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thesis entitled

MUSIC THERAPISTS’ BURNOUT AND JOB SATISFACTION
LEVELS ACROSS WORK SETTINGS

presented by

REBECCA WEST

has been accepted towards fulfillment
of the requirements for the

Master of degree in Music Therapy
Music

 

 

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MUSIC THERAPISTS’ BURNOUT AND JOB SATISFACTION LEVELS
ACROSS WORK SETTINGS

By

Rebecca West

A THESIS

Submitted to
Michigan State University
in partial fulfillment of the requirements
for the degree of

MASTER OF MUSIC
Music Therapy

2009

ABSTRACT

MUSIC THERAPISTS’ BURNOUT AND JOB SATISFACTION LEVELS
ACROSS WORK SETTINGS

By

Rebecca West

The purpose of this study was to compare burnout and job satisfaction levels
among music therapists across various work settings (i.e., hospital, forensic, private
practice) within the United States. Participants for this study included 116 music
therapists carrying the credentials of MT-BC, RMT, and CMT, who currently deliver
music therapy services through private, public, or govemment-operated
facility/institutions. Each participant completed four testing instruments: Maslach
Burnout Inventory (MBI), Utrecht Work Engagement Scale (UWES), Minnesota
Satisfaction Questionnaire (MSQ), and a researcher-developed questionnaire. From the
results of the data analysis, no significant difference in burnout levels across work
settings existed; however, music therapists in school (K-12) work settings reported
significantly lower scores in extrinsic and intrinsic job satisfaction compared to those in
several other work settings. Music therapists with advanced degrees did not report
significantly higher job satisfaction scores than music therapists with only a bachelor’s
degree. However, music therapists who have worked in the field at least 10 years
reported higher overall job satisfaction levels than music therapists working in the field

9 years or less.

DEDICATION

I would like to dedicate my thesis, in light of the moratorium placed on the historic 1944
music therapy program at MSU in February, 2009, to my fellow music therapy
colleagues and students, specifically my colleagues and students at MSU. Do not lose
hope or encouragement, but keep believing in the power of music and the work we do
every day with our clients. Keep pressing forward to build bridges, increase advocacy
and awareness for our profession, and keep on, keeping on. Stand by what you believe in

and never give up without a fight!

iii

ACKNOWLEDGMENTS

I would like to thank several people for their infinite guidance, support,
encouragement, and love during my graduate studies and during the completion of this
thesis.

To my parents, whose faithful love, support, and encouragement have guided me
and been a source of strength for me all these years, thank you. I love you both and am
truly blessed to have you as my parents. To my favorite and only sister, Melissa—thank
you for your support and excitement as I have pursued this degree; you’ll never know
how much your love, concern, encouragement, and helpful suggestions have meant to
me.

Thanks to all my friends and mentors who provided support and encouragement,
from offering to help proofread my thesis (Jackie), to excitement and pride over me and
my studies (Jon), to continually showing love and belief in me (Megan, Christy) to
faithfully asking how things were progressing (April), and to their concern when it
seemed like my studies consumed my life (Logan girls). Each one of your friendships has
made me a better person and I am blessed to know each one of you.

To Dr. Cynthia Taggart, thank you so much for being on my thesis committee. I
greatly appreciated the depth your insight, knowledge, and guidance brought to my
thesis.

To Professor Roger Smeltekop, I am so grateful for having had the opportunity to
work under you and learn and grow from your experience, insight, and wisdom while
completing my studies. Your dedication, passion, and insight both as a clinician and

teacher for the field of music therapy have been an inspiration to me and challenge to do

iv

likewise.

Many thanks to Dr. Frederick Tims, who graciously accepted to be the chair of '
my thesis committee. During my time at MSU, I appreciated the way you have
challenged me to think more deeply and intellectually and push the envelope and think
outside the box by stretching myself to become a better student, clinician, and researcher.
Thank you for your patience, knowledge, suggestions, and support during the completion
of my thesis.

Although most of them will never know, to all my clients—you have inspired me
to pursue a degree in this field; your smiles, laughs, interactions, setbacks, and progress
have fueled the passion and commitment I have for this profession. My experiences with
all of you have opened my heart and enriched my life, and for that, I am humbled and
grateful.

And, to my Savior, Jesus Christ, in whom I can do all things who gives me
strength, may I never cease to give You praise and honor for what You have

accomplished in and through me, and what You will continue to accomplish in my life.

TABLE OF CONTENTS

LIST OF TABLES .............................................................................. viii
CHAPTER ONE
INTRODUCTION .............................................................................. 1
Definition of music therapy and description of music therapists ..................... 1
Introduction and definition of burnout ................................................... 2
Rationale for exploring burnout levels in field of music therapy .................... 3
Burnout, job satisfaction, and longevity among music therapists .................... 3
Purpose of current study ................................................................... 6
CHAPTER TWO
JOB BURNOUT, STRESS, AND PREDICTING FACTORS ........................... 9
Emergence of burnout ..................................................................... 9
Causes of burnout ........................................................................... 9
Job stress and the correlation to burnout ................................................ 10
Job satisfaction and the correlation to burnout .......................................... 12
The relationship of workplace environment factors to burnout ...................... 19
Job commitment and embeddedness and the relationship to job turnover and
intent to quit ................................................................................. 21
Individual factors of organizational commitment ...................................... 26
Personality and its effect on burnout and job satisfaction levels ..................... 27
Workplace engagement .................................................................... 30
Summary of general literature ............................................................ 31
Burnout levels in the field of education ................................................. 32
Burnout and job satisfaction levels among related health care professionals ...... 35
Burnout and job satisfaction among physical therapists ............ 35
Burnout and job satisfaction among multiple-health related
professionals ............................................................... 36

Burnout and job satisfaction among hospital staff and nurses. . 36
Burnout and job satisfaction among individuals who work with

the developmentally disabled ........................................... 37
Burnout and job satisfaction among individuals who work with
those with intellectual disabilities ...................................... 37
Burnout and job satisfaction levels among self-employed individuals .............. 38
Music therapy burnout and job satisfaction ............................................ 38
Career longevity and burnout in music therapists ...................................... 45
Personality, burnout, and job satisfaction in music therapists ........................ 46
Summary of music therapy literature .................................................... 47
CHAPTER THREE
METHOD ........................................................................................ 50
Participants .................................................................................. 50
Procedure .................................................................................... 51
Test instruments ............................................................................ 53

vi

CHAPTER FOUR

RESULTS ........................................................................................ 56
Quantitative results ......................................................................... 56
Research Hypothesis #1 ................................................. 56
Research Hypothesis #2 ................................................. 65
Research Hypothesis #3 ................................................. 66
Research Hypothesis #4 ................................................. 68
Research Hypothesis #5 ................................................. 70
Results from the music therapy questionnaire .......................................... 73
Summary of quantitative and descriptive data .......................................... 76
CHAPTER FIVE
DISCUSSION ................................................................................... 77
Data collection complications and modifications ...................................... 77
MBI and burnout in music therapists .................................................... 78
First research hypothesis discussion ..................................................... 80
Second research hypothesis discussion .................................................. 82
Third research hypothesis discussion .................................................... 83
Fourth research hypothesis discussion ................................................... 83
Fifth research hypothesis discussion ..................................................... 84
Other quantitative results discussion ..................................................... 86
Future of music therapy burnout research ............................................... 87
APPENDICES ................................................................................... 90
E-mail invitation to participate in research study ....................................... 90
Postal mail invitation to participate in research study ................................. 92
Music therapy questionnaire .............................................................. 94
REFERENCES .................................................................................. 99

vii

Table 1.

Table 2.

Table 3.

Table 4.

Table 5.

Table 6.

Table 7.

Table 8.

Table 9.

Table 10.

Table 11.

Table 12.

Table 13.

Table 14.

Table 15.

Table 16.

Table 17.

Table 18.

LIST OF TABLES

Original Eighteen Work Setting Categories .................................
Final Eight Work Setting Categories .........................................
MBI and Work Setting ANOVA .............................................
MSQ Mean Job Satisfaction Levels Across Work Settings ...............
MSQ and Work Setting AN OVA .............................................
Work Setting and Intrinsic Satisfaction Post-Hoe Results ................
MBI Mean Burnout Scores Across Work Settings ........................
Comparison of MBI Scores With Other Related Work Professions. .
Mental Health Worker’s MBI Subscale Score Range .....................
MBI Correlation ................................................................
MBI and Work Setting ANOVA. . . . . . . . ...................................
Original Thirteen Degree Options of Highest Degree Earned ...........

MSQ Extrinsic and Intrinsic Mean Scores Among Highest Degree
Earned Categories ...............................................................

Job Satisfaction and Degree Earned ANOVA ..............................

MSQ Extrinsic and Intrinsic Mean Scores and Number of Years in
Field ................................................................................

MSQ Extrinsic and Intrinsic Subcategories and Number of Years in
Field AN OVA ..................................................................

Number of Years in Field and Extrinsic Satisfaction Post-Hoe
Results ...........................................................................

MBI and Intent to Look for Another Non-MT Job in the Next
Three to Six Months ANOVA ................................................

viii

57
57
58
59
59
60
62
62
63
64
66

67

67

68

69

69

7O

71

Table 19.

Table 20.

Table 21.

Table 22.

Table 23.

Table 24.

MBI and Intent to Look for Another Non-MT Job in the Next
Six to Twelve Months ANOVA ..............................................

MSQ Extrinsic and Intrinsic Job Satisfaction and Intent to Look for
Another Non-MT Job in the Next Three to Six Months AN OVA .......

MSQ Extrinsic and Intrinsic Job Satisfaction and Intent to Look for
Another Non-MT Job in the Next Six to Twelve Months AN OVA. . . ..

Total Response Count of Top Five Factors Music Therapists Seek
For Positive Job Support ......................................................

Top Three Positive and Negative/Challenging Work Setting Aspects
For Music Therapists ...........................................................

Comparison of Current Study’s MBI Scores and Vega’s 2007 Study
MBI Results ...... ‘ ...................... . .........................................

ix

72

73

73

75

75

78

CHAPTER ONE

INTRODUCTION

Definition of Music Therapy and Description of Music Therapists

Around the time of WWI and WWII, a new field began to emerge in response to
the growing number of soldiers in hospitals receiving care and support for their physical,
psychological, and socio-emotional rehabilitation and recovery. This field was music
therapy. According to the American Music Therapy Association (AMTA) website, the
definition of music therapy is “. .. an established healthcare profession that uses music to
address physical, emotional, cognitive, and social needs of individuals of all ages.
Music therapy improves the quality of life for persons who are well and meets the needs
of children and adults with disabilities or illnesses” (http://www.musictherapy.org,
08/04/2009). Currently, according to the Certification Board for Music Therapists (2003 ),
there are over 4,500 music therapists with the credential of Music Therapist-Board
Certified (MT BC). In 1983, the Certification Board for Music Therapists (CBMT) began
as a way to promote unity in the field of music therapy and monitor the competent
practice and advancement of music therapists. The CBMT currently awards music
therapists with the MT -BC credential upon successfirl completion of all music therapy
coursework and internship at an accredited site, and successfirl completion of the written
examination verifying competency in music therapy (Certification Board for Music
Therapists, 2003). Prior to 1983, music therapists mainly carried two credentials:
Registered Music Therapist (RMT) and Certified Music Therapist (CMT). From 1983
when the CBMT was started, all professionally trained music therapists who qualify are

given the unifying MT -BC credential. Because music therapists who carry the credentials

of RMT’s and CMT’s are typically in their 40’s-60’s, they have the option to take the
CBMT certification exam to change their credential to MT-BC or maintain their original
credential until 2020.

Because music therapy is considered an allied health care profession and because
music therapists primarily work with individuals with health, cognitive, or psychiatric
deficits or needs (Hanser, 1999), the field of music therapy can engender the same risks
to the therapists as other careers in health-related professions. Such related professions
include nursing, psychiatric ward staff, and speech-language pathologists. One such job-
related risk for music therapists is burnout.

Introduction and Definition of Burnout

Although several definitions of burnout exist, the most commonly known and
used definition comes from Maslach and Jackson (1986), which posits burnout as “a
syndrome of emotional exhaustion, depersonalization, and reduced personal
accomplishment that can occur among individuals who do ‘people work of some kind.’
(1986, p. 1).” Burnout refers to feelings of helplessness or hopelessness in a situation
that grows over time. Some researchers believe that once an individual reaches a state of
burnout, he or she cannot reverse the effects (Espeland, 2006). Burnout may result from
role conflict, role ambiguity, unsuccessful work situations, and lack of support (Potter,
1998)

These factors and more will be discussed in greater detail later in this chapter.
Consequently, much research literature has examined burnout as an antecedent of job
turnover (Albion, Fogarty, Machin, & Patrick, 2008; Griffeth, Horn, & Gaertner, 2000;

Wright & Cropanzano, 1998).

Rationale for Exploring Burnout Levels in Field of Music Therapy

Because research surrounding burnout levels has drawn so much attention, the
question of whether burnout among music therapists exists needs to be addressed.
Specifically, does burnout occur among music therapists? If so, how prevalent is it?
Do specific work settings or populations with whom music therapists work have a greater
risk for burnout or job dissatisfaction? If specific work settings within the field seem to
result in higher levels of burnout or job dissatisfaction, could proactive measures serve to
ensure that music therapists receive early, preventative interventions (Maslach & Leiter,
2008)? Would those measures succeed in preventing the exit of music therapists from the
profession?
Burnout, Job Satisfaction, and Longevity among Music Therapists

Research surrounding burnout levels and job satisfaction is relatively new to the
field of music therapy. Currently, a small number of studies exist that examine job
burnout and stress levels among music therapists. In the last 15 years, eleven studies have
examined burnout levels in music therapists (Decuir & Vega, 2003; DeFreitas, 1988;
Fowler, 2006; Glider, 1987; Hills, Norman, & Forster, 2000; Knoll, Reuer, & Henry,
1988; McKinney, 1992; Oppenheim, 1987; Richardson-Delgado, 2006; Vega, 2007).
Bitcon (1981) reported poor salary, decreased autonomy, constant change and adaptation
as sources of burnout. Knoll, Reuer, and Henry (1988) reported the same factors as
Bitcon (1981) in addition to lack of support from administration as reasons for burnout.
McKinney (1992) also reported lack of support from administration as a main source of
burnout. In 2003, Decuir and Vega reported the top two sources for burnout were lack of
support from administration and poor salary. In another study, Vega (2007) asked music

therapists to identify the main sources of burnout. Lack of respect and lack of support,

specifically from fellow staff members and administration, were the two most reported
sources.

Seven studies specifically examined job satisfaction levels in music therapists
within the last 10 years (Braswell, Decuir, & Jacobs, 1989; Cohen & Behrens, 2002;
Decuir & Vega, 2002; Hills, Norman, & Forster, 2000; Knoll, Reuer, & Henry, 1988;
Stewart, 2000; SUtton, 2002).

In an unpublished study by Decuir and Vega (2003), 176 music therapists
completed a questionnaire asking what music therapy competencies and aspects of their
job were important to them. In addition, they were asked if they had ever considered
changing professions and rating factors that contributed to staying in the field. While no
significant correlations existed between years in the field and important factors, the main
factors chosen were mentoring, creative process of music (the art), and new/unexpected
experiences. Other reasons mentioned included interaction between the client and music
and witnessing the change in their clients.

Although the existing studies have examined burnout and job satisfaction in
music therapists, researchers have also included exploring longevity as well as
demographic information. This has included an analysis of overall clientele by examining
the percentage of each client population with whom music therapists work, range of
salary, education level, and in which geographic area they are employed.

In a 1964 study by Shatin, Kotter, and Douglas-Longmore, the average number of
years a music therapist remained in the profession was 6.4. Braswell, Maranto, and
Decuir (1979) reported that music therapists remained in the profession an average of
3.98 years. Lathom (1982) also reported a lower average retention rate of 3 to 5 years for

music therapists.

Other studies have examined longevity and the average number of years music
therapists reported working in the field. These studies also reveal inconsistent results. In a
1987 study by Taylor, 68.6% of music therapists surveyed indicated they had been in the
field for less than five years. The reported average longevity in Oppenheim’s 1987 study
was 4.03 years. Maranto and Bruscia’s 1988 study (as cited in Vega, 2007) reported that
music therapists had been in the profession for an average of 8 years. In 1989, Braswell,
Decuir et al. reported that the average number of years working in the field out of the 1,344
music therapists interviewed was 5.41.

Several possibilities may account for the discrepancy of reported number of years
worked in the field. As music therapy continues to grow, more schools offer degrees, and
larger number of students enroll per year. This may account for the large percentage of
music therapists who have been in the field for less than 10 years. Another possibility is
that, although music therapists may have earned their degrees, they might not have started
out in the field of music therapy upon graduation if a music therapy job was not available
or created.

Within the last 15 years, only three studies have examined the average career
longevity among music therapists. In 1997, Cohen, Hadsell, and Williams reported an
average of 5 to 10 years for music therapists to remain in the field out of 250 music
therapists surveyed. Stewart (2000) reported those with 1 to 3 years of experience and
those with over 10 years experience constituted 60% of the 126 music therapists surveyed.
Finally, in their 2002 study, Cohen and Behrens reported that music therapists spent an
average of 13.04 years in the field.

Only one study specifically surveyed music therapists who left the field. DeFreitas’

1988 study (as cited in Vega, 2007) reported that the 133 music therapists who were

were surveyed spent an average of 3.91 years as a therapist before leaving the field.
However, because the majority of these studies only gathered information about the
average number of years in the field with current practicing music therapists, using the
term longevity poses some difficulty in accurately reporting this factor. Maintaining
consistency in defining longevity seems to be difficult. Some studies define longevity as
the number of years in the field when the study occurred, while others define it as the
length a music therapist retains their professional credentials or affiliation with AMTA
(Vega, 2007). Measuring the number of years from when a music therapist begins a
career to when he or she leaves the profession, either for voluntary or involuntary
reasons, would be a more accurate representation of longevity.

Conducting longitudinal studies examining turnover rates or career longevity in
music therapy is difficult for several reasons. First, there is an inherent decline in
participants available. Participants who were available for the first phase of data
collection may not be available for the second phase of data collection.

