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Heliyon
Heliyon
Heliyon
2405-8440
Elsevier

S2405-8440(24)13779-6
10.1016/j.heliyon.2024.e37748
e37748
Case Report
Transforming anxiety into resilience: A case report on the implementation of “rapid counseling” with single-session music therapy to reduce thesis-related anxiety
Oentarto Aloysius Selo Aryobimo
Situmorang Dominikus David Biondi david.biondi@atmajaya.ac.id
⁎
Department of Guidance and Counseling, Faculty of Education and Language, Atma Jaya Catholic University of Indonesia, Indonesia
⁎ Corresponding author. Department of Guidance and Counseling, Atma Jaya Catholic University of Indonesia, Jl. Jenderal Sudirman 51, DKI Jakarta, 12930, Indonesia. david.biondi@atmajaya.ac.id
12 9 2024
30 9 2024
12 9 2024
10 18 e3774824 4 2024
28 7 2024
9 9 2024
© 2024 The Authors
2024
https://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Objective

Thesis writing is considered a difficult task for many Indonesian students, often accompanied by anxiety, stress, depression, and panic. Students who experience academic anxiety will experience maladaptive cognitive, affective, psychological, and behavioral conditions. Currently, mental health counselors/psychologists/psychiatrists/therapists face increasing demands for rapid solutions, reflecting the instant expectation of developing times. Therefore, this study aimed to provide “Rapid Counseling” with single-session music therapy (RC-SSMT) as an intervention service.

Method

A case report of a 20-year-old female student experiencing thesis-related anxiety was presented.

Results

The result showed the effectiveness of implementing RC-SSMT in reducing the scales of anxiety about thesis.

Significance of results

The application of RC-SSMT effectively reduced anxiety in young women, providing an alternative for mental health professionals working with client experiencing thesis-related anxiety.

Keywords

Rapid counseling
Single-session music therapy
Academic anxiety
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pmc1 Introduction

Thesis writing is considered a difficult task for many Indonesian students, often accompanied by anxiety, stress, depression, and panic [1]. As part of academic requirements, the thesis must be prepared, as mandated by the Director General of Higher Education No. 152/E/T/2012 [2]. Writing a thesis cannot be separated from anxiety, stress, depression, and panic. Atkinson [3] defined anxiety as an uncomfortable feeling at a certain moment, characterized by worry, feelings of fear, and uncertainty. Ottens [4] reported thesis-related anxiety as a symptom of academic anxiety. Therefore, it is very important to carry out intervention services that are preventive, and provide curative intervention services [1]. Students who experience academic anxiety will experience maladaptive cognitive, affective, psychological, and behavioral conditions [1].

Anxiety occurs in every crucial part of life, including thesis writing, which is considered the most challenging task by many students. Some universities have introduced project-based alternatives, enabling individual or group work. However, this method is not widespread, and most universities still require students to develop and present thesis results to examiners, leading to significant anxiety. High expectations from family, friends, and also the supervisor increase anxiety experienced by students. According to Santrock [5], it is common for individuals to experience anxiety when facing difficulties in the academic process, including thesis exams. Anxiety about facing a thesis exam is triggered by uncontrolled thoughts, feelings, and motor behavior, leading to cognitive tension, feelings of impending doom, and nervousness [6]. This fear of thesis exams leads to students having a scary mindset regarding the thesis.

Mental health professionals currently face clients who have the desire to solve problems quickly, a trend supported by increasingly developing times. Hasugian [7] divided humans into five categories, each with unique characteristics. The first is “the Greatest Generation” who were born during World War II, from 1901 to 1924. Second is “the Silent Generation” who were born from 1925 to 1942 and the third is “Baby Boomers” born from 1943 to 1960. Fourth and fifth are “Millennials” and “Digital Natives” often referred to as “Generation Z”, born in 1982–2002 and 1994 until now, respectively. In addition, according to Gaith [5], Digital Natives have several characteristics, such as preferences for online activities, easy and fast access to information, collaboration in networks, and searching for information randomly. This generation prioritizes visual information processing, interactive content, and instant gratification. Therefore, it is hoped that every existing problem can be resolved quickly and easily, including problems related to mental health. To address this desire, “Rapid Counseling” with single-session music therapy (RC-SSMT) is provided as an intervention service. RC-SSMT was tested for the effectiveness in reducing anxiety and applied to COVID-19 patients [8].

