases in feelings of distress after participating in the choir for nine months. These findings support the use of music therapy for individuals recovering from or currently experiencing health issues both physical and psychological.
View the article here.
“The Psychological Benefits of Participating
in Group Singing for Members of the General Public”
Judd and Pooley conducted this study to investigate the effects of group singing on the general public, versus the various disadvantaged populations studied in previous research (2014). Specifically, the researchers focused on what the singers felt participation meant to them and how important the chorus was to them. The ten participants gave interviews and filled out surveys which revealed that choir participation was seen as a source of happiness which led to better overall well-being and better lives. The researchers also found that choirs as a group are able to identify individuals who may have talent but are bad for the group dynamic.
View the article here.
“An Investigation of Singing, Health and Well–Being as a Group Process”
In this study, Mellor investigates the benefits of group singing found by two previous research projects (2013). The study done by the Centre for Excellence in Teaching and Learning and the “iSING” project show improvements in well–being due to choir participation. Mellor explores the benefits found in the two studies, how these effects could be further researched, and how they can be translated into practice.
View the article here.
“The Effect of Therapeutic Music Interventions on
the Behavior of Hospitalized Children in Isolation: Developing
a Contextual Support Model of Music Therapy”
This study by Robb aimed to further the research available on music therapy as a tool for helping children “become more actively engaged with their environment” (2000). The three pillars of the contextual support model are 1) the forming of a supportive environment; 2) the raising of engagement levels; and 3) the link between the two. To test these three areas, Robb collected observational data from 10 young cancer patients over the course of four different intervention conditions. Robb found that the music intervention was much more successful at providing support for and encouraging engagement of the participants. However, these benefits did not last in the other conditions, and the behaviors were somewhat inconsistent.
View the article here.
“Music Therapy and Emotional Expression during Chemotherapy.
How Do Breast Cancer Patients Feel?”
This study, by Romito, Lagatolla, Costanzo, Giotta, and Mattioli (2013), sought to gauge the effect of music therapy on the emotional state of breast cancer patients receiving chemotherapy. Of 62 participants, half received group music therapy during chemotherapy, while the other half served as a control group, receiving the hospital’s usual form of care during treatment. To determine psychological and emotional state at baseline and after therapy, the researchers used the “Emotion Thermometers tool” (2013). The researchers found “significant reductions in stress, anxiety, depression and anger,” in the experimental group as well as lowered anxiety and stress in the control group (2013)
View the article here.
“Can Music Serve as a ‘Cultural Immunogen’? An Explorative Study.”
This study by Ruud presents a review of qualitative data collected to look at the different ways music is used to improve people’s sense of well-being (2013). He interviewed six individuals and found that there are many different ways people incorporate music for their own mental, spiritual, and physical well-being. The feedback from the interviews support the use of choir participation among other activities and also point to certain conditions that are favorable to the use of music in a therapeutic sense, such as an understanding of music. Ruud believed these findings would contribute to closing the gap between professional music therapy in a clinical setting and recreational music practice.
View the article here.
“Evidence for Strong Immediate Well–Being Effects of
Choral Singing—With More Enjoyment for Women than Men”
Sandgren (2009) surveyed a group of 212 choristers from 11 choirs near Stockholm, Sweden, to get a picture of their emotional states before and after choir practice, controlling for health and socioeconomic status. Previous research has indicated that women report positive emotions more than men, and Sandgren’s study partially contributed to this trend. However, while women did report more positive emotions, after rehearsals, all participants were more likely to report being happy, proud, and alert. Negative emotions did not differ significantly between the genders. As Sandgren was working with individuals from a choir who had been singing together for many years, it is possible that their shared experiences are accountable for the lack of differences between the genders.
View the article here.
“It’s Better Together: The Psychological Benefits of Singing in a Choir”
In 2016, Stewart and Lonsdale published this study which attempted to understand what specifically about group singing results in the benefits that participant’s experience. To answer this question, the researchers surveyed 375 people split between three groups: members of singing groups, individual singers, and sports team members. Stewart and Lonsdale found that the two group activities yielded higher well–being scores than individual singers and that between the two group activities, singers felt a deeper sense of meaning and cohesion in their group than athletes. The researchers conclude that group membership may be more influential to well–being than the activity of singing itself, though group singing does have added benefits.
View the article here.
“The Effects of Group Singing on Mood”
Unwin, Kenny, and Davis (2002) compared an experimental singing group to a listening control group to determine how mood was affected by singing. Both the singers and the listeners completed the Profile of Mood States Questionnaire before the activity as well as immediately and one week after. The researchers hypothesized that both groups would experience a positive change in mood, but that the singing group would have a greater impact. After the activity, both groups experienced significant positive changes. These improvements persisted over the course of the week and did not show differences between the groups. However, the effect in the singing group was not as vulnerable to potential variations, which led the researchers to believe that a more involved singing intervention would reveal differences between the two groups.
View the article here.
“Sound of Well–Being—Choir Singing as an Intervention to Improve Well–Being among Employees in Two Norwegian County Hospitals”
Vaag, Saksvik, Theorell, Skillingstad, and Bjerkeset conducted this study, published in 2013, to examine the effects of choir participation on well-being by including a non–singing control group and measuring several different aspects of physical and mental health as well as participants’ perspectives regarding any changes in their work environment and overall health. A total of 426 employees in two Norwegian hospitals participated, and the researchers found that certain employees were less likely to participate, including men, older people, younger people, and workers who were employed only part–time, had university–level education, or worked in healthcare. Those who did participate in the choir reported higher levels of engagement, commitment, work satisfaction, and health. These findings support the use of activities, singing in particular, in the workplace, though further research is needed.
