Dance therapy

Marian Chace spearheaded the movement of dance in the medical community as a form of therapy. She is considered the principal founder of what is now dance therapy in the United States.[10] In 1942, through her work, dance was first introduced to western medicine. Chace was originally a dancer, choreographer, and performer. After opening her own dance school in Washington, D.C., Chace began to realize the effects dance and movement had on her students.[11] The reported feelings of wellbeing from her students began to attract the attention of the medical community, and some local doctors began sending patients to her classes. She was soon asked to work at St. Elizabeth’s Hospital in Washington, D.C. once psychiatrists too realized the benefits their patients were receiving from attending Chace’s dance classes.[12] In 1966 Chace became the first president of the American Dance Therapy Association, an organization which she and several other DMT pioneers founded.[11] According to the ADTA, dance is "the psychotherapeutic use of movement as a process which furthers the emotional, social, cognitive, and physical integration of the individual."

The second wave of Dance Movement Therapy came around the 1970s to the 1980s and it sparked much interest from American therapists. During this time, therapists began to experiment with the psychotherapeutic applications of dance and movement. As a result of the therapists' experiments, DMT was then categorized as a form of psychotherapy. It was from this second wave that today’s Dance Movement Therapy evolved.[11]

Various hypothesis have been proposed for mechanisms by which dance therapy may benefit participants. There is a social component to dance therapy, which can be valuable for psychological functioning through human interaction. Another possible mechanism is the music that is used during the session, which may be able to reduce pain, decrease anxiety, and increase relaxation. Since dance requires learning and involves becoming active and discovering capacities for movement, there is also the physical training that could provide benefits as well. Dancing may be considered more uplifting and enjoyable than other types of exercise. Dance therapy can also involve nonverbal communication, "which enables participants to express their feelings without words. This might be helpful when normal communication is absent or has broken down (eg, for patients with dementia)."[17]

A Cochrane review entitled Dance therapy for schizophrenia in 2013[18] concluded:

"Overall, because of the small number of participants, the findings are limited. There is little evidence to support or refute the use of dance therapy. Larger studies and trials are needed that focus on important outcomes (such as rates of relapse, quality of life, admission to hospital, leaving the study early, cost of care and satisfaction with treatment). Further research would help clarify whether dance therapy is an effective and holistic treatment for people with schizophrenia, especially in terms of helping people cope with negative symptoms that do not respond so well to antipsychotic drugs."

A review by the Cochrane Collaboration entitled Dance/movement therapy for cancer patients was updated in January 2015[19] to say:

"The three studies included a total of 207 participants, which were women with breast cancer. The studies were small in size. We found no evidence of an effect for depression, stress, anxiety, fatigue, and body image. The findings of individual studies suggest that dance/movement therapy may have a beneficial effect on the quality of life, somatization (i.e. distress arising from perceptions of bodily dysfunction) and vigor of women with breast cancer. No adverse effects of dance/movement therapy interventions were reported."

The most recent Cochrane review for DMT was in February 2015 entitled Is dance movement therapy an effective treatment for depression? A review of the evidence.[20] The findings stated:

"Due to the low number of studies and low quality of evidence, it was not possible to draw firm conclusions about the effectiveness of DMT for depression. It was not possible to compare DMT with medication, talking therapies, physical treatments or to compare types of DMT due to lack of available evidence. Key findings were:

Overall, there is no evidence for or against DMT as a treatment for depression. There is some evidence to suggest DMT is more effective than standard care for adults, but this was not clinically significant. DMT is no more effective than standard care for young people.

Evidence from just one study of low methodological quality suggested that drop-out rates from the DMT group were not significant, and there is no reliable effect in either direction for quality of life or self esteem. A large positive effect was observed for social functioning, but since this was from one study of low methodological quality the result is imprecise."