Second, participants contact information may change depending on the length of time in
between the first and second phase of data collection. Locating music therapists who have
moved or do not update their contact information without impinging upon their privacy
rights remains difficult. Third, participants initially willing to complete the study may
change their mind and no longer wish to participate. Consequently, the existing literature
examining turnover rates among music therapists remains inconsistent.

Purpose of Current Study

Although several studies have examined factors leading to job satisfaction or
burnout, at the present time no research study exists that compares job satisfaction levels

or burnout rates in music therapists within or across specific work settings (i.e., hospital,

forensic, private practice). The purpose of this study was to compare burnout and job
satisfaction levels among music therapists who work in different settings, including
hospitals, forensics, and private practice. This study also sought to gain information about
the intent of music therapists who register higher levels of burnout or job dissatisfaction,
and whether these therapists intended to change to a different job within music therapy,
or leave the profession altogether. The following chapter will discuss specific studies
related to the etiology of burnout, job dissatisfaction, and related literature in music
therapy on burnout levels and job satisfaction. This study employed existing stress and
job satisfaction test instruments, including the Maslach Burnout Inventory (MBI) and
Minnesota Satisfaction Questionnaire (MSQ), and questions discussing intent to leave
the profession.

The researcher sought to examine the following hypotheses related to burnout and
job satisfaction levels in music therapists:

1. Music therapists will report significant differences in burnout and job satisfaction
levels across various work settings.

2. Music therapists who work in educational or school settings will report the
highest burnout levels .

3. Music therapists who possess higher levels of education will report higher levels
of job satisfaction, with individuals possessing a PhD. having the highest job
satisfaction scores.

4. Music therapists who have been in the field for at least 10 years will report higher
overall levels of job satisfaction than music therapists who have been in the field
less than 10 years.

5. Music therapists who report high levels of burnout or job dissatisfaction will be

more likely to actively search for another career.

CHAPTER TWO

JOB BURNOUT, STRESS, AND PREDICTING FACTORS

Emergence of Burnout

Attention to burnout and its initial development began as a response to social
problems, rather than from scholarly or academic beginnings (Maslach & Schaufeli, 1993).
The first articles specifically about burnout appeared in the 1970’s in the US and were
published by Freudenberger and Maslach (Maslach & Schaufeli, 1993). Much of the initial
research gained attention from occupations including education, medicine, criminal justice,
social services, and religion (Maslach & Schaufeli, 1993).

Leiter and Maslach (1998) posed three main sources of burnout: emotional
exhaustion, depersonalization, and reduced accomplishment. Emotional exhaustion refers
to the depletion of an individual’s emotional resources, resulting in fatigue and lack of
energy. Depersonalization refers to an individual’s emotional detachment from their job,
ofien coupled with feelings of cynicism and negative attitudes. Reduced personal
accomplishment refers to an individual’s reduced levels of productivity and effectiveness.
Causes of Burnout

Research examining burnout, and its possible causes and effects, has explored the
connection to various aspects of the job, including job satisfaction, job stress levels, job
expectations, workload, and job withdrawal. Currently, according to the research, it seems
that job factors provide a stronger connection or link to burnout than demographic
variables. Researchers also seem to agree that job dissatisfaction and job burnout are
separate items, although clearly linked together (Maslach & Schaufeli, 1993).

One model of burnout explores the etiology of burnout from the viewpoint of

achieving and maintaining “resources” (Hobfoll, 1989). The conservation of resources
(COR) posits that individuals seek to acquire and maintain resources and that stress and
burnout occur when those resources are eliminated, threatened, or do not yield results
proportional to the original level of investment.

Much debate surrounds approaches to examining burnout and selecting which
variables and relationships to study. Isolating and examining stress does not provide a
complete picture or representation, as it excludes’the influence of social networks and self-
cognition (Maslach, 1993). Factors linked to burnout also include work overload, lack of
control, lack of reward, lack of community, lack of fairness, or value conflicts (Maslach &
Leiter, 1997).

Rather than a uniform result or trigger, another viewpoint recognizes that burnout
involves a complex, variegated process that varies in symptoms and intensities within each
person. Burnout is a process or progression of these symptoms, which over time manifests
itself in physical, emotional, or psychological results (F reudenberger, 1975). Although
specific trends and patterns also seem to have emerged from the research, such as a strong
connection between emotional exhaustion and stress levels, based on the existing literature
and empirical research, burnout seems to be a complex process with multiple antecedents
and outcomes (Maslach, 1993).

Job Stress and the Correlation to Burnout

Burnout and job stress are often linked together in the literature research.

There are four main responses to job stress: behavioral, emotional, physical, and mental
(Dunham, 1992). The way people perceive stress and approach it cognitively affects the
impact on a person’s behavior. Worrying, constant thinking about the issue, and indecision

are some examples (May, .1996).

10

Worrall and May (1989) propose three types of work-related stress that may relate
to music therapists and potential warning signs that stress is present. These three types of
work-related stress are anticipatory stress, ambient stress, and core stress. An example of
anticipatory stress is feeling dread on Sunday evening of returning to work the next day.
Ambient stress refers to ‘noise’ of pressures and related issues either at school or related to
personal issues. Core stress refers to unresolved memories or traumatic experiences that
can manifest themselves in different ways.

Another theory related to stress is Seyle’s (1976) theory of resistance.

Seyle believes that there are three stages of resistance the body undergoes in response to
stress. They are the initial alarm reaction, coping, and physical or psychological burnout or
exhaustion. In the initial alarm reaction, the body responds to the initial source of stress.
During the coping stage, the body continues to respond to the source of stress, but the body
begins to experience depletion of resources and energy if the source of stress remains
present. Finally, the body begins to exhibit physical or psychological symptoms as a result
of constantly responding to the source of stress. Because individuals may perceive
stressors different ways, various stressors will appear more significant than others. This
may be affected by the individual’s level of emotional vulnerability (Ashkanasy, Ashton-
James, & Jordan, 2004).

Lazarus and Folkman (1984) argue that cognitive appraisal processes affect the
significance of the stressor and the meaning individuals put on it. They identify three forms
of stressors: irrelevant, benign-positive, and stressful. Events that have no direct impact on
an individual are irrelevant appraisals. Events that will serve to enhance, support, or
improve an individual’s situation are benign-positive. Events that will cause damage, loss,

or harm to an individual or situation are considered stressful appraisals.

ll

The presence or absence of specific jobaspects may also contribute to job stress
and burnout. Herzberg’s motivation-hygiene theory (Herzberg, Mausner, & Synderman,
1959) states that specific elements of job satisfaction (motivators) interact with specific
aspects of a job (hygiene factors). When specific hygiene factors are absent, job
dissatisfaction may result. One area of the work environment that has changed over time
has been the workload. The workload seems to have increased and currently demands more
of the individual in three ways: it is more complex, more intense, and requires more time
commitment (Maslach & Leiter, 1997). Another approach to studying burnout and job
stress include the cultural or social approach. These approaches emphasize the individual
needs and elements in the work environment and specifically address issues of community
or group cohesion and mutual support (Gold & Roth, 1993). Finally, the personal-
psychological reorientation approach argues that stress and burnout result from
individuals’ perception of the work situation, and cognitive restructming techniques will
prevent or lessen the level of job stress or burnout (Gold & Roth, 1993).

Job Satisfaction and the Correlation to Burnout

Studies examining burnout levels and job satisfaction have measured the results
through two main methods. The first is through subject ratings, which are viewed as more
subjective and can be prone to bias and error. The second method uses objective criteria,
such as measuring turnover rates, absenteeism, salary, and job production (Borman, 1991).
However, objective criteria do not provide a complete picture of an individual’s overall
performance or job requirements (Guion, 1965). Several problems or factors result from
judging job performance based on attendance, number of absences, salary, and job level.
The data usually provide only moderately reliable results, are subject to change, and run

the risk of ratee performance affecting the results (Borman, 1991).

12

If j ob satisfaction is directly linked to specific factors in the workplace, job
satisfaction and various elements of the workplace, including environment, demands,
requirements, and stress should be further explored. Even more specifically, how does an
individual react or respond to those demands? (Phillips, 2005). Do specific contributors
related to job dissatisfaction exist that result in individuals choosing to leave their job? One
model by Thibaut and Kelley (1959) posits two concepts under which a person will choose
to stay or leave their job. According to their model, an individual will examine and
compare the present situation with past or similar experiences, resulting in a comparison
level (CL). All of the outcomes that are associated with alternatives available to the
individual are considered comparative level alternatives (CLalt).

When the alternatives outweigh or are more positive than the current role or
situation, dissatisfaction and a desire to leave will follow. Subsequently, when the
alternatives are more negative or below the current role or situation, the individual will
choose to stay or remain in their present role. The Cornell model of job satisfaction (Smith,
Kendall, & Hulin, 1969), a similar model of job satisfaction to that of Thibaut and Kelley
(1959), views job satisfaction as a result of what individuals receive from their work, based
on their expectations, frame of reference, skill, education, and other contributions.

Lee and Mitchell (1994) give a different perspective on job satisfaction and job
burnout. They believe that individuals’ decisions to withdraw from their job stem from
various events that occur, known as shocks. Shocks are events that prompt individuals to
engage in thought processes and make decisions, sometimes to leave their job. In order for
a shock to lead to action, it must first attach meaning about the job to the individual and
integrate into the individuals’ belief or value system. Shocks come in three forms: positive,

neutral, or negative. Depending on the type of shock and its integration into the

13

individual’s belief system, four responses will occur. The first response involves the
individual removing him or herself from the situation or job with little thought or
processing. The next response results in the individual deliberating and re-assessing his or
her level of commitment to the organization, resulting in either leaving the organization or
changing their belief system. The third response leads the individual to deliberate and re-
assess his or her level of commitment, weighing potential alternatives for job
opportunities, resulting in pursuing the alternative opportunity or remaining satisfied with
the current situation. Finally, the fourth response differs from the first three in that no
shock event occurs. Rather, the individual engages in an ongoing assessment and thought
process. Over time, the organization will continue to align itself with the individuals’ belief
and value system, or will eventually deviate from that system of images. Dissatisfaction
emerges as a result and the individual chooses to seek alternative options, leading in
withdrawal and turnover.

According to March and Simon’s (195 8) model, individuals will either seek
alternative employment opportunities if dissatisfaction levels or other work-related factors
are high enough, or they will re-consider looking for alternative opportunities because of a
lack of hopeful possibilities. Individuals who seek alternative employment may not quit if
desirable alternatives are not present. On the other hand, individuals not originally looking
for alternative job options may consider leaving if a job opportunity presents itself with
more attractive or desirable qualities than their current job (Gerhart, 1990).

Other models have presented job dissatisfaction, burnout, and turnover as multi-
faceted processes. Mobley’s (1977) multistep model views organizational turnover starting
with an individual evaluating their current job and, when resulting in dissatisfaction, leads

to a series of cognitions about quitting, searching for alternative choices, and eventually

14

staying or quitting.

A different view of job satisfaction involves two components: intrinsic satisfaction
and extrinsic satisfaction. Intrinsic satisfaction results from the individual’s level of
satisfaction with the job itself, while extrinsic satisfaction results from satisfaction from the
various conditions or elements of the job including opportunities to use abilities and skills,
amount of work, control over pace and work methods, pay, and working conditions
(Locke, 1976). Another view of job satisfaction involves the theory that the higher the
level of j ob satisfaction, the greater the level of productivity, and the lower the intention to
turnover or be absent from work (Katzell, Thompson, & Guzzo, 1992).

Job satisfaction may also result from the methods individuals choose to accomplish
specific goals or tasks based on their existing abilities and skills.

Conversely, dissatisfaction and stress may result from an individual feeling his or her skills
and abilities are not matched well to the specific job requirements or tasks (Phillips, 2005).
Individuals dissatisfied with their jobs generally report average internal levels of
satisfaction. However, individuals who reported dissatisfaction with their jobs have higher
levels of dissatisfaction with their jobs than other areas in their life (Judge, 1993).

More recently, Edwards, Bell, Arthur, and Decuir, (2008) investigated the
relationship between job satisfaction and its effect on task and contextual performance.
Contextual performance in this study refers to behaviors which support the employers
overarching organizational, social, and psychological goals or core mission.

Contextual performance is considered a way for the employee to contribute or give
something back to their job. It is implied that the more satisfied an individual is with
his/her job, the more likely that employee will engage in contextual performance.

The researchers found that a significant positive relationship existed between overall job

15

satisfaction and task performance levels as well as between job satisfaction and contextual
performance levels. A significant positive relationship also existed between the level of
satisfaction with work and task performance and between supervision satisfaction and
contextual performance. Promotion also affected task performance levels, but did so
negatively. The researchers concluded that individuals seek to obtain a balance between
what they give and receive in their social networks in organizations. Additionally, the
match between attitudes and behaviors increases when specific areas align themselves with
the end target.

In a longitudinal study, Wright and Cropanzano (1998) examined the effect of
emotional exhaustion on job satisfaction, job performance, and turnover rates.

The researchers reported that emotional exhaustion did not directly affect job satisfaction
but rather job performance levels. Emotional exhaustion, however, had a positive
relationship to turnover rates. Individuals with higher positive affect levels had lower
emotional exhaustion levels.

Spector and Jex (1991) examined the effects of various job characteristics including
autonomy, feedback, skill variety, task identity, and task significance on job satisfaction,
intention to quit, health symptoms, absence levels, job frustration, anxiety at work, and
ntunber of doctor visits. They found that individuals with jobs higher in complexity that
possessed several of the job characteristics listed above had fewer doctor visits. No
significant results emerged between job characteristics and job satisfaction levels or
intention to quit.

Another aspect-of burnout and job satisfaction involves individuals’ locus of
control, or individuals’ expectations about their level of ability or power to directly change

or control events around them (Rotter, 1966). Internal locus of control refers to an

16

individual’s self-expectations, personally accepting any blame or accomplishment.
Individuals with a low locus of control attribute any accomplishment or defeat to outside
causes, such as people or specific situations, and have low expectations.

Social networks in the workplace on levels of job satisfaction and burnout levels
emerged from the literature as an important topic of study. Forming fiiendships with co-
workers is also known as a blended fiiendship (Bridge & Baxter, 1992).

Relationships within the work place are characterized by balancing accomplishing
organizational jobs and tasks with forming personal relationships. Friendships in the
workplace also serve as avenues to utilize resources, increase or transfer information to
make decisions, and other organizational-related functions (Lincoln & Miller, 1979). Trust,
feedback, and work-related productivity also can result from fiiendships in organizations
(Bridge & Baxter, 1992). Although friendships in the workplace can have positive results,
tension or conflict of interests, goals, or negative responses may also result. Examples of
these tensions and conflicts include balancing the level of disclosure and confidentiality,
levels of autonomy and connection with co-workers, and roles or structures.

Bridge and Baxter also investigated the types of relationships formed, and the
effect of friendships on the workplace. Based on the data, there exist three ways in which
work relationships benefit the friendship: accessibility, commonality, and bonding
opportunity. There also exist four ways that blended friendship benefits the work
relationship: information access, work-related assistance, psychological support, and
improved Work relationship. However, six types of strains on the fiiendship resulted from
blended fi'iendships: strained egalitarianism, relationship information management strain,
autonomy strain, consensus strain, acceptance strain, and display strain. Strains, within the

context of this article, were any problems, difficulties, or challenges that resulted when

17

close friends are embedded within the same job environment. Blended fiiendships also
negatively affected the workplace through favoritism or loyalty shown (objectivity strain),
inequality strain, performance strain, organizational information management strain, and
strained work relationship.

Emotional and instrumental supports are the two common areas of workplace
support or friendship studied and examined by researchers (Fenlason & Beehr, 1994).
Instrumental support is defined as receiving some verbal form of assistance or aid from
another in order to complete a task. Their study explored three sets of research, the first
examining how different types of social support affected levels of job strain, the second
examining Beehr’s social support theory (Beehr et al., 1990), and the third comparing
emotional conceptualizations of stress on communication. First, they found that a closer
relationship exists between communication and emotional support than communication
and instrumental support. Additionally, a stronger relationship exists between non-job
communication and emotional support than other forms of communication.

Supervisor support had the strongest affect on levels of strain, followed by co-worker
support and lastly support from friends and family. The researchers also concluded that
emotional forms of social support seem to have a greater effect on strain than on stressors.

Lee (2005) examined work relationships and their effect on job satisfaction. In her
study, Lee predicted that employees who shared similar perceptions of their job climate
with their friends at their place of employment would report higher job satisfaction levels.
Perceptions of j ob climate included factors of interpersonal milieu, organizational structure
and procedures, and responsibility. Strength of job satisfaction between job similarity with
one co—worker compared to similarity among a group of co-workers was also tested. Lee

reported no statistically significant differences between employees with similar perceptions

18

and job satisfaction. In addition, similarity in affective tone or responsibility did not show
a strong or statistically significant relationship with job satisfaction. Demographic
variables, including gender and educational level also did not have a significant effect on
job satisfaction levels. It appears emotional support may affect levels of burnout and job
satisfaction depending on the context (Kahn, Schneider, Jenkins-Henkelman, & Moyle,
2006)

The Relationship of Workplace Environment Factors to Burnout

Several components and factors go into an individual’s overall level of job
satisfaction including job performance, social networks, and emotional support.

Another area that contributes to job satisfaction is workplace environment. Factors that
comprise workplace environment include supervision, amount of pay, and role clarity
(Griffeth, Horn, & Gaertner, 2000).

Maslach and Leiter (2008) conducted a longitudinal study to examine whether their
proposed six key factors of workplace environment—workload, control, reward,
community, fairness, and values—predicted burnout levels. Other possible predictors of
increased burnout levels included inconsistent scores and job-person incongruence.

They found that the main essential workplace factor that affected burnout or engagement
levels was the perception of fairness.

One approach examining reward as a factor of workplace engagement explored
levels of contingent rewards and levels of satisfaction and the relationship to turnover
rates. When individuals possess high levels of performance, the rewards and outcomes are
greater, thus reducing the desire to seek alternative job options (Harrison, Virick, &
William, 1996). In their study, Harrison et a1. sought to examine the effect of contingent

reward levels on performance levels and turnover rates. The degree or level of reward

l9

contingency affected performance-turnover rates. Performance-turnover within this context
refers to employees who are rewarded for their job performance (e. g., commission-based
pay) and the number of employees who leave when moderate to maximum levels of reward
exist. Levels of turnover depended on the current performance level as well, as
performance velocity, more than on other factors.

