Music Therapy as a Collaborative Tool in the Recovery of Substance Use Disorder (SUD) Patients

REVIEW ARTICLE

NEPOMUCENO, Ricardo Martins ^[1]

NEPOMUCENO, Ricardo Martins. Music Therapy as a Collaborative Tool in the Recovery of Substance Use Disorder (SUD) Patients. Revista Científica Multidisciplinar Núcleo do Conhecimento. Year 08, Issue 10, Vol. 02, pp. 28-42. October 2023. ISSN: 2448-0959, Access Link: https://www.nucleodoconhecimento.com.br/health/music-therapy-as-a-collaborative, DOI: 10.32749/nucleodoconhecimento.com.br/health/music-therapy-as-a-collaborative

ABSTRACT

Music is considered worldwide as both a verbal and non-verbal tool because it influences an individual’s emotions, positively impacting their mood, individuality, and self-confidence, among other aspects. In the context of pharmacological treatments for substance dependence, the practices of Music Therapy are included and are considered a valuable tool to assist in the recovery of these patients. Music provides emotional and mental support during the detoxification and withdrawal processes experienced by individuals who develop substance-induced disorders. It is a complementary therapy that helps the patient express themselves, contributing to improvements in the sensory and motor experiences of the participants. In other words, it allows the individual’s subjectivity to re-emerge, enabling them to reconnect with themselves and with society. The literature demonstrates that drug addiction is a millennia-old phenomenon that affected approximately 11.2 million people around the world in 2020. Additionally, there has been an increase in consumption among young people, with rates growing by 26% compared to those recorded in 2012. This review article, prepared using the bibliographic research technique, aims to demonstrate the effectiveness of Music Therapy in the treatment and support of patients with substance use disorders. Based on the literature selected from electronic sources, it was found that Music Therapy, as an additional treatment alongside pharmacological approaches, significantly contributes to the recovery of individuals with substance-induced disorders.

Keywords: Substance Dependence, Substance Use Disorders, Music Therapy.

1. INTRODUCTION

According to Teixeira (2019, p.20), music is considered “a verbal and non-verbal tool for exploring feelings” because it positively impacts people’s moods and promotes the reduction of stress and anxiety, as well as improvements in self-esteem, personal motivation, emotional expression, and social cohesion.

As music contributes to the neuropsychological representations of the individual by acting on their emotions, affectivity, and motivation, music therapy can serve as an additional tool for the treatment of various diseases, especially for individuals recovering from substance dependence, promoting improvements in the physical, emotional, mental, social, and cognitive conditions of the person (Weigsding and Barbosa, 2015).

Alvarez, Gomes, and Xavier (2014, p.642) state that “drugs are substances that produce changes in sensations, the level of consciousness, and the emotional state of individuals.” The continued use of these substances affects all aspects of individuals’ lives, as users react differently from their normal state due to the substances’ impact on their interactions and social, academic, professional, and personal performance (Teixeira, 2019).

Regarding the regular use of synthetic chemical substances, as they affect the cognitive, social, and neurological capacities of individuals, there are many cases where individuals develop psychiatric disorders, including intoxication, withdrawal, and substance-induced mental disorders (Pedrosa, Garcia, and Loureiro, 2022; APA, 2014).

In addition to pharmacological treatments, Music Therapy (MT) is integrated as a complementary therapy, contributing to the individual’s strength during the period of abstinence and the improvement of anxiety-related symptoms and the ability to resist the temptation to return to drug use (Teixeira, 2019).

Thus, music therapy serves as an auxiliary activity to the necessary medication-based treatments for patients with substance dependence, and its practice should be carried out by a qualified professional, aiming to provide patient self-expression and sensory and motor experiences to participants.

This review article was prepared using the bibliographic research technique, based on electronic searches for scientific materials developed on the subject. Its objective is to demonstrate the effectiveness of Music Therapy (MT) in the treatment support for patients with disorders caused by psychoactive substances.

2. DEVELOPMENT

2.1. PSYCHOACTIVE SUBSTANCE USE

Over time, people’s motivation for using Psychoactive Substances (PSA) has shifted from religious or ritualistic settings to the leisure and entertainment of individuals, which, to some extent, has trivialized this serious family and social issue (Teixeira, 2019). According to Alvarez, Gomez, and Xavier (2014, p.642), it is a problem that “affects children, adolescents, men, and women of any social class, without distinction of sex, creed, or color.”

