[Research]
Neo-colonialism In Music Therapy: A Critical Interpretive Synthesis of the Literature Concerning Music Therapy Practice With Refugees
By Rachael Comte
Abstract
This paper presents the findings from a critical interpretive synthesis that explored the assumptions influencing music therapists writing about their work with refugees. Music therapy literature suggests that the profession appears to be uniquely suited to address the healthcare needs of the refugee population by transcending cultural and language barriers which often mitigate access to other services. However, when working with individuals characterised by trauma and whose identities have been dictated by political power, it is essential that music therapy practices oppose these forces and provide opportunities for empowerment. Therefore, eleven papers describing music therapy practice with refugees from the international literature were examined and interrogated to determine the assumptions embedded within the language used by music therapists. The synthetic construct of a neo-colonial music therapist emerged from the data and informed subsequent analysis. The concepts of refugees as a homogenous group defined by a dominant narrative of trauma, and musical improvisation as a universal language appeared to be influential in the ways music therapists were reporting on their work. These findings are discussed along with considerations for a music therapy practice that promotes empowerment and advocates for the voices of the refugee population.
Keywords: refugee, neo-colonialism, critical interpretive synthesis, music therapy
Introduction
Considering the Term Refugee
The moment an individual is identified as a refugee, there is an immediate overemphasis on the narratives of trauma and challenge, often to the detriment of the other aspects that comprise the individual’s identity as a human being. The very notion of a refugee is one dictated and mediated by political power; it defines an individual as being powerless and fearful (UNHCR, 1967, Article 1), and concerns one’s political legitimacy (McAdams & Chong, 2014). As it is within the realm of music therapy to explore identity constructs, the profession appears to be uniquely situated to respond not only to the dominant narratives of trauma within the refugee population, but also to function as a site for the promotion of human rights.
The term ‘refugee’ was originally defined by the United Nations High Commissioner for Refugees (UNHCR) in the 1951 Convention Relating to the Status of Refugees, and has since become an official legislative term within international and domestic law. Within the convention, a refugee is defined as a person who:
“Owing to well-founded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group or political opinion, is outside the country of his nationality and is unable, or owing to such fear, unwilling to avail himself of the protection of that country.” (Article 1)
In mid-2014, the UNHCR reported an increase in the number of individuals of concern to their agency: with figures estimated at 13 million and continuing to rise (UNHCR, 2015a).
Rationale
The World Health Organisation (WHO) has reported that those identified as refugees are at a higher risk than the general population of psychosocial disorders (World Health Organisation, 2015). The literature also suggests that posttraumatic stress disorder (Fazel, Wheeler, & Danesh, 2005), communicable diseases, and chronic illnesses (Navuluri et al., 2014) are over represented within this population when compared to the general population. As a result, healthcare services are often prioritised during the resettlement period.
A scan of the relevant literature, however, continues to reveal an emphasis on the narrative of challenge as a result of the barriers that mitigate access to healthcare services for refugees. Western models of healthcare have proved inaccessible for a large proportion of the refugee population, owing to factors such as the language barrier (Slobodin, 2014) differing conceptualisations of health and medicine (Chun, Organista, & Marín, 2003; May, Rapee, Coello, Momartin, & Aroche, 2014;), and a distrust of healthcare professionals (de Anstiss & Ziaian, 2010). Additionally, the location of healthcare service delivery has also contributed to inaccessibility. In most Western countries the dominant medical model dictates that healthcare should be provided by an expert in the context of a medical setting. The literature has indicated, however, that this model is often far removed from the refugee person’s previous experience of healthcare. For this reason, community based interventions have been implemented to meet the healthcare needs of this population, resulting in improved mental health outcomes (Fondacaro & Harder, 2014; Garakasha, 2014; Measham et al., 2014).
In response to what appears to be a challenging situation for healthcare providers, music therapists could be uniquely positioned to meet the needs of the refugee population. Recent studies have revealed a positive impact on the neurological responses to trauma following music therapy (Krout, 2007; Swallow, 2002) and in some cases, music therapy is being offered as an alternative to cognitive behavioural therapies for the treatment of trauma (Carr et al., 2012). Additionally, when language barriers prohibit or limit the accessibility of traditional talking therapies, music therapists emphasise the universality of music; thus providing a safe and acultural medium for traumatised individuals to explore healthy aspects of their identity (Pavlicevic, 1997). Furthermore, music therapy methods have been used to treat PTSD in adults and children (Carr et al., 2012), a pertinent factor considering children and young adults comprise of half of the refugee population (UNHCR, 2015b).
