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Zahedan J Res Med Sci. In Press(In Press):e104193.
Published online 2021 September 19.
doi: 10.5812/zjrms.104193.
Research Article
The Effect of Music Therapy on Sense of Loneliness and Life Expectancy
in Methamphetamine-Addicted Individuals Attempting to Quit
Reza Mohammadirad 1, * , Abas Ali Hosseinkhanzadeh1, Azra Zebardast 1and Hamed Salimi2, 3
1Department of Psychology, University of Guilan, Rasht, Iran
2Oxford University,London, UK
3Chalous Branch, Islamic Azad University,Chalous, Iran
*Corresponding author: Department of Psychology, University of Guilan, Rasht, Iran. Email: rm1759278@gmail.com
Received 2020 April 26; Revised 2020 November 16; Accepted 2020 December 01.
Abstract
Background: Since there has been no research on music therapy in a systematic way so far to develop motivation and hope in the
course of treating individuals who are addicted to drugs, especially stimulant drugs whose use has increased in Iran, the present
research was conducted to examine the effect of music therapy on the sense of loneliness and life expectancy in methamphetamine-
addicted individuals who were attempting to quit.
Methods: The research is pretest, posttest, and test and control groups. The research sample includes 30 methamphetamine-
addicted individuals who were quitting in a midterm residential center in Sowme’eh Sara who were selected by convenience sam-
pling and allocated to two control (N = 15) and experiment (N = 15) groups randomly. UCLA sense of loneliness scale and Schneider
statistical questionnaire (1991) were used for data collection.
Results: Studies showed that music therapy could reduce the symptoms related to the sense of loneliness and increased life ex-
pectancy (P < 0.001).
Conclusions: It is concluded that mental health professionals can use group music therapy to improve sense of loneliness and
life expectancy in methamphetamine-addicted individuals attempting to quit. Also, it is suggested that future research should
investigate the effectiveness of group music therapy in improving other psychological constructs in addicted females and males
who are attempting to quit.
Keywords: Music Therapy, Sense of Loneliness, Life Expectancy, Methamphetamine
1. Background
Addiction is considered a fundamental crisis in the
present era, which is increasingly developing among the
young generation. The use of meth, which is a stimulant
drug in the methamphetamines group, is a major problem
of public health, and its long-term use can lead to various
psychological consequences such as hallucinations, delu-
sions, depression, suicide, and aggression (1,2). In recent
years, the country is facing a challenge regarding the shift
in the use of patterns from traditional drugs to industrial
ones. According to researches, 8% of drug users are ad-
dicted to meth (3). The application of on-time and proper
treatment approaches are among significant issues, which
should be considered after the diagnosis of disorders re-
lated to substance use (4).
Using music as a method to treat addiction dates back
to 1970 (5). Studies show that music therapy is effective in
reducing symptoms related to senses of loneliness and de-
pression (6-9). Using music therapy is effective in enhanc-
ing the motivation and life expectancy in a drug-addicted
person and generally an individual who is in the process
of therapy and rehabilitation (10). According to what was
mentioned above, it is possible to use music therapy plans
in addiction quitting or group rehabilitation sessions (11).
All people trying to treat the addiction face a sense of lone-
liness. This painful emotional experience is exhibited with
more severity in addicted individuals compared to the gen-
eral population; they are weaker in terms of physical and
mental health that is associated with this level of loneli-
ness (12). Sense of loneliness can lead to depression (13),
which is considered a major predictor variable for high-
risk behaviors (14). By withdrawing from the social envi-
ronment, the addicted person develops a sense of loneli-
ness and social alienation (15). On the other hand, the moti-
vation in an addicted person to achieve personal goals and
desires reduces gradually, which, in turn, affects his/her ef-
fective role in society and leads to a lack of life expectancy
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Mohammadirad R et al.
(16). Since active involvement of the addicted person in
the treatment course is a fundamental factor, hope is re-
garded as a very significant predictor factor in treatment,
rehabilitation, and recovering mental health of individu-
als addicted to drugs (16).
