Music Therapy and Restorative Justice: Overcoming Risk to Fulfill the Promise of
Urban Youth
A Thesis
Submitted to the Faculty
of
Drexel University
by
Janice Ann Nieves
in partial fulfillment of the
requirements for the degree
of
Master of Arts in Music Therapy and Counseling
May 2018
© Copyright 2018
Janice A. Nieves. All Rights Reserved.
i
Acknowledgements
I wish to thank Flossie Ierardi for her patience, knowledge, and support in my pursuit of becoming a music therapist and writing this thesis. I would also like to thank
Elissa Goldberg for all of her help and guidance, as well as to the Bridging the Gaps program which truly inspired me to work with at-promise youth. Special thanks to my family and closest friends for lifting me up through this experience, as well as to the congregation of Elkton Presbyterian Church for always believing in me. ii
Table of Contents
ACKNOWLEDGEMENTS...... i
LIST OF TABLES...... iv
ABSTRACT...... v
1. INTRODUCTION...... 1
2. LITERATURE REVIEW...... 5
2.1 “AT-RISK” VERSUS “AT-PROMISE” ...... 5
2.1 TRAUMA...... 7
2.1.1 Poverty...... 7
2.1.2 Violence...... 8
2.1.3 Housing Insecurity and Instability...... 8
2.1.4 Education...... 9
2.1.5 Racism...... 10
2.1.6 Incarceration and the School-to-Prison Pipeline...... 11
2.1.7 Adverse Childhood Experiences...... 14
2.1.8 Physiological Effects and Epigenetics...... 16
2.2 CURRENT INTERVENTIONS...... 18
2.2.1 Government Assistance...... 18
2.2.2 Education Reform...... 19
2.2.3 Evidence-Based Multitiered System of Supports...... 20
2.2.4 Community-Based Recovery...... 20
2.2.5 Restorative Justice Model...... 21 iii
2.2.6 Community Arts Interventions...... 23
2.3 MUSIC THERAPY WITH AT-PROMISE YOUTH...... 25
2.3.1 Rap and Hip-Hop Music...... 30
3. SYNTHESIS...... 36
3.1 CYCLICAL NATURE OF POVERTY...... 36
3.2 MUSIC THERAPY AND TRAUMA...... 38
3.3 RESTORATIVE JUSTICE MODEL AND RECIDIVISM...... 41
3.4 MUSIC THERAPY WITHIN RESTORATIVE PROGRAMMING...... 43
3.4.1 Method-Specific Recommendations...... 45
4. DISCUSSION AND REFLECTION...... 48
4.1 PROGRAM RECOMMENDATIONS...... 50
4.2 SUMMARY OF RECOMMENDATIONS AND REFLECTION...... 58
REFERENCES...... 60
iv
List of Tables
1. Restorative Justice Music Therapy Goals and Suggested Interventions...... 57
v
Abstract
Music Therapy and Restorative Justice: Overcoming Risk to Fulfill the Promise of Urban Youth Janice A. Nieves Florence Ierardi, MM, MT-BC, LPC
Children and adolescents living in poor, urban environments are often exposed higher rates of trauma, abuse, and neglect compared to their middle- and upper-class counterparts. These youth have traditionally been referred to as “at-risk” in reference to the increased risk of poor mental health, poverty, crime, and death. Alternatively, this population can be referred to as “at-promise” to acknowledge the potential for resilience and to break the cycle of poverty. This critical review of the literature focuses on the role of incarceration and poor mental health in the perpetuation of the cycle of poverty. The
Restorative Justice Model is discussed as a framework for rehabilitative programs that aim to hold criminal offenders accountable for their actions, address the issues that caused them to offend in the first place, and protect and heal the community. The use of music therapy with at-promise youth is also discussed for its role in promoting safe self- expression and decreasing symptoms of depression and anxiety. Suggestions are made for the integration of music therapy practices within the Restorative Justice Model in an attempt to alleviate the cyclical impact of urban poverty on at-promise youth.
1
CHAPTER 1: INTRODUCTION
Children and adolescents who live in urban environments and are exposed to trauma, poverty, abuse, or neglect are often considered “at-risk” (Foote, 2005).
Alternatively, this population can also be labeled as “at-promise” in order to emphasize the positive potential as opposed to the adversity that they face (Search Institute, 2014).
At-promise youth face a number of challenges, including an increased risk for mental illness (Galea, Uddin, & Koenen, 2011), higher exposure to violence and drug use, and food and home insecurity (Foote, 2005). At-promise youth are also a widely diverse population and are therefore exposed to racism. The effects of racism can be long-lasting, damaging self-esteem and causing psychological distress (Chao, Longo, Wang,
Dasgupta, & Fear, 2014). The effects of trauma experienced by at-promise youth can also have biological effects. Studies have shown that the hippocampus can be negatively affected by chronic trauma in childhood, which can make the child more susceptible to developing posttraumatic stress disorder later in life. Furthermore, epigenetics suggests that the effects of trauma on our genetic expression can also be hereditary, regardless of whether the trauma is re-experienced or not (Carrion, Weems, & Reiss, 2007).
The Restorative Justice Model is a framework for rehabilitative programs that aim to hold criminal offenders accountable for their actions, address the issues that caused them to offend in the first place, and protect and heal the community. This framework acknowledges three parties: the offender, the victim, and the community. Crime is seen as an act done by the offender that harms the victim and the community. Programs based on the Restorative Justice Model aim to repair the harm done to the victim and community, as well as the relationship between the offender and the community (Rodriguez, 2007). 2
There are four models used within the restorative justice framework: victim- offender mediation (VOM), community reparative boards, family group conferencing, and circle sentencing (Bergseth & Bouffard, 2012). These programs focus on social relationships and have been shown to be more effective in improving communities and rehabilitating offenders by providing an opportunity for them to reenter the community
(Wood, 2015). Numerous research studies have shown that restorative justice programs are effective in reducing recidivism, but more research needs to be done to examine the effects on different populations.
Community arts programs have also been used to promote healing in marginalized communities. These programs have had a positive effect by giving the members a healthy means of self-expression to promote self-esteem and a sense of identity. The Philadelphia Mural Arts Program in Philadelphia, Pennsylvania began in
1984 as a restorative justice program, offering the of painting murals as an alternative sentence to people caught spray painting graffiti (Smith, 2008). The mission of the program now focuses on transforming neglected buildings throughout the city into works of art to promote a sense of community and hope. In Lima, Peru, “Mother’s Clubs” have formed in impoverished areas where women create wall hangings and tapestries in order to earn money and support each other. Through these groups, the women formed a support group to share resources and feel empowered (Smith, 2008).
Research has shown that arts therapies can have a positive impact on the emotional, social, and behavioral health of clients. Youth with behavioral problems, for example, have shown improvement in self-control, self-esteem, and resilience patterns after participating in an arts program (Forrest-Bank, Nicotera, Bassett, & Ferrarone, 3
2016). Music therapy, specifically, has been used with at-promise populations, allowing an opportunity for safe expression, relaxation, and as a coping skill. Children in foster care have used music as a way to escape stressors and worries about the past, as well as a tool for socialization and relaxation (Zanders, 2012). McFerran-Skewes (2000) worked with bereaved teenagers using group improvisation and music sharing. Treatment goals included improving self-esteem through exercising choice and control, as well as having successful peak experiences. The study reported that the teenagers experienced freedom and control within the safe environment of group music therapy (McFerran-Skewes,
2000).
One of the reasons that restorative justice programs are thought to be successful is that they address the factors that lead the offender to commit their crime in the first place.
Traditional juvenile correctional facilities focus on custody and control, which not only has a high recidivism rate, but also perpetuates delinquent behavior as the offenders adjust to delinquent subcultures amongst other inmates. Restorative justice programs incorporate more therapeutic interventions and therefore encourage rehabilitation by addressing the issues that lead them to commit their crime in the first place (Sellers,
2014). Music therapy, therefore, could be a valuable intervention to use within the
Restorative Justice Model because many of the therapeutic goals can be addressed through music therapy interventions. Restorative and rehabilitative programs focus on repairing the moral character of the offender. This can be done through music therapy by focusing on emotional awareness, improving self-esteem, identifying healthy coping skills, and addressing the traumas they have experienced in a safe environment. 4
This thesis addresses these challenges and perpetuating factors experienced by at- promise youth. The writer reviews the mental health needs of at-promise youth and what measures are currently being taken to address them, focusing on the Restorative Justice
Model and the role of incarceration in the cycle of poverty. While many programs, such as “Scared Straight” and “D.A.R.E.” exist to deter young people from committing crimes, they have not been successful due to an emphasis on external control as opposed to the psychological causes that affect recidivism (Sellers, 2014). Restorative justice programs, on the other hand, focus more on rehabilitation and have been found to be more successful at reducing recidivism through various studies and meta-analyses (Bergseth &
Bouffard, 2012).
In addition to the focus on restorative justice programs, the writer also reviews the current practices within music therapy and community arts programs in urban environments with at-promise youth. Delimitations include literature focused on at- promise youth living in urban environments. As previously discussed, music therapy has been used effectively with this population, but there are currently no studies linking it with the Restorative Justice Model. This thesis also includes suggestions for future practice of music therapy within the framework of the Restorative Justice Model for a comprehensive approach to overcoming the risk faced by at-promise youth. 5
CHAPTER 2: LITERATURE REVIEW
“At-Risk” versus “At-Promise”
The term “at-risk youth” in the United States dates back to the 1980’s from an article called “A Nation at Risk,” published by the National Commission on Excellence in Education (Placier, 1993). Academically, it refers to students who have poor attendance records and grades, and are often failing one or more grade level (Beekhoven
& Dekkers, 2005; Dynarski & Gleason, 2002; Flowers & Hermann, 2008). In 1988, the
Montana State Board of Education provides the following more comprehensive definition:
At-risk youths are children who are not likely to finish high school or who are apt
to graduate considerably below potential. At-risk factors include chemical
dependence, teenage pregnancy, poverty, disaffection with school and society,
high-mobility families, emotional and physical abuse, physical and emotional
disabilities and learning disabilities that do not qualify students for special
education but nevertheless impede their progress. (Minga, 1988, p. 14)
Many factors cause youth to be considered at-risk. Factors within four main environments—home, school, the peer group, and society—can greatly impact a youth’s vulnerability. Instability in the home, as well as high expectations, can be particularly stressful on youths. The desire to fit in with the peer group can also cause stress and introduce risky behaviors based on the values of associated peers. Additionally, conflicting values between the family and the peer group can cause increased stress.
Society influences include fewer legal rights as a minor and constant exposure to violence, ranging from the immediate neighborhood or exposure through media. Media 6 can also greatly influence youth as heavily as the peer group. Children and adolescents often have not developed the necessary coping skills to deal with this level of stress, placing them at increased vulnerability (Gross & Capuzzi, 2014).
Describing this population as “at-risk” highlights the influence of the negative forces in their lives as opposed to their positive potential. “At-promise” is the phrase that has been reclaimed from “at-risk” to focus more on how these risks can be mitigated when youth are given the support and resources to overcome adversity (Search Institute,
2014). This thesis will refer to this population as “at-promise” as opposed to “at-risk” for this reason.
It is important to consider what is developmentally appropriate behavior in youth and adolescents. Adolescents in particular are developmentally in a period of transition where much of their identity is based upon developing independence, peer acceptance, and determining one’s place in society. Therefore, differentiating maladaptive behavior from developmentally appropriate behavior is important. Some of the behaviors that signal developmentally inappropriate and risky behavior in youth include drug and alcohol abuse, eating disorders, suicidal ideation, and excessive aggression (Gross &
Capuzzi, 2014).
The statistics concerning at-promise youth are alarming. According to the
Children’s Defense Fund (2017), 4 children are killed by abuse and/or neglect, 7 youths commit suicide, and 167 children are arrested for violent crimes every day in the United
States. When considering how to mitigate these statistics, one may consider the causes, behavioral effects, or both. A focus on the precipitants of at-promise youth may involve prevention programs to reduce risks. A focus on the behavioral effects would emphasize 7 managing those behaviors. A focus on both factors would combine the two approaches, both managing the maladaptive behaviors and attempting to prevent them from developing or worsening (Gross & Capuzzi, 2014).
Foote (2005) states that the definition of at-promise youth changes as society changes. In this critical review of the literature, the writer defines at-promise youth as urban youth experiencing the hardships of their environment, with a focus on African
American youth but including all ethnic backgrounds, sexual orientations, and ages from birth until 18.
Trauma
At-promise youth experience trauma through environmental and social stressors.
This trauma is often chronic, which has a different effect compared to acute trauma.
These effects can have lasting damage on the psyche of at-promise youth as well as their future (McWhirter, McWhirter, McWhirter, & McWhirter, 1998).
Poverty. Much of the trauma experienced by at-promise youth is through the effects of poverty. Living in poverty is “stigmatizing and demoralizing” (Camilleri, 2007, p. 22), which negatively affects the self-esteem of those affected. Characteristics of impoverished neighborhoods include higher instances of violence, crime, and mental health problems. Children raised in these environments tend to develop physical, cognitive, behavioral, social and emotional difficulties. Adolescents living in poor environments are at greater risk for teen suicide. These effects can be cumulative
(Fergusson, Woodward, & Horwood, 2000). Due to a lack of resources and an overwhelming amount of difficulties, people living in poverty tend to focus on the 8 present as opposed to the future. This leads to feelings of hopelessness and an increase in depressive symptoms (Camilleri, 2007).
Violence. Violence can traumatize children whether they are the victim or witness of the crime. Violent trauma includes theft, assault, rape, murder, and abuse. Regular exposure normalizes this behavior and has been linked to an increased risk of teen suicide and behavioral problems (Dashiff, DiMicco, Myers, & Sheppard, 2009). The presence of violence in poor neighborhoods creates the perception of neighborhood disorganization.
Disorganization within a neighborhood is a chronic stressor due to the anticipation of constant threat. This leads to a constant stress response, which is linked to an increase in depressive symptoms and substance abuse as a means to cope (Anakwenze & Zuberi,
2013). Living in an environment with high violence and crime rates leads to at-promise youth, especially young black males, being more likely to succumb to an early and violent death (Teplin, McClelland, Abram, & Mileusnic, 2005).
Housing Insecurity and Instability. Poverty also promotes housing insecurity.
