How Music Therapy and Body Work Come Together for Trauma Treatment

A core aim of this project was to combine Sensory Motor Arousal Regulation Treatment (SMART) with therapeutic songwriting for adolescents who have experienced complex developmental trauma while living in a therapeutic boarding school. The goal was to strengthen three key areas: attachment, regulation, and competency.

Because music is inherently a sensory experience, pairing Music Therapy with SMART creates a strengths-based method that involves both the brain and the body. This allows clients to work through traumatic memories without relying solely on verbal processing, a skill that trauma itself can impair. According to the research, trauma affects the whole person, so treating both mind and body is critical for true healing.

When a music therapy approach is anchored in the rhythms and interventions of SMART, the processing of trauma becomes more contained and less threatening. The client's central nervous system settles into a more regulated state. Early observations in this work suggest that SMART-supplemented music therapy offers a valuable path toward rebuilding a positive sense of self and developing healthier responses to past trauma by strengthening the client’s attachment to the therapist.

A path out of silence

Gina Strehlow observed that in trauma treatment, music can serve as a “way out of silence” (2009, p.181). For clients who have been silenced, music therapy becomes a means for them to reclaim personal power and reshape their own narrative. The many non-verbal aspects of music therapy make it well-suited for fostering communication without demanding it as the primary mode of treatment.

Research has repeatedly demonstrated that trauma reshapes a person at a deep level—not only in the mind, but also in the body. It alters thought patterns, affects physiological reactions, and changes how a person handles everyday stress. Bessel van der Kolk, in The Body Keeps the Score, explains that “trauma by nature drives us to the edge of comprehension, cutting us off from language based on common experience or an imaginable past” (van der Kolk, 2014, p. 43). While talking through experiences can help many survivors, others need treatment that directly addresses how their physical functioning has been changed by trauma.

Memories may be expressed through words and explanations, but they are also stored physically—encoded into the nervous system, muscles, and even a person’s posture (Erskine, 2014). Combining music therapy with SMART helps clients process such memories in a space that feels contained and safe. The inclusion of physical awareness and body-centered interventions not only allows for more holistic treatment but also provides a therapeutic pathway that does not depend on spoken language.

Critique and possibility within the field

Miller (2011) described a tension within music therapy between the desire for professional legitimacy in a medical-model world and the need to honor the complex, human dimensions of the art form:

Music therapy has roots in traditional mystical and healing practices of cultures throughout the world. It has continually aspired to attain legitimacy as a profession, in large part by adopting the medical model as a guide to inform practice, research, and public interface. There are dissenters within the field, however, who disagree and argue that empirical, reductionist research methods are not equipped to capture the rich, human experience of music that can impact a person on multiple levels. (p. 34)

One aspect of music therapy that is often overlooked is the realm of energetic and physical responses to treatment. Adolescents with complex developmental trauma frequently have difficulty regulating their energy. Because energy regulation is already a focus of their overall treatment, incorporating SMART interventions offers a natural and accessible entry point for engaging these clients in music therapy.

This work is also grounded in the Attachment, Regulation, and Competency (ARC) model (Kinniburgh & Blaustein, 2005). The ARC model seeks to empower clients with trauma histories by helping them regain control of their behavior and functioning. Many students at the treatment site internalize their history by devaluing themselves, often blaming themselves for trauma that was inflicted upon them. For these students, it is essential to actively support them in seeing their bodies not as objects of harm but as tools for growth, hope, and healing. Experiences of physical and sexual abuse are common among the adolescents in this population, leaving many feeling disconnected from their own bodies. Combining SMART methods with music therapy fosters greater awareness of the mind-body connection and, in the context of a residential program, aims to help clients reclaim their power and break the silence that has been forced upon them.

Music therapy within a residential environment

Treatment in a residential setting involves several important considerations. The music therapist operates as part of a caregiving team, collaborating with other clinical professionals. While music therapy may look different from other modalities, every member of the team works to stabilize clients and prepare them for transfer to a less intensive level of care. Because residential treatment within the ARC framework is explicitly built around relationships and regulation through relationship, integrating music therapy with a modality that other clinicians already use ensures a consistent, coherent approach to treatment.

