Successful emotional processing is pivotal for the therapeutic change, and music can support emotional processing. However, we know little on how music-based emotional processing actually predicts clinical outcomes. This study investigated music therapeutic emotional processing (MEP) as a predictor of therapeutic outcome in treatment for depression. Data consisted of self-reports of 64 clients (age range 19–57, 74% female) from a clinical trial (12 sessions) of integrative improvisational music therapy (IIMT). A 19-item MEP questionnaire was developed for assessing clients’ experiences after sessions. Emergent MEP factors were correlated with clients’ perceptions of the therapeutic value of the sessions (Session Evaluation Questionnaire [SEQ]) and with recovery from depression (Montgomery–Åsberg Depression Rating Scale [MADRS]). MEP emerged as a constitution of three factors: expression, awareness, and pain. Expression and awareness increased across the process and correlated positively with session value and MADRS change. Pain demonstrated a more complex inverted u-shaped temporal curve and correlated with roughness of session experience. The presence of pain during the late part of the therapy predicted lower recovery. The findings support MEP factors as predictors of therapeutic outcome and provide conceptual insight into the mechanisms of change in art therapies. Knowledge on music-based emotional processing holds relevance also beyond therapy context for everyday music engagement.

成功的情绪处理是治疗改变的关键，而音乐可以支持情绪处理。然而，我们对基于音乐的情绪处理如何实际预测临床结果知之甚少。本研究调查了音乐治疗情绪处理 (MEP) 作为抑郁症治疗结果的预测因子。数据包括来自综合即兴音乐疗法 (IIMT) 临床试验 (12 次) 的 64 名客户 (年龄范围 19-57, 74% 女性) 的自我报告。制定了一份包含 19 项的 MEP 问卷，用于评估客户在会后的体验。紧急 MEP 因素与客户对会话治疗价值的看法（会话评估问卷 [SEQ]）和抑郁症的恢复（蒙哥马利-奥斯伯格抑郁量表 [MADRS]）相关。MEP 是由三个因素组成的：表达、意识和疼痛。表达和意识在整个过程中增加，并与会话价值和 MADRS 变化呈正相关。疼痛表现出更复杂的倒 U 形时间曲线，并与会话体验的粗糙度相关。治疗后期疼痛的存在预示着较低的恢复。这些发现支持 MEP 因素作为治疗结果的预测因子，并为艺术疗法的变化机制提供概念性见解。基于音乐的情绪处理知识也与日常音乐参与的治疗背景无关。疼痛表现出更复杂的倒 U 形时间曲线，并与会话体验的粗糙度相关。治疗后期疼痛的存在预示着较低的恢复。这些发现支持 MEP 因素作为治疗结果的预测因子，并为艺术疗法的变化机制提供概念性见解。基于音乐的情绪处理知识也与日常音乐参与的治疗背景无关。疼痛表现出更复杂的倒 U 形时间曲线，并与会话体验的粗糙度相关。治疗后期疼痛的存在预示着较低的恢复。这些发现支持 MEP 因素作为治疗结果的预测因子，并为艺术疗法的变化机制提供概念性见解。基于音乐的情绪处理知识也与日常音乐参与的治疗背景无关。