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LIBRARY 7
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This is to certify that the
dissertation entitled

A PHENOMENOLOGICAL STUDY OF A MUSIC THERAPY PEER
SUPPORT GROUP FOR SENIOR MUSIC THERAPY STUDENTS

presented by

Joni Milgram—Lut erman

has been accepted towards fulfillment
of the requirements for

_PL1-D-_ degree in Mus ic Educat ion

 

Major professor

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Date 3 9' 00

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A PHENOMENOLOGICAL STUDY OF A MUSIC THERAPY PEER
SUPPORT GROUP FOR SENIOR MUSIC THERAPY STUDENTS

By

Joni Milgram-Luterman

A DISSERTATION

Submitted to
Michigan State University
In partial fulfillment of the requirements
For the degree of

DOCTOR OF PHILOSOPHY
Music Education

2000

ABSTRACT

A PHENOMENOLOGICAL STUDY OF A MUSIC THERAPY PEER
SUPPORT GROUP FOR SENIOR MUSIC THERAPY STUDENTS

By

Joni Milgram-Luterman

The purpose of this study was to examine the integration of
personal growth experiences into the undergraduate music therapy
education. This was accomplished by observing, describing and analyzing
the phenomena of a series often Music Therapy Peer Support Group
(MTPSG) meetings that I organized and facilitated during a Fall Semester
at a large mid-western university.

Data included observations of the MTPSG meetings, participant
interviews, participantjournals, my research log, feedback from a clinical
supervisor and interviews with the professor who was currently teaching
the participating student’s core music therapy course.

The findings were divided into three sections that emerged from the
analysis: (1) The group process, (2) A case study and (3) Myself as
participant. Implications for inclusion of groups such as MTPSG in
undergraduate music therapy, physical therapy, occupational therapy,
music education and performance programs are discussed. Ideas for
future research are suggested, including replication, accountability and

longitudinal studies.

 

 

 

Copyright by
JONl M ILG RAM-LUTERMAN
2000

   

 

This dissertation is dedicated to
Maynard, Sara and Rebecca.
You have challenged me,
supported me and been patient with me

throughout my scholarly endeavors.

For this I am grateful.

 

L4...

 

 

ACKNOWLEDGMENTS

I wish to acknowledge and thank the many individuals who have been
involved in my scholarly development and this dissertation. A sincere thank-you
to Dr. Colleen Conway for her work as my dissertation advisor, teacher and
mentor. Thank you also to my committee members, each or their unique
contribution to the final product: Dr. Ted Tims for challenging me to think beyond
what I thought was possible, Dr. John Kratus for his creativity and Dr. Cindy
Taggart for her attention to detail and her advice and support.

I would like to thank the group of senior music therapy students who
volunteered to participate as group members, have blossomed each in their own
way and have helped my own development. Thank you also goes to Roger
Smeltekop, Roberta Wigle Justice and David Luce for their clinical and
educational advice and supervision and for their friendship. A special thanks
goes to Peter Hulan for helping me to put my music to the page.

Sincere appreciation goes to Connie lsenberg and Dr. Rosemary Fischer
— my mentors and good friends. I also wish to acknowledge my parents, Faygie
and Harry Milgram, my sister Karen Presner and my brother Joel Milgram who
have always been proud of me. Most importantly. t wish to thank my husband
Maynard Luterman and my daughters Sara and Rebecca Luterrnan for their

patience, support and love.

 

TABLE OF CONTENTS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LIST OF FIGURES ix
CHAPTER I
INTRODUCTION 1
Purpose ............... 3
Theoretical Perspective 6
Personal Context ..... 8
Research Questions .14
Final Research Questions ....... 15
CHAPTER II
REVIEW OF LITERATURE .......................................................................... 16
Undergraduate Music Therapy Education .16
Self-awareness 94
Experiential Music Therapy Training .................................................. 29
Experiential Music Therapy Case Studies ......................................... 40
Skills and Qualities of the Group Facilitator ....................................... 43
Conclusions 45
CHAPTER III
METHODOLOGY 47
Pilot Study .............................................. 47
Study Participants ‘30
Senior Music Therapy Students ..... ‘50
Clinical Supervisor ..... ’32
Professor of Music Therapy 53
Myself as Participant ............... 53
Research Site ......................... 54
Design/Data Collection Devices ...................... 55
Music Therapy Peer Support Group Observations.................55
Individual Student Interviews .................................................. 56
Group Interviews ..................................................................... 56
Student Journals 'n
Researcher’s Log ................... 57
A Measure of Self-awareness ................................................ 57
Interpersonal Aspects of the Research .............................................. 58
Chronology ................................... 59
Ethical Review ............................ 61
Trustworthiness ............................ 62
Prolonged Engagement ................ 6?.
Persistent Observation ............................................................ 64
Triangulation ......................... 64

 

vi

—n———+

 

Member Checks 64

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Peer Debriefing 65

Reflexive Journal 66
CHAPTER IV

ANALYSIS 67

Organizing the Data 6Q

Coding ....72

Re-coding ........ 73

Recording the Findings ....... 74
CHAPTER V

THE GROUP 80

The Ritual 80

The opening chant 81

Check-in ........ 81

Response to check—in 83

Closing 83

The Experiences ...... 83

Voice work 84

Listening 8';

Music and Imagery ..... 86

1. The Museum Pose 87

2. Opening to Shadow and Light .................................. 87

3. Encountering our Judges ............ 87

Improvisation 88

1. Opening to the Experience ....................................... 89

2. Drum Circle ....89

Songwriting ....90

Ceremony ...... 92

New Awarenesses ....93

Self ....93

Spirituality ...95

Relationship Q7

Effects of MTPSG on Group Supervision .......................................... 99

Conclusions ............. 102
CHAPTER VI

SALLY ........................... ................. 104

Background Information ................................................................... 104

Treatment Process ..................... 106

Phase 1: Beginnings 107

Phase 2: Sally’s Music Goes Deeper .................................... 110

Phase 3: Taking it in 114

Phase 4: Closure vs. Final Exams ....................................... 117

Conclusions . 118

 

vii

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Discussion .. 120

CHAPTER VII

MYSELF AS PARTICIPANT 122
Orientation and Goal Setting 123
“Being Open” 129
Participant’ Perceptions of Me as Facilitator .................................... 137
Conclusions 140

CHAPTER VIII

DISCUSSION AND CONCLUSIONS 145
Implications for Undergraduate Music Therapy Education ............... 147
Implications for Research 148

REFERENCES 150

APPENDICES ...... 159
A. AMTA Standards for Bachelor’s Degrees .................................... 160
B. NAMT Professional Competencies ......... 162
C. Course Syllabus 173
D. Personal Interviews Protocol ................ 176
E. Human Subjects Committee ............. 178
F. Indexes of Coded Data for Group and Sally ................................ 186
G. “Call to Spirit” . 189
H. “Sailing Away” 191
I. “The Invitation” .......... 193
J. “I am becoming [Me]” 195
K. “Peer Group: March ‘97" ......... 197

viii

 

LIST OF FIGURES

Student Developmental Characteristics

 

Expansion of the Self

90
....... 23

 

 

CHAPTER I

INTRODUCTION

Undergraduate music therapy programs must stay abreast of the ever-
increasing requirements of modern entry-level music therapy practice. This
evolution of the field of music therapy demands more knowledge, skill and
experience in musical expression and psychotherapeutic practice (Bruscia,
1989; Maranto, 1989; Tims, 1989). In a report to the American Music Therapy
Association, the Commission on Education and Clinical Training (AMTA,
1999) recommended that undergraduate academic programs be responsible
for

offering the necessary academic courses to achieve required

competency objectives, organizing and overseeing the student’s

clinical training, integrating the student’s academic and clinical learning
experiences according to developmental sequences, and evaluating

student competence at various stages of the program. (p. 22)

Missing from this recommendation and required of the student beyond
mere competence is the development of a disposition of personal and
professional growth necessary for expertise in music therapy practice
(Milgram-Luterman, 1999a). A disposition of expertise is the recognition that
personal and professional growth is a life-long journey. The young age,
narrow life experience, and limited self-awareness of most undergraduate
students may prevent them from accepting the journey of personal growth

and subsequently from developing necessary clinical skills. The above quote

also suggests a developmental sequence that integrates “the student’s

 

academic and clinical learning experiences." One way to address this
challenge is to integrate personal growth opportunities into the curricula
(Milgram-Luterman, 1997).

Offering experiential training groups may facilitate the incorporation of
personal growth opportunities into the university curriculum. Among the goals
of such groups are changes in self-awareness, behavior, attitudes, values,
lifestyle, relationships, and the self (Yalom, 1995). Yalom describes the
experiential training group as a weekly personal growth peer group
experience for psychotherapy trainees that is considered a valuable teaching
technique and an integral part of psychotherapy training. An experiential
music therapy training group is a weekly group for graduate music therapy
students as an integral part of their training, to give them the opportunity to
experience the process of music therapy (usually improvisation) authentically
as clients over time for educational and personal growth (Bruscia, 1998).

Music therapy scholars have suggested that experiential music therapy
groups are beneficial to training music therapists (Bruscia, 1987b; Clark,
1987; Hesser, 1985; Stephens, 1987, Tims, 1989) and continuing education
for professional music therapists (Arnason, 1998). However, to date there is
no research to indicate that such groups exist for undergraduate students.
There seems to be a perception that younger students cannot benefit from
group work and that entry-level jobs they will fill do not require insightful
clinicians (Hesser, 1985). However, in my experiences as both a music

therapist and a clinical teacher I have recognized that the lack of opportunity

 

for personal growth experiences is one of the limiting factors in the practical
effectiveness of undergraduate students and entry-level music therapists.

In an attempt to bring personal growth experiences to undergraduate
students I have developed the concept of Music Therapy Peer Support
Groups (MTPSG, Milgram-Luterman, 1999a). Similar to personal training
groups (Yalom, 1995) and experiential music therapy training groups
(Arnason, 1998; Bruscia, 1998, 1987; Clark, 1987; Hesser, 1985; Priestly,
1975; Stephens, 1987), MTPSG are weekly personal growth group
experiences. They are intended to introduce senior undergraduate music
therapy students to the idea of peer—support and offer them the opportunity to
experience the process of various music therapy interventions for educational
and personal growth.

The goals and process of the MTPSG are different from both group
supervision and classroom experiences in that there is opportunity to share
personal concerns, fears and successes within a group setting. However, as
is the case of experiential music therapy training groups, they are also
different from psychotherapy groups in that the intention of the MTPSG is
personal growth for educational purposes.

In those academic or field programs where this type of training
[Experiential Music Therapy Training] is offered, it is most often an
augmentative practice. That is, it is not intended to supplant any form
of therapy or healing that a student might need. In addition, although
the students participate as clients authentically, boundaries or limits
are usually placed on the kinds of personal problems they are asked to
reveal or explore, and no attempts are made to engage the students in
an in-depth therapeutic process. When significant issues are revealed,

students are advised to seek counseling or psychotherapy elsewhere
while receiving this kind of training. (Bruscia, 1998, p. 188)

 

 

Personal growth in MTPSG is motivated by peer support rather then
directed by the facilitator. The f rst objective to help group members toward
personal growth is for them to learn to support and be supported by peers.
The goal is for group members to develop self-awareness and begin to
understand the impact of their personal issues within their clinical practice
experiences.

Self-awareness is the discovery and acceptance of previously unknown or
unacceptable parts of one’s self (Yalom, 1995).

The therapist’s self-knowledge plays a role in every aspect of therapy. An

inability to perceive countertransference responses, to recognize personal

distortions and blind spots, or to use one’s own feelings and fantasies in

one’s work will limit the effectiveness of any therapist. (Yalom, p. 526)
During clinical placement sessions, undergraduate music therapy students
are often faced with difficult situations that they have not experienced before.
It has been my experience that their limited awareness of self inhibits
appropriate responses. Along with the development of new awarenesses may
come the ability to be more effective music therapists.

The goals and process of the MTPSGs, like training groups (Yalom,
1995), are also different from psychotherapy groups. In light of the fact that
the majority of undergraduate students have never had an experiential group
experience and are typically young adults, the facilitation of MTPSGs are
initially facilitator directed and structured. However, over time group members
learn to support and be supported and they function as a peer-support group.
Peer support, not therapy, is the most important training tool towards growth

in this setting. However, MTPSGs are also different from training groups in

 

 

that training groups train psychotherapists and MTPSGs train entry-level
music therapists. Therefore, there is more emphasis on developing new self-
awareness and less emphasis on psychotherapeutic process in the MTPSG.

MTPSGs that l have facilitated have usually met on a weekly or bimonthly
basis throughout the course of one semester. A ritual is followed each
session that includes an opening chant, a musical/verbal check-in, a verbal
response to check-in, a musical experience and a closing. A chant consists of
a simple melody and a few lyrics repeated many times. There are many uses
for chanting, including meditation or stimulation. (Marks, 1993). For the
purposes of MTPSG the chant is used to announce the start of a session and
bring the focus to the work of the group.

The musical/verbal check-in is an opportunity for individual group
members to reflect on feelings and thoughts. A musical instrument is selected
and passed around as group members present their reflections verbally,
instrumentally or both verbally and instrumentally. They may also pass the
instrument without speaking or performing. Other group members must not
interrupt the individual with the instrument. The response to check-in is
intended as an invitation for group members to respond to others’ check-ins
or elaborate on their own check-in. The response to check-in is a personal
reflection, whereas the check-in is more interactive.

The musical experiences include improvisation, music and imagery,
relaxation, songwriting, singing and chanting and are designed to challenge

group members towards new awarenesses and promote personal growth.

 

Group discussions are inspired by the opening, check-ins and/or musical
experiences. The intended process of the work is initially leader-facilitated
and eventually peer-focussed. Chapter 3 includes for a more detailed
description of a typical session.

I had the opportunity to implement and facilitate my first MTPSG during
the 1997 Spring Semester at a Canadian music therapy program in which I
was teaching part-time. Subsequent to that semester, I began my doctoral
work at this university where I served as a graduate assistant. During the
1998 Spring Semester and the 1998-99 academic year | implemented and
facilitated several MTPSG as part of my duties as a graduate assistant.

Purpose

The purpose of this study was to examine the integration of personal
growth experiences into undergraduate music therapy education. This was
accomplished by observing, describing and analyzing the phenomena of a
MTPSG from the perspective of both undergraduate seniors and myself as
the facilitator during a Fall Semester.

Theoretical Perspective
My approach to music therapy is humanistic/person-centered (Rogers,
1977). Corey (1996) explains that “The humanistic philosophy on which the
person-centered approach rests is expressed in attitudes and behaviors that
create a growth-producing climate” (p. 200). I believe that music in and as
therapy has the power to connect with the client in a genuine, non-threatening

way and in the process, the music therapist has the opportunity to

 

 

demonstrate empathic understanding. Within the humanistic, person-centered
music therapy environment, clients have the opportunity to find their way
towards change and healing.

As a music therapy instructor and clinical supervisor, l have tried to
maintain the person-centered philosophical concept and have integrated it
with an existential philosophy (May & Yalom, 1995). According to Corey
(1996), “the existential movement stands for respect for the person, for
exploring new aspects of human behavior, and for divergent methods of
understanding people” (p. 172). One of the basic premises of the existential
approach is that the development of self-awareness is an important
dimension of the human condition. I believe that in order for music therapy
students to excel in the development of the skills and knowledge necessary
for practice, they must adopt a disposition toward personal and professional
growth (Milgram—Luterman, 1997). The development of this disposition
requires a person-centered approach to education and training that directs
students towards continual self-awareness and growth.

In developing the theoretical perspective for this research, I have
primarily drawn from phenomenology. Forinash (1995) states that “it is the
phenomenologist’s job to shed light on aspects of human experience and, by
doing so, to provide a more thorough understanding of the experience” (p.
368). Experience as phenomenon could be the researcher’s own experience

and/or the experience of others (Aigen, 1995). For the purposes of this

 

research, phenomena to be studied will include both the experiences of the
students and the facilitator/researcher as group members.

My particular phenomenological paradigm is heurmaneutical in nature.
Whereas phenomenologists are interested in the meaning of an experience,
those who engage in heurmaneutical inquiry are also interested in the
interpretation of that experience (Patton, 1990). Aigen (1995) describes the
goal of hermaneutic research as deep engagement “in the circle of
understanding in order to develop insightful and plausible interpretations of
events” (p. 292). The focus of this study was to engage in the hermaneutic
“circle” in order to interpret the experiences of group members.

The phenomena of group process include the interactions between
group members. For the purposes of studying these interactions, a symbolic
interactionist approach was used. Symbolic interactionism is derived from the
field of social psychology (Mead, 1934; Blumer, 1969). As such, it is seeks to
understand the meaning of the experience of interactions in terms of the
shared symbols of a particular social culture (Patton, 1990). In the present
study, the verbal, non-verbal and musical interactions inherent in the MTPSG
group process will act as symbols. Also, the interpretations of those
interactions will be made in the context of the undergraduate student culture.

Personal Context

The literature review of a research study traditionally functions to

establish its professional context. Qualitative researchers also seek to

establish the personal context of their work, believing in the importance

of forging a common ground with readers on both levels of discourse.
This information is offered because of a fundamental epistemological

belief that all knowledge results from an interaction between the
knower and the known. (Aigen, 1995, p. 293)

The following fairy tale is intended as a creative presentation of my personal
and professional experience in terms of how it has affected my approach to
music therapy education and research.

Once upon a time there was a little princess who wanted to be a music
therapist, because she thought that it would be a “neat” profession. She
knew that she was musically talented, but she had not applied herself
because she could, at a very young age, get by with sight-reading and not
much practicing. Later, she was led to perceive that she was a mediocre
musician, based on certain experiences with certain music teachers. She
knew that she was a people person and that she was sensitive and caring.
But she could not understand the theories of psychology as she could not
relate, in her protected world to the horrors of people’s lives — they seemed so
remote. Still, she persevered and traveled to the land of the kings to pursue a
music therapy education. She did well but was constantly haunted by the
“shadow-of-the—fear—of—not-knowing-what—everybody-else—seemed-to—know.”
She was fine when she was performing what 5E thought QQQLIQ thought of
as elementary tasks like motivating a child with cerebral palsy to move with
fluidity to her music or putting a smile on an angry old man’s face with a song.
Nobody bothered to tell her that those skills were the essence of her life’s
chosen field. She did not talk to anybody about her strengths, needs and
fears, because if she did, she would be revealing that she lived in the land of

“not-knowing-what-everybody-else-seemed-to-know." She became frozen

 

 

and stuck at her violin lessons, and often cried in the bathroom next to that
studio, so conveniently situated. She could not grasp the concepts of the
psychology of music and often wondered why everyone was so interested in
w_hy something beautiful happens. That just seemed to make the
extraordinary simplicity of a small response to music seem ordinary. And she
could not tell anyone.

She went on to her internship and learned that she did not have the
knowledge required to function as a music therapist. “Although she seems to
empathize with the clients,” the wicked stepsisters said half way through the
training, “she lacks the theoretical knowledge and is not yet aware of the
impact that she has in music therapy sessions.” And there was nobody to talk
to. She completed her training, with a mediocre evaluation and set out into
the real world to become, what she then believed, a mediocre music therapist
(MMT) who eventually, by the end of her clinical training could write well
enough to pass.

The little princess’ first real job as a music therapist was at a day
center for ex-psychiatric patients. Two hours a week was fine. The rest of the
time she worked at a store in the local mall. That was safe. That was
comfortable. She was good at it — being nice to people — and selling things
that she did not know much about. The two-hour—a-week job was a wonderful,
empowering experience. Nobody there knew what music therapy was
supposed to be, nor did they suspect that she was an MMT. The clients were

responsive and the multidisciplinary team was supportive. She realized that

10

 

she could sing with, to and for people, she could help people to relax, she
could stimulate self-expression, she could assess need, she could set goals
and most of all, she felt that she was doing music therapy. Why didn’t she see
this before? Why didn’t any of her teachers or supervisors ever bother to help
her to see her strengths?

She went on to develop a freelance private practice, honing her skills
and continuing to grow as a therapist. She worked with many different people
in a variety of settings. She eventually had the opportunity to create and
develop a music therapy department in a large geriatric hospital. Life was
good. She was doing good work with and for people. She was helping many
angry old men to smile. Yes, the powers that be in that institution recognized
her good work, but now they were the ones saying, “Yes, you do good work -
why bother explaining why to us, just do it.” Ironically, this angered her, as
she felt that they did not take the power of her work seriously. Regardless of
the hospital politics, which she eventually learned to ignore, the little girl had
grown to be an adolescent music therapist (AMT), in that she did what she
needed to do to share her music to help people and was convincing at selling
her craft to others. But she still feared that other music therapists had
knowledge beyond her grasp.

One day, this AMT was strutting her stuff at a conference. A wise
crone attended her workshop and invited her to teach music therapy in a
university. What? Was this woman crazy? Didn’t she know that this AMT

didn’t know what she was supposed to know? What could she possibly teach

11

 

 

 

others about Lal music therapy? After all, she still didn‘t know what she was
supposed to know that all other music therapists knew. The wise woman told
her that she was a talented music therapist, and that she would like her
students to learn the “doing” clinical skills of this AMT.

And so, the adolescent growing music therapist (AGMT) set out to
teach others what she did know and hoped that nobody would find out that
she didn’t know why she did what she did. The AGMT grew like a wild weed
in this fertile music therapy greenhouse. Because she could finally talk to her
peers and share her experiences and concerns, she realized that what she
could do was unique, special and important. She had to figure out a way to
teach others how to do it. The only way she could teach others what she did
so well, she discovered, was to do it with them and for them. And then, she
became a young adult music therapist (YAMT), finally realizing that she knew
all along why and how she did what she did. She only thought she didn't
know what she knew.

The quest for knowledge grew and grew. She began to develop
strategies for teaching instinctive skills, now hoping that the powers that be
wouldn't find out that she was only teaching others what she knew, and not
teaching them what she thought she was supposed to teach them (which was
what all music therapists knew, but she didn’t). Further along her journey she
met a wizard from another kingdom who told her that most students think that

there is a big secret that they do not know that everyone else knows, and that

a good teacher must recognize this and teach accordingly. Whewl A theory

 

that she understood! A big weight was lifted off her shoulders, and she began
to grow into an adult music therapist (this is not the end of the story — it
actually continues throughout her adult music therapy life).

V\fith the help of the wizard, the crone, her students and her clients, this
music therapy adult (MTA) finally realized that she possessed a vast amount
of knowledge and skills. She was musical and knew how to use the powers
of music towards healing. She had worked with a variety of populations in
many settings, having developed many music therapy job opportunities. She
was motivated by opportunities to understand herself and others, and she had
courage all these years to go after the unattainable and reach her goals. She
realized that in order for anyone to grow, they must be willing to admit what
they do not know, ask questions and take some risks. She needed to stop
blaming others for the missing pieces in her education and take control of her
own learning experiences. And now, this music therapy clinical instructor
woman set out to discover how to teach people what she knew about
teaching music therapy, that nobody else knew!

She moved to the land of academia, where she met several wise
spirits who challenged her to make three wishes. Her first wish was for music
therapy students to begin the journey of personal growth early in their
education and training. Her second wish was for university music therapy
programs to include opportunities to further develop students’ awareness of
self so that they can begin the journey earlier and develop into more well—

rounded, depth-oriented, expert music therapists. Her third wish was for

recognition of MTPSG as a vehicle for personal growth and the development
of self-awareness. It is said that the spirits could not grant her these wishes.
Instead, they gave her scholarly tools and challenged her to examine the

possibilities.

Research Questions

Based on the results of a pilot study, the review of literature and my
experiences as a music therapy student, clinician, instructor, clinical
supervisor and scholar the following research questions were developed:

1. How do senior music therapy students describe their experiences as
members in the music therapy peer-support group?

2. How does the music therapy professor describe the relationship of
individual students’ understanding of music therapy skills and process to
involvement in peer-support group?

3. Does the experience of individual participants affect their developmental
level of self-awareness as demonstrated through scores on the Washington
University Sentence Completion Test of Ego Development (Hy & Loevinger,
1996)?

4. How does the experience of individual participants relate to their adoption
and/or development of a disposition of expertise? (Milgram-Luterman, 1997)?
5. What is the relationship that develops between group members, and do

they perceive this as helpful to their education and training?

6. What is the experience of the facilitator/music
therapist/instructor/researcher in this music therapy peer-support group?
7. Does the experience of the researcher-as-facilitator affect her teaching
skills?
8. Does the experience of the researcher-as-facilitator affect her clinical
practice?
Final Research Questions

Bruscia (1995) writes that “a qualitative focus is not a truth question or
cause-effect outcome to be tested; it is the starting place from which an open
inquiry will emerge” (p. 403). This suggests that it is possible for research
questions to change. During the analysis phase of this study, I grappled with
the vast amount of data, initially trying to address these eight questions. As
will be discussed, three main themes emerged that will be explored in
Chapters 5, 6 and 7. The emergence of these themes helped me to organize
the findings and identify three major research questions for this study.
1. What are the perceived benefits of the MTPSG to music therapy

educafion?
2. What is the experience of a MTPSG member over the course of ten
sessions?

3. What is the role of and what are the qualities specific to a facilitator of

MTPSG?

15

 

CHAPTER II
REVIEW OF LITERATURE

The purpose of this chapter is to review the literature that provided the
phiIOSOphical and practical context for the methodology and analysis of this
study. The first section describes the current status of undergraduate music
therapy education including the debate regarding the suitability of
undergraduate education and training for therapists. The second section
defines self-awareness and its implications for undergraduate music therapy
education and training. The third section describes experiential music therapy
training including three case studies. Finally, the fourth section examines the
skills of group facilitation.

Undergraduate Music Therapy Education

Undergraduate music therapy education involves study and experience
in music therapy, music foundations and clinical (therapeutic) foundations
(AMTA, 1999, September, see Appendix A). Music therapy core courses
include music therapy principles, psychology of music and practical
experience (clinical training). Music courses include music history and theory,
performance on a major instrument as well as functional skills in guitar, voice,
piano, improvisation and accompaniment, and music leadership.
BehavioraI/health/natural science courses must include psychology/sociology,
human science, exceptional children and research methods.

In a study to identify specific skills and knowledge for music therapy

students entering the internship (clinical training) phase of the undergraduate

16

 

music therapy degree (Petrie, 1989), professional music therapists identified
85 ideal learning outcomes listed hierarchically. Whereas most of the learning
outcomes were measurable musical and therapeutic skills and knowledge,
only a few described behaviors that are more subjective in nature. Of interest
to this study was number 75 that stated “The student will understand and
demonstrate the techniques involving self as a therapeutic tool." In a later
study using the same data (Petrie, 1993), twenty-two of the original eighty-five
learning outcomes were found to be perceived as ideal internship intended
learning outcomes and the demonstration of techniques involving self as a
therapeutic tool emerged as number 13. This seems to indicate that
professional music therapists view the internship and not the university as the
environment for adopting higher level therapeutic behaviors such as
awareness of self.

