Music Therapy’s Impact on the Mental Health of Refugees Diagnosed with PTSD

Music gives a soul to a universe, wings to the mind, flight to the imagination, and life to everything. This quote was written by Plato and it reminds myself why music is so important in the world, especially to those who suffer from various diagnoses. Music Therapy is a therapeutic method that incorporates music as a device to help improve both mental and behavioral problems that numerous people are suffering from. I have decided to focus on refugees who suffer from Post-Traumatic Stress Disorder or PTSD. Many refugees have traumatic experiences associated with war, poverty, political unrest, etc. In this thesis, I will prove that music therapy has a positive impact on the mental health of refugees who are diagnosed with Post-Traumatic Stress Disorder. Before I discuss experiments that have been performed recently, there has already been previous evidence showing that music therapy was a legitimate trauma treatment. The nervous system plays a role in the idea of music therapy as neurological studies have provided evidence that music listening plays an integral role on numerous areas of the brain. Music therapists believe that with a use of music therapy on a regular basis, patients with diagnosed trauma disorders can eventually improve the ways they deal with their traumatic experiences. This includes the patient learning to contain their experiences and emotions, regulating the arousal they get when they think of their traumatic experiences, and being able to incorporate these traumatic experiences as a memory among many that are part of their individual story. There have been several experiments completed to prove that music therapy does generally improve the mental conditions of those refugees who suffer from PTSD. This is the case for both refugee adults and refugee children who have suffered through traumatic events.

The first study that I will discuss was carried for eighteen months between the years 2014 and 2015 in The Trauma Clinic for Refugees in the Region Zealand of Denmark. Eligible participants in this study were refugees who had been diagnosed with PTSD by a medical doctor or some other anxiety, somatoform, or personality disorder. Even those with severe cases of PTSD were permitted as long the participant did not require hospitalization. The method used in this study was the use of Guided Imagery and Music (GIM). According to the Music and Imagery Association of Australia, Guided Imagery and Music is a psychodynamic therapy that integrates music listening in a relaxed state to stimulate memories, imagery, and feelings to help the client understand life issues from a holistic perspective. The participants of this study received one-hour sessions sixteen times throughout the study timeline. The primary treatment used for these participants was a modification of the Bonny Method of Guided Imagery and Music. During these sessions, the music therapists would direct the conversation to a deeper thought before the music is chosen. Then, the therapist would play the music while continuing the deep conversation about inner emotions and the traumatized experience. To conclude, the therapist guides the patient out of the deep dialogue and then process the entire experience. These sessions were adapted and updated to suffice the needs of the patients at hand. This included providing multiple music choices, changing the length of the music listening periods, changing the volume of the music itself, or providing music that participants could use at home between these weekly sessions. All these as well as other adaptions were done for the needs of the refugees' sense of stability, safety, and control. This allowed the participants to associate listening to music with a sense of safety, stability, and control even when discussing their traumatic experience. The outcomes of these sessions were measure by was a scale called the Harvard Trauma Questionnaire which had three subscales titled avoidance, hypervigilance and intrusion. Also, after each session the participants scored their satisfaction of each session on a seven-point scale and answered what the most helpful thing was in that session. After analyzing the data, many correlations were observed between changes in trauma symptoms and sleep quality, age, sex, mentalization levels, session helpfulness and the weeks in treatment. Sleep quality was measure three times over the course of the entire study. Generally, sleep quality improved gradually yet most efficiently during the first stage of the study. According to the study, the participants rated their sleep 78% better from before the music therapy to after the music therapy treatment. This is a statement that better clarifies why music therapy positively impacts the mental health of refugees diagnosed with PTSD. Sleep quality is a vital part of mental health and is essential to many daily functions of the brain. A lack of sleep causes changes in mood, potentially more stress, fatigue, etc. Overall in the study, it was shown that the dark emotions and traumatic experiences were subdued by the music therapy as it allowed the participants to cope with all the horrible events in their pasts. Some counterarguments made against the evidence of this study include that it was not a large enough sample size, music choice, translation needed, and possible bias. However, the music choice was adapted to the liking of the participants as many switched the music from western music to music from their homeland. This allowed the participants to truly feel the music during their sessions as it allowed them to connect on a deeper emotional level than music they may not find interesting. Twelve out of the sixteen refugees that participated in this study did not speak the same language, so translators were needed for these participants. The same translator was used for all these individuals and was taught by the music therapists in how to go about presenting the information the therapists were expressing. This smooth connection between the therapists, translator, and participants allowed the participants to fully comprehend the complete experience of a session of Guided Imagery and Music. In this study there was potential bias from the music therapists to persuade the participants to grade highly of the music therapy sessions. However, some participants wrote down that the sessions were not helpful or did nothing to better them. This shows that this study had no bias involved and the results obtained are true and factual. Thus, all the counterarguments against this study do not have evidence to prove that this study is inaccurate or not a well-designed experiment. The authors of this experiment believe that since the results from this study were positive that a certain version of Guided Imagery and Music can be very impactful for those refugees who suffer from Post-Traumatic Stress Disorder. The only thing the researchers believe would better support the evidence they obtained in this study is if they had a larger sample size to study. Even though there were not many participants, the evidence shows that music therapy is a legitimate theoretic method for refugees across the globe that suffer from PTSD.

