Informal carers—those supporting loved ones through serious illness and bereavement—often go unrecognised in healthcare. Dr. Lisa Graham-Wisener and Dr. Tracey McConnell, with Music Therapy Charity funding, led the first international review of music therapy’s role in supporting carers before and after death.
Their findings show that music therapy offers emotional, spiritual, and social benefits but the evidence base is fragmented. They convened an international workshop to co-produce a research agenda, which is now guiding future studies. The Music Therapy Charity’s support helped build a foundation for a major funding bid to the National Institute of Health Research. As one collaborator said, “This work reflects a commitment to research that is rooted in real-world practice and aligned to what truly matters in people’s lives.”
Although music therapy has a long-standing place in the hospice movement, research to date has largely focused on individuals with serious illness. However, music therapy for informal carers during caregiving and after bereavement is also an important area of clinical practice. Despite growing demand, research on music therapy’s role across the caregiving-bereavement continuum remains limited and fragmented. There is uncertainty about its effectiveness, how and why it may work, and how carers experience it. As a result, music therapy is rarely commissioned as a core NHS service, and its potential to support carers is not being realised.
We conducted the first international systematic review of the effectiveness and experience of music therapy for informal carers pre- and post-bereavement. Using the Joanna Briggs Institute mixed-methods approach, we mapped findings to a core outcome set for bereavement and to evidence-based risk factors for complicated grief. We then convened a half-day international online consensus-building workshop, using a World Café format to develop a best practice agenda for future research in this area.
Our review included 34 studies (2003–2022), mostly qualitative, and primarily focused on carers of people with dementia or advanced cancer. While quantitative findings on outcomes such as quality of life and mental wellbeing were mixed, qualitative evidence indicated a wide range of psychological, emotional, spiritual, and social benefits for carers. However, there was a notable gap in research on the post-bereavement phase, and the overall methodological quality of quantitative studies was low.
The international consensus workshop produced clear priorities and methodological recommendations. Stakeholders agreed that future research should robustly evaluate the effectiveness of music therapy across the caregiving-bereavement trajectory, with designs such as feasibility randomised controlled trials with process evaluation, guided by the bereavement core outcome set. Critically, they emphasised the need for theoretically informed interventions, grounded in a clear understanding of how and for whom music therapy works. Future research must also be co-designed with service users.
As a result of Music Therapy Charity (MTC) funding, we have built capacity in this research area. We now have a comprehensive synthesis of the evidence base, a co-produced research agenda, and strengthened international collaborations. We have disseminated this work at multiple conferences, public engagement events and to clinical teams, raising awareness of music therapy’s potential to support carers. We also secured internal funding to support the development of a National Institute of Health Research Health and Social Care Delivery Research funding application, which is currently under review. This proposed study will develop a programme theory for how music therapy works in this context.
Our findings to date demonstrate that music therapy has the potential to be used alongside the NICE model of bereavement support, particularly in its ability to address key risk and protective factors for complicated grief. However, high-quality, theory-informed research is needed, to inform commissioning and guide clinical practice.
Lisa Graham-Wisener is a Reader in Health Psychology in the School of Psychology at Queen’s University Belfast (QUB). A chartered psychologist, she has a research interest in the psychological and social dimensions of living with serious illness, informal caring and bereavement. Lisa has collaborated with music therapist colleagues on research for around 10 years.
Tracey McConnell is a Lecturer in Palliative and End-of-Life Care at the School of Nursing and Midwifery, Queen’s University Belfast (QUB). Her research interests include improving health service delivery for those with chronic and life-limiting conditions. Tracey has collaborated with music therapist colleagues on research for around 10 years.