RCT: Examining the Effects of Music, Imagery & Movement (MiM) to Reduce Depression in Assisted Living

Background and Purpose

Research findings suggest that older adults in residential care settings, compared with those in the community, are at risk for lower quality of life as indicated by higher depression rates (Grayson, Lubin, & Van Whitlock, 1995) and social isolation (Kemp, Ball, Hollingsworth, & Perkins, 2011). Engagement in creative arts activities, such as sculpting, drawing, painting, writing, music, and movement has positive effects on older adults’ physiological and psychological health (Stuckey, & Nobel, 2010). Specifically, creative arts provide purpose, meaning, and social connection for older adults living in long-term care facilities (Rollins, 2013).Considering the increasing number of people who are in need of residential care, advancing the adoption of evidence-based interventions that promote well-being and enhance quality of life for individuals in long-term care facilities is timely. This study presents results from a Randomized Controlled Trial (RCT) examining the efficacy of a 10-week 20-session music, imagery, and movement (MiM) intervention on depression scores, as compared to standard conversational social control condition, for older adults in assisted living.

Methods

MiM is individualized in music selection, participatory, and socially interactive, and is conducted in a group setting. Novel to other interventions, our MiM model integrates three creative arts modalities – music, imagery and visual expression, and movement. Siegel (2012) suggests that social experiences offer the opportunity for self-organization and new expressions of the self, and that creative processes that take place within the context of positive social relationships can offer both interpersonal and neural integration outcomes. In a RCT (N=20) we compared our MiM treatment protocol against a standard conversational social control group on depression scores as measured by the Geriatric Depression Scale.

 

Results

IBM SPSS statistical analytic package version 22 was used to analyze the quantitative data. Repeated measures analysis showed a statistically significant reduction in depression for the MiM group ( = 1.56) as compared to the social control conversation group ( = 4.10), at the end of the ten week treatment (p<.05). At six week follow up, both groups regressed slightly back to pre-treatment scores, with the MiM group showing less regression in scores as compared to the social control group. Data from the qualitative interviews suggested that enhanced positive social engagement may be a key therapeutic mechanism of change that differed across the MiM and social control conversation groups.

Conclusions and Implications

Creative arts can help older adults evoke positive memories, connect in emotionally meaningful ways with others, and reduce behavioral agitation (Stuckey & Nobel, 2010). Music and the visual arts help a person organize external sensory stimuli in familiar ways, and participation in creative activities has been shown to reduce depression in older adult populations (Bohlmeijer, et al., 2005).  Thus, in long term care facilities where isolation, depression, and minimal social interaction can be the norm, activities and groups that bring people together and help them connect in meaningful ways can improve resident mood and enhance residential community morale.  This study showed an impact of MiM on depression reduction; a finding consistent with the existing literature.