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Journal article
Music Therapy Versus Cognitive Behavioral Therapy via Telehealth for Anxiety in Cancer Survivors: A Randomized Clinical Trial
Journal of clinical oncology, v 44(5), Forthcoming
06 Jan 2026
PMID: 41494146
Abstract
Anxiety is prevalent, disruptive, and undertreated among cancer survivors. Cognitive behavioral therapy (CBT) is the first-line treatment, but not all individuals have access, respond to treatment, or prefer this option because of stigma. Music therapy is effective for short-term anxiety reduction, but it is unknown whether it is noninferior to first-line CBT for long-term anxiety reduction.PURPOSEAnxiety is prevalent, disruptive, and undertreated among cancer survivors. Cognitive behavioral therapy (CBT) is the first-line treatment, but not all individuals have access, respond to treatment, or prefer this option because of stigma. Music therapy is effective for short-term anxiety reduction, but it is unknown whether it is noninferior to first-line CBT for long-term anxiety reduction.This comparative effectiveness trial randomly assigned English- or Spanish-speaking cancer survivors to seven weekly telehealth sessions of music therapy or CBT. The coprimary end points were changes in the Hospital Anxiety and Depression Scale (HADS) anxiety score at weeks 8 and 26. The noninferiority margin was 0.35 standard deviations, informed by a minimal clinically important difference (MCID) of 1.7 points. Secondary outcomes included fatigue, depression, insomnia, pain, cognitive dysfunction, and health-related quality of life.METHODSThis comparative effectiveness trial randomly assigned English- or Spanish-speaking cancer survivors to seven weekly telehealth sessions of music therapy or CBT. The coprimary end points were changes in the Hospital Anxiety and Depression Scale (HADS) anxiety score at weeks 8 and 26. The noninferiority margin was 0.35 standard deviations, informed by a minimal clinically important difference (MCID) of 1.7 points. Secondary outcomes included fatigue, depression, insomnia, pain, cognitive dysfunction, and health-related quality of life.Among N = 300 patients, 74.7% was female, 76.5% was White, and 19.0% was Hispanic. At week 8, the mean change in HADS anxiety score was -3.12 (95% CI, -3.59 to -2.65) in music therapy and -2.97 (95% CI, -3.45 to -2.50) in CBT; the between-group difference was -0.15 (95% CI, -0.78 to 0.49), within the noninferiority margin of 1.20 (P < .001). At week 26, the mean change was -3.31 (95% CI, -3.78 to -2.85) in music therapy and -3.00 (95% CI, -3.47 to -2.53) in CBT; the between-group difference was -0.31 (95% CI, -0.95 to 0.32), within the noninferiority margin of 1.28 (P < .001). Both groups produced anxiety reductions exceeding the MCID and showed similar improvements in secondary outcomes.RESULTSAmong N = 300 patients, 74.7% was female, 76.5% was White, and 19.0% was Hispanic. At week 8, the mean change in HADS anxiety score was -3.12 (95% CI, -3.59 to -2.65) in music therapy and -2.97 (95% CI, -3.45 to -2.50) in CBT; the between-group difference was -0.15 (95% CI, -0.78 to 0.49), within the noninferiority margin of 1.20 (P < .001). At week 26, the mean change was -3.31 (95% CI, -3.78 to -2.85) in music therapy and -3.00 (95% CI, -3.47 to -2.53) in CBT; the between-group difference was -0.31 (95% CI, -0.95 to 0.32), within the noninferiority margin of 1.28 (P < .001). Both groups produced anxiety reductions exceeding the MCID and showed similar improvements in secondary outcomes.Music therapy is noninferior to CBT for anxiety in cancer survivors. Both telehealth interventions produced clinically meaningful, durable improvements in anxiety.CONCLUSIONMusic therapy is noninferior to CBT for anxiety in cancer survivors. Both telehealth interventions produced clinically meaningful, durable improvements in anxiety.
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Details
- Title
- Music Therapy Versus Cognitive Behavioral Therapy via Telehealth for Anxiety in Cancer Survivors: A Randomized Clinical Trial
- Creators
- Kevin T Liou - Memorial Sloan Kettering Cancer CenterJoke Bradt - Drexel UniversityM Beatriz Currier - Baptist Hospital of MiamiRaymond Baser - Memorial Sloan Kettering Cancer CenterKatherine Panageas - Memorial Sloan Kettering Cancer CenterJodi MacLeod - North American Menopause SocietyDesiree Walker - Young Survival CoalitionSusan Q Li - Memorial Sloan Kettering Cancer CenterAna Maria Lopez - Thomas Jefferson UniversityKelly McConnell - Memorial Sloan Kettering Cancer CenterJun J Mao (Corresponding Author) - Memorial Sloan Kettering Cancer Center
- Publication Details
- Journal of clinical oncology, v 44(5), Forthcoming
- Publisher
- ASCO Publications
- Number of pages
- 16
- Grant note
- Patient-Centered Outcomes Research Institute (PCORI) Program Award: CER-2020C3-21044 National Institutes of Health/National Cancer Institute Cancer Center Support Grant (CCSG): P30CA008748 Laurance S. Rockefeller Fund
Supported by a Patient-Centered Outcomes Research Institute (PCORI) Program Award (CER-2020C3-21044), by a National Institutes of Health/National Cancer Institute Cancer Center Support Grant (CCSG) to the Memorial Sloan Kettering Cancer Center (P30CA008748), and by the Laurance S. Rockefeller Fund.
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Creative Arts Therapies
- Web of Science ID
- WOS:001681793900008
- Other Identifier
- 991022152238404721