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穿越创伤:舞蹈/动作疗法作为一种基于身体的干预措施,用于应对叙利亚难民儿童的创伤和压力

Moving Through the Trauma: Dance/Movement Therapy as a Somatic-Based Intervention for Addressing Trauma and Stress Among Syrian Refugee Children.

作者信息

Grasser Lana Ruvolo, Al-Saghir Heba, Wanna Cassandra, Spinei Jenna, Javanbakht Arash

机构信息

Wayne State University School of Medicine, Detroit, MI.

Wayne State University School of Medicine, Detroit, MI.

出版信息

J Am Acad Child Adolesc Psychiatry. 2019 Nov;58(11):1124-1126. doi: 10.1016/j.jaac.2019.07.007. Epub 2019 Jul 23.

Abstract

Traumatic experiences are common in youth, with some reporting that 20% of youth have experienced trauma. Some populations have higher exposure. More than 50% of refugee youth with exposure to civilian war trauma and forced migration experience high anxiety; up to 30% screen positive for posttraumatic stress disorder (PTSD). Trauma exposure during critical developmental periods can have detrimental social, educational, and physical consequences. Current evidence-based therapeutics have primarily been researched in adults; child anxiety disorders are undertreated and underresearched. Psychotherapy for refugee and other highly vulnerable populations may be limited by high cost and scarcity of skilled trauma specialists; culturally informed and language-capable clinicians who can meet the needs of refugee populations are even more rare. Furthermore, pharmacotherapy is limited by a sparse evidence base, parental and child preferences, and cost-all factors that again are more prevalent in refugee populations. Overall, evidence for treatment of PTSD and anxiety in refugee children is limited and largely extrapolated from treatment for children with other types of trauma exposure. Dance/movement therapy (DMT) is a manualized, multimodal intervention that aims to strengthen emotional, cognitive, physical, and social integration. DMT sessions are led by a licensed dance/movement therapist with joint education in counseling. Owing to its integration of exposure, mindfulness, and somatic components, DMT may be a candidate for a multifaceted, multitarget treatment approach to trauma and stress addressing psychological and somatic symptoms, both of which can be present in trauma-related conditions. However, evidence of use of DMT to help traumatized children is lacking. With the state of Michigan's high volume of Syrian refugees and knowing the need for intervention with understanding of barriers of culture, language, and access, our team selected to test acceptance and feasibility of DMT as a possible way to address trauma-related symptoms in Syrian refugee youth.

摘要

创伤经历在青少年中很常见,一些报告称20%的青少年经历过创伤。一些人群的暴露率更高。超过50%经历过平民战争创伤和被迫迁移的难民青少年有高度焦虑;高达30%的人创伤后应激障碍(PTSD)筛查呈阳性。关键发育时期的创伤暴露会产生有害的社会、教育和身体后果。目前基于证据的治疗方法主要是在成年人中进行研究的;儿童焦虑症的治疗不足且研究较少。为难民和其他高度脆弱人群提供的心理治疗可能受到高成本和熟练创伤专家稀缺的限制;能够满足难民人群需求、了解文化且具备语言能力的临床医生更为罕见。此外,药物治疗受到证据基础薄弱、父母和儿童偏好以及成本等因素的限制,而这些因素在难民人群中更为普遍。总体而言,为难民儿童治疗PTSD和焦虑症的证据有限,且大多是从对其他类型创伤暴露儿童的治疗中推断出来的。舞蹈/动作治疗(DMT)是一种标准化的多模式干预方法,旨在加强情感、认知、身体和社会融合。DMT课程由具有咨询联合教育背景的持牌舞蹈/动作治疗师带领。由于其融合了暴露、正念和身体成分,DMT可能是一种针对创伤和压力的多方面、多靶点治疗方法的候选方案,可解决心理和身体症状,这两种症状都可能出现在与创伤相关的病症中。然而,缺乏使用DMT帮助受创伤儿童的证据。鉴于密歇根州有大量叙利亚难民,且了解到需要在理解文化、语言和获取障碍的情况下进行干预,我们的团队选择测试DMT作为解决叙利亚难民青少年创伤相关症状的一种可能方法的可接受性和可行性。

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