Article Text

Download PDFPDF

Group singing in bereavement: effects on mental health, self-efficacy, self-esteem and well-being
  1. Daisy Fancourt1,
  2. Saoirse Finn2,
  3. Katey Warran2 and
  4. Theresa Wiseman3
  1. 1 Department of Behavioural Science and Health, University College London, London, UK
  2. 2 Centre for Performance Science, Royal College of Music, London, UK
  3. 3 Applied Health Research, The Royal Marsden NHS Foundation Trust, London, UK
  1. Correspondence to Dr Daisy Fancourt, Department of Behavioural Science and Health, University College London, London WC1E 7HB, UK; d.fancourt{at}


Objectives Bereavement is associated with negative affective, cognitive, behavioural and physiological responses. However, factors, such as coping, self-efficacy and self-esteem, can buffer negative effects of grief, and can be increased through mutual support interventions, such as shared leisure activities. This study used a non-randomised controlled design to explore the effects of group choir singing on mental health among people who have been bereaved due to cancer.

Methods A total of 58 adults bereaved in the last 5 years who had not started psychological therapy in the last 12 weeks or medication for anxiety or depression in the last month were recruited and elected to join a choir (n=29) or participate in the non-intervention control group (n=29). Joining a choir involved engaging in 90 min weekly singing and social sessions for 12 weeks with a post-intervention assessment at week 24. We used linear mixed effects models adjusted for demographics, health-related variables, musical engagement and time since bereavement to model changes over time between the two groups in symptoms of anxiety, depression, well-being, self-efficacy and self-esteem.

Results Participants who sang in a choir had more stable symptoms of depression and levels of well-being, as well as gradual improvements in their sense of self-efficacy and self-esteem over the 24 weeks. In contrast, those in the control group showed gradual increases in depressive symptoms, reductions in levels of well-being and self-esteem and no improvement in their self-efficacy. These results were independent of all covariates.

Conclusions Weekly group singing could be a promising mutual support intervention for people experiencing grief.

Trial registration number NCT02756780.

  • bereavement
  • psychological care
  • depression

Data availability statement

Data are available on reasonable request.

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See:

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Data availability statement

Data are available on reasonable request.

View Full Text


  • Contributors DF and TW conceived and designed the study. SF and KW collected all the data. DF carried out the data analysis. All the authors worked on the interpretation of the data. DF drafted the paper and all the authors critically revised it and approved the final version.

  • Funding This research was funded by Tenovus Cancer Care (SWU2016-01). DF is funded by the Wellcome Trust (205407/Z/16/Z). TW is funded by the Royal Marsden Cancer Charity.

  • Competing interests The funding for this study was provided by the Tenovus Cancer Care, the charity that runs the choirs used as the intervention in this study. However, no member of the staff from Tenovus Cancer Care was involved in the specifics of the study design or in the collection, analysis or interpretation of data, the writing of the report or the decision to submit the paper for publication.

  • Provenance and peer review Not commissioned; externally peer reviewed.