There has been much debate regarding bachelor level music therapy
training and its effectiveness in providing the appropriate skills and knowledge
competencies ofa therapist (Bruscia, 1989; McNiff, 1986; Scartelli, 1987).
There has been a shift in the way music therapy is practiced resulting in the
need to add new core courses, and at the same time, universities continue to
increase liberal arts requirements (Bruscia, 1989). A distinction has
developed between undergraduate entry-level practice and graduate level
advanced practice (Bruscia, 1987b & 1989; Maranto, 1993; Wheeler, 1983).
Bruscia (1998) summarizes the results of these studies into four levels of

practice:

 

 

F.—

(1) Auxiliary Level where music is used for non-therapeutic yet useful
purposes
(2) Augmentative Level where music or music therapy is used to
support treatment
(3) Intensive Level where music therapy serves the central role toward
client growth
(4) Primary Level where music therapy serves the primary role towards
growth and leads to important changes for the client.
This scheme poses implications for the training of music therapists in terms of
the undergraduate and graduate programs. Bruscia (1998) believes that, in
light of the diversity and complexity of the field of music therapy, it is not
possible to train undergraduate students to practice at the higher levels. He
proposes that undergraduate music therapy education and training should
provide students with an eclectic introduction to the many areas (various
populations and settings) of music therapy practice, while preparing them to
practice each area only at the augmentative level. In contrast to that,
graduate music therapy education and training should prepare students to
practice at least one area at the intensive level, while also imparting basic
skills in research and theory.
Another criticism of the bachelor degree education is the high level of
maturity and insight required to practice therapy that young undergraduate
students may not possess. Still others view a problem with the accountability

of the profession of music therapy as the only creative arts therapy that does

18

 

not require at least a master’s degree entry level (McNiff, 1985; Scartelli,
1989).

I believe that with the appropriate music therapy education and clinical
training, undergraduates can begin to develop the skills necessary for a
higher level of music therapy practice. My master’s thesis (Milgram-Luterman,
1997) developed a theory of undergraduate music therapy student
development based on adult developmental theories (Belenky, Clinchy,
Goldberger and Tarule, 1986; Perry, 1970) integrated with the process of
reflective practice (Schon 1983, 1987). Skillful professional practice depends
on reflective practice that is described as the ability of an individual to reflect
on action and integrate knowledge into practice. I proposed that the
conception of reflective music therapy thinking and practice depicts the
expansion of the Self through experience that causes growth in six realms of
music therapy: (1) music therapy, (2) music, (3) therapy, (4) scholarship, (5)
professionalism and (6) life experience. The Self (upper case 8) refers to
Jung’s (1934) theory of personality. The Self is an energy force from which
the personality evolves. “The Self is the goal of personal growth” (Douglas,
1995).

I proposed five phases of development that music therapy students
experience over the four to five years of undergraduate study. Each
successive phase of development leads to new levels of self-awareness if an
environment of reflective practice is provided and maintained. Common

characteristics inherent in each phase are listed in Figure 1.

19

 

Figure 1.

Student Developmental Characteristics (Milgram-Luterman, 1997)

Phase I. Novice Music Therapy Student:

 

Dedicated to how to get good grades and please the teacher; Does not perceive his/herself
as having a voice; Adapts views of others; Is not aware, or does not believe in her own
intuitive knowledge; Does not perceive benefits of observation or experience; Does not see
big picture; Limited competencies in music, theoretical knowledge, common sense, intuition;
Unaware of limits.

Phase II. Immersion through Observation:

 

May not yet recognize the university setting as an environment for personal growth;

Feels capable of learning (defined here as receiving and reproducing knowledge; Feels
she cannot create knowledge; Has just begun to consider motivation to become a music
therapist; Does not yet recognize the scope of knowledge and skills required to become a
music therapist; May begin to recognize the real challenges involved in music therapy in
terms of specific skills and knowledge to meet clients' needs.

 

 

Phase III. Immersion through Experience:

Can easily become discouraged with the realization of little promise, terrible illnesses and/or
lack of means for communication of some music therapy clients; May be anxious and
discouraged; Not really connected yet with the power and beauty of the music as a means for
communication and growth; New awarenesses (may be painful or exciting); Begins to
understand implications of various theoretical orientations of music therapY; Begins to
recognize that commitment to learning is important; Begins to recognize her own personal
truths and knowledge; Begins to define herself in terms of a group; Begins to recognize
existence of relativistic thinking; New feelings of uncertainty.

 

Phase IV. Immersion through Reflection:

 

Begins to develop an ability to identify and communicate self-knowledge; Commits to finding
and applying more concrete ways to learn and express knowledge; Begins to take
responsibility for own growth; Begins to observe music therapy on a deeper level; Can
identify clinical problems and respond to the situation with some certainty; A new ability to
identify and communicate self-knowledge and knowledge of others; More independent, yet
still does not yet actively search for opportunities to develop her own clinical and musical
expression.

 

Phase V. Integration of Experience into Self:

 

Begins to contemplate how she will succeed in attaining his/her goals; Begins to formulate
personal philosophy of music therapy; COmmits to finding and applying more objective,
concrete ways to learn and express her knowledge; Considers herself a thinker, and
endeavors to expand the Self; Adopts an attitude of excitement of discovery or flow and a
disposition of expertise.

 

 

 

 

Phase I is labeled Novice Music Therapy Student. Students operating
in this phase learn best by immersing themselves into the university and
music department communities. Phase II is called Immersion through

Observation. Students operating in this phase learn best through exposure to

20

 

the music therapy community and learning to effectively observe music
therapists at work using specific music therapy techniques with a variety of
populations. Phase III is labeled Immersion through Experience. Here
students learn best through immersion into the music therapy community
through clinical practice. Phase IV is labeled Immersion through Reflection, in
which students begin to develop an ability to identify and communicate self-
knowledge through reflection on their clinical and other experiences. Finally,
Phase V is labeled Integration of Experience into Self, in which students
begin to commit to finding and applying more objective, concrete ways to
learn and express their knowledge and skills, and apply them to the entire
spectrum of music therapy practice. At this stage, they are on the road to
becoming expert music therapists in so much as they endeavor to expand the
Self.

The challenges inherent in accepting this theoretical conception are to
address the needs of the students at the appropriate time throughout the
process and offer opportunities to observe, experience and reflect on all
aspects of the music therapy curriculum. Opportunities to observe and
experience music therapy practice are currently the norm in undergraduate
music therapy programs. However, opportunities to reflect on music therapy,
music, therapy, scholarship, professionalism, life experience and particularly
on the Self are not as easily integrated into the undergraduate curriculum.

Reflection is a skill that I learned through experience and not during my

undergraduate years. An example of scholarly reflection is evident in the

21

 

recent publication of the expertise piece of my thesis (Milgram-Luterman,
1999). As I was reviewing my theory of a disposition of expertise, I realized
that spirituality and relationship more accurately represented what I viewed as
the part of life experience that we bring to our work as music therapists.
Therefore, the theory published as a journal article has seven realms: (1)
Music, (2) music therapy, (3) therapy, (4) professionalism, (5) scholarship, (6)
spirituality, and (7) relationship (see Figure 2).

More recently, as I was preparing to present my theory as the stimulus
for a music therapy educator’s panel at the Canadian Association for Music
Therapy Conference 2000 in Toronto, I realized that science should be
included as a realm of music therapy expertise. This realization was due to a
course that I had attended on Medical Music Therapy that l reflected on and
integrated into my theory. Although I had worked in medical settings for most
of my clinical career, I never perceived what I was doing as science. \Nrth the
opportunity to study the science of music therapy, new awarenesses
emerged. It is this process of constant growth and development as a result of
new awarenesses that I perceive as operating within Phase V: Integration of
Experience into Self.

Jensen and McKinney (1990) examined the current status of
undergraduate music therapy education and clinical training and made
suggestions for identifying competencies that reflect the developing field of
music therapy practice. They found that the many attempts to develop

competency lists were infected by the already existing curriculum. They

22

 

Relation-
ship

 

Figure 2. Expert Music Therapy Thinking as Expansion of the Self

23

 

 

suggested identifying and studying music therapy experts in terms of what
their competencies are and how and where they developed them. Of interest
to this study is one of the questions they would ask of these experts: “What
therapies or growth processes have they themselves experienced and how
do they relate them to their work?” As Jensen and McKinney suggest, the
answers to this and other similar questions may identify important
competencies as well as expand the scope of practice. The implication of this
question to the present study is the recognition of personal growth
experiences as important to the development of music therapists.
Self-awareness

Petrie (1993) identified three taxonomic levels of music therapy student
learning that were gleaned from his survey study of undergraduate academic
curriculum intended learning outcomes. Although the taxonomic levels are
interesting, Petrie neglected to describe how he developed them and did not
provide any references to support this aspect of his work. The first level is
conceptual knowledge and the second level is the application of conceptual
knowledge and the student’s own ideas. Petrie refers to the third level as
“affective understanding” that is defined as the student’s awareness of Self
and social interaction. Undergraduate music therapy educators and clinical
directors perceived the curriculum as meeting the needs of level one learning
primarily with a balance of level two and three learning. Most important to the
present study, the educators and clinical directors indicated level three higher

levels of learning were being taught or how they were being evaluated.

24

 

The American Music Therapy Association’s Standards of Clinical
Practice (AMTA, April 1998) provides a measurement of quality of music
therapy practice. The document indicates that continuing education is
indicated across all specialties and may include courses in
psychopharmacology, neurology, psychology, physiology, and special
education. Of interest to this study, the standards specific to music therapists
working in mental health recommend some form of personal counseling that
is explained as “opportunities for personal growth, awareness, and self-care”
(p. x/viii)

The National Association for Music Therapy’s Professional
Competencies (1996 [currently recognized by the AMTA], see Appendix B)
list (A) Musical Foundations, (B) Clinical Foundations and (C) Music Therapy
Skills and Knowledge, as essential to the practice of music therapy at the
entry level. Of interest to this study are the competencies related to the
Therapeutic Relationship (B13). In particular, (813.1) “Recognize the impact
of one’s own feelings, attitudes and actions on the client in the therapy
process,” (B133) “Use oneself effectively in the therapist role in both
individual and group therapy e.g., appropriate self-disclosure, authenticity,
empathy, etc. toward affecting desirable behavioral outcomes.”

As mentioned above, I have described the process of developing a
disposition of expertise in music therapy as the expansion of the Self
(Milgram-Luterman, 1999). Inherent in this process is the development of self-

awareness. Yalom (1995) describes self-awareness as the discovery and

25

 

 

acceptance of previously unknown or unacceptable parts of one’s self and
cites it as important to clients’ growth in therapy. Loevinger (1976, 1987) and
Hy & Loevinger (1996) describe self-awareness as the middle level of ego
development that is the transition from the conformist stage to the
conscientious stage. An individual at this level demonstrates an increase in
self-understanding and begins to appreciate multiple possibilities and
alternatives in situations. However, this understanding is still dependent on
stereotypes rather than individual differences in traits and needs (Loevinger,
1976). The ego levels that succeed the self-aware level seem to be a
continuous journey of new awarenesses of the Self.

Loevinger’s concept of ego development is based on Sullivan’s (1953)
theory of ego stability that he describes as “anxiety gating” in which
maturation is motivated by an awareness of anxiety and the subsequent
movement to overcome that anxiety. Loevinger describes ego development
as a developmental sequence and a dimension of individual differences in
any age cohort. There is no ultimate stage but only an opening to new
possibilities at each new level. Her levels of ego development are (1)
Presocial Symbiotic, or the stage of the infant; (2) Impulsive, or the stage
where the young child is governed by her impulses and characterized by a
dualistic view of “good-guy/bad-guy;” (3) Self-Protective, where the impulsive
child is now aware of the existence of rules and is motivated by the concept of
not getting ‘caught;’ (4) Self-Aware, as described above; (5) Conscientious, in

which major elements of an adult conscience is present (long-term self-

26

 

evaluated goals and ideals, differentiated self-criticism, sense of
responsibility); (6) Individualistic as the transition from ‘Conscientious’ to
‘Autonomous,’ in which moralism is replaced by an awareness of inner
conflict, but only as partly internal. New awarenesses in this level appear as
the discrepancies between inner reality and outward appearances, between
psychological and physiological responses and between process and
outcome. Within this level, psychological causality and development are
natural modes of thought; (7) Autonomous, in which the person has the
capacity to acknowledge and to cope with inner conflict in the form of and
between conflicting needs and duties. The final level is the Integrated level in
which there is a transcendence of the conflicts identified in the previous level
and the consolidation of a sense of identity. This level is rarely attained and
can be likened to Maslow’s (1954) Self-Actualizing stage of development.
Yalom (1995) identifies self-awareness or self-knowledge as one of
twelve therapeutic factors for group members. Magden and Shostrom (1974)
developed a rating sheet for groups that examined Yalom’s (1975) eight
dimensions of group effectiveness: (a) catharsis, (b) group as a second
family, (0) awareness, (d) group cohesiveness, (e) receiving information, (f)
imitative behavior, (9) faith in the process and (h) giving and receiving help.
Yalom also listed universality and altruism as important in the group process.
Subsequent to the development of the rating sheet, many researchers used

similar rating sheets in various forms to study particular group cultures.

27

 

Yalom (1975) listed twelve general categories that ranked in importance for
group members in group therapy:

Interpersonal input
Catharsis
Cohesiveness
Self-Understanding
Interpersonal output
Existential factors
Universality
lnstillation of hepe

. Altruism

10. Family reenactment
1 1 . Guidance

12. Identification

‘PP‘INP’P‘PP’NT‘

In an early study of personal growth groups Lieberman, Yalom and Miles
(1973) found that group members selected interpersonal input, self-
understanding and catharsis as the most valued.

More recently, Yalom (1995) organized the group therapeutic
experience into eleven primary factors that vary in importance depending on
the type of group, the members and the leadership:

lnstillation of hope

Universality

lmparting information

Altruism

The corrective recapitulation of the primary family group

Development of socializing techniques

lmitative behavior

Interpersonal learning

Group cohesiveness

Catharsis

Existential factors
Although this list does not list self-understanding or awareness as a curative

element, it seems that self-awareness is a necessary factor to each element.

It addresses the existential question of “who am I?” Yalom (1995) believes

28

 

that self-understanding promotes change by encouraging group members to
recognize, integrate and offer freedom of expression to previously unknown

or denied parts of themselves. He views this as liberating. However, he sees
therapeutic growth as more important than the pursuit of self-understanding.

If the therapist is to be effective in helping the client towards growth,
she must be self-aware. Yalom (1995) believes that “the therapist’s self-
knowledge plays a role in every aspect of therapy (p. 526).” If the therapist is
unable to recognize her own issues, motivations and fears and the impact
they have with the issues of her client then she will not be an effective
therapist. He cites life experience, supervision, co-therapy and video-
recording analysis as helpful feedback for the student therapist to identify new
awarenesses. However, he suggests personal psychotherapy and/or training
group experiences as necessary for deeper understanding and growth.

The capacity for self-awareness is the first of six basic dimensions of
the human condition described in Corey’s (1996) interpretation of key
concepts of the existential approach to therapy.

As human beings we can reflect and make choices because we are

capable of self-awareness. The greater our awareness, the greater our

possibilities for freedom. Thus, to expand our awareness is to increase

our capacity to live fully. (p. 173)

Experiential Music Therapy Training

Tims (1989) proposes that experiential learning is a necessary

component of contemporary undergraduate curriculum to prepare students for

modern practice and that music therapy students must be active learners. He

suggests participation in music psychotherapy groups —~organized as a

29

 

separate entity from academic classes - as a way to help music therapy
students to increase self-awareness and grapple with personal issues, as well
as explore their connections with music in therapy. He believes that the
academic setting is an appropriate venue for personal growth.

Bruscia (1998) defined the concept of experiential music therapy
training. He describes it as an augmentative, didactic growth oriented
practice. Didactic practice is one area of music therapy practice. The other
five areas of practice are medical, healing, psychotherapeutic, recreational
and ecological practices. Didactic practice refers to the therapist helping
clients to “gain knowledge, behaviors, and skills needed for functional,
independent living, and social adaptation” (p. 175). This implies that learning
is a function of the process, as in using music therapy experiences with a goal
towards educating, training, and supervising students and practicing
therapists.

Augmentative is the term that Bruscia uses for the second of four
levels of practice, where a level “describes the breadth, depth, and
significance of therapeutic intervention and change accomplished through
music and music therapy” (p. 162-163). Augmentative practice is supportive
in which the music therapy takes on a supportive role. This does not imply
that music therapy treatment is not important at this level. It does imply that
music used as therapy is a unique enhancement to the client’s overall

treatment.

30

Augmentative practice is not auxiliary (the first level) in that the goals
are therapeutic in nature. It is not intensive (the third level) in that the therapy
is not central to the client’s major treatment goals. Finally, augmentative
practice is not primary (the fourth level), in that it is not the singular
therapeutic intervention that facilitates changes in the client’s life.

Experiential music therapy training is usually considered augmentative
practice because it does not replace other types of therapy or healing that the
client - in this case the student — may be involved in. The students are
participating in the group as actual clients representing themselves and not
role-playing as they would in class. There are goals and objectives that are
formulated with the needs of the group-members in mind, and the
interventions are carefully planned in a meaningful sequence.

Bruscia makes the distinction between therapy and growth, in which
the latter refers to self-improvement and self-actualization and the focus is not
necessarily on health issues. Also, a growth situation may or may not involve
a therapist as facilitator, and the relationships formed are not therapeutic in
nature. He limits the particular goal area to personal growth that meets the
educational and personal needs of the students. He does not indicate any
other goal area such as interpersonal: peer-support or physiological:
relaxation/stress reduction.

Although he does not discuss the reason, Bruscia points out that there
are usually set boundaries regarding the depth of the therapeutic process

within experiential music therapy groups. Self-disclosure of significant

31

personal issues is not a requirement, and the facilitator does not generally
attend to them within the group session. If and when an issue arises that is
beyond the limitations of the group, the particular student is directed to seek
outside counseling or psychotherapy. Bruscia’s discussion of experiential
music therapy groups is based on the limited existing literature on the subject.

Corey and Corey (1997) differentiate group counseling from group
therapy. Group therapy is generally for people who seek to alleviate
psychological problems, such as depression or anxiety, and is considered
remedial treatment rather then developmental or preventive. The methods
used are designed to encourage regression to childhood experiences, work
within the unconscious realm and help group members to relive traumatic
situations for the purposes of catharsis.

The particular problems found in a counseling group typically focus on
personal, educational, social or vocational areas and are organized in
schools, university counseling centers and community mental-health clinics
with relatively healthy individuals. The goal of counseling groups is typically
personal growth and the group usually determines the focus.

In a scholarly paper Hesser (1985) presents her own philosophy of
teaching music therapy and describes a graduate music therapy program in
relation to that philosophy. Her philosophy seems to reflect a collaborative
learning environment, although she does not use the term. She views the

development of music therapists as a life-long, in-depth process and

32

describes the environment of the university setting as an immersion into the
world of music therapy.

Our community believes that continued growth - psychological,

physical, mental, and spiritual - is essential for a good therapist. We

see our lives as journies of personal growth and change and believe
that only in this way can we help others in their journies and with their

problems. (p. 68)

Hesser believes that opportunities for personal growth should be
included in the academic program, including opportunities for self-exploration
and that students must perceive peers as supportive rather than competitive.
Each student’s education should address his or her particular strengths and
needs and instructors should be instrumental in assessing students’ strengths
and needs as well as facilitating the process of growth. Music making
amongst peers is an integral part of the process of learning to be a music
therapist. It seems that Hesser’s philosophy of music therapy education and
training parallels the music therapy relationship and process.

Hesser describes her program as advanced-level music therapy
training that serves only graduate students. She views entry-level graduates
of Bachelor programs as beginners who work at the adjunctive level
(Bruscia’s auxiliary level) with a limited scope of practice and “unable to
practice in-depth” (p. 67).

Hesser cites three stages to her graduate music therapy program. She

includes the experiential music therapy group along with music therapy,

music and psychology coursework in all three stages. The content and

33

context of these experiences develops with the needs of the students. Clinical
training also follows a developmental path from observation to practice.

Participation in what Hesser calls the “music therapy group” facilitated
by a trained music therapist begins in the first stage. It is an integral aspect of
this stage because students are just beginning to understand the concept of
self-growth on a deeper level. Hesser attributes much of the personal growth
within this stage to the group. “Music therapy groups can significantly change
a student’s insights into the process and power of music therapy” (p. 71 ). My
study sought to explore this phenomenon in terms of undergraduate
educafion.

Personal growth groups continue into Hesser’s Stage II with an
emphasis on the identification of issues including perceived limits and blocks
regarding working with the problems and needs of clients. Hesser’s program
involves selecting a specialized population within this stage where all of the
clinical practice for a specific student will be with the client population that he
or she chooses. The intermingling of personal and professional issues may
surface during this process. “Since music therapy group continues during this
very important Stage, the student begins to understand the process of music
therapy in a much more meaningful way because of his or her own personal
experience” (p. 71).

Hesser’s Stage III is intended to help the student to develop his or her
personal style. There is no mention of a group experience during this stage.

However, the supervision relationship is mentioned as an opportunity to

34

encourage “a relationship in which the student can deeply explore personal
issues which arise in the clinical work” (p. 72). Although this article provides a
philosophical context and briefly describes the coursework, group work and
supervision experiences, there is no attention given to process.

Bruscia (1987a) describes Adult lmprovisational Music Therapy (AIMT)
as an approach to psychotherapy developed by Stephens (1987). Stephens
initiated AIMT in the early 1970’s in a psychiatric institution and continues to
practice it in private practice and for student training and professional
supervision in music therapy. In general, the goals of AIMT are the expansion
of self-awareness and self-understanding, the opening of blocked self-
expression, the expansion of coping skills, the acceptance of creativity into
their lives, and the discovery of self-healing capacities. Goals specific to
music therapy training also include the expansion of musical sensitivity and
the development of an awareness and understanding of others’ musical and
nonverbal expressions.

AIMT has three stages of process. The first is developing a connection
through playing music and discussion. The second is finding connections in
the group members’ experience with various aspects of their lives. Here the
music, silence and discussions may lead to self-healing. There is a
connection between group members and therapist that allows the music
improvisations to lead them towards change. The last stage is the
development of autonomy, in which the specific goal is to help the client to

discover and continue to discover new awarenesses. Each session proceeds

35

 

 

from a musical warm-up to a verbal discussion. This is followed by a music
improvisation intervention and discussion and ends with an appropriate
closure.

Stephens (1987) describes the music therapy group as a method of
training at New York University that Hesser (1985) refers to in the article
mentioned above. Stephens justifies the experiential music therapy group as
a method of training and supervision within a music therapy program. She
cites the complexity and unpredictability of the process of music therapy, the
power of the music, the individuality of the clients and therapists as typical
challenges for music therapy students. V\fith that in mind, she views the group
sessions as an opportunity for students to experience music therapy for
themselves resulting in improved empathy. Her approach is derived from
Adult lmprovisational Music Therapy (Bruscia, 1987) described above.

In order to learn the ‘ways’ of music in therapy, the music therapist

must experience in an intimate manner, not only the elements of music

but also the therapy process that emerges through and with them.

(Stephens, p. 169)

Stephens mentions two types of experiential music therapy groups
possible within an academic setting: the training group and the Supervision
group. The supervision group is more clinically and professionally oriented
then the training group. However, both types of groups can be experiential in
nature. For the purposes of the present study, only the information pertaining
to the training group will be discussed.

The training group as experiential music therapy can “enrich learning

and bring a more mature vision to the student in training” (p. 169). Although

36

Stephens recommends that training groups best serve the graduate student,
she mentions that it may be possible for mature undergraduates to
participate. She also recommends that the group parallel coursework and
training so that there is opportunity to integrate the learning into the
knowledge base. Group members who receive personal therapy during their
tenure in the training group fare better, giving them an outlet for more
personal in-depth exploration of issues that surface during the group
sessions.

The training group meets weekly for one-hour sessions throughout the
course of each semester and the facilitator attempts to keep the membership
and leadership constant for purposes of continuity. Appropriate boundaries
must be respected in terms of the limited amount of meeting times. There are
usually six to eight members in the group according to class size. Group
members keep logs describing their experiences that is initially more
structured" and later has a more open format. V\fithin the log, they describe
interventions, musical development and growth and their interpretations and
reflections of the meaning of what transpires. The facilitator reviews the logs
and provides the group members with feedback. Group members also write
summaries two times per semester.

The content of group sessions is briefly described as having a ‘here-
and-now’ focus, as is the case in most process groups. The issue of
boundaries between learning and personal exploration is the responsibility of

the facilitator. The media used is common music therapy instruments

37

(percussion, melodic-percussion, voice, guitar and piano) that offer
opportunities for improvisation and less threatening opportunities for self-
expression.

The only music therapy technique described by Stephens is
improvisation. Stephens believes that improvisation is the best means of
musical self—expression and interaction. The improvisation is initiated either
by group members or the facilitator and is based on a theme or issue.
Improvisations may be processed verbally, musically, verbally and then
musically or musically and then verbally. The primary focus is on the process,
which develops through typical group stages. The goal is delimited as offering
students personal, first-hand experience with the process of music therapy
through musical and verbal modes.

Priestly’s (1975,1994) Analytical Music Therapy (AMT) is an advanced
insight oriented therapy that originated in the 1970’s in Britain (Bruscia, 1987).
It is described as the “analytically-informed symbolic use of improvised music
by the music therapist and client” (1994, p. 3). The training involves the
trainee as client of an experienced analytical music therapist. In this situation,
the trainee learns about the process of AMT and has the opportunity to
explore his or her own issues and responses to the music and AMT. This part
of the training is experienced as individual therapy, and the trainee may need
anywhere from twenty to one hundred and twenty such sessions.

The second part of the AMT training is known as lntertherapy. Bruscia

(1987a) reports that Priestly applied her lntertherapy approach to the training,

38

 

 

 

 

personal development and supervision of music therapy students and
professionals. Trainees or other students work in dyads with a supervisor and
practice analytical music therapy with each other. This experience is intended
to provide opportunities to examine the personal issues involved in being a
music therapist.

A larger lntertherapy group experience provides group members with
opportunities identify and explore individual and group issues. The process
begins when a group member offers an issue to discuss. The therapist
formulates a title and assigns group members specific roles to improvise.
Role relationships are explored through the resulting improvisation.

Like Analytic Music Therapy, the Bonny Method of Guided Imagery
and Music (GIM) is an advanced music therapy model (Bonny, 1978). Unlike
any of the other models and interventions described above, GIM therapists do
not use improvisation. Clients listen to classical music as prescribed by the
therapist in a relaxed state of mind and body with the purposes of evoking
imagery. The major goal is self-actualization. The goals of GIM are generally
the development of self-understanding and spiritual insight.

Clark (1987) describes a specific program that has evolved for training
in Guided Imagery and Music that resembles the process of GIM. The training
ultimately results in the trainee becoming a Fellow of GIM. The training
involves personal experience as a client, practice sessions, readings, lectures
of case studies and demonstrations to learn about the process and eventually

practice the craft.

39

 

There are three phases that provide a developmental evolution to the
learning. Of interest to the present study is the residential intensive training
seminars. Among the many training techniques used to teach students to
adopt the skills and knowledge necessary to practice is the environment of
peer support as well as nurturing from the trainers. “The didactic and the
experiential components weave together throughout the GIM training,
providing a rich fabric of information for the GIM student” (p. 192).

Clark reports that in 1987 GIM training was offered in two graduate
music therapy programs as well as through various non-academic institutes
throughout North America. She states that the training is intended for mature
students with more clinical or life experience because of the depth work
involved. However, undergraduate students and entry-level music therapy
practitioners have participated in introductory sessions.

Experiential Music Therapy Case Studies
Scheiby (1991) defines her concept of “training-therapy” as an essential
part of educating master’s level music therapy students. She describes the
goals of this experiential music therapy work — both group and individual as
an opportunity

to enable the student to experience the deepest potential of music

therapy in addressing childhood traumas and other formative

experiences crucial to the development of the personality, as well as
more current personal issues; to provide the student with a deep
understanding of the meaning of a client-therapist relationship in music
therapy; to help the student discover the different ways music can be
used as a tool in therapy; to reveal “blind spots” in students’ self-
awareness; and to help the student develop his/her own musical

language, along with a framework for making musical and verbal
interventions. (p. 273)

40

The work that she describes in this individual case study is with a music
therapy student in training. Scheiby was a student of Priestly and describes
her music therapy as psychodynamically based, using free improvisation in
the spirit of Priestly’s Analytic Music Therapy (described above). The writer as
therapist/teacher identified areas of growth in the realms of personal issues,
ability to use music for self-expression and clinical skills.

