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Music therapy was noninferior to verbal standard treatment of traumatized refugees in mental health care: Results from a randomized clinical trial.
European journal of psychotraumatology Pub Date : 2021-07-06 , DOI: 10.1080/20008198.2021.1930960
B D Beck 1, 2 , S L Meyer 2, 3 , E Simonsen 4 , U Søgaard 5 , I Petersen 6 , S M H Arnfred 2, 7 , T Tellier 8 , T Moe 2
Affiliation  

Background: Many people with refugee backgrounds suffer from trauma-related complex social and psychological problems, and compliance with standard psychological treatment tends to be low. More culturally adaptable treatment options seem to be needed. Objective: We aimed to investigate whether the music therapy method: 'trauma-focused music and imagery' (tr-MI), characterized by a particular focus on arousal and affect regulation, would be equally effective as the standard psychological talk therapies for ameliorating trauma symptoms in Danish refugees. Methods: A pragmatic, noninferiority, parallel, randomized controlled trial with six-month follow-up was carried out at three clinics for refugees in the public mental health services of the Psychiatry (DK). Seventy-four adults diagnosed with posttraumatic stress disorder (PTSD) were allocated to either music therapy sessions (tr-MI, N = 39) or psychological treatment as usual (TAU, N = 35). Western classical music, new age music, and music from the participants' own national culture were used to generate inner imagery, following a phased treatment protocol. Homework entailed listening to music. The primary outcome was the measurement of trauma symptoms by the Harvard Trauma Questionnaire, section IV (HTQ-IV); secondary measures were somatoform and psychoform dissociation (DSS-20), SDQ-20), attachment (RAAS), and well-being (WHO-5). Treatment effects reflected by primary and secondary measures were estimated using linear mixed models. Results: Tr-MI was noninferior to TAU (mean difference at follow-up HTQ-IV: 0.14, CI (-0.10; 0.38), with a - 0.3 noninferiority margin). A high dropout rate of 40% occurred in the TAU group, compared to 5% in the music therapy group. Secondary measures generated small to medium effect sizes in both groups, with significant medium effect sizes for well-being and psychoform dissociation at follow-up in tr-MI. Conclusions: Tr-MI is an innovative form of psychological treatment in refugee mental health services. Trials comparing music therapy to standardized therapy are needed to substantiate the evidence base for tr-MI therapy.

中文翻译:

音乐疗法不劣于精神卫生保健中受创伤难民的口头标准治疗:一项随机临床试验的结果。

背景:许多有难民背景的人都患有与创伤相关的复杂社会和心理问题,对标准心理治疗的依从性往往很低。似乎需要更具文化适应性的治疗方案。目标:我们旨在研究音乐治疗方法:“以创伤为中心的音乐和意象”(tr-MI),其特点是特别关注唤醒和影响调节,是否与改善创伤的标准心理谈话疗法同样有效丹麦难民的症状。方法:在 Psychiatry (DK) 的公共心理健康服务机构的三个难民诊所进行为期六个月的实用、非劣效性、平行、随机对照试验。74 名被诊断患有创伤后应激障碍 (PTSD) 的成年人被分配到音乐治疗课程 (tr-MI, N = 39) 或照常进行心理治疗 (TAU, N = 35)。按照分阶段的治疗方案,西方古典音乐、新时代音乐和来自参与者自己民族文化的音乐被用来产生内在意象。家庭作业需要听音乐。主要结果是哈佛创伤问卷第四部分 (HTQ-IV) 对创伤症状的测量;次要措施是躯体形式和心理形式分离 (DSS-20)、SDQ-20、依恋 (RAAS) 和幸福感 (WHO-5)。使用线性混合模型估计主要和次要措施反映的治疗效果。结果:Tr-MI 不劣于 TAU(随访 HTQ-IV 的平均差异:0.14,CI(-0.10;0.38),a - 0. 3 非劣效性界值)。TAU 组的辍学率高达 40%,而音乐治疗组为 5%。次要措施在两组中产生了小到中等的影响大小,在 tr-MI 的后续行动中,幸福感和心理形态分离的影响大小为中等。结论:Tr-MI 是难民心理健康服务中一种创新的心理治疗形式。需要进行比较音乐疗法与标准化疗法的试验,以证实 tr-MI 疗法的证据基础。Tr-MI 是难民心理健康服务中一种创新的心理治疗形式。需要进行比较音乐疗法与标准化疗法的试验,以证实 tr-MI 疗法的证据基础。Tr-MI 是难民心理健康服务中一种创新的心理治疗形式。需要进行比较音乐疗法与标准化疗法的试验,以证实 tr-MI 疗法的证据基础。
更新日期:2021-07-06
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