Employment instability and low wages lead to families not being able to afford housing and risk eviction. Families also move more frequently in efforts to reduce their exposure to violence. Poor families are twice as likely to move in a year as compared to their middle-class counterparts (Koball & Douglass-Hall, 2003). Gentrification also affects housing stability because as development moves into once-poor neighborhoods, rent rates rise and original residents are no longer able to afford it. Frequent moving leads to inconsistency in education through changing schools and prevents children from establishing social supports, which limits their ability to overcome the other stressors of trauma (Camilleri, 2007). Families suffering from housing insecurity also often 9 experience food insecurity (Kushel, Gupta, Gee, & Haas, 2006). Food insecurity occurs when there is not enough access to food or when one is unsure of where their next meal will come from (Nord, Andrews, & Carlson, 2009). A survey conducted by Kushel, et al.
(2006) found that three-fourths of households experiencing difficulty in making mortgage or rental payments on time reported food insecurity, and that two-fifths of households experiencing food insecurity were having difficulty with mortgage or rental payments.
Housing instability leads to social segregation and isolation. As these families move seeking safety, they create homogenous environments that limit their access to a wider range of social supports and networks (Anakwenze & Zuberi, 2013).
Neighborhoods that lack diversity also tend to lack positive role models, which also impacts a child’s ability to overcome negative stressors. These isolated, impoverished neighborhoods have higher rates of social disorganization, crime, and gangs (McLeod &
Shanahan, 1996). A study conducted by Brody, Ge, Kim, Murry, et al. (2003) found that
African American adolescents living in such neighborhoods had a higher rate of developing conduct disorders.
Education. Schools also suffer in impoverished neighborhoods. The teachers in inner cities are often less qualified and undertrained to address the needs of at-promise youth (Camilleri, 2007). Inner-city schools also tend to have less funding and therefore fewer resources for their students. This also leads to cuts in staff, forcing teachers to bear a heavy load as they juggle administrative and teaching responsibilities with limited resources. This leads to a high rate of burnout amongst teachers and high turnover.
Students in inner-city schools tend to exhibit more behavioral problems as a result of their environmental trauma. This leads to more students being considered for special 10 education for issues that are behavioral, not intellectual. Teachers in inner city schools also tend to have lower expectations for students and hold them less accountable compared to students in neighborhoods with higher incomes (Camilleri, 2007).
Many at-promise youth drop out of school, further diminishing access to positive resources. Some of the behaviors identified as indicating higher risk that a student may drop out of school include tardiness, poor grades, truancy, language deficiencies, rebellious and aggressive behavior, and low frustration tolerance for structured activities
(Brooks, Schiraldi, & Ziedenberg, 2000; Davis, 2013; Flowers and Hermann, 2008;
Jimerson, Anderson, & Whipple, 2002; Reschly & Christenson, 2006; White & Kelly,
2010). Behavioral problems and poor academic performance has the most impact on whether students drop out of school, in addition to problems at home and associating with peers that do not value education (Gross & Capuzzi, 2014). Poverty also greatly influences whether students drop out of school, with the highest dropout rates happening in households in the lowest 20th percentile of income (Garnier, Stein, & Jacobs, 1997;
Rumberger, 1993). Students from marginalized populations also had an increased risk of dropout when the majority of faculty were White due to increased poor communication and lack of understanding (Fine, 1986).
Racism. Racism towards African Americans in the United States dates back to the practice of slavery. In order to justify enslaving African people for economic profit, colonial slaveholders legally established that black people were “different, less than human, and innately, intellectually, and morally inferior – and therefore subordinate – to white individuals” (Bailey, Krieger, Agénor, Graves, et al., 2017, p. 1454). This justification of racism through the government perpetuates institutionalized racism. 11
Examples of institutionalized racism include the Social Security Act of 1935, which excluded agricultural workers and domestic servants. Benefits through the Social
Security Act were based on employment and age. The majority of agricultural workers and domestic servants were black, therefore excluding them from the financial benefits of the act. The effects of this exclusion resulted in a gap in wealth between black and white
Americans carrying into the next generation (Omi & Winant, 2015; Zinn, 2015). Other examples of racism towards marginalized people include segregation to poorer neighborhoods and lower-paying jobs, inadequate access to and racially biased medical care, and voter restriction (Omi & Winant, 2015; Krieger, 2014; Gee & Ford, 2011;
Purtle, 2013; Blessett, 2015).
Both witnessing and experiencing racism leads to an increase of depressive symptoms and instill the idea that success is unattainable. These feelings are internalized and impact the child’s motivation and hope for the future (Camilleri, 2007). Hughes,
Kiecolt, Keith, and Demo (2015) found that negative self-identity amongst African
Americans was associated with lower levels of mastery and higher rates of depressive symptoms. These effects, combined with the social effects of structural racism, negatively impact employment rates and increase the likelihood of living in poverty. In
2014, the percentage of children under the age of 18 living in poverty in the United States was 38% for African American and 32% for Hispanic or Latino children, compared to
12% white non-Hispanic children (Bailey et al., 2017).
Incarceration and the School-to-Prison Pipeline. Incarceration has a traumatic impact on at-promise youth. High crime rates in urban environments lead to higher rates of incarceration. For children, this results in the loss of a parent and the difficulty of 12 being raised in a single-parent household (Anakwenze & Zuberi, 2013). The loss of a parent due to incarceration negatively affects the child’s mental health (Tolan, Gorman-
Smith, Huesmann, & Zelli, 1997). Single parent households often experience lower incomes due to the loss of a working parent. This stress contributes to a lower sense of self-efficacy of the parent, which affects parenting strategies. Parenting strategies are directly related to child development and behavioral risk (Elder, Eccles, Ardelt, & Lord,
1995). This stress also contributes to a diminished relationship between parent and child, which leads to inconsistent behavior management and discipline, less parental monitoring, and more conflict (Stern, Smith, & Jang, 1999). Single parents often have to work many hours in order to support their family, which also contributes to an increase in stress, harsh discipline, and a negative impact on the parent-child relationship (Brooks-
Gunn & Duncan, 1997; Duncan & Brooks-Gunn, 1997; McLeod & Shanahan, 1996).
These factors all contribute to the child prematurely taking on adult responsibilities and an increase in depression (Sagrestano, Holmbeck, Paikoff, & Fendrich, 2003).
Schools in the United States have increasingly adopted disciplinary policies that increase the likelihood of students facing punishment in judicial courts. This is referred to as the “school-to-prison pipeline” (Kang-Brown, Trone, Fratello, & Daftary-Kapur, 2013;
Mallett, 2015). Such policies began in the 1980’s with a shift from rehabilitative sentencing to mandatory punishments as a form of discipline (Jones, 1996). This in combination with a false perception that criminal behavior amongst youth was on the rise led to the “tough on crime” approach which introduced youth being tried as adults for their crimes (Levy-Pounds, 2013; Mallett, 2007). The “tough on crime” movement set the precedent for approaching juvenile behavior management through controlling measures 13
(Mallett, 2015). Followed by the Columbine shooting in 1999, many schools adopted
“zero tolerance policies” in response, despite Columbine not being the first school shooting in United States history (Muschert, Henry, Bracy, & Peguero, 2014; Verdugo,
2002).
Zero tolerance policies use mandatory suspension or expulsion for a range of student infractions, regardless of severity (Kupchik & Monahan, 2006; Verdugo, 2002).
Under zero tolerance policies, student infractions as minor as noise violations, which pose little threat to student safety, are treated with harsh punishment. This often results in students spending less time in the classroom and risking early exposure to the criminal justice system. These punishments contribute to the environmental conditions that often contribute to the misbehavior, therefore perpetuating the cycle of antisocial behavior
(Mallett, 2015).
Many schools, especially those in urban areas, use security guards, metal detectors, police officers, and surveillance cameras (Neiman & Devoe, 2009; Ruddy,
Bauer, Neiman, Hryczaniuk, et al., 2010). These changes normalize prison-like environments and contribute to institutionalized racism since they disproportionally affect urban schools, which have a higher percentage of students from marginalized populations. Students often have negative reactions to this environment, such as fear and resentment. This makes the learning environment less effective and contributes to the normalization of a prison-like environment. (Addington, 2014; Hirschfield, 2010;
Kupchik, 2010; Mallett, 2015).
These effects are further exacerbated by the No Child Left Behind Act of 2001
(NCLB). NCLB was intended to ensure that all students receive a thorough education. 14
However, since this is enforced through mandatory standardized testing which therefore influences school funding, NCLB has led to a decline in school funding and therefore resources (Heitzeg, 2014). Teachers are also forced to focus on a curriculum catered to passing the standardized tests, which often leads to lack of student engagement and more disruptive behavior (Kozol, 2005).
There is little evidence to prove that zero tolerance policies create safer school environments, yet there is evidence that they decrease academic achievement and student body cohesion (Carter, Fine, & Russell, 2014; Marsh, 2014). According to Petrosino,
Turpin-Petrosino, and Guckenburg (2010), once adolescents are exposed to court and incarceration through juvenile detention centers, it is increasingly difficult to break free of that cycle and recidivism.
Adverse Childhood Experiences. The Centers for Disease Control and
Prevention (2016) summarize many of these sources of trauma as adverse childhood experiences (ACEs). ACEs are divided into three main categories: abuse, household challenges, and neglect. Abuse includes emotional, physical, and sexual abuse.
Household challenges include witnessing the mother being treated violently, exposure to household substance abuse, the presence of mental illness in the household, parental separation or divorce, and having a criminal household member. Neglect includes both emotional and physical neglect (Centers for Disease Control and Prevention, 2016).
Increased exposure to ACEs is related to an increase in delinquency, aggressive behavior, substance abuse, and depression (Evans-Chase, 2014). Additionally, chronic exposure to ACEs alter the stress response in many ways. Hormone regulation is altered, resulting in hyper-reactivity, hyper-arousal, and impulsivity. The limbic system is also 15 affected, which alters an individual’s emotional response. These lead to impaired emotional, behavioral, cognitive, and social functioning. When the stress response is altered early in life, the effects follow children through development into adulthood
(Dube, Felitti, Dong, Giles, & Anda, 2003; Danese & McEwen, 2012).
Research also shows that chronic exposure to ACEs also influence juvenile criminal activity. 75%-93% of juveniles involved in the criminal justice system have been exposed to trauma related to ACEs (Evans-Chase, 2014). Baglivio, Wolff, Piquero
& Epps (2015) conducted a study in which ACEs were measured by a score whereby exposure to any one category of ACEs equals one point, regardless of frequency. The study shows that juveniles with higher ACE scores have higher rates of criminal activity and arrests. High ACE scores were also associated with earlier age at first arrest, as well as higher rates of arrests spanning from early childhood through late adolescence. This shows that exposure to ACEs is a predictor of chronic patterns of criminal activity
(Baglivio et al., 2015). Higher rates of mental illness have also been observed amongst juvenile offenders, suggesting that mental illness is also a predictor of juvenile offending and recidivism (Teplin, Abram, McClelland, Dulcan, & Mericle, 2002; Barrett,
Katisyannis, Zhang, & Zhang, 2014).
Understanding the risks and protective factors that impact the mental health of at- promise youth can improve the ability of the community to provide support to reduce delinquency and recidivism. Logan-Greene, Tennyson, Nurius, and Borja (2017) examined the impact of protective factors such as healthy coping skills, positive social supports, and impulse control on mental health. They found that improving impulse control helped reduce maladaptive behavior and that improving motivation through goal- 16 setting had a significant positive impact on mental health as well as family dysfunction.
They suggest that these positive changes in overall mental health will reduce rates of recidivism amongst adjudicated youth. Wolff and Baglivio (2017) also recommend therapeutic approaches that treat issues from a systems perspective that involve not only individuals but also their families and various communities, such as neighborhood or school.
Physiological Effects and Epigenetics. Epigenetics is the study of changes in gene expression that are inherited but not due to a change in DNA (Denenberg &
Rosenberg, 1967; Bird, 2002; Danchin, Charmantier, Champagne, Mesoudi, Pujol, &
Blanchet, 2011). Epigenetic mechanisms include DNA methylation, the addition and maintenance of methyl groups on carbons in DNA strands (Smart, Strathdee, Watson,
Murgatroyd, & McAllister-Williams, 2015). Genetics, epigenetics and environmental factors affect vulnerability for depression and other mental illnesses (Booij, Wang,
Levesque, Tremblay, & Szyf, 2013; Cohen-Woods, Craig, & McGuffin, 2013).
The neuroendocrine stress response system is the hypothalamic-pituitary-adrenal
(HPA) axis. Early adversity is associated with the HPA axis dysregulation, which is associated with unipolar depression (Gibbons, 1964; Fish, et al., 2004; Archer, Oscar-
Berman, Blum, & Gold, 2013). This hormonal dysregulation also occurs in chronic exposure to trauma as stress hormones are produced but the stressor is not resolved. This results in an excess of stress hormones, leaving the body in a constant “fight or flight” response as the perceived threat is never resolved. This anxiety can negatively impact cognitive function as well as contribute to maladaptive behaviors in an effort to protect oneself (Schneck & Berger, 2006). 17
The HPA axis is regulated by negative feedback loops from glucocorticoids and glucocorticoid receptors (GRs) (Alt et al., 2010). GR levels are higher in areas of the brain that are involved in the stress response (Karanth et al., 1997) Studies suggests that
DNA methylation at specific GRs as a result of environmental stress, such as early life trauma, shows a higher risk for depression later in life (Smart et al., 2015).
Research also suggests a link between early adversity, depression, and HPA axis function. Rat pups of mothers that engaged in lower levels of maternal care showed an increased rate of DNA methylation in hippocampus samples, which was associated with reduced GR expression. These effects continued into adulthood (Weaver et al., 2004).
Oberlander et al. (2008) studied children of depressed mothers and found that mothers that did not receive treatment for their depression gave birth to babies with increased methylation levels. The babies exposed to maternal depression also had an increase in cortisol as part of the stress response at 3 months of age. DNA methylation was also shown to have higher rates in children whose mothers were exposed to violence during pregnancy (Radtke et al., 2011). A study done by McGowan et al. (2009) looked at post- mortem samples of hippocampi in suicide victims with and without a history of childhood abuse and a control group. The suicide victims with a history of childhood abuse had higher rates of DNA methylation whereas the suicide victims without a history of childhood abuse and the control group did not. These results are however limited due to small sample size.
18
Current Interventions
Government Assistance. The government has programs to help families experiencing food and housing insecurity. Food assistance is through the United States
Department of Agriculture (USDA), which runs the Supplemental Nutrition Assistance
Program (SNAP), National School Lunch Program, and the Special Supplemental
Nutrition Program for Women, Infants, and Children (WIC). These programs serve 59% of food insecure households in any given month (Coleman-Jensen, Nord, & Singh, 2013).
