Pakistan Journal of Psychological Research, 2012, Vol. 27, No.

1, 53-64

Use of Music Therapy for Enhancing Self-esteem

among Academically Stressed Adolescents
Mamta Sharma and Tanmeet Jagdev
Punjabi University
1

The study aims to evaluate the efficacy of music therapy in

enhancing the self-esteem of academically stressed adolescents. It
was hypothesized that post-intervention scores on measure of selfesteem would be enhanced as compared to pre-intervention
scores. A pre and post-assessment design was adopted. School
form of the Self Esteem Inventory (Coopersmith, 1981) and
academic stress scales of the Bisht Battery of Sterss Scales (Bisht,
1987) were used to identify 30 adolescents with low self-esteem
and high academic stress. Music therapy was given for a period of
15 days. After intervention, self-esteem inventory was
administered again to see the effects of music therapy. Results
revealed that music therapy enhanced adolescents self-esteem as
post-intervention scores of experimental group on self-esteem
were high as compared to control group (t = 10.85,
p < .01). Significant difference (t = 10.28, p < .01) was also found
between pre and post-intervention scores of experimental group
whereas control group didnt show any statistical difference
between its pre and post-intervention scores (t = 1.06).
Keywords: Self-esteem, academic stress, music therapy

Student life coincides with adolescence and stress can manifest in

children as reaction to the changes in life in addition to academic
pressure and academic stress. Academic stress is the product of a
combination of academic related demands that exceed the adaptive
resources available to an individual. If a student is unable to cope
effectively with academic stress, then serious psychological, social,
and emotional health consequences may result (Arthur, 1998;
MacGeorge, Samter, & Gilligan, 2005; Tennant, 2002). Children are
constantly under the stress of studies and examinations, in short, they
are entangled in the web of academic stress and are often ill-equipped
to cope with stress during transitions from childhood to
Mamta Sharma and Tanmeet Jagdev, Department of Psychology, Punjabi
University, Patiala-147002 (Punjab) India.
Correspondence concerning this article should be addressed to Mamta Sharma,
Department of Psychology, Punjabi University, Patiala-147002 (Punjab) India.
E-mail: [email protected]

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SHARMA AND JAGDEV

preadolescence, and from preadolescence to adolescence phases

(Dharam, 1997).
Research has shown that low self-esteem makes the person more
vulnerable to as individuals with low self-esteem adopt passiveavoidant coping styles focused on emotions whereas individuals, with
high self-esteem or a high feeling of control, adopt active coping
strategies focused on problems (Thoits, 1995). Studies indicate that
self-esteem plays an important role in developing and controlling the
stress of students. Students who were more stressed were found to
have lower self-esteem and less awareness of their health (Hudd et al.,
2000).
Research findings have indicated an inverse correlation between
life stressors and self-esteem (Abramson, Metalsky, & Alloy, 1989;
Garber, Robinson, & Valentiner, 1997; Kliewer & Sandier, 1992).
Negative self-esteem predisposes adolescents to depression and other
psychiatric difficulty (Garber et al., 1997). The findings lend support
to the theoretical assumptions in the literature that high self-esteem
and supportive social relationships influence academic stress through
motivational and affective pathways.
Teachers, educationists, social scientists, and parents are
increasingly becoming concerned about issues related to academic
stress, examination anxiety, and their effect on students learning
process, well-being, and mental health and measures to control and
curb delirious effects of these. Self-esteem represents a motivational
force that affects perceptions and coping behavior; it buffers stress by
mitigating the perceived threat and by enhancing the selection and
implementation of efficacious coping strategies; it thus becomes the
prime duty of social scientists, particularly of psychologists, to
develop scientific ways of enhancing self-esteem to cope with stress
among adolescents emanating from educational and academic arena.
The present investigation was undertaken to examine music therapy as
an intervention on self-esteem of adolescents to eliminate stress. It is
an attempt to use music therapy as self-esteem booster.
Music therapy is based on the associative and cognitive powers
of the mind. It is one of the expressive therapies which are of late
interpreted as a complementary or integrative medicine. There are
areas where people are not able to express themselves. Tyranny,
socioeconomic status or hierarchy, fear of the powerful, feelings of
shame, are some of the few social reasons as to why the expression is
gagged in the social milieu and which snowballs over the years to
affect the mental as well as physical well-being of an individual
(Sairam, 2006).

