IDENTIFYING MEASURABLE CONTRIBUTORS TO STUDENTS CLINICAL CAPABILITIES IN THE FIELD OF MUSIC THERAPY by James Francis McQuiston, RMT A THESIS Submitted to Michigan State University in partial fulfillment of the requirements for the degree of MASTER OF MUSIC/MUSIC THERAPY Department of Music 1978 ABSTRACT IDENTIFYING MEASURABLE CONTRIBUTORS TO STUDENTS CLINICAL CAPABILITIES IN THE FIELD OF MUSIC THERAPY by James Francis McQuiston, RMT The purpose of this study was to identify measurable contributors to students clinical capabilities. Variables included: personality profile, music achievement, work per- formance, empathy skills, academic achievement, teacher ratings and age. Twenty-six senior music therapy students from Michigan State University were used for this investigation. Subjects were rated for clinical capability according to the Student Practicum Evaluation Instrument designed for this study. Variables were compared by computer statistical analysis. The following conclusions were drawn based on the results of this investigation: (1) Personality profile is a measurable contributor to students clinical capabilities. (2) Music achievement is a measurable contributor to students clinical capabilities. (3) Work performance is a measurable contributor to students clinical capabilities. (4) Empathy skills are measurable contributors to students clinical capabilities. (5) Academic achievement is a measurable contri- butor to students clinical capabilities. (6) Teacher ratings are measurable contributors to students clinical capabilities. (7) Age is a measurable contributor to students clinical capabilities. ACKNOWLEDGMENTS The author would like to express his sincere appreciation to Dale Bartlett, Ph.D., Robert G. Sidnell, Ph.D., and Mr. Robert F. Unkefer for their constructive criticisms and guidance in the preparation of this thesis. ii TABLE OF CONTENTS LIST OF TABLES . . . . . . . . . LIST OF FIGURES. . . . . . . . . . CHAPTER I. II. III. THE PROBLEM O O O O O O 0 Introduction . . . . . . Clinical Practicum . . . Music Therapy Clinic . . Clinical Skills. . . . . Statement of the Problem Need for the Study . . . Purpose of the Study . . Hypotheses . . . . . . . Definition of Terms. . . Instruments. . . . . . . Scope and Limitations of Overview . . . . . . . . REVIEW OF LITERATURE. . . Music Therapy. . . . . . Study 1. . . . . . . . Study 2. . . . . . . . Study 3. . . . . . . . Study 4. . . . . . . . Discussion . . . . . . Related Fields of Study. Occupational Therapy . Human Interaction. . . Discussion . . . . . DESIGN OF THE STUDY . . . Method . . . . . . . . . Subjects . . . . . . . iii Page vi viii \OKOKDCDO‘UIQH H 13 13 14 16 21 22 24 27 27 29 30 31 31 31 Supervisors. . . Setting. . . . . Required Task. . Instruments. . . Measures for Measure for Dependent Variable . Experimental Procedure . Multiple Regression. Discriminant Function Analysis Video-Taping . Testing. . . . Scoring. . . . Materials. . . . Independent Variables. Dependent Variables. Statistical Treatment. IV. Testing Results. PRESENTATION OF RESULTS Independent Variables Edwards Personal Preference Schedule Aliferis Music Achievement Test. Affective Sensitivity Scale. Teacher Ratings. Work Performance Academic Achievement Age. . . . . . Data Analysis. . Results. . . . . Descriptive Data . Multiple Regression. Discriminant Function Analysis Discussion . . . V. SUMMARY, CONCLUSIONS, AND RECOMMENDATIONS Summary... . . . Conclusions. . . Recommendations for Future Research. . . iv 32 32 33 34 34 36 37 37 38 38 39 39 39 40 40 40 42 43 43 45 45 45 45 49 49 49 55 55 55 61 75 76 76 78 81 APPENDICES A. B. C. D. E. BIBLIOGRAPHY Session Planning Sheet. Session Evaluation Sheet. List of Independent Variables . Student Practicum Evaluation Instrument Survey Questionnaire for Content Validity 83 84 85 86 88 89 10. 11. 12. 13. LIST OF TABLES Criterion Rating Schedule. . . . . . . . . . Means and Standard Deviations for the Edwards Personal Preference Schedule . . . . Individual Scores and Percentile Ranks for the Aliferis Music Achievement Test. . . . . Means and Standard Deviations for the Affective Sensitivity Scale. . . . . . . . . Individual Scores, Means and Standard Devia— tions for Teacher Ratings. . . . . . . . . . Individual Scores, Means and Standard Devia- tions for the Field Work Performance Report. Individual GPAs, Mean and Standard Devia- tion for Academic Achievement. . . . . . . . Chronological Age of Subjects, Mean and Standard Deviation . . . . . . . . . . . . . Mean and Standard Deviation Scores on the Twenty-One Independent Variables by Subject Groups and Total . . . . . . . . . . . . . . Multiple Regression--Stepwise. . . . . . . . Multiple Regression--Backward Elimination. . Discriminant Function Analysis Minus Edwards Personal Preference Schedule and Field Work Performance Report . . . . . . . . . . . . . Prediction Results of Discriminant Function Analysis without the Edwards Personal Pre- ference Schedule and the Field Work Per- formance Report. . . . . . . . . . . . . . . vi Page 15 44 46 47 48 50 53 54 56 59 60 62 63 14. 15. l6. l7. Discriminant Function Analysis Minus Field Work Performance Report . Prediction Results of the Discriminant Func- tion Analysis for All Variables . Discriminant Function Analysis for All Measures and Variables. Means and Standard Deviations by Group for All Variables vii 64 66 67 69 Figure l. 2. LIST OF FIGURES Contributors to Clinical Capabilities. Music Therapy Clinic . . . . . . . . . viii CHAPTER I THE PROBLEM Introduction The purpose of this studyvms to identify contributors to students clinical capabilities in the field of music therapy. Variables include personality profile, music achievement, empathy skills, work performance, teacher ratings, academic achievement and age (see Fig. 1). This study develOped from an interest in the investigation of the facilitation of student clinical skills in music therapy. The educator has an obligation to adequately prepare the student entering the field of music therapy and the clientele, for whom the music therapist is to provide activity and re- habilitation services, has the right to expect the best. The qualifications of a music therapist have been variously described. For example, the therapist should be businesslike, impartial, healthy, cheerful, objective, dis- arming, tactful, persistent, flexible, patient, inventive, 1 emotionally well balanced and self-controlled. The therapist should also be well integrated, a leader, and have experience 1Willem Van de Wall, Music in Hospitals (New York, New York: Russell Sage Foundation, 1946), pp. 80-86. Music Achievement Work Performance Teacher Ratings Age Clinical Capabilities Empathy Skills Academic Achievement Personality Profile Figure 1. Contributors to Clinical Capabilities 3 or training in group work.2 Genuine enthusiasm, resource- fulness, regularity, punctuality, organizing ability, social conformance, honesty, self-discipline, and the desire to help peOple should also be evident among his qualifications.3 Other educators and hospital administrators have consistently pointed out the importance of the individual's personality and musicality as well as achievement in curriculum require- ments for the prospective music therapist.4'5'6 It should be noted that these qualifications are opinions and empirical observations, not facts of research. However, the importance of the therapist develOping his clinical skills as a thera- peutic agent is best described by Barnard: It is not the music which is the real thera— peutic agent but the music therapist. It is he who molds the music to the therapeutic goal, who guides the patient in making a therapeutic experience out of the work or 2Esther G. Gilliland, "Preface," Music Therapy 1951 (Chicago, Illinois: National Association for Music Therapy, 1952), pp. vii—xvi. 3Edwina Eustis, "Personality Qualifications of the Vol- unteer Music Therapist," in Music Therapy 1952, ed. by Esther G. Gilliland (Lawrence, Kansas: National Association for Music Therapy, 1953), pp. 210-211. 