Music Listening Guidelines

American Music Therapy Association

Music Listening Guidelines

The AMTA Music Listening Guidelines are intended to provide guidance to individuals engaging or assisting others in regular music listening to address physiological, psychological, communicative, behavioral, educational, and/or wellness needs. The recommendations below should always be used in consultation with the listener’s health team, including but not limited to physicians, psychologists, psychiatrists, counselors, audiologists and music therapists.


It is important to note the difference between Personalized Music Listening (PML), Background Music Listening (BML), Leisure Music Listening (LML) and Music Listening (ML). For the purposes of this document:

  • PML is defined as music selections chosen from an individual listener’s preferences and life experiences. PML is designed to support the individualized needs of the listener.
  • BML is defined as music listening intended as an unobtrusive accompaniment to some activity such as eating or to help facilitate a type of atmosphere.
  • LML is defined as engaging in music listening as an activity for leisure and/or entertainment.
  • ML is defined as any music listening experience and includes PML, BML and LML.


  1. Auditory Safety-
    1. ML should be delivered at a volume controlled at 65dB or lower.
    2. When ML is to be delivered via headphones, the style of headphones should be selected based upon the listener’s comfort and safety.
    3. Bluetooth headphones are recommended for listeners whose safety could be at risk and/or music listening experience could be interrupted by become entangled in headphone wires.
    4. Listeners with hearing aids and/or hearing impairments should have a consultation with their audiologist prior to beginning a regular music listening program.


  1. Infection Control Safety-
    1. For cleaning and disinfecting, use EPA-registered, disposable disinfectant wipes, ultraviolet-C disinfection wands, or follow any other sanitary procedures provided by a person’s physician or facility infection control staff.
    2. Cleaning and disinfecting is recommended:
      • when visibly soiled,
      • before and after each use if person has an infection and/or is on infection control precautions,
      • when equipment is being transferred between individuals for use,
      • when a person has been traveling with their equipment, and,
      • when it may have come into contact with contagious diseases.


  1. Music Content Considerations-
    1. Song selections for ML, especially PML, should take into consideration lyric content that may promote or suppress healthy behaviors and information should be obtained on any songs, lyrics, subjects that should be avoided and note any negative reactions to song lyrics should they occur.
    2. Individuals with a history and/or predisposition for addictions and/or unhealthy behaviors, or who have a history of trauma, should consult with their physicians, counselors, music therapists and other treatment team members and practice caution when selecting ML, and especially PML, songs associated with and/or containing lyrics pertaining to those addictions, behaviors or memories.
    3. Use of ML songs, especially PML songs, known or likely to cause intense emotional and cognitive responses are not recommended for use outside of a treatment plan with a qualified healthcare professional.


  1. Health Considerations-
    1. Physiological Considerations:
      • Individuals with cardio-pulmonary health concerns should consult their physician prior to using a PML program in conjunction with a physical exercise regimen to determine ideal tempos for their heart and respiration.
      • Individuals with physical disabilities or injuries should consult their physical therapist, occupational therapist, music therapist and/or physician to determine PML tempos/beats per minute, rhythms and other music elements appropriate for engaging in specific motor repetition for habilitation or rehabilitation.
    2. Psychological Considerations:
      • Generally it is recommended that individuals with mental health diagnoses consult with their treatment team and music therapist (when possible) when planning to begin PML.
      • An individual experiencing strong and unpleasant thoughts or feelings from certain songs, genres, or artists should cease listening to music that elicits these reactions or responses and/or seek the help of a professional music therapist.
      • While selecting music to match an individual’s current mood can be effective, it is important that the music not prohibit the individual from changing moods and experiencing the full spectrum of feelings and emotions.
      • Individuals with mental health diagnoses that present with hyperactivity and/or mania should avoid selecting songs or playlists of songs that only express and elicit fast-paced sound and activity, high energy and/or excitement.
      • ML, whether individually or in groups, may be accompanied by other experiences (such as art composition, moving, story composition, or lyric discussion) designed to give form to thoughts, impressions, or emotions generated by the music.
    3. Cognitive, Communicative and Sensory Considerations:
      • Individuals with cognitive and sensory processing deficits should have PML delivered in consideration of their environmental stimuli, physiological stimuli and their ability to neurologically process the music stimuli within their current state of recovery from injury or disease.
      • An individual experiencing severe and/or chronic pain may demonstrate hypersensitivity to music stimuli and therefore may require frequent adaptations in delivery of music stimuli in order to meet their changing ability to process varying amounts and types of stimuli and to benefit from PML.
      • Individuals with seizure disorders may find that some music triggers seizures. Individuals with music-induced seizures should consult with a music therapist and/or their healthcare team when planning to engage in ML, especially PML.
      • Infants with delayed neurological development, especially those hospitalized in a Neonatal Intensive Care Unit (NICU), who have not fully developed the ability to process intense sound stimuli, should be provided music with the consultation of a music therapist or other qualified professional specializing in infants, neurology, and/or auditory processing, to avoid overstimulation and harm to the infant.
      • Individuals with disorders, diseases, and injuries that affect their ability to exhibit focused attention, comprehension, memory recall, and/or reality orientation should receive PML in a setting and with a plan of care that:
        1. Facilitates monitoring of the individual’s responses to music stimuli to allow for changes or discontinuation of the PML when unbeneficial responses are observed, or;
        2. Appropriately engages the individual in social, cognitive and communicative tasks that exercise the neurological pathways exhibiting improved functionality from the stimuli of PML when beneficial responses are observed.


