A dance/movement workshop series, when integrated with other social services, can be effective in relieving symptoms of post-traumatic stress disorder (PTSD) and psychological distress among women who have experienced domestic violence, a new study finds. Published last month in Frontiers in Psychiatry, the article was co-authored by Yasemin Özümerzifon of New York City-based Gibney Dance, which received a NEA research grant to support the study.

When browsing through peer-reviewed research articles, one often hops to the conclusions section. Did or did not the study yield positive results—and, if it did, then to what extent? In the case of Özümerzifon et al., the introduction is compelling in its own right, though “alarming” or “disquieting” would be the better word.

In the very first paragraph, we learn that “intimate partner violence,” worldwide, visits one in three women in the course of their lives. In the U.S., the U.K., and China, its incidence reportedly has surged during the COVID-19 pandemic. (The source of those statistics is the World Health Organization.) In the U.S. alone, according to the Centers for Disease Control and Prevention, 29 million women have experienced “severe physical violence by an intimate partner,” the article reports.

Less surprising are the associated risks of mental health disorders for victims of intimate partner violence—conditions such as depression and low self-esteem. But, in addition to any physical injuries, the violence can lead to long-term physiological changes, affecting the brain and peripheral nervous system.

The Gibney Dance study focused largely on understanding dance’s potential for reducing the mental health symptoms among survivors. More than 20 years ago, the company’s founder, choreographer Gina Gibney, and her team began working with the nonprofit Sanctuary for Families, also in New York, to design a dance workshop model called Move to Move Beyond (MTMB). Granting choice to the survivors is key to the four-part model, grounded in the work of trauma expert and Harvard Medical School psychiatry professor Judith Herman.

In particular, the workshop model addresses two stages of the recovery process, as described by Herman. One is characterized as improving one’s sense of personal safety and taking control of the body and environment. The other stage has to do with re-establishing connections with others, and removing feelings of isolation. As will be shown, Gibney’s researchers explored these factors through qualitative methods (e.g., focus group interviews) with workshop participants.

Notably, MTMB does not revisit traumatic events for these women. Rather, the workshops accentuate “the present and positive aspects, such as strengths of the survivors, things that spark joy, and what participants are looking forward to in their everyday lives,” the article states. The social work of Sanctuary for Families has been woven into every aspect of MTMB’s design and execution.

The study randomly assigned 45 women who had experienced intimate partner violence to either the dance workshop program plus standard care for their conditions or to a control group receiving only standard care. More than 75 percent of the women—ages 23 to 48—identified as Black, Indigenous, or people of color (BIPOC). For the intervention group, dance workshops were offered in 90-minute sessions, twice a week, over six weeks. The control group, whose members were given the option of dance program participation upon study completion, received “any combination of crisis counseling, legal services, economic empowerment programs, and housing assistance,” as warranted, the article notes. The control group also were emailed health tips and infographics, as a way for the study investigators to continue to engage with these participants.

As many human-subject researchers learned in the early days of the pandemic, constant communications can be crucial to study retention. Although the workshops had been planned to occur in-person, they were conducted entirely via Zoom because of COVID-19-related concerns and stay-at-home orders.

The workshops were led by two Gibney facilitators. In addition, Sanctuary for Families staff were present during the virtual sessions, and could be reached by phone. After each session, dance group participants received email prompts for the practice of creativity, stretching, and mindfulness exercises. These women were also invited to participate in focus groups, again conducted virtually.

Based on transcripts and field logs of the focus group meetings, six themes arose from the 16 participating women. The themes included: connecting to self and the body (sample comment: “I found myself really connecting to the music and to giving myself that time to connect, in a way, to my body, which, you know, had disconnected from for a long time”); self-expression through movement (“I think that being able to create your own movement and share it with others was, kind of, like, empowering”); and community-building (“I would say that the whole experience itself is, like, breathtaking because you taking a bunch of women from different walks of life and you're connecting us all by one specific tool, which is breathing”).

Other themes from the focus groups were: relaxation and stress relief (“I think it can be so helpful to women in this situation to release some of the pent-up energy, pent-up stress, pent-up pain and anger”); elicitation of positive emotions (“Like, you can have fun, you can be silly with people, and no one's judging you”); and self-care habits (“…even outside if I'm on an appointment and waiting, I would do stretches and it really helped”).

Those were qualitative findings. What did quantitative data reveal? The researchers administered pre- and post- surveys to measure the women’s scores on a checklist of PTSD symptoms. Both the dance and control groups showed overall score improvement after the study period. In particular, scores having to do with “negative cognition and mood” improved significantly. For both groups, there were no changes in heart rate variability, assessed at the start and end of the study.

Part of the reason that investigators were unable to detect a significant difference in outcomes across the two groups may have been “erratic” attendance at the dance workshops, as the authors put it. Only 27 percent of dance group participated in eight or more of the 12 sessions. Also, prior to the pandemic, the study was supposed to have occurred over 12 rather than six weeks. (The compressed timeframe was attributable to COVID-19-related delays in starting the study.) The virtual environment for dance/movement created its own hurdles. As reported by the article, one participant said of the experience:

It was a little bit weird to be honest. You know, especially when you're doing dance, I feel like sometimes you feed off the energies of other people. And, while you know it's great to have ZOOM and to see people, it doesn't always come across through the screen.

In the face of such challenges, the study investigators—who also were supported by the Laurie M. Tisch Illumination Fund—managed to pull off a rigorous study. While it can’t be said that the MTMB dance program fared better than social work alone in improving mental health outcomes for domestic violence survivors, there were clear emotional rewards for the participating women. It remains to be seen whether, as originally proposed, a study comparing an in-person dance program with standard care can yield substantial differences in results.