This study assessed the effectiveness of a combined individual and group cognitive-behavioural treatment (CBT) program to reduce music performance anxiety (MPA) in adolescent musicians. Twenty-three adolescents with high MPA from a selective high school were randomly assigned to either a seven-session intervention program or a behaviour-exposure-only control group. The intervention consisted of psychoeducation, goal setting, cognitive restructuring, relaxation training and behavioural exposure in the form of two solo performances with audience. Outcome measures included self-reports of MPA, trait and state anxiety, diagnostic interview for social phobia, heart rate, frontalis EMG, and performance quality. Significant improvements in self-reported MPA were observed at posttest for adherent students only (i.e., students who were actively engaged in the program and who adopted program techniques). Adherent students also had higher MPA at commencement. Non-adherent and behaviour-exposure-only students both showed reductions in MPA over the study period but not to the same degree as adherent students. There appeared to be no effect of CBT on performance quality.
Get full access to this article
View all access options for this article.
References
1.
AlbanoA. M.CauseyD., & CarterB. (2001). Fear and anxiety in children. In WalkerC. E. & RobertsM. C. (eds), Handbook of clinical child psychology (3rd ed., pp. 291–316). New York: Wiley.
2.
AlbanoA. M.MartenP. A.HoltC. S.HeimbergR. G., & BarlowD. H. (1995). Cognitive-behavioral group treatment for social phobia in adolescents. Journal of Nervous and Mental Disorders, 183, 649–56.
3.
AppelS. S. (1976). Modifying solo performance anxiety in adult pianists. Journal of Music Therapy, 13 (1), 2–16.
4.
ArenaJ. G.BlanchardE. B.AndrasikF.CotchP. A., & MyersP. E. (1983). Reliability of psychophysiological assessment. Behaviour Research and Therapy, 21 (4), 447–60.
5.
BarrettP. M.DaddsM. R., & RapeeR. M. (1996). Family treatment of childhood anxiety: A controlled trial. Journal of Consulting & Clinical Psychology, 64 (2), 333–42.
6.
BarrettP. M.DuffyA. L.DaddsM. R., & RapeeR. M. (2001). Cognitive-behavioral treatment of anxiety disorders in children: Long-term (6-year) follow-up. Journal of Consulting and Clinical Psychology, 69 (1), 135–41.
7.
BarrettP. M.RapeeR. M.DaddsM. M., & RyanS. M. (1996). Family enhancement of cognitive style in anxious and aggressive children. Journal of Abnormal Child Psychology, 24 (2), 187–203.
8.
BarriosB. A., & O'DellS. L. (1998). Fears and anxieties. In MashE. J. & BarkleyR. A. (eds), Treatment of childhood disorders (2nd ed., pp. 249–337). New York: Guilford Press.
9.
BergeeM. J. (2003). Faculty interjudge reliability of music performance evaluation. Journal of Research in Music Education, 31 (2), 137–50.
10.
BraswellL.KendallP. C.BraithJ.CareyM. P., & VyeC. S. (1985). “Involvement” in cognitive-behavioral therapy with children: Process and its relationship to outcome. Cognitive Therapy and Research, 9, 611–30.
11.
CacioppoJ., & TassinaryL. G. (1990). Inferring psychological significance from physiological signals. American Psychologist, 45 (1), 16–28.
12.
CacioppoJ. T.TassinaryL. G., & BerntsonG. G. (2000). Psychophysiological science. In CacioppoJ. T.TassinaryL. G. & BerntsonG. G. (eds), Handbook of Psychophysiology (2nd ed.). USA: Cambridge University Press.
13.
ChamblessD. L.TranG. Q., & GlassC. R. (1997). Predictors of response to cognitive-behavioral group therapy for social phobia. Journal of Anxiety Disorders, 11 (3), 221–40.
14.
ChorpitaB. F., & BarlowD. H. (1998). The Development of Anxiety: The Role of Control in the Early Environment. Psychological Bulletin, 124 (1), 3–21.
15.