  1. Music Listening Safety Considerations-
    1. It is important to be prepared to recognize and support, or obtain support for, any significant emotions and/or memories that emerge from PML experiences.
    2. Monitor the person listening. ML, especially PML, may cause an increase or decrease in movement that may need to be monitored, depending on what activity the individual is engaged in, and particularly if the person is considered a fall risk. See Appendix A. Responses to Watch For.
    3. Respond in the moment to significant changes, emotions and/or memories. See Appendix B. Responding to Observed Reactions to Music.
    4. Make note of significant changes, emotions, memories and/or observations, including the music playing at the time. This information may affect whether the playlist or listening regimen needs to be modified or whether follow up needs to be made by a qualified psychosocial healthcare provider such as a social worker, counselor, or music therapist (particularly beneficial for non-verbal listeners).


  1. Music Listening Frequency & Delivery-
    1. Individualized responses and reactions to PML can vary with time of day and from day-to-day.  When using or facilitating personalized music listening, it is imperative to watch for responses of pleasure and relaxation, but also signs of increased agitation and discomfort from music to allow you adjust music delivery accordingly as indicated in section 5.
    2. PML is not recommended to continue beyond 50 minutes for one session, and sessions may occur up to four times a day.
    3. See Appendix C. Considerations for Planning Music Listening Length, Frequency and Schedule.
    4. See Appendix D. Considerations for Determining Best Method of Music Listening Delivery.
    5. See Appendix E. Considerations for Caregivers to Enhance the Social and Relationship Benefits of Music Listening.


  1. Music Preference & Playlist Recommendations-
    1. Individual music preferences may be based on a wide variety of influences such as familiarity, artist or performer, preferences of friends/relatives, prior musical experience, composer, recommendations of authority figures or acquaintances, accompanying instruments or styles, or concurrent and changing mood. Playlist songs should always be selected with cultural, historical and ethical considerations relevant to the listener.
    2. Different preferences may often be expressed by the same individual depending on that person’s state of mind at a given moment.
    3. Research shows that most people prefer the music that they listened to in their teens and 20’s due to the association of that music with the formation of one’s self identity, goals, and development of mechanisms for independence. Music from adulthood can also be preferred, especially music which relates to significant periods of time, experiences and/or achievements in the person’s adult life.
    4. The needs of the individual should always be considered when building a PML playlist. For example, songs may be placed in an order so as to induce excitement/alertness or relaxation/sleepiness. Playlist may require periodic revisiting to ensure continued relevance to the individual’s needs.
    5. PML may be provided in a predictable set order of songs or in a mix or shuffle of songs, as indicated by the goal of the music listening and the listener’s responses to the music.

   Click here for AMTA’s website

ML Guidelines References 11.13.19 with Hyperlinks

AMTA Music Listening Guidelines Appendix