One in four households participated in one of these food assistance programs in 2014
(Oliveira, 2015). SNAP, in particular, served more than 46.5 million Americans in over
22 million households during the 2014 fiscal year (Coleman-Jensen, Rabbitt, Gregory, &
Singh, 2015). During that year, the average amount of benefits received through SNAP was roughly $125 per person. While all are eligible to apply for SNAP benefits, in order to receive benefits, households without elderly or disabled members must have a gross income of less than 130% of the federal poverty guideline. Households with an elderly or disabled member must have a net income below 100% of the federal poverty guideline.
Assets are also considered in this calculation, but varies state by state in regulation (Laird
& Trippe, 2014). Households receiving benefits from government food assistance programs are less likely to experience food insecurity. Families receiving WIC benefits saw 20% reduction in food insecurity in children, and children receiving SNAP benefits and assistance through the National School Lunch Program had improved health measures (Kreider, Pepper, & Roy, 2016; Gundersen, Kreider, & Pepper, 2012; Kreider,
Pepper, Gundersen, & Jolliffe, 2012). 19
The United States Department of Housing and Urban Development (HUD) offers government housing assistance in partnership with local housing authorities. Housing assistance is typically offered through government-owned housing, rent vouchers, energy assistance transfers, and through building more affordable housing. HUD assisted 4.8 million renters through housing assistance in 2013, specifically through vouchers (2.1 million renters), private housing developments (1.6 million renters), and public housing
(1.1 million renters) (Joint Center for Housing Studies, 2015). Subsidized rent payments are offered to low-income families through the Housing Choice Voucher Program, more widely known as “Section 8”. This program limits housing costs to 30% of the household income and assists roughly 5 million low-income households (Levy, Pendall, Abravanel,
& Biess, 2012).
Education Reform. High-need urban school districts often have fewer resources available, less-qualified teachers, and lack the appropriate training for their teachers to handle the challenges that their students face. Foote (2005) suggests that comprehensive school reform is needed with a concentrated effort on fewer, specific goals so that teachers can focus on teaching while changes in the school are being made. Changes in the school day schedule to limit classroom sizes, involvement of community organizations to assist with funding, professional development for teachers, and better salaries and teacher preparation are suggested for high-need urban education reform
(Foote, 2005).
Teacher training in cultural sensitivity is also beneficial. The majority of teachers that enter the education field are white middle-class females that only speak English
(Zeichner & Hoeft, 1996). This can lead to feelings of being misunderstood as well as 20 increase the likelihood of miscommunication in urban schools with increasingly culturally diverse students (Fine, 1986; Gay, 2000). Teachers must be held to the standard of genuinely and empathetically striving for cultural competency and sensitivity in order to better serve at-promise students (Cochran-Smith, 1998).
Evidence-Based Multitiered System of Supports. The United States does not adequately address the developmental needs of children and adolescents, especially those considered at-promise (America’s Health Rankings, 2013). Prevention science suggests a shift towards preventative measures as opposed to treating the effects of trauma in at- promise youth (Kingston, Mihalic, & Sigel, 2016). An evidence-based multitiered system of supports is recommended in order to comprehensively address the mental, emotional, and behavioral health needs of at-promise youth. Examples of such programs include
PROmoting School-community-university Partnerships to Enhance Resilience
(PROSPER), Communities That Care (CTC), Promise Neighborood Intiative, Strive-
Together, and School-wide Positive Behavioral Interventions and Support (PBIS). The implementation of evidence-based multitiered programs should be decided based on a comprehensive assessment of community and individual needs, as well as the prioritization of risks and protective factors. Community readiness also has an impact on the overall effectiveness of program implementation. Research has shown that such programs, when effectively implemented, have the potential to reduce problem behaviors in youth by 30% (Kingston, Mihalic, & Sigel, 2016).
Community-Based Recovery. Traditional community-based recovery programs for youth include Drug Abuse Resistance Education (D.A.R.E.), youth boot camps, scared straight programs, and juvenile correctional facilities that focus on custody, 21 control, and discipline as a result of fear. This approach dates back to the 19th century child-saving movement, which attempted social reform through harsh punishment and control. These methods are largely unsuccessful due to ignoring the psychological issues that delinquent youth face and are often retraumatizing. Rehabilitative, restorative, and therapeutic interventions such as Cognitive-Behavioral Therapy, Family Functional
Therapy, Multisystemic Therapy, and the Good Lives Model are recommended as more effective alternatives to traditional community-based recovery programs. These interventions are more effective at reducing recidivism among juvenile offenders because they focus on the moral character of the offender and equip them with the necessary skills to make better decisions (Sellers, 2015).
Restorative Justice Model. The Restorative Justice Model is a framework for rehabilitative programs that aim to hold criminal offenders accountable for their actions, address the issues that caused them to offend in the first place, and protect and heal the community (Bazemore & Griffiths, 1997). This framework consists of meetings of three parties: the offender, the victim, and the community, and are facilitated by a mediator.
These meetings can take place in a variety of settings and do not require a strict protocol.
Instead, specific values are enforced by the mediator. Crime is seen as an act done by the offender that harms the victim and the community, damaging interpersonal relationships.
Above all, each person in the meeting must be treated with respect (Zehr & Mika, 1997;
Zehr, 2002). Programs based on the Restorative Justice Model aim to repair the harm done to the victim and community, as well as the relationship between the offender and the community (Rodriguez, 2007). Restorative justice programs are thought to be effective through reintegrative shaming and procedural justice (Braithwaite, 1989; Tyler, 22
1990). Through reintegrative shaming, the community and victims are able to openly express their disapproval of the crime committed. It is followed by allowing the offender to reenter the community. This reduces stigmatization of the offender and makes it more likely that they will engage in prosocial behavior and not commit more crimes
(Braithwaite, 1989).
There are four methods used within the restorative justice framework: victim- offender mediation (VOM), community reparative boards, family group conferencing, and circle sentencing. These models have common features including the development of terms under which the offender can redeem themselves to the community, flexibility through less rigid processes, and involving all parties (offender, victim, and community) in decision making (Bazemore & Umbreit, 2001). These programs focus on social relationships and have been shown to be more effective in improving communities and rehabilitating offenders by providing an opportunity for them to reenter the community
(Wood, 2015).
VOM programs focus on the victim and empower them to tell the offender of the impact their crime has had on them. Both the victim and offender must meet individually with a facilitator before agreeing to meet face-to-face. A facilitator is then also present to mediate the conversation (Zehr, 2002). Community reparative boards consist of members within the community that meet with the offender to discuss the impact that their crime has had on the community. Circle sentencing is facilitated by a judge or respected member of the community and involves all three parties to discuss the meaning and impact of the crime committed by the offender (Boyes-Watson, 2005). Family group conferencing is similar to circle sentencing with the addition of involving family 23 members, as well as notable members of the community (Bazemore & Umbreit, 2001;
Zehr, 2002).
Restorative justice programs report higher victim satisfaction due to their inclusion in the mediation process. They are also less expensive than traditional criminal justice processing, making them a more affordable option compared to incarceration
(Umbreit, Coates, & Vos, 2004). Various studies have reported reduction in recidivism rates, but these results are inconclusive and dependent on types of crime and various offender demographics (Bergseth & Bouffard, 2012).
Community Arts Interventions. Protective factors have been proven to limit the effects of trauma from living in a low-income urban environment for at-promise youth
(Werner & Smith, 1992). Creative expression through the arts can serve as a protective factor through encouraging achievement, fostering prosocial behavior, and providing social support while also allowing a safe means of self-expression (Jenson & Fraser,
2011).
Examples of community arts interventions include the Philadelphia Mural Arts
Program, which uses art in the form of murals to beautify struggling communities and offer restorative opportunities to inmates and juvenile offenders. Additionally, “Mother
Clubs” in Lima, Peru were formed by women living in poverty. They create fabric art called cuadros and arpilleras which began as a way to earn money, but eventually grew into an activity that empowered the women and allowed them to form supportive relationships. The “Playback Theatre” is an improvisational theatre group that features stories brought by the members of the audience. Through the artistic expression of their 24 personal experiences, participants were able to make peace with their conflict (Smith,
2008).
Space of Her Own (SOHO) was developed in Alexandria, Virginia, in 2002 by
Linda Odell to address the lack of gender-specific programming for at-promise adolescent girls. It was designed to promote positive influences in the lives of at-promise adolescent girls through the artistic improvement of their personal space at home (Odell,
2007). This was done through creating intergenerational mentorships between adult females and program participants and engagement in art. Participants were chosen that were either on probation, the younger sibling of an adolescent on probation, had attempted to skip school or run away from home, struggling to get along with peers, or have an incarcerated parent. They also had to attend orientation with a parent or guardian and commit to working with a mentor and attend the program regularly. Volunteer mentors were given training specific to working with at-promise girls. Participants engaged in art projects, such as designing their living space, assembling and decorating furniture, painting, and making plaster molds with the goals of positive self-expression, developing practical skills, and experiencing empowerment through the creative process.
By the end of the program, all participants developed better social and life skills, as well as an appreciation for art. Many participants maintained their relationships with their mentors beyond a year and 95% of the girls had no court involvement after a year (Odell,
2007).
25
Music Therapy with At-Promise Youth
Literature for this section was found by searching for the following keywords and phrases: music therapy, at promise, at risk, urban youth, foster care, trauma, and traumatized. A survey conducted by Clark, Roth, Wilson, and Koebel (2013) showed that in North America, music therapists work with at-promise youth in a variety of settings, ranging from schools, hospitals, residential treatment facilities, community-based facilities, corrections facilities, and private practice. Music therapy can be used in both group and individual sessions and typically follow a 3-part format. The introduction can serve as an assessment to know how the client is feeling and determine if there are any immediate needs. The therapist can also outline the session plan to reduce anxiety.
Instruments can be introduced during this time if clients are unfamiliar with them. The second section would be the intervention as planned by the music therapist. This section would include music making and verbal processing. The third section would close the session and allow for any discussion of topics that came up during the intervention
(Carruthers, 2014).
The areas of treatment that are most often addressed are mental health, trauma, substance use, violence, bereavement, incarceration, and sexual offending. In regard to mental health, McFerran (2010) identifies identity, resilience, connectedness, and competence as key elements of adolescent mental health. Adolescents that have experienced trauma typically tend to suppress their emotions, leading to an increase in depression, anxiety, and anger, which further damages mental health (Zanders, 2012).
These treatment areas can all be addressed through music therapy. 26
Common music therapy treatment goals for at-promise youth include increasing prosocial behavior, healthy communication skills, promoting positive attachment, and preventing worsening mental health (Carruthers, 2014). Music therapy is used to increase self-esteem by offering opportunities for successful experiences and safe environments to exercise freedom of choice and control (McFerran-Skewes, 2000). Music therapy can also promote self-awareness in addition to awareness of others (Cassity & Cassity, 2006;
Molyneux, 2005; Clark, Roth, Wilson, & Koebel, 2013). Music therapy can also promote insight and cultural awareness, as well as increase coping skills, behavior management skills, and decision-making (Zanders, 2015; Roberts, 2006; Clark, et al., 2013).
Music therapists implement various different methods in addressing the needs of at-promise youth. One common method is songwriting, which can be used in various ways. Clients can lead the process and often choose to compose music, followed by lyric- writing, and vice versa. Since songwriting can be an intimidating new experience for some clients, more structure can be applied to lessen anxiety about the process. Lyric substitution is a method where the client alters previously written lyrics to change the meaning to suit their own. Songwriting can also be computer-based. This requires a computer or laptop with songwriting software and often incorporates the use of an electronic keyboard and recording equipment. This method promotes independence as it gives the client more freedom, choice, and control within the songwriting process. It is also more accessible since clients have access to various instrument sounds through the songwriting software, regardless of whether they can play those instruments or not. When using live instruments, the therapist can provide structure through their accompaniment of the client. Spontaneous songwriting can also emerge from instrumental improvisations. 27
This method works well with clients who are less inhibited in their creative expression
(Roberts, 2006).
Zanders (2015) incorporated songwriting into music therapy practice with at- promise youth through the musical journal and musical biography. Musical journal is a combination of instrumental improvisation, song recreation, songwriting, and recording.
It is recorded in order to allow the therapist and client to review and discuss issues that come to light during sessions and explore them more deeply. The process of creating the musical journal is reflective and therefore promotes insight in the client. It also helps build a healthy relationship between the client and therapist, allowing the musical relationship to mirror the therapeutic relationship. Similarly, the musical biography uses similar techniques to construct a musical narrative of the client’s life. The client gives a chronological narrative of their life, using music to represent each significant event. This can help the client work through past trauma through safe expression in music. Both the musical journal and musical biography can be altered by the client between sessions, giving the client freedom of expression and promotes a sense of identity and empowerment (Zanders, 2015).
Music therapy improvisation is an effective method that promotes healthy self- expression. Improvisation is typically combined with verbal processing in order to provide context and meaning to the music making. This is especially appropriate for teenagers as they are still developing their ability for abstract thought. The combination of verbal processing and improvisation combines both here-and-now and symbolic thinking, therefore both normalizing and further developing those cognitive functions.
Improvisation also allows adolescents more freedom in self-expression by giving them 28 control over the music that they do not have when listening to recorded music. This is especially beneficial for clients that report feelings of helplessness (McFerran-Skewes,
2000).
Zanders (2015) has used clinical improvisation to help clients identify emotions and then represent them in music through referential improvisation. An emphasis can be placed on how it feels to physically express that emotion, helping the client make a connection between emotional feelings or thoughts and physical action. These improvisations can also be recorded, allowing the client to review the experience after listening and making any changes to more accurately describe their feelings. This also helps promote insight as the client continues to process their emotions, how they express them, and whether the expression is congruent with their feelings (Zanders, 2015).
Music listening and sharing is a receptive method that is often used with at- promise youth. Teenagers in particular use music as a representation of their identity, feelings, and beliefs (McFerran-Skewes, 2000). Therefore, there are many therapeutic uses for listening to music. Clients are given the opportunity to choose the music that is shared as opposed to the therapist, giving more control to the clients. Clients are encouraged to share music that is meaningful to them, which gives an opportunity for self-expression. Lyric analysis gives the opportunity to process the meaning of the song with the client and explore the feelings that are associated with it (Carruthers, 2014).