Throughout the 20th century, the issue of PSA consumption was extensively studied from a scientific perspective, leading society to change its view on this matter, previously considered only a matter of character, to being seen and treated as a disease “of biological, psychological, and social nature” (Araújo, 2004, p. 2). Over time, specialized medical services were created to treat these patients – through hospitalization to promote abstinence – but they evolved into outpatient services, assisted living facilities, therapeutic monitoring, and day hospitals.

The initiation of psychoactive substance use usually arises from curiosity or dissatisfaction with a person’s home environment, or due to various psychological aspects inherent to certain individuals, related to “vulnerabilities in their personality, low self-esteem, self-destructive tendencies, depression, anxiety, and derivatives of such negative feelings” (Alvarez, Gomez, and Xavier, 2014, p.642). The selected literature shows that the initiation of use is common among adolescents with difficulties in family and/or school relationships, making them more vulnerable to PSA use, especially boys around the age of 13, who begin by experimenting with alcohol and tobacco.

According to the World Drug Report released in 2017 by the United Nations Office on Drugs and Crime (UNODC), drug use is considered a public health problem. Alvarez, Gomez, and Xavier (2014, p.642) refer to it as an “ancient and universal practice.” In this 2017 report, the World Health Organization (WHO) reported that drug use affected 5% of the world’s population, encompassing different age groups (Teixeira, 2019).

In 2022, the use of psychoactive substances affected approximately 11.2 million people worldwide, with a 26% increase among young people compared to the rates observed ten years earlier. According to the UNODC World Drug Report (2022), approximately 284 million people between the ages of 15 and 64 used illicit substances worldwide, with marijuana being the most commonly used.

This report provides an overview of the global supply and demand for opioids, cocaine, cannabis, amphetamine-type stimulants, and New Psychoactive Substances (NPS), including their impact on human health. The report also indicates that a significant proportion of individuals in Africa, South America, and Central America who are in treatment for mental disorders are associated with cannabis use (UNODC, 2022).

According to the World Health Organization (WHO), the type of substance, whether natural or synthetic, or the method of administration, does not concern its users. It can be a substance ingested, inhaled, or injected, as long as the user achieves their main goal, which is to experience the effects that affect the Central Nervous System (CNS), effects that alter their “sensory perception, cognition, consciousness, and mood” (Teixeira, 2019, p.22).

Since all psychoactive substances lead to dependency and different alterations in the human body by affecting its organic structures and modifying a person’s behavior, the impairments to an individual’s brain capacity occur based on “…individual, emotional, and physical characteristics of the user, the chosen drug, the quantity, frequency of use, and circumstances in which it is consumed” (Alvarez, Gomez, and Xavier, 2014, p.642).

Alarcon (2012) describes the existence of three types of classifications for psychotropics according to: 1. pharmacological effects on the Central Nervous System (CNS) and user behavior; 2. the origin of the drug, and finally, 3. according to legal status, as presented in Table 1.

Table 1 – Classification of psychoactive substances and effects on the CNS

Source: Compiled by the author based on ALARCON (2012, p. 105).

Rocha et al. (2019, apud Teixeira, 2019, p.20), mention symptoms described in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), including: “…irritability, anxiety, emotional stress, sleep disturbance, dysphoria, aggressive behaviors, and cravings, associated with stress-related neuroadaptive changes and brain reward circuitry alterations…” and that such effects should receive appropriate medication treatment for reduction.

According to the DSM-5 (APA, 2014, p. 482), psychoactive substances are subdivided into various categories: “alcohol, hallucinogens, amphetamines, marijuana, caffeine, cocaine, inhalants, nicotine, opioids, sedatives, hypnotics, and anxiolytics.” They are classified according to the origin of each substance, as shown in Table 2.

Table 2 – Psychoactive substances by origin

Source: ALARCON (2012, p. 105).

Teixeira (2019) explains that the fact that some substances are considered natural is due to their psychoactive composition being close to their plant origin, that is, with low mixing and concentration.

2.2. EFFECTS OF PSYCHOACTIVE SUBSTANCES

The problem of addiction has been a concern for all spheres of society, including civil society, government officials, educators, and religious leaders. From a social perspective, individuals with addiction issues often face “marginalization and exclusion” from common activities and environments, as they are often associated with dangerous behavior, civil irresponsibility, and idleness, as explained by MacRAE and Vidal (2006, apud Cardoso and Cunha, 2011, p.77).

From a medical perspective, the use of psychoactive substances leads to a pattern of behavior considered pathological because the effects on the user’s mind result in physical, mental, and behavioral problems, and yet these individuals cannot stop (Khan, 2022).