4Rudolph Dreikurs, “Psychiatric Considerations of Music Therapy," in Music Therapy 1957, ed. by E. Thayer Gaston (Lawrence, Kansas: National Association for Music Therapy, 1958). PP. 31-36. 5E. Thayer Gaston, "Functions of the Music Therapist," in Music Therapy 1953, ed. by Mariana Bing (Lawrence, Kansas: National Association for Music Therapy, 1954), pp. 28—29. 6Wayne W. Ruppenthal, "Objectivity in Clinical Prac- tice," in Music Therapy 1957, ed. by E. Thayer Gaston (Lawrence, Kansas: National Association for Music Therapy, 1958), pp. 81-84. 4 recreational activity with music. It is the atmosphere he creates, the relationship he establishes with the patients, the direction in which he turns their attention that makes music therapy out of musical activity. In respect to preparing the student in the field of music therapy, Madsen stated: He has to know how to use his medium in order to produce desired results, and it should be obvious that any program aimed toward preparing a student for a specific vocation should include in the program that which is necessary for the student to assume the responsibilities of his work. It may be inferred from this statement that it should be the responsibility of the educator to prepare the student through the guidance of curriculum and provide opportunity for active observation and participation in a clinical practicum. Clinical Practicum The clinical practicum at Michigan State University provides the music therapy student with an Opportunity to observe music therapy sessions, and for senior students, to actively participate in conducting music therapy sessions on a one-to-one basis with clientele. All students involved in working with the clientele are individually supervised by registered music therapists, the supervisors being master's degree candidates in music therapy. 7Ruth I. Barnard, "The PhiloSOphy and Theory of Music Therapy as an Adjuvant Therapy," in Music Therapy 1952, ed. by Esther G. Gilliland (Lawrence, Kansas: National Associa- tion for Music Therapy, 1953), p. 48. 8Clifford K. Madsen, "A New Music Therapy Curriculum," Journal of Music Therapy, Vol. 2, No. 3 (1965), p. 83. 5 The senior students are assigned to clients on the basis of ability, personality, and time availability with respect to class schedules. Assignments are made in the Fall term and continue throughout the academic year. During this time period, the student meets with his client once a week for a half-hour session. However, if the clinic space is available, some students have the Opportunity to meet with their clients twice a week. Students are responsible for planning their own sessions in accordance to the individual client's needs. Also, the students are responsible for evaluating the sessions. Forms for planning and evaluating sessions may be seen in Appendices A and B, respectively. Music Therapy Clinic The students at Michigan State University have a unique opportunity in that a music therapy clinic is housed on cam- pus within the Department of Music. The clinic offers free service to the community, with the understanding that the clients will be served by practicum students under the super- vision of a registered music therapist. The only requirement is one of regular attendance. Referrals are made to the clinic through the school system, special education programs, and community mental health services of East Lansing and surround- ing areas. The clinic consists of two treatment rooms: one large room with a one-way observation window and an audio system 6 for listening, and a smaller room for auditory observation only. A physical description of the clinic may be seen in Figure 2. Clinical Skills In order to insure consistency of goals for the student, a c00perative effort was made by the supervisors to develop a Student Practicum Evaluation Instrument fOr use in the music therapy clinic. The instrument was based on six goals to which the students were oriented in preparation for their internship programs. Goals were designed in the form of six skills that were determined as necessities for the student in a clinical setting: (1) To present sequentially materials and activities in a session: The student needs to be aware of presenting materials and activities in a sequence that will enable the client to understand, follow and participate in the activities. (2) To use varying and appropriate music activities in a session: The student needs to use apprOpriate music activities in respect to the client's ability and to provide variety and interest for the client while working towards therapeutic goals. (3) To use a form of communication that is therapeu- tically suited for the client: This communication may be verbal or nonverbal (i.e., body language, music). It should be appropriate for the therapeutic needs of the client. treatment room observation window clinic office waiting room treatment room sound observation room Figure 2. Music Therapy Clinic 8 (4) To pace the session in respect to the client's ability: The student must structure activities and concepts in respect to the ability of the client. (5) To have the client involved throughout the session: The student needs to affect or influence the client throughout the session by active and/or passive involvement. (6) To make sure that nonmusic activity (when used) is appropriate for therapy: Prior to the introduction or addition of music, there are times when physical movements and/or verbal phrases are used. These activities should be appropriate for the therapy procedure. (7) Overall evaluation of the session (this statement was added to allow for the subjective response of the super— visor). The Student Practicum Evaluation Instrument may be seen in Appendix C. Statement of the Problem The problem of this study is expressed in the following question: What easily available measures significantly corre- late with a reliable evaluation of students clinical skills? In an effort to find easily available measures and variables for the purpose of this study, the writer communi- cated with the Testing Office in the Counseling Center, and the Chairman of the Music Therapy Program at Michigan State University. A decision was made on the following variables: 9 (1) Personality Profile; (2) Music Achievement; (3) Empathy Skills; (4) Work Performance; (5) Teacher Ratings; (6) Academic Achievement; and (7) Age. Need for the Study Opinions of members of the music therapy profession who are concerned with professional standards and with the individuals who are considering entering the profession identify the need for a study concerning factors in the development of clinical skills. Purpose of the Study In respect to the student and the educational program for music therapy at Michigan State University, a study of this type may provide some concrete information that would be useful in advising the student, and referring him to appropriate counseling agencies and courses of study that may better enable him to ascertain vocational skills. Hypotheses The hypotheses of this study are expressed in the following statement: Variables obtained from personality profile, music achievement, empathy skills, work performance, teacher ratings, academic achievement, and age will significantly correlate with clinical skills as measured by the Student Practicum Evaluation Instrument. 