The Right to Rap

Hip Hop saved my life. It was my therapy long before I entered therapy, keeping me alive just long enough to make it there. I spent my teenage years in and out of rehabs and psych wards that left more wounds than they healed, but there was always one resource I could reliably turn to: Hip Hop. Writing in rhythm and rhyme was a way to structure the unmanageability inside my mind. Making beats allowed me to express my hurt and hope and make the unspeakable heard. Recording and performing connected me with others when I felt lost and alone.

Hip Hop provided me agency, but unfortunately, it was not always enough. The first time I was institutionalized was the summer before my senior year of high school. I spent two months involuntarily in a drug treatment center. Upon arrival, a staff member confiscated my CD player, headphones, and rhyme books. When I vehemently protested, I was told that rap music would only further encourage the substance abuse and criminality that brought me there. I did not know how to articulate that the music was a way to cope with my mental health struggles and find some semblance of purpose in life—and I did not feel I should have to. But I did know I was being punished for my love of and identification with Hip Hop.

This was a common experience for me across various institutions, from rehabilitation facilities to hospitals. For years prior to and after that first institutionalization, every mental health professional I encountered pathologized the cure. Making matters worse, therapy did not resonate with me because it was not relevant to my everyday experience. It wasn’t until years later, when I met a therapist who respected my love of the music, that I gave therapy a genuine try. Ultimately, it was both Hip Hop and therapy that saved my life.

Spawned from the rubble of the postindustrial urban climate of New York City in the 1970s, Hip Hop rose as a countercultural phoenix from the ashes of the “burning Bronx.”¹ In response to government abandonment of urban neighborhoods and removal of basic city services, such as those provided by police and fire departments, youth found a way to not only survive but thrive. What began as an economically feasible form of entertainment rapidly transformed into innovative styles of self-expression—including DJing, MCing, breaking, graffiti, beatboxing, and fashion—that took the world by storm. As an expressive form of alchemy, Hip Hop turned the commonplace to gold; through it, not only did forgotten youth find a way to cope, but they created multiple pathways to self-empowerment.²

In the face of systemic neglect of low-income urban neighborhoods, Hip Hop was much more than entertainment: it was a countercultural revolution embodied as a way of life bound to community action and social change. Across modalities, Hip Hop represents the democratization of art-making. No prior knowledge or formal training is needed to participate. Rap is conversational; if you can talk, you can rap. If you can hear, you can DJ; see, and you can tag (graffiti); move, and you can break (dance). Hip Hop’s accessibility embodies its equalizing function. Hip Hop is still considered a voice of the oppressed and a tool to confront those in power³ and fight injustice.⁴ Its mass appeal extends far beyond the aesthetic: people relate with the message. Its sociopolitical resonance is arguably the reason for its global reach.⁵ Hip Hop represents resilience, resistance, and redemption for those living on the margins; to this day, it is an art form for the underdog and is used in social action and political protest all over the world.⁶

Given their drastically different cultural underpinnings, it might seem counterintuitive to merge Hip Hop and therapy. In both, however, people are partaking in expressive practices to help them release, communicate, and connect. In a group setting, whether sitting in a circle or entering what we call a “cypher” in Hip Hop, individuals share their personal experiences in response to one another through verbal and nonverbal means. This interpersonal exchange is built on the curative capacity of connecting to a community. Hip Hop has always been healing—and will continue to be, with or without professionals. Whether intuitively or explicitly, Hip Hop has served therapeutic purposes since its inception, rooted in practices that trace back to the beginnings of humankind. We have used the arts, language, rhythm, and ritual to heal for millennia.⁷ In that sense, Hip Hop is a modern adaptation of ancient healing practices. Merging Hip Hop and therapy also helps address a primary critique of psychotherapy, which is that it represents Eurocentric, upper-middle-class ideals and is dismissive of cultural differences. A push for culturally competent treatments has been underway for several decades due to significant evidence of disparities in the quality of mental health services delivered to racial and ethnic minority groups⁸ as well as cultural bias in healthcare considerations and decision-making.⁹

While Western psychological traditions of healing focus primarily on verbal therapies, cultures around the world depend upon mindfulness and physical action, including rhythmic movements, in healing rituals that are also underscored in religious ceremonies. These traditions take into account the vitality of physical synchrony with oneself and others, particularly since the formation of relationships and attachment is embodied in expressions, gestures, and touch.¹⁰ Trauma results in visible bodily dysregulation; yet when individuals play and create together, the shared experience of agency and enjoyment generates a sense of physical attunement.

The Restorative Potential of
Hip Hop Therapy

In the mid-’90s, a clinical social worker began laying the empirical foundation for integrating Hip Hop’s healing capacities into mental health treatment. Hip Hop therapy (HHT) was first coined and introduced to the literature by my late professor, mentor, and friend, Dr. Edgar Tyson. HHT blends the inherently cathartic components of the culture with well-established treatment modalities, from music, poetry,¹¹ and other expressive therapies¹² to solution-focused,¹³ narrative,¹⁴ cognitive behavioral,¹⁵ psychodynamic,¹⁶ and dialectical behavioral therapies.¹⁷ It takes what is relevant to the client within these more traditional approaches and reimagines their applicability and procedural processes. Similar to how DJs created sonic arrangements by revising popular records or rejuvenating dated and abstract ones, HHT is a culturally resonant remix of therapeutic conceptions, revitalizing established forms of psychotherapy that have historically overlooked disenfranchised populations.

