Disclaimer: The views expressed herein are those of the authors and do not necessarily reflect the official policy of the Department of Defense or the U.S. Government. The opinions contained herein represent the private views of the authors and are not to be construed as official or as reflecting the views, opinions, or policies of the Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., the National Endowment for the Arts, or the U.S. Government. Mention of trade names, commercial products, or organizations does not imply endorsement by the US Government. This material was created free of branding or market affiliations. The authors are operating solely as contributors.

Authors: Rebecca Vaudreuil, Jonathan Crane, Mark Ettenberger, Samuel Gracida, Barbara Else, Diane Langston, Craig Larimer, Danielle Vetro-Kalseth

Background & Description: This blog reports on an interactive discussion that took place on September 11, 2020, presented by the IAMM Special Interest Group focused on healing trauma across a spectrum. A blog of their first presentation in July 2020 can be found here. The follow-up discussion on 9/11/2020 was open to the general public and integrated audience questions from the July 2020 SIG presentation. This blog is an interactive written and visual representation of discussions regarding the local and global impact that accompanies a diverse range of traumas that individuals, communities, and societies experience across micro, mezzo, and macro systems. Videos of both presentations can be found at the bottom of this page. 

Presentation Outline

Welcome	Public Reading of “Brave Space” poem (introduced during the July 2020 SIG presentation by Jennifer Hicks)Moment of silence in memory of 9/11/01
Opening	Introduction to inaugural IAMM Insights event and quick summary of the July 2020 SIG presentation Connections made since IAMM 2020 presentation Brian Schreck’s Heart SongsSamuel Gracida’s work with refugee youth in Germany
Discussant Introductions	Rebecca Vaudreuil, EdM, MT-BC, Lead Discussant/Moderator Chief Jonathan Crane, Discussant Barbara Else, MPA, MT-BC, Discussant Mark Ettenberger, PhD, MT-BC, Discussant  Diane Langston, MM, MT-BC, Discussant TSgt Craig Larimer, Discussant Danielle Vetro-Kalseth, MT-BC, Discussant
Moderated Discussion	Rebecca Vaudreuil, Trauma SIG Leader, moderated questions from the audience of the July 2020 presentation to discussants.
Virtual Exhibit: Art for Remembrance	Art products, musical instruments, songs, poems, and dance performances created in memory, response, and tribute to 9/11
Q&A/Discussion	Open forum for questions and discussion from the presentation

Moderated Discussion

Q1: Music therapists in community music therapy commonly encounter and/or uncover “silent trauma” in civilian settings. Can you offer suggestions on how to conduct trauma-informed therapy under these circumstances?

Ms. Barbara Else replied to this question by citing Evan Ruud, a scholar on faculty at the University in Oslo, Norway, who described community music therapy as a “way of doing and thinking about music therapy” such that the community’s cultural, institutional, and social contexts are considered. Community music therapy includes awareness of the systemic context where music therapists work; therefore, music therapy is directed not only to the individual, but it also aims to shift the system that may be part of the clients’ situations.

Given this, community music therapy, as well as music therapy in other settings, commonly uncovers trauma during the course of the interactions. Approaching this requires triangulating or linking three facets into the process:

1. First, it requires the music therapists to be alert to and aware of the social, institutional, and cultural background and trends.

2.  Second, the music therapist must know their own perspective and social, cultural, and institutional traditions and biases. This requires ongoing work on the part of the therapist.

3. Third, the music therapist must have a foundation in the principles of psychological first aid and trauma-informed care. A free e-learning course on disaster response for music therapists that provides an overview of psychological first aid can be found here. Note: CMTEs are an additional fee. 

Ms. Else noted the work that the AMTA COVID-19 Task Force has been doing referencing the work of Andrea Dalton, who created a condensed tip sheet on trauma informed care, found here. 

AMTA Website Navigation: www.musictherapy.org → Provider Resources → COVID-19 

The notion is to incorporate trauma-informed care principles of safety, trust, choice, collaboration, and empowerment into the design of music-based experiences and interventions.

Principles of psychological first aid overlap and complement trauma-informed care and include providing safety, as well as offering a sense of connectedness, individual and community efficacy or purpose, calm, and hope.

Q2: Do you differentiate between moral injury and PTSD? If so is there a significant difference in your methodology?