All Psychoactive Substances (PSAs) have in common “direct activation of the brain’s reward system,” which reinforces behaviors and creates memories (APA, 2014, p. 481). Such substances can lead to two types of disorders in users: “substance use disorders and substance-induced disorders.”

Rosa (2013) notes that many globally known musicians produced most of their lyrics and songs while using psychoactive substances, including Janis Joplin, Jimi Hendrix, Kurt Cobain, Amy Winehouse, individuals whose lives were cut short as a result of the abusive use of synthetic psychotropics.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (APA, 2014), there are distinct categories of drugs that cause mental disorders in individuals, leading their users to the necessary psychiatric treatments for recovery. Withdrawal, which is the reduction and/or discontinuation of the use of such substances, results in physical and emotional crises due to changes in the physical and behavioral reactions of the individual, as explained by Alvarez, Gomez, and Xavier (2014). The authors note that PSA users can no longer live and interact in their daily lives without drugs because they believe they are helpful in coping with their daily challenges.

Other important details highlighted in the DSM-5 (APA, 2014) relate to the classification of disorders that may arise in substance-dependent individuals since all types of substances activate the brain’s reward system. The constant and intense activation of the reward system causes individuals to no longer display natural adaptive behaviors for each situation due to the immediate sense of pleasure caused by the substances consumed. These effects are commonly known as “high or trip.”

The World Drug Report released in 2017 by the United Nations Office on Drugs and Crime (UNODC) stated that in 2015, approximately 250 million people worldwide used legal and/or illegal drugs, and 29.5 million of them (0.6%) consisted of adults who developed mental disorders due to the use of psychoactive substances (Teixeira, 2019).

There are various aspects to consider to assist in the treatment of substance addiction, including the involvement of the family. However, it is a fact that family members also need support and guidance to ensure the effectiveness of the treatment. Alvarez, Gomez, and Xavier (2014, p. 642) argue that the “formation of one’s own personality, as the foundation for incorporating patterns of behavior, beliefs, customs, experiences, and social ties,” highlights the importance of family involvement, as it is within the family that individuals develop.

The intensity of individuals’ reactions is related to their individual tolerance levels to the substances consumed (APA, 2014). Moreover, the abrupt cessation of the consumption of a specific substance, such as cannabis, may lead to symptoms like “irritability, anger or aggression, anxiety, depressed mood, restlessness, difficulty sleeping, and decreased appetite or weight loss,” as defined in the DSM-5 (APA, 2014, p.511).

2.3. MUSIC THERAPY (MT) AND ITS PRACTICES

According to Gimenes (2021), Music Therapy lies at the intersection of science and art, allowing for the holistic development of the human being by enriching them. This is because music impacts the emotions of individuals, as both body and mind are expressed through the individual’s expressiveness and creativity. Music Therapy emerged in the post-World War II era when it was used by musicians in rehabilitation hospitals to aid soldiers recovering physically and dealing with emotional trauma (Figueiredo and Amorim, 2020).

Weigsding and Barbosa (2015, p.47) state that “music therapy has extensive neuropsychological representation with direct access to emotions, impulse control, emotions, and motivation.” According to these authors, music stimulates non-verbal memory, leading individuals to access the brain functions where symbols organized throughout their lives are stored, helping people develop their capacity to retain and memorize facts, situations, and feelings.

Fernandes et al. (2016, p.30) define that “art is a tool favorable to the production of subjectivities, expression of the unconscious (repressed affects and emotions), and strengthening of self-esteem and confidence through the use of individual potentials revealed during activities.”

The use of psychoactive substances was historically treated from a medical and psychiatric perspective, and Art Therapy, which encompasses music, painting, theater, drawing, graffiti, reading, etc., was slowly adopted as a complementary activity to drug treatment. The use of music alongside patients recovering from drug addiction allows them to express themselves non-verbally, expressing their “feelings, dreams, desires, ghosts, conflicts, etc.,” allowing these individuals to experience small emotional victories and regain their hope for living and overcoming their addiction (Lopes et al., 2016, p.21).

Zanini (2004) explains that the connection between different areas of knowledge, the use of images, symbols, and languages, arises from research carried out by new fields of knowledge and various scientific areas. The author highlights that while Music Therapy (MT) emerged as an emerging science in the 1980s, interdisciplinary work across various areas of the humanities, exact sciences, and social sciences has existed since the 1960s.