The client/student was described as a 27-year old woman with some
personal issues (particularly her relationship with her boyfriend) and physical
problems (due to an abortion) which did not appear to interfere with her
academic achievement and daily life. She selected Scheiby as her therapist
for this required treatment because they had a good prior relationship as
student/supervisor.

The client/student’s personal diary, improvisations, compositions, body
language and verbalizations were used to evaluate her development. The
twenty-two sessions were organized into twelve phases of treatment process
that began with exploration, moved through new awarenesses regarding her
musical and feminine self, coming into contact with her own resources and
finally accepting the challenges of personal and professional growth yet to
come. Scheiby believes that students who undergo music therapy as part of
their training “can serve not only as a place for personal development but also
as an experiential laboratory for gaining the insights and skills essential to

becoming an effective music therapist.” (p. 290)

41

Arnason (1998) studied the process of five professional music therapists
in a series of music therapy improvisation group sessions that she facilitated.
She used descriptive and interpretive analysis as the means for discovering
meaningful and creative aspects of the improvisational experience that
emerged from the group members’ and her experience. Results included the
interpretation of the significant connections between musical improvisations
and the use of art as metaphor. Although her initial intention for her study was
to focus on the musical experience, the evolution of the group allowed her to
expand the study to include important aspects of the group process and
dynamics.

Arnason’s findings were described in narrative, poetry, songs and
artwork and interpreted through the researcher’s reflections. The story of the
group process and the researcher’s thoughts and feelings were used to report
the findings. Arnason concluded that both the musical improvisations and the
group process were helpful to the participants and to her self. She believes
that implementation of music therapy groups for practicing music therapists is
an important concept for the field of music therapy.

Bird, Merrill, Mohan, Summers and Woodward (1999) describe their
experiences as members of a music-centered peer supervision group over a
span of four years. The group was an outgrowth of a music therapy training
group that they were involved in as graduate students. They hired an outside
consultant, but the sessions were leaderless. They rotated various leadership

responsibilities. They described a basic structure to the session organized

42

according to the designated leader that included a “grounding,” a “check-in”
and a musical experience.

The goals of their group were personal and professional growth and
they found that the process led to “an increase in professional self esteem,
clarity about their workplace roles, and a stronger sense of their clinical
strengths” (p. 64). They identified the musical environment and the support of
their peers as the vehicle for their growth.

Skills and Qualities of the Group Facilitator

Toseland and Rivas (1984) listed three classifications of group
leadership skills: (a) facilitating group processes, (b) data gathering and
assessment and (0) action. Of interest to this study are the skills listed as
facilitating group processes: (1) attending to others, (2) expressing self, (3)

‘ responding to others, (4) focusing group communication, (5) guiding group
interaction, and (6) involving group members in the communication pattern.

Attending skills refer to the ways that the facilitator is present with
group members, both physically and psychologically. Group facilitators should
be able to help group members to express their thoughts and feelings freely.
Toseland and Rivas believe that facilitator self-disclosure, used appropriately,
may be helpful toward group member freedom of expression.

Responding skills refer to selectively supporting, amplifying or toning
down specific group members’ responses. Focusing skills include clarifying,
repeating or limiting group members’ responses to encourage exploration of

issues and problems. Guiding group interactions refers to redirecting, such as

43

limiting or blocking certain communications or encouraging group members to
speak or connect with another member. Involving group members refers to
the act of facilitating interest in a specific member’s issues for the purposes of
the other members’ identification with that issue, that member’s process and
solution.

Aveline cites five tasks of the leader of brief training groups for mental
health care professionals:

(1) contain the anxieties of the group, (2) quickly establish a

therapeutic atmosphere in the group, (3) guide the group toward issues

that can be addressed in the time available, (4) guard against
damaging self-disclosure and loss of self-esteem, and (5) help the

group and well. (p. 197)

Corey and Corey (1997) believe that the personality of the leader
influences the success or failure of a group. They list important personal
characteristics of an effective group leader: (a) courage, (b) willingness to
model, (c) presence, (d) goodwill and caring, (e) belief in group process, (f)
openness, (g) becoming aware of your own culture, (h) nondefensiveness in
coping with attacks, (i) personal power, (j) stamina, (k) willingness to seek
new experiences, (I) self-awareness, (m) sense of humor, (n) inventiveness
and (0) personal dedication and commitment.

Borczon (1997) cites the music along with the music therapist’s
qualities of presence, intuition, knowledge and common sense as the

elements of successful group music therapy. He suggests that music

therapists ask themselves how well they read the client’s nonverbal behaviors

44

and examine how they modify what the client or group member is saying
verbally.
Conclusions

The review of literature in the areas of undergraduate music therapy
education and training, self-awareness and experiential music therapy
training supports the need for personal growth in music therapy education
and training. The review of literature pertaining to experiential music therapy
training finds research that is theoretical in nature. Only two studies (Arnason,
1998 and Bird, Merrill, Mohan, Summers and Woodward, 1999) provide the
reader with insight into the experience from the participants’ perspectives
(group member and/or facilitator). Both groups are comprised of professional
music therapists. None of the cited studies address the needs of
undergraduate students. This study seeks to address the specific needs of
undergraduate students and group experiences that may be helpful in
addressing those needs.

The final topic of literature in this review considered the qualities of
group leaders. As the facilitator of the group being studied, I waited to review
this literature area until the data collection was complete. Patton (1990) views
the review of literature as an emerging process when he states,

reviewing literature can present a quandary in qualitative inquiry

because it may bias the researcher’s thinking and reduce openness to

whatever emerges in the field. Thus a literature review may not take
place until after data collection. Alternatively, the literature review may
go on simultaneously with fieldwork, permitting a creative interplay

among the processes of data collection, literature review, and
researcher introspection. (p. 163)

45

l have realized over the years that although I possess the personal
qualities necessary to facilitate music therapy groups for intellectually
challenged clients, I have not had enough training or experience as a group-
facilitator with cognitively intact people. This has been an issue for me as l
have challenged myself to facilitate groups with physically disabled adults and
university students. Perhaps I have blocked my ability to recognize my own
leadership qualities in support groups over the years because I did not
perceive them to be true music therapy skills. Perhaps not reviewing the
material as preparation for the group work was part of that block.

I chose to view this study as a challenge to my own development as
both music therapist and music therapy educator and ultimately to define the
specific qualities needed to facilitate a MTPSG. As will be evident in Chapter
7, l have learned a lot and further developed my skills as a result of the group
experience, clinical supervision and my own reflections on the process
integrated with this review of the most current information on training groups

and group facilitation.

46

 

CHAPTER THREE

METHODOLOGY

The purpose of this study was to examine the phenomena of a music
therapy peer-support group within the context of music therapy
undergraduate students’ penultimate semester. I organized and facilitated ten
music therapy peer-support sessions for the group during a Fall Semester at
Michigan State University (MSU). This study sought to interpret group
members’ verbal and musical responses, examine group members’
interactions, gain insight into the process from the students’ perspective, and
explore the development of the skills of the facilitator. These phenomena
were examined through music therapy peer support group participation and
observations, participant interviews, participant journals, the researcher’s log,
feedback from a clinical supervisor and interviews with the professor who was
currently interacting with the participants. The scores from a measure of self-
awareness were intended to be included as data but were not used in the
analysis.

Pilot Study

In the fall semester of 1998 I conducted a pilot study to investigate the
experience of MTPSG from group members’ perspectives. I interviewed four
music therapy students and two graduates of an undergraduate program who

had been or were attending a MTPSG that I had facilitated. Four major

47

themes regarding the benefits of the experience emerged: (1) New
understandings about music therapy clients; (2) personal and professional
growth; (3) improved relationships with peers (connection rather than
competition); and (4) a time and place to relax. The pilot study served as my
first opportunity to reflect on the concept of music therapy peer-support
groups. Previous to that, I had no idea as to how the group members had
perceived the experience.

In preparation for the present study, I reviewed the data once again. The
conclusions discussed below represent my reflections on that data. As I
looked back I realized that all six interviewees described benefits of having
participated in a MTPSG and spoke of integrating these benefits into their
lives as music therapy students, interns and/or clinicians.

I selected the interviewees so as to provide insight from several
different perspectives. The two interviewees who had been members of my
first peer-support group and had just completed their internships at the time of
the interviews reported the benefits after the experience itself in terms of how
it influenced their internship experiences. I learned that they had continued to
support each other, along with several of the other group members
throughout their internships and beyond. Those group members with
internship sites that were in close proximity to the university organized weekly
MTPSG. Those who trained further away kept in contact with the group
through e-mail chats. They reported that peer-support contributed to

successful internship experiences. This was a meaningful finding for me as I

48

 

remembered my own internship experience as lonely and difficult without
peers for support. They also reported that they would continue to seek out
peer support throughout their professional careers.

The two interviewees who had participated in a MTPSG previously and
were currently participating as second year seniors seemed to demonstrate
increased levels of insight since their first experience. They had become
leaders within the current group and seemed more self-aware. The remaining
two interviewees were new to the experience and used the interview to
disclose personal issues that they had not yet shared with the group. It was
apparent that, although the group experience had inspired them to begin to
develop new awarenesses, they were reluctant at that time to share their new
insights with their peers.

My review of the pilot study findings inspired me to reflect on my own
experience as facilitator. My new awareness was that experience in a
MTPSG could contribute to undergraduate music therapy student
development, but I was unclear as to what my role had been in the process. I
became increasingly interested in my own process and the phenomena of the
entire experience.

The idea for the current study was born out of my desire to examine
the importance of MTPSG for developing a disposition of expertise in music
therapy students and my curiosity about group-members’ processes. I also

recognized the prospect of studying the phenomena of the group as an

49

 

opportunity to examine and further develop my own skills and knowledge as
clinician and teacher.

The eight research questions posed in Chapter 1 of this study
emerged, in part, from the pilot study. The questions center around two main
themes: (1) the participants’ experience in and resultant effects of the group,
and (2) my own process and growth as both researcher and facilitator of the
group.

Study Participants

The study participants included the music therapy seniors from MSU
who volunteered to attend the MTPSG, their professor (my employer), my
clinical supervisor and me. Recruitment for the study was simplified by my
role as graduate assistant at MSU. Prospective participants were curious
about the concept and expressed an interest in supporting my research.
Senior Music Therapy Students

Eleven senior music therapy students were enrolled in the core music
therapy course “Music Therapy: Mental and Behavioral Disabilities” (see
Appendix C). All volunteered to participate in the group and the study.
However, scheduling the sessions was difficult due to senior music therapy
students’ heavy academic, clinical and work responsibilities. The time slot that
was selected was available to all but one student because of a conflict in his
work schedule. Therefore, there were eleven senior music therapy students

participating as group members in the MTPSG.

50

 

For the purposes of confidentiality, I selected pseudonyms for group
members. Of the eleven participants, three were male: Brad, Jack and Peter.
The female participants were Betty, Ellen, Hannah, Helen, Mary, Nancy, Sally
and Tina. Most participants were in their early twenties, except for one
woman who was in her late twenties and one man who was in his thirties.

The students of this senior class were identified as prospective
participants because in previous years the peer-support group that l facilitated
was assigned as a required activity for the senior music therapy core course.
However, because this group was to be the focus of my research project, the
students were given the choice as to whether they would participate or not.
Senior students at this university are just beginning their clinical placements
during this semester.

Student clinical placements began during the semester selected for
this study as students were assigned first and second (out of three)
supervised placements at the on-site music therapy clinic at the University.
This new challenge typically has many implications for the need for peer-
support. Four of the eleven objectives outlined on the senior core music
therapy course outline seem to relate to the peer-support group environment
(see Appendix D).

. To encourage greater other and self-awareness through didactic
and experiential introductions to the basics of individual and
group music therapy.

. To encourage assuming responsibility for one’s own behavior.

To explore and practice group and individual music therapy
strategies for adults.

51

 

. To provide role-playing experiences both of doing music
therapy in a variety of situations and being “done unto” by music

therapy. (p. 1)

My intention was that participation in the MTPSG allowed senior music
therapy students the opportunity to work toward these goals in an
environment that is a separate entity from the classroom. There are no
grades for the MTPSG resulting in more opportunity for healthy disclosure
and reflection. Whereas classroom practice sessions and role-playing
opportunities serve the purposes of learning skills and concepts, peer-support
is oriented towards self-discovery and self-reflection.

Clinical supervisor

I secured the services of a music therapist to serve as my clinical
supervisor for this study. Ms. Williams (pseudonym) is a music therapy
clinician, part-time instructor and clinical supervisor who is not affiliated with
this university. She is a Fellow of Guided Imagery in Music (GIM) and my
therapist as a requisite for my own training in GIM. Her area of expertise is
adult mental health.

I met with Ms. \Mlliams three times and we had three phone meetings
over the course of the research semester. My reflections from the supervision
were recorded in my own journal. Entries from my own journal served as the
data that evolved from our supervision meetings and were analyzed using
document analysis techniques. During the analysis phase, I met Ms. Williams
two times and had two telephone meetings. During meetings we listened to

the session tapes for the purposes of supervision and analysis.

52

 

Professor of Music Therapy

Professor Smith (pseudonym), the instructor of the senior music therapy
core course is a music therapist who has been teaching at MSU for over
twenty years. In fact, he was my professor when I was an undergraduate
music therapy student. This professor is also the director of clinical services
at MSU and I was serving as his assistant before, during and after the
research semester. As such, we had the opportunity to reflect on the progress
of the participants both formally and informally.

Professor Smith participated in two interviews exploring his observations
of the students regarding changes in skill and knowledge development over
the course of the Fall Semester. During these interviews, we discussed how
to integrate the MTPSG into the group supervision meetings required of
seniors each Spring Semester. We developed a new type of supervision that
we named Peer Supervision, and co-facilitated that group during the Spring
Semester.

Myself as Partflpant

“In clinical work, there is action and reflection; in clinical research,
there is an added perspective or metareflection” (Bruscia, 1995, p. 22). In that
I served as both facilitator and researcher, l was also a participant of this
study. In this sense, I consider this study to be action research, in that l was
working directly with the group members as facilitator and I was observing my

work as it happened to further inform my skill as both a clinician and an

53

 

instructor. I also studied my observations of my work as facilitator for research
purposes.

It seemed natural for me to engage in this study as action researcher,
because of my strong commitment to the inclusion of personal growth
experiences into the undergraduate music therapy curriculum. I had already
implemented and facilitated MTPSGs at MSU as part of my graduate
assistantship, and l was an active member of the music therapy community.
My position as assistant administrator of clinical services allowed me insight
into the concerns of both music therapy educators and students.

Research Site

The study took place at MSU, a university that is well known for its
music therapy program. It has an on-site clinic where undergraduate
students have the opportunity to observe professional music therapists and
students at work, assist and eventually work with clients. Faculty and
graduate assistants who are all Board Certified Music Therapists (MT-BC)
provide clinical supervision.

The MTPSG took place in the largest treatment room of this on-site
clinic. l secured the space through careful scheduling in my capacity as
assistant administrator of the clinic. The treatment area measured 14 feet by
14 feet and was carpeted. The space was somewhat small for twelve adults
and so we sat on the floor in an informal manner. Group members often

chose to lean against the walls or lie down when they so desired.

54

 

This space was convenient for several reasons. It was located in the
basement of one of the music buildings so it provided easy access between
classes. Music therapy instruments and materials were readily accessible in
the attached observation/office area. There was a piano, a stereo system, a
blackboard and a “write-on” board. Although the treatment area is traditionally
accessible to observers in the observation/office area, privacy was attained
by careful scheduling and posting a “keep out” sign. Finally, prospective
participants were familiar with the space.

Design/Data Collection Devices
M_us_ic Therapy Peer Support Group Observations

As I was immersed in the session process as facilitator, each peer support
group session was audio taped and/or video taped. An orientation meeting
was held for one half hour before the first session, to describe the study,
administer the Washington University Sentence Completion (see page 58 “A
Measure of Self-awareness), discuss issues of confidentiality and collect
letters of consent.

The orientation meeting was not taped, but the short session that followed
that and all subsequent sessions were audio and video taped. All ten
sessions including the orientation were held on Tuesday evenings throughout
the semester from 7:45 pm. to 9:00. There were eight consecutive sessions
followed by a two-week break and concluding with two consecutive sessions.

The final session took place during the last week of classes.

55

Individual Student Interviews

I interviewed each of the eleven group participants once during the study,
using a ‘micro-cassette’ audio tape recorder. Interview protocols (see
Appendix D) were developed after several sessions so that data collected
through my logs could contribute to the interview process. I hired the services
of a secretarial service to transcribe the tapes verbatim. They provided me
with hard copies and floppy disk copies.

Group Interviews

A second interview occurred in the form of a focus group during the last
week of classes of the spring semester, one full semester after the research
semester. Due to scheduling conflicts, the focus group was divided into two
sub-groups. The first focus group session was attended by eight group
members and a second focus group was attended by two group members
including one who had dropped out of the music therapy program at the end
of the research semester. The remaining group member was more difficult to
schedule and did not participate in a focus group interview.

Although the individual interviews served to provide insight into group
members’ experiences, they were also intended to provide group members
with opportunities for self-reflection and disclosure. The focus group
interviews served to clarify points made during first interviews. Both focus
group interviews were audio taped and transcribed verbatim as above.

Student Journals

56

All 11 participants were asked to keep a journal for reflecting on their
experiences, observations and reflections as group members. I requested
(but did not require) group members to share their journal reflections with me.
One group member (Sally) kept reflective responses and e-mailed them to me
after each session. Three group members provided one or two reflective
responses mostly during the beginning of the semester. I imported e-mailed
journal entries and transcribed handwritten journal entries onto a Microsoft
Word file within my dissertation folder.

Researcher’s Log

l maintained a log of all relevant observations, interactions and personal
reflections before, between and/or after, group sessions. I typed the log
directly into a file that was kept in my Microsoft Word dissertation folder.

A Measure of Self-awareness

The proposal for this study included the use of the Washington University
Sentence Completion Test (Hy & Loevinger, 1996) was administered before
and after the series of ten sessions. The test was developed by Jane
Loevinger and based on Sullivan’s (1953) theory of ego development, as
discussed in the previous chapter. It is a free-response, semi-projective
instrument that was developed to assess ego-development level. The results
designate an Ego Level score (E-Level) based on Loevinger’s stages of ego
development (1976).

Although originally proposed as data for this study, I found that the

implementation of the test conflicted with my worldviews specific to my work

57

 

 

as a music therapist and to my role as a researcher. As a facilitator with a
humanistic/existential perspective, I was concerned that the test would
interfere with the natural process of the MTPSG work. As a researcher with a
heurmaneutic/phenomenological/symbolic interactionist perspective, I was
concerned with the effect that the implementation of the test would have on
my findings. I felt the test to be an imposition on me, the group members and
on the process. Ego-development is a life-long journey and thus more
appropriate to be measured in the context of a longitudinal study.

Although results of the test were not used as data for the study,
responses were coded and rated by Ms. Williams and I four months after the
ten sessions were completed so that this information would not infect the
natural process of the group. It must be recognized that the implementation of
the test during the first and last MTPSG meetings may have influenced the
experience for the group members. Participation in the test may have
facilitated a change in their self-awareness. Conversely, I not believe that the
scoring of the test influenced the results due to the confidentiality of the
analysis.

Interpersonal Aspects of the Research

My role as researcher was to observe the process of the group. My
role as facilitator was to provide an environment of musical and verbal
process interventions within which group-members may experience the
process of peer-support and personal growth. My goal as participant was to

further develop my clinical and teaching skills.

58

The role of the senior music therapy student participants was to agree
to be observed within the process of the MTPSG, to participate in interviews
as well as participate in providing data through journal writing and the
Sentence Completion Test. The role of the clinical supervisor was to provide
clinical supervision regarding the researcher’s clinical and teaching skills
within the group as well as rate the Sentence Completion Tests. The role of
the professor of MUS 470 was to participate in interviews regarding possible
changes in students’ participation in class.

Chronology

The following chart provides a chronology of the data collection
including the sessions themselves with the themes and type of intervention.
Mid September: Confirmed human subject’s consent

letter approval (See Appendix F);
recruited participants and scheduled
session meetings.

September 21: Session #1: Orientation, Sentence

 

Completion Test and mini-session:
What is the work? And individual
goal setting.

September 28: Session #2: Issues of spirituality and
“Opening to the experience”

improvisation

59

October 5:

 

October 12:

 

October 1 9:

 

October 22:

 

October 26:

 

October 27:

 

November 2:

 

November 9:

 

November 17 — 21:

November 23:

 

 

November 27:

 

November 29:

 

November 30:

 

December 7:

 

Session #3: Affirmations through
songwriting

Session #4: The Journey - my song
Session #5: The Invitation — a poem
Meeting with Clinical Supervisor
Session #6: Drumming - support &
escape

Phone meeting with Clinical
Supervisor

Session #7: Shadow and Light —
imagery & music

Session #8: Honoring Each Other
Ceremony

Most participants attended the World
Congress of Music Therapy.

No group, break for Thanksgiving
Individual group members’ and
professor interviews

Meeting with Clinical Supervisor
Session #9: Dealing with our
fiudges"

Session #10: Termination &

Sentence Completion Test.

December 13: Meeting with clinical supervisor

 

 

December 16: Follow-up interview with professor

January through May Implementation of Peer Supervision
Group

January, February & March Interviews are transcribed verbatim

by a secretarial service

 

 

April 18 Focus group #1 (8 group members)
April 27 Focus group #2 (2 group members)
May Focus group interviews are

 

transcribed verbatim by a secretarial
service

May 15 Meeting with clinical supervisor

Ethical Review

There are potential conflicts of interest inherent in the situation of
researcher as therapist. As stated in the letter to Human Subjects Committee
(see Appendix E), participants “will be assured that this is a peer-support
group and not a therapy group” during their initial orientation and as part of
the process of the group work. The intention of this research study was to
describe, not infect the natural process. My clinical supervisor was
instrumental in helping me focus my intention to keep research goals from
interfering with session interventions.

There are potential conflicts of interest when participants are students.

During the initial orientation and consent and as part of the process of the

61

 

 

group work, it was made clear to the participants that there was no grade
attached to this particular experience. Furthermore, it was decided that I
would not serve as a clinical supervisor during the data collection semester so
that l was not responsible for evaluating participants.

As reported at the orientation, the possible benefits were cited as
opportunities for self-reflection, personal and professional growth, peer-
support and stress reduction.

Trustworthiness

Aigen (1995) believes that carrying out a research study in music
therapy is worth doing when its findings are both trustworthy and valuable to
music therapists. Trustworthiness in qualitative research is the credibility
(internal validity), transferability (external validity), dependability (reliability),
and confirmability (objectivity) of data collection and analysis and ultimately
the findings (Lincoln & Guba, 1985).

For the purposes of trustworthiness, I used the standards of prolonged
engagement and persistent observation to provide the scope and depth of my
experience at the research site as well as the techniques of triangulation,
member checking, peer debriefing and reflexive journals (Lincoln & Guba,
1985)

Prolonged engagement

The concept of prolonged engagement requires the researcher to

spend ample time in the research site to appreciate its cultural intricacies,

check for perceptual errors in information and gain the trust of the participants

62

(Aigen, 1995). My experience with the Music Therapy Clinic at this university
goes back twenty years when l was an undergraduate music therapy student
here. My subsequent experiences as a music therapist, music therapy
educator and music education masters student and then as a Ph.D. graduate
assistant back at MSU have provided me with opportunities to reflect on the
environment of the undergraduate music therapy student culture.

As undergraduate music therapy education is my research focus and a
large part of my responsibilities as a teaching assistant, I have taken every
opportunity to reminisce about my own experience as well as to study the
present environment. I have tried to be careful not to assume that these
students have the same perceptions of the experience as I do. In addition to
classroom instruction, clinical supervision, facilitating group supervision and
peer-support groups, I had attended some social functions hosted by the
campus Student Music Therapy Club and participated in two sessions as a
peer in a voluntary improvisation group. My informal and formal study of this
population before the onset of the research semester had attempted to reflect
each student’s unique perspective.

Although I had not taught this particular group, I had met them informally
at music therapy club social functions and during their required clinical
observation assignments as Juniors. It is important to note that l was not, in
any way, responsible for grading these students during the research

semester.

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Pepsistent observation

“Persistent observation allows a researcher to identify the most important
aspects of a given setting or course of therapy." (Aigen 1995, p. 306) My
desire to enhance the experience for undergraduate music therapy students
comes from my own experience as a music therapy student and my
fascination with collaborative learning and reflective practice. This has led me
to focus on what I perceive to be the most important aspects of the
educational environment. I am interested in an education that helps students
to construct their own meaning and develop self-awareness and insight.
These qualities may enhance learning (Milgram-Luterman, 1997). I view the
undergraduate experience as an important part of a whole education and thus
chose to study it in more depth.
Triangulation

Qualitative researchers use the practice of triangulation by collecting
different kinds of data and/or obtaining data from different sources for the
purposes of “a holistic picture of the phenomenon” (Bruscia, 1995, p. 408). In
this study, data collection triangulation was addressed through the use of
personal logs, session observations, participant journals and interviews,
interviews with the professor and clinical supervision.
Member checks

“This sharing of findings initiates a process in which researcher and
participant can explore areas of agreement and disagreement” (Aigen, p.

306). I used the focus group interviews as an opportunity to check my

64

 

 

analysis ideas and preliminary inferences with the group members. They
confirmed that one or two individual case studies, the process from their
perspective and the experience from my perspective were appropriate
analysis categories. I listened to participants’ feedback and took note of areas
of agreement and disagreement. “While it is ultimately the researcher’s
decision as to which findings are reported, it is important to consider and give
weight to the participants’ perspectives” (p. 306).

Peer debriefing

For the purposes of formulating new awarenesses about the research I
met with a peer. “Because these sessions can also involve a catharsis for the
researcher regarding feelings brought up by the research activity, we can see
a parallel with the supervision session typically engaged in by therapists”
(Aigen, p. 306). My clinical supervisor was helpful in the peer debriefing
process. I met with her for the purposes of reflecting on analysis, for
professional and personal support and to increase my own self-awareness
regarding clinical, ethical and research issues. Another opportunity for peer
debriefing was interviews with the professor of the senior music therapy core
course regarding students’ development of self-awareness.

In my capacity as administrative assistant to the clinical director, I
attended staff meetings during which supervisors (my peers) discussed the
progress of senior students’ clinical practice. As has been the case for past
peer-support groups, I was careful not to disclose any information that

students presented within the group process. I was grateful for this added

65

 

 

opportunity to listen to issues and progress of the members of the peer-
support group.
Reflexive ioumal

For the purposes of avoiding possible biases or preconceptions, this is a
“diary in which the researcher records personal feelings, intuitions, and
reactions to the research, as well as considerations that impact on
methodological decisions and interpretations of data” (Aigen, p. 306). I kept a
reflexive journal in much the same way that I use the subjective/interpretive

portion of clinical process notes as a music therapy clinician and supervisor.

66

CHAPTER IV
ANALYSIS
“Qualitative data analysis is a thorough examination of data in an effort

to establish meaning (Amir, 1996). As is common in qualitative research, I

had more data than I could analyze and I searched to find different ways to

organize it. By allowing several months between data collection and formal
analysis I came to the analysis with a fresh perspective.
The structure of the analysis included seven stages:

1. All interviews were taped by me and transcribed verbatim by a secretarial
service. I reviewed the transcripts and made some reflective observations
in my log.

2. All journal entries were downloaded into my hard-drive. I reviewed them
and made some reflective observations in my log.