Chief Jonathan Crane answered this question sharing his perspective on moral injury and post-traumatic stress disorder (PTSD), noting, “I view these as separate issues, although they can present in the same person”. Moral injury often presents in military members when they take an action, which is directed or authorized, but doesn’t align with their personal ethics and/or morality whereas PTSD is more of a neurochemical change that occurs in response to a traumatic event. Awareness of these different conditions is key, as they present in a multitude of ways.

The U.S. Department for Veteran Affairs National Center for PTSD defines PTSD as a mental health problem that some people develop after experiencing or witnessing a life-threatening event, like combat, a natural disaster, a car accident, or sexual assault. Moral injury is the distressing psychological, behavioral, social, and sometimes spiritual aftermath of exposure to such events. A moral injury can occur in response to acting or witnessing behaviors that go against an individual’s values, ethics, and/or moral beliefs.

Music, and all the arts offer unique opportunities for externalizing thoughts, feelings, emotions, memories, joys, fears, etc. that are stored in the brain and the body. The arts’ powerful and evocative qualities can be used to uncover what is hidden within us, process past and current experiences, and shape the future. 

The arts can promote healing processes through learning how we can attune to our psychology and physiology. Integrating psychoeducation and the arts on the topics of insight of self and others, acknowledgement rather than ignoring or invalidating thoughts and feelings, stepping outside of comfort zones, and embracing vulnerability as a mechanism that promotes recovery are initial steps to processing and ultimately healing traumas. 

Q3: Music therapy as a profession began with post-war veterans. How can modern music therapists advocate for more services at VA Medical Centers?

Ms. Diane Langston and Ms. Rebecca Vaudreuil shared their experiences pertaining to service provision for military-connected individuals and communities starting with the acknowledgement that the Department of Veterans Affairs (VA) is highly tasked with caring for service members and veterans from multiple service eras and their families. 

The professional positioning of creative arts therapists to facilitate individual and group creative arts therapies directives and interventions as core service of interdisciplinary treatment teams that are internal to the VA healthcare system while also having the ability to collaborate with external community-based artists is essential in providing comprehensive care plans that resonate beyond the clinic walls. 

Ms. Vaudreuil introduced an important inter-agency partnership that supports creative arts therapies and community arts engagement for military-connected populations. Creative Forces®: NEA Military Healing Arts Network is an initiative of the National Endowment for the Arts (NEA) in partnership with the U.S. Departments of Defense and Veterans Affairs and state and local arts agencies with administrative support provided by Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Americans for the Arts, and Mid-America Arts Alliance. 

Creative Forces seeks to improve the health, well-being, and quality of life for military-connected populations exposed to trauma as well as their families and caregivers.

Creative Forces operates using three distinct pillars: 

1. Clinical. The clinical pillar supports creative arts therapies for their target population — active-duty service members and veterans exposed to trauma, including those diagnosed with traumatic brain injury and/or concussion accompanied by psychological conditions (Bronson et al., 2018; Jones et al., 2018). The initiative also supports its patients’ family members and caregivers (Chilton et al., 2021).

2. Community. The community pillar is facilitated through partnerships with state arts agencies and collaborations with local artists and arts organizations. The multi-directional clinic-to-community continuum supports patients who seek to engage in arts experiences once they are discharged from treatment as well as those who start out in a community arts program but may enter or return to clinical care (NEA, n.d.a).

3. Capacity. The capacity pillar reflects Creative Forces’ efforts to support clinical and community research activities and resources. The image below demonstrates multi-directionality of the pillars (NEA, n.d.b). 

Creative Forces Operational Pillars, NEA National Resource Center (NEA, n.d.b) 

Ms. Langston introduced the Rural Veteran TeleRehabilitation Initiative (RVTRI), which is part of the VA’s Office of Rural Health. The aim is to place creative arts therapists, namely art therapists, music therapists, and dance/movement therapists, into different VA sites as part of the interdisciplinary team to provide creative arts therapies practices to be delivered via telehealth for remotely-located veterans. 

The integration of creative arts therapies and non-clinical arts engagement into RVTRI relies on multi-level partnerships focused on demonstrating the need for creative arts therapies. For example, the outcomes of positions that were first funded by Creative Forces, like Ms. Langston’s position, warranted investment on the VA healthcare systems level to continue this impactful work. 

Ms. Barbara Else provided insights regarding advocacy for music therapy and the arts, specifically in the Veterans Health Administration, stating,

Advocacy can happen at multiple levels from grass roots — from speaking with state legislators regarding components of state-based Veterans services, to networking with the cohort  of creative arts therapists in place now, to team science, since research in the VA requires at least one VA employee in their studies, to active support of state task forces representing improved access to services in music therapy to Veterans.

