Evidence Summary Art and music therapy.pdf

Evidence Summary: Art
and music therapy

Version:
4
Date:
26 November 2024
Author:
Evidence and Practice Leadership Branch
Division:
Policy, Evidence and Practice Leadership Division

Executive summary
This document summarises the current evidence on art and music therapy for people
with disabilities. Evidence was generated through a rapid review focused on
functional capacity outcomes (e.g. language and communication, personal care,
mobility and movement, interpersonal interactions, functioning, and community
living) following art and music therapy delivered by a therapist (i.e. allied health
professional).
This rapid review was undertaken to inform practice considerations and guidance
related to the implementation of the S10 transitional rule, Schedule 1, and may be
used as evidence by the NDIS Evidence Advisory Committee to assist with making
recommendations made about art and music therapy.
This rapid review shows that there is some evidence which supports the use of art
and music therapy for certain disability groups (e.g. art therapy for children with
autism, music therapy for people with multiple sclerosis and people who have had a
stroke). Overall, the identified evidence was not conclusive in supporting art and
music therapy as evidence-based, therapeutic supports for all disability groups.
Considering the low risk of art and music therapy to participants and the Scheme,
the evidence generated through this rapid review is likely sufficient to understand the
state of evidence and meet current needs. Any decision regarding the need for
further evidence needs to consider the relative priority of art and music therapy
against other supports.
Evidence for art therapy
Art therapy includes the therapeutic use of art materials. The available evidence for
art therapy showed:
•  Some evidence for the benefit of art therapy for children with autism across a
range of outcomes (mobility and movement, interpersonal interactions, and
other outcomes such as hyperactivity and inattention).
•  Limited but positive indications for the benefit of art therapy across some
outcomes for adults with learning disabilities (on interpersonal interactions
and psychosocial functioning outcomes), children with cerebral palsy (on
language and communication outcomes), people with PTSD (on psychosocial
functioning outcomes), and people with anxiety and depression (on
psychosocial functioning outcomes).
•  Limited evidence which indicated mixed and unclear benefit for people with
eating disorders and people with non-psychotic mental disorders.

•  Limited evidence which indicated that art therapy may not provide any benefit
for children with learning disabilities and people with schizophrenia.
Evidence for music therapy
Music therapy is a form of therapy that uses music within a therapeutic relationship
between a client and trained professional. The available evidence for music therapy
showed:
•  Some evidence for the benefit of music therapy for people with multiple
sclerosis and people who have had a stroke on mobility and movement
outcomes.
•  Limited but positive indications for the benefit of music therapy for people
living with Parkinson’s disease (on communication, mobility and movement
and psychosocial functioning outcomes), and people with depression and
anxiety (on interpersonal interactions and psychosocial functioning
outcomes).
•  Limited evidence which indicated mixed and unclear benefits for people with
autism, people with schizophrenia, people with PTSD, children with epilepsy,
and children with an intellectual disability and auditory processing disorder.

Introduction
This document summarises the current evidence on art and music therapy for people
with disabilities on functional capacity outcomes, based on a NDIA rapid review
process. The evidence from this rapid review may inform practice considerations and
guidance in the short term related to the implementation of S10 transitional rule,
Schedule 1.
Schedule 1 of The National Disability Insurance Scheme (Getting the NDIS Back on
Track No. 1) (NDIS Supports) Transitional Rules 2024, as well as the participant-
facing translation document (“Supports that are NDIS supports”) lists therapeutic
supports as NDIS supports. In both the legislation and the participant-facing
translation, therapeutic supports are defined as:
•  Supports that provide evidence-based therapy to help participants improve or
maintain their functional capacity in areas such as language and
communication, personal care, mobility and movement, interpersonal
interactions, functioning (including psychosocial functioning) and community
living.
Art and music are not specifically listed in the Section 10 NDIS Supports lists.
However, we know that people enjoy art and music as part of community activities.
Often, these activities don’t need to be provided by a therapist. However, adding the
word “therapy” suggests that these activities provide therapeutic benefits and should
be delivered by a qualified health professional. This is in line with NDIS Pricing
Arrangements, which state that therapy supports must be provided by a therapist or
a supervised therapy assistant.
Evidence is needed to determine whether art and music therapy meet the legislative
criteria for therapeutic supports. The Evidence and Practice Leadership Branch was
asked to undertake a rapid review of the evidence to inform guidance. A rapid review
can provide decision makers with insights into the state of evidence and whether
there is an indication or not that these therapies may be beneficial.
Definitions of art therapy and music therapy
Art therapy is a form of therapy that includes the therapeutic use of art materials. It
uses the art-making process as its primary mode of communication and can
therefore be particularly helpful to people who find it hard to express their thoughts
and feelings verbally. Art therapy can sometimes be regarded as a three-way
process between the client, the therapist and the image or artefact. Art therapy may
include an individual or combination of modalities, including painting, drawing,
sculpting and modeling clay.