According to Barcellos (1992, p.41, apud  Zanini, 2004, p.5), Music Therapy serves as a facilitator of “communication with patients, as a point of reference or parameter with reality.” Due to the benefits Music Therapy brings to patients in American hospitals, the National Association for Music Therapy (NAMT) established an undergraduate course in this field, which began to be recognized as a new profession from the 1950s (Figueiredo and Amorim, 2020).

Regarding the application of Music Therapy (MT) in Mental Health, as a complementary treatment to pharmacological and conventional treatments, it contributes to reducing symptoms such as “anxiety, depression, and anger,” while also promoting improvements in feelings of “pleasure and happiness” for the patient (Teixeira, 2019, p.21). The author reports that individuals experiencing the withdrawal process from substance dependence exhibit symptoms common to other drugs, including anxiety, depression, and manic or hypomanic states.

These symptomatic processes can be addressed through group activities. Fernandes et al. (2016) explain that arts, such as music therapy, play therapy, dance therapy, and drawing and painting therapy, have favorable effects on rehabilitation, allowing participants in therapeutic groups to relax, create bonds within these groups, and express their feelings. This helps participants become more spontaneous during therapeutic workshops by creating connections with others.

The use of artistic expression allows these patients to experience synchronized sensory and motor experiences, aiming to reduce stress and anxiety, as well as improve mood, self-esteem, emotional expression, and social cohesion (Teixeira, 2019, p. 21).

Pedrosa (2023, p.17) notes the observation of “improvements in aspects such as attendance, attention, positive thoughts, immediate memory, short-term memory, long-term memory, and motor perception of patients” in studies conducted by different musicians, which highlighted the benefits observed in groups of drug-dependent patients and those with substance-induced disorders.

Fernandes et al. (2016, p. 32) state that clinical Music Therapy includes “lyric analysis, relaxation training, musical composition, games, and improvisation based on emotions or other relevant themes for treatment.” The use of music in conventional therapies allows patients to establish a connection between their emotions and needs, some of which may be difficult to express through conversations with a psychologist or social worker. It also serves to motivate patients to engage in treatment, promoting their involvement and enabling addicts to bring out their feelings and overcome the barriers to their recovery (Fernandes et al., 2016).

2.4. THE ROLE OF THE MUSIC THERAPIST

There are associations of music therapy practices with various areas of individual care, such as Speech Therapy, Neuroscience, Nursing, and Physical Therapy (Gimenes, 2021). As a non-verbal form of communication, music is a composition that, whether just a tune or having lyrics, allows an individual to express important elements of their identity, experienced conflicts, traumas, and aspirations, among other information that helps the person express themselves.

Figueiredo and Amorim (2020, p.2) state that music therapy is “an intervention that uses music and its elements, provided by a qualified person, to promote learning, the acquisition of new skills, to improve the quality of life. It can be applied for prevention, rehabilitation, or treatment,” as defined by the World Federation of Music Therapy in 1996.

Therapy through music therapy is a blend of a recently emerged science combined with the Human and Health Sciences since music facilitates communication between the patient and their therapist, conveying most of the time, maladjustments, gaps, and omissions, and how such issues are interconnected, without the patient expressing these problems verbally. The author argues that “it is in the melodic horizon sung by the patient that information is revealed and becomes concrete, punctuated, and applied through techniques” (Rosa, 2013, p.15).

The applicability of music therapy is extensive for different age groups, such as the elderly population and individuals with Alzheimer’s, Parkinson’s, hypertension, muscle disorders, and even cases of Stroke; kidney diseases, etc.; for children and adolescents, music therapy applies to cases such as “respiratory syndromes and neonatal infection cases; autism cases, cerebral palsy cases, and even in the development of expressive language and orofacial motor skills” (Gimenes, 2021, p.33). Regarding issues related to emotional, psychological, and/or psychic aspects, music therapy contributes to conditions such as depression, anxiety disorders, and stress, among other psychological illnesses.

According to the definition provided by the World Federation of Music Therapy (WFMT), music therapy is considered a pathway to the well-being of individuals, influencing their quality of life and health, and is also important for educational purposes. Kenneth Bruscia, an American music therapy theorist, emphasizes the importance of music for rehabilitation processes and treatments related to physical, social, and emotional aspects, and in promoting individuals’ health and quality of life (Bruscia, 2016, apud Gimenes, 2021).

3. CONCLUSION

Among the works and authors selected for the writing of this article, it is a common understanding that the use of Music Therapy, among other forms of Art Therapy, as a complementary treatment to medication therapies, is a recent but highly significant fact for individuals in recovery from the use of psychoactive substances and those who have developed psychiatric disorders related to such use.