10 Definition g£_Terms Student: A senior undergraduate music therapy student enrolled in the music therapy clinical practicum at Michigan State University. Supervisor: A registered music therapist enrolled as a master's degree candidate in music therapy at Michigan State University. Variable: A construct or property of study; a symbol to which numerals or values can be assigned. Evaluation: An appraisal or estimate based on per- formance of clinical skills. Teacher Ratings: Two separate numerical appraisals assigned by the instructor of the Music Therapy Techniques course at Michigan State University. The appraisals were based on achievement in course material and leadership/ participation in additionally required group activities for the multihandicapped of the community. The numerical value assigned was based on a 100 point scale. Empathy Skills: The facilitation of emotional iden- tification in interpersonal relationships. Instruments Edwards Personal Preference Schedule: An instrument designed for research and counseling purposes to provide quick and convenient measures of a number of relatively independent personality variables. The scale is designed in terms of Murray's fifteen manifest needs: achievement; ll deference; order; exhibition; autonomy; affiliation; intra- ception; succorance; dominance; abasement; nurturance; change; endurance; heterosexuality; and aggression. Aliferis Music Achievement Test: An instrument de- signed to measure the music student's power of auditory— visual discrimination of melodic, harmonic, and rhythmic elements and idioms. This seems to be the only available test at college level for music achievement. Affective Sensitivity Scale: A media-based multiple choice test, designed and validated as a predictor of empathy skills. The scale consists of a series of personal encounters between two or more persons taken from actual interpersonal interactions. These encounters range from discussions between friends, couples, teachers, and students to physician- patient, counseling and psychotherapeutic interactions. Field Work Performance Report: An instrument designed for evaluation of clinical work performance. The report con- sists of five subcategories: data gathering; treatment planning; treatment implementation; communication skills; and professional characteristics. Scope and Limitations pf the Study The development of clinical skills refers only to those specified in this study. As measured by the data gathering instruments in this study, the variables under investigation are: personality profile; music achievement; empathy skills; work performance; teacher ratings; academic achievement; and age. The dependent variable used is 12 clinical capability as measured by the Student Practicum Evaluation Instrument designed for the music therapy clinic at Michigan State University. The subjects of this study were twenty-six senior music therapy students at Michigan State University, Spring term, 1977. All subjects were actively involved in the music therapy clinical practicum at the University. Overview In Chapter 2, literature pertaining to the evaluation and attributes of music therapists as well as related fields of study is reviewed. Although some of the literature does not specifically involve clinical skills per se, it does concern attributes that may contribute to the functional level of the music therapist in clinical performance. The design of this study is described in Chapter 3, and the analysis of results obtained from the data gathered herein is presented in Chapter 4. CHAPTER II REVIEW OF LITERATURE The purpose of this study was to determine and identify what easily available measures significantly correlate with a reliable evaluation of a students clinical capabilities. A survey of literature which concerns the evaluation of clin- ical skills and performance, and attributes of the music therapist as well as literature in related fields should serve as sources from which to draw inferences for this study. Music Therapy Since the field of music therapy first became a desig- nated profession with the establishment of the National Assoc- iation for Music Therapy in 1950, there has been concern as to the clinical skills and attributes a music therapist should possess. It has been voiced consistently by some educators and hospital administrators that the individual's personality, musicality, and achievement in curriculum requirements are of importance for the prospective music therapist.9'10'11 9Dreikurs, "Psychiatric Considerations of Music Therapy," pp. 31-36. 10Gaston, "Functions of the Music Therapist," pp. 28-29. llRuppenthal, "objectivity in Clinical Practice," pp. 81-84. 13 14 In an effort to make some beginnings toward an objec- tive description of music therapists, from the standpoint of psychological traits and aptitudes, a series of four studies was conducted by a research team consisting of two executive supervisors of music therapists and a consultative clinical psychologist. These studies are presented and reviewed in consecutive order. Study 112 The purpose of study 1 was to develop some external measure or criterion of the good versus the poor music therapist. The sample consisted of thirty music therapists: thirteen female and seventeen male. The mean age of the subjects was 42.2 years. They had been employed as music therapists for a mean of 6.4 years and the mean of their edu- cational level was 15.6 years. Terms used in the criterion rating schedule were carefully defined and delineated by the authors. The criterion rating schedule may be seen in Table 1. In essence, this criterion rating schedule was evolved on the basis of those personal and social qualities which were found to be consistently high in therapists who performed well on the job, who were praised for their treatment results by colleagues and medical supervisors, and who were approved by the administration of the medical and rehabilita- tion settings where they worked. 