Music also inherently elicits emotional responses, which can aid client sharing in verbal processing. In a group setting, music sharing can promote group cohesion. When one group member shares a song, other group members have the opportunity to practice prosocial behavior by being respectful in listening. Group members can also feel 29 acceptance when their musical choice is met with respect, or if other members share similar feelings. Group members can support each other as lyrics are discussed in verbal processing, which can highlight personal strengths as well as identify healthy coping skills (McFerran, 2010). Lastly, the ability to choose music also allows clients to feel a sense of freedom and empowerment (Carruthers, 2014).
Relaxation methods can be used to help reduce anxiety, identify and address tension in the body, and provide closure to a session. Zanders (2015) used deep breathing exercises in conjunction with live music to help clients relax during the initial stages of treatment. This helped the client feel more comfortable and therefore helped build rapport and trust. Once relaxation through breathing became familiar, he incorporated suspended chords as a musical cue to direct breathing and deepen the sense of relaxation. Zanders
(2015) also used progressive muscle relaxation to help the client become more aware of tension in their body. Through tensing and then relaxing specific body parts one by one, the client became more aware of where they felt tension in their body. Since tension is often a response to negative stimuli, this helped the client become more aware of their physical response to stressors and how to release that tension (Zanders, 2015).
Mindfulness meditation can also be used in combination with music to help develop awareness of the relationship between the mind, body, thoughts, and feelings.
During the meditation, intrusive thoughts can be expressed through music. This brings awareness to those thoughts and can help reduce flight of ideas and anxiety (Zanders,
2015).
Visualization can also be used for relaxation. In visualization, the client is induced into an altered state of consciousness. The therapist then suggests imagery for the 30 visualization experience. This is often referential and the client can be encouraged to imagine a safe or positive place. The client can be given an active role and be invited to sing or play instruments to represent the visualization. This promotes healthy self- expression by using music to represent the feeling or imagery of the visualization and assist in learning and reinforcing coping skills (Cassity & Cassity, 2006).
Pasiali (2012) emphasizes resilience as a treatment goal with at-promise youth due to the chronic trauma from ACEs that they experience. Resilience is the “ability to withstand adverse environmental stressors” (p. 36). This can be done through the therapeutic relationship by emphasizing the strengths and internal resources that at- promise youth already possess. Coping skills can be taught to utilize individual strengths and give the client more internal resources to cope with ACEs. A flexible session structure, as well as a welcoming atmosphere, are suggested in order to counter the chaotic environment that at-promise youth are often accustomed to and to provide as many opportunities for success in the session (Pasiali, 2012).
Rap and Hip-Hop Music. Music therapy is inherently intertwined with popular music and culture (Lightstone, 2012). Many people identify with rap music and Hip-Hop culture as they can relate their personal experiences to it, regardless of cultural background (Yancy & Hadley, 2012; Lightstone, 2012). For clarification, Hip-Hop is the culture that started in the 1970’s by young, urban African Americans (Keyes, 2002).
Keyes continues to describe Hip-Hop culture as an “expression that embodies those attitudes, language, dress, and gestures affiliated with street culture” (1996, p. 231). Rap is “the music, the beats, and the rhyme” of Hip-Hop culture (Elligan, 2012, p. 28). Since it is the musical expression of Hip-Hop culture, the terms “rap” and “Hip-Hop music” 31 can be used interchangeably, although some make the distinction that rap music is commercially influenced, whereas Hip-Hop music is not (Lightstone, 2012).
Hip-Hop culture is the “universal language” of young people (Lightstone, 2012, p.
40) and rap music is the most commercially successful musical genre over the past two decades (Rose, 1994; Tyson, 2002). As a result, many populations identify with the themes in Hip-Hop culture and rap. Since it also has roots in African culture, both in its origin and borrowed elements from African music, such as the use of polyrhythms, it is also culturally sensitive to incorporate into practice. It is therefore important to consider the role of rap music and Hip-Hop culture in music therapy when working with at- promise youth (Lightstone, 2012).
Rap music, in essence, is rhythmic, syncopated chant layered over a programmed beat, often created electronically or using sampling from turntabling (Salaam, 1995). It represents Hip-Hop culture through the use of slang and incorporating various themes which allows rap to be categorized into various genres (Lightstone, 2012). Gangsta rap incorporates themes of violence, crime, and misogyny. Gangsta rappers often lived in impoverished neighborhoods with high crime rates. These themes are thought to be a result of this upbringing, forcing young people to grow up prematurely and glorify these actions. While the argument can be made that gangsta rap reinforces this negative behavior, gangsta rappers often defend their lyrical themes as making their living conditions known to the outside world and many people identify with their experiences.
Gangsta rap, despite the prevalence of antisocial themes, can be used in therapy to teach the consequences of that lifestyle (Elligan, 2012). 32
Materialistic rap focuses on an extravagant lifestyle. It is a popular genre of rap and appeals to people of different cultures, demonstrating the universality of rap. Many rappers that rap about materialism have worked hard to achieve that lifestyle and many young adults aspire to become successful rappers in their footsteps. This can be used therapeutically to reinforce the value of hard work and perserverance to achieve a goal
(Elligan, 2012).
Political or protest rap brings awareness to political issues and demonstrates how rap can be used as an educational tool. It has declined in popularity but was used widely in the 1990’s to promote voter registration and public health issues such as safe sex.
Positve rap promotes wholesome and pro-social messages, such as the value of hard work, education, and responsibility. Spiritual rap incorporates gospel music, introducing it to people that may otherwise not listen to or be exposed to gospel music. These genres promote positive themes but are less popular amongst young people. Many rappers also write music that spans various genres and rarely limit themselves to one category
(Elligan, 2012).
Hip-hop and rap music have been used clinically in a variety of settings. Viega and MacDonald (2012) used songwriting in an after-school program called “Hear Our
Voices.” In this program, music therapists facilitated songwriting with at-promise youth in Philadelphia, Pennsylvania. Children used freestyle rapping to express both their personal strengths as well as comment on social themes. McFerran (2012) used songwriting in a school setting through individual sessions. Ahmadi and Oosthuizen
(2012) used music therapy in a community setting through a nonprofit organization called the Music Therapy Community Clinic. Through this organization, music therapy was 33 offered to at-promise youth from various schools through teacher referral to address various ACEs. They used drumming, songwriting incorporating rapping, and a performance to allow for creative expression. Lightstone (2012) also used songwriting in music therapy sessions at an urban youth shelter, in which youth used rap to express faith, gratitude, and coping with violence. Ierardi and Jenkins (2012) used rhythmic and lyric improvisation, composition, and music listening in a short-term juvenile detention center as a means of fostering positive self-esteem, reality orientation, and impulse control. They emphasize the importance of using music that is authentic to client cultural identity in sessions. Donnenwerth (2012) used rap music as a means of fostering communication skills with at-promise youth in a residential treatment center for juvenile offenders. Additionally, Uhlig (2011) used rap in a school setting for the relaxation effects of vocalization. In individual sessions with a teenage boy that was exhibiting aggressive behaviors as a result of chronic neglect, Uhlig supported him in freestyle rapping to express his feelings and also ease his anxiety through the use of his voice.
Music therapists may encounter difficulty in using rap music in sessions due to unfamiliarity with this genre, censorship of lyrics deemed inappropriate by the facility, or personal difficulty with themes of violence, sexism, and drug use (Elligan, 2012). Rap music has many beneficial uses; however, and should still be considered when it is the primary musical preference of the client. To ignore this preference would diminish the therapeutic relationship between therapist and client (Lightstone, 2012). The use of colloquial slang can help build positive communication skills through word play and composing raps. Rap has transformative power and even the act of creating music in the preferred genre can be an enjoyable experience and build group cohesion among clients. 34
Rap can also be used as a creative element through which clients can master a skill and develop trust for others, which Buchele (2000) identifies as important aspects of overcoming trauma. Rap also incorporates themes of empowerment and can be beneficial for oppressed and marginalized populations in order to develop not only a sense of empowerment, but how to use that feeling to overcome oppression (Bishop, 2002).
Music therapists should also strive for cultural competence when using rap and
Hip-Hop music in their practice with at-promise youth. This is especially important when the music therapist is less familiar with Hip-Hop culture or comes from a separate cultural background in order to reduce the likelihood of appropriating Hip-Hop culture or causing harm due to their incompetence. Sue and Sue (2016) stress that culturally competent professionals must be aware of their own values and beliefs as the first step of understanding how those personal beliefs influence their views of people from other cultures. They must also strive to understand the values and beliefs of their clients, as well as their clients’ worldview. Lastly, they should continually develop skills and interventions that are both appropriate and sensitive in working with people of different cultures (Sue & Sue, 2016). Viega (2015) offers suggestions and guidelines for exercising cultural competence for using rap and Hip-Hop music when the music therapist has a different cultural background. He first suggests that the music therapist study the history of Hip-Hop culture and cultivating skill in one of its refinitions, such as deejayin’, graffiti art, or street knowledge. This proficiency helps develop a sense of authenticity when working with rap and Hip-Hop music. Viega also encourages the use of music technology in order to accurately use sampling and mixing. This allows clients to recreate music that is authentic in sessions. Music therapists may wish to allow for creative expression 35 through other art forms since Hip-Hop Culture is also multi-modal. This could include the use of art or dance in interventions. Lastly, music therapists must understand the impact of sociopolitical oppression on at-promise youth, as well as Hip-Hop culture’s ability to foster a sense of unity and community as a protective factor (Viega, 2015). For
Viega himself, his efforts towards cultural competence when using Hip-Hop and rap music with at-promise youth involved being aware of his own privilege as a Caucasian male and being careful to not appropriate it when using it in sessions, lectures, or workshops.
36
CHAPTER 3: SYNTHESIS
In this chapter, the author first discusses the cyclical nature of urban poverty and the need to disrupt that cycle. She will then discuss how current music therapy practices addressing the effects of chronic exposure to trauma at a young age can help mitigate the factors that contribute to urban poverty. The effect of restorative justice programming on recidivism is then described, highlighting the role of incarceration in the cycle of poverty and how the restorative justice model works to reduce crime and recidivism rates. Lastly, recommendations are made for the integration of music therapy and restorative justice methods in order to address the effects of urban poverty on at-promise youth.
Cyclical Nature of Poverty
The cyclical nature of poverty is impacted by the trauma experienced by community members and how those effects impact various aspects of daily life. Social stressors are a prominent source of stress and trauma for at-promise youth. Since at- promise youth are often people of color, systematic, direct, and implied racism affect their lives and is the underlying root in nearly all of the traumatic effects of living in urban poverty (Bailey et al., 2017). This has a negative effect on self-esteem and identity, resulting in higher rates of depression. Depression is also linked to lower achievement in school, which ultimately impacts future job options (Hughes, Kiecolt, Keith, & Demo,
2015). Institutionalized racism also affects various systems that make it more difficult for low-income urban families to obtain higher paying jobs and be financially stable (Omi &
Winant, 2015; Krieger, 2014; Gee & Ford, 2011; Purtle, 2013; Blessett, 2015). This not only has an immediate impact on the family, but also affects the family on a 37 transgenerational level as children are born into poverty and are unable to build the resources to help them overcome their circumstances (Omi & Wining, 2015; Zinn, 2015).
Other social stressors that impact the mental health of at-promise youth are social stigma and the balance between peer influences and parental expectations at home.
People living in poverty are often portrayed negatively in media with stereotypes ranging from being lazy, violent, and unable to make responsible decisions. This places a social stigma on at-promise youth and negatively impacts their sense of self (Gross & Capuzzi,
2014). At-promise youth often lack positive role models in their community, therefore more negative reinforcement from society and media sets low expectations for future goals and achievements. When parents are both under stress and also attempting to set high expectations for their children, their parenting style tends to be more strict (Elder,
Eccles, Ardelt, & Lord, 1995). This can conflict with social pressure from peers to focus less on achievement and more on recreation. While it is developmentally appropriate for at-promise youth, in their adolescence, to want to fit in with their peers, the juxtaposition of expectations from family versus friends can cause additional stress (Gross & Capuzzi,
2014). This stress also negatively impacts mental health (McWhirter et al., 1998;
Fergusson, Woodward, & Horwood, 2000).
These social stressors lead to an increase in depressive symptoms, which has also been linked to an increase in behavioral problem. At-promise youth are more likely to engage in criminal activity (Dashiff, DiMicco, Myers, & Sheppard, 2009). Criminal activity leads to more trauma exposure in different ways. Involvement in the criminal justice system, especially as a minor, is in and of itself traumatic and damaging to self- esteem and mental health. It also contributes to an increase in the crime rate of poor 38 neighborhoods (Anakwenze & Zuberi, 2013). Violent crime can also lead to injury or death. At-promise youth are more likely to be the victims of violent crime resulting in death (Teplin, McClellan, Abram, & Mileusnic, 2005). At-promise youth experience grief when losing a friend or family member, which can also lead to depression (Tolan,
Gorman-Smith, Heusmann, & Zelli, 1997).
It is important to consider how the effects of mental health diagnoses affect at- promise youth through different social systems. A child suffering from depression experiences lower energy, sad affect, and lower motivation. This impacts school performance and the ability to pursue and maintain friendships. Anxiety and PTSD also result in presenting symptoms that negatively impact the ability to pursue and maintain social relationships as they can both lead to fear of specific social situations and isolative behavior. The loss of a healthy social life limits a person’s access to potential protective factors through positive social supports.
Overall, the impact of trauma as a result of living in poor urban neighborhoods perpetuates the cycle of poverty. Trauma negatively impacts the mental health of community members, making it more difficult to successfully thrive as coping with mental health symptoms become both an obstacle and a priority to be addressed. In turn, the negative effects of trauma contribute to the experience of more trauma within the community. This contributes to further financial strain as well as decreases motivation for a better future, making it more difficult to people to positively change their environment.
Music Therapy and Trauma
The mental health issues that are directly related to chronic exposure to trauma include anxiety, depression, and increased risk of suicide (Ferguson et al., 2000; Dashiff 39 et al., 2009; Evans-Chase, 2014). Music therapy with at-promise youth directly addresses many of these resulting symptoms and is one way in which music therapy can have a meaningful impact in reducing the perpetuating factors in the cycle of poverty.
Reduction of mental health symptoms reduces the long-term impact of trauma.
Music therapy has been used in a variety of ways to address poor mental health.
