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Voices: A World Forum for Music Therapy, v. 16, n. 3 (2016)

[Research]

Neo-colonialism In Music Therapy: A

Critical Interpretive Synthesis of the
Literature Concerning Music Therapy
Practice With Refugees
By Rachael Comte

Abstract
This paper presents the findings from a critical interpretive synthesis that explored
the assumptions influencing music therapists writing about their work with
refugees. Music therapy literature suggests that the profession appears to be
uniquely suited to address the healthcare needs of the refugee population by
transcending cultural and language barriers which often mitigate access to other
services. However, when working with individuals characterised by trauma and
whose identities have been dictated by political power, it is essential that music
therapy practices oppose these forces and provide opportunities for empowerment.
Therefore, eleven papers describing music therapy practice with refugees from the
international literature were examined and interrogated to determine the
assumptions embedded within the language used by music therapists. The
synthetic construct of a neo-colonial music therapist emerged from the data and
informed subsequent analysis. The concepts of refugees as a homogenous
group defined by a dominant narrative of trauma , and musical improvisation
as a universal language appeared to be influential in the ways music therapists
were reporting on their work. These findings are discussed along with
considerations for a music therapy practice that promotes empowerment and
advocates for the voices of the refugee population.

Keywords: refugee, neo-colonialism, critical interpretive synthesis, music therapy

Introduction
Considering the Term Refugee

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The moment an individual is identified as a refugee, there is an immediate

overemphasis on the narratives of trauma and challenge, often to the detriment of
the other aspects that comprise the individuals identity as a human being. The
very notion of a refugee is one dictated and mediated by political power; it defines
an individual as being powerless and fearful (UNHCR, 1967, Article 1), and
concerns ones political legitimacy (McAdams & Chong, 2014). As it is within the
realm of music therapy to explore identity constructs, the profession appears to be
uniquely situated to respond not only to the dominant narratives of trauma within
the refugee population, but also to function as a site for the promotion of human
rights.

The term refugee was originally defined by the United Nations High
Commissioner for Refugees (UNHCR) in the 1951 Convention Relating to the
Status of Refugees, and has since become an official legislative term within
international and domestic law. Within the convention, a refugee is defined as a
person who:

Owing to well-founded fear of being persecuted for reasons of race, religion,

nationality, membership of a particular social group or political opinion, is
outside the country of his nationality and is unable, or owing to such fear,
unwilling to avail himself of the protection of that country. (Article 1)

In mid-2014, the UNHCR reported an increase in the number of individuals of

concern to their agency: with figures estimated at 13 million and continuing to rise
(UNHCR, 2015a).

Rationale
The World Health Organisation (WHO) has reported that those identified as
refugees are at a higher risk than the general population of psychosocial disorders
(World Health Organisation, 2015). The literature also suggests that posttraumatic
stress disorder (Fazel, Wheeler, & Danesh, 2005), communicable diseases, and
chronic illnesses (Navuluri et al., 2014) are over represented within this population
when compared to the general population. As a result, healthcare services are
often prioritised during the resettlement period.

A scan of the relevant literature, however, continues to reveal an emphasis on the

narrative of challenge as a result of the barriers that mitigate access to healthcare
services for refugees. Western models of healthcare have proved inaccessible for
a large proportion of the refugee population, owing to factors such as the language
barrier (Slobodin, 2014) differing conceptualisations of health and medicine (Chun,
Organista, & Marn, 2003; May, Rapee, Coello, Momartin, & Aroche, 2014;), and a
distrust of healthcare professionals (de Anstiss & Ziaian, 2010). Additionally, the
location of healthcare service delivery has also contributed to inaccessibility. In
most Western countries the dominant medical model dictates that healthcare
should be provided by an expert in the context of a medical setting. The literature
has indicated, however, that this model is often far removed from the refugee
persons previous experience of healthcare. For this reason, community based
interventions have been implemented to meet the healthcare needs of this

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population, resulting in improved mental health outcomes (Fondacaro & Harder,

2014; Garakasha, 2014; Measham et al., 2014).

