Music therapy with forcibly displaced persons

Elizabeth Coombes, Samuel Gracida, and Emma Maclean (Eds.) (2025). Music Therapy with Displaced Persons: Trauma, Transformations, and Cultural Connections. Foreword by Viggo Krüger. Jessica Kingsley Publishers, 288 pages.

A new anthology from a group of highly qualified music therapists on an exceptionally timely topic. As the title suggests, this is a book about music therapy for displaced people — those who are forced to flee, asylum seekers, or refugees. The main focus is on so-called “forcibly displaced persons,” meaning people who have been driven from their homes by force. According to the UN High Commissioner for Refugees, there were around 117 million people in this situation in 2024. Many are displaced across national borders, while others are internally displaced within their own countries. We are all too familiar with this from our daily news: the civil war in Sudan, Russia’s terror bombing of Ukraine, or the ongoing genocide and ethnic cleansing in Gaza and the West Bank.

What can music therapists offer in such circumstances, in encounters with people undergoing such dramatic and traumatic life changes? As Viggo Krüger points out in the foreword, this is above all a matter of human rights — the right to one’s own culture, religion, and language. These rights must also be upheld for people living as refugees in other countries.

A Serious Prelude

The editors introduce this anthology, which consists of thirteen chapters from a range of countries. We are given a brief overview of the themes, which are divided between more clinical and trauma-related narratives and articles with a community music therapy focus, emphasizing education, co-production, and sustainable approaches through creating cultural connections.

The book opens with a deeply moving prelude: “A Sudden Displacement Due to War in Palestine-Israel, and its Impact on Present and Future Plans.” It is written by Eva Marija Vukich and the Palestinian music therapist Hala Hamdan, who lives in Israel and works with Israeli children. The authors were in the process of writing their chapter for the anthology when Hamas attacked on October 7, 2023 — turning Hamdan’s life upside down. She continues as long as possible to provide music therapy for the Israeli children she has committed to working with, at the parents’ request. But it becomes too difficult. She eventually ends up displaced herself, in a European country. The process of adjustment is so demanding that the article must be set aside. Their reflexions are published instead as a prelude to the book.

What we thus missed was an article about the importance of self-reflection in work with refugees — the need to examine one’s own motives, roles, and the power dynamics that arise in practice, Hamdan and Vukich write. This is essential for ensuring greater therapeutic benefit, as well as a dignified and ethically responsible practice. They also planned to write about the importance of co-writing and how difficult it is for displaced people to find the time and energy to engage with the academic language typical of such anthologies. They call for solidarity, reciprocity, and ethical responsibility — and, not least, for music therapists to take a clearer stance on the ongoing assault on Gaza.

Review of the Literature

In the first chapter, Emma MacLean provides a critical review of the literature published between 2014 and 2024 on the use of music and music therapy with displaced persons. The overview shows that there has been more written on the subject than one might expect. We even find some Norwegian contributions, such as the article “Hope and Recognition: A Music Project among Youths in a Palestinian Refugee Camp” by Vegar Storsve, Inger Anne Westby, and the present reviewer, published in Voices: A World Forum for Music Therapy. Another often cited article is by Kaja Enge and Brynjulf Stige, based on Enge’s doctoral work.

The topics covered in the research literature are wide-ranging: trauma and post-traumatic stress in clinical and educational contexts; the building of trust; language and identity; group work and social capital; social transformation and cultural connection; integration and acculturation; cultural humility; emotional regulation; skill sharing and empowerment, among others. Anyone wishing to learn more or write about these topics will find this literature review highly useful.

A Neurological Basis for Trauma Treatment

The anthology is divided into three sections. Part 1 deals with trauma and trauma treatment in music therapy. The first article, by Gene-Ann Behrens, is titled “Impact of Trauma on Displaced Persons: Integrating a Neuroscience Perspective.” It provides a clear introduction to key neuropsychological mechanisms — an excellent entry point for those interested in the topic of “music and the brain.” Placing this article first in the anthology makes sense, as many of the following chapters refer to the brain mechanisms underlying relaxation, stress reduction, and the experience of calm and safety — psychological conditions necessary for trust and readiness to process difficult experiences.