This study reports the effectiveness of implementing RC-SMMT on young women experiencing academic anxiety, particularly regarding thesis. RC-SSMT is provided as a new method that is suitable for individuals experiencing thesis-related anxiety. Given the time constraint of thesis completion, typically 6–7 months or one semester, prompt intervention is needed. Delayed anxiety management may impact thesis progress, completion, and trial schedule, potentially extending the lecture period. RC-SSMT's single-day counseling session addresses this need for swift intervention. One RC-SSMT method, “Soundtrack of My Life”, is particularly suitable for thesis anxiety. During counseling session, counselee select a song, modify the lyrics to reduce anxiety, and can replay it independently to manage anxiety and increase motivation. This study focused on academic anxiety, specifically thesis-related anxiety, aiming to induce instant changes in thinking and behavior patterns through a single counseling session.

2 Case report

A 20-year-old female student experienced thesis-related anxiety. To assess anxiety levels, a questionnaire instrument was administered, followed by interviews with individuals close to counselee to obtain secondary data. Observations were then made to determine the behavior of counselee at the time before implementing RC-SSMT. According to the student, anxiety is caused by a lack of support from external or internal factors, including parental pressure to graduate in a semester without providing support, as well as pressure from older siblings who graduated on time. Uncertainty about thesis title and confusion about how to proceed added to anxiety. Initially, the student gave a fairly high academic anxiety scale, which was represented by a score of 9 on the scaling questions given. During the implementation of the work phase, specifically when giving miracle questions, the student provided good answers and was quite able to participate well in implementing the strategy, namely “invite them to sing a song that they love” and “invite them to create new lyrics using the song that they love” [8]. The student has an interest in music that has the pop soul and jazz-pop genres. With the genre interest, the counselor needs to select songs that are suitable to be used as the soundtrack to assist in overcoming anxiety. In the closing stages, the student was able to develop new lyrics from songs, which became the “Soundtrack of My Life”. At the end session, the student admitted that anxiety experienced regarding the thesis had decreased to 6. Furthermore, after 2 months of implementing RC-SSMT, the level of anxiety problems regarding the thesis remained at a score of 6 (see Fig. 1).

In this study, informed consent was provided as an agreement from the student to publish the problems experienced without mentioning identity. In addition, an analysis was carried out using a quasi-experiment with a single-subject design to determine the tendency of a long-lasting new behavior. The analysis result of the design used on the counselee who accepted RC-SSMT is shown in Fig. 2, Fig. 3, Fig. 4.Fig. 1 Level of academic anxiety.

Fig. 1

Fig. 2 Academic anxiety graph subject.

Fig. 2

Fig. 3 Graph of estimated tendency direction subject.

Fig. 3

Fig. 4 Tendency of subject mean stability.

Fig. 4

3 Discussion

A difference in effectiveness was observed in reducing negative feelings compared to the previous case. In the case of clients who experience anxiety about death due to COVID-19, the scale decreased from 10 to 5 as measured by scaling questions [8]. Similarly, a study conducted by Situmorang [9] showed that RC-SSMT reduced academic procrastination. In this case, thesis-related anxiety reduced from an initial score of 8 to 6 after the session. Anxiety felt by the counselee started in the 1st month of writing, commencing from concern about enough references. Over the next 2 months, anxiety intensified, leading to avoidance of thesis. By the 4th month, RC-SSMT was administered, and after counseling, a decrease in thesis anxiety was reported. Two months later, the counselee showed increased courage in compiling the thesis, thereby leading to the completion. Each person with a different problem background will feel a different impact from the implementation of RC-SSMT. Frankl [10] stated that every life situation or event has meaning which must be found through an existential search and discovery. According to Piaget [11], problem-solving includes a goal and obstacles, requiring considerable effort. After 2 months of RC-SSMT intervention, the counselee reported feeling calmer and more motivated while working, showing enthusiasm and a strong desire to complete the thesis.

In the initial stages of implementing RC-SSMT, the counselor played sedative music to ensure a comfortable atmosphere during the counseling session. A previous study showed that music was a positive integrative tool for reducing patient anxiety and pain [11]. Soft music such as classical, jazz, and pop music can lighten the workload of the nervous system and body organs [12]. This was followed by implementing “playing sedative music during the rapid tele-psychotherapy session”, after which the counselee was asked to rate anxiety feeling regarding thesis as a pre-test, giving a score of 9. At the closing stage, the counselor asked the counselee to hope for a reduced score, and the counselee desired a score.

