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SHARED SPIRITUAL BELIEFS IN MUSIC THERAPY AND
EMOTIONAL RESPONSES OF A MOTHER
WHO HAS A CHILD WITH MENTAL RETARDATION

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Jee-Sun Lee

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SHARED SPIRITUAL BELIEFS IN MUSIC THERAPY AND EMOTIONAL
RESPONSES OF A MOTHER
WHO HAS A CHILD WITH MENTAL RETARDATION
By

J ee-Sun Lee

A THESIS
Submitted to
Michigan State University
in partial fulfillment of the requirements
for the degree of
MASTER OF MUSIC

MUSIC THERAPY

2007

ABSTRACT
SHARED SPIRITUAL BELIEFS IN MUSIC THERAPY AND EMOTIONAL
RESPONSES OF A MOTHER
WHO HAS A CHILD WITH MENTAL RETARDATION
By
lee-Sun Lee
With the intent of improving the quality of life of parents who have a child with a

disability, the purpose of this study is how shared spiritual beliefs in music therapy affect
the positive emotional responses in parents’ images of themselves and emotional
relationships with their child, their spouse, and the external enviromnent. A case study
was designed to gain an in-depth understanding of the Korean Christian parents of an
elementary school student with mental retardation. The parents were asked to write
personal journal entries and to have one-to-one interview. As a primary participant, the
mother participated in the one-hour interventions based on shared spiritual beliefs for 10
weeks, and the verbal discussion and music products were analyzed. The benefits of the
intervention for the mother were found to be as follows: increasing the personal
awareness of the inner-self, improving the mother’s self-esteem by establishing a
positive self-image and achieving simple tasks, and supporting expressive skills of her

child in productive ways, which are accepted in her culture.

TABLE OF CONTENTS

LIST OF TABLES .................................................................................. vi

LIST OF FIGURE .................................................................................. vii
CHAPTER 1

INTRODUCTION ................................................................................... 1

Prevalence of Disability ....................................................................... 1

Family reactions to the disability ............................................................ l

Parents-Child Relationship ................................................................... 2

Husband-Wife Relationship ................................................................... 4

Sibling Relationship ........................................................................... 5
CHAPTER 2

RELATED RESEARCH ............................................................................ 7

Current Programs and Studies ................................................................. 7

Parents’ emotions ................................................................................ 7

Parents’ self-esteem/self-efficacy ........................................... 7

Emotions toward the child and the spouse ................................. 8

Parents’ optimism ............................................................. 9

Spirituality ..................................................................................... 10

Definition of spirituality ..................................................... 10

Needs of spirituality for caregivers of people with disabilities. . . . . 11

Music Therapy ................................................................................ 12

Definition of music therapy .................................................. 12

Emotions and music therapy ................................................. 12

Interpersonal relationships and music therapy ............................ 13

Spirituality and Music Therapy ............................................................. 13

Purpose and Research Problems .............................................................. 14
CHAPTER 3

RESEARCH STANCE & METHODOLOGY ................................................. l6

Researcher’s lens ............................................................................ 16

Participants .................................................................................. 17

Design ........................................................................................ 18

Procedure .................................................................................. 18

Music in therapy vs. music as therapy ....................................... 21

Data Collection ............................................................................... 21

Journal entries .................................................................. 21

One-on-one interview .......................................................... 22

Transcripts ...................................................................... 23

Observations .................................................................... 23

Documents of the songwriting products .................................... 23

Data Analysis ................................................................................ 23

iii

Trustworthiness .............................................................................. 24

CHAPTER 4
CASE STUDY .................................................................................... 26
Background history ......................................................................... 26
Session description ......................................................................... 27
Initial meeting (May 20, 2006) ............................................. 27
lSt session (May 29, 2006) ................................................... 27
2Ind session (June 5, 2006) .................................................... 29
3rd session (June 12, 2006)31
4th session (June 19, 2006) ................................................... 32
5‘h session (June 26, 2006) ................................................... 34
6‘h session (July 3, 2006) ..................................................... 36
7‘h session (July 10, 2006) .................................................... 37
8‘h session (July 24, 2006) .................................................... 38
9th session (July 31, 2006) .................................................... 40
10th session (August 7, 2006) ................................................. 40
CHAPTER 5
RESULTS & DISCUSSION ...................................................................... 42
The mother (Primary participant) ...................................................... 42
Low self-esteem .................................................................. 42
Resistance ......................................................................... 47
Feelings toward the child with a disability ................................... 50
Feelings toward the spouse ..................................................... 52
Feelings toward parentsein-law ................................................. 53
Feelings toward other people .................................................. 55
Spirituality ......................................................................... 56
Evaluation of Jessica’s music therapy goals ................................. 61
The therapist (The researcher) ........................................................ 62
The father (The secondary participant) ............................................... 65
CHAPTER 6
CONCLUSION ...................................................................................... 69
Benefits of the interventions ............................................................. 70
Increasing self-awareness .................................................... 70
Finding solutions for self-regulation ....................................... 71
Improving and/or maintaining optimism .................................... 72
Providing physical separation from the child with a disability ......... 72
The social conditions for the population .............................................. 72
The uniqueness of the intervention .................................................... 73
Limitations ................................................................................ 74
Future recommendation ................................................................. 74
APPENDICES ........................................................................................ 77

iv

Suggestions for Writing the Personal Journal Entries ......................... 77

Interview Questions ................................................................ 79
Example of Coded Response from the participant ............................. 80
Example of Category Formation .................................................. 81
Example of a Thematic DeveIOpment ............................................ 82
L“l Pl 1:: 7&6] 9.101 (Be still) .................................................... 83
'55qu g" 5815325} 31 “—‘I (Confession to God) ...................................... 84
Eli ‘3 (The chosen person) .......................................................... 85
REFERENCES ..................................................................................... 88

LIST OF TABLES

TABLE 1 ............................................................................................ 29
TABLE 2 ............................................................................................ 33
TABLE 3 ............................................................................................ 35
TABLE 4 ............................................................................................ 40
TABLE 5.. .......................................................................................... 41
TABLE 6 ............................................................................................ 44
TABLE 7 ............................................................................................ 45
TABLE 8 ............................................................................................ 45
TABLE 9 ............................................................................................ 46
TABLE 10 .......................................................................................... 58
TABLE 11 .......................................................................................... 59

vi

FIGURE

FIGURE 1 .......................................................................................... 61

vii

CHAPTER ONE
Introduction

Prevalence of disability

The World Health Organization (2006) reported, “an estimated 10 percent of the
world’s population - approximately 600 million people, of which 200 million are
children - experience some form of physical, mental, or intellectual disability.” In
addition, according to estimates of the United Nations, about 10% of the world’s
population is disabled. Looking only at developing countries, the numbers are expected
to be much higher (The World Bank, 2004). Based the huge number of affected people,
we should study how to meet their needs.
Family reactions to the disability

A family of a child with physical, intellectual, or behavioral disabilities may have
unique and diverse challenges (Sherman, 1988). Hardman, Drew, Egan, and Wolf (1990)
stated that the child may lead the family into crisis and conflicts. Moreover, unexpected
physical, emotional, and financial stress may weaken family relationships. From another
point of view, “family members may see the child with disabilities as a source of unity
that bonds them together and actually strengthens relationships (p. 458).” Carmichael,
Pembre, Turner, and Bamicoat (1999) reported that most families feel that having a
diagnosis is an advantage rather than disadvantage.

The initial reactions of families to diagnoses of disabilities with family members
are diverse. Many factors influence the responses of family members, including
socioeconomic status, the emotional stability of each family member, religious values

and beliefs, type of child’s disability, and severity Ofthe disability (Hardman, et al.

1990). Shontz (1965) suggests that general parental responses can be separated into four
stages: 1) shock, 2) realization, 3) defensive retreat, and 4) acknowledgement. In
addition, the parents’ emotional responses to their child’s disability can be negative and
unproductive emotions, including shock, disbelief, denial, anger, helplessness,
depression, and discouragement.

Seligman (1979) described a developmental cycle that families go through in
responding to the needs of caring for a child with a disability. The cycle includes the
following phases: “1) the time at which parents learn about a disability with their child,
2) the period in which the parents determine what action to take regarding the child’s
education, 3) the point at which the disabled individual has completed his or her
education, and 4) the time when the parents become older and may be unable to care for
their adult offspring.”

Parents-Child Relationship

“NO one plans to have a handicapped child” (Hardman, et al., 1990). This citation
sounds harsh to people who have disabilities, but, frankly speaking, parents do not
expect to have a child with a disability. Many studies have demonstrated that parents of
a child with an intellectual disability (Rodrigue, Morgan, & Geffken, 1990; Dyson,
1997; Roach, Orsmond, & Barratt, 1999), Down syndrome (Roach, et al., 1999), and
autism (Bromley, Hare, Davison, & Emerson, 2004) are likely to experience
significantly higher levels of parenting stress and more care-giving difficulties than are
parents of non-disabled children. Some studies about parents’ stress have shown that
there was not much difference between mothers’ stress and fathers’ stress concerning the

child with disabilities (Dyson, 1997). In contrast, other studies have shown there was a

[\J

difference between mothers’ and father’s stress levels (Roach, et al., 1999).

Generally, a mother is the primary caregiver of a child with a disability (Hassall,
Rose, & McDonald, 2005). Compared to the father, Hardman, et al. (1990) reported that
it is Often the mother becomes the “primary responsible” for relating to the child if a
child’s disability is congenital. In addition, according to Cleveland (1980), the mother
usually becomes the “guardian of affective needs.” She has the role of the primary
responsibility fornurturing the child’s emotional adjustment, and then she becomes the
child’s personal representative or interpreter. In this role, the mother is the bridge of
communicating the child’s needs and desires to other family members. Roach, et al.
(1999) found, “mothers’ stress was associated with children’s care-giving difficulties,
and mothers reported more responsibility for childcare, and perceived more difficulties
with health, role restriction, and spousal support.” Without at least minimal levels of
appropriate support from other adults or professionals, many mothers of children with
disabilities become alienated from their children and difficult to begin the caring process
(Cleveland, 1980).

According to the literature, fathers’ reactions to the birth of a child with a
disability are generally more reserved than those of other family members (Lamb, 1983).
Fathers are more disposed to respond with coping mechanisms, such as
intellectualization, withdrawal, and sublimation. They are more likely to internalize their
feelings rather than to express them openly (Hardman, et al., 1990). For instance, fathers
of children with mental retardation are typically more concerned than mothers about
their children’s capacity to develop socially adequate behavior, particularly if the child is

a son (Lamb, 1983). Compared to mothers, fathers were found to have more difficulty

accepting a son with a mental handicap (Price-Bonham & Addison, 1978) or physical
disabilities (Tavormina, Boll, Dunn, Luscomb, & Taylor, 1981). Fathers cared more
about their children’s ultimate educational and social status. Likewise, the visiability of
their children’s retardation affected fathers more than mothers (Lamb, 1983). According
to Roach, et al. (1999), fathers who have a child with Down syndrome reponed more
responsibility for childcare, and they perceived fewer difficulties with attachment and
parental competence.

Husband— Wife Relationship

Dyson (1997) found that fathers’ and mothers’ stress was related to their special
perspectives of family functioning. According to Hardman’s (1990) descriptions of
husband-wife relationships of parents who have a child with a disability, a mother pays
attention to the life of the child who requires more intensive, immediate, and prolonged
focus from the mother for treatment and general cares. As a result, the balance between
being a mother and a wife is absent. A wife tends to lean to a mother’s role by caring for
the child with the disability, while the intensity and quality of other relationships may be
changed. Similarly, a husband may also become desperately associated with his child’s
lives.

Cleveland (1980) studied the adaptation made by seventeen families Of youths
with spinal cord injury shortly after the accident and after on year later in order to find
changes in family functioning and relationships between family. She identified several
sources of irritation and distress in marital filnctioning. Wives in the families of youths
with the disabilities are in the major charge of caring the youths as mothers. Husbands

reported feeling of angry toward their wives due to the excessive involvement with the

youths. Most husbands felt that their wives were overly concerned and protecting in their
care—giving activities. On the other hand, wives reported feelings of hostility to spouses
because of the husbands’ lack of empathy and understanding. In addition, the mothers’
“over-protectiveness” for the youths with disabilities was identified as a major cause of
conflicts in marital relationship.
Sibling Relationship

The responses of siblings to their sister or brother with a disability are diverse.
Farber (1962) identified several factors that may be predictive in family and sibling
adjustment to a brother or sister with a cognitive disability. These include the quality of
the interpersonal relationship between the child’s parents, the gender of the child with a
disability, the social status of the family, and the interaction patterns. Siblings who learn
that they have a brother or sister with a disability are often concerned with many
different kinds of issues. Sometimes siblings play a critical role in fostering the
intellectual, social, and affective development of a brother or sister with a disability.
However, like their parents, siblings frequently want to know and understand as much as
they can about the condition of their siblings with disabilities.

The attitude of the parents toward a child with a disability is an important factor
that can influence on the attitudes of the child’s siblings (Love, 1973), because children .
show the tendency to imitate the values and attitudes of their parents. If the parents’
view toward the child with a disability is optimistic and realistic, other children without
disabilities are likely to follow these attitude values. According to Hardman (1990),
anger is one of the many feelings that children without disabilities may express or

response to siblings with disabilities. In addition, feelings of loneliness can be shown in

children who expected a brother or sister with whom they could play. Anxiety may be
present in children who wonders who will care for siblings with disabilities when parents
are no longer capable or alive. Children without disabilities may be obligated to care for
the siblings with disabilities. However, in their minds, failure to provide the care can
make them immoral. Similarly, they may feel guilty about the true thoughts and feelings
they have about their siblings. These feelings may be associated with frustration,
resentment, and even hate. Many parents would not respond positively and optimistically
to the expression of such heavy feelings; therefore, some children without disabilities
keep them in their mind for a long time and express them later like an emotional

explosion.

6

CHAPTER TWO
Related Research

Current Programs and studies

Blatt (1987) reported that, since 1970, over eighty percent of the litigation for
rights and service has been decided in favor of children with disabilities and their
families. However, subsequent improvement in opportunities and programs still has not
much accomplished legally for their specific needs. Some research has touched the
general needs of children with disabilities and their families. Hileman, Lackey, and
Hassanein (1992) reported that, like people with disabilities, caregivers also have their
own needs—including psychological, patient care, informational, personal, household,
and spiritual. However, most studies about children with disabilities and their families
were focused on only parents’ coping skills (Beresford, 1994), their parenting and stress
(Hassall, et al., 2005), and/or the relationship between parents and the child (Baker,
Blacher, & Olsson, 2005). Therefore, this study will be focused on the parents’ own
emotional issues under the conditions of a child’s disability.
Parents ' emotions

Parents ' sey-esteen'z/self-efficacy. Studies of parents’ self-esteem and efficacy
have been conducted with parents of hyperactive children (Johnston & Patenaude, 1994)
and parents of children with diabetes (Rodrigue, Defflcen, Clark, Hunt, & Fishel, 1994).
Hastings and Brown (2002) reported that self-efficac y reconciles the relationship
between behavioral problems of children with autism and mothers’ anxiety and

depression.

According to Hardman, et al., (1990), parents who have a child with a disability
may experience assaults on their own self-value. They may blame themselves for the
presence Of disabilities in their children, and they may seriously question about their
perceptions toward themselves. They may be easily irritated or upset. In addition, the
parents may be anxious or wondered about their abilities and adaptations to face on the
demands of caring for a child with unique needs. They may spend some time to consider
about self-accusation, self-pity, or self-hate.

Hassall, Rose, and McDonald (2005) studied parenting stress in mothers of
children with intellectual disabilities. They investigated the relationships between
parental cognition—which is related to parenting self-esteem including efficacy and
satisfaction—and parental locus of control, child characteristics, family support, and
parenting stress. Forty-six mothers of children with intellectual disabilities participated
in this study through completing questionnaires and interviews. The results indicated
that parental locus of control, parenting satisfaction and child behavior difficulties
showed the influences on the relationships. In addition, it was found that parental locus
of control mediates the strength of relationship between family support and parenting
stress.

