J.C. Hall swears by the effectiveness of the burgeoning field of hip hop therapy. Every day he uses the technique – which combines writing and performing hip hop with more traditional methods of helping people process trauma – to help students work through negative emotions or trauma at Mott Haven Community High School in the South Bronx.
From his six years as a social worker at the school, Hall has dozens of stories that demonstrate that some aspect of using hip hop in mental health treatment can have a positive impact on teenagers. He has also been collecting his own as yet unpublished data on the effectiveness of his program.
But the fact that Hall has to collect his own, small-scale, data in this way points to the lack of rigorous research into hip hop health interventions’ effectiveness. Like so many people working to address complex health disparities, practitioners must rely on their gut in the absence of a clear evidence base.
Connecting Through Hip Hop
Cendrine Robinson, a clinical psychologist and expert in behavioural health, was a trainee working within the juvenile justice system in Washington, D.C. when she began researching new ways to connect with her clients.
She came across the work of Adia McClellan Winfrey, who founded the HYPE method (Healing Young People thru Empowerment), which integrated hip hop culture and psychology.
“I got the point where people were opening up talking to me about their traumas, and I was like, ‘Wow, this is amazing as a strategy for addressing trauma and substance use’,” she says.
Hall also found that to be true. As a teenager growing up in Long Island, he suffered from addiction and severe mental health problems himself. He was in and out of treatment for much of his late teens, including stays in the hospital, but he says he never got anything out of therapy. “I didn’t connect at all,” he said. “I would just sleep on the psychiatrist’s couch.”
Instead, Hall found solace in hip hop. He says the music of Nas, Mobb Deep, Eminem and 2Pac reached him in a way that psychiatry never could. By his early twenties, he had two goals: become a rapper and study psychology. That’s when he came across the work of Edgar H. Tyson, a researcher and social worker who had founded a formal discipline, Hip Hop Therapy, which combined the two.
As Hall practices it today, the therapy involves encouraging students to express their feelings by writing, performing and recording tracks in the studio at Mott Haven. He says this gives them a venue to talk about issues they’d otherwise be reluctant to share with an adult in a position of power.
“I would never say that kid graduated because of me and my work, or that kid graduated because of the hip hop therapy program,” he says. But he does think the higher passing rate shows that there are benefits to using hip hop to connect with students. “Had I not met them on that turf, maybe they wouldn’t have ever felt comfortable.”
Does Hip Hop Therapy Work?
Robinson wanted to see what the wider researcher literature said about hip hop interventions, not just in the realm of psychology but also promoting public health messages for issues such as stroke awareness, HIV prevention and healthy eating.
But the review she carried out as part of her post-doctoral research at the National Cancer Institute showed there was little conclusive evidence to demonstrate the effectiveness of using hip hop to change behaviour.
She says that’s not because hip hop interventions don’t work, but rather that most of the studies that have been carried out so far are not wide enough in scope in terms of participants or control groups to capture the real effects. That means it’s not possible to say whether hip hop interventions are scientifically proven to improve outcomes.
Robinson says for this kind of work to be implemented at a national scale in the U.S., there would need to be at least two large-scale randomized controlled trials that demonstrated effectiveness. Most of the work done so far has been small-scale in nature, and often lacking a control group for comparisons.
The good news about hip hop interventions, Robinson says, is that we already know that many of the practices that underpin the interventions are effective on their own – from the cognitive behavioural therapy Hall uses at Mott Haven, to the obesity programs that use rap to promote healthy eating.
“Most of that work has evidence-based intervention underneath it, and hip hop is integrated into it,” she says. “That increases the likelihood that it will work.”
Hall’s school, Mott Haven, sits in the poorest congressional district in the country, and many students of the students there are grappling with severe trauma arising from a range of issues such as homelessness, hunger and street violence. “There’s this accumulation of trauma, and you’re just trying to chip away at it,” Hall says.
As well as offering daily counselling to students, Hall implements hip hip therapy at after-school sessions, held from 2:30 pm to 6 pm every day. Here, in a recording studio the school installed for him, students write, perform, record and produce their own music, based on their own experiences.
A documentary filmed at the school in 2014 follows participants in Hall’s group following the death of a classmate, Joshua Acosta, who was murdered outside the school. It’s clear from the footage that the sessions are a source of comfort and stability for a student population dealing with levels of trauma many people won’t experience in a lifetime.
Hall tells the story of one student from the documentary, who was upset one Friday afternoon that he did not get to record during the group session. Hall and the other group members assured him that he would be able to go first the following Monday. On Saturday, that student was attacked on the street by strangers, stabbed ten times and saved from dying only by a passing driver who took him to the hospital.
After his recovery, the student eventually got his turn and, Hall says, it was the studio sessions that helped him deal with what had happened. “With him, a lot of the work was processing that trauma and trying to get him to a place where he didn’t want to go and get revenge,” he says.
Hall describes a scene that didn’t make it to the final cut of the documentary in which the student who was stabbed describes what happened after the attack: “He wakes up, finally comes to in the hospital, and his first thought is, ‘Fuck, I can’t go record on Monday.’”
“That’s where you really see how much this means to these kids,” he says.
Hall is currently working on completing a book, started by Tyson before he died in February last year, that will set out the discipline of hip hop therapy at length, using the data he has collected at Mott Haven.
He’s hopeful this will encourage more people to start applying hip hop in their own work. Until the kinds of studies Robinson recommends are carried out at a national scale, it will take individual efforts like this to popularise this approach to a wider audience. –Megan Clement
(Picture Credit: Unsplash)