Albion et a1. (2008) explored various psychological responses on work
characteristics and the relationship between the organizational climate and job withdrawal
behaviors, including absenteeism and intention to leave. Individual morale and quality of
work life had a significant positive relationship with job satisfaction at the group level,
while individual distress had a significant negative relationship with job satisfaction at the
group level. Only individual morale had a significant negative relationship with levels of
absenteeism. The researchers concluded quality of work life and job satisfaction both
mediate the relationship between role clarity and the intention to quit.

Individuals may choose specific jobs or careers based on the fit of their
personalities and values with an organization’s aspects or attributes (Bretz & Judge, 1993).
Does the person-organization (P-O) fit occur before the individual begins the job, during,
or a combination of both (Cable & Judge, 1996)? Research seems to indicate that
individuals with higher levels of congruence with their organization’s values have higher
job satisfaction levels and have lower turnover rates (Bretz & Judge, 1993).

Individual’s subjective P-O fit seems to result from a combination of the perceived views
of the organization and the individual’s value system. Subsequently, the subjective P-O fit
affects an individual’s job selection or intention (Cable & Judge, 1996).

Unrealistic expectations and goals may also be a factor in job or career burnout.

Pines and Aronson (1988) suggested individuals who enter their career with high ideals

20

and motivation, expecting to find meaning through their job, are more susceptible to
burnout. Likewise, Greenberg (1984) concluded that individuals are more at risk for
burnout in the helping professions when they contribute or give more to their job than what
they receive back from it. Similarly, stressful experiences can hinder or prevent an
individual from feeling successful or competent, which may result in feeling a sense of
failure (Pines, 1993). However, objective failure may not be the ultimate cause of burnout,
but rather a sense of never accomplishing anything significant or having a meaningful
impact on another person (Pines, 1993).

Job Commitment and Embeddedness and the Relationship to Job Turnover and Intent to
Quit

Most studies involving job turnover distinguish between two types: voluntary and
involuntary. Voluntary turnover involves termination from the employer by the employee
through resignation. Involuntary turnover involves initiation to terminate by the employer
through firing of the employee, retirement, disability leave, or death (McEvoy & Cascio,
1985). In the 20th century alone, over 1,000 studies related to turnover were published
(McEvoy & Cascio, 1985).

Turnover intentions and self-monitoring had significant positive correlations with
tmnover rates, while satisfaction had a significant negative correlation with turnover rates,
according to a 2005 study by Allen, Weeks, and Moffitt. The researchers also reported no
statistically significant correlation between levels of commitment, ease of movement, locus
of control, and proactive personality with turnover rates. In a second sample, turnover
intentions, satisfaction, and levels of commitment had significant correlations with
turnover rates and ease of movements, while locus of control and risk aversion did not.

Tett & Meyer (1993) reported in their meta-analysis, that commitment to an

21

existing job does not result in a stronger correlation than satisfaction does with levels of
intention to quit. Like previous researchers, they concluded that turnover intention or
withdrawal cognitions strongly predicts actual turnover, followed by the level of
organizational commitment. They concluded that satisfaction and commitment levels both
contribute to turnover rates.

Irving et al. (1997) explored Meyer and Allen’s 1991 three-component model of
organizational commitment in a variety of occupations of individuals within a single
organization, specifically exploring the relationship between the three-component model
and variables including age, gender, job satisfaction, locus of control, and turnover
intentions. The researchers reported no significant relationship existed between age,
education level and occupational commitment. A positive relationship did exist between
job satisfaction and affective and normative occupational commitment. In addition, a
negative relationship existed between gender and continuance commitment, with men
more likely to express a need to remain with the organization. The researchers also
reported a negative relationship between turnover intentions and continuance occupational
commitment levels, although these levels had no significant relationship to affective or
normative commitment levels.

Mitchell, Holtom, Lee, Sablynski, and Erez (2001) proposed a new way of looking
at job commitment and levels of employee retention. Their construct, job embeddedness,
explored the level to which an individual feels trapped within their social networks or
responsibilities. Those with higher levels of embeddedness have closer knit links, making
it more difficult to leave. In addition, links that are more difficult to break also affect an
individual’s ability to leave. The authors also prOposed that embeddedness may have many

levels or specific elements that also make up the holistic picture of embeddedness.

22

They explored the relationship between job embeddedness and intent to leave,
predicting voluntary turnover rates, and the strength of the relationship compared to other
variables including desirability of movement, job satisfaction, and organizational
commitment. A negative relationship existed between embeddedness and intentions to
leave and embeddedness and levels of voluntary turnover. The researchers concluded that
levels of embeddedness affect an individual’s decision to leave—those with higher levels
are less likely to leave. They also concluded that job embeddedness better predicts turnover
rates than combining ease of movement, job satisfaction, and organizational commitment.

Jenkins (1993) examined self-monitoring, exploring the effect of self-monitoring
on turnover intentions on levels of job satisfaction and organizational commitment.
Self-monitoring is a personality trait in which individuals will monitor their expressive
behavior and self-expression. Individuals with high levels of self-monitoring are more
likely to base relationships on immediate outcomes, whereas individuals with low levels of
self-monitoring are more likely to base relationships based on shared values.

From the data, the level of affective commitment had a significant positive
correlation with levels of job satisfaction, but a negative relationship to intention to quit.
The researcher also reported a significant correlation between self-monitoring levels and
turnover intentions. A negative correlation between age and intention to quit also existed.
The researcher concluded that self-monitoring effectively predicted turnover intention and
moderated the relationship between levels of job satisfaction and intention to quit.

Motivation also seems to influence levels of burnout. Highly motivated individuals
seem to experience feelings of either success or failure based on their perceptions of the
work environment. Perceptions of the work environment seem to affect individual’s

feelings of success or failure, which may result in burnout (Pines, 1993).

23

In their 2004 study, Maertz & Griffeth posed eight motivational forces for deciding
whether or not to stay with an organization. Affective forces refer to positive or negative
responses about the organization, resulting in dealing with the situation or avoiding it.
Calculative forces involve a process of considering and weighing Options and continued
commitment to the organization, resulting in positive or negative calculations. Contractual
forces involve obligations to the organization based on a feeling or perception of
psychological contract or commitment. If an individual feels an obligation or responsibility
to remain with an organization, leaving the organization before that obligation or
responsibility has been fulfilled would result in a breach of that perceived commitment.
Behavioral forces involve psychological and'tangible costs based on levels of investment
and commitment. If an individual perceives a higher cost in leaving, they are more likely to
stay, while perceiving a lower cost will most likely result in the individual leaving.
Alternative forces refer to the strength of available and desirable options or alternatives
based on the individuals’ self-efficacy. Lower self-efficacy levels lead the individual to
stay, while higher self-efficacy levels lead the individual to leave. Normative forces deal
with the expectations of those outside the organization and the individuals’ desire to adhere
to those expectations. Moral/ethical forces involve the individuals’ belief system regarding
behavior towards turnover and leaving. One belief or viewpoint regards turnover as a
positive or healthy act, while another belief views perseverance and longevity as such.
Finally, constituent forces depend on the individuals’ social connections and level of
attachment.

In their meta-analysis, McEvoy and Cascio (1985) suggest that job enrichment
experiences are two times more effective in reducing turnover rates than realistic job

previews, which provide potential employees an overview of the job and any expectations

24

during the interview process. In 2000, a more recent meta-analysis by Griffeth et al.,
examined antecedents and correlates of employee turnover rates, highlighting differences
from previous meta-analyses. The researchers reported a low correlation between cognitive
ability and turnover. Unlike previous meta-analyses, women were no more likely than men
in their quit rate. Furthermore, no strong correlation existed between race and turnover
rates. However, levels of work satisfaction exhibited a strong negative correlation to
turnover rates. The level of organizational commitment better predicts turnover rates than
overall job satisfaction. When reward contingencies are present, the performance-turnover
rate is negative; subsequently, when reward contingencies are absent, the performance-
turnover rate is positive. The researchers concluded that various aspects including job
satisfaction, withdrawal cognitions, organizational commitment, and comparison of
alternatives were the top predictors of job turnover. Other factors included specific job
characteristics such as work group cohesion, autonomy, and job content.

Wright and Bonett (1992) examined levels of work satisfaction in social welfare
staff workers in a two-year longitudinal study. They examined and compared levels of
work satisfaction and mental health in workers who remained in their same job two years
later, those who had intraoccupational turnover, and those who had interoccupational
turnover. They found that those who remained in the same job at the posttest had a slight
decrease in work satisfaction levels, those in the intraoccupational turnover group had a
slight increase in work satisfaction, and those in the interoccupational group had the
highest increase in work satisfaction levels. Those in the no turnover group had a slight
increase in mental health at the posttest. Those in the intraoccupational group had a
moderate increase in mental health, and those in the interoccupational group had the largest

increase in mental health, with statistically significant differences between the no turnover

25

group and the interoccupational group mental health levels.

In their 2001 study, Horn and Kinicki explored the relationship between turnover
rates and job dissatisfaction, job avoidance, and interrole conflict. They reported that
interrole conflict increases levels of dissatisfaction and withdrawal intent.

Increasing levels of dissatisfaction affect levels of job avoidance, which, in turn, affects
withdrawal intent. They concluded that withdrawal intent and job comparisons directly
affect turnover rates by mediating the impact on other antecedents, including
unemployment, interrole conflict, and tardiness.

Leiter and Maslach (2004) reported that burnout is the mediating link between the
organizational context and work-related outcomes. Burnout is not only a psychological
outcome, but also is related to people’s commitment to their job and their evaluation of
organizational change.

Individual Factors of Organizational Commitment

Although much of the existing literature has examined organizational commitment
based on behaviors exhibited, judging behaviors alone does not provide a complete picture
or insight into organizational commitment. While behaviors may indicate either
commitment or a lack of choice, the interpretation of the behaviors in addition to the
individual’s attitudes or cognitive process is equally important (Hulin, 1991). It appears
that the presence of two factors, personal competencies and organizational competencies,
are largely influential in achieving goals and personal satisfaction (Hallsten, 1993).

One view suggests three forms of organizational commitment (Meyer and Allen,
1991). The first, affective commitment, involves the level of psychological attachment or
commitment to the organization. Individuals remain in their jobs because they enjoy their

job and want to stay. Continuance commitment involves weighing the risks or possible

26

losses for leaving the organization and making a decision. When the risk or cost becomes
too high, individuals stay because they have no better choice. Normative commitment
involves individuals’ beliefs or internal perceived commitment to the organization.

These individuals remain because they feel they should. Although all three forms affect an
individual’s decision to either stay with an organization or leave, a myriad of factors may
affect each of the three forms (Irving, Coleman, & C00per, 1997).

Personality and its Effect on Burnout and Job Satisfaction Levels

Although several studies have examined the role of organizational factors, such as
workload and social support, studies focusing on more individual variables including
personality have emerged (Maslach, 2003). Two of the most common measures of
identifying and categorizing personality types are the five-factor model (FF M) posed by
Costa and McCrae (1985) and the Myers-Briggs 12 model of personality (Myers-Briggs,
McCaulley, Quenk, & Hammer, 2003). Maslach, Schaufeli, & Leiter, (2001) proposed five
general personality traits that affect burnout levels: hardiness, locus of control, coping
styles, personality type, and attitude.

Based on their Affective Events Theory (AET), Weiss and Cropanzano (1996)
suggest that an individual’s affect and how he or she interprets the situation affects his or
her behavior and how he or she views and responds to the stressor. Other studies have
examined emotional intelligence (Jordan, Ashkanasy, & Hartel, 2002; Ashkanasy et al.,
2004) as the moderator between affect response and job stress. They propose that
individuals with high emotional intelligence will more likely response positively or
favorably to stressful situations. Individuals who are able to self-regulate through coping
skills will minimize the impact of emotions on affective events and prompt the individual

to engage in helpful coping strategies or responses (Ashkanasy et al., 2004).

27

Other studies have examined one aspect of personality in the level of extraversion
in an individual, suggesting that individuals higher in extraversion have larger social
networks, better social integration, and more job embeddedness (McCrae & Costa, 1997).
Self-efficacy, as posed by Bandura (1997), hypothesizes that expectations of self-efficacy
affect how a person thinks, feels, and then acts. This subsequently affects how actions are
initiated, how much effort and energy is expended, and how the individual will c0pe in
challenging situations. Individuals with high self-efficacy typically choose tasks or
situations that are more challenging and set difficult goals. Highly self-efficacious
individuals also invest more into the situation and regroup more quickly from setbacks or
difficulties.

In 1984, Diener and Emmons, suggested one way of looking at personality traits,
separating individuals into two dimensions: those with positive affect (PA) and those with
negative affect (NA). Those with PA typically are excited, enthusiastic, energetic, and
joyful. Those with NA typically exhibit apathetic, listless, and lethargic characteristics, are
less likely to focus on the positives, and more likely to exhibit signs of anger, fear, and
anxiousness. PA also measures the predisposition of an individual towards happiness (Chiu
& Francesco, 2003). Individuals with PA are more likely to take a proactive stance in
changing their environment or unfavorable conditions.

Likewise, NA measures the predisposition of an individual towards negativity. Individuals
with NA are less likely to act in changing their environment and usually adapt instead to
the unfavorable conditions.

Cropanzano, James, and Konovsky (1993) conducted two studies to explore the
relationship of individuals with PA and NA on turnover intentions, level of organizational

commitment, and job performance. In the first sample, PA had a significant positive

28

relationship to predicting organizational commitment. PA also had a significant negative
relationship to intention to quit, while NA had a significant positive relationship to
intention to quit. In the second sample, NA did not have a significant relationship to
affective commitment. However, PA had a significant positive relationship to job
satisfaction while NA had a significant negative relationship to job satisfaction. No
significant relationship existed between PA and continuance commitment levels or NA and
continuance commitment levels. The researchers concluded dispositional affectivity
significantly relates to work attitudes since PA and NA had direct relationships to
satisfaction, turnover intentions, commitment levels, and performance.

A more recent study explored PA and NA in mediating the roles between job
satisfaction, affective commitment, and turnover intentions (Chiu & Francesco, 2003).
A negative relationship exists between PA and turnover intention, while a positive
relationship exists between both PA and job satisfaction and PA and organization
attachment. Among the PA group, relationships at work, job satisfaction and turnover
intention seem to be factors in reducing turnover rates, explaining 36.5 percent of the
variance of turnover intention.

Judge (1993) examined the effect of disposition on job dissatisfaction levels and
turnover. The researcher found that when individuals possess a positive disposition, a
statistically significant negative relationship exists between job satisfaction and turnover
rates, and only a slight relationship exists between job satisfaction and turnover rates on
those with negative dispositions. The researcher concluded that individuals with positive
dispositions who were dissatisfied with their job were more likely to leave than individuals
with negative dispositions.

Snyder explored the concept of self-monitoring, which suggests individuals have

29

different ways in which they express or present themselves and act (Snyder, 1974).
Individuals with high self-monitoring levels desire public image and will regulate their
behavior when responding to situational and interpersonal circumstances. On the other
hand, individuals with low self-monitoring levels are deficit in their motivation or ability
to regulate their behavior to promote their public image or self-expression. They display
their disposition and attitudes the same way in every situation.

Recently, Zimmerman (2008) conducted a meta-analysis review of personality
traits in turnover. Based on their findings, a summary of previous studies and meta-
analyses, the highest three correlation’s with intent to quit were emotional stability,
conscientiousness, and extraversion. Variables with the strongest relationship to actual
turnover rates were agreeableness, conscientiousness, emotional stability, and openness.
The researcher concluded that an individual’s personality largely influences their intent to
leave and impulsive behavior affects turnover decisions. In addition, although several
factors account for an individual’s level of job satisfaction, personality seems to have a
larger influence than job complexity.

Workplace Engagement

Schaufeli and Bakker (2004) proposed a new way of looking at burnout, arguing
that burnout and engagement are separate constructs. They define engagement as a
consistent and present state not specific to one dimension or variable. Schaufeli and
Bakker also propose that vigor and dedication are the opposites of exhaustion and
cynicism. They proposed a new dimension of absorption, or an individual’s content
engrossment in his or her work, where detaching or pulling away becomes difficult.
Whereas the original burnout model suggests that specific demands coupled with lack of

resources leads to burnout and various other negative effects, Schaufeli and Bakker posit

30

that the job-resource model (Demerouti, Bakker, Nachreiner, & Schaufeli, 2001) with
variables of engagement are better predictors of burnout and engagement. Their study
included participants from four different organizations using the Dutch version of the MBI
(Schaufeli & Van Dierendonck, 2000). The researchers concluded that burnout and
engagement have no one underlying dimension but are multi-faceted. They also concluded
that burnout has a direct relationship with job demands and health problems, but has a
negative relationship with job resources.

Summary of General Literature

Based on reviews of the general literature, it seems that burnout is a complex issue,
comprised of several contributing factors. Leiter and Maslach’s (1998) definition of
burnout remains the most widely held definition of burnout, which defines burnout as a
combination of three areas: emotional exhaustion, depersonalization, and personal
accomplishment. Since the 1970’s, when articles surrounding burnout first appeared
(Maslach & Schaufeli, 1993), there remains a high interest in investigating the causes and
contributors to burnout. Such causes and contributing factors include job satisfaction, and
workplace environment aspects.

Job factors provide a stronger connection or link to burnout than demographic
variables (Maslach & Schaufeli, 1993). Other factors linked to burnout include work
overload, lack of control, lack of reward, lack of community, lack of fairness, and value
conflicts (Maslach & Leiter, 1997). Researchers also seem to agree that job dissatisfaction
and job burnout are separate items, although clearly linked together (Maslach & Schaufeli,
1993).

Emotional exhaustion does not directly affect job satisfaction but job performance

levels. Emotional exhaustion also has a positive relationship to turnover rates (Wright &

31

Cropanzano, 1998). Leiter and Maslach (2004) report that burnout is the mediating link
between the organizational context and work-related outcomes. Burnout is not only a
psychological outcome, but also is related to people’s commitment to their job and their
evaluation of organizational change.