In response to what appears to be a challenging situation for healthcare providers,

music therapists could be uniquely positioned to meet the needs of the refugee
population. Recent studies have revealed a positive impact on the neurological
responses to trauma following music therapy (Krout, 2007; Swallow, 2002) and in
some cases, music therapy is being offered as an alternative to cognitive
behavioural therapies for the treatment of trauma (Carr et al., 2012). Additionally,
when language barriers prohibit or limit the accessibility of traditional talking
therapies, music therapists emphasise the universality of music; thus providing a
safe and acultural medium for traumatised individuals to explore healthy aspects of
their identity (Pavlicevic, 1997). Furthermore, music therapy methods have been
used to treat PTSD in adults and children (Carr et al., 2012), a pertinent factor
considering children and young adults comprise of half of the refugee population
(UNHCR, 2015b).

Also relevant to the current discourse is the field of community music therapy,
which promotes a holistic definition of health encompassing social and cultural
factors (Stige & Aar, 2012). For the refugee individual whose understanding of
health is intrinsically connected to concepts of spirituality embedded within a
broader cultural framework, the Western medical models concept of health as
being the absence of disease, has proved problematic (Chun et al., 2003; May et
al., 2014). Therefore, community music therapy has been identified as a bridge to
close the gap between culturally situated understandings of health, by promoting a
definition that is culturally inclusive and mutually negotiated. Community music
therapy also aligns with the literature supporting community based health care
services for this population (Fondacaro & Harder, 2014; Garakasha, 2014;
Measham et al., 2014).

The music therapy literature has suggested that the profession appears to be
uniquely suited to address the healthcare needs of the refugee population.
However, this notion is based upon literature steeped in the rhetoric of human
beings as refugees and thus the current discourse may be unintentionally
privileging the dehumanising aspects of the refugee identity and focusing on
narratives of trauma. Therefore, a critical review of the literature is essential to
unpack the assumptions influencing music therapists reporting on their work with
refugees, so as not to perpetuate a system of disempowerment, both within the
therapeutic relationship but also in the broader music therapy discourse. The
following research question was designed to guide the investigation: What
assumptions appear to be influential in the ways that music therapists report on
their work with refugees?

Design
Critical Interpretive Synthesis
A critical interpretive synthesis aims to integrate and critique a diverse body of

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literature. This method intends to critically analyse data through the development
of integrative concepts and theories that ultimately allow for a new understanding
of the literature to emerge (Dixon-Woods et al., 2006). Where a traditional
systematic review or qualitative synthesis aims to evaluate and synthesize, the
critical interpretive synthesis is unique in that the researcher actively seeks to
make critical judgements throughout the research process, examining the way
authors conceptualize and construct the phenomenon under consideration
(Harden & Thomas, 2010, p.755; McFerran, Garrido, & Saarikallio, 2014). In a
sense, this method of synthesis aims to transcend the epistemological value
systems that inevitably shape the presentation of information. For this reason, both
qualitative and quantitative research papers, in addition to other practice examples
and journal articles can be included (Annandale, Harvey, Cavers, & Dixon-Woods,
2007).

Another unique feature of this research design is the analysis process itself, which
is described as iterative, interactive, dynamic and recursive (Annandale et al.,
2007, p. 465). The research question is considered a compass rather than an
anchor, and an initial analysis of the data is intended to inform the subsequent foci
of the research (Eakin & Mykhalovskiy, 2003). The emergent, process-oriented
nature of this research design was considered crucial to uncover the assumptions
informing the way music therapists are reporting on their work with refugees.

Methodology
Literature Search and Inclusion
The initial literature scan was a systematic and structured search within the
following online electronic databases for publications: PsycINFO, RILM, CINAHL,
International Index to Music Periodicals, Scopus, and Web of Science. The search
terms used were refugee AND music therapy, and articles were excluded if they
were not in English. Initially, the number of publications generated was too large for
a detailed analysis (N = 92), therefore I decided to limit the included publications
firstly to those authored by credentialed music therapists, and secondly to those
which included a practice example of music therapy work with a refugee individual
or group (N = 11, see Table 1). This decision was based upon my interest in what
the local and international professionals of my field are currently contributing to this
particular discourse, from the position of an Australian Masters of Music Therapy
student at the University of Melbourne, Australia.