In sum, the impact of creative arts therapies with military-connected populations was presented and it was emphasized that initiatives that extend reach to rural communities truly meet the veterans where they are, whether that is at the VA Medical Center, community based outpatient clinic, or in their homes is efficacious.

Q4: When working with foreigners abroad, for example in Afghanistan, how do you go about bridging the cultural differences?

TSgt Craig Larimer initiated the reply to this question by reframing that when he, as a soldier, deploys to other countries, he is the foreigner. He emphasizes the importance of self-awareness when he deploys to new spaces, whether that be abroad or in various locations across the U.S., such as inner cities. He elaborated that being uniformed adds an additional layer of awareness regarding positionality in both present day and historical capacities. Being a performer and an educator, TSgt Larimer shared a check-list that he references when he engages with new people in new spaces, especially those in volatile areas in which people are dealing with trauma that includes: 

1. Asking myself what is my overall purpose in going into this space?
2. Researching the history and culture of where I am going.
3. Reflecting on what my presence may initiate and how I may be received, even prior to engagement. 
4. Understanding how I can be useful in my position in support of the purpose of the mission.

Bridging cultural differences must start with acknowledging who you are and what the situation is before you even get there, and once you are there, giving yourself over to the situation with that awareness. In this way, I have found that sitting down and having a meal with people and being real with them is helpful. “In my experiences, when I play it cool and let others lead the way, good things follow.”

Chief Crane shared a story from the U.S. Army 1st Armored Division Band in 2017 on a regular rotation to Iraq. For this deployment, the band members partnered with a local ethnomusicologist near their base to learn traditional Iraqi songs; the vocalist learned to sing in Arabic. When the band performed for military and community leaders in Baghdad, they were demonstrating cultural humility. As Westerners who are trained in Western musical system, they were being both musically vulnerable and showing that they wanted to learn about a different way of expressing music. The leaders showed deep appreciation for the band’s attempt to learn traditional Iraqi music, and in that process, understanding more about the culture. This was a critical piece of community-building on that deployment. Chief Crane further shared,

I have learned from my peers about cultural humility and Recognizing my own culture and how it came to be. Through my musical training, I am able to make connections with almost anyone, even if I don’t know their music, by shifting into a learner mindset. If I play the blues with others, it can be a transformative experience if I recognize where that sound comes from and why. If I learn to express a particular raga in the Hindustani tradition, I must be humble to its creation and be open to understanding it based on its own merit. Western European art and music have infiltrated the entire globe, so if we desire to use music for healing, we must realize that all humans create music in diverse and unique ways, none of which is inherently ‘superior’. We must learn from those we engage with, as well as offer our expertise and whole person to advance the healing process.

In sum, the sharing and recognizing of how music is expressed in a community builds trust, improving the health of the group. As outsiders, we must always come to the situation with respect and not come in with a ‘this is how music is supposed to be created’ mindset.

Members of the U.S. Army 1st Cavalry Division Band and the Afghanistan National Institute of Music (ANIM) teach each other different musical styles in preparation for a joint performance in 2017. The ANIM has since been displaced to Portugal, after the Taliban regained control of the Country, banning most forms of musical expression.  

Q5: How do you approach fostering resilience in fragile populations? Do you see building resilience as a cognitive process? There is lots of trauma work being done with cognitive behavioral therapy (CBT), in your experience is that approach (combined with music experiences perhaps) adaptable to building resilience?

Ms. Danielle Vetro-Kalseth addressed this question and shared her thoughts of music therapy being a cognitive process that is instrumental to building resilience. By looking at resilience-building as increasing the ability to handle difficulties in life, through music therapy, we can address this through cognitive processes, confidence building, challenging thoughts, and creating coping skills. Group music therapy lends itself to this by providing social support and finding commonality and shared experiences. Other modalities for trauma processing, for example, CBT, address the individual voices in a talk therapy setting, namely, individuals sharing their individual experiences. Like CBT, music therapy uses elements of cognitive reframing, cognitive reorganization, and social support. Something unique to music therapy is the opportunities for shared experiences by the group that validates each individual’s experiences and creates therapeutic connection with others through non-verbal expression. Support and bonding often occur quickly in the music therapy setting and creates a sense of belongingness with each other. Ultimately, it creates connection to something bigger than ourselves, and that is a foundational component of mitigating isolation and building resilience. 

