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SOME EFFECTS OF PREFERRED RECORD LISTENING
’ . ON THE FREQUENCY OF SPONTANEOUS
VERBALIZATIONS OF LOW-VERBALIZING, CHRONIC
CLIENTS IN A DISCUSSION GROUP THERAPY SETTING

 

I Thesis for the Degree of M. Mus.

MICHIGAN STATE UNIVERSITY.

CHRISITNA MARIE LUCIA, RMT
1977

 

 

    

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ABSTRACT

SOME EFFECTS OF PREFERRED RECORD LISTENING ON THE FREQUENCY OF
SPONTANEOUS VERBALIZATIONS 0F Low-VEREALIZING, CHRONIC CLIENTS IN
A DISCUSSION GROUP THERAPY SETTING
By

Christina Marie Lucia, R.M.T.

The purpose of this study was to investigate some effects of pre-
ferred record listening on the frequency of spontaneous verbalizations of
low-verbalizing, chronic clients in a discussion therapy setting. It was
an attempt to provide quantifiable data to support the use of this music
therapy technique in the treatment of mentally ill geriatric patients.

A sample of six nursing home residents, all diagnosed as low-verbal-
isers with a chronic psychiatric illness, met with the therapist for 18
discussion therapy sessions. Prior to the first session, subjects were
tested to detenmine their music preferences from among these categories
of vocal music: Country/Western; POp (TOp 40's); Blues; Musicals/Sound-
tracks; Inspirational; and Easy Listening Favorites. The music prefer-
ences of subjects determined the selection of records available through-
out the course of the study.

The subjects were tested for increases in verbal spontaneity during
alternating cells of "Music" and "No Music" condition. A standardized
set of discussion tOpics was designated prior to the onset of the study.

At the beginning of the 50 minute sessions, the therapist announced
the tOpic for discussion. During the "Music" condition, the lyric con-

tent from records selected by subjects was used to facilitate discussion.

Christina Marie Lucia
During the "No Music" condition, only verbal techniques were used to
facilitate discussion. I

Verbal data were analyzed for frequencies of spontaneous verbal

output by both subjects and therapist. Measures of correlation provided
evidence to suggest that the therapist's spontaneous verbal output was
not a significant factor in determining the high or low frequencies of
subject verbal spontaneity. A one way analysis of variance produced no
statistical evidence to support the use of preferred record listening
rather than verbal techniques only during discussion group therapy.
Missing data caused by subject absences made more refined statistical
analyses illadvised. However, inspection of subjects' raw score verbal
frequencies suggests some internal interaction patterns occurring among

subjects.

SOME EFFECTS OF PREFERRED RECORD LISTENING
ON THE FREQUENCY OF SPONTANEOUS VERBALIZATIONS
OF LOW-VERBALIZING, CHRONIC CLIENTS IN A
DISCUSSION GROUP THERAPY SETTING

By

Christina Marie Lucia, RMT

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

Department of Music

1977

ACKNCMLEDGMENTS

Grateful appreciation is extended to Robert F. Unkefer, Associate
Chairman, Department of Music; Dale Bartlett, Ph.D.; and Robert Sidnell,
Ph.D. for their individual contributions of expertise, guidance, and
support during this research effort. I

Indebtedness is also acknowledged to the administration, staff, and
personnel of the Barton House for their cOOperation and committment to

this study.

TABLE OF CONTENTS

Chapter

I.

II.

III.

IV.

ImmmmMHmI”.u.u.n.n.u.n.n.u.u.n.n.u.u.u.n.
The Problem .................................................
Significance of the Problem .................................
Purpose of the Study ........................................
Limitations of the Study ....................................
Definition of Terms .........................................
Methodology .................................................
Overview of Procedure .......................................

REVIEW OF SELECTED LITERATIIRE O O. O. .0 O. O. O. .0 O. .0 .0 O. .0 .0 O. I.
8381CA88‘mpti-0n8 O......OOOOOOOOOOOOOOOOOO.....OOOOOOOOOOOOO
The Pilot StUdy 0.........................OOOOOOOOOOOOOOOOOOO

METHODOLmY 0......00..............O.......OOOOOOOOOOCOOOOOOO

Setting .....................................................
Subjects ....................................................
Determination of Music Preference ...........................
Procedures ..................................................
Collection of Data ..........................................
Analyses of Data ............................................

FINDINGS AND INTERPRETATION OF RESULTS ......................
Reliability Between Recorders ...............................
Therapist's Effects on Subject ReSponses ....................
The "Music" versus "No Music" Condition .....................
Individual Subject Responses by Condition ...................
Tapic Presentation During "Music" or "No Music" Condition ...

SUMMARY, CRITICAL REVIEW, AND RECOMMENDATIONS FOR FURTHER
STUDY .......................................................
Summary of Purpose ..........................................
Summary of Procedures .......................................
Findings and Discussion .....................................
A Critical Review ..........................................
Recommendations for Further Study ..........................

APPENDICES
APPENDIX A: CATEGORIZATION OF SELECTED VOCAL MUSIC FOR THE MUSIC

PREFERENCE TEST ....I...O..........OOOOOOOOOOOOOOOOOO

APPENDIX B: ‘MUSIC USED ON THE MUSIC PREFERENCE TEST .............
APPENDIX C: MUSIC PREFERENCE TEST ...............................
APPENDIX D: TABLE 5. FREQUENCIES OF INDIVIDUAL SUBJECT AND TOTAL

GROUP MUSIC PREFERENCES BY MUSIC STYLE ..............

iii

Page

mNNO‘O‘NI-‘H

16

20
20
21
22
24
26
27

29
29
29
31
31

36
36
36
37
38
40

41
45
48

49

APPENDIX E:
APPENDIX F:

APPENDIX C:
APPENDIX H:

BIBLIOGRAPHY

CATEGORIZATION OF SELECTED VOCAL MUSIC FOR RESEARCH
SESSIONS ............................................
RECORD ALBUMS AVAILABLE DURING RESEARCH SESSIONS.....
VERBATIM DISCUSSION FROM A "MUSIC" CONDITION SESSION.
VERBATIM DISCUSSION FROM A "NO MUSIC" CONDITION

SESSIONOO......OOOOOOOOOOOOOOO......OOOOOOC‘OOOOOOOOOO

iv

50
54
S7
62

67

LIST OF TABLES

FREQUENCY OF THERAPIST'S SPONTANEOUS VERBAL OUTPUT DURING
"MUSIC" AND "NO MUSIC" CONDITIONS LISTED BY TOPIC ..........

ANALYSIS OF VARIANCE FOR "MUSIC" VERSUS "NO MUSIC"
CWDITIWS 00......O....0O....O..0.0.......OOOOOOOOOOOOOOOOO

FREQUENCY OF INDIVIDUAL SUBJECT'S SPONTANEOUS VERBAL OUTPUT
DURING "MUSIC" AND "NO MUSIC" CONDITIONS LISTED BY TOPIC ...

U TEST RESULTS FOR TOPIC COMPARISON DURING "MUSIC" AND "NO
MUSIC.' CONDITIONS 0.0.000.......0............OOOOOOOOOOOOOOO

FREQUENCIES OF INDIVIDUAL SUBJECT AND TOTAL GROUP MUSIC
PREFERENCES BY MUSIC STYLE IO.........OOOOOOOOOOOOOOOOOOO...

Page

30

31

33

35

49

CHAPTER I

INTRODUCTION

The Problem

This current research attempted to provide evidence to support the
use of music therapy as a preferred treatment modality with some mental-
ly ill persons. It was an outgrowth of a pilot study conducted while
the researcher was engaged in music therapy clinical practice with adult
psychiatric clients at a Midwestern community mental health center. It
was a further attempt to quantify the extent to which the frequency of
spontaneous verbalizations of low-verbalizing, chronic clients could be
increased as the result of preferred record listening introduced into a
discussion group therapy setting. An awareness of the following prob-
lems provided the impetus for this study: (1) the traditional methods
of verbal therapy used with chronic, mentally ill clients emphasize the
inadequate verbal skill level characteristic of the illness; and (2)
the therapist responsible for the direction of care may be severly
limited in that capacity as the result of an incomplete or misrepresent-
ed view of the client's needs as depicted solely by information elicited
and obtained through verbal expression. Further, it had been observed
that low-verbalizing, chronic clients seemed to relate more verbal in-
formation during those discussion therapy sessions that involved record
listening than during comparative discussion therapy sessions where only

verbal techniques were employed.

Significance of the Problem

The ability to effectively communicate one's thoughts, feelings,
problems, or Opinions is of significance to all persons. The need for
communication skills on at least a functional level is considered
desirable, if not necessary, for maintaining a healthful and productive
interdependent societal role. Although nonverbal messages comprise
additional communication cues, the spoken word remains the most direct
form of message relaying from one individual to another.

The degree to which a person deve10ps this highly prized skill of
effective verbal communication can depend on one or more of several
contributing factors. Such factors include the following: intelli-
gence, adaptive learning, adequate modeling, Opportunity for practice of
the desired skill, and confounding by physical or psychological hmpair-
ments. The area of psychological tmpainment was the focus for this
research.

To determine an adequate model of psychological impairment, an
assessment was made of the dichotomous facets of mental health as they
differ from the dynamics of mental illness. Garner presents five con-
siderations of the meaning of mental health as purported by Jahoda:

1. Ability to perceive reality and ability to maintain

sufficient degree of contact with reality for appro-
priate orientation to person, place, and time;

2. Ability to deve10p, maintain, and sustain healthy

relationships with peOple;

3. Ability to communicate effectively with peOple;

4. Availability of efficient and apprOpriate defense

mechanisms;
5. Ability to use sound judgements and make decisions.1

 

1Grayce Cynthia Scott Garner, "Qualitative and Quantitative Analy-
ses of SchizOphrenic Verbal and Non-Verbal Acts Related to Selected
Kinds of Music" (Unpublished Ed.D. dissertation, Columbia University,
1973), pp. 9-10.

3
Mental health and mental illness may, then, be described as a series of
regression and approach experiences through time with regard for the
above cited considerations.

It is the function of the therapist in the therapist/client inter-
action to facilitate the approach process toward these desired aspects
of positive mental health. Des Lauriers states:

. . . the effort at therapy with a mentally ill individ-

ual is an attempt, not at changing his problems or con-

flicts, but rather at giving him more adequate and more

sound means of dealing and caping with them.2

The therapeutic process itself can involve an individual encounter
between the therapist and the client or may involve the client in a
group process with the therapist. Michel presents a perspective on the
group advantage:

. . . some of the benefits are: the group presents a

medium for stimulation of socialization; the group

helps the isolated person to begin to relate to others;

. . . the interaction of a group discussion may help to

generalize problems which have previously been thought

of as specifically and peculiarly those of the individ-

ual.

