Dance therapy

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Dance/Movement Therapy
Intervention
MeSH D003614

Dance/movement therapy (DMT) or dance therapy is the psychotherapeutic use of movement and dance to support intellectual, emotional, and motor functions of the body.[1] As a form of expressive therapy, DMT looks at the correlation between movement and emotion.[2] A typical DMT session has four main stages: preparation, incubation, illumination, and evaluation.[3] Organizations such as the American Dance Therapy Association and the Association for Dance Movement Therapy, maintain standards of professional courtesy and high levels of educational standards within the field. DMT is practiced in various clinical settings and is used for psychotherapy purposes and physical therapy.

History[edit]

Dance has been used therapeutically for thousands of years. It has been used as a healing ritual in the influence of fertility, birth, sickness, and death since early human history. Over the period from 1840 to 1930, a new philosophy of dance developed in Europe and the United States, defined by the idea that movement could have an effect on the mover vis-a-vis that dance was not simply an expressive art.[4]The actual establishment of dance as a therapy and as a profession occurred in the 1950s, beginning with future American Dance Therapy Association founder Marian Chance.[5]

Although dance has been a method of expression for centuries, it wasn’t until the past half century that it was characterized as a form of therapy. The development of DMT can be split into two waves throughout history.

First wave[edit]

Marian Chace, spearheaded the movement of dance in the medical community as a form of therapy. She is considered the principal founder of what is now dance therapy in the United States.[6] In 1942, through her work, dance was first introduced to western medicine. Chace was originally a dancer, choreographer, and performer. After opening her own dance school in Washington, D.C., Chace began to realize the effects dance and movement had on her students.[7] The reported feelings of wellbeing from her students began to attract the attention of the medical community, and some local doctors began sending patients to her classes. She was soon asked to work at St. Elizabeth’s Hospital in Washington, D.C. once psychiatrists too realized the benefits their patients were receiving from attending Chace’s dance classes.[8] In 1966 Chace became the first president of the American Dance Therapy Association, an organization which she and several other DMT pioneers founded.[7] According to the ADTA, dance is “the psychotherapeutic use of movement as a process which furthers the emotional, social, cognitive, and physical integration of the individual.”

Second wave[edit]

The second wave of Dance Movement Therapy came around the 1970s to the 1980s and it sparked much interest from American therapists. During this time, therapists began to experiment with the psychotherapeutic applications of dance and movement. As a result of the therapists' experiments, DMT was then categorized as a form of psychotherapy. It was from this second wave that today’s Dance Movement Therapy evolved.[7]

Principles[edit]

The theory of DMT is based mainly upon the belief that body and mind interact. Both conscious and unconscious movement of the person, based on the dualist mind body premise, affects total functioning, and also reflects the individual’s personality. Therefore the therapist-client relationship is partly based on non-verbal cues such as body language. Movement is believed to have a symbolic function and as such can aid in understanding the self. Movement improvisation allows the client to experiment with new ways of being and DMT provides a manner or channel in which the client can consciously understand early relationships with negative stimuli through non-verbal mediation by the therapist. [7]

Through the unity of the body, mind, and spirit, DMT provides a sense of wholeness to all individuals. The body refers to the “discharging of energy through muscular-skeletal responses to stimuli received by the brain.” The mind refers to “mental activities...such as memory, imagery, perception, attention, evaluation, reasoning and decision making.” The spirit refers to the “subjectively experienced state of feeling in engaging in or empathically observing dancing.”[9]

Dance therapy works to improve the social skills, as well as relational dynamics among the clients that choose to participate in it to better improve their quality of life. Through this form of therapy clients will gain a deeper sense of self-awareness through a meditative a process that involves movement, motion, and realization of one's body. Dance therapy is different from other forms of rehabilitative treatments because it allows creative expression and is more holistic, meaning it treats the full person: mind, body, and spirit.[10]

The therapy process[edit]