At the transition stage, the counselee explained RC-SSMT procedures and asked to set session goals. According to Suhesti [13], counseling help students develop their potential and master values. The goals set were to reduce anxiety about working on a thesis, start working on it, and increase motivation. At the work stage, miracle questions were used to help gain a new perspective [14]. The counselee aimed to manage time effectively, which is the act or process of planning and implementing conscious monitoring of the amount of time used for specific activities, specifically to increase effectiveness, efficiency, productivity [15], and spiritual activities. Music preferences were discussed, and the study conducted by Soliha [16] showed that music can reduce anxiety, given 15 minutes every day, for 2 weeks. The counselee often listened to “fall in love alone” and was asked to sing and create new lyrics with positive and motivating content, such as “If we never try, how will we know? Baby how far this thing could go, give me a fight, if I'm on your mind, I don't want to be long.” Afterward, the counselee felt more enthusiastic and calmer. Music can also help in increasing energetic feelings, confidence, reduce sadness, eliminate anger, release stress, and reduce anxiety [17]. In this section, the counselee developed a “Soundtrack of My Life” that can be interpreted and used in life when anxiety reappears. The study conducted by Situmorang [18] showed that the use of music therapy can significantly reduce academic anxiety in college students. The results showed that the soundtrack of my life had a very important influence. After 3 weeks of counseling, the counselee experienced feelings of anxiety about the thesis again, leading to repeatedly playing “Soundtrack of My Life”. The counselee admitted experiencing a feeling of calm and also subconsciously had more motivation to work and complete the thesis. This result is consistent with the report of Soliha [16] that music can reduce anxiety, given 15 minutes every day, for 2 weeks.

Finally, at the closing stage, insights gained during the RC-SSMT process were solicited. Relief from the process was expressed, along with acknowledgment of the ability to construct own solutions. Motivation and support were provided to enhance confidence and independence in problem-solving. The “Soundtrack of My Life” created earlier was recommended as encouragement when facing future problems. Murphey [19] reported that songs could evoke memories and emotions through lyrics or music. A scaling question was administered as a post-test to assess changes in negative feelings, aiming to make vague problems concrete [20]. A decrease in thesis-related anxiety was reported, scoring 6, which is expected to decrease further.

4 Conclusion

In conclusion, the application of RC-SSMT to women who experience thesis-related anxiety was effective in reducing negative feelings. This method was proven to empower individuals to struggle independently in solving problems. This study contributed to the science of counseling and psychology by introducing a new method applicable to various kinds of psychological problems, with instant services. In addition, an overview and awareness were provided that the problems experienced by humans will continue to develop. Therefore, RC-SSMT was offered as a novel method, and a new figure was provided regarding counseling services combined with music that was not boring. This was helpful in the counseling process, because the presence of music provided a more calming atmosphere for the counselee, and indirectly the counselee was more open.

5 Suggestions

The counselee was expected to grow into a more independent person after the session while continuing to carry out the commitments made previously. Furthermore, the “Soundtrack of My Life” developed during the session was suggested as a lifelong reminder that through this counseling session, personal growth and development into a greater person than before was possible. The soundtrack was intended to serve as a lasting tool for motivation and encouragement, helping the counselee to overcome future challenges and continue on a path of self-improvement.

6 Theoretical implications

This study showed the effectiveness of RC-SSMT in reducing thesis-related anxiety and also provided a foundation for future investigation. The application of RC-SSMT enables individuals to be calmer, reduce anxiety, and be motivated in working on thesis. A calm and focused mindset facilitates a deeper understanding of complex topics, including thesis work.

7 Practical implications

The results of this study provide a valuable reference for mental health counselors/psychologists/psychiatrists/therapists attempting to implement new methods for existing anxiety, specifically thesis-related. To effectively reduce anxiety, it is important to consider the unique factors influencing the experience of each individual. Furthermore, the RC-SSMT method provides a viable solution and can be implemented in a single session, allowing for quick problem resolution. The incorporation of music therapy also provided a comfortable counseling environment, while the “Soundtrack of My Life” enabled counselee to develop independent problem-solving skills.

8 Direction of future study

RC-SSMT intervention will continue to experience development and refinement over time. To further understand the effectiveness and efficiency, future studies should explore applying the theory to other mental health problems that are also increasingly developing.

9 Limitation of study

The limitation of this study is the focus placed on only music when “Rapid Counseling” can be modified with other arts, such as humor, drawing, writing, and others. A more comprehensive study examining the combination of RC-SSMT with values art forms could produce valuable insights.

Ethical statement

This study was reviewed by the Ethics Committee of the Guidance and Counseling Department of the Atma Jaya Catholic University of Indonesia. The committee ensured that this study adhered to the ethical standards of the Psychology/Guidance & Counseling discipline, Atma Jaya Catholic University of Indonesia Ethics Code.

Patient consent

Informed consent was obtained from the counselee.

Data availability

The data that support the findings of this study are available from the corresponding author, upon reasonable request.

CRediT authorship contribution statement

Aloysius Selo Aryobimo Oentarto: Writing – review & editing, Writing – original draft, Visualization, Validation, Software, Resources, Project administration, Methodology, Investigation, Funding acquisition, Formal analysis, Data curation, Conceptualization. Dominikus David Biondi Situmorang: Writing – review & editing, Validation, Supervision, Formal analysis, Conceptualization.

Declaration of competing interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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