Music therapy is a form of therapy that uses music within a therapeutic relationship
between a client and qualified therapist to address physical, emotional, cognitive,
and social needs. Music therapy may involve a variety of different activities, including
music improvisation, music listening, song writing, music performance, learning
through music, and others.
Review questions
This rapid review aimed to answer the following questions:
1.  What is the state of evidence for the impact of art therapy on functional
capacity outcomes for people with disabilities?
2.  What is the state of evidence for the impact of music therapy on functional
capacity outcomes for people with disabilities?
Method
We applied our responsive rapid review methodology to answer the review questions
and provide the Agency with an overview of the state of evidence taking into
consideration the immediate need for evidence. This may inform practice
considerations and guidance in the short term related to the implementation of S10
transitional rule, Schedule 1.
Inclusion criteria for studies
We included systematic reviews or primary studies (in cases where we were unable
to locate systematic reviews) which met the following criteria:
•  The population was people with disabilities. Any disability group relevant to
the NDIS was eligible.
•  Investigated art therapy and/or music therapy (not dance therapy) which met
the following criteria:
o  Delivered by a therapist
o  Art or music were the focus of the intervention, not a component of a
larger intervention
o  Goal was to achieve a functional outcome (e.g. language and
communication, personal care, mobility and movement, interpersonal
interactions, functioning, and community living)
Search strategy

To identify relevant studies, we used a range of methods:
1.  Key words and subject headings were searched through a research database
(PubMed). This included the subject headings, “Art Therapy” and “Music
Therapy” in combination with the subject heading for systematic reviews. It
also included targeted searches for primary research in different disability
groups, with key words and subject headings for disability searched.
2.  We searched for the term "Disability” in the archives of the International
Journal of Art Therapy (the official journal of the British Association of Art
Therapists)
3.  We also undertook a snowballing method which involves checking identified
studies for other relevant studies.
Searches were limited to the last 10 years.
Evidence for art therapy
A range of systematic reviews and primary studies reporting evidence for art therapy
were identified. The overall quality of the evidence was variable and was not formally
assessed. Studies included people with autism, learning disabilities, cerebral palsy,
PTSD, schizophrenia, anxiety, depression, eating disorders, and non-psychotic
mental disorders. Table 1 includes a summary of the available evidence for art
therapy by disability group and functional capacity outcomes (grouped into areas
described in the legislation). No studies reported personal care or community living
outcomes.
Overall, there is mixed and limited evidence for art therapy for people with
disabilities. Therefore, there is not enough evidence to indicate a benefit for art
therapy across all disability groups.
It is also important to note that art therapy approaches within included studies varied
across several factors, including:
•  Modality (e.g. painting, sculpting, molding clay, or a combination of modalities)
•  Length (duration and intensity of intervention)
•  Group or individual delivery
•  Setting, including country (each country has their own understanding of art
that is relevant to their local context)
The potential impact of these factors on outcomes was unable to be investigated due
to limited evidence and time constraints.