ChuB. C., & KendallP. C. (2004). Positive Association of Child Involvement and Treatment Outcome Within a Manual-Based Cognitive-Behavioral Treatment for Children With Anxiety. Journal of Consulting and Clinical Psychology, 72 (5), 821–29.
16.
ClarkD. B., & AgrasW. S. (1991). The assessment and treatment of performance anxiety in musicians. American Journal of Psychiatry, 148 (5), 598–605.
17.
CobhamV. E.DaddsM. R., & SpenceS. H. (1998). The role of parental anxiety in the treatment of childhood anxiety. Journal of Consulting and Clinical Psychology, 66 (6), 893–905.
18.
CraskeM. G., & CraigK. D. (1984). Musical performance anxiety: The three-systems model and self-efficacy theory. Behaviour Research & Therapy, 22 (3), 267–80.
19.
CreedT. A., & KendallP. C. (2005). Therapist Alliance-Building Behavior Within a Cognitive-Behavioral Treatment for Anxiety in Youth. Journal of Consulting and Clinical Psychology, 73 (3), 498–505.
20.
DaddsM. R., & BarrettP. M. (1996). Family processes in child and adolescent anxiety and depression. Behaviour Change, 13 (4), 231–39.
21.
DaddsM. R.HollandD. E.LaurensK. R.MullinsM.BarrettP. M., & SpenceS. H. (1999). Early intervention and prevention of anxiety disorders in children: Results at 2-year follow-up. Journal of Consulting & Clinical Psychology, 67 (1), 145–50.
22.
DaddsM. R.SpenceS. H.HollandD. E.BarrettP. M., & LaurensK. R. (1997). Prevention and early intervention for anxiety disorders: A controlled trial. Journal of Consulting & Clinical Psychology, 65 (4), 627–35.
23.
DavidsonJ. W.HoweM. J. A.MooreD. G., & SlobodaJ. A. (1996). The role of parental influences in the development of musical performance. British Journal of Developmental Psychology, 14 (4), 399–412.
24.
DeenD. R. (2000). Awareness and breathing: Keys to the moderation of musical performance anxiety. Dissertation Abstracts International, A (Humanities and Social Sciences), 60 (12-A), 4241.
25.
DiGiuseppeR.LinscottJ., & JiltonR. (1996). Developing the therapeutic alliance in child-adolescent psychotherapy. Applied and Preventive Psychology, 5, 85–100.
26.
DweckC. S. (1986). Motivational processes affecting learning. American Psychologist, 41 (10), 1040–48.
27.
EisenA. R.SpasaroS. A.BrienL. K.KearneyC. A., & AlbanoA. M. (2004). Parental expectancies and childhood anxiety disorders: Psychometric properties of the Parental Expectancies Scale. Journal of Anxiety Disorders, 18, 89–109.
28.
ElyM. C. (1991). Stop performance anxiety. Music Educators Journal, 78 (2), 35–9.
29.
FehmL., & SchmidtK. (2005). Performance anxiety in gifted adolescent musicians. Journal of Anxiety Disorders, 20 (1), 98–109.
30.
GallagherH. M.RabianB. A., & McCloskeyM. S. (2004). A brief group cognitive-behavioral intervention for social phobia in childhood. Journal of Anxiety Disorders, 18, 459–79.
31.
GarciaJ. A., & WeiszJ. R. (2002). When youth mental health care stops: Therapeutic relationship problems and other reasons for ending youth outpatient treatment. Journal of Consulting and Clinical Psychology, 70 (2), 439–43.
32.
GatchelR. J. (1978). A multiple-response evaluation of EMG biofeedback performance during training and stress-induction conditions. Psychophysiology, 15 (3), 253–58.
33.
GrishmanA. (1989). Musicians' performance anxiety: The effectiveness of modified progressive muscle relaxation in reducing physiological, cognitive, and behavioral symptoms of anxiety. Dissertation Abstracts International, 50 (6-B), 2622.
34.
GutinB.HoweC. A.JohnsonM. H.HumphriesM. C.SniederH., & BarbeauP. (2005). Heart rate variability in adolescents: Relations to physical activity, fitness, and adiposity. Medicine and Science in Sports and Exercise, 37 (11), 1856–63.
