Synchrony during music therapy and its relationship to self-reported therapy readiness: a mixed-methods case series study

Nonverbal synchronisation is a crucial aspect of therapeutic relationships, and heart-rate synchrony relates to shared states and joint participation. Differentiating who leads during the synchrony provides further important information.

This mixed-methods PhD study investigated the emergence of these synchronies and their relationships to therapy readiness during single music therapy sessions. 11 patients from a neurorehabilitation setting, without restrictions of verbal processing or physical movements, participated with a music therapist. A comparison of dyadic therapy interactions and leading characteristics in segments of high and low heart-rate synchrony, and between dyads with high positive and negative change in nonverbal synchrony were made. Heart-rate synchrony and dyadic therapy interactions during moments of interest were also examined. The aim is to deepen the understanding of interpersonal synchrony in music therapy research, probe the tools available, and make recommendations to improve music therapy in neurology.

Nonverbal and heart-rate synchrony were found to exist beyond randomness during music therapy sessions. After music intervention, nonverbal synchrony and patient leading increased, and a negative correlation was found between nonverbal synchrony and self-reported therapy readiness. Patients showed more empowerment and external awareness, and the dyads appeared more connected and relaxed, in segments of high heart-rate synchrony as compared to low heart-rate synchrony segments. Changes in nonverbal synchrony were found to be related to the relationship quality (independent vs dependent) and the revelations during music interventions. Heart-rate synchrony was negatively correlated to the therapist’s assessment of the patient’s therapy readiness. Moments of interest appeared during high and low heart-rate synchrony segments, and their prevalence suggests the perceptions of such moments. Based on the interaction observations, high heart-rate synchrony is desirable in neurorehabilitation. Music intervention duration was found to influence the level of heart-rate synchrony, and the results indicated an optimal active music intervention duration of about 25 minutes.