Reasonable evidence for benefit
For some disability groups, there is reasonable evidence for the benefit of art therapy
on functional outcomes.
•  For children with autism, benefits of art therapy have been demonstrated
across a range of outcomes (mobility and movement, interpersonal
interactions, and other outcomes such as hyperactivity and inattention). There
are also some indications of benefit for language and communication.
Limited evidence with some positive indications
For some disability groups, there was very limited evidence for the impact of art
therapy on functional outcomes, but the available evidence provided some initial
positive indications.
•  For adults with learning disabilities, a small pilot study showed some
benefit to social anxiety, wellbeing, quality of life and resilience. Evidence for
other functional capacity outcomes were not reported. This is a positive
indication, but more evidence is needed to demonstrate the effectiveness of
art therapy for this group.
•  For children with cerebral palsy, one study showed improvement in
language and communication outcomes. Evidence for other functional
outcomes were not reported. This is a positive indication, but more evidence
is needed to demonstrate the effectiveness of art therapy for this group.
•  For people with post-traumatic stress disorder (PTSD), there was some
evidence for benefit above a control group on positive non-PTSD-specific
outcomes (e.g. quality of life), but inconclusive evidence for other outcomes
(e.g. depression and intrusions). Evidence for other functional capacity
outcomes were not reported. More evidence is needed to demonstrate the
effectiveness of art therapy for this group.
•  For people with anxiety and depression, there was some evidence for the
benefit of art therapy above a control group on general functioning and
wellbeing, and mental health outcomes. Evidence for other functional capacity
outcomes were not reported. More evidence is needed to demonstrate the
effectiveness of art therapy for this group.
Limited and mixed evidence
For some disability groups, there was limited and mixed evidence for the impact of
art therapy on functional outcomes.

•  For people with eating disorders, there was evidence for benefit on some
psychopathological and emotional outcomes, but no difference in others.
Evidence for other functional capacity outcomes were not reported. More
evidence is needed to determine the effectiveness of art therapy for this
group.
•  For people with non-psychotic mental disorders, there was evidence for
some mental health outcomes, but not all. One study also showed no
difference between art therapy and a control group. Evidence for other
functional capacity outcomes were not reported. More evidence is needed to
determine the effectiveness of art therapy for this group.
Limited evidence indicating no added benefit
For some disability groups, there was limited evidence, but some indication that art
therapy may not provide added benefit for functional outcomes.
•  For children with learning disabilities, no difference in interpersonal
interactions and other outcomes (self-concept, coherence) were seen
compared to a control group. However, there was very limited information
available. No studies reported language and communication, mobility and
movement, or functioning outcomes. This means we do not have information
on the impact of art therapy on these outcomes.
•  For people with schizophrenia, little or no benefit of art therapy compared to
standard care was demonstrated for interpersonal interactions, mental health,
and global functioning. There were mixed results for negative symptoms, with
one study reporting a significant reduction and one reporting no benefit above
standard care. There was limited evidence, with only a few primary studies
investigating the impact on schizophrenia.
No available evidence
In other disability groups, we were unable to identify any evidence to understand
how art therapy impacts functional capacity. This includes all disability groups not
already mentioned. This means there might be benefits or they may not be, but we
do not have any evidence to understand this.

Table 1. Evidence for art therapy by disability group and outcome.
Note: Wellbeing and quality of life outcomes alone are not considered functional outcomes.
Disability
Language and
Mobility and
Interpersonal
Functioning (incl.
Other outcomes
group
communication
movement
interactions
psychosocial)
Autism
Positive increases (not
No available evidence
Significant
Significant
Significant reduction
(children)
significant) in verbal
improvement in
improvement in social
in hyperactivity and
communication
motor skills (fine
skills (communication,
inattention (Vogel,
(Vogel, Mullins et al.
motor skills,
interpersonal
Mullins et al. 2024)
2024)
balance,
relationships, social
Significant
flexibility) (Vogel, behaviour) (Vogel,
improvement in
Mullins et al.
Mullins et al. 2024)
assertion (Vogel,
2024)
Positive increases (not
Mullins et al. 2024)
Change in gross
significant) in eye
motor skills not
contact (Vogel, Mullins
determined
et al. 2024)
(Vogel, Mullins et
al. 2024)
Learning
No available evidence
No available
No better results in art
No available evidence
No better results in
disabilities
evidence
therapy group
art therapy group
(children)
compared to different
compared to
intervention or no
different
intervention on
intervention or no
loneliness or feelings of
intervention for self-
social inadequacy
concept, coherence

