Music and mental health: a practical guide to music therapy

As a counsellor, I have become interested in music therapy, and very recently, an opportunity has arisen for me to use music therapy as an intervention for a client. This article explains some of the links between music and mental health, and explores what music therapy is, what it might look like, and how it works.

When I was training as a social worker fifteen years ago, I studied and practised therapeutic ways of examining your past, culture, and values to understand yourself and others more, and I became aware that music is an important aspect of my life.

Music is everywhere and part of every culture. It’s a powerful force that connects us deeply to our feelings and memories. It can be used to express love, grief, joy, and community. For some, music can feel calming, regulating, and transformative.

As a mature adult, before any professional training, I had developed a view that you need to be careful what music you listen to. As a teenager, I used to listen to some depressing and excitable songs, which I feel at the time affected me negatively.

Music can remind us of things. Perhaps we can relate to the feelings and situation that the singer is singing about, and their feelings kind of transfer to us, or we replicate the feelings we had towards what the song is reminding us of. These feelings may be unpleasant.

Music doesn’t have to affect us negatively, though, and many people advocate its positive effects. It can reflect the mood we are in, and it is healthy to play music to acknowledge the mood and feeling we currently have. Music can also uplift our spirits and minds.

What is music therapy and how does it work?

Music therapy is an established psychological intervention, delivered by therapists to help clients with their emotional, physical, and social needs (British Association of Music Therapy, 2026).

In psychotherapy, music can be used to help clients express feelings that may be difficult to verbalise. Sound is used as a medium to explore, release, and understand a client’s feelings. For many, just simply listening to music mindfully provides a pathway of self-awareness and therapeutic effect.

Music therapy can benefit many different aspects of a person's well-being – mental, emotional, physical, social, and cognitive. Zaatar, Alhakim, Enayeh, & Tamer (2023) evidence that music can affect the brain’s emotional centres, releasing dopamine, the chemical linked to pleasure and reward. This is why a powerful song can move us to tears or lift our spirits instantly.

In an earlier career as an activity organiser in care homes for older people, I put on musical events for people living with dementia, where service users had mainly lost the ability to communicate verbally, but familiar old songs would awaken their memories and old feelings.  

Music is experienced by the body as well as the mind. Movement is embodiment. When we dance, tap a foot, or sway, we bypass the thinking process and let the body express emotions that may have no words. Moving to music helps us let go of stress and reconnect with ourselves.

Music can connect us to others, and clients may want to join group musical activities, e.g. drum circles, being in a band, or singing in a choir – all of which promote a sense of belonging and community. Through shared rhythms and harmonies, people can experience unity and emotional resonance, breaking down feelings of isolation.

What a typical music therapy session might involve

Music therapy may include playing music, singing, playing musical instruments, and even writing music. Sessions are planned and led by the therapist, in the context of the therapeutic relationship with the client, and qualify as a form of therapeutic intervention, as agreed in the therapy based on the client's needs and goals in therapy.

The average session time is 50 minutes, so there needs to be a plan and intention agreed and made for each session, for some activity with music, and then discussion and reflection as to how the music has made the client feel (physically as well as mentally), and what they can take from this. If the music is a song, then lyrics and meaning can be discussed.  

How music can support emotional expression

Making music, whether through singing or playing an instrument, offers a unique form of expression. Music allows us to release tension, anger, sadness, and joy in a nonverbal way. It can be cathartic and a way to connect with our inner selves.

Music-making can help build self-esteem and confidence. By finding our own voice, rhythm, and self-expression, we nurture identity and self-awareness. This can be deeply healing and accessible to everyone, regardless of musical skill. Many cities and large towns have music venues where they hire out studios and instruments and provide jamming and karaoke sessions where people can release their distress, express themselves in a non-judgmental environment, have a good time, and connect with others. 

A case study

The music therapy I applied in practice came from a client expressing his love of rock music and his ability to sometimes express his feelings in the form of describing a song he’d just listened to. He had issues of unexpressed anger, which were internalised as depression and low self-esteem.

Discussing ways of channelling and expressing his anger, the client was initially finding it difficult to think of ideas on how to do this. He wasn’t into physical exercise and sport, didn't see himself as creative in any way, and didn't want to connect with many people to talk about his feelings. A breakthrough moment came when we both discovered we liked the same rock band.

Through a skilful use of self, I was able to relate to the client and empathise with some of the feelings he got from the songs I liked too. Making sure I didn’t spend the whole session discussing this favourite band of ours, we talked about the ideas behind music therapy.

I consulted with my supervisor to make sure I was on the right track, which I was, and the next week, the client agreed to three weeks of music therapy. He agreed to set an intention to pick one song each week that reflected a feeling that he had that week. He would play the song to me and then would explain what the song meant to him and express the feeling that the song was reflecting.

We would discuss the lyrics of the song and their meaning. We also discussed the context of the song, the band, the singer, its era, location, and the music – the sounds, different instruments, and genre/style of music it was, and whether he experienced any physical effects as well as mental effects.

After the three music therapy sessions, the client said that he had found them therapeutic. He enjoyed sharing his favourite music with someone, but more importantly, he said he felt happier and more well in himself through the therapy in general, but particularly, learning how to channel his anger and frustration and to express his feelings through music.

He said that the music sessions had been an uplifting experience for him. He was able to partly fulfil our therapeutic contract of him becoming more aware of his feelings, especially his anger, and to learn ways of channelling his anger. The client is even thinking of hiring a music studio and a drum kit for an hour at his local music venue, or finding a karaoke bar with his partner to try out some singing.

What does music mean to us?

I have been reminded of the therapeutic qualities of music. That it’s OK to listen to sad songs when we feel down, or upbeat tunes when feeling good. It’s great to become aware and conscious of the music we select. Through this, you can start a mindful practice of self-care. Music can become a companion on your journey toward emotional health, a way to express, regulate, and heal.

We can often feel isolated in the world today and be overwhelmed by so much information provided to us. We can counter this through music and benefit ourselves and others. Music is timeless and can be used to transform us. We can learn to listen more consciously and play more freely.

Music is universal, but as a male therapist, I am noticing that I get quite a lot of male clients. The music therapy experience I have recently had has made me aware that music therapy may be a way into a lot of men’s feelings. Many men may connect strongly with male artists and bands they relate to. Perhaps some awareness of this and the benefits of music therapy could assist therapists in encouraging men to be more open with their feelings?

Disclaimer: Any client work mentioned in this article has been anonymised, with no mention of names or location, plus the client gave consent for the work to be included in this article.