The therapy process has four stages, which occur during DMT and can be a creative time for both the therapist and patient(s). Each stage contains a smaller set of goals which correlate to the larger purpose of DMT. The stages and goals of DMT vary with each individual. Although the stages are progressive, the stages are usually revisited several times throughout the entire DMT process. The four stages are:

Preparation: the warm-up stage, a safe space is established without obstacles nor distractions, a supportive relationship with a witness is formed, comfort for participants to to be familiar with moving with their eyes closed.
Incubation: leader verbally prompts participant to go into subconscious, open-ended imagery used to create an internal environment that is catered to the participant, relaxed atmosphere, symbolic movements.
Illumination: process which is integrated through conscious awareness via dialogue with witness, self-reflection in which the participant uncovers and resolves subconscious motivations, increased self awareness, can have positive and negative effects.
Evaluation: discuss insights and significance of the process, prepare to end therapy[10]

Dance styles used[edit]

A variety of dance styles are used in DMT depending on the needs to the client. These include: modern dance with its emphasis on the pure elements of movement, various culturally-based dances, Turkish dance, ballroom dance, tango, waltz, foxtrot, aerobic dance, line dancing and body psychotherapy[11]

Research[edit]

Proposed mechanisms[edit]

Various hypothesis have been proposed for mechanisms by which dance therapy may benefit participants. There is a social component to dance therapy, which can be valuable for psychological functioning through human interaction. Another possible mechanism is the music that is used during the session, which may be able to reduce pain, decrease anxiety, and increase relaxation. Dance incorporates body, mind and emotion into a single activity, and consequently affects people not only physically, but also spiritually. It aids in both social and psychological health. In addition to helping physically abused people cope with emotions, such as anger and frustration, it also helps them develop a more gentle, yet powerful way of thinking. This makes it a great tool for development programs, which aim to increase the sociability of the participants and improve their position in society.[12]

Since dance requires learning and involves becoming active and discovering capacities for movement, there is also the physical training that could provide benefits as well. There are many known physical and psychological benefits of exercise, which is a key component of dance therapy. Consequently, dance has been shown to be effective as a preventive measure for ailments such as heart disease, diabetes, osteoporosis and hypertension.[13] Dancing may be considered more uplifting and enjoyable than other types of exercise, due to its uncompetitive and free spirited nature. Dance therapy can also involve nonverbal communication, "which enables participants to express their feelings without words. This might be helpful when normal communication is absent or has broken down (eg, for patients with dementia).[14]

Studies[edit]

A recent study used Dance Movement Therapy to create a sense of ease between the therapist and the patient. The issue being discussed in therapy was sexual orientation and the feelings associated with embracing identity. Sexuality can be difficult to discuss between seated individuals in a sterile and closed environment, thus dance therapy was used to enable the patient and therapist to become more comfortable with their bodies and each other’s. This allows the patient to expand their sexual confidence and gives them a sense of comfort when talking about past trauma. Dance therapy therefore allowed significant progress to be made between the therapist, the patient, and helping patient’s somatic discomfort. [15]

One study found DMT to be an effective treatment for mild depression in female adolescents. A sample of 40 students (mean age 16) underwent 12 weeks of dance movement therapy. Neurohormonal concentrations in plasma and surveys of psychological symptoms were used to monitor the effects of the treatment. It was found that during and after treatment participants demonstrated higher self esteem and lower emotional disturbance according to the surveys. In addition, heightened serotonin levels were observed during treatment from the blood tests. This evidence suggests that DMT can be used to relieve psychological and physiological distress in adolescents with mild depression. [16]

One review of the effect of DMT on Parkinson's disease noted that there have been few studies in this area. DMT appears to meet most requirements for exercise programs for patient's with Parkinson's. Benefits in gait function, balance, and quality of life were found in short-term studies, though further studies need to be done to see if any of these benefits are seen long-term.[17]

