Guided Imagery and Music with Military Women and Trauma: A Continuum Approach to Music and Healing
By Kristin Maya Story
Women are the fastest growing demographic among veterans in the United States. In response, the Veterans Hospital Administration (VA) has increased attention to the care and research of female veterans. Military Sexual Trauma (MST) is an issue among returning veterans that causes a significant amount of distress with a high occurrence of Post-Traumatic Stress Disorder (PTSD). There is a need to evaluate and develop treatment protocols for MST related PTSD. This study sought to evaluate Guided Imagery and Music (GIM) and its modifications as a treatment modality for female veterans with MST related PTSD.
The thesis describes five components that comprised the PhD study. A systematic literature review details issues that women encounter in the military and on return to civilian life, including impact of MST, and current services available to them. Conclusions from the literature reviews led to a conceptual framework for the research and initial research questions. A feasibility study was implemented that gathered qualitative and quantitative data to explore five female veterans’ experiences with a continuum model of music and imagery and GIM (MI/GIM Continuum) sessions. Research questions sought to explore the participants’ experience of components of the MI/ GIM sessions, including: music, imagery, guiding and creative processing. Identified themes from transcribed sessions and a focus group interview revealed that the participants found music helpful in regulating emotions, decreasing arousal, expressing feelings and as a means to connect with others. Imagery was experienced as a new resource for grounding, a reminder of goals and a mediator to insights. Participants experienced the guiding as supportive, structuring and empowering. Initially resistant to the creative processing, all participants found it helpful as a manner of self-expression and a way to continue processing between sessions. Overall, participants found the sessions to be a means for increased coping skills, increased self-awareness and empowerment. Completed PCL-5 scales demonstrated a decrease in PTSD symptoms, and data related to compliance and attrition demonstrated positive results. The feasibility study is detailed in a peer-reviewed journal article, published during the course of this study and included as a link in the thesis.
The feasibility study helped to refine the protocol for a proposed Randomised Controlled Trial (RCT). For the purpose of improving therapy fidelity in the clinical trial, a therapy manual was created that used a MI/GIM Continuum Model for working with clients who have experienced trauma. The manual details a flexible protocol for adapting the MI and/or GIM method to three different working levels: resource-oriented, issue-oriented and transformation-oriented. The levels are meant to support the various stages of trauma work, beginning with the strengthening of trust and inner-resources before progressing to issues related to trauma and its symptoms, and finally exploring the re-integration of a new sense of self into society.
In order to further examine benefits from the MI/GIM sessions, a collaborative inquiry with one participant utilized an Arts Based Research process to investigate the musical and personal growth that followed participation in the sessions. A short documentary was filmed, edited and released through a collaboration between the participant and researcher. The inquiry used a transformative framework and sought to empower the participant to tell her story in her own manner, to engage in an equal creative collaboration and to raise awareness beyond academia. Portraiture was the method that guided the data collection and presentation of her story through film and creative writing. A link to the film is included in the thesis.
This timely and original study aims to make an impact by adding to the small body of research on female veterans and raising awareness in the greater community, specifically in the understanding of female veterans with MST related PTSD and their experience with MI/GIM as a treatment modality for MST related PTSD.