Disability
Language and
Mobility and
Interpersonal
Functioning (incl.
Other outcomes
group
communication
movement
interactions
psychosocial)
(Cohen-Yatziv and
(Cohen-Yatziv and
Regev 2019)
Regev 2019)
Better adjustment
outcomes following
art therapy
compared to
academic
assistance only
(Cohen-Yatziv and
Regev 2019)
No difference
between art therapy
and academic
assistance on
academic
achievement
(Cohen-Yatziv and
Regev 2019)
Learning
No available evidence
No available
Some reduction in
Some improvement in
Some improvements
disabilities
evidence
social anxiety after
positive wellbeing and
in quality of life and
(adults)
mindfulness-based art
reduced negative
resilience after
therapy (Newland and
symptoms such as low
mindfulness-based
Bettencourt 2020)
mood after mindfulness-
art therapy
based art therapy

Disability
Language and
Mobility and
Interpersonal
Functioning (incl.
Other outcomes
group
communication
movement
interactions
psychosocial)
(Newland and Bettencourt
(Newland and
2020)
Bettencourt 2020)
Cerebral palsy
Significant
No available
No available evidence
No available evidence
No available
(children)
improvement in
evidence
evidence
intelligibility, volume,
tempo, control of
pauses, pronunciation,
and fluency of speech
(Cohen-Yatziv and
Regev 2019)
Schizophrenia
No available evidence
No available
Little or no effect on
Not associated with
Mixed results:
evidence
social functioning
improvements above
(Regev and Cohen-
control group for mental
No benefit above
Yatziv 2018)
health or global
treatment as usual
functioning (Regev and
for treating negative
Cohen-Yatziv 2018)
symptoms (Lutgens,
Gariepy et al. 2017)
Significant positive
effect on negative
symptoms in one
study (Regev and
Cohen-Yatziv 2018)
Fewer positive
symptoms in activity

Disability
Language and
Mobility and
Interpersonal
Functioning (incl.
Other outcomes
group
communication
movement
interactions
psychosocial)
group than art
therapy group
(Regev and Cohen-
Yatziv 2018)
Use of services (e.g.
inpatient care, home
treatment, drop-in
centres) comparable
across art therapy
and control group
(Crawford and
Patterson 2007)
PTSD
No available evidence
No available
No available evidence
Inconclusive
Favourable results for
evidence
evidence for PTSD-
visual arts therapy group
specific outcomes
above control group for
(e.g. intrusions)
positive non-PTSD-
(Maddox, Bodner et
specific outcomes (e.g.
al. 2024)
quality of life) (Maddox,
Bodner et al. 2024).
Inconclusive evidence for
negative non-PTSD
specific outcomes (e.g.
depression) (Maddox,
Bodner et al. 2024).

Disability
Language and
Mobility and
Interpersonal
Functioning (incl.
Other outcomes
group
communication
movement
interactions
psychosocial)
Anxiety and
No available evidence
No available
No available evidence
No available
Some evidence in favour
depression
evidence
evidence
of art therapy over control
group on general
functioning and wellbeing
(Barnish and Nelson-
Horne 2023)
Statistically significant
benefit on anxiety and/or
depression outcomes
above the control arm
(Barnish and Nelson-
Horne 2023)
Eating
No available evidence
No available
No available evidence
No available
Mixed evidence:
disorders
evidence
evidence
Significant positive
reduction in global
psychopathology and
negative emotion levels,
but no difference in other
outcomes (e.g. body
dissatisfaction, self-
esteem, quality of life)
(Pedra Cruz Bettin,
Urquiza Nogueira et al.
2024)