Developed as a specific intervention using rap music to initiate therapeutic dialogue, HHT has evolved into a conceptual framework that entails various methodologies from song analysis to creation of the art itself (music or otherwise). Based on Tyson’s assertion that Hip Hop culture is the “central mechanism of HHT” and cannot be distilled down to one element,¹⁸ Hip Hop therapy is an umbrella term for all Hip Hop–based psychotherapeutic interventions. Much like the culture, Tyson’s original model has evolved into an approach with significant global resonance.¹⁹ In fact, one of the greatest strengths of bringing Hip Hop into treatment is its propensity for cross-cultural diplomacy. Its transcendence of geography, race, ethnicity, religion, and socioeconomic status highlights Hip Hop as an intercultural tool with the unique capacity to address the traditional lack of multiculturalism in therapy. The same way Hip Hop culture was born out of oppressive structures that pathologized marginalized communities, HHT was born from the need for culturally competent treatment amid a nonrepresentative and even harmful mental health care system.

HHT highlights the innate hardiness within a maligned and criticized culture. Over the decades, the mainstream conversation about Hip Hop has highlighted its supposedly corrupting influence on youth.²⁰ When researching the use of Hip Hop in treatment, all Tyson found was literature on the negative influence of rap music.²¹ There was no acknowledgement of its social justice goals, its empowering of individuals and communities, or its rich history as a culture. Given its many art forms, parallels can be drawn between HHT and expressive arts therapy, which is a synthesis of the creative arts therapies (also known as expressive therapies) that include music, writing, drama, dance, and art therapy.²² Similar to HHT, expressive arts therapy transitions freely and purposefully between two or more creative forms of expression to aid in deeper personal and social exploration and promote individual growth, community development, and transformative healing.²³ Although the majority of HHT-related research focuses on music, some studies—not to mention five decades of testimonials from the Hip Hop community²⁴—also indicate the therapeutic potential of Hip Hop dance and visual art.²⁵

As a component of HHT, rap’s form and function make it particularly well-equipped for use in treatment. Its form mirrors an effective therapeutic environment²⁶ similar to Vygotsky’s zone of proximal development, where the ideal setting for growth involves something that is optimally challenging (not too hard or too easy). Rap vocals have rhythmic complexity that can feel somewhat chaotic in comparison to singing but are within the context of a basic, grounding drumbeat. When done well, it is a beautiful, efficient balancing act between order and chaos. The same occurs in therapy, or anywhere (including educational spaces) that meaning-making occurs. A holding environment—a psychological space that is simultaneously safe and challenging, structured but not stifling—must be established. In function, rap is deeply rooted in self-analysis and vulnerability, which is evident in the fact that some of its biggest artists (e.g., Tupac, Biggie, Eminem, Jay-Z, Nas, Kendrick Lamar, J. Cole, and Drake) are those who have most deeply explored their own internal worlds and sociopolitical circumstances. Rapping has also been notoriously uncensored, with lyrical content often tackling taboo subjects—this is ideal for therapy sessions in which you need to be able to discuss anything.

Hip Hop and Trauma

When individuals relive a traumatic experience, their capacity to clearly think and speak becomes impaired. This limits their ability to make sense of what is going on within themselves and others around them.²⁷ Opening lines of communication between the verbal and nonverbal parts of the brain can allow us to process trauma and break free from the rigid patterns it locks us into. Uncoupling these thoughts, emotions, and physical sensations is essential to the reevaluation and reintegration of memories.

As a result, theorists have endorsed approaches such as expressive arts therapy and eye movement desensitization and reprocessing (EMDR) when traditional talk therapy is unsuccessful.²⁸ Engaging in artistic endeavors involves a complex array of cognitive, sensory, and motor activities, encouraging the holistic functioning of the brain. In addition to their incorporation of nonverbal processes, the expressive arts embody “patterned, repetitive, rhythmic activity,”²⁹ a crucial tool for regulating the nervous system. Drumming, dancing, drawing, and singing engage and settle the mind and body, making relational and cognitive processes more accessible.³⁰

Rap music is optimal for processing trauma because of its marriage of rhythm and meaning. Aside from the instrumentation, each unit of rhythm (stressed and unstressed syllables) holds verbal significance, making it impossible to separate the meaning from the music. Not only does rap create a grounding environment that regulates the nervous system through rhythm, but part of that rhythmic engagement is also rooted in cognition, bridging the mind-body gap.            