Q6: Have you had experiences working with historical trauma, and if so, what lessons you all have learned around the world that might be helpful for white music therapists working with Black clients in a country built on white supremacy and systemic racism?

As Lead Discussant and panel moderator, Ms. Vaudreuil acknowledged the importance of this question and stated appreciation for the brave space in which respondents can share their experiences.

TSgt Larimer first acknowledged his positionality as a white male addressing this question, especially in his role as a performer who enters spaces to provide a service often for minorities and as such have different experiences from him. TSgt Larimer often goes into inner city schools to recruit for the U.S. Air Force Academy and educate through his expertise as a musician. This all relies on making a connection, and whether he is entering a small or large group, there needs to be awareness of the history of white supremacy in the United States and across the world. 

TSgt Larimer shared a story about being in an impoverished inner city part of Los Angeles, California where he was presenting, entertaining, and answering questions at a school to approximately 1,000 students. He referenced his check-list, listed above in question 4, and recognized that he, as a white man in uniform, could potentially be seen as a threat. The addition to the self-awareness piece in this situation is the understanding of what you represent in history and being honest and give what you can to each situation. TSgt Larimer recommended, “immersing yourself, go in and come out with love, and really demonstrate that, and expect that it may not be well-received, and you may not establish the connections you seek”. He further shared from this experience,  

All-in-all, I have made some great connections using this approach, and I have also not connected. Each experience is unique, and I really have to feel the energy of a room to make the best connections, whether that be in-person in a school-setting or in a Zoom meeting with embassy leaders from Kyrgyzstan and Afghanistan. 

TSgt Larmier acknowledged that experiences may be different for a music therapist than a performer, and he deferred to Ms. Langston for her perspective as a music therapist in Gainesville, Florida. Ms. Langston was born and raised in Florida and grew up in the deep south, the panhandle of Florida. She shared,

The concept of systemic racism is something that hassurrounded me throughout my entire life, so on a personal level, it is always there, and I am aware of its presence and prevalence. I pull from my personal experiences to inform my professional positioning as a music therapist and someone who can facilitate healing, which is not without challenge. I don’t have the solution, but I have found that one of the most effective ways to navigate this is listening.

Furthermore, Ms. Langston has found that being compassionate and without judgment has been effective for her in her clinical practice. She distinguished being without judgment as different that being without bias, which she says is not feasible, because we all have biases, and hence, it is important to know your biases and recognizing their presence. She elaborated, “I don’t know anyone else’s experience but my own and it would be ignorance of me to make assumptions”. 

This is part of something that we learn in training as music therapists, and every day, as she works with people who have lived this, have fears, and generational trauma, she employs compassion, empathy, vulnerability, humility, and lets her patients know that she wants to learn more about their experiences and how they can use music to convey something deeper than words are able to is essential in this work. 

TSgt Larimer shared a sentiment from his favorite trumpeter, Wynton Marsalis, who regards music, particularly Jazz, as a communication process where you can talk and listen at the same time. TSgt Larmier very much resonates with this as he speaks through his piano every time he is presenting, performing, or educating. 

Lead discussant and panel moderator, Ms. Vaudreuil reflected responses of TSgt Larimer and Ms. Langston regarding the use of music, certain genres, and styles such as improvisation to connect and communicate, and acknowledged the evocative nature of music, which was amplified in each of the responses. Thinking historically of music and music therapy as a professional field and clinical discipline, Ms. Vaudreuil acknowledged that some of the music that she was trained to use in music therapy, she has since learned have racist undertones and roots (e.g., Oh, Suzanna, Home on the Range, Camptown Races). She elaborated that as music therapists, the music that we use needs to be informed, and the client’s perspective is critical to the musical selection process.  

Additional quotes from renowned trumpeter, Wynton Marsalis related to this topic are included below. 

“As long as there is democracy, there will be people wanting to play jazz because nothing else will ever so perfectly capture the democratic process in sound. Jazz means working things out musically with other people. You have to listen to other musicians and play with them even if you don’t agree with what they’re playing. It teaches you the very opposite of racism and anti-Semitism. It teaches you that the world is big enough to accommodate us all.”

“When you study our greatest artists, you will find that they give us a key to understanding how to deal with each other, and that our bloodlines are intertwined. It’s not hyphenated America. That there is an America, and it is expressed in those arts. It gives us a key to figure out how to negotiate with each other, and it tells us 

Q7: Has MT been discussed in conjunction with peacebuilding/post-conflict theory as well?