3. All sessions had been taped. I reviewed the tapes and made some
reflective observations in my log.

4. I became more familiar with the data and three main themes emerged:

a. Group members reported new awarenesses.

b. Sally’s case intrigued me because of the contrast between her
articulate journals and her participation in MTPSG.

c. l was motivated to explore my qualities as facilitator because of group
members’ perceptions of my role and my reflections of my dissertation

committee’s feedback regarding therapy versus peer support.

67

5. l accessed the NUD*IST program, imported my data in the form of
interview transcripts and my log.

6. I began to code the imported data. I tried to organize the data into nodes
that reflected my realms of music therapy expertise (Milgram-Luterman,
1999) and sub-nodes of the three emerging themes: “Group,” “Sally" and
“Me.” This became confusing and I started again, this time with the nodes
as the three emerging themes and the sub-nodes for “Group” and “Sally”
as the realms of music therapy expertise.

7. I used my NUD*IST coding nodes, sub-nodes and sub-sub-nodes and
began to write. The writing became the sole analysis tool.

The analysis of this study was an ongoing process that began with my
own reflections as a result of my pilot study and ended with the last word
written in this dissertation. In the analysis phase I became obsessed with the
analysis, and wanted to organize yet more interviews. Many more questions
arose as the categories were formed.

This chapter describes the journey that I traveled to establish meaning
in this study. I began with the organization of the data, the creation of
categories and then subcategories and finding links between the data. Next,
there was the process of unifying and reshaping the categories. Three data
sets emerged: (1) Growth of the group (2) an individual case study, and (3)
my own growth. The analysis of these three emergent themes will be

presented in Chapters 5, 6 and 7.

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Organizing the Data

I listened to some of the tapes with my clinical supervisor during the
research semester. These experiences served as opportunities to reflect on
my skills as facilitator, the interventions, the topics covered and the process
for my own purposes as facilitator as well as analysis for the research. I
listened to the tapes again during the spring semester after the research
group ended several times.

All interview transcripts, journals and my personal logs of sessions and
observations were entered as separate subfolders into a folder in my
Microsoft Word processor. Within each of the former subfolders were files of
each interview or each journal entry. The review of my personal logs also
contributed to reflection on the experience of administering the measure of
self-awareness.

Once I had all the data organized in a folder on my hard-drive, I read
through all interview transcripts and reviewed several session tapes in order
to get a sense of what to cover in the focus group. After the focus group tape
was transcribed, I read through that transcript.

I then took some time to read through my dissertation proposal and all
of my documents and listen to some of the session tapes. I began to reflect
on the group members’ perceptions of the experience and integrate that
information. Three major themes began to emerge during this phase based

on the integration of my research questions and the data:

69

 

1. There were many more individual group members’ new awarenesses as a
result of participation in musical experiences and the whole process than I
thought. The MTPSG research group had a major impact on how group
supervision was organized and facilitated during the subsequent
semester. Focus group reflections that compared the experiences from
the two semesters revealed interesting insights into the benefits of the
MTPSG. See Chapter 5 for findings regarding group experiences and
group member processes.

2. Sally emerged as an interesting case study as she was the only one to
provide journals consistently and she was more articulate in her journals
than in the sessions. She was also more verbal in the spring semester
Peer Supervision group than during the research MTPSG. Her growth
emerged as a theme that I became curious about. I interviewed her one
more time during the summer, just before her internship was to begin. See
Chapter 6 for findings regarding Sally’s process.

3. It had been my intention from the onset of this study to improve my own
skills as a teacher and a clinician. It became clear as I studied my logs
that I had growing pains and anxiety in relation to my skills. See chapter 7
for findings regarding my own process.

Observation of the session tapes as analysis began during the research
semester with my clinical supervisor. I did not observe the tapes again until
early June after I had identified the three themes described above. Each

series of session observations focussed on data that reflected the emerging

70

 

themes. The first time I observed the session tapes I focussed on topics,
interventions and interpersonal relationships as they related to the seven
realms of music therapy expertise (Milgram-Luterman, 1999a). The second
series of observations focussed on Sally’s participation in the group — as she
was selected as the case study example — also in relation to the seven
realms. Details regarding the selection of Sally as the case example can be
found in Chapter 6. The final observation focussed on my skill as facilitator
concentrating on Toseland and Rivas’ (1984) six facilitation skills and Corey
and Corey’s (1997) list of fifteen personal characteristics of an effective group
leaden

Qualitative Solutions and Research’s (QSR) “Non numerical Unstructured
Data Indexing searching and Theory Building, Version 4” (NUD*IST 4) was
used to organize and code the data.

QSR NUD*IST is a computer program package designed to aid users

in handling Non-numerical and Unstructured Data in qualitative

analysis, by supporting processes of coding data in an Index System,

Searching text or searching patterns of coding and Theorizing about

data. (QSR NUD*IST User Manual, 1997, p. 2)

My first task was to import all the data into the NUD*IST program. This
process served as a wonderful way for me to take inventory, organize and
review my various data. In order to import the data to NUD*IST, I had to
request a floppy disc of my transcripts in Word ’97 from the secretarial
service. I saved them onto my hard drive and then re-saved them as ‘text

only’ files. My own logs were in a file on my hard drive that I then saved as

‘text—only’ files. The student journals that were e-mailed to me had been

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saved on my Microsoft Outlook e-mail program. As such, they were already in
‘text only’ format. The remaining few student journals were handwritten, and I
typed them into my Microsoft Word ’97 and saved them as ‘text only.’

To import all these documents into NUD*IST I entered the program
and selected ‘Start a New Project.’ I selected ‘Documents’ and then ‘lmport
Document’ from the menu bar. I then selected one of the ‘text only’ document
files from Word ’97 and clicked ‘OK.’ I did this for each document (referred to
as a RAWFILE in NUD*IST) and each document filename was then displayed
in the Document Explorer window in the form of a list.

Coding

The next task was to code the data. I entered appropriate data units
(each data unit is usually a paragraph) into an index. The index is displayed
as a tree that starts with the trunk and branches out. My initial feeling was that
I would categorize the data by the “seven realms of a disposition of expertise”
(See Figure 2 in Chapter 2) and by the three themes that had begun to
emerge: (1) group process and experience, (2) individual case study of ‘Sally’
and (3) my own process. My first attempt began with seven main branches;
each one labeled as one of my ‘seven realms of a disposition of expertise.’
However, it was difficult to find subgroups of the realms in terms of the
emerging themes. Therefore, I tried the opposite way, using the three
emerging themes as the main branches and the seven realms branching off
of those. This worked for the (1) the group and (2) Sally, but not for (3) my

own process (see Appendix F for illustrations of the Index Systems for the

72

group and Sally) No branches were found within the seven realms in relation
to my own process. I then decided to use the lists of skills (Toseland and
Rivas, 1984) and personal qualities (Corey and Corey, 1997) for the analysis
of the third emerging theme, because they seemed to be more within the
context and depth that I wanted to study my own growth.

Re-coding

After coding several journal entries and the large focus group Raw
Files, I found the need to add two more branches to the seven sub-branches
of the group and Sally themes. The first was the setting, as there were many
references to the clinic as the setting, and the other was the Self. In the
development of my theory of a disposition of expertise, I put the Self in the
center as expert thinker who is expanding as the surrounding seven realms
expand. The Self was therefore not included as a realm. It was considered as
connected to each realm. However, group members referred to their
experiences in terms of themselves and not in reference to any of the seven
realms on many occasions.

This led me to consider adapting my theory for the purposes of this
study, to include the Self as a separate realm. The realm of Music Therapy
was not referred to as much. I felt that this was due to the fact that the group
experience was about music therapy, and therefore all the other realms
related to it. For the purposes of this study, then, the growing music therapy
student is represented by the center realm -- as Music Therapy -- and the

seven realms are Self, music, therapy, relationship, spirituality, scholarship

73

 

 

and professionalism. Setting is considered for analysis, but not considered as
a realm.
Recording the Findings

Once I had coded about half of the data and moved and created
themes, it was clear to me that the organization of the branches was
appropriate, and I began to mentally analyze the data. Each of these
categories seemed to be synthesized. I stopped coding and began to write
the chapter on the group experience. The individual case study was written
next and then the piece on my own process.

Because of the nature of the NUD*IST program, I did not have to cull,
or eliminate pieces of data that did not contribute to the analysis. I simply did
not select them to be coded. For the purposes of using appropriate quotes I
searched through the branch of the tree pertaining to my topic and found what
I felt to be the data unit that best enhanced the point I was making. I then
located the selected quote in my Word folder and then exported the
paragraph from the selected Word file into my dissertation document.

There was a continual evaluation of the data sets in relation to the
perceived phenomenon as l reflected, interpreted and theorized to find the
emerging themes. My own experiences as action researcher interacted with
the analysis. There were four scholarly experiences described in my log that I
reflected on during the analysis that effected the way I chose to organize the
data. The first was a discussion that ensued during the defense of my

proposal for this dissertation. One of the committee members voiced concern

74

over the fact that I may have misrepresented what I was doing with the group
to the Human Subjects Committee. He stated that it seemed as if I was acting
as therapist rather than facilitator and that l was conducting a psycho-therapy
group with the students. At the time, I responded with a confirmation that what
I intended was to teach the group members how to support each other in a
peer group setting. I was secretly flattered, as I do not perceive myself as a
psychotherapist and this professor perceived what I was doing as good work.
However, my intention has always been to help students to come to new
awarenesses for personal growth, support each other and cope with their
demanding curriculum.

Upon further reflection, I decided to bring that question to the group,
and it became part of the first interviews. I asked, “Do you perceive our group
as therapy or peer-support? Is my role facilitator or therapist?” See Chapter 7
for the findings related to this issue.

Another experience that helped to shape the analysis of the data was a
panel discussion I attended at the World Congress of Music Therapy that took
place before the last two sessions of the MTPSG. The topic of the panel
discussion was clinical supervision. One of the panelists described an
experiential music therapy group for her students as one element of the
supervision experience. As her program is solely graduate level, she could
only speak of graduate student participation. She commented that although
she is not familiar with undergraduate education, she doubted that an

experiential group would be appropriate. I remember my body becoming

75

tense and warm, as I became more and more anxious. Several audience
members, including me, disputed this claim explaining the needs of entry
level practitioners to be self-aware and emotionally stable.

I approached her after the presentation and told her that l was doing
such a group for undergraduate students. Her response was “That’s OK as
long as they don’t get the idea that they can do what you are doing.” I
contemplated the meaning of this comment for days aften/vard. I realized that
her perception was that I was doing psychotherapy with the group, just as my
professor had suggested. I became even more motivated to clarify the
difference in the approach that I was taking. Undergraduate students need a
facilitator to help them to begin their journeys. I agree that deep
psychotherapy group work within the undergraduate setting is not
appropriate. I concluded that the peer support group environment is just right
for the undergraduate setting, and that it was not that I did not have the skills
to do psychotherapy, but that I had made a wise decision to act as facilitator
rather then therapist. A discussion of the findings related to this issue can be
found in Chapter 7.

Reflecting on the research group experience with Professor Smith also
served as a catalyst to the analysis. As he also serves as the director of
clinical services and supervision, and l assisted him as a graduate assistant,
our interview became more then merely his thoughts about the process. We
began to develop a plan for the group supervision experience that is required

of seniors in the Spring Semester music therapy core course. He was

76

reluctant to make any concrete analysis about his observations, as he was
ambivalent about the efficacy of the results not having any quantitative
elements. However, he did admit that the group seemed to demonstrate a
deeper understanding of the material and thus he suggested that maybe we
could incorporate the ritual aspect of the MTPSG into the group supervision.
We developed a protocol for the new peer-supervision group, and planned
and implemented two groups. One was co-facilitated by that professor and
me and the other was co-facilitated by a fellow graduate assistant and me.
The peer-support group seemed to be more productive than previous peer
supervision groups for many reasons, including willingness of group members
to participate and self-disclose and we covered more relevant issues more
thoroughly. Findings related to this issue can be found in Chapter 5.

Recently I was preparing for an education panel that I was chairing at a
Canadian music therapy conference. I presented my theory of expertise and
had the directors of the four undergraduate music therapy programs reflect on
how they teach for a disposition of expertise. In my preparations, I reflected
on the seven realms of experience within which I propose that expert music
therapists are growing in order to expand the Self: Music, music therapy,
therapy, scholarship, professionalism, relationship and spirituality. This
experience helped me to solidify my theory that music therapy educators
must be responsible for helping students to grow in all these realms.
Furthermore, I became more convinced that the Peer Support group

experience is one way to address the areas of relationship and spirituality that

77

are not as easily addressed within the typical academic environment. This
prompted me to analyze the session tapes in relation to the seven realms.
New questions arose, such as “Are the students learning about themselves in
terms of their relationships and spirituality, and is this unique to this group
(not available in a typical classroom or supervision experience)?” And “How
are the discussions proportioned in terms of each of the seven realms?”
Findings related to this issue can be found in Chapter 5.

The analysis of the individual and focus group interviews, my reflexive
logs of my own observations and clinical supervision, the interviews with the
group members’ professor along with a final interview with Sally all
contributed to monitoring trustworthiness and assuring triangulation. The
focus group also contributed to member checks, where l clarified statements
from the first interviews.

Arnason (1998) likens the process of qualitative analysis to a music
therapy improvisation.
As with an improvisation, there were times of playfulness and spontaneity,
and moments of uncertainty and unpredictability. There were times of
planning, thinking, and conscious reflection. A spectrum of emotions
emerged that was intertwined with a distinct sense of movement.
Throughout the study there was an underlying organic direction to the
unfolding group process. (p. 18)
l was surprised to feel the same feelings of excitement and challenge during
the analysis of this data that I have often felt as a participant in music related
personal growth experiences.

The findings that resulted from this analysis will be communicated in a .

written format that illustrates aspects of the participants’ (including my own)

78

experiences in the next three chapters. Meanings that were derived from

these experiences will be included in the narrative.

79

CHAPTER V
THE GROUP

This chapter presents findings related to MTPSG activity and individual
group members’ growth. The results of my analysis in terms of the group
revealed that my reflections about the group emphasized the structure and
content of the MTPSG. In contrast to that, the group members’ group
reflections tended to emphasize their new awarenesses.

The chapter is organized into three sections. The first section provides
a description of a typical session including how participants perceived the
elements of ritual and a depiction of the various musical experiences that I
brought to the MTPSG over the semester. The second section provides a
synthesis of each group member’s reported new awareness(es) of Self and
others and learning in the realms of Spirituality, Self and Relationship. The
third section discusses the effect of the MTPSG on the group members’
experiences in the subsequent spring semester Peer Supervision Group.

The Ritual

Each MTPSG session was structured into five main stages: “Opening,” .
“Check-in,” “Response to Check-in,” “The Experience,” and “Closing.” These
stages are the ritual that enable “the cycle of the group to connect all that is
before and all that is after, and thus cannot be ignored” (Borszon, 1997, p.
25). No matter what transpired during our stressful week, we could always
find solace in the ritual.

Sally: I love how we start and end the session with music. It draws us
together as a musical group.

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The Opening Chant

“Sound, especially the human voice is a powerful catalyst for healing
and transformation. As we sound and sing, we harmonize our being, lift our
spirits and dissolve our pain” (Marks, 1993). I selected the chant “Call to Spirit
- Invocation Song” (Marks, 1993, see Appendix G) to open every session. I
began each session with an opportunity to sing because of the healing
qualities of singing and as transition from the hectic world of academia. I
taught the chorus to the group and took the verses as my
solo/offering/greeting to the group members.

Sally: The opening song really relaxes me and opens my mind to
concentration.

In the beginning, we used lyric analysis to identify the group goals. I
taught the song by rote, and the word “work” was heard differently by different
group members. Nancy thought the phrase was “spirit of the world” and Jack
thought the phrase was “spirit of the word.” I remember feeling that perhaps
they were not listening, but it became clear that the lyrics were perceived as
secondary to the melody for this chant.

Nancy: I like the opening song, even though I couldn’t seem to get the

words right.

Sally: I love the key that it’s in. It just really speaks to me.

Check-in
A musical instrument was selected and passed around. The group

member who had the musical instrument was to reflect on any issues of the

81

past week and a given theme that I suggested based on where we were in
the work. The group member with the instrument was the only one to talk,
play, both or pass. No response was allowed from other group members
during individual check-ins. After the first group member indicated that he was
finished with his check-in, he was to pass it to the person next to him.

Initial check-ins were short and filled with “I’m fine” statements. It took
a while for group members to identify and then share their true feelings with
the group as evinced by these journal entries that were not shared during
MTPSG:

Sally: Sometimes I have trouble organizing my thought and don’t really

know what to talk about when it’s check-in time but I’m trying to get a

little deeper with what I say.

Helen: It was really difficult for me to focus during the improvisation. I

felt too sick to be “free.”

The instrument that was passed around seemed to be more of a
“talking stick” symbol rather than a useful tool for expression. Check-ins were
mostly verbal and occasionally musical. Jack and Brad were the only group
members to present musical check-ins and only on one occasion each.

It seemed difficult at first for group members to really hear their peers
during check-in as evinced by frequent interruptions. Eventually, group
members learned to hold their responses until the response to check-in. I felt
that this was an exercise in listening and an opportunity to demonstrate

respect and develop intimacy.

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Peter: I think the rest of the group agrees that the group was intimate

and we got to know each other better. We got to laugh together. We

got to . . . shoot, I don’t know . . . shoot the breeze.
Response to Check-in

The response to check-in was intended as the opportunity to respond
to another group member’s check-in or elaborate on one’ own check-in.
Initially, the responses seemed judgmental as several group members
suggested to each other that “you shouldn’t feel that way.” Eventually,
response to check-in became more respectful and evolved into the
opportunity for clarification and support. Brad often asked his peers to
elaborate or explain their check-in.
ngsjflg

Session closure was usually in the form of a chant or song that I felt
summarized the learning for that particular session. Sometimes a larger
musical experience such as Voice Work and the Drum Circle, as described
below was used to close the session and at other times, there was no closure
because of time constraints.

The Experiences

There were five different types of musical experiences presented
during the middle stage of each MTPSG: Voice Work, Listening (including
Imagery and Music), Improvisation, Songwriting and Ceremony. Also, there

were times when we did not have a planned musical experience because of

an extended response to check‘in.

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Voice Work

“Being an inner instrument of the body, the voice is at a unique and
powerful vantage point for working with the self from within” (Bruscia
describing Vocal Improvisation Therapy, Sokolov, 1987). Music therapists use
vocal exercises as a vehicle to self-awareness towards empowerment. The
voice is perceived as a reflection of the Self. The vocal exercise that I brought
to the MTPSG (O’Loughlin, 1983) began with breathing, moved into humming
and then singing the vowels "ah” and “ee.” Wrth each sound that we explored,
we focussed on the location of the vibrations in the body. Finally, we sang the
two vowels together to form a “hayee” shout. As a group, we shouted hayee
and then individuals performed solo shouts. Some group members presented
loud, clear shouts that came from the power within their bodies, yet others
could not get past a thin, weak, quiet sound. This experience revealed a
connection or lack of connection between voice and body, and several group
members became aware of uncomfortable feelings regarding the issue of
using the voice in a powerful way. Most group members found the experience
to be stimulating.

Brad: I came to the awareness that I feel uncomfortable speaking up in

groups. When we did the ‘Hayee’ exercise for example . . . I don’t think

of myself as a vocalist and I’ve always kind of stayed away from

anything like that. It automatically started making me feel unnerved . . .
but I just went for it!

Betty: Well, it was fun and it was body awareness. I thought back to my
childhood . . . it was feel good. And it also releases tension, maybe not
muscular tension but just tension that’s like yelling at somebody. You
know, like you can’t always yell at the people that you want to yell at,
especially in a work setting. You get in trouble for that.

84

Sally: I thought it was a great idea to leave on an up note after so
much talking.

Listening
Music therapists typically use listening to music for physical, emotional,
intellectual and/or spiritual stimulation or relaxation (Bruscia, 1991). I
presented two kinds of listening to the MTPSG: Listening with the intention of
relating to the story, and imagery and music. I used the former type of
listening experience during sessions #4 and #5 in an attempt to bring group
members to a deeper level of thinking and feeling. During session #4, I
presented my song “Sailing Away” (Milgram-Luterman, 1997, see Appendix
H) that I composed during my experiences as a member of an improvisation
group for professional music therapists. l was inspired to compose this song
because of my initial feelings of being lost in the middle of an ocean with no
land in sight and finally realizing that l was ready to take the challenge of
creating my own adventure towards growth. During the subsequent session, I
read the poem “The lnvitation” (Mountain Dreamer, 1999, see Appendix I).
This is a poem that invites its readers or listeners to share their true selves.
Helen: Like you sang to us one time about the ocean . . . it seems like I
feel like I have to do a lot in my practicum sessions and I thought that l
was the only one. I can’t do everything. Now the other thing is to
befieveit
Brad: It (the MTPSG) made me reflect on some things that I’ve known
but I have buried. It’s good to have buried some of those things and it’s

good to bring them out front again. An example, which was the
reflection of your song, “Sailing Away.” You know, being engulfed in

85

the middle of the ocean, about performance and that feeling of making
a mistake and what it represents.

Tina: Remember that song that I heard on the radio between sessions

that I told the group that I connected with? It helped me to realize that

I’m the person that always strips everything away from myself and

makes me afraid of things that I don’t necessarily need to be afraid of.
Music and Imagery

Over the course of the ten sessions, I presented three different music
and imagery experiences to the group to facilitate thoughts and feelings about
personal goals, encountering the shadow and dealing with being judged and
judgmental. I am in training to use Guided Imagery and Music (GIM) using
prescribed classical music to stimulate journeys into the subconscious. As I
am not yet fully trained, and my intention with this group is not psychotherapy,
I did not bring GIM to the group.

The method of music and imagery I used was to read carefully
selected imagery scripts with my own guitar and/or vocal improvisation
enhancement. I began with an invitation to the group members to relax by
concentrating on their breathing, adapted from Campbell (1989) accompanied
by my interpretation of soothing music that simulates breathing. Next, I set the
stage in terms of where the particular imagined journey began enhancing the
image with music that I perceived brought us to that place. For the journey
itself, I stopped playing the guitar and/or singing because I did not want to
interfere with individuals’ images. When each journey was complete, I

provided my own re-entry music as I invited group members to leave their

86

imaginations and return to the room. An opportunity for reflection on the
experience followed each imagery experience.

1. The Mfiugeum Pose (Rogers, 1993): I used this experience to help
group members to begin to have an awareness of where they are in their own
journeys currently as well as to begin to develop their own goals. This
imagery script begins in a museum where the participant sees a statue that
reflects the way I am feeling right now. The instructions are to physically take
the pose of that statue. Next, the image moves to the way! would like to feel
and participants are to physically take that pose. Next, participants are to
practice moving from the first pose to the second. The emphasis is on what is
physically, mentally and metaphorically needed to move into the desired
state.

2. Openm to Shadow and Light (Rogers, 1993): I use this experience
to help group members to become aware of and to connect with their deeper,
darker selves. The script invites individuals to imagine they are taking a walk
down a hillside. They eventually come upon a cave and may enter if they
choose. They encounter two doors -- one labeled ‘shadow’ and the other
labeled ‘light.’ They open one of the doors and observe and/or communicate
with what they see. When finished, they do the same with the other door. The
emphasis here is on whether or not they challenged themselves to encounter
their ‘shadow’ and/or ‘Iight’ and in what form they experienced it.

3. Encountering our Judges (Ristad. 198;); I use this experience to

help group members to become aware of what and who they perceive as their

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judges and how they are or are not affected by their perceived judges. It is a
script that invites the individual to encounter their judges, feel their physical
and emotional responses during those encounters and manipulate the
imagined judges to take on various forms. Eventually, the script invites them
to become more comfortable with their judges, accept them as part of
themselves and ultimately to accept them as part of their personal power.

Hannah: I guess I don’t have as much of an open mind about the
music and imagery as other people. Other people saw so much and I
just didn’t. You know I didn’t see all that much and I think I just realized
that. . . I don’t know . . .that they think more spiritually, I guess. When
I’m listening to people talk about their images, I can understand some
things that are spiritual, but I can’t always picture or get to a level that
they’re at or how they perceive things, you know, through their
religious beliefs, or spiritual, or whatever.

Tina: The music and imagery that we did . . . I really recognized that I
hide my true feelings from people . . . more than I realized.

Betty: I realized that I want to get into imagery more . . . | feel more
confident because of the MTPSG. That’s one thing I remember in the
first imagery and music is that I went form feeling very closed in my
first pose into a stance of confidence in my second pose. I think I did
gain confidence through the group.

Helen: During the statue music and imagery, I kind of realized that
what I wanted to be was more confident in myself, I guess.
I used imagery and music in several sessions.

Improvisation

 

Bruscia (1987) defines Julliette Alvin’s Free Improvisation as an
expenencethat

may consist of any or all attempts to create sounds or music that were

not composed or written beforehand, ranging from merely sounding an

instrument in different ways, or producing unorganized vocal sounds,
to inventing musical themes and creating musical forms. (p. 77)

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It is free in that there are no imposed musical rules, restrictions, directions or
guidelines on the music produced (p. 77). Although Alvin typically worked in
clinical or special education settings, I adapted the concept for the purposes
of the MTPSG. I found that her use of music therapy in educational settings
seemed to parallel the use of music in the MTPSG, particularly her use of free
improvisation “within an instructional setting to advance learning and to
develop learning skills” (p. 76). Bruscia cited the socio-emotional goals of free
improvisation as opportunities for improved “communication, self-expression,
identification with others, interpersonal skills, and group interaction” (p. 80).

1. Openigm the Experience

“Opening to the Experience” was the title for an improvisation that I
proposed for our second session closing. Group members were requested to
find instruments that they felt reflected the theme and engage in a free
improvisation of their perception of that theme.

I suggested this intervention after a lengthy discussion about Ellen’s
resistance to commit to the group because of her perceived religious
limitations. I felt that this would provide a non-threatening opportunity for Ellen
to experiment with self-expression with her peers and for the other group
members to be supportive.

; Drum Circle

During one session, Jack was the last person to check-in, and the
instrument we were using was the bongo drums. He continued to tap on the

drum in a quiet yet rhythmic manner throughout the unusually long response

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to check-in. After we finally pointed this out to him, he explained that he had
just quit smoking and that he had consumed a large quantity of caffeine
before coming to the group. I decided to abandon my intended experience,
moved a large table drum into the center of the room and I invited the group
to support Jack in his drumming. What emerged was a ten-minute supportive,
partly wild/partly heartbeat, pulsating, sometimes playful drum circle. In
reflecting on it afterward, it was interesting to note that everyone contributed
in his or her own rhythm and style to create a unified, supportive feeling.

Sally: I loved the free improv session that we had. Ifelt that we

somehow connected even though we tended to play our own thing.
Songwriting

Compositional methods in music therapy have been used to identify
and develop themes and document inner thought and feelings, among other
objectives. Songwriting is the most common compositional method and is
most often used for the purposes of self-expression and expression of
feelings (Bruscia, 1991). One of the ways to write a song is to use a pre-
existing song and change the lyrics. I used the song “I am Becoming You”
(Michael Tierra, 1993, see Appendix J) in our third session for the purposes of
developing personal affirmations and goals. I changed the original title/first
line to “I am Becoming Me” to reflect personal development.

The original song is sung in five parts that are each beautiful in their
own right and harmonious as an ensemble. The first part reflects the process

(I am becoming me) and the next four parts invoke the elements (air, water,

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fire and earth). I taught the song to the group using the write-on board for the
lyrics and line-in for the melody. Group members were then encouraged to
connect with one of the lines, either because of the melody, the particular
element or the lyrics.