Depressive symptoms can be addressed in a variety of ways. Songwriting can be used to promote healthy self-expression, reflection, and insight (McFerran-Skewes, 2000;
Zanders, 2015). Improvisation can also be used as a means of self-expression, as well as provide an opportunity for clients to have choice and control over their environment
(McFerran-Skewes, 2000). Since at-promise youth often do not have safe outlets in which to express themselves, or have freedom of choice, the ability to experience them in a safe and structured environment is beneficial to their development.
Music therapy can also be used in a variety of settings, especially in schools, hospitals, and within the community, making it adaptable to reach at-promise youth. This makes it more likely for treatment to be sought by eliminating some of the logistical barriers that can make seeking treatment difficult. One of the strengths of music therapy, especially with this population, is that it provides a creative and nonverbal outlet for self- expression for a population that is already more likely to repress emotions (Zanders,
2012). By offering clients a form of self-expression that is familiar, such as the use of familiar or preferred music, they often have an easier experience in sharing feelings compared to verbal therapy alone (McFerran-Skewes, 2000).
Improving mental health can contribute to better focus in schools. This could potentially increase the number of at-promise youth pursuing a college education or 40 pursuing a skilled trade school after completing high school. These career paths would allow at-promise youth to work in higher paying fields, thus helping to break the cycle of poverty.
The music therapy interventions used with at-promise youth could also be used with adults in low income urban neighborhoods. This is worth discussing since the mental health of adults directly impacts at-promise youth through daily interactions, influence on parenting strategies, and accessibility of resources. Stress in adults has been linked to substance use (Anakwenze & Zuberi, 2013) and inconsistent parenting (Stern,
Smith, & Jang, 1999). Reducing the need for substance use by reducing symptoms of stress, depression, or anxiety through music therapy would mean it is less likely for adults to develop substance abuse disorder or engage in illegal activity related to drug use. It also reduces youth exposure to substance use, therefore limiting exposure and making it less likely that they will also turn to substance use to cope with stress. Inconsistent parenting contributes to social and environmental trauma through unpredictable and excessively harsh punishments, often including physical or verbal abuse (Brooks-Gunn &
Duncan, 1997; Duncan & Brooks-Gunn, 1997; McLeod & Shanahan, 1996). Reducing the impact of stress on parents allows them to more consistently and compassionately discipline their children, reducing their exposure to potential abuse
Overall, these approaches address the effects of trauma on at-promise youth.
While this is helpful in assisting this population in overcoming adversity, preventative measures that build upon a person’s own ability to overcome adversity would be most effective by lessening the impact of trauma (Pasiali, 2012). This ability to overcome adversity is referred to as resilience. Masten (2001) identifies asset-building, mediating, 41 and risk-activated interventions as the three main types of strategies to foster resilience.
Pasiali (2012) suggests normalizing the environment in music therapy practice as part of an asset-building intervention. This can be done by having sessions in a welcoming, inviting space. An informal session format is also recommended for the purpose of flexibility to ensure that the client will successfully reach goals and objectives. Music therapy that promotes positive interactions between family members can be used as both asset-building and mediating interventions. This can be done by promoting and modeling appropriate behaviors between clients and their parents or guardians (Pasiali, 2012).
Restorative Justice Model and Recidivism
Restorative justice programming is believed to help reduce recidivism of criminal offenders by addressing the factors that contributed to them committing a crime in the first place, holding them accountable for their actions, and promoting successful reintegration into the community. This addresses the trauma experienced by the offender, the victim, and the community. The victim plays a more active role in restorative justice programming, sometimes even addressing the offender directly to discuss the impact of their crime on their life, therefore leading to higher satisfaction with retribution. This provides an outlet for the victim to process their emotions and continue to be a productive member of the community. The community, oftentimes in conjunction with the victim, determines what the offender must do as retribution in order to reenter the community as a respected member. This allows for healing of the community as well. Lastly, since the offender has a chance for redemption while also receiving social supports, they are given a second chance to make positive changes in their life and continue to be a member of the community (Bazemore & Griffiths, 1997). 42
Since programs within the Restorative Justice Model have had some success in reducing recidivism with various types of offenders (Umbreit, Coates, & Vos, 2004), we can discuss the impact of reduction in crime rates as a result of restorative programs. An overall decrease in crime rate in urban communities would contribute to residents feeling safer, thus reducing the trauma, as well as the impact of said trauma, on people. A reduction in crime would also mean less exposure of youth to criminal activity, which would also have a positive impact on residents within the community.
Less recidivism also means that people that do commit crimes can escape the criminal justice system. Through escaping juvenile detention sentences, juvenile offenders will not be exposed to the trauma of incarceration. Restorative justice programs that promote rehabilitation not only help juvenile offenders change their lives toward a more positive and productive path, but they also set a positive example for other youth in the community. Petrosino, Turpin-Petrosino, and Guckenburg (2010) state that the cycle of recidivism, incarceration, and involvement in the court system is a difficult cycle to break. Juvenile offenders that successfully complete restorative justice programming and commit no further crimes set the example to other at-promise youth that it is possible to choose a safer lifestyle and return as a productive member of the community.
The positive impacts on the lives of the offenders is often discussed when examining the effectiveness of restorative justice programming, but the impact on the victim must be considered as well. The victim of a crime experiences trauma to varying degrees of severity. Since the victim rarely plays a vocal role in traditional punitive sentencing, they may feel a sense of hopelessness. Victims that participate in restorative 43 justice programming report high rates of satisfaction due to playing a role in sentencing.
This promotes healthy treatment of the trauma experienced
Music Therapy within Restorative Programming
In this section, the author will synthesize the music therapy, Restorative Justice
Model, and trauma literature and make recommendations for integrative practice.
According to Braithwaite (2002), restorative justice programs provide a more balanced approach to crime by addressing the harm done to the victim, determining consequences for the offender, and providing support in reintegration of the offender back into the community. Wolff and Baglivio (2017) also support a systems-based therapeutic approach to address the impact of ACEs and trauma on at-promise youth in order to reduce recidivism. A systems-based approach views different social circles as systems and focuses on how these systems interact with each other. Examples of systems related to at-promise youth include the family system, school system, and community system.
Psychological support is a key factor in all three of these goals. Additionally, the positive impact of the program on youth is dependent on the support and involvement of the criminal justice agents involved, the victims, and the community (Bazemore & Umbreit,
2001).
This justifies the integration of music therapy within restorative justice programming. It has been proven to be an effective way to treat trauma with at-promise youth, addresses trauma from a systems-based approach by involving individuals, families, and communities, and provides additional psychosocial support in order to reinforce the potential effectiveness in reducing recidivism. In order to best address the cyclical nature of poverty, an approach that is both preventative and addresses immediate 44 concerns would be most effective. In order to address immediate concerns, resources should be made available and poor mental health symptoms should be addressed. This can be done using music therapy within the restorative justice model. Music therapy can be implemented through one of the four the main methods of restorative justice programming, such as VOM, community reparative boards, family group conferencing, and circle sentencing (Bazemore & Umbreit, 2001). These different models allow for music therapy to be used in different settings with offenders, victims, and communities.
Treatment goals that focus on immediate concerns include promoting prosocial behavior, relaxation, and safe self-expression. Promoting prosocial behavior would help clients communicate their feelings respectfully, which is useful both in and out of sessions. This would help create a safe environment for feelings to be expressed so that they can be effectively processed in session.
Preventative therapeutic goals would focus on building resilience. According to
Pasiali (2012), developing resilience builds on a person’s ability to adapt to adversity. By fostering resilience, at-promise youth are more likely to have the innate skills needed to overcome trauma and therefore lessen its impact. This can be done by building upon personal strengths as well as creating an environment that promotes healthy development.
In music therapy, this can be done through a strengths-based approach and incorporate various methods, such as songwriting, improvisation, or lyric analysis. A safe environment that promotes healthy development and prosocial behavior can be created by the therapist by setting a warm, inviting space. This approach would both contribute to the potential effectiveness of restorative justice programming in reducing recidivism, 45 therefore reducing crime rates in communities. It also lessens the impact of trauma on all parties involved, promoting healing in the community and better mental health.
Method-Speecific Recommendations. The following sections will include recommendations based on specific restorative justice methods. In victim-offender mediation (VOM), the victim and offender separately meet with a mediator before meeting with each other. The mediator supervises the sessions and the main purpose is to empower the victim by giving them an opportunity to share the impact of the crime on their life with the offender (Zehr, 2002). Examples of treatment goals would include developing resilience and expression of emotions. Songwriting could be used to help the victim communicate both verbally and nonverbally. Improvisation could also be used as a nonverbal form of communication where the victim can safely confront the offender through their music. Afterwards, both victim and offender could verbally process their experiences in the music. Song sharing could also be used as a way for the victim to express themselves by choosing songs with themes similar to their experience. Verbal processing can again be done afterwards in order to communicate meaning. Treatment goals for the offender would include prosocial behavior and developing resilience. Since the focus is on empowerment of the victim in VOM, it is more important that the offender be able to listen to the victim appropriately. This involves active listening, frustration tolerance, and empathy. Improvisation could support building these skills by assuming a supportive role in the music. The offender can also express their feelings through songwriting. Building resilience for both can be done through the successful experience of the sessions, in addition to the therapist highlighting both victim and offender strengths in their perseverance. 46
The other three restorative justice models focus on the impact and meaning of the crime. Community reparative boards give community members an opportunity to share the impact of the crime with the offender. Circle sentencing involves members of the community, the victim, and the offender. Sessions are facilitated by a judge and include discussing the meaning of the crime for all parties involved. Family group conferencing is similar to circle sentencing, but also includes family members (Bazemore & Umbreit,
2001; Zehr, 2002).
In communicating the impact of the crime, whether it be by members of the community or the victim, similar goals and methods can be used as described above in
VOM. Songwriting can be both expressive while also providing an opportunity for community members, the victim, and their family to work together. This ability to work together would foster group cohesion, which would be useful in helping the community recover from the trauma of the crime that was committed. When discussing the meaning of the crime as part of circle sentencing and family group conferencing, the ability for all three parties to work together towards a common goal supports the goal of reintegrating the offender back into the community.
In all four methods of restorative programming, it is also important to be emotionally supportive of the offender through the process while still focusing on the needs of the victim and community members. Restorative programming acknowledges that social factors often contribute to offenders committing crime (Bazemore & Griffiths,
1997), demonstrating that they, too, are victims of trauma. This support can be provided by the music therapist. A music therapist working within the restorative justice model should be aware of the challenges that at-promise youth face. A trauma-informed 47 approach is suggested, as well as a humanistic orientation in order to see the strengths of all parties involved, which is necessary to further develop resilience. They should also be familiar with various genres of music, especially rap and Hip-Hop music. A music therapist working within the restorative justice model must be culturally sensitive and competent. They must be aware of different cultural attitudes towards therapy, as well as how culture affects social systems and musical preference (Viega, 2015).
48
CHAPTER 4: DISCUSSION AND REFLECTION
At-promise youth experience higher rates of trauma due to increased exposure to
ACEs (Foote, 2005; Galea, Uddin, & Koenen, 2011). This trauma has psychological, behavioral, and physiological impacts on at-promise youth through development and even on future generations. Chronic exposure to trauma and ACEs is linked to a higher rate of depression, anxiety, PTSD, and other mental illnesses. It is also linked to maladaptive behavior that can lead to criminal activity and incarceration (Centers for
Disease Control and Prevention, 2016; Evans-Chase, 2014). Lastly, trauma is related to physiological changes in the stress response through the HPA axis, resulting in a constant
“fight, flight, or freeze” response which impacts behavior through increased sensitivity to stressors (Fish, et al., 2004; Archer, Oscar-Berman, Blum, & Gold, 2013). These physiological changes, as well as their contribution to anxiety and depression, can be passed on to future generations through epigenetic pathways (Booij, Wang, Levesque,
Tremblay, & Szyf, 2013; Cohen-Woods, Craig, & McGuffin, 2013). This highlights the cyclical nature of poverty and its negative impact on the population since the various effects of chronic exposure to trauma and ACEs feed into each other and are perpetuated across generations, regardless of trauma exposure to future generations (Oberlander et al.,
2008; Radtke et al., 2011; McGowan et al., 2009).
Currently, many programs and interventions exist to help mitigate the impact of this trauma. Government assistance programs are used by millions of Americans to address food and housing insecurity (Coleman-Jensen, Nord, & Singh, 2013; Oliveira,
2015; Joint Center for Housing Studies, 2015). Many schools in low income urban environments are being reformed to better accommodate both the educational, social, and 49 psychological needs of their students (Fine, 1986; Chochran-Smith, 1998; Gay, 2000;
Foote, 2005). Community arts programs help unite neighborhoods through positive self- expression through the arts, and restorative justice programs aim to rehabilitate offenders and heal communities after crimes have been committed, reducing the impact of trauma, as well as recidivism rates amongst offenders (Smith, 2008; Odell, 2007; Bazemore-
Griffiths, 1997; Rodriguez, 2007).
The literature suggests that the use of music therapy interventions within the various restorative justice methods could be effective by adding a mode of creative and nonverbal self-expression and clinical goals. Many of the treatment goals applicable to restorative justice and rehabilitative programming overlap with treatment goals of music therapists when working with at-promise youth. Combining these goals in a way that is part of a treatment plan, therefore adding a clinical element to restorative justice programming, can allow more effective and efficient treatment.
Music therapy can be used either as interventions within a program, or as a complete program in and of itself. Music therapy as a program within the restorative justice model would involve the same parties as in traditional restorative justice programming, but would accomplish these goals entirely through a community-based music therapy program. Community music therapy programs in low income urban neighborhoods have been successful in promoting prosocial behavior, therefore a community-based music therapy program rooted in the principles of restorative justice have the potential to both promote prosocial behavior and reduce recidivism rates.
While most music therapy interventions with at-promise youth address behavioral issues, Pasiali (2012) recommends a systems-based approach focusing on fostering 50 resilience. The incorporation of a systems-based approach reinforces external supports, which have been proven to make therapeutic measures with juvenile offenders more effective. These external supports, in addition to focusing on individual strengths and talents, work as protective factors against trauma and ACEs. Building these external supports helps reduce recidivism amongst juvenile offenders by helping them develop healthier coping skills to use instead of resorting to criminal activity. It also helps victims of crime by helping them become more resilient to trauma. This has implications for both restorative justice programming and preventative or early intervention programs within the community.
