The Use of Art and Music Therapy in Substance Abuse Treatment Programs

Abstract

Although the implementation of evidence-based practices in the treatment of substance use disorders has attracted substantial research attention, little consideration has been given to parallel implementation of complementary and alternative medical (CAM) practices. Using data from a nationally representative sample (N = 299) of U.S. substance abuse treatment programs, this study modeled organizational factors falling in the domains of patient characteristics, treatment ideologies, and structural characteristics, associated with the use of art therapy and music therapy. We found that 36.8% of treatment programs offered art therapy and 14.7% of programs offered music therapy. Programs with a greater proportion of women were more likely to use both therapies, and programs with larger proportions of adolescents were more likely to offer music therapy. In terms of other treatment ideologies, programs' use of Motivational Enhancement Therapy was positively related to offering art therapy, whereas use of contingency management was positively associated with offering music therapy. Finally, our findings showed a significant relationship between requiring 12-step meetings and the use of both art therapy and music therapy. With increasing use of CAM in a diverse range of medical settings and recent federal legislation likely to reduce barriers in accessing CAM, the inclusion of CAM in addiction treatment is growing in importance. Our findings suggest treatment programs may be utilizing art and music therapies to address unique patient needs of women and adolescents.

Full text

The Use of Art and Music Therapy in Substance Abuse
Treatment Programs
Lydia Aletraris, PhD*,
University of Georgia
Maria Paino, PhD,
Oakland University
Mary Bond Edmond, PhD,
University of Georgia
Paul M. Roman, PhD, and
University of Georgia
Brian E. Bride, PhD, MSW, MPH
Georgia State University
Abstract
While the implementation of evidence-based practices (EBPs) in the treatment of substance use
disorders (SUD) has attracted substantial research attention, little consideration has been given to
parallel implementation of complementary and alternative medical (CAM) practices. Using data
from a nationally representative sample (N = 299) of U.S. substance abuse treatment programs,
this study modeled organizational factors falling in the domains of patient characteristics,
treatment ideologies, and structural characteristics, associated with the use of art therapy and
music therapy. We found that 36.8% of treatment programs offered art therapy and 14.7% of
programs offered music therapy. Programs with a greater proportion of women were more likely
to use both therapies, and programs with larger proportions of adolescents were more likely to
offer music therapy. In terms of other treatment ideologies, programs’ use of Motivational
Enhancement Therapy (MET) was positively related to offering art therapy, while use of
Contingency Management (CM) was positively associated with offering music therapy. Finally,
our findings showed a significant relationship between requiring 12-step meetings and the use of
both art therapy and music therapy. With increasing use of CAM in a diverse range of medical
settings, and recent federal legislation likely to reduce barriers in accessing CAM, the inclusion of
CAM in addiction treatment is growing in importance. Our findings suggest treatment programs
may be utilizing art and music therapies to address unique patient needs of women and
adolescents.
*Corresponding author: Lydia Aletraris, Owens Institute for Behavioral Research, 104 Barrow Hall, University of Georgia, Athens,
GA 30602, T: (706) 542-6054, F: (706) 652-6436, lydia@uga.edu.
Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of
the paper.
NIH Public Access
Author Manuscript
J Addict Nurs. Author manuscript; available in PMC 2014 December 17.
Published in final edited form as:
J Addict Nurs. 2014 October ; 25(4): 190–196. doi:10.1097/JAN.0000000000000048.
NIH-PA Author Manuscript NIH-PA Author Manuscript NIH-PA Author Manuscript

Keywords
art therapy; music therapy; substance abuse treatment; treatment centers; substance use disorder;
complementary therapies; alternative therapies
Introduction
While the importance of implementation of evidence-based practices (EBPs)in the treatment
of substance use disorders (SUD) has attracted substantial research attention, (Carroll &
Rounsaville, 2003; Compton et al., 2005; Institute of Medicine, 2006),little consideration
has been given to parallel implementation of complementary and alternative medical (CAM)
practices.CAM refers to non-mainstream treatments that are either used in addition to, or in
lieu of, conventional treatment (National Center for Complementary and Alternative
Medicine, 2013). CAM includes diverse treatments, such as art therapy, music therapy,
hypnotherapy, acupuncture, and herbal remedies.