The second study I will discuss is about the evaluation of a school-based creative arts therapy Program for adolescents from refugee backgrounds. Many children are forced to move from their homes due to war, political unrest, poverty, etc. Many of these children experience traumatic events throughout their past and are more prone to be diagnosed with Post-Traumatic Stress Disorder than adults. According to the Refugee Health Technical Assistance Center, adolescents and children who are refugees have PTSD rates of 50-90 percent in different areas while adults who are refugees have PTSD rate of 10-40 percent in those same areas. This shows that even more children are impacted by traumatic events and are diagnosed with Post-Traumatic Stress Disorder. Also, for someone to suffer through a traumatic experience at such a young age can have a huge impact on how they deal with their stress for the rest of their life. Therefore, some schools have created art therapy programs for those children who suffer from ranges of trauma based on the experiences they have had. These programs are essential as many students who do not speak the language of the country don't seek help if they are going through dark times in their lives. This arts therapy allows the refugee children to have a better approach to cope with all the emotions inside after experiencing possible horrific events. The study I will be discussing took place at Milpera State High School located in Brisbane, Australia. This high school is a highly intensive English language school and a large proportion of the school are students who are refugees from locations such as the Middle East, East Asia, and Africa. The title of the creative arts program at this school was HEAL, which stands for the Home of Expressive Arts in Learning, and it helps the students deal with emotional, behavioral, and social issues they are dealing with. This program also connects the school with welfare and community organizations to provide the best practice towards the students of the school. In this study there were forty-two students that participated, and the average age of these participants was approximately fifteen years and five months. These participants engaged in the HEAL program over the course of ten weeks. Three scales were used to measure mental health including a scale for depression, anxiety, and somatic symptoms. According to the study, some of the music therapy activities used during session included lyric analysis, song-writing, song-parody, instrumental/vocal improvisation (with percussive instruments, drums, keyboards, guitar and vocal sounds), rapping and musical games, learning how to play guitar or keyboard, listening to musical favorites, sharing songs from original culture or religious background, dancing, performance during exit parades and school events. The students of the HEAL program experienced a minimum of one hour of a session each week of the program timeline. Based on the results of the entire HEAL program timeline, the arts therapy created at this school has been proven to positively impact young children who come from refugee backgrounds especially on their emotional and behavioral obstacles. According to the study, one student who went through the entire HEAL program stated, I like HEAL, if I have any feelings they can help me solve my problems. Another student within the program said, I think HEAL helps me to like my new life and to make me remember good things in my mind. I believe that after hearing these two personal responses from students who went through the entire HEAL program, you can tell that these two students were extremely impacted by the therapy they were offered. They felt more comfortable about their emotions after the program and they felt as though they were in a more positive state of mind then compared to before the program. For this study, there were some counterarguments against the evidence obtained including that the sample size wasn't larger enough or that the sessions were not the exact same every time for every person. However, even though the sample size wasn't huge many individuals who participated were still affected in a positive way by the HEAL program. This shows that music therapy is a legitimate therapeutic method that can positively impact the mental health of refugees who suffer from Post-Traumatic Stress Disorder. The authors of this study believe that their evidence proves art therapy-based programs do improve how these refugee children deal with their trauma and that in the future using a larger sample size will confirm this statement to an even higher degree.

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