Vol. 15 no. 2 (2025)

Trauma-Informed Pedagogy and Universal Design to Benefit Music Students with PTSD

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Post-Traumatic Stress Disorder (PTSD) affects an estimated 6 percent of the US population—roughly thirteen million people in 2020—though the true numbers are difficult to determine given the limits of self-reporting and diagnostic access. Classified in the Diagnostic and Statistical Manual of Mental Disorders (5th ed., DSM-5-TR) as a trauma- and stressor-related disorder, PTSD manifests through symptoms such as avoidance, hyperarousal, and reexperiencing traumatic events, often accompanied by dissociation, emotional numbing, and difficulties in concentration or regulation. In the music classroom, these symptoms can surface still further as withdrawal, agitation, or inconsistent engagement, behaviors too often misinterpreted as resistance or lack of discipline. As scholars such as Deborah Bradley and Juliet Hess have argued, trauma is pervasive and deeply intertwined with learning itself. For music educators, this recognition calls for pedagogies grounded in empathy, flexibility, and collaboration. Universal Design for Learning (UDL) offers such a framework: one that anticipates variability, centers emotional safety, and creates conditions where all students, including those living with trauma, can participate meaningfully in music study.1

Understanding PTSD in Music Education

Music students with PTSD face numerous psychological and physiological challenges, some unique to the demands of music study and others common to all who live with the disorder. Core symptoms include “intrusive, flashback memories” along with “persistent anxiety, hyperarousal, cognitive impairments, and autonomic and immune system dysfunction.”2 While not everyone who experiences trauma develops PTSD, certain individuals are more susceptible to it due to biological, psychological, or environmental factors. In educational settings, these symptoms may present themselves as behaviors often misread as resistance, defensiveness, withdrawal, or defiance—manifestations that can also include anxiety, depression, self-isolation, or self-harming actions.3 As far as specific issues and triggers that music students may face, these can include music-specific triggers, neurological and emotional triggers, as well as social and emotional triggers.

First, music can become bound to traumatic experiences or to an abuser, creating associations that persist regardless of, for example, a song’s content, lyrics, or style. Because music powerfully evokes autobiographical memory,4 it can trigger emotional responses deeply tied to past events. Elements such as lyrics, tone, and genre all interact with individual preference, shaping how listeners experience emotion. People with PTSD are no exception. Some students with PTSD gravitate toward music they perceive as sad or melancholic, what researchers term coping songs, using them to process or contain difficult emotions.5 The listener’s personal interpretation, therefore, plays a critical role in shaping emotional response. While educators cannot anticipate the inner associations students bring to musical material, fostering a classroom environment where students feel safe to express themselves offers an important measure of protection.

Second, the culture of music schools and departments can itself cause or intensify trauma. Group rehearsals and ensemble settings may feel unsafe to students whose trauma involves authority figures or complex group dynamics. Instructors’ pervasive use of harsh criticism can further retraumatize students. The widespread preoccupation with perfection in music education, too, risks heightening anxiety and can trigger physiological responses resembling those of PTSD, including panic and dissociation.6 This legacy of perfectionism is deeply rooted in the culture of musical training and difficult to disentangle from its traditions. In previous work, I have argued for a broader understanding of “rigor” in music education, one that recognizes the diverse rates at which students develop as musicians. Trauma-informed pedagogy and Universal Design for Learning make such inclusivity possible, demonstrating that “rigorous training” need not be synonymous with exclusion.7

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Finally, PTSD often involves discomfort with sound and noise. Studies show that sound can act as a powerful trigger for individuals with PTSD, even at volumes that most listeners would find tolerable.8 Instructors should also be mindful of music-specific triggers when cultivating a trauma-informed classroom. These could involve sensitivity to lyrical content, especially in songs associated with trauma, lyrics depicting violence or abuse, or genres tied to distressing experiences. Music linked to a traumatic event or an abuser can provoke flashbacks, while songs with troubling themes may resurface painful memories. I do not advocate censoring or removing such material; rather, offering a brief content warning allows students to make informed choices and minimize the risk of dissociation or panic in public settings. Neurologically, such triggers activate the amygdala, the brain’s center for fear and memory, initiating the fight-or-flight response. Sudden changes in volume or dynamics can heighten this reaction, amplifying anxiety and hypervigilance in students with PTSD.

