Scoping the Concept of Five-Element Based Music Therapy: Can Its Philosophical Framework Become the Music Intervention?

다국어 초록 (Multilingual Abstract)

Five-Element Music Therapy (FEMT) is a traditional Chinese music-based intervention linking five tones with five internal organs to regulate physiological and emotional functions. Despite expanding clinical use, FEMT research remains fragmented and methodologically inconsistent, and this scoping review aimed to map current empirical evidence. Following Arksey and O’Malley’s framework and PRISMA-ScR guidelines, we searched PubMed, Web of Science, Scopus, and CINAHL for studies implementing FEMT as a primary or adjunctive intervention, published up to March 2025. Twenty studies met inclusion criteria: 17 randomized controlled trials, two retrospective studies, and one mixed-methods study, all conducted in China. Interventions most commonly targeted depression, anxiety, and sleep quality, often in multimodal programs combining FEMT with acupuncture, herbal medicine, or qigong and typically using passive listening protocols. Overall findings suggest beneficial effects of FEMT, but design limitations, heterogeneous protocols, and limited theoretical and physiological validation highlight the need for theory-driven, standardized interventions and objective biological and functional outcomes.