Dance-based interventions in clinical populations: Not all are the same

Michail Elpidoforou^1,2*Effie Polyzogopoulou²John Parissis²DIMITRIOS FARMAKIS³

• ¹Laboratory of Neuromuscular and Cardiovascular Study of Motion – LANECASM, Department of Physiotherapy, University of West Attica, Athens, Greece
• ²Department of Emergency Medicine, Athens University Hospital Attikon, National and Kapodistrian University of Athens Medical School, Athens, Greece
• ³Department of Cardiology, Athens University Hospital Attikon, National and Kapodistrian University of Athens Medical School, Athens, Greece

Introduction Dance is described as a phenomenon in which the human body and its movement, that may have a symbolic or aesthetic value within a variable cultural and rhythmical context, are the primary tools for the human expression and communication under artistic, educational, training, recreational, therapeutic, religious, or other purposes (Basso et al., 2020; Elpidoforou, 2016; Elpidoforou et al., 2025). As a physical activity, dance motivates physical, cognitive, psychological, and social individual's integration, while it enhances neuroplasticity and functional autonomy (Dhami et al., 2014; Foster, 2013; Kattenstroth et al., 2010). As a performing art form, dance seems to be extremely close to music, as both arts have a common aspect, the dependence upon rhythm (Schrader, 2005). The therapeutic use of music concerns two main domains, Music Therapy (MT) and Music Medicine (MM) or Therapeutic Music (TM). MT refers to the psychotherapeutic use of music, while MM or TM refers to the use of music during conventional therapeutic interventions (Kang et al., 2025; Lee, 2016). Specifically, the American Music Therapy Association defines MT as "the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program" (AMTA, 2025). Meanwhile, the British Association for Music Therapy describes it as the psychological clinical music intervention, delivered by allied healthcare professionals registered in music therapy to help people who, due to an injury, illness or disability, have a certain psychological, emotional, cognitive, physical, communicative and social need (BAMT, 2025). MM or TM refers to the "pre-recorded music listening experiences administered by medical personnel", who are not registered in MT (Browning et al., 2020; Lee, 2016; Lorek et al., 2023). Both approaches are performed by specially registered healthcare professionals and are indicated for several purposes, such as pain relief, in clinical practice (Guetin et al., 2012; Korhan et al., 2014; Lee, 2016; Roy et al., 2012). While the use of different terms in the field of "music interventions in clinical populations" seems to be better established, this does not seem to be the case for "dance interventions in clinical populations". Dance can be applied in populations with various physical, cognitive, sensory, developmental or other impairments or diseases within three different contexts: (i) dance therapy (DT), dance movement psychotherapy (DMP) or dance movement therapy (DMT); (ii) adapted dance (AD) or inclusive dance (ID); and (iii) therapeutic dance (TD) or dance as therapy (DaT). As the popularity of dance-based interventions grows in healthcare, education, and community settings, it becomes essential to clarify the terminology used to describe the various approaches. This distinction is not merely semantic, but is crucial for the design of future interventional programs, the definition of their outcome measures, as well as the standards of professional training. Dance therapy or dance movement psychotherapy or dance movement therapy The terms DT, DMP or DMT (Table 1) refer to the psychotherapeutic use of movement and dance for the promotion of the emotional, cognitive, physical and social integration of an individual to enhance health and wellbeing, while its practice is facilitated by registered dance-movement therapists or psychotherapists (ADTA, 2025; Koch et al., 2019; Michels et al., 2018; Woolf & Fisher, 2015); the European Association of Dance Movement Therapy includes the "spiritual integration" to the above list (EADMT, 2025). It is a recognized psychotherapeutic modality with diverse professional rights depending on national laws and regulations. There are various clinical indications, such as depression, anxiety, dementia, autism, behavior disorders, addictions, trauma, eating disorders and learning difficulties (Aithal et al., 2021; Biondo, 2023; Bucharova et al., 2020; Karkou et al., 2023; Karkou et al., 2019; Moratelli et al., 2023; Savidaki et al., 2020). The terms DT, DMP or DMT are used interchangeably by different organizations. DMT is the term used by the American Dance Therapy Association (ADTA, 2025) and the Dance Movement Therapy Association of Australasia (DTAA, 2025), while DMP is the term used by the Association for Dance Movement Psychotherapy of United Kingdom (ADMPUK, 2025). DT is commonly used in research (Barcelos de Souza et al., 2025; Tomaszewski et al., 2023) and, along with DMT and DMP, refers to the same intervention, although there is not a unique accepted universally name for it (Dunphy et al., 2021). National dance therapy associations have outlined several pathways for becoming a dance-movement therapist or psychotherapist, ranging from private institutions to PhD programs at universities (Dunphy et al., 2021). A minimum of two years of full-time training is required, including personal psychotherapeutic treatment, clinical training, fieldwork, internships, and supervision, to become a registered dance-movement therapist or psychotherapist (Dunphy et al., 2021). Adapted or inclusive dance AD or ID (Table 1) refers to a dance program appropriately modified for individuals with movement, sensory, cognitive, developmental or other impairments for their recreation, inclusion, social integration, as well as the enhance of their health and physical fitness, and is delivered by certified dance educators or instructors experienced or trained in a field of special education (Côté-Séguin, 2020; Joung et al., 2024; Lentzari et al., 2023; McGuire et al., 2019; Mendoza-Sanchez et al., 2022). Psychomotor dance-based exercise (Guzman-Garcia et al., 2013), has been used in the literature interchangeably with the above term. AD or ID programs are designed to be inclusive, allowing individuals of varying abilities or disabilities to participate in dance practices. These programs often focus on the joy of