Short-Term Music Therapy Attention and Arousal Regulation Treatment (SMAART) for Prisoners with Posttraumatic Stress Disorder: A Feasibility Study

Abstract

ABSTRACTHyperarousal and attention problems as a result of posttraumatic stress disorder (PTSD) are being recognized as a risk for offense recidivism. Short-term Music therapy Attention and Arousal Regulation Treatment (SMAART) was designed as a first step intervention to address responsivity and treatment needs of prisoners who were not eligible for or unwilling to undergo eye movement desensitization and reprocessing (EMDR) therapy. This article describes a pilot study of the manualized SMAART protocol in a Penitentiary Psychiatric Center (PPC) and whether there is an increase of focused and sustained attention and a decline of arousal symptoms in prisoners suffering from PTSD, attributable to SMAART. A single case baseline-treatment-design with pre- and post-assessment (N = 13) was used. PTSD prevalence and severity were assessed using the Primary Care-PTSD screen and the PTSD Symptom Scale Interview. Selective and sustained attention was assessed using the Bourdon–Wiersma dot cancellation test. The results show a promising decline of arousal symptoms as well as improved selective and sustained attention levels in the subjects. Also, after the SMAART intervention, five participants no longer met the threshold for a PTSD diagnosis. The results show that the SMAART protocol could be implemented in the PPC-setting. Although the clinical results of the manualized SMAART protocol suggest improvement, this is a small feasibility study so the results must be interpreted with care. Suggestions for future research are offered.