Music therapy for mental health in children and adolescents: a systematic review and meta-analysis of randomized trials.

BACKGROUND

Child and adolescent mental disorders impose substantial individual and societal burdens. This study synthesized randomized evidence on the effects of music therapy on depressive and anxiety symptoms, self-esteem, and health-related quality of life in young people, and explored whether intervention characteristics were associated with variations in effect estimates.

METHODS

Following PRISMA 2020, this review was retrospectively registered with PROSPERO (CRD420261382585). PubMed, Embase, Cochrane CENTRAL, Web of Science, Google Scholar, ClinicalTrials.gov, and the WHO International Clinical Trials Registry Platform were searched from inception to July 31, 2025, without language limits. Eligible studies were randomized controlled trials enrolling participants aged 6 to 18 years; comparators were no treatment, waitlist, attention control, or usual care; the planned intervention duration was at least four weeks; and outcomes were validated continuous measures at end of treatment. Random-effects models with restricted maximum likelihood generated standardized mean differences (SMD) and 95 percent confidence intervals. Prespecified moderators included age group, session length, session frequency, program duration, and adherence.

RESULTS

Nine trials (n = 690) met inclusion criteria. Music therapy reduced depressive symptoms versus controls (SMD - 0.55; 95% CI, - 0.71 to - 0.38) and improved self-esteem (SMD 0.45; 95% CI, 0.26 to 0.64) and quality of life (SMD 0.69; 95% CI, 0.37 to 1.01). Two trials showed reduced anxiety (SMD - 0.42; 95% CI, - 0.75 to - 0.08). Exploratory subgroup analyses suggested larger effect estimates in younger children and in interventions with longer sessions, higher weekly frequency, longer duration, and higher adherence; however, these findings should be interpreted cautiously given the small number of trials.

CONCLUSION

Music therapy may offer meaningful benefits for youth mental health, although evidence for anxiety and quality of life is based on a limited number of studies. Findings related to age and intervention delivery characteristics should be considered exploratory and hypothesis-generating rather than evidence of causality or optimal dosing.