Kagan & Spinazzola (2013, p. 708) point out that “inclusion of multi-modal, multi-sensory, and nonverbal activities in each session helps practitioners to engage troubled children, caregivers, and residential staff to work together to cultivate trust with caregivers.” Within this residential site, clients work with their primary clinicians in the SMART room to process their trauma histories and become more comfortable in their bodies.

Music is an inherently multi-sensory experience, and music therapy can be very effective in using that characteristic to address clinical goals. However, many clients approach music therapy with hesitation, believing that they need to possess a particular level of musical ability to participate. Starting with familiar SMART interventions allows clients to enter the artistic process through a more approachable and less intimidating pathway.

The treatment site operates under Justice Resource Institute, so much of the literature referenced remains closely connected to this network. This means that other trauma frameworks are also available and treat trauma differently. In addition, the literature linking music therapy to allied health professions still contains significant gaps.

Three frameworks: ARC, SMART, and Feminist Music Therapy

The ARC framework organizes trauma treatment around three primary domains: attachment, regulation, and competency (Kinniburg, Blaustein & Spinazzola, 2005). Music therapy naturally addresses each of these areas. Clients learn how to form attachments through the medium of music. They use rhythm to navigate and regulate a range of energy states. They build competence by achieving both clinical goals and creating a satisfying musical product. By applying the ARC model alongside music therapy, traumatized adolescents begin to see their bodies not as obstacles but as vehicles that can carry them through their trauma toward healing.

One way to bring physical functioning into the music therapy room is to combine body-centered trauma interventions with therapeutic songwriting. Although the combination of embodied music therapy practices may not appear in the literature as an explicitly feminist approach, the process itself aims to help clients regain control over their bodies, reclaim their personal narrative, and open new possibilities for growth.

Reviewing the literature and stating the epistemology

As a practitioner, I do not enter this field without biases or frameworks. I identify as a feminist music therapist working within community music therapy and resource-oriented models. As a feminist, I acknowledge the inherent power differential between client and therapist and actively work to reduce it. I seek to work alongside individuals from marginalized groups, aiming toward healing for those whom society has discarded or mistreated.

As a Biracial, Mexican, and Chamorro female music therapist, I claim ownership of a practice rooted in largely Eurocentric traditions in order to serve those who are most disenfranchised by racialized and misogynistic systems. I recognize that all therapeutic work operates within a larger context of structural power. That power comes with a serious responsibility to use it ethically and justly. With a background in anthropology, I am also attuned to systems of oppression and the ways individuals act within their social circles. Finally, my goal as a feminist music therapist is to bring attention to so-called unimportant ways of knowing and to honor them fully.

As a community music therapist, I understand each client exists within multiple relational systems. The growth they achieve—or the barriers they face—in therapy has ripple effects within their larger communities. From a community music therapy perspective, the relationship changes from one of performer and receiver to one of two participants sharing space and jointly creating a unique, individual musical experience that builds connection (Stige, 2004). Combined with feminist music therapy, the community approach helps participants find common ground through their shared musical expression. Within the ARC model, this means that clients become better at attaching and regulating, leading to stronger ties within their communities.

As a resource-oriented music therapist, I enter sessions knowing that clients bring both struggles and strengths. Each person arrives with a unique set of talents and survival skills that have helped them endure hardship (Rolvsjord, 2009). For students with complex developmental trauma, the body may feel like a site of violence. But the work aims to empower them to view their bodies instead as places of healing and strength, reclaiming those bodies as instruments of their own transformation.

The peculiar history of trauma

Although trauma has re-emerged recently as a prominent topic in the counseling field, it has been relevant since psychology began. Judith Herman (1997) observed that the concept of trauma has a curious pattern: “episodic amnesia. Periods of active investigation have alternated with periods of oblivion. Repeatedly in the past century, similar lines of inquiry have been taken up and abruptly abandoned, only to be rediscovered much later.” She adds, “Though the field has in fact an abundant and rich tradition, it has been periodically forgotten and must be periodically reclaimed” (p. 7).