Disability
Language and
Mobility and
Interpersonal
Functioning (incl.
Other outcomes
group
communication
movement
interactions
psychosocial)
Non-psychotic
No available evidence
No available
No available evidence
No available
Mixed results:
mental
evidence
evidence
disorders
Benefit for some but not
all mental health
outcomes. No difference
between art therapy and
control group (Uttley,
Stevenson et al. 2015)

Evidence for music therapy
Systematic reviews and primary studies reporting evidence for music therapy were
identified. The overall quality of the evidence was variable and was not formally
assessed. Studies included people with neurodevelopmental disorders (autism
spectrum disorder and intellectual disability), neurological disabilities (Parkinson’s
disease, multiple sclerosis and stroke), neurodevelopmental disease (cerebral palsy)
and mental health (PTSD, schizophrenia, anxiety and depression). Table 2 includes
a summary of the available evidence for music therapy by disability group and
functional capacity outcomes (grouped into areas described in the legislation). No
studies reported personal care or community living outcomes.
There is mixed and limited evidence for music therapy for people with disabilities.
The evidence for music and art therapy differs by disability group. Therefore, it is
important to look at the evidence for each disability group individually.
It is also important to note that music therapy approaches within included studies
varied across several factors, including:
•  Modality (e.g. educational music therapy, improvisational music therapy,
family-centered music therapy, rhythmic auditory stimulation, music-based
movement therapy, listening to music, playing an instrument, singing, writing
songs, music imagery, Chinese ‘5-elements music’ therapy, Orff therapy, etc.)
•  Intensity (length, frequency and duration of the intervention)
•  Group or individual delivery
•  Setting, including country
The potential impact of these factors on outcomes was unable to be investigated due
to limited evidence and time constraints.
Reasonable evidence for benefit
For some disability groups, there is reasonable evidence for the benefit of music
therapy on functional outcomes.
•  For people with multiple sclerosis (MS) there is evidence from several
studies that music therapy may be a safe and effective complementary
approach for rehabilitation of MS patients. Music therapy can improve some
aspects of gait and walking, fatigue level, fatigability, coordination, dexterity,
balance, walking endurance, lower extremity functional strength, emotional
status and pain. There is some evidence that music therapy may improve
depression, self-acceptance and quality of life in people living with MS. The

evidence for cognitive improvement, mental fatigability and memory is
unclear.
•  For people who have had a stroke there is evidence that music therapy may
assist in rehabilitation. There is evidence for improvements in physical status
(upper-limb activity, various aspects of walking - such as stride length, gait
velocity and balance), cognition (paying attention, communication), and mood
in people who have had a stroke. There is evidence for the beneficial effects
of rhythmic auditory cueing on walking velocity, cadence and stride length.
Receptive music therapy may assist mood and some aspects of cognitive
function (i.e. verbal memory, focused attention). There is some evidence
‘Five-Element music’ therapy may have moderate benefit in language
rehabilitation for people with post-stroke aphasia (such as improvements in
functional communication, repetition and naming, but not comprehension).
Limited evidence with some positive indications
For some disability groups, there was very limited evidence for the impact of music
therapy on functional outcomes, but the available evidence provided some initial
positive indications.
•  For people with Parkinson’s Disease (PD) there is some limited evidence
that rhythmic auditory stimulation may significantly improve gait speed and
stride length. However, the quality of evidence was low, and the number of
studies and participants was small. There is some evidence that music-based
movement therapy may improve motor function, balance, freezing of gait,
walking speed and mental health, but not gait cadence, stride length, or
quality of life in people with PD. There is some evidence that singing may
have a beneficial effect on speech in people with PD.
•  For people with depression and/or anxiety there is some evidence that
music therapy in addition to usual treatment may improve depressive
symptoms when compared with usual treatment alone. There is evidence that
music therapy in adults, adolescents and children with depression improved
symptoms of depression and improved functioning compared with usual
treatment alone. Music therapy also decreased anxiety symptoms and
cognitive ability, although showed no improvement in quality of life.