Article Rationale for inclusion

Ahonen & Participants in therapy were referred to as refugees

Mongillo within paper
Desideri Practice example of therapy included
(2014) Authors were credentialed music therapists

Table 1: Rationale for Inclusion of Articles for Critical Interpretive

Synthesis

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Akombo Practice example of music therapy included

(2001) To my knowledge, there is no formal music therapy
accreditation in Kenya, however Akombo discussed the
way in which he incorporated music therapy into his
practice. He also discussed working collaboratively with
Music Therapy International. Therefore I deemed this
appropriate to be included in the CIS

Baker & Authors were credentialed music therapists in Australia -

Jones (2005) Includes practice examples of music therapy -
Participants in therapy were referred to as refugees

Choi (2010) Author was a practicing music therapist at mental health

facility in North Korea, I deemed this appropriate to be
considered in the CIS
Participants were referred to as refugees
Practice example of music therapy included

Dixon (2002) Author was credentialed music therapist - Practice

example of music therapy included
Participants were labelled as refugees or asylum
seekers in the first part of the article, subsequently
referred to as victim of political violence.

Dunbar Author was credentialed music therapist

(2009) Participant was labelled as a refugee within the article
Practice example of music therapy included

Edwards, Edwards was a registered music therapist in Australia

Scahill, & Participants were labelled as refugees within the article
Phelan (2007) Practice example of music therapy included

Hunt (2006) Author was credentialed music therapist in Australia

Practice example of music therapy included
Participants were referred to as refugees

Jones, Baker, Authors were credentialed music therapists in Australia

& Day (2004) Practice example of music therapy included
Participants were referred to as refugees

Orth (2005) Author was a music therapist at Phoenix Centre in

Netherlands
Practice examples of music therapy included
Participants were referred to as refugees

Zharinova- Author was credentialed music therapist

Sanderson Practice example of music therapy included
(2004) Participants were referred to as refugees

The articles that were excluded following the initial search discussed the use of
music or dance with people identified as refugees, however were not referring to a
specific music therapy program, nor were the authors credentialed music
therapists. While some papers were authored by credentialed music therapists and
documented a music therapy program, the participants were not clearly identified

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as being refugees for the purpose of therapy, even though it was eluded to that
these individuals had refugee backgrounds, and therefore these papers were
excluded from the synthesis.

Data Extraction and Interrogation

The inductive and iterative approach adopted to extract and interrogate the data
set was geared towards the creation of a coherent theoretical framework.
Throughout these processes, I was conscious of my own assumptions influencing
the direction and focus of the research. Therefore, I maintained a reflexive journal
to document my decision-making and reflect on my own values that I felt might
have shaped the data extraction and interrogation.

While I did not have fixed ideas about what the data would reveal, I began the
initial data extraction process with a number of deductively created headings that
provided a platform for subsequent inductive and iterative analysis. This approach
was influenced by evidence-oriented methodologies whereby data extraction
tables are used to summarise key characteristics and findings of each article
(Jones & Evans, 2000): a suggested starting point for a critical interpretive
synthesis with a small sample size (Dixon-Woods et. al, 2006). An Excel
spreadsheet was used as an organising frame for the extracted data, with relevant
quotes or summaries of content from the articles grouped under column headings.

The data interrogation was closely aligned with the extraction process, as
proposed by McFerran and colleagues (McFerran, Hense, Medcalf, Murphy &
Fairchild, 2016). The interrogation involved reflexively examining the headings of
each column to see if they adequately reflected the data collected from the articles
or to see if there were subgroups or themes within the column heading. As I read
through each article additional headings emerged and were added to the
spreadsheet, prompting a return to previous literature to extract more data. This
recursive process is what Dixon-Woods and colleagues (2006) emphasised as
being integral to the emergence of new themes. Following this, I began comparing
columns to look for interesting connections, themes, or patterns among the
headings: for example comparing the authors nationality with theoretical
orientation.

