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. 2025 Mar 25:12:e44.
doi: 10.1017/gmh.2025.31. eCollection 2025.

Impact of a music therapy program on mental health and school attendance among female adolescents in Kasai-Central province, Democratic Republic of Congo

Lisa Zook  1 , Ali Bitenga Alexandre  2 , Michelle M Hood  3 , Sioban D Harlow  3
Affiliations

Impact of a music therapy program on mental health and school attendance among female adolescents in Kasai-Central province, Democratic Republic of Congo

Lisa Zook et al. Glob Ment Health (Camb). .

Abstract

This study assessed whether a music therapy program improved mental health and school attendance among girls in the Democratic Republic of Congo (DRC) following economic and conflict-related insecurity. It included 483 girls aged 10-14 who participated in the Healing in Harmony (HiH) program, implemented by World Vision and Make Music Matter in Kasai-Central province. Participants completed surveys before and after the program, and up to two follow-up interviews assessing depression, anxiety, self-esteem, and school attendance. Before the program, 36.0% (95% CI 31.7%-40.3%) and 60.5% (95% CI 56.1%-64.8%) screened positive for depression and anxiety, respectively. After participation, the risk of screening positive declined by 75% for depression (RR = 0.27, 95% CI 0.22-0.32) and by about half for anxiety (RR = 0.46, 95% CI 0.41-0.53), with improvements sustained up to 17 months. Self-esteem scores increased by 3.93 points (95% CI 3.22-4.64, p<0.001). School absenteeism decreased from 10% (95% CI 7.2%-12.6%) to 5.4% (RR = 0.54, 95% CI 0.40-0.73). Participation in HiH was associated with sustained improvements in mental health and school attendance. These findings support integrating psychosocial care into humanitarian responses to improve both mental health and educational outcomes for crisis-affected children.

Keywords: Democratic Republic of Congo; humanitarian crisis; mental health; music therapy; school attendance.

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Conflict of interest statement

The authors declare no competing interests.

Figures

None
Graphical abstract
Figure 1.
Figure 1.
Illustration of the study design. The HiH program was implemented sequentially across five time periods (gray): April–August 2021, October–December 2021, April–June 2022, August–October 2022 and November 2022–January 2023, with data collection occurring at the start and end of each program (white stars), in addition to October 2022 and February 2023 (black stars).
Figure 2.
Figure 2.
Boxplots of depression, anxiety and self-esteem average scores by time.
Figure 3.
Figure 3.
Boxplot of days absent over the last 4 weeks for Cohort 5 by pretest and posttest.
See this image and copyright information in PMC

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References

    1. Aalbers S, Fusar-Poli L, Freeman RE, Spreen M, Ket JC, Vink AC, Maratos A, Crawford M, Chen XJ and Gold C (2017) Music therapy for depression. The CochraneDatabase of Systematic Reviews 11(11), CD004517. - PMC - PubMed
    1. Altman, BM (ed.) (2016) International Measurement of Disability: Purpose, Method and Application (Vol. 61). Springer.
    1. Alozkan-Sever C, Uppendahl J R, Cuijpers P, de Vries R, Rahman A, Mittendorfer-Rutz E, Akhtar A, Zheng Z and Sijbrandij M (2023) Research review: Psychological and psychosocial interventions for children and adolescents with depression, anxiety, and post-traumatic stress disorder in low- and middle-income countries - a systematic review and meta-analysis. Journal of Child Psychology and Psychiatry, and Allied Disciplines 64(12), 1776–1788. 10.1111/jcpp.13891. - DOI - PubMed
    1. Aston R, Raniti M and Shinde S (2023) Editorial: The role of schools in adolescent mental health in low- and middle-income countries: Considerations and future directions. Frontiers in Psychiatry 14, 1307350. 10.3389/fpsyt.2023.1307350. - DOI - PMC - PubMed
    1. Ba I and Bhopal RS (2017) Physical, mental and social consequences in civilians who have experienced war-related sexual violence: A systematic review (1981–2014). Public Health 142, 121–135. - PubMed

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