View the article here.
“The Use of Singing–in–a–Group as a Response to Adverse Life Events”
This study by Von Lob, Camic, and Clift (2010) used interviews of 16 nonprofessional choir singers in England to determine the effect of choir singing on individuals after a significant negative life event. The researchers analyzed the interviews in order to better understand participants’ well–being and mental health, finding six common themes. On an interpersonal level, the singers said the choir helped them to build new relationships and also was an opportunity for a positive collective experience. The other themes were more personal in nature, with the choir providing an opportunity to build competence in singing, feel a sense of purpose, improve their ability to manage their emotions, and foster a sense of meaning in their lives.
View the article here.
Aging
Studies Summarized
Clift, S., Skingley, A., Coulton, S., & Rodriguez, J. (2012). “A controlled evaluation of the health benefits of a participative community singing programme for older people.”
Cohen, G., Perlstein, S., Chapline, J., Kelly, J., Firth, K., & Simmens, S. (2006). “The impact of professionally conducted cultural programs on the physical health, mental health, and social functioning of older adults.”
Coulton, S., Clift, S. Skingley, A., & Rodriguez, J. (2015). “Effectiveness and cost–effectiveness of community singing on mental health–related quality of life of older people: randomised controlled trial.”
Davidson, J., & Faulkner, R. (2010). “Meeting in music: The role of singing to harmonise carer and cared for.”
Johnson, J. K., Louhivuori, J., Stewart, A. L., Tolvanen, A., Ross L., & Era P. (2013). “Quality of life (QOL) in older adult community choral singers in Finland.”
Skingley, A., Martin, A., & Clift, S. (2015). “The contribution of community singing groups to the well–being of older people: Participant perspectives from the United Kingdom.”
Teater, B., & Baldwin, M. (2012). “Singing for successful ageing: The perceived benefits of participating in the Golden Oldies community–arts program.”
Zanini, C. R. O., & Leao, E. (2006). “Therapeutic choir—a music therapist looks at the new millenium elderly.”
“A Controlled Evaluation of the Health Benefits of a Participative Community Singing Programme for Older People”
Over the course of two years, Clift, Skingley, Coulton, and Rodriguez evaluated the effects of a twelve–week singing group on seniors’ health (2012). Participants, separated into an experimental group who participated in the choir groups and a control group who did not, filled out health surveys at the beginning and end of the choral group, as well as an additional follow–up survey three months later. Singers reported improved mental health, including lower anxiety and depression levels, at the end of participation in the choral group, and these effects persisted through the three–month follow-up, though to a lesser degree. The levels of depression had started as higher than the national average, so these findings were encouraging, though they could not pinpoint the exact source of the benefit—the group or the singing.
View the article here.
“The Impact of Professionally Conducted Cultural Programs on the Physical Health, Mental Health, and Social Functioning of Older Adults”
This study by Cohen, Perlstein, Chapline, Kelly, Firth, and Simmens (2006) investigated the effects of a community choir on the physical and mental health of elderly individuals. It was a controlled study, with participants separated into an experimental choir group and control group which participated in another group activity. Researchers used questionnaires and self–reports to determine a baseline and potential differences. The results showed that individuals participating in the choir benefited from better health, indicated by self–reported feelings as well as decreased doctor appointments, medications, and falls. Individuals who participated in the choir also had significantly higher morale, felt less alone, and engaged in more activities than the control group. These findings provide staunch support for the use of group singing as a preventative measure for individuals as they age.
View the article here.
“Effectiveness and Cost–Effectiveness of Community Singing on Mental Health–Related Quality of Life of Older People:
Randomised Controlled Trial”
ABSTRACT NEEDS TO BE WRITTEN View the article here.
“Meeting in Music: The Role of Singing
to Harmonise Carer and Cared For”
Davidson and Faulkner (2010) investigated a singing–based music therapy program’s effects on the well–being of the participants, all of whom were elderly or disabled and participating in another community support program. The project focused not only on the effects on patients, but also on caregivers. The researchers postulate that this type of music therapy may actually be best facilitated by a local musician versus a professional therapist, as long as the musician has the basic skills necessary to lead this type of group. After the choir had been active for one year, the benefits seen by the researchers and facilitators encouraged them to continue running the choir.
View the article here.
“Quality of Life (QOL) in Older Adult Community
Choral Singers in Finland”
This 2013 study by Johnson, Louhivuori, Stewart, Tolvanen, Ross, and Era reviewed the effects of choir participation on quality of life for the elderly. There was no control group, but 117 choral singers in Finland filled out several surveys which showed significant increases in participants’ psychological well–being, relationships with others, and connection with the environment. These findings further the overall body of research with encouraging results for group singing as a therapeutic or preventative health measure for the elderly.
View the article here.
“The Contribution of Community Singing Groups to the Well–Being of Older People: Participant Perspectives from the United Kingdom”
Skingley, Martin, and Clift (2015) built on the existing body of research on group singing for the elderly by designing a randomized, controlled study including qualitative analysis. In their study, 131 participants volunteered for the group singing program for 14 weeks and submitted feedback regarding their well–being at three different points. Their feedback was reviewed for emerging themes, and the researchers found “specific, incremental benefits” to participants’ well–being in four different aspects, including physical and mental health.
View the article here.