Although external factors including level of pay, amount of supervision, and
administrative support affect levels of burnout and job satisfaction, internal factors
including personality also seem to affect job satisfaction levels and burnout. Zimmerman
(2008) reports an individual’s personality largely influences their intent to leave and
impulsive behavior affects turnover decisions.

In 2004, Schaufeli and Bakker proposed a new way of looking at bmnout, arguing
that burnout and engagement are separate constructs. Engagement is seen as a consistent
and present state, not specific to one dimension or variable. Work engagement consists of
three components: dedication, vigor, and absorption. Based on the job-resource model
(Demerouti, Bakker, Nachreiner, & Schaufeli, 2001), Schaufeli and Bakker suggest that
variables of engagement are better predictors of burnout and engagement. In summary, it
seems that burnout is a complex process, and that several individual and work-related
antecedents or factors interact with one another, ultimately affecting whether an individual
becomes burned out or remains engaged in his or her present job (Maslach, 1993).
Burnout Levels in the Field of Education

Are individuals who work in specific jobs more susceptible to burnout than others?
Do demands, resources, and work environment factors specific to certain jobs affect job
satisfaction or burnout levels, and if so, how do they? As of 1999, high school teachers
experience the greatest levels of burnout over other health or public professionals,

including nurses, personal-care professionals, and mental-health professionals (de Heus &

32

Diekstra, 1999).

Does burnout result from factors specific to teachers who work in educational
settings, or do these factors also extendto other health professionals who work in
educational settings? More specifically, do music therapists who work within school
settings face challenges or job requirements unique to school settings, which may lead to
higher levels of stress, job dissatisfaction and burnout? Music therapists, in addition to
working alongside or in conjunction with administration and added paperwork, might also
deal with interpersonal conflict with the teachers or staff that is not present in other work
settings (May, 1996). Currently, no study has explored burnout levels and job
dissatisfaction levels in music therapists who are employed in school settings.

Working within a school setting may also increase the likelihood of working with larger,
more heterogeneous groups, often with a wider range of needs (Robertston, 1996).

Meeks (1995) conducted a study to examine if any differences existed between job
satisfaction levels in speech-language pathologists in school settings versus those in non-
school settings. Individuals within the school setting reported that the most positive work
setting characteristics were autonomy, facilities and materials, reference group, technical
competence, service ideal, and standards of control. However, unfavorable characteristics
within the school group included salary, supervision, evaluation, and opportunities for
advancement. Individuals within the non-school group reported autonomy as the most
positive or‘favorable work setting characteristic.

Other positive work characteristics reported included standards of control, technical
competence, service ideal, duties/responsibilities/workload, reference group, facilities and
materials, importance, salary, staff development, and opportunities for advancement.

Out of the 12 work setting characteristics, individuals within the school group

33

reported lower levels of satisfaction in 9 of the 12 characteristics than those in the non-
school group. However, the mean scores of j ob satisfaction for both groups indicated
positive levels. The researcher concluded that speech-language pathologists within school
settings appear to have higher levels of job satisfaction when given appropriate workloads
and job requirements that are synonymous with their professional ethics or beliefs than
those who work outside of school settings (Meeks, 1995).

Klusmann et a1. (2008), sought to examine the differences between exhaustion and
engagement levels in teachers both individually and at the school level.

They examined the effect that differential demands and amount of resources had on
exhaustion and engagement levels. Demographic variables included workload amount and
social support. Based on the results, little between-school variance existed in the level of
teacher’s engagement or emotional exhaustion. The researchers concluded the variances
resulted from individual factors, rather than school factors.

Greater administrative support from the school resulted in higher levels of teacher
engagement when individual teacher factors were controlled for, suggesting the importance
of administrative support from principles. The researchers also reported that male teachers
and older teachers had lower levels of engagement.

Kahn et a1. (2006) investigated levels of positive affect and negative affect in
teachers and its effect on job burnout levels. Based on the results, teachers with high
negative affect and low positive affect reported higher job burnout levels. Additionally,
teachers with more positive interactions with co-workers reported lower levels of j ob
burnout. Low levels of emotional support had a significant positive relationship to
emotional exhaustion levels in teachers. The researchers concluded that, although

dispositional affectivity is an important factor to work stress and burnout levels, it cannot

34

fully explain stress and burnout levels. Schwarzer & Hallum (2008) conducted a study
with German and Syrian teachers, examining self—efficacy and its relationship to burnout
and job stress levels. They found that levels of job stress mediate the effect of self-efficacy
on burnout levels.

Having unrealistic expectations of working with children with special needs may
also be a source of stress or burnout. For music therapists who strongly desire to help
children with special needs, seeing little or no positive change may be frustrating and
discouraging, possibly leading to feelings of diminished self-worth, doubt, and burnout
(Freeman, 1989). Seeing potential in students and wanting to see its realization is a
challenging task. Working with children with special needs requires more realistic goals
and expectations, perhaps even more simplistic or modest in nature (Jones & Sharma,
1996)

Music therapists, like teachers working in school settings, may also feel uncertainty
or confusion if they feel the range of students’ behaviors or needs lies beyond their current
experience, training, or expectations (Dunham, 1992). While unique in its own set of
challenges and demands, school settings offer some similarities across schools. Teacher’s
roles and organizational structures are usually similar in approach and execution
(Klusmann et al., 2008).

Burnout and Job Satisfaction Levels Among Related Health Care Professionals

Burnout and Job Satisfaction Levels Among Physical Therapists

Phillips (2005) examined the job satisfaction levels in physical therapists.

From the results, a wide range of overall job satisfaction existed, with an average of 80.9
out of 100. Results from the data also revealed that older therapists reported the highest

levels of job satisfaction. The highest dissatisfaction levels came from the individuals who

35

had been in the field for less than 5 years. Phillips also reported no strong relationship
between the amount of workload and job satisfaction.

Burnout and Job Satisfaction Levels Among Multiple Health-related

Professionals

Lyons, Lapin, and Young (2003) found that nurses, physical therapists,
occupational therapists, and other health-related professionals reported fairly high levels of
job satisfaction. The top reasons of job satisfaction were feelings of accomplishment,
recognition, personal and professional grth opportunities, and satisfaction with their
workloads.

Another study including physical therapists, occupational therapists, and speech-
language pathologists reported job satisfaction ranging from somewhat to very satisfied.
Randolph and Johnson (2005) reported that working in an environment congruent with the
professional’s values and professional growth opportunities was among the top reasons for
job satisfaction.

Burnout and Job Satisfaction Levels Among Hospital Staff and Nurses

Burnout levels in nurses and staff workers in hospitals has also received much
attention and focus in the literature research. “Beehr et a1. (1990) found in their sample of
225 registered nurses that perceptions of supervisors support is strongly related to positive
job-related communication. Supervisor support also affected employee strains, which was
not specifically defined by the researchers. In their study with a sample of 68 nurses,
Zellars and Perrewé (2001) found that individuals who engage in more positive
interactions reported significantly lower levels in each of the three areas of the MBI.

They also reported that individuals who engage in interactions with negative content

reported increased levels of emotional exhaustion and depersonalization of the MBI.

36

In 1995, a longitudinal study among nurses examined relationships between various factors
including job variety, level of autonomy and levels of withdrawal within the hospital and
theprofession of nursing (Krausz, Koslowsky, Shalom, & Elyakim, 1995). Job scope had a
direct effect on nurses desire to leave the ward, but not the profession. The only
demographic variable to affect intention to leave the hospital was age.
Burnout levels only had a direct effect on the desire to leave the hospital. While the degree
of burnout levels strongly affected which individuals would leave the hospital, it did not
strongly predict who would leave the ward or the profession of nursing.

Burnout and Job Satisfaction Levels Among Individuals Who Work With the

Developmentally Disabled

Only a handful of research exists on burnout levels among people who work with
the developmentally disabled. This research has been limited to staff workers (Beck &
Garguilo, 1983; Caton, D. J ., Edwards & Miltenberger, 1991; Kay, 1993). One hundred
forty one supervisors and direct care workers participated in Kay’s 1993 study.
Between 65% and 72% of the respondents reported low burnout, with between 8% and
13% reporting high burnout levels. The researcher also reported that emotional exhaustion
was positively linked with job satisfaction, and that the higher level of depersonalization,
the lower level of job satisfaction.

Burnout and Job Satisfaction Levels Among Individuals Who Work With Those

With Intellectual Disabilities 7

There are only three known studies that examine morale and levels of stress in staff
working with intellectual disabilities: Harris & Thomson, 1993, Gardner & Rose, 1994,
and Lawson & O’Brien, 1994 (Mascha, 2007). The most recent examined burnout levels,

levels of support, sources of stress and other variables in staff of adult day services

37

(Mascha, 2007). The researcher reported variance in emotional exhaustion and
depersonalization scores. However, co-worker support and contact seemed to positively
affect overall satisfaction levels, with supervision support also being important.
Burnout and Job Satisfaction Levels Among Self-employed Individuals

Self-employment is another area worth considering when discussing burnout and
job satisfaction levels. Because individuals who are self-employed have greater freedom
and control to choose their schedule and organizational constructs, they have higher levels
of self-determination (Benz & Frey, 2008). Self-employed individuals also seem willing to
accept lower pay as a balance for more independence and freedom (Hamilton, 2000). Some
research studies seem to indicate that individuals who are self-employed have higher job
satisfaction levels (Blanchflower, 2000; Hundley, 2001; Kawaguchi, 2002). In their review
of three data sets from various European countries, Benz and Frey (2008) reported
statistically significant positive differences in job satisfaction levels for self-employed
individuals, after work characteristic variables were controlled for.
The researchers concluded that procedural utility, the concept that people possess
preferences about how outcomes are generated, largely affects self-employment job
satisfaction levels.
Music Therapy Burnout and Job Satisfaction

Given the extensive literature review and various angles presented, what motivates
individuals to stay in their jobs or careers? Do specific trends or patterns exist? More
specifically, do specific trends or patterns emerge within various professions?
Do specific health-related professions experience an increase in the risk of burnout and job
dissatisfaction and how do all these studies relate to burnout levels and job dissatisfaction

in the field of music therapy?

38

Because music therapists are educated and trained in areas including music theory,
music performance, psychology, medical terminology, and music therapy techniques and
interventions, one source of stress or burnout may result from feeling one has a lot of
general knowledge and skills, but feeling inadequate or unskilled in specific areas
(Robertson, 1996).

Music therapists work in a variety of settings. According to the 2008 AMTA
Sourcebook, 19% of registered music therapists work in mental health. 12% of music
therapists work with individuals with developmental disabilities, 9% for the elderly and
those with Alzheimer’s, 9% work with medical/surgical, 5% work with individuals with
neurological disorders, and the remaining 44% fall under the category of “other.”

Music therapists report that 18% of services occur in children’s facilities or schools, 15%
occur in geriatric facilities, 13% occur in mental health, 12% occur in private practice/self-
employment, 10% occur in medical settings, and the remaining 31% occur in “all others”
(AMTA sourcebook, 2008).

Because various organizational constructs, including workload, organizational
support, and social bonds, may affect the level of burnout and job satisfaction, these areas
need to be explored within the field of music therapy to identify if any differences or
discrepancies exist. One study in 1999 reported high school teachers experience the highest
levels of burnout over any other health or public professions (de Heus & Diekstra, 1999).
Factors including appropriate workloads and job requirements synonymous with individual
beliefs or ethics affected job satisfaction levels (Meeks, 1995). Another study (Klusmann
et al., 2008) reported emotional exhaustion and engagement levels were affected by
individual factors instead of work environment. Kahn et al., (2006) reported similar results

in their study, indicating that teachers with high negative affect and low positive affect

39

reported higher burnout levels. If the general research indicates that individual factors and
some work environment factors affect teachers’ burnout levels, and teachers seem to report
higher burnout levels than nurses or those in other related health or public professions, it is
worth exploring whether similar findings exist in music therapists employed in school
settings, and whether music therapists report higher burnout levels in school settings than
music therapists in other work settings.

Currently, the music therapy literature surrounding burnout and job satisfaction
include surveys, commentaries or editorials, theses, and dissertations and other quantitative
studies. Included in these studies are factors including demographic variables such as age,
number of years in the field, and salary. Factors such as personality and level of
administrative support were also examined.

Decuir and Vega (2003) reported that as of 2003, the number one reason music
therapists seek to leave the field of music therapy and pursue a different profession stems
from burnout. They also reported that 70% of music therapists have either changed or
considered changing professions. Of the 70%, 55% considered leaving the profession for a
different profession.

In her 1981 guest editorial, Bitcon discussed the need to address the issue of
burnout among music therapists. She included her own descriptions of the causes of
burnout, including receiving disrespect for the amount of accomplishments achieved, the
inability to find supportive sources to channel frustration or dissatisfaction, feelings of
disillusionment, and self-doubts about achievements gained. Bitcon discussed possible
sources of burnout among music therapists, including the need to continually adapt and
adjust to changes, unrealistic workloads, low salaries, and lack of respect from others.

Bitcon encouraged music therapists to adapt to their situations by seeking resources or help

40

through networking with other music therapists to gain encouragement and support,
increasing hobbies or interests outside of work, appropriately managing and budgeting
time, and maintaining a sense of humor.

While Bitcon discussed burnout in music therapists, Oppenheim (1987) was the
first music therapist to specifically investigate occupational stress in music therapists.
Through her quantitative study, Oppenheim gathered demographic data including client
age range served and population served, as well as age, gender, and employment of music
therapists. Two hundred thirty nine music therapists successfully completed the MBI as
well as answering demographic questions. Results from the MBI among the music
therapists who had been in the field at least five years indicated that 52 of the 68 qualifying
music therapists scored a moderate degree of burnout on at least one of the six subscales.
Twenty nine of the 68 scored a high level of burnout on at least one of the six subscales. In
addition, no strong relationship existed between the demographic variables and the six
subscales of the MBI. Oppenheim concluded that individuals tend to report higher levels of
burnout the longer they remain in their career.

Although Oppenheim measured burnout levels among music therapists, Hills,
Norman, and Forster (2000) examined burnout levels in music therapists who worked as
part of a multidisciplinary team. At the time of their study, no other study existed that
specifically examined evaluations of music therapists in multidisciplinary teams.

The researchers collected the data using the MBI, demographic information, as well as a
questionnaire consisting of open-ended and closed questions. From the 151 participants
who completed the study, the researchers reported that lack of understanding from non-
music therapists was the most frequently reported source of pressure for music therapists

who worked independently. The researchers did not define who the non-music therapists

41

were (i.e., co-worker, employer). A statistically significant positive difference existed
between levels of pressure fi'om work colleagues surrounding organizational issues
between the group of music therapists who worked individually and the group of music
therapists who worked as part of a multidisciplinary team. Music therapists who worked as
part of a multidisciplinary team were more likely to report organizational issues or work
colleagues as sources of problems. However, music therapists working as part of a team
reported greater feelings of personal accomplishment than music therapists working
independently. The researchers also reported that music therapists who worked
individually were more likely to report team members as sources of reward, rather than
music therapists who worked on a team. From the data involving MBI scores, music
therapists reported average levels of burnout in the areas of emotional exhaustion and
personal accomplishment, and low levels of burnout in the area of depersonalization.

In 1987, Glider wrote a report that reviewed the research on burnout in music
therapists, specifically exploring trainee distress in entry-level music therapists.
He assessed research existing at the time of the effect of the clinical experience and
support or training through supervision of music therapists prior to entering the field and
its impact on adequately preparing music therapists. From his research, Glider posed the
question of trainee’s unpreparedness and unrealistic expectations or goals as’a factor in
burnout, suggesting that music therapy programs and educators should provide better
training to improve student’s coping skills, conduct seminars to encourage students to
identify potential issues and troubleshoot solutions, and form support groups. Glider also
wrote that there was a connection between burnout and specific work settings of music
therapists. More specifically, Glider found that individuals working in state supported

institutions reported low levels of job satisfaction.

42

DeFreitas took a different approach in 1988 (as cited in Vega, 2007), surveying 133
music therapists who were former members with the National Association for Music
Therapy (NAMT), and asked the reasons music therapists choose to leave the field, and
whether they personally would return to the field. In the two-part questionnaire, the
researcher included 32 possible reasons for leaving the field. Based on the results, the top
five reasons for leaving the field were a limited job market, limited opportunities for
advancement, lack of support from administration, low salary, and lack of staff
recognition.

More recently, Richardson-Delgado's 2006 dissertation (as cited in Vega, 2007)
specifically targeted music therapy faculty's level of burnout and coping strategies.

The researcher used both quantitative and qualitative measures through the use of
interviews, to collect and analyze the data. Music therapy faculty reported low levels of
burnout, indicating they used music to help them from becoming burned out.

Knoll, Reuer, and Henry (1988) discussed stress management through a question
and answer discussion. The authors defined stress as pressure stemming from difficult
situations either at home or work. The researchers commented that unmanaged stress could
lead to burnout or frustration at work. Some factors they believed contributed to such
feelings included lack of administrative support, constantly having to adapt or adjust, poor
salary, and unreasonable workloads or schedules.

Using a 36-item questionnaire including demographic information and job
satisfaction questions, Braswell, Decuir et a1. (1989) examined sources of job satisfaction
levels among 1,344 music therapists. Salary was among the most significant sources that
affected job satisfaction. No significant gender differences existed in the scores between

male or female music therapists. However, significant relationships existed between job

43

satisfaction levels and degree earned, with higher job satisfaction levels occurring in
individuals who held doctoral degrees. Similarly, individuals who had been in the field for
over six years also reported higher levels of job satisfaction. Music therapists in urban or
suburban areas also reported higher job satisfaction levels than music therapists working in
rural areas.

Job satisfaction among music therapists is also of concern in other countries.
Stewart (2000) investigated the sources of job satisfaction in British music therapists, using
a self-created and administered questionnaire to 126 music therapists. Seventy five point
two percent of all the responses listed job satisfaction levels as satisfactory or mixed.
Twenty point six percent reported they were very satisfied, while 3.3% reported they were
not satisfied and .8% were very dissatisfied. The therapists reported three main categories
to improve job satisfaction: peer contact, personal or professional development, and
organizational context. Levels of support significantly affected job satisfaction levels. The
researcher did not report any other significant relationships between job satisfaction and
any of the demographic variables.

Cohens and Behrens (2002) explored job satisfaction in relation to level of degree
achieved in the field of music therapy. Two hundred eighteen music therapists completed
the questionnaire. Twenty eight point eight percent of the participants had been in the field
for six years or less, while 44.3% had been in the field for at least nine years.