Trauma—particularly sexual trauma and the abuse of power—was the foundation for early Freudian psychoanalysis. Freud used the term “transformation” to describe the overwhelming, consuming weight of trauma and the mind's drive to disguise it (Freud, 2002). Van der Kolk (2014) speaks of trauma as being “beyond comprehension,” and Richard Erskine (2014) explains how trauma becomes encoded in the very fabric of a person:

All experience, particularly if it occurs early in life or if it is affectively overwhelming, is stored within the amygdala and the limbic system of the brain as affect, visceral, and physiological sensation without symbolization and language. Instead of memory being conscious through thought and internal symbolizations, our experiences are expressed in the interplay of affect and body as visceral and somatic sensations. (p. 21)

Even when trauma resists language, it persists—manifesting through physiological symptoms. The act of recognizing trauma continues to be a highly political act. The ability of the psychotherapy field to respond to trauma has been inconsistent (Herman, 1997). In fact, Posttraumatic Stress Disorder (PTSD) was only added to the official diagnostic manual in 1980 (American Psychiatric Association, 1980).

Acknowledging trauma demands looking at power and agency within broader systems. In cultures built on unequal power relationships, there is often little incentive to hold the perpetrators of trauma accountable. Even today, in an environment where oppression still thrives, the reality of trauma is contested in discourse and practice.

Because I approach this work as a feminist music therapist, I aim to shine light on issues that are often dismissed and to validate the experience of marginalized people. Although Freud was pivotal in developing our understanding of trauma, he eventually turned away from his own early findings, suggesting that the stories his clients told were fantasies (Herman, 1997). Herman interprets this moment:

The dominant psychological theory of the next century was founded in the denial of women’s reality. Sexuality remained the central focus of inquiry. But the exploitative social context in which sexual relations actually occur became utterly invisible. Psychoanalysis became a study of the internal vicissitudes of fantasy and desire, dissociated from the reality of experience. (p. 14)

Freud concluded, “I was at last obliged to recognize that these scenes of seduction had never taken place, and that they were only fantasies which my patients had made up.” Fighting the social silencing of trauma remains an ethical duty for clinicians, and especially for a feminist music therapist seeking anti-oppressive treatment approaches.

Moving beyond talk therapy

Although understanding of trauma is still evolving, treatment has recently shifted in crucial ways. Historically, psychological treatment grew out of a Eurocentric model focused on verbal processing. However, newer modalities have emerged to serve clients when language-centered therapy has proven inadequate (Hinz, 2009). Classical talk therapy is fundamentally problematic for clients cut off from communication by trauma.

According to Bessel van der Kolk (2014, p.3):

There are fundamentally three avenues: 1) top down, by talking, (re-) connecting with others, and allowing ourselves to know and understand what is going on with us while processing the memories of the trauma; 2) by taking medicines that shut down inappropriate alarm reactions, or by utilizing other technologies that change the way the brain organizes information and 3) bottom up: by allowing the body to have experiences that deeply and viscerally contradict the helplessness, rage, or collapse that result from trauma. Which one of these is best for any particular survivor is an empirical question. Most people I have worked with require a combination of all three.

Thinking of trauma processing only as “top-down” or “bottom-up” can create a binary view that doesn’t fully capture human complexity. Still, it offers a useful starting point to understand that traumatized clients often need different solutions. Those who experience trauma have a fragmented sense of self and time, making models that reach beyond cognitive verbal reflection both necessary and clinically appropriate.

Trauma’s effects on a person’s mental outlook are undeniable. But it also changes physical and physiological function. van der Kolk (2014) makes this powerful observation about the somatic impact of trauma. His work confirms that the body registers experiences alongside—or even before—the thinking mind.

After trauma, the world is experienced with a different nervous system. The survivors’ energy now becomes focused on suppressing inner chaos, at the expense of spontaneous involvement in their life. These attempts to maintain control over unbearable physiological reactions can result in a whole range of physical symptoms… This explains why it is critical for trauma treatment to engage the entire organism, body, mind, and brain. (p. 53)

As a fairly new and still developing field, music therapy derives much of its strength and clinical effectiveness from the fact that it is a multisensory experience. In playing instruments, clients are engaged physically. In listening to music, clients are experiencing auditory processing. Because music therapy is an inherently sensory experience that engages both mind and body simultaneously, when conducted with careful client-attuned pacing, it can facilitate a powerful treatment method for individuals healing from trauma.

