Music therapy is an effective intervention for working with traumatized children and adults. It helps reduce anxiety, offers emotional relief, and facilitates life-affirming social interactions, to name just a few of its benefits. The purpose of this article is to shed light on how music therapy addresses trauma for anyone interested in a music career that truly changes lives.

by Barbra Weidlein

Trauma settings

Music therapists have been called upon to support the recovery of individuals and communities following horrific events as well as natural disasters. Settings have included New York City metropolitan area after the 9/11 terrorist attacks; New Orleans after Hurricane Katrina; Umpqua Community College after a mass shooting on campus; various war- and post-war zones; and other disaster recovery situations.

According to the American Music Therapy Association, music therapy addresses trauma by providing:

• Non-verbal outlets for emotions associated with traumatic experiences

• Anxiety and stress reduction

• Positive changes in mood and emotional states

• Active and positive participant involvement in treatment

• Enhanced feelings of control, confidence, and empowerment

• Positive physiological changes, such as lower blood pressure, reduced heart rate, and relaxed muscle tension

“With individuals who have experienced trauma,” says Jim Borling, director of Radford University’s Music Therapy program, “music becomes an outlet for expressing emotion. Music therapy has a way of letting people know that it is ok to feel what you are feeling. It is ok to acknowledge what has happened.”

Borling brought his skills as a music therapist to Newtown, Connecticut where a 2012 shooting at Sandy Hook Elementary School took the lives of 20 children and six staff members, and to Virginia Tech (Virginia Polytechnic Institute and State University) after a campus shooting in 2007 killed 32 and injured many others.

Other uses of music therapy

Music therapy also serves those who’ve experienced trauma as a result of chronic pain, chemical addiction, child abuse, asylum-seeking, domestic violence, incarceration, and other sources of emotional distress.

• Janice Lindstrom, a visiting lecturer in Music Therapy at SMU Meadows School of the Arts, has utilized music therapy with abused children and with patients at Veterans Administration hospitals. She has also applied music therapy to her work with the International Rescue Committee (IRC) to support individuals around the world who are affected by war and natural disasters.

• Kimberly Sena Moore, clinical training director of Music Therapy at the Frost School of Music at University of Miami, is researching the impact of music therapy on the emotional self-regulation of children with a history of trauma. Emotional regulation refers to the ability to effectively manage and respond to emotional experiences.

• Ron Borczon, director of Music Therapy at California State University, Northridge, worked with the therapists of family members and survivors of the 1995 Oklahoma City bombing as well as with school-age children who experienced the 1994 earthquake in Northridge, California. He also helped in planning music therapy interventions after shootings at Columbine High School in Littleton, Colorado and Santee High School near San Diego, California.

• Yasmine Iliya, adjunct faculty at Saint Mary-of-the-Woods College, New York University and Molloy College, is working on a pilot program using music therapy with Syrian refugee children in Jordan.

• Maggie Connors, a music therapist in private practice in Vermont, has worked with children and adolescents with a history of domestic violence in the home and/or sexual abuse. She’s also worked at a children’s hospital, where she relates that “trauma was more often related to medical procedures or events that precipitated hospitalization.”

• Jessica Cole-Robinette uses music therapy with patients at Akron Children’s Hospital’s Palliative Care Program. She has also used music therapy with victims rescued from human trafficking; homeless veterans; and those dealing with medical trauma within the family.

Music therapy in the NICU

Joanne Loewy, director of New York City’s Mount Sinai Beth Israel’s Louis Armstrong Center for Music & Medicine, has found music therapy to be a vital intervention for premature infants in neonatal intensive care units (NICU).

She says that music therapy for premature infants “addresses the trauma of missing out on the ‘warmth and soundscape’ of the womb environment. Preemies are deprived of the ‘whoosh’ and warmth of the womb. Studies show this affects the development of premature newborns especially in the areas of sleep, feeding behavior, weight gain, and because of the trauma from any procedures they have to undergo.”

Loewy’s research shows that singing to infants in the NICU increases their alertness. She developed a rhythm technique in conjunction with the Remo drum company, using a small two-toned wooden “gato” box to mimic the heartbeat of the infants’ mothers.

She also worked with Remo to develop the Lullaby Ocean Disc to imitate the missing whooshing sounds of the womb. The Disc has been shown to slow and regulate the breathing of premature infants whose lungs are not yet fully developed. It has also been effective at reducing stress and facilitating sleep. Parents are taught how to use these techniques in order to feel more engaged with their premature infants and to be able to continue working with these interventions when their babies are ready to go home.