Trauma survivors often lack clear memories of the events that have come to shape their daily lives until they begin to process and understand their effects. Persistent trauma can impair memory and concentration, disrupting one’s sense of identity and stability. For music students, trauma affects how they learn and memorize music.9 A 2009 study by Inette Swart reveals a wide range of problems experienced by musicians with trauma, including

poor concentration, an inability to focus, uncharacteristic behavior, and mood swings or depression. Participants in the study also cited issues such as inability to adjust, withdrawal, insomnia, dissociation or regression, lack of creativity, loss of self-esteem, and a drop in the standard of work performance. They described the emergence of performance anxiety, changes in commitment to practicing (either more or less), changes in musical preferences, decreased enjoyment of music, detachment from playing, repeated mistakes, inability to connect emotionally to the music, and panic attacks before or during performances. Participants reported that sometimes the music itself served as a “trigger,” leading to flashbacks, re-living of the trauma, and even re-traumatization.10

Triggers can cause emotional overload that, without treatment, produces severe distress and disruption in the classroom. Too often, peers and faculty respond negatively or with rebuke to such reactions rather than compassion, leaving the affected student isolated and misunderstood. If the injury were visible rather than an invisible overload of the amygdala, it would likely be met with empathy. Yet emotional pain has a clear physiological basis. Emotional states arise from neural processes that integrate memory, perception, and learning, forming the basis for how individuals interpret and respond to their surroundings.11

In addition to concentration barriers and performance stress, individuals with PTSD may experience triggers tied to sound and movement. Research on trauma’s neurological effects shows that auditory processing, motor coordination, and memory recall can all be disrupted, influencing how people with PTSD engage with music, sound, and their musical training. Accessibility and flexibility in curriculum and pedagogy are therefore essential to supporting full participation alongside one’s peers. Triggers such as hyperarousal or dissociation can occur unpredictably in the classroom. They may be prompted by loud or chaotic music, strong bass frequencies, particular vibrations, or other sounds that are personally significant to an individual. Physiological arousal can lead to increased heart rate, muscular tension, and anxiety, while dissociation, the feeling of detachment from one’s body or surroundings, can be disorienting and especially distressing in public.12 Some individuals may respond in ways that appear emotionally inappropriate within professional or performance settings, as feelings of grief, depression, and isolation intensify under stress.13

But along with functioning as a trigger, music can also serve as a tool for healing, a duality well documented across both clinical research and reflective writing. A study led by Catherine Carr found that “group music therapy appears feasible and effective for PTSD patients who have not sufficiently responded to CBT [cognitive behavioral therapy],” recommending further investigation into its long-term sustainability and more research to better understand music therapy scientifically.14 Music’s therapeutic potential lies in its impact on both emotional regulation and neurological function, including its ability to:

  • Regulate stress hormones by lowering cortisol levels, which are often elevated in people with PTSD
  • Increase oxytocin and dopamine, chemicals that promote feelings of safety and connection
  • Activate the parasympathetic nervous system by producing soothing feelings of safety and connection15

Clinical and therapeutic applications of music build upon these physiological effects. In individual music therapy sessions, activities such as improvisation, listening, or songwriting help clients process trauma. Group sessions promote collaboration, reduce isolation, and strengthen trust among participants. Moreover, music has been shown to lessen nightmares in individuals with PTSD, contributing to improved sleep quality and overall wellbeing.16

The specificities of music’s ability to awaken emotional memory allows trauma survivors to reconnect with experiences that words alone often fail to express, a phenomenon documented in two recent studies, one led by Mathilde Groussard and Hervé Platel and the other by Lutz Jäncke.17 Suvi Saarikallio likewise emphasizes the role of music-related emotional experiences as integral to human behavior and psychosocial development in adulthood.18 Music provides predictable and structured sensory input that helps regulate emotional responses and reduce dissociation. As Elizabeth Hellmuth Margulis observes, the repetitive nature of music, so often dismissed in other art forms, is central to its appeal and psychological function:

Musical repetitiveness is so common as to seem almost invisible. But when something draws your attention to it, this repetitiveness comes to seem quite strange. Try replacing the word “music” in the quotation at the start of this chapter with the word “Freddy.” Freddy can never have enough of saying over again what he’s already said dozens of times. Once he’s finished telling one repetitive story, Freddy goes back to the start and tells the whole thing again. Would you want to spend time with Freddy? Yet this is precisely what our favorite music is like, and we go back again and again to rehear its stories.19

As an evidence-based field, music therapy demonstrates clear benefits for alleviating the symptoms of PTSD. While a comprehensive discussion of such programs lies beyond the scope of this roundtable contribution, abundant evidence affirms music’s value for mental health.20

Universal Design, Trauma-Informed Pedagogy, and PTSD in the Music Classroom

The concept of a trauma-informed environment has gained increasing traction across higher education, though its integration into music programs remains limited. In contrast to approaches that locate responsibility within the individual, trauma-informed practice, like Universal Design, places the primary responsibility on the environment itself. It is a collaborative framework that requires awareness, commitment, and institutional effort. A trauma-informed classroom or workplace recognizes the prevalence of trauma and acknowledges how it shapes behavior, learning, and interpersonal dynamics.21 According to the Substance Abuse and Mental Health Services Administration (SAMHSA), trauma-informed care rests on four key principles:

  • Recognizing how trauma affects individuals, families, and communities
  • Identifying the signs and symptoms of trauma
  • Responding by embedding trauma-informed principles across all levels of functioning
  • Actively working to prevent retraumatization for both students and staff22

As Kathryn Becker-Blease emphasizes, trauma is “inextricably linked to systems of power and oppression,” and it is therefore essential to notice “how trauma is defined, and who is and who is not defining trauma, and how victims/survivors are affected by those definitions.”23 When trauma-informed practice becomes a buzzword, it risks being coopted in ways that obscure its social and ethical imperatives. At its core, a trauma-informed approach must connect individual experiences to broader systems, acknowledging how institutions can perpetuate harm while striving to prevent future trauma through education and collective responsibility.

Conclusion

Grounded in the principles of multiple means of engagement, representation, and expression, Universal Design for Learning emphasizes flexibility, choice, and student agency, fostering an environment of safety and personal expression.24 When applied through a trauma-informed lens, Universal Design also accounts for the sensory and psychological needs of students with PTSD.25 This includes attentiveness to common triggers such as sudden volume shifts or pervasive sound bleed, issues especially acute in music buildings, where overlapping rehearsals and performances can overwhelm. Departments should prioritize proper soundproofing and provide quiet spaces where students and also faculty can decompress, particularly adjunct instructors who may lack private offices. Clear communication about changes in sound environments, such as visits from guest performers or the acquisition of new instruments, can help everyone plan for sensory safety. Universal Design’s commitment to accessibility also extends beyond acoustics to the integration of assistive technologies, such as vibration-based metronomes, adaptive software, or guided composition tools, which expand equitable participation for music students with PTSD.

Together, trauma-informed practice and Universal Design offer a model for transforming music education into an environment that dismantles barriers rather than reinforces them. This transformation requires more than institutional compliance: It demands a cultural shift grounded in empathy. Faculty and staff need to be trained to respond to distress with understanding rather than defensiveness, and to approach moments of disruption as opportunities for connection rather than discipline. Compassion, patience, and awareness are the first and most essential instruments of inclusion in an active pedagogy of care that values adaptability, safety, and the wellbeing of every learner and teacher.

