What This Article Covers
- Music-Based Interventions in Occupational Therapy
- What Is Occupational Therapy?
- Why Music Can Be Relevant in Occupational Therapy
- How Music-Based Interventions May Support People With Dementia
- What This Means for Support at Home Participants
- Music, Movement, and Motor Performance
- Music Listening After Stroke
- Autism, Participation, and Communication
- A Practical OT Framework for Using Music
- The Real Role of Music in Occupational Therapy
Music-Based Interventions in Occupational Therapy
Occupational therapy is all about helping people do the everyday activities that matter to them. That might mean getting dressed more easily, preparing meals more safely, managing routines at home, joining social activities, or building the skills needed for work, school, or community life. Occupational therapy can help people by improving function, participation, and quality of life through practical, goal-focused support.
One growing area of interest is how music can help occupational therapy. Music is not just entertainment in this context. When it is used deliberately, it can become a therapeutic tool that supports movement, attention, emotional regulation, motivation, and participation in daily tasks. A recent Cochrane review found that structured music-based therapeutic interventions for people living with dementia probably improve depressive symptoms and may improve overall behavioural problems at the end of treatment, especially when music is used as an active therapeutic intervention rather than passive background sound.
In my experience, I have also seen how familiar and purposeful use of music. It can help some people feel more settled, engaged, and willing to participate in therapy. In this blog, we explore how music can support occupational therapy when it is used intentionally and in line with a person’s goals.
What Is Occupational Therapy?
Occupational therapy helps people participate in meaningful daily activities, often called “occupations.” These occupations include self-care, home tasks, community access, learning, leisure, and social participation. An occupational therapist looks at the person, the activity, and the environment, then adapts tasks, routines, tools, and supports so that daily life becomes safer, easier, and more achievable.
That is why the question of how occupational therapy can help people is such an important one. OT is rarely about one isolated skill. It is about helping a person function better in real life. In music-based practice, this means linking music to a clear functional goal, such as improving tolerance for a shower routine, supporting attention during meal preparation, increasing upper-limb practice after stroke, or improving engagement in a group setting.
Why Music Can Be Relevant in Occupational Therapy
The strongest point in the evidence is simple: music works best in occupational therapy when it is used for a clear therapeutic purpose. Not just because it sounds nice. Not just because it creates a calm atmosphere. And not as background entertainment.
It helps most when it is tied to a specific goal.
- Music can increase engagement and participation in therapy.
- Rhythm can provide an external timing cue for movement.
- Music listening can support attention, memory, and emotional regulation.
This matters because many occupational therapy goals depend on repetition, motivation, and routine. A task may be clinically appropriate, but if the person is distressed, disengaged, fatigued, or unable to sustain attention, progress can stall. Music may help bridge that gap for some people.
How Music-Based Interventions May Support People With Dementia
A 2025 Cochrane review included 30 studies with 1,720 participants and found that, compared with usual care, music-based therapeutic interventions probably improved depressive symptoms slightly and may improve overall behavioural problems at the end of treatment. However, the same review found no clear improvement in agitation or aggression, and it found no evidence of lasting long-term effects after treatment ended.
Music may help some people with dementia in the short term, especially around mood, behaviour, and social engagement, but it should not be promoted as a cure or as a guaranteed long-term solution.
The Australian MIDDEL trial adds local relevance. In residential aged care, recreational choir singing was associated with reduced depressive symptoms at six months, while group music therapy alone did not show the same effect on the primary depression outcome. The uploaded Lancet paper reports a beneficial effect for recreational choir singing, with a mean difference of -4.25 on the MADRS depression scale.
For occupational therapists, that suggests structured singing groups may support some clients in aged care by improving mood, encouraging participation, and increasing willingness to engage in daily routines and shared activities. It does not mean every person with dementia will respond the same way.
What This Means for Support at Home Participants
The home setting is different from a structured care facility. In the HOMESIDE trial, Baker et al. (2023) found that caregiver-delivered music did not produce a clinically important reduction in enduring behavioural and psychological symptoms over 90 days compared with usual care.
That does not mean music has no role at home. It means clinicians and providers should be careful not to oversell it. In practice, music may still help with:
- easing transitions between tasks
- improving connection between a person and their carer
- creating calmer routines
- supporting in-the-moment regulation
- making care tasks more tolerable
A careful OT approach would be to trial music for a defined purpose, monitor the response, and continue only if it is helping a meaningful functional outcome. That is more evidence-based, more person-centred, and more consistent with Ahpra expectations around honest health communication.
