Music therapy in community-based substance misuse treatment: Exploring psychometric, qualitative and EEG measures related to craving, inhibition and affective processing

Music therapy (MT) is a promising adjunctive intervention for substance use disorder (SUD), yet multi-modal studies integrating neural, psychometric and qualitative measures are lacking. We conducted a mixed-methods pilot study with sixteen participants from a community-based substance-use treatment service to explore adjunctive MT plus standard treatment (ST) compared with ST alone. Participants received either six weekly MT sessions plus ST or ST alone. Assessments included resting-state and event-related electroencephalography, psychometric measures and semi-structured interviews addressing craving, affective symptoms, inhibitory control and participants’ therapeutic experiences. Craving Thermometer ratings suggested immediate reductions in present-moment craving after MT sessions, indicating that the conscious perception of craving improvement may emerge primarily in the immediate post-session window. Baseline-adjusted analyses showed no significant group differences at post intervention in Brief Substance Craving Scale scores or resting-state beta power z-scores, although the latter showed a larger descriptive reduction in the MT group. MT and ST differed significantly in post-intervention frontal alpha asymmetry after baseline adjustment, identifying affective-motivational processing as a candidate domain for future research. The MT group also showed a nominal, non-significant increase in P3d amplitude during a Go/NoGo task, suggesting response-inhibition-related EEG activity as a candidate signal for future investigation. Qualitative themes contextualised these findings by highlighting craving reduction, emotional reflection, reluctance to discuss craving and therapeutic connection. This pilot supports combining session-level, psychometric, qualitative and EEG measures in community-based MT for SUD. Future trials with larger samples, robust allocation, clearer comparators and longer-term follow-up are needed. Trial registration. NCT********, Registered * January 20**.