Therapeutic songwriting to address distress tolerance for adults on an acute care mental health unit: A pilot study

The Stress Vulnerability Model describes how stressors can function as a precursor for mental health episodes that may result in hospitalization. As such, it is crucial for people with mental health conditions to be able to anticipate and tolerate distress. The purpose of this pilot study was to determine the effects of a group therapeutic songwriting intervention on distress tolerance with adults in an acute care mental health setting. Due to the temporal parameters of acute mental health care in the United States, participants (N = 58) were cluster-randomized to a single songwriting session or control condition. Experimental participants composed lyrics for a two-verse blues song identifying causes of distress and how to tolerate them while living in the community. Results indicated no significant between-group difference. However, the songwriting condition tended to have slightly more favorable scores in all subscales (tolerance, absorption, appraisal, and regulation) and total distress tolerance than the control condition. While results of this underpowered pilot effectiveness study should be interpreted with caution, highly-structured group-based songwriting may be clinically relevant for addressing distress tolerance. Implications for clinical practice, limitations, and suggestions for future research are provided.