What defines this process as critical, however, is the emphasis upon the authors
use of particular language to present information, in addition to the critical nature of
the headings used to arrange and interpret the data set (McFerran, Hense,
Medcalf, Murphy, & Fairchild, 2016). In this way, I was positioning myself as the
researcher to uncover the assumptions and beliefs that may have been influencing
the way the authors constructed and presented information. Similarly, by grounding
the research in the specific language used by authors, I was able to uncover the
values and assumptions embedded within the language music therapists used to
report on their work with refugees. From these critical interrogations, a synthetic
construct began to emerge.

Generating a Theory: The Neo-Colonialal Music Therapist

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Dixon-Woods and colleagues (2006) proposed synthetic constructs are the result
of a transformation of the underlying evidence into a new conceptual form (p. 5),
grounded in a critique of the literature. As the literature is interrogated, the
synthetic construct can be used as a lens through which to view the data, while at
the same time functioning as a theory constantly shaped by the emergence of new
data.

It became apparent during the extraction and interrogation process that authors
were generally emphasising the cultural divide between themselves as members of
a Western cultural group and the refugee individuals with whom they were working.
From this emphasis on cultural difference, the concept of a neo-colonial music
therapist emerged as a synthetic construct.

In terms of politics and economics, colonialism can be defined as the process by

which powerful European countries have forcefully occupied land belonging to less
powerful countries throughout the 19th and 20th centuries; essentially it is a
bipartite concept whereby one individual or group exerts dominance and power
over another individual or group (Macqueen, 2014). In this sense, I used the
concept of neo-colonialism to denote the way in which values belonging to the
dominant Western cultural group are often imposed upon the cultural group who
form the minority. This seemed a fitting concept considering nine of the 11 papers
included in the synthesis were written from a Western perspective (Baker & Jones,
2005; Dixon, 2002; Dunbar, 2009; Edwards, 2006; Hunt, 2006; Jones, Baker, &
Day, 2004; Orth, 2005; Zharinova-Sanderson, 2004;).

This synthetic construct then served as a lens through which to further interrogate
the data. While maintaining a reflexive journal, I began to examine the data from
what I considered the perspective of a neo-colonial music therapist. In
problematising the data, as suggested by Dixon-Woods and colleagues (2006, p.
10), I was able to look for examples of explicit or implicit cultural dominance,
specifically relating to music therapy methods, orientations to practice, and
understandings of health and trauma. With this synthetic construct shaping the
interrogation, I was able to deeply explore some of the assumptions that began to
emerge from the data.

Results and Discussion

Following a critical examination of 11 articles from the international music therapy
literature, two key assumptions emerged as being influential in the ways music
therapists were reporting on their work with refugees. In examining the literature
against the synthetic construct of a neo-colonial music therapist the assumptions
of homogeneity among the refugee population and musical improvisation as a
universal language were found. These two findings will now be discussed in
relation to the implications for music therapy practice.

Refugee Identity and The Narrative of Trauma: A Homogenous

Group

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The first theme that emerged from the data was that of refugees as a homogenous
group; a collective unified by a common narrative of trauma. In the clinical and
community contexts alike, it appeared that music therapists were working with
refugees in such a way that privileged the individuals status and therefore identity
as a refugee over other aspects of the individuals identity, such as race or religion.
While there were examples of music therapists promoting other aspects of identity,
such as age (Baker & Jones; 2005, Choi, 2010; Hunt, 2006; Jones, Baker, & Day,
2004), or gender (Ahonen & Mongillo Desideri, 2014; Edwards, 2007), the
emphasis of the therapeutic work focused largely on the narratives of adolescent
trauma or female trauma. This has led to a discourse in the music therapy
literature wherein the narrative of trauma is dominant and refugee people from
diverse cultural backgrounds are considered largely homogenous. Therefore it
appears that music therapists are reporting on their work with refugees with the
assumption that there is a particular narrative of trauma associated with the
refugee identity that is the most salient aspect of the individuals experience, and
therefore that all refugees, regardless of their nationality or religion, will have
similar needs.