Emotions toward the Child and the spouse.

“1 can distinctively remember the first thoughts that I had as I spoke to
my husband after I had my brief visit with the pediatrician. I wanted to throw my
new son out the window . . . not literally, but somehow I didn’t want to deal with
this immensely new and complex problem.” “A million thoughts raced through

my groggy mind: Can I handle this? Why did this happen to us? What could I

have done to have this happen to our family? Bill must be very disappointed in

me!” (Hardman, et al., 1990)

Like these mothers, parents who have a child with a disability may have not many
positive images of their child. In fact, they may have grievances toward their child, even
though they feel guilt at the same time. Unfortunately, despite of the need for research
about parents’ unhealthy feelings, few researchers have studied mothers’ emotions about
their child with a disability.

Cleveland (1980) briefly mentioned the emotions between husbands and wives
who have a child with a disability. Husbands express feeling angry toward their wives
because of their over—protection and obsessive involvement with their children.
However, wives express hostility toward their husbands for a lack of empathy and
understanding about the care they provided.

Parents ’ optimism. Scheier and Carver (1985) stated, “Optimism and pessimism,
defined as generalized positive and negative outcome expectancies, represent relatively
stable individual difference variables that promote or abate psychological well-being.”
Optimists have a favorable outlook on life. Therefore, they believe that good things will
happen to them rather than bad things (Olason & Roger, 2001 ). Researchers have
considered many pathways by which optimism may function to affect healthier
outcomes, invoking effects on the immune system, cognition, emotions, social
relationships, and health-promoting behavior (Aspinwall & Brunhart, 2000; Peters,
2000). Clarke and Beck (1999) reported that, according to the optimism literature,

mother’s optimism may lead to less distress as a result of challenging child behaviors.

Moreover, cognitively, less optimistic thinking is linked to vulnerability in experiencing
negative feelings and emotions.

Baker, Blacher, and Olsson (2005) investigated the relationship between parents’
optimism/well-being and the behavioral problems of their children with and without
developmental delay. It was found that optimism moderated the parents-child
relationship, especially for mothers. Mothers who were less optimistic reported lower
scores on measures of well-being than mothers who were more optimistic when child’s
behavioral problems were high. Moreover, Greenberg, Seltzer, Krauss, Chou, and Hong
(2004) found that by the effect of optimism mediated totally or partially, mothers of
adults with schizophrenia and autism had better psychological well-being when the
mother/adult child relationship was positive. Therefore, optimism was related to better
mental and physical health.

Spirituality

Definition of Spirituality. Hiatt (1986) defined spirituality as “that noncorporeal
and nonmental dimension of the person that is the source of unity and meaning, and
spirituality refers to the concepts, attitudes, and behaviors that derive from one’s
experience of that dimension. Spirit can be addressed only indirectly and inferentially,
while spirituality can be understood and worked with in psychological terms.” (P. 742)
Emblen (1992) wrote, “Definitions of spirituality referred to a dynamic, principle, or an
aspect of a person that related to God or god, other persons, or aspects of personal being
or material nature. The spiritual dimension was used to refer to a quality beyond

religious affiliation that is used to inspire or harmonize answers to questions regarding

10

infinite subjects, e. g., meaning and purpose of life and one’s relation to the universe.” (P.
43)

Needs of Spirituality for caregivers of people with disabilities. Spiritual factors
are also important for the caregivers of people with disabilities. Zigmond (1987)
mentioned, “On our own, or in our most intimate groups, we devise more personal and
idiosyncratic beliefs, rituals and protocols to ward off the potential storms or deserts of
uncertainty.” (p. 69) Aldridge (2004) added, “The spiritual dimension, while perhaps not
warding off uncertainty, Offers a satisfactory strategy by which uncertainty may be
understood and coped with.” (p. 127)

Rukholm, Bailey, P., Coutu-Wakulczyk, and Bailey, W. (1991) studied 166 adult
family members of intensive care unit (ICU) patients to examine their perceived needs
and anxiety levels, and found that family needs and situational anxiety were significantly
related. Thirty-eight percent of the variation of situational anxiety was related to worries,
trait anxiety, age and family needs. Spiritual needs and situational anxiety accounted for
thirty-three percent of the variation of family needs.

Additionally, Chang, Noonan, and Tennstedt (1998) examined how
religious/spiritual coping relate with specific conditions of caregiving and psychological
distress. Informal caregivers to community-residing disabled elders participated in this
study. They found that, to improve the quality of the relationship between caregivers and
care recipients, spiritual coping skills indirectly influence caregivers’ distress.
Caregivers who practiced religious/spiritual beliefs experienced lower levels of
depression and an increased dedication to the role of caring, resulting in a better

relationship quality.

ll

Music Therapy

Definition of music therapy. According to the American Music Therapy
Association (AMTA), music therapy may be defined as “a planned, goal-directed
process of interaction and intervention, based on assessment and evaluation of individual
client’s specific needs, strengths, and weaknesses, in which music or music-based
experiences are specifically prescribed to be used by specially trained personnel to
influence positive changes in an individual’s condition, skills, thoughts, feelings, and
behaviors” (Peters, 2000). Goldman (1988) believed that in holistic healing processes,
the mind, body, and spirit are interdependent on each other in order to maintain health
and well-being. As both the mind and the body affect all aspects of a person—physical,
mental, emotional, and spiritual aspects—music can help the mind-body interaction and
promote the holistic methods of healing. Holistic practices facilitate individual’s
potential, self—awareness, and growth by finding answers within one’s self (Bonny,
1986). Moreover, the holistic approach for health has generated interest not only in
ancient healing practices using music, but also in contemporary ways to use music to
facilitate healing, relaxation, centering, stress reduction, emotional release,
consciousness expansion, and the highest possible state of well-being (Bonny, 1986;
Goldman, 1988).

Emotions and music therapy. Different types of music have varying effects on
listeners’ moods, emotional, and affective responses (Abeles & Chung, 1996; Radocy &
Boyle, 1988). Luetje (1989) found that structured experiences involving lyric analysis,
song writing, improvisation, and music-assisted guided imagery may 1) support

cognitive and emotional processing of the crisis, 2) assist individuals to find alternative

12

and productive solutions or responses, 3) help individuals find new way of adaptation, 4)
help to be aware of potential Strengths, and 5) facilitate the internal affirmative messages
within individuals. Many music therapy techniques and approaches can be used with
individuals or groups to help enhance cognitive functioning, expand consciousness,
increase creativity and self-expression, improve life satisfaction, facilitate self-
awareness, and promote personal growth and optimum health (Peters, 2000).
Gabrielsson (2001) mentioned, “Music may arouse strong emotional experiences as it
interacts with listener aspects such as physical well-being, memories, and personality,
and with situational aspects such as location, acoustic conditions, and social aspects of
an audience.”

Interpersonal relationships and music therapylPeters (2000) noted that, through
music’s ability for structure and organization and its ability to carry and affect on ideas
and feelings, music has powerful effects on interpersonal interactions. Sorel (2005) used
Nordoff-Robbins music therapy, which is a creative music therapy technique using
instrumental and vocal improvisation, as a mean of improving the relationship between a
mother and a son with autism. This case study showed the effects of the music therapy as
an example for improving interpersonal relationships.

Spirituality and Music Therapy

Mussulman (1974) notes that “music has functioned more consistently and
positively in religious ritual than in any other area of life in Western civilization, even to
the extent that religious music comprises one of Western music’s longest and richest

traditions (p. 129).” In the field of music therapy, Bonny and Pahnke (1972) identified

13

the importance of spiritual considerations in the early work of Helen Bonny'. Munro
and Mount (1978) also note the need for spiritual consideration in palliative care work.
Aldridge (2004) introduced Lucanne Magill’s responses concerning music therapy in
spirituality at the last World Congress in Oxford (Magill 2002). She said, “ So much of
what we do is beyond words and it is really because of this transcendental nature of
music that important healing in music therapy can and does occur.” She proposed four
functions of music in spirituality: 1) music creates interpersonal relationships, 2) music
supports recalling the past experiences and remembrances, 3) music gives a voice to
prayer, and 4) music instills peace. She concluded, “To the presence of music when
transformation begins to occur and healing begins, that it is the lived moments of music
therapy that the essence of our work—music therapy, spirituality and healing—is
experienced and known.” (p. 107)

Aldridge (2004) emphasized that these considerations of spirituality are not
unique to music therapy. The need for spiritual considerations in health care still is in
debate; however, be strongly proclaimed that the discussion of spirituality is “a
legitimate topic in music therapy.” (p. 108)

Purpose and Research Problems

Most studies about children with disabilities and their family are focused only on
parents’ coping skills (Beresford, 1994), parenting skills and stress (Hassall, et al.,
2005), and/or the relationship between parents and the child (Baker, et al., 2005). Few
studies were found concerning the effects of a music therapy intervention for parents

who have a child with a disability. Therefore a major focus of this study was identifying

 

1 Helen Lindquist Bonny : a courageous pioneer in the uncharted territories of music and
consciousness, and an inspiration to all who travel there through the method she created: Guided
Imagery and Music (Bruscia & Groke, 2002; p. V).

I4

and working through emotional and spiritual problems within a family of a child with a
disability.

With the intent of improving the quality of life of parents who have a child with a
disability, the purpose of this study is to examine the effects of a music therapy
intervention using spiritual beliefs—which are shared by client’ and therapist’ own
spirituality with in trust-based relationship—on the parents’ positive emotional
responses, including images of themselves and emotional relationships with their child,
spouse, and their external environment. The research problems are as follows: 1) to
determine how shared spiritual beliefs in music therapy interventions affect the self-
image of a mother who has a child with a disability, 2) to determine how shared spiritual
beliefs in music therapy interventions affect a mother’s emotional responses toward her
child with a disability, 3) to determine how shared spiritual beliefs in music therapy
interventions affect a mother’s emotional responses toward a spouse, 4) to determine
how shared spiritual beliefs in music therapy interventions affect the mother’s emotional
responses toward the external environment, and 5) to determine how music affects the

participant’s spirituality, facilitating the maintenance of health.

15

CHAPTER THREE
Research Stance & Methodology
Researcher '3 lens
The reason I chose this topic, the effects of songwriting on a mother who has a
child with autism, is related to the reason why I started to study music therapy. In 1996,
when I was preparing for university admissions, my high school music teacher
introduced me to a private composition teacher (Lim, S. D.) who was a part—time
instructor in a couple of universities. I took private lessons from her, and our relationship
was built on trust and honesty. Both of us have a strong belief in God, so our
conversation was usually based on religious topics, such as faith, love, and respect of
God. After a couple of composition lessons, she shared with me that she has two
daughters, and the older daughter had Down syndrome. At that time, I was shocked, and
wondered why God gave this traumatic event to someone who had a strong faith. While
I was thinking this, the teacher told me that she also wondered why God had done this to
her, but now she thanks God for giving her a beautiful daughter. The teacher honestly
shared with me her emotions toward her daughter and about herself. Before my
university auditions, I visited the teacher’s house to take composition lessons, and
sometimes I played with her daughters. I observed the dynamics between the daughters.
One has Down syndrome and the other has no disability.
After I was admitted to Yonsei University in Korea, my teacher had an
opportunity to teach music students in the university in a part-time position. In
continuing to build a relationship with her, I decided to study music therapy in response

to her suggestion. After I left Korea to study music therapy in the US, the teacher’s

16

daughter who had Down syndrome died. When I visited Korea during a summer
vacation, I could have a chance to talk with the teacher. She shared that she and her
family had an extremely hard time right before and after her daughter’s death. At that
time that I met the teacher, she and her family went through almost at the end of the
emotional tornado. Since that moment, I have wondered how I could help other parents
who are like my teacher in that they have a child with a disability.

Currently, as a music therapist and graduate‘student, I am a piano tutor for a 7-
year-old girl with autism. Even though I started private piano tutoring with confidence,
because I was a music therapist who could accept exceptionality more easily than other
piano tutors, I am struggling to communicate and interact with this child. Whenever I
struggle with the child, I feel empathy for her mother, and I recall the conversation that I
had with my teacher. Because I realized that I must be able to help the mother with my
talents as a music therapist, I designed this study to focus on releasing the mother’s
negative feelings and emotions and constructing positive emotions about herself, her
child, and her husband, and on being optimistic about her external environment.
Participants

A mother with a 9-year old elementary school child with mental retardation
served as the primary participant. In fact, her youngest son who is an infant (age 1) also
has a disability. Even though she has two children with disabilities, to the goal was to
examine emotional changes in a mother who has an elementary school student; therefore,
the participant met the selection criteria for participants. Her husband was a secondary
participant for this study. The researcher built a rapport with the primary and secondary

participants through a meeting and personal interviews before the music therapy

17

interventions in order to provide them with a more supportive and comfortable
environment in which to share their emotions.
Design

Smeijsters (1997) mentioned qualitative research is focused on “meaning” rather
than “truth.” According to Merriam (1998), “a descriptive case study is an examination,
intense analysis, and description of a single unit or bounded system.” Moreover, Yin
(1993) mentioned that a case study is designed “to gain an in-depth understanding of a
situation and meaning for those involved in the study; to explore questions, programs,
populations, issues, or concerns in order to determine appropriate research questions;
and to explain linkages between causes and effects.” Hilliard (1993) also defined single-
case research as intra-personal research that emphasizes on the individual’s internal
changes.

In quantitative research, the essence of music therapy—“identified as that which
is experienced by the music therapy and the client during music therapy”—is often lost
(Smeijsters, 1997). The use of a case study design can provide a detailed description and
analysis of therapeutic processes in a music therapy setting. In music therapy settings,
the case study design is popular because of its flexibility and adaptability. The data in
this study is a detailed narrative of a mother’s emotional changes during songwriting
activities.

Procedure

A rapport was built with the primary participant through a meeting before the

interventions. The brief official contact with two participants—the mother and the

father—was by phone and occurred in the early part of May 2006, and the first meeting

18

with them was on May 20, 2006. The purpose and research problems for this study were
explained, and the process of the music therapy sessions. Each participant voluntarily
signed a consent form for their participation in the study.

The music therapy intervention in spiritualin was in a one-to-one setting,
including the researcher and the mother of a child with a disability. The intervention
took place every week for 10 weeks in Korea. The 10 sessions were approximately one-
hour in length. Music listening, singing, songwriting, and improvisation were used for
warming up for or wrapping up the sessions. Among those music therapy techniques, the
process-oriented songwriting intervention was emphasized more than other techniques.
Baker and Wigram (2005) offered a definition of songwriting in music therapy as:

“The process of creating, notating, and/or recording lyrics and music by the

client or clients and therapist within a therapeutic relationship to address

psychosocial, emotional, cognitive, and communication needs of the client.(p.

16)”

According to Gfeller (1987) and Peters (2000), song lyric discussion and personal/ group
song writing intervention can stimulate increased personal awareness, help clients see
other points of view or other possible solutions, and. support emotional expression and
interaction. Studies of song writing have showed it is a powerful tool with psychiatric
clients for aiding self-expression (Ficken, 1976), children who are reluctant to disclose
their feelings (Miles, 1993), and abused adolescents in order to promote communication
and trust, to develop group cohesiveness, to enhance self-expression, to increase self-

esteem, to develop insight into feelings and needs (Edgerton, 1990; Lindberg, 1995;

I9

Clendenon-Wallen, 1991). Ficken (1976) mentioned that the composed song acts as a
source of immediate feedback, since it can be written down or tape-recorded.

Based on Brunk’s (2003) suggestion for songwriting, the sessions developed
from recreating pro-composed songs, such as fill-in-the—blank songs and piggyback
songs, to composing the mother’s own songs. The process of songwriting intervention
mostly followed Baker and Wigram’s (2005) the Therapeutic Lyric Creation which
contains 9 steps to creating a song: 1) finding topics, 2) selecting, 3) brainstorming ideas,
4) identifying principal idea, 5) developing the ideas identified as central to the topic, 6)
grouping the points together, 7) discard irrelevant ideas, 8) constructing outline, 9)
writing lyrics. As mentioned, the discussion parts for the actual songwriting process are
a significantly important portion to identify and develop ideas for songwriting. Therefore,
discussions were valued just as important as the music making. During the discussion,
my role was to be an active listener, stimulating the role of a therapist in person-centered
therapy approach. No significant suggestions were offered to the participant, but an
effort to make the relationship include genuincness, warmth, empathy, unconditional
acceptance, and caring were the primary focus.