Dance therapy is used not only in recovery from serious illness, but can also be used to promote positive psychosocial behavior in adults and children. In a study that sampled 54 multicultural elementary children and was conducted over 12 weeks, it was found that DMT reduced violent behavior in the sample. This potentially lays the groundwork for further research on DMT as a means to reduce aggressive behavior in all ages. This finding could have many implications for dance in positive psychology, as a positive influence on social environments and relationships, and as a means of reducing aggressive behavior. [18]

A review by The Cochrane Collaboration on dance/movement therapy for improving psychological and physical outcomes in cancer patients stated "We did not find support for an effect of dance/movement therapy on body image. The findings of one study suggest that dance/movement therapy may have a beneficial effect on QoL. However, the limited number of studies prevents us from drawing conclusions concerning the effects of dance/movement therapy on psychological and physical outcomes in cancer patients."[19]

Another review for patients with schizophrenia concluded, "This therapy remains unproven" and "There is no evidence to support – or refute – the use of dance therapy in this group of people."[20]

Another review concluded, that while studies have found benefits for DMT, these were based on poor quality evidence, so higher quality research is needed to come to any firm conclusion and suggested DMT "should be considered as a potentially relevant add-on therapy for a variety of conditions that do not respond well to conventional medical treatments."[14]

The American Cancer Society states, "Few scientific studies have been done to evaluate the effects of dance therapy on health, prevention, and recovery from illness. Clinical reports suggest dance therapy may be effective in improving self-esteem and reducing stress. As a form of exercise, dance therapy can be useful for both physical and emotional aspects of quality of life."[21]


Adverse effects[edit]

There have been instances in which group DMT interventions had adverse effects on the clients. In a study done by Brauninger, several different DMT approaches were applied to group interventions, which were referred to as ICL2. The Integrative DMT approach correlated negatively with aspects such as psychological health, and positively with somatization. Authentic Movement increased interpersonal sensitivity and phobic anxieties, while Visualization negatively correlated with physical health, and in combination with Breathing exercises, phobic anxiety. Progressive Muscle Relaxation exercises resulted in a decrease in independence and an increase in phobic anxiety. In addition, certain leadership styles correlated with a decline in wellbeing. An Explorative leadership style negatively correlated with social relationships, as did Empathetic Leadership Style, and social support in addition to an increase in depression. [22]

Most trials studying dance therapy did not specifically comment on whether or not adverse effects occurred, though one noted a broken finger thought related to dancing. [14]

Another possible adverse effect of dance is dependency. It has been found that professional dancers, pre-professional dancers, and others who dance several times a week may, when painfully injured and prevented from dancing, suffer additional pain from being "titrated," experiencing dance withdrawal symptoms. This means that once someone has become accustomed to the physical and emotional effects of dance, they are at risk of developing withdrawal symptoms such as nervousness, anxiety, and depression when inhibited from dancing (often resulting from an injury).[23] In general physicians assign patients to DMT if there is no other course of treatment.

Skepticism[edit]

Ritter and Low study the effects of Dance Movement Therapy on children, psychiatric patients, in terms of their body awareness, anxiety levels, and strength or improvement in the individuals identity. Their study shows that DMT is a positive treatment for patients suffering from a wide array of symptoms. In addition, adults and adolescents are seen to have benefitted more from therapy than children, potentially because they embrace the social aspects of Dance Therapy more than younger individuals. However, it is mentioned that studies on DMT still lack proper control groups, sampling, and appropriate measures of assessment, which seriously damages the reputation of science related to DMT. This allows skeptics to endorse DMT as an additional ‘Eastern' form of medicine that is not actually taken seriously by internationally approved and accredited treatment, and is only looked to only in dire straits where its possible placebo effect could be relevant. [24]

Further Research Needed[edit]

Dance based therapy potentially slows the progression of movement limitations in older adults. Bed sensors were used to see if dance based therapy increased nighttime restfulness. Although it seemed like there was a difference in levels of sleep, there was no significant finding. It is clear, however, that bed sensors may be used in future studies of this sort. [25] Another study found study found that there was no significant effect of dance/movement therapy on body image in women with breast cancer, however there was a possible increase in participant’s quality of life. It is clear that dancing could help people, but more research needs to be funded to create more data to imply causation.[26]