Further, Greenblatt, York, and Brown suggest that progressive de-
socialization is symptomatic of mental illness and, as such, the hospi-

tal environment should promote resocialization by presenting to the in-

dividual a rich assortment of socializing possibilities suited to his

 

2Austin Des Lauriers, "Psychiatric Concepts of Music Therapy,"
Mbsic Therapy 1956, Sixth Book of Proceedings of the National Associa-
tion for MMsic Therapy (Lawrence, Kansas: NAMT, 1957), pp. 32-33.

3Donald E. Michel, "Some Applications of Group Therapy with Music
Therapy," Music Therapy 1954, Fourth Book of Proceedings of the National
Association for Music Therapy (Lawrence, Kansas: NAMT, 1955), pp. 205-8.

4
needs and toward invoking his own social motivation.“ The music thera-
pist can provide for such treatment objectives in the therapy encounter.

The use of music within the therapy group has been cited in the
literature for several of its attributes. Cholden emphasizes the value
of music as an expediter of group communication and feeling:

. . . in the listening experience there is a community

of feeling that becomes more readily observable in the

discussion of the musical experience. The patient may

feel himself belonging to a group in which his place

is clear.

The social character of music described by Dreikurs relates to the
need of the mentally ill person for social readjustment. The use of
music as both a stimulator and expressor of emotions can serve to inte-
grate each within the context of the group.6

Music can also become a structured reality, an organizational tool
for the thinking that precludes verbal expression. Accordingly, Des
Lauriers states:

Music is a medium which by its very structural require-

ments allows feelings to be expressed in a rational way.

. . . Exposed to such an experience, the mentally ill

patient has the Opportunity to let flow for himself what

he cherishes most, and what he is most afraid to lose
and derive gratification from, in an atmosphere of

 

4Milton Greenblatt, Richard H. York, and Esther Lucille Brown, Prom
Custodial to Therapeutic Patient Care in Mental Hogpitals (New York:
Russell Sage Foundation, 1955), pp. 106-7.

5Louis Cholden, "Psychiatric Concepts Of Music Therapy," Music Ther-
apy 1952, Second Book of Proceedings of the National Association for
Music Therapy (Lawrence, Kansas: NAMT, 1953), pp. 27-31.

6Rudolf Dreikurs, "The Dynamics of Music Therapy," Music Therapy
1953, Ipird Book of Proceedings of the National Association for Musip
Therapy (Lawrence, Kansas: NAMT, 1954), pp. 15-23.

5
order, of organization, of rationality.7

The music therapy group, then, can be regarded as a safe atmosphere
for resocialization and the communication skill building process. Both
promote the mentally ill person in his approach toward a more satisfying
level of mentally healthy functioning. Within the music therapy group,
the mentally ill person can rely on both the music and the therapist to
support his efforts toward more effective interaction within the group
setting. The therapist and the tool of music employed service the group
as catalyst, facilitator, and motivator for the communication and re-
socialization process. Yet, it is the client himself and his degree of
comfortableness allowing for spontaneous expression that determines the
effectiveness of the relearning over a period of time. Reusch empha-
sizes this as follows:

Therapeutic communication relies upon spontaneous ex-

pression. . . . The inner experience of a patient can

only be approached by studying the spontaneous eXpress-

ions of the patient. The therapist who relies upon the

patient's habitual ways of communicating will quickly

detect whether the patient's means of expression are in-

adequate.

In retrospect, the significance of this research stemmed from an
awareness of the mentally ill person's need for acquiring verbal skills
that indicate healthy functioning. Further, such healthy functioning
precludes a need for spontaneous expression within the group setting.

The group music experience can provide a structure highly suitable for

therapeutic movement toward such goals.

 

7Des Lauriers,‘gp..21£., pp. 32-33.

BJurgen Reusch, Therapeutic Communication (New York: W. W. Norton
and Company, Inc., 1973), pp. 36-37.

Purpose of the Study

It was the purpose of this study to investigate some effects of
preferred record listening on the frequency of spontaneOus verbaliza-
tions of low-verbalizing, chronic clients during discussion group ther-
apy. It was an attempt to provide quantifiable data to support the
choice of music therapy as a preferred treatment modality for some
clients who seek psychiatric treatment. The following was the hypothe-
sis tested:

The frequency of spontaneous verbalizations of low-ver-

balizing, chronic clients in discussion group therapy

will increase significantly during those sessions which

employ preferred record listening as a verbalizing agent

as compared to those sessions which utilize only verbal
techniques.

Limitations of the Study

The scOpe of this research was limited to selected residents of a
Miswestern nursing home facility. Each subject had been previously
assessed as a low-verbalizer with a chronic psychiatric illness charac-
terized by withdrawn and asocial behavior. Although the subjects were
within the age limits of the normal geriatric pOpulation, they were sel-
ected for inclusion in this study with specific regard for their psych-
iatric dynamics. Accordingly, this research may suggest similar trends
for younger psychiatric clients displaying the same behavioral charac-
teristics. Because of the small sample tested, however, the reader is
cautioned when generalizing these results to other geriatric or adult
psychiatric treatments in sflmilar settings.

Also acknowledged at the onset of this research was the possible
contamination of results due to the novelty element generated by both

the music therapy treatment and the music therapist. However, the field

7
application rather than the laboratory nature of this research provides
information regarding the practical and realistic application of this

music therapy technique with the geriatric mentally ill person.

Definition of Terms

1. Low-verbalizer: that client assessed by an attending psychiatric
nurse as having deficit verbal skills. This deficit was determined
by a minimal output of verbal material with secondary regard for the
quality of the content.

2. Chronic client: that client with a documented psychiatric diagnosis
of a chronic nature.

3. Preferred record listening: individual client selection of songs
from a collection of record albums containing representative samples
of the group's preferences as determined by a music preference pre-
test.

4. Spontaneous verbalization: a verbal expression that is independent-
ly initiated or in response to an Open-ended question or statement.

5. Discussion group therapy: treatment designed to encourage a verbal

exchange among group members.

Methodology

In this study, one group of six subjects met for a period of nine
weeks for discussion group therapy as a scheduled portion of their
treatment at a nursing home facility. This group utilized a predeter-
mined set of tOpics as the basis for discussions. Half of the sessions
employed preferred record listening as a verbalizing agent. The other

sessions were structured to begin with twenty minutes of tOpic discussion

8
followed by thirty minutes of unstructured record listening. Data with
regard for the occurrences of spontaneous verbalizations were collected
from twenty minute segments of tapes made during each session. From
these data, an analysis of variance and measurements of correlation pro-
vided the basis for a statistical interpretation and discussion of the

results.

Overview of Procedure

Chapter 11 presents a selected review of the literature pertinent
to the use of music with the mentally ill and the geriatric client. In-
cluded is a presentation of the pilot study and a descriptive analysis
of the results which shaped the direction for this current study. A
rationale for the use of preferred record choice determined by subjects
is also included. Chapter 111 describes the methodology: the scOpe of
the study, the subjects, the setting, the determination of a music pre-
ference test, the procedures, and the methods of analyzing the data.
The findings and interpretations of the data are presented in Chapter IV.
Chapter V provides a summary, a critical review of the findings, and re-
commendations for further research. The Appendix includes those forms
used for the jury selections of music, the pretest form, those records
used throughout the course of this research, and verbatim samples from

the research sessions.

CHAPTER II

REVIEW OF SELECTED LITERATURE

Accounts of the use of music as a means toward a psychotherapeutic
and have pervaded the literature for decades. Yet, published studies
providing quantifiable support for purported hypotheses relating to the
effects of music on group interaction are of limited quantity and pre-
sent incongruous results.

During the late 1950's, Sommer1 and Dollins2 investigated some
effects of background music on verbal output of psychiatric clients
during psychotherapeutic group sessions. Their results were supported
by Shatin and Zimet, who concluded that stimulative music generates more
verbal interaction than either sedative music or no music.3 In 1963,
Garner provided qualitative and quantitative analyses of schizOphrenic

verbal and nonverbal acts related to selected kinds of music. She

 

1Dorothy Twente Sommer, "The Effect of Background Music on Frequen-
cy of Interaction in Group Psychotherapy," Music Therapy 1957, Seventh
Book of Proceedipgs of the Natippal Associatiopyfor Music Therapy (Law-
rence, Kansas: NAMT, 1958), pp. 167-8.

2Curtis N. Dollins, "The Use of Background Music in a Psychiatric
Hospital to Increase Group Conversation Frequency," Music Thegppy 1956,
Sixth Book of Proceedipgs of the National Association for Music Therapy
(Lawrence, Kansas: NAMT, 1957), pp. 229-30.

3Leo Shatin and Carl Zimet, "Influence of Music upon Verbal Parti-
cipation in Group Psychotherapy," Diseases of the Nervous System, 19
(February, 1958), 66-72.

10

substantiated the theory that subjects will verbalize more frequently
following the playing of recorded music.4

Contrastingly, however a 1965 study by Bonny, Cistrunk, Makuch,
Stevens, and Tally concluded that background music of a stimulative and/
or sedative type did not significantly influence verbal interaction of
peer interaction study.5 Traub suggested further that a music listening
activity of either a sedative or stimulative nature will not significant-
ly alter the initiation of verbal behavior of low-verbalizing, regressed
mentally ill subjects.6

Studies of the use of music activity with the elderly client were
noticeably scant throughout the literature. General observation points
to the value of music activities to stimulate minds and uplift the
spirits of geriatric persons (Hall7). In a descriptive report, Hart
more specifically suggests:

Group listening was always well received. . . . The

music recalled memories of past times; this conversation

was stimulated. The latter was expecially valuable to

the residents, because tOpics of conversation and con-

tributions by the members had been stereotyped for al-
most as long as each had been living there in the

 

4Garner,‘gp.lg;_§., p. 126.

5He1en L. Bonny; Martha Cistrunk; Rebecca Makuch; Emily Stevens;
and Junotte Tally, "Some Effects of Music on Verbal Interaction in
Groups," Journal of Music Therapy, 11 (1965), 61-63.

6Carol Traub, "The Relation of Music to Speech of Low Verbalizing
Subjects in a Music Listening Activity," Journal of:Music Therapy, X
(Winter, 1969), 105-7.