For the effectiveness of the intervention, each session had a routine sequence of
phases. This included a greeting, brief discussion or conversation about current feelings
or events, songwriting activity, discussion about lyrics and/or harmony of the song, and
closing. The sessions were conducted in Korean, including the interviews, discussions,
and the lyrics of songs. This helped to establish a better rapport between the participants

and the therapist in a culture boundary.

20

Music in therapy vs. Music as therapy. Bruscia (1998) mentioned that one of the
unique characteristics of music therapy intervention is the involvement of both music
and the therapist as interactive partners. Music can take place as the primary role or the
secondary role in a music therapy session. Music as therapy means that music takes the
primary role in the intervention while music in therapy means that music takes the
secondary role (Bruscia 1998).

Specifically, the most primary music therapy technique for the primary
participant’s music therapy sessions was process-oriented songwriting intervention in
sipirituatlity. According to Baker and Wigram (2005),

“Compared to writing song for clients, writing song with clients serves a different
purpose and is akin to the concept of music as therapy (p. 12).” They also emphasized,
the process and product of songwriting as the “therapeutic intervention.” In Jessica’s
music therapy sessions, the verbal discussion took a big portion even more than the time
spent actually creating music. However, like Baker and Wigram’s emphasis, the verbal
discussion was the bridge between identifying innate emotional responses and
expressing them in a constructive way.

Data Collection

Journal entries. Alford, Malouff, and Osland (2005) stated, “combining concepts
of emotional disclosure and intelligence suggests that expressing positive emotions in
words may also have psychological benefits.” It can help a person (a) extend the
emotion, (b) harness the emotion to produce positive behavior, and (c) find ways to
recreate the emotion by experiencing in a certain way or by reentering the same

situation. Studies have shown that writing about strong emotions leads to health benefits

21

(e.g., Petrie, F ontanilla, Thomas, Booth, & Pennebaker, 2004). Written disclosure
studies that have examined psychological health have shown reductions in distress,
negative moods, and depression (e. g., Sloan & Marx, 2004).

During the music therapy interventions, the primary participant (the mother of a
child with mental retardation) and the secondary participant (the father of a child with
mental retardation) were asked to write personal journals that were be a part of the
collected data for this study. The participants maintained a journal one day before the
treatment, immediately following the treatment day, and a day between the two journal
entries. The participants focused on writing about their emotions and feelings about
themselves, the child, the spouse, and the external environment, such as interacting with
others, and perception of the world (Appendix A).

One—on-one interview. In Case Study Designs in Music Therapy (edited by
Aldridge, 2005), Aasgaard stated that interview can provide “spontaneous conversation
with the people encountered—not totally by chance and aimlessly—but in order to shed
new light on the song’s lives. Both researcher and the interviewee might actually be led
into new knowledge, self-understanding, and reflections through theses encounters (p.
73).” The purpose of an audio-recorded interview was to remind the participants of the
purpose and problems of this study, to clarify their questions or concerns about the study,
and to check the participants’ adjustment or feedback about the music therapy sessions.
The interview questions were open-ended and focused on the participant’s emotional
changes (Appendix B). The primary participant was interviewed briefly before and afier
each session, and the secondary participant was interviewed twice—before and after the

period of the intervention.

Transcripts. Afler each session, the researcher made a transcript of the sessions
by reviewing the audio tape. The transcripts were saved in the password-protected
computer as a word file for further analysis.

Observations. The researcher wrote field notes after every music therapy session.
They included descriptions of activities used in music therapy sessions, the participants’
emotional or behavioral responses, facial expressions, and interaction with the researcher.

Documents of the songwriting products. The lyrics and songs that were
composed by the primary participant were analyzed according to the use of emotional
words and musical elements, including choice of mode, rhythm, melodic texture, and
range of pitch based on the participant’s current situations and responses.

Data Analysis

According to Strauss and Corbin (1990), grounded theory is, “inductively
designed from the study of the phenomenon it represents . . . It is discovered, developed,
and provisionally verified through systematic data collection and analysis of data
pertaining to that phenomenon”i( p. 23). For this study, I also followed inductive data
analysis, which means that I does not predetermine the verification of data for coding.
During repeated reviews of the data, the codes merge into categories, the groups of
relative codes. The data in each of the categories were gathering in several contexts.
Therefore, constant and repeated comparative analysis is required (Glaser & Strauss,
1967)

I highlighted words, that I thought were significant. These words were classified
into categories by “a classification of concepts, developed by comparing concepts and

grouping them together as they appear to pertain to a similar phenomenon” (Strauss &

23

 

Corbin, 1990, p. 61). After the brief classification, I combined the words from previous

sessions and all categories and developed themes. A theme is “a statement of meaning

that runs through all or most of the pertinent data by linking data in and across

categories” (Ely, Anzul, Friedman, Garner, & Steinmetz, 1995, p. 150-151).

The analysis for this study contained the following steps.

1.

Data. All data from personal journal entries, one-on-one interviews,
observations, and transcripts retyped as Microsoft Word files by the therapist-
researcher after each session.

Coding. The labels were inductively derived by the therapist-researcher to
indicate the characteristics of the participant’s responses. An example of
coded data transcribed from a participant in music therapy session is in
Appendix C.

Categories. The codes were compared and contrasted several times. The
Similar codes were grouped into categories, inductively created by the
therapist-researcher. An example of a category’s codes representing a
participant’s responses is in Appendix D.

Themes. The codes under verified categories were compared and contrasted.
The relative categories were grouped into descriptive thematic labels

(Appendix E).

Trustworthiness

Trustworthiness was established by using several methods specific methods. For

the validation of subjectivity in qualitative research, Smeijster (1997) states,

“Repeated analysis involves researchers regularly comparing old data with new,

thus checking their previous hypotheses. They can also check whether the old

data corroborate their latest interpretations, whether previous interpretations need

to be changed, or whether previous interpretations can be used for old data, but

new data require new interpretation (p. 18).”

The data for this study were reviewed repeatedly several times after each session and
during the process of the data analysis.

Smeijster (1997) suggested that the triangulation methods, which entail the use of
several observers, various techniques of collecting data, or diverse theoretical models,
improve “reliability.” It consequently allows checking “whether the phenomena are
verbally represented as adequately as possible” (p. 32). The triangulation methods are 1)
data source triangulation, which is to use multiple sources for obtaining data on the
research topic, 2) methods triangulation, which is to collect data by multiple methods,
and 3) researcher triangulation, which is to form a research team, with each member of
the team participating in the collection and analysis of data (Patten, 2005).

For this study, data source triangulation was addressed through the rapport with
and data collected from the mother, the father, and the researcher. Methods triangulation
was achieved through the variety of data collection tools, including personal joumaling
of the primary participant and the secondary participant, one-on-one interviews with
both participants, the researcher’s field notes, and the songwriting products from the
music therapy sessions. Researcher triangulation was established through reviewing data
with each participant and another professional music therapist. For the accuracy of the
Korean-English translation, a Korean doctoral music therapy student reviewed the

briefly analyzed Korean data and English translation.

CHAPTER FOUR
Case Study

Background history

Jessica (pseudonym) is a mother of four children (two daughters: aged 11 and 3;
two sons: aged 9 and l). The second child, David (pseudonym), who is an elementary
school student, has been diagnosed with mental retardation. Jessica took a cold medicine
during the pregnancy before she knew that She was pregnant. Her parents suggested that
she should have an abortion, but she decided to keep the baby after the discussion with
her husband, Paul (pseudonym). The baby was born without any problems; however, he
showed very delayed physical development, compared with other children. David could
not control his neck even though he was 4 months old. One day David got a cold, so
Jessica and Paul took him to see a physician. The doctor noticed David’s disability and
suggested that the parents to visit a rehabilitation service system.

Jessica and Paul had lived with Paul’s parents since they got married. The
parents had exercised strong control over them, including a job, a placement, financial,
and even religious issues. Paul’s mother allowed Jessica to go to church only on Sunday,
and prohibited her participation in a small group for bible study or fellowship. Because
Jessica and Paul depended on the parents due to financial issues, they could not even
consider living apart from them. After the disclosure of David’s disability, Jessica and
Paul made the difficult decision to move out of the parents’ home. They became more
active in their Christian faith. When David started to go to an elementary school, Jessica
was pregnant again with the forth child. Six months later, a doctor diagnosed the baby

with Tuberous Sclerosis. After the birth, John (pseudonym) displayed the characteristics

26

of epilepsy a number of times. Moreover, the doctor told her that no remedy existed for
John’s disability at that time.

Session Description
Initial meeting (May 20, 2006)

To select participants for this research, I verbally presented a brief description of
the research to my church community. I got the phone number of a mother who had a
child with a mental retardation and was interested in participating in music therapy. I
called her to provide more specific details of the study. The prospective participant
seemed to need some time to think more carefully about participation, so I gave her a
week to consider her participation. After a week, I called the prospective participant
again. She and her husband decided to be the participants for this study, and I made an
appointment with her for the initial meeting.

During the initial meeting, I explained the purpose of the study, research
questions, and the procedures. Since confidentiality and signing a consent form for
research participation are not familiar in the Korean culture, I explained them to the
participants. In addition, I also mentioned that participation in this experiment is
voluntary, so they had right to quit or stop their participation at any time.

1" session (May 29, 2006): Assessment

I provided a brief second orientation for this research project, including the
purpose of the study, research questions, the planned procedures, and the research
regulations that were not familiar to Koreans. Also, I mentioned that they could

withdraw from the study whenever they felt uncomfortable.

27

Jessica started to share her personal history briefly, including the marriage, the
children’s disabilities, and social relationships. According to the assessment, she
preferred to sing rather than to perform on instruments. However, she also liked to play
the piano. She could read music notes and understood basic chords. She liked gospel
music. She also liked Korean pop ballad music; however, she disliked rock music. She
was talkative and shared life events specifically, but did not share much deep self-insight.
She reported that she had low self-esteem, and she is somewhat exhausted caring for the
children with disabilities. Sometimes she wanted to give up the children, and she needed
more support from the husband and her children who had no disabilities. She also
mentioned that she expected and needed the warmth and support from other people.
Jessica has a strong faith in God. Her beliefs have helped her to deal with the'children.
She avoids or hates unreasonable sympathy towards her sons, but generally has good
relationships with other people.

Based on the assessment and interview, I developed the following goals for
music therapy:

I. To identify emotions related to life events and family relationships

- Feelings toward herself
- Feelings toward the child with a disability
- Feelings toward her spouse
- Feelings toward the world around her
2. To express those feelings in constructive ways

3. To rationalize the feelings about the events and find solutions by

herself

28

4. To build positive feelings about herself, the child with a disability, the

spouse, and others
As mentioned, she felt that were focused toward herself, the child with a disability, the
spouse, and external environment, including other relationships. I did not plan to suggest
specific ways to release her negative feelings or stress, but I wanted to encourage her to
construct ways of expressing her feelings.

2"“ session (June 5, 2006)

The session started with choosing and singing gospel songs. Jessica chose some
songs without much hesitance: “2F?“ 7I_C2_Li (The power of love),” “Zr“El %%61*1E
(If God says),” “EB-I Ll §I E T3 94 ”$31 (See! Don’t be afraid)” etc. Immediately she
joined in singing the songs. According to the observation notes, it was described:

“She sang with a beautiful voice. She smiled a lot during singing. She

showed the ability to read notes, and sing in tune.”

She also shared her feelings and personal history that is related to the chosen songs. The
meanings of the songs were related to her emotional responses about her child’s
disability and her relationships with other people. Before writing lyrics about herself, I
asked her to share her self-image. She mentioned she has low self—esteem. She shared
her experiences in her childhood that she thought could have affected the building the
self-esteem for her. She also mentioned that she realized God’s love and she could be
confident about herself with God’s image. Her faith in God seemed to be a powerful
positive stimulus in improving her self-esteem. Based on the discussion, I asked her to
write lyrics about herself (Table 1).

Table 1

29

Lyrics of " PT i L701 girl) ..

 

Korean

EEEEz¢EEEeeEEEEEEE
"EEwwEEEEEEMEEEEE
,z’x L7M 014;: L/ C}
57-2;- 0/ 33 57 353—85 0 c4071.: 12.3 5' 273; 3237;:
u- weenn
3‘33 7/ if 10 51/07 ('3‘ i; =3 ‘3‘ 17 “El-.117
EEEEEEEEE
EEEEveeeEEEEEEEEE7
of 37 0 F: at gym/E 2412. .2. 15,13} aslaj/

EEEEE

:13“!

(ii/X7 33f.
EEEEEEEEEEEEEEEEE
E {9:} f: g!”
-7 5: L7 £5- 9??? KM! {fol ~71 353391’ {Ml
(is? L/ El.
.EEEEEEEEEEEEEEu
5’/.§?_ ”’1 O/L/iglfl EL? 57/ Ll/xflg- {lg}; o/{rj
.74 0/04 in M 0’7/ 37/
/EEENEEEEEE3EMW7

EEEEE

:EEEEEE-
iEEEEEowuzenessuo
Ja/L/ o}O/7} 3330/ otglg-L/E/W
#WErE"“’E%%SEEW
filfi’t E;- 3/ El.
-212“)? 071-37, EH1 57m 331.

JET/L}

=3 OI/Ki-r 7 Eliot 57.2.1.9 flat/g?- 5727/ 3;;
sot-7.3:-
E7 E EEE 3.3 Eta-7277 Eat—sue.
AHREEEHVEEW

:EEEEEEEEEE-EEEEEEEE

C_.

0/74/41E L’l’iTZ 7f 17 will?! 7// 57/11:; (Z;
333:1 "HS—z..— 7735! $33 30 {—33 0 e L777
3:73/3/57-

-3] 0/ 0/” it Q '21.} X/L} z/ 7/10 01--

3;: 9- «,2 97 .3 37 3:7 E n/ Eel v:/

67 37 37 77/ 37 3’3 .37 37/212 7.367 1? 334’ 3273/ 37.

English Translation

There is a girl who is shy and introverted
The girl is demure to have as a
nickname, "unripe bean "
The girl repressed her friends ’ injustice
and kept this to herself
The girl was changing after she met
God in her teenage dreams.
The girl spent time with God 's love
and passion, that she did not understand
exactly

However,

There was a feeling that something was missing

in her latent personality... .

The girl always needed more self-confidence.

The girl felt inferior about her self

Not only the outlook but also nothing to proud
of herself

The girl could not be confident in front of
people

The girl was maturing...
The girl was married and has children

But, a child was very sick...
Through the child, the girl experienced
Sorrow, pain, discouragement, fear...

On the other hand,

The girl found the meaning through the
relationship with God
Love, faith, hope, grace...

These findings in God are amazing!

As far as the girl with God,

She is not the girl who is shy and is narrow
minded.

The girl cannot ignore the pains from people

The girl confesses that God gives her the

fullness of the heart to accept them

 

30

Table l (cont’d)
37L} 3531’} 2%? E5735: 9:3
574 37 9.3077 373333.333? 37 3330/ £79717

As far as the girl with God,

The girl becomes the girl who receives God ’3
love 7

The girl becomes confident in front of people
even though the life is an exhausting
and challenging environment

#0/ 12' El 3,152 I27 .1? .4??- 5’ 23’ 13/875 A} 535;: 9107/
23* ‘5" 31‘ i: :31 E X} 33’0/ El?! 33‘- 37 El.

rearwnawEo
EE33EE

7‘9 7/o (”—17— The girl is dignified rather than shrunk

anymore
13/17 E} 3" 01—57": 331:: 7/ "(fol £1733" L/L} The girl has smilesjrnfldlyalways
7351,]? iii/L} :’//// Kt}? bib? 53’3“? The girl is...