Clemens-Cortes and Bartel (2018) explained how music therapy is a sensory experience by stating that “making music is a function that requires auditory, emotional, linguistic, motor, and structural memories. Attention, auditory perception, executive function, memory, and motor control are activated when a person makes music” (p. 59). Music therapy, therefore, when at its best, is a holistic treatment approach that engages clients both in their mind and body, and can therefore regulate and help to mend the mind-body connection. While traumatized individuals need regulation due to lack of consistency and predictability in their life, music therapy can help establish both a literal and figurative baseline rhythm for them to regulate through with consistency and predictability. In developing the SMART manual, Warner, Cook, Westcott, and Koomar (2014) stated:

Trauma happens in a developmental context derailing healthy biological, sensory and motor, emotional, cognitive and social development. Sensory experiences involving the body based senses, e.g. touch, proprioception, and vestibular input, are key to enhancing regulation. Treatment must begin with intervention at the foundational developmental level of the sensory motor systems. (p. 4)

While music therapy may traditionally be thought of as a mainly auditory experience, the clinical application of music as a “holding container” provides structure that allows clients to be more oriented to time and space, and as a result, to other body senses. Music therapy engages the sensory experiences mentioned above and aid in motor, emotional, cognitive, and social development. While music therapy may seem to be separate from body rhythms as a process involved with creation of a new musical product, typical basic self-soothing strategies often revolve around rhythms and repetition (Warner et al, 2014). These strategies can be carried out by increasing awareness and attunement to inner body rhythms and externalizing them through musical expression.

Music therapy can bridge the gap from awareness of rhythmic regulation to internalization of affect regulation and later, trauma processing.

Music Therapy and Teens

Each clinical population has unique skill sets and clinical needs, which are often correlated to their developmental stage and history. Teenagers are often thought of as being a particularly challenging population to work with, and in particular teenagers in residential settings. As Erikson has stated, adolescence is the stage when individuals begin to crystallize and act on individual identity (Arnold, 2017). This proves particularly challenging in a residential therapeutic school, where the teenagers have experienced great losses, including the loss of a sense of self and self-identity. Due to their trauma history, these clients struggle with appropriate boundaries and reading social pragmatics, and need carefully attuned support regarding containment within a therapy session. Many teenagers who have experienced trauma interpret their traumas as being their fault, and often tie their identity to being a fundamentally “bad” person (Sharma-Patel and Brown, 2016, p. 401). When they internalize these self-critical messages, they often act accordingly. Due to these complex histories and internalized messages, many adolescents in this situation may test boundaries and limits. Bruscia (1998) explained how this may influence treatment:

When a client enters therapy with problems emanating from the preoedipal period, the lack of clear boundaries complicates the transference considerably. In fact, it might be argued that in these cases, the way the past is replicated goes beyond the construct of transference. (Bruscia, 1998, p. 14)

Clients exposed to long-term chronic trauma often function with a higher baseline level of anxiety than clients who have not experienced trauma. Therefore, successful treatment with this population involves intentionally creating a predictable space, and responding consistently to clients in ways that creates attunement.

One feature of music that helps to establish attunement and predictability is rhythm. In developing the SMART model, Warner et all (2014) explained the clinical impact of rhythm:

Rhythm increases the engagement of the child with the therapist. It creates order in the movement and thus the child’s behavior, and simultaneously it can regulate arousal such that the child can remain in her Window of Tolerance while playing and engaging with the adult. (p. 40)

While conversational and social rhythms absolutely exist in non-musical forms of therapeutic treatment, in other treatment forms rhythm is incidental as opposed to being central to treatment. In a residential setting, rhythm is the glue that holds treatment together through highly structured schedules and routines. If rhythm is what is crucial to developing a healthy therapeutic relationship with traumatized children, creativity is what is required and necessary to help those clients move from a mindset of surviving, to a mindset of thriving. While many clients with severe trauma exposure may not be aware of it, creativity is something that they innately have used to survive the situations that they have. Highlighting that fact and showing how creativity can be harnessed as a way to thrive can bring music therapy to a level that feels more accessible and less intimidating to clients. In other words, music therapy changes a focus on rhythm from being an entirely new experience to being a continuation of their strengths. Smyth (2002) described the transformative power of creativity:

Creativity is necessary in the process of rebuilding a new schema after the shattering of one’s belief system, of reconnecting with a changed ‘reality’ and of rediscovery of the mind– body connection. Anxiety and panic must either be understood and transformed, or new responses learned. (Smyth, 2002, p. 76)

While it may be daunting to enter a therapeutic relationship with clients who have had their trust violated and personhood shattered, in using rhythm and creativity as the foundation for new possibilities and realities, the music therapist can provide the structure for clients to flourish and heal (Borczon, 2004).

