Dance Movement Therapy Eases Trauma Symptoms in Refugee Women, Trial Finds

For millions of women who have fled war, persecution and violence, the journey does not end when they reach safety. The psychological wounds they carry—often layered across traumatic experiences in their home countries, along migration routes, and even within host communities—frequently go untreated. In Germany, where this new study was conducted, fewer than ten percent of refugees in need of mental health care actually receive treatment. Against this backdrop, a research team led by Sabine C. Koch of Alanus University and SRH University Heidelberg has published a clinical controlled trial suggesting that an unlikely-sounding intervention, dance movement therapy, can produce striking reductions in trauma, stress, depression and anxiety symptoms among traumatized refugee women. The study, published in BMC Complementary Medicine and Therapies, offers one of the more carefully documented examinations to date of how embodied, movement-based approaches might reach people that conventional talk-based therapies often fail to reach.

The trial enrolled 24 traumatized refugee women living in communities across Southern Germany, drawn from six different countries of origin. The researchers used a controlled within-group design in which every participant served as her own comparator across time. Each woman was assessed at three points: a baseline measurement (t1), a pretest after an eight-week waiting period (t2), and a posttest following the intervention (t3). This waiting-period structure is methodologically important. Because the women received no other psychotherapy during the entire study period, any change in symptoms during the waiting phase could be attributed to natural recovery, the passage of time, or the mere attention of being assessed. When all symptom scores remained essentially unchanged across those first eight weeks, the researchers could be considerably more confident that whatever happened afterward was linked to the therapy itself.

The measurement strategy reflected the linguistic and cultural diversity of the sample. The primary outcome was the Refugee Health Screener-15 (RHS-15), a validated instrument developed specifically to detect emotional distress in refugee populations. Secondary measures included the Depression Anxiety and Stress Scale (DASS21) and the Posttraumatic Stress Disorder Symptom Checklist (PCL-S), the latter a 17-item instrument used to characterize posttraumatic stress severity. Crucially, all scales were administered in an interview format in each participant’s native language or a language she spoke well, with trained interviewers rather than self-completed questionnaires. This attention to language matters enormously in refugee research, where literacy barriers, unfamiliar response formats and subtle translation problems can systematically distort results. The researchers also conducted an exploratory follow-up with ten participants to examine whether gains persisted beyond the end of treatment.

The intervention itself consisted of eight weekly group sessions, each lasting 1.5 hours, delivered by trained dance movement therapists. Dance movement therapy, or DMT, is one of the creative arts therapies recognized by professional bodies such as the American Dance Therapy Association and its German counterpart. Rather than asking clients to narrate traumatic memories verbally, DMT works through the body: movement improvisation, rhythmic coordination, and expressive physical activity are used as the primary channels of therapeutic work. Two design features of this trial stand out. First, the sessions incorporated music that was emotionally meaningful to the participants themselves, drawing on their own cultural traditions rather than imposing a Western therapeutic soundtrack. Second, the women created their own dance improvisations within the group setting, making the therapy a participatory and culturally adaptive process rather than a standardized protocol imposed from outside.

The results were remarkable in their consistency. At baseline, every woman in the study showed clinically relevant levels of trauma symptoms, confirming the depth of need in this population. During the waiting period, as noted, nothing changed—symptoms of trauma, stress, depression and anxiety all held steady. After the eight weeks of dance movement therapy, however, all four symptom domains dropped significantly. Most strikingly, on the PCL-S trauma measure, scores fell so markedly that the group average dropped below the clinical cutoff value, meaning that the women moved, on average, from a symptom range that would warrant a PTSD diagnosis into the non-clinical range. The statistical analysis employed Greenhouse-Geisser corrected F-tests, a technique that adjusts for potential violations of sphericity in repeated-measures data, alongside t-tests for related samples comparing the matched time points.

The exploratory follow-up added an important nuance to the picture. When ten of the participants were reassessed eight weeks after the intervention ended, the symptom reductions appeared to hold—the benefits carried on. At a one-year follow-up, however, the effects were no longer evident. This pattern, common across many psychotherapy studies for posttraumatic stress, suggests that dance movement therapy can initiate genuine recovery but that some form of maintenance—booster sessions, ongoing group participation, or continued low-intensity support—may be needed to sustain the gains over the long term. For a population whose lives remain marked by insecure residency status, separation from family, and ongoing acculturation stress, the disappearance of treatment effects at one year is less a failure of the therapy than a reminder that trauma recovery is rarely a single event.