”if: Li (3)” L/ C} - Mysel who receives love from God
After writing the lyrics, Jessica said to me, “Don’t make homework like this

again!” and giggled. Before the songwriting session, she needed to build a close rapport
with me by expressing her emotions and sharing experiences.
3rd session (June 12, 2006)

Jessica mentioned that she talked with her husband about this study. Both of
them felt burdened and responsible, especially after they signed the consent forms.
However, they decided to participate in this study in order to help people who have the
same or similar situations. AS people of faith, they could convey their thinking to people
who were suffering.

The session started with singing two gospel songs that Jessica chose. I asked her
to read the lyrics that she wrote last session, and then, the song was complete by
choosing accompanying music from gospel songs, a voice type, an instrument, and

tempo. Jessica chose a Korean gospel song called “LI 9i "1 7P1 '5I 0‘ MOI (Be still), ”
which featured female voice, piano solo, and a slow tempo. I played the piano, and

Jessica read the lyrics. Afier reading, she had tears in her eyes. During the perfomlance,

she recalled the suffering when David’s disability was discovered. She seemed to be

31

connected with her emotions at that moment. She mentioned that she wanted to keep her
current positive emotions given by God. I suggested free improvisation on the piano to
express her feelings. She played repeated chords and arpeggio (C-Am-Dm—G) with
limited variations. Even though she did not have much hesitation about piano
performance, she showed strong resistance to the improvisation. As a result, I changed
the improvisation from an unstructured improvisation to a one-note improvisation on
“C.” From the observation notes, it was described:
“Jessica showed the strong resistance to perform and played the piano.

She played for about just thirty seconds. She seemed to be bothered and showed

extremely flat affect.”
I finished the session by introducing some tips for performing chords on the piano.
Jessica said she would like to try them on the piano by herself.
4:}: session (June 19, 2006)

During the week, Jessica disclosed her feelings about the study to other people.
This was understandable because keeping confidentiality was not familiar to Korean
people. Since I had observed Jessica’s resistance to improvisation in the previous session,
I planned the session to start with a discussion about the issue of “taking a risk or
challenge.” Because, at this time, Jessica mentioned that she was feeling more
comfortable talking rather than performing musically, I suggested we discuss the topic
verbally. She mentioned that her resistance to take a risk or challenge could be related to
the condition of her child, but she emphasized that the resistance was not related to

personal feelings about music therapy or the therapist. She mentioned that she liked to

32

play the piano, but she felt very uncomfortable improvising something on the piano
without adequate direction and structure.

Jessica gradually opened up and shared her life events and family relationships.
She shared her relationship with the mother-in-law. She mentioned that her mother-in-
law does not have a close relationship with her own husband, so the mother-in-law
vented her wrath on Jessica. Moreover, her father-in-law encouraged Jessica to attend
church with him. He currently mentioned that, if Jessica chose to attend another church,
he would ask her to move out. Jessica said that she changed churches due to her children
with disabilities. She thought the previous church was not able to accept her wound. She
felt that her church family was not supportive at the previous church. She believed that
her mother-in-law understood some parts of her thinking. However, the mother-in-law
also persuaded Jessica that she should not to object to the father-in-law’s intention. As
mentioned earlier, Jessica’s husband, Paul, is dependent on his parents due to the
financial support they provide; therefore, it is hard to act against the parents’ wishes.

I gave her a fill-in—the-blank sheet to look at for the next session so that she could
feel more comfortable in participating in the music task (Table 2). To reduce her
difficulty in the sessions, I emphasized that she should not fill in the blanks until the next
session.

Table 2

Blank sheet for a fill-in-the-blank song

 

 

 

Korean English Translation
77151 ___ Title:
Ell/El 7} Li 9/ 9;" [fl/"ll. Someday when I .
1%" f? if 07-3. to Inc/for me/me/my

 

 

59 17/7} 9707 _ _ , l7- ? ”ll. And, when [feel

33

Table 2 (cont’d).

 

 

 

 

 

 

:Q/ E Ll/F/l/ 17:7; _. to Inc/for me/me/my _
LIL §13t_____g_§3 357% ”/71: When I always feel tired due to ,
04/7} Ll” 7” Ll 73‘ ______- to me/for me/me/my __
Ll/7l‘ Kl *7/17 ____- g} ”/7 5. When I am tired, so ,
0l/7l ”l ’ll/ Ll 73“ _____« to me/for me/me/ my _

 

 

We sang some songs to wrap up the session. Singing was a good tool to help Jessica to
be comfortable and to have soothing feelings in the music therapy session.
5'” session (June 26, 2006)
“I feel bad today” were the first words I heard from Jessica this session. She
seemed to have had an argument with Paul. She said:
“I want to exchange my personality with Paul’s. He is irresolute. .. I can
understand Paul’s mind, but I want to be separated from his parents... I need 3
people on my side. Today I am very upset.”
She poured out her feelings toward the husband. During the interview, she stated,
“He often does not put his stuff in the proper place. I gave up expecting him to
fix the behavior because I want to be more emotionally comfortable. He helped
me when we had only two children, but now he does not help me. He helps me
only when I feel bad or extremely tired. What I want from him is to spend time
with his children and replacing his stuff on the proper place... But, now I am
filled with spirituality, so I can do all.”
However, Jessica mentioned that her husband was one of her best supporters
when she had difficulties dealing with her children with disabilities. Recently, when she

found out about the forth child’s disability, she thought, “Did I marry the wrong guy? Or

34

did he marry the wrong girl?” She mentioned she cried everyday. She talked only to
herself and did not express her feelings, but they burst out one day. She felt sad when
some people said to her that it would be good after the kids were raised- She said, “How
can they know my mind, my suffering, and my wounds?” She showed a strong aversion
to people who do not know her well and just still give advices. She expects people to
look at or experience her life situations from both sides—positive and negative— and
then, to give advice, encouragement, and suggestions based on their understanding of the
conditions. During the post-session interview, I asked her how she wanted to respond to
the situation. She said:

“I am waiting until Paul understands me. I can do whatever God wants me to do.

I want to obey God unconditionally. But, he seems not to obey God... I think it is

necessary to be patient. I will keep some distance from the in-laws, because I feel

bad for them.”

I prepared a fill-in-the-blank song in order to make a piggyback song based on
Jessica’s current emotions. The melody to the song was “T he Londonderry Air. " Jessica
showed some nervousness at first, but got more comfortable and focused on the
songwriting task as we continued(Table 3). She mentioned, “I like it because I can do
everything by myself.” After Jessica completed the lyrics, I performed the song on the
piano. Then, Jessica also sang the song. She said, “I’ve got MY song!” and smiled.

Table 3

Lyrics of " 67 L} 15'5- EE .2 ‘17 (Confession to God) "

 

 

 

Korean English Translation.
23.7 7// Ll Ll 9/ ‘EE’ '3'- ?! ‘3" E} ”l/ Oil. Always when my faith is weaken,
5'} L7 5’ :5; £757 {’2 K/J'Z, God is waitingfor me
ELI, L// 77- ,.fszI/ .99/{71731/ f: {13/ 11/7 And, when I feel Ling/y,

 

Table 3 (cont’d).

 

 

 

 

 

9:71,} Lat—3. 1,} 9,1 .3: .3. 22%;; fig 17/ God holds my hands

Ll $57 3" ;;-I_’_‘r’l—_9f (Pl :5 ”6’ "ll. When [feel always (Wham.
371 1,} 3310/ L} g; 27 #1 K/jz, God isfilling me

17/7} 2/ 274/ —’r7-tr/ X/e/ <3} III/£7, When I am tired and upset.
M 0/ 45 W God makes me standflrmlfiy.

 

 

I notated the song for her in order to encourage her to sing this song when she does not
feel happy and healthy.
6111 session (July 3, 2006)

When I entered the room, Jessica said, “Could you send me a text message in
order to remind to me write in my journal?” She was worried that she rarely kept
journals. So, since that day, I sent text messages as a reminder for her to write the
journal entries.

I asked her whether during the week she sang the song that she had written in the
last session. Jessica said that she boasted to her husband and was very proud of herself.
To touch Jessica’s feelings in different ways, I provided three different compositions as
tools for her to explore her feelings: 1) Beethoven: Moonlight Sonata No. 14, In C#
minor, op. 27/2 mov.l, 2) Strauss: Tritsch-Tratsch-polka op. 214, and 3) Tchaikovsky:
Piano Concerto No. 1. After listening a composition, Jessica shared her imagination and
feelings evoked by the music. I supported and encouraged Jessica to share her feelings in
depth. She was more insightful, but still only self-disclosed surface matters. She reported
that the Beethoven made her feel down and heavy. The Strauss was powerful and light,
so she felt she needed to move forward with God. When she listened to the Tchaikovsky,
she imagined being at the seashore. She said, “I imagined... I was dancing at the

seashore... and I walked with Jesus... I felt very peaceful and calm.”

36

I also asked which composition matched her current feelings. She mentioned that
the Strauss composition was matched with her current emotions because she needed to
move forward. Moreover, the Tchaikovsky matched her ideal feelings. She wanted to
walk with Jesus in her mind. Jessica spontaneously shared her emotions and events. She
seemed to be under stress during the week. We talked about the piggyback song that she
wrote at the previous session.
7th session (July [0, 2006)

We started to talk about being optimistic. She recalled the moment when she
watched an animated movie with her children: Totoroz, the cartoon character, moves into
a very old house. The pillars in the house seemed to be almost collapsed. However, the
children in the movie smiled and said with excitement, “Wow~ It is old! !” Jessica
mentioned that, if she had been there, she could not have smiled and said those words.
Rather than, she would be disappointed. When she saw the movie, she thought she
would be like the children, being optimistic!

In addition, she shared one more story about being optimistic. She mentioned the
Sunday sermon about the principles of the faith: 1) the faith through salvation, 2)
blessing through living of God’s words, and 3) problem solving through prayer. Jacob},
who was a God’s servant described in the Genesis from the Bible, had a hard time due to
his greediness. Moreover, due to Esau", who was Jacob’s older brother, Jacob prayed for
a long time to God in order to be blessed. Therefore, Jacob met God. For our life, God

sends Esau to us in order to discipline us. Jessica said that we could feel burdened and

 

2 . . . . .
Totoro: a main character in a Japanese animation movre, The Camphor Tree.

3 Jacob: the son of Isaac and Rebeccah, and the youger twin brother of Esau from the Genesis of the Bible.
He traded Esau’s birthright for the paternal blessing with soup. As a result, Jacob fled to the uncle, Laban,
to avoid Esau’s rage.

4 Esau: the older twin brother of Jacob.

37

bear a grudge against God about Esau. On the other hand, through the appearance Esau
in our life, we could be disciplined and could have a chance to experience God. She
added that we should thank God for sending us Esau and should pray to have power in
order to win the journey.

After listening to the story in the sermon, I asked, “Who is your Esau?” Jessica
replied, “My children. David and the baby.” She continued:

“Because I was not fulfilled by having David, God gave me one more

Esau... (laugh). . .When I listened to the Strauss composition, I felt I

wanted to move forward actively. I will pray more. I will seek God more and

more. It helps me to challenge myself. (From the transcripts)”

I suggested that this coming week, she thinks how she could improve herself through the
discipline with “her” Esau in God and asked her to share her accomplishments and
experience in the next session.

8’" session (July 24, 2006)

To warm up, Jessica and I started with singing. She sang with a very soft voice
compared to the previous sessions. Then, I checked her current feelings and events.
Jessica shared more specific feelings about the situation and her relationships with
family members. She showed more insight about her core emotion, which was anger
about her laziness. The laziness affected her spirituality, and she described a “spiritual
depression” during the past week. For Jessica, the main symptom of being “spiritually
depressed” was embodied in the feeling of extreme tiredness. She could accept her
children’s demands easily when she was refreshed with spirituality. However, when she

faced to spiritual depression, she was easily angered and irritated by the children,

38

especially the first child. Jessica also mentioned that she could not pray when she felt
spiritual depression. She could not go to the daily early morning services.5 Moreover, the
repetition of this inability to pray also made the situation worse. Jessica mentioned:
“I had a hard time with the first child during this week. I yelled at her. I
expected her to change her behaviors, so I told her to do this many times. But
she did not change. I really feel bad for her.” (From the transcripts)
She mentioned that she knew that changing behavior is hard, but she cannot be tolerate
the first child’s tendency, especially in her current condition. She expects much of her
first child—who is a middle school student and does not have a disability. She seeks this
child’s support, both emotionally and physically. Unfortunately, the first child cannot
meet Jessica’s expectations. I asked her, “Do you think ‘mind follows behavior’ or
‘behavior follows mind’?” She replied:
“I think behavior follows mind, but doing something also calls mind. If I am
doing nothing, my mind was not followed. I have a longing to do something...
God must have given me the mind, but I need to do something with it. Then, the
mind will follow my behaviors.”
I suggested that she try to “do” something during this week and to share her experiences
in the next session.
For songwriting, I asked her to think about her own purpose for creating the final
song. Jessica mentioned that she did not know how to approach writing the lyrics at this
time, but the purpose of writing this song would be to encourage herself to keep in mind

the current decision for the future events.

 

5 . . . _ _- —- . . . . .
Daily early morning servrces ( laud; 7““ ”I ]I Ir. 9] ): In Korea, it 15 common for Christians to go to church
early in the morning for services. It happens everyday at dawn, commonly at 5:00 am.

39

9m session (July 31, 2006)

Jessica looked pale and had little energy. She did not feel good enough to do
much, but she was willing to participate in the session. Because only two more sessions
were left, I planned to touch deeper emotions and discuss them with Jessica. The session
started with verbal discussion about current feelings and events. Jessica shared feelings
about the previous session: joy, energetic, and expectation for both the previous and this
session. After the discussion, I asked her to write the lyrics for the final composed song,
based on her needs (Table 4).

Table 4

Lyrics for the final composed song

 

 

Korean English Translation
If 571 L} git/27 1:1,! 2;} 233,3 .4} g} 0/ £71.77 1 am a chosen person of God.
57 77;?— I’7’/ 215- .X/ EIE 'rI LI/ E/ 27% If) 17/AI He never abandons me even though I am
L7- 571,71“ 14,71 51 1,11%}- 9 7L5) EL 72 010/ a sinner.

77.- u (3):on u} x/ U] 7H} ”L07 iii/o] L 7,2 5727/ I am not capable of carrying out His amazing love,
So I give thanks to God whenever I stand in front of

Him.
0/ Llu ” r0 Ll-Q/ 1.7 23: 557-57 1‘] r3215" God hears my moaning in suffering.
£52 1‘] CI 17/ He wants to accomplish his intention through the
Ill #9/ .7- H44 0/23: O 5 all 7‘ ’z’ 5’ 1' sorrow and pain in my life.
0/ $— A/ Z/ file/715717 I want to move on with only obedience.
HI 0 37 25—31“ 67 0 52’ L} O} 7} Z] {I 6‘} 17/ [ am happy if [ would be used for God ’5 purpose.

272210 ..__5_ e "/o/Oi—éle’é/

ages/(y 519%? If 7/1IECIII/

Ill 97;; 3 £6,77— 2 I”IV/3 OI O’IE '3 F O’CIIfl Through my life, if I can glorifi/ God,
ICIO OI {3] 67 ,3 I;I-§« g: 77 0/3717 II 72 fl £17177 [ want to live with the joy of God forever.

 

10m session (August 7, 2006) & interviews for both participants
Using the lyrics that were composed in the previous session, Jessica and I

rhymed the lyrics rhythmically (Table 5).

4O

Table 5

Lyrics of" I” (If! (The Chosen Per son)”

 

Korean

English Translation

 

l. L} 57L ft: '1/7// L-‘II )I Ill-T0 -x/u LII
'2/7/C)[//OIOX/7}L 'IH/IIII’I17‘7L7]
L/~ 5/L’1L107- IA/IEZI- lit/oi f. (Ho/2/

7’5 5.1-I0I/ .1I {II/BI J? "I 5.”