Data from the Centers for Disease Control and Prevention indicate the use of CAM has
rapidly increased over time (Su & Li, 2011; Tindle, Davis, Phillips, & Eisenberg, 2005),
with a recent estimate that 40% of adults use some form of CAM (Barnes, Bloom, & Nahin,
2008). Importantly, the Patient Protection and Affordable Care Act (PPACA) of 2010
includes specific encouragement of both increased insurance coverage and research
concerning effectiveness of CAM techniques (“ PPACA,” 2010), while Section 2706 of the
Act expressly forbids insurance companies from discriminating against any healthcare
professional with a state recognized license. Further, CAM practitioners are specifically
included in the PPACA's description of its patient-centered medical homes. These features
of PPACA support suggest future expansion in the use of CAM technology.
A further dimension of CAM's potential importance lies in the fact that traditional
approaches to SUD treatment have been criticized for not taking women's unique
psychosocial needs, expectations, and social roles into account (Gordon, 2004; B. A. Miller,
Wilsnack, & Cunradi, 2000; Tinney, Oser, Johnson, & Roman, 2004). By contrast, CAM
has been regarded as being particularly useful for women and others with unique needs
(Brady & Ashley, 2005; Feen-Calligan, Washington, & Moxley, 2008)).
In this paper we focus on two forms of CAM: art therapy and music therapy, and explore
organizational contexts in which they are used. Understanding the context in which these
therapies are utilized is an important component for designing diffusion efforts to enhance
the use of art and music therapy, and possibly other CAM techniques, within SUD
treatment.
Art Therapy
The use of art therapy in the treatment of SUDs dates back to the 1950s (Moore, 1983).The
American Art Therapy Association (AATA) specifically acknowledges the role that art
therapy can play in managing addictions (American Art Therapy Association, 2014).Main
assumptions underlying art therapy are that the patient will be able to express him/herself
through a non-verbal, imaginative, and creative exercise. Art therapy includes an array of
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activities, including incident drawings (i.e., a drawing of an incident that occurred while
using substances), drawing/painting emotions, stress painting (i.e., painting during times of
anxiety and/or stress in order to relieve feelings of stress), creating an art journal, and
creating sculptures. The majority of art therapy techniques for patients with SUDs employ a
creative process, whereby the patient is creating art, but some select applications include
interpretation and contemplation of established works of art (Feen-Calligan et al., 2008).
Extant research on the benefits of art therapy is widely documented, although the research
designs limit conclusive generalization. These findings suggest several benefits for SUD
patients, such as decreasing denial (Cox & Price, 1990), reducing opposition to alcoholism
treatment (Allen, 1985), providing an outlet for communication (Harms, 1973; Moore,
1983), and lessening shame (Johnson, 1990). Viewing, discussing, and interpreting existing
art can help in group discussions (Dewdney & Dewdney, 1970), and can motivate patients to
change (Holt & Kaiser, 2009) by moving them away from reflection and into a state of
action (Matto, Corcoran, & Fassler, 2003).
Music Therapy
Music therapy is a more recent development in SUD treatment, dating back to the 1970s
(Baker, Gleadhill, & Dingle, 2007; A. S. Miller, 1970). Just like art therapy, it is thought to
help patients tap into emotions and needs that may be difficult to express through more
traditional forms of communication. Furthermore, music therapy also provides a way to
motivate patients to receive treatment. The American Music Therapy Association (AMTA)
states that music therapy is useful regardless of musical background, and examples of
clinical music therapy include lyric analysis, relaxation training, songwriting, musical
games, and improvising music based on emotions or other topics relevant to treatment. In
these treatments, patients go beyond simply listening to music to engage emotions,
motivations, and barriers to recovery through lyrics and melody (American Music Therapy
Association, 2014).
Studies on music therapy have found numerous benefits for SUD patients. For example,
songwriting and lyric analyses are related to positive emotional change in patients (Baker et
al., 2007; Jones, 2005), drumming is associated with relaxation and can be useful for
patients who have experienced repeated relapses (Winkelman, 2003), and activities in music
therapy (e.g. movement to music) are associated with a decrease in anxiety, depression,
anger, and stress, although data suggests that no one activity is more important than another
(Cevasco, Kennedy, & Generally, 2005). In addition, music therapy is positively related to a
willingness to participate in SUD treatment (Dingle, Gleadhill, & Baker, 2008).While music
therapy is growing in popularity, a comprehensive meta-analysis concluded that the overall
database is not adequate to establish music therapy as an EBP (Silverman, 2010), with the
majority of studies being descriptive (Silverman, 2009).
