Effect of music therapy on emotional resilience, well-being, and employability: a quantitative investigation of mediation and moderation | BMC Psychology

Music therapy
Music therapy (MT) is a clinical, evidence-based practice involving music interventions by a qualified professional to achieve therapeutic goals within a structured relationship [3]. The therapy consists of a variety of techniques, including active music-making, music listening, and music improvisation, to address physical, emotional, cognitive, and social needs. The effectiveness of music therapy lies in its ability to harness the therapeutic potential of music to improve overall well-being and support holistic care.
The general effectiveness of music therapy is well-supported by research. It has been shown to enhance emotional regulation, reduce stress, and improve psychological resilience. For example, Bradt and Dileo [6] conducted a meta-analysis on the impact of music interventions in clinical settings, particularly for patients undergoing surgery. They found that music therapy significantly reduced anxiety and pain, demonstrating its effectiveness in improving patient comfort and well-being during medical procedures.
The use of music therapy in physical rehabilitation is also well-documented. Magee et al. [33] reviewed studies on stroke rehabilitation and found that rhythmic auditory stimulation (RAS), a music therapy technique, helped improve motor function and gait, underscoring the therapeutic role of music in physical recovery and enhancing independence in individuals with movement disorders.
In the area of mental health, music therapy has been widely recognized for its role in improving emotional regulation and promoting social interaction. Cassola et al. [7] reported that music therapy led to significant improvements in emotional well-being for patients with severe mental illnesses, while Mössler et al. [34] found it to be effective in alleviating symptoms of depression and anxiety in individuals with psychosis. These findings emphasize music therapy’s value as an intervention for improving psychological health.
Moreover, music therapy is increasingly applied in cognitive health, particularly for individuals with neurodegenerative diseases. A study by Gallego and Garcia [23] demonstrated the positive effects of music therapy on memory recall and communication skills in patients with Alzheimer’s disease. This highlights its potential to support cognitive functioning, especially in older populations, and improve their quality of life.
Additionally, music therapy has broader applications in promoting social cohesion and emotional well-being. Fancourt and Finn [16] reviewed community-based music therapy programs and found that group music-making activities fostered social connections, reduced isolation, and improved overall well-being, particularly in marginalized communities.
In summary, music therapy is a versatile and evidence-based therapeutic approach, effective across a wide range of domains including emotional, cognitive, and physical health. Recent research consistently supports its ability to reduce anxiety and pain, improve mental health, enhance cognitive function, and facilitate physical rehabilitation. As an interdisciplinary field, music therapy continues to evolve, offering promising interventions for a variety of needs and populations.
Emotional resilience
Emotional resilience (ER) is defined as an individual’s ability to adapt to stress and adversity, and it is a critical component of mental health [5]. In recent years, researchers have extensively explored the roles of internal resources (such as positive emotions and self-efficacy) and external resources (such as social support) in maintaining and restoring mental health [27, 29].
The role of positive emotions in enhancing emotional resilience has garnered significant attention. Fredrickson’s broaden-and-build theory posits that positive emotions expand an individual’s thought-action repertoire, thereby fostering the development of enduring personal resources [19]. Empirical studies support this theory, demonstrating that positive emotions can buffer against stress and improve coping mechanisms [44]. Moreover, self-efficacy, defined as an individual’s belief in their ability to achieve desired outcomes, is considered a crucial predictor of emotional resilience. A meta-analysis by Schwarzer and Warner [41] confirmed that higher levels of self-efficacy are associated with better stress management and recovery from adversity.
Social support also plays a pivotal role in promoting emotional resilience. Social relationships provide emotional, informational, and practical support, which can mitigate the effects of stress [8]. Recent research indicates that individuals with robust social networks are more likely to exhibit resilient behaviours and maintain mental health during challenging times [36].
Music therapy has gained widespread attention as a promising intervention for enhancing emotional resilience. Research shows that music therapy can reduce stress, anxiety, and depression while fostering emotional expression and social connection. For example, a study by Fancourt and Perkins [17] found that group singing improved participants’ social connections and mental health, suggesting that music therapy can bolster the internal and external resources necessary for emotional resilience. Similarly, a study by Vasionytė and Madison [46] reviewed the impact of music interventions on patients with dementia, reporting significant improvements in emotional regulation, cognitive functioning, and quality of life. These findings indicate that music therapy not only provides a medium for emotional expression but also helps build self-efficacy and social support, thereby enhancing resilience.