12Leo Shatin, Gladys Douglas-Longmore and Wallace L. Kotter, "A Quantified Criterion for Evaluating the Music Therapist," Journal of Rehabilitation, Vol. 29, No. l (1963), pp. 18-19. —_ 13Ibid. 15 .ma .8 .Amomac H .02 .mm .Ho> .:0fiumuflawnmnmm mm HMGHDOH =.umwmmumsa cams: map mcwumsam>m How cofiumufluo owfluflucmso é: .umuuom .A momaamz can whoemcoqummHmsoo mmowaw .cflumsm omA "Eon“ cmxma: III. be mmoom Adeoe ma III mm: mcaeooum coco Awmav III bwl nuammn coco ”umnuo om Ho mfimumoum ©um3 can GOHUMHomHmmm cams: Ho A.oum .moflenumnusm .mcflocmp xHOMV museum Hafiommm umnuo Ho masoum Banana Ho Acmuumum .mcauum .mmmunv mucmaouumcfi mo mmooum Ho mucmEdHumcH meow Ho mzonm can msmumoum Ho auowne mo mummflumd mo mmmmu Ham suflz x603 Hafiz No mucmasuumcfi pawn new .nouo HH¢ mo unmesuumcfl mamcam Hmnuo mam Ho coflouooom .umuflsw No wowo> mo oamflm "suflaflummum> Awomv III mm: m>HumfluHaH “mafiaflna III MMI Hmowcnome 0H muflaflnmummca ma mumoacsesoo 0» sugafiam ma mafiaflbflmqommmm Ammmc ma mmmcflaocmwum "muwamcomumm muoom muoom m.uomnnsm manwmmom «masomnom mcflumm coflumufluo .H manna 16 The initial ratings of the subjects were made jointly by the two supervisors. After a twelve—month interim, allowing for changes in work attitudes and performance, the subjects were rated independently by each supervisor. Reliability was assessed by rank order correlation computed between the two independent ratings. The interobserver reliability was reported as rho = .96, significant at the .001 level of probability. When correlating the two inde- pendent ratings with the twelve-month earlier joint ratings, observer A was reported to have a correlation of rho = .88 (p = .01), and observer B to have a correlation of rho = .90 (p = .01). It is apparent that the supervisors were consistently employing the same rating criteria, and despite the twelve-month interim, the ratings showed considerable stability. m 214 The purpose of study 2 was to determine, through the use of a selected battery of psychological tests, whether there are specific or designated psychological traits of music therapists. Designed as a comparative study, group 1 consisted of the same subjects in study 1. The contrast group consisted of nineteen music specialists (seven male and twelve female). The music specialists are designated as musician entertainers working in a hospital setting. l4L. Shatin, G. Douglas-Longmore and W. L. Kotter, "A Psychological Study of the Music Therapist in Rehabilita- tion," Journal pf General Psychology, Vol. 71 (1964), pp. 193-205. 17 Mean age of the music specialists was 39.3 years. Their mean educational level was 15.5 years and they had been working as music specialists for a mean of 6.6 years. Psychological tests administered to both groups were: (a) Otis Self-Administering Test of Mental Ability (Higher Form A); (b) Kuder Preference Record (Vocational Form BB); (c) Social Intelligence Test (George Washington University Series, Revised Form, Second Edition); and (d) Psycho-Somatic Inventory (McFarland & Seitz). Results of the testing between therapists and specialists are as follows: (a) Otis Self-Administering Test of Mental Ability: Mean Otis of the therapists was reported to be IQ = 107 and specialists IQ = 109.5. By means of statistical testing there was no significant differences between the two groups. (b) Kuder Preference Record: There was no difinitive differences among the groups. The therapists ranked their four highest interests as Musical, Social Service, Artistic, and Literary areas, consecutively. Lowest interest was in Computational, Mechanical, and Clerical areas. The special- ists placed Social Service at the fourth rather than the second rank. Scientific area was placed among their lowest interests. Aside from the two group comparison, the mean Kuder scores of the therapists were contrasted with a group of musician/teachers from the Kuder manual of norms. Findings were that Social Service interest was substantially higher for therapists, being a prominent differentiator 18 between the two groups. Therapists were also more scientifi- cally inclined. Other than this, the profiles were similar with very little interest in Computational, Mechanical, and Clerical areas. (c) Social Intelligence Test: Using the scores of 1,275 employed adults from the Middle Atlantic area of the United States, the percentile ranks of both the therapists and the specialists were within average limits (52nd and 57th, respectively). Music therapists revealed no unusual abili- ties (such as are measured by this test) when compared with music specialists (per- formers) or with em loyed (white-collar) adults in general.lg The results of this test were nonsignificant. (d) Psycho-Somatic Inventory: Group mean scores for the therapists were within the normal limits for this test: 47th+ percentile for physiological complaints, 58th+ percentile for psychological complaints, and 53rd+ percen- tile for both types of complaints combined. There were no statistically significant differences between the male and female therapists. The scores for the music specialists were similar to those of the therapists, but because the differences were so minute and the variances were so great, the differences were nonsignificant. Regarding External Criterion and Psychological Tests, therapists were rated jointly according to the criterion 15Ibid., p. 201. 19 rating schedule. They were rated by two supervisors for their therapeutic adequacy in rehabilitation techniques. After the ratings were compiled, they were ranked from high to low adequacy within the group. Rank-order correlations were then made between the various psychological test scores and rank standing on the criterion rating schedule. Results are as follows: (a) Otis Intelligence Scores: Scores for this test were not correlated with rank standing for the criterion rating schedule. The functional performance of the music therapists relies upon other qualities than the academic- type Intelligence Quotient. (b) Kuder Preference Record: Each interest area in the inventory was analyzed separately. The area of musical interest was inversely correlated with the criterion rating schedule (rho = -.35, p = .05). In other areas such as Social Service and Mechanical interest, there'wereainegative correlations,however these did not attain statistical significance. (c) Social Intelligence Test: The scores for this test significantly correlated with the criterion rating schedule (rho = .33, p = .05). Subtest analysis revealed positive but nonsignificant correlations. The subtest correlations were reported as follows: Judgment in social situations, rho = .18; Recognition of mental state, rho = .27; Memory for names and faces, rho = .23; 20 Observation of human behavior, rho = .28; Sense of humor, rho = .06i Total score (percentiles), rho = .33. 5 (d) Psycho-Somatic Inventory: The scores for this inventory were uncorrelated with the criterion rating schedule. However, separate analysis by sex yielded an inverse correlation for female therapists (N = 13, rho = -.55, p = .02). In reference to this the authors stated: This meant that the number of somatic and psychological complaints tended to be greater for those women who received higher rankings on the criterion of competence. This was an unexpected relationship, and even more sur- prising was its limitation by sex to female therapists. It may be hypothesized that the female therapists who (within limits) have inner problems of adjustment are more empa- thetic with and understanding of the patients with whom they work--or, alternatively, that the female therapists who admit to inner ten- sions are less defensive or less on guard, so that they can form interpersonal relationships more readily. As tested by rank-order correlation and chi squares respec- tively, age and sex were unrelated to the criterion rating schedule. There is no reason therefore, to believe that the sex of the therapist makes a difference in his overall competence or that age alone of the therapist will influence the quality of his rehabilitation performance. 16Ibid., p. 202. 17Ibid., p. 203. lSIbid. 