Forty nine point one percent of the participants had received a bachelor’s degree in music
therapy, 17.4% earning a master’s degree in music therapy, while only 5.5% had earned a
doctoral degree. From the results of the 5-point Likert scale examining job satisfaction

levels, with a 5 indicating the highest level of satisfaction, 65% reported a score of at least

4, and 95% reported at least a 3.1. Job satisfaction levels were higher among music

44

therapists who had been in the field a longer period of time, as well as those who held
more jobs. Significant relationships did not exist among the other eight examined variables
and job satisfaction levels. Although job satisfaction levels were higher among music
therapists who had been in the field longer, did the concept of self-fulfilling prophecy
affect the results because music therapists who were unsatisfied had already lefi the
profession or were unsatisfied or did not want to complete the study?

Only one study (Bastable, 1996) has specifically explored job satisfaction levels
among music therapists in private practice. Among the questions the researcher sought to
examine were the reasons music therapists chose private practice and the advantages and
disadvantages of private practice. The 132 music therapists who completed the study
reported that flexibility of schedule, being your own boss, no available employment, better
pay, and diversity of clients were among the reasons they chose private practice. Flexibility
of schedule, being your own boss, and diversity of clients were the top three advantages of
private practice while uncertainty of continuing year to year, providing own health
insurance, and fulfilling dual roles were among the disadvantages of private practice.
Music therapists reported overall high levels of job satisfaction with private practice with
over 94% indicating very satisfied or somewhat satisfied levels of job satisfaction. Only
4.7% reported somewhat dissatisfied levels, and a mere .8% reported very dissatisfied
levels of job satisfaction with private practice music therapy.

Career Longevity and Burnout in Music Therapists

Fowler (2006) used a correlation study to examine the relationship of well-being
among music therapists to longevity in the field and demographic variables. Forty nine
music therapists completed the MBI, Stress Profile created by Nowack in 1999 as well as

demographic questions. From the results of the data, the researcher concluded that a strong

45

positive relationship existed between longevity and music therapists who exhibited
positive attitudes or coping strategies. In addition, a positive relationship existed between
longevity and lifestyle habits, including a healthy diet and proper sleep.

Unlike Oppenheim’s study that reported moderate to high levels of burnout using the MBI,
Fowler reported no significant relationship between burnout levels and years in the field.

Decuir & Vega (2003) sought reasons for remaining in the field of music therapy,
as well as examining the importance of AMTA competencies and personality traits of a
good music therapist. Two hundred thirty one music therapists with at least 10 years
experience as a music therapist completed the study. Each music therapist completed 20
questions comparing the importance of AMTA professional competencies when they
entered the field and to their current practice. Additionally, each participant answered
questions about whether they had thought about changing professions, factors contributing
to their desire to remain in the profession, and personality traits of a good music therapist.
Some of the reasons for remaining in the field included receiving mentoring, experiencing
new or unexpected experiences, and the creative process of music.

Although in her editorial, Sutton (2002) acknowledges that music therapists need to
be cognizant of maintaining our own level of mental or psychological health, she did not
explore in great detail any factors that may make us more vulnerable. Rather, the emphasis
is on increasing the music therapist’s awareness of such vulnerability. Sutton does mention
that support networks seem to be important to music therapists’ levels of fulfillment.
Personality, Burnout and Job Satisfaction in Music Therapists

Most recently, Vega (2007) examined the role personality plays in burnout levels in
music therapists. Specifically, the researcher sought to identify the prevalence and severity

of burnout in music therapists using the Maslach Burnout Inventory (MBI), which

46

personality factors may contribute to higher levels of burnout and longevity among music
therapists, and if demographic variables also contribute to longevity or burnout among
music therapists. One hundred thirty seven music therapists completed MBI as well as a 16
personality factor questionnaire. The majority of music therapists scored in the average
range for the emotional exhaustion subscale and low in the depersonalization and personal
accomplishment subscales. A total of 11% of the music therapists scored high levels of
burnout from combining the 3 subscales. Overall, this sample of music therapists scored
slightly lower than the average scores for overall burnout levels.
The researcher reported that 14 of the personality factors combined together had a
significant relationship to all three sub-scales of the MBI. More specifically, anxiety
seemed have the strongest causal relationship to emotional exhaustion, social boldness and
vigilance to depersonalization, and dominance to personal accomplishment. From the
demographic results, the longer music therapists remain the field, the lower emotional
exhaustion levels they report. In addition, the level of degree earned seemed to predict
longevity, with the highest level of degree predictive of longevity.
Summary of Music Therapy Literature

In summary, lack of administrative or organization support seems to be one of the
most cited responses for burnout or job dissatisfaction in music therapists (Knoll, Reuer, &
Henry, 1988; McKinney, 1992; Oppenheim, 1987). Inadequate salary also has been largely
mentioned as a source of burnout or job dissatisfaction (Bitcon, 1981; Decuir & Vega,
2003; Knoll, Reuer, & Henry, 1988; Oppenheim, 1987). Other reasons most ofien noted
include unrealistic or demanding work schedules and workloads, lack of autonomy, and
constantly adapting or frequent flexibility (Biton, 1981; Knoll, Reuer, & Henry, 1988).

Additionally, lack of available jobs or lack of advancement within the job was also reason

47

for job dissatisfaction (Decuir & Vega, 2003).

The literature also seems to indicate several factors that increase music therapists’
levels of job satisfaction. Sharing in the music experiences with their clients and watching
the progress in their clients seems to be among the most frequently reported factors (Hills,
Norman, and Forster, 2000; Decuir & Vega, 2003; Vega, 2003). Additionally, beginning a
music therapy program also seems to contribute to a desire to remain in the profession
(Vega, 2003). Support from fellow music therapists or other professionals also seems to be
a factor related to job satisfaction among music therapists (Knoll, Reuer, & Henry, 1988;
Stewart, 2000; Sutton, 2002). Other noteworthy reasons reported by music therapists that
contributed to higher job satisfaction levels included receiving higher levels of education
and length of time in the field (Braswell, Decuir et al., 1989; Cohens & Behrens, 2002;
Vega, 2007).

Perhaps because music therapists, like several other health-related services, have
the option and fi'eedom to choose and adapt their treatment depending on the work setting,
population served, and size of group, this may account for higher levels of job satisfaction

(Phillips, 2005).

. Another possible explanation for higher job satisfaction in music therapists who
remain in the field longer may be the process of refining one’s techniques, strategies, and
skill in administering music therapy. In addition to possible lifestyle, values and preference
changes, these might contribute to higher levels of reported job satisfaction in older music
therapists or music therapists who have been in the profession over 10 years (Phillips,
2005)

Although Oppenheim (1987) concluded that burnout levels seem to increase the

longer music therapists stay in the field, and Fowler (2006) reported no significant

48

relationship to burnout levels and length of time in the field, Braswell, Decuir et al. (1989),
Cohens and Behrens (2002), and Vega (1993) all reported higher levels of satisfaction in
music therapists who had been in the field longer. Other factors contributing to longevity
in the field include higher levels of education and music therapists who are able to employ
positive coping strategies (Braswell, Decuir et al., 1989; Cohens & Behrens, 2002; Fowler,
2006; Vega, 2007).

Several studies have used the MBI to measure burnout among music therapists:
Oppenheim (1987), Hills, Norman, and Forster (2000), Fowler (2006), Vega (2007).

The majority of music therapists seem to score in the average range for burnout, but with
some scoring in the high range. Currently, no music therapy study has used a standardized
job satisfaction questionnaire outside of researcher-developed questions.

Perhaps the future of music therapy includes more specific training for students and
music therapists within each subfield of music therapy, in the hopes that those who receive
more specialized training or education will feel a larger personal investment, more
confidence, and possess a larger desire to remain in the field (Irving et al., 1997).T'he
current literature seems to indicate inconsistent results about the number of music
therapists who report moderate to high levels of burnout. The literature also provides
conflicting results about whether music therapists report higher levels of burnout and job
satisfaction earlier or later in their careers. Currently, no study has specifically examined
burnout levels among music therapists who work in different settings, such as hospitals,
education, and psychiatric facilities. No study has employed existing job satisfaction
questionnaires and only a few studies have sought to examine the percentage of music
therapists who are leaving the field to pursue another career (DeFreitas, 1988; Decuir &

Vega, 2003).

49

CHAPTER THREE

METHOD .

Participants

Current practicing music therapists with the credentials of MT-BC, RMT, and
CMT were asked to complete this study. The researcher used the 2008 AMTA Sourcebook
to randomly select music therapists within the work settings section. Although the AMTA
Sourcebook lists 37 work settings, the researcher only selected these 18 work settings to
provide a diverse enough sample. This resulted in a potential 900 participants. The work
settings chosen by the researcher were adult day care, child/adolescent treatment center,
children’s hospital/unit, community based service, correctional facility, drug/alcohol
program, forensic facility, general hospital, geriatric facility-not nursing,
hospice/bereavement services, inpatient psychiatric unit, nursing home/assisted living,
oncology, outpatient clinic, school (K-l2), self-employed/private practice, state institution,
and university/college. To help ensure the random selection of the participants, the
researcher assigned each therapist within each work setting a different number in
ascending order, and through Microsoft Excel, mixed the numbers out of numerical order,
then selected the first 50 names for each work setting.

The following factors lowered the total number of initial number of participants
invited:

1. Because certain work settings had fewer than 50 music therapists listed (e. g.,
Correctional Facility), all music therapists within that work setting listed were
invited to complete the study.

2. Some potential participants had no postal mail or e-mail address listed, but only

50

their name.

3. Not all members of AMTA are music therapists, but may be other professionals or
organizations that support music therapy; Any potential participants that did not
have the music therapy credentials of MT-BC, RMT, or CMT following their name
were eliminated.

4. A few participants were listed under the work settings section, but not in the
alphabetical directory section that contains the contact information.

5. This study only targeted music therapists working in the United States. Any
potential participants from Canada or other countries outside the United States
were also excluded.

6. Because some music therapists listed working in multiple settings, there were
duplicates across work settings.

As a result, a total of 471 music therapists remained as possible participants.

Four hundred forty-three were sent an invitation to participate in the study through their e-
mail address listed in the AMTA sourcebook (see Appendix A), and the remaining twenty-i
eight through postal mail (see Appendix B). Each participant received a postal letter or e-
mail of invitation, information regarding the study, and the procedure for completing the
study either online through a web-generated test, or for filling out the paper version of the
study. Those filling out the postal mail version of the study also were asked to sign a
consent form at the end of the letter of invitation and return it with their completed study,
while those completing the study online were instructed clicking on the link indicated their
consent to participate.

Procedure

After signing the consent form or clicking on the web link, each participant

51

completed four test instruments: the Maslach Burnout Inventory (MBI), the Utrecht Work
Engagement Scale (UWES), the Minnesota Satisfaction Questionnaire (MSQ),
a researcher-developed questionnaire (see Appendix C) containing questions about
turnover intent, and demographic questions including gender, age, number of years in the
field, and education level. Fourteen of the e-mail invitations returned as undeliverable, so a
postal invitation was then sent. Of the 42 total postal mail responses, the researcher
received 16 surveys back, but only eight music therapists completed the survey.
The remaining eight indicated they were not working as a music therapist anymore or
returned the survey blank and uncompleted. From the 429 e-mail invitations, 108
completed the study, for a combined e-mail and postal mail total response rate of 24.6%.

Of the 116 completed surveys, 109 of the participants or 94% were females and
the remaining 7 participants or 6% were male. Each participant was asked to select the
work setting where they spent the most hours per week employed. A total of four or 3.4%
of the participants indicated they worked in adult day care, eight or 6.9% in
child/adolescent treatment centers, nine or 7.8% in children’s hospital/unit, eight or 6.9%
in community based service, one or .8% in drug/alcohol program, two or 1.7% in forensic
facility, eleven or 9.5% in general hospital, three or 2.6% in geriatric facility-not nursing,
eight or 6.9% in hospice/bereavement, six or 5.2% in inpatient psychiatric unit, six or 5.2%
in nursing home/assisted living, five or 4.3% in outpatient clinic, nine or 7.8% in school
(K-12), nineteen or 16.4% in self-employed/private practice, eight or 6.9% in state
institution, and eight or 6.9% in university/college. The two work settings not chosen as
the primary work setting were correctional facility and oncology.

F ifiy-seven or 49.1% reported the highest degree earned was a bachelor’s or

bachelor equivalency in music therapy. Twenty-seven or 23.3% reported a master’s in

52

music therapy, twelve or 10.3% reported a Ph.D. in music therapy. The remaining twenty
or 17.2% listed a masters or Ph.D. degree other than music therapy as their highest degree.
The mean number of hours employed was 34 with range from 5-60. Because each
employer is responsible for determining how many hours is considered full time,
(http://www.dol.gov/dol/topic/workhours/full-time.htm, 08/04/09) no pre-existing division
of categorizing the number of hours for part and full time exists. However, fifty-four or
46.6% of the 116 total participants indicated they worked 40 hours per week. Nine or 7.8%
indicated they worked over 40 hours a week and the remaining 53 or 45.7% indicated they
worked less than 40 hours a week.
Test Instruments

Each participant answered questions from four test instruments: the Maslach
Burnout Inventory (MBI), the Utrecht Work Engagement Scale (UWES), the Minnesota
Satisfaction Questionnaire, and a researchepdeveloped questionnaire including
demographic questions.

The Maslach Burnout Inventory (MBI) consists of 22 items that examine three
areas: emotional exhaustion, depersonalization, and personal accomplishment.
Nine questions target emotional exhaustion, five examine depersonalization, and the
remaining eight look at personal accomplishment. An example of emotional exhaustion
refers to feeling physically and/or emotionally tired or depleted. Depersonalization
signifies feelings of indifference towards your job or the people with whom you work, and
an example of personal accomplishment refers to feelings of energy or that you have
influenced another person’s life and have made a positive difference in your job.
Each item uses a 7-point Likert scale, 0 indicating “never” up to 6 indicating “always.”

The scores are then tallied into low, average, or high divisions. These divisions will be

53

discussed in detail in the next chapter. High overall scores in emotional exhaustion or
depersonalization indicate a high level of burnout, whereas high overall scores in personal
accomplishment indicate a lower level of burnout. Consequently, low overall scores in
emotional exhaustion and depersonalization indicate a low level of burnout, whereas low
overall scores in personal accomplishment indicate a higher level of burnout.

Using Cronbach's coefficient alpha (n=l,316), the MBI reliability coefficient for
emotional exhaustion is .90, .79 for depersonalization, and .71 for personal
accomplishment. Other peer ratings support its validity through three-factor structures
(Maslach & Jackson, 1986; Maslach, Jackson, & Leiter, 1996).

The Utrecht Work Engagement Scale (UWES) uses 17 questions separated into
three categories to measure levels of work vigor, dedication, and absorption. UWES also
uses a 7-point Likert scale, with 0 indicating you have never had that feeling up to 6,
indicating the feeling occurs everyday. Recently, researchers exploring the construct
validity of UWES reported the 9-question version of UWES reported. more structure
stability than the original 17-question version (Seppala, et al., 2008). Stability of the
coefficients ranged from .82 for absorption, .85 for vigor, to .86 for dedication.

No information regarding reliability was provided in the study. This study employed the 9-
question version. The 9-question version of the UWES evenly divides three questions for
each of the three subcategories: vigor, dedication, and absorption. Vigor asks questions
related to physical feelings of energy and endurance, dedication questions ask about the
level of feelings of pride you have in your work, and absorption asks questions about the
extent of immersion you feel while working.

The Minnesota Satisfaction Questionnaire (MSQ) comes in two versions, the long

form and the short form. The long form consists of 100 questions and the short form

54

consists of 20 questions, exploring levels of job satisfaction within the workplace.

In addition,the short version of the MSQ specifically divides job satisfaction into two

subcategories: extrinsic satisfaction and intrinsic satisfaction, with 10 questions for each

subcategory. Extrinsic satisfaction refers to aspects of your job including salary,
supervision, and job security. Intrinsic satisfaction refers to aspects of your feelings of
accomplishment and achievement and sense of responsibility. The MSQ employs a 5-point

Likert scale, with 1 indicating “not satisfied” with that aspect of your job up to a 5,

indicating you are “extremely satisfied” with that aspect of your job. Questions range from

managerial or supervision topics to salary, working condition, and harmony with co-
workers. Coefficient alpha in a 1997 occupational commitment study (Irving et al.)

reported .92 reliability. This study used the short form as the long form had a total of 100

questions and the short form divided job satisfaction into two categories: extrinsic

satisfaction and intrinsic satisfaction.

Each participant also completed a researcher-developed questionnaire comprised of fifteen
questions that investigated positive and negative aspects about each participant’s current
work setting, the strength of influence that attending music therapy conferences, retreats,

seminars, and communicating with other music therapists and professionals has on his/her

desire to remain in the profession, and the likelihood of whether each participant has or
will actively search for another music therapy or non-music therapy job. The questions
varied in response methods, from simple yes/no responses to selecting multiple choice
items or short answer responses for specific questions. Finally, each participant answered
seven demographic questions that asked gender, age, highest level of education received,
number of years as a music therapist, state in which he/she works, work setting where

he/she spends the most hours employed, and number of hours employed per week.

55

CHAPTER FOUR

RESULTS

The purpose of this study was to compare burnout and job satisfaction levels
among music therapists across various work settings (e. g., hospital, forensic, private
practice) within the United States. Data collected by the researcher included responses to
four questionnaires: the MBI, the MSQ, the UWES, a music therapy questionnaire, and
demographic information. Data were analyzed using one-way analysis of variance
(AN OVA) procedures and LSD post-hoe tests to determine any differences between work
settings and other factors. Bivariate correlations were used to ascertain whether or not test
subscores were related to each other. This chapter includes both quantitative results
presented in order of the stated hypotheses and descriptive data where necessary to provide
further clarification to definitions or further information about the questionnaires used.
Quantitative Results

Research Hypothesis #1 .' Music therapists will report significant difiizrences in
burnout and job satisfaction levels across various work settings

Because of the low return in the number of participants in some of the work
settings (e. g., one response under drug/alcohol), the sixteen work settings that had at least
one participant select it as their primary work setting were combined under eight headings,
taking into account similarity in age, population, or focus of treatment.

