Dance holds value as a cathartic, therapeutic act.1 Dance and movement therapies may help reduce symptoms of several medical conditions and aid overall motor functioning. Studies have shown that they have been used to improve gait and balance in patients with Parkinson disease.2,3
Many theorists believe in the psychological healing power of dance/movement therapies, and researchers have begun to examine the ability of these therapies to enhance well-being and quality of life. Their findings suggest that dance fosters a sense of well-being, community, mastery, and joy.3-8 Bräuninger found that a 10-week dance/movement intervention reduced stress and improved social relations, general life satisfaction, and physical and psychological health.9 Other research has shown that subjective well-being is maintained through dance in elderly adults.10,11
Dance/movement also has been found helpful in reducing symptoms associated with several psychiatric conditions. Kline and colleagues reported that movement therapy reduced anxiety in populations with severe mental illness.12 Koch and colleagues found larger reductions on depression measures and higher vitality ratings in a dance intervention group compared with music-only and exercise groups.13 An approach integrating yoga and dance/movement was found to improve stress-management skills in people affected by several mental illnesses.14
Compared with the amount of data demonstrating that dance and movement are helpful treatment modalities for psychiatric conditions, there is relatively little empirical evidence that dance or movement is effective in treating posttraumatic stress disorder (PTSD). This is particularly surprising given the somatic or bodily nature of PTSD. Traumatic events trigger significant bodily reactions—flight, fight, or freeze reactions—and PTSD involves reexperiencing bodily sensations, such as hypervigilance, agitation, and elevated arousal.15 Although dance/movement has consistently been used to treat PTSD, the evidence for its effectiveness comes mainly from case studies.16 Further empirical studies are needed to determine whether dance/movement therapies are effective in treating PTSD.
Recently, as part of the VHA patient-centered, innovative care initiative, efforts have been made to augment treating disease with improving wellness and health. For example, the VA Greater Los Angeles Healthcare System (VAGLAHS) has supported Dance for Veterans (DFV), a dance/movement program that uses movement, creativity, relaxation, and social cohesion to treat veterans with serious mental illnesses. In a recent VAGLAHS study of the effect of DFV on patients with chronic schizophrenia, bipolar disorder, major depression, PTSD, and other serious mental illnesses, Wilbur and colleagues found a 25% decrease in stress, self-rated at the beginning and end of each class; in addition, veterans indicated they received long-term benefits from taking the class.17
This pilot study investigated the effectiveness of DFV as an adjunctive treatment for PTSD. The goal of the study was to assess whether the dance class helped reduce stress symptoms in veterans diagnosed with PTSD. As rates of PTSD are much higher in veterans than in the general population, the VA has taken particular interest in the diagnosis and has prioritized treatment of this disorder.18
Toward that end, the VA began a wide-scale national dissemination of 2 empirically validated PTSD-specific treatments: prolonged exposure therapy and cognitive processing therapy. These evidence-based therapies produce clinically significant reductions in PTSD symptoms among veterans.19,20 Nevertheless, concern exists about the dropout rates and tolerability of these manualized trauma-focused treatments.19,21 Patient-centered, integrative treatments are considered less demanding and more enjoyable, but there is little evidence of their effectiveness in PTSD treatment. The VA Los Angeles Ambulatory Care Center (LAACC) had been using DFV as an adjunct treatment for veterans diagnosed with PTSD. This pilot study examined whether participating in the program reduced veterans’ stress levels.
Methods
Development of DFV was a collaborative effort of members of the department of psychiatry at VAGLAHS, dancers in the community, and graduate students in the department of World Arts and Cultures/Dance at the University of California, Los Angeles (UCLA). The first class, in January 2011, was offered to patients in the Psychosocial Rehabilitation and Recovery Program at the West Los Angeles campus of VAGLAHS. The program quickly spread to LAACC, the Sepulveda Ambulatory Care Center, the East Los Angeles Clinic, and other VAGLAHS campuses.
The goals of DFV were to introduce techniques for stress management, enhance participants’ commitment to self-worth, increase participants’ faith in their physical capabilities, encourage focus and self-discipline, build confidence, have participants discover the value of learning new skills, challenge participants to use a variety of learning styles (eg, kinesthetic, aural, musical, visual), create opportunities for active watching and listening, decrease feelings of isolation, improve group (social) and personal awareness, cultivate expressive and emotional range, develop group trust, and improve large and small muscle coordination.22