Also relevant to the current discourse is the field of community music therapy, which promotes a holistic definition of health encompassing social and cultural factors (Stige & Aarø, 2012). For the refugee individual whose understanding of health is intrinsically connected to concepts of spirituality embedded within a broader cultural framework, the Western medical model’s concept of health as being ‘the absence of disease,’ has proved problematic (Chun et al., 2003; May et al., 2014). Therefore, community music therapy has been identified as a bridge to close the gap between culturally situated understandings of health, by promoting a definition that is culturally inclusive and mutually negotiated. Community music therapy also aligns with the literature supporting community based health care services for this population (Fondacaro & Harder, 2014; Garakasha, 2014; Measham et al., 2014).
The music therapy literature has suggested that the profession appears to be uniquely suited to address the healthcare needs of the refugee population. However, this notion is based upon literature steeped in the rhetoric of human beings as refugees and thus the current discourse may be unintentionally privileging the dehumanising aspects of the refugee identity and focusing on narratives of trauma. Therefore, a critical review of the literature is essential to unpack the assumptions influencing music therapists reporting on their work with refugees, so as not to perpetuate a system of disempowerment, both within the therapeutic relationship but also in the broader music therapy discourse. The following research question was designed to guide the investigation: What assumptions appear to be influential in the ways that music therapists report on their work with refugees?
Design
Critical Interpretive Synthesis
A critical interpretive synthesis aims to integrate and critique a diverse body of literature. This method intends to critically analyse data through the development of integrative concepts and theories that ultimately allow for a new understanding of the literature to emerge (Dixon-Woods et al., 2006). Where a traditional systematic review or qualitative synthesis aims to evaluate and synthesize, the critical interpretive synthesis is unique in that the researcher actively seeks to make critical judgements throughout the research process, examining the way authors “conceptualize and construct the phenomenon under consideration” (Harden & Thomas, 2010, p.755; McFerran, Garrido, & Saarikallio, 2014). In a sense, this method of synthesis aims to transcend the epistemological value systems that inevitably shape the presentation of information. For this reason, both qualitative and quantitative research papers, in addition to other practice examples and journal articles can be included (Annandale, Harvey, Cavers, & Dixon-Woods, 2007).
Another unique feature of this research design is the analysis process itself, which is described as “iterative, interactive, dynamic and recursive” (Annandale et al., 2007, p. 465). The research question is considered a compass rather than an anchor, and an initial analysis of the data is intended to inform the subsequent foci of the research (Eakin & Mykhalovskiy, 2003). The emergent, process-oriented nature of this research design was considered crucial to uncover the assumptions informing the way music therapists are reporting on their work with refugees.
Methodology
Literature Search and Inclusion
The initial literature scan was a systematic and structured search within the following online electronic databases for publications: PsycINFO, RILM, CINAHL, International Index to Music Periodicals, Scopus, and Web of Science. The search terms used were “refugee” AND “music therapy”, and articles were excluded if they were not in English. Initially, the number of publications generated was too large for a detailed analysis (N = 92), therefore I decided to limit the included publications firstly to those authored by credentialed music therapists, and secondly to those which included a practice example of music therapy work with a refugee individual or group (N = 11, see Table 1). This decision was based upon my interest in what the local and international professionals of my field are currently contributing to this particular discourse, from the position of an Australian Masters of Music Therapy student at the University of Melbourne, Australia.
| Article | Rationale for inclusion |
|---|---|
| Ahonen & Mongillo Desideri (2014) |
|
| Akombo (2001) |
|
| Baker & Jones (2005) |
|
| Choi (2010) |
|
| Dixon (2002) |
|
| Dunbar (2009) |
|
| Edwards, Scahill, & Phelan (2007) |
|
| Hunt (2006) |
|
| Jones, Baker, & Day (2004) |
|
| Orth (2005) |
|
| Zharinova-Sanderson (2004) |
|
The articles that were excluded following the initial search discussed the use of music or dance with people identified as refugees, however were not referring to a specific music therapy program, nor were the authors credentialed music therapists. While some papers were authored by credentialed music therapists and documented a music therapy program, the participants were not clearly identified as being refugees for the purpose of therapy, even though it was eluded to that these individuals had refugee backgrounds, and therefore these papers were excluded from the synthesis.
Data Extraction and Interrogation
The inductive and iterative approach adopted to extract and interrogate the data set was geared towards the creation of a coherent theoretical framework. Throughout these processes, I was conscious of my own assumptions influencing the direction and focus of the research. Therefore, I maintained a reflexive journal to document my decision-making and reflect on my own values that I felt might have shaped the data extraction and interrogation.