- )U/OT—(I) riéZA/‘llf _;Z_L‘:/

”(t/LT 2LI

2. IIB/ 115 i675;-
LE.EEEEE£E72”0H
533 21 4': sew oi ”L707 7} 2] 0/67177
E" :2 E 9/ new/E ELIE...

<5E>
EEEEEEEEEE
zIEEEEEEEEEEEEEE-

II 27/ 11’ CI 17/ If .7!!! Lil- I-I/
If ‘3" f! 31 +5? :4? 7I 70/ til-III {IEII/l

1. I am the person who is chosen by God

He never abandons me even though I am a
sinner

I am not capable of carrying out His amazing
love

I can only confess and thank Him

2. God hears my sorrows and pains

He accomplishes His plan through the sorrow
and pains in my life

I would like to obey in order to be close to Him

If I would be used for His intention.

<Refrain>

I am happy, I am happy

If I can glorifii God through giving my life
I am happy, I am happy

I live to rejoice God forever

 

I had observed Jessica’s ability to compose a melody with her voice in past sessions, so I

suggested that she sing and create the melody. By listening, I made notes on the staff

paper. She hesitated to sing and created a melody for a short time; however, with verbal

encouragement and supports, she enthusiastically completed the melodies of the song.

She modified one melody after humming it by herself and suggested a new melody and

rhythms to me. After the session, I had interviews with both Jessica and Paul. They both

agreed with the need for this kind of intervention for parents of children with disabilities.

41

CHAPTER FIVE
Results & Discussion

Based on the session description which was described in the previous chapter,
specific responses and events of each participant, including the therapist were described
in this chapter: 1) The primary participant’s self-esteem issue, resistance, feelings toward
family and other people, spirituality, 2) The therapist’s feelings of the intervention and
the participants, 3) The secondary participant’s aspect about the family and other people.
The Mother (Primary Participant)

Low self-esteem. During the interview, Jessica reported that she had low self-
esteem.

“I was excluded from play with peers when l was an elementary school student. I

don’t know the reasons why they did that to me. Because of that, I lost

confidence... Also... I was not satisfied with my appearance... The low self-

esteem has affected on my relationships with others.”
Her low self-esteem was related not only to the mother’s actions in the past, but also to
her parents—in-law. It was difficult for her to express her opinions to them. They
expected her to obey them like a typical traditional model of a daughter-in-law. She
mentioned that, especially after giving a birth to David, she was withering. She thought
that she could accept a child with a disability, but it was hard to accept her son’s
disability, even though she had an abundant of love, sympathy, and tolerance for him.
Her son’s disability affected her identity about herself. However, she was improving her

self-esteem through looking for her image in God’s sight.

42

During an interview, I asked questions to check her current thinking about her
self-esteem:
Sunny: Do you still have the low self-esteem that you had in the past? Do you
think your self-esteem is improved?
Jessica: You know what? . . . I can reveal myself and even my weakness to God.
He was the only true supporter and listener to me. I can be confident
because God is always with me. My own negative thinking need to be
gone and changed. . . I can smile now. . . because I have my image from
the heaven. I don’t understand why I had strong negative image. . . I
was pretty when I was young. . . (laugh). . . I thank for God everything.
As she mentioned, she currently wants to recognize herself as an image of God, so she
tries to be view herself positively. However, she questioned herself:
June 11, 2006
. . (omission). . . I think that I was loved enough by my parents and
especially by my grandmother. But, I often see myself as withered and
with no confidence. Is there something wrong with my
personality?. . .(omission). . . I wish that the aroma of Jesus Christ is
revealed through me.
The source of Jessica’s positive self-esteem building seemed to be identified. However,
it was a challenge to keep her positive self-esteem as she faced the everyday life
challenges. Based on one of Jessica’s music therapy goals—To express the feelings in
constructive ways, the session was planned to create lyrics about her emotional feelings.

For the first step for songwriting intervention, Jessica was asked to write lyrics about

43

herself. The written lyrics represented her from the past to the present, including events
in her childhood, the disclosure of her child’s disability, and her confession of faith. The
lyrics that were related to her childhood experiences convey how her low self-esteem
was constructed through natural characteristics, peer groups, and negative self-image.
Counteracting that, the significance of her relationship with God represents a possible
means to improve self-esteem (Table 6).

Table 6

Lyrics of " {5:} i Li (A girl) ": part 1

 

Korean English Translation
Ll/éy’ 3,’ 0/,2 75531.9 {#591 L77} 5053,75: LI 5}. There is a girl who is shy and introverted
” fills—"I" 0/ r3} ’5‘! I515? 7/ {92’ I312?“ All ‘é/DCI The girl is demure to have as a
:1: L7,. "’—— ”‘ L/ 1:}. nickname, "unripe bean "
{171:5 0/, ’1 CI (321—0 510/1115: 5315‘} Z/E {15/11 The girl repressed her friends ' injustice
4:95! {I}, 11 5,1 235!!! 1g— * 21,1 2;}; A 177} and kept this to herself
{12:3 275/ [0 17/01] 0,7: ,L-j g at '1 H TE] A 1,145] The girl was changing after she met
35/157! 7/ A] {,1 2311,}: L/ 1;,1 God in her teenage dreams.
Egg; 8/ 7:}; *1/11 17 :3 5/17} 7 Tun/.7 AL] 5,1 35;} The girl spent time with God 's love
951 z»; o ._ 2.71 355/3213? 7 L1 3,1 557/” and passion, that she did not understand
£13313; L/L-,1_ exactly
5‘} 27, D} However,
25 ”/51 51 g ,5}: 7k?- E// (:5 W} 0/ El 7} -715; .31. I: 53:]. There was afeeling that something was
LL: g1.“ missing in her latent personality...
1 3, 175—6 --1. ,4; 1,115] [7350/ 3537353115115 The girl always needed more self— confidence.
31; L/ L} The girl felt inferior about her self:
9/3: 0// 10,.) ‘l- E 0/3331; III/7} {35' (231—, Not only the outlook but also nothing to proud
9/3, u 5,5 oiL/ .75-, E :557 15/5/3 0 :255} ,7. 0/57 0f/70rself
:1, 0 / .1‘2’1717/0” The girl could not be confident in front of
.1 5A 51/ 55 55:55- 2/ 5 «:5 15/75 555 5:5. PIOP’I

 

Jessica expressed a little about her emotions that were related to the discovery of
David’s disability. Even though the situation pulled her into the crisis, she could move

forward with positive emotions from God (Table 7).

44

Table 7.

 

 

Lyrics of “ {I} 5.5 if (A girl) ": part 2
Korean English Translation
-1 .1“. L—77I E/ XI BI... The girl was maturing...
{If—‘32.: 6‘IJZ 0/0/55 '5—I.'/// 5/ 1’.’ .3 17/ CI. The girl was married and has children

.mh5555mwefiIwe
55575w9555555555
£555

LIA] - (gr/[(3’-

"71:1.I

L/ 5,1

:ZE/L}

:5 — 3-01/4/ 2L1..,1 CI .755?
7u+w17eeeweewe
,(f'II' nl._. 0 ADI (lei/f”.
77. 0501/5; til-{:75} .7—I 31.3.3

11.1 II/ .5- 6‘} /// £1

53?, E} 17/ 5}

555-75555

But, a child was very sick...
Through the child, the girl experienced
Sorrow, pain, discouragement, fear...

On the other hand,
The girl found the meaning through the
relationship with God
Love, faith, hope, grace...
These findings in God are amazing!

 

Finally, she developed a positive self-image from God’s perspective. She tried to

develop and improve her self-esteem through strong connections between not only God

and herself, but also herself and other people (Table 8).

Table 8.
Lyrics of “ {I .4: L7 (A girl) "2 part 3

Korean
Old/illi- +‘- ’E’iI (EM/l 6I—'_-.- {I}
”0- ”I” 7Ii/1AH" —‘-.’- ”‘3’ *1/7/ OI IL/L‘I.
3,39, 0/131?" 1% ZlL-I lA/ta "'4’
555.3 .7: 211‘: III—7 {I "I 5177/ 2/

5555555525525555

555555555

15‘}le 3,4 9501/ #1351153 L- 5} 350/ 5.734]

32,,‘0/ J'g 37,15,747] arr/TE 31-10 71 01 x/ -_1}-__1- - ,1} 331-33. .7110”
CW2}? - 0’: ‘ 5171.5 EA. 3111-;

() 0

English Translation

As far as the girl in God,

The girl is not the girl who is shy
and has narrow mind.

The girl cannot pass by the pains around
people

The girl confesses that God gives her the
fullness of the heart to accept them

As far as the girl in God,

The girl becomes the girl who receives God's
love

The girl becomes confident in front of people
even though the life is the exhausting
and challenging environment

 

45

Table 8 (eont’d)

 

1 5":— LI i; OIAII L‘I 0/ ”(3‘ 5r) 315: Al {355} f The girl is dignified rather than shrunk
15¢ gt gr 1,; 1:) anymore

:1 E/JZ, Eff-3‘ :f‘ :3 5'75 ,5?" i 7/ if,” 0/ 5].? LI CI. The girl hasjoy to smile always

.1 5’: L75 ZS‘ILI 'E,l//// KI 53-1-541- ”7 94’5” The girl is....

HIE LI (.3,’ L/ CI. Myself who receives love from God

 

This song would be her reminder to look back on the past and move forward. In addition,
she expressed her inner prayer as the song lyrics. To enhance and support for the
expressed prayer, she chose a song called, “L1 '97] E 7l‘i} 5i (Idol (Be still)” as the slow
background music for the lyrics she wrote. It is a slow song in A major composed by
Stephen Hah, who is a famous Korean pastor (Appendix B). The lyrics were based on

the Bible, Psalm 46 (Table 9).

Table 9.

Lyrics of “ L797? 7I E} 5‘ 5310/ (Be still) ”

 

 

Korean English Translation
5} LI big. 70— 13/ 9,1 .317 til-.577 7]- sip/1:)” God is our refuge and strength,
,5ng55) -70— E/Q/ £513} 3.: .3- o/ x/ e/ And ever—present help in trouble

“Be still, and know that I am God,"

LIiIIL—LE 7I {I (II 210/, *7“ 7I (III/551%] ELI/"I LI I will be exalted among the nations,
9! IéII’I AI/ VII 7/‘27? "II. 5757/“ 33:" 17% {#2 HI LII I will be exalted in the earth. ”

”I 53* ‘3 LI IJI LII "I “I II I love you, my Father

{II ‘3"??? LI EI LII :9 3‘ ' 5I‘1I l worship you with all my heart
”5.735 {5‘ LI EI “II-‘7: SJ 8/: .E I declare you, Jesus Christ

77: ‘E/ 53 15’ :9“ 7/ EI£7I ”I I am expecting you coming back

 

These lyrics are the confession of the Israelites that God is their God. Jessica wanted to
confess like that. She expected God to be her personal God in the life. She chose the
slow tempo, only one instrument—piano—and a female voice to perform it. I suggested
that I would play the piano and Jessica would read the lyrics. When she read “But, a

child was very sick,” she took a deep breath. After the performance, she immediately

46

showed her satisfaction with smiles, but also showed the impact of the lyrics with tears.
This song was the first brick in building her “new” resolution and finding the “different”
aspects of herself during the treatment period.

During the intervention, she said her self-esteem was affected by her
achievement. She was proud of herself that she could create lyrics and music. In the
post-session interview, she mentioned,

“I felt somewhat reluctant to participate, but I was really proud of myself. I’ve

got my song. I’ve had my confession.”

Moreover, she said that having a listener who tries to understand her without judgment
makes her feels more comfortable and safe. The songwriting intervention helped her to
remember and be reminded of God’s support in her life. In God’s grace, she could find
herself. The songs that Jessica composed were a tool for improving her self-esteem and
keeping the positive self-image.

Resistance. During the early sessions, she showed strong resistance to
participation. The resistance was observed from instant verbal responses to non-verbal—
physical—refusal to keep participating in the piano improvisation activity. Some verbal
responses were followed as:

Session 2: During writing the lyrics,

“I don’t know how to write.”

“I cannot do this.”

“I am not comfortable doing this.”
“No homework, please.”

Session 3: During participating in the piano improvisation

47

“It’s very embarrassing.”

“No. .
Even though she expressed her discomfort for the activities, she completed the lyrics for
the first song and attempted to participate in the piano improvisation

It was necessary to discuss her resistance since it was identified on the surface

level and to see she could recognize her resistance. During the pre-intervention interview,
I asked Jessica about taking a risk and challenge.

Sunny: What did you feel when you were asked to play the piano

improvisation in the last session?

Jessica: (giggled) . . . It was very hard for me . . . I liked to play the piano, but I
felt very uncomfortable improvising something on the piano without
direction and structure.

Sunny: Did only “no direction and structure” bother you? Or anything else?

Jessica: (thinking); . Nope. . . nothing else. . .

Sunny: Let me, ask you one more question. Was your feeling related to the
music activity itself, or your personal innate feeling about something or
someone?

Jessica: Someone?

Sunny: It can be me, your husband, David, your children, or other people.

Jessica: Um . . . (pause) . . . THAT can be related to the condition of David . . .
I might want to avoid additional feelings of burden. . . Maybe. . .
(thinking). . .

Sunny: The condition of David?

48

Jessica: Do you know? . . . Um. . . In my mind. . . there is no space to penetrate
something. . . [don’t know.

Sunny: . . . In fact, I was concerning about your responses. If you felt that

much burden about the sessions or me, I needed to decide whether I keep

doing this.

Jessica: Oh, no. It is not be related to music therapy or you.

Sunny: That sounds good to me. (smile) . . . So, how do you want me to
approach you in the music therapy session?

Jessica: Honestly . . . I am feeling more comfortable talking rather than
performing musically.

Sunny: I am happy to hear that. You said several times, “I cannot do
this,” I am not comfortable doing this” . . . But, one interesting thing
is. . . you have completed the tasks even though you kept saying that.

Jessica: Did I? (Laugh)

Sunny: (Laugh). . . Please let me know if you feel too uncomfortable to
participate in a task.

Jessica: O.K. (Laugh).

As she mentioned, her resistance could be related to the condition of her child, and her

strong responses seemed to be associated with transferenceé process. Therefore, her

resistance might be wired with the condition of her children, some degree of a struggle

feeling burdened by the music therapy task, to her habit of saying negative verbal

expression, or to feelings toward me. Based on her replies, the other possible reason for

 

6 Transference: the way of unconscious shifting that a client projects relationships with feelings
and fantasies directly to a therapist (Hanser, 1999).

49

her resistance may be the style of Korean education. Kim (2004) discussed the Korean
education system in his book, Camouflaged School. The Korean education did not vest
the value of developing individual autonomy and personality and improving the
appropriate fields and majors based on an individual’s abilities. Compared to the style
of US. education, which emphasizes group discussion or free talking, most Korean
education follows specific guidelines and usually teachers have high authority. So, the
information flowing is from the teachers to students. Generally, teachers provide specific
directions or “absolute” ways for a task. Therefore, Jessica was not comfortable in
expressing her feelings in an “unstructured” environments, or with the improvisation.
Feelings toward the child with a disability. Jessica mentioned She had a difficult
time after learning about David’s disability. She reported she could not even describe her
feelings in words. She considered leaving David’s care to a professional service for
those with disabilities. She thought about giving David up. However, she did not do that
because she was concerned about other people’s judgments. Currently, she often feels
the limit of accepting the child’s repetitive words and behaviors. Sometimes she yelled
at him. She shared that she was very happy when David went to a school camp for 3
days. She mentioned it was the special “vacation” for her. She has a desire to enjoy the
private time and silence in the house. She had considered suicide due to the destroyed
relationship with the parents-in-law and her feeling of heaviness. During the sessions,
she tried to find David’s abilities rather than disabilities. One day, when she was
sleeping, David took care of answering phones by himself. She felt that this was

praiseworthy.

50

During the period of the study, all of Jessica’s children had a summer vacation.
Because she spent time with the children at home everyday, she felt lack of sufficient
energy to handle the kids. She expressed her feelings on the journal entry.

