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Background: Meta-analyses of studies on psychological treatment of refugees describe highly varying outcomes, and research on multi-facetted and personalized treatment of refugees with post-traumatic stress disorder (PTSD) is needed. Music therapy has been found to affect arousal regulation and emotional processing, and a pilot study on the music therapy method Trauma-focused Music and Imagery (TMI) with traumatized refugees resulted in significant changes of trauma symptoms, well-being and sleep quality. The aim of the trial is to test the efficacy of TMI compared to verbal psychotherapy., Methods: A randomized controlled study with a non-inferiority design is carried out in three locations of a regional outpatient psychiatric clinic for refugees. Seventy Arabic-, English- or Danish-speaking adult refugees (aged 18-67 years) diagnosed with PTSD are randomized to 16 sessions of either music therapy or verbal therapy (standard treatment). All participants are offered medical treatment, psychoeducation by nurses, physiotherapy or body therapy and social counseling as needed. Outcome measures are performed at baseline, post therapy and at 6 months' follow-up. A blind assessor measures outcomes post treatment and at follow-up. Questionnaires measuring trauma symptoms (HTQ), quality of life (WHO-5), dissociative symptoms (SDQ-20, DSS-20) and adult attachment (RAAS) are applied, as well as physiological measures (salivary oxytocin, beta-endorphin and substance P) and participant evaluation of each session., Discussion: The effect of music therapy can be explained by theories on affect regulation and social engagement, and the impact of music on brain regions affected by PTSD. The study will shed light on the role of therapy for the attainment of a safe attachment style, which recently has been shown to be impaired in traumatized refugees. The inclusion of music and imagery in the treatment of traumatized refugees hopefully will inform the choice of treatment method and expand the possibilities for improving refugee health and integration., Trial Registration: ClinicalTrials.gov ID number NCT03574228, registered retrospectively on 28 June 2016.

Traumatized refugees seeking treatment in special units of psychiatry are in need of treatment options that can help them stabilize and cope with post-traumatic stress disorder (PTSD) in their everyday life. Guided Imagery and Music (GIM) has improved psychological health for clinical populations including trauma survivors with PTSD. Prior to the implementation of a randomized controlled study, a clinical non-controlled study was carried out to assess the feasibility and acceptability of a trauma-focused modification of GIM combined with standard treatment with medication, and to examine the suitability of chosen instruments to measure reduction of PTSD symptoms in refugees. Sixteen adult refugees with PTSD were enrolled and they all completed 16 one-hour individual sessions. Pre–post measures of PTSD symptoms, sleep quality, well-being and social function demonstrated significant changes with large effect sizes. Evaluation of the single sessions showed that participants found the therapy acceptable and helpful. All participants used music listening for self-care in their homes between sessions. The findings indicate that trauma-focused modified GIM was well accepted and has a potential as an effective treatment for refugees with PTSD. A larger randomized controlled trial to validate these findings is warranted. [ABSTRACT FROM PUBLISHER]