While I did not have fixed ideas about what the data would reveal, I began the initial data extraction process with a number of deductively created headings that provided a platform for subsequent inductive and iterative analysis. This approach was influenced by evidence-oriented methodologies whereby data extraction tables are used to summarise key characteristics and findings of each article (Jones & Evans, 2000): a suggested starting point for a critical interpretive synthesis with a small sample size (Dixon-Woods et. al, 2006). An Excel® spreadsheet was used as an organising frame for the extracted data, with relevant quotes or summaries of content from the articles grouped under column headings.
The data interrogation was closely aligned with the extraction process, as proposed by McFerran and colleagues (McFerran, Hense, Medcalf, Murphy & Fairchild, 2016). The interrogation involved reflexively examining the headings of each column to see if they adequately reflected the data collected from the articles or to see if there were subgroups or themes within the column heading. As I read through each article additional headings emerged and were added to the spreadsheet, prompting a return to previous literature to extract more data. This recursive process is what Dixon-Woods and colleagues (2006) emphasised as being integral to the emergence of new themes. Following this, I began comparing columns to look for interesting connections, themes, or patterns among the headings: for example comparing the author’s nationality with theoretical orientation.
What defines this process as critical, however, is the emphasis upon the author’s use of particular language to present information, in addition to the critical nature of the headings used to arrange and interpret the data set (McFerran, Hense, Medcalf, Murphy, & Fairchild, 2016). In this way, I was positioning myself as the researcher to uncover the assumptions and beliefs that may have been influencing the way the authors constructed and presented information. Similarly, by grounding the research in the specific language used by authors, I was able to uncover the values and assumptions embedded within the language music therapists used to report on their work with refugees. From these critical interrogations, a synthetic construct began to emerge.
Generating a Theory: The Neo-Colonialal Music Therapist
Dixon-Woods and colleagues (2006) proposed synthetic constructs are the result of “a transformation of the underlying evidence into a new conceptual form” (p. 5), grounded in a critique of the literature. As the literature is interrogated, the synthetic construct can be used as a lens through which to view the data, while at the same time functioning as a theory constantly shaped by the emergence of new data.
It became apparent during the extraction and interrogation process that authors were generally emphasising the cultural divide between themselves as members of a Western cultural group and the refugee individuals with whom they were working. From this emphasis on cultural difference, the concept of a neo-colonial music therapist emerged as a synthetic construct.
In terms of politics and economics, colonialism can be defined as the process by which powerful European countries have forcefully occupied land belonging to less powerful countries throughout the 19th and 20th centuries; essentially it is a bipartite concept whereby one individual or group exerts dominance and power over another individual or group (Macqueen, 2014). In this sense, I used the concept of neo-colonialism to denote the way in which values belonging to the dominant Western cultural group are often imposed upon the cultural group who form the minority. This seemed a fitting concept considering nine of the 11 papers included in the synthesis were written from a Western perspective (Baker & Jones, 2005; Dixon, 2002; Dunbar, 2009; Edwards, 2006; Hunt, 2006; Jones, Baker, & Day, 2004; Orth, 2005; Zharinova-Sanderson, 2004;).
This synthetic construct then served as a lens through which to further interrogate the data. While maintaining a reflexive journal, I began to examine the data from what I considered the perspective of a neo-colonial music therapist. In problematising the data, as suggested by Dixon-Woods and colleagues (2006, p. 10), I was able to look for examples of explicit or implicit cultural dominance, specifically relating to music therapy methods, orientations to practice, and understandings of health and trauma. With this synthetic construct shaping the interrogation, I was able to deeply explore some of the assumptions that began to emerge from the data.
Results and Discussion
Following a critical examination of 11 articles from the international music therapy literature, two key assumptions emerged as being influential in the ways music therapists were reporting on their work with refugees. In examining the literature against the synthetic construct of a neo-colonial music therapist the assumptions of homogeneity among the refugee population and musical improvisation as a universal language were found. These two findings will now be discussed in relation to the implications for music therapy practice.
Refugee Identity and The Narrative of Trauma: A Homogenous Group
The first theme that emerged from the data was that of refugees as a homogenous group; a collective unified by a common narrative of trauma. In the clinical and community contexts alike, it appeared that music therapists were working with refugees in such a way that privileged the individual’s status and therefore identity as a refugee over other aspects of the individual’s identity, such as race or religion. While there were examples of music therapists promoting other aspects of identity, such as age (Baker & Jones; 2005, Choi, 2010; Hunt, 2006; Jones, Baker, & Day, 2004), or gender (Ahonen & Mongillo Desideri, 2014; Edwards, 2007), the emphasis of the therapeutic work focused largely on the narratives of adolescent trauma or female trauma. This has led to a discourse in the music therapy literature wherein the narrative of trauma is dominant and refugee people from diverse cultural backgrounds are considered largely homogenous. Therefore it appears that music therapists are reporting on their work with refugees with the assumption that there is a particular narrative of trauma associated with the refugee identity that is the most salient aspect of the individual’s experience, and therefore that all refugees, regardless of their nationality or religion, will have similar needs.