21 Study 319 This study was developed in an attempt to establish a pattern of personality traits of music therapists as measured by the Sixteen Personality Factor Questionnaire. The therapists' (who employ music as a treatment modality) group test profile was compared to that of a musician/ performers group (who play music solely as a performing art) to ascertain any differences in personality traits between the two groups. The subjects consisted of thirty-one music therapists (seventeen male and fourteen female) and twenty-three musician/performers (nine male and fourteen female). Mean age of the combined groups was 44.1 years. The Sixteen Personality Factor Questionnaire was administered to both groups and scored according to the test instructions. Computations were based on sten scores (standard ten scores) which were derived from the norms for the general adult p0pu- lation corrected for sex. Results show that two traits, Sober-Lively (Factor F) and Expedient-Conscientious (Factor G), were significantly different (p = .05) for the therapists and musician/ performers. Although statistically nonsignificant, a third trait, Trusting-Suspicious (Factor L), showed a tendency toward such differentiation. The authors state: 19L. Shatin, G. Douglas-Longmore, and W. L. Kotter, "Personality Traits of Music Therapists," PsycholOgical Reports, Vol. 23 (1968), pp. 573-574. 22 These findings suggest that the music therapists are more sober and prudent, more conscientious, and tend to be more trusting than their musician/performer counterparts. However, it must be emphasized that the differences lie within the central area of the profile and therefore require further verification before they may be accepted as definitive.20 Comparing the mean test profile in stens for music therapists vis-a-vis the mean test profile for the general adult p0pulation, it was suggested that the therapists are substantially more intelligent (Factor B), more tender-minded or sensitive (Factor I), more conscientious (Factor G), more trusting (Factor L) and placid (Factor 0), and more self-sufficient or resourceful (Factor Q2) than the general adult population. In a similar comparison of the musician/performers with the trait norms for the general adult population, the results suggest that the musician/performers are substantially more intelligent (Factor B), more lively or happy-go-lucky (Factor H), more tender-minded or sensitive (Factor I), and more self-sufficient or resourceful (Factor Q2) than the general adult population. Study 121 The purpose of study 4 was to determine the dif- ference (if any) in personality profile of more successful music therapists versus less successful music therapists. 20Ibid. 21L. Shatin, G. Douglas-Longmore, and W. L. Kotter, "Personality Profile of Successful Music Therapists," Journal pf Music Therapy (December 1968), pp. 111-113. 23 Subjects consisted of thirty-one music therapists (seventeen male and fourteen female). The mean age was 39.3 years. Educational levels ranged from high school graduates with music conservatory training to college graduates. Instruments used were: (a) the Sixteen Personality Factor Questionnaire (Form A), an objective test derived by factorial methods which was administered to yield a pattern of sixteen trait scores for each music therapist; (b) a quantified criterion rating schedule which was used to evaluate the competence of each music therapist; (c) coding methods to insure confidentiality of findings. The subjects were divided into two groups by means of the criterion rating schedule. The ten highest-rated therapists were placed in one group and the ten lowest-rated therapists were placed in a second group. These two groups were then contrasted as extreme groups on the Sixteen Personality Factor Questionnaire. Significance (t) tests were employed between the mean standard scores of the groups for each trait. Findings indicated that one trait was statistically significant in favor of the ten highest—rated therapists (Outgoingness, Factor A). Other then this one factor, there were no significant differences in the trait means. Rank order correlations were conducted for the entire group of music therapists (N = 31) between each of the trait scores and the criterion rating for each therapist. Correlations were nonsignificant. 24 Discussion In the previously cited literature the authors were investigating pertinent questions as to the evaluation, psychological profile, personality profile, and personality traits of the music therapist. Pioneering such research, their studies contributed to some marked beginnings in the field of music therapy. The criterion rating schedule in study 1 was a workable evaluation for the authors' needs.22 However, one may question the weighting of specific cate- gories contained therein: Personality (55%); Technical Ability (30%); and Other (15%). According to assigned values, the individual's personality is the most prominent factor in the evaluation of the music therapist. This phenomenon raises a question for further investigation: Should an individual's personality outweigh his technical ability as a music therapist? A second study was conducted to delineate the psycholo- gical profile of thirty music therapists through the use of tests for intelligence, occupational interest, social 23 In contrast intelligence, and psycho-somatic symptoms. with a group of nineteen musicians and published test norms, results revealed that: 22L. Shatin, G. Douglas-Longmore, and W. L. Kotter, "A Quantified Criterion for Evaluating the Music Therapist," pp. 18-19. 23Ibid. 25 Group mean intelligence of music therapists was high average, their psychic and somatic symptoms were within healthy ranges, and their social intelligence was equivalent to that of the employed adult. Their interest profile had certain dissimilarities from that of musicians/teachers. Correlational study between test scores and an external criterion of therapeutic adequacy in rehabilitation work indicated that excessively high interest in music per sg was incompatible with the task of the music therapist. In a third study, a group of thirty-one music therapists (seventeen male and fourteen female) were con- trasted with a group of twenty-three musicians/performers (nine male and fourteen female) by use of the Sixteen Per- sonality Factor Questionnaire, to ascertain any differences in personality traits.25 The music therapists proved to be more sober and prudent, and more conscientious. They also tended to be more trusting than the musician/performers. Comparing individual test results of the therapists with test norms suggests that this group of music therapists is sub- stantially more intelligent (Factor B), more tender-minded or sensitive (Factor I) and placid (Factor 0), and more self- sufficient or resourceful (Factor Q2) than the general adult population. Now that some of the personality traits of music therapists have been delineated, another step should be taken to investigate what (if any) implications these traits may have on the clinical capabilities and performance of the music therapist. 24Ibid., p. 204-205. 25L. Shatin, G. Douglas-Longmore, and W. L. Kotter, "Personality Traits of Music Therapists," pp. 573-574. 