7Dorothy Hall, "Music Activity for the Older Patient," E22$£_IE2£’
any 1956, Sixth Book of Proceedings of the National Association for
IMusic Therapy (Lawrence, Kansas: NAMT, 1957), pp. 115-118.

11

convalescent home.8

Bright also commented on the associative quality of music:
Because elderly peOple tend to dwell in the past too
much, it may seem unwise to accentuate this by calling

up the past still more by music. The aim, however,
should be to encourage discussion, relating one

person's memories of a particular period of time with

those of others in the group, to talk about the past in
relation to the present . . .9

Noticeably lacking, however, was any statistical evidence support-
ing the above cited observations. Only Cotter submitted a review of
any quantitative relevance:

. . . physical and verbal behavior were considered app-

rOpriate when the patient took part in any of the music

activities, held realistic verbal conversation with

other patients or observers and performed any physical

act which observers thought apprOpriate. . . . Both ob-

servation and statistical treatment showed significant

changes in the physical and verbal activities of the

patients as a group.

Of concern was the awareness that little research regarding musical
influences upon the behavior of geriatric or adult mentally ill persons
has been conducted since the late 1950's - early 1960's. Further, this
early research emphasized the use of music as a background stimulus
with the therapist's role primarily that of a responder to group-initia-

ted interaction.

This current research differed from the literature reviewed

 

8Ann Hart, "The Development of a Music Therapy Program in a Conval-

escent Home," Music Therapy 1252, Ninth Book of Proceedingp_of the Nat-
ional Association for Music Therapy (Lawrence, Kansas: NAMT, 1960), pp.

116-120.

9RuthBright, Music in Geriatric Care (New York: St. Martin's
Press, Inc., 1972), p. 6.

10Vance Cotter, "The Influence of Music on Geriatric Patients -
Physical and Verbal Activity," Music Therapy 1957, Seventh Book of Pro-
ceedings of the National Association for Music Therapy (Lawrence,
Kansas: NM, 1958), p. 162.

12
according to these basic assumptions:
1. Subjects actively determined the music used during research
sessions;
2. The music listening was a directed task rather than a back-
ground stimulus;
3. The therapist was an active participant in the group inter-
action;

4. Only music with lyrics was available for selection.

Basic Assumptions

Determination of music selection. It was observed in the preceed-
ing studies that music selections introduced as the research variable
were categorized by panels of judges of varying expertise. However, no
regard for the musical preferences of the subjects tested was acknow-
ledged. Dreikurs cites musical taste as a factor in the individual's
responsiveness to the medium:

There can be no doubt that music constitutes a "lang-
uage." Each culture apparently has its own musical
language, which may break up into separate dialects.

We witness on our American scene the co-existence of
various musical dialects, which are understood only by
those familiar with each. Jazz, pOpular, classical,
modern, and atonal music use completely different forms
of expression; some peOple are familiar only with one

or the other and may reject all other forms . . . There-
fore, it seems unwarranted to assume a correlation between
an individual's personality and his preference for a
type of music or composer. While certain personality
factors may enter the picture, musical preference is
probably more affected by social contacts, through
identification with peOple who have a definite taste or
affinity for certain Tpsical dialects and styles, used
by certain composers.

 

11Dreikurs, pp, cit., pp. 15-23.

13

In a study by Meadows, such factors as socioeconomic status, race,
musical experience, and geographic location were found to be statisti-
cally significant in determining music preferences.12

More pointedly, Bright describes the use of music in the reactiva-
tion of the withdrawn or psychotic geriatric patient:

The initial contact with patients must be through music

which is likely to be familiar. We can thus penetrate

the outer shell of indifference and gain some response.

Having done this, we can go on to rebuild patient's

self-respect by asking them to choose songs . . . by

making it clear that it is their requests for music

which are of paramount importance . . .13

Prior to the onset of this research, then, the musical preferences
of subjects were determined. The group's preference served as the cri-
terion for the selection of record albums available during the research
sessions.

Music listening as a directed task. A second difference in this
research as compared to those previously reviewed was the focus for the
music presented. In contrast to those studies which used music as a
background stimulus, this research emphasized the subjects' focused at-
tention on the music for the duration of each selection played.

The music therapist as an active participppp. The literature re-
viewed depicted the therapist in varying levels of group involvement.
Some studies had no therapist present in the group with data collection

compiled from tapes of sessions or through one-way mirrors. Other

studies collected data by placing Observer-recorders in the group as

 

12Eddie Spencer Meadows, "The Relationship of Music Preference to
Certain Cultural Determiners" (Unpublished Ph. D. dissertation, Michigan
State University, 1970), pp. 161-64.

”Bright, pp. 535., p. 103.

l4
silent members. Butler14 and Shatin and Zimet15 emphasize the involve-
ment of a therapist as an active group member.

This latter model was adapted for the purposes of this research
based on the assumption that any realistic psychotherapeutic treatment
involves therapist interaction.

Exclusivitygof vocal music. Prior to the onset of this study, the
frequency of spontaneous verbal output of subjects was determined as the
desired behavior for shaping. As such, it is assumed that vocal music
provides a directly useable model for such behavior. The subject can
initiate a response related to the lyrics he has just heard. Further,
the musical context affords a nonthreatening medium through which the
lyric content can be presented. Butler concurs as follows:

. . . using the lyrics as a basis, a patient may inter-

pret and verbalize freely, projecting his own feelings

into the discussion. . . . A patient can verbalize and

project his own personality into the discussion more

easily by using the lyrics of the song as the object of
discussion. 6

The normal geriatgicypatient versus the mentally ill geriatric pat-

$525, The process of aging carries with it specific adjustment reac-
tions. Physical decline and retirement accompany family structural
shifts that may jeOpardize ego strengths and a sense of continuing life
fulfillment. Although the precipitating events may vary considerably
from person to person, core emotional stresses typify the aging pOpula-

tion. Bright cites loneliness, grief, and loss as the central concerns

 

14Becky Butler, "Music Group Psychotherapy," Journal of Music Ther-
ppy, III (June, 1966), 53-66.

15Shatin and Zimet, pp.‘p$£., p. 66-72.

16Butler, pp. cit., pp. 53-56.

15

of the elderly.17 In a longitudinal study comparing men without disease
or previous psychiatric illness to healthy young men, Libow substanti-
ates: "Mild reactive depression constituted the most common single di-
agnosis."18

In contrast, the mentally ill geriatric patient more probably has
manifested a chronic psychiatric illness with an onset much earlier in
life. In a study of the differential diagnosis model for psychiatric
assessment of the aged, Varner and Calvert clearly separate the mental
state of depression associated with the "normal" stresses of growing old
from the dynamics of chronic mental illness. This latter group is termed
the "recurrent functional" group and is characterized as follows:

These persons have clearly defined mental illness

which began earlier in life. . . . Chronic

schizOphrenia as well as major affective disorders

occur in this group. Frequently we find that there has

been a long history of mental hospitalization, and reg-

ular to infrequent use of psychotrOpic medication over

the years. Ths usual mental health center serving

mainly younger adults would probably identify this

group as "aftercare." We have found, not too surpris-

ingly, that many such elderly persons prove to be

suitable for traditional kinds of intensive psycho-

therapy as part of the total therapeutic plan and that

even the "long-term mental Ease" can benefit from

therapy quite late in life. 9

The subjects chosen for participation in this study dynamically

represent the preceeding description of the recurrent functional patient.

As we suggested in the literature, it is reasonable to parallel both

 

17Bright, 9p. pig” p. 10.

18Leslie S. Libow, "Interaction of Medical, Biologic, and Behavior-
al Factors on Aging, Adaptation, and Survival. An ll-year Longitudinal
Study," Geriatrics, 29 (November, 1974), 75-88.

19Roy V. Varner, and W. R. Calvert, "Psychiatric Assessment of the
Aged: A Differential Model for Diagnosis," Journal of the Amegican Ger-
iatrics Society, XXII (June, 1974), 273-277.

16
treatment and its outcome for this geriatric pOpulation with that of the
younger, aftercare sector of the mentally ill pOpulation. It is, there-
fore, a basic assumption of this research that when this music therapy
technique is applied during discussion therapy sessions of younger,

aftercare clientele, similar results are likely to occur.

The Pilot Study

The purpose of the pilot study which served as the basis for this
current research was to determine some effects of using record listening
as an adjunctive approach for group aftercare follow-up in the treatment
of adult psychiatric clients at a Midwestern community mental health
center. The null hypothesis was established as follows:

There is no significant difference in the effectiveness

of a "music listening" aftercare group as compared to a

"verbal only" aftercare group when the following var-

iables are measured:

1. attendance for treatment;

2. frequency of spontaneous client verbalizations;

3. frequency of interdependent socializations among

group members outside the treatment session.

The subjects were selected from the general pOpulation of Team A
aftercare clientele at the Midtown Community Mental Health Center,
Indianapolis, Indiana. Aftercare treatment was defined as a meeting
between the therapist and client wherein the client was assessed for
current mental status and medication evaluation. The subjects were cho-
sen without regard for age, sex, or diagnostic consideration; with re-
gard for the assessment of chronically ill status, unemployed or shel-
tered workshOp employment, and a prior attendance figure of having kept

four of their last six scheduled appointments (this attendance figure

was established as an average attendance figure of aftercare clientele

17
for a six month period prior to the onset of the pilot study).

Subjects were randomly assigned to one of four subgroups of eight
subjects each. Two subgroups composed the control group, Group A, and
two subgroups were designated as the experimental group, Group B. The
control group received treatment administered by Therapist I, who util-
ized only verbal cues in the group sessions. The experimental group re-
ceived treatment administered by Therapist II, who utilized both verbal
cues and record listening cues in the group session. Each subgroup met
on a regularly scheduled monthly basis for five consecutive months in a
designated conference room. Sessions were of an hour and a half dura-
tion. The only distinction in equipment present was for Group B which
utilized a portable stereo record player and assorted record albums.

All sessions were recorded with a Sony cassette tape recorder for the
first 45 minutes of each treatment session.

The content areas available for verbal initiation by both Therapist
I and Therapist II were standardized as follows: (1) psychiatric medi-
cation review and related information, (2) leisure time useage and per-
sonal time management, (3) affective responses, and (4) situational
changes since the preceeding treatment session. Therapist II in Group
B treatment sessions incorporated the use of record listening as well as
verbal cues during the experimental sessions. To distinguish from re-
cord listening as a background stimulus, it should be noted that for the
duration of the playing of the recorded music, the subjects' attention
was directed to the listening task. Specific songs were chosen by the
subjects and/or Therapist 11 following a verbal directive given by the
therapist to define a discussion topic shaped from one of the pen-iss-

ihle content areas outlined above.

