Stress Disorders, Post-Traumatic Clinical Trial
Official title:
Music Therapy Versus Treatment as Usual: A Randomized Non-inferiority Study With Traumatized Refugees Diagnosed With PTSD
This study compares music therapy with verbal psychotherapy (treatment as usual) in an
outpatient psychiatric clinic for traumatized refugees. Based on positive results from a
pilot study, the randomized clinical trial has a non-inferiority design to detect whether
music therapy is not less effective than verbal therapy carried out by psychologists and can
serve as a complementary treatment modality (n=70).
The participants are adult Arabic, English or Danish speaking refugees suffering from
posttraumatic stress disorder (PTSD). The patients are referred to outpatient treatment by
their medical doctor. Data collection takes place in three locations of the clinic in Region
Zealand, Denmark. The music therapy method used is Guided Imagery and Music (GIM).
Primary outcome is pre, post and 6 months follow-up measures of HTQ (Harvard Trauma
Questionaire) and two measures of PTSD-8 during treatment. Secondary outcomes are pre, post
and 6 months follow-up measures of Quality of Life Questionnaire (WHO-5), Dissociation
Symptom Scale (DSS), Somatoform Dissociation Questionaire (SDQ-20), Revised Adult Attachment
Scale (RAAS) and physiological measures (salivary oxytocin, betaendorphin and Substance P).
Subjects are randomized to 16 sessions of trauma modified GIM or 16 sessions of verbal
psychotherapy (standard treatment).
N (70) is based on a power calculation using HTQ measures from similar refugee studies, with
an estimated effect size in the range 0.6-0.8.
Sampling All baseline measures are scored during interview with a therapist before
randomization. The primary post and follow-up measures (HTQ-R) are scored during interviews
conducted by external psychologists blinded to the treatment group. The secondary post and
follow-up measures are self-report questionnaires scored by the patients with the help of an
educated translator who is blinded with regards to the treatment group.
0.5 ml salivary samples are collected in plastic tubes and stored at -20 degrees C.
The concentration of tree hormones (oxytocin, betaendorphin, substance P) are analyzed in a
multiplex solution.
Intervention
The intervention is a phased trauma-oriented modification (tmGIM) of the Bonny Method of
Guided Imagery and Music (GIM), where music listening and spontaneous imagery in an altered
state of consciousness is used within a psychotherapeutic session to promote inner
transformation and growth. The method was adapted by certain constraints:
Using only a limited selection of music with musical parameters, that fully support the
trauma-oriented therapeutic goals and do not provoke flashbacks.
Using short music listening periods (2-10 minutes). Listening in an upright position.
Inclusion of music from Middle-Eastern cultures. Inclusion of psychoeducation and
introductory mindfulness based exercises such as mindful breathing and body awareness.
Initial focus on inner resources such as positive memories, imagining a safe place and the
use of the music breathing technics.
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