With the possibility of creativity and the containment of rhythm, adolescents can move through challenges to build stronger identity. Due to the emphasis on music and rhythm, some music therapists would naturally turn to Neurological Music Therapy (NMT) as the inevitable method to treat clients. NMT is defined as “a research-based system of 20 standardized clinical techniques for sensorimotor training, speech and language training, and cognitive training” (“NMT”, 2015). However, from this standpoint as well as my epistemological framework, I believe that is ignoring the person as a whole in order to favor intellectual and cerebral processes. Though NMT may be effective for treating certain populations and clinical goals, due to its medical – as opposed to expressive - basis, its use does not appear to be clinically indicated for trauma processing, nor does it seem to facilitate strengthening the mind-body connection. In following the development of music therapy as a field, Aigen (2013) explained, “There is no place for a conception of [neurological] music therapy as a form of psychotherapy, community building, identity creation…. All of these ways of conceptualizing music therapy are proscribed in favor of a strictly medical conception of music therapy” (p. 190). Because this paper is focused on music therapy as it relates to holistic health, the NMT framework and practices will not be utilized.

Gaps

While the understanding of trauma has developed greatly since the inception of the field of psychology, there are still noticeable gaps in the relevant literature.

Though the disconnect of mind from body is an important concept in understanding bottom-up versus top-down treatment, it furthers a Eurocentric view of treatment. Additionally, the reviewed literature, while explaining trauma as an incredibly individualized experience, tends to ignore societal factors that influence trauma processing. From a resource-oriented music therapy perspective, this capstone seeks to fill in the gap of resources for marginalized people groups healing from trauma, and comes from the perspective of a marginalized therapist. Though literature exists that states how marginalized social identities affect one’s access to treatment, that is beyond the scope of this paper. While I have attempted to represent an accurate understanding of the generalized understanding of trauma, unfortunately there continues to be a lack of varied literature on the topic. Due to this fact, many of the authors referenced in this paper are related through the network of Justice Resource Institute and The Trauma Center. Due to their connection and overall similar ideology, it is important to acknowledge that other trauma frameworks exist that define and treat trauma differently. Additionally, there are many gaps in the literature linking music therapy to other allied health professions.

Identity in Practice

As a music therapist of color, I am often looking for ways to adapt treatment to the varied cultural contexts in which our clients experience in the world. While I understand that cultural humility is a lifelong process and practice, I believe that it starts with acknowledging the ways in which non-Eurocentric treatment methods have been erased and left out of therapeutic treatment narratives. This requires questioning what information is valued as valid research results, and reframing the way that we design our research to include a broad range of responses, and in particular non-verbal responses and gains.

While the work referenced in this capstone project is only one small part of that, I believe that it shows how crucial it is to analyze our own position and power as clinicians to validate various forms of therapeutic gains as important and worth seeking after. While this method was only implemented with one client, it is important to note that the importance of including treatment results of marginalized people groups is crucial in creating a music therapy culture that is inclusive and ethical. Within the therapeutic field, including opinions and narratives of people of color, and especially young women of color, has not been the norm.

Method

One individual SMART-supplemented music therapy session was implemented at a therapeutic boarding school for adolescents in the greater Boston area. Common diagnoses of residents at the site are PTSD, Major Depressive Disorder, Bipolar Disorder, Reactive Attachment Disorder and Attention Deficit Hyperactivity Disorder. Clients are typically referred to the site when they have demonstrated an inability to remain safe in their home communities and require stabilization and intensive clinical care. A typical stay in residential care ranges from 12-18 months. Staff are encouraged to maintain a continuum of care through holding tight limits, working on clinical goals, and modeling appropriate relationship boundaries. Expressive arts therapies, and music therapy in particular, are utilized at the site in both mandatory clinical class groups and optional individual music therapy sessions. This session was individualized and facilitated in the school’s SMART room. The site’s SMART room is a sensory room equipped with various tools and toys to provide various kinds of sensory input. The client involved in the method was comfortable and familiar with the use of the SMART room within her therapeutic treatment. This session occurred in order to observe the benefits of using the SMART room to regulate students’ energy in order to benefit more fully from music therapy sessions.