As a group, we sang the five parts together, singing parts that we connected
with. This resulted in what I heard as beautiful, inspiring music. The next task
was to create new lyrics of affirmations to replace parts two through five. After
a lengthy, difficult process of debate and attempts to fit the lyrics to the
rhythms, we came up with the following affirmations (including the original
part 1):

[Part 1] “I am becoming me”

[Part 2] “Free from the stress of life” or “I am filled with the Holy Spirit”

Part 3] “I am confident, in control”

[Part 4] “I am standing strong” (2x) or “I am fun & light (2x)

[Part 5] “I am dealing with my life”

We then sang through the song with the new lyrics, each of us singing the
part that we connected with most.

Nancy: I felt the activity where we all sang different parts was cool, but
I started to lose interest after we were making up our own lyrics.

Sally: I enjoyed discussing the meaning of the phrases. I though it was
a good idea to make up our own verses. It seemed to draw the group
together . . . The phrase “free from the stress of life” was very
important to me especially on Tuesday nights because I have an
incredibly long day, and I am feeling every ounce of stress possible.

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Ceremony

I used an experience I call “Honoring Each Other” that I adapted from
an old camp game. Each person begins with a piece of paper on which they
write their name. They then pass the papers and each person writes
something that they honor about the person whosename is at the top of the
sheet and then they fold it over. The papers go all around the circle, until each
person receives a piece of paper with their name on it with a list of statements
honoring them. One of the group members in a previous MTPSG that l
facilitated suggested this experience when the group was showing some
personality conflicts. Although this was a great idea, I had to adapt it because
one of the group members was visually impaired and could not participate in
the written aspect. The adaptation for the visual challenge was to do it orally,
where each group member was honored by everyone until all group members
were honored. My musical adaptation was to preface each group members’
turn to be honored with a musical presentation of their name.

I decided to use this experience during session #8, because we were
to have a two-week break and return to only two more sessions after that. We
needed to begin to let each other know that they were respected for who they
were and deserved support. Because the interviews took place shortly after
that session, there was a lot of data about new self-awarenesses in reaction
to others’ perceptions.

Hannah: The way people see me is basically how I see myself too. I

took in what they said, but I kind of knew that about myself. Ellen said
that she liked the way I showed my feelings whether they were good or

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bad, like I’m not always pretending to be happy when I’m not. I don’t
necessarily see this as a good thing, though.

Madeline: I realize that I need to relax more. Like someone said last
session that they respect that I study all the time. This is true, but I
don’t think that it’s such a great thing. So its like this is my last year
and I’m not having any fun. I’m really hard on myself about getting
perfect grades. I should have had more college experiences, so to
speak, like gone out more.

Tina: It’s kind of interesting that people were telling me that I’m really
open when I know that I hide a lot of stuff and keep a lot of things
inside. That was probably the biggest real awareness.

New Awarenesses

Self

Group members learning had a lot to do with the stresses that they
endured as music therapy seniors. Professor Smith cited the music therapy
class curriculum as falling short on helping students to reflect on their
stresses in terms of their work as future therapists.

Professor Smith: We [the music therapy program] were basically
business and so I think there has always been a need because of
student’s questions or anxieties. In a sense maybe we denied some of
them. Because students would say, “I don’t know what I’m going to do
about my internship.” Or, “I’m scared about this or that.” We would say
that this is a topic for our clinical work, you know, here and now, but we
usually didn’t address those concerns. I guess I can’t remember how
important internship was. Maybe it wasn’t that important to me. I didn’t
know any better, but kids are really . . . they really get very uptight
about that.

During the individual interviews between sessions 8 and 9, group
members were asked if they had any new awarenesses. Several group

members initially had difficulty understanding the question and required an

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explanation of the term “new awarenesses.” However, they did report new

awarenesses about themselves.

Session 8 was the night that we did the “Honoring” experience and
several individuals’ self-awarenesses evolved from their responses to how
others’ perceived them. It seemed to me that listening to other people talk
about their strengths challenged them to look at themselves through different
eyes. Many of the new self-awarenesses contrasted what others had said
about them.

Brad: I’m uncomfortable with group situations.

I don’t have as much of a “voice” as I would like.

Betty: I need to make my own decisions.

I’m not ready to be a music therapy student.
I don’t want to make waves.

Ellen: I’m stressed out.

Professional support is as important as religious
suppon.

Hannah: I’m nervous being around people I don’t know well.
The MTPSG has helped me to become more
comfortable with my peers.

I’m not as open or as spiritually connected as the
other group members are.

Helen: I’m not as confident as I’d like to be.

I want to know me better.

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Jack:

Madeline:

Nancy:

Peter:

Sally:

Tina:

Spiritualiy

I avoid getting deep.

I’m too serious.

I need to relax more.

I have learned not to have such high expectations
of others and myself.

I’m ovenrvhelmed with schoolwork.

I’m a little too hard on myself.

I like making people smile.

I’m always growing.

I’m exploring my spirituality.

I need to connect with my brother.

I can be open in a group when I feel safe.
I’m my own worst enemy.

I hide my true feelings.

After the first session, Ellen stayed behind to tell me that she was not

going to continue in the group because of religious reasons. She felt that the

chants that I presented were not Christian and that made her feel

uncomfortable. She was also concerned that she would be perceived as rude

by group members as she tended to condemn others for their lack of faith.

She stated that she receives support from Christian study groups and that

she did not need to participate in the MTPSG.

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I did not act on my initial reaction to defend the necessity for
participation except to inform her that I had found, in previous groups, that
those who were grounded in their religions had wonderful insights to share
with the group. Instead, my excitement grew as I identified her reflections as
the first big issue for the group. I asked her if she would be willing to bring her
concerns to the next session, and she agreed.

Ellen stated her case during the second session check-in. The
response to check-in was filled with questions about her beliefs and evolved
into a confirmation to accept and respect Ellen for who she is from each of the
other group members. Nobody openly objected to what Ellen was saying, but
they did reflect on their initial reactions in their journals and personal
interviews.

Helen: Ellen's religious proclamation bothered me a little bit. I

understand that she’s entitled to her own feelings, but she seemed a

bit closed minded toward the rest of the group. It almost felt like she

was trying to tell us that she didn't need us because she was part of a

special Jesus club. I know she didn't mean to offend any one, but she

seemed a bit offensive to me. I guess it is hard for me to understand
her point of view.

Nancy: I found myself thinking a lot about what Ellen had said about

the religion thing. At first I felt a little angry that she would be so

exclusive. Now I feel a little sad that she would limit herself that way.

It's exactly her kind of person that turns me off to Christianity.

Sally: I was really surprised when Ellen mentioned the possibility of not

staying in our group because of her religion. I didn't even think religion

was going to be an issue. At first I was shocked about how close-
minded she was, but it’s a choice that is up to her. I know I wouldn't be
offended by her though. She is free to believe in whatever she wants

to, and I would hope that she won't feel threatened to be around
people who have other faiths.

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Ellen agreed to stay in the group and eventually developed an appreciation
for professional peer-support as a separate, yet complimentary entity from
religious support.

Ellen: Peer support group is more work and therapy related . . . Well

yeah it helps me deal with my clinic stuff and class stuff and

frustrations with my therapy class and whatever other classes people
have together. You can definitely tell (that it’s beneficial) when people
are in class together.

The discussion about this issue also inspired others to begin to think
about their own connection with religion and/or spirituality and how that may
or may not be integrated with their persona as future music therapists.

Helen: l was raised in a religious household also. Religion is very

personal to me. My beliefs give me an inner support. Although I feel

that my religious beliefs guide me they don't really dominate who I am

or what I do. Religion has also never affected the way I view people. I

don't really care how/if people worship a God.

Sally: As for me, I've experienced many different religions, but I don't

practice an organized religion at this time. I am more spiritual than

religious, I guess.

Hannah: The discussion about Ellen's beliefs kind of surprised me

because I don't think of the group as being religious at all and I would

never associate it with religion. But as long as Ellen doesn't push her
beliefs on us then none of that will bother me. I think we are all there
to learn more about ourselves.

Relationship

Although the individual group members had been together as a class
for two or three years, they did not seem to feel a connection prior to the

MTPSG. New relationships developed in the MTPSG and group members

began to feel supported by each other.

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Helen: I thought it’s just been a really supportive environment and it’s
nice to get to know my classmates a little bit better because I’ve been
sitting next to them for four years now. It’s nice to find out that a lot of
people have the same concerns and the same stuff is going on in their
lives.

Madeline: I think that it’s kind of nice to know that everyone else is
having the same problems with their clinical placements. It’s just kind
of nice to know that everyone is going through the same thoughts and
stuff.

Nancy: I think it [MTPSG] has brought us all closer together. I think on
the whole, we all feel more comfortable letting our guard down and
letting down our walls and letting our personalities come out.

Peter: I love [MTPSG]. Every time, after each session I am always in a
great mood. I always feel like I am on cloud nine because it is a great
feeling of acceptance and being able to connect to your peers and
sharing your problems and fears as well as yourjoys.

The relationships that developed seemed to transfer to the music

therapy class.

Professor Smith: This class has felt good. I think they like each other. I
think they are concerned about each other.

Sally: Relationships are forming in the group and we are not so
inhibited in class.

Helen: [The MTPSG] brought us all closer together as a class. Like we
all studied together for the final together.

Ellen and Tina both reported a new intensity in their friendship that was
developed in the MTPSG. Their relationship seemed to strengthen because
of the similarity in their spiritual beliefs. Although they both participate in
spiritual groups, this was the only opportunity for them to connect their
spirituality in the context of their work.

Ellen: It [MTPSG] helped to strengthen my friendship with Tina
because of our conversation after the first week (spirituality

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discussion). I told her that l was kind of surprised that she didn’t say

anything based on some of the things she has confronted me about.

She said that she had thought about it but that she was really glad that

I brought it up.

Tina: It’s been really neat to develop closer relationships with

classmates.

Effects of MTPSG on Group Supervision

Group supervision has always been a requirement during the spring
semester of the senior music therapy class at MSU. Professor Smith’s
intention in developing group supervision was to provide a forum for students
to discuss their clinical issues with peers in an environment that simulated
professional meetings. However, most of the group supervision groups fell
short of this goal. My own experience co-facilitating group supervision at MSU
was frustrating, because students would spend most of the time describing
their clients and little time discussing issues. Furthermore, the students
presented the cases and issues with no thought as to how their own
involvement impacts the therapeutic relationship and ultimately the client’s
progress.

During Professor Smith’s reflections on his perceived effects of the
MTPSG on the music therapy class during his individual interviews with me,
we began to talk about integrating MTPSG with Group Supervision and we
developed a plan for what we named Peer Supervision. He reported that
although all classes seem to have their own personalities, the students in his

music therapy class seemed more insightful and connected as a group than

in previous classes. He postulated that bringing the peer support aspect to

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group supervision may enhance the experience. Our excitement grew as we
developed a protocol for Peer Supervision. We implemented the new concept
the following semester.

There were many changes to the original group. There were some new
additions to the class, including two transfer students and one non-major.
Other additions included the one student who could not participate in the
MTPSG and two second-year seniors (who I did not include in my study).
There were now sixteen students to serve and we decided to split the group
up into two. Professor Smith and l facilitated one group and a fellow graduate
assistant and l facilitated the other. The venues had to be changed because
of schedules and both groups took place during the school day. Peer
Supervision was a class requirement whereas MTPSG had been voluntary.

The focus group for this study took place after the next semester when
the Peer Supervision experience had just ended. As such, many of the group
members’ reflections were in the form of a comparison between the MTPSG
and Peer Supervision. This phenomenon allowed for a new perspective on
the MTPSG, particularly in regards to its’ effect on the music therapy class.

Brad: I guess I feel that because of this group last semester, it was

easier to participate in this semester's peer supervision group. I kind of

knew the format even though it was somewhat different. And in
regards to that, I enjoyed last semester's atmosphere better.

The group members felt that the Peer Supervision group was different
from the MTPSG in many ways, including the venue and the scheduling.

Brad: My wishes are to suggest that in the future that [the Peer

Supervision Group] setting be in a more intimate room. I didn't feel
very warm and fuzzy, I guess, in there.

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Jack: I didn't like the room at all. I mean, I hated the Recital Hall. I
didn't like it.

Sally: As for the room, I think the conference room is good. We were
in the conference room so I thought that was better just because we
could get in a circle. I thought that was a good idea. And comfy
chairs.

Ellen: I kind of liked last semester's atmosphere better, but I liked
having it [Peer Supervision Group] during the day. It was a scheduled
class that we could account for into our schedule from the beginning of
the semester.

They also felt a loss in terms of splitting the group and in the addition
of new students.

Brad: Yeah, I felt very comfortable with people in the second group as
well, but I don't think we touched on as deep as topics so I didn't feel
that it was quite the closeness.

There was a perceived difference in depth between the two groups.

Ellen: The first semester was more personal and the second semester
was more topical.

Sally: I liked the diversity of both semesters. Like the first semester
was really personal and we got to know the group and everything.
Then the second semester was when I really started freaking out about
clients, and like the real world was coming really fast. So I thought it
was kind of a relief to be able to talk about clients and get other
peoples’ input for that because that was on my mind constantly.

Peter: I liked both of them for different reasons. I think the rest of the
group agrees that the first semester was more intimate and we got to
know each other better. We got to laugh together. We got to . . .
shoot, I don't know. Shoot the breeze. This semester I enjoyed
because it was more subjective and, dealing with clients, we got to
vent our frustrations and to receive advice from our peers.

Helen: I agree with everyone else that last semester was definitely
more personal. Everyone got to know each other. This semester, it
was good to talk about all the client stuff that we did. It definitely
wasn't as personal or anything like that. It was a different group to me.

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Madeline: I liked last semester because it was more personal, I guess
so did everybody. This semester, it seemed very artificial, but it was
nice to talk about clients. But I didn't feel as close to anybody because
it was all surface crap that we dealt with this semester.
Lastly, there was an appreciation for how the experience with the MTPSG
enhanced the Peer Supervision group experience.
Sally: I really enjoyed having the first part for me, getting to know me a
bit more before putting that aside and getting to my client. I liked
having both of them. I think it helped bring the group together a lot too
the first semester.
Peter: Well, first of all, just going back to what we said earlier that the
first semester it was more intimate and we got to know each other
better. In turn, for me, that made it a lot easier to deal with everybody,
to be a lot more comfortable.
Jack: I think I've been listening more to people in general. It’s amazing
how much I used to miss. I don't know if that's a direct result of the
group or some of it I might think is because of my sessions. You know,
growing as a therapist. But I’m definitely -- outside of school and with
friends and stuff -- I'm listening a lot more. And I can respond much
better to what people are saying -- good or bad.
Conclusions
It seems that there was much new awareness that developed as a
result of participation in the MTPSG. Music and peer support seemed to be
the outstanding catalysts for these new awarenesses.
Although there was growth in all of the realms of a disposition of
expertise (as described in Chapter 3), new awarenesses in the realms of Self,

relationship and spirituality prevailed. These are not issues that are spoken of

in a typical classroom setting, yet they are issues of which music therapists

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must be aware. In order to be effective music therapists, they must integrate
their feelings and thoughts regarding these issues into their work.

In the regular core classroom setting, music therapy students are
learning about music therapy and how to integrate the realms of music,
therapy, professionalism and scholarship into their future work. However, the
current curriculum may not be addressing the realms of spirituality, Self and

relationship. A group such as the MTPSG could fill the void.

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CHAPTER VI

SALLY

I selected Sally as a representative MTPSG case study for several
reasons. She was the only group member to submit regular journals. Her
journals were articulate and included descriptive reflections of her
experiences and an opportunity for me to view the experience from the
students’ perspectives. During MTPSG sessions Sally fully immersed herself
in the musical experiences but was not actively verbal. The new awarenesses
that she developed seemed to emerge from the music and her private
reflections in herjournal rather then through verbal reflection during sessions.

Once I selected Sally as the focus of this case study, I arranged for a
follow-up interview with her that took place in June. I do not typically
investigate the background information related to members of MTPSGs
because I want them to feel comfortable with exploring who they are and their
own growth. However, I felt that it would be important for the purposes of
context to provide the reader with that information. The background
information included here was data that was collected through that personal
interview in June.

Background Information

Sally is a 22 year-old music therapy senior at Great Lakes University.

She grew up in a large city in the Great Lakes area. Her mother is a pre-

school teacher, her father is a high school science teacher and she has a

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twenty-five year old brother who is a musician. Although her family did not
have any religious affiliation, Sally chose to attend a private Catholic school,
because she was frustrated with the public school system. “I was in kind of a
bad school system and the kids didn’t take school seriously and I just couldn’t
deal with that.” She describes her family as being very supportive, particularly
in her pursuit of academic and musical endeavors. She perceived her family
life as “open and loving,” although her brother went to a boarding school for
several years and they were not as close as she would have liked. She
describes a recent family crisis as an experience that helped bring her family
closer together.

She reports being exposed to music at a very young age. “I think I was
three when I started . . . I did Suzuki everything.” She began with Suzuki violin
and piano and continued with piano lessons until she was ten years old. She
took up the flute and began voice lessons while in elementary school. In high
school she took professional voice lessons, picked up the piccolo and was
active in both the choir and band programs. She was also involved in musical
theatre and drama in high school and throughout her freshman year at GLU.

Sally chose music therapy as her major because she felt that she had
to do something with her music. “I could not give music up for anything.” At
the time, music therapy seemed to be a “combination of things that I was
interested in.” She made the decision with careful consideration. During high

school, she did some research on the field of music therapy and observed a

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local music therapist at work and she did some volunteer work during her
freshman and sophomore university years with another music therapist.

She realized that she did not want the lifestyle of a vocalist because it
“would not be very fulfilling if I just went and performed for other people.” Her
understanding was that music therapy was a way to share her music. “I feel
that I needed to use the gifts that l was given for the good of other people and
music therapy was exactly what I was looking for.”

Sally functioned very well in the undergraduate music therapy
program. She did well academically, excelled in vocal performance and
volunteered to involve herself in clinical experiences beyond what was
required of the department. Although we did not know each other very well
before the MTPSG, I remember seeing her quite frequently during herjunior
year as she volunteered to work in our professional clinic. She began her
senior year eager to delve into the clinical practice and immediately
volunteered for extra clinical experiences. Upon joining the group, the only
personal issue that she was aware of was the stress she endured as a highly
involved student.

Treatment Process

Sally was eager to participate in the MTPSG, mostly because she
believed that it was important to support music therapy research. Initially, I felt
as if her only goal was to help me with my dissertation and I struggled to
explain to her that it was the natural work of the group that l was studying.

She came to the experience with the perception that we would be working on

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clinical issues. Actually, the idea of personal growth seemed to be a new idea
to her.

Sally attended all ten sessions and provided me with journal entries on
a regular basis. I perceived her position in the MTPSG as a quiet participant
during sessions, yet articulate and thoughtful in her written journals and
during our individual interviews. Her journal entries illustrated that she
involved herself in every aspect of the work of the group, particularly the
musical experiences. Sally had several new self-awarenesses over the
MTPSG semester. Her development was interesting to witness as she
integrated the learning from the group into her academic, clinical and
personal life and vice-versa.
Phase One: Beginning§

Sally presented herself as responsible and committed to the group.
However, initially it seemed to me that her commitment was to my research
rather then to herself or her peers. In reference to several group members’
absences in session #4, Sally commented, “I thought it was a good session,
but I was disappointed in my fellow classmates who didn’t let you know that
they couldn’t make it . . . They signed an agreement with you, and they need
to stick to it.” Her session check-ins were short and trite, usually stating that
“everything is fine” or “I’m stressed, but that’s OK.” During this first phase she
only spoke when requested.

Because of her commitment to the research, Sally submitted journals

to me after every session, and her writing was wonderful to read. She had

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rich insights about her learning as a result of the MTPSG — particularly her
connection with the musical experiences - that she shared only through her
journals and individual interviews. Her journaling began after the second
session with a hand written note and followed every session through e-mail
after that.

From the beginning, her writing revealed her strong connection with
the music. She wrote in her session 2 journal “The opening song really
relaxes me and opens my mind to concentration” and “I loved the free improv
session that we had. I felt that we somehow connected even through we
tended to play our own thing. I love how we start and end the session with
music. It draws us together as a musical group.” and in her session 4 journal
“Again, I love the opening song. It really helps me focus and I love the key
that it’s in. It just really speaks to me."

As was the case with most group members (see Chapter VI), Ellen’s
check-in about her ambivalence with the group because of religious reasons
inspired Sally to examine her own spiritual beliefs. Initially, she could not
understand Ellen’s perspective, “I didn’t even think religion was going to be an
issue. At first I was shocked about how close-minded she was, but it’s a
choice that is up to her.” Sally described herself as not practicing any religion.
“I am more spiritual than religious I guess you could say.”

Sally’s reflections of session 3 illustrated that the song-writing
experience helped her to recognize her need to connect with the group and

move into a deeper space. “I thought it was a good idea to make up Our own

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verses. It seemed to draw the group together. I feel that we are becoming
more trusting of each other, and with time, our discussions will reach deeper
into our minds.” She seemed to understand that this was going to be a
process. “It is good for now to establish trust among the group members and
create a safe atmosphere for everyone to contribute.”

She established her first goal during the songwriting experience with
her contribution of the phrase, “Free from the stress of life." Being free of
stress “is very important to me especially on Tuesday nights because I have
an incredibly long day, and I am feeling every ounce of stress possible. If
there is one thing I take from this group, it will be in techniques of how to deal
with my stress and life.” The stress seemed to be related to her frustration
with not being able to perform all of her responsibilities perfectly as she had
perceived she had always done. “This year is insane, and it really bothers me
that I can’t seem to get everything done on time and the way I would like it.”

During session 4, she revisited her spirituality journey, this time with
more depth. In her journal, she responded to my song “Sailing Away” by
describing what she called a “lost period” in her spirituality.

Sometimes I feel like I’m just sinking into a rut in the middle of the

ocean with no one to relate to. I seem to be searching for a religion of

some sort, but I’m having a hard time relating to organized religion. I

think going to a Catholic school is making me feel guilty about that.

But, I’m still figuring things out for myself and I have a long ways to go.

The voice work experience that | used as the closing to session 4 (see

Chapter VI) seemed to me to be a metaphor for Sally’s difficulty expressing

herself verbally. Even though she is a vocalist, she did not produce a very

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powerful vocalization. There were several group members who did not
actually ‘shout.’ I see this as individuals who have not yet come into their
voices as powerful people. It is unclear to me as to how they perceived their
own sounds. Without mentioning who the ‘non-shouters’ were, I suggested
that those who felt they had difficulty with the ‘shout’ reflect on possible
reasons why during the subsequent week.

Sally did not seem to perceive her ‘shouting’ as weak. Her reflections
of that experience were not related to her voice, rather the effect that the
experience had on her motivation to study that night. “I thought it was a great
idea to leave on an up note after so much talking. I was awake enough to get
some homework done when I got home that night.”

Phase II: Sallv’s Music Goes Deeper

I began session 5 with the poem “The lnvitation” with the intention of
breaking down some barriers. Although she did not mention the poem as the
stimulus, Sally perceived this session as a turning point for the group. “I’m
glad that we were very honest with each other and were able to express what
was going on in our heads. It sounds like everyone is very frustrated with time
and school and work. It’s difficult to be a student!” She delved further into her
stress related to her new lack of ability to get everything done, as she wants it
to be done.

Right now is very stressful and I can relate to much of what was being

said. I always have things planned in advance and I am a very

organized person, but it’s impossible to be organized this year and to

plan sessions in advance. That has been my biggest stress, because I

have to take things as they come and I can’t plan for them. I am very
uncomfortable with that.

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This issue seemed to develop into a new awareness about her chosen
profession that I have found many students do not understand until they are
well into their internships — the uncertainty of the music therapy experience.
She wrote, "It’s so hard to know what a client is going to do so you can plan
activities in advance.”

It was during this session that Ellen talked about her fear of the
unknown in terms of the internship. She told the group that she was
concerned about possibly having to be far from her boyfriend. She was
concerned about how he would figure in and, as is consistent with her
religious beliefs, she admitted that nothing is more important then having a
family.

In response to this Sally presented what I perceived as a much
healthier attitude in terms of her responsibility to her partner. This was the first
time that she shared an insight with the group without a prompt. Her comment
was that communication with one’s partner throughout decision making is
important. In her journal, she viewed the situation as another unknown
situation that she has difficulty dealing with. “I hate not knowing what I will be
doing after May. I have a serious boyfriend to consider and money is always a
problem. All I can do is get as much done as I can and wait and see what
happens”

We ended this session with the same voice work exercise as the

previous week and Sally Offered a much louder and slightly deeper ‘shout.’

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Perhaps this was an indication that she was ready to move to a deeper level
in her process.

Session 6 seemed difficult for Sally in that the response to check-in
was unusually long. She seemed to find more comfort in focussing on the
musical, non-verbal experiences. “I thought that group was good this week
but I do wish we could have gotten to your activity. I think it’s a good thing to
keep us talking, but we have to focus on why we are there more often.” Paul
requested some help with dealing with grief towards the end of the response
to check in and Sally reflected on the importance of the support of the group.
“I like how the group was able to help out Paul in his time of need. This
seemed to help us share a little more of ourselves.”

I believe that it was the result of this more verbal session that Sally
came to recognize her lack of verbal participation as an issue.

Sometimes I have trouble organizing my thoughts and don’t really

know what to talk about when it’s check-in time but I’m trying to get a

little deeper with what I say. Sometimes, my life is so insane I can’t

verbalize all what’s going on or I don’t have the energy.

We ended session 6 with the drum circle inspired by Jack’s incessant
drumming throughout the discussion. Although Sally reflected on the personal
benefits of the experience I was surprised that she did not mention the
importance of it as supportive to Jack. “I LOVED the drum improv. I think that

is what we needed at the end of our session together. I left there feeling

refreshed and peaceful and very happy."

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Session 7 also proved to be filled with new awarenesses for Sally. She

was ready and receptive to the imagery and music experience, and had no

difficulty describing her journey to the group. She was pleased that she was

able to express herself and grateful that as a group they were able to be so

open.

It was great to hear how everyone was contributing to the group.
Everyone really opened up about themselves and let us know what
their image was. I think if we do these insight activities more often, it
may give us the opportunity to share more personal things. Sometimes
it’s hard for a group to just all of a sudden talk about very personal
issues without a prompt.

During the session, she briefly described her image. She chose to open the

light door first and felt very happy in a field of flowers. She did not hesitate to

open the shadow door and was surprised to see her brother in that doonrvay.

She wondered what that could mean, but did not elaborate with the group.

Sally expanded on her image in her journal entry:

I’m so glad we got to the music and imagery activity. It was an
incredible experience for me. When I entered the light door, I saw a
beautiful field full of daisies and blue sky and a warm sun. I was
extremely happy there. Then I went to the shadow door and I entered it
not being scared or hesitant. I first saw a shade of gray and then a
figure of my brother appeared. I realized that I hadn’t talked to him in a
long time and I needed to call him. His image was very friendly and the
good side of my brother. I think he was in the gray part because I
haven’t really had a chance to get to know my brother. He went to a
choir boarding school in [another state] and we didn’t really grow up
together. Sometimes it’s hard to consider him my brother rather he’s a
good friend. We are finally getting to know each other more now
although now it’s hard because this time I’m away from home. I’m
hoping we can repair any damage that may have occurred from this
separation.

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Sally briefly mentioned this experience a few more times in subsequent
sessions and in the first individual interview two weeks later. She seemed to
have resolved the issue, but did not fully share the details until our follow-up
interview seven months later. My question was, “You talked about wanting to
do something about your relationship with your brother in response to the
imagery that night. I was just wondering if you had.” Her response reflected
the importance of the experience.

Yeah, actually I did. I did a big thing about it. The vision of him coming

to me was just kind of a wake up call to me that I haven’t been in touch

with him as much as I used to be. I don’t know, if it’s just because of

college and it’s hard to keep in touch with family when you’re away . . .