Limited and mixed evidence
For some disability groups, there was limited and mixed evidence for the impact of
music therapy on functional outcomes.
•  For children and adolescents with autism it is uncertain whether music
therapy has any benefit. Music therapy has been attributed to likely or
probable improvements across a range of autism outcomes (including global
improvement, symptom severity, quality of life, speech production, social
engagement, joint attention and social functioning). There is conflicting
evidence for verbal and non-verbal communication and no evidence for social
interaction. No reduction in a measure of autism symptom severity was
observed in children from short-term (6 months) exposure to improvisational
music therapy. Mothers with children on the autism spectrum who were
followed up four years after completing a 16-week home-based family-centred
music therapy program reported long-term program benefits leading to
improved social relationships in the family and quality of life. For
(predominantly younger) adults with autism without intellectual impairment,
music therapy may have a positive impact on mental health and wellbeing.
•  For people with schizophrenia there is moderate to low quality evidence for
the short- to long-term effects of music therapy on global mental state
(including general and negative symptoms), general and social functioning,
and quality of life. Positive results may be mediated by the intensity
(frequency) of the intervention. There are mixed results for cognitive
functioning and inconclusive data on behavioural outcomes.
•  For people with post-traumatic stress disorder (PTSD) there is low certainty
of the evidence for music therapy in reducing moderate to severe PTSD and
depressive symptoms.
•  For children with epilepsy there is inconclusive evidence to determine the
effectiveness of listening to Mozart’s music (the ‘Mozart effect’) to reduce
seizures in children (and EEG abnormalities associated with increased
seizure risk) either as an adjunct to medical management or in children with
epilepsy refractory to medications.
•  For children with intellectual disability and auditory processing disorder,
Orff music therapy (a developmental approach to music therapy) was found to
significantly improve auditory processing skills.
No available evidence
In other disability groups, we were unable to identify any evidence to understand
how music therapy impacts functional capacity. This includes all disability groups not

mentioned. This means there might be benefits or they may not be, but we do not
have any evidence to understand this.

Table 2. Evidence for music therapy by disability group and outcome.
Note: Wellbeing and quality of life outcomes alone are not considered functional outcomes
Disability group
Language and
Mobility and
Interpersonal
Functioning (incl.
Other outcomes
communication
movement
interactions
psychosocial)
Autism
No available
Some improvement in
Mixed evidence:
Mixed evidence:
Reduction in autism
evidence
mental health and
symptoms, slight increase
Significant positive
Some significant
wellbeing, limited
in QoL (Geretsegger,
effect on verbal and
positive effect on
evidence (Lorenc,
Fusar-Poli et al. 2022)
non-verbal
social
Rodgers et al. 2018)
communication,
engagement and
limited evidence
joint attention,
(Weitlauf, Sathe et al.
limited evidence
2017)
(Weitlauf, Sathe
et al. 2017)
No improvement in
verbal and non-verbal
No improvement
communication
in social
(Geretsegger, Fusar-
interaction
Poli et al. 2022)
(Geretsegger,
Fusar-Poli et al.
2022)
Intellectual
No available evidence No available
No available
No available evidence
Significant improvement in
disability
evidence
evidence
auditory processing skills

(Senkal and Muhtar 2021)

Disability group
Language and
Mobility and
Interpersonal
Functioning (incl.
Other outcomes
communication
movement
interactions
psychosocial)