Experts have noted the neurobiological underpinnings of meaning-making, highlighting that flashbacks occur when the brain fails to properly situate traumatic events in the past.³¹ A simple grounding beat and the rhythmic arrangement and delivery of syllables help create an environment for reprocessing and novel meaning-making to situate a past trauma so that it is no longer triggered by present reminders. The dual focus established by writing rhymes to a beat is also reminiscent of EMDR, where a rhythmic, body-based task provides enough distraction for the mind to access and evaluate (reprocess) experiences that would normally trigger one’s stress response system.³²

Hip Hop Therapy in Practice:
Mott Haven Community High School

With the foundation built by Dr. Tyson, I hit the ground running as a clinical social work intern in pursuit of my master’s degree. A Hip Hop artist myself, I incorporated the more expressive elements of the culture, such as writing, producing, recording, and performing, into my work with clients.* In 2012, I was placed at Mott Haven Community High School, a newly founded “second-chance” transfer school in the South Bronx for over-age and under-credited students two or more years off track. Transfer schools are small public high schools that offer accelerated coursework and an opportunity to earn credits at a faster rate for students 16–21 years old who have either dropped out or fallen behind.³³ Compared to citywide school averages, these schools have predominantly Black and Hispanic students, with significantly lower Asian and white populations and much higher percentages of English language learners and students receiving special education services.

Mott Haven Community falls within the country’s poorest congressional district;³⁴ 94 percent of students are economically disadvantaged,³⁵ and 45 percent of children live below the federal poverty line.³⁶ The students I work with face tremendous obstacles, from community violence and juvenile justice involvement to foster care placement, homelessness, teenage pregnancy, physical and sexual abuse, and mental health issues. Much of my work involves processing trauma rooted in these and a wide range of other experiences. In my internship, I used Hip Hop therapy with some students to address both trauma and specific mental health conditions, including mood disorders, substance use, and PTSD (more accurately conceptualized as developmental trauma,³⁷ which is complex trauma,³⁸ or the existence of multiple, often ongoing events, that begins in early childhood).

After my internship, I was hired full-time at Mott Haven Community as a social worker and continued engaging students through HHT. Upon seeing the interest and involvement of students who were the most difficult to engage, the school’s principal provided me with a budget to build a professional recording studio in an old storage room. The origins of the studio program are chronicled in the award-winning short documentary Mott Haven, which is available for free at go.aft.org/sis. I have been running the studio for over a decade now, and in that time the space has more than doubled in size. Being able to provide this outlet to youth in the birthplace of the culture that saved and helps sustain me is beyond my wildest dreams. It is truly poetic justice.

The Hip Hop Therapy Studio

The HHT studio is a voluntary afterschool program open for several hours a day. There are typically 12 to 15 total participants at a time, although due to varying schedules, most sessions range from 8 to 12 students. In the studio, I offer direction, assistance, materials, and hands-on training in the expressive components of HHT, and I facilitate group therapy and discussions surrounding relevant themes.³⁹ I also meet with group members for individual sessions throughout the school day, where I employ both expressive and receptive (i.e., listening) methodologies. Group discussions regularly involve students showing me and each other songs and videos, which naturally evolves into conversations about related topics relevant to their lives. I find that this informal, natural flow of events is conducive to engaging students in therapeutic dialogue because it is noninvasive and a more realistic reflection of social interaction.

The studio provides students a space to socialize and express themselves freely through creative processes in a positive, supportive environment.⁴⁰ They form strong bonds and help each other through these undertakings—and they tend to keep each other in check, making sure everyone respects one another and follows group norms. Once these norms have been co-constructed, redirection is rarely needed. Because only so many individuals can create a song per session, and only so many songs can be shared and discussed, members are invested in the group progressing smoothly and efficiently. Participation alone is positive reinforcement for respecting one another and the space. To this point, Hip Hop–based interventions are particularly powerful in that what is therapeutic is perceived as a reward rather than a punishment. The implications this has for youth engagement and investment cannot be overstated, particularly for youth whose introduction to therapy is too often coerced and based on thoughts and actions deemed problematic by adults in their lives. Adolescents are commonly considered resistant to treatment,⁴¹ but it is vital to evaluate how mental health professionals are failing to engage them in authentic, strengths-based ways.

In the studio, students are encouraged to engage in music-making and are given the tools to do so. For those who need it, I illustrate how to rap by detailing the technical aspects of rhythm and rhyme and structuring lyrics within a beat. I demonstrate how to use the recording, engineering, and production equipment and professional audio software. I also guide them through performances: I teach them how to authentically express their content through emotional attunement in the recording booth and on stage, and I teach techniques such as visualization, breathing, and relaxation exercises for overcoming performance anxiety.⁴² We discuss how to portray moods and meanings nonverbally, through posture, facial expressions, and tone. At the end of the year, we put on an annual showcase, which serves as a narrative through song with themes determined by the students and based on their work. The students codirect the show, developing skits, dances, props, and artwork to advance the storyline, which diversifies the modalities through which the therapeutic process materializes. All these experiences translate into social and emotional competencies, from emotional regulation through self-awareness and reflection to enriched verbal and nonverbal communication skills. Ultimately, the cultivation of these proficiencies is central to students’ ability to navigate intra- and interpersonal conflicts,⁴³ and their skill development also increases their self-esteem and sense of self-efficacy.⁴⁴

Healing and Feeling: Ephraim’s Story

Although the youth I have the privilege of working with face incredible odds, they embody a degree of resilience that would be difficult for most people to comprehend. The grit, untapped talent, and growth I get to witness daily is profoundly inspiring.

Consider Ephraim Weir, a young man you’ll meet in the Mott Haven documentary (and hear from in the article here). I was first introduced to Ephraim, a Caribbean American male, a couple of months into the 2013–14 school year. Only 17 years old, he had just returned from a month’s stay in an inpatient psychiatric setting for a suicide attempt.^† He had stabbed himself in the chest, and his mother explained that he seemed incoherent and unable to express himself beforehand, going days without eating or sleeping. The school was trying to re-engage Ephraim, and after debriefing me earlier that day, a school counselor brought him over for an introduction.

