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The strains of reassurance

Music plays a part in the work to promote health among refugee children, of that music therapist Merete Hoel Roaldsnes is convinced. She submitted her doctoral dissertation last year.

“Music therapy can provide positive feelings and the experience of recognition and continuity, creating security in a group and forging interpersonal relations. Quite clearly, these parameters can be linked to a person’s health and quality of life,” says Merete Hoel Roaldsnes.

In the summer of 2017 Roaldsnes submitted her doctoral dissertation entitled Music in health-promotion work with single under-age refugees – a qualitative study of a music group for youths with a background as single refugee children.

What aroused your interest in music therapy for refugee children?

“As a newly trained music therapist I was doing project work at a transit reception centre for single, under-age refugees in the winter of 2008-2009. It was a collaboration between Save the Children and Hvalstad Transit Reception Centre. That set the process in motion for me because I saw challenges, but also opportunities in such work, and I saw what it meant to the participants. It awoke a desire within me to explore this further, so then I applied for a research fellowship at the Norwegian Academy of Music.”

Open, sensitive and flexible

Roaldsnes invited young people to take part in a music group over time. The participants lived mainly in shared accommodation for single refugees.

What were you hoping to achieve?

“I had hopes and expectations of positive experiences. Based on my own work experience and what I’d read, I thought music could contribute to positive experiences. But I didn’t know if that was true, you know, and what it entailed,” she says.

“After all, it could go really badly too. There was no foreseeing how the gatherings would go, and there were many things we didn’t know.”

The research issue was threefold. She wanted to find out how the participants felt about cooperating and participating in the music group, what health-promotion factors emerged in the participants’ experiences and what challenges the participants in the music group experienced.

“I was interested in their experiences! Their experience of taking part in the music group. The way my colleague [Marianne Lie Eide, ed.] and I set up the group did provide some guidelines for their experiences, of course, but I wanted to go into it with an investigative mind, and I was keen to have the greatest possible degree of cooperation with the young people: how they wanted to work with music, their interests and preferences. Together we found a path, and music to concentrate and focus on.”

Is it difficult to conduct research on the significance of music for a group that has been through so much – and may be experiencing a lot of stigmatisation?

“Single refugee children are vulnerable and particularly prone to mental health complaints. They may have traumas, may have a long journey behind them, and in all probability have experienced war and armed conflict, and lost family members,” Roaldsnes says. She stresses that the young people had a great deal to contribute nonetheless.

“By the same token they are resourceful children and adolescents! They need to be understood and viewed as both resourceful and vulnerable,” Roaldsnes emphasises.

“Yes, they had experienced difficult and bad things, but they were also undergoing a process to which they were adapting well. They were preoccupied with their schooling, had expectations for their future. I was apprehensive and didn’t know what I might encounter, whether situations might arise and things might be triggered, and how I was supposed to deal with it. So it was important to approach it with an open, sensitive and flexible mind.”

“I left my homeland, but this music helps me to remember where I come from.“

Teenager At a transit reception centre for single, under-age refugees

From dispirited to high-spirited

But how do you measure the results of such a study? Merete Hoel Roaldsnes admits that it was no easy matter.

“Systematising and analysing the findings was a huge task. It’s always a challenge in qualitative studies.”

She divided the results into three parts, but the music therapist stresses that everything is interconnected.

“The first was emotional change. I saw that very clearly, as a participating observer.”

In particular, she was able to see the emotional changes from the beginning to the end of a meeting.

“On several occasions they seemed dejected when they came into the group. They might be having an off day, avoiding your gaze, unwilling to speak. Then they’d often say they wanted a short session, that they were tired and worn out, without wanting to say why. But as we started playing, I observed a change in mood and in the group dynamic: More participation, more smiling, more chatting, more initiative. And it tended to end up with us running over instead of finishing early.”

Roaldsnes sensed that the music gathering gave them energy and put them in high spirits.

“In the interviews the young people also spoke a lot about the emotional change they were experiencing. They felt happier, had more energy and were less tired after the music gatherings. That feeling would sometimes linger after the rehearsal was over. They had a break from other things, when the young people were able to focus on the music and not worry about the future and other concerns. The break was extremely welcome.”

The other topic Roaldsnes found in her research was the feeling of mastery.

“It’s about mastery. The participants learned to play a variety of instruments, and joined in on activities they didn’t think they would dare participate in. None of the people there had been particularly involved with music before, but they took the initiative themselves to play drums, guitar, piano and percussion instruments. And they performed – invited friends and worked on music as they had never done before. In that way they discovered new aspects of themselves.”

But it was not necessarily the music per se that was the most important goal.

“The most important thing was greater belief in themselves, daring to try new things. Daring and accomplishing. The rational aspect was important. Both giving and receiving support and recognition from us and from one another. That’s necessary for what the psychologists call ‘self-efficacy’.”

Emergent sense of belonging

The perception of belonging was the last topic to emerge from the analysis in Roaldsnes’s research.

“The young people experienced a sense of belonging on several levels through their participation in the music therapy. They describe receiving support from the music therapists, and some also describe us as friends. Amongst themselves they say that they had affirmation of “how much I care for my mates, and they for me”. If one of them was late one day, they would ring and ask for him or her. If someone was having a rough day, coming to the group meeting helped, and things were better afterwards,” Roaldsnes explains.

But belonging also has to do with nationality and what is home.

“Belonging to the homeland or country of origin was important. Some wanted to demonstrate music they associated with their background and identity. The rest of us listened, singing and playing along. This is linked to identity and roots.”

“My music reminds me of who I am and where I come from.“ “I left my homeland, but this music helps me to remember where I come from.“ “I’m an Afghani, even though I live here.“

Roaldsnes heard statements like these from the young people in the music therapy group.

“But also a growing sense of belonging to the society they have come to, Norway. They wanted to learn more about my culture, Norwegian culture. Those were the terms they used. There’s a lot of cultural exchange in the music, in the encounter between the people who took part.”

Merete Hoel Roaldsnes is now working as a music therapist for Ålesund Cultural School and for the psychiatric health care service in the county of Møre og Romsdal. She hopes more people will be offered music therapy as a result of her research. She is no less convinced of the effect and the importance of the work now. On the contrary.

“I hope more children at refugee reception centres and in child care can be offered the service whenever needed. It’s not that widespread yet, but my hope is that it will be. It’s an overarching goal for me, which is why it’s so important that research is done in this area.”

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