July, 18, 2006

David wants to sleep with his grandfather (Jessica’s father-in~law), so he
goes to the grandparents’ house. My house without David is so quiet. Instead of

David, I have a struggle with my first child who does not have a disability. Do I

expect too much of her? It seemed that I needed to do many things for my family,

so it makes me struggle. Yesterday, I spent with family at home for the holiday,
but I was the only one who was very busy. I want to escape from the children and

all situations. Today. . .

She was seemed clinically depressed. She expected the first child to help her by taking
care of the sister and the brothers. However, this child could not meet her expectation.

For the summer break, she felt a heavier burden on her shoulders and wanted to escape
from the environment.

The music therapy sessions provided a special time that Jessica could enjoy away
from her children. I encouraged her to look at David positively. Jessica also tried to
endure her feelings toward the child with spirituality and to consider the challenges as
the positive ones. Depending on the child’s behavioral problems, her feelings fluctuated.
The possible reason for the fluctuation might be the Korean social norm, which is
focused on normality and collective. She sought to look at David as a person who God

made rather than to focus on David’s disability and behavioral problems.

51

Feelings toward the spouse. Jessica admired how Paul was able to face David’s
disability. She thanked God for his being a normal person and serving David with
gratitude. However, Jessica sometimes struggled with Paul’s indecisiveness, which he
said was influenced by his parents’ stubbornness and their personalities. Jessica’s
negative feelings toward Paul’s indeterrnination seemed to be bothering to her during the
study period, due to the conflicts she was having with the parents-in-law. The journal
entry showed her feelings.

June 18, 2006

After the Sunday that was challenging, the atmosphere in my family
became calm. I was disappointed at Paul who cannot decide something with
confidence. However, it is obvious that victory is ours who God always be with.

In addition, during the post-intervention interview, she mentioned that Paul would save
his mother if both Jessica and her mother-in-law would be drowning.

After having the third child, Jessica asked Paul to have a vasectomy, but he
refused. A few months later, she got pregnant with the forth child. Even though for most
of struggle, Paul was with Jessica, she bore a grudge against her husband for this. She
poured out her feelings toward the husband. During the interview, she mentioned,

“He often does not put his stuff in the proper place. I gave up expecting him to

fix the behavior because I want to be more emotionally comfortable. He helped

me when we had only two children, but now he does not help me. He helps me
only when I feel bad or extremely tired. What I want from him is to spend time
with his children and replacing his stuff on the proper place... But, now I am

filled with spirituality, so I can do all.”

52

Paul did not put the “stuff” back where he got it. Jessica expected him to help her, such
as playing with children and putting things back. Jessica complained about Paul’s
introverted personality and his deliberate care in speaking. She expected him to more
clearly express his feelings and what he was thinking. As the religious issue related to
the parents-in-law arise, Jessica’s feelings toward Paul was expressed more directly.
During the verbal discussion in a session, she said:
“I want to exchange my personality with Paul’s. He is irresolute. .. I can
understand Paul’s mind, but I want to be separated from his parents... I need
people on my side. Today I am very upset.”
Overall, the music therapy activities did not influence directly the emotional changes of
Jessica’s relationship with her spouse, Paul. However, either the conflicted situation with
her parents-in-Iaw or the rational verbal discussion about the spouse during the
intervention might have had an affect on Jessica’s feelings or her tendency to keeping
feelings inside, only revealing them on surface level. During the post-session interview,
she mentioned:

“During the session, I was realized that I need to talk with Paul. We spent a long

time to talk about my and his feelings and issues.”
It also provided Jessica a chance to communicate with Paul verbally in order to express
her feelings about the situations and Paul.

Feelings toward the parents-in-law. Jessica could understand her mother-in-
law’s behavior rationally, but not emotionally. She spent quiet a long time under her
mother-in-law’s restricted authority. When David was born, her mother-in-law visited a

female shaman to ask about him. The shaman told her that he would be fine as a normal

53

kid when he became the age 10. The mother-in—law believed the words, even though she
is also a Christian. Recently, her mother-in-law observed that David went to the
restroom by himself, and then told Jessica about the connection between the shaman’s
words and David’s behaviors. Jessica was really disappointing her mother-in-law’s
faithlessness toward God. However, her mother-in-law functions as a bridge and buffer
in the relationship between the father-in-law and Jessica’s family. She advised Jessica to
obey the father-in-law’s words, even though she understood what Jessica was thinking.

To Jessica, her father-in-law focuses on his own honor and authority rather than
his grandson. He strongly insists on attending the same church with Jessica’s family.
Finally, he almost threatened that Jessica would have to move out unless she attended his
church. Jessica could not be emotionally connected with him. Her feelings toward her
father-in-law were expressed by this personal journal entry.

June 15, 2006

There is a spiritual conflict in families. It is hard to deal with the father-—

in-law who thinks his own prestige and authority first rather than his grandson.
As the conflict worsened, Jessica showed significant distress over the situation.
Moreover, at that time, all her children started the summer vacation, so Jessica’s stress
was getting higher. She tried to find solutions through her spirituality and to be able to
distinguish conflicts toward her own family in a rational way. She decided to speak up
about the issue to express her viewpoint and to support the needs of the family. The
composed songs were the “reminder” of Jessica’s decision and basic motivation for
living even though the lyrics were not exactly describing the solutions for the issue.

During the post-intervention interview, the mentioned them to be like a close supporter.

54

When she sang the songs, she could get clear about situations and how to respond to
them.

Feelings toward other people. Jessica showed a different tendency when
thinking about other people, including 1) people in the similar or same condition with
her, 2) people who have unreasonable sympathy for her, and 3) people who sincerely
support her. She believed that God called her as a helper for people in the similar or
same conditions as hers. This was the biggest reason why she participated in this study.
She wants to let them know how God uses her with His will. Jessica showed strong
discomfort around people who have the “unreasonable sympathy” for David and her.
During the post-session interview, I asked Jessica about the view point of other people
around her.

Sunny: How do you view the way other people view your situation?

Jessica: I do not like other people’s unreasonable sympathy for me and my child.

They just feel sorry for us even though they do not know whether I feel
fine about the condition. I often cannot appreciate their true and deep
sympathy.”
However, she tried to change their viewpoint. She believed that they talked about the
disabilities, even though they did not know exactly what they wanted to say. Jessica
feels thankful for people who support her and truly care about her. These people pray for
her and the family. Especially the people in church are very supportive and helpful. They
take care of David with unconditional love from God. They sometimes encourage her to

keep her faith in God. She is often touched due to their true love and care.

55

During the verbal discussion, she identified her true supporters who she had not
previously noticed at the same degree.

Sunny: What or who is the positive supporter to you?

Jessica: My faith... family... good relationships... I am very supported by the

pastor, deacons, other church members.
She listed some who she feels free to ask advices or counsel. Therefore, she expressed
her emotions not only to God in heaven, but also to those supporters on the earth.
Spirituality

Jessica’s spirituality significantly influenced her emotional changes and
resolution. At the beginning of the intervention period, I tried to avoid talking about or
sharing spirituality; I preferred to focus on music itself. However, gradually I realized
that the spirituality was the most important aspect for Jessica, because almost all of her
perceptions related to children’s disabilities and relationships were based on spirituality.
I thought that, if appropriate services cannot be provided for Jessica, it is important to
support her source for energy to live. Therefore, the direction of the songwriting
intervention aimed to facilitate her spirituality for improving her emotional and social
relationships.

According to the literature, spirituality positively supports the quality of life for
families of people with disabilities (Poston & Tumbull, 2004; Aldridge, 2004). Zea,
Quezada, and Bel grave (1994) mentioned that faith in God supports the positive
understanding and acceptance of disabilities. In addition, Sevensky (1981) stated that,
for people who have disabilities, religion provides three benefits: “a framework to make

meaning of illness, practical resources, and hope (p. 745).” Poston and Tumbull (2004)

56

mentioned that families of children with disabilities expect the religious community to
meet their three needs: I) socially accepting their children, 2) supporting their
spirituality and emotions, and 3) supporting the spiritual growth of both their children
and themselves by participating in religious activities, including services. These benefits
and needs of the family of children with disabilities also can be applied to Jessica’s
family. She was looking for the meaning of life with David’s disability in the family, and
she had a longing for hOpe consciously and unconsciously. She developed her practical
resources to deal with David and his disability through prayer. Magaletta and Brawer
(1998) mentioned, “Prayer may be the client’s ongoing effort to seek healing from
emotional and/or physical distress, or it may occur as the result of a prescriptive or
encouraging suggestion given by the therapist (p. 323).” Through the music therapy
sessions, she had a chance to pull out her inner prayers in order to create the constructed
lyrics for her own sake. Then, the prayer became an expressive form (Aldridge, 2004).
The music supported the meaning of the lyrics to create mood and atmosphere and evoke
deeper emotions.

After I read the support in the literature, it was clear to me why Jessica wanted to
attend the “new” church, even though the parents—in-law were strongly opposed to it.
She needed an environment for acceptance of her child without judgments or prejudices.
She also needed spiritual and emotional support her from the pastor and deacons in
church. Moreover, she wanted to participate in religious activities not only for her
spiritual growth to handle the condition, but also for David’s spiritual growth. Therefore,
spirituality can play an important role in the quality of life for families of children with

disabilities. During the difficult times, practical resources in religion bring meaning and

57

strength, as well as emotional and practical support, for the family. Based on her current
spirituality, two songs were created: “Confession to God” and “The Chosen Person.”
“Confession to God” is a piggyback song. I prepared two different kinds of
songs so that Jessica could have a chance to choose. One was an exciting and upbeat
song, and the other was a serene and slow song. Jessica chose the sedate song for
creating the piggyback song. The original song was called, “the Londonderry Air, "
which is an anthem of Northern Ireland. When I played this melody on the piano, Jessica
liked the touching melody. She emotionally related to the mood created by the melodies
and harmonies. When she wrote the lyrics, she struggled to complete the task and to
express her emotions. However, after a couple of minutes, she filled in the blanks

without much difficulty (Table 10).

 

 

 

 

 

 

 

 

 

Table 10.
Lyrics of“ 5‘} blip L :9 93E _ L7H” (Confession to God)"
Korean English Translation
07 11/ L} 149/ t; F" {3 ‘3] 0‘ 9:} [fl/0”. Always when myfaith is weaken,
25/ ___L__}U L’ 3’: 7/ __E/l£____ 4734/41! God is waiting for me
55 i// 7}- .jfihy/ s7___/-,‘, Eli] -: Z! [05’ And, when I feel lonelv,
0/ _L__} 513 L49]- 4: <3 5!— C “177, God holds my hands
L} gal—3‘ {147. a"? 0. 5’ 251-; 5"- II// 0//, When I feel always exhausted
67h ,l__._L-_’0/ 14-5 - :2__‘____//—,—’— K/jz, God is filling me
Ll/ 7} x/ x/ A/—§~ L-f </ ____t‘_al 6“} (Ii/{:- When I am tired and upset,
6,14 50/ L it: 73;; 0'] x//.7- z//_ God makes me stand firmlv.

 

She seemed to have not much emotional disturbance at that moment. She was
glad to express her current emotions in a positive way. She added that, if she filled in the
blanks with the emotions of the past, she would say, “One day when l was depressed,
God avoided me. And, when I felt lonely, God was far and far away from me.” After

making a joke, she laughed loudly. Her struggles and hurt emotions were conveyed

58

through her voice tone and facial expression. She must have gone through a difficult
time with these disguised and suppressed emotions rather than with true expressions of
her burdens and asking help from other people. In addition, she was truly going through
the long tunnel of her heavy life with the strong faith and confession of God. The songs
that she composed might be helpful to her in keeping her spirituality, which is Jessica’s
core energy source in life (Appendix C).

The third song in the period of music therapy intervention, “The chosen person,”
took about a month to complete the final song. With enough verbal discussion, Jessica
found the appropriate topic for the lyrics. She mentioned that she wanted to write a song
for accepting God’s calling. The song would be a reminder to keep in mind about her
and her husband’s obedience to God. The original lyrics were written by Jessica, and I
modified them for rhythmic rhyme. Moreover, the lyrics were reviewed by Jessica one

more time to modify some words (Table II).

Table 1 1.

Lyrics of " 54’ if} (The Chosen Person) "

 

Korean English Translation

if dated as are Ale
1. 57/ 7h?- H/ 21:3 1/ 8/17: 12‘ Hi all (:35: f H
e 6M 92/ e 43* as] .f :7: $10M

7’:- ar :1 942/ :2 at e

1.] am the person who is chosen to God
He never abandons me even though I am in
sins.

I am not capable of carrying out His
amazing love

Only confession of thank in front of Him

2. 49/ .117 ($5575 11/ :31 ’ 2552 A/ E ‘7: b’ 2. God hears my sorrows and pains
Ll/ 32‘97/ ~17 51771 0115! 3; st/ —7 «'55 "HZV 57‘ ~77: it] He accomplishes His mind through the
5:4: 3:: 331‘ fry—9:5": “40/" 7} 3] {15—71% sorrow and pains in my life
"' 9*“ ”1"” ”<4 52-9/0] ’5! L755] 1 would like to obey in order to be close to
Hint
If I would be used for His intention.

 

59

Table II (cont’d)

+31 g1 Refrain

1;} ,7/3”! L’ill/ H 7/1’13’Ell—i/ I am happy, I am happy

l-l/ ail—é) 13:" 07/ “ii/’l/ (5,315 if! '7: 53425; W... [f] can g[0rlfi; God through giving my life
{2* 7/1’35/17/ if 7/.”1’ 511177 I am happy, I am happy

:5" (5’70! 5’7 72‘ it 5'7 *7 5717 #54 W I live to rejoice God forever

Jessica created the melodies of the song by vocal improvisation. It was interesting that
two weeks prior, she seemed to be extremely shy and uncomfortable to improvise music.
With my encouragement, she seemed to be confident and to forget about her resistance.
The safe and comfortable environment must been related to the rapport that had been
built with me. She sang the melodies, and I wrote the notes on the staff paper. She
showed an unconscious sensitivity for the cadence and the form. After she sang the song,
Jessica was not satisfied with the first version of the refrain (Figure l), and suggested
modifying some of the melody in order to lead up to the climax of the song.

Finally, she completed the meaningful song, which is in the A(a+b)B(a+b) form
(Appendices D). Even though only three songs were created during the ten weeks of the
period, the songwriting interventions provided her with an achievement, the confidence
that she could do something creative, a reminder to improve her spirituality, and the

courage to take a risk.

60

Figure 1.

1St version of the refrain part

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Evaluation of Jessica '5 music therapy goals. Jessica’s personal music therapy

goals were established based on the assessment and interview during the first session.
The following goals for music therapy were developed:
1. To identify emotions related to life events and family relationships
- Feelings toward herself
- Feelings toward the child with a disability
- Feelings toward her spouse
- Feelings toward the world around her
2. To express her feelings in constructive ways
3. To rationalize the feelings about the events and find solutions by
herself
4. To build positive feelings about herself, her child with a disability, her

spouse, and others

61

Based on Jessica’s music therapy goals established during the first session—to identify
emotions related to life events and family relationships (Goal #1), her feelings related to
life events and family relationships were identified. For the goal, to express the feelings
in constructive ways (Goal #2), the verbal discussion and songwriting intervention were
planned to support her expression. Jessica was actively participating in the verbal
discussion, and she created three of her own songs. During the sessions, based on the
third goal, to rationalize the feelings about the events and find a solution by herself
(Goal #3), after the emotional feelings about events were identified on the surface level,
I tended to not provide specific solutions for the events and issues, but she came up with
ideas and decisions for them. The achievement of the goal, to build positive feelings
about her, the child with a disability, the spouse, and other relationships (Goal #4) were
observed in some part of improvement during the session period.