Patient Characteristics
Conventional treatment approaches have often been criticized for failing to address women's
unique needs, and research suggests that CAM could be a useful way to account for such
needs (Brady & Ashley, 2005; Feen-Calligan et al., 2008). Research on art therapy suggests
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that it is particularly useful when working with women who have experienced sexual assault
(Glover, 1999), quite common among women in addiction treatment (Simpson & Miller,
2002; Wadsworth, Spampneto, & Halbrook, 1995). Art therapy is also thought to be an ideal
technique for engaging adolescents, since this creative aspect provides an opportunity to
take an inner experience to an outer visualization, which in turn can make them more
amenable to treatment (Cox & Price, 1990). Indeed, past research has suggested the need for
treatment models that are tailored to adolescents’ unique needs (Vourakis, 2005). Music
therapy is also asserted to be particularly helpful for adolescents and women (American
Music Therapy Association, 2014; Cevasco et al., 2005; Feen-Calligan et al., 2008).
Furthermore, Doak (2003) finds that adolescents, in particular, use music and drugs for
similar objectives (e.g. reduce psychological distress), suggesting particular utility for music
therapy in adolescent populations.
Combining Art and Music Therapy with Conventional Treatment Approaches
The use of art and music therapy fits well within specific existing ideological frameworks
for treating SUDs that rely on actively engaging and motivating SUD patients (Dean,
2005).Motivational Interviewing (MI) is a therapeutic style that addresses client
ambivalence and seeks to enhance clients’ intrinsic motivation for change (W. R. Miller &
Rollnick, 2002), and Motivational Enhancement Therapy (MET), a specific application of
MI, promotes client engagement in treatment (W. R. Miller, Zweben, DiClemente, &
Rychtarik, 1999; Polcin, 2002). Art and music therapy can be used toward all of these goals.
Research has argued that art therapy employs “active, mind-body strategies” (Holt & Kaiser,
2009: 250) that fit well with the principles of MI/MET (Holt & Kaiser, 2009). Specifically,
art therapy complements the MI/MET framework, as it utilizes the same cognitive processes
of valuing, choosing, and deciding (Horay, 2006). It can be used to engage clients and
enhance internal motivation for change through the creation of imagery (Holt & Kaiser,
2009). Research on music therapy over the past several decades has shown that this type of
treatment can also increase client motivation and engagement (Blackett & Payne, 2005;
Brooks, 1973; Cevasco et al., 2005; Murphy, 1983), and facilitate the exploration of
emotions (Baker et al., 2007; De l'Etoile, 2002; Ghetti, 2004; Jones, 2005; Soshensky,
2001). Moreover, the ideal counselor characteristics for a motivational therapist (see,
Rollnick et al., 2002) are congruent with qualities often associated with art therapists
(Horay, 2006).
Most examples of scholarly work on art and music therapy and SUD treatment have linked
these treatments with use of a 12-step model (Horay, 2006) and suggest complementarity
with that approach. For example, past research has suggested that art therapy can facilitate
the First Step, since tasks that tap the creative spark can break down resistance and facilitate
acceptance of the disease (Cox & Price, 1990; Julliard, 1995).Additional research indicates
how art therapy can effectively promote a 12-step model by creating positive images of
recovery, which in turn break down resistance to receiving treatment (Feen-Calllgan, 1995;
Potocek & Wilder, 1989).Furthermore, treatment centers that provide music therapy are
often centers that rely upon a 12-step model (Silverman, 2009), and art therapy and music
therapy is often provided by counselors who are trained in the 12-step model (Johnson,
1990; Silverman, 2009).
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There is a lack of nationally representative data addressing the organizational settings of art
and music therapy. In the current study, we assess the utilization and organizational
correlates of art and music therapies in a national sample of SUD treatment centers by
addressing three specific aims. First, we document the prevalence of both types of therapies
in SUD treatment programs. Second, we examine the association between the use of art and
music therapy and patient populations in a treatment program. Art and music therapies are
promoted as important and useful types of treatment for specific patient populations;
therefore, we examine how the proportion of women and adolescents in a treatment center
encourages the use of art and music therapy. Finally, we highlight the relationship between
the use of EBPs and implementation of art and music therapies in the treatment center.