HallamS. (1997). The development of memorisation strategies in musicians: Implications for education. British Journal of Music Education, 14, 87–97.
37.
HarrisS. R. (1987). Brief cognitive-behavioral group counselling for musical performance anxiety. Journal of the International Society for the Study of Tension in Performance, 4, 3–9.
38.
HaywardC.VaradyS.AlbanoA. M.ThienemannM.HendersonL., & SchatzbergA. F. (2000). Cognitive-behavioral group therapy for social phobia in female adolescents: Results of a pilot study. Journal of the American Academy of Child and Adolescent Psychiatry, 39 (6), 721–26.
39.
HoweM. J. A., & DavidsonJ. W. (2003). The early progress of able young musicians. In SternbergR. J. & GrigorenkoE. L. (eds), The psychology of abilities, competencies and expertise. New York, NY: Cambridge University Press.
40.
HudsonJ. L. (2005). Efficacy of Cognitive-Behavioural Therapy for Children and Adolescents with Anxiety Disorders. Behaviour Change, 22 (2), 55–70.
41.
JuslinP. N.FribergA.SchoonderwaldtE., & KarlssonJ. (2004). Feedback learning of musical expressivity. In WilliamonA. (ed), Musical excellence: Strategies and techniques to enhance performance. Oxford, UK: Oxford University Press.
42.
KaspersenM., & GoetestamK. (2002). A survey of music performance anxiety among Norwegian music students. European Journal of Psychiatry, 16 (2), 69–80.
43.
KatkinE. S. (1987). Psychophysiological assessment for decision-making: Conceptions and misconceptions. In PetersonD. R. & FishmanD. B. (eds), Assessment for decision. New Brunswick, NJ: Rutgers.
44.
KazdinA. E.HollandL., & CrowleyM. (1997). Family experience of barriers to treatment and premature termination from child therapy. Journal of Consulting and Clinical Psychology, 65 (3), 453–63.
45.
KazdinA. E., & WeiszJ. R. (1998). Identifying and developing empirically supported child and adolescents treatments. Journal of Consulting and Clinical Psychology, 66 (1), 19–36.
46.
KellerJ.HicksB. D., & MillerG. A. (2000). Psychophysiology in the study of psychopathology. In CacioppoJ. T.TassinaryL. G. & BerntsonG. G. (eds), Handbook of Psychophysiology (2nd ed.). USA: Cambridge University Press.
47.
KendallP. C. (1994). Treating anxiety disorders in children: Results of a randomized clinical trial. Journal of Consulting and Clinical Psychology, 62, 100–10.
48.
KendallP. C., & ChuB. C. (2000). Retrospective self-reports of therapist flexibility in a manual-based treatment for youths with anxiety disorders. Journal of Clinical Child Psychology, 29 (2), 209–20.
49.
KendallP. C.Flannery-SchroederE.Panichelli-MindelS. M.Southam-GerowM. A.HeninA., & WarmanM. (1997). Therapy for youths with anxiety disorders: A second randomized clinical trial. Journal of Consulting and Clinical Psychology, 65, 366–80.
50.
KendrickM. J.CraigK. D.LawsonD. M., & DavidsonP. O. (1982). Cognitive and behavioural therapy for musical-performance anxiety. Journal of Consulting and Clinical Psychology, 50 (3), 353–62.
51.
KennyD. T. (2004). Music performance anxiety: Is it the music, the performance or the anxiety?Music Forum, 10 (4), 38–43.
52.
KennyD. T. (2005). A Systematic Review of Treatments for Music Performance Anxiety. Anxiety, Stress and Coping, 18 (3), 183–208.
53.
KennyD. T., & OsborneM. S. (2006). Music performance anxiety: New insights from young musicians. Retrieved 2 July 2006, from http://www.ac-psych.org.
54.
KeoghE.BondF. W., & FlaxmanP. E. (2006). Improving academic performance and mental health through a stress management intervention: Outcomes and mediators of change. Behaviour Research and Therapy, 44, 339–57.