18

Procedures for notification of subjects and follow-up reminders
were standardized for both Group A and Group B. The two therapists con-
jointly reviewed all tapes to alleviate possible bias of interpretation.
The manner of data collection was a tallying procedure from the tapes
recorded during each subgroup session. One mark indicated one spontan-
eous verbal attempt of a subject. There was no attempt made to quantify
either the content or the duration of responses. Attendance figures
were also recorded for each subject.

It is worthy to note that although the original sample pOpulations
for both Group A and Group B were set at [816, extraneous factors occurr-
ing after the determination of the sample pOpulations required the slim-
ination of some subjects from consideration for analysis in the results
of this study. These factors were as follows: (1) the subject failed to
respond to a request to participate as indicated by a nonattendance from
the onset of the study; (2) the subject moved out of the geographical
area serviced by the treatment facility prior to the termination of the
study; or (3) the subject was terminated from the research groups by the
attending therapist with the assessment that the subject's status requi-
red an alternate treatment regime.

Due to the degree of mortality generated over the five month course
of the study, a statistical treatment was not applied as the results
would be unrepresentative of the sample. Therefore, the null hypothesis
was accepted.

Both Therapist I and Therapist 11 did, however, concur as to cer-
tain trends that seemed to appear during the course of the study. From
an inspection of graphs recording the spontaneous verbalizations of

those subjects present at various times during the study, it appeared

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19
that more subjects in the experimental group evidenced a positive trend
of increased verbal spontaneity than did those subjects in the control
group. Of those subjects completing the study, the attendance figures
were as follows: for Group A, the control group, 34 visits out of a
possible 35 visits, or 97 per cent; for Group B, the experimental group,
50 visits out of a possible 55 visits, or 90 per cent. Both these fig-
ures suggest a more valued sense for the group experience than that
evidenced by the individual aftercare attendance figure which had been
previously determined as approximately 70 per cent. Both therapists
agreed that the study was not of sufficient duration to suggest any evi-
dence with regard to the deveIOpment of interdependent socializations
among subjects outside of the treatment session.
From the pilot study, these recs-endations for further research
were generated:
1. include in the criteria for subject selection those who regard
music as a positive experience;
2. conduct the study over a shorter duration of time and decrease
the time interval between sessions;
3. identifya residential treatment facility as the research
setting to reduce the mortality potential;
4. standardize more closely the discussion tOpics for each
research session;

5. determine a more refined tool of measurement of research data.

CHAPTER III

METHODOLOGY

Setting
The Barton House of Indianapolis, Indiana, was the site for this

present research. The 110 bed facility is an accredited nursing home
which receives referrals fro-{numerous community agencies. Besides the
typical geriatric population, the Barton louse accepts referrals from a
nearby state hospital for the mentally 111. Once referred, residents
usually remain as life placements within the facility. Permission for
running the study was obtained from the administrative staff of Barton
louse.

The Barton louse is staffed by a medical team of doctors, nurses
and aids. Activity personnel provide a limited number of recreational
programs such as bingo and craft projects. No planned music activity
was available to residents prior to this project with the exception of
the singing of hymns during the weekly church services.

All research sessions were held in an enclosed dining room.area
which also served as the craft and recreation room. Subjects were seat-
ed around a table without regard for seating arrangement. The research-
er was the group discussion facilitator with no additional personnel
present during the research sessions. Equipment present during all
sessions were a Sony cassette tape recorder, a Lyons Band portable

phonograph, and 20 assorted record albums.

20

21
Subjects

line subjects were initially selected for inclusion in this study
upon the recommendations of two psychiatric nurses employed by the
Barton House. Subjects were chosen with regard for these criteria:

1. The subject indicated a prior interest in music.

2. The subject carried a diagnosis of chronic mental illness and

displayed a low verbal output.

3. The subject had the mental capability to comprehend staple dir-

actions, questions, or statements.

0f the nine subjects originally selected, one subject required more
extensive treatment and was transferred from the Barton house during the
week between the nusic preference test and the first experinental
session. A second subject refused to attend after the first experinent-
al session. An additional subject terminated fro. the study following
the second experimental session. It is worthy to note that the latter
two subjects were new residents of the Barton House at the time of their
referral to the discussion group. It may be speculated that an incon-
plete adjustment to the nursing,home setting contributed to their ex-
pressed disinterest in continuing with the study.

Of the remaining six subjects, all had been residents of the Iarton
House for approximately two and one-half years. Ages ranged from.67-87
years. Five subjects were diagnosed as chronic schizOphrenic, the sixth
with a manic-depressive illness. All subjects regularly received uajor
psychotropic nedications. The subjects were also sinilar in their lack
of social awareness and infrequent participation in the planned recrea-

tion activities at Barton House.

22
Determination of Music Preference

An initial compilation of vocal album selections was categorized
by a panel of radio disc jockeys according to these classifications:
Country/Western, POp (TOp 40's), Blues, Musicals/Soundtracks, Inspira-
tional, and Easy Listening Favorites. See Appendix A for a listing of
the album selections categorized. An artist/album combination was re-
garded as indicative of one of the above stated categories if it was
reported as such by three out of four of the panel members. From.this
categorized collection, representative samples of each were used for the
music preference test administered to the research subjects prior to the
first experimental session.

The music preference test followed the method of paired compari-
sons.1 This method was chosen because of its relative simplicity of
administering and ease of obtaining subject responses. Due to the na-
ture of some mental illnesses, it was decided that the subjects would
find most ease in responding to a test with a limited choice indicator
and one which did not involve an extended concentration for each item
examined. Therefore, the test was a listening comparison of 15 matched
items, examples from each category paired once with examples from every
other category. Appendix 8 lists those selections included in the test.
Each of the items paired was of a 45 second duration. The subjects were
to circle their preferences on a form sheet (see Appendix C) according

to these instructions:

 

1Ray Robert Welch, "The Deve10pment of an Instrument to Assess the
Musical Preferences in College Music Appreciation Classes" (Unpublished
Ed.D. dissertation, Indiana University, 1974), p. 20.

23

The purpose of this music listening test is to aid the

therapist in understanding your likes and dislikes in

choosing music. She can then provide a selection of

the music you like best for those discussion sessions

that will include the use of records. Your task now is

to listen to the following tape. You will hear 15 pair-

ed items. For each of these items, you will hear parts

of two different songs. You are to circle on this form

the letter A if you prefer the first example or circle

letter B if you prefer the second example. You are to

circle only one response for each item. Please answer

all items - there are no right or wrong responses.

Following the preference test, each subject's test was scored to
determine the number of times each category was selected as the pre-
ferred choice. These raw scores were compiled for all subjects to pro-
duce the total number of times each category was preferred for the group
as a whole (see Appendix D). Percentage scores were determined which
represented the number of times the subjects chose a style of music in
comparison to the number of times they could have chosen that style.
The group's percentage scores for each category were as follows: Coun-
try/Western: 191; Pap (Tap 40's): 21%; Blues: 141; Musicals/Sound-
tracks: llZ; Inspirational: 14%; and Easy Listening Favorites: 21%.

A new categorization of albums for research sessions was necessary
due to the researcher's relocation and a shift in the availability of
albums since the making of the music preference test. Albums were this
time categorized by four area music therapists, again requiring a three
out of four vote agreement to be considered indicative of a category
style. Although the categorizations of music were judged by two differ-
ent panels of exports, a 912 agreement was reached for items appearing
on both tests. See Appendix E for the categorization of music by music
therapists.

A total of 20 albums was available for each session. Of these 20,

the following indicates the breakdown according to preferred categories:

24
Country/Western - 4 albums; Pap (TOp 40's) - 4 albums; Blues - 3 albums;
Musicals/Soundtracks - 2 albums; InSpirational - 3 albums; and Easy
Listening - 4 albums. The same groupings of albums were used for six
consecutive sessions. This allowed subjects to become sufficiently
familiar with the selections available and also provided the consistency
of using the same albums under both the experimental and control condi-

tions. See Appendix F for a list of record groupings used.

Procedures

This study was comprised of 18 discussion group therapy sessions.
One week prior to the initial session, an introductory meeting of sub-
jects was held for the purpose of explaining the procedures of the
following sessions and to administer the music preference test. Subjects
also signed release forms to allow the necessary taping of therapy ses-
sions. The group met on a regularly scheduled, twice a week basis for
the next nine consecutive weeks. The 50 minute sessions were held each
Wednesday at 3:00 P. M. and each Saturday at 10:00 A. M.

The design implemented was a version of the Equivalent Time Samples
Design described by Stanley and Campbell.2 It included an alternation
of experimental and control cells that followed a patterned tapic ser-

ies. The design can be realized according to this representation:

Week I Introductory Session - Music Preference Testing
Week II Session I Session II
Music - TOpic 1 Music - Tapic 2

 

2Donald T. Campbell and Julian C. Stanley, Experimental and
Quasi-Experimental Designs for Research (Chicago, Illinois: Rand
McNally College Publishing Company, 1963), pp. 43-46.

25

Week III Session I Session 11

Music - TOpic 3 No Music - TOpic 4
Week IV Session I Session II

No Music - TOpic 5 No Music - TOpic 6
Week V Session I Session II

Music - Tapic 7 Music - Topic 8
Week VI Session I Session II

Music - TOpic 9 No Music - Tapic 1
Week VII Session I Session II

No Music - Tepic 2 No Music - Tapic 3
Week VIII Session I Session II

Music - TOpic 4 Music - TOpic 5
Week IX Session I Session II

Music - TOpic 6 No Music - TOpic 7
Week X Session I Session II

No Music - Topic 8

No Music - TOpic 9

Those sessions identified above as "Music" sessions refer to those
sessions which actively used preferred record listening throughout the
50 minute session. At the beginning of those sessions, the therapist
announced the topic for group discussion, following which subjects were
directed to choose a song from the albums available to aid them in be-
ginning the discussion. The lyric content was used as the catalyst for
group discussion. See Appendix G for an example of a "Music" condition
session.

