Book Review: Trauma-Informed Music Therapy: Theory and Practice

By Christine MacIntyre

The timely book Trauma-Informed Music Therapy: Theory and Practice is a collaboration of the expertise of music therapists, educators with experience in psychological health and trauma-informed education, clinicians, and psychotherapists. Based on the intersection of music therapy and trauma healing, the resulting body of work is an expansive text readers can utilize repeatedly.

Trauma-Informed Music Therapy presents aspects of trauma treatment relative to music therapy, and trauma-informed practice is a heavy presence throughout the pages. Therefore, the directness to the narrative is evident: “the foundation of which is in the ways we listen to ourselves and others,” including how music therapists think about and resource their practice. Readers, likely those teaching and training to be music therapists or individuals who commission trauma services, can glean off the spread of work which will stimulate, provoke, and challenge them in considering and shaping their approach.

Trauma takes many forms, and its effects are nondiscriminatory, meaning anyone could experience trauma, and the physical, emotional, and psychological presentation are as unique as the individual. Ruptures in normalcy that upheave everydayness and well-being can potentially leave individuals traumatized. Authors Laura E. Beer and Jacqueline C. Birnbaum reveal that “given its far-reaching and deep impact… trauma is often a factor in the treatment provided by music therapists….” This is the intersecting space of music therapy and trauma. Advancements in neuroscience provide evidence of the efficacy of music as therapy.

However, the text reveals why music is therapy and effective in trauma healing and how and when to (and not to) utilize music when addressing trauma. The sensitive nature of trauma requires ethical practice and a comprehensive understanding of how and why trauma plays a role in clients’ lives, as well as music therapy as a treatment modality. Trauma-informed practice theories include clinical implementation, social justice practices, and music therapy theories.

Trauma-Informed Music Therapy is divided into sections, including Theories and Perspectives, Children and Adolescents, and Adults. Part I, penned by Jennifer Sokira, Joy Allen, and Heather Wagner, provides insights on trauma-informed practice and constructs a framework within which music therapists can clearly and concisely identify and contextualize the clinical relationship, music, and therapeutic interventions. The resilience framework highlights the importance of developing client resilience to gain choice, control, and agency throughout their healing journey. Clinical focus, clinical considerations for music therapists, and questions for reflection add to the practicality and implementation of the narrative.

Case vignettes recount real-life scenarios involving traumatic events or circumstances and the intervention methods to offset the resulting symptoms and promote healing. The conceptual model and theoretical foundations utilized within these examples give readers further insights into how interventions are developed and used.

Further detailed sections include participant goals, organization and summary of services provided, lessons learned, and recommendations, demonstrating the frameworks that guide the design and delivery of music-based interventions to trauma.

The final chapters in Part I present a case for cultural humility and structuring safety, each being crucial for anyone utilizing music therapy through a trauma-informed lens.

Part II shifts the focus to a specific client base–children and adolescents–and provides a reference for music therapists on using a trauma-informed approach with all children to avoid further traumatization, provide a healing setting and presence, and create experiences that promote resilience. The pages within this section emphasize the need for proactivity when working with children and the consideration of cultural, historical, and gender issues. Including the Substance Abuse and Mental Health Services Administration’s (SAMHSA) outline of the six key pillars of a trauma-informed approach lends credibility to the text. Suggestions for consideration include utilizing PRIDE skills (an acronym for play, reflect, imitate, describe, and enthusiasm) while following Perry’s engagement sequence (regulate, relate, and reason). Used in conjunction, these “can promote felt safety, trust, collaboration, and empowerment.” Again, a case example illustrates how music therapists working with children might incorporate these components. Practice recommendations provide a guide for what the approach entails.

The chapters within Part II are seemingly all-encompassing, as they touch on various forms of trauma, including race-based, natural disasters, life-threatening illness, and household dysfunction. The authors provide an overview of the indicated trauma followed by the respective considerations, foundations, and suggested steps for trauma-informed care.

Part III shifts gears, shedding light on adult trauma. Sexual violence and intimate partner violence head this section, as authors Rachel Ebeling and Sarah Michaelis approach this section with care, advising readers of the “serious and long-term effects” of trauma and components such as confidentiality, sense of safety, and empowerment. “Trauma-informed practice (TIP) seeks to mitigate the risks of re-traumatization through realizing the prevalence of SV/IPV, recognizing the signs and symptoms of trauma, and responding to trauma’s vast impact on an individual’s general functioning.” Throughout the text, readers begin to conceptualize music as trauma therapy, as the authors highlight how music therapy provides empowering experiences through the prioritization of individual experiences.

A therapeutic songwriting project demonstrates how music therapists might utilize creating and sharing music to provide a vehicle for traumatized individuals who feel silenced to be heard and seen. Further, a music therapy individual case study describes a sexual violence survivor’s journey. In her music therapy sessions, she expresses her desire to reclaim her identity and identifies feeling confined due to trauma. The music therapist then took phrases listed by the client to create song lyrics, to which they improvised a vocal melody over a chord progression. Throughout the process, the client made the decisions and maintained complete control. In the end, the client expressed that she felt empowered and accomplished. Through the text, readers can see how music therapy becomes a powerful coping skill in a healing journey.

Models for trauma-informed music therapy in various settings include working with symptoms, topics, and improvisation. When incorporated into trauma-informed music therapy for treating trauma in musicians, author Joanne Loewy delves into play’s potency. This chapter highlights the myriad of challenges musicians face, often resulting in trauma due to musicianship.

Brian Harris authors a chapter exclusively geared toward trauma, the LGBTQAI+ community, and music psychotherapy. An arts-based exploration of how trauma is experienced in gender expression leads to an overview of the systemic supports and failures within the LGBTQAI+ community and how analytical music therapy, which emphasizes awareness of self as a clinical tool, is helpful in such cases due to its emphasis on creative intersubjectivity.

Special care was taken in authoring this book, as the authors acknowledge the sensitive nature of working with trauma patients. “Working in inpatient psychiatric treatment and recovery can be deeply rewarding, but it is not for the faint of heart,” says Cadesky. Working with clients suffering from trauma and its deep-rooted symptoms means potentially dredging up unexpected feelings and business from the music therapist’s life, “including our own experiences around mental health, bias, and stigmatization.” However, the authors’ narratives create a structured path by which music therapists might cultivate positivity in others’ lives in meeting them where they are with compassion, support, and understanding.

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