Locations[edit]

DMT is practiced in a large variety of locations. Such locations include:[5]

Organizations[edit]

Organizations such as the American Dance Therapy Association were created in order to uphold high standards in the field of DMT. Such organizations help connect individuals to therapists and DMT.[27]

American Dance Therapy Association[edit]

American Dance Therapy Association (ADTA) was founded in 1966 in order to uphold high standards throughout dance therapy. The ADTA was created by Marian Chace, the first president of the ADTA, and other pioneers in dance movement. Along with setting standards for which therapists must attain to become licensed therapists, ADTA keeps an updated registry of all movement/dance therapists who have met ADTA’s standards. In addition, ADTA also publishes the American Journal of Dance Therapy and sponsors annual professional conferences.[27]

Association for Dance Movement Psychotherapy, United Kingdom[edit]

The Association for Dance Movement Psychotherapy, United Kingdom (ADMP UK) was one of the first organizations established to regulate the field of dance therapy. ADMP UK accredits therapists and oversees that all regulations are followed.[28]

Allied professions[edit]

Allied professions are areas that a person could do, special studies, short courses, or eventually become trained in the area of DMT.[29]

Therapist qualifications[edit]

ADTA is the main regulator of the required education and training in order to become a dance/movement therapist.[27] A master's degree is required to become a dance/movement therapist. “Registered Dance/Movement Therapist” (R-DMT) is the title given to entry-level dance/movement therapists who have completed requisite education and a minimum 700-hour supervised clinical internship. Those who have completed over 3,640 hours of supervised professional clinical work may hold the advanced credential “Board Certified Dance/Movement Therapist (BC-DMT).[8]

Education[edit]

Because becoming a dance therapist requires a graduate degree of at least a Master's level, the undergraduate track that a student chooses to take is very important, as well. There is no specific undergraduate degree that a student is required to obtain. However, it is highly recommended that they choose a degree in a behavioral science, like Psychology, or in something related to dance, such as Performing Arts.[30]

There are only 6 ADTA approved master's programs from which to earn Registered Dance/Movement Therapist (R-DMT) credentials: Antioch University New England in New Hampshire, Columbia College Chicago in Illinois, Drexel University in Pennsylvania, Lesley University in Massachusetts, Naropa University in Colorado, and Pratt Institute in New York [1]. Each of these programs require two to three years of study. Students are expected to complete sixty to sixty-two credit hours, along with an internship/practicum of two to four semesters.[31]

Those with a master's or doctoral degree in a human services-related field may have the option to become an R-DMT via alternate route[32]

In addition to the R-DMT, which stands for Registered Dance Movement Therapist, there is the BC-DMT, which stands for Board Certified Dance Movement Therapist. The R-DMT requires a master’s degree with 700 hours of supervised clinical work, while the BC-DMT is the “advanced” qualification requiring a master’s degree of 3,640 hours of supervised clinical work and passing a grueling exam.[33]

There are five universities in the United Kingdom that offer graduate programs in Dance Movement Therapy and have been approved by the ADMP-UK: Dance Voice Therapy and Education Centre, Bristol, Derby University, Goldsmiths University of London, University of Roehampton, and Queen Margaret University in Edinburgh, Scotland. Goldsmiths University even offers a doctoral degree in dance therapy. Each of these programs require two to three years of study, depending on whether the student chooses to take a full-time or part-time track. The curriculum is quite rigorous. The students are expected to complete a total of 240 credit hours, or more, in the short time they are enrolled. Along with regular coursework, students are obligated to undergo psychotherapy while in the program. Most programs also require that each student create their own method of dance therapy prior to graduation.[34]

See also[edit]

References[edit]