As he entered my makeshift office, the old storage room I was turning into a music studio, Ephraim had a suspicious look on his face. I could tell his trust would be hard-earned, as I know all too well the harm well-intentioned mental health professionals and educators can cause in the name of “helping.” In addition to his legitimate mistrust of my profession as a social worker and therapist, my being white and dressed in professional garb likely did not help. Ephraim was wearing the latest street fashion and had a swagger that gave me the impression he was immersed in Hip Hop culture—for me, a promising sign that we could connect. Even if we were from two very different walks of life at first glance, Hip Hop is something you can smell on people. As a culture, it goes well beyond the artistic expressions associated with it, being rooted in shared beliefs and customs affecting everyday existence.

When Ephraim entered, we engaged in an awkward handshake that was half shake and half slap. He was polite but clearly not looking forward to this interaction. He presented as sad and solemn—hopeless even—with his eyes glued to the floor. Other than the occasional cagey, fight-or-flight glance at me, Ephraim seemed resigned and indifferent to what he likely perceived would be another disconnected lecture forced upon him. I knew these looks because I had seen them in the mirror countless times.

After our somewhat uncomfortable introduction, I asked Ephraim what kind of music he listened to. When he said “Hip Hop,” I inquired about his favorite artists and songs. He obliged, surprised by my familiarity and mutual appreciation. We began trading songs, and what started as awkward silences and one-word answers soon evolved into an in-depth discussion of favorite lines, their meanings, and the intricacies of rhyming and creative writing. It felt like having a conversation with a long-lost friend about the current state of Hip Hop—until the bell rang. I knew we had made progress though, regardless of how momentary the lapse in hierarchy.

What may have appeared to some as a waste of time at best and a neglect of duty at worst, this first session with Ephraim laid the foundation for a strong therapeutic alliance that would last for several years until our work together concluded. In this initial meeting, I intentionally did not bring up his hospitalization. I wanted him to know that this experience did not define him, nor was it the most interesting or important thing about him that we could talk about. Maybe because I have been hospitalized on numerous occasions for psychiatric reasons, including at the very facility he had just been released from; maybe because during those stays, I had developed close friendships with many teens just like him—like me. Or maybe it was because I know that to develop a working relationship with a person, I need to see them for who they are, not just what they’ve done or what has happened to them. I need to see their strengths as well as their struggles. Knowing that Ephraim had Hip Hop as a cultural source of strength was a much more important finding in that moment than digging immediately into his past and presenting issues.

As I began working with Ephraim, his identification with Hip Hop culture became my window into his reality. After a while, he revealed that he wrote poetry, that all of his poetry rhymed, and that he had attempted to rap before and secretly always wanted to, but he felt he was not good at it. He insisted that he was not a rapper, and when asked what he meant by this, he explained that he did not like to write about money, cars, and women. This is a common reflection of the stereotypes associated with rap as opposed to the “more refined” poetic forms such as literary verse or spoken word. I found this deeply disconcerting. There was an injustice being perpetuated here: a cultural form of expression that resonated with him was being reflected back in such a way that he was discouraged from exploring something he had a natural knack for. A resource was portrayed as a vice, and a strength masked as a liability.

Ephraim should never have been steered away from rap and made to feel ashamed for a desire to rap, whether by someone he respected or the mainstream representation and criticism of this fundamentally Black art form. As a white kid from the suburbs, Hip Hop is not my native tongue, so I can understand the skepticism I’ve received about it my whole life. Misguided as it is, I get how my appreciation of and participation in the culture can lead to the occasional accusation of appropriation because of my appearance. But for Ephraim, a Bronx-born Black youth of the culture, in the birthplace of the culture, to have received the message that rapping is wrong was unacceptable. If anyone had the right to rap, it was him.

As a therapist, I tried to remain objective in exploring why Ephraim felt that way about rap. I challenged his preconceptions of what defined a rapper, and I explained that we create our own definitions. A rapper is merely one who raps. To me, a rapper is a warrior for human rights and social justice; to Ephraim, based on what he predominantly heard and saw, as well as the larger society’s general interpretation and what was projected back at him, a rapper was selfish, materialistic, and antisocial. I clarified that both definitions can be true at the same time.

Ephraim seemed invigorated by the idea that rap can be what you make it, but he still believed he did not have enough innate talent. I told him that anyone can rap or write rap lyrics. Each individual has a unique perspective and story to tell. With some guidance and a blueprint for the form of rap music, I assured him he could be rapping in no time. Ephraim was skeptical, later admitting he initially thought I might have been trying to turn him into something he was not. However, he noticed I never pressured him or told him what I thought he should do; I merely offered assistance if he decided to give it a shot one day, in the meantime expressing interest in reading his poetry. He was not ready to share at that moment, and I did not push, simply suggesting he stop by the studio after school for a group session if he was interested. He had not made any friends in the school at this point, and I thought coming could be good for him whether he participated or not.

