Music therapy: Clinical and socioeconomic outcomes and long-term measures in substance use disorder

Background

Substance use disorder (SUD) carries a substantial global burden of disease. Music therapy (MT) has shown promise as a supplementary intervention, engaging the brain’s reward system while fostering, e.g. stress reduction and emotional regulation. Given high relapse rates post-treatment, investigating MT’s long-term effectiveness and appropriate outcome measurement instruments are critically important.

Objectives

Within the Horizon Europe project FALCO, this report aimed to: (1) identify clinical and socioeconomic outcome parameters, tools, and adverse event monitoring instruments; and (2) characterise validated instruments for long-term measurement, complemented by service user interviews.

Methods

A systematic search (February 2025) across 4 databases identified 7 reviews from 451 citations. 14 instruments were selected based on frequency, validity, and outcome coverage. 9 interviews with service users from Austria, Norway, and Poland were analysed using content analysis.

Results

7 reviews yielded 60+ outcomes across 11 parameters. No adverse event tools were identified. A Minimal Clinically Important Difference (MCID) was established only for depression. Instruments measuring stable constructs such as depression, problem severity, and self-efficacy were most suitable for long-term use. Limitations included self-report bias, cultural adaptation, and training requirements. Service users prioritised social parameters; findings revealed underrepresentation of social recovery. Latent analysis identified four patterns around social exclusion, cycles of use, and recovery; children, pets, and employment as facilitators.

Conclusions

Validated instruments exist, but gaps remain: absent MCIDs for SUD, limited long-term evidence, and no adverse event protocols. Future research should prioritise follow-ups, core outcome sets, and culturally adapted instruments incorporating social/socioeconomic dimensions. A participatory mixed-methods design is recommended.

Key messages

• Validated outcome instruments for MT in SUD exist, but lack MCIDs, long-term evidence, and adverse event tools; social recovery remains systematically undermeasured.

• Future research should prioritise long-term follow-up, consensus-based core outcome sets, culturally adapted instruments incorporating social/socioeconomic dimensions, and participatory methods.