The innovative aspect of this research is music ther-
apy method, which has not been performed in a system-
atic way so far, while each method was applied separately
in previous researches. Moreover, the necessity of high-
lighting the notions of motivation and hope in the pro-
cess of treatment of addiction, especially in individuals ad-
dicted to stimulant substances that experience an increas-
ing trend in Iran by using novel therapies and respond-
ing to their mental and existential needs, are considered
the research gaps in this field of study. Therefore, the re-
sults of this study can be applied as a promising perspec-
tive in planning institutions and organizations supporting
the consumer.
2. Objectives
The aim of this study was to investigate the effect of
music therapy methods on reducing the sense of loneli-
ness and increasing life expectancy in individuals quitting
meth addiction.
3. Methods
In a quasi-experimental study of pre-test-post-test type
with a control group, 30 men consuming crystal material
in the age range of 20 to 30 years in the city of Soomehsara
in 2016 - 2017, who voluntarily went to one of the res-
idential centers in 1996-95. They paid in the medium
term. Inclusion criteria were type of consumables (crys-
tal), male gender, and age between 20 - 30 years. Exclu-
sion criteria also were withdrawal and non-cooperation
of each member of the group from continuing the treat-
ment process, lack of appropriate physical or mental con-
ditions in each member to continue working. Data col-
lection tools included the UCLA Loneliness Scale (Russell
1980) and life expectancy (Schneider 1991). The UCLA Lone-
liness Scale was developed by Russell and Pilva, and Cor-
tona (1980) and consists of 20 questions in four options, 10
negative sentences, and 10 positive sentences. The items
of this questionnaire are scored on a 4-point Likert scale
(never score (1), rarely score (2), sometimes score (3) and
always score (4). Moreover, 5, 6, 9, 10, 15, 16, 19, 20 are
the other ways around, the range of scores is between 20
(minimum) and 80 (maximum). As reported by Russell,
Pilva, and Ferguson (1978) 0.89. This test was translated by
Shokrkan and Mirdrikund (2008) and used after prelimi-
nary implementation and corrections (17). Schneider (1991)
Life expectancy scale is also a 12-point scale with 8 Likert
scores from strongly disagree (1 point) to strongly agree (8)
points. Agent thinking subscale consists of four questions
2, 9, 10, 12: The path subscale consists of four questions 1,
4, 7, 8 and four questions 3, 5, 6, 11 as deviant questions
that are scored for increased test accuracy is eliminated’.
Lopez and Schneider (2007) reported internal consistency
through Cronbach’s alpha of 0.74 to 0.84 and its validity
coefficient by retest method 0.80 and psychometric prop-
erties of the Persian version of this scale in Iran by Kermani,
Khodapnahi, and Heidari (2011) and in Tehranstudents, the
validity coefficient of this scale was 0.86 using Cronbach’s
alpha formula and 0.81 through retesting (18).
Sampling was done by available selection method. In
order to conduct the study, after referring to one of the
medium-term accommodation centers of Sowme’eh Sara
city, out of 50 people leaving the materials, after an indi-
vidual interview and according to the existing background
regarding the sample size (4), 30 people Who volunteered
to attend the meetings and met the inclusion criteria were
selected.
To carry out the research, after referring to a mid-term
welfare residential center in Sowme’eh Sara, sample size
was determined based on Nademi’s study (7). Thirty in-
dividuals were selected out of 50 men who were quitting
the drug and volunteered to participate in sessions, and
had the criteria to enter the study. Initially, the question-
naires of sense of loneliness and life expectancy were per-
formed one week before pretest intervention for test and
control groups. The incorporated method of music ther-
apy) type of music was pop music (with oriental themes)
was administered in the experimental group for ten 60-
minute sessions (2 weeks 4 sessions and 1 week 2 sessions),
while control group received no intervention (Table 1). It
should be mentioned that Standley’s music therapy pack-
age, along with guided imagination, was used in this study
(19). Passive music therapy (hearing) was used along with
guided imagination. Discussion was used for feelings and
notes related to music lyrics. In music therapy with guided
imaginations, the participants in the experimental group
were asked to focus their attention totally on the clip which
was playing and keep their concentration. Moreover, mu-
sic therapist guided the mental conceptualization of par-
ticipants during the music therapy process. Motivating
clips were selected from instrumental music “songs of the
heart” to be played in each session.