It worked as kind of a wake-up call for me and I actually called him that

night after that experience and said “We need to get together.” We’re

not as close as we used to be. We kind of talked about that for a while
and that was really interesting for me and for him because he was kind
of feeling the same way . . . l was very thankful for the activity that we

did in the group that I was able to see him in my mind and realize that I

had forgotten about him.
Phase 3: Taking it in

During session 8, the last one before we took our two-week break for
Thanksgiving and the Music Therapy Conference, the group members
participated in “Honoring Each Other.” Group members had the opportunity to
communicate what they admire about each individual. Although many group
members had difficulty offering and/or receiving what they perceived as

compliments, Sally did not appear uncomfortable. She presented herself as

insightful and articulate. Here is the list of comments she offered to her peers:

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I love your sense of humor, everyone feels comfortable with you

I like your contribution to the class

I like that you’re laid back, comfortable about what you say

I love how you work with children, I get a lot of ideas from you

You are solid and insightful. I learn about balance from you

I like your personality. You are very free and very grounded. Very down to
eanh

You are a very peaceful calm person.

You are very willing to laugh, you have a very good positive sense about
you

You have an easy-going personality, you are easy to talk to. You always

seem to know what your beliefs are.

And here is a glimpse of how Sally is perceived by her peers:

Always positive, even when exhausted or in a bad mood, you're always
laughing. Your name suits you. You are a beautiful person.

Always happy

Always in a good mood

I love being around you

You have a happy personality. You are not biased.

You are a comfortable person. Someone you could talk to

You are laid back, but upbeat. You blew me away in our first music

therapy class with the animal song that you led. You are very talented.

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. You always do a great job. You are a great role model for performance
and therapy. You are not stuck up about your incredible talent.
0 You are inviting and you help people.

During our follow-up discussion, I engaged the group to reflect on how
they felt during this exercise. The discussion revealed that most group
members had difficulty giving and/or receiving praise. Issues about studio
lessons emerged as group members discussed how different teachers have
different styles in terms of praising or insulting the student and it was
interesting to note that different group members noted different learning
environments that are or are not helpful. Sally did not participate in this
discussion at all. Nor did she write about the experience, or talk about it in
any of the interviews.

Sally attended session 9 even though she was not feeling well. She
mentioned during her check-in that she had a bad cold and was having
difficulty thinking and this affected her participation. Betty used her check-in to
announce that she had made the decision to take a leave this year, but was
not intending to drop out. During response to check-in group members
supported her decision and offered suggestions. Sally offered validation
withoutjudgement. “I’m glad that you (Betty) figured out what you needed to
do.” Sally reported in her journal that she offered words of support to Betty
after the session, as well.

Because of the long check-in and response to check-in, we did a

shortened version of the “Judging” imagery and music. Although Sally did not

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reflect on her experience during the session, she wrote in her journal that it
was difficult for her to get into the imagery because, “My head was almost
about to explode.” Despite her difficulties, she did remember that her first
image about judges was her parents and she perceived that as “pretty
normal.”

Phase 4: Closure vs. Final Exams

The final session took place during the last week of classes. Most
group members did not perceive this as closure in that they still had an entire
semester before they would end their relationships with each other. Sally
used her check-in to reflect on her experience. “I enjoyed the opportunity to
get to know everybody. I though that this was a good way to spend the
beginning of our last year here.” Her journal revealed that she was also one of
the group members who could not relate to the end of the MTPSG. “As for
closure, I agree with the others that it didn’t feel like we were done yet. I don’t
know if I’ll ever experience a sense of closure with this group because I am
with them so much of the day and I know that I’ll still see them next
semester.”

It was evident during check-in that group members seemed to be
preoccupied with papers and finals and so I decided to present a relaxing
music and imagery. The exercise “Healing the Listener” (Campbell, 1989)
suggests breathing and vocalizing the sound "ah” to bring awareness to the
body. Listeners were to reflect on their experiences over the past few months

in terms of good times and bad being heard and listening. For Sally, the

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vocalizing seemed to get in the way of her connection with the images. After
the experience, she reflected that it was difficult for her to make the sound
and remain relaxed. “I was concentrating on the difficulty making the sound
while lying here.” However, herjournal reflected that although she did not
experience the imagery, she was grateful for the opportunity to relax. “The
activity gave me the opportunity to relax and forget about all the major things
that are due very soon. It was good to do a full relaxation at this time in the
semester.”
Conclusions

I came to know Sally as a wise person. She is someone who only
speaks when there is something important to say. That is a quality that l have
always respected in others. During the focus group interview, Sally identified
her growth as a result of the support of her peers and the development of new
self-awarenesses. “Well, the MTPSG has helped me to feel more confident in
myself and in my professional life just having reinforcement and listening to
what people have to say.” While other group members used up the space and
time during that focus group session with many words that did not always end
in any conclusion, Sally identified her learning in a succinct manner. However,
I am not sure if she recognizes her own wisdom.

From the very beginning, Sally immersed herself in the musical
experiences. I realize now in retrospect that she excels as a music therapy
student because of her deep connection with the music. Those who were

more verbal did not seem to have as much growth as Sally. Perhaps it is

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easier to use and abuse words to cover up feelings, but not so with music.
During the first individual interview after session 8, I invited her to bring her
insightful reflections to the group. She agreed, but did not do so. During our
later individual interview, she cited her difficulties expressing herself during
MTPSG as a new awareness. She realized that she is the type of person who
needs to feel extremely comfortable before she could open up to others. “It
usually takes me a little bit to warm up to people before I can just talk freely in
front of them. That’s one thing I discovered in the group." She described her
growth in regards to speaking up in a group as developmental. “I thought the
second semester was a bit easier for me to talk in front of them."

The positive aspect of Sally’s tendency towards silence was a new
awareness about the type of learner that she is.

It was because of the MTPSG and all the time I spent with my peers

that I really learned about opening up. I love listening to what they

have to say. I wouldn’t contribute all the time because I would be so
enraptured with what they had to say. But I do think my peers
contributed a lot to helping me open up in a bigger group. Just being

able to talk in front of them and not really thinking too hard about what I

have to say and how they’re going to react to everything. So, the

MTPSG helped me with this new awareness about myself.

In relation to how this new self awareness may impact her work as a
music therapist, Sally recognized that she would have to develop comfort with
a group or client sooner in the process if she was too be an effective
therapist.

Particularly if I am going to work in psychiatry in that I won’t have the

opportunity to see clients for an extended period of time. I’m not going

to have a lot of time to warm up to them before I can really feel
comfortable. So that is a new discovery that I do need to work on.

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I too feel that it is important for Sally to learn to express herself in a
group. However, I have learned much from the way that Sally was able to
learn through active listening, to express herself with the written word and
more importantly to grow through the music. To me, Sally exemplified the
type of person whose insight and wisdom comes from the music. She
seemed more connected with group members during the musical experiences
then during verbal discussions. The feelings that emerged within and in
response to the musical experiences were deep and often difficult to describe
with mere words. I expect that Sally will be a good music therapist not merely
because she is a good student and not only because she is a good listener,
but because she connects with the music. It is the music, after all that
separates us from other types of therapist. It is the music that works in
partnership with us towards growth — our own, and ultimately those who we
seek to help.

As is typical of music therapy seniors, Sally did not seem to
understand the importance of or make the connection between her personal
growth to her development as a music therapist. She did, however recognize
involvement in music as important to her work as a music therapist and she
reported that she was going to look for an ensemble to play with.

Discussion
Reflecting on Sally’s case provided me with the opportunity to view the

life of a successful undergraduate music therapy student. I believe that her

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lack of verbal participation during the MTPSG is probably evident in all of her
other classes. However, despite her limited verbal participation in the MTPSG
her development was inspired by her connection with the music in
combination with her written reflections.

I sensed that Sally was ready and open for personal growth at this time
in her life. However, had she not participated in the MTPSG, she may not
have made these gains. She may have remained in the middle of the ocean
because there was no shore in sight. MTPSG may be a unique opportunity for
the music therapy undergraduate student to recognize the shore and begin to

move towards it.

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CHAPTER VII

MYSELF AS PARTICIPANT

This chapter presents findings related to my own experience as the
facilitator of the MTPSG as well as the researcher of this study. This is not the
first time that l have facilitated a MTPSG. However, this was the first time that
l have studied the phenomena of the MTPSG. I found that the research
analysis helped me to observe the challenges of facilitating this group and
has accelerated my own development as facilitator.

My intention was to further develop my skills and knowledge as a
music therapist and teacher. However, the analysis of the data illustrated that
the role and qualities specific to a facilitator are not merely therapist and not
merely teacher. Therefore, I sought to explore my role and the qualities that I
brought to the MTPSG in order to identify specific MTPSG facilitator qualities.

The chapter is organized into three sections. The first section provides
a description of the orientation meeting/15' session. My analysis of that first
session resulted in a representation of my thoughts and feelings regarding
group members’ initial responses to the MTPSG concept. It also provided me
with the opportunity to reflect on the particular qualities necessary of a
facilitator of MTPSG.

The second section is a narrative analysis of the improvisation, “Being

Open” that occurred during our second meeting. I found that my experience

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during that improvisation paralleled my experience as facilitator and my
relationships with group members over the course of the entire semester.

The last section addresses the specific role and qualities required of a
facilitator of a MTPSG in reference to group members’ perceptions. The data
for this analysis came from the question I posed to group members in
reference to the questions, “Is it therapy or is it peer-support?” and “What is
my (Joni’s) role?”

Orientation and Goal Setting

All day I felt uneasy. Was I prepared? Would they show up? Would

they agree to participate? Would I be understood? Heard? I didn’t do

much work today. I was too nervous. At the last minute I was running

around buying the tapes and pencils. Typical! (Joni’s Personal Log)

The orientation was scheduled for 7:30 and took place in the outer
office of the clinic. Everyone arrived on time except Nancy. She did not show
up at all that evening. I remember feeling disappointed, but she approached
me the next day to inform me that she was attending to a family crisis. We
met individually before the next session for the orientation and a brief
description of the first meeting.

Carla (a pseudonym), one of my colleagues who works in our
professional clinic was just finishing up in the clinic. I knew that she usually
finished seeing clients at 7:30 PM, but I did not know that she typically makes

her phone calls after that. She called a client’s mother and talked for what

seemed like an eternity. I tried to make light of the situation, but I felt angry. I

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followed up with her the next day, and we agreed that I would start the group
at 7:45 and that she would leave by that time.

There were not too many questions about the consent form. Jack was
concerned about the journal. He felt that it may be too much work. I assured
him that although it would be helpful to me, he was not required to journal to
participate in the study. However, I used that as an opportunity to explain to
the group the benefits ofjournaling both as personal reflection and as a
contribution of data to my study.

There were no other questions. Everyone else was silent and
seemingly agreeable. They all signed the consent forms. They all completed
the Sentence Completion Tests. During the test writing, they laughed and
poked fun at certain sentence stems. I rushed them along because it felt like it
was getting late and I wanted to have at least half an hour of session time.
(Note: The atmosphere during the post-test was also casual and rushed
because of a music therapy class assignment that students were struggling to
complete before our last meeting) The instruction manual of the test stated to
give them as much time as needed. I was concerned that my rushing them to
finish the test and allowing for a casual atmosphere would effect the results of
the test (see p. 58).

When I collected all the signed consents and completed tests, we
moved into the clinic to begin the work. We had a half-hour session. My
intention for this evening was to introduce them to the idea and the ritual. I

began with the chant, “Spirits of the Work” as I intended to use that as the

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opening for all sessions. They learned the chorus quickly and I sang the
verses. The beautiful mix of voices touched me. A warm feeling came over
me as we shared this music. This was so right. I forgot about my angst. A
new awareness for me was that when l immerse myself in the music, I feel
comfortable and secure. When the music stops, and it is my job to facilitate,
my angst returns.

When we were done singing, I posed the question, "What is the work?”
Once I had asked the question, I realized that I forgot to explain the check-in
concept. I dealt with that later. Brad gave a succinct answer, “the therapy -
our work.” Paul responded with “The work is life, I guess.” Betty suggested
that perhaps it was “the work that we will do here, in this group.” I was
impressed with the depth of these answers and I was relieved that they
seemed to understand the essence of the MTPSG. I then explained that this
was like a check-in, but that we will do a more formal check-in next week.

We then moved on to the imagery and music experience. I selected
the Museum Pose (Rogers, 1993) because I had used it many times before
as an introduction to MTPSG and found it to be a non-threatening way for
group members to engage in beginning to think about personal goals. I gave
the instructions to get comfortable on the floor and everyone struggled to find
their own space and lie down. All of a sudden, the room seemed small. There
was some chatter about finding space, but finally there was silence and we
were ready. I felt a great responsibility at that moment. I began to play my

guitar and gave the breathing and relaxation instructions, and I began to relax

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with the music. I noticed Jack having a difficult time settling down as he
quietly snickered.

I looked around after describing the first pose “this is how I’m feeling
right now” and noticed that most group members were responding physically
but with minimal movement. The second pose “this is how I would like to feel”
resulted in some physical change, but not too noticeable. I worried that they
were having difficulty understanding. However, during the discussion that
followed I realized that the movements that they made were internal, and that
I should not have been so quick to judge their insight.

Five of the then group members shared their images. My facilitative
questions were “What did you imagine?” “Describe each pose” “How did you
get from the first pose to the second?” What could that mean for your own
journey in terms of what your goals may be and how you will get there?”
“What do you have to do to reach your goals?” and “Is there anything
stopping you from moving toward your goals?”

The first group members to speak up were Ellen and Brad. Ellen
referred to her images as coming from a children’s film that "was exactly the
same story as your imagery script.” Both poses felt good to her, the first
“cuddled up and resting” and the second “tired but I allowed myself to rest.”
She seemed to be resisting any negative feelings. Brad also did not report
feeling much of a difference. His first pose felt good and positive” and the
second pose was the same, only “more delightful.” He described the entire

experience as “feeling open.”

126 I
|

I sensed that both of them felt that their first pose was supposed to be
more negative and that they were disappointed that they had misunderstood.
I realized at that moment that the group members were being what they felt to
be “good students” and answering the questions but not admitting anything
that they would consider negative. I said, “Ba-d is good, too, you know. It’s OK
to let us know if you were uncomfortable.” Some interesting responses came
next.

I was most intrigued by the dark images that were in response to the
breathing instructions “imagine your body as a balloon, and with each breath
in imagine your body, the balloon expanding. Nth each breath out imagine
your body releasing air from all its pores.” (Campbell, p.19). Jack said, “I
imagined my head as a balloon that got so big it exploded. It was funny. I’m
sorry that I laughed.” He was laughing when he described it to us, and we
laughed with him. I remember thinking that the image may be a reflection of a
student who had too much going on in his life, but I did not reveal that to the
group. I wanted everyone to have a chance to speak, and my intention was to
facilitate, not to analyze.

Betty referred to the song, “Black Balloon” that she said is “about a
woman in her own little world.” She described her first pose as being “curled
up in a ball on the floor” and her second pose as “strong, standing, confident.”
She had to stand up and put her head up to reach her goal and stated that
"lt’s about opening up.” She disclosed to the group that she had “some

issues” and that she was in the process of looking for a therapist as one way

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to open up. I was impressed that she could reveal this to the group during the
first session.

Helen reported that she remembered worrying about standing up to
assume the second pose with her eyes closed. She did not elaborate. I
wanted to make sure that we had enough time for the closing, so I stopped
asking for reflections and clarified my intention for this imagery and music
exercise. “This was an opportunity for you to begin to reflect on your goals,
how you’re feeling now and where you would like to see yourself in the
future.”

I decided to end with a chant that I call “Buddhist Chant." The lyrics are
from a Buddhist blessing that came to my attention a few years ago for which
I had created a melody. l prefaced the chant by thanking them for their
participation in my study, and for their openness, “I think it’s going to be great,
interesting, rich!” I then sang the blessing as if the music was coming from my
head.

“May you be filled with loving kindness, may you be well
May you be peaceful and at ease, may you be happy.”

Everyone joined in the third time and some group members started to
harmonize. The sound was so pleasurable to me. I felt that we were truly
“blessed.” I began to sing louder and improvise the melodies and everyone
else stopped singing. That felt weird, as if I imposed my own music on them
and they stopped participating.

In reflecting on the singing after the session, I came to the realization

that if I were to stay true to my desire to facilitate and not push the work of the

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group I would have to reflect that in the music as well. The harmony of the
group was dependent on equal opportunity for all voices. My best tool for

facilitating growth would be to provide the grounding - both musically and
verbally.

Ellen approached me immediately after the session to talk to me about
her difficulties with the MTPSG as a conflict with her religious convictions.
When she commented, “I do not need to or want to be open with this
particular group” I felt hurt but I did not share that with her. Instead, I informed
her that she is “free to bring up these issues in the group. That’s what it’s for.
Being open and honest may help others to do the same." I chose to see this
as healthy resistance and l was grateful that we had our first issue!

“Being Open”
The second meeting was the first full session.

I was nervous and had been thinking about the responsibility of this

project all week. This is a big project! (Joni’s Personal Log)

Before the session, I checked with Ellen to see if she was going to bring her
issue to the group. She said, "Sure” and she used her check-in to do so. I was
so impressed with her courage and with the subsequent support of her peers.
Her peers were mostly surprised by her declared fear that she would offend
group members with her religious convictions. I facilitated a ritual where group
members were to report if Ellen had ever offended them. The answer was a
resounding, “No.” Several group members informed her that if she would

offend her, they would tell her.

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The topic seemed to spark some personal reflection on the issue of
spirituality. l was pleased with the process. Where else would this group of
music therapy students have to tell each other how they feel about each other
and discuss how they could better communicate with each other? Where else
would they have the opportunity to reflect on their spirituality in terms of who
they are and how that may impact on their professional lives?

The discussion turned into what seemed to me to be a verbal
improvisation. Each group member provided different timbres, volume, rhythm
and melodies. Together, they produced an intense harmony. I decided to
bring this music to life in the form of our first musical improvisation. I
announced that we would perform an improvisation called “Being Open” and l
instructed group members to find instruments that would reflect that theme.

What transpired after that seems to me to be an illustration of my
perception of the personalities of the group members and the relationships
that developed over the next ten weeks. Upon further reflection of this
improvisation, I recognized that it became a metaphor for my own reactions,
thoughts, feelings and actions as a facilitator for this group. Therefore, I have
decided to illustrate my reflections of the piece of music “Being Open” that
was created by our group to help the reader to understand my perception of
the process and my new awarenesses as a result of my participation as
facilitator in the MTPSG.

First of all, I was scared. What was I thinking? I was no improvisation

expert. I could think of it as courageous. Yeah - courageous. That’s it. It was

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my courage and my conviction that this would be a good experience for the
students that brought me to this point. The idea to improvise on the title
“Being Open” was a good one. All I had to do now was sit back, observe and
participate in the music making. What would happen now? What if it got out of
control?

The improvisation lasted 21 minutes! Overall, it felt loud and playful. As
soon as I gave the instructions, I went to find the gong. I felt that with the
gong I could possibly control things if they got out of hand.

Nancy went to the right side of the piano bench and invited Peter to sit
next to her. She started to play the Blues in C and he followed. I wondered if
she felt as if she intended to take control of this music. Nobody else was in
the room. They were all off looking for instruments. They slowly came back to
the room with various instruments, clusters of two or three leisurely engaging
in small talk. Jack had an echo tube that he was exploring and he engaged
me in conversation.

For that moment, it felt like we were students hanging out at a bar, and
Nancy and Peter were providing the background music. I was sitting on the
floor with Nancy on the piano bench to my right side and Jack on the floor
next to me. I was playing the gong, trying to provide a macro beat. Nancy
stopped playing and looked around. Peter was still playing. Nancy looked
down at me and tried to engage me in her playing. At that moment I felt as if

she was trying to control me. I wanted to tell her that l was busy trying to

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make sure everything was going well. I had no time for her. She seemed to
be able to take care of herself. I didn’t respond to her.

Jack noticed Ellen coming into the room with a pianica and said,
"What’s that?” Ellen proceeded to blow as loud as she could and the sound
she produced was overpowering and unpleasant to me. Was I being
judgmental? Was she trying to get us to react to her? Nancy gave up on me
and tried to respond to Ellen’s imposing sounds. Everyone else had settled
into their own rhythmic percussion instruments, exploring the various sounds.
Where was this going? I was hoping that everyone was involved in some way.
I was hoping that nobody was apathetic about the experience.

Jack was making faces as if to indicate that he didn’t want to use the
echo tube any more. Oh, no. I forgot to tell them that they could change
instruments any time they wanted to. Did I have to? I assured Jack that he
could get another instrument. He got up to explore other choices. There was
an “oriental” sound to the music now. The rhythm was a disorganized
alternation of long and short drum and bell sounds. The scale on the melodic
instruments was a five note scale that moved from the tonic up a major 2"d to
the next note, up a minor 3'“, up a major 2"“, and up one last major 2"“. This
is known as the First Form Chinese Pentatonic scale (Robbins & Robbins,
1998). I got up to retrieve the metalophone thinking that I could help to bring
some order to the music, harmonically and rhythmically. On my way out I
heard Ellen playing a First Form Chinese Pentatonic theme on the pianica

and some loud, interesting laughter that seemed to be part of the music.

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I tried to engage Ellen with her pianica and we played together a bit. I
was extremely aware of how much mellower the metolophone sounded
compared to the pianica. Ellen began to play "Twinkle, Twinkle Little Star” and
I joined in with her. She then started to play “Three Blind Mice” and all of a
sudden there was a cacophony of sounds. Everyone was playing louder and
faster. I heard a twinkling chime, a percussive piano and laughter. Now it
sounds like a traffic jam. The pianica was the horn as if Ellen was saying,
“Come on. Get out of my way! Let’s get on with it.”

Quieter now. There’s a kind of “Sentimental Journey” feel to the music.
Oh no. More loud clusters of Ellen’s pianica and now Nancy and Peter are
responding to her with loud clusters of their own. I hear a whistle. I’m not sure
who it is, but it feels like a traffic cop saying, “Settle down, drivers!” There’s a
moment of quieter music mixed with verbal conversation. Peter starts to play
the base line of the "Peanuts Theme” and Nancy responds with the theme.
I’m impressed with her ability to do that as the rest of us provide the
percussive accompaniment. The rest of us are holding the space. There is no
sign of the pianica. Ellen appears with a red scarf and begins to dance around
the room. Jack returns with the temple blocks. The music escalates to a
rhythmic frenzy followed by a gradual slowing down.

Nancy stopped playing the piano and went out to find another
instrument. Peter stopped playing the piano and started tapping the piano
bench. Could he not play without her? Nancy returns with a snare drum.

There is no more pianica sound, but now Ellen has an accordion! It produces

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that same annoying sound! I returned to the solace of my metalophone,
playing a repeating slow, downward scale. I’m not sure if the music was
actually quieter, but I felt quieter.

I looked at the clock. We had to end soon. I didn’t want to end and not
have the opportunity to reflect on this experience. But we didn’t talk about
how it would end. I didn't give any instructions about ending. I hit the gong.
Nobody responded. I returned to the metalophone to think about what to do. I
tried another tap on the gong. Again there was no response. However, the
music in the room sounded more together. I became more percussive with
the gong as if to say to the group, “Yay, we have finally come together.” Still,
I had to stop the music. I hit the gong one more time. Still no response.
Finally, I sang as loud as I could "We have to stop.”

Little by little the music became quieter. Nobody just stopped
immediately. That lounge-like casual feeling returned. Finally, there were
only the sounds of people chatting. I asked if anyone would like to say
anything about the experience, and we had a short discussion. Betty noticed
that everyone had been smiling at some time during the improv. Oh, how she
wanted everyone to be happy. Nancy remarked that for a group of such
accomplished musicians, we certainly were not making cohesive music. She
was always the critic. Peter responded that he felt that there was
cohesiveness at times. He always looked for the positive. Ellen mentioned
that she could not hear Brad playing the guitar. She could always be

depended on to challenge us. Brad responded that he recognized that he felt

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comfortable not being heard, as it reminded him of his experience as a
nightclub musician. He could always find a new awareness.

I worked toward synthesis and closing as I said, “This was certainly a
group effort. Everyone played each in their own way and together we
produced interesting music.” Then I asked them if it felt “open" as we had
intended. Peter felt that we were free because we were expressing ourselves.
Ellen believed that it was free because we didn’t pay attention to the quality of
the music. It was not following any musical rules, so it was open. Her
perception was that other improvisation methods usually impose certain
music-related rules. “They tell you what you are supposed to do it.” I didn’t
understand that. It sounded like a judgement. It was as if she was judging
other music therapists. I suggested that “perhaps keeping it open is like an
exercise in playing with our judges."

It occurred to me that up to this point nobody mentioned any negative
aspects of the experience. I invited group members to talk about any
unpleasant reactions to the music. Ellen felt that it was not productive except
that it was fun. She seemed to be concerned about what she perceived as
her own child-like tendencies. She loved to work and play with children, but
she perceived this as a lack of maturity. I asked her if having fun was allowed.
She responded affirmatively.

Nancy remarked that this was more fun then Jazz Improvisation class
because there was less pressure here. The discussion broke down at this

point, into a complaint session about the pressures group members had felt

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about certain music teachers. I felt uncomfortable about this particularly
because we didn’t have time to get past their complaints about their teachers
to the real issues of lack of confidence and performance anxiety. I intervened
and ended with a performance of my Peer Support song (Milgram-Luterman,
1997). I felt that this was a good way to frame what the possibilities were for
this group. I also knew that there had to be a good ending, and I tend to feel
more comfortable ending in the music.

Helen, Sally, Hannah, Tina and Madeline did not participate in the
discussions. I also don’t remember much about what they did during the
improvisation. This was reflective of my perception of their participation
throughout the ten sessions. However, Helen, Sally and Hannah reflected on
the experience in their journals.

Helen admitted that she wasn’t feeling well and that she was “too sick
to be free. I tried to pretend that I felt fine so my negative energy wouldn’t
effect the group.” That seemed to be a big responsibility for Helen. Sally
reported that she loved the improv session. She wrote, "I felt that we
somehow connected even though we tended to play our own thing.” Hannah
mentioned that experiences such as the improv could draw us closer together
as a group before graduation. No one else had mentioned connecting as a
group. I wish that they had brought that to our attention during the session.
Nancy also submitted a journal that week. She wrote, “The free form jam got

kind of loud, but it was cool.” Finally, someone who admitted that it was loud.

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Each of the voices in this MTPSG was different. Some were loud and
showy. Others were quiet yet strong. There were also those who rarely
spoke. They performed their music in quiet unassuming ways. As an
ensemble, we were a powerful sound. Individually, we all learned about
ourselves. I felt that perhaps my role was that of the conductor — the type of
conductor that helps musicians to interpret the music themselves. In my own
experience in school and community orchestras, this was the type of
conductor that l was drawn to. l froze if the conductor was the type to scream
and threaten. I lost my imagination if the conductor was the type to impose
her interpretation on us in too much detail. I cringed at the type of conductor
who was always critical. l blossomed with the type of conductor who shared
the responsibility of the music, yet provided us with the comfort of her
suppon.

Participants’ Perceptions of Me as Facilitator

Although I intended to be the consummate facilitator, I often grappled
with exactly what my role of facilitator was. Although I am a music therapist I
did not want to be the psychotherapist, because I did not feel that it was
ethical. Although I am a music therapy educator I did not want to be the
teacher, because what I wanted students to learn skills and think about issues
that were not conducive to the classroom setting. Although I am a musician, I
did not want to perform for them, because that might stifle their own growth. I

wanted to make music with them. I had to create a new role as facilitator for

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this new concept of MTPSG. During her individual interview, Helen
demonstrated what I believe to be a clear understanding of my role.