“Singing for Successful Ageing: The Perceived Benefits of
Participating in the Golden Oldies Community–Arts Programme”
Teater and Baldwin (2012) investigated the effectiveness of group music therapy as an alternative source of support for senior citizens, which is a growing need in the UK. The researchers evaluated the program’s effect on participants’ “sense of health, self–development and social connectedness” (2012). The vast majority of the 120 participants reported that these areas were greatly improved and that their health was significantly better than prior to participating in the music group. In a few interviews, participants reported feeling less isolated and feeling that the group was a form of therapy. The researchers believed that these results supported the use of group music therapy in a preventative capacity.
View the article here.
“Therapeutic Choir—A Music Therapist Looks
at the New Millennium Elderly”
This study was conducted by Zanini and Leao to investigate the effects of choir participation on elderly individuals in Brazil (2006). The researchers interviewed singers and found multiple themes relating to better well-being, including the joy derived from singing and using their voices. Participants also enjoyed learning how to use their voices as instruments, seeing their improvement, and forming bonds with others in the choir. Singing classic songs served as a form of reflection, and singing in general helped to boost self–confidence and feelings of hope. The interviews also lend support to the idea that choir participation can prevent issues with mental health and poor quality of life.
View the article here.
Conclusion
References
Amengual, J. L., Rojo, N., Heras, M. V., Marco-Pallares, J., Grau-Sanchez, J., Schneider, S., … Rodriguez-Fornells, A. (2013). “Sensorimotor plasticity after music–supported therapy in chronic stroke patients revealed by transcranial magnetic stimulation.” PLoS ONE, 8(4), e61883. http://dx.doi.org/10.1371/journal.pone.0061883
Anshel, A., & Kipper, D. A. (1988). “The influence of group singing on trust and coöperation.” Journal of Music Therapy, 25(3), 145-155. http://dx.doi.org/10.1093/jmt/25.3.145
Bailey, B. (2006). “Perceived holistic health effects of three levels of music participation.” Canadian Acoustics, 34(3), 22-23. http://jcaa.caa-aca.ca/index.php/jcaa/article/view/1803
Bailey, B., & Davidson, J. (2001). “Emotional, social, and cognitive enrichment through participation in group singing: interviews with members of a choir for homeless men.” The Phenomenon of Singing, 3, 24-32. http://journals.library.mun.ca/ojs/index.php/singing/article/view/625
Bailey, B., & Davidson, J. (2005) “Effects of group singing and performance for marginalized and middle–class singers.” Psychology of Music, 33(3), 269-303. http://dx.doi.org/10.1177/0305735605053734
Baines, S. (2003). “A consumer–directed and partnered community mental health music therapy program: Program development and evaluation.” Voices: A World Forum for Music Therapy, 3(3), http://dx.doi.org/ 10.15845/voices.v3i3.137
Bannan, N., & Montgomery-Smith, C. (2008). “Singing for the brain: Reflections on the human capacity for music arising from a pilot study of group singing with Alzheimer’s patients.” The Journal of the Royal Society for the Promotion of Health, 128, 73-78. http://dx.doi.org/10.1177/1466424007087807
Baumeister, R. F., & Leary, M. R. (1995). “The need to belong: Desire for interpersonal attachments as a fundamental human motivation. Psychological Bulletin, 117(3), 497-529.
Beck, R. J., Cesario, T. C., Yousefi, A., & Enamoto, H. (2000). “Choral singing, performance perception, and immune system changes in salivary immunoglobulin a and cortisol.” Music Perception: An Interdisciplinary Journal, 18(1), 87-106. http://www.jstor.org/stable/40285902
Bento Allpress, R., Clift, S., & Legg, L. (2012). “Effects of Group Singing on Psychological States and Cortisol.” Proceedings from the 12th International Conference on Music Perception and Cognition and the 8th Triennial Conference of the European Society for the Cognitive Sciences of Music, Thessaloniki, Greece. http://icmpc-escom2012.web.auth.gr/files/papers/90_Proc.pdf
Bittman, B., Berk, L., Shannon, M., Sharaf, M., Westengard, J., Guegler, K. J., & Ruff, D. W. (2005). “Recreational music-making modulates the human stress response: A preliminary individualized gene–expression strategy.” Medical Science Monitor, 11(2), BR31–BR40. http://www.medscimonit.com/abstract/index/idArt/14140
Bonde, L. O. (2011). “Health musicing—music therapy or music and health? A model, empirical examples and personal reflections.” Music and Arts in Action, 3(2), 120-140. http://www.musicandartsinaction.net/index.php/maia/article/view/healthmusicingmodel
Bonilha, A. G., Onofre, F., Vieira, M. L., Prado, M. Y. A., & Martinez, J. A. B. (2009). “Effects of singing classes on pulmonary function and quality of life of COPD patients.” International Journal of Chronic Obstructive Pulmonary Disease, 4, 1–8. http://dx.doi.org/10.2147/COPD.S4077
Brown, S., Martinez, M. J., Hodges, D. A., Fox, P. T., & Parsons, L. M. (2004). “The song system of the human brain.” Cognitive Brain Research, 2(3), 363-375. http://dx.doi.org/10.1016/j.cogbrainres.2004.03.016
