Luxembourg’s Music Therapy Association [Gesellschaft fir Musiktherapie zu Lëtzebuerg asbl] (GML) started working for and with young refugees and asylum seekers in Luxembourg in December 2016. Since then, music therapy sessions are available in a group setting as well as for individuals.

Musical parameters, such as rhythm, melody and harmony, are used by certified music therapists to address acute stressors or past traumatic events. Quality of life and feelings of control – self-control or control of one’s surroundings – are some of the therapeutic objectives while using a non-verbal medium with often heavily traumatized young people.

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Luxembourg’s Music Therapy Association [Gesellschaft fir Musiktherapie zu Lëtzebuerg asbl] (GML) started working for and with young refugees and asylum seekers in Luxembourg in December 2016. Since then, music therapy sessions are available in a group setting as well as for individuals.

Musical parameters, such as rhythm, melody and harmony, are used by certified music therapists to address acute stressors or past traumatic events. Quality of life and feelings of control – self-control or control of one’s surroundings – are some of the therapeutic objectives while using a non-verbal medium with often heavily traumatized young people.

In 2015 and 2016 Luxembourg – as with many other European countries –welcomed several migrants seeking asylum, hoping for a chance of a better life.

INTRODUCTION

Fleeing home, leaving behind family members and friends, and giving up a job, school and relationships – everything you were used to – constitute huge stress factors and would pose extraordinary life challenges for anyone. But in addition of a difficult journey with many uncertainties and unexpected setbacks, and arriving in an unknown country, not knowing where to go or who to turn to, may contribute to an even higher risk of developing psychological and/or psychiatric disorders, such as post-traumatic stress, emotional disorders, anxiety or general grief (1−3). Children and youth – unaccompanied or accompanied minors (UAM or AM) – are even more at risk. They are in a particularly vulnerable time of their lives and helping them to cope with what they had to endure, to be able to thrive and develop perspectives for their future, is of utmost importance (4).

Aware of the risks of mental health issues in refugee populations and knowing that music can be a strong and helpful medium in addressing problems – such as loss of control, restlessness, anxiety, depression, isolation or a lack of resources – faced by these people, Luxembourg’s Music Therapy Association [Gesellschaft fir Musiktherapie zu Lëtzebuerg asbl] (GML) received project funding from the Foundation Oeuvre [Oeuvre Nationale de Secours Grande-Duchesse Charlotte]. The funding enabled the association to implement the music therapy project, Mateneen [Together], for minor refugees and asylum seekers living in the shelters run by the Luxembourg Red Cross. Since December 2016 weekly group sessions have been offered to young women and men from the refugee population.

Music, as a non-verbal medium, is the driving force behind the therapeutic relationship, helping to overcome language barriers and to open up constructive exchange as well as new channels of communication.

The GML defines music therapy as follows:
“Music therapy (MT) consists of using music to further, to
develop and to re-establish people’s physical and mental balance.

It mobilizes resources and its aim is to optimize quality of life through dealing with problems on a different level or through supporting a healing process.

As a non-verbal means of expression and communication, music appeals to people’s emotions; it stimulates cognitive as well as social and creative abilities, which will in turn allow the person to deal with the conflicts and challenges in life.

Due to the different parameters of music, MT, whether active and/or receptive, generates intrapsychic and relational processes. According to the respective need, a qualified music therapist approaches these processes in verbal or non-verbal, in individual or group therapy sessions.
MT belongs to the group of art therapies. Based upon psychotherapeutic schools and on the music therapist’s own training, the methods used in music therapy include elements from psychodynamic, behavioural, systemic, holistic-humanistic and integrative concepts.” (5)

The Oxford Handbook for Music Therapy divides the application of music therapy into four contexts: medical, developmental/educational, mental health, and community. The population range benefitting from MT extends from infants and children to adults and elderly adults (6). A relevant Cochrane review has shown moderate-quality evidence that music therapy is beneficiary in reducing depression in people with dementia (7).

Beck et al. provide an overview of the available research on the effect of music therapy on people with post-traumatic stress disorder (PTSD), and more specifically, on refugees with PTSD. Research shows that music therapy can reduce core PTSD symptoms, depression, hyperactivity, aggressive behaviour, anxiety and somatization, and increase social function, hope, resilience, sleep quality and quality of life (8). Most of these studies describe group music therapy interventions and improvisational music therapy while the more specific sleep- based studies analyse the effect of receptive music therapy (8).

PROJECT OBJECTIVES

Group MT sessions aim to reduce stress and anxiety levels related to issues faced by young refugees and asylum seekers, such as the perilous conditions of their migration; loss of their linguistic, cultural and material references; and distance from their families.
Through MT, GML tries to contribute to an improvement in the quality of life of young refugees and asylum seekers, to make it easier for them to overcome their problems, through activating their personal resources, developing a form of resilience, and helping to integrate them into their new host environment.

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Music therapy is an established, research-based health profession. In Europe, more than 6,000 certified music therapists work in health and community institutions, schools, nursing homes or private practices, with a wide range of client groups across the entire age range – from infants to the elderly.

Music therapists work with people with learning disabilities, autism or behavioural disorders, depression and severe mental health problems, trauma and anxiety, Parkinson’s disease or dementia, in hospice care, neuro disability, in prisons and other settings.

A well-trained music therapist supports clients musically and psychologically, stimulating development or change according to individual needs. The use of music therapy is effective, cost-efficient and contributes to a holistic care plan.

Music therapy clinical sessions (in person)

During the pandemic crisis many music therapy venues are closed, although some music therapists are able to continue as usual. In the case of in person therapy, the musical instruments and the environment are disinfected before and after each session. Most wind instruments are not used due to the increased risk of infection. For a greater sense of safety, clients can bring their own instruments to sessions if they wish. It is important that therapists and clients wash their hands and observe physical distancing guidelines. Music therapists can also offer live sessions through windows or from a garden, to keep sufficient distance from vulnerable participants. This way of working can limit the possibilities of in person music therapy, but can also be of great value to isolated people.

Remote sessions (by phone or online)
Music therapists can offer remote sessions over the phone or online, using secure software programs. There must be a clear privacy policy regarding the choice of program and the way it is used. Music therapists offer this service to ensure continued support, and it is not intended as a permanent alternative to ‘live’ sessions. In online sessions, it may not be possible to offer music therapy exactly as usual. Making music online is often difficult because of the delay and poor sound quality, but some possibilities can work well.

Here are some examples:
• Songwriting and composing music (a crisis can surprise us with creative impulses!)
• Adding lyrics to instrumental music or loops
• Receptive music therapy, including sharing
playlists or watching videos together
• Turn-taking – making musical dialogues
• Singing and accompanying vocals while one
microphone is turned off
• Reflecting verbally on the music made and
feelings that arise during the crisis

Text: Albert Berman