MUSIC THERAPY FOR ACADEMICALLY STRESSED ADOLESCENTS

55

Modern neurologists while analyzing human brain have attributed

functional characteristics to the two hemispheres; assigning the left to
perform analytical functions and the right to emotional functioning.
These hemispheres are interconnected through the corpus callosum.
Music therapy is thought to activate biochemical and electrical
memory material across corpus callosum, thus enhancing the ability of
the two hemispheres to work in unity, rather than in opposition
(Updike, 1990). Music can stimulate the production of endorphins, the
bodys natural opiates, as well as reduce levels of cortisol and
noradrenaline, hormones related to stress (Watkins, 1997). According
to an ancient Indian Swara Sastra (oneness of breath, mind and
senses, the renunciation of all existence), the 72 melakarta raags
(musical scales) control the important 72 nerves of the body (Bagchi,
2003).
Self-esteem and self-confidence are factors found to be improved
with the application of music as a therapeutic tool (Henderson, 1987;
Kliewer & Sandler, 1992; Magee, 1999). Within the literature there is
a wide variety of examples of music helping to increase selfconfidence and self-esteem with various types of individuals. Certain
diagnostic groups, such as depressed patients, are clearly more in need
of activities to build self-confidence. Sausser and Waller (2006)
concluded that music enhances self-expression and self-esteem.
Moreno (1995) described music therapy as similar to traditional
healing methods in its ability to support positive belief systems,
enhance feelings of group support and individual self-esteem.
Research by Henderson (1983), found self-esteem had increased
following a music therapy intervention with thirteen hospitalized
patients diagnosed with adjustment reaction to adolescence. Within a
population of autistic children, Brunk (1999) argued that music
therapy and adapted music lessons may both influence self-esteem.
Music therapy has been highly effective with individuals who
typically lack crucial self-esteem and self-concept (Henderson, 1983;
Johnson, 1981; Kivland, 1986). Disclosure and awareness of self has
been precipitated through the music as the relationship with music,
therapist and self has developed. Songwriting, according to Goldstein
(1990) provides a successful, pleasant experience and that a great deal
of additional information about the participant can be gained through
such techniques. Music therapy not only allows for the development
of self-esteem through successful educational and social interactions,
it also enables the child to use the group as a support system, a
replacement for what has lacked in family structure and rituals. Music
has structure within itself, and has been used to mark rituals
throughout time for as long as man has known music. Also, it is

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SHARMA AND JAGDEV

important to remember that toning (the release of tension and anxiety

through the voice), is the body's natural regulation mechanism for
healing, both emotionally and physically (Bradway, 2009).
Music therapy is presented in two modes. One is passive mode
which gives importance to listening; the other one is active mode,
which gives importance to participating. Passive form of music
therapy may be beneficial to almost all forms of ailments. Active form
is of immense help in neurological problems, like neurological aphasia
(receptive aphasia and expressive aphasia) in the segment of
alternative medicines to help children to reduce speech problems, to
enhance speech fluency, to reduce hyper activity in hyperactive
children, and so on. Passive form is more helpful in enhancing the
concentration and memory, in boosting self-confidence, to reduce the
stress and strain, to cope up with series of heart problems, like
hypertension, in bringing down the blood pressure and normalize the
patients (Mythili, 2010).
Music therapy works with the relationship between learning and
music by reflecting an awareness of self-perception, allowing
subsequent growth and facilitating intrinsic change at many levels
(Wilson, 1991). Music can reduce aggressive behavior and improve
self-esteem in children with highly aggressive behavior (Choi, Lee,
& Lee, 2007). Though various researches have been conducted in west
to understand the effect of music therapy on children, few studies have
been under taken in India on the subject. Understanding the efficacy
of music therapy on the lives of children in Indian setting would be
useful for programming remedial measures. This study aims to
understand the effect of music therapy to enhance self-esteem of
academically stressed children.
Hypothesis 1: Post-intervention self-esteem scores of individuals
in experimental group would be significantly higher as compared
to post-intervention self-esteem scores individuals in control
group.
Hypothesis 2: Post-intervention self-esteem scores of individuals
in experimental group would be significantly higher as compared
to the pre-intervention self-esteem scores.
Sample
The sample comprised of 60 adolescents between the age group
of 15 to 18 years of age. The mean age range was 16.85.