Those sessions identified as "No Music" refer to sessions not using
preferred record listening to facilitate topic discussion. These sess-
ions began with the announcement of the discussion tOpic followed by 20
minutes of talk time with no verbalizing agent present other than the
subjects and the therapist. Following the 20 minutes of talk time, the
subjects were allowed to choose any music desired for the remainder of

the session. In contrast to the "Music" sessions, this record listening

26
time was unstructured in that no tapic was identified and no directed
discussion of the lyrics was maintained. See Appendix H for an example
of a "No Music" condition session.
The tOpics for discussion were adapted from Analysis of Music Ther-

3 as follows:

apy Group Procedures by Wolfe, Burns, Stoll, and Wickmann
Tapic l - PeOple I admire
Tapic 2 - Something I've got going for me is . . .
TOpic 3 - If I were to change something about myself, this is what
it would be
Tapic 4 - What do I do when I'm feeling down?
TOpic 5 - Anger - What's it all about for me?
Tapic 6 - Confidence - How do I get it and keep it?
Tapic 7 - Leisure time, hobbies, and finding fun
TOpic 8 - Looking back . . . . a happy time of the past
Tapic 9 - These are the gifts of life
Each of the tOpics was presented twice, once each for the condition
of "No Music" and the condition of "Music". The order, initially chosen

with some regard for continuity from one session to the next, remained

stable.

W

Verbal data were collected from tape recordings made of each session.
From these tapes, two trained recorders independently analyzed twenty

minute segments of each session. For those sessions using music, the

 

3David E. Wolfe; Sally Burns; Mary Stoll; and Karen Wickmann, Anal-
ysis of Music Therapy Group Procedures (Minneapolis, Minnesota: Golden
Valley Health Center, 1975), pp. 23-49.

27
recorders did not include the time spent in record listening when deter-
mining the twenty minute segment for analysis.

The recorders tallied the spontaneous verbal responses made by each
subject. A tally was recorded for each spontaneous verbalization of
undetermined length. However, a second tally was recorded if the flow
of an initial response was interrupted by a question, comment, or state-
ment of another group member and then carried to completion. A new tally
period followed a three second silence. A separate collection was made
of the spontaneous verbal comments made by the therapist.

From each session, the spontaneous verbal responses collected for
analysis were as follows: 1.) individual subject responses, 2.) group

total responses, and 3.) therapist responses.

Analyses of Data

The Spearman rank order measurement of correlation was used to

establish reliability between recorders for the collection of data.
The Pearson product moment correlation measure was used to assess the
influence of the therapist's spontaneous verbal frequency on subject
frequencies of verbal spontaneity. A confidence interval was set to
establish a range for therapist's frequency of verbal spontaneity for
both "Music" and "No Music" conditions.

An analysis of variance was applied to compare group total respon-
ses per session between the "Music" and "No Music" conditions. The re-
searcher had anticipated conducting an internal analysis of variance for
repeated measures to determine the following interactions: 1.) indi-
vidual subject responses by "Music" or "No Music" condition; 2.) indi-

vidual subject responses by tapic condition; and 3.) individual subject

28
responses by "Music" or "No Music" condition by tOpic condition. How-
ever, an incomplete set of data caused by subject absences made statis-
tical treatment illadvised. Therefore, a descriptive analysis of raw
scores by subject for the conditions of "Music" and "No Music" is pre-
sented for the reader's inspection. Finally, Mann-Whitney 0 tests were
applied to determine any significant differences for tOpics presented

during the "Music" or "No Music" conditions.

CHAPTER IV

FINDINGS AND INTERPRETATIONS OF RESULTS

Reliability Between Recorders

The measuring instrument for data collection was an independent
tallying procedure by two recorders. To determine reliability between
their calculations, the Spearman rank order test of correlation was
applied. Auf3==.6l was obtained. From inspection of Klugh's Table R
for Critical Values of the Correlation Coefficient,1 the p: .61 is
accepted at the .01 level of significance. From the above results, it
is unlikely that a significant margin exists between the two recorders'

reports of spontaneous verbal interaction.

Therapist's Effects on Subject Responses

The active participant role of the therapist in this research
poses two questions regarding influences on subject responses. These
questions are: 1.) To what extent does the therapist's frequency of
verbal spontaneity influence the group's frequency of verbal spontaneity?
2.) Is the therapist more verbal during the research condition of
"Music" than during the "No Music" condition?

The Pearson product moment correlation measure was used to

determine the degree of relationship between the therapist's and the

 

1Henry E. Klugh, Statistics: The Essentials for Research (New York:
John Wiley and Sons, Inc., 1974), p. 403.

29

30
group's verbal spontaneity. An r = .42 was obtained. At the .05 level
of significance, no clear pattern can be established between frequencies
of spontaneous verbal output of therapist and subjects. Thus, question
one posed above is answered. No significant relationship exists to sug-
gest that a high or low spontaneous verbal output by the therapist will
effect a similar output by the subjects.

Question two asks: "Is the therapist more verbal during the re-
search condition of 'Music' or 'No Music'?" To compare the therapist‘s
frequency of verbal output between the "Music" and "No Music" conditions,
a confidence interval across both conditions was established at the 95%
level. For raw scores ranging from 94 to 170 with.§'=:134.55, confidence
limits were set at 93.28 and 175.82. An inspection of Table 1 below re-
veals the frequencies of the therapist's verbal spontaneity between these
limits for all research sessions.

TABLE 1. FREQUENCY OF THERAPIST'S SPONTANEOUS VERBAL OUTPUT DURING
"MUSIC" AND "NOiMUSIC" CONDITIONS LISTED BY TOPIC

 

 

TOPIC
CONDITION 1 2 3 4 5 6 7 8 9
MUSIC 104 157 135 132 161 167 94 121 117
N0 MUSIC 136 119 145 105 170 137 137 139 146

 

Question two is, therefore, answered. With a 95% confidence level,
the therapist verbalized within the same limits for both the "Music and

"No Music" conditions.

31

The "Music" versus "No Music" Condition

A null hypothesis was specified for statistical analysis as
follows:

There is no significant difference in the frequency of

spontaneous verbalizations of low-verbalizing, chronic

clients during those sessions which employ preferred

record listening than during those sessions which

utilize only verbal techniques.

A one way analysis of variance was applied to determine the signi-
ficance of the interaction between the "Music" and "No Music" conditions.
The area of rejection for the null hypothesis was set at a<£é,05 level

of significance. Table 2 provides a summary of the analysis producing

an r ratio of F =2 1.007, df = 1/16, p > .05.

TABLE 2. ANALYSIS OF VARIANCE FOR "MUSIC" VERSUS "NO MUSIC" CONDITIONS

 

Source of Variation SS df MS F
Between conditions 256.88 1 256.88 1.007 N.S.
Within conditions 4079.12 16. 254.95

Total 4336.00 17

 

At the .05 level of significance, the data failed to reject the null
hypothesis. No statistical evidence was obtained to support the use of
preferred record listening rather than verbal techniques only during

discussion group therapy with low-verbalizing, chronic clients.

Individual Subject Responses by Condition
The researcher had anticipated conducting an analysis of variance
for repeated measures for these internal interactions: 1.) individual

subject responses by "Music" or "No Music" condition; 2.) individual

32
subject responses by topic condition; and 3.) individual subject re-
sponses by "Music" or "No Music" condition by tOpic condition. However,
subject absences produced missing data across the treatment conditions.
Such incomplete data produced the effect of unequal and different groups
thereby making statistical treatment impossible.

A descriptive analysis is offered to account for some of the var-
iation observed among verbal output of individual subjects. The raw
scores are presented in Table 3 according to "Music" or "No Music" condi-
tion and arranged in order of tOpic presentation.

From inspection of Table 3 an obvious disparity is observed be-
tween the verbal frequency range for Subjects A, B, and C as compared
to Subjects D, E, and P. All subjects were initially selected by two
attending psychiatric nurses according to the criteria for low verbal-
izers with a chronic psychiatric illness. However, it appears that the
potential for verbal spontaneity differed widely among subjects.

Subject B was observed as the most frequent verbalizer across both
conditions. Worthy to note was the shift in participation among other
subjects during those sessions when Subject B was absent. All other
subjects produced their highest individual raw score during Subject B's
absence. Most notable are Subjects A and C.

Subject A presented a range of raw scores from 16 obtained during
Subject B's presence to 56 obtained in her absence. The mean scores
for Subject A varied as follows: 1.) during Subject B's presence, is:
24.2; 2.) during Subject B's absence, §3= 40.5.

Similarly, Subject C presented a range of raw scores from 10 ob-
tained during Subject B's presence to 54 obtained in her absence. The

mean scores for Subject C varied accordingly: 1.) during Subject B's

33

 

 

 

 

 

 

TABLE 3. FREQUENCY OF INDIVIDUAL SUBJECT'S SPONTANEOUS VERBAL OUTPUT
DURING "MUSIC" AND "NO MUSIC" CONDITIONS LISTED BY TOPIC
TOPIC
Subject
1 2 3 4 5 6 7 8 9
A 21 23 56 35 16 24 21 25 34
‘M
B 27 35 - - 50 44 32 39 42
U
C 13 16 47 30 19 19 18 21 21
S
C D 0 12 - 8 6 6 3 - 2
I
0 E l 1 4 3 1 0 2 2 5
C
N F __Q_9._.Z_.Q__Q_£+._.Q_9.__l
D Totals 62 87 109 76 92 97 76 87 105
I
A 33 26 21 42 36 41 27 30 22
T
N B - 45 27 - - - 55 60 50
I O
C 28 21 24 54 40 - 10 17 24
O 'M
U D 6 8 11 11 27 22 5 7 0
N S
I E 3 3 3 3 1 6 3 2 0
C
F ..Q_2_9.__.9.__9._.9_1_.1_3
Totals 70 103 86 110 104 69 101 117 99

 

 

 

 

11

 

34
presence, i: 18.6; 2.) during Subject B's absence, 3(- = 39.8.

It is acknowledged that the interaction patterns attributed to Sub-
ject B's presence or absence in the group are only contributory elements
in the total interaction spectrum. However, the limits of the measuring
instrument and the process for subject selection do not allow for a more
refined sociometric analysis of the group's interaction. Thus, the ob-

servations are offered for the reader's speculation.

TOpic Presentation During "Music" or "No Music" Condition

To determine any significant differences existing for tOpics pre-
sented during one or the other of the research conditions, Mann-Whitney
U tests were applied. The reason for this analysis was due to the miss-
ing data reported in Table 3. These missing data prohibited the use of
a two way ANOVA for repeated measures.

A pzé .05 level of significance was set. Results are presented in
Table 4. At the p é..05 level of significance, all U scores are non-
significant. Thus, the element of tOpic can be considered an unlikely
influence on the results obtained during either the "Music" or "No Music"

condition.

