engage the right hemisphere in language production. overall, by stimulating the right hemisphere during language tasks, therapists hope to decrease dependence on the left hemisphere for language production. while results are somewhat contradictory, studies have in fact found increased right hemispheric activation in non-fluent aphasic patients after mit. this change in activation has been interpreted as evidence of decreased dependence on the left hemisphere. there is debate, however, as to whether changes in right hemispheric activation are part of the therapeutic process during/after mit, or are simply a side effect of non-fluent aphasia. in hopes of making mit more effective, researchers are continually studying the mechanisms of mit and non-fluent aphasia. cancer there is tentative evidence that music interventions led by a trained music therapist may have positive effects on psychological and physical outcomes in adults with cancer. the effectiveness of music therapy for children with cancer is not known. adults there is weak evidence to suggest that people with schizophrenia may benefit from the addition of music therapy along with their other standard treatment regieme. potential improvements include decreased aggression, less hallucinations and delusions, social functioning, and quality of life of people with schizophrenia or schizophrenia-like disorders. in addition, moderate-to-low-quality evidence suggests that music therapy as an addition to standard care improves the global state, mental state (including negative and general symptoms). further research using standardized music therapy programs and consistent monitoring protocols are necessary to understand the effectiveness of this approach for adults with schizophrenia. music therapy may be a useful tool for helping treat people with post-traumatic stress disorder however more rigorous empirical study is required. for adults with depressive symptoms, there is some weak evidence to suggest that music therapy may help reduce symptoms and recreative music therapy and guided imagery and music being superior to other methods in reducing depressive symptoms. in the use of music therapy for adults, there is "music medicine" which is called for listening to prerecorded music as treated like a medicine. music therapy also uses "receptive music therapy" using "music-assisted relaxation" and using images connecting to the music. children for children and adolescents with major depressive or anxiety disorders, there is moderate to low quality evidence that music therapy added to the standard treatment may reduce internalizing symptoms and may be more effective than treatment as usual (without music therapy). mental wellness there is some discussion on the process of change facilitated by musical activities on mental wellness. scholars proposed a six-dimensional framework, which contains emotional, psychological, social, cognitive, behavioral and spiritual aspects. through conducting interview sessions with mental health service users (with mood disorders, anxiety disorders, schizophrenia and other psychotic disorders), their study showed the relevance of the six-dimensional framework. impact of music therapy on general mental health music therapy has been used to help bring improvements to mental health among people of all age groups. it has been used as far back as the 1830s. one example of a mental hospital that used music therapy to aid in the healing process of their patients includes the hanwell lunatic asylum. this mental hospital provided "music and movement sessions and musical performances" as well as "group and individual music therapy for patients with serious mental illness or emotional problems." two main categories of music therapy were used in this study; analytic music therapy and nordoff-robbins music therapy. analytic music therapy involves both words and music, while nordoff-robbins music therapy places great emphasis on assessing how clients react to music therapy and how the use of this type of therapy can be constantly altered and shifted to allow it to benefit the client the most. treatment of bereavement the dsm-iv tr (diagnostic and statistical manual of mental disorders) lists bereavement as a mental health diagnosis when the focus of clinical attention is related to the loss of a loved one and when symptoms of major depressive disorder are present for up to two months. music therapy models have been found to be successful in treating grief and bereavement (rosner, kruse & hagl, 2010). diagnosing bereavement as of 2017, bereavement is listed as its own diagnosis in the dsm-iv tr, but proposed changes in the dsm-v may impact the way bereavement is diagnosed. the dsm-iv tr states the following about bereavement: this category can be used when the focus of clinical attention is a reaction to the death of a loved one. as part of their reaction to the loss, some grieving individuals present with symptoms characteristic of a major depressive episode (e.g., feelings of sadness and associated symptoms such as insomnia, poor appetite, and weight loss). the bereaved individual typically regards the depressed mood as "normal," although the person may seek professional help for relief of associated symptoms such as insomnia or anorexia. the duration and expression of "normal" bereavement vary considerably among different cultural groups. the diagnosis of major depressive disorder is generally not given unless the symptoms are still present 2 months after the loss. however, the presence of certain symptoms that are not characteristic of a "normal" grief reaction may be helpful in differentiating bereavement from a major depressive episode. these include 1) guilt about things other than actions taken or not taken by the survivor at the time of the death; 2) thoughts of death other than the survivor feeling that he or she would be better off dead or should have died with the deceased person; 3) morbid preoccupation with worthlessness; 4) marked psychomotor retardation; 5) prolonged and marked functional impairment; and 6) hallucinatory experiences other than thinking that he or she hears the voice of, or transiently sees the image of, the deceased person. in many countries, including the united states, music therapists do not diagnose, therefore diagnosing a bereavement-related disorder would not be within their scope of practice. grief treatment it has become well known in the music therapy field that music can be an effective tool in the treatment of grief and bereavement but francesca albergato-muterspaw looked at how music actually played a role in the healing from grief. in her study, three primary themes presented themselves from the interviews and observation of the participants. she found firstly that, music has a significant connection with emotion. music can be used to express oneself, keep a client distracted when there is a need for distraction, and can help clients reflect on themselves and past experiences leading to changes in identity. secondly, a sense of community, culture, and spirituality was found when music was used in treatment. employing the ides of community, culture, and spirituality have shown to be vital in the process of dealing with grief so using music to elicit these concepts makes it a powerful tool indeed. lastly, it was found that music was important to clients as a way to give tribute to the deceased. on top of these areas of note, it was also discussed that the participants had a better understanding of each other – more so than they had simply by talking with each other.