Camic, P. M., Williams, C. M., & Meeten, F. (2013). “Does a ‘singing together group’ improve the quality of life of people with dementia and their carers? A pilot evaluation study.” Dementia, 12(2), 157-176. http://dx.doi.org/10.1177/1471301211422761
Chapin, H., Jantzen, K., Scott Kelso, J. A., Steinberg, F., & Large, E. (2010). “Dynamic emotional and neural responses to music depend on performance expression and listener experience.” PLoS ONE, 5(12), e13812. http://dx.doi.org/10.1371/journal.pone.0013812
Chorus America (2009). “The Chorus Impact Study.” https://www.chorusamerica.org/publications/research-reports/chorus-impact-study
Clements-Cortes, A. (2013) “Buddy’s Glee Club: Singing for life.” Activities, Adaptation & Aging, 37(4), 273-290. http://dx.doi.org10.1080/01924788.2013.845716
Clift, S. M., & Hancox, G. (2001). “The perceived benefits of singing: Findings from preliminary surveys of a university college choral society.” Perspectives in Public Health, 121(4), 248-256. http://dx.doi.org/10.1177/146642400112100409
Clift, S., & Hancox, G. (2010). “The significance of choral singing for sustaining psychological well–being: Findings from a survey of choristers in England, Australia and Germany.” Music Performance Research, 3(1), 79-96. http://mpr-online.net/Issues/Volume%203.1%20Special%20Issue%20[2010]/Clift%20Published%20Web%20Version.pdf
Clift, S., & Morrison, I. (2011). “Group singing fosters mental health and well-being: Findings from the East Kent ‘Singing for Health’ Network Project.” Mental Health and Social Inclusion, 15(2), 88-97. http://dx.doi.org/10.1108/20428301111140930
Clift, S., Morrison, I., Skingley, A., Page, A., Coulton, S., Treadwell, P., … Shipton, M. (2013). “An evaluation of community singing for people with COPD.” Sidney De Haan Research Centre for Arts and Health, Canterbury Christ Church University. https://www.canterbury.ac.uk/health-and-wellbeing/sidney-de-haan-research-centre/documents/Singing-and-COPD-Final-report.pdf
Clift, S., Skingley, A., Coulton, S., & Rodriguez, J. (2012). “A controlled evaluation of the health benefits of a participative community singing programme for older people.” Sidney De Haan Research Centre for Arts and Health, Canterbury Christ Church University. http://www.ahsw.org.uk/evaluation.aspx?id=448
Clift, S., Manship, S., & Stephens, L. (2017). “Further evidence that singing fosters mental health and wellbeing: the West Kent and Medway project.” Mental Health and Social Inclusion, Vol. 21 Issue: 1, pp.53-62. http://dx.doi.org/10.1108/MHSI-11-2016-0034
Clift, S., Page, S., Daykin, N., & Peasgood, E. (2016). “The perceived effects of singing on the health and well–being of wives and partners of members of the British Armed Forces: a cross–sectional survey.” Public Health, Volume 138 , 93—100. http://dx.doi.org/10.1016/j.puhe.2016.03.022
Cogo-Moreira, H., de Ávila, C. R. B., Ploubidis, G. B., & Mari, J. dJ. (2013). “Effectiveness of music education for the improvement of reading skills and academic achievement in young poor readers: A pragmatic cluster-randomized, controlled clinical trial.” PLoS ONE, 8(3), e59984. http://dx.doi.org/10.1371/journal.pone.0059984
Cohen, G., Perlstein, S., Chapline, J., Kelly, J., Firth, K., & Simmens, S. (2006). “The impact of professionally conducted cultural programs on the physical health, mental health, and social functioning of older adults.” The Gerontologist, 46(6), 726-73. http://dx.doi.org/10.1093/geront/46.6.726
Cohen, M. (2007). “Explorations of inmate and volunteer choral experiences in a prison–based choir.” Australian Journal of Music Education, 1, 61-72. http://search.informit.com.au/documentSummary;dn=098450341151360;res=IELHSS
Cohen, N., & Masse, R. (1993). “The application of singing and rhythmic instruction as a therapeutic intervention for persons with neurogenic communication disorders.” Journal of Music Therapy, 30(2), 81-99. http://dx.doi.org/10.1093/jmt/30.2.81
Coulton, S., Clift, S. Skingley, A., & Rodriguez, J. (2015). “Effectiveness and cost–effectiveness of community singing on mental health–related quality of life of older people: randomised controlled trial.” The British Journal of Psychiatry, Sep 2015, 207 (3) 250-255. http://dx.doi.org/10.1192/bjp.bp.113.129908
Davidson, J., & Faulkner, R. (2010). “Meeting in music: The role of singing to harmonise carer and cared for.” Art & Health: An International Journal for Research, Policy and Practice, 2(2), 164-170. http://dx.doi.org/10.1080/17533010903488608
Davidson, J., & Fedele, J. (2011). “Investigating group singing activity with people with dementia and their caregivers.” Musicae Scientiae, 15(3), 402-422. http://dx.doi.org/10.1177/1029864911410954
Di Benedetto, P., Cavazzon, M., Mondolo, F., Rugiu, G., Peratoner, A., & Biasutti, E. (2009). “Voice and choral singing treatment: A new approach for speech and voice disorders in Parkinson’s disease.” European Journal of Physical and Rehabilitation Medicine, 45(1), 13-9. http://www.minervamedica.it/en/journals/europa-medicophysica/article.php?cod=R33Y2009N01A0013