55.
KirchnerJ. M. (2003). A qualitative inquiry into musical performance anxiety. Medical Problems of Performing Artists, 18, 78–82.
56.
KortlanderE.KendallP. C., & Panichelli-MindelS. M. (1997). Maternal expectations and attributions about coping in anxious children. Journal of Anxiety Disorders, 11 (3), 297–315.
57.
KratochwillT. R., & Van SomerenK. R. (1995). Barriers to treatment success in behavioral consultation: Current limitations and future directions. Journal of Educational and Psychological Consultation, 6 (2), 125–43.
58.
KubzanskyL. D., & StewartA. J. (1999). At the intersection of anxiety, gender and performance. Journal of Social and Clinical Psychology, 18 (1), 76–97.
59.
LangP. J. (1971). The application of psychophysiological methods to the study of psychotherapy and behavior change. In BerginA. E. & GarfieldS. L. (eds), Handbook of psychotherapy and behavior change: An empirical analysis. New York: Wiley.
60.
MansbergerN. B. (1988). The effects of performance anxiety management training on musician's self-efficacy, state anxiety and musical performance quality. Unpublished Master of Music Thesis, Western Michigan University, Kalamazoo, Michigan.
61.
MaroonM. T. J. (2003). Potential contributors to performance anxiety among middle school students performing at solo and ensemble contest. Dissertation Abstracts International, 64 (2-A), 437.
62.
MartinD. J.GarskeJ. P., & DavisM. K. (2000). Relationship of therapeutic alliance with outcome and other variables: A meta-analytic review. Journal of Consulting and Clinical Psychology, 68, 438–50.
63.
MartinG., & PearJ. (2002). Behavior modification: What it is and how to do it. Upper Saddle River, New Jersey: Prentice-Hall.
64.
Masia-WarnerC.KleinR. G.DentH. C.FisherP. H.AlvirJ.AlbanoA. M. (2005). School-based intervention for adolescents with social anxiety disorder: Results of a controlled study. Journal of Abnormal Child Psychology, 33 (6), 707–22.
65.
MathesonD. W.TobenT. P., & de la CruzD. E. (1988). EMG scanning: Normative data. Journal of Psychopathology and Behavioural Assessment, 10 (1), 9–20.
66.
McBurneyD. H. (1994). Research methods (3rd ed.). Pacific Grove, California: Brooks/Cole.
67.
McPhersonG. E., & McCormickJ. (2006). Self-efficacy and music performance. Psychology of Music, 34 (3), 322–36.
68.
MorrisT., & ThomasP. (1995). Approaches to applied sport psychology. In MorrisJ. & SummersJ. (eds), Approaches to applied sport psychology. Birsbane: Jacaranda Wiley.
69.
NeftelK. A.AdlerR. H.KappeliL.RossiM.DolderM.KaserH. E. (1982). Stage fright in musicians: A model illustrating the effect of beta blockers. Psychosomatic Medicine, 44 (5), 461–69.
70.
NiemannB. K.PrattR. R., & MaughanM. L. (1993). Biofeedback training, selected coping strategies, and music relaxation interventions to reduce debilitative musical performance anxiety. International Journal of Arts Medicine, 2 (2), 7–15.
71.
NockM. K., & KazdinA. E. (2001). Parent expectancies for child therapy: Assessment and relation to participation in treatment. Journal of Child and Family Studies, 10 (2), 155–80.
72.
OllendickT. H., & SchroederC. S. (eds). (2003). Encyclopedia of clinical child and pediatric psychology. New York: Klewer Academic/Plenum.
73.
OsborneM. S., & FranklinJ. (2002). Cognitive processes in music performance anxiety. Australian Journal of Psychology, 54 (2), 86–93.
74.
OsborneM. S., & KennyD. T. (2005). Development and validation of a music performance anxiety inventory for gifted adolescent musicians. Journal of Anxiety Disorders, 19 (7), 725–51.
75.