</ref name=a-m> it appears that music allows for context and meta messages to be more easily and successfully communicated between a group, an important point for therapists in any field, and also especially important when working with the bereaved. in 2008, kathryn lindenfelser and colleagues looked at the experiences parents of terminally ill children had with music therapy. they found that music therapy was effective in altering perceptions in the midst of adversity, was a strong component of remembrance, provided a multifaceted treatment, and as the other study also mentioned, increased communication and expression in both the adults and children (lindenfelser grocke & mcferran, 2008). in a separate study that explored the effects of music therapy on pain in children and families, it was found that music therapy can be used to reduce physical pain and anxiety, enhance relaxation, and promote positive moods and compliance. there was also an inverse relationship found between music therapy and behavioral distress (whitehead-pleaux, baryza & sheridan, 2007). since bereavement is diagnosed when elements of depression are found, and since music therapy has shown to be effective in enhancing mood and lowering distress, one could conclude that elements of music therapy could also be effective in the treatment of depression and other adjustment disorders, though further research would need to be done to make that conclusion. grief treatment for adolescents grief treatment is also very valuable within the adolescent age group. just as adults and the elderly struggle with grief from loss, relationship issues, job-related stress, and financial issues, so do adolescents also experience grief from disappointments that occur early on in life, however different these disappointing life events may be. for example, many people of adolescent age experience life-altering events such as parental divorce, trauma from emotional or physical abuse, struggles within school, and loss. if this grief is not acted upon early on through the use of some kind of therapy, it can alter the entire course of an adolescent's life. in one particular study on the impact of music therapy on grief management within adolescents used songwriting to allow these adolescents to express what they were feeling through lyrics and instrumentals. in the article development of the grief process scale through music therapy songwriting with bereaved adolescents, the results of the study demonstrate that in all of the treatment groups combined, the mean gps (grief process scale) score decreased by 43%. the use of music therapy songwriting allowed these adolescents to become less overwhelmed with grief and better able to process it as demonstrated by the decrease in mean gps score. empirical evidence since 2017, providing evidence-based practice is becoming more and more important and music therapy has been continuously critiqued and regulated to provide that desired evidence-based practice. a number of research studies and meta-analyses have been conducted on, or included, music therapy and all have found that music therapy has at least some promising effects, especially when used for the treatment of grief and bereavement. the amta has largely supported the advancement of music therapy through research that would promote evidenced-based practice. with the definition of evidence-based health care as "the conscientious use of current best evidence in making decisions about the care of individual patients or the delivery of health services, current best evidence is up-to-date information from relevant, valid research about the effects of different forms of health care, the potential for harm from exposure to particular agents, the accuracy of diagnostic tests, and the predictive power of prognostic factors". both qualitative and quantitative studies have been completed and both have provided evidence to support music therapy in the use of bereavement treatment. one study that evaluated a number of treatment approaches found that only music therapy had significant positive outcomes where the others showed little improvement in participants (rosner, kruse & hagl, 2010). furthermore, a pilot study, which consisted of an experimental and control group, examined the effects of music therapy on mood and behaviors in the home and school communities. it was found that there was a significant change in grief symptoms and behaviors with the experimental group in the home, but conversely found that there was no significant change in the experimental group in the school community, despite the fact that mean scores on the depression self-rating index and the behavior rating index decreased (hilliard, 2001). yet another study completed by russel hilliard (2007), looked at the effects of orff-based music therapy and social work groups on childhood grief symptoms and behaviors. using a control group that consisted of wait-listed clients, and employing the behavior rating index for children and the bereavement group questionnaire for parents and guardians as measurement tools, it was found that children who were in the music therapy group showed significant improvement in grief symptoms and also showed some improvement in behaviors compared to the control group, whereas the social work group also showed significant improvement in both grief and behaviors compared to the control group. the study concludes with support for music therapy as a medium from bereavement groups for children (hilliard, 2007). though there has been research done on music therapy, and though the use of it has been evaluated, there remain a number of limitations in these studies and further research should be completed before absolute conclusions are made, though