35

 

 

TABLE 4. U TEST RESULTS FOR TOPIC CWARISON DURING "MUSIC" AND "NO
MUSIC" CONDITIONS

TOPIC TEST RESULTS
1 =12 = 11 P = .331, p > .05
2 ‘-"~‘l7 =- 12 p = .469, p > .05
3 =8 =10 p=.238,p>.05
4 = 10 :- 10 p -'= .345, p 7 .05
5 =13 I 11 p = .396, p 7.05
6 =12 1‘ 10 p2 .545, p7.05
7 2: 10.5 3"- 12 p = .138, p 7 .05
8 2 14.5 : 11 p = .500, p > .05
9 :13 =12 p: .242, p7.05

 

CHAPTER V

SUMMARY, CRITICAL REVIEW, AND RECOMMENDATIONS FOR FURTHER STUDY

Summary of Purpose

The acquisition of functional verbal skills is a therapeutic goal
for many mentally ill persons. Verbal communication that is spontaneous-
ly initiated is one indicator of movement toward such a goal. The group
music experience can provide a structure highly suitable for facilitating
this therapeutic movement.

It was the purpose of this research to investigate some effects of
preferred record listening on the frequency of spontaneous verbalizations
of low-verbalizing, chronic clients during discussion group therapy. It
was an attempt to provide quantifiable data to support the choice of
music therapy as a preferred treatment modality for some clients who
seek psychiatric treatment. The research hypothesis was stated as
follows:

The frequency of spontaneous verbalizations of low-

verbalizing chronic clients in discussion group therapy

will increase significantly during those sessions which

employ preferred record listening as a verbalizing agent

as compared to those sessions which utilize only verbal
techniques.

Summary of Procedures
A sample of six chronic, low-verbalizing nursing home residents met
with the therapist for nine weeks for discussion group therapy. Prior

to the first meeting, subjects were tested to determine their music

36

37
preferences from among these categories of vocal music: Country/Western,
POp (Top 40's), Blues, Musicals/Soundtracks, Inspirational, and Easy
Listening. The results of the music preference test determined the selec-
tion of records available to subjects during the course of the study.

The subjects were tested during alternating cells of "Music" and
"No Music" conditions. Each cell consisted of three consecutive sess-
ions. A total of 18 research sessions were held. A standardized set of
discussion tOpics was designated prior to the onset of the study. Each
tOpic was presented under both conditions.

At the beginning of the 50 minute sessions, the therapist announced
the tOpic for discussion. During the "Music" condition, the lyric con-
tent from records selected by the subjects was used to facilitate dis-
cussion. During the "No Music" condition, only verbal techniques were
used to facilitate discussion.

The spontaneous verbal output of subjects and therapist were col-
lected by tape for each session. Two recorders independently tallied the
responses from twenty minute segments of each tape. Analyses of spon-

taneous verbal output formed the basis for the interpretation of results.

giggingsiand Discussion

The frequency of Spontaneous verbal output of chronic, low-verbal-
izing subjects did not significantly change for the course of the study.
The conditions of "Music" and "No Music" generated no substantial differ-
ences when comparing group scores. As a result, the research hypothesis
was not accepted. Further, the element of tapic was determined to be a
nonsignificant factor in eliciting spontaneous verbal output of subjects.

A descriptive inapection of the interaction among individual

38

subjects suggested a trend related to the absence of Subject B. The raw
score frequencies of all subjects were higher during Subject B's absence,
with particular influences on Subjects A and C. This trend may reflect
an interpersonal conflict between Subject B and other group members that
produced an atmosphere of discomfort in the treatment setting. It is
also reasonable to consider that the high verbal output by Subject B was
time consuming and decreased the Opportunity available for others to
contribute spontaneously to the discussion. Further, Subject B's high
verbal output may have influenced the other subjects' sense of respon-
sibility for maintaining the flow of discussion. Such Speculations are
offered for the reader's consideration with the acknowledgment that a
more refined criteria for subject selection and the measuring instrument

could have contributed more conclusive results.

A Critical Review

Of initial consideration for review was the criteria for subject
selection. The obvious disparity in the range of verbal spontaneity pro-
duced among subjects suggests a question regarding their comparable po-
tential for verbal output. It may be speculated from the consistently
high level of verbal output of Subject B from the onset of the study that
she was not really a low-verbalizer at the time of subject selection.
More specific guidelines should have been provided for defining the dimen-
sion of "low-verbalizer". Also, a personality inventory could have been
useful to match subjects according to particular dynamic components.

The problems manifested by broad subject selection criteria were
further compounded by the small sample studied. The sample was not large

enough to incorporate the diversity of incoming verbal potential of

39
subjects.

A further problem was in the isolation of a nursing home pOpulation.
The nursing home setting was originally chosen by the researcher to re-
duce the potential for absences or withdrawal from the study. However,
prevalent was the fact that once referred to the nursing home, residents
were generally life placements within the facility. This permanency may
have had some effect on the motivation of these residents as compared to
other mentally ill geriatric patients who have greater Opportunity for
independent living. The reader is reminded that while the use of pre—
ferred record listening to promote spontaneous verbal output was not
substantiated for the sample of nursing home residents studied, these
results can not be generalized to other geriatric or mentally ill pOp-
ulations.

The variable for study chosen to indicate more healthy verbal
functioning was that of increased spontaneous verbal output. A more
complex sociometric instrument would have allowed more detailed obser-
vations of the internal subject interaction. While spontaneous output
is one measure of healthy verbal functioning, contributory elements such
as apprOpriate gestures, eye contact, and direction of responses among
group members are also available for observation. A measure to
determine growth in duration of subject responses would have also added
an additional dimension to the variable of spontaneous verbal output.

Some question may have been aroused by the reader regarding experi-
mental bias since the researcher served as the group facilitator. The
significantly low statistical correlation between the frequencies of

therapist and subjects' verbal spontaneity suggests no pattern of

40
influence during the "Music" versus the "No Music" condition. Further,
when comparing therapist verbal frequencies during both conditions, all

session scores were within the limits of the 95% confidence level.

Recommendations for Further Study
The small sample studied provides little basis for generalization

of results to other groups of chronic, low-verbalizing, mentally ill

persons. For future attempts in determining the effects of preferred

record listening on the frequency of spontaneous verbal output, the fol-
lowing recommendations are offered:

1. Refine the criteria for subject selection. A personality inventory
revealing interpersonal characteristics is suggested as well as
more specific guidelines for determining a range of frequencies for
the "low-verbalizer" definition.

2. Include a sociometric measure to aid in the interpretation of sub-
jects' and therapist interactions.

3. A pretest and posttest design may be considered to measure growth of
the subjects over time. Such a measure could alleviate the problem
of incomplete data related to occassional subject absences.

4. A younger adult sample of low-verbalizing mentally ill subjects may
be considered for study.

5. The nature of chronicity in the major mental illness studied may re-
quire a much longer duration of study for change occuring to be

quantitatively measured.

APPENDICES

APPENDIX A

CATEGORIZATION OF SELECTED VOCAL MUSIC FOR THE MUSIC PREFERENCE TEST

Panel of experts: Radio disc jockeys

Directions: Please categorize the following artist(s)/a1bums, choosing

1.
2.
3.
4.

5.

13.

only one of the categories listed below:

A. Country/Western D. Musicals/Sountracks
B. Pap (Top 40's) E. Inspirational
C. Blues F. Easy Listening Favorites

(The letter designation signifies at least a three out of four
panel member agreement on the classification style. A blank re-
presents those examples for which less than a three out of four
agreement was established.)

__jL__Ray Charles Singers, "Moods of Love"

__A__ Tammy Wynette, "Another Lonely Song"

___1_>__ "My Fair Lady"

__§__ Mormon Tabernacle Choir, "Onward Christian Soldiers"

B Cher, "Dark Lady"

B Olivia Newton-Hohn, "Have You Never Been Mellow"

 

B The Ozark Mountain Dare Devils, "It'll Shine When It Shines"

 

B Linda Ronstadt, "Heart Like a Wheel"

 

B Poco, "Cantanamous"

 

C Elmore James, "Southside Blues"

 

B Rolling Stones, "Let It Bleed"

 

D "Godspell"

 

F Tony Bennett, "All-Time Hall of Fame Hits"

41

14.

15.

16.
17.
l8.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.
38.
39.

40.

 

 

 

 

B

 

E

 

 

 

 

B

 

 

 

 

 

 

 

...!)—

 

 

 

 

 

 

 

 

42
Jerry Lee Lewis, "Southern Roots"
Nitty Gritty Dirt Band, "Will the Circle Be Unbroken?"
Spinners, "New and Improved"
Barbra Streisand, "Greatest Hits"
Ray Charles, "Crying Time"
Cat Stevens, "Teaser and the Firecat"
John Denver, "An Evening with John Denver"
Robert Shaw Chorale, "What Wondrous Love"
Neil Young, "Harvest"
Louisiana Red, "Louisiana Red Sings the Blues"
Moody Blues, "A Question of Balance"
Jim Croce, "Life and Times"
B. B. King, "Guess Who"
Charley Pride, "A Sunshiny Day"
"The Sound of Music"
Frank Sinatra, "Adventures of the Heart"
Charlie Daniels Band, "Fire on the Mountain"
Porter Wagoner, "Blue Moon of Kentucky"
Merle Haggard, "If We Make it Through December"
"Fiddler on the Roof"
Andy Williams, "Days of Wine and Roses"
Stevie Wonder, "Fullfillingness"
Jim Nabors, "The Lord's Prayer"
Judy Collins, "Colors of the Day"
Bob Dylan, "Greatest Hits, Volume II"
Elvis Presley, "Good Times"

Barry White, "Can't Get Enough"

41.
42.
43.
44.
45.
46.
47.
48.
49.
50.
51.
52.
53.
54.
55.
56.
57.
58.
59.
60.
61.
62.
63.
64.
65.
66.

67.