Neurological
No available evidence  Improvements in
No available
No available evidence
Improvements in cognition
disabilities
upper limb
evidence
(Moumdjian, Sarkamo et
(Parkinsons,
function, mobility
al. 2017)
multiple
(Moumdjian,
sclerosis, and
Sarkamo et al.
stroke)
2017)
Multiple
No available evidence  Positive effect on
No available
No available evidence
No available evidence
Sclerosis
motor function
evidence
(e.g. gait) (Lopes
and Keppers
2021, Kong,
Zhang et al. 2023)
Parkinsons
Partial evidence of
No available
Significant
Significant
Mixed evidence:
Disease
benefit on singing
evidence
improvement in
improvements in
intervention on
mental health (Zhou,
No effect found on
walking velocity,
speech (Barnish,
Zhou et al. 2021)
cognitive flexibility,
stride length, and
Atkinson et al. 2016)
executive inhibition, or
mobility. No effect
quality of life (Lee and Ko
on gait cadence
(Lee and Ko
2023)
2023)
Some improvement in
quality of life, cognitive
Significant
outcomes (Barnish and
improvement in
motor function,
Barran 2020)

Disability group
Language and
Mobility and
Interpersonal
Functioning (incl.
Other outcomes
communication
movement
interactions
psychosocial)
freezing of gait,
No observed effect on
walking velocity,
cognitive function or quality
balance (Zhou,
of life (Zhang, Liu et al.
Zhou et al. 2021)
2017)
Positive effect on
motor outcomes,
including balance
and probability of
falls (Zhang, Liu et
al. 2017)
Post stroke
Significant effect of
No available
No available
No available evidence
No available evidence
aphasia
‘five elements music’
evidence
evidence
(Chinese music
therapy) on repetition,
spontaneous speech,
and naming. Limited
evidence  (Yang,
Fang et al. 2019)
Stroke – motor
No available evidence  Significant positive  No available
No available evidence
Significant improvement in
dysfunction
effect on upper
evidence
executive function (Zhang,
limb function,
Cai et al. 2016)
stride length, and
gait velocity
(Zhang, Cai et al.
2016)

Disability group
Language and
Mobility and
Interpersonal
Functioning (incl.
Other outcomes
communication
movement
interactions
psychosocial)
Children with
No available evidence  No available
No available
No available evidence
Inconclusive evidence for
epilepsy
evidence
evidence
efficacy of the Mozart
Effect on seizure activity
(Brackney and Brooks
2018)
Depression
No available evidence  No available
Improvement in
Improvement in
No observed improvement
evidence
social participation  functioning (Aalbers,
in quality of life (Aalbers,
(Barnish and
Fusar-Poli et al. 2017)
Fusar-Poli et al. 2017)
Nelson-Horne
Improvement in
2023)
depression symptoms
(Barnish and Nelson-
Horne 2023)
Improvements in
clinician and patient-
rated depressive
symptoms (Aalbers,
Fusar-Poli et al. 2017)
Improvements in
anxiety symptoms
(Aalbers, Fusar-Poli et
al. 2017)
Improvement in
depression and

Disability group
Language and
Mobility and
Interpersonal
Functioning (incl.
Other outcomes
communication
movement
interactions
psychosocial)
anxiety symptoms, and
cognitive ability, in
older adults, when
music therapy is
combined with
treatment as usual
(e.g. drug therapy,
psychological care)
(Wang, Wu et al.
2023)
Improvement in
Anxiety
No available evidence  No available
No available evidence
Improvement in anxiety
social participation
evidence
symptoms (Barnish and
(Barnish and
Nelson-Horne 2023)
Nelson-Horne
2023)
Improved symptom
severity in children and
adolescents – limited
evidence (Belski, Abdul-
Rahman et al. 2022)
No available
Eating
No available evidence  No available
No available evidence
Significant effect to reduce
evidence
disorders
evidence
negative emotional states
(Pedra Cruz Bettin,
Urquiza Nogueira et al.
2024)