Engagement with music allows people to perceive feelings, memories, and positive reactions, leading to a sense of belonging, joy, and even happiness due to the sensations caused by musicalization.

REFERENCES

ALARCON, Sérgio. Drogas Psicoativas: classificação e bulário das principais drogas de abuso. [In]: ALARCON, Sérgio; JORGE, Marco Aurélio Soares. Álcool e outras drogas: diálogos sobre um mal-estar contemporâneo [online]. Rio de Janeiro: FIOCRUZ, 2012, p[p. 103-129. ISBN: 978-85-7541-539-9. https://doi.org/10.7476/9788575415399.0006. Disponível em: <https://books.scielo.org/id/8q677/pdf/alarcon-9788575415399-06.pdf>; Acesso em: 08 ago. 2023.

ALVAREZ, Simone Quadros; GOMES, Giovana Calcagno; XAVIER, Daiani Modernel. Causas da dependência química e suas consequências para o usuário e a família. Rev Enferm UFPE on line. Recife, vol. 8, n. 3, p. 641-8, mar.2014. DOI: 10.5205/reuol.5149-42141-1-SM.0803201419. Disponível em: <https://periodicos.ufpe.br/revistas/revistaenfermagem/article/view/9720>. Acesso em: 10 jul. 2023.

APA – American Psychiatric Association. Manual Diagnóstico e Estatístico de Transtornos Mentais – 5. ed. Texto revisado. DSM-5-TR. São Paulo: Artmed. 2014.

ARAÚJO, Marcelo Ribeiro de. “Organização de serviços de tratamento para a dependência química PARTE I: O estrutural – enquadre terapêutico”. [In]: FIGLIE, Neliana; LARANJEIRA, Ronaldo; BORDIN, Selma. Aconselhamento em Dependência Química. 1.ed. São Paulo: Roca, 2004, p. 460-512. Disponível em: <https://www.researchgate.net/publication/283158113_Organizacao_de_servicos_de_tratamento_para_dependencia_quimica_o_estrutural_e_o_dinamico>. Acesso em: 10 jul. 2023.

CARDOSO, Leonardo Nascimento; CUNHA, Rosemyriam Ribeiro dos Santos. Trocas afetivas e psicossociais em musicoterapia: grupos no centro de atenção psicossocial álcool e drogas. Rev. Núcleo de Estudos e Pesquisas Interdisciplinares em Musicoterapia. Curitiba, vol.2, p. 74–94. 2011. Disponível em: <https://periodicos.unespar.edu.br/index.php/incantare/article/view/178/185>. Acesso em: 10 jul. 2023.

FERNANDES, Larissa Dias et al. O lúdico e a dependência de drogas: revisão integrativa da literatura. Arteterapia Cores da Vida. Ano 12 – vol. 23, n.23 jul./dez. 2016.  Disponível em: <https://www.abcaarteterapia.com/_files/ugd/217038_63e69515dcd14e3ea8e5679dda78d5db.pdf#page=29>. Acesso em: 10 jul. 2023.

FIGUEIREDO, Gabriele Simião de; AMORIM, Maria Izabel de. Musicoterapia: uma estratégia de autorreflexão na vida de adolescentes em situação de vulnerabilidade social. Artigo de Conclusão de Curso [Graduação em Psicologia] apresentado à Universidade do Sul de Santa Catarina (UNISUL), 2020.  Disponível em: <https://repositorio.animaeducacao.com.br/handle/ANIMA/16688>; Acesso em: 10 jul. 2023.

GIMENES, Públio. Associação entre musicoterapeutas, professores de canto e cantores sobre o conhecimento e a aplicabilidade da Musicoterapia. Dissertação [Mestrado em Fonoaudiologia] apresentada ao Programa de Estudos Pós-graduados em Fonoaudiologia da Pontifícia Universidade Católica de São Paulo (PUC SP). São Paulo, 2021. Disponível em: <https://repositorio.pucsp.br/bitstream/handle/24086/1/Públio%20Gimenes.pdf>. Acesso em: 10 jul. 2023.

KHAN,  Mashal. Transtornos por uso de substâncias. Manual MSD – Versão profissionais de Saúde. Outubro de 2022. Disponível em: <https://www.msdmanuals.com/pt-br/profissional/transtornos-psiquiátricos/transtornos-relacionados-ao-uso-de-substâncias/transtornos-por-uso-de-substâncias>. Acesso em: 14 jul. 2023.