The Therapist (The researcher)

Before I started the study, I had heard many suggestions and concerns from
people about how to approach families of people with disabilities. It is especially
uncommon and uncomfortable for Korean families of people with disabilities to speak
up or express their feelings to other people. Rather, they believe they should keep these
family issues private to avoid conceming others. Based on this prejudice, I was
extremely careful in my contact and communication with Jessica and Paul. This is
reflected in my effort to build a rapport with Jessica. Before starting the second session, I
thought I needed to check Jessica’s desire to continue as a participant. I did not want to
influence her to feel a responsibility or duty to participate in this study. Earlier, Jessica

had emphasized that she was participating in the study voluntarily, but she also

62

mentioned that she felt it was a burden. Since Jessica seemed to feel burdened by the
songwriting, I thought I needed to use a receptive music therapy approach—which is
music listening technique—for her. I unconsciously modified my plans to match her
response, until I realized that I needed to balance her responses and my purpose for the
study. During the time that I was struggling with my role in the intervention, I heard her
comments through another person who attends the same Christian community as I do.
The person suggested that I should use a less demanding approach. Immediately, I
thought:

“Does she not consider me a ‘good’ therapist?”

“Who is in charge of the therapy sessions?”

“Do I make her feel more burdened even though she has enough burdens due to

the child?”

My negative initial reaction kept arising:

“Who are you? Why are you suggesting me even though you are not my

supervisor?”

“Don’t intrude on my territory in music therapy!”
Then, I was sorry that Jessica had not mentioned her feelings to me directly. Then, I felt
negative counter-transference7 toward Jessica.

Since I experienced my negative counter-transference about her talking to
another person about the sessions, I planned the next session to start with a discussion
about “taking a risk or challenge.”.I needed to check her thinking and to regain about my

self-identification as a therapist. Jessica mentioned that her resistance to accept a

 

Counter-transference: a therapist s pr0jection of unresolved emotional responses onto a client (Hanser,
1999).

63

challenge could be related to the condition of her child, but she emphasized that the
resistance was not related to personal feelings about music therapy or the therapist.
However, she seemed to show the transference process upon me in the session. I
surmised that possible reasons for the strong resistance came from: her characteristic
traits—especially shyness, the burden imposed by the experiment, the pressure to
participate, the stress and challenges in everyday life, and the challenging relationship
with David.

From my perspective, the core emotion that might be related to her resistance
was her negative self-image. Through discussions and music therapy activities, Jessica
tried to strengthen a positive self-image from God who is the source of Jessica’s identity.
The more sessions we had, the more I could understand her hesitance to undertake a new
challenge. Moreover, her assurance that her resistance was not directly related to me as
the music therapist made me regain my self-confidence as a music therapist. I also had
positive feelings of accomplishment during the songwriting process, including building
closer rapport with Jessica.

One day after a session, I experienced Jessica’s everyday life situation, which
included having four children in the house. There was no private time for Jessica, but
there were demanding children and a chaotic environment. The experience outside of the
music therapy intervention caused me to reconsider whether I truly understood her. I was
the same as the people who have a lack of sympathy for Jessica and her family until I
“experienced her life” and developed empathy. I could observe how the environment had
affected Jessica’s ability to build self-image and self-esteem. Positive reinforcement was

rarely provided for her.

64

During the intervention period, because she had found values and beliefs in life
from her spirituality, Jessica and I shared our spiritual values in order to challenge,
encourage, and support each other. At the time that Jessica was experiencing “spiritual
depression,” I also was having a difficult time due to personal reasons. My father was
diagnosed with lung cancer, and he was undergoing radiation and chemotherapy. My
situation could not be compared to Jessica’s long-temt situation, but the impact of my
father’s disease affected my everyday life and even the summer online-class that I was
taking. When I came to Korea, my mother and sister expected me to take care of the
father, because they were exhausted from dealing with my father’s extremely demanding
attitude. They wanted to have their private time to spend for themselves, and I was
getting tired and overwhelmed by my father and his disease. Finally, I almost gave up
the summer class because I could not focus on the class and did not have much energy to
complete the assignments. This enabled me to better understand what Jessica was going
through. This important connection between Jessica and me contributed to the
songwriting activities. Not only I could support her creativity for the activity with
genuine understanding, but also Jessica could express her feelings, concerns, and
spirituality in a safe environment.

The father (The Secondary Participant)

Paul, the secondary participant, did not participate in the music therapy sessions,
but observed Jessica and himself to identify emotional changes in everyday life. He
seemed to be detached from the relationship between Jessica and me like a bystander,
but he was secondarily connected with us through conversations with Jessica. At the

beginning of the treatment period, Jessica mentioned she talked with Paul about this

65

study. They felt burdened and responsible, especially after they signed the consent form.
However, he agreed with Jessica’s intention to participate in this study in order to help
people who have the same or similar situations as them.
According to his journal entry, Paul, like Jessica, reported that he had negative
self-image.
June 23, 2006
I have low self-esteem, low self-confidence, and inferiority. I sometimes
felt confidence about David’s development, but I often felt inferiority due to
David’s slow improvement. Especially, I felt helplessness when faced with the
Korean culture, which emphasize “normalcy.”
However, during the interview, Paul reported that he appreciated being with David by
playing and communicating. However, Paul would like to keep the balance between
intimacy with David and being assertive.
Paul reported the marital relationship with Jessica on the personal journal entry.
June 29, 2006
I was satisfied with the relationship with Jessica. I think we connected
each other by sharing spiritual beliefs. I appreciated Jessica’s caring and
sometimes felt sorry for her about the situation.
With these feelings, he tries to understand Jessica through conversation. However, his
feelings seemed to depend on other people’s feelings too much, especially Jessica’s. For
example, he mentioned several times that, if Jessica liked the song that she created and
felt happy, he was also happy to see her bright face. He seldom expressed his own

feelings. At the time that Jessica expected Paul to be assertive in dealing with a family

66

conflict about the religious issue, he seemed to be pushed to the edge. He tried to
provide balanced affection to Jessica and his parents, but she seemed dissatisfied. During
the interview, he mentioned that he currently expected effort from both sides for an
improved relationship with her. He could understand that Jessica, as a primary caregiver,
was easily irritated and exhausted by the children. Moreover, Paul observed Jessica
sometimes seemed to be depressed. Therefore, he tried to help her at least with the house
chores.

Paul felt a strong desire to help children with disabilities with genuine empathy.

July 1, 2006

When I saw children without disabilities, I envied their healthy body, and

expected them to help people with special needs. I sometimes thought that I

needed people who could carry our burdens together.
Since David’s disability was discovered, Paul and Jessica had never relaxed. During the
verbal discussion in a session, Jessica shared an experience related to David’s absence.
Last year, when David went to a camp, they could relaxed and take a rest without him.
They seemed to need some time to spend for themselves.

July 19, 2006

. . . (omission). . . I am sometimes thinking that I need people who can

share my burdens. Most environments are focused on people without disabilities.

Especially, it is strongly necessary to provide appropriate education for people

with disabilities, especially for people with mental retardation (From Paul’s

journal entry).

67

Finally, Paul strongly mentioned about the necessity of social programs for those

population including people with disabilities and their family.

68

CHAPTER SIX
Conclusion .

Based on the research problem 1) to determine how shared spiritual beliefs in
music therapy interventions affect the self-image of a mother who has a child with a
disability, the interventions provided Jessica with increasing personal awareness by
touching the deeper inner-self and improving her self-esteem by establishing a positive
self-image and achieving simple tasks.

The research problem 2) how shared spiritual beliefs in music therapy
interventions affect a mother’s emotional responses toward her child with a disability
and 3) how the interventions affect a mother’s emotional responses toward a spouse
were not fully discussed because the intervention period was too short to cover those
issues and she needed to work on her feelings toward herself more. However, during the
interview, she mentioned that after the intervention that she poured out her feelings, she
could step back from the negative feelings toward David. She got a chance to have an
enough emotional room to interact with David. Moreover, she also had a time to talk
with Paul in order to share her emotional feelings toward him.

During the period of the intervention, Jessica acknowledged that her spirituality
is the source for building positive self-images and the glasses to interpret external
environments positively. Her thinking could support the research problem 4) to
determine how shared spiritual beliefs in music therapy intervention affect the mother’s
emotional responses toward her external environment.

For the research problem 5) how musicvaffects the participant’s spirituality

facilitating the maintenance of health, this study combined the music therapy approach

69

and sharing spiritual beliefs in order to achieve the benefits from both sides. Jessica
wanted to improve her spirituality in order to support her physical condition and to solve
emotional conflicts with other people. To enhance her spirituality, the music therapy
approach introduced a way how to maintain the spirituality with her favorite art field,
music. The process-oriented songwriting intervention in spirituality also provided a
steady stimulation in order to keep Jessica’s first-mind toward family, events, and God.
Benefits of the Interventions

Increasing self-awareness. The intervention serves as a stimulus for increasing
personal awareness, encouraging clients to see other possible solutions, and supporting
emotional expression and interaction (Gfeller, 1987; Peters, 2000). Baker and Wigram
(2005) stated, “A majority find that the creation of songs provides a tool for
externalizing emotions, and consequently themes for the songwriting often relate to the
client’s emotional life, and the issues, experiences and conflicts with which they have
been, are or expect to be working in therapy. (p. 249)” In addition, they mentioned that
the development of self-esteem is one of the therapeutic outcomes of using songwriting
technique in music therapy session (Baker and Wigram, 2005). The interventions
provided Jessica with some benefits: increasing personal awareness by touching the
deeper inner-self, improving her self-esteem by establishing a positive self-image and
achieving simple tasks, and supporting expression skills in productive ways that are
socially acceptable in the Korean culture.

Peters (2000) stated that music therapists have promoted health and wellness in

the general population and applied music therapy for the expansion of their services

beyond institutional settings. Little research exists concerning the effectiveness of the

70

spiritual-related music therapy interventions in a variety of populations. The results and
findings of this study support the effectiveness of music therapy intervention for this
specific population, mothers of children with disabilities. In addition, it can support
attempts to apply music therapy intervention for more people and for wider populations.
Finding solutions for self-regulation. One of clinical goals for Jessica in the music
therapy intervention was “To rationalize the feelings about the events and find solutions
by herself.” Lee (1996) stated, “Listening is at the heart of music therapy (p.89).” I was
not an expert counselor to provide any exact possible solutions or strategies to Jessica,
but an active listener. Through the therapist’s listening, a client can communicate his or
her conditions and needs (Lee, 1996). The reason that my role could be a listener is that
Jessica seemed to know the solutions and how she needed to respond to the events
already. It is the thread that connects the verbal discussion approach in this study and the
person-centered therapy approachg. Corey (2001) mentioned that one of key concepts of
the person-centered therapy is “the client has the capacity for resolving life problems
effectively without interpretation and direction from an expert therapist (p. 83).” I did
not follow the exact therapeutic ways of the person-centered therapy for Jessica’s
intervention, but the relationship between Jessica and I seemed to be similar with the
relationship between a client and a therapist in the person-centered therapy. The qualities
of the therapist in the person-centered therapy include “genuineness, non-possessive
warmth, accurate empathy, unconditional acceptance of and respect for the client,

perrnissiveness, caring, and the communication of those attitudes to the client (p.84).

 

a Person-Centered Therapy: Carl Rogers developed a branch of humanistic psychology that emphasizes a
phenomenological approach. Based on a subjective experience, it stresses a client’s self—awareness and
resolution of conflicts to personal growth. The client takes a place at the center of therapy rather than the
therapist (Corey, 2001).

7l

Corey (2001) also mentioned that the client in the person-centered therapy can apply his
or her learning into the relationship with others outside.

Improving and/or maintaining optimism. As mentioned in the related research,
parents’ optimism, especially mother’s optimism may be helpful for challenging child
behaviors (Clarke & Beck, 1999). Greenberg, Seltzer, Krauss, Chou, and Hong (2004)
suggested that optimism can provide beneficial effects for mothers who have lifelong
caregiving responsibilities. During the period of the intervention, Jessica acknowledged
that her spirituality is the source for building positive self-images and the glasses to
interpret external environments positively. Therefore, to improve and/or maintaining
Jessica’s optimism, the sessions were focused on increasing her self-esteem and
supporting spirituality by participating in the songwriting process. Through achievement
of songwriting intervention and sharing spiritual beliefs with me, she recovered her
potentials and prepared a step to maintain her optimism by recalling the created songs.

Providing physical separation from the child with a disability. The intervention
provided Jessica a time for physical separation from David and his disability. During the
period of the intervention, Jessica and Paul mentioned several times in the interview or
personal journal entries about their pleasant experiences of being separated from David
for his summer camp. Escaping from the impacts of the disability was one of Jessica’s
pleasures in the intervention. Moreover, because Jessica had never taken any therapeutic
counseling since David was born, she mentioned in her journal entry that she was
appreciative for being cared for and supported.

The social support conditions for the population

72

Through this study, the need for intervention for a family of children with
disabilities as primary clients became clear. Especially, in Korea, it is necessary to
provide appropriate social education and service systems for this population. In addition,
music therapy is not approved officially to provide adequate governmental or insurance
supports. Therefore, it is imminent to establish more proper social approaches to people
with disabilities and their families in Korea.

This study also supports the application of music therapy to wider populations for
improving the quality of life and well-being. A songwriting intervention was effective in
identifying the client’s inner feelings and taking them on surface level in order to work
through her feelings and to find solutions.

The uniqueness of the intervention

As mentioned before, although the reciprocal relationship between music therapy
and spirituality for the quality of life of people with disabilities and their families has
mentioned in literature (Aldridge 2004), not many studies have directly introduced the
approach. This study combined the music therapy approach and sharing spiritual beliefs
in order to achieve the benefits from both sides. Jessica wanted to improve her
spirituality in order to support her physical condition and to solve emotional conflicts
with other people. To enhance her spirituality, the music therapy approach introduced a
way how to maintain the spirituality with her favorite art field, music.

Compared to most songwriting interventions, which were focused on awareness
and improvement of clients’ deeper emotional and interpersonal responses (Gfeller,
1987; Peters, 2000; Ficken, 1976; Miles, 1993; Edgerton, 1990; Lindberg, I995;

Clendenon-Wallen, 1991), the process-oriented songwriting intervention in spirituality

73

also provided a steady stimulation in order to keep Jessica’s first-mind. toward family,
events, and God.
Limitations

There were limitations for this research. 1) The researcher might have a
stereotypical-like faith-based lens through her personal experience with the professor. It
is through spirituality-based conversations that questions concerning faith and suffering
surface. Why does God allow people to suffer even though they are good Christians?
How can families receive help for their situations? These questions are asked by many
people who have children with disabilities and seem to be at the core of the purpose for
this study even though I did not address it on purpose. 2) The intervention period was
too short to touch the participant’s deeper levels of feelings toward events and
relationships. 3) The feelings could be surface emotions rather than deeper insight. Even
though the therapist worked to identify the feelings for certain events and relationships,
deeper insights were likely still there. Nordoff-Robbins (NR) approach or Guided
Imagery and Music (GIM) approach would perhaps be more effective in gaining insight.
Moreover, 4) dealing with self-esteem was effective in the individual setting; however,
dealing with relationship issue may be more effective in family therapy or a dyad setting
in music therapy to apply outcomes immediately and appropriately in a real setting. 5)
The design of this research is a case study, so it is not reasonable enough to generalize
these findings to other situation.
Future Recommendation

For future research, it is recommended that group therapy be employed. Yalom

(1995) emphasized interpersonal relationships and suggested therapeutic process in

74

group therapy, which provides some advantages: “1) a strong expression of emotion,
which is interpersonally directed and is a risk taken by the client, 2) a group supponive
enough to permit this risk taking, 3) reality testing, which allows the client to examine
the incident with the aid of consensual validation from the other members, 4) a
recognition of the inappropriateness of certain interpersonal feelings and behavior or of
the inappropriateness of certain avoided interpersonal behavior, and 5) the ultimate
facilitation of the individual’s ability to interact with others more deeply and honestly (p.
26).” The group dynamics and support could provide more support and understanding
for clients. Also, a longer intervention is recommended to build the trust-based rapport
with the clients to share deeper insight. Moreover, Mash and Wolfe (2005) mentioned
that many problems in childhood could have lifelong consequences for children with
disabilities, their family, and society. Primary caregivers’ emotional stress may depend
on the development and life events of their children with disabilities; therefore, it is
recommended to make research into needs of the caregivers, according to the children’s

age difference.