26 The last of this series of studies was an attempt to delineate the personality profile of successful music therapists in comparison to less successful (although still adequate) music therapists.26 Thirty-one therapists were rated for competence by means of the criterion rating schedule. The ten highest-rated therapists and the ten lowest-rated therapists were then placed in two groups,respec- tively. The groups were then contrasted as extremes on the Sixteen Personality Factor Questionnaire. The use of t tests yielded only one factor to be statistically significant. The more successful therapists proved to be more Outgoing (Factor A). The authors point out that because the group size was so limited, it may account for the presence of only one significant difference in traits. It was also stated that: Perhaps this test did not tap the personality's roots of competency in music therapy; or perhaps large groups and more sophisticated methods of statistical analysis were required, or perhaps the range of talent was too narrow. On the premise herein, it may be inferred that a successful music therapist is very outgoing or possesses a highly de- veloped personality trait of outgoingness. Reviewing the criterion rating schedule and its weighted categories one may ask: How does outgoingness (as a personality trait) relate to the specific area of technical 26L. Shatin, G. Douglas-Longmore, and W. L. Kotter, "Personality Profile of Successful Music Therapists," pp. 111-113. 27Ibid. 27 abilities or clinical skills? In order to point the reader in the direction of this study, the following statement is presented in the form of a summarizing question: What aSpects of personality affect the facilitation of clinical skills? Related Fields pf Study Occupational Therapy Englehart (1957) conducted a study on the relationship between college grades and on-the-job performance during clinical training of occupational therapy students. He used a sample of 104 college graduates as subjects. A total of seven course grades were reported for each subject: O.T. Crafts, O.T. Laboratory, Social Recreation, Biological Sciences, Medical Information, Sociology, and O.T. Theory. No attempt was made to estimate the reliability or validity of the grades used in the study. Ratings were reported in the four fields of performance (i.e., Tuberculo- sis, Psychiatry, Orthopedics, and Pediatrics) according to the occupational therapy student clinical training report. In addition to academic achievement and clinical performance, the registration examination of the American Occupational Therapy Association was also used. Pearson product-moment correlations were computed for the data. Grades were found to be a significant (p = .01) predictor of on-the-job performance in orthOpedics. College grades which predict performance on the registration exam were significant 28 (p = .01) for all but two courses: O.T. Crafts and Social Recreation. A study conducted by Anderson and Jantzen (1965) investigated the prediction of clinical performance in terms of ratings and achievement measures. The sample consisted of twenty-eight college students who graduated between 1961 and 1964. Ratings were reported according to the Report on Performance in Student Affiliation (RPSA). Grades were reported for eight courses at the freshman and sophomore levels: American Institutions, Physical Sciences, English, Mathematics, Humanities, Biology and Psychology. In addition to course grades, the Florida Placement Examination (FPE) scores were available for eighteen of the subjects. Pearson product-moment correlations were computed for the data. Correlations between course grades and the clinical rating scale (RPSA) were not significant. Correlations between the FPE and the clinical rating scale were also nonsignificant. Lind (1970) conducted an exploratory study of pre- dictive factors for success in the clinical affiliation ex- perience. Three instruments were used: The Allport-Vernon- Lindzey Study of Values, the Edwards Personal Preference Schedule, and the Strong Vocational Interest Blank. In addition, cumulative grade point average was reported at the beginning of the junior year after completion of sixty semester hours. The Report of Performance in Student Affiliation was also used. Subjects consisted of two groups: twenty-five graduates and fifty undergraduates. Multiple regression equations were computed on the data of the twenty-five 29 graduates to identify those variables that would predict clinical success. Criteria for equations were the scores derived from the Report of Performance in Student Affilia- tion. Predictive equations found through the multiple regression in the four clinical areas were significant at the .05 level of probability. Human Interaction The phenomenon of human interaction,in the form of interpersonal communication skills and empathy skills, has recently become an object of investigation in respect to the facilitation of skills in counseling and therapy. Kagan et al. (1969) conducted a study on human inter- action by means of interpersonal process recall. The process used stimulated recall of videotaped interactions to facili- tate therapy and counselor training. The researchers found that videotape was a useful technique for gaining knowledge about underlying thought and feeling in human interaction. The process proved valuable in a variety of therapeutic and training situations directed toward helping people change certain interpersonal behaviors. The study focused on the role of the interrogator in the interpersonal process recall system. Another study by Archer et a1. (1972) describes the use and documentation of the interpersonal process recall in terms of physi010gical feedback. This approach gave added support to previous findings and enhanced the variety of 30 applications in which the interpersonal process recall could be used (i.e., therapy, counseling, education, and research). In an Open letter to colleagues, Kagan (1975) dis- cusses the development and revised version of a measure of empathy. This measuring instrument is called the Affective Sensitivity Scale. The scale is a media-based multiple choice test, designated and validated as a predictor of empathy skills. Discussion In the previously cited literature, it has been shown that academic achievement and work performance are signifi- cant contributors to clinical performance. In addition, personality profile, as measured by the Edwards Personal Pre- ference Schedule, was shown to be a predictive factor in clinical affiliation experience. Further, investigation of interpersonal communication skills classified as empathy skills, has been shown to be a contributor in the facilita- tion of clinical capability in therapy and counseling situa- tions. It is the Objective of this experimenter to investi- gate the aforementioned variables (i.e., academic achieve- ment, work performance, personality profile and empathy skills) in addition to music achievement, teacher ratings and age to determine and identify measurable contributors to students clinical capability in music therapy. CHAPTER III DESIGN OF THE STUDY Method Twenty-six senior music therapy students were evalu- ated for their clinical capability according to the Student Practicum Evaluation Instrument (see Appendix C). In addition, a selected battery of tests and measures was administered to all subjects. The measures included: per- sonality profile; music achievement; work performance; empathy skills; academic achievement; teacher ratings and age. Scores were recorded from these