Refugee Identity Privileged over Cultural Identities
The assumption of homogeneity was clearly evident in practice examples illustrating group music therapy wherein individuals from diverse cultural backgrounds were often treated as a group of refugees; therefore the individual’s refugee identity, as defined by experiences of trauma, was privileged over the individual’s cultural identity. In the Netherlands, men and women from cultures as vastly different as Vietnam, Somalia, Azerbaijan, Cambodia, and Chile were grouped together for music therapy treatment within a specialized treatment centre specifically for refugees (Orth, 2005). Similarly, in two different practice examples within Australian high schools, it was common for adolescents with varying cultural backgrounds to be considered a group of refugees (Baker & Jones, 2005; Hunt, 2006).
In the case examples illustrating individual music therapy, the dominant narrative of refugee trauma was also evident by virtue of the contexts within which the service was being offered: treatment centres for torture victims (Zharinova-Sanderson, 2004), medical foundations, (Dixon, 2002) and inpatient treatment facilities (Dunbar, 2009). While this focus on trauma as a unifying and prevalent feature of the refugee population may reflect a broader issue regarding access to healthcare services along the healthcare continuum for refugees (Colucci et al., 2014; Davidson et al., 2004; Slobodin, 2014), it does appear to highlight an assumption regarding the refugee population as having similar therapeutic needs as a result of traumatic experiences. Additionally, the language music therapists used to describe the individuals with whom they were working often prioritised the use of the word refugee rather than the nationality of the individual. In fact, some authors made no mention of the cultural background of the individuals with whom they were working and referred to the individuals only as refugees (Ahonen & Mongillo Desideri, 2014).
There also appeared to be a contradiction within the literature in the way that some music therapists identified the need to foster the cultural identities of the individuals with whom they were working (Dunbar, 2009; Orth, 2005; Zharinova-Sanderson, 2004). However, they wrote about their work in such a way that privileged not the unique cultural heritage of the individual, but rather their status as a refugee and the associated experiences of trauma.
These findings highlight the need for music therapists to be more reflexive in their practice and challenge neo-colonial assumptions about the refugee population being a homogenous group characterized by a narrative of trauma, so as not to perpetuate oppression and disempowerment. If music therapists acknowledge that it is valuable to strengthen the individual’s cultural identity as a means of dealing with the grief and loss associated with forced migration, then it is essential that music therapists privilege the cultural identity rather than the refugee identity of that person, not only in their conceptualisation of the therapy work, but also in the language used to document the work. In order to privilege the cultural identity of an individual, music therapists need to continue to examine the relevance of Western models of therapy and concepts of music for health, but with a particular focus on unique cultural groups as opposed to the refugee population generally.
Challenging Assumptions Concerning The Refugee Identity in The Public Domain
It should be acknowledged that the literature does suggest most refugees experience trauma as a result of the pre-flight, flight, and re-settlement experiences (Murray, Davidson, & Schweitzer, 2010). In response, music therapy is considered an accessible therapeutic medium for refugee individuals excluded from traditional talking therapies as a result of the language barrier (Pavlicevic, 1997), and has been shown to have a positive impact upon neurological responses to trauma (Krout, 2007; Swallow, 2002). However, if music therapists are working with the assumption that the refugee population is homogenous because of the dominant narrative of trauma, music therapists may be further disempowering these individuals by privileging the refugee identity; an identity which is reflective of one’s status as being displaced and powerless.
This finding coincides with the general rhetoric surrounding refugees in the mass media, and also embedded within the legislation governing these individuals. Since the early 1990s, there has been an increase in the amount legislation concerning the control of the refugee population, as evident across Australia, Canada, America, and countries within Europe (Jeffers, 2011, p.23). Since this time, particularly in Australia, the legislative focus has shifted away from humanitarian aims and towards the control and regulation of the refugee population (McMaster, 2001). Additionally, the language used in the legal-political discourse played out through mass media continues to emphasise the refugee identity of these individuals, promoting the notion that refugees pose a threat to national security and local economies (Kisiara, 2015). In turn, refugees are often faced with hostility from the general public within these countries; despite studies demonstrating these hostile attitudes are often grounded in misinformation (Jeffers, 2011; Penderson, Watt & Hansen, 2006). As long as political leaders and mass media continue to emphasise the refugee identity, the general public will continue to privilege this identity at the expense of seeing this culturally diverse group of individuals as human beings.