We are introduced to regulating and dysregulating brain responses to threat, persistent trauma, and toxic cortisol levels. The article discusses brain development and maturation, synaptic changes, and the neurological effects of trauma. Other neuropsychological concepts relevant to trauma-informed care are explored, including neuroplasticity, the vagus nerve, resilience, the sense of personal safety or calm, and the importance of co-regulation between therapist and client.

Danish GIM Research

The first clinical article is written by Bolette D. Beck, Associate Professor at the music therapy program at Aalborg Univerity, Denmark. She has conducted research on the use of the Guided Imagery and Music (GIM)  with refugees in Denmark suffering from post-traumatic stress. The article is titled “Homecoming: Resettlement and Acculturation Processes in Music and Imagery Therapy for Female Refugees Suffering from Post-Traumatic Stress Disorder.”

Like several other articles, it addresses trauma and trauma therapy, but its main focus is on the process of finding a sense of belonging in a new country and culture. We gain insight into how difficult it can be for refugees to connect with new places, people, institutions, and natural surroundings. Being separated from one’s homeland, family, work, nature, and climate can easily lead to alienation and stress. Many also carry traumatic experiences from childhood or from their journey into exile. These burdens can lead to dissociative symptoms, common in PTSD. One therapeutic goal is to synchronize the client’s experiences of past and present — a process Beck refers to as presentification.

Beck provides theoretical justifications for how music can help clients experience being in the here and now, linking her approach to polyvagal theory. She offers important reflections on music selection, cultural understanding, and, not least, attention to material conditions — for instance, the importance of safe and stable housing as a prerequisite for trauma recovery.

We are given concrete insight into her research project through three vignettes, showing how three women are supported through music listening and dialogue to face their fears and the suffering linked to tragic life events. Homecoming is also about reconnecting with one’s body, inner world, and family life in entirely new surroundings.

Narrative Music Psychotherapy

The next article also has Nordic roots. Heidi Ahonen, originally a Finnish music therapist, has worked for over twenty years in Canada as a professor at Wilfrid Laurier University in Ontario. She is also a certified psychotherapist, holds a certificate in Global Trauma Recovery from Harvard Medical School, and has developed a method of Analytical Group Music Therapy.

Here too we learn about trauma and its neurological basis, but the focus is primarily on narrative psychology as the foundation for analytical music therapy. Her article, “Sounds of Pain and Hope: Storytelling with Music – Narrative Music Psychotherapy Through the Lens of Trauma and Recovery,” explains why and how narrative theory can be applied in music therapy to help clients build more coherent and functional life stories. The article also provides a detailed, practice-oriented account of the various methods Ahonen employs to process clients’ fragmented narratives — a deeply psychotherapeutic approach that integrates listening, instrument use, improvisation, and verbal interventions.

Safe & Sound

The last of the three articles in the trauma section is by the Dutch music therapists Sander van Goor and Evelyn Heynen, describing their work on the project “Safe and Sound: A Music Therapy Intervention for Refugee and Asylum Seeker Children.” This project focuses on helping children, and it gives valuable insight into how music therapists have gained an important role in Dutch primary schools by offering music therapy to refugee children. The project is well presented on their website: http://www.safeandsoundfoundation.com/.

Again, we are provided with a clear and detailed account of their practice, including many practical and methodological guidelines, all grounded in solid theoretical rationale. Through vignettes, we see how songwriting can help individual pupils articulate personal worries and potentially trauma-related experiences. The project offers group music therapy sessions for all refugee-background children at the start of each school year. Those identified as needing additional support are then offered individual music therapy. This article is highly recommended for music therapists working in this field. The project’s structure — as described on its website — could inspire similar initiatives in other countries.

Social Transformation

Part Two of the book is titled “Supportive Social Transformation”, containing chapters on resilience, children in transit camps, the transfer of music therapy skills to other aid workers in Palestine, and music therapy in a war-torn country such as Colombia.

The section begins with The Heidelberg Bridges Project, where German music therapists, trauma-sensitive musicians, music educators, and performing artists have launched a large-scale initiative to provide refugee children and youth with regular access to music—and to help them build bridges into the new society they have arrived in. Supervision is offered by a music therapist with psychotherapeutic training. The project is presented in depth, combining theoretical background and practical illustrations. Among the topics discussed, besides the importance of safe spaces, are resilience and regulation, as well as theoretical and empirical insights linking neuroscience, therapeutic best practice, and a grounded sense of realism intended to enrich and nuance the project discourse.