_§_

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

C

 

 

B

 

D

 

F

 

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__3__

43
Mahalia Jackson, "1 Believe"
Memphis Slim, "Blues Memphis"
America, "Holiday"
Donna Fargo, "The Happiest Girl in the Whole USA"
The Staple Singers, "The Staple Singers Pray 0n"
Goosecreek Symphony, "Words of Earnest"
Simon and Garfunkel, "Bridge Over Troubled Water"
Glen Campbell, "Greatest Hits"
"Funny Girl"
Perry Como, "Dream Along With Me"
Carole King, "Tapestry"
Charlie Rich, "Behind Closed Doors"
Gordon Lightfoot, "If You Could Read My Mind"
Pure Prairie League, "Two Land Highway"
Marian Anderson, "Spirituals"
Leadbelly, "Leadbelly Legacy - Number One (Take This Hammer)"
The 5th Dimension, "Age of Aquarius"
Steve Miller Band, "The Joker"
Muddy Waters and Howlin' Wolf, "London Revisited"
The Dillards, "Roots and Branches"
Gladys Knight and the Pips, "All I Need Is Time"
"Lost Horizon"
Judy Garland, "Very Best of Judy Garland"
Helen Reddy, "Free and Easy"

The Impressions, "Finally Got Myself Together"

_____,New Riders of the Purple Sage, "Gypsy Cowboy"

Janis Joplin, "JOplin in Concert"

68.
69.
70.
71.
72.
73.
74.
75.
76.
77.

78.

..__§_
..é...
__A_.
__L_
_E_
_§_

_.G_

...L.
._1_3_

...L.

44

Tennessee Ernie Ford, "We Gather Together"

Johnny Cash, "Any Old Wind that Blows"

Loretta Lynn, "Love is the Foundation"

John Gary, "John Gary Sings Especially for You"

Aretha Franklin, "Let Me in Your Life"

Stylistics, "Let's Put It All Together"

Mike Bloomfield and Paul Butterfield, "Steelyard Blues"
Don Fogelberg, "Souvenirs"

Kate Smith, "Here and Now"

Kris Kristofferson and Rita Coolidge, "Full Moon"

Neil Diamond, "Jonathan Livingston Seagull"

45

 

 

 

 

 

 

 

 

 

 

 

 

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APPENDIX C

MUSIC PREFERENCE TEST

"The purpose of this music listening test is to aid the therapist
in understanding your likes and dislikes in choosing music. She can
then provide a selection of the music you like best for those discussion
sessions that will include the use of records."

Directions: Your task now is to listen to the following tape. You
will hear 15 paired items. For each of these items, you will hear parts
of two different songs. You are to circle on this form the letter A if
you prefer the first example or circle the letter B if you prefer the
second example. You are to circle only 225 response for each item.
Please answer all items - there are no right or wrong responses. We
will now begin.

1. A B
2. A B
3. A B
4. A B
5. A B
6. A B
7. A B
8. A B
9. A B
10. A B
11. A B
12. A B
13. A B
14. A B
15. A B

48

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APPENDIX E

CATEGORIZATION OF SELECTED VOCAL MUSIC FOR RESEARCH SESSIONS

Panel of eXperts: Registered Music Therapists

Directions: Please categorize the following artist(s)/albums, choosing
only one of the following.

A. Country/Western D. Musicals/Soundtracks
B. Pap (Top 40's) E. Inspirational
C. Blues F. Easy Listening

(The letter designation signifies at least a three out of four
panel member agreement on the classification style. A blank re-
presents those examples for which less than a three out of four
agreement was established.)

1. C Charlie McCoy, "Harpin' the Blues"

 

2. E Jim Nabors, "The Lord's Prayer"

 

3. D "My Fair Lady"

 

4. Glen Campbell, "Greatest Hits"

 

5. B Helen Reddy, "Love Song for Jeffrey"

 

6. Ray Price, "She's Got to be a Saint"

 

7. D "Godspell"

 

8. F Johnny Mathis, "I'm Coming Home"

9. E Anita Bryant, "Abide With Me"

 

10. B Simon and Garfunkel, "Bridge Over Troubled Water"

 

11. A Charley Pride, "In Person"

 

12. C B. B. King, "King Size"

 

50

 

 

 

 

 

 

 

 

 

 

 

 

 

51
Norman Luboff Choir, "Side By Side"
Vicki Carr, "Ms. America"
Gordon Lightfoot, "Summertime Dream"
Ray Charles, "Crying Time"
"The Sound of Music"
Mahalia Jackson, "In Concert"
Elmore James, "Southside Blues"
Johnny Mann Singers, "The Church's One Foundation"
Johnny Cash, "Any Old Wind That Blows"
Judy Garland, "Greatest Hits"
Donna Fargo, "The Happiest Girl in the Whole U.S.A."
Memphis Slim, "Raining the Blues"
Frank Sinatra, "Some Nice Things I've Missed"
Cat Stevens, "Teaser and the Firecat"

Charlie Rich, "Behind Closed Doors"

Roy Clark, "Sings Gospel"

 

 

 

 

 

 

 

 

 

 

"Funny Girl"

Bessie Smith, "Nobody's Blues But Mine"

Tammy Wynette, "Til I Can Make It On My Own"
Carpenter's, "The Singles"

Andy Williams, "The Other Side of Me"

Lou Rawls, "You're the One"

Marty Robbins, "Have I Told You Lately That I Love You"
Mac Davis, "All the Love in the World"

"Camelot"

Loretta Lynn, "Somebody Somewhere"

Tennessee Ernie Ford, "Faith of Our Fathers"

40.
41.
42.
43.
44.
45.
46.
47.
48.
49.
50.
51.
52.
53.
54.
55.
56.
57.
58.
59.
60.
61.
62.
63.
64.
65.

66.

 

B

 

F

 

 

D

 

E

 

A

 

 

F

 

A

 

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B

 

...!—
D

 

C

 

 

A

 

 

 

 

C

 

D

 

52
Linda Ronstadt, "Greatest Hits"
Carol King, "Tapestry"
Jack Jones, "...Sings Michel Legrand"
Elvis Presley, "Good Times"
Charlie McCoy, "Good Time Charlie"
"Fiddler on the Roof"
The Staple Singers, "Great Day"
Merle Haggard, "If We Make It Through December"
Chicago, "Chicago VI"
Ray Charles Singers, "Moods of Love"
Lynn Anderson, "All the King's Horses"
John Hurt, "The Immortal John Hurt"
Stevie Wonder, "Songs in the Key of Life"
Kate Smith, "Here and Now"
"West Side Story"
Mormon Tabernacle Choir, "The Lord is My Shepard"
Louisiana Red, "Louisiana Red Sings the Blues"
Cher, "Dark Lady"
Connie Smith, "I Got A Lot of Hurtin' Done Today"
Jim Croce, "Life and Times"
Perry Como, "Hello, Young Lovers"
Spinners, "Happiness Is ..."
Leadbelly, "Leadbelly Legacy - Number One"
Mike Bloomfield/Paul Butterfield, "Steelyard Blues"
"Lost Horizon"
Don Shirley, "The Gospel According to . . ."

George Jones, "Alone Again"

67.
68.
69.
70.
71.
72.
73.
74.
75.
76.
77.
78.
79.

80.

.2—

 

 

 

 

 

...?—
..L
..L

.15..

..é...

53
America, "Holiday"
Barbara Streisand, "Greatest Hits"
Porter Wagoner, "Blue Moon of Kentucky"
Anita Kerr Singers, "Walk A Little Slower"
Kris Kristofferson/Rita Coolidge, "Full Moon"
Paul Williams, "A Little Bit of Love"
Tony Bennett, "All Time Hall of Fame Hits"
Nancy Wilson, "All in Love is Fair"
Olivia Newton-John, "Have You Never Been Mellow"
Mormon Tabernacle Choir, "Sheep May Safely Graze"
Roy Clark, "Classic Clark"

The Marshall Tucker Band, "Long Hard Ride"

Engelbert Humperdinck, "My Love"

_§._

Tennessee Ernie Ford, "Sings About Jesus"

APPENDIX F

RECORD ALBUMS AVAILABLE DURING RESEARCH SESSIONS

SESSIONS 1 - 6

CountrylWestern

Porter Wagoner, "Blue Moon of Kentucky"

Marty Robbins, "Have I Told You Lately That I Love You?"
Lynn Anderson, "All the Kings Horses"

Loretta Lynn, "Somebody, Somewhere"

P02 (T02 40's)

Carole King, "Tapestry"

Carpenters, "The Singles"

Mac Davis, "All the Love in the World"
Jim Croce, "Life and Times"

Blues

B. B. King, "King Size"
Charlie McCoy, "Harpin' the Blues"
Memphis Slim, "Raining the Blues"

MusicalslSoundtracks

"Fiddler on the Roof"
"West Side Story"

Inspirational

Jim Nabors, "The Lord's Prayer"
Mormon Tabernacle Choir, "Sheep May Safely Graze"
Anita Bryant, "Abide With Me"

54

55
EasyiListening Favorites

Perry Como, "Hello, Young Lovers"
Johnny Mathis, "I'm Coming Home"
Judy Garland, "Greatest Hits"
Vicki Carr, "Ms. America

SESSIONS 7 - 12

Country/Western

Donna Fargo, "The Happiest Girl in the Whole U.S.A."
Charlie Rich, "Behind Closed Doors"

Marshall Tucker, "Long Hard Ride"

Charley Pride, "In Person

P02 (T02 40's)

Olivia Newton-John, "Have You Never Been Mellow"
Stevie Wonder, "Songs in the Key of Life"
America, "Holiday" '

Helen Reddy, "Love Song for Jeffrey"

Blues

Ray Charles, "Cryin' Time"
Bessie Smith, "Nobody's Blues But Mine"
Elmore James, "Southside Blues"

MusicalslSoundtracks

"The Sound of Music"
"Godspell"

Inspirational

Roy Clark, "The Gospel According to Roy Clark"
Johnny Mann Singers, "The Church's One Foundation"
The Staple Singers, "Great Day"

Easy Listening Favorites

Andy Williams, "The Other Side of Me"
Rate Smith, "Here and Now"

Barbara Streisand, "Greatest Hits"

Tony Bennett, "All-Time Hall of Fame Hits"

 

56

SESSIONS 13 - 18

CountrylWestern

Merle Haggard, "If We Make it Through December"
Tammy'Wynette, "'Til I Can Make it on My Own"
Johnny Cash, "Any Old Wind That Blows"

Connie Smith, "I Got A Lot of Hurtin' Done Today"

POpj(T0p 40's)

Simon and Garfunkel, "Bridge Over Troubled Water"
Gordon Lightfoot, "Summertime Dream"

Spinners, "Happiness Is . . ."
Cher, "Dark Lady"

Blues

Leadbelly, "Leadbelly Legacy - Number One"‘
John Jurt, "The Immortal John Hurt"
Louisiana Red, "Louisiana Red Sings the Blues"

MusicalslSoundtracks

"Funny Girl"
"Camelot"

Inspirational

Don Shirley, "The Gospel According to Don Shirley"
Anita Kerr Singers, "Walk a Little Slower"
Tennessee Ernie Ford, "Sings About Jesus"

Easy Listening Favorites

Norman Luboff Choir, "Side By Side"

Ray Charles Singers, "Moods of Love"

Frank Sinatra, "Some Nice Things I've Missed Along the Way"
Nancy Wilson, "All in Love is Fair"

APPENDIX C

VERBATIM DISCUSSION FROM A "MUSIC" CONDITION SESSION

(This segment is from SESSION # l3, TOPIC # 4.)