  1. ^ Ekman, S.-L.; Palo Bengtsson, L. and Winblad, B.; Ekman, S.-L. (1998). "Social Dancing: A Way to Support Intellectual, Emotional and Motor Functions in Persons with Dementia". Journal of Psychiatric and Mental Health Nursing. 6 5 (6): 545–554. doi:10.1046/j.1365-2850.1998.560545.x. PMID 10076285. 
  2. ^ Schore, A. (1994). "affect regulation and the origin of the self: the neurobiology of emotional development". Journal of the American Academy of Child & Adolescent Psychiatry 35 (11): 1561. doi:10.1097/00004583-199611000-00028. 
  3. ^ Hadamard, J. (1954). "The Psychology of Invention in the Mathematical Field". Journal of Chemical Education. 2 32 (2): 110. Bibcode:1955JChEd..32..110. doi:10.1021/ed032p110.3. 
  4. ^ Schwartz, H. (1992) "Torque: The new kinaesthetic of the twentieth century". In Crary, J. and S. Kwinter (Ed.) Zone 6: Incorporations. New York: Urzone ISBN 9780942299298
  5. ^ a b Strassel, Juliane; Daniel Cherkin; Lotte Steuten; Karen Sherman; Hubertus Vrijhoef (May–June 2011). "A Systematic Review of the Evidence for the Effectiveness of Dance Therapy". Alternative Therapies 17 (3): 50–9. PMID 22164813. 
  6. ^ "Who was Marian Chace?" American Dance Therapy Association.
  7. ^ a b c d Levy, Fran J. '1988) Dance Movement Therapy: A Healing Art. Reston, VA: The American Alliance for Health, Physical Education, Recreation, and Dance.
  8. ^ a b "Dance Therapy". American Cancer Society.
  9. ^ Hanna, Judith (2007). "The Power of Dance: Health and Healing". The Journal of Alternative and Complementary Medicine 1 (4): 323–331. 
  10. ^ a b Meekums, Bonnie, Dance Movement Therapy, (Thousand Oaks, CA: SAGE Publications Inc.).
  11. ^ Strassel, Juliane; Daniel Cherkin; Lotte Steuten; Karen Sherman; Hubertus Vrijhoef (May–June 2011). "A Systematic Review of the Evidence for the Effectiveness of Dance Therapy". Alternative Therapies 17 (3): 53. PMID 22164813. 
  12. ^ Aktas, Gurbuz. [<http://apjcpcontrol.net/paper_file/issue_abs/Volume6_No3/Gurbuz Aktas .pdf> ""Dance as a Therapy for Cancer Prevention.""] (PDF). Asian Pacific Journal of Cancer Prevention 6: 408-11. 
  13. ^ Hanna, Judith (2007). "The Power of Dance: Health and Healing". The Journal of Alternative and Complementary Medicine 1 (4): 323–331. 
  14. ^ a b c Strassel, JK; Cherkin, DC; Steuten, L; Sherman, KJ; Vrijhoef, HJ (May–Jun 2011). "A systematic review of the evidence for the effectiveness of dance therapy.". Alternative therapies in health and medicine 17 (3): 50–9. PMID 22164813. 
  15. ^ S, Kierr (2011). "Is Dance/Movement Therapy Relevant to the Process of Achieving a Healthy Sexuality?". American Journal of Dance Therapy 33 (1): 42–56. 
  16. ^ Jeong, Young-Ja et al. (December 2005). "Dance Movement Therapy Improves Emotional Responses And Modulates Neurohormones In Adolescents With Mild Depression". International Journal of Neuroscience 115 (12): 1711–1720. doi:10.1080/00207450590958574. 
  17. ^ Earhart, GM (Jun 2009). "Dance as therapy for individuals with Parkinson disease.". European journal of physical and rehabilitation medicine 45 (2): 231–8. PMC 2780534. PMID 19532110. 
  18. ^ Zilius, Marie Newsom (2005). "Dance/Movement Therapy in Pediatrics: An Overview.". Alternative and Complementary Therapies 26 (2): 87–92. 