75

APPENDICES

76

APPENDIX A

Suggestions for Writing the Personal Journal Entries

You can write the journals on the session day after the session, the day before of
the session, and one day between those two days. You can write CURRENT emotions
that you are feeling write now based on the questions below. However, you do not have .
to follow the question if you want to write in your own.

For Primary participant
l) About self
- What kinds of emotions toward yourself? (self-esteem, self-confidence,
self-image, etc.)
- What parts of you are you satisfied?
- Do you want to change yourself? If yes, please describe specifically.
- Is there a change during participating the music therapy session?
2) About the child with a disability
- Are you satisfied the emotions and the relationship between you and your
child with a disability? If yes, please describe specifically.
- Do you want to improve the emotions and the relationship between you
and your child with a disability? If yes, please describe specifically.
- How are you feeling about the child with a disability?
- How are you feeling about the children without disabilities?
- Is there a change during participating the music therapy session?
3) About the spouse
- Are you satisfied about the emotions and the relationship with your
spouse? If yes, please describe specifically.
- Do you want to improve the emotions and the relationship with your
spouse? If yes, please describe specifically.
- How are you feeling about the spouse?
- Is there a change during participating the music therapy session?
4) About external environment
- How do you think about your external environment? Do you need more
help? Do you want the external environment to be improved?
- How are you feeling about the external enviromnent?
- Is there a change during participating the music therapy session?

For Secondary participant
1) About self
- What kinds of emotions do you have to yourself?
- What parts of yourself are you satisfied?
- What parts of yourself do you want to change? If yes, please describe
specifically.

Is there a change during participating this experiment?
2) About the child with a disability

77

Are you satisfied the emotions and the relationship between you and your
child with a disability? If yes, please describe specifically.

Do you want to improve the emotions and the relationship between you
and your child with a disability? If yes, please describe specifically.

How are you feeling about the child with a disability?

How are you feeling about the children without disabilities?

Is there a change during participating the experiment?

3) About the spouse

4)

Are you satisfied about the emotions and the relationship with your
spouse? If yes, please describe specifically.
Do you want to improve the emotions and the relationship with your
spouse? If yes, please describe specifically.
How are you feeling about the spouse?
Do you think your spouse’s emotions are changed through the music
therapy treatment?

0 About herself

0 About the child with a disability

0 About the spouse (you)

0 About external environment including other relationships
Is there your emotional change toward the spouse during participating the
experiment?

About external environment

How do you think about your external environment? Do you need more
help? Do you want the external environment to be improved?

How are you feeling about the external environment?

Is there a change during participating the music therapy session?

78

APPENDIX B

Interview Questions

To a primary participant
I) Could you tell me about your background history?
- Education history
- Marriage
- Baby birth
- Social interaction
2) What do you think or feel about yourself (self-esteem)?
3) What do you think or feel about your child with a disability?
4) What do you think or feel about your spouse?
5) What do you think or feel about the world (optimism)?
6) How was the session?
7) What did you feel during the week?

To a secondary participant
1) Could you tell me about your background history?
- Education history
- Marriage
- Baby birth
- Social interaction
2) What do you think or feel about yourself (self-esteem)?
3) What do you think or feel about your child with a disability?
4) What do you think or feel about your spouse?
- The spouse’s emotions toward you
- The spouse’s emotions toward the child with a disability
- The spouse’s emotions toward the world (optimism)
5) What do you think or feel about the world (optimism)?

79

APPENDIX C

Example of Coded Response from the participant in a music therapy session

 

Korean

English Translation

 

Written responses
from the participant

Written responses
from the participant

Codes

 

 

‘semaneee
6&8], 7H 0] 01018..
94a;- C’l 510’ M21372. 9]]
Jail? xii] 0].?“
3.9.2112] aka. 0]
aeaaaes:
aenaaaaas
asaaaaa
coin. 213011
wgalfig (1191013_
:1. Elli}. Oil
gangs:
gfllfill 915101]

114490] 8153101 3.

61219}, sibleol Lie

aaantae
aaaa,aaan
aaauureul
anaenaaa
733101] 7W fill/Pal 0]
Hint-(3T H E‘UIZI 01-31
711/43: ‘43 S. 9:7"

an oio.eaa
i351 14x1 :1
ol‘érgs 0] iii-i- Eliot/‘1

”8231010119 Xi] —’i‘-%%

El 115:3}3— Xi‘xtol 8..

2117.11 Sltl‘é 0i
sexiness
514‘s} ”ll 4% E931
919—: a ‘atrllilil,
avian/<1
agar/xi 1:}01

saan:ese

 

[aseaeaa
aaaaieai

[avaaea :1

[awed F5
aaanta]
reaea

aokaacrern

311111]

[Swaaaai
gall] 0L1
74] A] 1:]: 7i]
[ti-£01 93131]
[neanaa
atom a 21 aura]
[aaaasae
ea]
[aeeena
annaaaai
[21an 819130]
sea]
[filbi‘a‘ ”ll 4% 2211
still
[filbl‘é ”1W
4%6‘Hltl-‘fl 3%]

 

When I was an
elementary school
student, I was shunted
aside. I was withered.
I do not know the
reasons until now.
The withering
affected on building
the relationships with
other people after
marriage. Also, I was
not satisfied for my
appearance. At that
time, I was skinny
enough to have
positive images about
my own body, but I
did not have any self-
confidence. However,
after I have known
that God is touching
me now, I could
confess, “God is
alive.” I realized that
God knows me in
detail. After tearing
and the wounds were
healed, the
experience did not be
recalled.

My mother has the
thrusting personality,
so it was hard to
assert my opinion.”
For me, God is the
counselor. I know
that God loves me, so

 

[Shunted aside during
elementary school]
[I was withered]

[It affected on
building the
relationships with
other people after
marriage]

[not satisfied for my
appearance]

[God is touching me
now]
[“God is alive”)

[God knows me in
detail.] [tearing]
[wounds were healed]

[My mother has the
thrusting personality]
[ it was hard to assert
my opinion]

[God is the
counselor.]

[God loves me]

:2]? 5:19}?! ‘8‘] I have faith that if [if God wants to use
God wants to use me, me, I will obey Him]
I will obey Him. [faith]

 

80

 

APPENDIX D

Example of Category Formation: Codes Grouped into the category, “Spirituality”

 

Korean

English Translation

 

 

0 01“][01015 15 61161 6171171 £1
013266 61161, “o‘uaL 614712191
11'] [7: 161 71. 61961711741
7.461 61711 61*. HUMP?
6%71711 61916161] [61146.1 1116101 Ul%-S.— 26.71
l1161711610161][713616161 716161916361110
[71E61617‘i 71%} 6.1617H11011 3161 771—8 26%
6161] [iUOtOI ‘61 *3 716161-7611 [01 OIOIE
aaaaaaggsmiaeaaaaai
[enaenaaaaquaaaeqaaa
annanvaneawaa-Envwwn
wHPLJM%QHHPP”366/V 36
#1 71 “EOIOWEH [67.6101161—1— L’ 6— 61] [61”L
6161” ”2101711*‘14771] [6197‘ M01711616161.
‘53“ 2. 1 61*‘61711616111—6161 71] [til 71
26663 amnwaeanacw+
CELEO‘CH [51.14.1131 01kg“ :16. :1 1:134] [1” 0100]
6 6] [6196:1719] 7.16711711716— 6171
661831.016] [161. 73711-301 61741-01 61L] 771
0701 301L165 71013] [3114.130] 6.171616% 71
7.1613] [619%] '01 1611 7&711‘17-1/1] [Lil “lg-91
‘ 61°L 7 71112776111171 6.1.0.6-}:
“6161-01 61521 (7111][61 L711 17161 Ll 33-
:11] 3.]le 5.111- 0 2 #1?le [1112015]:
% [2]»A] 3:]6110
{—16.1 61-L71%1% L117101: 1111917161 ‘66!“ i
4614119.;in ][ 7.7065; 61Ll‘1‘7116171711” 4‘
71] [6171 7617371 01 01017171716171!
ElIOILI-E- 71] [Lil 716011596: 7101017611 u
~87‘fi6171 96.96% %%01‘d 6161711 61L1~11171
[616173 “a“?! 711 ”86.1 61 E 71 0161566161]
16%”1666E66MWH7WWV“
<1—aeaan6666666661
2317;153:211] [Lil 619...??— 01617116} ”771%? L1771]
[611717131 6157016697 {FE ‘31"1‘719]
[719- -. 7.2177161] [LIE 611—173 91011 7a} all. 1711
7? 116-16701 51:3 6519771116153 512716111
61616101 6.10171 61716131 :1 El :11 7379.171633]
[1111‘s 711 6111161? 9.] [71171 019%} 711 6116171
612:: "1" 013161711618. [01 211E 6147101

aaaaaeam

0:1 0 4.....1

,\1

.3—4

L---

40 -lo

1
l
in

n
:Eolrgl 1111

il

 

[having a belief before marriage] [building a
closer relationship through David]
[Experiencing God’s grace through David]
[Thank for God to make me experience
various events] [I changed the church] [I could
not open my mind in the previous church] [I
was waiting by praying] [Recovering my mind
in a short time by prayer] [I could have hope]
[David is precious in God’s sight] [I need to
respect David] [God is also connected in my
suffering] [God’s child] [I cannot stop praying
for David] [Seminarin church] [God, are you
really alive?] [If you are alive, tell me] [I am
seeing and knowing your suffering] [the
biggest sin to God] [recovering my spirit]
[distortion of the relationship with God] [my
spirit is living by recovering the relationship
with God] [God is touching me] [He touched
me at that time] [He knows my every wound]
[That is the encouragement to me] [I was
recovered] [God gave me a daughter to
encourage] [Recovering the love] [I know
God, but his power is not empowered in my
life] [God will give us good health] [What I
want to God is my baby would be born in
healthy] [What can I do if God does not
respond to my prayer like David’s situation?]
[God, you know my situation] [I cannot
overcome from the extreme suffering] [I
cannot deal with this] [I could not die because
of God] [I don’t want to go to hell] [When I
face to God, I do not want to show Him my
shameful decision] [I don’t know God. You
can do everything, and then I gave a birth to
the forth child] [I tried to avoid my greedy] [I
put up with what I need to do] [It’s time that
God show his power in my life]

 

81

 

APPENDIX E

Example of a Thematic DeveIOpment

 

Korean English Translation

 

[aqamqseaaqi
[aqewrawaAuH
[66%66666EWN
E16M6u6%%w
4%Eflflqi
[fi6fidfiEfiE

aqewaaam

4%%%fl

[God is touching] [He
is alive] [He knows
me in detail] [God
loves me] [Self-image
from God] [Thank for
God] etc.

Finding positive self-
image in God

 

aqanqauwana;
[aawmes6utaa
aqaqaagnapl
aana66aaaa
enama:ny6%%
figufiHENEUM%f
aawanmwequa
qanaa?qnag
[6666a66n666
6%a6e6gaawai

mlo

Ci
n [r]
é
19.
19
l*

[Experiencing God’s
grace after David’s
birth] [Recovering
positive mind by
praying] [God is
touching me] [He
knows my wounds]
[Encouragement] [I
cannot kill myself due

Encouragement in
suffering

 

53% to God] etc.
[6lLl‘El 9] U]%E 0]}5’3 DH [God is also hurt]
[23 6E} @ng [God is that you?] [I

awaMUVMINVi
nemaaqaeama
‘qEflfl magnaqi
[66%6V666571
a66n66666
fififihfliEEWEEW]
[6666666666

am seeing and
knowing your
suffering] [God is
touching me] [He
knows my wounds]
[God, you know my
circumstances] etc.

Only listener and
supporter

 

 

7] 0H] atom] EE—
[6$%%E%6%
663%?WHW#flfia
3. 6%] [Cl Ol-OIE
fiWEQEQBEEE,
6666M?%H%66
6666666n64%%
I46660VVWWWE6]
[AWL-6%:- Ul%% CHI
6HH%%

 

David 0|] El] 65}
i3. xii ‘3". 35-]

 

[Jesus respects a soul
more than the world]
[David is a precious
living soul in God’s
sight] [I need to
respect David] [God
is appreciated all
people] [Recovering
love toward David]
etc.

 

Changing the view
point oft David

 

82

 

APPENDIX F

14612.: was} 9.101
(Be still)

 

5103 A

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Korean

571.} g-j-B- #1 .3/52/ .67 5} 2,7,7} 5/.x/zz/_
e 5766/ -?— any 272'} 5366/7/67-

276/5 .7} 5176/ 531/ 6 7/ 574L151 72/6/27
67 7M 77/ 2x/ 71.. a. .7} .26 (.2! 2.7.72. a/ a}

A} 1231?} 1,] a} z.}/ 0/ 11/ z/

3} (2,7 6,714 El 11/ :9 {if £7676
1‘] If ELI/l L? all 47: Ind/155
2 LI 0 ALQ 7/5/13/ [I/

'r'n A—ua

English Translation

God is our refuge and strength,
And ever-present help in trouble

“Be still, and know that I am God;
I will be exalted among the nations,
1 will be exalted in the earth. "

I love you, my Father

I worship you with all my heart
I declare you, Jesus Christ

I am expecting you coming back

83

 

APPENDIX G

6lLl‘El % 636} 5161]
(Confession to God)
ab

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

l ’1 El :71 Al .1. SI; lll 7} :3 °l 9| 8* ll J
EL 817 F7 Bl’ JA
6 .6 ~—+——. . 74:
@ V i 1' 1' i I i fir i i j— ‘ I I I I -. fi::&‘::JE—fi_‘ “’
6 Jaggjgrd -- 6666 a
C.
'0 “l 8] Ll ‘l {5 LI °l xi *3. 9 ii lll Ll “J o‘

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Korean

._ 9.7 6‘ U// 77/,
67277;! :7 .7/6/87—67/627.
.621 11/17/ .4707 57/ .37- :12 __._._ {7! ”It

aflH£fl$¥§§gEflW

66466W66

 

 

_ _. —7 V -7 _[_._.'.
L/ ‘5’ 3‘ Eu? $3753-? ‘5 a

annmwx666yg
wavavgamvea:

iii—Z 77/ LE? 77 1.7 6/ 77/67- 17/.

”IV n//_

 

English Translation

Always when myfaith is weaken
God is waitingfor me

And, when I feel lonely,

God holds my hands

When I feel always exhausted
God isfilling me
When I am tired and ugset,

God makes me standfirmlv.

 

84

APPENDIX H

66.7

(The chosen person)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Am Am/G F C/E G C
_ 413' J 1 “"- ; _%_
_- 1 E _ _____ fi__f__4
- __ i I i I y _ frig— l-3::i 1 1 1
J 4‘ J 4'
v v‘
J :23 4 Li Ll 2.: 4 9t .v. 1 a:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Korean English Translation
5* 6} Lin L’ 77/ 6” .6?" 5711’ 2611‘” 7’ [.1 am the person who is chosen to God
l"/ 7/19-17/44 L”:‘3-X/ Ell—5’2 Lz‘ ”/i -’——l 2/ $7.77“ .2 iv’ He never abandons me even though I am in

IL]- o—flpflJ 0/ .2 4.0 at #5491 a! .2: {go/q
9.7 or a 2.72/6 .z 7:7

sins.
I am not capable of carrying out His
amazing love

 

85

 

2. L'tl—Ql 5167737} 17.7 £15373 57—9 ‘I if '77“ L57,

71/ 5‘9 .22 57?} 0/- 253 561/1 +1“— 0/757/ 5 55 H
H .9. .4 :——5‘ «5822' WM a! $65M

55 ii e/a‘i/ 7/55/0/ {IE/5:7...

52

eneeweneew
weeeeeneegeeeee-
eneeweneew
eeee¢ggnweeeew

Only confession of thank in front of Him

2. God hears my sorrows and pains

He accomplishes His mind through the
sorrow and pains in my life

I would like to obey in order to be close to
Him

If I would be used for His intention.

Refrain

I am happy, I am happy

If I can glorifi2 God through giving my life
I am happy, I am happy

I live to rejoice God forever

 

86

REFERENCES

87

“In. LA LA“!

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