The Lyden av Oss (“The Sound of Us”) music workshop was implemented as a twelve-week afterschool initiative in a culturally diverse lower secondary school in Norway. Each week, sessions were held with small groups of 6–8 students. The activities were student-driven, encouraging participants to take the lead in creating, arranging, and performing music. The program emphasized creativity, collaboration, and self-expression, culminating in live performances where students showcased their work to peers, teachers, and the wider community. Recruitment was carried out in close collaboration with the school to ensure diverse participation and strong engagement from the student body. In the Norwegian school context, where inclusion, well-being, and student participation are key educational goals (20), this kind of music-based initiative supports both individual and collective development. Lyden av oss was designed to offer a trauma-informed, inclusive space for creative engagement and emotional exploration. Sessions were facilitated by a community-based music therapist in collaboration with the school’s social educator. They were held in the school’s music room, which was equipped with digital audio workstations, musical instruments, and recording technology. Each session followed a consistent structure, beginning with grounding techniques such as rhythmic clapping, breathing exercises, and guided drumming, followed by improvisational jam sessions, lyric development, and collaborative beat production using platforms like GarageBand and Soundtrap. Students were invited to contribute personal and cultural musical elements, which led to the integration of Syrian melodies, Somali rhythms, and Norwegian folk motifs into original compositions. These acts of cultural sharing fostered mutual respect and curiosity, transforming the workshop into a site of intercultural dialogue. As the program progressed, participants developed a strong group identity, culminating in the co-creation of a final song titled Sterkere Sammen (“Stronger Together”) and a public showcase attended by peers, educators, and family members. Student reflections revealed increased emotional articulation, creative confidence, and peer connectedness, with several participants describing the experience as their first opportunity to express personal narratives in a supportive group setting.

“A Place to Be” was designed as an after-school music-based wellness program for students attending a culturally diverse high school in an under-resourced urban setting in the northeastern United States. This pilot program was designed to provide a no-barrier, no-experience required entry point for students who wished to engage in a variety of music experiences such as listening, song discussion, composing, improvising, recording, and performing as a means of fostering social interaction and wellness. Our aim was to complement the existing music and fine arts programs, and school-based mental health services by giving students the opportunity for a creative means of self-expression and exploration. The program was facilitated by a board-certified music therapist and a music therapy practicum student who were supervised by music therapy faculty from the local university. A trauma-informed, co-collaborative approach was taken to all sessions.

Students were invited to participate in the program by their music teachers and members of the pupil-personnel staff. Weekly sessions, lasting for approximately 1 hour, were held in the school’s Black Box Theater. Chairs were set up in a circle to create a contained space for the sessions in the middle of the large theater space. Each session followed a similar structure: checking in with students, engaging in music activities as suggested by the therapist in collaboration with the participants, and closure. The closing included a review of what the students were taking away from the session, and what they might like to work on the next week. Music experiences included song discussion, adapted piano, guitar, and ukulele lessons, drumming, improvisation, and music creation.

Attendance was minimal and inconsistent as only one student attended most sessions. Over the course of the 8-week program the student became more engaged in sessions and willing to share more about themself, and the resultant positive effect on their mood. They consistently reported feeling anxious at the beginning of the group and significantly more relaxed by the end, the music therapists facilitating the group noticed an increase in their frustration tolerance, and willingness to try different ways of engaging in music. They also noticed a change in affect and posture as the session went on. The student who participated in the program consistently seemed to benefit in terms of anxiety management and ability to tolerate tasks (such as learning how to finger guitar and ukelele chords) that required attention and practice. They also became more active in suggesting how they wanted to engage in music.