Mark Ettenberger outlined the possible relationship between peace, conflict, and music therapy. First, it is important for music therapists working in the field to be aware at what stage the conflict is currently at, differentiating between peacekeeping, peacebuilding, or peacemaking. Johan Galtung, a Norwegian sociologist who founded in 1959 the first International Institute for Peace, differentiated between direct, structural, or cultural violence. While direct violence might be the most visible aspect of a conflict, cultural and structural violence are much harder to change and are often long-lasting. As listening and communication are key in any approach to conflict transformation, Marshall Rosenberg’s approach to non-violent communication might also be a useful framework for anyone interested in this topic. 

Recommended literature on this topic includes the following resources: 

Marian Liebmann (Ed.) (1996). Arts approaches to conflict. London and Bristol, Pennsylvania:

Jessica Kingsley Publishers. 179 pages. ISBN 1-85302-293-4.

Jean-Paul Lederach. (2005). The Moral Imagination: The Art and Soul of Building Peace. 

Print ISBN-13: 9780195174540, DOI:10.1093/0195174542.001.0001 

Agosto Boal. (1993). Theatre of the Oppressed. Theatre Communications Group. 208 pages. ISBN: 0930452496 

United Nations (UNICEF). People Building Peace 35 Inspiring Stories from Around the World. 411 pages, ISBN: 9789057270291

Julie Sutton. (2002). Music Therapy International Trauma Perspectives. Jessica Kingsley 

Publishers. London, England. 272 pages. ISBN: 1843100274

Barbara Else cited the work of Musicians for World Harmony and referenced ties to peace building through culturally-informed music and the arts. In terms of military populations, there are numerous instances of creative arts therapists, artists, and the arts more broadly in post conflict peace building efforts. Coordination and sustainability of ongoing programs is another matter and very challenging.

Q8: It is often the communities that need trauma support that don’t receive it.  I’m curious about how to get musical support to the communities, especially in the U.S. that are in desperate need of it.

Ms. Danielle Vetro-Kalseth shared her experiences of building communities through the arts in Anchorage, Alaska regarding geographic location and the transition work that she is doing with service members transitioning from active duty to veteran status. Ms. Vetro-Kalseth spoke of the importance of engaging community artists, musicians, and organizations. Historically, music therapy has strong roots, and is still a small but growing profession there are 8,000 board-certified music therapists in the U.S., so it is not feasible for music therapist to be in every community so engaging community entities and adapting approaches to community music experiences that are music therapy-informed. 

She outlined a phased approach that she uses with the service members and veterans that she works with in Anchorage, which starts with the clinical treatment, moving into group socialization experiences and then moving to community outreach. Part of her community outreach is training veterans as the trainers for example, how to lead a community jam session at community -based locations such as the Veterans Homeless Shelter. Ultimately, this is mobilizing veterans who have gone through clinical treatment, fostered strong social relationships with each other, and then go to the community together and give it back to other veterans who may not receiving music as a routine part of their lives. 

Virtual Exhibit: Art for Remembrance

Ms. Barbara Else initiated the virtual exhibit by reviewing the concepts of historical trauma, which refers to cumulative emotional harm to an individual, group of individuals, and even a generation caused by a traumatic experience or event. Thinking about historical trauma in that context, the events of 9/11, now over 20 years in the past, continue to manifest in the present in many forms. Empowerment of people through all the arts may serve to help memorialize and perhaps help repair the community culture. To this end, we have assembled a brief sampling of the arts in response to 9/11 in this post-9/11 world. 

Ms. Else introduced the concept of peace reconciliation using art starting with a display of musical instruments upcycles from weapons. These are functional upcycled art pieces that say so much about historical trauma, memorialization, reconciliation, hope, and peace. 

Upcycled weapons: Barrel flute (left) and Helmet banjo (right)

Artist: Pedro Reyes

Ms. Rebecca Vaudreuil shared an art therapy product using reclaimed materials from a combat zone, which was referenced from a publication by her colleague and art therapist, Ms. Melissa Walker. 

“At the next session the patient went right to work on his mortar attack scene, adding more details to include little pieces of shrapnel coming out of the explosion, a figure of an Army man frozen with fear on the ground, and some buildings in the background. Fillmore stated he was enjoying the process and believed it was helping him, as he still saw the images/flashbacks in his mind, though he reported that they were not as intense as before. Fillmore was able to obtain some dirt from the actual blast site and some shrapnel from the attack which included one piece that was taken out of his leg after his injury. These elements, as well as representations of pieces of wood and other debris that were blown up/into him during the attack, were planned to be incorporated as three-dimensional objects into the piece. Fillmore shared with his therapist that he felt the art-making process was helping decrease his flashbacks or was at least allowing him to view them in a different way.”