The goal was to use an integrated approach of therapeutic songwriting and Sensory Motor Arousal Regulation Therapy (SMART) methods to optimally support positive identity formation by addressing attachment, regulation, and competency (ARC).

Participant

This intervention included one 16-year-old participant engaging in one individual music therapy session. She has lived at the site for over 6 months and is well-integrated into the program. The participant is female and identified as Afro-Latina. The participant had been thoroughly informed of the purpose of the study and agreed to participate freely, with the understanding that she could withdraw from the study at any time. This researcher consulted with the participant’s primary clinician in order to identify triggers and clinical strengths to meet the client’s individual needs and integrate into the continuum of care. The participant had already established a therapeutic relationship with this researcher over a period of 5 months in individualized and group music therapy, and had been selected through conversation with her primary clinician. The participant was selected for this method due to her identified use of the SMART room as a coping skill, and identified physical activity as well as musical competency as valuable parts of her identity. The client had identified utilizing tools in the SMART room to regulate when feeling excessively energetic, dysregulated, or angered.

Procedure

The sessions consisted of three components. These components were SMART warm-up, songwriting, and SMART closure. Songwriting was chosen as the music therapy intervention in order to facilitate the development of positive self-identity and personal narrative in the words of the client, leading to empowerment through storytelling (Baker, 2015). Additionally, the participant had identified songwriting as a preferred music therapy intervention.

Songwriting addresses the three components of the ARC formula through building attachment through song, facilitating emotional regulation through validating emotional experience, and building competency through developing communication and organizational skills. For the purpose of this capstone, I chose to do semi-structured songwriting, and provided the client with a one-word feeling prompt and used a pre-recorded background track chosen by the client to create a melody over. A pre-recorded background track was chosen to structure the session focus on the lyrics, and not any other musical components. For both the SMART warm-up and closure, in following a client-centered perspective, the participant engaged with sensory tools and activities of their own choosing, based on their presented energy levels at the time. The procedure is illustrated in Figure 1.

Figure 1. Intervention Method

Data Recording

In order to closely replicate the client’s experience without breaking confidentiality by using their creations, I chose to engage in a parallel experience after each client session that repeated each step of the method, as detailed in Figure 2. This involved following the same procedure outlined earlier, paying careful attention to energy shifts and connection to my own body and analyzing the lyrical content created as a result of these sessions. In order to get as close to the client’s experience as possible, I used the same SMART activities and background track to write lyrics over. This process is illustrated in Figure 2.

Figure 2. Data Collection Method

Results

Method Execution

While the method was initially planned to do over a series of three sessions with the same format, due to time constraints and site limits, I was only able to conduct one session using the method outlined above. While this impacts the scope and amount of data generated, it also points to the systematic challenges of working in a residential setting. In this case, even though I as the music therapy intern received support from staff, barriers such as space availability and scheduling continued to interfere with more research possibilities, as well as carefully planned clinical treatment. As a result of these challenges, the research method was based on just one session.

Reflection on use of SMART Room

While I had already established strong therapeutic rapport with the client in sessions not utilizing the SMART room, I did notice a significant difference in my own ability to reflect and attune to her body language and energy in the sessions utilizing the SMART room. In the session in the SMART room, I noticed an increased awareness and ability to respond to her energy states in a way that was not available in other sessions. In the session using the method with the SMART room, I was more aware of where I was holding tension in my own body, and felt a decrease of tension following the SMART interventions.

Lyrical Content

In my own lyrical content that I generated following the method, I noticed themes of identity as a process with stages, as opposed to a fixed and stagnant construct. This is evident from the lyrics written after the session, as shown in Figure 3.

Figure 3. Songwriting Excerpt

In reflecting on the lyrics above (see Figure 3), I found themes of attachment, resilience, and growth. Additionally, the lyrics allude to feeling comfortable and using body senses as a way of working through trauma, instead of shutting down and feeling disconnected from one’s body. These lyrics reflect a resource-oriented mentality and ability to look to one’s own skills during times of conflict and distress.

Themes

Certain themes that were of significance during the songwriting process emerged in the art response after the method. These themes were connection to body, identity, trauma processing, and attachment. Below I will review the content created by me in the art response, as the researcher. I remain focused only on my art responses as data to protect client confidentiality, although similar themes arose in the client’s lyrical content.

