The Effect of Improvisation-Assisted Desensitization, and Music-Assisted Progressive Muscle Relaxation and Imagery on Reducing Pianists’ Music Performance Anxiety: a review by Rebecca Dideum

Article written by music therapy intern, Becca Dideum


The Effect of Improvisation-Assisted Desensitization, and Music-Assisted Progressive Muscle Relaxation and Imagery on Reducing Pianists’ Music Performance Anxiety: a Review


A study done by Youngshin Kim, PhD, MT-BC, NRMT, of Seoul, Korea, the purpose was to investigate the effects of two different music therapy approaches: improvisation-assisted desensitization, and music-assisted progressive muscle relaxation and imagery. MPA (Music performance anxiety) tends to be a prevalent problem for musicians, and thus there is a need for therapeutic interventions to manage stress and alleviate the effects of MPA.

Why use music therapy as a treatment of anxiety and stress? Music can promote relaxation response and thus reduce anxiety (Scartelli, 1989). Dileo-Maranto suggested that the most viable approach in treating MPA was the use of music: musicians have different physiological and psychological responses than non-musicians as a result of training (1992). A long-term and intense relationship with music may also allow musicians to feel more comfortable with music and to relate to a musical and therapeutic environment.

Dr. Kim’s study sampled thirty college-aged female piano students from a metropolitan area in northeast Asia. Participants were randomly assigned to one of two conditions: improvised music-assisted desensitization, or music-assisted progressive muscle relaxation and imagery. Previous to the start of the experiment, participants were asked to have prepared two 10-minute pieces of music that reflected their highest level of technical achievement: the two pieces had to include similar difficulties. Each participant participated in a beginning performance, a pretest, six weeks of music therapy intervention (30 minute sessions), a second performance, and a posttest.

The first performance compiled baseline data and was completed before beginning music therapy. Each subject performed for three professional musicians in a music studio. Prior to the performance, subjects measured their finger temperature with a thermometer taped to the left forefinger. After two minutes, subjects recorded their temperatures and performed their prepared pieces. Immediately after performing, subjects recorded self-report measures that included tension, stress, and comfort level.

All music therapy sessions were held in a private music studio. The same board-certified music therapist conducted every single session with each participant. Each session was conduced once a week and was approximately thirty minutes long. Subjects in the improvisation-assisted desensitization condition attended sessions with the following procedures:

  1. a) rhythmic breathing exercises and free piano improvisation (rhythmic breathing at 80 bpm; improv with no rules: therapist and subject took turns playing melody and chords),
  2. b) guided meditation and conversation (meditation through musical development and memory),
  3. c) development of hierarchy and desensitization training (made basic anxiety scale with fifteen performances; imagining a relaxing image and improvising to match image).

Subjects in the music-assisted progressive muscle relaxation (MPMRI) attended sessions with these procedures:

  1. a) rhythmic breathing and muscle relaxation training (breathing at 80 bpm; listening to subject’s preferred music while relaxing specific muscle groups),
  2. b) guided meditation and conversation (meditation through musical development and memory).

Results of the study concluded that there was no statistically significant difference between the two approaches in MPA, stress, and comfort. However, visual inspection of the mean scores showed that post-test scores were lower than pre-test scores by a small percentage. The first group (Improvisation-assisted desensitization) indicated statistically significant differences in 3/7 measures, while the second group (MPMRI) resulted in differences in 6/7 measures. This result could be due to the fact that the techniques used did not require any prerequisites; a non-musician could master the technique.

Improvisation is different for every musician. For me personally, improvisation took years of practice before I was comfortable with the concept. This was the case in the experiment; many musicians such as I are uncomfortable with the improvisation rule that there are no wrong notes. As a classically trained pianist, it took a lot to break out of the mold of chords and triads. During college, I often exhibited traits of MPA and used similar techniques to the ones used in the MPMTI group. I would recommend that technique based on personal experience, but just like improvisation, there is no wrong way to treat music performance anxiety.

To learn how music therapy can help you relax and cope with anxiety click here for a free consultation!

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Jamie George


Jamie founded The George Center for Music Therapy, Inc. in 2010 in order to expand and increase access to quality music therapy programs in the metro Atlanta area. She is a licensed and nationally board-certified music therapist. Jamie holds additional certifications in Neurologic Music Therapy (NMT) and Neonatal Intensive Care Unit Music Therapy (NICU-MT).

Jamie received a Bachelor of Fine Arts degree from Western Michigan University, and a Master of Music with a concentration in Music Therapy, from the University of Georgia. She completed her graduate research studying music therapy and its effects on children with sensory processing disorder. Jamie completed her internship working with exceptional children in the Fulton County Schools Music Therapy Department in metro Atlanta. Jamie specializes in autism and other neurologic conditions. In addition to teaching and treating, she actively consults with parents, therapists, allied health, and therapeutic and educational programs across the country.

Jamie serves on the Ethics Board for the American Music Therapy Association, and serves as Government Relations Co-Chair for the Southeastern Region of the AMTA. She serves as Reimbursement Chair for the Music Therapy Association of Georgia, having previously served as Treasurer for the organization from 2007 – 2012.  Jamie also serves on the Georgia state task forceand the Georgia Secretary of State appointed Music Therapy Advisory Committee.

Jamie is an accomplished vocalist, and comes to Atlanta after having performed for several years in New York City and Walt Disney World in Orlando, FL.

Check out some of Jamie’s work over on the blog!