Therefore, this notion of reinforcing the refugee identity serves to perpetuate a system whereby those in a position of political power are able to maintain control by shaping the public’s perception of this population. For this reason, it is essential music therapists and other professionals working with the refugee population, cultivate an awareness of the ways language and privileging the refugee identity may in fact be supporting a system of political manipulation and perpetuate the disempowerment of these human beings.
“Musical Improvisation Is a Universal Language” Say Neo-Colonial Music Therapists
The second assumption that emerged from the data was that musical improvisation is a universal language. In 10 out of the 11 articles included in the synthesis, improvisation was cited as a method used by music therapists with refugee individuals for the purpose of transcending traditional language barriers to find a common musical language through which the therapeutic dialogue could occur. With the exception of Jones, Baker, and Day (2004) who explored the musical characteristics typical of the Sudanese students with whom they worked, there appeared to be an assumption that improvised musical dialogue not only transcends the language barrier but also surpasses a broader cultural barrier. This in turn suggests that the musical vocabulary from which a refugee person draws upon within the context of improvisation in therapy is devoid of cultural characteristics, thereby allowing the music therapist of a different culture to engage the individual a meaningful musical dialogue.
There appears to be a contradiction in the literature wherein music therapists are recognising the cultural significance of music for health promotion in the cultures of the refugee population as being distinct from Western culture, yet are not examining the specific musical characteristics which contribute to this difference. On the one hand, authors generally appear to recognise the culturally situated significance of active music making for health and participation in community life (Baker & Jones, 2005; Hunt, 2006; Orth, 2005; Zharinova-Sanderson, 2004) yet fail to acknowledge that these practices are often founded upon strong musical vocabularies embedded within and intrinsically connected to the cultural landscape of a particular community.
The assumption that improvisation is an appropriate forum for therapeutic dialogue across a cultural divide is further evidenced by the general lack of reflexive consideration or evaluation of this method within the literature. Few of the authors make explicit what improvisation actually involves in a musical sense, and even when musical encounters are described in practice examples, most authors appear to be making judgements about the refugee person’s improvised music from a Western viewpoint of orderliness (Dunbar, 2009, p.29) or harmonic and rhythmic consonance (Dixon, 2002, p.126; Hunt, 2005; Orth, 2005, p. 12).
It could be argued that by using improvisation as a means of therapeutic conversation with refugees without an awareness of this concept of culturally informed musical vocabularies, music therapists are advancing neo-colonial ideals. By not recognising the musical values that shape decisions regarding the significance of musical moments as they unfold within improvisation, music therapists may be imposing a set of Western values upon the therapeutic encounter. This point is highlighted by Jones, Baker, and Day (2004) who found that it was culturally appropriate for the Sudanese students with whom they were working to play in a rhythmically syncopated way; this constituted playing together in Sudanese culture, however the therapists initially felt that the music was representative of chaos, fragmentation, and disconnection. This example highlights how improvisation is in fact mediated by culturally informed musical vocabularies.
Furthermore, it is integral that music therapists are aware of the ways in which specific musical elements constitute meaning within the musical culture of the refugee person. With the increase in global immigration, a discourse has emerged in the music therapy literature wherein music therapists are reflecting on the relevance of their practice in relation to a culturally and linguistically diverse population (Mahoney, 2015; Shoemark, 2014). Culturally centred practice is becoming increasingly important in dismantling values steeped within a Western medical model of therapy, and music therapists are reflexively examining their own cultural values to understand how these inform therapeutic practice (Swamy, 2014; Truasheim, 2014). This culturally centred critique is also echoed in the literature concerning anti-oppressive practice, wherein authors consider the ways in which dominant socio-cultural norms and privilege more broadly can perpetuate oppression within the therapeutic relationship (Baines & Edwards, 2015; Baines, 2013). In continuing this discourse, if music therapists are to acknowledge that the practice can be meaningful and relevant to a culturally and linguistically diverse population, then the current findings suggest a specific exploration into the use of musical elements within improvisation through a culturally centred lens. Without an awareness of the notion of culturally informed musical vocabularies, music therapists may be advancing neo-colonial ideals and in fact disempowering the refugee individual by misinterpreting their musical contributions to the therapeutic dialogue within the context of a musical improvisation.