MUSIC THERAPY FOR ACADEMICALLY STRESSED ADOLESCENTS

57

Instruments
Scale of Academic Stress (SAS-3). The scale of academic
Stress from Bisht Battery of Stress Scale (Bisht, 1981) was used for
the study. It consists of 80 items. It contains for scales measuring
academic anxiety, academic frustration, academic pressure, and
academic conflict. Academic anxiety 15 items, academic frustration
has 26 items, academic pressure has 24 items, academic conflict has
15 items. Its dependability coefficient and stability coefficients are .87
.82 respectively and it has internal consistency of .88.
Self Esteem Inventory (SEI). The school form of the selfesteem inventory by Coopersmith, 1987) was used. This inventory
consists of 58 items, eight of which comprise a lie scale. The items
measure childrens attitudes toward peers, parents, school, and their
perceptions about themselves. Its internal consistency coefficients are
.80 for grade 8, .86 for grade 9, and .80 for grade 12. The predictive
validity is reported to be .53 and concurrent validity is reported to be
.33 (p < 0.1).
Intervention design
The music therapy was applied through a cassette with a 30minute recording of Raga being played by a flute. A cassette player
with headphones was utilized for this purpose. A raga can be defined
as:
A raga (Sanskrit word) is one of the melodic modes used in
Indian classical music. A raga uses a series of five or more
musical notes upon which a melody is constructed.
However, it is important to remember that the way the notes
are approached and rendered in musical phrases and the
mood they convey are more important in defining a raga
than the notes themselves. In the Indian musical tradition,
ragas are associated with different times of the day, or with
seasons... Therefore, the word is used in the literal sense of
color passion, or the act of dyeing, and in the figurative
sense of something that colors one's emotions (Jairazbhoy,
1995, 45).
The use of raga for emotionally moving or healing was first
initialed by Tansen (a famous musician) could work miracles with his
singing. Many raga are ascribed to Tansen. Such raga as Mian ki

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SHARMA AND JAGDEV

Malhar, Mian ki Todi, and Darbari Kanada are the most famous. A
Mian ki Todi was used as the intervening raag for the present study.
The participants in the experimental group were subjected to the
flute-version of the raag for half an hour daily for 15 days. The
experimenter discussed neutral or unrelated issues like study habits,
time-management and career selection with the participants of the
control group to avoid unethical practice.
Procedure
Experimental and control groups were employed to examine the
efficacy of music therapy on self-esteem. Scales of academic stress
and self-esteem were administered on 100 students, out of which 60
subjects were found to have high academic stress and low self-esteem.
Half of the screened subjects (n = 30) were selected for music therapy,
whereas the remaining subjects were assigned to the control group.
Consent of the respective authorities and subjects was taken in
advance. All the participants were very comfortable with English
language. The subjects were seated in such a way that they could not
look at each other and were instructed to enjoy music through
headphones till the music continued. After 15 days of intervention,
self-esteem scale was administered again to assess the efficacy of
music therapy to both the groups.

Results
In the light of stated hypothesis, means, standard deviations, and
t-test were computed.
Table 1
Means, Standard Deviation, t-test, for Post-intervention Scores of
Experimental and Control Group on Self-esteem (N = 60)
Experimental

Control

(n = 30)

(n = 30)

M
Self-esteem 45.80

SD

6.13

28.93

SD

Cohens
t(59)

5.92 10.85**

d
2.799

95% CI
LL

UL

13.76 9.98

Note. CI = Confidence Interval; LL = Lower Limit; UL = Upper Limit.

**p <.01

Table 1 is depicts means and standard deviations of control and

experimental group obtained on self-esteem. The difference between

59

MUSIC THERAPY FOR ACADEMICALLY STRESSED ADOLESCENTS

control group and experimental group on self-esteem is found to be

statistically significant proving effectiveness of music therapy
intervention in enhancing self-esteem (t = 10.85, p < .01). It is evident
in this table that after getting music therapy intervention, individuals
in experimental group scored high on self-esteem (M = 45.80,
SD = 6.13) as compared to those who did not receive any such
treatment i.e. control group (M = 28.93, SD = 5.92).

Table 2
Means, Standard Deviation, t-test for Pre-intervention and Postintervention Scores on Self-esteem (N = 60)
Self-esteem scores
Preintervention
Groups

Postintervention
M

Experimental 29.53 6.13

6.12

45.80 10.28*

2.65

13.10 19.44

Control

5.76

28.93

0.27

-1.41

5.92

t(59)

1.06

95% CI

SD

27.32

SD

Cohens

LL

UL

4.63

Note. CI = Confidence Interval; LL = Lower Limit; UL = Upper Limit.

*p <.01

To provide more confidence in the efficacy of intervention, preintervention scores on self-esteem were compared with postintervention scores in both control and experimental group.

SELF ESTEEM SCORES

SELF ESTEEM IN RELATION TO INTERVENTION

55
45.80

45

SELF
ESTEEM

35
29.53
25
15
PRE-INTERVENTION
POST-INTERVENTION
INTERVENTION

Figure 1: Graphical representation of self-esteem scores in both pre-intervention

and post-intervention assessment session.

Finding of these pre-intervention post-intervention comparisons

are presented in Table 2 and Figure 1, which shows that post-

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SHARMA AND JAGDEV

intervention self-esteem mean scores are higher than pre intervention

mean scores of experimental group. Pre-intervention and postintervention self-esteem scores differ significantly (t = 10.28, p < .01),
whereas no significant difference has been found between preintervention and post-intervention scores of control group. The
following figure depicts the graphical representation of self-esteem
scores in both pre-intervention and post-intervention assessment
session (t = 1.06).