Why might moving the body help where words struggle? The theoretical rationale draws on a growing understanding of how trauma is encoded and expressed physiologically. Posttraumatic stress is not purely a cognitive condition; it involves autonomic dysregulation, muscular bracing, disrupted breathing, and a fragmented sense of bodily self. Survivors of violence often experience profound disconnection from their own bodies, and talk-based therapies depend precisely on the verbal reflective capacities that chronic stress and hypervigilance can suppress. Dance movement therapy targets these somatic dimensions directly: rhythmic group movement can regulate arousal, synchronized movement with others rebuilds experiences of trust and social connection, and improvised expression allows emotions to be externalized without requiring linguistic articulation. The incorporation of familiar music from participants’ own cultures may further enhance emotional engagement and safety, addressing a well-known barrier in cross-cultural mental health care where standardized Western interventions can feel foreign or intrusive.

The clinical and economic implications are significant. The authors describe DMT as a low-threshold and cost-effective approach, and the characterization is apt. Group therapy requires fewer therapist hours per patient than individual treatment. It does not depend on a shared spoken language between therapist and client in the way cognitive behavioral therapy does, although skilled, culturally competent therapists remain essential. It can be delivered in community settings rather than specialized clinics, and the participants in this study were recruited through psychosocial centers for refugees and torture victims rather than through psychiatric pathways. For health systems in Germany and across Europe that are chronically unable to meet the mental health needs of refugee populations—remember that fewer than one in ten refugees in need in Germany receives care—interventions that are accessible, acceptable across cultural backgrounds and scalable hold obvious appeal.

Honest appraisal requires acknowledging the study’s limits, and the authors are transparent about them. The within-group design, while strengthened by the waiting-period control, is less rigorous than a randomized controlled trial with an active comparison group; placebo effects, expectancy effects and non-specific therapeutic attention cannot be fully excluded. The sample of 24 women is small, although the authors note it was fully powered for the primary analyses, and the loss of more than half the sample at follow-up restricts the long-term conclusions. The trial was also retrospectively registered at the Center for Open Science in March 2023, which some methodologists would flag. The authors themselves emphasize that the lack of high-quality studies with proper control conditions and long-term follow-ups in this field points to a clear need for future research with more rigorous methodologies, ideally multi-site randomized trials that replicate the culturally adaptive elements that appear central to this intervention’s success.

Even with those caveats, the study adds meaningful weight to the evidence base for creative arts therapies in trauma care, a field that has often relied on smaller or less controlled studies. What makes these findings resonate beyond the statistics is the population at their center: women who survived violence in the countries they left, danger along the routes they traveled, and precarity in the places where they landed, and who in most cases had never before received any mental health treatment. That eight weekly sessions of moving together, accompanied by music that mattered to them, could pull their average trauma symptoms below a clinical threshold is a result worth taking seriously. It suggests that healing for survivors of displacement may not always require words—and that the body, so often the register in which trauma is written, can also be the medium through which recovery begins. The next step is to confirm these effects in larger, randomized trials and to determine how the benefits can be sustained over years, not months. For the twenty-four women who took part, however, the value of those eight weeks has already been measured.

Subject of Research: Effects of dance movement therapy on trauma, stress, depression and anxiety in traumatized refugee women

Article Title: The effect of dance movement therapy on traumatized refugee women – a clinical controlled trial

Article References: Koch, S. C., Nazemi, Z., Arnaud, C., Cook, K., Steltmann, S. J., & Tomaszewski, C. (2026). The effect of dance movement therapy on traumatized refugee women – a clinical controlled trial. BMC Complementary Medicine and Therapies, 26(1), Article 277. https://doi.org/10.1186/s12906-026-05299-1

Image Credits: AI Generated

DOI: 10.1186/s12906-026-05299-1

Keywords: dance movement therapy, refugee women, PTSD, trauma, stress, depression, anxiety, creative arts therapies, RHS-15, clinical controlled trial, mental health, cultural adaptation