Program Recommendations
This section will include detailed recommendations for future practice combining music therapy with restorative justice methods. A restorative justice music therapy program would be community-based in order to incorporate the offender, victim, and community. Examples of locations for such a program could be community centers, schools, or churches. It would be facilitated by a music therapist but would also benefit from the involvement of parole officers and other personnel familiar with criminal justice and the justice system. Additionally, the music therapist should be specifically trained in both the psychosocial needs of the community as well as the adjudication process.
A process would be needed to select participants for the program. All participants would be selected based on a singular crime, such that the victims and community members chosen as participants would have been directly impacted by the crime committed by the offender. Basic requirements for victims would be that they are victims of a crime in the community. The crime affecting the victim should have occurred at least 51
12 weeks in advance because the program will not be designed to address the immediate impact of trauma. Victims should have a support system already in place to ensure that they will continue to receive support throughout the program as meeting with their offender and discussing the crime they experienced can be retraumatizing. A support system outside of the program acts as a mediating factor to support the victim and minimize the negative effects of retraumatization. Victims should also be assessed for mental illness. If a victim is diagnosed with major depressive disorder or PTSD, then they would not be an appropriate candidate for a restorative justice music therapy program as it may not be intensive enough treatment for them. Treating their mental illness would be a higher priority and addressing the impact of the crime committed against them could be explored after they receive more intensive treatment. Approval from a mental health professional would be required for such a person to engage in the program.
Offenders should be assessed for their capacity for insight and motivation for treatment. If they are not interested in reintegrating in the community, then other treatment options would be more appropriate in order to reduce the risk of retraumatizing victims. They should also be assessed for mental illness. An offender with schizophrenia, for example, may not be a good candidate as their illness would impact their ability to engage with the other parties in treatment. As with victims with mental illness diagnoses, an offender that has received and is compliant with treatment for their mental illness can be considered if approved by a mental health professional to engage in the program.
Offenders would also be selected based on their criminal history and risk of aggression.
Extremely violent crimes such as first-degree murder would disqualify an offender from participating if supported by a history of aggression and violence. On the other hand, first 52 time offenders or crimes such as manslaughter can be considered on a case by case basis.
Offenders should have character references that have worked with them individually to provide information on their character and background in order to best determine whether they are appropriate candidates for restorative justice music therapy.
Community members chosen to take part in a restorative justice music therapy program should be representative of overall population of the community and include prominent community members. For this purpose, the community is defined as the neighborhood, school, church, or other system in which the crime was committed. Since one of the goals of restorative justice is to heal communities, it is important that members of the community are represented and heard. Choosing prominent members of the community also carries a sense of authority; if a prominent community member takes part in the program and responds favorably, it is more likely that the program will gain overall community support. Therefore, community members chosen for this program should be agreed upon amongst other program participants. These members should also be assessed for prior mental illness, as well as for any biases or prejudices. Again, this is not an immediate disqualification, as it may be productive to discuss the role of prejudice or bias in treatment and how it contributed to the crime. It is still good to assess this in order to better understand the cultural dynamics of a community and allow that to inform treatment.
Once participants are selected, the music therapist should meet with each party separately, as is the case in victim-offender mediation. If multiple victims are involved, then they would meet as a group. Similarly, multiple offenders would also meet as a group, as would multiple community members. If there is only one person in each 53 respective party, then these sessions would be individual sessions. These meetings would occur until all parties feel safe and prepared to meet as a group. They serve the purpose of both rapport building and assessment; the music therapist can develop treatment goals for each party based on their needs as well as gather information about cultural norms and musical preferences. It would also be an opportunity to provide information about what to expect in sessions, both related to session format and interventions, as well as treatment outcomes. Client goals can be established, and questions can be answered to ensure that all parties involved understand how treatment will progress and what is expected of them in sessions.
After these separate meetings, treatment plans can be developed for each party.
Goals for offenders may include increasing safe self-expression in order to become more aware of feelings, developing healthy coping skills in order to process those feelings, as well as impulse control and establishing goals for the future. Treatment goals for victims would be similar, encouraging the expression of feelings to work through the trauma of being victimized, as well as promoting hope for the future. Goals for community members could also be focused on future goals, as well as self-expression to process the damage done as a third party to the crime. Promoting insight could also be useful in order to work through the society issues in the community that contribute to crime and addressing them.
Short-term treatment as a group is recommended, ranging from 3 to 4 months.
Weekly hour-long sessions are recommended in order to provide support to all participants while also allowing for some time for reflection outside of sessions. This writer recommends that treatment occur in three phases in order to build rapport amongst 54 group members and promote safety. In the first phase, each party would be allowed the opportunity to express themselves. Victims and community members would discuss the impact of the crime on their lives. Offenders would additionally discuss the impact of the crime on their life, as well as the factors that led to them committing the crime. This phase can be supported through song writing and song sharing, using metaphor through lyrics as a safe way to express feelings. In the second phase, participants would explore how they feel towards each other and work towards repairing those relationships.
Improvisation would be emphasized as a mode of nonverbally working through the dynamics of these newly-forming relationships. After improvisation, verbal processing would help provide context and meaning to what is expressed through the music. In the final phase, participants will move towards closure by establishing goals and expectations, including reparations from the offender as determined by the victim and community members. Support systems will be identified and secured to promote success in treatment after its completion. Coping skills, such as relaxation through guided imagery and music or music meditation, would be taught during this phase as a psychoeducational aspect of the program.
Overall, the end goals for each party in this program are that victims feel a sense of closure, offenders feel supported in reentering the community, and the community supports all parties by instilling hope for the future. Music therapy treatment goals will support this outcome. Victims will primarily achieve closure through creating a musical trauma narrative which will be shared with the group. This is done through either writing songs or curating a playlist of songs that tell their experience of the crime. When shared with the group and then processing both their feelings, as well as the feelings of the other 55 parties in response to their musical trauma narrative, the victims can feel “heard” in their experience. This also helps them feel safe in expressing their feelings towards all parties, therefore promoting a feeling of safety in the community.
Offenders will seek support in reentry from the victims and community in addition to offering forms of retribution for their crime. This allows the offender to both express remorse for their crime and open the discussion for how they can mend the relationship with the victim and community in order to reenter the community with their support. These goals also support the victim and community members feeling closure in regard to the crime. Forms of retribution will be discussed and determined by all parties.
The offender can express their remorse by individually writing songs that can both express what led to them committing their crime as well as feelings of remorse. Lyrical topics can also include what they would change about the past and how that would affect the future, demonstrating increased capacity for insight. Forms of retribution can also be offered and explored through group songwriting, where the victim and community members can state their needs and the offender can offer how they will address those needs. The victim and community members would state their needs through the verses of the songs while the offender, after gaining approval from the group as a whole, would write about their retribution for the chorus. The bridge of the song can be written together, focusing on the theme of how this retribution will change their relationships and the community. Additionally, the act of playing together as an ensemble can provide a feeling of support and belonging for the offender within the group. The offender can also explore various roles, such as leadership or supportive roles, through instrumental improvisation. 56
Community members will support all parties by instilling hope for the future. This can also be done through songwriting. A different way to approach songwriting but still support this goal would be to use a pre-existing song as the original structure. The group would choose a song that they feel represents the current state of the community. They would then either listen to or perform the song and discuss the lyrics. The group would then change the lyrics, focusing on what they want in the community in order to feel safe and supported. The community members of the group would assume a leadership role by leading this discussion to practice their roles as leaders outside of the group. Leadership roles can be further explored in instrumental improvisation with the community members determining the structure of music making for the group. Lastly, relaxation would be promoted through a guided meditation focusing on the visualization of a safe community.
Group members would agree upon music to be played during the meditation and afterwards, discuss what they visualized as a safe version of their community. They can then continue to verbally process ways to make those visualizations a reality and how living in their ideal safe community would impact their lives. 57
Table 1. Restorative Justice Music Therapy Goals and Suggested Interventions
Suggested Music Therapy Party Primary Goals Interventions • Achieve a sense of closure • Create a trauma narrative through having their through songwriting or creating a Victim(s) experience acknowledged playlist and feeling safe • Song share and lyric analysis • Feeling supported in • Retributive songwriting reentering the community by • Playing a song or improvising as expressing remorse and an ensemble Offender determining forms of • Role play through improvisation retribution
• Support all parties by • Songwriting (Past-Future) instilling hope for the future • Assume a leadership role in Community improvisation Members • Guided meditation visualizing safe community
In order to respect the culture and identity of at-promise youth, it is important that the music therapist running this program strive for cultural competency. Considering the impact of racism on nearly every aspect of these children’s lives, it is imperative that the music therapist avoid appropriating aspects of their culture by educating themselves about the culture and practicing cultural humility. They should also be self-aware of their own personal biases in order to challenge them so that they do not impact their relationship with clients. Given the popularity of rap and Hip-Hop music with this population, the music therapist should be prepared to embrace that style of music and familiarize themselves with the history, as well as music, of the genre. In order to fully address the impact of racism, a social justice orientation is also recommended to address social change and reduce the impact of racism on the lives of at-promise youth. They should also practice a humanistic, strengths-based, and person-centered approach. This 58 population can often be challenging, as it can be difficult to work with offenders, especially when also seeing the impact of their crime on the victims. Music therapists should seek supervision to help address their personal feelings towards clients in order to still respect them and see their strengths through a humanistic lens.
Summary of Recommendations and Reflection
Music therapy within restorative justice programming has the potential to address maladaptive behaviors amongst juvenile offenders, build resilience for all parties involved to reduce the impact of ACEs, and facilitate the conversation amongst offenders, victims, and communities in order to heal. Such programming can potentially reduce recidivism rates amongst juvenile offenders which would positively impact their lives in addition to reducing the crime rate in their community. It can also provide community support for offenders to overcome their circumstances and lead more productive and successful lives. Victims can receive emotional support to reduce the impact of the trauma experienced from the crime, thus helping them to also live a more productive and successful life and prevent the potential development of serious mental illness. Communities reap the benefits through reduced crime rates, which impact the
ACEs experienced by its members for generations to come. Through these changes, the impact of trauma as a result of ACEs can be reduced, therefore removing many of the environmental, institutional, and physiological barriers that often prevent at-promise youth from pursuing a more successful future.
Writing this thesis has been an inspiring challenge. The sheer breadth of literature related to ACEs, trauma, at-promise youth, and music therapy was daunting: one of the limitations of this thesis is the fact that it would be impossible to saturate the literature for 59 each topic. Yet it has been enlightening to learn more about restorative justice, the criminal justice system, and how at-promise youth interact with it. I also have a newfound interest in neuroscience and how it relates to music therapy.
Overall, I am grateful for this experience and look forward to using what I have learned to inform my future work with at-promise youth and other underprivileged populations. My current work with at-promise youth has been at a short-term inpatient psychiatric facility. I have had the opportunity to use some of these interventions and see the impact that music therapy can make in a person’s life firsthand, which has been very validating. It also pushed me to become more familiar with rap music, as it is a genre with which I was less familiar with before working with this population. It has helped me understand the importance of cultural competence and humility, as well as the role it plays in building rapport and a strong therapeutic relationship. I look forward to having more opportunities to apply what I have learned from conducting this literature review in my own clinical practice.
In the future, I hope to develop a method for working with at-promise youth that is informed by the restorative justice model, as well as other therapeutic approaches.
I am particularly interested in TF-CBT for its evidence-based effectiveness in address trauma in children and adolescents. I would like to focus on how to incorporate aspects of
TF-CBT into these music therapy interventions also addressing trauma and how to use that in a community music therapy program for both juvenile offenders and their victims.
My hope is that further education and research on this topic can be used to develop programs that positively impact the lives of at-promise youth.
60
REFERENCES
Addington, L. A. (2014). Surveillance and security approaches across public school
levels. In G. W. Muschert, S. Henry, N. L. Bracy, & A. A. Peguero (Eds.),
Responding to school violence: Confronting the Columbine effect. Boulder, CO:
Lynne Reinner Publishers Inc.
Ahmadi, M., & Oosthuizen, H. (2012). Naming my story and claiming my self. In S.
Hadley & G. Yancey (Eds.), Therapeutic uses of rap and hip-hop (pp. 191-210).
New York, NY: Routledge.
Alt, S. R., Turner, J. D., Klok, M. D., Meijer, O. C., Lakke, E. A., Derijk, R. H., &
Muller, C. P. (2010). Differential expression of glucocorticoid receptor transcripts
in major depressive disorder is not epigenetically programmed.
Psychoneuroendocrinology, 35(4), 544-556. doi: 10.1016/j.psyneuen.2009.09.001
America’s Health Rankings. (2013). Annual report. Minnetonka, MN: United Health
Foundation. Retrieved from
http://www.americashealthrangings.org/reports/Annual
Anakwenze, U. & Zuberi, D. (2013). Mental health and poverty in the inner city.
National Association of Social Workers, 38(3), 147-157. doi: 10.1093/hsw/hlt013
Archer, T., Oscar-Berman, M., Blum, K., & Gold, M. (2013). Epigenetic modulation of
mood disorders. Journal of Genetic Syndromes and Gene Therapy, 4. doi:
10.4172/2157-7412.1000120
Baglivio, M. T., Wolff, K. T., Piquero, A. R., & Epps, N. (2015). The relationship
between adverse childhood experiences (ACE) and juvenile offending trajectories 61
in a juvenile offender sample. Journal of Criminal Justice, 43, 229-241. doi:
10.1016/j.jcrimjus.2015.04.012
Bailey, Z. D., Krieger, N., Agénor, M., Graves, J, Linos, N., & Bassett, M. T. (2017).
Structural racism and health inequities in the USA: evidence and interventions.
The Lancet, 389, 1453-1463.
Barrett, D. E., Katisyannis, A., Zhang, D., & Zhang, D. (2014). Delinquency and
recidivism: A multicohort, matched-control study of the role of early adverse
experiences, mental health problems, and disabilities. Journal of Emotional and
Behavioral Disorders, 22(1), 3-15. doi: 10.1177/1063426612470514
Bazemore, G., & Griffiths, C. (1997). Conferences, circles, boards, and mediations: The
“new wave” of community justice decision making. Federal Probation, 61(2), 25-
37.
Bazemore, G., & Umbreit, M. (2001). A comparison of four restorative conferencing
models (Juvenile Justice Bulletin). Washington, DC: U.S. Department of Justice,
Office of Juvenile Justice and Delinquency Prevention.
Beekhoven, S., & Dekkers, H. (2005). Early schools leaving in the lower vocational
track: Triangulation of qualitative and quantitative data. Adolescence, 40, 197-
210.