LOPES, Jordana Magalhães Silva et al. Arteterapia e dependência de substâncias psicoativas: uma revisão sistemática. Revista Científica de Arteterapia Cores da Vida. ISSN: 1809-2934. Ano 12 – vol. 23, n. 23, p. 20-28. jul./dez. 2016. Disponível em: <https://sigaa.unb.br/sigaa/public/docente/producao.jsf?siape=1279470>. Acesso em: 10 jul. 2023.

PEDROSA, Frederico Gonçalves; GARCIA, Frederico Duarte; LOUREIRO, Cybelle Maria Veiga. Musicoterapia na Dependência Química: Uma Revisão Integrativa. Música Hodie, vol.22, e70651, 2022. Disponível em: <https://www.researchgate.net/profile/Frederico-Pedrosa-2/publication/366349502_Musicoterapia_na_Dependencia_Quimica_Uma_Revisao_Integrativa/links/645423e5809a53502149c60b/Musicoterapia-na-Dependencia-Quimica-Uma-Revisao-Integrativa.pdf>. Acesso em: 10 jul. 2023.

PEDROSA, Frederico Gonçalves. Escala de Avaliação dos Efeitos da Musicoterapia em Grupo na Dependência Química (MTDQ). Tese [Doutorado em Música] apresentada ao Programa de Pós-Graduação em Música da Escola de Música da Universidade Federal de Minas Gerais. UFMG. 2023. Disponível em: <https://repositorio.ufmg.br/bitstream/1843/50963/3/Tese_corrigida.pdf>. Acesso em: 10 jul. 2023.

ROSA, Sandro Santos da. Musicoterapia e cuidado humano: a música e a reabilitação de pessoas que fazem uso abusivo de substâncias psicoativas.  Dissertação [Mestrado em Teologia] apresentada ao Programa de Pós-graduação da Escola Superior de Teologia. São Leopoldo. 2013. Disponível em: <http://dspace.est.edu.br:8080/jspui/bitstream/BR-SlFE/381/1/rosa_ss_tm259.pdf>. Acesso em: 10 jul. 2023.

TEIXEIRA, Andressa Toledo. Musicoterapia receptiva com a Mesa Lira no período de desintoxicação em dependentes químicos: estudo randomizado controlado. Monografia [Mestrado em Música] apresentada ao Programa de Pós-graduação em Música da Escola de Música e Artes Cênicas da Universidade Federal de Goiás.  Goiânia. 2019. Disponível em: <https://ubammusicoterapia.com.br/wp-content/uploads/2022/08/Dissertacao-Andressa-Toledo-Teixeira-2019.pdf>. Acesso em: 10 jul. 2023.

UNODC – Escritório das Nações Unidas sobre Drogas e Crime. Relatório Mundial sobre Drogas 2022 do UNODC destaca as tendências da pós-legalização da cannabis, os impactos ambientais das drogas ilícitas e o uso de drogas por mulheres e jovens. 2022. Disponível em: <https://www.unodc.org/lpo-brazil/pt/frontpage/2022/06/relatorio-mundial-sobre-drogas-2022-do-unodc-destaca-as-tendencias-da-pos-legalizacao-da-cannabis-os-impactos-ambientais-das-drogas-ilicitas-e-o-uso-de-drogas-por-mulheres-e-jovens.html>. Acesso em: 09 ago. 2023.

WEIGSDING, Jessica Adriane; BARBOSA, Carmem Patrícia. A influência da música no comportamento humano. Arquivos do Mudi, vol. 18, n. 2, p. 47-62, 22 jan. 2015. Disponível em: <https://periodicos.uem.br/ojs/index.php/ArqMudi/article/view/25137>. Acesso em: 10 jul. 2023.

ZANINI, Claudia Regina de Oliveira. Musicoterapia e Saúde Mental: um longo percurso. [In]: VALLADARES, Ana Claudia Afonso (Org.). Arteterapia no novo paradigma de atenção em saúde mental. São Paulo: Vetor, 2004. p.181-203. Disponível em: <https://www.researchgate.net/publication/228601788_MUSICOTERAPIA_E_SAUDE_MENTAL_-_UM_LONGO_PERCURSO>. Acesso em: 10 jul. 2023.

^[1] Graduated in Art Education from UFMT. ORCID: https://orcid.org/0009-0006-1694-346X.

Sent: August 28, 2023.

Approved: September 1, 2023.