Discussion
Healing by means of music is a very ancient medical art with
many approaches to both learning and practice. Music therapy, as it is
practiced today, is the systematic application of music in the treatment
of physiological and psychological aspects of any disequilibrium in
the body. The present study was designed to assess the impact of
music as therapy in enhancing self-esteem. The aim of the therapy was
to regain the lost touch to ones own body self-regulatory processes.
The aim of the research was to facilitate change through the use of
music as therapy in the students behavior with particular emphasis on
self-esteem.
The hypotheses of this research that music therapy would
enhance self-esteem have been supported. The results are in line with
the previous researches which indicated that self-esteem had increased
following a music therapy intervention with thirteen hospitalized
patients diagnosed with adjustment reaction to adolescence
(Henderson, 1983), musical performance can also help to build selfesteem and expression (Gardstrom, 1987). Another example is by
Smeijsters and Hurk (1999) who conducted an in-depth case study of
a woman suffering badly from grief and had issues finding a personal
identity. They found music therapy enabled the client to express part
of her personality, which had been suppressed, and during the music
therapy process, her self-esteem increased. Music helps in enhancing
self-esteem, self-expression, and interpersonal communication (Freed,
1987). It is clear that a range of musical activities can all produce a
positive effect on self-esteem and self-confidence. It seems that this
effect should be particularly apparent in a therapeutic environment,
especially if it is emphasized as an aim of the therapy.
Support for the present findings could be derived from some
previous studies which explain that self-esteem is not only seen as a
basic feature of mental health, but also as a protective factor that
contributes to better health and positive social behavior through its
role as a buffer against the impact of negative influence (Mann et al.,
2004). Music therapy is important for establishing and recreating

MUSIC THERAPY FOR ACADEMICALLY STRESSED ADOLESCENTS

61

identity (Aldridge, 1989; Magee, 1999). Much of the literature

supporting the use of music therapy describes how music therapy
enhances self-esteem and self-efficacy (Purdie, 1997; Purdie &
Baldwin, 1994) as well as develops positive self-image (Jochims,
1995; McMaster, 1991). Music has the ability to facilitate language
acquisition, general intellectual development, creativity and self-worth
(Hanschumaker, 1980). Montello and Coons (1998) study results give
the evidence of improved self-worth and self-esteem as a result of
using music.
The findings of the study clearly indicate that music is an
incredibly powerful form of expression. It combines both words and
sound to deliver a message. Music therapy can trigger specific
memories in ones mind. There is no doubt about strong connection
existing between music and feelings. High self-esteem in turn declines
individuals proneness to stress. Kittredge (1911) beautifully quoted
Ingersoll who believed that music expresses feeling and thought,
without language; it is below and before speech, and it is above and
beyond all words.
Limitations and Suggestions
This research carries certain identifiable limitations which need
to be addressed. The sample is the urban middle SES adolescents
aged between 15-18 years attending schools. Thus, the interpretation
of study result would refer to only school-based, mid to late
adolescence, studying in District Yamunanagar schools in Haryana,
India. These findings could not be generalized to the whole
adolescents aged between 15-18 years in other regions of India.
Secondly, this study used only self-report questionnaires; the finding
of the present study must therefore be interpreted in light of the
limitation of them because questionnaires asking for personal
information on such issues might make adolescents feel
uncomfortable. Research also lacks follow-ups and cross-sectional
design. Therefore, it is suggested that replication studies with
longitudinal data and others adolescents are needed to confirm and
extend the boundary conditions of the findings. In addition, the study
across age group in other region of the country, with early adolescents
or with young adults in the north, north-eastern, central, and south
should be conducted. Larger samples from more English as well as
government schools of different states should be used for further
research. Follow-ups provide the direction that whether the effects of
music therapy are transitory or persistent.

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SHARMA AND JAGDEV

Implications
The most significant implication of this study is that, by the use
of a music therapy as a therapeutic intervention, self-esteem can be
enhanced, at least within the selected adolescent population. In our
fast-paced world, sometimes adolescents can benefit from simple
information on interventions to cope with day to day stress. The teens
in this survey indicated, they would like to learn new options like
music therapy to deal with daily life stressors. These findings can be
used to encourage the use of music as a therapeutic intervention with
similar cultural populations in India and elsewhere. Music therapy
offers potential to meet psychological, social, and emotional needs
that very few other non-pharmacological interventions can address.
Creating an evidence base in music therapy for this selected group
will assist clinicians, psychologists, and medical practitioners in
establishing best practices in mental health care.

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Received October 25, 2010

Revision received March 22, 2012