Resilience

The project conveys a strong theoretical framework with a clear protocol for activity implementation and well-argued aims and measures. In addition to the focus on safety—a recurring theme throughout all work with refugees—regulation is highlighted as a core theme, referencing Porges’ theory of the vagus nerve’s role in downregulating the sympathetic nervous system.

Resilience generally refers to a person’s ability to develop sound psychological health and cope with the negative effects of stress despite adverse life circumstances. Key components include a positive self-concept, emotional self-regulation, and self-control. It is also emphasized that the presence of at least one stable attachment figure during childhood, providing positive experiences, is crucial. A model summarizing key factors in the development of resilience highlights “character, competence, confidence, coping, control, connection, and contribution.”

Children in Transit Camps

In 2015, more than 850,000 people arrived in Greece in inflatable boats from the Turkish coast. On the island of Chios alone, 120,000 refugees landed—an island with a population of just 50,000. Greek music therapist Mitsi Akoyunoglou mobilized colleagues and organized a voluntary music therapy program for the many children passing through the camps each week. Refugees came from Syria, Afghanistan, Iran, and Iraq, and children accounted for 37% of those arriving on Chios.

Akoyunoglou, who teaches music therapy at the Ionian University on Corfu, holds a U.S. master’s degree (Michigan), a PhD and postdoc from the same university, and serves as Greece’s representative in the EMTC. With this activist and inclusive initiative for children, she aligns her work with the principles of community music therapy. Her article, “Researching Safe Spaces, Addressing Ethical Challenges: Music with Children on the Move in Transit Camps,” explores solidarity with refugees as a central value, grounded in altruistic and humanistic ethics.

She expands on what it means to live in a transit camp. The key concept here is liminality, drawn from van Gennep’s theory of rites of passage—existing in an in-between state where one has lost all previous points of reference: home, friends, belonging. It is a state of structural invisibility, exclusion from normal social participation, marginalization, and isolation.

The article provides insight into the working methods, goals, and challenges of such large-scale work with children who participated only briefly in the open music groups. Trauma-informed approaches, group organization, and supervision for the therapists are discussed. Given the emotional demands of this work, the need for self-care is a recurring theme.

Indirect Music Therapy

Music therapists Elizabeth Coombes and Saphia Abou Amer both have extensive experience working with Palestinian communities and describe their practice in “Interactive Therapeutic Music-Making (ITM-M) in Palestine.” The focus here is on how to offer interactive musical experiences with therapeutic value in contexts where access to formal music therapy is limited or impossible.

In other words, the authors explore how music therapists can share their expertise and train others—musicians, health workers, teachers, assistants, parents, and volunteers—to lead musical activities with therapeutic intent. The training takes place in the occupied Palestinian territories, benefitting local children.

This project-based work has been conducted over several years, with time-limited and evaluated interventions supported by online supervision. It is contextualized within the historical and political realities of forced displacement and intergenerational trauma. Especially in light of the current situation in Gaza, this serious research and education project offers important insights. As the authors note, there are far too few music therapists to meet global needs in areas of conflict; therefore, training programs should also emphasize such project-based dissemination of music therapy knowledge.

Internally Displaced People in Colombia

Colombian music therapist and professor Andrés Salgado Vasco provides a nuanced and insightful account of how community music therapy can be applied in a country scarred by decades of war and conflict—where over eight million people have been forcibly displaced in the past forty years.

When visiting Bogotá a few years ago, I realized how different a Colombian music therapist’s working life can be compared to that of one in peaceful Norway—not only working with war injuries and related psychological trauma, but also with communities that have been uprooted, traumatized, and must rebuild their lives from scratch.

Vasco describes how music has been used as a means of integration, with individuals and groups—including members of the FARC guerrilla—participating in local musical initiatives. He outlines Colombia’s bloody history: 25 civil wars and 60 regional conflicts over 185 years, alongside numerous paramilitary, revolutionary, and drug-related groups.

