Each year, thousands of children are victims of some form of child abuse. Whether it be neglect, sexual abuse, emotional abuse, or physical abuse, the maltreatment of children has become a hidden epidemic. Music therapy is a proven tool to help children combat the emotional, physical, and social repercussions brought on by multiple forms of child abuse through the use of music interventions and the incorporation of other behavioral techniques.
When looking into the effects of child abuse, there are both immediate and long-term effects that can occur. These effects are present in a child’s physical, emotional, and behavioral well-being and can carry over into adulthood if left untreated. Some of the common effects reported in children and adults who have experienced abuse in their childhood are anxiety, depression, low self-esteem, aggression, social withdrawal, and PTSD. In severe cases, when child abuse has gone unnoticed or improperly addressed, children are at a higher risk for death.
Some of the aftereffects of child abuse might result in goal areas of increasing management of pain, self-esteem, and social skills, as well as decreasing outbursts of anger. Through music therapy, this can be accomplished with interventions such as music listening for sustained focus, music-assisted relaxation, music-guided imagery, and singing client-preferred songs (Bradt). The purpose of these interventions is to refocus attention away from the pain that the client is feeling. For example, music listening for sustained focus shifts the attention away from the pain and puts it on the music. The music therapist will play the client's chosen music usually accompanied by a guitar and observe the client as they listen to the music, making sure to take note of relaxed breathing or facial expressions as a sign of improvement.
Another area in which music therapy can be helpful is improving the low self-esteem caused by abuse. Oftentimes, children who have gone through physical, emotional, sexual abuse, or neglect will blame themselves for the maltreatment that they are receiving and go on to carry shame and self-contempt, leading to an overall low level of self-esteem. In this area, a multimodal treatment can be used, for example, the combined use of music therapy and cognitive behavioral therapy (CBT). CBT is an effective psychotherapy treatment that helps with identifying and changing current negative thoughts or behaviors.
In combination with music therapy (CBMT), it can prove to be beneficial in the treatment of abused children. Some possible CBMT interventions used for increasing self-esteem are songwriting, emotional identification and expression through instruments, musical dialogues, and lyric analysis. For example, in the treatment of a 6-year-old girl who experienced physical and sexual abuse, songwriting, along with the use of art, was used to increase the child’s self-esteem while also providing her with a safe emotional outlet (Christenbury). The music therapist begins by allowing the client to color a picture of an emotion of their choice, followed by the music therapist composing a song about the contents of the drawing.
Socialization with peers is a major part of a child’s developmental growth; however, that can be taken away due to abuse. Music therapy, often in the form of group treatment, can provide great ways to address social skills in children. In a group music therapy session, some interventions may include instrument turn-taking, collaborative instrumental play, drum circles, and collaborative songwriting. These interventions allow the participants to work on team-building and appropriate social behaviors. In instrument turn-taking, the music therapist begins with everyone playing their given instrument and singing along to a familiar song, followed by giving each child the opportunity to have a solo with either just their instrument, with singing, or with both. This allows the children to work on patience, impulse control, and building confidence amongst their peers.
Another effect commonly seen in children who have experienced child abuse is difficulty managing anger or aggressive outbursts. With so much anger being projected onto a child through abuse, it is not a rare occurrence for that child to begin displaying similar acts or attitudes toward peers or authoritative figures. In music therapy, it can be helpful to address these issues with interventions such as drum dialogues, emotional expression through songwriting, and musical improvisation. One of the key factors in a lot of these interventions is the use of the Iso principle. This technique allows the client to release their current emotional state, whether that be anger, frustration, or sadness, and then, with the help of the music therapist, begin to find a way to gradually substitute in a desired emotion that is positive.
When looking at drum dialoguing, there are great opportunities for the child to engage in a non-verbal conversation with the music therapist. In doing so, they are working towards releasing their aggression and channeling it into a better form of coping. The music therapist can engage in a conversation through the drums or follow the lead of the child, providing support for the emotions that are being expressed. After this, the music therapist can bring the child back by asking open-ended questions about the feelings that they were experiencing while drumming. To end, the music therapist can give an example or prompt the child to show them a version of drumming opposite of what they just expressed.
To conclude, child abuse can have multiple immediate and long-term effects on a child’s life that can lead to complications throughout development. Through the use of music therapy along with cognitive behavioral techniques, children who have gone through abuse can receive treatment in a non-threatening way. The use of music interventions has been proven to be an effective treatment option for children who have experienced maltreatment because of the expressive outlet that provides the child with the opportunity to communicate their emotions and hurt in a fun and unique way.
-Beatriz Leal, Music Therapy Intern
References
Bradt, J. (2013). Guidelines for Music Therapy Practice in Pediatric Care. Barcelona Publishers.
Christenbury, K. R. (2017). I Will Follow You: The Combined Use of Songwriting and Art to Promote Healing in a Child Who Has Been Traumatized. Music Therapy Perspectives, 35(1), 1–12. https://doi-org.uiwtx.idm.oclc.org/10.1093/mtp/miv005
Goldbeck, L., & Ellerkamp, T. (2012). A Randomized Controlled Trial of Multimodal Music Therapy for Children with Anxiety Disorders. The Journal of Music Therapy, 49(4), 395-413. https://doi-org.uiwtx.idm.oclc.org/10.1093/jmt/49.4.395
Toth, S., & Manly, J. (2019). Developmental Consequences of Child Abuse and Neglect: Implications for Intervention. Child Development Perspectives, 13(1), 59-64. https://doi-org.uiwtx.idm.oclc.org/10.1111/cdep.12317.