In summary, emotional resilience is a multifaceted construct supported by both internal and external resources. Recent literature underscores the importance of positive emotions, self-efficacy, and social support in fostering resilience. Music therapy, by strengthening these resources, emerges as a valuable intervention for promoting emotional resilience.
Well-being
Well-being (WB) typically encompasses both subjective well-being and psychological well-being, forming a multidimensional construct that is crucial to an individual’s overall health. Subjective well-being includes life satisfaction and emotional balance, while psychological well-being involves aspects such as self-acceptance, personal growth, and a sense of purpose in life [39]. Theoretically, well-being is an important outcome of emotional resilience, as individuals with greater adaptability are more likely to experience positive emotions and higher life satisfaction [43].
Recent research has provided extensive insights into the components and determinants of well-being. Subjective well-being is typically measured through life satisfaction and the balance between positive and negative emotions, and it is closely related to daily experiences and broader life contexts. A meta-analysis by Diener et al. [15] found that positive social relationships, physical health, and a supportive environment significantly enhance levels of subjective well-being.
On the other hand, psychological well-being addresses deeper aspects of human functioning, such as self-acceptance, autonomy, and environmental mastery. Ryff’s [39] model of psychological well-being outlines six key dimensions: self-acceptance, personal growth, purpose in life, environmental mastery, autonomy, and positive relationships with others. Higher rates of these dimensions are associated with lower rates of psychological disorders and higher levels of life satisfaction and resilience.
Music therapy has garnered widespread attention as a promising intervention for enhancing well-being. Numerous studies have shown that music therapy can improve both subjective and psychological well-being by reducing stress, anxiety, and depression, while also promoting emotional expression and social connection [6].
In conclusion, well-being encompasses both subjective and psychological dimensions and serves as a crucial outcome of emotional resilience. Recent literature emphasizes the importance of positive social relationships, health, and a supportive environment in fostering well-being. By enhancing these factors, music therapy emerges as a valuable intervention for promoting well-being.
Employability
Employability (EA) refers to an individual’s ability to obtain and maintain employment, encompassing a range of skills, attributes, and psychological factors necessary for improving job performance and adaptability [20]. Theoretically, well-being is an important predictor of employability, as mental health and positive emotions can enhance an individual’s performance and adaptability in the workplace [25].
Recent studies have highlighted the significance of psychological well-being in enhancing employability. Psychological well-being includes dimensions such as self-acceptance, personal growth, and a sense of purpose in life, and research indicates that these dimensions influence job satisfaction, career success, and adaptability [39]. A meta-analysis by De Cuyper et al. [10] found that employees with higher psychological well-being are more likely to demonstrate resilience, maintain employment, and progress in their careers.
Subjective well-being, which includes life satisfaction and emotional balance, also plays a crucial role in employability. Research shows that individuals with higher levels of life satisfaction and emotional balance tend to exhibit better job performance, lower absenteeism, and greater organizational commitment [28]. For instance, a longitudinal study by Lyubomirsky et al. [32] demonstrated that happier individuals are more likely to achieve employment and career success, as they exhibit more positive behaviours, higher creativity, and better social skills.
Music therapy significantly impacts employability by enhancing individuals’ subjective well-being. Research indicates that music therapy can improve life satisfaction and emotional balance, thereby increasing work performance and career success [30]. For instance, music therapy helps regulate emotions, reduce stress, and promote psychological relaxation, leading individuals to maintain a positive mindset and good emotional balance [9]. Consequently, participants demonstrate higher efficiency and creativity at work, reduced absenteeism, and greater organizational commitment. Thus, music therapy not only enhances subjective well-being but also supports career development, contributing to greater success and satisfaction in the workplace [10].
In conclusion, employability, defined as the ability to obtain and maintain employment, is significantly influenced by well-being. Recent literature emphasizes the importance of both psychological and subjective well-being in improving job performance and adaptability. By enhancing emotional and psychological well-being, music therapy emerges as a valuable intervention for promoting employability.
