Gabriella Rudstam, Wollmars Yxkullsgatan 25, Stockholm, Sweden.
Tlf: +46-851516767 E-mail: Gabriella.Rudstam@krisochtraumacentrum.se
Candidate in Musictherapy 1992. Dipl. Expressive arts therapist 1997. Licenced psychotherapist spec. in clinical hypnosis 2005. Certified EMDR 2008, Teacher and supervisor 2006. FAMI in BMGIM 2010. Fil Mag in Musictherapy 2010. IFS level I and 2 2011. Structural dissociation, level 1 and 2 2012. Somatic experience advanced level 2015.
Since 2007 80% Music therapist / licensed psychotherapist at Kris- and traumacentrum in Stockholm. In addition a small Private practice. Since 1st of September 2014 part time PhD student at Aalborgs University, Department of Communication and Psychology, Doctoral Programme in Music Therapy.
Music therapist MA, PhD, professor in Music Therapy, Aalborg University, Lars Ole Bonde
Music therapist PhD ass. professor in Music Therapy, Aalborg University, Bolette Beck
General psychiatrist, MD, PhD, licensed psychotherapist, ass. professor at Karolinska Institute, Stockholm, Hans Peter Sondergaard.
title of PhD research study
Group Music and imagery(GrpMI) and expressive arts in trauma treatment with clients with complex PTSD. A mixed methods study.
According to guidelines from Sweden’s “Socialstyrelse” evidence-based methods should be used with clients with complex PTSD, i.e. primarily cognitive behavioral therapy (CBT) and secondarily, eye movement and desensitization and reprocessing (EMDR). Studies have shown that around 50 % of the population suffering from PTSD benefits from these methods (Bradley, Greene, Russ, Dutra & Westen, 2005). EMDR and CBT appear to work well for PTSD (often single trauma), but these methods are insufficient for the more complex traumatized patients (individuals who have been exposed to prolonged repetitive traumatic experience-often from early childhood) (Herman, 1992; Courtois & Ford, 2009). They have often problems with verbalizing and need treatment methods that can increase the ability for affect regulation and symbolization. Music and art might be a way to circumvent the speechlessness that comes with terror (Rudstam, 2010; Körlin, 2005; Van der Kolk, 2014). There is a need to strengthen the bottom-up regulation that can recalibrate the autonomic nervous system (Van der Kolk, 2014; Levine, 2010; Porges, 2011): Consequently, my clinical experiences have led me to develop the present study in search for the effects of GrpMI and expressive arts for this clientele.
The purpose of this study:
The purpose of the study is to examine if GrpMi together with expressive arts can be helpful in trauma treatment for clients suffering from complex traumatization.
The primary research questions are:
Can participation in GrpMI and expressive arts sessions:
- Be helpful in reducing PTSD symptoms and dissociation in these clients?
- Enhance quality of life?
- Increase capabilities for regulating the autonomic nervous system in complex PTSD measured in HRV?
Can participation in GrpMI and expressive arts sessions:
- Be helpful in processing and integrating traumatic experiences of a population with complex PTSD /DDnos, and if so, in what ways?
- What characteristic features and development processes can be observed in the internal imagery evoked by the music as well as external imagery produced after the music listening phase in order to process the internal imagery?
The groups will meet 12 times weekly 2,5 hours. A clinical protocol will be followed grounded in a phase-oriented way of working with trauma treatment, according to the guidelines of ISSDT (ISSDT, 2005). All sessions will involve a GrpMI followed by artmaking. Experience and paintings will be shared within the group. Opportunities will be given for further processing of the material via expressive arts methods and musical improvisations. There will also be short psycho-educational moments around trauma and PTSD.
The study is designed as a Mixed-methods investigation with a quantitative and a qualitative part (Robson, 2011). The quantitative part will be a block-randomized control study consisting of 8 groups with 6-8 participants in each group (48 individuals). Self-rating scales and a physiological stress test for measurement of HRV and other biomarkers will be used to measure the PTSD symptoms and the ANS flexibility. The qualitative part will involve analysis of the external and internal imagery in search for development processes. There will also be analysis of a semi-structured interview done after the treatment and analysis of questions answered by the participants in a journal after each session.
Subjects with complex PTSD (women, men, refugees, and other residents in Sweden). They will be selected from a database of individuals who are referred to Kris- och trauma centrum for trauma-focused treatment and asked if they´re interested in participating in the study.
12 weekly GrpMI and expressive arts sessions – each session lasts 2,5 hour .
Measurement with self- rating scales and physiological stress-test one time at intake and then one time just before treatment starts for baseline, one time directly after treatment and a follow –up after 3 months, altogether 4 times.
Analysis of external images, participants’ ´journals and semi-structured interviews.
Bradley, R; Greene, J; Russ, E; Dutra, L; Westen D (2005) A multidimensional meta-analysis of psychotherapy for PTSD. Am J Psychiatry, 162(2): 214-27
Courtois, C.S, Ford, J.D (2009) Treating complex Traumatic Stress Disorder. New York: The Guilford Press.
Herman, J. (1992) Trauma and recovery.USA: Harper Collins. ´
International Society for the Study of Trauma and Dissociation, ISSTD. (2005). Journal of Trauma and Dissociation, 6(4), 69-149.
Levine, P. (2010). In an Unspoken Voice. California; North Atlantic.
Nijenhuis, E., Van der Hart, O. & Steele, K. (2006). The Haunted Self. New York & London: W.W. Norton & Company.
Körlin, D. (2005). Creative Arts Therapies in psychiatric Treatment. Stockholm; Karolinska institutet.
Porges, S. (2011). The Posyvagal Theory. Neurophysiological foundations of Emotions, Attachment, Communication, Self-regulation. New York. London. W.W. Norton & Company.
Robson, C. (2011). Real world research, Cornwall: Wiley.
Rudstam, G. (2010). Modified GIM i stabiliseringsgrupp med flyktingkvinnor. Magister uppsats. Stockholm: KMH.
Van der Kolk, B. (2014). The body keeps the score. London: Penguin Books.