  1. The literature on PTSD is vast and growing. The following sources informed the content of this introductory paragraph: National Center for PTSD, “How Common Is PTSD in Adults?” US Department of Veterans Affairs, last modified March 26, 2025, https://www.ptsd.va.gov/understand/common/common_adults.asp; American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 5th ed., Text Revision (DSM-5-TR) (American Psychiatric Association, 2022); Deborah Bradley and Juliet Hess, eds., Trauma and Resilience in Music Education: Haunted Melodies (Routledge, 2022); National Health Service (NHS), “Complex PTSD––Post-Traumatic Stress Disorder,” NHS.uk, last reviewed May 13, 2025, https://www.nhs.uk/mental-health/conditions/post-traumatic-stress-disorder-ptsd/complex/; Madeline J. Bruce and Sara M. Stasik-O’Brien, “Trauma Centrality Moderates the Relationship Between PTSD Symptoms and Trigger Warning Receptivity,” Journal of Psychopathology and Behavioral Assessment 45 (2023): 1163–1171, https://doi.org/10.1007/s10862-023-10093-1; and Arieh Y. Shalev, “What Is Posttraumatic Stress Disorder?” Journal of Clinical Psychiatry 62 (2001): 4–10, PMID 11495095.↗
  2. Phillip Zoladz and David M. Diamond, “Predator-Based Psychosocial Stress Animal Model of PTSD: Preclinical Assessment of Traumatic Stress at Cognitive, Hormonal, Pharmacological, Cardiovascular and Epigenetic Levels of Analysis,” Experimental Neurology 284, part B (2016): 212, https://doi.org/10.1016/j.expneurol.2016.06.003.↗
  3. Zoladz and Diamond.↗
  4. Kelly Jakubowski and Emma Francini, “Differential Effects of Familiarity and Emotional Expression of Musical Cues on Autobiographical Memory Properties,” Quarterly Journal of Experimental Psychology 76, no. 9 (2022): 2001–16, https://doi.org/10.1177/17470218221129793.↗
  5. Adi Levy et al., “Lyrics Do Matter: How ‘Coping Songs’ Relate to Well-Being Goals. The COVID Pandemic Case,” Frontiers in Psychology 15 (2024): 1–13, https://doi.org/10.3389/fpsyg.2024.1431741.↗
  6. Cheryl Regehr and Vicki Leblanc, “PTSD, Acute Stress, Performance and Decision-Making in Emergency Service Workers,” Journal of the American Academy of Psychiatry and the Law 45 (2017): 184–92.↗
  7. Samantha Bassler, “Trauma-Informed and Universal-Design Approaches for Rigorous Training in Aural Skills,” in Trauma-Informed Pedagogy and the Post-Secondary Music Class, ed. Kimber Andrews and Kristy Swift (Taylor & Francis, 2025), 104–13.↗
  8. For example, a 2007 study found that 34 percent of patients admitted to the Veterans Affairs Medical Clinic’s Tinnitus Clinic in Brooklyn, New York, also had PTSD. A 2023 study further examined the psychiatric and psychological dimensions of misophonia, a condition in which individuals experience extreme emotional or physical distress in response to sounds that would not bother most people, with no identifiable physiological cause. See Marc A. Fagelson, “The Association Between Tinnitus and Posttraumatic Stress Disorder,” American Journal of Audiology 16, no. 2 (2007): 107–17, https://doi.org/10.1044/1059-0889(2007/015); and Bruce and Stasik-O’Brien, “Trauma Centrality.”↗
  9. See Colleen A. Q. Sears, “Grief as Transformation: Teaching and Traumatic Loss,” in Trauma and Resilience in Music Education: Haunted Melodies, ed. Deborah Bradley and Juliet Hess (Routledge, 2022), 93–95.↗
  10. This discussion of Swart’s research is from Deborah Bradley, “When Music Haunts Memory: Effects of Trauma on Music Learning,” in Trauma and Resilience in Music Education: Haunted Melodies, ed. Deborah Bradley and Juliet Hess (Routledge, 2022), 68. Swart’s study can be found in Inette Swart, “Overcoming Adversity: Trauma in the Lives of Music Performers and Composers,” Psychology of Music 42, no. 3 (2014): 386–402, https://psycnet.apa.org/doi/10.1177/0305735613475371.↗