Ephraim took me up on the offer, initially coming and sitting against the wall, not communicating with anyone. He witnessed the other members taking risks, attempting to rap, some effectively and others clumsily. From the outside, it may have appeared like he was silently judging from a distance, but I knew he was just gauging the temperature of the group. He wanted to see if it was truly a safe space before he became willing to put some skin in the game. After a few weeks, Ephraim approached me in the hallway with a poem he wanted to show me. Elated, I asked him to read it to me, but he insisted that I read it on my own. This reminded me of when I first began sharing my writing. My lyrics were pieces of me, and they were so fragile that I could not bear to watch a person’s initial response out of fear that they would hate it or, worse, pretend to enjoy it. I would ask others to read it or listen to a recording when I was not there, and this is what Ephraim was requesting. I enthusiastically obliged, taking his poem back to the studio. What I read looked much like my first attempts at writing lyrics: deeply introspective rhyming poetry that simply lacked a defined structure.

When we next met for an individual session, I expressed how genuinely impressed I was with his writing and openness to sharing it with me. My excitement was palpable, and Ephraim’s smile let me know he could see I was authentically engaged. I began going over it with him line by line and explained that he had already written a rap without knowing it. I illustrated how it fit on different beats with different tempos through a few simple rearrangements, and that because of its rhythmic structure, it would fit within a certain range as long as its delivery was sped up or slowed down. He was amazed, and at that point, his journey as both a rapper and a fully invested group member began. In group, Ephraim was applauded for his efforts by the other members, who had started to become wary of his silence. Slowly, he went from letting others read his work to rapping out loud and then recording and collaborating with the rest of the group. Despite being extremely nervous, he even mustered enough courage to perform in that year’s showcase, shocking everyone who had met him beforehand.

I wish I could say it was all smooth sailing from there on out. However, many of the youth I work with are returning to war zones when they go home, often crossing gang lines just to attend school. One Friday evening in April 2014, weeks after that showcase, the group was wrapping up and Ephraim was annoyed that he did not get the chance to record what he had been working on because our time had run out. I proposed that the upcoming Monday be all his. The rest of the group agreed; they were excited to see what he had been working on. But over the weekend, Ephraim was jumped by two assailants and stabbed eight times. Abandoned by his friends, he was left bleeding on the sidewalk alone. By some miracle, a stranger in a minivan pulled over, applied pressure to his wounds, and called an ambulance. He was rushed to the ER with a punctured lung and ruptured spleen, among other serious injuries. When he came to, fighting for his life in a hospital bed, Ephraim told me his first thought was of the studio and how he would not be getting his Monday.

After an extended recovery period, Ephraim returned to school with a cane and a stack of new writings. For the rest of that year, we spent much of our time processing his emotions surrounding that trauma—including anger and betrayal, with a desire for revenge at the forefront—particularly through his writings and recordings. He wrote an extraordinary song, his first full song ever completed, elucidating his healing process and renewed appreciation for life. What could have easily initiated a destructive downward spiral of retaliation became a point of reference for Ephraim reframed as a rebirth. The song is called “Heaven’s Gates.” It is an ode to his recovery, and the chorus sums it up best:

Healing and feeling, we all just dealing
Praying to the ceiling, hope for the realest 
Secrets revealing, then a lot of tearing
Try to keep achieving, everything I believe in

This anthem about how he was healing, feeling all his feelings, and then moving on to achieve greater things is the essence of therapy: the means and the end. (To listen to “Heaven’s Gates,” go to go.aft.org/cmp.)

Ephraim was given a second chance at life, and through his art, he took on the challenge. After barely attending and failing the majority of his classes at a traditional public high school, at Mott Haven Community his attendance improved from 29 percent to 92 percent⁴⁵ and he passed every class he took. He entered Mott Haven Community in 2013 with three of the 44 credits and none of the five New York State Regents Examinations required to graduate. In 2016, he graduated with honors, receiving two scholarships for growth and perseverance for a total of $2,500 toward college tuition. The biggest change, however, extended far beyond academics. He exhibited tremendous self-awareness, confidence, and willingness to share and relate with others. He greatly improved his relationships at home, and his mother was especially amazed with his transformation. From having no friends, barely speaking to anyone, and getting into a fight during his first month at the school before his suicide attempt, Ephraim developed into a social butterfly loved by students and staff alike. To this day, Ephraim continues to turn to Hip Hop and making music as a source of solace.^‡

Each student I have worked with has as awe-inspiring a story as Ephraim. They have all made incredible personal strides against inestimable odds, and it has been one of the utmost privileges of my life to work with each of them. From improved peer, familial, and community relations to personal development, the HHT studio has had a positive impact on all participants over the past decade. Even students who had previously been deemed unreachable and who were closed off to the idea of therapy have excelled at identifying and exploring emotions, learning and utilizing positive coping mechanisms, and developing self-regulation capacities and tolerance for discomfort. They have flourished in fostering social awareness and skill sets through open interaction and developed communicative abilities that have allowed them to practice navigating social relationships, dynamics, and structures. They also have enhanced their critical thinking, in terms of themselves and society at large, leading them to examine the power of the individual and group and better understand how to effectively advocate for themselves. The studio provides a safe, supportive space for all of this to occur, where open dialogue, authenticity, and respect are primary.

