Music Therapy and Co-Morbid Disorders

Music Therapy to Regulate Arousal and Attention in Patients with Substance Use Disorder and Posttraumatic Stress Disorder: A Feasibility Study

A collaborative effort of researchers from ArtEZ University of the Arts, VU University, and Tactus Addiction Care in the Netherlands, examined impacts of a recently developed music therapy protocol on attention and arousal regulation in individuals with both substance use disorder (SUD) and posttraumatic stress disorder (PTSD). Authors noted the frequent comorbidity of the two disorders, emphasizing the complex interaction of symptoms this creates and reviewing studies indicating symptoms of SUD may be more severe in those who additionally have PTSD. In a further summarizing related research, Hakvoort et al. (2020) suggested that music, particularly its rhythmic component, may be used as a therapeutic tool to help regulate and calm hyperactivity of the brain associated with both disorders. Six participants with diagnoses of SUD and PTSD, averaging 44 years of age, participated in six, one-hour music therapy sessions following Macfarlane’s (2019) short-term music therapy arousal and attention regulation treatment (SMAART) protocol. Music therapy sessions were facilitated in an outpatient treatment setting and involved abdominal breathing, singing, body percussion, and specific instrument play techniques. Attention shifts and stress responses in participants were carefully monitored and managed by the music therapists. Standardized assessment measures of PTSD symptoms, withdrawal and craving symptoms, and sustained and selective attention skills were administered pre and post intervention by a trained psychologist. Study outcomes revealed a decrease in hyperarousal and an improvement in mood, cognition, and sustained attention after completion of the sessions. Hakvoort et al. (2020) highlighted that these preliminary results suggest with further research, the short term music therapy protocol may be a promising treatment for reduction of undesired symptoms experienced by individuals with SUD and PTSD.


Hakvoort, L., de Jong, S., van de Ree, M., Kok, T., Macfarlane, C., & de Haan, H. (2020). Music therapy to regulate arousal and attention in patients with substance use disorder and posttraumatic stress disorder: A feasibility study. Journal of Music Therapy, 57(3), 353-378.

Macfarlane, C. (2019). Development of the SMAART protocol for adult male prisoners with PTSD. Music Therapy Today, 15(1), 21–32.