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Music Therapy and Military Populations: An Update

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I am very pleased to inform our readers that the American Music Therapy Association (AMTA) has just announced the publication of Music Therapy and Military Populations: A Status Report and Recommendations on Music Therapy Treatment, Programs, Research, and Practice Policy. You can obtain this landmark report, which discusses the profession of music therapy with a focus on both active duty service members and veterans, online under the "Latest News" section.

Music therapy services are an integral part of care delivered in military treatment facilities and VA medical centers throughout the US. Board-certified music therapists serve as members of patient-centered interdisciplinary teams. They work alongside other creative arts therapists and allied health professionals, providing a very vital service at America's veteran hospitals, military health facilities and military installations.

Readiness, rehabilitation, and recovery are the "3 R's" of the rich and enduring contributions the music therapy profession has provided to America's military populations. Throw in a generous dose of wellness programming and you have an accurate overview of the variety of focus areas for music therapy with active duty service members, veterans and their families.

Let's take a look at an exemplary program focusing on readiness: The Institute for Therapy through the Arts (ITA) at the Music Institute of Chicago designed "Operation Oaktree" to help military children and families throughout the cycle of deployment. One component of "Operation Oaktree" is Get Ready, Get Set, a family pre-mobilization program, the mission of which is to "strengthen family and individual resilience and readiness in advance of the disruption caused by a service member's mobilization." Services in this program are provided by a team of creative arts therapists including music therapists. (p. 21)

A model project focusing on rehabilitation was developed by Resounding Joy, Inc. in San Diego. The Overcoming Adversity and Stress Injury Support (OASIS) Program is conducted in a 10-week residential inpatient treatment setting at Naval Base Pt. Loma. It provides intensive rehabilitation, teaching strategies for managing symptoms of Post Traumatic Stress Disorder (PTSD), Traumatic Brain Injuries (TBI), and substance abuse diagnoses. Music therapy interventions utilized in this program include music making, lyric interpretation, songwriting, therapeutic instrumental musical performance and other Neurologic Music Therapy techniques. Through these experiences, groups have been "able to build cohesion, increase acknowledgement and insight of self and others, improve appropriate communication skills, and focus on strengths and abilities." Program goals can range all the way from assisting service members to return to active duty to providing support in the process for individuals in re-integrating into their communities. (p. 17)

The report highlights recovery and music therapy through a "Case in Point" with Wisconsin-based Iraq Veteran, Jason Moon, and Shep Crumrine, his music therapist at Milwaukee VA Medical Center. Moon has helped not only himself but also other veterans through his songwriting and performances at the VA Creative Arts Festival and through his nonprofit, Warriors Songs. He says he was "able to merge the horrible experiences with the happy ones through music in order to help other veterans." Crumrine shares his belief that "music and creative arts therapies don't just help with the initial momentum needed for effective treatment; they keep veterans engaged for sustainable recovery." (p. 24)

One of several examples of programs with a wellness focus featured in the report is the Intensive Outpatient Program (IOP Group) under the auspices of Resounding Joy, Inc. The music therapy component of this 8-week closed outpatient group for service members experiencing extreme symptoms of PTSD focuses on progressive wellness sessions that include patient-preferred music. The program helps participants understand ways in which PTSD can manifest. Mental health professionals working in the program have observed music therapy groups, and they report positive outcomes in communication, processing and advocacy. (p. 18)

Currently music therapy as a profession is recognized throughout agencies of the federal government, including the Departments of Education and Health and Human Services and the National Endowment for the Arts (NEA). In fact, in November 2012, NEA expanded its landmark partnership with the Department of Defense by funding music therapy programming at the National Intrepid Center of Excellence (NICoE), as well as in other parts of the Walter Reed National Military Medical Center (WRNMMC) in Bethesda, Maryland.

Music therapy interventions at NICoE are part of a four-week interdisciplinary and comprehensive treatment program. They address multiple goal areas, such as awareness of the mind/body connection by identifying feelings and emotions and their relationships to behaviors in daily life; mood; physical discomfort/pain; attention, memory and executive functioning; and non-verbal means of expression of thoughts, feelings and emotions (p. 20).

Patients at WRNMMC, including active duty, retirees of the military, and dependents, are eligible to receive music therapy on either an inpatient or outpatient basis. Patients participating in music therapy at WRNMMC have a wide array of diagnoses: TBI, stroke, dysarthria, anxiety, depression, PTSD, trauma-related injuries, children with autism spectrum disorder, and cancer (p. 21).

The demand for music therapy services for America's service members, veterans and their families by board certified music therapy clinicians is growing. As I wrote last year in a previous HuffPost blog, more troops are coming home with diagnoses such as PTSD and TBI, both of which are considered "signature wounds" for veterans of our most recent conflicts. There is also a high incidence of "polytrauma," where individuals have been subjected to multiple traumatic injuries in their deployments.

The report articulates that the benefits of music therapy services are largely untapped at America's military health facilities. While music therapy in the US military has a history of over 70 years, "covering the entire continuum of care among service members, veterans, and their families" (p. 36), music therapy programs exist in VA hospitals in only 27 states plus Puerto Rico and Washington, DC. The report lists barriers to access to music therapy services and makes recommendations for practice policy and for treatment and program development to attempt to overcome these obstacles.

The report also highlights the strong foundation of published research and evidence to inform music therapy practice. The authors give recommendations in this area, including testing and adapting established music therapy interventions and protocols among military populations and replicating studies in military populations where the evidence base was formed in civilian populations (p. 35).

This historic whitepaper is an important step toward fulfilling AMTA's mission, "to advance public awareness of the benefits of music therapy and increase access to quality music therapy services in a rapidly changing world." The focus on military populations and their families is especially timely and meaningful as we are all challenged to meet the needs and issues faced by active duty personnel and veterans. We must do all we can to care for those who serve our country!

According to the paper's lead author, Barbara Else, and its many other contributors, Dr. Alicia Clair, Dr. Andrea Farbman, Julie Garrison, Tina Haynes, Dr. Bryan Hunter, Judith Pinkerton, Dr. Barbara Reuer, Jenni Rook, Dr. Margaret Rorke, Judy Simpson, and Rebecca Vaudreuil, the bottom line is this: "More music therapy and credentialed music therapists are needed to keep pace with the current needs of our military populations."