Dingle, G. A., Brander, C., Ballantyne, J., & Baker, F. A. (2013). “To be heard: The social and mental health benefits of choir singing for disadvantaged adults.” Psychology of Music, 41(4), 405-421. http://dx.doi.org/10.1177/0305735611430081
Dunbar, R.I., Kaskatis, K., MacDonald, I., & Barra, V. (2012). “Performance of music elevates pain threshold and positive affect: Implications for the evolutionary function of music.” Evolutionary Psychology, 10(4), 688-702. http://www.ncbi.nlm.nih.gov/pubmed/23089077
Eerola, P. S., & Eerola, T. (2013). “Extended music education enhances the quality of school life.” Music Education Research, 16(1), 88-104. http://dx.doi.org/10.1080/14613808.2013.829428
Elefant, C., Baker, F., Lotan, M., Krogstie Lagesen, S., & Skeie, G. O. (2012). “The effect of group therapy on mood, speech, and singing in individuals with Parkinson’s disease – a feasibility study.” Journal of Music Therapy, 49(3), 278-302. http://dx.doi.org/10.1093/jmt/49.3.278
Evans, C., Canavan, M., Foy, C., Langford, R., & Proctor, R. (2012). “Can group singing provide effective speech therapy for people with Parkinson’s disease?” Arts & Health: An International Journal for Research, Policy and Practice, 4(1), 83-95. http://dx.doi.org/10.1080/17533015.2011.584883
Fredenburg, H. A., & Silverman, M. J. (2014). “Effects of cognitive–behavioral music therapy on fatigue in patients in a blood and marrow transplantation unit: A mixed–method pilot study.” The Arts in Psychotherapy, 41(5), 433-444. http://dx.doi.org/10.1016/j.aip.2014.09.002
Freudenhammer, W., & Kreutz, G. (2009). “Development of vocal performance in 5th grade children: A longitudinal study of choral class singing.” Proceedings of the 7th Triennial Conference of European Society for the Cognitive Sciences of Music. https://jyx.jyu.fi/dspace/handle/123456789/20868
Gale, N. S., Enright, S., Reagon, C., Lewis, I., & van Deursen, R. (2012). “A pilot investigation of quality of life and lung function following choral singing in cancer survivors and their carers.” Ecancermedicalscience, 6, 261. http://dx.doi.org/10.3332/ecancer.2012.261
Gardstrom, S. C., & Diestelkamp, W. S. (2013). “Women with addictions report reduced anxiety after group music therapy: A quasi–experimental study.” Voices: A World Forum for Music Therapy,13(2). http://dx.doi.org/10.15845/voices.v13i2.681.
Grape, C., Sandgren, M., Hansson, L. O., Ericson, M., & Theorell, T. (2002). “Does singing promote well-being? An empirical study of professional and amateur singers during a singing lesson.” Integrative Physiological & Behavioral Science, 38(1), 65-74. http://dx.doi.org/10.1007/BF02734261
Grocke, D., Bloch, S., & Castle, D. (2009). “The effect of group music therapy on quality of life for participants living with a severe and enduring mental illness.” Journal of Music Therapy, 46(2), 90-104. http://dx.doi.org/10.1093/jmt/46.2.90
Groß, W., Linden, U., & Ostermann, T. (2010). “Effects of music therapy in the treatment of children with delayed speech development—results of a pilot study.” BMC Complementary & Alternative Medicine, 10, 39. http://dx.doi.org/10.1186/1472-6882-10-39
Harvey, R., Smith, M., Abraham, N., Hood, S., & Tannenbaum, D. (2007). “The hurricane choir: Remote mental health monitoring of participants in a community–based intervention in the post–Katrina period.” Journal of Health Care for the Poor and Underserved, 18(2), 356-361. http://dx.doi.org/10.1353/hpu.2007.0033
Hessenberg, C., & Schmid, W. (2013). “Sounding bridges—An intergenerational music therapy group with persons with dementia and children and adolescents in psychiatric care.” Voices: A World Forum for Music Therapy, 13(2), 1504-1611. http://dx.doi.org/10.15845/voices.v13i2.692
Irons, J. Y., Kenny, D. T., McElrea, M., & Chang, A. (2012). “Singing therapy for young people with cystic fibrosis: A randomized controlled pilot study.” Music and Medicine, 4(3), 136-145. http://dx.doi.org/10.1177/1943862112452150
Johnson, J. K., Louhivuori, J., Stewart, A. L., Tolvanen, A., Ross L., & Era P. (2013). “Quality of life (QOL) in older adult community choral singers in Finland.” International Psychogeriatrics, 25(7), 1055-1064. http://dx.doi.org/10.1017/S1041610213000422
Judd, M., & Pooley, J. A. (2014). “The psychological benefits of participating in group singing for members of the general public.” Psychology of Music, 42(2), 269-283. http://dx.doi.org/10.1177/0305735612471237
Kang, J., Scholp, A., Jiang, J. (2017). “A Review of the Physiological Effects and Mechanisms of Singing” Journal of Voice. http://dx.doi.org/10.1016/j.jvoice.2017.07.008
Kenny, D. T., & Faunce, G. (2004). “The impact of group singing on mood, coping and perceived pain in chronic pain patients attending a multidisciplinary pain clinic.” Journal of Music Therapy, 41(3), 241-258. http://dx.doi.org/10.1093/jmt/41.3.241
Khalaf-Beigi, M., Akbarfahimi, M., Ashayeri, H., Dorood, N., & Doostdar, H. (2012). “The effect of music on attention in schizophrenia.” Zahedan Journal of Research in Medical Sciences, 14(9), 8-13. http://www.zjrms.ir/browse.php?a_code=A-10-1092-1&slc_lang=en&sid=1
Kolyada, Y. (2009). A compendium of musical instruments and instrumental terminology in the Bible. New York, NY: Routledge.