Concluding Thoughts: Advocacy For the Refugee Person’s Voice
Upon examining the relevant literature against the synthetic construct of the neo-colonial music therapist two key assumptions appeared to be influential in the ways music therapists were reporting on their work with refugees. It appeared that music therapists assumed the refugee population was homogenous by virtue of the dominant trauma narrative that is embedded within the identity of a refugee. The language used by music therapists to convey their work privileged the refugee identity over the cultural identities of these individuals. Thus, music therapists may be further disempowering these individual by perpetuating a homogenous identity of displacement and powerlessness, rather than promoting the vast cultural differences and unique narratives, traumatic or otherwise, within this population.
The second neo-colonial assumption that emerged during the research was that of musical improvisation as a universal language. With the exception of one paper, all of the music therapists cited musical improvisation as a method used for the purpose of therapeutic dialogue with refugee individuals based on the assumption that music transcends language barriers. Additionally, music therapists were using improvisation without reflexively considering how the musical vocabulary one draws upon within an improvisation is informed by the musical language embedded within the individuals culture; a vocabulary which can often be misinterpreted by the Western ear.
What can be taken from this critical interpretive synthesis is the need for Western music therapists to cultivate awareness that knowledge about music and health is culturally situated. To varying degrees, music therapists are keen to highlight the difference between how individuals identified as refugees use music for health and community building within their own cultures in contrast to the Western perspective. However, the language used to describe this population as homogenous perpetuates Western ethnocentricity and continues to privilege the refugee identity of these individuals over the unique cultural identities within this population. Similarly, the relevance of specific music therapy methods requires continuous reflexive consideration; specifically in relation to the way Western values may be unintentionally shaping the therapeutic encounter.
Furthering this notion of neo-colonialism, I would like to conclude with a comment on the absence of the refugee’s voice within the current discourse. Music therapists have a history of working with vulnerable populations: individuals within society who have often faced social stigma, marginalization and sometimes the violation of human rights. For this reason, music therapists often conceive of their role as that of an advocate for the people with whom they work. Particularly in the field of community music therapy, the notion of ‘attending to unheard voices’ is imperative in working towards social inclusion and equity (Stige & Aarø, 2012, p.5). The current literature regarding refugees, however, does not appear to adequately reflect the myriad of experiences or the diversity of cultural identities within this population. Therefore I would argue music therapists are not doing enough to truly advocate for these disempowered human beings whose voices are often self-silenced owing to a “well founded fear of persecution” (UNHCR, 1951, Article 1).
If music therapists continue to write about their work with refugees without truly providing a forum for the voices of these individuals, music therapists will continue to promote neo-colonial values. Whilst considering the implications of privileging the refugee identity over the cultural identity of these individuals may be a worthwhile academic pursuit with poignant ramifications, would it not be more relevant to ask these individuals how they construct their own identify? Does a narrative of trauma in fact strengthen one’s sense of identity in a positive way, as a survivor? Do these individuals actually wish to identify with their cultural heritage, or rather do they wish to construct a new acculturated identity? By making assumptions about these ideas, music therapists may be silencing the voices of refugees and perpetuating a system of disempowerment. Therefore, music therapists need to challenge the assumption that the knowledge we hold is relevant to the refugee population, and perhaps find ways to bring these individuals into the discourse and ask what is meaningful and relevant to them.
References
Ahonen, H., & Mongillo Desideri, A. (2014). Heroine's journey: Emerging stories by refugee women during group analytic music therapy. Voices: A World Forum for Music Therapy, 14(1). doi:10.15845/voices.v14i1.686
Annandale, E., Harvey, J., Cavers, D., & Dixon-Woods, M. (2007). Gender and access to healthcare in the UK: A critical interpretive synthesis of the literature. Evidence & Policy, 3(4), 463–486. doi: 10.1332/174426407782516538
Baines, S., & Edwards, J. (2015). Considering the ways in which anti-oppressive practice principles can inform health research. The Arts In Psychotherapy, 28. doi:10.1016/j.aip.2015.01.001
Baines, S. (2013). Music therapy as an anti-oppressive practice. The Arts in Psychotherapy, 40, 1-5. doi:10.1016/j.aip.2012.09.003
Baker, F., & Jones, C. (2005). Holding a steady beat: The effects of a music therapy program on stabilising behaviours of newly arrived refugee students. British Journal of Music Therapy, 19(2), 67–74. doi: 10.1177/135945750501900205
Carr, C., d’Ardenne, P., Sloboda, A., Scott, C., Wang, D., & Priebe, S. (2012). Group music therapy for patients with persistent post‐traumatic stress disorder–an exploratory randomized controlled trial with mixed methods evaluation. Psychology and Psychotherapy: Theory, Research and Practice, 85(2), 179–202. doi: 10.1111/j.2044-8341.2011.02026.x
Choi, C. (2010). A pilot analysis of the psychological themes found during the CARING at Columbia- music therapy program with refugee adolescents from North Korea. Journal of Music Therapy, 47(4), 380–407. doi: 10.1093/jmt/47.4.380
Chun, K., Organista, P., & Marín, G. (Eds.). (2003). Acculturation: Advances in theory, measurement, and applied research. Washington, D.C.: American Psychological Association.
