# Efficacy of transformational breath for anxiety management in professional voice users

## TL;DR

This study explores whether a breathing technique called Transformational Breath helps reduce anxiety in professional voice users.

## Contribution

The study is the first to evaluate Transformational Breath as a potential intervention for music performance anxiety in professional voice users.

## Key findings

- TBr showed a significant reduction in music performance anxiety over time.
- No significant changes were observed in general anxiety levels or physiological measures.
- Results suggest TBr may acutely decrease music performance anxiety but not broader anxiety symptoms.

## Abstract

Music Performance Anxiety, a subset of social anxiety disorder (SAD), can significantly impede the lives of professional voice users (PVUs). This pilot cohort study evaluates the efficacy of Transformational Breath (TBr), a facilitated conscious breathing technique that employs high ventilation breathing, as a therapeutic intervention for anxiety management in PVUs. We recruited PVUs diagnosed with mild to moderate SAD and randomly assigned them to an intervention group (n = 12) that completed three TBr sessions with a certified practitioner, or to a waitlist control group (n = 12). Both groups were assessed using a battery of psychological (Generalised Anxiety Disorder Scale (GAD-7), Patient Health Questionnaire (PHQ-9), Social Phobia Index (SPIN), Kenny’s Music Performance Anxiety Inventory (K-MPAI), Warwick-Edinburgh Mental Well-Being Scale (WEMWBS)) and physiological (blood pressure, heart rate, respiratory rate, oxygen saturations, peak expiratory flow rate) measures on three separate occasions. The outcome measures were evaluated before and after each session in the intervention group. No Group x Time interaction was found for any of the physiological or psychological measures. However, a significant Time main effect was found for K-MPAI (X2(5)=20.157, p = .001) and GAD-7 (X2(5)=12.79, p = .025) within the TBr group. Post hoc Wilcoxon-signed rank tests with Bonferroni correction for multiple comparisons revealed significant differences between K-MPAI scores at time points Post 3 and Pre 3 (z = 3.00, adj. p = .040), Post 3 and Pre 2 (z = 3.27, adj. p = .016) and Post 3 and Pre 1 (z = 2.95, adj. p = .048). No pairwise differences were found for GAD-7. The pattern of results suggests that TBr may be effective in acutely decreasing music performance anxiety.