At the same time, Colombia possesses rich musical traditions, including the use of music as resistance. With its wide variety of regional genres, instruments, and cultural organizations employing music to strengthen solidarity and local identity, the country provides fertile ground for music therapy. The master’s program in music therapy at the National University in Bogotá is central to this development, and Vasco presents an overview of student research focusing on people affected by war and displacement.

Democratic Songwriting

The chapters in Part Three address the theme of “Co-Creating Cultural Connections.” The first, by Danny D. Kora, a Turkish-American music therapist raised in Los Angeles and educated at Berklee College of Music, is titled “The Songwriter’s Democracy.” Since 2008, Kora has been based in Istanbul, working as a singer, multi-instrumentalist, and songwriter with refugees in Turkey and beyond, including in the world’s largest refugee camp—Kutupalong in Bangladesh, home to the Rohingya people displaced from Myanmar.

The interdisciplinary nature of his projects—combining art, dance/movement, and music therapy—is essential, as participating children have diverse interests. Those in Kora’s songwriting groups experience his democratic songwriting approach: every participant contributes stories and lyrical ideas, which are voted on collectively before the song takes shape. Interpreters play an important role, as does the use of familiar musical idioms from participants’ own cultures. The process fosters mutual understanding, social interaction, and pride in shared creative results.

Kora and his colleagues also train local workers to continue the program. He is active in an international network of music therapists working with refugees and regularly shares methods and experiences. Kora also publishes his own music on SoundCloud under the name Danny S. Lundmark.

Ukrainian Parents with Young Children in London

“Music for Displaced Dyads”, authored by Elizabeth Coombes and colleagues, presents a feasibility study offering music therapy to Ukrainian parents of preschool children who sought refuge in London after Russia’s invasion. The study explored whether music therapy could help reduce parental stress and strengthen parent–child attachment. Participants attended weekly 45-minute group sessions for eight weeks, engaging in a range of musical activities.

Data collection included questionnaires, physiological measures, and interviews in a mixed-methods design. The large research team plans to follow up with a larger study. The results were encouraging: both quantitative and qualitative data showed reduced stress and improved bonding, with strong correspondence between measures. The study has now been published in Frontiers in Psychiatry (2025):

https://public-pages-files-2025.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2025.1707023/pdf

Music Video as Documentation and Activism

The chapter “Our Humanity: Creating a Music Video with an Asylum Seeker While He Was in Mandatory Offshore Detention”, written by Australian music therapist Emma O’Brien with contributions from cellist Blair Harris and producer Craig Pilkington, tells the harrowing story of Moz, a Kurdish asylum seeker held for six years in Australia’s notorious detention camp on Manus Island, Papua New Guinea. Before reading, one should watch the resulting video on YouTube:

https://www.youtube.com/watch?v=fq85xIn6Kf4

The chapter documents how O’Brien and Moz created the video remotely using a smartphone for recording and Messenger for communication. Despite constant threats of confiscation, Moz directed the creative process, while O’Brien handled editing and musical accompaniment with help from colleagues.

The video eventually reached festivals, YouTube, and activist networks across Australia. Moz was later released and has since become a celebrated visual artist and outspoken advocate for humane asylum policies.

O’Brien, long recognized for her contributions to music therapy in Australia and internationally, reflects on her own commitment to refugee advocacy. Although Moz was the creative originator, O’Brien’s deep experience with songwriting in music therapy enabled her to realize the project ethically and collaboratively.

A Pioneer in Musical Work with Refugee Children

The final chapter is written by Nigel Osborne, a distinguished British composer known for his work with children in Bosnia, Kosovo, Ukraine, and elsewhere. His early songwriting projects in Sarajevo revealed effects far beyond pedagogy. Though not a trained therapist, Osborne soon collaborated with music therapists and became a strong ally of the field.

At the Pavarotti Music Centre in Mostar, a music therapy unit was established—later researched by Canadian music therapist Alpha Woodward, who also interviewed Osborne for Voices (see https://voices.no/index.php/voices/article/view/2040).

In this anthology, Osborne writes reflectively about his songwriting experiences with children in Sarajevo, Mostar, Lebanon, Syria, and Ukraine. His chapter includes detailed examples of lyrics and music, demonstrating his sensitivity to local languages and musical traditions—he speaks eight languages himself and moves seamlessly between melodic and rhythmic modes of different cultures.