  19. ^ Bradt, J; Goodill, SW; Dileo, C (Oct 5, 2011). "Dance/movement therapy for improving psychological and physical outcomes in cancer patients.". The Cochrane database of systematic reviews (10): CD007103. doi:10.1002/14651858.CD007103.pub2. PMID 21975762. 
  20. ^ Ren, J; Xia, J (Oct 4, 2013). "Dance therapy for schizophrenia.". The Cochrane database of systematic reviews 10: CD006868. doi:10.1002/14651858.CD006868.pub3. PMID 24092546. 
  21. ^ "Dance Therapy". American Cancer Society. Retrieved 30 April 2014. 
  22. ^ Brauninger, I (2014). "Specific Dance Movement Therapy Interventions - Which Are Successful? An Intervention and Correlation Study". The Arts in Psychotherapy 14 (5): 445–457. 
  23. ^ Hanna, Judith (2007). "The Power of Dance: Health and Healing". The Journal of Alternative and Complementary Medicine 1 (4): 323–331. 
  24. ^ Ritter, Meredith; Low, Kathryn. "Effects of Dance/movement Therapy: A meta-analysis". The Arts in Psychotherapy: 249–260. 
  25. ^ Bradt, J; Goodill, SW; Dileo, C (Oct 5, 2011). "Dance/movement therapy for improving psychological and physical outcomes in cancer patients.". The Cochrane database of systematic reviews (10): CD007103. doi:10.1002/14651858.CD007103.pub2. PMID 21975762. 
  26. ^ Krampe, Miller; Echebiri, C.; Rantz, M.; Skubic, M. "Nighttime Restfulness During Daytime Dance Therapy: An Exploratory Study Using Bed Sensors". Western Journal of Nursing Research 36 (3): 362–373. 
  27. ^ a b c "Who We Are". American Dance Therapy Association.
  28. ^ Payne, Helen (2006) Dance Movement Therapy: Theory, Research, and Practice. Hove, East Sussex: Routledge.
  29. ^ Payne, Helen (2004-03-09). Dance Movement Therapy: Theory and Practice. Taylor & Francis. ISBN 9780203359266. 
  30. ^ "Undergraduate Coursework". Retrieved 5 December 2013. 
  31. ^ Approved Graduate Programs in Dance/Movement Therapy. adta.org
  32. ^ Alternate Route Education in Dance/Movement Therapy. adta.org
  33. ^ "Alternative Therapy-Art Therapy, Dance Therapy, Music Therapy, and Imagery". Beaumont Health System. Beaumont Health System. Retrieved 5 December 2013. 
  34. ^ Association for Dance Movement Therapy UK: Training. admt.org.uk

Further reading[edit]

  • Meekums, B. (2002). Dance Movement Therapy: a Creative Psychotherapeutic Approach. London: Sage.
  • Chodorow, J. (1991). Dance Therapy and Depth Psychology. London.
  • Lewis, P. (1984; 1986). Theoretical Approaches in Dance Movement Therapy. Vols I & II, USA: Kendall/Hunt.
  • Payne, H. (ed). (2006). Dance Movement Therapy: Theory, Research and Practice (2nd edn). Tavistock / Routledge.
  • Siegel, E. (1984). Dance Movement Therapy: Mirror of Ourselves: The Psychoanalytic Approach. New York: Human Science Press.
  • Stanton-Jones, K. (1992). An Introduction to Dance Movement Therapy in Psychiatry. London: Tavistock/Routledge.
  • North, M. (1990). Personality Assessment Through Movement. Northcote House.
  • Payne, H.L. (2000). Creative Movement and Dance in Groupwork. Oxon: Speechmark.
  • McCormack, D. (2003) An event of geographical ethics in spaces of affect. Transactions of the Institute of British Geographers, 28, (4), 488–507.

External links[edit]