Helen: I don’t feel like you’re really giving us therapy so much as

making us have it. Because you’re not really ever specifically saying

anything like “you have a complex.” You just kind of pose unbiased
questions.

By virtue of the fact that l arranged to have a clinical supervisor for this
study, one may think that I was acting as therapist. However, I viewed her as
more of a coach as we analyzed my group leadership skills. There were
often times that I complained to her that I had missed an opportunity to bring
an issue to a group members’ attention. She reminded me that my job was to
help them to learn about being in a group and help them to begin to think
about their own growth. This was not accomplished by constant attention to
issues, but by helping them to figure things out for themselves. She said that
she had learned a lot from supervising me that she would bring to her own job
as clinical supervisor. My problem is that although I listened to her praise, I
doubted that she was right. I assumed that she was merely being polite.
However, Ms. Williams is known to be the type of person who “tells it like it is”
so I eventually learned to hear the praise.

By virtue of the fact that I interviewed the music therapy professor who
was teaching the group members during the MTPSG semester, one might
think that l was acting as teacher. However, I was most concerned with how

students’ experiences in the MTPSG effected their music therapy learning.

What evolved from our meetings was a new opportunity to facilitate a peer

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supervision group. Ronald was intrigued by interpersonal developments of his
class and wanted to bring the idea to supervision. I believe that my
experiences with the group members of the MTPSG helped me to provide a
stimulating environment for group supervision. Also, Ronald and I worked well
as a team together during group supervision. I feel that this was due to the
fact that we had spent so much time analyzing the concept. Also, I grew to
respect his facilitation skills and I sensed his support of mine.

I brought the question, “Is it therapy or is it peer support” to the group
members after the eighth session during personal interviews. Eight group
members described my role as part of their answers to that question. Four of
them saw my role as a balance of therapist and peer.

Betty: You’re the instigator. You’re the one that says, “Mmm, you
know, they probably need to do this, so I’ll bring this up.” And you’re
just kind of like the flint. You start something and then you let it
progress where it would go. I think that we developed a relationship
with you but I think more so we developed our relationships with each
other. I think our relationship with you is based on the fact that you
start things, you bring insight to the group and that would further our
discussion and understanding.

Helen: When you sang your song about the feeling like you’re in the
middle of the ocean I felt as if you were one of us. You were letting us
know you more. But then the therapy aspect would be you’re there and
you guide us through a lot of things and you do a lot of motivational
thinking things like imagery and music. You guide whatever we’re
doing into a certain direction.

Hannah: I almost think it is more peer support because you’re not
totally leading. You’re there, you start it off, but almost every time we
get into discussions and half the time you don’t say anything and it just
ends up being us helping each other out. I’ve never really thought of it
as therapy. More [like] peer support.

Sally: I see you as a guide, not as the therapist. I think you are a guide
to present different opportunities for us to explore.

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Three group members felt that the group was more peer-facilitated.

Madeline: It’s more run by us and you’re just kind of there to
help us along.

Jack: You didn’t do much leading. You were just kind of there
observing it. And once in a while you would initiate conversation
or topics.

Nancy: Your role is to coordinate things. To be sort of an
outside observer and take data on how we can support each
other as peers in a structured group session.

Finally, one group member admitted her frustration with the confusion

surrounding my role.

Ellen: There’s a role that you have that’s not really part of the group
because a lot of times you share with us and you’re facilitating us. So
that’s kind of like a mixed signal on your role. Are you in the group or
out of the group? Are you leading or are you one of us? Just by virtue
of what you’re doing — that’s kind of a fine line that you’re on.
Sometimes we [I] would like to hear what do you think. But you know
that may also come from my whole academic performance thing where
I need to know the right answer. Even though I don’t necessarily take
what a teacher says as the right answer, I need to know what you
perceive is the right answer because you’re the one that’s grading us. I
know you’re not grading us. But even though you’re not grading us
you’re facilitating this so what do you want us to get out of it? Maybe
that’s the reason why you can’t do that [tell us what to do], but I’ve
noticed that often. That is really an issue for me.

Conclusions
The concept of MTPSG is new to undergraduate music therapy
education. As such, the role and qualities of the facilitator of MTPSG must be

clarified. l have found my role has been that of facilitator in the sense of

somebody who supports and facilitates but does not analyze. The participants

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of this study perceived me as peer, teacher and initiator. The experiences that
I brought to the MTPSG were derived from my experiences as music
therapist, but not psychotherapist, and served as the catalyst for new
awareness.

In reference to the facilitation skills outlined by Toseland and Rivas
(1984): (1) attending to others, (2) expressing self, (3) responding to others,
(4) focusing group communication, (5) guiding group interaction, and (6)
involving group members in the communication pattern, the findings reveal
that I have used these skills effectively.

I have attended to group members by being with them in the music. l
have expressed my own thoughts and feelings with the group members
through the performance of my own reflective songs. Although I have
responded to group members’ responses by supporting them, I did not
engage in the therapeutic skills of amplifying or toning down. I did not feel that
that would be appropriate in my role as facilitator.

l focussed group communication during verbal reflection discussions
by clarifying or repeating, but I did not limit group members’ responses toward
deeper exploration of issues and problems. My goal was for group members
to come to a new awareness and reflect on that awareness. Delving deeper
into that reflection would be a step that they would have to take on their own,
with a therapist and/or through continuing professional education. I felt my job
was to help them toward a new awareness as a catalyst for pursuing the type

of personal work that they would have to do as future music therapists.

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I believe that l guided group interaction through the musical
experiences that I brought to the MTPSG. I worked at involving group
members in the communication pattern more in the beginning stages (i.e.,
directing group members to respond to Ellen’s fear of appearing insulting to
others). Eventually, the group seemed to operate as a unit of peers,
interacting effectively both in and out of group meetings.

It has been interesting to reflect on my personal qualities as a facilitator
in reference to Corey and Corey's (1997) list of personal characteristics of an
effective group leader: (a) courage, (b) willingness to model, (0) presence, (d)
goodwill and caring, (e) belief in group process, (f) openness, (g) becoming
aware of your own culture, (h) nondefensiveness in coping with attacks, (i)
personal power, (j) stamina, (k) willingness to seek new experiences, (I) self-
awareness, (m) sense of humor, (n) inventiveness and (0) personal
dedication and commitment.

I believe that it took a lot of courage on my part to implement and study
this MTPSG. I faced my fear of group facilitation, choosing to view it as an
opportunity for my own growth. I perceived myself as willing to model support
with the intention that group members would learn to support each other —
and they did. I tried to be as present with them as I could but I also chose to
hold myself back so that they could be more present with each other. I feel
that my goodwill and caring attitude was the catalyst for group members to

feel comfortable in the MTPSG setting. I believe strongly in the concept of

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opportunities for personal growth for undergraduate music therapy students
and the strength of the group to facilitate that development.

This opportunity to study the phenomena of the MTPSG allowed me to
reflect on my own challenges to be more open and continue to develop my
awareness of how my own culture impacts my work. As an undergraduate
student, I felt my own religious and socioeconomic culture to be different from
that of my peers and that set me apart from them. However, I learned through
this experience that my religion or my socioeconomic status does not
necessarily bind my spiritual journey. What I came to understand is that
undergraduate music therapy students have their own culture, just as l and
my peers do as music therapists and doctoral students. That is our
connection and what helps us to meet our challenges.

I have learned that although I sometimes felt personally attacked by
others’ responses to me and what I brought to the MTPSG meetings, (i.e.,
Ellen’s declaration that she was going to withdraw from the MTPSG and a
committee member’s comment that I had misrepresented the concept of the
MTPSG to the Human Subject’s Committee) I learned a lot by facing these
issues as challenges toward my own growth.

My sense of personal power has developed as well. I have always
seen myself as a person with little power, but with this opportunity to study my
own process so closely, l have begun to recognize that when I acknowledge
my power, I am powerful. In terms of stamina, I realized that any fatigue I was

feeling quickly dissipated once a MTPSG session began.

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My willingness to seek new experiences was reflected not only in the
implementation and study of this MTPSG, but during sessions as well, where
l challenged myself to face my fears of facilitating groups. In my struggle to
help group members to develop new awarenesses about themselves, I
developed new awarenesses about myself, mostly that my life is a continuous
journey of new awarenesses and issues. I continue to challenge myself to
confront these issues.

I feel that I brought my sense of humor, my inventiveness, my musical
talent and my skill as a music therapist and music therapy educator to my
work as the facilitator of this MTPSG. Most of all, I brought a strong sense of
personal dedication and commitment to the MTPSG because I believe so
strongly in the importance of personal growth for undergraduate music
therapy education.

I invite music therapy programs to consider the MTPSG concept. As is
evident in this study, it is challenging yet rewarding work. Although university
administrators may perceive instructors as facilitators as a conflict of interest,
the participants of this study, including my clinical supervisor, the music
therapy professor and myself did not experience it as such. Instead, we saw it
as an integral part of music therapy education during which undergraduate
music therapy students begin to reflect on who they are and how that impacts
on their work as music therapists. As educators, do we not have the
responsibility of helping our students to grow? And as music therapists, do we

not have the skills and qualities to do so?

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CHAPTER 8

IMPACT OF MTPSG AND IMPLICATIONS

The implementation and study of the MTPSG has played an important
role in the personal, professional and academic growth of the eleven group
members, their professor, my clinical supervisor and me. Ultimately, it has
effected the learning environment of the senior music therapy class at GLU.
The students cited the musical environment and peer support as the major
vehicles for their development.

In terms of my theory of a disposition of expertise in music therapy, all
realms of experience have been effected by the MTPSG: (1) music, (2)
therapy, (3) music therapy, (4) spirituality, (5) relationship, (6)
professionalism, and (7) scholarship. Self, particularly in terms of self-
awareness, also emerged as a realm that effected the students’ development.
The realms of spirituality, relationship and Self emerged as the most
important for the students in terms of their own growth and awareness. These
three realms are not typically addressed within the curriculum, yet they are
important to the development of music therapy students. A group such as the
MTPSG could fill the curricular void and enhance the development of music
therapy expertise.

The case of “Sally” reflects the experience of a successful music

therapy senior who seemed to be ready and open for personal growth.

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Although her verbal participation during MTPSG was limited, her growth was
reflected in her connection with the music and her journals. She developed
new awarenesses regarding her relationship with her family and her learning
and communication styles. She reported more confidence in herself and an
increased ability to listen to others. Had she not had the opportunity to attend
the MTPSG, it is likely that she would not have made these gains.

The experience seemed to have an effect on group members’
interpersonal behavior in music therapy class resulting in a more supportive
environment. All group members reported new self-awarenesses and began
to integrate the learning from the group into other aspects of their curriculum,
such as music therapy class, Jazz Improvisation class and Clinical Practice.

The music therapy professor implemented a curriculum change
inspired by the success of the MTPSG. The professor and I altered the format
and structure of Group Supervision to more closely resemble the MTPSG and
developed the new Peer Supervision Group. Group members took their
comfort with the environment and their new awarenesses into the Peer
Supervision Group the following semester.

My clinical supervisor had the opportunity to learn about the MTPSG
concept and observe group members’ growth. She plans to implement the
idea into her curriculum in her capacity as music therapy instructor at another
university. My own experience as facilitator and researcher has allowed me
the opportunity for more concrete organization of the MTPSG and for

identifying the role and qualities specific to a facilitator of MTPSG. l have

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developed new awarenesses and skills as a facilitator and I have learned
about the benefits of action research to my practice as both clinician and
educator and ultimately to the quality music therapy education.
Implications for Undergraduate Music Therapy Education

I believe that it is possible for undergraduate music therapy students
to begin the journey of personal growth before finishing their coursework and
beginning their internships. Furthermore, I feel that participation in groups
such as MTPSG may enhance students’ experiences with the curriculum.

Undergraduate students typically have many issues to work through.
Undergraduate music therapy students have many more issues then other
undergraduates because of the clinical component. Seniors are struggling
with impending graduation and internships, time constraints and performance
anxiety, to name a few issues. Music therapy educators are aware of these
issues but have not typically been able to provide a forum for dealing with
them. The MTPSG has filled that need for the senior music therapy students
at GLU.

One group member mentioned that she wished that the MTPSG had
started earlier in her academic career. I concur, as I believe that clinical
observations and experience may be enhanced and new awarenesses may
be integrated into the coursework. Other clinically oriented undergraduate
programs may also benefit, such as music education, occupational therapy
and physical therapy. Performance programs such as music and drama may

also benefit to help students to address issues of performance anxiety.

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Implications for Research

This action research study has enhanced my experience as MTPSG
facilitator and has given me the opportunity to further develop my clinical and
teaching skills and knowledge. There are many interesting and useful areas
of research that could evolve from this study. As suggested in Chapter 2,
there are several music therapy competencies that are not typically
addressed in the current curriculum. Maranto (1989) suggests accountability
studies to assess the success of music therapy education and training
techniques in preparing students in the various competency areas. A future
study could examine accountability in terms of the inclusion of MTPSG into
the curriculum.

This study of MTPSG proposes one type of group that offers
undergraduate students opportunities for personal growth. Perhaps other
undergraduate music therapy programs have similar groups. It would be
interesting to implement a survey study to investigate current personal growth
opportunities in undergraduate music therapy programs.

I would be interested in following the group of students who
participated in this study as they experience their internships, beginning
practice and beyond. Attention would be given to if, how and what kind of
support and personal growth experiences they seek.

A replication study would be interesting to implement in other
undergraduate music therapy programs, as well as other clinically oriented

undergraduate programs such as music education, physical and occupational

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therapy. Finally, an historical study of music therapy associations worldwide
would be helpful to track the development of the education of music therapists
and provide perspective regarding trends in personal growth as part of the
curriculum.

It is hoped that music therapy educators, clinical trainers, researchers
and practitioners will consider exploring the concept of personal growth as
part of the music therapy curriculum, particularly for undergraduate students.
The implementation of the MTPSG presented here is but one conception to
address student development. Other types of training experiences for
undergraduate students specific to the needs of particular university programs
would be interesting to explore.

The implementation of this research project has reminded me of the
fact that my development is never ending. I plan to continue to grow
personally, professionally, academically and spiritually for the rest of my life.
This quote from a song that I wrote for the first peer support group that l
facilitated reflects my thoughts and feelings regarding life-long learning and
development (see Appendix K for the complete notated version of “Peer
Group, March ’97):

“We are but babies just now born to the journey of life.”

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References

Aigen, K. (1995). Principles of qualitative research. In B. Wheeler

 

(Ed.), Music therapv research: Quantitative and Qualitative perspectives (pp.
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APPENDICES

159

APPENDIX A

AMTA Standards for Bachelor’s Degrees

Final report and recommendations of the commission of education and

clinical training of the American Music Therapy Association

160

 

 

 

 

STANDARDS FOR BACHELOR’S DEGREES

Academic Component

1) The bachelor’ 3 degree in music therapy (and equivalency programs) shall be designed to
impart 611.121.122.61 competencies in three main areas: musical foundations, clinical
foundations, and music therapy foundations and principles, as specified in the “NAMT
Professional Competencies” passed by the NAMT Assembly of Delegates in 1996.

2) As stipulated in NASM standards the bachelor’s degree in music therapy shall be
divided into areas of study as follows (based on 120 semester hours or its equivalent).
Please note that the courses listed below each area of study are only suggested titles of
possible courses or course topics.

MUSICAL FOUNDATIONS (45%)
Music Theory
Compositionand Arranging
Music History and Literature
Applied Music Major
Ensembles
Conducting
Functional Piano, Guitar, and Voice

CLINICAL FOUNDATIONS (16%)
Exceptionality and Psychopathology
Normal Human Development
Principles of Therapy
The Therapeutic Relationship

MUSIC THERAPY (16%) _
Foundations and Principles
Assessment and Evaluation
Methods and Techniques
Pre-Internship and Internship Courses
Psychology of Music
Music Therapy Research
Influence of Music on Behavior
Music Therapy with Various Populations

GENERAL EDUCATION (22%)
English, Math, Social Sciences, Arts,
Humanities, Physical Sciences, etc.

ELECTIVES (5%)

161

APPENDIX B

NAMT Professional Competencies

162

National Association for Music Therapy, Inc.
8455 COLESVILLE ROAD, SUITE 930, SILVER SPRING, MD 20910-3392 (301)
589-3300 FAX (301) 589-5175

Professional Competencies
Revised 1996

In moving from a course based to a competency-base curriculum, it must be
emphasized that the approved list of competencies not be viewed as a static
requirement. As the clinical and research activities of music therapy provide new
information, the competency list can and must be revised to reflect the growth of
the knowledge base of the profession. As such, this list provides a common
ground from which present state, comparisons, and trends can be determined.
They also provide a cumulative definition of what we do as music therapists and,
therefore, better enable us to convey that definition to others. Scartelli (1994). pp.
1,3)

A. Music Foundations

1. Music Theory and History

1.1 Recognize standard works in the literature.

1.2 Identify the elemental, structural, and stylistic characteristics of
music from various periods and cultures.

1.3 Sight-sing melodies of both diatonic and chromatic makeup.

1.4 Take aural dictation of melodies, rhythms, and chord progressions.

1.5 Transpose simple compositions.

2. Composition and Arranging Skills

2.1 Compose songs with simple accompaniment.

2.2 Adapt, arrange, transpose, and simplify music compositions for
small vocal and nonsymphonic instrumental ensembles.

3. Major Performance Medium Skills

3.1 Perform appropriate undergraduate repertoire, demonstrate
musicianship, technical proficiency and interpretive understanding on a principal
instrument/voice.

3.2 Perform in small and large ensembles.

4. Keyboard Skills

4.1 Accompany self and ensembles proficiently.

4.2 Play basic chord progressions (I-IV-V-l) in several keys.

4.3 Sight-read simple compositions and song accompaniments.

4.4 Play a basic repertoire of traditional, folk and popular songs with or
without printed music.

4.5 Harmonize and transpose simple compositions.

163

5. Guitar Skills

5.1 Accompany self and ensembles proficiently.

5.2 Employ simple strumming and finger picking techniques.

5.3 Tune guitar using standard and other tunings.

5.4 Perform a basic repertoire of traditional, folk and popular songs with
or without printed music.

5.5 harmonize and transpose simple compositions in several keys.

6. Voice Skills

6.1 Lead group singing by voice.

6.2 Communicate vocally with adequate volume (loudness).

6.3 Sing a basic repertoire of traditional, folk and popular songs in tune
with a pleasing quality.

7. Nonsymphonic Instrument Skills

7.1 Play percussion instruments alone or in ensemble.

7.2 Demonstrate basic knowledge of care and maintenance of
nonsymphonic and ethnic instruments.

7.3 Play autoharp or omnichord with same competence specified for
guitar.

7.4 Demonstrate basic understanding of technologically advanced
instruments (omnichord, MIDI, electronic keyboard).

7.5 Demonstrate basic skills (i.e., rudiments) on several standard
percussion instruments sufficient to facilitate rhythm-based experiences for
groups and individuals.

8. Improvisation Skills

8.1 Improvise on percussion instruments.

8.2 Compose and develop original melodies, accompaniments, and
short pieces extemporaneously in a variety of moods and styles, vocally and
instrumentally.

8.3 Improvise in small ensembles.

9. Conducting Skills
9.1 Conduct basic patterns with technical accuracy.
9.2 Conduct small and large vocal and instrumental ensembles.

10. Movement Skills

10.1 Direct structured and improvisatory movement experiences.

10.2 Move in structural rhythmic and improvisatory manners for
expressive purposes.

10.3 Move expressively and with interpretation to music within rhythmic
structure.

164

B. Clinical Foundations

11. Exceptionality

11.1 Demonstrate basic knowledge of the potentials, limitations,
problems of exceptional individuals.

11.2 Demonstrate basic knowledge of the causes and symptoms of
major exceptionalities, and basic terminology used in diagnosis and
classification.

11.3 Demonstrate basic knowledge of typical and atypical human
systems and development (e.g., anatomical, physiological, psychological, social).

12. Principles of Therapy

12.1 Demonstrate basic knowledge of the dynamics and processes of a
therapist-client relationship.

12.2 Demonstrate basic knowledge of the dynamics and processes of
therapy groups.

12.3 Demonstrate basic knowledge of accepted methods of major
therapeutic approaches.

13. The Therapeutic Relationship

13.1 Recognize the impact of one's own feelings, attitudes, and actions
on the client and the therapy process.

13.2 Establish and maintain interpersonal relationships with clients that
are conducive to therapy.

13.3 Use oneself effectively in the therapist role in both individual and
group therapy, e.g., appropriate self-disclosure, authenticity, empathy, etc.
toward affecting desired behavioral outcomes.

13.4 Utilize the dynamics and processes of groups to achieve
therapeutic goals.

C. Music Therapy

14. Foundations and Principles

14.1 Demonstrate basic knowledge of existing music therapy methods,
techniques, materials, and equipment with their appropriate applications.

14.2 Demonstrate basic knowledge of principles and methods of music
therapy assessment and their appropriate applications.

14.3 Demonstrate basic knowledge of the principles and methods for
evaluating the effects of music therapy.

14.4 Demonstrate basic knowledge of the purpose, intent, and function
of music therapy for various client populations.

14.6 Demonstrate basic knowledge of the psychological and
physiological aspects of musical behavior and experience (i.e., music and affect;
influence of music on behavior; physiological responses to music; perception and
cognition of music; psychomotor components of music behavior; music learning
and development; preference; creativity).

165

14.7 Demonstrate basic knowledge of philosophical, physiological,
psychological, and sociological bases for the use of music as therapy.

15. Client Assessment

15.1 Communicate assessment findings and recommendations in written
and verbal forms.

15.2 Observe and record accurately the client's responses to
assessment. ‘

15.3 Identify the client's appropriate and inappropriate behaviors.

15.4 Select, design and implement effective culturally based methods for
assessing the client's assets and problems through music.

15.5 Select, design, and implement effective culturally based methods
for assessing the client's musical preferences and level of musical functioning or
development.

15.6 Identify the client's therapeutic needs through an analysis and
interpretation of music therapy and related assessment data.

15.7 Demonstrate knowledge of professional standards of clinical
practice regarding assessment.

16. Treatment Planning

161 Select or create music therapy experiences that meet the client's
objectives. .

16.2 Formulate goals and objectives for individual and group music
therapy based upon assessment findings.

16.3 Identify the client's primary treatment needs in music therapy.

16.4 Provide preliminary estimates of frequency and duration of
treatment.

16.5 Select and adapt music consistent with strengths and needs of the
client.

16.6 Formulate music therapy strategies for individuals and groups
based upon the goals and objectives adopted.

16.7 Select and adapt musical instruments and equipment consistent
with strengths and needs of the client.

16.8 Organize and arrange the music therapy setting to facilitate the
client's therapeutic involvement.

17. Therapy Implementation

17.1 Recognize, interpret, and respond appropriately to significant
events in the music therapy session as they occur.

17.2 Provide music therapy experiences to change nonmusical
behaviors.

17.3 Provide verbal and nonverbal directions and cues necessary for
successful client participation.

17.4 Utilize singing skills in music therapy sessions.

166

17.5 Provide models for appropriate social behavior in group music
therapy.

17.6 Utilize therapeutic verbal skills in music therapy sessions.

17.7 Sequence and pace music experiences within a session according
to the client's needs and situational factors.

17.8 Conduct or facilitate group and individual music therapy.

17.9 Establish closure of music therapy sessions.

17.10 Implement music therapy program according to treatment plan.

17.11 Promote a sense of group cohesiveness and/or a feeling of group
membership.

17.12 Provide music therapy experiences that assist the client in
development of social skills.

17.13 Communicate to the clients expectations of their behavior.

17.14 Assist the client to communicate more effectively.

17.15 Provide music therapy experiences to improve the client's sense of
self and sense of self with others.

17.16 Create a physical environment (e.g., arrangement of space,
furniture, equipment, and instruments) that is conducive to effective therapy.

17.17 Provide music therapy experiences to elicit social interactions.

17.18 ‘Provide music therapy experiences to promote client decision-
making.

17.19 Develop and maintain a repertoire of music for age, culture, and
stylistic differences.

17.20 Provide music therapy experiences that assist the client in
increasing on-task behavior.

17.21 Provide music therapy experiences to elicit affective responses
from the client.

17.22 Provide feedback on, reflect, rephrase, and translate the client's
communications.

17.23 Establish closure of treatment issues.

17.24 Provide sensory stimulation through music therapy experiences
that allow the client to use visual, auditory, or tactile cues.

17.25 Utilize nonsymphonic instruments (pitched and unpitched) in music
therapy sessions.

17.26 Provide music therapy experiences to encourage creative
responses from the client.

17.27 Use music with techniques of relaxation and/or stress reduction.

17.28 Provide music therapy experiences to improve the client's
orientation to person, place and time.

17.29 Provide music therapy experiences to enhance the client's
cognitive/intellectual development.

17.30 Recognize and respond appropriately to effects of the client's
medications.

17.31 Demonstrate knowledge of professional standards of clinical
practice regarding implementation.

167

18. Therapy Evaluation

18.1 Recognize and respond appropriately to situations in which there
are clear and present dangers to the client and/or others.

18.2 Modify treatment approaches based on the client's response to
therapy.

18.3 Recognize significant changes and patterns in the client's response
to therapy.

18.4 Revise treatment plan as needed.

18.5 Establish and work within realistic time frames for evaluating the
effects of therapy.

18.6 Review treatment plan periodically within guidelines set by agency.

18.7 Design and implement methods for evaluating and measuring client
progress and the effectiveness of therapeutic strategies.

18.8 Demonstrate knowledge of professional standards of clinical
practice regarding evaluation.

19. Documentation

19.1 Write progress notes that accurately reflect client change and meet
the requirements of internal and external legal, regulatory, and reimbursement
bodies.

19.2 Document clinical data.

19.3 Write professional reports describing the client throughout all
phases of the music therapy process in an accurate, concise, and objective
manner.

19.4 Communicate orally with the client, parents, significant others, and
team members regarding the client's progress and various aspects of the client's
music therapy program.

19.5 Document and revise the treatment plan and document changes to
the treatment plan.

19.6 Develop and use data-gathering techniques during all phases of the
clinical process including assessment, treatment, and evaluation.

19.7 Demonstrate knowledge of professional standards of clinical
practice regarding documentation.

20. Termination/Discharge Planning

20.1 Inform and prepare the client for approaching termination from
music therapy.

20.2 Establish closure of music therapy services by time of
termination/discharge.

20.3 Determine termination of the client from music therapy.

20.4 Integrate music therapy termination plan with plans for the client's
discharge from the facility.

20.5 Assess potential benefits/detriments of termination of music
therapy.

20.6 Develop music therapy termination plan.

168

20.7 Demonstrate knowledge of professional standards of clinical
practice regarding termination.

21. Professional Role/Ethics

21.1 Adhere to professional code of ethics.

21.2 Interpret and apply ethical standards of the music therapy
profession.

21.3 Adhere to professional standards of clinical practice.

21.4 Demonstrate dependability: follows through with all tasks regarding
education and professional training.

21.5 Accept criticism/feedback with willingness and follow through in a
productive manner.

21.6 Resolve conflicts in a positive and constructive manner.

21.7 Meet deadlines without prompting.

21.8 Express thoughts and personal feelings in a consistently
constructive manner.

21.9 Demonstrate critical self-awareness of strengths and weaknesses.

21.10 Interpret and apply laws and regulations regarding the human rights
of the clients. -

21.11 Demonstrate basic knowledge of professional music therapy
organizations and how these organizations influence clinical practice.

22. Interdisciplinary Collaboration

22.1 Demonstrate a basic understanding of the roles and develop
working relationships with other disciplines in the client's treatment program.

22.2 Define the role of music therapy in the client's total treatment
program.

22.3 Collaborate with team members in designing and implementing
interdisciplinary treatment programs.

23. Supervision and Administration
23.1 Participate in and benefit from supervision.
23.2 Manage and maintain music therapy equipment and supplies.