In addition to socioemotional development, HHT has shown to be tremendously effective at helping youth process significant traumas they have experienced. I have worked with numerous students who used the creative process to address and reframe experiences they were previously too ashamed to talk about with anyone, let alone record and perform in front of the community. I have seen the process help reunite families by creating a space where they could authentically express how they felt about certain dynamics or events and then initiate communication and behavioral change. I have seen it cut across gang lines and create a space for collective healing and bond-building. I have seen youth come to terms with previous activities that led to incarceration, from harm inflicted upon others to harm inflicted upon them in the streets or by the justice system. I have seen youth process realizations about gang involvement and decide to avoid that lifestyle while prioritizing their personal goals and developing healthier relationships. I have seen it steer individuals away from retaliation for events that anybody would want revenge for. I have seen them work through losing multiple people in their lives, from friends and family to fellow classmates. I have seen it bring some back from the brink of serious self-harm and suicide.

I have also seen HHT breathe new life into students, providing joy, connection, and purpose. In creating a safe space to play, I have seen youth hardened by their environments get the opportunity to let loose and be children, often for the first time in their lives. I have seen them develop tremendous insight into their thoughts, behaviors, and actions and become change agents for themselves and those around them. And while education is only one focus of our work together, I have witnessed these students’ graduation rates nearly double compared to other transfer schools in the borough as a result of the mental health benefits they experienced.

Although we work toward the same aims in other approaches, the advantage of Hip Hop therapy is its cultural responsiveness and cross-cultural applications. Very few things in this world can bridge racial, ethnic, socioeconomic, religious, and geographic divides. Hip Hop is clearly one of them.

J.C. Hall, LCSW, EXAT, is a Hip Hop artist and social worker at Mott Haven Community High School in the South Bronx, where he founded the Hip Hop Therapy Studio program to provide culturally resonant treatment to youth through artistic media. In 2020, he won a national Jefferson Award for Outstanding Public Service Benefiting the New York Community. He is also the 2024 recipient of the Psychotherapy Networker Vanguard Award and a 2024 winner of The David Prize.

*Although people of all backgrounds can benefit from elements of HHT, such as writing down their feelings and vocalizing them rhythmically, Hip Hop is not culturally resonant with everyone. In these cases, I do not incorporate it into interventions tailored to meet clients’ specific needs. (return to article)

^†If you or anyone you know needs support, call or text 988 for the Suicide and Crisis Lifeline. (return to article)

*To learn how Ephraim and another studio participant continued to utilize the therapeutic relationship they developed with Hip Hop long after treatment ended, watch Byways, a follow-up to Mott Haven, available at go.aft.org/aj2. (return to article)

Endnotes

1. J. Chang, Can’t Stop Won’t Stop: A History of the Hip-Hop Generation (New York: St. Martin’s Press, 2005).

2. Chang, Can’t Stop.

3. J. Chang, “It’s a Hip-Hop World,” Foreign Policy, October 12, 2009, foreignpolicy.com/2009/10/12/its-a-hip-hop-world; S. Watkins, Hip Hop Matters: Politics, Pop Culture, and the Struggle for the Soul of a Movement (Boston: Beacon Press, 2005); and D. Fernandes and S. Raphelson, “The Sound of Global Hip Hop: Why the Genre Resonates Around the World,” WBUR, September 12, 2023, wbur.org/hereandnow/2023/09/12/hip-hop-global-sound.

4. A. Lippman, “50 Years of Hip-Hop: Its Social and Political Power Resonates Far Beyond Its New York Birthplace,” The Conversation, October 2, 2023, theconversation.com/50-years-of-hip-hop-its-social-and-political-power-resonates-far-beyond-its-new-york-birthplace-209784; and A. Morrison, “Down for the Cause,” Associated Press, August 9, 2023, projects.apnews.com/features/2023/hip-hop-50th-history/down-for-the-cause.html.

5. Watkins, Hip Hop Matters; and S. Watkins, “Why Hip-Hop Is Like No Other,” Foreign Policy, October 12, 2009, foreignpolicy.com/2009/10/12/why-hip-hop-is-like-no-other.

6. A. Morrison, “Hip-Hop and Justice: Culture Carries the Spirit of Protest, 50 Years and Counting,” Associated Press, August 10, 2023, apnews.com/article/hip-hop-social-justice-protest-50th-anniversary-5351511d2cd79ffe0b10d70db7772357; and S. Hadley and G. Yancy, eds., Therapeutic Uses of Rap and Hip-Hop (New York: Brunner-Routledge, 2012).

7. C. Malchiodi, Trauma and Expressive Arts Therapy: Brain, Body, and Imagination in the Healing Process (New York: Guilford Publications, 2020): 14–15.

8. F. Castro-Ramirez et al., “Racism and Poverty Are Barriers to the Treatment of Youth Mental Health Concerns,” Journal of Clinical Child & Adolescent Psychology 50, no. 4 (2021): 534–46.

9. S. Sue et al., “The Case for Cultural Competency in Psychotherapeutic Interventions,” Annual Review of Psychology 60 (2009): 525–48; J. Maura and A. de Mamani, “Mental Health Disparities, Treatment Engagement, and Attrition Among Racial/Ethnic Minorities with Severe Mental Illness,” Journal of Clinical Psychology in Medical Settings 24, nos. 3–4 (December 2017): 187–210; and V. Koç and G. Kafa, “Cross-Cultural Research on Psychotherapy: The Need for a Change,” Journal of Cross-Cultural Psychology 50, no. 1 (2019): 100–115.