Bergseth, K. J., & Bouffard, J. A. (2007). The long-term impact of restorative justice
programming for juvenile offenders. Journal of Criminal Justice, 35, 433-451.
doi: 10.1016/j.jcrimjus.2007.05.006
Bergseth, K. J., & Bouffard, J. A. (2012). Examining the effectiveness of a restorative
justice program for various types of juvenile offenders. International Journal of 62
Offender Therapy and Comparative Criminology, 57(9), 1054-1075. doi:
10.1177/0306624X12453551
Bird, A. (2002). DNA methylation patterns and epigenetic memory. Genes and
Development, 16, 6-21. doi: 10.1101/gad.947102
Bishop, A. (2002) Becoming an ally: Breaking the cycle of oppression in people (2nd
ed.). Halifax: Fernwood.
Blessett, B. (2015). Disenfranchisement: Historical underpinnings and contemporary
manifestations. Public Administration Quarterly, 39(1), 3-50.
Booij, L., Wang, D., Levesque, M. L., Tremblay, R. E., & Szyf, M. (2013) Looking
beyond the DNA sequence: The relevance of DNA methylation processes for the
stress-diathesis model of depression. Philosophical Transactions of the Royal
Society of London, Series B, Biological Sciences, 368, doi:
10.1098/rstb.2012.0251
Boyes-Watson, C. (2005). Seeds of change: Using peacemaking circles to build a village
for every child. Child Welfare, 84, 191-208.
Braithwaite, J. (1989). Crime, shame, and reintegration. Cambridge, UK: Cambridge
University.
Braithwaite, J. (2002). Restorative justice and response regulation. New York: Oxford
University Press.
Brody, G. H., Ge, X., Kim, S. Y., Murry, V. M., Simons, R. L., Gibbons, F. X., et al.
(2003). Neighborhood disadvantage moderates associations of parenting and older
sibling problem attitudes and behavior with conduct disorders in African
American children. Journal of Consulting and Clinical Psychology, 71, 211-222. 63
Brooks, K., Schiraldi, V., & Ziedenberg, J. (2000). School house hype: Two years later.
Washington, DC: Justice Policy Institute.
Brooks-Gunn, J., & Duncan, G. J. (1997). The effects of poverty on children. The Future
of Children: Children and Poverty, 7(2), 55-71.
Buchele, B. (2000). Group psychotherapy for survivors of sexual abuse and physical
abuse. In R. Klein & V. Schermer (Eds.), Group psychotherapy for psychological
trauma. New York: Guilford.
Camilleri, V. A. (2007). Challenges faced by at-risk children in the inner city. In V. A.
Camilleri (Ed.), Healing the inner city child: Creative arts therapies with at-risk
youth (pp. 21-40). Philadelphia: Jessica Kingsley Publishers.
Carrion, V. G., Weems, C. F., & Reiss, A. L. (2007). Stress predicts brain changes in
children: A pilot longitudinal study on youth stress, posttraumatic stress disorder,
and the hippocampus. Pediatrics, 119(3), 509-515. doi: 10.1542/peds.2006-2028
Carruthers, E. (2014). Safety, connection, foundation: Single-session individual music
therapy with adolescents. Canadian Journal of Music Therapy, 20(2), 43-63.
Carter, P. L., Fine, M., & Russell, S. (2014). Discipline disparities overview. Discipline
Disparities: A Research-to-Practice Collaborative. The Equity Project at Indiana
University, Center for Evaluation and Education Policy, Bloomington, IN.
Cassity, M., & Cassity, J. (2006). Multimodal psychiatric music therapy for adults,
adolescents, and children: A clinical manual (3rd ed.). London, England: Jessica
Kingsley. 64
Centers for Disease Control and Prevention. (2016, June 14). About the CDC-Kaiser ACE
study. Retrieved from
https://www.cdc.gov/violenceprevention/acestudy/about.html
Chao, R. C., Longo, J., Wang, C., Dasgupta, D. & Fear, J. (2014). Perceived racism as
moderator between self-esteem/shyness and psychological distress among African
Americans. Journal of Counseling & Development, 92, 259-269. doi:
10.1002/j.1556-6676.2014.00154.x
Children’s Defense Fund. (2017). Every day in America. Retrieved from
http://www.childrensdefensefund.org/child-research-data-publications/each-day-
in-america.html
Clark, B. A., Roth, E. A., Wilson, B. L., Koebel, C. (2013) Music therapy practices with
high-risk youth: A clinician survey. Canadian Journal of Music Therapy, 19(1),
66-83.
Cochran-Smith, M. (1998). Color blindness and basket making are not the answers:
Confronting the dilemmas of race, culture, and language diversity in teacher
education. American Educational Journal, 32(3), 493-522.
Cohen-Woods, S., Craigh, I. W., & McGuffin, P. (2013) The current state of play on the
molecular genetics of depression. Psychological Medicine, 43, 673-687. doi:
10.1017/S0033291712001286
Coleman-Jensen, A., Nord, M., & Singh, A. (2013). Household food security in the
United States in 2012. U. S. Department of Agriculture: Economic Research
Service. http://www.ers.usda.gov/publications/err-economic-research-
report/err155.aspx#U1g7Vf3zilI 65
Coleman-Jensen, A., Rabbitt, M. P., Gregory, C., & Singh, A. (2015). Household food
security in the United States in 2014. U.S. Department of Agriculture: Economic
Research Service. http://www.ers.usda.gov/publications/err-economic-research-
report/err194.aspx
Corcoran, M. (1995). Rags to rags: Poverty and mobility in the United States. Annual
Review of Sociology, 21, 237-267.
Danchin, E., Charmantier, A., Champagne, F. A., Mesoudi, A., Pujol, B., & Blanchet, S.
(2011). Beyond DNA: Integrating inclusive inheritance into an extended theory of
evolution. Nature Reviews, Genetics, 12, 475-486. doi: 10.1038/nrg3028
Danese, A., & McEwen, B. S. (2012). Adverse childhood experiences, allostasis,
allostatic load, and age-related disease. Physiology & Behavior, 106(1), 29-39.
doi: 10.1016/j.psyhsbeh.2011.08.019
Dashiff, C., DiMicco, W., Myers, B., & Sheppard, K. (2009). Poverty and adolescent
mental health. Journal of Child and Adolescent Psychiatric Nursing, 22(1), 23-32.
Davis, T. (2013). School counseling. In D. Capuzzi & D. R. Gross (Eds.), Introduction to
the counseling profession (6th ed., pp. 445-470). New York, NY: Routledge.
Denenberg, V. H., & Rosenberg, K. M. (1967) Nongenetic transmission of information.
Nature, 216, 549-550.
Donnenwerth, A. M. (2012). Song communication using rap music in a group setting
with at-risk youth. In S. Hadley & G. Yancey (Eds.), Therapeutic uses of rap and
hip-hop (pp. 275-290). New York, NY: Routledge.
Dube, S. R., Felitti, V. J., Dong, M., Giles, W. H., & Anda, R. F. (2003). The impact of
adverse childhood experiences on health problems: Evidence from four birth 66
cohorts dating back to 1900. Preventive Medicine, 37(3), 268-277. doi:
10.1016/S0091-7435(03)00123-3
Duncan, G. J., & Brooks-Gunn, J. (1997). Welfare’s new rules: A pox on children.
Retrieved January 4, 2018, from http://www.issues.org/14.2/duncan/
Dynarski, M., & Gleason, P. (2002). How can we help? What we have learned from
recent federal dropout prevention evaluations. Journal of Education for Students
Placed at Risk, 7, 43-69.
Elder, G. H. Jr., Eccles, J. S., Ardelt, M., & Lord, S. (1995). Inner-city parents under
economic pressure: Perspectives on the strategies of parenting. Journal of
Marriage and Family, 57, 771-784.
Elligan, D. (2012). Contextualizing rap music as a means of incorporating into
psychotherapy. In S. Hadley & G. Yancey (Eds.), Therapeutic uses of rap and
hip-hop (pp. 27-38). New York, NY: Routledge.
Evans-Chase, M. (2014). Addressing trauma and psychosocial development in juvenile
justice-involved youth: A synthesis of the developmental neuroscience, juvenile
justice and trauma literature. Laws, 3, 744-758. doi: 10.3390/laws3040744
Fergusson, D. M., Woodward, L. J., & Horwood, L. J. (2000). Risk factors and life
processes associated with the onset of suicidal behavior during adolescence and
early adulthood. Psychological Medicin, 30, 23-39.
Fine, M. (1986). Why urban adolescents drop into and out of public high school.
Teachers College Record, 87, 393-405.
Fish, E. W., Shahrokh, D., Bagot, R., Caldji, C., Brady, T., Szyf, M., & Meaney, M. J.
(2004). Epigenetic programming of stress responses through variations in 67
maternal care. Annals of the New York Academy of Sciences, 1036, 167-180. doi:
10.1196/annals.1330.011
Flowers, L. R., & Hermann, M. A. (2008). “This isn’t the place for me”: School dropout.
In D. Capuzzi & D. R. Gross (Eds.), Youth at risk: A prevention resource for
counselors, teachers, and parents (5th ed., pp. 457-478). Alexandria, VA:
American Counseling Association.
Foote, C. J. (2005). The challenge and potential of high-need urban education. Journal of
Negro Education, 74(4), 371-381.
Forrest-Bank, S. S., Nicotera, N., Bassett, D. M. & Ferrarone, P. (2016). Effects of an
expressive art intervention with urban youth in low-income neighborhoods. Child
and Adolescent Social Work Journal, 33, 429-441. doi: 10.1007/s10560-016-
0439-3
Galea, S., Uddin, M., & Koenen, K. (2011). The urban environment and mental
disorders. Epigenetics, 6(4), 400-404, doi: 10.4161/epi.6.4.14944
Gay, G. (2000). Culturally responsive teaching: Theory, research, and practice. New
York, NY: Teachers College Press.
Garnier, H. E., Stein, J. A., & Jacobs, J. K. (1997). The process of dropping out of high
school: A 19-year perspective. American Educational Research Journal, 34, 395-
419.
Gee, G. C., & Ford, C. L. (2011). Structural racism and health inequities. Du Bois
Review, 8, 115-132. doi: 10.1017/S1742058X11000130
Gibbons, J. L. (1964). Cortisol secretion rate in depressive illness. Archives of General
Psychiatry, 10, 572-575. doi: 10.1001/archpsyc.1964.01720240026004 68
Gross, D. R., & Capuzzi, D. (2014). Defining youth at risk. In D. Capuzzi & D. R. Gross
(Eds.) Youth at risk: A prevention resource for counselors, teachers, and parents.
Alexandria, VA: American Counselling Association.
Gundersen, C., Kreider, B., & Pepper, J. (2012). The impact of the National School
Lunch Program on child health: A nonparametric bounds analysis. Journal of
Econometrics, 166, 79-91.
Heitzeg, N. A. (2014). Criminalizing education: Zero tolerance policies, police in the
hallways, and the school to prison pipeline. In A. J. Nocella II, P. Parmar, & D.
Stovall (Eds.), From education to incarceration: Dismantling the school-to-prison
pipeline. New York: Peter Lang.
Hirschfield, P. J. (2010). School surveillance in America: Disparate and unequal. In T.
Monahan & R. D. Torres (Eds.), Schools under surveillance: Cultures of control
in public education. New Brunswick, NJ: Rutgers University Press.
Hughes, M., Kiecolt, K. J., Keith, V. M., & Demo, D. H. (2015). Racial identity and
well-being among African Americans. Social Psychology Quarterly, 78(1), 25-48.
doi: 10.1177/0190272514554043
Holliday, R., & Pugh, J. E. (1975). DNA modification mechanisms and gene activity
during development. Science, 187, 226-232.
Ierardi, F., & Jenkins, N. (2012). Rap composition and improvisation in a short-term
juvenile detention facility. In S. Hadley & G. Yancey (Eds.), Therapeutic uses of
rap and hip-hop (pp. 253-274). New York, NY: Routledge.
Jenson, J. M., & Fraser, M. W. (2011). Social policy for children and families: A risk and
resilience perspective. Thousand Oaks: Sage. 69
Jimerson, S. R., Anderson, G. E., & Whipple, A. D. (2002). Winning the battle and losing
the war: Examining the relation between grade retention and dropping out of
school. Psychology in the Schools, 39, 441-457.
Joint Center for Housing Studies. (2011). America’s rental housing: Meeting challenges,
building on opportunities. Harvard University.
http://www.jchs.harvard.edu/sites/jchs.harvard.edu/files/americasrentalhousing-
2011.pdf
Jones, V. (1996). Classroom management. In J. Sikula, T. Buttery, & E Guiton (Eds.),
Handbook of Research on Teacher Education. New York: Macmillan.
Kang-Brown, J., Trone, J., Fratello, J., & Daftary-Kapur, T. (2013). A generation later:
What we’ve learned about zero tolerance in schools. New York, NY: Vera
Institute of Justice, Center on Youth Justice.
Karanth, S., Linthorst, A. C., Stalla, G. K., Barden, N., Holsboer, F., & Reul, J. M.
(1997). Hypothalamic-pituitary-adrenocortical axis changes in a transgenic mouse
with impaired glucocorticoid receptor function. Endocrinology, 138(8), 3476-
3485. doi: 10.1210/endo.138.8.5331
Keyes, C. L. (1996). At the crossroads: Rap music and its African nexus.
Ethnomusicology, 40(2), 110-125.
Keyes, C. L. (2002). Rap music and street consciousness. Chicago: University of Illinois
Press.
Kingston, B. E., Mihalic, S. F., & Sigel, E. J. (2016). Building an evidence-based
multitiered system of supports for high-risk youth and communities. American
Journal of Orthopsychiatry, 86(2), 132-143. doi: 10.1037/ort0000110 70
Koball, H., & Douglas-Hall. (2003) Where do children in low-income families live?
National Center for Children in Poverty. New York, NY: Columbia University
School of Public Health.
Kozol, J. (2005). The shame of the nation: The restoration of apartheid schooling in
America. New York: Three Rivers Press.
Kreider, B., Pepper, J., Gundersen, C., & Jolliffe, D. (2012). Identifying the effects of
SNAP (food stamps) on child health outcomes when participation is endogenous
and misreported. Journal of the American Statistical Association, 107(499), 958-
975.
Kreider, B., Pepper, J., & Roy, M. (2016). Identifying the effects of WIC on food
insecurity among infants and children. Southern Economic Journal, 82(4), 1004-
1122.