Colucci, E., Szwarc, J., Minas, H., Paxton, G., & Guerra, C. (2014). The utilisation of mental health services by children and young people from a refugee background: A systematic literature review. International Journal of Culture & Mental Health, 7(1), 86–108. doi: 10.1080/17542863.2012.713371
Convention Relating to the Status of Refugees, opened for signature 28 July 1951, 189 UNTS 137 (entered into force 22 April 1954).
Davidson, N., Skull, S., Burgner, D., Kelly, P., Raman, S., Silove, D., . . . Smith, M. (2004). An issue of access: Delivering equitable health care for newly arrived refugee children in Australia. Journal of Paediatrics & Child Health, 40(9/10), 569–575. doi: 10.1111/j.1440-1754.2004.00466.x
de Anstiss, H., & Ziaian, T. (2010). Mental health help-seeking and refugee adolescents: Qualitative findings from a mixed-methods investigation. Australian Psychologist, 45(1), 29–37. doi: 10.1080/00050060903262387
Dixon, M. (2002). Music and human rights. In J. Sutton (Ed.), Music, music therapy and trauma: International perspectives (pp. 119–132). London: Jessica Kingsley Publishers.
Dixon-Woods, M., Cavers, D., Agarwal, S., Annandale, E., Arthur, A., Harvey, J., . . . Sutton, A. J. (2006). Conducting a critical interpretive synthesis of the literature on access to healthcare by vulnerable groups. BMC Medical Research Methodology, 6(35). doi: 10.1186/1471-2288-6-35
Dunbar, N., & (2009). Quietening the voices: Making a space for music in individual music therapy with an elderly refugee. British Journal of Music Therapy, 23(2), 25–31. doi: 10.1177/135945750902300204
Eakin, J., & Mykhalovskiy, E. (2003). Reframing the evaluation of qualitative health research: Reflections on a review of appraisal guidelines in the health sciences. Journal of Evaluation in Clinical Practice, 9, 187–194. doi: 10.1046/j.1365-2753.2003.00392.x
Edwards, J., Scahill, M., & Phelan, H. (2007). Music therapy: Promoting healthy mother-infant relations in the vulnerable refugee and asylum seeker community. In J. Edwards (Ed.), Music: Promoting health and creating community in healthcare contexts (pp. 154–168). Newcastle, England: Cambridge Scholars.
Fazel, M., Wheeler, J., & Danesh, J. (2005). Prevalence of serious mental disorder in 7000 refugees resettled in western countries: A systematic review. Lancet,365(9467), 1309–1314. doi: 10.1016/S0140-6736(05)61027-6
Fondacaro, K., & Harder, V. (2014). Connecting cultures: A training model promoting evidence-based psychological services for refugees. Training and Education in Professional Psychology, 8(4), 320–327. doi: 10.1037/tep0000071
Garakasha, N. (2014). Working with refugee young people: A nurse’s perspective. Australian Journal of Advanced Nursing, 32(2), 24–31.
Harden, A., & Thomas, J. (2010). Mixed methods and systematic reviews: Examples and emerging issues. In A. Tashakkori & C. Teddlie (Eds.), Sage handbook of mixed methods in social & behavioral research (2nd ed.) (pp. 749–774). Los Angeles: SAGE. doi: 10.4135/9781506335193.n29
Hunt, M. (2006). The use of group music therapy to develop a sense of belonging in young refugees an action research project. (Unpublished master’s thesis). The University of Melbourne, Melbourne, Australia.
Jeffers, A. (2011). Refugees, theatre and crisis: Performing global identities. Basingstoke, Palgrave: Macmillan.
Jones, T., & Evans, D. (2000). Conducting a systematic review. Australian Critical Care, 13(2), 66–71. doi: 10.1016/S1036-7314(00)70624-2
Jones, C., Baker, F., & Day, T. (2004). From healing rituals to music therapy: Bridging the cultural divide between therapist and young Sudanese refugees. The Arts in Psychotherapy, 31(2), 89–100. doi: 10.1016/j.aip.2004.02.002
Kisiara, O. (2015). Marginalized at the centre: How public narratives of suffering perpetuate perceptions of refugees' helplessness and dependency. Migration Letters, 12(2), 162–171.