Loewy has also shown that music therapy is an effective intervention with children suffering from a number of problems including cancer, diabetes, asthma, eating disorders, suicidal tendencies, and emotional distress.

Techniques used

Songwriting and improvisation are two of the most common ways music therapy addresses trauma.

• Alejandra Ferrer, coordinator of Music Therapy at Belmont University School of Music, has worked in mental health facilities with victims of trauma and abuse. She says, “Music therapists who work with these populations may implement techniques such as songwriting and lyric analysis, music-based relaxation activities, and combined music and art interventions.”

•  Andrew Knight, assistant professor of Music Therapy at Colorado State University, says that music therapists incorporate “song lyrics, musical elements, and metaphors/analogies” that can help clients gain new insights to help them move through difficult problems. “Composition includes songwriting as a way to express oneself in a musical medium,” he says.

• Jim Borling finds that “Music therapy serves to help people connect with each other and experience support…When working with groups, sometimes large groups, music (often times drumming) provides a safe space for people to come together and be in close proximity with each other, but not need to verbally discuss or process traumatic events or experiences. Music, and rhythm in particular, can communicate safety, connectedness, community, and support all at the same time.”

• Cathy H. McKinney, coordinator of Music Therapy at the Hayes School of Music at Appalachian State University utilizes the Bonny Method of Guided Imagery and Music (see sidebar) to help clients recover from trauma. Through the Bonny Method, images are brought to mind to assist clients in working through trauma and related unresolved issues.

Training

Undergraduate music therapy programs do not focus on working with traumatized populations. Those drawn to this area of concentration gain some of the necessary training through their required supervised internship. Many enter graduate programs in music therapy for additional clinical skills and further training. Others seek a degree in a relevant area of counseling.

Jessica Cole-Robinette sees trauma as a fairly universal phenomenon. As a result, she says, “All music therapists working with any population need trauma-informed education, whether it be at the undergraduate level or for continuing education.”

Continuing education is an important part of the professional life of a music therapist. Training and support are available through workshops, seminars, and publications offered by the American Music Therapy Association. The World Federation of Music Therapy is another resource for continuing education.

Most music therapists who have worked in the area of trauma agree that training beyond the entry level is essential. According to Kimberly Senna More, “A professional board-certified music therapist with a bachelor’s degree should provide supportive, activity-oriented music therapy services, whereas a professional board-certified music therapist with a master’s degree has the advanced training to provide more insight-oriented music therapy services.”

She adds, “Trauma-informed training does not look like a one-time continuing education course. It should be integrated into every course in some way. It’s becoming more and more apparent as to how early trauma with or without attachment wounds impacts the psychological well-being of the populations that we serve. This ranges from geriatric to pediatric, from physical rehabilitation to hospice.”

Alejandra Ferrer at Belmont stresses the importance of gaining “significant clinical knowledge about the population itself. This will help in guiding the therapist as to what goals, techniques, and interventions may be most important/effective/beneficial. It is important to have a high level of sensitivity towards (traumatized) populations.”

By the same token, Maggie Connors reminds, “Your job is to support and guide clients or patients through their journey…Some music therapy settings focus on crisis stabilization where you may only see a person once or twice and other settings (may better) allow for long-term processing and learning.”

Beyond skills

Katurah Christenbury teaches at Appalachian State University and works as a music therapist at the school’s Institute for Health and Human Services. She asserts that those who want to work as music therapists to address traumatized populations need to “have a strong sense of self, and the ability to be able to empathize with another.”

Christenbury adds, “We must learn more about the cultures of our clients to better understand, serve, and sympathize/empathize with them before pursuing our own therapeutic agendas.” Music therapists need to be aware that trauma manifests for different people in different ways, she says, including anger, withdrawal, sexual acting out, and addictive behaviors. “Being open and accepting of each person’s journey, religious beliefs, views of humanity –– especially if they are different from one’s own” is essential. “Being patient; trusting the process of healing; and going at the client’s pace” – these are all important when working with traumatized clients.

Maggie Connors describes “compassion fatigue” as a legitimate concern for music therapists who work with people who have experienced trauma. “The idea that you can’t take care of someone unless you take care of yourself first is true,” she says. “Selflessness and empathy are characteristics that probably have contributed to your wanting to be a music therapist. It is not selfish to take a moment for yourself. It is not insensitive to not being thinking about your clients at every moment. Acknowledging when you need a break or need to talk with a co-worker or supervisor will make you a stronger and more effective music therapist.”

Music Therapy in the NICU:  The Columbian, Ariane Kunz

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