One review of the effect of DMT on Parkinson's disease noted that there have been few studies in this area. DMT appears to meet most requirements for exercise programs for patient's with Parkinson's. Benefits in gait function, balance, and quality of life were found in short-term studies, though further studies need to be done to see if any of these benefits are seen long-term.[21]

The latest Cochrane review entitled Dance Movement Therapy for Dementia published in 2017 concluded that there we no high quality trials to assess the effect of DMT on behavioural, social, cognitive and emotional symptoms in people with dementia.[22]

Research has found that using dance movements as a form of therapy activates several brain functions at once: kinesthetic, rational, musical, and emotional. This type of movement requires mental, physical, and emotional strength to work simultaneously.[23] In one research study, senior citizens were placed in a 21-year study to see if any physical or cognitive recreational activity influenced mental acuity. Researchers monitored rates of dementia in the elderly participants. The study included cognitive activities such as reading books, doing crossword puzzles, and playing musical instruments and physical activities such as golf, walking for exercise, and dancing. Results showed that almost none of the physical activities appeared to offer any defense against dementia. The activity with the highest percentage of protection against dementia was dancing frequently (76%). It was the greatest risk reduction of any activity studied, cognitive or physical. This is because dance therapy combines multiple areas of the brain to work together at once rather than just stimulating one area at a time.

Dance movement therapy is found to have beneficial results on children who have been abused. Research has found that this therapy is a useful form of support and intervention for these children.[24] Through a case study with a sexually abused female, the researcher stated that the individual felt a sense of empowerment after the dance therapy sessions and reported greater success in school. The individual also felt a stronger sense of self-confidence and a higher view of self-esteem. The study states that using dance therapy would be a beneficial experience in a multi-disciplinary treatment for abused and neglected children.

Another researcher studied the effects of dance therapy with children at risk of abuse and their relationship with their mothers. During this study, mothers and their children were surveyed on their relationship prior to the session, asking questions regarding their communication, physical touch, and sense of security felt by the child. After the dance therapy session, the participants were surveyed again with the same measure. The results reported a stronger bond between mother and child.[25] The participants reported a stronger sense of belonging in the pair and felt more openness in terms of communication. Through dance therapy practices, these mother and daughter pairs were able to develop a starting point in rebuilding their relationship.

The effects of dance intervention were also found to be therapeutic to psychiatric participants and those who are emotional disturbed. In one research study, psychiatric patients were randomly assigned to one of three conditions: a dance group in a traditional dance circle, a group that just listened to the music, and another group that rode stationary bikes without music but same time duration as the dance circle. While all three conditions lessened or stabilized the condition of the patients, the results found that the dance group benefitted the most from the dance intervention.[26] The dance circle group reported less depression and more vitality than the other groups. This study shows that not just physical activity or listening to music is enough; the combining of the two into dance is the most beneficial for achieving a positive impact.

Another research study completed with children in psychiatry also showed a positive relationship with this type of therapy. The ending result was a newfound cohesion among children who were previously labeled disorderly and misbehaved.[27] The participants reported an increase in self-confidence and a positive body image after the dance intervention. The children had stronger communication and social skills, such as team work, after the dance intervention.

Most trials studying dance movement therapy did not specifically comment on whether or not adverse effects occurred.

American Dance Therapy Association (ADTA) was founded in 1966 in order to uphold high standards throughout dance therapy. The ADTA was created by Marian Chace, the first president of the ADTA, and other pioneers in dance movement. Along with setting standards for which therapists must attain to become licensed therapists, ADTA keeps an updated registry of all movement/dance therapists who have met ADTA’s standards. In addition, ADTA also publishes the American Journal of Dance Therapy and sponsors annual professional conferences.[28]

The Association for Dance Movement Psychotherapy, United Kingdom (ADMP UK) was one of the first organizations established to regulate the field of dance therapy. ADMP UK accredits therapists and oversees that all regulations are followed.[16]

The European Association of Dance Movement Therapy is an umbrella association which represents national professional bodies for Dance Movement Therapy in Europe. It represents members in Germany, Greece, Hungary, Italy, Latvia, Netherlands, Poland, Russia, Spain and the UK; with partial members in Austria, Czech Republic, Finland, France, Switzerland, Ukraine and associate members in Croatia, Cyprus, Denmark, Israel, Portugal, Romania and Sweden.

NVDAT (Nederlandse Vereniging voor Danstherapie-Dutch Dance Movement Therapy Association) The Nederlandse Vereniging voor Danstherapie supports the interests of dance movement therapists based in The Netherlands.