Kreutz, G., Bongard, S., Rohrmann, S., Grebe, D., Bastian, H. G., & Hodapp, V. (2003). “Does singing provide health benefits?” Proceedings of the 5th Triennial ESCOM Conference, Hanover University of Music and Drama, Germany, 2003, 216-219. http://www.epos.uos.de/books/k/klww003/pdfs/168_Kreutz_Proc.pdf
Kreutz, G., Bongard, S., Rohrmann, S., Hodapp, V., & Grebe, D. (2004). “Effects of choir singing or listening on secretory immunoglobulin A, cortisol, and emotional state.” Journal of Behavioral Medicine, 27(6), 623-35. http://dx.doi.org/10.1007/s10865-004-0006-9
Krout, R.E. (2001). “The effects of single-session music therapy interventions on the observed and self–reported levels of pain control, physical comfort, and relaxation of hospice patients.” The American Journal of Hospice and Palliative Care, 18(6), 383-390. http://dx.doi.org/10.1177/104990910101800607
Liebowitz, M., Tucker M. S., Frontz M., & Mulholland S. (2015). “Participatory choral music as a means of engagement in a veterans’ mental health and addiction treatment setting.” Arts & Health: An International Journal for Research, Policy and Practice, 7(2), 137-150. http://dx.doi.org/10.1080/17533015.2014.999246
Lindblad, F., Hogmark, A., & Theorell, T. (2007). “Music intervention for 5th and 6th graders—effects on development and cortisol secretion.” Stress and Health, 23(1), 9-14. http://dx.doi.org/10.1002/smi.1109
Lord, V., Cave, P., Hume, V. J., Flude, E. J., Evans, A., Kelly, J. L., …Hopkinson, N. S. (2010). “Singing teaching as a therapy for chronic respiratory disease—a randomised controlled trial and qualitative evaluation.” BMC Pulmonary Medicine, 10(41). http://dx.doi.org/10.1186/1471-2466-10-41
Lord, V., Hume, V. J., Kelly, J. L., Cave, P., Silver, J., Waldman, M.,… Hopkinson, N. S. (2012). “Singing classes for chronic obstructive pulmonary disease: A randomized controlled trial.” BMC Pulmonary Medicine, 12(69). http://dx.doi.org/10.1186/1471-2466-12-69
Ludke, K. M., Ferreira, F., & Overy, K. (2013). “Singing can facilitate foreign language learning.” Memory & Cognition, 42(1), 41-52. http://link.springer.com/article/10.3758%2Fs13421-013-0342-5#page-1
Mellor, L. (2013). “An investigation of singing, health and well-being as a group process.” British Journal of Music Education, 30(2), 177-205. http://dx.doi.org/10.1017/S0265051712000563.
Millard, K. O., & Smith, J. (1989). “The influence of group singing therapy on the behavior of Alzheimer’s disease patients.” Journal of Music Therapy, 26(2), 58-70. http://dx.doi.org/10.1093/jmt/26.2.58
Mitchell, L. A., MacDonald, R. A. R., Knussen, C., & Serpell, M. G. (2007). “A survey investigation of the effects of music listening on chronic pain.” Psychology of Music, 35(1), 37-57. http://journals.sagepub.com/doi/abs/10.1177/0305735607068887
Moreno, S., Bialystok, E., Barac, R., Schellenberg, E.G., Cepeda, N.J., & Chau, T. (2011). “Short-term music training enhances verbal intelligence and executive function.” Psychological Science, 22(11), 1425-1433. http://dx.doi.org/10.1177/0956797611416999
Morrison, I., Clift, S., Page, S., Salisbury, I., Shipton, M., Skingley, A.,… Treadwell, P. (2013). “A UK feasibility study on the value of singing for people with chronic obstructive pulmonary disease (COPD).” UNESCO Observatory Multi-Disciplinary Journal in the Arts, 3, 1-19. http://education.unimelb.edu.au/__data/assets/pdf_file/0003/1067421/ 003_MORRISON_PAPER.pdf
Müller V., & Lindenberger, U. (2011). “Cardiac and respiratory patterns synchronize between persons during choir singing.” PLoS ONE, 6(9), e24893. http://dx.doi.org/10.1371/journal.pone.0024893
Osman, S. E., Schneider, J., & Tischler, V. (2014). “‘Singing for the Brain’: A qualitative study exploring the health and well–being of singing for people with dementia and their carers.” Dementia: The International Journal of Social Research and Practice, 15(6), 1326-1339. http://dx.doi.org/10.1177/1471301214556291
Pacchetti, C., Mancini, F., Aglieri, R., Fundaro, C., Martignoni, E., & Nappi, G. (2000). “Active music therapy in Parkinson’s disease: An integrative method for motor and emotional rehabilitation.” Psychosomatic Medicine, 62(3), 386-393. http://dx.doi.org/10.1097/00006842-200005000-00012
Pai, I., Lo, S., Wolf, D., & Kajieker, A. (2008). “The effect of singing on snoring and daytime somnolence.” Sleep and Breathing, 12(3), 265-268. http://dx.doi.org/10.1007/s11325-007-0159-1
Pavlakou, M. (2009). “Benefits of group singing for people with eating disorders: Preliminary findings from a non–clinical study.” Approaches: Music Therapy & Special Music Education, 1(1), 30-48. http://approaches.gr/wp-content/uploads/2015/09/Approaches_112009_Pavlakou_Article.pdf
Pearce, E., Launay, J., & Dunbar, R. (2015). “The ice-breaker effect: singing mediates fast social bonding.” Royal Society Open Science, 2015 2 150221. Published 28 October 2015. http://dx.doi.org/10.1098/rsos.150221.