  11. Goran Šimić et al., “Understanding Emotions: Origins and Roles of the Amygdala,” Biomolecules 11, no. 6, 823 (2021), https://doi.org/10.3390/biom11060823.↗
  12. Ruth Lanius et al., National Center for PTSD, “Dissociative Subtype of PTSD,” US Department of Veterans Affairs, last modified December 9, 2025, https://www.ptsd.va.gov/professional/treat/essentials/dissociative_subtype.asp.↗
  13. Jiyoung Song et. al., “Provider Decisions to Use Evidence-Based Psychotherapy for PTSD Among Veterans: Assessments of Overidentification with the Sick Role and Comorbid Personality Disorders,” Traumatology 30, no. 3 (2024): 279–87, https://psycnet.apa.org/doi/10.1037/trm0000433.↗
  14. Catherine Carr et al., “Group Music Therapy for Patients with Persistent Post-Traumatic Stress Disorder––An Exploratory Randomized Controlled Trial with Mixed Methods Evaluation,” Psychology and Psychotherapy 85, no. 2 (2011): 179–202, https://doi.org/10.1111/j.2044-8341.2011.02026.x.↗
  15. Muriel T. Zaatar et al., “The Transformative Power of Music: Insights into Neuroplasticity, Health, and Disease,” Brain, Behavior, & Immunity Health 35 (2024): 7, https://doi.org/10.1016/j.bbih.2023.100716.↗
  16. Nora Landis-Shack et al., “Music Therapy for Posttraumatic Stress in Adults: A Theoretical Review,” Psychomusicology 27, no. 4 (2017): 334–42, https://doi.org/10.1037/pmu0000192.↗
  17. Elodie Fraile et al., “Musical Experience Prior to Traumatic Exposure as a Resilience Factor: A Conceptual Analysis,” Frontiers in Psychology 14 (2023): 1–12, https://doi.org/10.3389/fpsyg.2023.1220489; Lutz Jäncke, “Music, Memory and Emotion,” Journal of Biology 7 (2008): 21.1–21.5, https://doi.org/10.1186/jbiol82.↗
  18. Suvi Saarikallio, “Music as Emotional Self-Regulation Throughout Adulthood,” Psychology of Music 39, no. 3 (2010): 307–27, https://doi.org/10.1177/0305735610374894.↗
  19. Elizabeth Hellmuth Margulis, On Repeat (Oxford University Press, 2013), 1. The quote comes from Victor Zuckerkandl’s Sound and Symbol: “Music can never have enough of saying over again what has already been said, not once or twice, but dozens of times; hardly does a section, which consists largely of repetition, come to an end, before the whole story is happily told all over again.” Quoted in Margulis, 1.↗
  20. The benefits of music therapy for veterans with PTSD are well documented. See, for instance, Negin Vaez, “Healing Through Harmony: Music Therapy as a Complementary Treatment for Post-Traumatic Stress Disorder: A Systematic Review,” Iranian Biomedical Journal, 28 Supplementary (2024): 175, https://doi.org/10.61186/ibj.25th-11th-IACRTIMSS; and David Victor, “Harmony & Healing Begins Virtual Visits with the Martinez VA Hospital,” Harmony & Healing, November 4, 2023, https://www.harmonyandhealing.org/harmony-healing-begins-visits-with-martinez-va-hospital/.↗
  21. Chrissy Bulling and Kristine Hickle, “Creating a Trauma-Informed Environment,” University of Sussex, September 2023, https://theinnovateproject.co.uk/wp-content/uploads/2023/09/Creating-a-Trauma-Informed-Environment-FINAL2_Aug-2023.pdf.↗
  22. “Trauma-Informed Approaches and Programs,” Substance Abuse and Mental Health Services Administration (SAMHSA), last modified December 3, 2024, https://www.samhsa.gov/mental-health/trauma-violence/trauma-informed-approaches-programs.↗
  23. Kathryn A. Becker-Blease, “As the World Becomes Trauma-Informed, Work to Do,” Journal of Trauma & Dissociation 18, no. 2 (2017): 131–32, https://doi.org/10.1080/15299732.2017.1253401.↗
  24. CAST, Universal Design for Learning Guidelines version 2.2 (2018), retrieved from http://udlguidelines.cast.org.↗
  25. Nicol Hammond, “Firmly Grounded, So You Can Soar: How I Used Universal Design for Learning to Keep Teaching After Trauma,” in Trauma-Informed Pedagogy and the Post-Secondary Music Class, ed. Kimber Andrews and Kristy Swift (Taylor & Francis, 2025), 197–206.↗

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