Refugee Identity Privileged over Cultural Identities

The assumption of homogeneity was clearly evident in practice examples
illustrating group music therapy wherein individuals from diverse cultural
backgrounds were often treated as a group of refugees; therefore the individuals
refugee identity, as defined by experiences of trauma, was privileged over the
individuals cultural identity. In the Netherlands, men and women from cultures as
vastly different as Vietnam, Somalia, Azerbaijan, Cambodia, and Chile were
grouped together for music therapy treatment within a specialized treatment centre
specifically for refugees (Orth, 2005). Similarly, in two different practice examples
within Australian high schools, it was common for adolescents with varying cultural
backgrounds to be considered a group of refugees (Baker & Jones, 2005; Hunt,
2006).

In the case examples illustrating individual music therapy, the dominant narrative of
refugee trauma was also evident by virtue of the contexts within which the service
was being offered: treatment centres for torture victims (Zharinova-Sanderson,
2004), medical foundations, (Dixon, 2002) and inpatient treatment facilities
(Dunbar, 2009). While this focus on trauma as a unifying and prevalent feature of
the refugee population may reflect a broader issue regarding access to healthcare
services along the healthcare continuum for refugees (Colucci et al., 2014;
Davidson et al., 2004; Slobodin, 2014), it does appear to highlight an assumption
regarding the refugee population as having similar therapeutic needs as a result of
traumatic experiences. Additionally, the language music therapists used to
describe the individuals with whom they were working often prioritised the use of
the word refugee rather than the nationality of the individual. In fact, some authors
made no mention of the cultural background of the individuals with whom they
were working and referred to the individuals only as refugees (Ahonen & Mongillo
Desideri, 2014).

There also appeared to be a contradiction within the literature in the way that some

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music therapists identified the need to foster the cultural identities of the individuals
with whom they were working (Dunbar, 2009; Orth, 2005; Zharinova-Sanderson,
2004). However, they wrote about their work in such a way that privileged not the
unique cultural heritage of the individual, but rather their status as a refugee and
the associated experiences of trauma.

These findings highlight the need for music therapists to be more reflexive in their
practice and challenge neo-colonial assumptions about the refugee population
being a homogenous group characterized by a narrative of trauma, so as not to
perpetuate oppression and disempowerment. If music therapists acknowledge that
it is valuable to strengthen the individuals cultural identity as a means of dealing
with the grief and loss associated with forced migration, then it is essential that
music therapists privilege the cultural identity rather than the refugee identity of
that person, not only in their conceptualisation of the therapy work, but also in the
language used to document the work. In order to privilege the cultural identity of an
individual, music therapists need to continue to examine the relevance of Western
models of therapy and concepts of music for health, but with a particular focus on
unique cultural groups as opposed to the refugee population generally.

Challenging Assumptions Concerning The Refugee Identity in

The Public Domain
It should be acknowledged that the literature does suggest most refugees
experience trauma as a result of the pre-flight, flight, and re-settlement
experiences (Murray, Davidson, & Schweitzer, 2010). In response, music therapy
is considered an accessible therapeutic medium for refugee individuals excluded
from traditional talking therapies as a result of the language barrier (Pavlicevic,
1997), and has been shown to have a positive impact upon neurological responses
to trauma (Krout, 2007; Swallow, 2002). However, if music therapists are working
with the assumption that the refugee population is homogenous because of the
dominant narrative of trauma, music therapists may be further disempowering
these individuals by privileging the refugee identity; an identity which is reflective
of ones status as being displaced and powerless.

This finding coincides with the general rhetoric surrounding refugees in the mass
media, and also embedded within the legislation governing these individuals. Since
the early 1990s, there has been an increase in the amount legislation concerning
the control of the refugee population, as evident across Australia, Canada,
America, and countries within Europe (Jeffers, 2011, p.23). Since this time,
particularly in Australia, the legislative focus has shifted away from humanitarian
aims and towards the control and regulation of the refugee population (McMaster,
2001). Additionally, the language used in the legal-political discourse played out
through mass media continues to emphasise the refugee identity of these
individuals, promoting the notion that refugees pose a threat to national security
and local economies (Kisiara, 2015). In turn, refugees are often faced with hostility
from the general public within these countries; despite studies demonstrating these
hostile attitudes are often grounded in misinformation (Jeffers, 2011; Penderson,
Watt & Hansen, 2006). As long as political leaders and mass media continue to

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emphasise the refugee identity, the general public will continue to privilege this
identity at the expense of seeing this culturally diverse group of individuals as
human beings.

