Music therapy helps reduce depression among children and adolescents, according to a new study from Queen’s University Belfast, North Ireland.

The study, which was the largest ever of its kind, found that music therapy lowers the rate of depression among children and adolescents with behavioral and emotional problems. The researchers, working in partnership with the Northern Ireland Music Therapy Trust, discovered that children who underwent music therapy had significant improvements in self-esteem along with reduced depression in comparison with those who received treatment without music therapy.

Additionally, the study discovered that those who received music therapy had improved interactive and communicative skills when compared to those who only received traditional care options.

A total of 251 children and adolescents were involved in the study, which occurred between March 2011 and May 2014. Participants were divided into two groups, with 128 undergoing the usual care options while 123 received music therapy in addition to the typical care. All participants received treatment for emotional, developmental, or behavioral problems. Early findings indicate that the benefits are continued in the long term.

Professor Sam Porter of the School of Nursing and Midwifery at Queen’s University, who led the study, said in a statement, “This study is hugely significant in terms of determining effective treatments for children and young people with behavioral problems and mental health needs.”

According to the National Institute of Mental Health, depression in children and adolescents may cause the individual to pretend to be sick, cling to a parent, refuse to go to school, or be worried that the parent might die. In older children, the disorder may involve sulking, getting into trouble at school, feeling misunderstood, or being negative or grouchy.