Creating a brave and empowering space for equality with – race, gender, sexuality, age, economic status, cognitive, physical, spiritual needs and those living with mental illness – through trauma informed care: music therapy, art therapy, dance/movement therapy and psychotherapy, to improve health and well-being.
Supporting Research
art therapy
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VR (Virtual Reality) provides an escape from the real world by activating visual, auditory and motor processes. It creates a space to “practice” psychological and behavioral concerns and prepare for adaptive responses in the real world. It can also help patients with sensory, cognitive and motor related disabilities who are unable to use traditional art media in therapeutic ways or who need alterative options for self- expression. Kaimal, G., Carroll-Haskins, K., Berberian, M., Dougherty, A., Carlton, N., & Ramakrishnan, A. (2019). Virtual reality in art therapy: A pilot qualitative study of the novel medium and implications for Practice. Art Therapy, 37(1), 16–24.
This article outlines a 10-week treatment plan of compassion-focused art therapy for individuals with cluster B/C personality disorders. Compassion focused art therapy combines aspects of CBT, mindfulness, and the biological theory of evolution. Haeyen & Heijman, Compassion Focused Art Therapy for people diagnosed with a cluster B/C personality disorder: An intervention mapping study, The Arts in Psychotherapy, Volume 69, 2020, 101663, ISSN 0197-4556
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In this study, researchers compared mood modulation between three, randomized groups of adults ages 18 to 46 (N=70). They found that groups using drawing and coloring as a means of distraction demonstrated improved mood more so than the group drawing as a means of expression. However, all three groups showed improved mood. Forkosh, J., & Drake, J. E. (2017). Coloring versus drawing: Effects of cognitive demand on mood repair, flow and enjoyment. Art Therapy: Journal of the American Art Therapy Association, 34(2), 75-82.
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Music therapy
This article describes music therapy services provided to a six-year-old child who had been physically and sexually abused. Its focus is on an intervention implemented over the course of approximately six months wherein the music therapist facilitated interventions to promote emotional healing from trauma, anger in particular. These interventions combined song-writing and visual art to facilitate emotional expression, specifically the use of therapist-composed songs in response to the child’s drawings. After eight weeks and five sessions, the client chose to draw and discuss the feeling of anger while using this intervention. Christenbury, K. R. (2017). I will follow you: The combined use of songwriting and art to promote healing in a child who has been traumatized. Music Therapy Perspectives, 35(1), 1-12.
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This article discusses the use of a structured creative arts group program that individuals followed for 4 weeks. This program included groups of receptive music therapy (GIM), body awareness, art therapy, occupational therapy and verbal group therapy. Individuals who were patients in this study had a variety of diagnoses including anamnestic trauma, substance abuse, eating disorders, suicidal ideation and attempts, intrusive trauma, separation trauma and mood disorders. Korlin D., Nyback, H., Goldberg, F. S. (2000). Creative arts groups in psychiatric care: Development and evaluation of a therapeutic alternative. Nord Journal of Psychiatry, 54(5), 333-340.
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“The use of performance in music therapy is not without controversy primarily because therapy is considered a process, not a product, and confidentiality and privacy are essential components of therapy...We discuss the potential of music performances to contribute to individual developments, reinforce rehabilitation, enhance function, and facilitate change at the community level to support reintegration of military service members.” Vaudreuil R., Bronson, H., & Bradt, J. (2019). Bridging the clinic to community: Music performance as social transformation for military service members. Frontiers in Psychology, 10(119), 1-6.
oncology
This article assess music therapists` perceptions on the uses of singing and vocal interventions within palliative and oncology settings. It explores commonly used music therapy approaches within these settings as well as the goals that these sites are often trying to achieve. Journal of Music Therapy, Volume 54, Issue 3, Fall 2017, Pages 336–361
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addiction
The purpose of this study was to measure the effects of a single group songwriting session on motivation and readiness for treatment. Inpatients in a detoxification unit were invited to a single songwriting intervention during their stay in the detox unit. The songwriting session involved a Board-Certified music therapist (MT-BC) leading participants in composing a group song. The beginning of the session included the MT leading participants through a 12-bar blues progression where they stated their names and their current mood. They were then led through composing two verses that focused on “change to help them ‘‘get out and stay out of’ inpatient treatment.” The study showed that individuals who participated in the intervention had a higher mean motivation and readiness for treatment scores than control participants. This demonstrates that the use of songwriting in music therapy is effective for adults living with addiction. Silverman, M. J. (2012). Effects of group songwriting on motivation and readiness for treatment on patients in detoxification: A randomized wait-list effectiveness study. Journal of Music Therapy, 49(4), 414-429. doi:10.1093/jmt/49.4.414
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Benefits of art therapy and substance use Include; Bypassing defenses, promoting emotional expression, encouraging a spiritual recovery and fostering creativity. This article describes a protocol created for art therapy designed for the initial stages of substance abuse treatment. The First Step Series (FSS) target denial for the eventual acceptance of lifestyle changes necessary for recovery. Holt, E., & Kaiser, D. H. (2009). The first step series: Art therapy for early substance abuse treatment. The Arts in Psychotherapy, 36(4), 245-250.