Artwork and excerpt retrieved from: Walker, M., Kaimal, G. Koffman, R., & DeGraba, T. J. (2016). Art therapy for PTSD and TBI: A senior active duty military service member’s therapeutic journey. The Arts in Psychotherapy, 49(2), 10-16. 

Ms. Langston introduced a piece of art created in an art therapy session facilitated by her college, Ms. Heather Spooner, whom Ms. Langston also works with in music therapy. The veteran who created this piece was working at the Pentagon on 9/11. This is reflected in the second “1” of 9/11 in this piece. The Veteran artist created this Zentangle form of artwork during Hurricane Irma in September 2017, which can be seen in the lower left hand corner of the piece. Creating this piece during this Category 5 hurricane that crated widespread destruction across its path provided a space for the artist to be mindful and present and refocus her attention from the trauma she experienced in 9/11 that was being brought up again during this natural disaster.

Artwork retrieved from: Spooner, H., Lee, J. B., Langston, D. G., Sonke, J., Myers, K. J., & Levy, C. E. (2019). Using Distance Technology to deliver the creative arts therapies to veterans: Case studies in art, dance/movement, and music therapy. The Arts in Psychotherapy, 62, 12

Ms. Vaudreuil and Chief Crane presented a collective poem to music created by a cohort of service members during a music therapy session at a specialty clinic for TBI and PTSD on an anniversary of September 11.

Ms. Vaudreuil shared an excerpt from a patient’s original song, “Turbulent Wars” created in a music therapy session facilitated by music therapist, Ms. Natalie Quintana at James A. Haley Veterans Medical Center in Tampa, Florida. This song is part of the Creative Forces Virtual Exhibit and can be viewed in its entirety here. 

“Turbulent Wars”

SOF Missions, Song Excerpt

James A. Haley VA, Tampa, FL

Watch/Listen to “Turbulent Wars” 

“Scars from the war, lose your family and faith

All your friends are gone, and all that remains 

The enemy’s come, he’s taken our freedom, he did it all by force

We strapped up our armor, we gathered our weapons

We fought the righteous war

The war begins, the blood is shed 

Bombs explode, in the sky

Bodies fall, the bullets fly

The war begins, the blood is shed 

The guilt is fear, the innocence is gone, the dark is here, 

The light is far, so far”

Ms. Vaudreuil shared an excerpt from a dance performance by Exit 12 Dance Company headed by Roman Baca, entitled, “War Leaves Pieces”, released on 9/11/20. 

Music by: Roman Baca. 

Choreography: Roman Baca and dancers

Dancers: Lisa Fitzgerald, Adrienne de la Fuente, Taylor Gordon, Danielle Rutherford, Sean Scantlebury

Veteran Collaborators/Readers: Everett Cox, Omar Columbus, Jenny Pacanowski

Videographer: Leighann Kowalsky

Production and Lighting: Zach Jacobs

Image capture from War Leaves Pieces

TSgt Larimer introduces the Compilation of John Adams commissioned musical piece “On the Transmigration of Souls” and displayed a photo slideshow to music, as shown below. Ms. Else provided photo permissions for all pictures shared. 

Kids heading home from school in Pakistan 

Nighttime helicopter Returning from Forward Operating Base (FOB) to Baghdad, Iraq

Military jet on display juxtaposed by cart and donkey in Pakistan

Joint performance by U.S. Army 10th Mountain Division Band members and Afghan music students playing John Philip Sousa’s, “Stars and Stripes Forever” 

Dr. Mark Ettenberger introduced a virtual Peace-building rally/movement “A song for Colombia” event comprised of artists and social leaders engaged through speaking, music making, and collective creativity. Dr. Ettenberger spoke to the post-conflict violence in Colombia during 2020, where over 200 social leaders were killed as of September 22, 2020. He stated that it is common for artists to respond through community organizing during times of civic unrest and violence. Dr. Ettenberger shared an image of César López, a musician instrumental in initiating the event, who transformed weapons from the conflict into musical instruments, and artist, Fundación Prolongar, who works with the Japanese tradition of Kintsugi as a way of symbolically repairing history. 