Method
Data for this study were collected between June 2009 and January 2012 from a national
sample of SUD treatment organizations. Centers for the study were randomly sampled from
the Substance Abuse Treatment Facility Locator, a directory supported by the Substance
Abuse and Mental Health Services Administration (SAMHSA). Requirements for inclusion
in this study focused on treatment programs that were open to the general public and that
offered a minimum level of care at least equivalent to structured outpatient services, as
defined by the American Society of Addiction Medicine's placement criteria (Mee-Lee,
Gartner, Miller, Shulman, & Wilford, 1996). Treatment programs had at least 25% of their
patients admitted with alcohol as a primary substance abuse problem. These criteria
excluded counselors in private practice, transitional living facilities, Veterans Health
Administration facilities, correctional facilities, court-ordered driver education classes or
detoxification-only programs, and methadone-only treatment programs. Centers screened as
ineligible during a telephone screening were replaced by a random selection of alternate
treatment centers. The research procedures were approved by the Institutional Review Board
of the University of Georgia.
Data were collected using face-to-face interviews with the administrator and/or clinical
director of each treatment program. Interviews were conducted by a team of trained
interviewers with at least a bachelor's level of education. The final randomly selected sample
resulted in 307 treatment programs, a response rate of 68% among eligible organizations.
Measures
Dependent Variables
We used two dependent variables for our analyses – art therapy and music therapy.
Interviewees indicated whether or not these approaches were used in the organization.
Treatment programs that used art therapy or music therapy, respectively, were coded “1”
and non-users were coded “0” on the dichotomous variables.
Independent Variables
Two continuous measures of patient characteristics were included: percentage of female
patients and percentage of adolescent patients.A series of dichotomous variables indicated
whether the following types of EBPs were used in the treatment program: medication-
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assisted treatment, motivational enhancement therapy (MET), and contingency management
(CM), also known as motivational incentives. We excluded cognitive behavioral therapy
(CBT) from our analyses because of its near-universal presence. Treatment orientation was
measured by a dichotomous variable denoting whether 12-step meetings were required.We
controlled for several organizational variables. Program size was measured by the number of
full-time equivalent employees (FTEs); the measure was log-transformed to adjust for skew.
Program age was measured as a continuous variable. Accreditation by the Joint Commission
or the Commission on Accreditation of Rehabilitation Facilities (CARF), and receipt of
revenues from Medicaid were dichotomous variables. Workforce professionalism was
measured by the percentage of counselors with a Master's degree or higher.
Analytic Strategy
First, we examined descriptive statistics of the study variables. Next, we performed two
logistic regressions to identify patient characteristics, other treatment practices, and
organizational characteristics associated with the availability of art therapy and music
therapy. Diagnostic tests revealed no evidence of multicollinearity. For this analysis, 8 cases
(2.6% of the sample) that were missing on any of the study variables were excluded from
analysis, resulting in a sample of 299 treatment programs. Little's test indicated that cases
were missing completely at random. Analyses were conducted using STATA 13.
Results
Descriptive statistics are presented in Table 1. Overall, 36.8% of programs used art therapy
and 14.7% used music therapy, with 11.7% using both (not shown). We report use of two
other forms of CAM – hypnotherapy and acupuncture – to offer a broader perspective on
CAM use and to explain our focus on art and music therapy. Just 3.3% of programs offered
hypnotherapy and 8% offered acupuncture to their patients. The small number of programs
using the latter two forms of alternative therapies precluded further multivariate analyses.
The mean for percent female patients and percent adolescent patients was 34.9% and 10.8%,
respectively. Turning to the other types of treatments offered, 42.5% of programs used
medication-assisted treatment, almost half (47.8%) used MET, and 39.1% used CM. All of
the centers using medications also used at least one of the psychosocial therapies. Just over
half of the programs (53.1%) required 12-step meetings for their patients. The average
logged program size was 2.6, which represented 27.1 FTEs (the median was 12.5 FTEs),
while the average age of a treatment program was 28.4 years. Around 37% of programs
were accredited by either the Joint Commission or CARF, and more than half of the
programs (61.5%) received revenues from Medicaid. Finally, programs reported that, on
average, 43.8% of their counselors held at least a Master's degree level of education.
The results of the multivariate logistic regression predicting whether programs offered art
therapy are displayed in Table 2. Programs with a higher percentage of female patients were
significantly more likely to offer art therapy (OR=1.011). The percentage of adolescent
clients was also positively associated with the use of art therapy but this did not reach
standard level significance (OR=1.010). Programs that used MET were significantly more
likely to offer art therapy (OR=1.682)), while the use of CM or of medication-assisted
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treatment was not significant. Centers that required 12-step meetings for their patients were
also significantly more likely to use art therapy. More specifically, the odds of providing art
therapy were 2.12 higher in programs that required 12-step meetings than in programs that
did not have such a requirement. Two organizational characteristics were significant in the
model, with size positively associated with the use of art therapy (OR=1.550) and the receipt
of Medicaid revenues negatively associated with offering art therapy (OR=.514).