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Parent/Child Interaction
8 children diagnosed with Autism aged 2-5 and their parents engaged in virtual coaching and music therapy sessions over the course of 6 sessions. This study was completed in Mexico and researcher was also of the same heritage despite living in the U.S. Goal was to see if virtual coaching and sessions made an impact on parents and their children focusing on both teaching parents how to better engage with their children, is virtual coaching a viable method, and if this improved their child’s social engagement. Sessions were recorded for data to be analyzed and there was a follow up parent interview. Study was not statistically significant for child’s behavior categories but overall there was improvement in receptive joint attention, initiation of joint attention, and verbalizations/vocalizations. During follow up interviews, parents noted that they saw the benefits and had a greater understanding of the child’s needs and skills. They also noted that virtual was a useful tool even if it does have drawbacks. Eugenia Hernandez-Ruiz, PHD, MT-BC, Virtual Parent Coaching of Music Interventions for Young Autistic Children in Mexico, Music Therapy Perspectives, 2023;, miac030
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Speech/Language
This article discusses the use of music therapy in the treatment of speech and language impairments, such as aphasia and dysarthria. The brain is always reorganizing, especially after an injury. Certain qualities of music, such as emotional connection and strong beat, enhance dopamine production, synchronize neural firing, and engage the entire brain. Interventions can be developed to target and strengthen activity in the remaining brain regions that contribute to speech production so as to assist in the rehabilitation of speech. Stegemoller, E. (2017). The neuroscience of speech and language. Music Therapy Perspectives, 35(2), 107-112.
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This study investigated combining aspects of singing with speech therapy such as prosodic elements for learning speech and rehab, melody for recall, rhythm for language learning, and practicing songs for repetition. Findings reported fewer sessions required when song cues were used to achieve several goals when speech cues were used. Ping Tan, E. Y., & Shoemark, H. (2017). The feasibility of using song to cue expressive language in children with specific language impairment. Music Therapy Perspectives, 35(1), 63–70.
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Autism
Impact on trauma on individuals with anxiety and depressive disorders has been studied extensively, experience on trauma in individuals with DD/ASK is lacking. This specific population has 3 times the risk of trauma exposure than neurotypical children due to factors such as inability to communicate/report. The article noted that stress in ASD population has a greater impact due to how their neuroendocrine system responds during times of stress or threat with higher level of cortisol than those without ASD. Individuals “may perseverate on thoughts and feelings related to an event, putting them at risk of re-experiencing their past trauma over and over. The article mentions the Trauma Symptom Investigations Form. It was found that those with ASD measured new behaviors after experiencing trauma such as aggression, self-injury, and agitation. Several elements of Trauma-Focused Cognitive Behavior Therapy were discussed as well as ways to adapt components for clients w/ASD. Currently, evaluations for PTSD in autistic youth are lacking. Some elements discussed were Imagery Rehearsal Therapy to treat chronic nightmares. Instead of recording dreams in writing, each scene of dream was drawn as a picture with therapist and client collaborating to make positive changes in the dream. General modifications such as extensive use of visuals, increased structure, motivating metaphors related to preferred interests, social stories, and the use of communication devices were encouraged to add to success of treatment. Incorporating the most up-to-date evidence-based practices was stressed. These included use of visual support and schedules, use of rote memory for learning information, social stories, social modeling, and using scaffolding to learn coping strategies. In the middle of this article, there was a good visual breakdown of adaptations to use for categories of communication, social strategies, restricted and repetitive behaviors, restrictive interests, routine and rules, sensory sensitivities, and safety. Trauma exposure screening was also briefly mentioned. Peterson, Jessica L. Earl, Rachel K., Fox, Emily A., Ma, Ruquian, Haidar, Ghina, Pepper, Micah, Berliner, Luch, Wallace, Arianne S., Bernier, Raphael A. (2019) Trauma and Autism Spectrum Disorder: Review, Proposed Treatment Adaptations and Future Directions (Journal of Child and Adolescent Trauma. Journal of Child &Adolescent Trauma (529-547).