Therefore, this notion of reinforcing the refugee identity serves to perpetuate a

system whereby those in a position of political power are able to maintain control
by shaping the publics perception of this population. For this reason, it is essential
music therapists and other professionals working with the refugee population,
cultivate an awareness of the ways language and privileging the refugee identity
may in fact be supporting a system of political manipulation and perpetuate the
disempowerment of these human beings.

Musical Improvisation Is a Universal Language Say Neo-

Colonial Music Therapists
The second assumption that emerged from the data was that musical
improvisation is a universal language. In 10 out of the 11 articles included in the
synthesis, improvisation was cited as a method used by music therapists with
refugee individuals for the purpose of transcending traditional language barriers to
find a common musical language through which the therapeutic dialogue could
occur. With the exception of Jones, Baker, and Day (2004) who explored the
musical characteristics typical of the Sudanese students with whom they worked,
there appeared to be an assumption that improvised musical dialogue not only
transcends the language barrier but also surpasses a broader cultural barrier. This
in turn suggests that the musical vocabulary from which a refugee person draws
upon within the context of improvisation in therapy is devoid of cultural
characteristics, thereby allowing the music therapist of a different culture to engage
the individual a meaningful musical dialogue.

There appears to be a contradiction in the literature wherein music therapists are

recognising the cultural significance of music for health promotion in the cultures of
the refugee population as being distinct from Western culture, yet are not
examining the specific musical characteristics which contribute to this difference.
On the one hand, authors generally appear to recognise the culturally situated
significance of active music making for health and participation in community life
(Baker & Jones, 2005; Hunt, 2006; Orth, 2005; Zharinova-Sanderson, 2004) yet
fail to acknowledge that these practices are often founded upon strong musical
vocabularies embedded within and intrinsically connected to the cultural landscape
of a particular community.

The assumption that improvisation is an appropriate forum for therapeutic dialogue

across a cultural divide is further evidenced by the general lack of reflexive
consideration or evaluation of this method within the literature. Few of the authors
make explicit what improvisation actually involves in a musical sense, and even
when musical encounters are described in practice examples, most authors appear
to be making judgements about the refugee persons improvised music from a
Western viewpoint of orderliness (Dunbar, 2009, p.29) or harmonic and rhythmic
consonance (Dixon, 2002, p.126; Hunt, 2005; Orth, 2005, p. 12).

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It could be argued that by using improvisation as a means of therapeutic

conversation with refugees without an awareness of this concept of culturally
informed musical vocabularies, music therapists are advancing neo-colonial ideals.
By not recognising the musical values that shape decisions regarding the
significance of musical moments as they unfold within improvisation, music
therapists may be imposing a set of Western values upon the therapeutic
encounter. This point is highlighted by Jones, Baker, and Day (2004) who found
that it was culturally appropriate for the Sudanese students with whom they were
working to play in a rhythmically syncopated way; this constituted playing together
in Sudanese culture, however the therapists initially felt that the music was
representative of chaos, fragmentation, and disconnection. This example highlights
how improvisation is in fact mediated by culturally informed musical vocabularies.