This provided a larger number of participants in each category of the sample. Table 1
shows the original 18 work settings and Table 2 shows the final eight categories.

Any results reporting data on work setting findings reflect this change.

56

Table 1
Original Eighteen Work Setting Categories

 

Work Setting

 

1. Adult Day Care

2. Child/Adolescent Treatment Center
3. Children’s Hospital/Unit

4. Community Based Service

5. Correctional Facility“

6. Drug/Alcohol Program

7. Forensic Facility

8. General Hospital

9. Geriatric F acility-not nursing

10. Hospice/Bereavement Services
11. Inpatient Psych Unit

12. Nursing Home/Assisted Living
13. Oncology*

14. Outpatient Clinic

15. School (K-12)

16. Self-Employed/Private Practice
17. State Institution

1 8. University/College

 

*No participants chose correctional facility or oncology as the work setting where they
work the most hours per week.

Table 2
Final Eight Work Setting Categories

 

Combined Work Setting

 

1. Adult Health: Adult Day Care, Nursing Home/Assisted Living, Geriatric Facility-not
Nursing

2. Hospital/Medical Health: Children’s Hospital, General Hospital

3. Community Based Service

4. Behavioral Health: Drug/Alcohol Program, Forensic Facility, Inpatient Psych,

57

Table 2 cont.

Outpatient Psych, State Institution, Child/Adolescent Treatment Center
5. Hospice/Bereavement
6. School (K—12)
7. Self-Employed/Private Practice
8. University/College

 

Because the first research hypothesis sought to examine burnout levels and job
satisfaction scores which required two separate questionnaires, the results for the first
research hypothesis were broken down into two sections: the first addressed burnout level
results, and the second addressed job satisfaction results. Using SPSS, a one-way ANOVA
was conducted to see if any significant differences existed between each subscale of the
MBI and each work setting; however, no statistically significant difference existed between

each subcategory of the MBI and the eight combined work settings, as shown in Table 3.

 

 

Table 3

MBI and Work Setting ANO VA

Source SS df MS f p
EE“

Between Groups 753.701 7 107.672 .782 .603
Within Groups 14862.437 108 137.615

Total 15616.138 115

DE*

Between Groups 137.474 7 19.639 1.287 .264
Within Groups 1648.353 108 15.263

Total 1785.828 115

PA“

Between Groups 189.877 7 27.125 .892 .515
Within Groups 3282.563 108 30.394

Total 3472.440 1 15

 

*EE signifies emotional exhaustion, DE signifies depersonalization, and PA signifies
personal accomplishment.

58

According to the results, no significant burnout level differences exist among music

therapists across various work settings, indicating music therapists in one work setting are

not significantly more burned out than music therapists in a different work setting.

Regarding results for the second part of the first research hypothesis, Table 4

represents the MSQ mean scores of both extrinsic and intrinsic satisfaction for each work

setting in this study. Higher scores for both subcategories indicate higher levels of job

satisfaction.

Table 4

MSQ“ Mean Job Satisfaction Levels Across Work Settings

 

 

Work Setting Extrinsic Satisfaction Intrinsic Satisfaction

1. Adult Health 30.54 36.54
2. Hospital/Medical Health 33.63 42.53
3. Community Based Service 32.89 39.22
4. Behavioral Health 30.73 38.53
5. Hospice/Bereavement 32.00 41 .38
6. School (K-12) 25.00 32.22
7. Self-employed/Private Practice 34.85 42.80
8. University/College 34.75 42.38

 

An AN OVA was performed to determine if any significant differences existed

between work settings groups in either extrinsic or intrinsic satisfaction levels. Table 5

shows the results from this AN OVA.

 

 

Table 5

MSQ and Work Setting ANO VA

Source SS MS p
Extrinsic

Between Groups 797.508 113.930 .092
Within Groups 6778.457 62.763

Total 7575.966

Table 5 cont.

Intrinsic 1099.677
Between Groups 6233.495
Within Groups 7333.172
Total

7 157.097
108 57.718
115

2.722

.012*

 

*=significant difference

The only significant difference among work categories occurred in intrinsic

satisfaction. Significant differences existed in seven separate pairs of work settings, as

shown in Table 6, along with each pairing where no significant difference existed.

 

 

Table 6

Work Setting and Intrinsic Satisfaction Post-Hoe Results

Work Setting Paired Work Setting J Value

Adult Health Hospital/Medical Health .031 *
Community Based Service .417
Behavioral Health .431
Hospice/Bereavement .159
School (K-12) .193
Self-Employed/Private Practice .023*
University/College .090

School (K-12) Hospital/Medical Health .001 *
Community Based Service .053
Behavioral Health .031 *
Hospice/Bereavement .015*
Self-Employed/Private Practice .001*
University/College .007*

Hospital/Medical Community Based Service .285
Behavioral Health .076
Hospice/Bereavement .720
Self-Employed/Private Practice .911
University/College .962

Community Based Service Behavioral Health .812
Hospice/Bereavement .561
Self-Employed/Private Practice .243
University/College .395

Behavioral Health Hospice/Bereavement .349
Self-Employed/Private Practice .054
University/College .207

Hospice/Bereavement Self-Employed/Private Practice .655

60

Table 6 cont.

University/College .793
Self-Employed/Private Practice University/College .894

 

*=significant difference

When looking at music therapists’ burnout levels, it is helpfirl to compare their
mean MBI scores with mean scores obtained from other areas and related disciplines
(Maslach & Leiter, 1986). Higher scores in the subscales of emotional exhaustion and
depersonalization indicate higher levels of burnout. However, high scores in personal
accomplishment indicate lower levels of burnout. Table 7 shows the mean average of all
three subscales of the MBI for each work setting in this study and Table 8 provides the
mean average of all three subscales of the MBI for related work professions.

Lower scores in emotional exhaustion and depersonalization indicate lower levels of
burnout, while higher scores in personal accomplishment indicate lower levels of burnout.
According to Table 7, music therapists who are self-employed reported the lowest mean
levels of burnout in all three subcategories. Music therapists who work in school (K-12)
settings report the highest emotional exhaustion levels, music therapists who work in
behavioral health settings reported the highest depersonalization levels, and music

therapists who work in adult health reported the lowest personal accomplishment levels.

61

Table 7

MBI Mean Burnout Scores Across Work Settings

 

 

Work Emotional Depersonalization Personal

Setting Exhaustion Accomplishment

1. Adult Health 20.31 2.23 39.77

2.Hospital/Medical 17.58 2.5 8 42.79

Health

3. Community Based 18.11 3.00 39.78

Service

4. Behavioral Health 21.37 4.27 41.33

5. Hospice/Bereavement 19.63 2.25 42.63

6. School (K-12) 24.22 3.44 40.67

7. Self-Employed/ 15.75 1.05 43.50
Private Practice

8. University/College 22.50 2.88 41.50

 

Table 8

Comparison of MBI Scores With Other Related Work Professions

 

 

Work Professions Emotional Depersonalization

Exhaustion Accomplishment
Current study 19.59 2.81 41.70
Teaching 21.25 1 1.00 33.54
Social Services 21.35 7.46 32.75
Mental Health 16.89 5.72 30.87

 

In comparison with three related job professions, the mean scores for emotional

exhaustion for music therapists are lower than for teachers or those in the social services,

but music therapists had higher emotional exhaustion means than those in other mental

health professions. However, music therapists had lower mean depersonalization scores

than all three other work professions listed, as well as higher personal accomplishment

mean scores. Although this table provides information about overall means, it still does not

62

provide information of what score on the MBI for each subscale is considered either low,

average, or high.

For consistency and validity across several studies, Vega’s (2007) approach of
comparing the range of music therapists’ burnout scores to mental health burnout scores as
the most appropriate closest occupation was chosen. Table 9 shows the range of scores

from the mental health burnout scores of the MBI (Maslach & Jackson, 1996).

 

 

Table 9
- Mental Health Workers’ MBISubscale Score Range
Low range Average range High range
Emotional Exhaustion S 13 14-20 2 21
Depersonalization .<_ 5 6-10 2 11
Personal 2 40 39-34 S 33
Accomplishment

 

According to this burnout score range, the typical music therapist in this study is at
the high end of the average range for emotional exhaustion at 19.59, falls in the low range
of depersonalization at 2.81, and the high range for personal accomplishment at 41.70.

F orty-eight or 41.4% of the total 116 participants in this study scored in the high range for
emotional exhaustion, 24 or 20.7% scored in the average range for emotional exhaustion,

' and the remaining 44 or 37.9% scored in the low range for emotional exhaustion. Results
of depersonalization score ranges for music therapists in this study indicate that four or
3.4% scored in the high range, 13 or 11.2% scored in the average range, and the remaining
99 or 85.4% scored in the low range. Finally, 12 or 10.3% of participants scored in the

high range of burnout for personal accomplishment, 22 or 19% scored in the average

63

range, and the remaining 82 or 70.7% of participants scored in the low range of burnout in
personal accomplishment. Using a bivariate correlation to determine the relationship of the
three subscales to each other, significant correlations existed between all three subscales of
the MBI, as shown in Table 10. In summary, music therapists have overall lower mean
burnout levels than other related professions, as compared with the most similar category
of mental health. Music therapists who score high on emotional exhaustion are more likely
to also score high on depersonalization with the reverse also being true. Music therapists
who score high in either emotional exhaustion or depersonalization tend to score low in

personal accomplishment with the reverse also being true.

 

 

Table 10
MBI Correlation

EE* DE" PA*
EE* r=.572, p=.000** r=-.357, p=.000**
DE* r=.572, p=.000** r=-.391, p=.000**
PA* r=-.357, p=.000** r=-.391, p=.000**

 

*EE signifies emotional exhaustion, DE signifies depersonalization, and PA signifies
personal accomplishment.
** =significant difference

Unlike the MBI, the short version of the MSQ has no similar profession with whom
to compare extrinsic or intrinsic satisfaction levels. The MSQ short version collected data
from the following professions: assemblers, clerks, engineers, janitors and maintenance
men, machinists, and salesmen (Weiss, Dawis, England, & Lofquist, 1969). In addition,
unlike the MBI, the MSQ provides no range of scoring, but takes the raw scores and
organizes them by percentile rankings; therefore, no scoring range of similar professions

was available, and therefore, not included in these results.

In summary, because no significant differences exist among work settings on the

64

MBI, but significant differences on the MSQ existed in intrinsic satisfaction among work
settings, the first hypothesis was rejected for burnout and only accepted for the intrinsic
satisfaction subscale for job satisfaction.

Research Hypothesis #2: Music therapists who work in educational or school

settings will report the highest burnout levels

From the mean scores shown in Table 7, the combined average score for emotional
exhaustion and depersonalization in music therapists’ who work in School (K-12) settings
is 13.83, which is higher than the combined average emotional exhaustion and
depersonalization scores than the other seven work settings, indicating music therapists
who work in School (K-12) settings have higher burnout levels. Music therapists who
work in School (K-12) settings reported the third lowest personal accomplishment score.
Lower personal accomplishment scores indicate higher levels of burnout. Because personal
accomplishment scores are tallied the opposite of emotional exhaustion and
depersonalization, they were not included in the combined mean score.
Although the mean score for both emotional exhaustion and depersonalization was highest
in music therapists who work in School (K-12) settings, the ANOVA procedures found no
significant differences among the groups, as shown in Table 11. Thus, the second research

hypothesis was rejected.

65

Table 11
MBI and Work Setting ANO VA

 

 

Source SS df MS f p
EE*

Between Groups 753.701 7 107.672 .782 .603
Within Groups 14862437 108 137.615

Total 15616.138 115

DE*

Between Groups 137.474 7 19.639 1.287 .264
Within Groups 1648.353 108 15.263

Total 1785.828 115

PA*

Between Groups 189.877 7 27.125 .892 .515
Within Groups 3282.563 108 30.394

Total 3472.440 1 15

 

*EE signifies emotional exhaustion, DE signifies depersonalization, and PA signifies

personal accomplishment.

Research Hypothesis #3: Music therapists who possess higher levels of education

will report higher levels of job satisfaction, with individuals possessing a Ph. D.

having the highest job satisfaction scores

On the music therapy questionnaire, thirteen options for highest degree earned were

offered for participants to select which one best applied. However, to increase the n size of .

each degree earned category, the thirteen degree options, as shown in Table 12, were

condensed into a total of three final categories: participants with at least a bachelor’s

degree or equivalency in music therapy, those with a master’s degree in music therapy or

another area, and those with a doctoral degree in music therapy or another area.

66

Table 12
Original Thirteen Degree Options of Highest Degree Earned

 

Music Therapists’ Highest Degree Earned

 

1. Bachelor of Arts, Music Therapy

2. Bachelor of Science, Music Therapy
3. Bachelor of Music, Music Therapy

4. Bachelor Equivalency, Music Therapy
5. Master of Art, Music Therapy

6. Master of Music, Music Therapy

7. Master of Music, Music Education

8. Master of Social Work

9. Master of Education

10. Master of Psychology

11. Master of Counseling

12. Ph.D. in Music Education with cognate/emphasis in Music Therapy
13. Other“

 

*Responses from participants in the “other” category included those who had earned dual
degrees in music therapy and another area, those who had advanced training including
Neurologic Music Therapy (NMT) certification, LCAT certification, those who had a
Ph.D. in Music Therapy, and those whose degree title was not one of the thirteen choices.

Table 13 shows the mean scores for extrinsic and intrinsic satisfaction and the three

 

 

highest degree categories.

Table 13

MSQ Extrinsic and Intrinsic Mean Scores Among Highest Degree Earned Categories
Highest Degree Earned Extrinsic Satisfaction Intrinsic Satisfaction
Bachelor’s Degree 30.96 38.45

Master’s Degree 31.87 40.45

Ph.D. Degree 36.77 42.62

 

Music therapists with advanced degrees have higher numerical job satisfaction
scores in both extrinsic and intrinsic satisfaction than those with only a bachelor’s degree.
However, because results from the ANOVA, as shown in Table 14, indicate no statistically

significant differences existed between the groups, hypothesis three was rejected.

67

Table 14
Job Satisfaction and Degree Earned ANO VA

 

 

Source ' SS Df MS f p
Extrinsic

Between Groups 356.495 2 178.248 2.790 .066
Within Groups 7219.470 113 63.889

Total 7575.966 1 15

Intrinsic

Between Groups 224.639 2 112.320 1.785 .172
Within Groups 7108.533 1 13 62.907

Total 7333.172 115

 

Research Hypothesis #4: Music therapists who have been in the field for at least

10 years will report higher overall levels of job satisfaction than music therapists

who have been in the field less than 10 years

Participants were instructed to enter the number of years they had worked as a
music therapist since entering the field, rounding down to the nearest whole number.
Several participants either gave an approximation of how many years they had been in the
field (e.g., 25-26), or with a set minimum number followed by a plus sign (e.g., 35+),
indicating an unspecified number higher than what was given. In both cases, the researcher
always used the first number reported. The researcher categorized all participants into one
of four categories: 1. Nine or less years of experience as a MT, 2. 10-19 years of
experience as a MT, 3. 20-29 years of experience as a MT, and 4. 30+ years of experience
as a MT. Of the total 116 participants, 54 or 46.6% had worked 9 years or less in the field,
19 or 16.4% had worked 10-19 years in the field, 28 or 24.1% had worked 20-29 years in
the field, and the remaining 15 or 12.9% had worked 30+ years in the field. The number of
years working in the field of MT ranged from 1-36. Extrinsic and intrinsic mean scores for
each of the four groups designating a set number of years in the field are shown in Table

15.

68

Table 15
MSQ Extrinsic and Intrinsic Mean Scores and Number of Years in Field

 

 

# of Years in Field N Extrinsic Satisfaction Intrinsic Satisfaction

19 years in field 54 29.85 38.70
10-19 years in field 19 ’ 31.95 39.32
20-29 years in field 28 33.93 41.93
30+ years in field 15 36.07 39.80

 

Results from the one-way AN OVA indicated a statistically significant difference
existed among the categories of the number of years in the profession and extrinsic

satisfaction, but not for intrinsic satisfaction. Table 16 shows the results from the ANOVA.

 

 

Table 16

MSQ Extrinsic and Intrinsic Subcategories and Number of Years in Field ANO VA
Source SS Df MS F P
Extrinsic

Between Groups 356.495 3 200.471 3.219 .026*
Within Groups 7219.470 112 62.273

Total 7575.966 115

Intrinsic

Between Groups 224.639 3 65.184 1.023 .385
Within Groups 7108.533 112 63.729

Total 7333.172 115

 

*=significant difference.

A post-hoe analysis indicated significant differences existed in two pairs of
extrinsic satisfaction and number of years in the profession, as shown in Table 17. A
statistically significant positive difference existed between music therapists who have
worked in the field nine years or less and music therapists who have worked 20-29 years,
and between music therapists who have worked in the field nine years or less and music
therapists who have worked in the field 30 years or more. Subsequently, the fourth
research hypothesis was retained for extrinsic satisfaction but rejected for intrinsic

satisfaction.

69

Table 17
Number of Years in Field and Extrinsic Satisfaction Post-Hoe Results

 

 

Number of Years in Field Paired Group p value
1-9 10-19 .322
20-29 .029*
30+ .008*
10-19 20-29 .400
30+ .134
20-29 30+ .399

 

*=significant difference

Research Hypothesis #5: Music therapists who report high levels of burnout or job
dissatisfaction will be more likely to actively search for another career

As previously discussed, 48 or 41.4% of the total 116 participants in this study
scored in the high range for emotional exhaustion, 24 or 20.7% scored in the average range
for emotional exhaustion, and the remaining 44 or 37.9% scored in the low range for
emotional exhaustion. Results of depersonalization score ranges for music therapists in this
study indicate that four or 3.4% scored in the high range, 13 or 11.2% scored in the
average range, and the remaining 99 or 85.4% scored in the low range. Finally, 12 or
10.3% of participants scored in the high range of burnout in personal accomplishment, 22
or 19% scored in the average range, and the remaining 82 or 70.7% of participants scored
in the low range of burnout in personal accomplishment. Table 9 provides the range of
what constitutes a low, average, or high score, using the mental health profession’s range
as a guide.