Pearce, E., Launay, J., van Duijn, M., Rotkirch, A., David-Barrett, T., & Dunbar, R. (2016). “Singing together or apart: the effect of competitive and coöperative singing on social bonding within and between sub–groups of a university fraternity.” Psychology of Music, Vol 44, Issue 6, pp. 1255—1273. First published date: March-29-2016. http://dx.doi.org/10.1177/0305735616636208
Petchkovsky, L., Robertson-Gillam, K., Kropotov, J., & Petchkovsky, M. (2014). “Using QEEG parameters (asymmetry, coherence, and P3a Novelty response) to track improvement in depression after choir therapy.” Advances in Mental Health: Promotion, Prevention and Early Intervention, 11(3), 257-267. http://dx.doi.org/10.5172/jamh.2013.11.3.257
Repar, P. A., & Reid, S. (2014). “Creatively caring: Effects of arts–based encounters on hospice caregivers in South Africa.” Journal of Pain and Symptom Management, 47(5), 946-954. http://dx.doi.org/10.1016/j.jpainsymman.2013.10.023
Ridder, H. M. O. (2003). Singing dialogue: Music therapy with persons in advanced stages of dementia.: A case study research design. (Doctoral dissertation). Retrieved from Institut for Musik og Musikterapi, Aalborg Universitet. http://vbn.aau.dk/en/publications/singing-dialogue–music-therapy-with-persons-in-advanced-stages-of-dementia%2872c09dd0-0ced-11db-b2f1-000ea68e967b%29.html
Robb, S. L. (2000). “The effect of therapeutic music interventions on the behavior of hospitalized children in isolation: Developing a contextual support model of music therapy.” Journal of Music Therapy, 37(2), 118-146. http://dx.doi.org/10.1093/jmt/37.2.118
Roma, C. (2010). “Re–sounding: Refuge and reprise in a prison choral community.” International Journal of Community Music, 3(1), 91-102. http://dx.doi.org/10.1386/ijcm.3.1.91/1
Romito, F., Lagatolla, F., Costanzo, C., Giotta, F., & Mattioli, V. (2013). “Music therapy and emotional expression during chemotherapy. How do breast cancer patients feel?” European Journal of Integrative Medicine, 5(5), 438-442. http://dx.doi.org/10.1016/j.eujim.2013.04.001
Rumball, K. (2010). “The effects of group musical activity on psychiatric patients in India.” Voices: A World Forum for Music Therapy, 10(2), 1504-1611. http://dx.doi.org/10.15845/voices.v10i2.164
Ruud, E. (2013). “Can music serve as a ‘cultural immunogen’? An explorative study.” International Journal of Qualitative Studies on Health and Well-being, 8(1), 1748-2631, http://dx.doi.org/10.3402/qhw.v8i0.20597
Sakano, K., Ryo, K., Tamaki, Y., Nakayama, R., Hasaka, A., Takahashi, A., … Saito, I. (2014). “Possible benefits of singing to the mental and physical condition of the elderly.” Biopsychosocial Medicine, 8(11), 1-10. http://dx.doi.org/10.1186/1751-0759-8-11
Sanal, A. M., & Gorsev, S. (2014). “Psychological and physiological effects of singing in a choir.” Psychology of Music, 42(3), 307-324. http://dx.doi.org/10.1177/0305735613477181
Sandgren, M. (2009). “Evidence for strong immediate well-being effects of choral singing—with more enjoyment for women than men.” Proceedings of the 7th Triennial Conference of European Society for the Cognitive Sciences of Music. Jyvaskylan, Finland. https://jyx.jyu.fi/dspace/handle/123456789/20916
Schafer, T., Sedlmeier, P., Stadtler, C., & Huron, D. (2013). “The psychological functions of music listening.” Frontiers in Psychology, 4, 511. http://dx.doi.org/10.3389/fpsyg.2013.00511
Schellenberg, E. G. (2005). “Music and cognitive abilities.” Current Directions in Psychological Science, 14(6), 317-320. http://journals.sagepub.com/doi/abs/10.1111/j.0963-7214.2005.00389.x
Schlaug, G., Marchina, S., & Norton, A. (2008). “From singing to speaking: Why singing may lead to recovery of expressive language function in patients with Broca’s aphasia.” Music Perception, 25(4), 315-323. http://dx.doi.org/10.1525/MP.2008.25.4.315
Skingley, A., Martin, A., & Clift, S. (2015). “The contribution of community singing groups to the well-being of older people: Participant perspectives from the United Kingdom.” Journal of Applied Gerontology, 25(4), 1-23. http://dx.doi.org/10.1177/0733464815577141
Skingley, A., Page, S., Clift, S., Morrison, I., Coulton, S., Treadwell, P., Vella-Burrows, T., Salisbury, I., Shipton, M. (2014). “Singing for Breathing”: Participants’ perceptions of a group singing programme for people with COPD.” Arts & Health 6:1, pages 59-74. http://dx.doi.org/10.1080/17533015.2013.840853
Slater, J., Strait, D.L., Skoe, E., O’Connell, S., Thompson, E., & Kraus, N. (2014). “Longitudinal effects of group music instruction on literacy skills in low-income children.” PLoS ONE, 9(11), e113383. http://dx.doi.org/10.1371/journal.pone.0113383
Let’s Not Sing Tipperary. http://letsnotsingtipperary.co.uk/
Southcott, J., & Joseph, D. (2010). “Sharing community through singing: The Bosnian Behar Choir in Victoria, Australia.” E-Journal of Studies in Music Education, 8(2), 17-27. http://hdl.handle.net/10536/DRO/DU:30024769