Logistic regression results examining factors associated with offering music therapy are
presented in Table 3. Programs with a higher percentage of female patients (OR=1.014) and
programs with a higher percentage of adolescent patients were significantly more likely to
offer music therapy (OR=1.016). There was also a positive association between offering
music therapy and the use of other psychosocial therapies. Specifically, the odds of
providing music therapy were 4.47 higher in centers that offered CM compared to centers
that did not offer CM, but the use of MET or of medication-assisted treatment was not
significant. Finally, the requirement of 12-step meetings was positively associated with the
use of music therapy (OR=2.628).
Discussion
We examined the provision of two complementary and alternative treatment practices, art
therapy and music therapy, in a nationally representative sample of U.S. substance abuse
treatment programs. Art and music therapy have a history of suggested effectiveness with
specific patient populations, and our findings extend understanding of how patient
characteristics are associated with various types of treatment. The percentage of patients in a
program who were adolescents was positively associated with offering music therapy and
percentage of patients who were women was positively related to offering both art and
music therapies. The governing bodies for art therapy and music therapy (AATA and the
AMTA, respectively) both endorse their use for these groups of patients. Women's unique
psychosocial needs and social roles suggest that traditional treatment approaches may not be
as effective for them (Gordon, 2004; B. A. Miller, Wilsnack, & Cunradi, 2000; Tinney,
Oser, Johnson, & Roman, 2004). Further, adolescent patients may find music therapy
especially appealing, given their use of music in daily life (Doak, 2003). Recent research
suggests that using music therapy with hospitalized youth offers them a safe way to
internalize a healthy self-image alongside their patient identity (O Callaghan, Dun, Baron, &
Barry, 2013). Our finding that an increase in the percentage of adolescent patients is
associated with offering music therapy demonstrates how treatment centers may be
accommodating their adolescent population with a treatment model that better serves their
needs (Vourakis, 2005).
For many years, scholars have associated art and music therapy with the 12-step model, and
assumed that art therapy could supplement and enhance an already successful model of
treatment. Our findings showed a positive and significant relationship between requiring 12-
step meetings as part of treatment and the use of both art therapy and music therapy. This
finding supports previous research that links the use of art and music therapy with a 12-step
model (Johnson, 1990), and suggests that treatment centers continue to pair these treatments
with a 12-step approach.
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Our analyses explored how different categories of psychosocial treatment are related to the
use of art and music therapy, and we found differing patterns among the use of psychosocial
treatment and the use of these therapies. SUD treatment centers’ use of MET was positively
related to providing art therapy, a notable finding for those suggesting the evident link
between MET and the use of art therapy (Holt & Kaiser, 2009; Horay, 2006). Further,
training in MET could be linked to training in art therapy for those interested in expanding
and diversifying the purview of specific types of treatment methods. MET was not
associated with the use of music therapy; although, CM was positively related to the use of
music therapy. Neither the provision of art therapy nor the provision of music therapy was
associated with medication-assisted treatment. Just two of the organizational characteristics
proved significantly related to the use of art therapy. Organization size had a positive
association with the use of therapy while receiving revenues from Medicaid was negatively
associated with the use of art therapy. This may suggest that some Medicaid plans are
unlikely to reimburse for art therapy, or that barriers exist for centers attempting to claim
reimbursement. While some CAM therapies have become increasingly covered under state
Medicaid formularies (Steyer, Freed, & Lantz, 2002), the national coverage of art and music
therapy is understudied.
Limitations
Several limitations of the current study should be noted. First, the findings cannot be
generalized to treatment programs located in Veterans Health Administration facilities or
based in correctional facilities, since these were excluded from the study. These data are
cross-sectional, restricting our ability to make causal arguments. Finally, our data do not
allow us to examine whether these therapies are typically being used as part of a multi-
dimensional treatment approach (i.e. complementary) for patients, or as a sole intervention
in place of conventional care (e.g. alternative).
Conclusion
The utilization of art and music therapy within SUD treatment centers has been
understudied. However, with increasing use of CAM in a diverse range of medical settings,
and recent federal legislation likely to reduce barriers in accessing CAM (“ PPACA, ”
2010), the inclusion of CAM in addiction treatment may grow in importance. Our study
addressed three specific components of art and music therapy in addiction treatment. We
assessed the prevalence of their use, the relationship between treatment centers’ patient
characteristics and the use of art and music therapy, and the associations between other
treatment modalities and art and music therapy.