' Because data were not collected for a profession similar to music therapy, nor were

any ranges of low, average, or high scores provided for the MSQ, only an AN OVA was
run to determine if differences existed in music therapists’ satisfaction levels and intent to

look for another career. Two participants did not answer the question about their intent to

70

look for a non-MT job within the next three to six months and were excluded from the
following results. Similar to the first research hypothesis, which was broken down into two
sections, one that addressed burnout level results and one that addressed job satisfaction
results, results for this research hypothesis also were broken down into two sections: the
first for burnout level results and the second for job satisfaction results. Table 18 shows the
results of the ANOVA for the MBI and music therapists’ intent to search for a non-MT job

within the next three to six months.

 

 

Table 18

MBI and Intent to Look for Another Non-MT Job in the Next Three to Six Months ANO VA
Source SS Df MS f p

EE*

Between Groups .321 2 .160 .543 .583
Within Groups 33.123 112 .296

Total 33.442 1 14

DE*

Between Groups .256 ' 2 .128 .432 .650
Within Groups 33.187 1 12 .296

Total 33.443 1 14

PA"

Between Groups 1.131 2 .565 1.960 .146
Within Groups 32.313 112 .289

Total 33.443 114

 

*EE signifies emotional exhaustion, DE signifies depersonalization, and PA signifies
personal accomplishment.

The AN OVA revealed no statistically significant differences among the groups,
suggesting that music therapists with higher burnout levels are no different than music
therapists with average or low burnout levels in their search for a non-MT job in the near
future. An AN OVA was also run to determine if significant differences existed between
music therapists with low, average, and high burnout scores and their intent to search for a

non-MT in the next six to twelve months. Only one participant did not answer this

71

question, resulting in a total of 115 responses that were included in the results. Table 19
shows the AN OVA of the MBI and music therapists’ intent to look for a non-MT job in the

next six to twelve months.

 

 

Table 19

MB] and Intent to Look for Another Non-MT Job in the Next Six to Twelve Months ANOVA
Source SS Df MS f p

EE*

Between Groups 1.629 2 .814 2.633 .076
Within Groups 34.949 113 .309

Total 36.578 115

DE*

Between Groups .191 2 .096 .297 .744
Within Groups 36.386 1 13 .322

Total 36.578 115

PA*

Between Groups .038 2 .019 .059 .943
Within Groups 36.540 113 .323

Total 36.578 115

 

*EE signifies emotional exhaustion, DE signifies depersonalization, and PA signifies
personal accomplishment.

An AN OVA was then run to determine if significant differences existed suggesting
music therapists with lower job satisfaction levels were more likely to search for a non-MT
job within the next three to twelve months. Table 20 shows the results of the AN OVA for
extrinsic and intrinsic satisfaction and intent to look for a non-MT job in the next three to
six months. Table 21 shows the results of the ANOVA for extrinsic and intrinsic

satisfaction and intent to look for a non-MT job in the next six-twelve months.

72

Table 20
MSQ Extrinsic and Intrinsic Job Satisfaction and Intent to Look for Another Non-MT Job
in the Next Three-Six Months ANO VA

 

 

 

Source SS Df MS f p
Extrinsic

Between Groups 8.747 32 .273 .908 .611
Within Groups 24.696 82 .301

Total 33.443 1 14

Intrinsic

Between Groups 8.811 28 .315 1.099 .360
Within Groups 24.632 86 .286

Total 33.443 114

Table 21

MS Q Extrinsic and Intrinsic Job Satisfaction and Intent to Look for Another Non-MT Job
in the Next Six- Twelve Months ANO VA

 

 

Source SS Df MS F p
Extrinsic

Between Groups 11.865 32 .371 1.245 .213
Within Groups 24.713 83 .298

Total 36.578 115

Intrinsic

Between Groups 10.545 28 .377 1.259 .208
Within Groups 26.032 87 .299

Total 36.578 115

 

No statistically significant differences existed among the groups, indicating job
satisfaction does not have a strong impact on music therapists’ intent to look for a non-MT
job within the next twelve months. In addition, because no significant differences existed
between music therapists’ MBI scores and intent to search for a non-MT job within the
next year, the fifth hypothesis stating that music therapists’ with high burnout levels or
lower job satisfaction scores would be more likely to search for a non-MT job was
rejected.

Results fiom the Music Therapy Questionnaire

In addition to the data results from the five hypotheses, several other results from

73

the data analysis are worth reporting. Of the 116 participants, when asked if they could go
back to choosing their careers, would they still choose music therapy, 82 or 70.7% said
yes, nine or 7.8% said no, and the remaining 25 or 21.5% said maybe or they were unsure.
Each participant was asked to choose, from a list of thirteen options, which top five
options they seek when dealing with difficult physical, financial, emotional, or
psychological aspects of their job. The thirteen options each participant chose from were:
1. Family, 2.Friends, 3.Religious/spiritual beliefs, 4.Meditation/relaxation, 5.Hobbies,
6.Reduced work hours, 7.Reduced responsibilities, 8.Consulting with another MT,
9.Consulting with another co-worker, 10.Consulting with supervisor/employer,
11.1ncreased salary/benefits, 12.Better time management, 13.“Other,” requiring an answer
not already mentioned. Overall, the top five sources music therapists seek most when
dealing with difficult physical, financial, emotional or psychological aspects of their job
are: 1. Family, 2. Friends, 3. Hobbies, 4. Consulting with supervisor/employer, and 5.
Better time management. Table 22 shows the overall number of responses per option in
order from the highest number of respondents to the lowest. Although the top five chosen
responses were mentioned above, Table 22 shows the total number of responses overall
from all 116 participants. For example, although spirituality was the third overall chosen
response, not enough music therapists chose it as one of their top five options they seek for

positive job support.

74

Table 22

 

Total Response Count of Top Five Factors Music Therapists Seek For Positive Job
Support

 

Family 95
Friends 86
Spirituality 63
Hobbies 61
Consult with co-worker 48
Better time management 45
Consult with MT 44
Consult with employer 40
Meditation 39
Reduced Work 17
Other 14
Increased Salary 10
Reduced Responsibilities 10

 

Some of the answers in the “other” category included going on vacation, exercise,
engaging in outside clinical supervision, and finding online resources. Not all participants
responded with five total sources they seek during difficult job situations. In addition, two
of the mail surveys checked their five responses instead of numbering them according to
significance and were not included in the total percentage.

In addition, each participant answered questions about the top three positive and
negative aspects about his/her work setting. Table 23 shows the combined top three

positive and negative aspects for all work settings.

 

 

Table 23
Top Three Positive and Negative/Challenging Work Setting Aspects for Music Therapists
Positive Work SettinLAspect Negative/Challenging Work Setting Aspect
1. Flexibility of schedule/ 1. Salary/benefits
ability to determine own schedule
2. Amount of direct contact with 2. Amount of administrative work (i.e., session
clients notes, documentation, billing, etc.)
3. Co-worker/colleague 3. Opportunities for advancement
support/respect

 

75

Summary of Quantitative and Descriptive Data

Three of the five research hypotheses set by the researcher were rejected and the
remaining two were partially rejected. Overall, because no significant differences exist
between the MBI and work setting, it cannot be said that music therapists suffer from
burnout in one work setting more than another. Music therapists who work in School (K-
12) work settings seem to report the lowest levels of extrinsic and intrinsic satisfaction. No
significant differences exist between job satisfaction and obtaining advanced degrees,
suggesting music therapists with advanced degrees are not significantly more satisfied with
their jobs than music therapists with only a bachelor’s degree. Some significant differences
existed between exuinsic job satisfaction and number of years in the field as a MT,
suggesting one or more variables affect job satisfaction in music therapists the longer they
remain in the field. Music therapists with high levels of burnout or job dissatisfaction are
not significantly more likely than music therapists with low levels of burnout or job
dissatisfaction to search for a non-MT job within the next twelve months. Most of the
participants indicated they would choose music therapy as their career if they had the
option to go back and choose what career they would pick. The top five sources music
therapists choose to deal with difficult job aspects are relationships with family, friends,
hobbies, consulting with their supervisor/employer, and better time management. The top
three positive work settings aspects for MT are flexibility of schedule, amount of direct
contact with clients, and amount of respect from their co-worker or colleagues. The t0p
three negative or challenging work setting aspects for MT are salary, amount of

administrative work, and opportunities for advancement.

76

CHAPTER FIVE

DISCUSSION

This chapter will discuss in more detail the findings from the previous chapter, the
connection to the existing research literature, the limitations of the design and findings,
other confounding factors/variables, and suggestions for future research.

Data Collection Complications and Modifications

During the data collection process, several modifications or changes to the data
were necessary: 1. An unfortunate error occurred that was identified afler the data
collection process had begun. The original MBI has a total of 22 questions with nine
questions in the emotional exhaustion subcategory, five in the depersonalization
subcategory and eight in the personal accomplishment subcategory; however, the
researcher unintentionally omitted the last question under the depersonalization
subcategory when uploading the questions for the online version. Therefore, all data
reporting music therapists’ burnout scores under the emotional exhaustion and personal
accomplishment subcategories reflect responses from the correct nrunber of questions.
Results from the depersonalization subcategory only reflect answers from four of the five
questions. 2. Not all the participants chose five top factors they seek when dealing with
difficult job situations. One reason could be they simply do not have five factors they seek
out. Subsequently, the number of responses they did answer were still included in the
study. 3. Several participants responded to the number of music therapists and other health
professionals they keep in contact with each year in a range format (i.e., 10-15) or with a

set minimum number followed by a plus sign (i.e., 35+), indicating an unspecified number

77

higher than what was given. In both cases, the researcher consistently chose the first
number given. 4. Not all participants selected three positive aspects about their job and/or
three negative or challenging aspects about their work setting. Music therapists who chose
not to select three may not have a total of three positive or negative aspects about their
work setting. They also may not have wished to disclose their answers.
The responses they did provide were still included in the study. 5. Three participants
entered working in two states. It is likely that they live close to the border between two
states, thus providing services for both states. The researcher consistently chose the first
state listed. 7. Several music therapists also gave a range of hours they were employed (i.e.,
35—40) or a set number followed by a plus sign (i.e., 20+). In both cases, the researcher
consistently chose the first number listed.
MBI and Burnout in Music Therapists

Currently, this study is the fifth to use the MBI to measure burnout levels in music
therapist. Results from the other four studies using the MBI: Oppenheim (1987), Hills,
Norman, and Forster (2000), Fowler (2006), Vega (2007), overall indicate that music
therapists demonstrate an average level of burnout. Table 24 compares the current study’s

results of the MBI with the most recent study using the MBI (Vega, 2007).

 

 

Table 24

Comparison of Current Study ’s MBI scores and Vega ’s 2007 Study MBI results

Study Emotional Depersonalization Personal
Exhaustion Accomplishment

Current study 7 19.93 2.71 41.50

Vega’s 2007 study 18.16 4.45 40.29

 

In comparison to the other four music therapy studies using the MBI, music

78

therapists are at the high end of the average range for emotional exhaustion at 19.93, fall in
the low range of depersonalization at 2.71, and high in personal accomplishment at 41.50.
Results from the one-way AN OVA indicates music therapists who remain in the field
longer have lower levels of emotional exhaustion and no significant difference in
depersonalization or personal accomplishment, which does not support Oppenheim’s study
(1987) that concluded burnout levels seem to increase the longer music therapists stay in
the field, but supports Fowler’s 2006 study that reported no significant relationship to
burnout levels and length of time in the field in the depersonalization and personal
accomplishment subcategories only.

A possible explanation for significant differences in emotional exhaustion, but not
in depersonalization and personal accomplishment, may be better time management in
finding or using resources to decrease the amount of emotional and/or physical exhaustion
felt at the end of a long work day, which Leiter and Maslach (1998) indicate is one of the
sources for burnout. One potential reason why music therapists report no significant
differences in depersonalization the longer they work in the profession may relate to their
ability to adhere to the code of ethics set by the AMTA , which discusses the responsibility
of the music therapist towards the client’s well-being.

However, music therapists may not also want to disclose they see their clients as an
impersonal object at times, or that they occasionally feel a lack of empathy or support
towards them. Music therapists’ perceptions of their work environment may have affected
the lack of significant difference in personal accomplishment and number of years in field,
in accordance with Pines (1993), stating that an individual’ perception of his/her work
environment is directly related to feelings of success or failure, which may lead to burnout.

According to the mean scores for each of the four groups of number of years in the field,

79

personal accomplishment scores were highest in music therapists who had worked 10-29
years in the field, but declined in music therapists 30+. Future research might explore
specific causes or factors that increase/decrease a music therapists’ feelings of personal
accomplishment over the course of their career.
First Research Hypothesis Discussion

Results from the first research hypothesis indicated no. significant differences
existed in music therapists’ MBI scores and work settings ormusic therapists’ MSQ
extrinsic satisfaction and work settings, but significant differences existed in intrinsic job
satisfaction in music therapists and their current work setting, partially rejecting the first
hypothesis. Because this was the first music therapy study to specifically explore
differences. in burnout across various work settings, no other studies exist with which to
compare/contrast burnout and job satisfaction levels as they relate across various work
settings.

One possible explanation may be MBI scores alone are not enough to depict
burnout differences across music therapists’ work settings, but in combination with other
factors, specifically extrinsic job factors such as workload and salary amount, may account
for overall differences of burnout levels in music therapists across various work settings.
This was also the first music therapy study to use the MBI and a standardized job
satisfaction questionnaire. Several examples of factors that contribute to extrinsic
satisfaction include amount of pay, job security, and supervision, and working conditions
or environment. Examples of factors that contribute to intrinsic Satisfaction include
feelings of accomplishment, achievement, and the ability to have growth, variety, and
responsibility.

Significant differences in intrinsic job satisfaction existed between music therapists

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who work in adult health and two other work settings, with music therapists who work in
adult health having significantly lower intrinsic satisfaction scores. For the purposes of this
study, adult health was a combined work setting of three work settings: adult day care,
nursing home/assisted living, geriatric facility-not nursing. Music therapists who work in
adult day care work settings may not feel they are seeing enough positive change or growth
in their clients because such change or growth is typically more limited or subtle in elderly
adults. Music therapists may not feel they are getting enough of a variety in their clientele
or may have unrealistic expectations about the change, growth or variety in their work
setting, which might affect their overall levels of intrinsic satisfaction, and might make
music therapists who work in adult day care work settings more susceptible to higher
levels of burnout (Pines & Aronson, 1988). Future studies might examine the roles of
music therapists’ personalities in adult day care work settings, and how their levels of
expectations and motivation changes over time.

Significant differences also existed between music therapists intrinsic job
satisfaction scores who work in school (K-12) settings and five other work settings, with
lower satisfaction scores in music therapists who work in school settings.

Music therapists’ personalities might affect their perceptions and reactions to various
extrinsic job factors, affecting their intrinsic job satisfaction (Weiss & Cropanzano, 1996).
For example, music therapists in school settings might not emotionally view a stressful
lsituation as a positive challenge or an opportunity for growth, negatively affecting their
intrinsic satisfaction of what they are accomplishing or achieving.

Specific personality traits related to intrinsic satisfaction, such as self-efficacy, might also
affect music therapists’ intrinsic levels of satisfaction in school settings (Bandura, 1997).

Kahn et al.’s (2006) study concluded dispositional affectivity is an important factor in job

81

stress and burnout, but in combination with other factors. Future research might focus on
music therapists who work in school settings and compare/contrast extrinsic and intrinsic
job satisfaction to see where specific similarities or discrepancies exist.

BecauSe this study was the first to use a standardized job satisfaction questionnaire,
future research might also continue to test the validity and reliability of standardized job
satisfaction questionnaires in music therapists, or devise a standardized music therapy job
satisfaction questionnaire, specific to factors related to the field of music therapy. Future
research might also target more specific questions related to each subscale of the MBI and
work settings to determine if similarities in each work setting exist that contribute to
overall differences across work settings, or if several factors including aspects of job
satisfaction (e. g., salary) in combination with the MBI result in differences across work
settings.

Second Research Hypothesis Discussion

AN OVA procedures found no significant burnout level differences existed among
music therapists who work in school (K-12) settings, which resulted in the rejection of the
second hypothesis. One possible explanation, as suggested by several researchers, may be
that burnout results from several integrated factors, rather than one specific factor or
isolated issue (Freudenberger, 1975; Maslach, 1993). Existing literature indicates that
teachers have the highest burnout levels (de Heus & Diekstra, 1999). Future studies may
look at whether differences exist in administrative support, which may affect opportunities
for advancement, available options, and salary (Klusmann et al., 2008). Another area to
explore could include if differences exist in caseload amounts or the degree of control
music therapists have over their job requirements (Meeks, 1995). Finally, future research

could include more studies that specifically examine the connection or interrelatedness of

82

various aspects including personality, job satisfaction, and working conditions on a music
therapists’ burnout level or desire to remain the field of music therapy, specifically in
school (K-12) work settings.
Third Research Hypothesis Discussion

Although overall mean extrinsic and intrinsic satisfaction scores were highest in
music therapists with advanced degrees, no significant difference among the groups existed
from AN OVA procedures, which rejected the third research hypothesis. From the results,
it appears that simply pursuing and attaining advanced degrees is not significant enough to
change music therapists’ overall job satisfaction, which has both positive and negative
ramifications on the field of music therapy. One indicator that music therapists are satisfied
with their job and want to continue to challenge themselves may be through pursuing an
advanced degree in music therapy or another field. However, if significant differences did
exist between earning advanced degrees and job satisfaction, music therapists might
inadvertently feel more pressure to pursue advanced degrees to achieve or feel they have
obtained more job satisfaction. Future research could include a longitudinal study that
compares/contrasts music therapists extrinsic and intrinsic job satisfaction scores as they
pursue advanced degrees.
Fourth Research Hypothesis Discussion

The fourth research hypothesis posed that music therapists who have worked in the
field 20 years or more would report higher job satisfaction levels than music therapists
who have worked in the field less than 10 years. Some significant differences existed
between extrinsic satisfaction and number of years in the field, but not between intrinsic
satisfaction and number of years in the field, which partially rejected the hypothesis. The

results partially coincided with previous research (Braswell & Decuir, 1989; Cohens &

83

Behrens, 2002; Vega, 1997) that all report higher levels of satisfaction in music therapists
who have been in the field longer. Although overall mean scores in extrinsic and intrinsic
satisfaction were higher for music therapists who have worked at least 10 years, AN OVA
procedures indicated only significant differences existed in extrinsic scores in music
therapists who have worked 10 years or more and music therapists who have worked less
than 10 years.

