Along with music-listening, social interaction was consistent between active and passive groups throughout the study. This interpersonal interaction may also have had an effect on mood and motivation, as piano instructors provided high levels of encouragement and complimented the participants' progress often. Relationship quality between patient and therapist is correlated with efficacy of therapy. This concept of increased socialization contributing to dexterity improvements is also supported by a study that identified social participation as a preventative factor of perceptual speed decline in older adults.