measures for each subject and computed in multiple regression analyses to determine the power and effect Of each variable as a contri- buting factor to clinical capability. In addition, the scores were also computed in a discriminant function analysis to statistically distinguish three levels of clinical capability established for the sample. Subjects Subjects for this study were drawn from the senior undergraduate class of music therapy students at Michigan State University, Spring term, 1977. They ranged in age from 31 32 twenty to thirty-five years with the mean age being twenty- three years, SD = 3.76. Two of the subjects were Afro- American and twenty-four were Caucasian; no other race nor ethnic group was represented. Two of the subjects were guest students from Wayne State University and were enrolled only for Music Therapy Techniques courses at Michigan State University. Also, there were three subjects who had pre- viously received bachelor degrees in music education or performance and were enrolled specifically for equivalency courses in music therapy. All subjects were actively in- volved in student practicum at the music therapy clinic on campus and when working with clientele, were under the super- vision of registered music therapists. Supervisors Supervisors consisted of five (two male and three female) registered music therapists who were master's candidates at Michigan State University, Spring term, 1977. Mean age of the supervisors was 27.6 years, SD = 8.56. The supervisors came from various regions of the United States and their clinical experience included the following areas: deaf-blind, mental retardation, psychiatric patients and multihandicapped individuals. The mean for clinical exper- ience was 2.45 years, SD = 1.53. Setting The physical setting for video-taping was the large treatment room in the music therapy clinic as described 33 under Music Therapy Clinic. It should be noted that because two of the clients were not able to come to the University campus, the setting for two of the subjects was at Forrest Road School. The setting at Forrest Road School was as similar as possible to that of the music therapy clinic. The rooms used in both situations contained a piano and bench, a table, and two chairs. However, each subject had at his disposal additional instruments and materials necessary for conducting the therapy session in a manner suited for his individual client. All testing of the subjects occurred in classroom settings in the Department of Music at Michigan State Univer- sity. The door to the room was closed during testing to prevent interruption and to eliminate extraneous noise. Required Task The task subjects performed to indicate clinical capability was a one-to-One music therapy session with assigned clientele. The task itself varied from subject to subject because of the individual functioning level or handicap of the client. However, for the purposes of this study, it was assumed that this would not affect the criteria of designated clinical skills under Observation. Subjects were informed of the clinical skills being evaluated only through the orientation they had previously received for two academic terms. No mention was made as to 34 what specific things the supervisors were evaluating at the time of experimentation. Instruments Measures for Independent Variables The instruments used for data collection of the independent variables are as follows: Edwards Personal Preference Schedule: This instrument was used to yield a personality profile for each subject. Reliability estimates for test-retest, based on a three- week interval, range from .55 to .87, with a median of .78.28 Split-half reliability coefficients reported in the manual range from .60 to .87, with a median of .78.29 The schedule is an ipsative measure (forced choice); therefore, it will not be included in the main data analyses. However, it will be included in a separate discriminant function analysis for comparison of personality characteris- tics by level of clinical capability. Aliferis Music Achievement Test: This instrument was used to yield a measure of music achievement in respect to auditory-visual discrimination of melodic, harmonic, and rhythmic elements and idioms. Reliability estimates are: melodic section, .90; harmonic section, .84; and rhythmic 28Lawrence J. Stricker, "Tests and Reviews," in The Sixth Mental Measurements Yearbook, ed. by Oscar Krisen Buros (Highland Park, N.J.: The Gryphon Press, 1965), p. 202. 29Allen L. Edwards, Manual: Edwards Personal Preference Schedule (New York, N.Y.: Psychological Corp., 1959), p. 19. 35 30 section, .69. Reliability for the test taken as a unit is reported to be .92.31 Field Work Performance Report: This instrument was used to yield a profile of clinical capability. Reliability is reported to be .97.32 Because of the similarity between this instrument and the dependent variable, it will not be included in the main data analyses. However, it will be included in a separate discriminant analysis for comparison to the dependent variable. Affective Sensitivity Scale: This instrument was used to Obtain a measure of empathy skills. Reliability of test-retest, based on a one-week interval is .64. Reliability for the total scale based on the computation of Chronbach's Alpha is .74.33 Teacher Ratings: This rating was incorporated spec— ifically for this study. The rating was used to yield two separate scores for each subject in respect to the Music 30Paul R. Farnsworth, "Tests and Reviews: Fine Arts- Music," in Egg Sixth Mental Measurements Yearbook, ed. by Oscar Krisen Buros (Highland Park, N.J.: The Gryphon Press, 1965), p. 620. 3lIbid. 32L. M. Crocker et al., "A Performance Rating Scale for Evaluating Clinical Competence of Occupational Therapy Students," American Journal 9f Occupational Therapy, Vol. 29, NO. 2 (February 1975), p. 81. 33Donald W. Werner, "The Structure, Reliability and Validity of the Affective Sensitivity Scale (Form D); A Measure of a Component of Empathy," (unpublished Ph.D. dissertation, Michigan State University, 1977), p. 115. 36 Therapy Techniques course at Michigan State University. One score reflected the comprehension of course material and the other score reflected leadership/participation qualities of the subject in additionally required group activities for the multihandicapped of the community. No attempt was made to establish the reliability of the ratings. Academic Achievement: The cumulative grade point average was used for each subject. No attempt was made to establish the reliability of the grades. Measure for Dependent Variable The measure used for clinical capability was the Student Practicum Evaluation Instrument. This instrument was designed specifically for the clinical practicum at Michigan State University. In order to establish content validity for the instru- ment, a questionnaire was mailed to colleges and universities with music therapy curriculums approved by the National Association for Music Therapy. It was decided by the researcher, that the positive response of 75 percent of the total questionnaires mailed would establish content validity. Forty-three questionnaires were returned (84.3%). Of the returns, 97.6 percent were in agreement with the researcher in respect to the six goals to be used in clinical practicum for undergraduate senior music therapy students. On the basis of the total number of questionnaires mailed (51), this accounted for 82.3 percent in affirmative response. 