Body

In examining identity formation through the use of SMART processing, I paid careful attention to felt senses, shifts in energy, and the level of attunement that I felt in my body throughout the session. Throughout the sessions I focused on how attuned I felt to my body, and how the SMART activities increased my own ability to engage in the songwriting process. From my perspective, this was because the session with SMART provided an outlet and way to work through both high and low energy states. Moving beyond the warm up activity, I also paid

I paid close attention when lyrical content pointed to physical processes or bodily movement.

Identity

A second theme I examined throughout songwriting was identity. When analyzing the lyrics I produced, I looked specifically at themes of fixed versus fluid identity, to determine whether the procedure helped the client perceive identity as something they can influence. Working through the parallel process of writing my own lyrics after each intervention encouraged lyrical reflections on identity as something intricate and ongoing.

Trauma Processing

Closely linked to identity, I carefully examined how trauma connected to identity. I attended to moments when trauma was portrayed as an overwhelming, defining experience, as well as moments when it was placed within a broader, more complex sense of self.

Attachment

Lastly, when situating the client’s experience within the ARC framework, I analyzed how combining SMART and music therapy enhanced my ability to build attachment with the client, and how working through that attachment facilitated progress on clinical issues. Physically regulating in the SMART room appeared to create a supportive environment for the client to explore trauma history with me, using sensory tools to stay grounded and supported. Through mutual engagement with sensory tools and disclosure, the client seemed to deepen attachment to me.

Data Processing

Although the method was grounded in literature and suited both the population and setting, I struggled with the arts-based component of this research. While the project is fundamentally arts-based, coming from a theoretical rather than experiential starting point made creating data for the method feel anything but natural. From a feminist music therapy perspective, I wrestled with the ethics of counting my own responses as validation for research conducted with and done to others. As a researcher, I already have a bias toward seeing my work as valid, and I do not share the same life experience or trauma history.

Discussion

All things considered, this method holds potential as a valuable, viable option for addressing the clinical needs of adolescents in a therapeutic boarding school. Through this method, the client seemed better able to connect some of her current relationship patterns to her trauma history, and to explore that theme through songwriting in a contained, safe environment. Moreover, through my own observations, I was able to attune to the client more

effectively by incorporating sensory activities. Finally, I was able to generate lyrical content that pointed to positive self-identity and the ability to move through conflict and anxiety rather than re-triggering trauma responses, reflecting the client’s response to the method.

Limits

Reviewing the results, it should be noted that although I used the site’s SMART room and worked from the SMART manual, I do not hold formal certification as a SMART-trained clinician. Given adequate resources and time, I would revisit this method after completing formal SMART training to maximize the benefits of the opening and closing session portions. A second limitation is that this was a single-person, single-session study, requiring replication on a larger scale to continue this work and validate results. For further work, I would revisit the method with a larger sample and at least three sessions per participant. To moderate the influence of my own biases, I would redo the study under a formal research method using the clients’ own data rather than my own, to conduct the research more ethically and accurately.

Multidisciplinary Trauma Treatment

Though music therapy is a unique field requiring specific, focused training, we as health professionals need to align with related disciplines and use the many tools already available to maximize music therapy’s reach. As mental health professionals, we should familiarize ourselves with other treatment modalities to enrich and expand our practice, generating new possibilities for healing and growth in our field. While this research explored only one such modality (SMART), it underscores the importance of further combinations with other approaches.

Further Development of Method

Reviewing the results and literature, I found that combining songwriting with physical components in trauma treatment is clinically indicated and can provide many benefits for clients with trauma history. These benefits include strengthening and developing a positive sense of self-identity, enhancing attachment skills through a regulated, attuned experience of working with a clinician, and providing greater control by equipping clients to move through different energy states.

Music Therapy Futures

Although music therapy is a viable treatment option for survivors of various types of trauma, music therapists must develop and treat trauma using as many resources as possible to bring the field to the level of trauma-informed care. Like other healthcare professions, music therapy must develop treatments that address clients holistically, rather than simply treating symptoms without addressing their root cause. While this work highlighted some challenges inherent in arts-based research, such research is central to developing new music therapy methods. However, this project also illustrates the ethical implications and challenges of validating arts-based research through the therapist’s own artistic responses to an intervention, rather than through client-based data.

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