The profession of music therapy is rooted in service to America’s service members and veterans. As a professional organization representing 6,000+ music therapists nationwide and in some thirty countries around the world, AMTA has a tradition and steadfast commitment to providing service members access to high quality music therapy services and research. This commitment spans all phases of military service.
In 1945, the U.S. War Department issued Technical Bulletin 187 detailing a program on the use of music for reconditioning among service members convalescing in Army hospitals. This program demonstrated how music could be incorporated in multiple therapeutic services including recreation, education, occupational therapy, and physical reconditioning (Rorke, 1986; U.S. War Department, 1945). Following WWII, music therapy grew and developed as a profession and as a direct result of research endorsed by the Army and Office of the Surgeon General. However, the seeds planted early on in the military have not mirrored the rate of growth and development of the profession relative to other public and private practice settings.
The reasons for inconsistencies in access to evidence-based music therapy services among service members are considered in the context of a white paper sponsored by the American Music Therapy Association (AMTA):
Music Therapy and Military Populations: A Status Report and Recommendations on Music Therapy Treatment, Programs, Research, and Practice Policy
The information and recommendations detailed in this paper provide the groundwork to improve access to music therapy services among military populations; and inform strategic plans for expanded and prioritized implementation of music therapy programs, research, and practice policy. The overall intentions are to keep pace with the current needs of service members and to support mission readiness and a resilient military and veteran population.
While many individuals exposed to trauma follow a normal or typical course of recovery from acute stress reactions and acute stress disorder, some develop post-traumatic stress disorder (PTSD) or PTSD with delayed onset. The signature injuries of recent wars include post-traumatic stress disorder (PTSD), traumatic brain injury (TBI and mTBI), major depression, polytrauma, and a whole host of complicating sequelae such as substance abuse, family conflict, and suicide risk. The prevalence of PTSD among the 1.7 million service members deployed under Operation Iraqi Freedom and Operation Enduring Freedom is estimated to be about 15% (Ramchard, Schell, Jaycox, & Tanielian, 2011). Among America’s veterans of earlier conflicts, including the Vietnam war, the incidence of cases is large. In order to support service members and their families in prevention, wellness, and recovery, music therapists are qualified professionals who possess the skills and abilities to determine appropriate interventions to support resilience and recovery. Furthermore, music therapists are an integral part of treatment teams in the context of interdisciplinary services.
There are numerous examples of music therapy programs in the military across the country, and examples are cited in the AMTA white paper. They range from a program for active duty airmen to foster coping and stress management around deployment, to programs that center on the use of songwriting to address issues associated with symptoms of PTSD, to programs that address the needs of service members and veterans with polytrauma in rehabilitation.
Music therapists are actively involved in contributing to a strong base of evidence in support of various music therapy interventions, drawing from high quality research. There is an urgent call for better understanding of what works in supporting service members’ combat and noncombat injuries. The current range of interventions in use and approved for the management of PTSD, such as prolonged exposure (PE), cognitive processing therapy (CPT), and eye movement desensitization and reprocessing (EMDR), and pharmacotherapy, do not take place in isolation and are not without limitations. Understanding the role and contribution of music therapy interventions on clinical outcomes and dose-response in recovery and therapy is an important and understudied priority.
Numerous studies of significance over the nearly 70 years of research history in the profession of music therapy are relevant to service members and veterans. Research on music based interventions designed to inform evidence-based music therapy interventions for service members and families is a priority. Collaborative studies, interdisciplinary, and cross-disciplinary research are important undertakings to support service members and their families. Though the music therapy literature has numerous studies that investigate topics relevant to the military, there is a need for more clinical studies to support evolving music therapy practices necessary to improve life functions in service members and families across the country.
References:
Ramchand, R., Schell, T. L., Jaycox, L. H., & Tanielian, T. (2011). Epidemiology of trauma events and mental health outcomes among service members deployed to Iraq and Afghanistan. In J. I. Ruzek, P. P. Schnurr, J. J. Vasterling, & M. J. Friedman (Eds.). Caring for veterans with deployment-related stress disorders. Washington, DC, US: American Psychological Association. doi: 10.1037/12323-001
Rorke, M. A. (1996). Music and the wounded of World War II. Journal of Music Therapy, 33(3), 189–207.
U.S. War Department. (1945). Technical Bulletin 187: Music in reconditioning in American Service Forces convalescent and general hospitals. War Department Technical Bulletin, TB Med 187, 1–11. Washington, DC: U.S. War Department.