3.1. Statistical Analysis
The results were entered into SPSS 16 software
Kolmogorov-Smirnov test (K-S Z) test were used for de-
termine of quantitative variable, respectively. P-value <
0.05 was considered significant.
2 Zahedan J Res Med Sci. In Press(In Press):e104193.
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Mohammadirad R et al.
Table1. A Summary of Intervention Sessions of Logotherapy Along with Music Therapy
Session Content
1Music therapy: Conceptualizing passive music therapy sessions and expressing the necessity of concentration on music, exhibition of emotions, and
physical and mental fatigue after playing soothing audio tracks from “songs from the heart” album.
2Music therapy: 20 minutes of passive music therapy will be performed, and members will express the insight, thoughts, and emotions obtained from self
during the session. Finally, a task will be assigned to members accordingly.
3Music therapy: After playing the musical clips, each member will express his concerns and emotions. Finally, a task will be assigned for the next session.
4Music therapy: After performing the music therapy process, each member will try to express the emotions, feelings, and memories related to played music.
5Music therapy: In this session, members will try to remember their positive memories after listening to music, and they will express the feelings and
emotions related to memories associated with song text.
6Music therapy: Members will engage in deeper thinking and learning about the concept of loneliness during music therapy sessions and then will state
their personal experiences, attitudes, feelings, and emotions related to the notion.
8 & 7 Sessions 7 and 8 will be held as incorporated in one session. Music therapy: It is mainly focused on each member trying to develop a goal and basically a
meaning unique to him in the course of life. Each member will express his experience, meaning, and objective.
9Music therapy: Members will think about question “how they feel about accepting the responsibility of their behavior?” in the course of listening to music
and will try to express their positive experiences about accepting responsibility after ending music intervention and state the associated memories.
10 Session ten: in the final session, the relationship and basically treatment chain between sessions is stated, and the relationship between notions of
self-awareness, freedom, responsibility,death, and meaninglessness is explained, and the obtained insight will be expressed through music therapy
method.
4. Results
The mean and standard deviance of pretest-posttest
scores of research variables are presented in two control
and experimental group (30 men with meth addiction
ranging 20-30 years) in Table 2. Moreover, the result of
Kolmogorov-Smirnov test (K-S Z) test is reported to study
the normality of the distribution of variables in groups.
Therefore, it can be concluded that the distribution of vari-
ables is normal, and it is possible to use parametric tests
such as covariance analysis to analyze these variables.
One-way Covariance analysis (Table 3) was used to in-
vestigate the effect of music therapy on meth-addicted
individuals (categorized by control and test groups) ac-
cording to variables of sense of loneliness, life expectancy,
agency thinking, and strategic thinking. According to Ta-
ble 3, statistic F (sense of loneliness) was 440.82 in posttest,
and it was significant at P = 0.001 level, which indicated
that there was a significant difference in sense of loneli-
ness between the two groups. Effect size 0.94 showed that
this difference in society was great and significant. The F-
statistic was also a pretest of loneliness (4.67), which was
significant at the level of 0.05. Accordingly, pretest had a
significant effect on post-test scores, and the use of analy-
sis of covariance was essential.
The results of covariance analysis showed that the cor-
rected mean of the test group was 34.96 and the control
group was 61.76 in sense of loneliness. Difference of mean
in these two groups was -26.80, which was significant at
0.001. Therefore, it can be said that mean value of the test
group that was sense of loneliness was significantly lower
than the mean of the control group. With respect to these
findings, the first hypothesis was confirmed, and it might
be declared that music therapy might decrease the sense
of loneliness in meth-addicted individuals.