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Children with Autism Spectrum Disorder might experience social skill difficulties such as the inability to understand and use nonverbal behaviors, to interpret other people's thoughts and emotions, and to develop age-appropriate peer relationships. Read the full article to discover art therapy's effect in one research study focusing on children 10-12 years old with an Autism Spectrum Disorder diagnosis. D'Amico, M., & Lalonde, C. (2017). The effectiveness of art therapy for teaching social skills to children with autism spectrum disorder. Journal of the American Art Therapy Association, 34(4), 176-182.
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Music is a powerful tool and can help individuals regulate emotions, overcome difficult situations, and find joy in their everyday life. This research study explores a system for teaching empathy (the ability to recognize emotions in others) and systemizing (the ability to predict what will happen and learn how things work). Greenberg, D., Rentfrow, P., Baron-Cohen, S. (2010) Can music increase empathy? Interpreting musical experience through the empathizing–systemizing (E-S) theory: Implications for autism. Empirical Musicology Review, 10(1-2), 80-95.
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This article discussed a feasibility study and the findings that using music to teach parents the behavioral strategies of the Denver Model is culturally and developmentally acceptable and that it supports joyful and effective interactions between parents and their children. Concepts included letting the child step into the spotlight, making activities more engaging, teaching of gestures, making every day activities a joint activity, and transitions. Hernandez-Ruiz, E. (2018) Music therapy and early start denver model to teach social communication strategies to parents of preschoolers with ASK: A feasibility study. Music Therapy Perspectives, 36(1), 26–39.
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Cerebral Palsy
This article was a systematic review and meta-analysis of clinical studies on the topic of music therapy combined with physical therapy for people with cerebral palsy. The meta-analysis was conducted to provide results from before intervention to after. The results indicated that combined PT and MT sessions for CP improved stride length, velocity, symmetry, cadence, step length, knee extension power, balance, upper limb position, and locomotor stages. Treatment did not improve walking speed. Overall, in the literature considered, MT and PT for CP treatment has been viewed positively and it can be concluded that MT and PT does have a positive effect on motor function in people with CP. There is not much research on this topic and the researchers believe this is an area of need for research. Vinolo-Gil, M. J., Casado-Fernández, E., Perez-Cabezas, V., Gonzalez-Medina, G., Martin-Vega, F. J., & Martín-Valero, R. (2021). Effects of the Combination of Music Therapy and Physiotherapy in the Improvement of Motor Function in Cerebral Palsy: A Challenge for Research. Children (Basel), 8(10), 868.
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Mental health
The purpose of this study was to gain an understanding of adolescents’ experiences of MT during inpatient crisis stabilization, explored from the adolescents’ perspective, in order to further the understanding of how MT supports the recovery process. The majority of research in mental health care with adolescents has focused on long-term care, addressing goals of: emotion regulation, emotional expression, motivation for treatment, sense of empowerment, positive social connections, and identity development. Overall, studies suggest that MT interventions positively impact symptoms associated with mental health diagnoses, while also improving self-esteem, coping resources, and connection to others. This study focused on inpatient crisis stabilization instead of long-term, with the following research questions: 1) In what ways do adolescents describe their experiences of MT sessions during short-term crisis stabilization? 2) What themes regarding treatment benefit emerge, if any, and how do these themes relate to the inpatient milieu? Rosado, A. (2019). Adolescents’ experiences of music therapy in an inpatient crisis stabilization unit. Music Therapy Perspectives, 37(2), 133-140.
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LGBTQIA+
This article discussed the importance of trauma-informed care for LGBTQ+ clients. It translated the use SAMHSA’s six guiding principles of trauma-informed care into practice. The six guiding principles that SAMHSA offers are: safety; trust and transparency; peer support; collaboration; empowerment; and awareness of cultural, historical, and gender-based trauma. The article provides specific examples for how each of these principles can be applied in a clinical setting. Levenson, J. S., Craig, S. L., & Austin, A. (2023). Trauma-informed and affirmative mental health practices with LGBTQ+ clients. Psychological Services, 20(Suppl 1), 134–144.