“Un Canto Colombia/A song for Colombia” Event Flyer

César López holding an upcycled guitar made from a rifle

Open Forum Discussion 

Mr. Samuel Gracida introduced his work with refugee children and adolescent populations in Heidelberg, Germany. He joined a previously-established music group which consists of music therapists and local musicians visiting a residential area that was built for refugees to offer music activities for approximately one hour per week. 

Based on this work he wrote his master’s thesis, “Music therapy for refugee children in a permanent residence in Germany: a program proposal,” in which he explored diverse topics, including trauma, a salutogenic orientation to health, the refugee journey, and more.

To think about how to support refugee children in their paths from illness to wellness it is necessary to bring into awareness the complex array of life stressors that affect their lives. Not only have refugee children probably witnessed war, conflict, persecution, loss

of friends and families, and more in their countries of origin, but they now also

face stressors in their current environment such as discrimination, cultural

barriers, poverty, and more. 

While some children could in fact be closer to achieving their fullest potential for their individual wholeness, it is also true that for many of them, there are many factors that could prevent this from happening. 

Codrington, Iqbal, and Segal (2011) have written about the challenges of working with families from a refugee background and have proposed a discussion of the refugee journey. The refugee journey they proposed served to identify the possible life stressors in a refugee’s life. It is divided into three sections: 

• the country of origin,
• flight, 
• and the new country (resettlement). 

In their country of origin, refugee children could have had experiences of grief, loss, war, and violence, as well as possible child abuse or neglect. Biological predisposition to mental illnesses as well as developmental disabilities could have existed and exacerbated the effects of the stressors in their lives. As they left their country and embarked on a journey to a country of refuge, refugee children may have experienced loss or separation from family members, loss of personal belongings, basic needs not being met, difficult experiences in their first country of asylum or refugee camps, and more. 

Lastly, as refugee children arriving with or without their families to the new country of resettlement, they face new difficulties such as language and educational barriers, housing difficulties, cultural differences, social isolation, ongoing mental health problems, experiences of racism and discrimination, and ongoing effects of past trauma.

Presentation attendee, Nathan Case, a college of Samuel Gracida in Heidelberg, Germany spoke of his master’s work designing a songwriting intervention for active duty U.S. service members stationed in Germany. He shared that through his work, he noticed a difference between the music therapy with activity duty service members and veterans, specifically how it is received. He inquired to gain more insight on this. 

Ms. Vetro-Kalseth, who works at a joint venture base that serves both active duty service members and veterans shared that she has combined music therapy groups comprised of both populations. Ms. Vetro-Kalseth shared that there is a core difference in the goals, wherein for active duty service members, the goals revolve around rehabilitation, return to duty, and medical readiness of the force and for the veterans that she serves, the goals involve creating social connections and community building to mitigate isolation. 

She stated that the combined groups that include service members, veterans, army, air force, air national guard, and special forces exemplify connectedness through the stories they share with each other and the experiences of where each of them are in their military service or post-military process. They learn so much from each other from recovering from traumatic brain injury while in service, readiness to return to duty, and the transition out of service, and beyond.

Ms. Langston stated that with the veterans that she works with is more long-term treatment goals and there is no set time-frame for rehabilitation. Working with the veteran population often spans multiple conflicts and service eras and such, there are challenges that can be compounded within that, from their traumas as well as society’s perception of veterans from different eras. Ms. Langston elaborated that she works with veterans from ages 18 to 90, from all different races, ethnicities, gender identities, and other points of identity and intersectionality.  

Ms. Else spoke to the family dynamics of active duty service members and how she uses music and the arts to address transition of leaving for and homecoming from multiple deployments. Ms. Else elaborated that a key to working with the caregivers is to provide them a brave space in which to have fun and be able to let loose. 

Ms. Vaudreuil shared a quote from a family member that she worked with regarding the impact of music therapy treatment, 

Through art and music, we are healing. And I say we because most of the time when the soldier comes, the family, we’re here with them and we all heal together. It’s truly a miracle. I think without what all of our team have done, we couldn’t have in my family, the quality of life that we have. We don’t even think that we are disabled anymore. We don’t see the disability, we onlysee the possibility.

Ms. Vaudreuil concluded the Insights Discussion presentation with sharing that Creative Forces research inventory are all open access, provided here. 