movement, fostering creativity, and building community among participants. Although they may have therapeutic effects, they are not structured as formal therapy sessions and do not require conduction by licensed therapists. AD or ID interventions focus on facilitating an inclusive and creative learning process for individuals of different abilities or disabilities in educational or community settings (Dinold & Zitomer, 2015). Suggested practices include adapting and modifying dance techniques and teaching methods, using inclusive language in instruction, encouraging participation, and fostering social interaction in an individualized, team-oriented approach (Dinold & Zitomer, 2015). Numerous AD or ID programs (Massó-Guijarro et al., 2025; McGuire et al., 2019), suggested guides for developing an inclusive dance intervention (Duarte Machado et al., 2025), and teacher training programs (ALLPlayDance, 2025; Candoco, 2025; DanceAbility, 2025; ParableDance, 2025; Seedbed, 2025; SENDance, 2025; SENDTraining, 2025) exist. However, the lack of clear professional standards and a representative international organization highlight the need for the development of a unified framework for these interventions. Therapeutic dance or dance as therapy The term TD or DaT (Table 1) is often used in the scientific literature in different contexts without having yet been clearly defined. As the most loosely defined category, it encompasses structured dance interventions designed to promote health and well-being aspects of clinical populations without necessarily meeting the criteria of DT, DMP or DMT. Examples include studies in patients with hypertension (Peng et al., 2024; Peng et al., 2021; Wang et al., 2024), heart failure (Gomes Neto et al., 2014), breast cancer on treatment with anticancer therapies (Karkou et al., 2021), Parkinson's disease (Elpidoforou et al., 2022), multiple sclerosis (Davis et al., 2023), chronic pain (Hickman et al., 2022), Alzheimer's disease (Ruiz-Muelle & Lopez-Rodriguez, 2019), and HIV/AIDS (Morgan, 2014). There are many studies in which the term of DT or DMP or DMT has been used – instead of TD or DaT – to define a dance program applied to clinical populations with specific therapeutic endpoints, but with non-specific DT or DMP or DPT assessment and therapeutic tools and/or facilitated by non-dance movement therapists. DaT, as a term, is used to define dance interventions in clinical populations conducted by healthcare practitioners who are not dance-movement therapists (Tomaszewski et al., 2023). Thus, TD or DaT could be defined as the complementary non-pharmacological therapeutic use of dance for the improvement or relief of symptoms related to a disorder or disease – not necessarily mental – or symptoms that appear as side effects of medical care, and is facilitated by registered healthcare practitioners trained in dance (Bognar et al., 2017; Brito et al., 2021; Bruyneel, 2019; Elpidoforou et al., 2022; Karkou et al., 2021). The above definition is closely related to the existing definition of TM or MM, that differentiates it from MT (Browning et al., 2020; Kang et al., 2025; Lee, 2016; Lorek et al., 2023), as it is written above. According to that, both TM or MM and TD or DaT are complementary, non-pharmacological, arts-based interventions delivered by registered healthcare practitioners in clinical contexts for non-psychotherapeutic purposes. TD or DaT interventions aim to use dance as a complementary non-pharmacological therapeutic tool in clinical settings, facilitated by healthcare practitioners with non-psychotherapeutic training backgrounds (Tomaszewski et al., 2023). Several TD or DaT programs and teacher training programs exist (DfPD, 2025; McRae, 2018; WSU, 2025), but no professional standards have been clearly yet established. The development of an appropriate consensus on these standards could clarify the role of TD or DaT professionals. Discussion and future directions Each of the three different dance-based interventions contribute uniquely to human health and experience and may offer profound benefits in a variety of different populations. However, clarity in terminology is crucial for refining practice, advancing research and ensuring ethical service delivery. Recognizing their differences allows us to better harness their potential. The question that arises is what practical recommendations could be derived from the above clarified definitions. We recommend the use of the terms DT or DMP or DMT in the case of a registered in DT or DMP or DMT mental health care professional and in the context of a primary psychotherapeutic goal for a population with an appropriate need. Instead, we recommend the use of the term AD or ID in the case of a certified dance educator or instructor with a further training in a field of special education and in the context of a primary goal of artistic expression, recreation, physical fitness, personal empowerment, or social integration and inclusion. Finally, we recommend the use of the term TD or DaT in the case of a registered healthcare practitioner with additional training in dance in the context of facilitating a dance intervention with a primary goal of improving or relieving disease symptoms or medical care side effects. Table 1 Key differences among dance-based interventions DT or DMP or DMT a AD or ID b TD or DaT c Primary goal Psychotherapeutic treatment Artistic expression, recreation, physical fitness, personal empowerment, social integration and inclusion Improving or relieving disease symptoms or medical care side effects Facilitator Registered in DT or DMP or DMT mental healthcare professional Certified dance educators or instructors trained in a field of special education Registered healthcare professionals trained in dance Target population Individuals with mental health needs Individuals with disabilities or impairments Individuals with chronic diseases or disorders Setting Clinical or therapeutic Community or educational Clinical or therapeutic Clinical assessment and planning Yes No Yes Background Psychodynamic, humanistic, and developmental theories Inclusive arts education, community programs, adapted physical education, special education Arts and physical activities as complementary non-pharmacological therapeutic tools a DT: Dance therapy, DMP: Dance/Movement psychotherapy, DMT: Dance/Movement therapy. b AD: Adapted dance, ID: Inclusive dance. c TD: Therapeutic dance, DaT: Dance as therapy.