After examining music therapy on the experimental
and control groups in the post-test of total life expectancy
in comparison to the pretest, it was observed that total life
expectancy in the post-test (696.26) was significant at the
level of 0.001. This indicated a significant difference be-
tween the two groups. The effect size of 0.96 also showed
that this difference was large and significant in society. Sta-
tistical F is also a predictor of total life expectancy (44.64),
which is significant at the level of 0.001. Accordingly,
pretest has a significant effect on post-test scores.
According to table three, F statistic for variables of
agency thinking (201.23) and strategic thinking (165.82) is
significant at 0.001. The findings indicate that there is a sig-
nificant difference in these components between the con-
trol and test groups. The effect size for agency thinking
(0.88) and strategic thinking (0.86) indicated that this dif-
ference was significant in society.
Generally, the mean and standard deviation of pretest-
posttest scores for life expectancy variable are presented in
Table 4 for the two control and test groups. The difference
in obtained mean between the control and test groups
was 29.25, and standard deviation (0.79) was significant at
0.001. Therefore, total life expectancy in the test group was
significantly higher than in the control group.
5. Discussion
The findings of this study indicate, for the first time,
that music therapy can reinforce psychological constructs
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Mohammadirad R et al.
Table2. Descriptive Indices of Research Variables Categorized By Control and Test Groups
Variables Mean Standard Deviation K-S Z P-Value
Sense of loneliness
Pretest
Test 64.47 5.29 0.76 0.59
Control 62.27 4.92 0.68 0.73
Post test
Tests 35.27 4.30 0.99 0.27
Control 61.47 2.80 0.68 0.47
Agency thinking
Pretest
Test 14.73 1.79 0.67 0.75
Control 15.87 2.10 0.92 0.36
Post test
Tests 24.67 1.49 0.79 0.55
Control 15.27 1.94 0.95 0.32
Strategic thinking
Pretest
Test 13.33 3.94 0.52 0.94
Control 11.20 3.05 0.46 0.98
Post test
Tests 25.60 2.5 1.27 0.08
Control 13.14 2.78 0.55 0.91
Life expectancy
Pretest
Test 27 3.74 0.67 0.75
Control 27.93 5.23 0.64 0.79
Post test
Test 50.07 2.73 0.70 0.71
Control 29.53 4.08 0.71 0.68
Table3. The Result of Analysis of Music Therapy on Meth-Addicted Individuals Categorized By Research Variables
Variable Mean F Statistic P-Value Effect Size
Sense of loneliness
Pretest 54.34 4.67 0.05 0.15
Posttest 5131.84 440.82 0.001 0.94
Agency thinking
Post test 24.89 201.23 0.001 0.88
Strategic thinking
Post test 14.59 165.82 0.001 0.86
Life expectancy
Pretest 211.03 44.64 0.001 0.62
Post test 3300.82 698.26 0.001 0.96
Table4. Final Estimated Mean of Total Life Expectancy in the Two Groups
Group Mean Mean Difference Standard Error Significance Level
Test 50.34 21.09 0.79 0.001
Control 29.25
4 Zahedan J Res Med Sci. In Press(In Press):e104193.
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Mohammadirad R et al.
such as the sense of loneliness and life expectancy with re-
spect to recovery of drug-addicted individuals. The results
were consistent with the results of previous studies (5-7) re-
garding the effect of music therapy on the sense of lone-
liness and life expectancy. The findings indicate the posi-
tive effect of music therapy on the recovery of symptoms
related to the sense of loneliness and life expectancy. The
results indicating the positive effect of music therapy are
consistent with the studies of Aletraris et al. (5) and Dingle
et al. (20).