10. B. van der Kolk, The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma (New York: Penguin Books, 2015).

11. E. Tyson, “Hip Hop Therapy: An Innovative Therapeutic Synergy Between Biblio-Therapy and Music Therapy in Group Work with At-Risk and Delinquent Youth,” in “Strengthening Resiliency Through Group Work,” ed. T. Berman-Rossi, paper presented at the 20th Annual Symposium for the Association for the Advancement of Social Work with Groups, Miami, FL, October 1998; and E. Tyson, “Hip Hop Therapy: An Exploratory Study of a Rap Music Intervention with At-Risk and Delinquent Youth,” Journal of Poetry Therapy 15, no. 3 (Spring 2002): 131–44.

12. J.C. Hall, “Reimagining Hip Hop Therapy,” in “Hop Hop Critical Consciousness Circles and Hip Hop Therapy 2.0: Innovations in Youth Mental Health Intervention,” ed. E. Tyson, workshop, 2016 Coalition for Juvenile Justice’s National Disproportionate Minority Contact Conference, Baltimore, MD, December 2016, youtube.com/watch?v=zoqsYscwmt4.

13. E. Tyson and T. Baffour, “Arts-Based Strengths: A Solution-Focused Intervention with Adolescents in an Acute-Care Psychiatric Setting,” Arts in Psychotherapy 31, no. 4 (2004): 213–27.

14. N. Allen, “Exploring Hip-Hop Therapy with High-Risk Youth,” Praxis 5 (2005): 30–36.

15. C. Kobin and E. Tyson, “Thematic Analysis of Hip-Hop Music: Can Hip-Hop in Therapy Facilitate Empathic Connections When Working with Clients in Urban Settings?,” Arts in Psychotherapy 33, no. 4 (2006): 343–56.

16. A. Hara, “RAP (Requisite, Ally, Protector) and the Desperate Contemporary Adolescent,” in Therapeutic Uses of Rap and Hip-Hop, ed. S. Hadley and G. Yancy (New York: Brunner-Routledge, 2012).

17. Hall, “Reimagining Hip Hop Therapy.”

18. Tyson, “Hip Hop Therapy: An Exploratory Study,” 134.

19. Hall, “Reimagining Hip Hop Therapy.”

20. D. Zaru and L. Brown, “Hip-Hop Has Been Standing Up for Black Lives for Decades: 15 Songs and Why They Matter,” ABC News, July 12, 2020, abcnews.go.com/Entertainment/hip-hopHip Hop-standing-black-lives-decades-15-songs/story?id=71195591; Chang, “It’s a Hip-Hop World”; and Lippman, “50 Years of Hip-Hop.”

21. E. Tyson, interview by K. Morrison and P. Whiteside-McFadden, “Interview for Mott Haven,” Fordham University Graduate School of Social Service, YouTube, February 24, 2022, youtube.com/watch?v=NVizvtzdAHA.

22. Hall, “Reimagining Hip Hop Therapy.”

23. C. Malchiodi, ed., Handbook of Expressive Arts Therapy (New York: Guilford Press, 2022).

24. A. Aziz, “10 Times Hip-Hop Has Given a Voice to Mental Health: Eminem, J. Cole, Logic & More Speak Out,” Grammy Awards, May 20, 2024, grammy.com/news/10-moments-hip-hop-mental-health-awareness-month-jay-z-joe-budden-j-cole.

25. S. Ciardiello, “Meet Them in the Lab: Using Hip-Hop Music Therapy Groups with Adolescents in Residential Settings,” in Social Work with Groups: Social Justice Through Personal, Community, and Societal Change, ed. N. Sullivan et al. (New York: Haworth Press, 2003), 103–15; and S. Leafloor, “Therapeutic Outreach Through Bboying (Break Dancing) in Canada’s Arctic and First Nations Communities: Social Work Through Hip-Hop,” in Therapeutic Uses of Rap and Hip-Hop, ed. S. Hadley and G. Yancy (New York: Routledge, 2012), 129–52.

26. Hara, “RAP (Requisite, Ally, Protector).”

27. B. van der Kolk, “The Neurobiology of Childhood Trauma and Abuse,” Child and Adolescent Psychiatric Clinics of North America 12, no. 2 (April 2003): 293–317.

28. S. Talwar, “Accessing Traumatic Memory Through Art Making: An Art Therapy Trauma Protocol (ATTP),” Arts in Psychotherapy 34, no. 1 (2007): 22–35.

29. B. Perry and O. Winfrey, What Happened to You?: Conversations on Trauma, Resilience, and Healing (New York: Flatiron Books, 2021).

30. B. Perry and M. Szalavitz, The Boy Who Was Raised as a Dog: And Other Stories from a Child Psychiatrist’s Notebook (New York: Basic Books, 2007).

31. Van der Kolk, The Body Keeps the Score.

32. R. Landin-Romero et al., “How Does Eye Movement Desensitization and Reprocessing Therapy Work?: A Systematic Review on Suggested Mechanisms of Action,” Frontiers in Psychology 9 (2018): frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2018.01395.

