Frances’* spouse was killed in a terrible car accident last year. She has been struggling with nightmares and depression ever since the accident, and while she is working with a psychiatrist and taking medicine, her children are concerned that she does not seem to be herself and her symptoms of trauma are significantly limiting her quality of life.
*Frances is a hypothetical client, not based upon any specific individual.
No single therapeutic modality is a universal solution to trauma. When trauma is part of a person’s history, as it is with so many older adults, an individual’s unique personality, experiences and preferences will help determine the therapies and activities from which they might most benefit.
Many older adults have experienced adverse life events such as abuse and assault, have witnessed wars and atrocities, systemic racism and violence, and experienced traumatic losses. While these experiences often result in trauma symptoms, PTSD, and/or complicated grief, they are not always identified as such.
Like all trauma survivors, older adults can experience a range of symptoms that can limit their quality of life. This can include emotional dysregulation, intrusive memories, avoidances, mood changes, being easily startled, difficulty sleeping. Traumatic stress also is associated with heightened anxiety and depression.
What Is Music Therapy?
According to the American Music Therapy Association (AMTA), music therapy is the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program.
There are more than 10,000 board-certified music therapists in the United States who have received a degree from an AMTA-approved college or university, completed clinical training and have passed the board certification exam to be credentialed as Board Certified Music Therapist (MT-BC) by the Certification Board for Music Therapists.
Music therapy goes far beyond simply listening to music for enjoyment. There are a wide range of ways that music therapy can support older adults who have survived trauma. Music therapy brings a unique flexibility in setting, depth of support and individualization, based upon what is needed by the client and what is helpful and appropriate to their setting.
What happens in music therapy may look very different depending upon where the session takes place (home, nursing home, hospice, private office) and depending upon the client’s needs.
Various Approaches to Music Therapy
Music therapy is not a “one-size fits all” approach. The music therapist is trained to assess clinical needs, create a clinical plan, and evaluate progress toward the goals of the people being served.
This means that the music and experiences will vary greatly depending upon the client’s needs and preferences. Generally, music experiences will include receptive experiences (for example, listening, relaxation exercises, lyric analysis), songwriting (writing songs to meet specific needs), recreative (re-creating music to meet various goals), and improvisation (creating the music in-the moment).
Music therapy can help people regulate emotions, reduce stress, and develop coping strategies.
As part of a clinical team, a music therapist works alongside psychotherapists, social workers, occupational therapists, physical therapists, physicians and more in caring for clients’ holistic needs. At a supportive level, music therapy can help individuals regulate emotions, reduce stress and develop coping strategies that may have been negatively impacted by trauma. Ultimately these types of musical experiences can bring an additional layer of engagement and interest, helping to encourage physiological and nervous system changes that support symptom reduction.
Some older adults who have experienced trauma may be hesitant to participate in more traditional therapy settings for various reasons. Stigma or lack of awareness around mental health, previous negative experiences, financial concerns or personal preferences may present barriers to accessing traditional therapy. Despite this, music therapists offer creative ways to help survivors in mitigating trauma symptoms, reconnecting to their bodies, encouraging wellness and mindfulness, and reducing stress. With this type of support, they can feel more regulated and safer in their bodies and settings.
For older adults who have experienced significant trauma and are able to/have the desire to process that trauma, they may be able to engage in music psychotherapy. Some music therapists are trained in advanced methods that use music experiences to explore, process, and integrate trauma memories and experiences and help the client move forward. Vocal psychotherapy, Analytical Music Therapy and Bonny Method of Guided Imagery in Music are examples of this type of work in which many practitioners specialize in trauma processing. These methods are in-depth and intensive, offering significant support by advanced professionals to survivors on their healing journeys.
Therapies Must Be Trauma-informed
It is important that music therapy (and all other uses of music) with older adults who have experienced trauma are also trauma-informed. To be trauma-informed, the common occurrence of trauma and potential for re-traumatization must always be top of mind. As nice as participating in music can be at first glance, it is important to realize that music connects deeply to our clients’ memories, both the good and the difficult.
Trauma survivors may be reminded of trauma memories through music and therefore they may experience re-traumatization. This highlights the importance of older adults who might benefit from such therapy working with qualified professionals who are trained to avoid and mitigate this potential for harm. Music therapists also can be great consultants to organizations and programs that want to ensure that their decision making around music selections and programming are trauma-informed, safe and effective.
With a board-certified music therapist, music therapy is easy to implement in clinical settings and offers an attuned and creative opportunity to support and heal trauma. Music therapists can be found in medical, nursing home, home health, hospice, private practice, and community wellness settings. To learn more about music therapy or to find a music therapist, reach out to the American Music Therapy Association and the Certification Board for Music Therapists
Frances’ children involved her in a music therapist–led bereavement group in her community. Through this group, Frances was able to re-connect with the music she and her late spouse enjoyed listening to together, as well as to connect with others who were experiencing grief. Because she found the group to be so helpful, she asked to be referred to a music therapist specializing in trauma for individual work, so she could begin to use music listening and singing to process these difficult memories. Her children are proud of her for doing the brave work of healing.
Jennifer Sokira, MMT, LCAT, MT-BC, is a board-certified music therapist and educator who specializes in trauma. She is founding director of Connecticut Music Therapy Services, director of Educational Programming for Enlighten-CE and on faculty at Quinnipiac University and Alverno College.
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