Krieger, N. (2014). Discrimination and health inequities. International Journal of Health
Services, 44(4), 643-710. doi: 10.2190/HS.44.4.b
Kupchik, A. (2010). Homeroom security: School discipline in an age of fear. New York:
New York University Press.
Kupchik, A., & Monahan, T. (2006). The new American school: Preparation for post-
industrial discipline. British Journal of Sociology of Education, 27, 617-632.
Kushel, M. B., Gupta, R., Gee, L., Haas, J. S. (2006). Housing instability and food
insecurity as barriers to health care among low-income Americans. Journal of
General Internal Medicine, 21(1), 71-77. 71
Laird, E., & Trippe, C. (2014). Programs conferring categorical eligibility for SNAP:
State policies and the number of characteristics of households affected.
Mathematica Policy Research.
Levy, D., Pendalls, R., Abravanel, M., & Biess, J. (2012). Housing programs in the
United States responding to current and future challenges. Bipartisan Policy
Center. http://www.bipartisanpolicy.org/library/report/housing-programs-united-
states-responding-current-and-future-challenges/
Levy-Pounds, N. (2014). Warehousing, imprisoning, and labelling youth “minorities”. In
A. J. Noceslla II, P. Parmar, & D. Stovall (Eds.), From education to
incarceration: Dismantling the school-to-prison pipelines (pp. 131-144). New
York: Peter Lang.
Lightstone, A. J. (2012). The importance of hip-hop for music therapists. In S. Hadley &
G. Yancey (Eds.), Therapeutic uses of rap and hip-hop (pp. 39-56). New York,
NY: Routledge.
Lightstone, A. J. (2012). Yo, can ya flow! Research findings on hip-hop aesthetics and
rap therapy in an urban youth shelter. In S. Hadley & G. Yancey (Eds.),
Therapeutic uses of rap and hip-hop (pp. 211-252). New York, NY: Routledge.
Logan-Greene, P., Tennyson, R. L., Nurius, P. S., Borja, S. (2017) Adverse childhood
experiences, coping resources, and mental health problems among court-involved
youth. Child Youth Care Forum, 46, 923-946. doi: 10.1007/s10566-017-9413
MacDonald, S., & Viega, M. (2012). Hear Our Voices: A music therapy songwriting
program and the message of the Little Saints through the medium of rap. In S. 72
Hadley & G. Yancey (Eds.), Therapeutic uses of rap and hip-hop (pp. 153-171).
New York, NY: Routledge.
Masten, A. S. (2001). Ordinary magic: Resilience processes in development. American
Psychologist, 56(3), 227-238. doi: 10.1037/0003-066X.56.3.227
Mallett, C. (2007). Death is not different: The transfer of juvenile offenders to adult
criminal courts. Criminal Law Bulletin, 43, 523-547.
Mallett, C. A. (2015) The school-to-prison pipeline: A critical review of the punitive
paradigm shift. Child and Adolescent Social Work Journal, 33, 15-24. doi:
10.1007/s10560-015-0397-1
Marsh, S. (2014). School pathways to juvenile justice system project. Reno, NV: National
Council of Juvenile and Family Court Judges.
McFerran, K. (2010). Adolescents, music and music therapy: Methods and techniques for
clinicians, educators and students. London, England: Jessica Kingsley.
McFerran, K. (2012). “Just so you know, I miss you so bad”: The expression of life and
loss in the raps of two adolescents in music therapy. In S. Hadley & G. Yancey
(Eds.), Therapeutic uses of rap and hip-hop (pp. 173-190). New York, NY:
Routledge.
McFerran-Skewes, K. (2000). From the mouths of babes: The response of six younger,
bereaved teenagers to the experience of psychodynamic group music therapy. The
Australian Journal of Music Therapy, 11, 3–22.
McGowan, P. O., Sasaki, A., D’Alessio, A. C., Dymov, S., Labonte, B., Szyf, M., . . .
Meaney, M. J. (2009) Epigenetic regulation of the glucocorticoid receptor in 73
human brain associates with childhood abuse. Nature Neuroscience, 12(3), 342-
348. doi: 10.1038/nn.2270
McLeod, J. D., & Shanahan, M. J. (1996). Trajectories of poverty and children’s mental
health. Journal of Health and Social Behavior, 37, 207-220.
McWhirter, J. J., McWhirter, B. T., McWhirter, A. M., & McWhirter, E. H. (1998). At-
risk youth: A comprehensive response. Pacific Grove, California: Brooks/Cole
Publishing Company.
Minga, T. (1988). States and the “at-risk” issues: Said aware but still “failing.” Education
Week, 8, 1-16.
Molyneux, C. (2005). Music therapy as a short-term intervention with individuals and
families in a child and adolescent mental health service. British Journal of Music
Therapy, 19(2), 59-66.
Muschert, G. W., Henry, S., Bracy, N. L., & Peguero, A. A. (2014). Responding to school
violence: Confronting the Columbine effect. Boulder, CO: Lynne Rienner
Publishers Inc.
Neiman, S., & DeVoe, J. F. (2009). Crime, violence, discipline, and safety in US public
schools: Findings from the school survey on crime and safety. Washington, DC:
U.S. Department of Education.
Nord, M., Andrews, M., & Carlson, S. (2009). Household food security in the United
States, 2008. U.S. Department of Agriculture: Economic Research Service.
http://www.ers.usda.gov/publications/eib-economic-information-
bulletin/eib137.aspx 74
Oberlander, T. F., Weinberg, J., Papsdorf, M., Grunau, R., Misri, S., & Devlin, A. M.
(2008) Prenatal exposure to maternal depression, neonatal methylation of human
glucocorticoid receptor gene (NR3C1) and infant cortisol stress responses.
Epigenetics, 3(2), 97-106.
Odell, L. K. (2007). SOHO – Space of her own: Creating community through art with
children on Chicago’s South Side. In V. A. Camilleri (Ed.), Healing the inner-city
child: Creative arts therapies with at-risk youth (pp. 145-163). Philadelphia:
Jessica Kingsley Publishers.
Oliveira, V. (2015). The food assistance landscape: FY 2014 annual report (EIB-137).
U.S. Department of Agriculture: Economic Research Service.
http://www.ers.usda.gov/publications/eib-economic-information-
bulletin/eib137.aspx
Omi, M., & Winant, H. (2015). Racial formation in the United States. New York, NY:
Routledge.
Pasiali, V. (2012). Resilience, music therapy, and human adaptation: Nurturing young
children and families. Nordic Journal of Music Therapy, 20(1), 36-56. doi:
10.1080/08098131.2011.571276
Petrosino, A., Turpin-Petrosino, C., & Guckenburg, S. (2010). Formal system processing
on juveniles: Effects on delinquency. Washington, D.C.: U.S. Department of
Justice, Office of Community Oriented Policing Services.
Purtle, J. (2013). Felon disenfranchisement in the United States: A health equity
perspective. American Journal of Public Health, 103(4), 632-637. doi:
10.2105/AJPH.2012.300933 75
Radtke, K. M., Ruf, M., Gunter, H. M., Dohrmann, K., Schauer, M., Meyer, A., & Elbert,
T. (2011). Transgenerational impact of intimate partner violence on methylation
in the promoter of the glucocorticoid receptor. Translational Psychiatry, 1, e21.
doi: 10.1038/tp.2011.21
Reschly, A. L., & Christenson, S. L. (2006). School completion. In G. G. Bear & K. M.
Mike (Eds.), Children’s needs III: Development, prevention, and intervention (pp.
103-113). Washington, DC: National Association of School Psychologists.
Richardson Jr., J. B., & Van Brakle, M. (2013). The everyday struggle: Social capital,
youth violence, and parenting strategies for urban, low-income black male youth.
Race and Social Problems, 5, 262-280. doi: 10.1007/s12552-013-9103-0
Roberts, M. (2006). “I want to play and sing my story”: Home-based songwriting for
bereaved children and adolescents. Australian Journal of Music Therapy, 17, 18-
34.
Rodriguez, N. (2007). Restorative justice at work: Examining the impact of restorative
justice resolutions on juvenile recidivism. Crime & Delinquency, 53(3), 355-379.
doi: 10.1177/0011128705285983
Rose, T. (1994). Black noise: Rap music and Black culture in contemporary America.
London: Wesleyan University Press.
Ruddy, S. A., Bauer, L., Neiman, S., Hryczaniuk, C. A., Thomas, T., & Parmer, R. J.
(2010). 2007-08 school survey on crime and safety (SSOCS): Survey
documentation for restricted-use data file uses. Washington, DC: U.S. Department
of Education. 76
Rumberger, R. W. (1993). Chicano dropouts: A review of research and policy issues. In
R. Valencia (Ed.), Chicano school failure and success: Research and policy
agendas for the 1990’s (pp. 64-89). London, England: Falmer Press.
Sagrestano, L. M., Holmbeck, G. N., Paikoff, R. L., & Fendrich, M. (2003). A
longitudinal examination of familial risk factors for depression among inner-city
African American adolescents. Journal of Family Psychology, 17, 108-120.
Salaam, M. (1995). The aesthetics of rap. African American Review, 29(2), 89-97.
Schneck, D. J. & Berger, D. (2006). The music effect: Music physiology and clinical
applications. Philadelphia: Jessica Kingsley Publishers.
Search Institute. (2014, August 29). Our Youth Are At-Promise, Not At-Risk. Retrieved
from http://www.sustainability.ucsb.edu/at-promise-youth/
Sellers, B. G. (2014). Community-based recovery and youth justice. Criminal Justice and
Behavior, 42(1), 58-69. doi: 10.1177/0093854814550027
Smart, C., Strathdee, G., Watson, S., Murgatroyd, C., & McAllister-Williams, R. H.
(2015). Early life trauma, depression and the glucocorticoid receptor gene – an
epigenetic perspective. Psychological Medicine, 45, 3393-3410. doi:
10.1017/S0033291715001555
Smith, W. A. (2008). Everyone but Rizzo: using the arts to transform communities.
Forum on Public Policy: A Journal of the Oxford Round Table. Retrieved from
http://link.galegroup.com.ezproxy2.library.drexel.edu/apps/doc/A218606554/AO
NE?u=drexel_main&sid=AONE&xid=474ce1eb
Stern, S. B., Smith, C. A., & Jang, S. J. (1999). Urban families and adolescent mental
health. Social Work Research, 23, 15-27. 77
Sue, D. W., & Sue, D. (2016). Counseling the culturally diverse: Theory and practice
(7th ed.). Hoboken, NJ: John Wiley & Sons, Inc.
Sullivan, P. F., Neale, M. C., & Kendler, K. S., (2000). Genetic epidemiology of major
depression: Review and meta-analysis. American Journal of Psychiatry, 157,
1552-1562. doi: 10.1176/appi.ajp.157.10.1552
Teplin, L. A., Abram, K. M., McClelland, G. M., Dulcan, M. K., & Mericle, A. A.
(2002). Psychiatric disorders in youth in juvenile detention. Archives of General
Psychiatry, 59(12), 1133-1143. doi: 10.1001/archpsych.59/12/1133
Teplin, L. A., McClelland, G. M., Abram, K. M., & Mileusnic, D. (2005). Early violent
death among delinquent youth: A prospective longitudinal study. Pediatrics,
115(6), 1586-1593.
Tolan, P. H., Gorman-Smith, D., Huesmann, L. R., & Zelli, A. (1997). Assessment of
family relationship characteristics: A measure to explain risk for antisocial
behavior and depression among urban youth. Psychological Assessment, 9, 212-
223.
Tyler, T. (1990). Why people obey the law. New York, NY: Russell Sage Foundation.
Tyson, E. (2002). Hip hop therapy: An exploratory study of a rap music intervention with
at-risk and delinquent youth. Journal of Poetry Therapy, 15(3), 131-144.
Uhlig, S. (2011). From violent rap to lovely blues: The transformation of aggressive
behavior through vocal music therapy. In A. N. Meadows (Ed.), Developments in
music therapy practices: Case studies (pp. 182-197). New Braunfels: Barcelona
Publishers. 78
Umbreit, M. S., Coates, R. B., & Vos, B. (2004). Victim-offender mediation: Three
decades of practice and research. Conflict Resolution Quarterly, 22, 279-303.
Verdugo, R. R. (2002). Race-ethnicity, social class, and zero-tolerance policies: The
cultural and structural wars. Education and Urban Society, 35, 50-75.
Viega, M. (2015). Exploring the discourse in hip hop and implications for music therapy
practice. Music Therapy Perspectives, 34(2), 138-146. doi: 10.1093/mtp/miv035
Weaver, I. C., Cervoni, N., Champagne, F. A., D’Alessio, A. C., Sharma, S., Seckle, J.
R., . . . Meaney, M. J. (20014). Epigenetic programming by maternal behavior.
Nature Neuroscience, 7, 847-854. doi: 0.1038/nn1276
Werner, S. L., & Smith, R. S. (1992). Overcoming the odds: High risk children from
birth to adulthood. Ithaca: Cornell University Press.
Wolff, K. T., & Baglivio, M. T. (2017). Adverse childhood experiences, negative
emotionality, and pathways to juvenile recidivism. Crime & Delinquency, 63(12),
1495-1521. doi: 10.1177/0011128715627469
Wood, W. R. (2015). Soliciting community involvement and support for restorative
justice through community service. Criminal Justice Policy Review, 26(2), 131-
155. doi: 10.1177/0887403413499580
Zanders, M. L. (2012). The musical and personal biographies of adolescents with foster
care experience. Qualitative Inquiries in Music Therapy, 7, 71-109.
Zanders, M. L. (2015). Music therapy practices and processes with foster-care youth:
Formulating an approach to clinical work. Music Therapy Perspectives, 33(2), 97-
107. doi: 10.1093/mtp/miv028 79
Zehr, H., & Mika, H. (1997). Fundamental concepts of restorative justice. Contemporary
Justice Review: Issues in Criminal, Social, and Restorative Justice, 1(1), 47-56.
Zehr, H. (2002). The little book of restorative justice. Intercourse, PA: Good Books.
Retrieved from http://www.unicef.org/tdad/littlebookrjpakaf.pdf
Zeichner, K. M., & Hoeft, K. (1996). Teacher socialization for cultural diversity. In J.
Sikula, T. Buttery, & E. Guyton (Eds.), Handbook of research on teacher
education. New York, NY: Macmillan.
Zinn, H. (2015). A people’s history of the United States: 1492- present. New York, NY:
Harper Perennial.