One explanation may be music therapists’ ability to increase or maintain their level
of expectations, return for their work, and skills (Thibaut & Kelley, 1959). Perhaps the
longer music therapists remain in the field the higher their feelings of accomplishing
specific goals or tasks, or perhaps that their skills are better matched or suited to their job
requirements (Phillips, 2005). Specific job factors, such as amount of pay, may also
positively affect music therapists overall job satisfaction and the number of years they have
been in the field (Braswell, Decuir, et al., 1989). Future longitudinal studies might track
how music therapists’ job satisfaction levels change over the course of their career and
what specific factors seem to be contribute to those changes.

F ifih Research Hypothesis Discussion

Because no significant difference existed in music therapists’ MBI and MSQ scores
and their intent to actively search for another career, the fifth hypothesis was rejected. One
factor that possibly affected the results was although the research hypothesis used the word
“career,” the music therapy questionnaire asked how likely you would be to search for a
non-MT jgb in the next year. Because jobs and careers are not necessarily the same thing,
more discussion and research is needed surrounding this topic. For example, music
therapists who work part-time.rrright want or financially need a second job, or another

music therapy job might not be available, which would affect if music therapists looked for

84

a non-MT job. However, even though individual answers were confidential, it is also
possible that some of the participants may not have wanted to disclose they were looking
for a different non-MT job, which would have also affected the results.

Another possible reason is the present condition of the United State’s economy. At
the time of this study, the entire country was experiencing a significant economic
regression, which negatively affected the job market. Music therapists may have
considered quitting their job and looking for a different career at the present time too risky,
which would support the models by Thibaut and Kelley (1959) and Lee and Mitchell
(1994), that argue individuals will base decisions about their job and intent to quit by
weighing the positive and negative factors at their current job, and evaluating what other
options exist. Music therapists in states like Arizona had recently experienced severe
budget cuts, up to 55% of what they had been previously charging and receiving. Another
possible explanation is music therapists’ overall burnout or job dissatisfaction may not
have reached a significant enough level to spur them to want to find a different job, or they
may not have had enough motivation or desire to look for a different career, which
supports Maertz & Griffeth’s (2004) arguments that an individuals’ self-efficacy affects
whether that individual decides to leave or stay. According to their study, individuals with
lower self-efficacy typically remain in the organization. According to March and Simon’s
(195 8) model, individuals will either seek alternative employment opportunities if
dissatisfaction levels or other work-related factors are high enough, or they will re-consider
looking for alternative opportunities because of a lack of hopefirl possibilities. Individuals
who seek alternative employment may not quit if desirable alternatives are not present. On
the other hand, individuals not originally looking for alternative job options may consider

leaving if a job opportunity presents itself with more attractive or desirable qualities than

85

their current job (Gerhart, 1990). Future research could specifically ask if music therapists
are intending on permanently leaving a career in music therapy to pursue a different career
or what specific factors go into music therapists deciding to pursue a different non-MT job
or career.

Other Quantitative Results Discussion

The top five aspects music therapists seek for support during difficult job situations
are 1. Family, 2. Friends, 3. Hobbies, 4. Consulting supervisor/employer, 5. Better time
management. Unlike Beehr’s social support theory (Beehr et al., 1990) which stated that
supervisor support had the strongest affect on levels of strain, followed by co-worker
support and lastly support from fiiends and family, music therapists chose to seek out
support from family and then friends first. However, out of the total number of responses
for each aspect music therapists seek, family was the first aspect, friends was still second,
but consulting a co-worker was the fourth most chosen response, and consulting a
supervisor/employer was the eighth most overall selected aspect. Although seeking support
from family, friends, and hobbies support’s Bitcon’s (1981) suggestions in her editorial of
how to prevent burnout, how effective are those supports? Continued research in this area
might explore music therapists’ perceptions of how effective seeking these systems of
support are.

This study was also the first in the music therapy literature on burnout and job
satisfaction to specifically ask about positive and negative/challenging work setting aspects
instead of overall reasons for burnout or job dissatisfaction. The top three positive aspects
of all work settings where music therapists are employed were: 1.Flexibility of
schedule/ability to determine own schedule, 2. Amount of direct clients, Co-

worker/colleague respect. The top three negative/challenging aspects of all work settings

86

where music therapists are employed were: 1.Salary/benefits, 2. Amount of administrative
work, and 3.Lack of opportunities for advancement. Three of these aspects match what
Meeks (2005) found in a study with speech-language pathologists, where autonomy was
one of the positive aspects, and salary and opportunities for advancement were two
negative aspects. As found in previous studies, (Bitcon, 1981; Decuir & Vega, 2003;
Knoll, Reuer, & Henry, 1988; Oppenheim, 1987), inadequate salary continues to be a main
reason for job dissatisfaction. Future research in this area could continue to identify what
the top three positive and negative aspects are for individual work settings and how much
that contributes to music therapists’ overall level of job satisfaction, engagement, and
burnout.

Each participant was asked on the music therapy questionnaire, if you could start
your career over again, would you still choose to be a music therapist? Sixty-nine percent
said they would, only 7.8% said they would not, and the remaining 23.2% indicated they
did not know or were unsure. One possible explanation is music therapists with lower
burnout levels and higher job satisfaction and work engagement levels may have had more
positive work experiences, or perhaps have found positive and effective ways of coping or
managing stress, positively affecting their longevity and desire to remain in the field,
which seems to then follow that they would be more likely to choose music therapy again
as their career (Decuir & Vega, 2003; Fowler, 2006).

Future of Music Therapy Burnout Research

As of 2003, the number one reason music therapists seek to leave the field of music
therapy and pursue a different profession stems from burnout (Decuir & Vega, 2003).

More research in this area needs to continue. Areas for future research and

exploration could include: 1.Longitudinal studies examining how music therapists’ job

87

satisfaction, burnout levels, and other factors change over time, 2.Qualitative studies
including interviews with music therapists who have remained in the field for over 10
years and what specific resources, strategies, or aspects contributed to their career
longevity, and 3.Further investigation into the positive and challenging aspects of various
work settings where music therapists are employed. Based on research that seems to
indicate individuals with higher levels of congruence with their organization’s values have
higher job satisfaction levels and have lower turnover rates (Bretz & Judge, 1993), future
research could look at specific values within work settings to see if there is any congruence
with music therapists’ values. If the literature is fairly consistent that music therapists who
stay in the field longer than 10 years are more satisfied, what specifically is causing their
job satisfaction levels to go up? Is it extrinsic factors, such as pay, opportunities for
advancement, intrinsic factors, such as being willing to compromise, feeling you are
accomplishing a lot or are successful, or is it a combination of both? Future music therapy
studies exploring job satisfaction may want to conduct qualitative studies with interviews
as the method of analysis, specifically with music therapists who have been in the field at
least 10 years, which may provide helpful and insightful information to what causes job
satisfaction levels to increase and specifically what external and/or internal factors
contribute to the increase over time. Another potential approach is conducting a
longitudinal study that explores how music therapists’ values, job satisfaction, and other
factors change or remain the same over the first ten years of their career in the field.
Because of the low return rate in participants who completed the study, which may have
affected some of the results, firture studies should also target a higher number of music
therapists overall as well as the number of music therapists within each work setting.

This study was the first to compare burnout and job satisfaction levels in music

88

therapists across various work settings. Based on ANOVA procedures, no significant
relationship existed between work settings and burnout, but significant differences existed
between work settings and job satisfaction levels in music therapists. This study was also
the first music therapy study to use a standardized job satisfaction questionnaire, the
UWES to determine burnout levels, and the MBI, MSQ, and UWES in the same study.
Music therapists who have been in the field 10 years or more reported significantly higher
extrinsic job satisfaction levels than music therapists who have not been in the field over
10 years. Finally, no significant differences existed between music therapists’ job
satisfaction levels and highest degree earned. Because previous research (Decuir & Vega,
2003) indicates burnout is the number one reason music therapists leave the field, more
intensive research needs to occur to discover more specific antecedents for burnout and job
dissatisfaction and what factors seem to counteract or prevent burnout from happening

before burned out music therapists seek another career.

89

APPENDD( A
E-mail Invitation To Participate In Research Study

Dear Music Therapy Colleague,

You are being asked to participate in a research study conducted by Rebecca
West, MT-BC from Michigan State University. Your name was chosen through random
selection and your contact information was obtained through the American Music
Therapy Association (AMTA) 2008 sourcebook. The purpose of this study is to
investigate and compare burnout and job satisfaction levels in Board—Certified Music
Therapists (MT-BC) who work in various settings (i.e. hospital, education, selfJ
employed/private practice). This study will contribute to the researcher’s completion of
her master’s thesis in Music Therapy at Michigan State University.

Should you decide to participate in this research study and once all your questions
have been answered to your satisfaction, clicking on the link below will indicate your
consent to participate in this study. This study consists of four test instruments: the
Maslach Burnout Inventory, the Utrecht Work Engagement Scale, the Minnesota
Satisfaction Questionnaire, and a Music Therapy Questionnaire with demographic
questions that you will complete through an online survey. The survey provides a series
of questions you will answer related to various aspects of your job as a music therapist
(i.e. pay, administrative support) and your level of satisfaction about them.

Participation in this study will require approximately 20-25 minutes to complete
online through the link provided at the bottom of the document. Once you begin the
study, you must answer all questions for your responses to be included in the study. You
will not be able to save your answers mid-way through, and complete them at a later
time.

The researcher does not expect you to have more than minimal risks from your
involvement in this study. Potential benefits from participation in this study include
contributing to understanding of burnout in music therapists. It is hoped that the
information will suggest preventative or proactive measures to deal with burnout.

The researcher will code the results from the study in such a way that each

90

respondent’s identity will not be attached to the final form of this study. The researcher
retains the right to use and publish non-identifiable data. While individual responses are
confidential, aggregate data will be presented representing averages or generalizations
about the responses as a whole. All data will be stored in a secure location accessible
only to the researcher. Upon completion of the study, the researcher will destroy all
information that matches individual respondents with their answers.

Your participation is entirely voluntary. You are free to choose not to
participate. Should you choose to participate, you may withdraw at any time without any
negative consequences. Please complete the online study by April 30, 2009. You will not
be reimbursed in any way for completing this study.

If you have questions or concerns during the time of your participation in this
study, or after its completion or you would like to receive a copy of the results of this
study, please contact:

 

Rebecca West, MT-BC Frederick Tims, Ph.D., MT-BC
Teaching Assistant Professor and Chair of Music Therapy
Michigan State University Michigan State University
westrebe@msu.edu (517) 353-9856

tims@msu.edu
Link to survey:

http://www.survevmonkey.com/s.aspx?sm=AL1 3 OHFhSLszODV9stVsO_3 d_3d

91

APPENDD( B

Postal Mail Invitation To Participate In Research Study

Dear Music Therapy Colleague,

You are being asked to participate in a research study conducted by Rebecca
West, MT-BC from Michigan State University. Your name was chosen through random
selection and your contact information was obtained through the American Music
Therapy Association (AMTA) 2008 sourcebook. The purpose of this study is to
investigate and compare burnout and job satisfaction levels in Board-Certified Music
Therapists (MT-BC) who work in various settings (i.e. hospital, education, self-
employed/private practice). This study will contribute to the researcher’s completion of
her master’s thesis in Music Therapy at Michigan State University.

Should you decide to participate in this research study, you will be asked to sign
this consent form once all your questions have been answered to your satisfaction. This
study consists of four test instruments: the Maslach Burnout Inventory, the Utrecht Work
Engagement Scale, the Minnesota Satisfaction Questionnaire, a Music Therapy
Questionnaire, and demographic questions that you will complete through a paper
survey. The survey provides a series of questions you will answer related to various
aspects of your job as a music therapist (i.e. pay, administrative support) and your level
of satisfaction about them. Participation in this study will require approximately 20-25
rrrinutes to complete.

The researcher does not expect you to have more than minimal risks from your
involvement in this study. Potential benefits from participation in this study include
contributing to understanding of burnout in music therapists. It is hoped that the
information will suggest preventative or proactive measures to deal with burnout.

The researcher will code the results from the study in such a way that each
respondent’s identity will not be attached to the final form of this study. The researcher
retains the right to use and publish non-identifiable data. While individual responses are
confidential, aggregate data will be presented representing averages or generalizations

about the responses as a whole. All data will be stored in a secure location accessible

92

only to the researcher. Upon completion of the study, the researcher will destroy all
information that matches individual respondents with their answers.

Your participation is entirely voluntary. You are free to choose not to
participate. Should you choose to participate, you may withdraw at any time without any
negative consequences. Please complete the online study by April 30, 2009. You will not
be reimbursed in any way for completing this study.

If you have questions or concerns during the time of your participation in this

study, or after its completion or you would like to receive a copy of the results of this

study, please contact:

Rebecca West, MT-BC Frederick Tims, Ph.D., MT-BC
Teaching Assistant Professor and Chair of Music Therapy
Michigan State University Michigan State University
westrebe@msu.edu (517) 3 53-9856

tims@msu.edu

Please check one of the following boxes and sign your name underneath the appropriate
box to indicate your willingness to participate in the study. Return this signed form with
your completed survey. All questions must be answered in order for your survey to

be included in the results.

DYes, I wish to participate in this study. I understand that I am completing this study of
my own volition, and that this study may incur physical or psychological risk associated

with completing paper surveys.

 

(signature)

DNo, I do not wish to participate in this study. Please take my contact information off
from future mailings.

 

(signature)

93

1.

APPENDIX C
Music Therapy Questionnaire

If you could start your career over again, would you still choose to be a music
therapist? (check one) [:lyes [:Ino Elmaybe/don’t know

When aspects of your job got difficult physically, financially, emotionally,
psychologically, what top five factor(s) did you seek out to provide positive support?
(number the top five, 1,2,3 ,4,5)

L—JFamily

EIFriends

DReligious/spiritual beliefs

DMeditation/relaxation

DHobbies

DReduced work hours

[:IReduced responsibilities

DConsulting with another MT

DConsulting with another co-worker

[:IConsulting with supervisor/employer

DIncreased salary/benefits

[:IBetter time management

DOther (please specify)
From the time you entered the field as a music therapist, how many times have you
changed jobs to another music therapy job? (enter number) _

Rate the strength of influence on your desire to remain in the profession of attending
Music Therapy conferences, retreats, or seminars (check one)

[:IStrong positive influence

DModerate positive influence

DNeither positive nor negative influence

[:lModerate negative influence

DStrong negative influence

94

5. Rate the strength of influence on your desire to remain the in profession of
communicating with other MT (check one)
I:IStrong positive influence
DModerate positive influence
DNeither positive nor negative influence
DModerate negative influence
DStrong negative influence

6. How many other music therapists do you keep in electronic or personal contact with
at least two-three times a year apart from your workplace?

(enter number)

7. How many other health or related professionals (i.e. speech-language pathologists,
psychologists, social workers, etc.) do you keep in electronic or personal contact with
at least two-three times a year apart from your workplace? (enter number)

8. What are the top three positive job aspects about your current work setting? (number
top three 1, 2, 3)

DSalary/benefits

[Flexibility of schedule/ability to determine own schedule
DNumber of hours per week

DOpportunities for advancement
DAdministrative/managerial support/respect
DCo-worker/colleague support/respect

DCommunity or client family support/respect

DAmount of direct contact with clients

DCaseload amount

[:IVariety of caseload or clients

DAmount of administrative work (i.e. session notes, documentation, billing, etc.)

DAvailable work and professional resources

DOther (please specify)

 

95

9. What are the top three negative/challenging aspects about your current work setting?
(number top three, 1,2,3)
DSalary/benefits
DFlexibility of schedule/ability to determine own schedule
DNumber of hours per week
DOpportunities for advancement
DAdministrative/managerial support/respect
DCo—worker/colleague support/respect
DCommunity or client family support/respect
DAmount of direct contact with clients
DCaseload amount
DVariety of caseload or clients
DAmount of administrative work (i.e. session notes, documentation, billing, etc.)
DAvailable work and professional resources

DOther (please specify)
10. Within the last year have you actively searched to find another Music Therapy job?

(check one) Dyes Dno
1 1. Within the last year have you actively searched to frnd another job/career not related

 

to Music Therapy?
(check one) Dyes Dno
12. Within the next 3-6 months do you expect/intend to actively search for another Music
Therapy job?
(check one) Dyes Dno Dunsure/don’t know
13. Within the next 3-6 months do you expect/intend to actively search for another
job/career not related to music therapy?
(check one) Dyes Dno Dunsure/don’t know
14. Within the next 6-12 months do you expect/intend to actively search for another
Music Therapy job?
(check one) Dyes Dno Dunsure/don’t know
15. Within the next 6-12 months do you expect/intend to actively search for another

job/career not related to music therapy?

96

16.

17.
18.

19.
20.

21.

(check one) Dyes Dno Dunsure/don’t know
Highest degree achieved
DBachelor of Arts, Music Therapy
DBachelor of Science, Music Therapy
DBachelor of Music, Music Therapy
DBachelor equivalency, Music Therapy
DMaster of Arts, Music Therapy
DMaster of Music, Music Therapy
DMaster of Music Education
DMaster of Social Work
DMaster of Education
DMaster of Psychology
DMaster of Counseling
DPhD. in Music Education with an emphasis in Music Therapy
DOther Ph.D. (please specify)

DOther (please specify)
What is your age?

 

 

What is your gender?

DMale

DFemale

In which state do you work?
How many years have you been in the field of Music Therapy? (defined as number of
years since beginning your first music therapy job. Round down to the nearest whole
number)
What work setting do you spend the most hours per week? (pick one)
Adult Day Care
Child/Adolescent Treatment Center
Children’s Hospital or Unit
Community Based Service
Correctional Facility

Drug/Alcohol Program

97

Forensic Facility

General Hospital

Geriatric Facility-not nursing
Hospice/Bereavement Services
Inpatient Psychiatric Unit
Nursing Home/Assisted Living
Oncology

Outpatient Clinic

School (K-12)
Self-employed/private practice
State Institution
University/College

How many hours a week are you employed?

98

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