Therapist:

Subject A:

Therapist:

Subject A:

Therapist:

Therapist:

Subject C:
Subject A:
Therapist:

Subject A:

Today we'll be using the records to help us with our discuss-
ion. We'll play a song, then talk awhile about what we hear,
then play another song and talk some more. Our topic for
today is "what's it like for you when you get down in the
dumps?" I wonder if you can find a song that tells us what
gets you feeling down, or what you do to help pick up your
spirits when you're down. When you play the song, I'll ask
you if it's a song to help pick up your spirits or one that
describes feeling down for you.

Take a few minutes now to look through the records and
find one that will help you get started in the discussion.

(PAUSE)
"Walk A Little Slower".

Okay. Now, is this a song for when you're feeling down or
when you're trying to cheer yourself up?

Trying to cheer myself up.
Okay. Let's all listen to John's song to decide if it's a
"cheer him up" song. This is a song called "Walk A Little
Slower" by the Anita Kerr Singers.

(song is played)
Well, what do you all think? Is that a song that makes you
feel more down in the dumps or one that helps pick up your
spirits?
I don't know.
Picks up your spirits.
Pick up your spirits you say?
Yeah.

57

Therapist:

Subject A:
Therapist:
Subject A:
Therapist:
Subject C:

Therapist:

Subject A:

Therapist:

Subject A:

Therapist:

Subject A:

Therapist:

Subject A:

Therapist:

Subject A:
Subject C:
Therapist:
Subject C:

Therapist:

Subject C:

Therapist:

58

What words did you hear in that song that go along with that
idea of picking up your spirits?

Well, it's hard to do.

Hard to pick up your spirits?

Yeah, it is.

Anybody else find that to be true?

I think it's kind of hard to do.

Well, in the song they gave a couple of suggestions. They
suggested we walk a little slower and take a look at the
world around us, the flowers that were blooming.

Yeah.

. . . and the sun that's shining. Take a look at some of

the o e O
reality.

. . . Yeah, some of reality and also signs of hape and
better times.

Yeah.

Do you think this is a season (Spring) that we could look
around us?

Yeah.

What is it that makes you sad?
have that make you sad?

What kind of thoughts do you

(PAUSE)
Well, being penned in.
Helen might have taken a walk.
Uh-huh. Are you concerned about her?
Oh, I think she's alright. She just went somewhere.

You'll have to tell her you missed her - that you're sorry
she's not here.

1111-1101! e

John was saying that he feels down in the dumps when he's
penned in. Does anybody else have that feeling?

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59

(PAUSE)
When you say you're feeling penned in, John, are there other
words that go along with it that describe that feeling for
you?
Uh.

I wondered if you feel like you don't have much control over
what happens in your life.

I have more control when I'm penned in.
What are some things you have control over in your life?
(PAUSE)

Well, I don't know. . . (laughter) . . .I can't figure it
out. It's confusing.

A confusing question?
Yeah.
Okay. Should we go on and hear another song?

Yeah.

I've got one here.

Okay. Which one was yours?

Well, I believe that first one there, or "You Are the Sun-
shine of My Life." Either one's alright with me.

Okay. Why don't you decide then?

Can you find this one?
I like that.

"You Are the Sunshine of My Life" -

Let's listen to the words of this one now. When it's over,
we'll decide if it was a peppy song - a cheerful song, or
one that's more down in the dumps.

(song is played)
Thank you. I liked that.
So, is that a down in the dumps song or a cheery song?

Cheery one.

What did anyone else think?

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60
Cheery song.
(garbled comment)

Un-huh. Allie, how about for you? Was that a cheery song
or a down in the dumps song?

Cheery.

He was singing a song about his favorite person.

Uh-huh.

He was singing the song to the "sunshine" of his life.
Yeah. To his girlfriend.

Maybe his girlfriend . . . or whoever helps him feel good.
Yeah.

Anybody have a favorite person who is the sunshine of your
life? Helps pick up your spirits?

Yeah.
Who's that for you, John?
Pearl.
Tell us about Pearl.
Pearl . Do you mean her?
Yeah.
Yeah, she's pretty nice.
How does she help pick up your spirits, John?
Well, we go down to White Castle and get a hamburger and a
hot chocolate once in awhile. Then I don't feel so lone-
some.
Good for you! . . . How about anybody else? Does anybody
else have a "sunshine of your life" who helps pick up your
spirits?
(PAUSE)
I think my daughter helps pick my spirits up. We don't go

out very often, but once in awhile. . . I'm going to try
and find out when Mother's Day is and go out that day.

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61
Oh, let's see . . .

I can't find it out on the calendar. It's not on my calen-

dar.
It isn‘t?

No it isn't. I looked twice.

But it is in May.

It's in May but I don't know just when. I'll ask the beauty
shOp lady. I'm going to get my hair done tomorrow and I'll
ask her then.

Well, what about that? Getting your hair done - does that
make a brighter day for you?

It makes me feel better.
Uh-hUh e

I have a cold, though. I hate to get it done, but I guess

it won't make me worse.

I bet it'll make you feel prettier.

Uh-huh. It's so short, she can't do much with it.

Mesolsit
up when you take

true for anyone else that your spirits pick
care of how you look?

Yeah, they do.

I noticed you've been shaving quite regularly, John.
Yeah, I have . . .

(simultaneously) Yeah, he has.

You been feeling a little better these days?

Yeah, I've been feeling a little better.

APPENDIX H

VERBATIM DISCUSSION FROM A "NOiMUSIC" CONDITION SESSION

(This segment is from SESSION # 5, TOPIC # 5.)

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Again, like on Saturday, we'll have our talk time for the
first twenty minutes, then go into music at the end of the
session. So - today our tapic - something we can get start-
ed talking about - is what it's like for us when we get
angry. I think we all get mad from time to time, and I
wonder what experiences you've had being angry - and what
you've done about it.

(PAUSE)
It's been a long time since I've been angry.
Has it?
Yeah. I can't remember . . .
I haven't been angry for a long time.

(PAUSE)

Well, thinking back . . . what kinds of experiences do you
remember that used to cause some anger for you?

I don't remember any. Do you? Do you remember any times

you was angry?

Well, if somebody tells a story about you, and it wasn't
true . . . or something like that.

Yeah, that would make me mad, too.

(PAUSE)
How do we get over feelings of being angry? How do you
think you shifted, Edna, from having things bother you to

now when things don't bother you so much?

Well

62

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63
I go to my room.
How does that help, John?

Well, I try to figure out why - who was right and who was
wrong . . . Meditate . . . I meditate.

After you've figured out who's right and who's wrong, then
what?

Oh, next time I see that person, I tell him whether he was
wrong or right.

So you tell that person your feelings about it?

Yeah . . . if they was wrong . . . if they was right, I apol-
ogize. If they was wrong, I tell them.

That's a pretty healthy way to handle it.
(PAUSE)
Allie, can you remember a time when you've been angry?
Yes, I can remember that. It's been a long,time ago, though
. . . Sometimes it makes me mad when we don't get waited on
right (laugh).
Ah . . . that's something that happens here?
Yes.

Waited on at the table you mean?

Well, sometimes she leaves our coffee 'til last - to pour it,
you know.

Hmmmm.

I think she ought to pour it first.
And that makes you a little mad.
Yeah.

What do you think you could do about feeling mad when that
happens?

Ask her to . . (cut off)
Well, I usually pass it off.

That's one way. The only problem with that is you probably
stay mad every time it happens. . . . Did you hear Edna's

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64

suggestion?
No, I didn't hear it.
(to Edna) You said to ask her to pour it first.
Oh, yeah. But she wouldn't do it, would she?
No.
They always pour it last.
Is that the procedure here?
(garbled response) . . . (to Allie) You sit right over
there - over there at the last table. I sit there at the
next to the last table.
Do you have assigned places where you're supposed to sit?
Yes, uh-huh. When you come in, you take your same place.
Do you mind that?
No.
Anybody mind that?
Mind what?
Having the same place for dinner every night?
NO.
Do you ever wish you could mix around with other pecple?
No, I'm satisfied.
Huh.
I'm satisfied.

(PAUSE)
You know, when we think about the word "angry", it sometimes
sounds like a pretty strong word. There are also some other
words that describe not liking what's going on. Anybody
have any idea what other feeling words go a long with being
mad?
I think you get moody.
Uh-huh.

Get moody. Ever get frustrated?

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65
Frustrated.
Do you know what frustrated is all about?
I don't know the definition of it.
You know, Allie, that's kind of what fits your situation.
You get frustrated in a situation where you don't like
what's going on but you probably can't do much to change it.
Oh, I didn't know that.

When you don't say a whole lot.

When you don't have much power to change the situation, a
lot of times you end up feeling frustrated.

What does frustrated mean?

Well, it means you wish you could make a change happen, but
you can't, so you're stuck with the anger just sitting in
your stomach.

m1-hUh e

Have you ever felt that way about anything?

Yeah, I've felt that way.

Can you remember anything that caused you to be frustrated
while you were doing it?

(PAUSE)

Oh, I know an example. Do you two (Edna and John) remember
when you were making those rugs - just learning how - and
having gotten stuck, not knowing just what to do next?

Yeah.

That's a frustrating situation.
get out of it.

You just don't know how to

Uh-huh.

You just don't know how to get out of it.
Frustration.

Not really angry, but frustrated.

Uh-huh . . . Yeah.

Sometimes I don't allow myself to get angry. I used to get

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66
angry quick - you know, about anything.
Uh-huh.
After I got saved, I was better.

You were more patient?

Yes. I had more patience then.
(PAUSE)
Are there any peOple that live here that you just think

"they're mad all the time!" Can you picture anyone around
here who looks mad all the time?

Some of them.

Think some of them are?

I don't know about all of them, but some of them are.
A few.

What do peOple look like when they're mad?
certain expressions on their faces, or . . .

Do peOple have

They have a frown on their face.

Do I look like I'm mad all the time?
Uh-uh.

Not to me. Why do you ask that?

I thought maybe you were referring to me - I don't know.
Were you referring to him Allie?

NO.

I didn't think so.

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