Furthermore, it is integral that music therapists are aware of the ways in which
specific musical elements constitute meaning within the musical culture of the
refugee person. With the increase in global immigration, a discourse has emerged
in the music therapy literature wherein music therapists are reflecting on the
relevance of their practice in relation to a culturally and linguistically diverse
population (Mahoney, 2015; Shoemark, 2014). Culturally centred practice is
becoming increasingly important in dismantling values steeped within a Western
medical model of therapy, and music therapists are reflexively examining their own
cultural values to understand how these inform therapeutic practice (Swamy, 2014;
Truasheim, 2014). This culturally centred critique is also echoed in the literature
concerning anti-oppressive practice, wherein authors consider the ways in which
dominant socio-cultural norms and privilege more broadly can perpetuate
oppression within the therapeutic relationship (Baines & Edwards, 2015; Baines,
2013). In continuing this discourse, if music therapists are to acknowledge that the
practice can be meaningful and relevant to a culturally and linguistically diverse
population, then the current findings suggest a specific exploration into the use of
musical elements within improvisation through a culturally centred lens. Without an
awareness of the notion of culturally informed musical vocabularies, music
therapists may be advancing neo-colonial ideals and in fact disempowering the
refugee individual by misinterpreting their musical contributions to the therapeutic
dialogue within the context of a musical improvisation.

Concluding Thoughts: Advocacy For the Refugee Persons

Voice
Upon examining the relevant literature against the synthetic construct of the neo-
colonial music therapist two key assumptions appeared to be influential in the
ways music therapists were reporting on their work with refugees. It appeared that
music therapists assumed the refugee population was homogenous by virtue of the
dominant trauma narrative that is embedded within the identity of a refugee. The
language used by music therapists to convey their work privileged the refugee
identity over the cultural identities of these individuals. Thus, music therapists may
be further disempowering these individual by perpetuating a homogenous identity
of displacement and powerlessness, rather than promoting the vast cultural
differences and unique narratives, traumatic or otherwise, within this population.

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The second neo-colonial assumption that emerged during the research was that of
musical improvisation as a universal language. With the exception of one paper, all
of the music therapists cited musical improvisation as a method used for the
purpose of therapeutic dialogue with refugee individuals based on the assumption
that music transcends language barriers. Additionally, music therapists were using
improvisation without reflexively considering how the musical vocabulary one
draws upon within an improvisation is informed by the musical language
embedded within the individuals culture; a vocabulary which can often be
misinterpreted by the Western ear.

What can be taken from this critical interpretive synthesis is the need for Western
music therapists to cultivate awareness that knowledge about music and health is
culturally situated. To varying degrees, music therapists are keen to highlight the
difference between how individuals identified as refugees use music for health
and community building within their own cultures in contrast to the Western
perspective. However, the language used to describe this population as
homogenous perpetuates Western ethnocentricity and continues to privilege the
refugee identity of these individuals over the unique cultural identities within this
population. Similarly, the relevance of specific music therapy methods requires
continuous reflexive consideration; specifically in relation to the way Western
values may be unintentionally shaping the therapeutic encounter.

Furthering this notion of neo-colonialism, I would like to conclude with a comment

on the absence of the refugees voice within the current discourse. Music
therapists have a history of working with vulnerable populations: individuals within
society who have often faced social stigma, marginalization and sometimes the
violation of human rights. For this reason, music therapists often conceive of their
role as that of an advocate for the people with whom they work. Particularly in the
field of community music therapy, the notion of attending to unheard voices is
imperative in working towards social inclusion and equity (Stige & Aar, 2012, p.5).
The current literature regarding refugees, however, does not appear to adequately
reflect the myriad of experiences or the diversity of cultural identities within this
population. Therefore I would argue music therapists are not doing enough to truly
advocate for these disempowered human beings whose voices are often self-
silenced owing to a well founded fear of persecution (UNHCR, 1951, Article 1).

If music therapists continue to write about their work with refugees without truly
providing a forum for the voices of these individuals, music therapists will continue
to promote neo-colonial values. Whilst considering the implications of privileging
the refugee identity over the cultural identity of these individuals may be a
worthwhile academic pursuit with poignant ramifications, would it not be more
relevant to ask these individuals how they construct their own identify? Does a
narrative of trauma in fact strengthen ones sense of identity in a positive way, as a
survivor? Do these individuals actually wish to identify with their cultural heritage,
or rather do they wish to construct a new acculturated identity? By making
assumptions about these ideas, music therapists may be silencing the voices of
refugees and perpetuating a system of disempowerment. Therefore, music
therapists need to challenge the assumption that the knowledge we hold is
relevant to the refugee population, and perhaps find ways to bring these individuals

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into the discourse and ask what is meaningful and relevant to them.

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