Differences by gender, age, and education level
In contemporary society, emotional resilience, well-being, and employability are critical factors for individual psychological well-being and career success. Although the interplay between these factors has been studied to some extent, the moderating effects of demographic variables such as gender, age, and educational level on these relationships have not been thoroughly explored. Investigating these moderating factors can provide a more precise understanding and optimization of the relationships among emotional resilience, well-being, and employability.
Firstly, there is empirical support for the moderating effect of gender on psychological interventions. Research indicates that gender differences may influence the relationship between emotional resilience, well-being, and employability. For example, Ullibarriarana-Garate et al. [45] found that men and women may experience and benefit from well-being interventions differently, potentially affecting their employability outcomes. This suggests that the role of gender as a moderating variable warrants further investigation to understand its specific impact on the mediation model involving emotional resilience, well-being, and employability.
Secondly, age is another crucial factor affecting these psychological relationships. Research shows that individuals at different life stages may perceive and respond to emotional resilience and well-being interventions differently. For example, younger individuals often exhibit greater psychological flexibility and better career decision-making abilities following emotional management training, whereas these effects may be less pronounced in older adults [14]. Exploring the moderating role of age in the relationships among emotional resilience, well-being, and employability can enhance our understanding of these factors mechanisms across different age groups.
Lastly, educational level (EL) is a key variable influencing these psychological relationships. Di Fabio and Cumbo [11] noted that individuals with higher levels of education generally demonstrate greater adaptability and resilience in career management and employability. Additionally, the mediating role of well-being in the relationship between emotional resilience and employability may be moderated by gender, age, and educational level. For example, individuals with higher educational attainment might perceive and utilize well-being differently in enhancing emotional resilience, thus affecting its impact on employability [12, 13]. These moderating effects provide important perspectives for understanding the relationships among emotional resilience, well-being, and employability.
By investigating the moderating effects of gender, age, and educational level on these psychological relationships, we can offer valuable insights for personalized psychological interventions and career development strategies, thereby improving their overall effectiveness and applicability.
Research hypotheses
This study aims to investigate the impact of music therapy on emotional resilience and explore the collaborative effects of emotional resilience and well-being on employability. We involve individuals who have undergone music therapy and construct a mediation model to explore the role of well-being as a mediator between emotional resilience and employability (see Fig. 1). Based on this, we propose the following hypotheses:

Experimental effect hypotheses
Participants who receive music therapy will show significant improvements in emotional resilience, well-being, and employability.
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H1a: Participants who receive music therapy will exhibit a significant improvement in emotional resilience scores, indicating a notable difference between pre- and post-therapy emotional resilience scores.
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H1b: Participants who receive music therapy will demonstrate a significant increase in well-being scores, indicating a notable difference between pre- and post-therapy well-being scores.
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H1c: Participants who receive music therapy will experience a significant enhancement in employability scores, indicating a notable difference between pre- and post-therapy employability scores.
Mediation effect hypothesis
Well-being mediates the relationship between emotional resilience and employability, such that music therapy indirectly affects emotional resilience by enhancing well-being, which in turn improves employability.
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H2: Well-being mediates the relationship between emotional resilience and employability. Specifically, music therapy improves well-being, which indirectly enhances emotional resilience, leading to increased employability.
Moderation effect hypotheses
Gender, age, and educational level moderate the mediation effect of well-being.
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H3a: Gender moderates the mediation effect of well-being on the relationship between emotional resilience and employability, meaning that the mediation effect of well-being varies significantly across different genders.
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H3b: Age moderates the mediation effect of well-being on the relationship between emotional resilience and employability, meaning that the mediation effect of well-being differs significantly among different age groups.
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H3c: Educational level moderates the mediation effect of well-being on the relationship between emotional resilience and employability, meaning that the mediation effect of well-being varies significantly across different educational levels.
Through these hypotheses, this study aims to comprehensively explore the mechanisms by which music therapy affects emotional resilience, well-being, and employability, and analyze how gender, age, and educational level modulate these effects.
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