Krout, R. E. (2007). Music listening to facilitate relaxation and promote wellness: Integrated aspects of our neurophysiological responses to music. The Arts in Psychotherapy, 34, 134–141. doi:10.1016/j.aip.2006.11.001
Mahoney, E. (2015). Multicultural music therapy: An exploreation. Voices: A World Forum for Music Therapy, 15(2), doi:10.15845/voices.v15i2.844
Macqueen, N. (2014). Colonialism. Hoboken: Taylor and Francis, 2014.
May, S., Rapee, R., Coello, M., Momartin, S., & Aroche, J. (2014). Mental health literacy among refugee communities: Differences between the Australian lay public and the Iraqi and Sudanese refugee communities. Social Psychiatry & Psychiatric Epidemiology, 49(5), 757–769. doi: 10.1007/s00127-013-0793-9.
McAdam, J., & Chong, F. (2014). Refugees: Why seeking asylum is legal and Australia's policies are not. Sydney: UNSW Press, 2014.
McFerran, K., Garrido, S & Saarikallio. (2014). A critical interpretive synthesis of the literature linking music and adolescent mental health. Youth Society, 46(2). doi: 10.1177/0044118X13501343
McFerran, K., Hense, C., Medcalf, L., Murphy, M. & Fairchild, R. (2016 ). Doing a critical interpretive synthesis. Manuscript submitted for publication.
McMaster, D. (2001). Asylum seekers. Melbourne: Melbourne University Press.
Measham, T., Guzder, J., Rousseau, C., Pacione, L., Blais-McPherson, M., & Nadeau, L. (2014). Refugee children and their families: Supporting psychological well-being and positive adaptation following migration. Current Problems in Pediatric and Adolescent Health Care, 44(7), 208–215. doi: 10.1016/j.cppeds.2014.03.005
Navuluri, N., Haring, A., Smithson-Riniker, K., Sosland, R., Vivanco, R., Berggren, R., & Rosenfeld, J. (2014). Assessing barriers to healthcare access among refugees living in San Antonio, Texas. Texas Public Health Journal, 66(3), 5–9.
Orth, J. (2005). Music therapy with traumatized refugees in a clinical setting. Voices: A World Forum for Music Therapy, 5(2). doi: 10.15845/voices.v5i2.227
Pavlicevic, M. (1997). Music therapy in context: Music, meaning and relationship. London: Jessica Kingsley Publishers.
Penderson, A., Watt, S., & Hansen, S. (2006). The role of false beliefs in the community’s and the federal government’s attitudes towards Australian asylum seekers. Autralian Journal of Social Issues, 41(1), p. 105–124.
Swamy, S. (2014). Music therapy in the global age: three keys to successful culturally centred practice. New Zealand Journal of Music Therapy, 12, 34–57.
Slobodin, O., & de Jong, J. (2015). Mental health interventions for traumatized asylum seekers and refugees: What do we know about their efficacy? International Journal of Social Psychiatry, 61(1), 17–26. doi: 10.1177/0020764014535752
Shoemark, H. (2014) Editorial: regarding culture and music therapy. Australian Journal of Music Therapy, 25, 1–2.
Stige, B., & Aarø, L. (2012). Invitation to community music therapy. New York: Routledge.
Swallow, M. (2002). Neurology: The brain – its music and its emotion: The neurology of trauma. In J. Sutton (Ed.), Music, music therapy and trauma: International perspectives (pp. 41–43). London: Jessica Kingsley Publishers.
Truasheim, S. (2014). Cultural safety for Aboriginal and Torres Strait Islander adults within Australian music therapy practices. Australian Journal of Music Therapy, 25, 135–147.
UNHCR (2015a). Refugee Figures. Retrieved from http://www.unhcr.org/pages/49c3646c1d.html
UNHCR. (2015b) Children. Retrieved from http://www.unhcr.org/pages/49c3646c1e8.html
World Health Organization (2015). Frequently asked questions on migration and health. Retrieved from http://www.who.int/features/qa/88/en/
Zharinova-Sanderson, O. (2004). Promoting integration and socio-cultural change: Community music therapy with traumatized refugees in Berlin. In M. Pavlicevic & G. Ansdell (Eds.), Community music therapy (pp.358-387). London, Great Britain: Jessica Kingsley.