As part of music therapy services offered by a local Music Therapy not-for-profit organization (NPO), weekly music therapy sessions were held at small school within a large local hospital treating patients with Tuberculosis (TB). For almost two years, 20–25 children aged five to 14 participated in the weekly group music therapy sessions: all from under-resourced communities marked by poverty, unemployment, and crime. The hospital spans a large area and includes three larger buildings enclosed by high barbed wire fences that house women, men and children separately, connected to the admin and management buildings by network of roads. Majority of the TB patients hail from communities in which group music and singing is deeply and culturally embedded. Our music therapy sessions aimed to provide a safe, musical, and playful space to support their overall wellbeing, development, and sense of community amidst the isolation. Sessions were informed by the Nordoff-Robbins Creative Music Therapy and Community Music Therapy (CoMT) approaches. The children sat on small chairs laid out in a circle in the large school room. Each week, using a guitar and various percussive and smaller melodic instruments, the group would sing our greeting songs and other favorite songs, play instruments, improvise, dance, and play music games. We adapted a well-known South African sports song called “Feeling hot, hot, hot” into a musical greeting experience where each child expressed how they were feeling that day: pap (weak) or strong. Each week, the group sang hello to every child in a manner that reflected that child’s chosen feeling. The energy the children exuded, and the engagement and interaction belied the isolating effects of their illness and clinical environment.

The children were very excited when I proposed forming an impromptu marching band The goal was to foster a sense of cooperation, collaboration, community, and reduce their isolation. During sessions leading up to our Marching Band debut, children spoke energetically about sharing their music with others and ‘showing off’ their musical skills to staff and other patients. They negotiated and agreed on songs to include. On the day of our Marching Band ‘debut’, the children marched through the pedestrian roads linking the men’s, women’s and baby’s wards. They danced and sang their chosen songs complete with improvised vocal and instrumental sections using shakers, drums, and tambourines. Staff and patients from the various wards came out to listen, sing, clap and dance along with the children (from across the barbed wire fences). The energy and excitement were contagious. Back at the children’s ward, we talked about our marching band, about sick people and helping others to feel better. Sessions continued for another few months, before the NGO had to cease services at the hospital due to lack of funding.

Children who experience trauma often have their perception of safety shattered (10). Further, trauma experiences negatively impact relationships that should afford safety and protection (32) leaving children with a diminished sense of trust in others and their environment (14, 33). We intentionally considered how to provide both physical and relational safety into our work choosing to incorporate practices that have been suggested by adolescents (e.g. 17, 34). These practices included allowing enough physical space between participants, collaborating in the creation of creating group ground rules, and using consistent and warm way of welcoming participants into the group each week. Further, incorporating student-led music experiences, encouraging open expression of ideas, and providing a stable and consistent environment supported sense of relational safety and trust.

Children are not typically in a position of power in their interactions with adults in the best of circumstances. Traumatic events such as forced migration, living in under-resourced communities, or having a chronic and potentially life-limiting illness remove a child’s sense of power and control (33) and increases that power differential (10). Equalizing this power-imbalance, when possible, allows for children’s voices to be heard and respected in the decision-making process (35). Students in each program were empowered to make decisions and work collaboratively with peers and the music therapists in the co-creation of music experiences approach fostered supportive peer interactions and allowed for the creation of cultural relevant music-making.

Each case vignette highlights the students’ active engagement in collaboration and co-creation. The music therapy content was shaped by the students taking the lead, co-authoring songs, improvising, planning, and negotiating their music making and performances. This is a powerful expression of their agency, identity and voice (metaphorically and literally). Trauma can disempower and contribute to emotional dysregulation, and executive functioning and interpersonal difficulties (36, 37). The proffered opportunities for self-expression, acceptance and peer connection promoted the students as active ‘agents of change’ (38) and served to ‘rewrite’ their trauma narratives (39). Shifting from isolated to together, rigid to creative, the co-created music therapy spaces repositioned the students as ‘agents of change’, which promoted their resilience.

Collaborative music-making enabled the students to express and reflect their identities through the music, and supported their capacities for self-reflection, self-regulation, and self-expression. Students reflected on their growth in self-expression, confidence, group connection, frustration tolerance, and shifts in mood. When acknowledged and validated by the group, the students’ self-expressed music fostered opportunities for dialogue and collective reflection. This two-way process of expression and reflection termed “musical witnessing as a self-object” by Bensimon (40, p. 250), can support identity construction, especially in adolescence (41). Furthermore, the development of group identity was highlighted in the cases. Bridging the social and cultural diversity of their individual contexts, the students appeared to forge distinct musical micro-communities of belonging characterized by intercultural learning and respect. Music became a social phenomenon (29) created and shared by the students.