33. New York City Public Schools, “Transfer High Schools,” schools.nyc.gov/enrollment/other-ways-to-graduate/transfer-high-schools.

34. Food Research & Action Center, “Table 1. Number and Percent of People Below Poverty by Congressional District, 2017,” frac.org/maps/acs-poverty/tables/tab1-acs-poverty-cd-2017.html.

35. New York State Education Department, “NYC Geog Dist #7 - Bronx Data,” data.nysed.gov/profile.php?instid=800000046647.

36. P. Mendoza et al., The South Bronx: An Economic Snapshot (Albany, NY: Office of the New York State Comptroller, November 2023), osc.ny.gov/files/reports/osdc/pdf/report-13-2024.pdf.

37. B. van der Kolk, “Developmental Trauma Disorder: Toward a Rational Diagnosis for Children with Complex Trauma Histories,” Psychiatric Annals 35, no. 5 (May 2005): 401–8.

38. J. Herman, Trauma and Recovery: The Aftermath of Violence—from Domestic Abuse to Political Terror (New York: Hachette, 1992).

39. Tyson, “Hip Hop Therapy: An Exploratory Study.”

40. Ciardiello, “Meet Them in the Lab.”

41. A. Rodwin et al., “A Systematic Review of Music-Based Interventions to Improve Treatment Engagement and Mental Health Outcomes for Adolescents and Young Adults,” Child and Adolescent Social Work Journal 40 (November 2022): 537–66.

42. Hall, “Reimagining Hip Hop Therapy.”

43. Hall, “Reimagining Hip Hop Therapy.”

44. A. Bandura, “Self-Efficacy: Toward a Unifying Theory of Behavioral Change,” Psychological Review 84, no. 2 (1977): 191–215.

45. Y. Khan, “Hip Hop Therapy Boosts Attendance at Bronx High School,” WNYC, June 23, 2015, wnyc.org/story/high-school-recording-studio-boosts-spirits-and-attendance.

Sidebar Endnotes

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1. National Association of School Psychologists, “The Relationship Between Mental Health and Academic Achievement,” 2020, nasponline.org/Documents/Research%20and%20Policy/Research%20Center/MentalHealthAcademicAchievement_2020.pdf.

2. K. Mahnken, “The Hidden Mental Health Crisis in America’s Schools: Millions of Kids Not Receiving Services They Need,” The 74, November 7, 2017, the74million.org/the-hidden-mental-health-crisis-in-americas-schools-millions-of-kids-not-receiving-services-they-need.

3. National Alliance on Mental Illness: York-Adams Counties PA, “PAUSE (Youth Support Group),” namiyorkadams.org/p-a-u-s-e-youth-support-group/#:~:text=Suicide%20is%20the%20second%20leading,rate%20of%20any%20disability%20group.

4. Centers for Disease Control and Prevention, Youth Risk Behavior Survey: Data Summary & Trends Report, 2013–2023 (Washington, DC: US Department of Health and Human Services, 2024), cdc.gov/yrbs/dstr/pdf/YRBS-2023-Data-Summary-Trend-Report.pdf.

5. National Institute of Mental Health, “Suicide,” nimh.nih.gov/health/statistics/suicide.

6. National Alliance on Mental Illness, “Mental Health by the Numbers,” nami.org/about-mental-illness/mental-health-by-the-numbers.

7. Castro-Ramirez et al., “Racism and Poverty Are Barriers.”

8. J. Fisher et al., “Perceived Need for Treatment and Engagement in Mental Health Services Among Community-Referred Racial/Ethnic Minority Adolescents,” Administration and Policy in Mental Health and Mental Health Services Research 45, no. 5 (September 2018): 751–64.

9. W. Lu et al., “Barriers and Facilitators for Mental Health Service Use Among Racial/Ethnic Minority Adolescents: A Systematic Review of Literature,” Frontiers in Public Health 9 (March 7, 2021), frontiersin.org/journals/public-health/articles/10.3389/fpubh.2021.641605/full.

10. National Alliance on Mental Illness, “Mental Health Conditions,” nami.org/about-mental-illness/mental-health-conditions.

11. A. Prothero, “Schools Feel Less Equipped to Meet Students’ Mental Health Needs Than a Few Years Ago,” Education Week, May 9, 2024, edweek.org/leadership/schools-feel-less-equipped-to-meet-students-mental-health-needs-than-a-few-years-ago/2024/05.

12. N. Tamez-Robledo, “Why Schools Still Struggle to Provide Enough Mental Health Resources for Students,” EdSurge, February 19, 2024, edsurge.com/news/2024-02-19-why-schools-still-struggle-to-provide-enough-mental-health-resources-for-students.

13. W. Rock, “The School Counselor’s Role in Student Mental Health,” ASCA School Counselor, September 1, 2022, schoolcounselor.org/Magazines/September-October-2022/The-School-Counselor-s-Role-in-Student-Mental-Heal#:~:text=There%20are%20many%20reasons%20why,for%20a%20variety%20of%20reasons.

[Illustrations by Mink Couteaux. Photos: by Markus Schwer for the documentary Back to Tape 3; courtesy of Leo Pfeifer for the documentary Haven in the Booth; courtesy of Kyle Morrison from the documentary Mott Haven]