Sense of loneliness, seclusion, and lack of cohesive and
stable interpersonal relationship are related to depression
in terms of Semiology while listening to music leads to
relaxation and reduce the depression (20,21). Therefore,
music therapy provides an opportunity to enhance group
and interpersonal relationships for each participant so
that they can share their thoughts, feelings, and emotions.
When an individual with the sense of loneliness is involved
in non-verbal relationship with music therapy, he can dis-
cover and identify certain aspects of himself and achieve
responsibility for certain conditions in basic events of life
by relying on identification of emotions in this process (21).
As it was mentioned earlier, achieving the sense of re-
sponsibility in the process of treatment, especially in the
period of recovery and rehabilitation leads to effective ef-
forts and positive prognosis in the treatment. Presence
of an individual in music therapy sessions and knowing
one’s feelings help enhance the sense of control in life and
improve mental and physiological conditions and reduce
symptoms related to anxiety, stress, and sense of loneliness
(7). To explain the finding that music therapy leads to im-
provement of life expectancy in drug-addicted individuals,
it can be said that music, as a mediator of the relationship
between therapist and client, increases the motivation by
reducing negative behaviors, improves temper, and pro-
duces favorable events (10). An individual can review all
ways to achieve certain goals by enhancing required mo-
tivation to move toward favorable goals by relying on per-
sonal responsibility (11).
On the other hand, music therapy triggers emotions
and needs and hence provides the opportunity for increas-
ing hope in the treatment process (19). In the present
study, therefore, music therapy significantly provokes the
emotions, feelings, and basically motivation to move to-
ward certain goals, which are identified based on aware-
ness about responsibility and internal capability of the pa-
tient. The results of the present study indicated music ther-
apy can reduce the symptoms related to sense of loneliness
and improve life expectancy in meth-addicted individuals.
Since spiritual unconsciousness and its achievement by a
patient are considered basic goals of music, music therapy
can play a significant role as a facilitator for expressing fur-
ther and deeper emotions and feelings in patients.
Individuals can understand the self again in a safe, cor-
dial environment that is full of interpersonal trust and
sympathy. Compared with the situation before research,
the symptoms related to sense of loneliness were modi-
fied, and life expectance was improved significantly, which
is the proof of efficiency of this treatment method. The
present study indicates that music therapy, as a treatment
method for drug-addicted individuals, can meet the needs
of group and improve various psychological areas. Also, it
is suggested that future research should investigate the ef-
fectiveness of group music therapy in improving other psy-
chological constructs in addicted females and males who
are attempting to quit.
5.1. Limitations of the Research
Limitations include lack of follow-ups due to problems
of access to sample individuals and controlling the gender
due to the limitation of access to female trials. Accordingly,
it is suggested to evaluate treatment stability in future re-
searches and perform the treatment method on both gen-
ders that are in the rehabilitation process after drug addic-
tion.
5.2. Suggestion
It is suggested that the present study should be per-
formed separately on both genders that are in the rehabil-
itation process after drug addiction. Moreover, the incor-
porated treatment method used in this study can be used
in the treatment of other illnesses and healthcare areas.
Acknowledgments
The respected officials and deputy of research at Uni-
versity of Guilan are highly appreciated for their supports.
This study is extracted from a Master’s thesis by Mr. Reza
Mohamadi Rad.
Footnotes
Authors’ Contribution: All authors contributed equally
to performing all stages of the paper.
Conflict of Interests: The authors declare no conflict of
interest.
Ethical Approval: All the stages of the research are re-
lated to human participants based on ethical criteria of
institutional/national research committee and according
to the Declaration of Helsinki 1964 and its further amend-
ments or ethical principles. Moreover, this study was ap-
proved and registered in the Ethics Committee of Univer-
sity of Guilan by code IR.GUMS.REC.1395.163.
Zahedan J Res Med Sci. In Press(In Press):e104193. 5
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Mohammadirad R et al.
Funding/Support: This study was funded by Guilan Uni-
versity.
Informed Consent: Informed consent was obtained from
all individual participants included in the study.
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