Patient characteristics were associated with the use of art and music therapies. Previous
research highlights the difference between chemically dependent men and women,
suggesting a need for different treatments (Brady & Ashley, 2005; Feen-Calligan et al.,
2008). Our findings illustrate that centers with a greater proportion of women are more
likely to use art and music therapies, suggesting that women are receiving treatment that is
effective for their SUD. Further, we found that centers with larger proportions of adolescents
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were more likely to use music therapy. Our findings suggest treatment centers may be
utilizing art and music therapies to address unique patient needs.
While the use of art and music therapy in U.S. substance abuse treatment programs was
relatively uncommon, their use was associated with other treatment modalities. Centers’ use
of the 12-step approach was positively associated with art and music therapy. Additionally,
centers’ use of MET was also positively related to art therapy and use of CM was positively
associated with music therapy. This could suggest that art and music therapies are being
used as complements to other psychosocial treatments, which may ultimately improve
patient outcomes by offering more robust treatment options (MW. R. iller et al., 1999).
Acknowledgments
Data collection for these analyses was funded by the National Institute on Alcohol Abuse and Alcoholism (Grant
R01AA015974).
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Table 1
Descriptive Statistics
Complementary and Alternative Therapies % or mean (n) or (SD)
Offers Art Therapy 36.79 (110)
Offers Music Therapy 14.72 (44)
Offers Acupuncture 8.03 (24)
Offers Hypnotherapy 3.34 (10)
Independent Variables
Percent female patients 34.87 (23.58)
Percent adolescent patients 10.80 (23.36)
Uses medication-assisted treatment 42.47 (127)
Uses Motivational Enhancement Therapy 47.83 (143)
Uses Contingency Management 39.13 (117)
Requires 12-step meetings 53.18 (159)
Organization size (logged) 2.58 (1.09)
Age 28.45 (16.59)
Accredited 36.79 (110)
Receives revenues from Medicaid 61.54 (184)
Percent counselors with Master's degree or higher 43.80 (35.10)
N=299
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Table 2
Logistic Regression of Art Therapy on Patient Characteristics and Evidence-Based Practices (N=299)
b(SE) OR (95% CI)
Percent female patients 0.011 (0.005) 1.011 (1.000, 1.022) *
Percent adolescent patients 0.010 (0.006) 1.010 (.998, 1.022) †
Uses medication-assisted treatment 0.222 (0.293) 1.248 (.703, 2.216)
Uses Motivational Enhancement Therapy 0.520 (0.261) 1.682 (1.009, 2.805) *
Uses Contingency Management 0.453 (0.275) 1.573 (.917, 2.699)
Requires 12-step meetings 0.753 (0.278) 2.124 (1.231, 3.664) **
Organization size (logged) 0.438 (0.155) 1.550 (1.144, 2.101) **
Age -0.011 (0.009) 0.989 (.971, 1.006)
Accredited -0.122 (0.298) 0.885 (.493, 1.587)
Receives revenues from Medicaid -0.665 (0.290) 0.514 (.291, .908) *
Percent counselors with Master's degree or higher 0.000 (0.004) 1.000 (.991, 1.008)
†p<.1;
*p<.05;
**p<.01;
***p<.001
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Table 3
Logistic Regression of Music Therapy on Patient Characteristics and Evidence-Based Practices (N=299)
b(SE) OR (95% CI)
Percent female patients 0.014 (0.007) 1.014 (1.000, 1.027) *
Percent adolescent patients 0.016 (0.006) 1.016 (1.004, 1.029) *
Uses medication-assisted treatment 0.295 (0.409) 1.343 (.603, 2.993)
Uses Motivational Enhancement Therapy 0.442 (0.365) 1.556 (.761, 3.183)
Uses Contingency Management 1.498 (0.399) 4.471 (2.046, 9.774) ***
Requires 12-step meetings 0.966 (0.419) 2.628 (1.157, 5.971) *
Organization size (logged) -0.113 (0.200) 0.893 (.603, 1.321)
Age 0.000 (0.012) 1.000 (.976, 1.025)
Accredited 0.619 (0.399) 1.858 (.850, 4.059)
Receives revenues from Medicaid -0.565 (0.389) 0.569 (.265, 1.219)
Percent counselors with Master's degree or higher -0.004 (0.006) 0.996 (.985, 1.007)
†p<.1;
*p<.05;
**p<.01;
***p<.001
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