Mindfulness-Based Music Therapy Enhances Well-Being in Older Adults with Visual Impairments
- Lillian Chang, AMFF
- May 9
- 5 min read
This mindfulness-based practice report from Hong Kong explores whether Mindfulness-Based Music Therapy (MBMT) can effectively improve emotional regulation in older women with visual impairments. Let’s take a closer look at this fascinating study:"Clinical Effectiveness of Mindfulness-Based Music Therapy on Improving Emotional Regulation in Blind Older Women: A Randomized Controlled Trial" (Chan, 2023).
Theoretical Framework of MBMT
MBMT aims to intervene at different stages of the emotional regulation process, which is categorized as “Situation – Attention – Appraisal – Response.”The study hypothesizes that combining mindfulness and music creates a synergistic effect, enhancing the attention and appraisal components of emotional regulation.
For individuals with visual impairments, music serves as an ideal auditory anchor for mindfulness practice, allowing them to focus their attention and emotional processing effectively.
Mindfulness Component in MBMT
· Targets the "Attention" and "Appraisal" stages, encouraging present-moment awareness and non-judgmental acceptance of emotions.
· Mindful breathing is a core MBMT practice, helping individuals redirect attention from negative thoughts.
· Viewing emotions and thoughts as temporary experiences reduces self-blame and excessive rumination.
Music Component in MBMT
· Influences the "Situation" stage, where different music types and rhythms evoke various emotional experiences.
· Acts as an auditory guide, helping individuals focus on the present moment and interrupt negative thought cycles.
· Musical attributes (e.g., pitch and tone quality) impact emotional appraisal and interpretation of experiences.
Recruitment and Screening Process
· 106 participants were recruited from the Hong Kong Society of the Blind.
· 14 individuals were excluded due to not meeting eligibility criteria or being unavailable for participation.
Eligibility Criteria
To participate, individuals had to meet the following criteria:
1. Gender: Female
2. Visual Impairment: Blind or best eye visual acuity ≤ 20/400
3. Age: 65 years or older
4. Cognitive Function:
o Score > 12 on the Hong Kong Montreal Cognitive Assessment (HKMoCA-VI)
5. Language Ability: Fluent in Cantonese
· 92 eligible participants were randomly assigned to three study groups.
Random Assignment
· Participants were randomly assigned using computer-generated randomization lists.
· Simple randomization was used since all participants resided in care homes managed by the Hong Kong Society of the Blind.
Components of the MBMT Intervention
The MBMT program lasted 8 weeks, with one session per week, integrating mindfulness and music therapy.
Mindfulness Practices
· Guided mindful breathing exercises
· Breathing integrated with movement
· Enhancing awareness of bodily sensations
Music Therapy Components
· Listening to different types of music, including forest sounds and traditional Chinese songs
· Imagining oneself in specific emotional scenarios
· Simultaneously focusing on breathing while listening to music
The curriculum gradually integrates mindfulness exercises with music stimuli, training individuals to observe their breathing and emotions, fostering self-awareness and self-acceptance.
Research Findings: MBMT Improves Emotional Regulation
1. Enhancing Emotional Regulation
· Post-test results showed that both MBMT and Music Intervention (MI) groups scored significantly lower on the Difficulties in Emotion Regulation Scale (DERS) than the control group.
· MBMT participants showed a greater reduction in total DERS scores and in the "Emotional Awareness" subscale compared to the MI group.
o This suggests that integrating music with mindfulness provides additional benefits in emotional regulation.
2. Reducing Depression and Enhancing Mood
· MBMT participants demonstrated a significant reduction in Geriatric Depression Scale (GDS) scores.
o Compared to the MI group, MBMT showed a stronger trend towards reducing depressive symptoms (p = 0.053).
· Both MBMT and MI groups had significantly lower Depression Anxiety Stress Scale-21 (DASS-21) scores compared to the control group, indicating improved overall mood.
3. Qualitative Observations
· Researchers observed that MBMT participants were more attentive to music during sessions than MI participants.
· This suggests that mindfulness training helped sustain focus, increasing engagement with music and enhancing its therapeutic effect.
Comparing MBMT and Music-Only Intervention (MI)
Findings indicate that MBMT is more effective than MI alone in improving emotional regulation.
· Mindfulness training enhances attention control, reducing fixation on negative thoughts.
· Music elicits emotional responses and acts as an auditory intervention to further support emotional regulation.
· The combination fosters non-judgmental acceptance of emotions, promoting adaptive emotional responses.
Breakdown of MBMT’s Effects on Emotional Regulation
1. Improved Overall Emotional Regulation
· MBMT participants scored significantly lower on the DERS post-test compared to the control group.
· Lower DERS scores indicate smoother emotional regulation, showing that MBMT effectively helped participants manage emotions.
2. Enhanced Emotional Awareness
· Compared to MI alone, MBMT participants had significantly lower scores on the DERS Awareness Subscale.
· This suggests that MBMT is more effective than standalone mindfulness in improving emotional awareness.
3. Synergistic Effect of Mindfulness and Music
MBMT strengthened both attention and appraisal processes in emotional regulation.
Attention
· Mindfulness practices guided participants to focus on present-moment experiences, reducing fixation on negative thoughts.
· Music served as an auditory anchor, helping participants maintain attention and disrupt repetitive negative thinking.
· Qualitative observations showed that MBMT participants were more engaged during sessions than MI participants.
Appraisal
· Mindfulness encouraged non-judgmental acceptance of emotions, as reflected in the significant reduction in the DERS Non-Acceptance Subscale for both MBMT and MI groups compared to the control group.
· Music in MBMT evoked emotional experiences and potentially triggered memories, helping participants reappraise emotions and accept them more effectively.
4. Mood Improvement
· GDS results indicated MBMT participants had significantly reduced depressive symptoms, with a trend toward greater improvement than the MI group.
· Both MBMT and MI improved mood, as shown by lower DASS-21 scores.
· Emotional regulation improvements in MBMT were directly linked to significant reductions in depressive symptoms.
Conclusion
This study demonstrates that MBMT enhances emotional regulation in older women with visual impairments through:
1. Greater emotional awareness, allowing participants to better recognize and understand emotions.
2. Increased attention control, as mindfulness trained participants to focus on the present while music provided an auditory anchor.
3. Enhanced emotional reappraisal, as music helped participants reinterpret emotional triggers and accept emotions non-judgmentally.
4. Reduction in depressive symptoms, with MBMT participants showing greater improvements in mood than MI participants.
Significance for Visually Impaired Populations
The study highlights the unique role of music in mindfulness interventions for individuals with visual impairments, as music serves as an accessible focus point to enhance mindfulness practice.
Future Research Directions
Despite positive findings, researchers identified several limitations:
· No music-only control group, making it unclear how much of the benefit was from music alone.
· Small sample size, limiting generalizability.
· Lack of standardized music assessment tools, making it difficult to quantify music’s impact.
· Participants were not screened for emotional dysregulation levels, which may have influenced results.
· Findings are specific to older women with visual impairments, and future studies should include men and broader demographics.
Final Thoughts
MBMT represents an innovative approach to mindfulness interventions, integrating music to enhance emotional regulation for visually impaired individuals. Future studies should explore MBMT’s long-term effects and applicability across diverse populations.
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