Lastly, our observations reflect current research that suggests adolescents’ participation in music experiences can promote overall wellness. Over the past ten years, researchers have identified both psychological and physiological benefits adolescents may experience as a result of their participation in music-based experiences (e.g. 15). This paper focuses primarily on the psychological benefits afforded the participants in each of these programs. However, the physiological and neurological responses to music engagement that underlie the psychological effects shouldn’t be overlooked. These include various neurological (e.g. relaxation response); neurochemical (e.g. dopamine, serotonin, and oxytocin) and associative (e.g. emotional contagion; episodic memory) responses to music which seem to be the underlying mechanism for these benefits (42, 43).

The case vignettes presented in this paper underscore the importance of embedding sociocultural awareness, collaboration, and client empowerment into everyday practice across school and hospital settings. For music therapists, this translates into creating environments that prioritize safety, trust, and mutual respect, which are core components of trauma-informed care. Practitioners should adopt consistent routines to foster predictability while also incorporating flexible, student- or patient-led decision-making to support autonomy and creativity. For example, allowing students to choose instruments, compose lyrics, or shape performance structures encourages co-creation and empowers participants to take ownership of their musical experiences. Given that institutional contexts often impose constraints, such as limited resources, time, or varying levels of trauma-informed readiness, music therapists must cultivate adaptability, reflexivity, and advocacy skills. This includes continually reflecting on one’s own assumptions, actively seeking feedback from participants, and advocating for policy and structural changes that support trauma-informed, culturally sensitive, and participatory music therapy practices.

It is important to consider that the trauma-informed care (TIC) perspective we used for guidance often has the potential to over generalize or medicalize individual’s experiences (44). As such, critics of this framework will argue that by emphasizing individual past trauma as a primary lens for understanding behavior, TIC has the potential to pathologize normal responses to adversity and reduce accountability for current actions. TIC can also be criticized through a post-colonial lens for relying on Western definitions of trauma.

As we reflected on our work, we wondered how each student carried what they learned across social/emotional domains, into their everyday life. Further, we were curious to know if others in the students’ lives noticed any changes in overall mood and behavior. These questions are ripe for exploration and will shape our future research. Currently, most research involving youth across disciplines usually fits into one of 3 categories: 1) research on youth, 2) an analysis of how youth’s problems effect their well-being, and 3) problem-focused studies attempting to determine how to help youth survive (45). Additionally, research studies are often developed by the investigator with little input from study participants. This approach, reinforces a top-down power dynamic that is contrary to trauma-informed approach that we believe created meaningful experiences for the students. Based on our observations across all 3 sites, we would argue that moving forward, researchers should in engage in youth participatory action research (YPAR) (46). YPAR focuses on strengths, attempts to yield solutions, and most importantly involves youth as co-researchers in each step of the research process. It requires researchers to be flexible with willingness to act as a collaborator with the adolescents from study conception to presentation of the final results (47).We recommend interviewing students to learn more about their life experiences, and how they believe engagement in music therapy or music-based wellness programs might be beneficial. Following the tenets of YPAR, interview results can inform future research with adolescents as co-creators of the research process from conception through dissemination.

The present report is limited by the subjective position of the authors. Hence, observations and reflections are processed without direct inclusion of student voices. As such, the perspectives of the students are represented indirectly through the authors’ interpretations, which may introduce bias or overlook nuances in the participants’ experiences. Additionally, this report focuses primarily on psychological benefits of music therapy, leaving physiological and neurological responses underexplored. The trauma-informed care framework, while providing valuable guidance, may also risk overgeneralizing or medicalizing individual experiences and may reflect predominantly Western conceptions of trauma. As such, by centering Western expertise and universalizing its approach to music therapy settings TIC can unintentionally repeat colonial power dynamics, depoliticize structural violence, and appropriate cultural practices without addressing the systems that continue to cause trauma (48). Finally, the study’s descriptive, case study design limits the generalizability of findings beyond the specific school and hospital contexts included.