Voice-work in music therapy under continuous traumatic situations: Perspectives, adaptations and modifications

The human voice is an innate, early channel for communication and regulation. In music therapy, it serves as a means for expression, embodiment, and relational connection. Vocal methods can support relaxation and emotional regulation while enabling access to traumatic material within a safe therapeutic frame. Today many populations live under Continuous Traumatic Situations (CTS) where danger is ongoing, thus making it important to examine how voice-work can be safely and effectively adapted to these situations. Objectives: Explore therapists’ perceptions of voice-work in CTS, including techniques, influences, and adaptations in cases of ongoing threat. Method: Eight music therapists and voice-work practitioners working with adults in CTS were interviewed using semi-structured protocols. Themes were extracted from the transcripts using reflexive thematic analysis. Findings: Three themes emerged: (1) Voice-Work Foundations, capturing dimensions such as embodiment, relational attunement, and a continuum between structured and improvisational techniques. (2) Voice-Work Affordances, covering identity formation, self-awareness enhancement, and access to unconscious material, and (3) Changes in Voice-Work during CTS, reflecting adaptations under ongoing threat, including managing emotional flooding, navigating blurred relational boundaries, and leveraging group voice-work. Conclusion: Voice-work is a rich modality supporting regulation and trauma-related processes. Its relational, embodied, and integrative qualities make voice-work suitable for trauma work, and its facilitation through grounding, safety, and resource-building make it suitable for CTS. Group voice-work can foster a sense of unity and connection, and potentially promote resilience. The findings can be used by clinicians as a basis for practical guidance in voice-based methods with clients experiencing CTS.