Disability group
Language and
Mobility and
Interpersonal
Functioning (incl.
Other outcomes
communication
movement
interactions
psychosocial)
No available
Post Traumatic
No available evidence  No available
No available evidence
PTSD symptoms were
evidence
Stress Disorder
evidence
lower after intervention
when compared to passive
controls, but no change
when compared to active
controls. Low certainty due
to high risk of bias across
all included studies (Ma,
Yuan et al. 2024)
Improvements in
Schizophrenia
No available evidence  No available
Improvements in
Large improvements in
social functioning
evidence
general functioning for  general mental state,
in the short,
high-dose music
improving further over
medium and long
therapy (more than 20  time. Medium-sized
term
sessions)
positive effects on
(Geretsegger,
(Geretsegger, Mössler  negative symptoms.
Mössler et al.
et al. 2017)
Mixed results for cognitive
2017)
functioning. Inconclusive
data on behavioural
outcomes. Some evidence
for improvements on
quality of life after high
dose music therapy
(Geretsegger, Mössler et
al. 2017)

Summary
We applied a rapid review process to investigate the impact of art and music therapy
delivered by an allied health professional on functional outcomes for people with
disabilities. There is evidence for the benefit of art and music therapy for some
disability groups. However, there is not enough evidence to indicate whether there is
a benefit across all disability groups. Additionally, for some disability groups, there is
evidence which indicates no added benefit of art and music therapy above a control
group.
The available evidence for art therapy showed:
•  Some evidence for the benefit of art therapy for children with autism.
•  Limited evidence but positive indications for the benefit of art therapy across
some outcomes for adults with learning disabilities, children with cerebral
palsy, people with PTSD, and people with anxiety and depression.
•  Limited evidence with mixed indications for the benefit of art therapy for
people with eating disorders and people with non-psychotic mental disorders.
•  Limited evidence with some indication that art therapy may not provide added
benefit for children with learning disabilities and people with schizophrenia.
The available evidence for music therapy showed:
•  Some evidence for the benefit of music therapy for people with multiple
sclerosis and people who have had a stroke.
•  Limited evidence but positive indications for the benefit of music therapy
across some outcomes for people living with Parkinson’s disease, and people
with depression and/or anxiety.
•  Limited evidence with mixed indications for the benefit of music therapy for
people with autism, people with schizophrenia, people with PTSD, children
with epilepsy, and children with an intellectual disability and auditory
processing disorder.
It is likely that the evidence generated through this rapid review meets the level of
evidence required for art and music therapy as low risk and relatively low value
supports. A more rigorous and time-intensive review may be excessive considering
these factors and may reach the same conclusions as this rapid review. As such, this
rapid review could be used as evidence tabled at the NDIS Evidence Advisory
Committee to assist with making recommendations made about art and music
therapy.

Any need for further evidence would need to be determined with an assessment of
the relative priority and opportunity cost of investigating art and music therapy in the
short term compared to other higher risk therapies and high-cost assistive
technology. If a need for further evidence is identified, a systematic review could be
undertaken. A standard systematic review can take 4-8 months.
Limitations
Research spanning the broad range of disability groups relevant to the NDIS was
greatly limited, with studies only available for certain disability groups. Some studies
may have been missed, considering limited timeframes, or more primary research
may be needed to fill these evidence gaps. Where studies on relevant populations
were identified, the breadth of functional capacity outcomes relevant to the NDIS
were also rarely measured. While functional outcomes were not often measured, it is
important to note the link between improved mental health and wellbeing and
increased functional capacity, especially for people with psychosocial disability.
It is also important to note that while rapid reviews are useful when evidence is
needed quickly, a rapid review cannot:
•  Definitively answer questions of efficacy or effectiveness
•  Identify all the literature associated with a review question
•  Include all the relevant studies or all the information contained in the studies
•  Appraise the quality of the studies.
This means that a rapid review cannot assess how reliable the evidence is, and how
confident we can be in any observed effects. A rapid review can only show some of
the evidence that is available, and what that evidence says in broad terms. This
method is useful when evidence is needed quickly to inform interim guidance, in
cases where the risk to the participant and the Scheme is likely to be low.
However, it is important to note that this type of research is not robust enough to be
considered adequate for high level decision-making, and in cases where supports
have a high associated cost or a risk of harm to participants. In these instances, a
more robust approach to evidence is needed. This could look like a systematic
review.

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