OsborneM. S., & KennyD. T. (in press). The role of sensitising experiences in music performance anxiety in adolescent musicians. Psychology of music.
76.
OsborneM. S.KennyD. T., & HolsombackR. (2005). Assessment of music performance anxiety in late childhood: A validation study of the Music Performance Anxiety Inventory for Adolescents (MPAI-A). International Journal of Stress Management, 12 (4), 312–30.
77.
PulliamC. P.GatchelR. J., & RobinsonR. C. (2003). Challenges to Early Prevention and Intervention: Personal Experiences With Adherence. Clinical Journal of Pain, 19 (2), 114–20.
78.
RaeG., & McCambridgeK. (2004). Correlates of performance anxiety in practical music exams. Psychology of Music, 32 (4), 432–39.
79.
RapeeR.BarrettP. M.DaddsM. R., & EvansL. (1994). Reliability of the DSM-III-R childhood anxiety disorders using structured interview: Interrater and parent-child agreement. Journal of the American Academy of Child and Adolescent Psychiatry, 33 (7), 984–93.
80.
RolandD. J. (1994). The development and evaluation of a modified cognitive-behavioural treatment for musical performance anxiety. Dissertation Abstracts International, 55 (5-B), 2016.
81.
RyanC. (2005). Experience of Musical Performance Anxiety in Elementary School Children. International Journal of Stress Management, 12 (4), 331–42.
82.
ShawR. J. (2001). Treatment adherence in adolescents: Development and psychopathology. Clinical Child Psychology and Psychiatry, 6 (1), 137–50.
83.
ShirkS. R., & KarverM. (2003). Prediction of treatment outcome from relationship variables in child and adolescent therapy: A meta-analytic review. Journal of Consulting and Clinical Psychology, 71 (3), 452–64.
84.
ShirkS. R., & SaizC. C. (1992). Clinical, empirical, and developmental perspectives on the therapeutic relationship in child psychotherapy. Development and Psychopathology, 4 (4), 713–28.
85.
ShirleyM. C.MattD. A., & BurishT. G. (1992). Comparison of frontalis, multiple muscle site, and reactive muscle site feedback in reducing arousal under stressful and nonstressful conditions. Medical Psychotherapy: An International JournalVol. 51992, 133–48.
86.
SilvermanW. K. (1991). Diagnostic reliability of anxiety disorders in children using structured interviews. Journal of Anxiety Disorders, 5 (2), 105–24.
87.
SilvermanW. K., & AlbanoA. M. (1996). Anxiety Disorders Interview Schedule for DSM-IV: Child Interview Schedule. San Antonio: The Psychological Corporation.
88.
SmithA. J., & RickardN. S. (2004). Prediction of music performance anxiety via personality and trait anxiety in young musicians. Australian Journal of Music Education, 1, 3–12.
89.
SpielbergerC. D. (1983). State-Trait Anxiety Inventory STAI (Form Y). Palo Alto, CA: Consulting Psychologists Press, Inc.
90.
SteptoeA., & FidlerH. (1987). Stage fright in orchestral musicians: A study of cognitive and behavioural strategies in performance anxiety. British Journal of Psychology, 78, 241–49.
91.
SweeneyG. A., & HoranJ. J. (1982). Separate and combined effects of cue-controlled relaxation and cognitive restructuring in the treatment of music performance anxiety. Journal of Counseling Psychology, 29 (5), 486–97.
92.
ThompsonS., & WilliamonA. (2003). Evaluating evaluation: Musical performance assessment as a research tool. Music Perception, 21 (1), 21–41.
93.
VeltingO. N.SetzerN. J., & AlbanoA. M. (2004). Update on and advances in assessment and cognitive-behavioral treatment of anxiety disorders in children and adolescents. Professional Psychology: Research and Practice, 35 (1), 42–54.
94.
WardleA. (1975). Behavior modification by reciprocal inhibition of instrumental music performance anxiety. In MadsenC. K.MadsenC. H. & GreerR. D. (eds), Research in music behavior: Modifying music behavior in the classroom (pp. 191–205). New York: Teachers College Press.