Stewart, N. A. J., & Lonsdale, A. J. (2016). “It’s better together: The psychological benefits of singing in a choir.” Psychology of Music, 44(6), 1240-1254. https://doi.org/10.1177/0305735615624976
Sun, J., & Buys, N. (2013). “Effectiveness of a participative community singing program to improve health behaviors and increase physical activity in Australian Aboriginal and Torres Strait Islander people.” International Journal on Disability and Human Development, 12(3), 297-304. https://www.degruyter.com/view/j/ijdhd.2013.12.issue-3/ijdhd-2012-0131/ijdhd-2012-0131.xml
Svansdottir, H.B., & Snaedal, J. (2006). “Music therapy in moderate and severe dementia of Alzheimer’s type: A case–control study.” International Psychogeriatrics, 18(4), 613-621. http://dx.doi.org/10.1017/S1041610206003206
Tamplin, J. (2008). “A pilot study into the effect of vocal exercises and singing on dysarthric speech.” NeuroRehabilitation, 23(3), 207-216. http://www.ncbi.nlm.nih.gov/pubmed/18560137
Tamplin, J., Baker, F. A., Grocke, D., Brazzale, D. J., Pretto, J. J., Ruehland, W. R., … Berlowitz, D. J. (2013). “Effect of singing on respiratory function, voice, and mood after quadriplegia: A randomized controlled trial.” Archives of Physical Medicine and Rehabilitation, 94(3), 426-434. http://dx.doi.org/10.1016/j.apmr.2012.10.006
Tamplin, J., Baker, F. A., Jones, B., Way, A., & Lee, S. (2013). “ ‘Stroke a chord’: The effect of singing in a community choir on mood and social engagement for people living with aphasia after a stroke.” Neurorehabilitation, 32(4), 929-941. http://dx.doi.org/10.3233/NRE-130916
Tang, W., Yao, X., & Zheng, Z. (1994). “Rehabilitative effect of music therapy for residual schizophrenia: A one-month randomised controlled trial in Shanghai.” The British Journal of Psychiatry, 165(24), 38-44. http://www.ncbi.nlm.nih.gov/pubmed/7946230
Tavormina, R. J., & Gao, J. H. (2013). “Maslow and the motivation hierarchy: Measuring satisfaction of the needs.” The American Journal of Psychology, 126(2), 155-177. http://dx.doi.org/10.5406/amerjpsyc.126.2.0155
Tavormina, M.G., Tavormina, R., & Nemoianni, E. (2014). “The singing–group: A new therapeutic rehabilitation for mood disorders.” Psychiatria Danubia, 26(1), 173-177. http://www.ncbi.nlm.nih.gov/pubmed/25413536
Teater, B., & Baldwin, M. (2012). “Singing for successful ageing: The perceived benefits of participating in the Golden Oldies community–arts program.” The British Journal of Social Work, 44(1), 81-99. http://dx.doi.org/10.1093/bjsw/bcs095
Ulrich, G., Houtmans, T., & Gold, C. (2007). “The additional therapeutic effect of group music therapy for schizophrenic patients: A randomized study.” Acta Psychiatrica Scandinavica, 116(5), 362-370. http://dx.doi.org/10.1111/j.1600-0447.2007.01073.x
Unwin, M., Kenny, D. T., & Davis, P. (2002). “The effects of group singing on mood.” Psychology of Music, 30(2), 175-185. http://dx.doi.org/10.1177/0305735602302004
Vaag, J., Saksvik, P. O., Theorell, T., Skillingstad, T., & Bjerkeset, O. (2013). “Sound of well–being—choir singing as an intervention to improve well–being among employees in two Norwegian county hospitals.” Arts & Health, 5(2), 93-102. http://dx.doi.org/10.1080/17533015.2012.727838
Vickhoff, B., Malgren, H., Åström, R., Nyberg, G., Ekström, S. R., Engwall, M., … Jörnsten, R. (2013). “Music structure determines heart rate variability of singers.” Frontiers in Psychology, 4, 334. http://dx.doi.org/10.3389/fpsyg.2013.00334
Von Lob, G., Camic, P., & Clift, S. (2010). “The use of singing–in–a–group as a response to adverse life events.” International Journal of Mental Health Promotion, 12(3), 45—53. http://dx.doi.org/10.1080/14623730.2010.9721818
Wan, C.Y., Bazen, L., Baars, R., Libenson, A., Zipse, L., Zuk, J., … Schlaug, G. (2011). “Auditory–motor mapping training as an intervention to facilitate speech output in non–verbal children with autism: A proof of concept study.” PLoS ONE, 6(9), e25505. http://dx.doi.org/10.1371/journal.pone.0025505
Weinstein, D., Launay, J., Pearce, E., Dunbar, R., & Stewart, L. (2015). “Singing and social bonding: changes in connectivity and pain threshold as a function of group size.” Evolution and Human Behavior, Volume 37 , Issue 2 , 152—158. http://dx.doi.org/10.1016/j.evolhumbehav.2015.10.002
Wilkinson, E. (2015). Chinese history: A new manual (4th ed.). Cambridge, MA: Harvard University Press. ARTICLE NOT USED IN BOOK
Yasuhara, A., & Sugiyama, Y. (2001). “Music therapy for children with Rett syndrome.” Brain and Development, 23(1), S82-S84. http://dx.doi.org/10.1016/S0387-7604(01)00336-9
Zanini, C. R. O., & Leao, E. (2006). “Therapeutic choir—a music therapist looks at the new millenium elderly.” Voices: A World Forum for Music Therapy, 6(2), 1504-1611. http://dx.doi.org/10.15845/voices.v6i2.249
Zarate, J. M., Delhommeau, K., Wood, S., & Zatorre, R. J. (2010). “Vocal accuracy and neural plasticity following micromelody–discrimination training.” PLoS ONE, 5(6), e11181. http://dx.doi.org/10.1371/journal.pone.0011181
|