References

Boal, Agosto. (1993). Theatre of the Oppressed. Theatre Communications Group. 208 pages. ISBN: 0930452496 

Bronson, H., Vaudreuil, R., & Bradt, J. (2018). Music therapy treatment of active duty military: An overview of intensive outpatient and longitudinal care programs. Music Therapy Perspectives, 36(2), 195-206. https://doi.org/10.1093/mtp/miy006  

Chilton, G., Vaudreuil, R., Freeman E., McLaughlan, N., Herman, J., & Cozza, S., (2021). Creative Forces®: programming with military families: Art therapy, dance/movement therapy, and music therapy brief vignettes. Journal of Military, Veteran, and Family Health. Retrieved from: https://jmvfh.utpjournals.press/doi/pdf/10.3138/jmvfh-2021-0031

Dalton, A. (2020). Trauma informed care, the COVID-19 pandemic, and music therapy. Resources for Music Therapists and Students. AMTA COVID-19 Task Force. Retrieved from: https://www.musictherapy.org/assets/1/7/TIC,_COVID-19_and_Music_Therapy_AMTA_COVID-19_Task_Force.pdf

Jones, J. P., Walker, M. S., Masino Drass, J. & Kaimal, G. (2018). Art therapy interventions for active duty service members with post-traumatic stress disorder and traumatic brain injury. International Journal of Art Therapy. doi: 10.1080/17454832.2017.1388263 

Lederach, Jean-Paul. (2005). The Moral Imagination: The Art and Soul of Building Peace. Print ISBN-13: 9780195174540, DOI:10.1093/0195174542.001.0001 

Liebmann, Marian (Ed.) (1996). Arts approaches to conflict. London and Bristol, Pennsylvania:Jessica Kingsley Publishers. 179 pages. ISBN 1-85302-293-4.

National Endowment for the Arts. (n.d.a) Community engagement. Creative Forces National Resource Center. Retrieved from: https://www.creativeforcesnrc.arts.gov/what-we-do/community-engagement

National Endowment for the Arts. (n.d.b) What we do. Creative Forces National Resource Center. Retrieved from:  https://www.creativeforcesnrc.arts.gov/what-we-do

National Endowment for the Arts. (2022). Creative Forces clinical peer-reviewed publications inventory. Retrieved from: https://www.arts.gov/sites/default/files/Creative-Forces-Clinical-Peer-Reviewed-Publications-Inventory-January-2022.pdf 

Sherin, J. E., & Nemeroff, C. B. (2011). Post-traumatic stress disorder: the neurobiological impact of psychological trauma. Dialogues in clinical neuroscience, 13(3), 263–278. Retrieved from: https://doi.org/10.31887/DCNS.2011.13.2/jsherin 

Spooner, H., Lee, J. B., Langston, D. G., Sonke, J., Myers, K. J., & Levy, C. E. (2019). Using Distance Technology to deliver the creative arts therapies to veterans: Case studies in art, dance/movement, and music therapy. The Arts in Psychotherapy, 62, 12–18. Retrieved from: https://www.sciencedirect.com/science/article/abs/pii/S0197455618301345 

Sutton, Julie. (2002). Music Therapy International Trauma Perspectives. Jessica Kingsley Publishers. London, England. 272 pages. ISBN: 1843100274

United States Department of Veterans Affairs. (2022). What is PTSD?: PTSD basis. National Center for PTSD. Retrieved from: https://www.ptsd.va.gov/understand/what/ptsd_basics.asp 

United Nations. People Building Peace 35 Inspiring Stories from Around the World. 411 pages, ISBN: 9789057270291

Vaudreuil, R., Crane, J., Ettenberger. M., Gracida, S., Iyengar, S., Langston, D., Larimar, C., McGuire, M., Vetro-Kalseth, D., & Wacks, K. (2021). The use of music for resilience-building and healing trauma. International Association of Music Medicine. Retrieved from: https://iammonline.com/2021/08/20/the-use-of-music-for-resilience-building-and-healing-trauma/

Vetro-Kalseth, D., Vaudreuil, R., & Segall, L. (2021). Treatment description and case series report of a phased music therapy group to support veteran reintegration. Military Psychology. Retrieved from: https://urldefense.com/v3/__https://www.tandfonline.com/doi/full/10.1080/08995605.2021.1962194__;!!FykDdelvMO2VvRk!mT3FV0alzeomaGkdjfuEc_9pouPCdfdUCPZstFHuMjYZEEAZVI9G5WwNVUAwx1Q$ 

Walker, M., Kaimal, G. Koffman, R., & DeGraba, T. J. (2016). Art therapy for PTSD and TBI: A senior active duty military service member’s therapeutic journey. The Arts in Psychotherapy, 49(2), 10-16. Retrieved from: https://www.sciencedirect.com/science/article/pii/S0197455616300636