Music, Movement, and Motor Performance
Music can also support physical and motor goals when rhythm is used as an external cue.
In Parkinson’s disease, Burrai et al. (2024) reported meta-analytic evidence that rhythmic auditory stimulation can improve stride length and cadence during gait training. For occupational therapy, that may be relevant when mobility supports participation in home and community activities, although any use of rhythm-based cueing should still be individualised and safety-focused.
In stroke rehabilitation, Schneider et al. (2007) described music-supported training using instruments such as piano and drum set. In that study, upper-limb outcomes improved on measures including the Action Research Arm Test and the Box and Block Test, with effect sizes of up to 0.89. This is promising for occupational therapy because upper-limb rehabilitation often focuses on reach, grasp, bilateral hand use, coordination, and meaningful task practice.
The practical lesson is straightforward:
rhythm and music may help create a structured, repetitive, and feedback-rich practice environment. But their value in occupational therapy is strongest when they are linked to real functional tasks, rather than used in isolation.
Music Listening After Stroke
Not all music-based interventions require active singing or instrument playing. In a single-blind randomised controlled trial, Särkämö et al. (2008) found that daily self-selected music listening during the first two months after stroke was associated with significant improvements in verbal memory and focused attention at key follow-up points. The authors concluded that music listening during the early post-stroke stage can “enhance cognitive recovery and prevent negative mood.”
For OT, that kind of intervention may fit naturally into home programs. For example, music listening may be paired with structured morning routines, meal preparation, gentle exercise, or attention-building tasks.
Still, music listening was used alongside standard medical care and rehabilitation, so it is better understood as an adjunct rather than a stand-alone rehabilitation program.
Autism, Participation, and Communication
Research suggests that music-based interventions may support people living with autism, particularly in communication, engagement, participation, and sensory regulation. A Cochrane review found short- to medium-term improvements in overall symptom severity and global functioning, while also noting that the strength of evidence varies depending on the outcome being measured.
This is especially relevant in disability services because occupational therapy often focuses on participation, regulation, routines, and functional communication support. In these contexts, music may be useful when it is linked to a measurable goal, such as turn-taking, shared attention, smoother transitions, group participation, or co-regulation.
Again, the key message is precision: music is most useful when it serves a clearly defined occupational goal. Not simply because it is enjoyable or appealing in general.
A Practical OT Framework for Using Music
Clinical guidance suggests a structured approach when using music in occupational therapy practice. A stepwise process is often recommended to ensure interventions remain goal-directed, measurable, and relevant to real-world function.
- start with assessment of goals, triggers, routines, and baseline measures
- identify the main target area, such as mobility, upper-limb function, mood, agitation, care tolerance, communication, or participation
- choose the music approach to match that target
- define dose and safety considerations
- implement in the real context
- measure change
- adjust the plan if meaningful improvement is not seen
This kind of framework is clinically useful because it keeps the focus where it belongs. On function, safety, and measurable outcomes. It also helps ensure that music is used as a therapeutic tool, rather than as a general activity without a defined purpose.
The Real Role of Music in Occupational Therapy
Music-based interventions can play a meaningful role in occupational therapy when they are purposeful, individualised, and linked to real-life function. Current research supports their targeted use in areas such as mood and behavioural symptoms in dementia, movement cueing in neurological rehabilitation, upper-limb practice after stroke, and participation goals for some people living with autism.
At the same time, the evidence has limits. Not every outcome improves. Some benefits appear modest, and long-term effects are often uncertain. Research in home-based settings also suggests that while music may help with routine, connection, and in-the-moment support, it should not be overstated as a reliable solution for persistent symptoms across all contexts.
Used well, music can be a valuable tool within occupational therapy. It is not a cure-all, but for the right person and the right goal, it may help make daily life more manageable, more engaging, and more meaningful.
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references:
- https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(23)00401-7/fulltext
- Burrai et al. (2024), https://www.sciencedirect.com/science/article/pii/S2950307824000845
- Schneider et al. (2007), https://pubmed.ncbi.nlm.nih.gov/17260171/
- Särkämö et al. (2008), https://www.researchgate.net/publication/5565197_Music_listening_enhances_cognitive_recovery_and_mood_after_cerebral_artery_stroke
- Elefant et al. (2022), https://pubmed.ncbi.nlm.nih.gov/35532041/.
- https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003477.pub5/full
- https://www.thelancet.com/journals/lanhl/article/PIIS2666-7568(22)00027-7/fulltext
- https://www.thelancet.com/action/showPdf?pii=S2666-7568%2822%2900027-7