24. Research Methods

24.1 Interpret information in the professional research literature.

24.2 Determine if conclusions drawn in a study are supported by the
results.

24.3 Demonstrate basic knowledge of the purpose and methodology of
historical, quantitative and qualitative research.

24.4 Perform a data-based literature search.

24.5 Apply selected research findings to clinical practice.

169

The NAMT competencies are based on music therapy competencies authored
for the American Association for Music Therapy from:

Bruscia, K. E., Hesser, B., 8 Boxill, E. H. (1981). Essential competencies for the
practice of music therapy. Music Therapy, 1, 43-47.

Adapted and reprinted with permission.

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The University of Iowa.

Sandness, M. l., McGuire, M. G., 8 Cohen, N. (1995). Roundiable Discussion:
The process of implementing the NAMT Professional Competencies into the
academic curriculum. A presentation at the National Association for Music
Therapy Conference, Houston, TX.

Scartelli, J. (October-November, 1994). NAMT Notes, pp. 1-3.

171

 

Taylor, DB. (1984). Professional music therapist’s opinion concerning

competencies for entry level music therapy practitioners. Dissertation Abstracts
International, 43, 8424243.

Taylor, DB. (1987). A survey of professional music therapists concerning entry
level competencies. Journal of Music
Therapy, 24, 114-145.

172

APPENDIX C

Course Syllabus

173

MUSIC THERAPY: MENTAL AND BEHAVIORAL DISORDERS
Michigan State University - Fall Semester

COURSE OBJECTIVES:

0

To identify the aspects of the influence of music on human behavior in the
contexts of neuropsychological processes, physiological responses,
communication/expression functions, social/cultural activities, and aesthetic
expenences.

To identify the characteristics of mental and behavioral disorders in adults
and children: schizophrenia, mood disorders, anxiety disorders, personality
disorders, substance abuse, and others.

To identify the treatment objectives and appropriate music therapy
interventions for mental and behavioral disorders.

To identify the treatment objectives and appropriate music therapy
interventions for older adults.

To delineate a taxonomy of programs and techniques used in music therapy,
with emphasis on the psychotherapeutic aspects of music therapy.

To explore the various theories of psychotherapy and their relation to music
therapy.

To encourage greater other— and self-awareness through didactic and
experiential introductions to the basics of individual and group music therapy.

To explore and practice group and individual music therapy strategies for
aduks.

To provide role-playing experiences, both of doing music therapy in a variety
of situations and being “done unto” by music therapy.

To encourage assuming responsibility for one’s own behavior.

To identify the fundamental classes and uses of psychotropic medications in
treating mental disorders.

To develop the following music therapy skills in the context of direct clinical
application in the Music Therapy Clinic:

a) treatment conceptualization

b) documentation

0) interpersonal approach

d) session management

e) music leadership

(
(
(
(
(

174

TERMINAL BEHAVIORS EXPECTED:

0 As the year progresses becoming more and more equiped to function
successfully as a music therapy intern.

o Possessing a commitment to reform the “establishment” toward effective
delivery of healthcare services to all in need of these services.

0 Being aware of and identifying feelings within oneself and others.

0 Demonstration of clinical skills necessary to plan, write, and evaluate music
therapy treatment interventions for various psychiatric and behavioral needs.

- Demonstration of clinical skills needed to conduct music therapy sessions
with individuals who have psychiatric or behavioral conditions, and the
problems associated with aging.

TEXTS:
Purchase the following at the bookstore:

American Psychiatric Association. (1994). Desk reference to the
diagnostic criteria from DSM IV.

Borczon, RM. (1997) Music therapy: group vignettes.

Bruscia, K. (1991). Music therapy casebook.

Clair, AA (1996). Therapeutic uses of music with older adults.

Corey, G. (1996). Manual for theory and practice of counseling and
psychotherapy, (5th ed.)

Michigan State University. (1999). Music Therapy Clinic procedures
manual. (purchased for Music 371 in a previous year, or to be obtained from the
instructor)

Find the following on reserve in the Fine Arts Library:

Unkefer, R.F.,Ed. (1990). Music therapy in the treatment of adults with
mental disorders. (purchase at bookstore if possible)

Lathom, W. and Eagle, C. (1982, 1984). Music therapy for handicapped
children, Vol. 2, Emotionally Disturbed, Mentally Retarded, Speech Impaired.

Course packet

Additional readings will be placed on reserve in the Fine Arts Library or
distributed in class.

RECOMMENDED TEXT:
Corey, G. (1996). Theory and practice of counseling and psychotherapy.

175

 

 

 

 

 

APPENDIX D

Personal Interviews Protocol

176

Sample Personal Interview Protocol

. How has the experience of MTPSG been for you? How has theprocess
been?

. Have you developed any new awarenesses? What are they?

. How has your participation in our group influenced your performance as a
student therapist in your placement?

. How has your participation in our group influenced your learning in class?
. How has your participation our group influenced your interpersonal
relationships with your classmates?

. How has your experience in the group influenced any decisions you have
made or changes you would make in other aspects of your life?

. What is peer-support? What is therapy? Is the MTPSG peer-support or
therapy?

. What is my (Joni’s) role in MTPSG?

. Would you perceive a conflict of interest in terms of my role as facilitator
and my role as clinical supervisor and/or instructor if I had accepted to
carry out the role of clinical supervisor and/or instructor for this class?

10. Has your experience in the group influenced your relationship with your

clinical supervisor?

11.How would you explain the concept and the benefits of MTPSG to

university administrators?

12. Do you have any other concerns or questions?

Thank You

177

 

 

APPENDIX E.

Human Subjects Committee

178

37/99

.—-_‘

 

OFFICE OF
RESEARCH
AND
GRADUATE
STUDIES

sity Committee on
lesearch Involving
Human Subjects

iigan State University
lministratior. Building
lSi Lansing, Michigan

48524-1046

517/355-2180

FAX: 517/353—2976
'.nsu.ecL/userlucrihs
lail: u:rlhs@rnsu.edu

15: 49 FAX 5173532976

MICHIGAN STATE
u N r v E R s l T Y

 

December 6, 1999

TO: Colleen Conway
102 Music Building

RE: IRB # 98-790 CATEGORY: 2-F
RENEWAL APPROVAL DATE: December 2, 1999

WHO AM I AND WHAT AM I DOING HERE ANYWAY? A PROPOSED STUDY OF
THE EFFECTIVENESS OF PEER SUPPORT GROUPS FOR UNDERGRADUATE
MUSIC THERAPY STUDENTS

TITLE:

The University Committee on Research Involving Human Subjects’ (UCRIHS) review of this
project is complete and I am pleased to advise that the rights and welfare of the human subjects
appear to be adequately protected and methods to obtain informed consent are appropriate. -
Therefore, the UCRIHS APPROVED THIS PROJECT'S RENEWAL.

Due to changes in the federal definitions of research categories, your
protocol has been reassigned to category 2-F.

RENEWALS: UCRIHS approval is valid for one calendar year, beginning with the approval date
shown above. Projects continuing beyond one year must be renewed with the green renewal
form. A maximum of four such expedited renewal are possible. Investigators wishing to
continue a project beyond that time need to submit it again for complete review.

REVISIONS: UCRIHS must review any changes in procedures involving human subjects, prior
to initiation of the change. If this is done at the time of renewal, pleaseuse the green renewal
form. To revise an approved protocol at any other time during the year, send your written
request to the UCRIHS Chair, requesting revised approval and referencing the project's IRB#
and title. Include in your request a description of the change and any revised instruments,
consent forms or advertisements that are applicable.

PROBLEMS/CHANGES: Should either of the following arise during the course of the work,
notify UCRIHS promptly: 1) problems (unexpected side effects, complaints, etc.) involving
human subjects or 2) changes in the research environment or new information indicating greater
risk to the human subjects than existed when the protocol was previously reviewed and
approved.

If we can be of further assistance, please contact us at 517 355-2180 or via email:
UCRiHS@pilot.msu.edu.

mat)

David E. Wright
Chair, UCRIHS

  

DEW: bd 179

_ -. lnni Milnramd uglier-man

 

_._—

 

 

 

Joni Milgram-Luterman, M Mus, MT A. MT -BC
511 Marshall Street
East Lansing, MI
48823
Phone: 337-8972
Fax: 337—8975

e-mail: nulgrgrpilQpilotmsuedu

Date: August 12, 1999

To: University Committee on Research Involving Human Subjects

Re: Revision of protocol for IRB #98790

Title: Who amI and what amI doing here anyway? A proposed study of the
effectiveness of peer support groups for undergraduate music therapy
students.

From: Joni Milgram-Luterman, Doctoral Student

Faculty Advisor: Colleen Conway, Music Education

Please be advised that I wish to revise the procedures involving human subjects
for this study. I have completed the interview study that I proposed as a class assignment
and now I plan to expand on the study as dissertation research project. I would like to
take this project further to include the study of the process of peer-support groups for
music therapy undergraduate students. This would entail video and audio taping ten
music therapy peer-support group sessions over the course of Fall Semester, 1999.

The tapes will be used as data and will be held in confidence. They will be used
to corroborate the participants’ and my reflections on the process. Interview will also be
audio taped as in the previous study. Although the entire class of MUS 470 is required to
attend the group, only those who agree to participate in the study will be videotaped
during sessions.

I also intend to administer an adapted version of the Washington University
Sentence Completion Test of Ego Development (WUSCT)(Loevinger, 1970, 1996) as a
pre-test/post-test. I may use the test scores as data. I am interested in the effects of the
group experience in reference to studpnts’ developmental levels of self-awareness.

I have also secured a clinical supervisor who is a music therapist not afiiliated
with this university. Her responsibilities will be to supervise my clinical and teaching
skills in the process of the group. She has also agreed to score WUSCT tests for the
purposes of inter-judge reliability. One of my goals for this study is to enhance and
improve my skills as facilitator. As a clinical supervisor, she maintains the
confidentiality of group members.

I understand that all group members, including those who agree to participate in
the study and those who do not agree to participate in the study deserve their rights to
privacy. All data will be coded, and tapes will be held in the strictest confidence.

In terms of my relationship with prospective participants, 1 have not had any
supervisory role with this group, except for observing senior music therapy students’
clinical practice with a few of them as part of their observation requirements as juniors,

180

 

 

last year. I have declined the opportunity to supervise this particular group of seniors this
semester so as to eliminate the possibility of any conflict of interest.

As in the previous study, a potential benefit of participation in this study is the
opportunity for self-reflection. Analysis of the data of the previous study indicated
perceived benefits or participation in peer support groups as 1) important to personal and
professional growth, 2) instrumental in the development of peer-support relationships
within the class and 3) an opportunity to relax

There are no obvious risks to the participants. They will be assured that this is a
peer-support group and not a therapy group. As such, it is the group experience, the
recognition of the process and the development of new awarenesses that supercede
individual therapeutic change. As has been the case with past groups, students who
present with issues that are outside the boundaries of the intention of the group may be
referred to appropriate therapists or counselors.

Logistical changes in the protocol will be reflected in a slight title change: “Who am I
and what am I doing here anyway? A study of the process of peer support groups
for undergraduate music therapy students.” This implies that I will be expanding the
observations to the group and the group process. We will all be required to keep journals
reflecting our experience throughout the semester. As a result of these changes, please
see the updated attached consent form. My intention is to begin the study with an
orientation meeting during the second or third week of Fall Semester 1999. This
would coincide with the beginning of their clinical placement sessions and assure that we
could have ten sessions before the end of the semester.

In accordance with your revised categories, this study should now be considered as
an “Expedited 2-G.”

Thank you for your attention to this matter.

Sincerely,

  

Joni ' gram-Luterman
PhD. Student, Department of Music Education
Michigan State University

Colleen Conwaay—wa/

Responsible Project Investigator
Department of Music Education
Michigan State University

181

 

MUSIC THERAPY PEER SUPPORT GROUP STUDY
CONSENT FORM

RESEARCHER: Joni Milgrarn-Luterman, M.Mus., MT A, MT-BC
PlLD. Student, Michigan State University

. You are being asked to participate in research that seeks to understand the
development of self—awareness in undergraduate music therapy students within a music
therapy peer-support/training group. The purpose of this study is to gain an
understanding of how music therapy students experience the process of these groups.

As has been the case over the past two years, I plan to facilitate ten weekly music
therapy peer-support group sessions for senior music therapy students of one to 1.5 hours
each (depending on scheduling availability) atthe MSU music therapy clinic. During this
fall semester 1999, I plan to study a group of music therapy seniors who decide to
participate and I, as researcher-facilitator, will investigate the experience of the group
process.

If you decide to participate, you will have the opportrmity to reflect on your
experiences in the peer support group that you will attend as a music therapy senior. You
will be asked to keep a journal of your reflections and share that journal with the
researcher for the purposes of the research. You will be required to attend one or two
personal interviews with the researcher that will not exceed one half hour each. All
sessions will be videotaped and audio taped and interviews will be audio taped. Tapes
will be transcribed for research purposes. Please note that any and all responses will be
kept confidential and your identity will be kept in the strictest confidentiality. Most
important to remember is that there are no wrong answers and that the
researcher/facilitator’s goal is to facilitate and listen to your answers and not to make any
criticisms or conclusions about your feelings and thoughts. Also know that you may
refuse to answer certain questions, you will be free to ask for clarification if you do not
understand, and you may withdraw fiom the study at any time.

As one of my intentions for this research study is to improve my skills as a
facilitator, I have sought supervision from a colleague who is not afi'rliated with this
university or music therapy department.

In order to protect the intereSts of students who decide to participate, I will follow
guidelines to guard against coercion and for participant confidentiality:

1. no potential participant Will be required to participate in the study;

2. a participant may elect to withdraw from the study at any time, in which event
any data collected from or about that participant will not be used in any
written or published materials which result from the study;

3. a participant has the choice of opting out of the study but continuing in the
peer-support group, in which event data will not be collected from or about
that person;

4. the identities of all participants will be disguised in any written or published

materials which result from the study;

the identity and location of the site will be disguised in the study;

all research materials including notes, tapes, and logs will be stored in a
locked cabinet in an office at a location outside of the research site;

cum

182

 

7. permission will be sought from participants to retain research logs and tapes
for possible fixture publications and presentations. I will be the only one who
has access to tapes. All tapes will be identified by participants’ pseudonyms
and the dated. Tapes and logs will not be destroyed. My clinical and research
advisors and I will be the only pe0ple to have access to the logs. Written
commentary about data will be shared with my clinical supervisor and my
dissertation committee;

8. Opportunities for feedback to participants will occur spontaneously during the
peer-support group, during interviews and after the group is over in which
participants and I will discuss research findings. Participants will also have
access to the final research report.

Please confirm your participation and consent by signing below. You will be
contacted regarding scheduling shortly. If you have any questions regarding the study,
please feel free to contact Joni Milgram-Luterman, Department of Music Therapy,
Michigan State University, by telephone at 517-353-6426 or by e-mail at
milgraml@msu.edu. If you have any questions regarding being a human subject of
research, please contact Dr. David E. Wright, Chair of the University Committee on
Research Involving Human Subjects (UCRIHS) at 517-355-2180. Thank you for your
interest in music therapy education and the future of the rewarding field of music therapy.

Sincerely,

Joni Milgram-Luterman
PhD. Candidate
Michigan State University

1 indicate my voluntary agreement to participate in this study.
Signature of Consent: Date:

 

UCRIHS APE-"30VA L FOR
THIS project E215 ?:~'%c.'..-5:

DEC ‘ 11.999

SUBMIT RENEWAL firm. at. -.; iON
ONE MONTH PRIOR If)
ABOVE DATE TO CONTINUE

183

 

MUSIC THERAPY PEER SUPPORT GROUP STUDY
CONSENT FORM

RESEARCHER: Joni Milgram-Luterman, M.Mus., MTA, MT ~BC
PhD. Student, Michigan State University

. You are being asked to participate in research that seeks to understand the
development of self-awareness in undergraduate music therapy students within a music
therapy peer-support/training group. The purpose of this study is to gain an
understanding of how music therapy students experience the process of these groups.

As has been the case over the past two years, I plan to facilitate ten weekly music
therapy peer-support group sessions for senior music therapy students of one to 1.5 hours
each (depending on scheduling availability) at the MSU music therapy clinic. During this
fall semester 1999, I plan to study a group of music therapy seniors who decide to
participate and I, as researcher-facilitator, will investigate the experience of the group
process.

If you decide to participate, you will have the opportunity to reflect on your
experiences in the peer support group that you will attend as a music therapy senior. You
will be asked to keep a journal of your reflections and share that journal with the
researcher for the purposes of the research. You will be required-to attend one or two
personal interviews with the researcher that will not exceed one half hour each. All
sessions will be videotaped and audio taped and interviews will be audio taped. Tapes
will be transcribed for research purposes. Please note that any and all responses will be
kept confidential and your identity will be kept in the strictest confidentiality. Most
important to remember is that there are no wrong answers and that the
researcher/facilitator’s goal is to facilitate and listen to your answers and not to make any
criticisms or conclusions about your feelings and thoughts. Also know that you may
refuse to answer certain questions, you will be free to ask for clarification if you do not
understand, and you may withdraw from the study at any time.

As one of my intentions for this research study is to improve my skills as a
facilitator, I have sought supervision from a colleague who is not affiliated with this
university or music therapy department.

In order to protect the interests of students who decide to participate, I will follow
guidelines to guard against coercion and for participant confidentiality:

1. no potential participant will be required to participate in the study;

2. a participant may elect to withdraw fi'om the study at any time, in which event
any data collected from or about that participant will not be used in any
written or published materials which result fi'om the study;

3. a participant has the choice of opting out of the study but continuing in the
peer-support group, in which event data will not be collected from or about
that person;

4. the identities of all participants will be disguised in any written or published

materials which result from the study;

the identity and location of the site will be disguised in the study;

6. all research materials including notes, tapes, and logs will be stored in a
locked cabinet in an office at a location outside of the research site;

 

U:

184

7. permission will be sought from participants to retain research logs and tapes
for possible future publications and presentations. I will be the only one who
has access to tapes. All tapes will be identified by participants’ pseudonyms
and the dated. Tapes and logs will not be destroyed. My clinical and research
advisors and I will be the only people to have access to the logs. Written
corrrrnentary about data will be shared with my clinical supervisor and my
dissertation committee;

8. Opportunities for feedback to participants will occur spontaneously during the
peer-support group, during interviews and after the group is over in which
participants and I will discuss research findings. Participants will also have
access to the final research report.

Please confirm your participation and consent by signing below. You will be
contacted regarding scheduling shortly. If you have any questions regarding the study,
please feel free to contact Joni Milgram-Luterman, Department of Music Therapy,
Michigan State University, by telephone at 517-353-6426 or by e-mail at
milgraml@msu.edu. If you have any questions regarding being a human subject of
research, please contact Dr. David E. Wright, Chair of the University Committee on
Research Involving Human Subjects (UCRIHS) at 517-355-2180. Thank you for your
interest in music therapy education and the future of the rewarding field of music therapy.

Sincerely,

Joni Milgram-Luterman
PhD. Candidate
Michigan State University

I indicate my voluntary agreement to participate in this study.
Signature of Consent: Date:

 

UCRIHS APPROVAL FOF
THIS project EXPIRES:

DEC 242000

SUBMIT RENEWAL APPLICATIOI‘x
ONE MONTH PRIOR TO
ABOVE DATE TO CONTINUE

185

 

 

APPENDIX F

Indexes of Coded Data for Group and Sally

 

186

 

(11}.txt page: 1 7/31/ 0 OS:

Q.S.R. NUD.IST Power version. revision 4.0.
Licensee: Joni Milgram-Luterman.

PROJECT: Dissertation Nudist. User Joni Milgram-Luterman. 5:02 am. Jul 31. 2000.

ww---—-----—-—-—-—--—-— w——————— —————-——————— ..._ ———-------———————————

(1 1) EVERYTHING/GROUP
"" No Definition

"‘ Created: 2:08 pm. Jun 20, 2000.
"' Last modified: 2:08 pm. Jun 20. 2000.
'” The siblings of this node are:

(1 2) [EVERYTHING/SALLY

(1 3) lEVERYTI-IINGIME

"‘ The chiIdren of this node are:

(1 1 1) lEVERYTHING/GROUPIMUSIC THERAPY
(1 1 2) lEVERYTHING/GROUP/MUSIC

(1 1 3) IEVERYTHING/GROUP/‘n-IERAPY

(1 1 4) EVERYTHING/GROUPISPIRITUALITY

(1 1 5) EVERYTHING/GROUP/RELATIONSHIP
(1 1 6) lEVERWHINGIGROUPISCHOLARSHIP.
(1 1 7) [EVERYTHING/GROUPIPROFESSIONALISM
(1 1 8) IEVERYTHING/GROUPISETI‘ING

(1 1 9) EVERYTHING/GROUPISELF

187

 

 

Nodes.txt

page: 1 7/09/ 0 10:53:37

Q.S.R. NUD.IST Power version, revision 4.0.
Licensee: Joni Milgram~Luterman

PROJECT: Dissertation Nudist, User Joni Milgram-Luterman. 10:52 am. Jul 9. 2000.

(13
(121)
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(1221)
(1222)
(1223)
(1224)
(1225)
(1226)
(1227)
(1228)
(123)
(1231)
(1232)
(1233)
(1234)
(1235)
(124)
(125)
(1251)
(1252)
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(1255)
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(126)
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(127)
(1271)
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(128)

[EVERYTHING/SALLY

IEVERYTHING/SALLY/MUSIC THERAPY
IEVERYTHING/SALLY/MUSIC
lEVERYTHINGISALLY/MUSICISTRESS
IEVERYTHING/SALLY/MUSlC/CONCENTRATION
lEVERYTHING/SALLY/MUSICICONNECTION
lEVERYTHlNG/SALLYIMUSICIMUSICAL ELEMENT
lEVERYTHINGISALLY/MUSlC/RELAXATION
lEVERYTHING/SALLY/MUSICIEXISTENIIAL
lEVERYTHING/SALLY/MUSICISTIMULATING
[EVERYTHING/SALLY/MUSlC/EMOTION
IEVERYTHING/SALLYfTHERAPY
IEVERYTHINGISALLY/THERAPY/STRESS RELIEF
lEVERYTI-lINGISALLY/THERAPYIFEELINGS
IEVERYTHINGISALLYI'I’HERAPY/EXPRESSION
[EVERYTHINGISALLY/THERAPY/CATALYST

IEVE RYTHING/SALLY/THERAPY/SELF
lEVERYTHING/SALLYISPIRITUALI‘IY
IEVERYTHINGISALLY/RELATIONSHIP
lEVERYTHING/SALLY/RELATIONSHIPIDEPTH
[EVERYTHING/SALLYIRELATIONSHIPISAFETY
lEVERYTHlNG/SALLY/RELATIONSHIP/HEALTH
lEVERYTHlNG/SALLYIRELATIONSHlP/PARTNER
lEVERYTHING/SALLY/RELATIONSHIP/SUPPORT
lEVERYTHING/SALLY/RELATIONSHlP/FAMILY
lEVERYTHlNG/SALLYIRELATIONSHIPIINTIMACY IN GROUP
lEVERYTHlNG/SALLYIRELATIONSHIP/FRIENDS IN GROUP
[EVERYTHING/SALLYIRELATIONSHlP/FACILITATOR
lEVERYTHINGISALLY/SCHOLARSHIP
lEVERYTHINGISALLY/SCHOLARSHIP/INTERNSHIP
lEVERYTHING/SALLY/SCHOLARSHlP/ESCAPE
lEVERYTHING/SALLY/SCHOLARSHIP/CLASSES
lEVERYTHlNG/SALLY/PROFESSIONALISM
lEVERYTHlNG/SALLYIPROFESSIONALISM/DEALING WITH THE UNKOWN
lEVERYTHING/SALLY/PROFESSIONALISM/MONEY
lEVERYTHING/SALLY/PROFESSlONALISM/ATTENDANCE
lEVERYTHING/SALLYISELF

188

 

APPENDIX G

“Call to Spirit”
Based on the melody “Spirit of the Wind” by Craig & Star Williams,
1993. Photocopied for this dissertation with verbal persmisison from Kate
Marks (Ed), July 29, 1999. All attempts were made to contact the original

composers.

189

 

 

 

 

 

 

Call to Spirit - Invocation Song

This was learned at the 1985 Pagan‘Spirit Gathering from Anodea Judith

 

 

 

 

 

 

 

 

 

 

 

and Selene Vega.
flair X A fi L 1 *fi
3E rv _' E ‘1. m ; fl
Spi- rits of the-— we're cal- Iing- you

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SPi' rits 0‘ the we're cal- ling vou here Spi- rits of the —, we‘ re cal-
a
53:5 x. e: - , - x - x. g :=-_-—__:
ling YOU here and now ' 5M6 of the air, bring your bles- sings fair;

fl Y ——r— I 1
FE ‘ .4: A; r - A - 2; ,V A ,1

k 4. : 4 :4 , ' ' - : 1
0 v v ' *—"_l:.L—a fi 0- fi :12: .-

Spi- rits of the sky, teach us how to fly; Spit-its of the East in - to our Ci:- cle

 

 

 

 

 

 

7" j

I A u]

E _ 4
come.\ /

 

 

Spirits of the Fire, bring us our desire: Spirits of the ocean, deepen our emorion;
Spirits Of the flame, burn 1‘91? um pain; Spirits of the see, let the soul be free;
Spirits of the South into our Circle come! Spirits of the West. into our Circle come!

Spirits of the land. help us undersrand;

Spirits of the earth. bring to us rebirth:
Spirits of the North, into our circle come!

190

APPENDIX H

“Sailing Away”

© Joni Milgram-Luterman, 1997

191

Words and Music by
Joni Milgram-Luterman

Sailing Away

CMaj7 Dmin7 CMaj7

  

V

 
 

1. I’m sail—ing a - way on a boat__._ to some-where. Wa - ter's wide and the air—
2. I'm sail-ing a - way on a boat_ to some-where. Long a go I feared-
Dmin7 CMaj7 Dmin7

 

Q‘.

 

 

is free. I'm sail - ing a - way on a boat to some-where;
this place. I'm sail - ing a - way on a boat to some-where;
C Maj 7 D min 7 CHORUS 95 F

    

 

v
climb a-board and we can see. The wind has no dis - tinct_
now it has a dif - ferent taste.
G F G

 

 

 

di - rec - tion. The boat holds on - Iy our col-lec - tion of
F G C C Fine
0
dreams, ad - ven - ture. and life.
Dmin7 G7 C Emin/B

 

V

3. The boat has tak-en me to plac - es 1 did - n't know I want -
Amin Amin/G Dmin7 G7

 

ed to see. but now I'm rea - dy to take_.._ the rap - ids
C Emin/B Amin G7 C 0,5. 01 Fine

 

\'

where-ev - er they may. where they may take- me. The

© 1997 Joni Milgram-Luterman

192

 

 

APPENDIX l

“The Invitation”

Oriah Mountain Dreamer, 1999

 

 

193

The I matatcow
By Oriah MWDVW

Itdoemiftérmtmewhatyowdoforwbwmga I wmwkmw what'yow
adwfor, and/Efyowdare/w-dreamofmeetmgwyour Wylonw

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194

APPENDIX J

“I am becoming [Me]”
Michael Tierra, 1993. Photocopied for this dissertation with verbal

permission from the composer, July 29, 1999.

195

I Am Becoming You

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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wa- ters flow- in; pu- ri- ly- in;
Part 4 EL: - ’
U . I f I J
Fi- re a- blaze with. in
Part 5 if:
all my bones
flesh

196

APPENDIX K

“Peer Group: March ‘97”

© Joni Milgram-Luterman, 1997

 

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