37 Therefore, content validity was established. The questionnaire may be seen in Appendix D. A reliability test was computed to determine consis- tent application of the Student Practicum Evaluation Instru- ment by the supervisors. Reliability was reported in terms of Chronbach's Alpha being equal to .96. Experimental Procedure This research is a study of interrelationship between variables. The study is designed in terms of mul- tiple regression and discriminant function analysis. Multiple Regression The multiple regression is expressed in the following equations: If x1, x2, . . . x27 then Y more specifically: Y. = a + lel . . . +b27X27 whereas Y' is the predicted score of the dependent variable, a is the intercept constant, b is the regression coefficient and X is the score of the independent variables. Multiple regression analysis is a method for studying the effects and the magnitudes of the effects of more than one independent variable on one dependent variable using prin— ciples of correlation and regression. 34Fred N. Kerlinger, Foundations pf Behavioral Research (New York: Holt, Rinehart and Winston, Inc., 1973), p. 603. 38 In essence, the multiple regression analysis will allow for the determination Of how the Y scores "go back to" or "depend upon" the X scores. Because of the small N (N = 26), stability of the regressions will not be good, however by use of this procedure, it is possible to gain insight of contributors to a student's clinical capability. Discriminant Function Analysis The discriminant function analysis is expressed in the following equation: Dj = djlzl + djzzz + . . . dj27227 whereas Dj is the score on discriminant function j, the d's are weighting coefficients, and the Z's are the standardized values of the number of discriminating variables used in the analysis. The functions are performed in such a way as to maximize the separation of the groups. Use of the discriminant function analysis for a small sample is dubious, however it is possible to distinguish levels of clinical capability. Video-Taping Each subject was video-taped during the second ten- minute period of a thirty-minute music therapy session. The video equipment was readied prior to sessions to avoid any distraction of the subject or his client. Filming was done through a one-way observation window. This allowed for the "natural" response of the client to the subject. 39 Testing There were three tests administered to all subjects: the Edwards Personal Preference Schedule; the Aliferis Music Achievement Test; and the Affective Sensitivity Scale. Because of time availability and class schedules each test was given on three different occasions: two afternoon times and one evening time. The subjects had to choose a time most convenient to them. The tests were administered according to the instructions printed in the individual test manuals. Scoring Subjects received scores computed from the Student Practicum Evaluation Instrument (see Appendix C). The instrument allowed for a score ranging from 1 to 3 for each of the seven subdivisions; consequently, a total score assigned by each supervisor could range from 7 to 21. The total scores for each subject were then added together to constitute the recorded score. Scores for all testing were recorded according to the individual test manuals. Materials The materials used in this study included a stopwatch, video-taping equipment, film projector, pencils and scoring sheets. Specifications of materials are as follows: Stopwatch. . . . . Meylan 204BD (30 minute calibration) Videocorder. . . . Sony AV-3600 Solid State 40 Camera Adapter. . . Sony CMA-Z Videocamera . . . . Sony AVG-3400 Microphone. . . . . Sony Dynamic F-97 (low impedance) Video Tape. . . . . Scotch, (4) %“ x 2400 ft. (1) %" x 600 ft. Film Projector. . . Bell & Howell, 16mm (self- threading) Scoring sheets, pencils and film projector were used for testing administration and procedures. Independent Variables There were 21 independent variables established for this study. The variables are a composite of five measures: music achievement; empathy skills; academic achievement; teacher ratings; and age. The listing of independent varia- bles may be seen in Appendix E. Dependent Variables The dependent variable in this study is clinical capability defined in terms of clinical skills and measured according to the Student Practicum Evaluation Instrument (see Appendix C). Statistical Treatment All variables were computed in a stepwise and back- ward elimination multiple regression. This process was used tO obtain five Optimum variables as contributors to a student's clinical capability. A discriminant function 41 analysis was computed to determine the percentage of correct classification of subjects in accordance with clinical capability. CHAPTER IV PRESENTATION OF RESULTS The purpose Of this study was to identify measurable contributors to students clinical capabilities in the field of music therapy. Seven hypotheses were established for in- vestigation: (1) Personality profile as represented by the Edwards Personal Preference Schedule is a contributor to students clinical capabilities. (2) Music achievement as represented by the Aliferis Music Achievement Test is a contributor to students clinical capabilities. (3) Empathy skills as represented by the Affective Sensitivity Scale are a contributor to students clinical capabilities. (4) Work performance as represented by the Field Work Performance Report of the American Occupational Therapy Association is a contributor to students clinical capabilities. (5) Academic achievement as represented by the cumu- lative grade point average is a contributor to students clinical capabilities. 42 43 (6) (a) Comprehension of course material as repre- sented by Teacher Ratings is a contributor to students clinical calabilities. (b) Leadership/Participation in required class activities as represented by Teacher Ratings are contributors to students clinical capabilities. (7) Age is a contributor to students clinical capabilities. Twenty-six senior music therapy students were rated for clinical capabilities according to the Student Practicum Evaluation Instrument designed for this study (see Appendix C). Subjects were then rated, tested and measured in accord- ance with the following: Edwards Personal Preference Schedule; Aliferis Music Achievement Test; Field Work Performance Report; Teacher Ratings; Academic Achievement; and Age. Testinngesults Edwards Personal Preference Schedule Results obtained from the Edwards Personal Preference Schedule reveal the group totals to be similar to the norma- tive sample presented in the testing manual. Means and standard deviations of the group are presented with the normative sample by variable in Table 2. It should be noted that the means of the subject group are within one standard deviation of the means of the normative sample. Differences are believed to be attributed to the small N of the subject group as compared to the large N of the normative sam- ple. 44 Table 2. Means and Standard Deviations for the Edwards Personal Preference Schedule Group Normative Total Sample Variable (N=26) (N=1509) Achievement § 14.11 14.38 SD 4.07 4.36 Deference § 11.50 11.80 SD 3.33 3.71 Order i 9.65 10.24 SD 5.38 4.34 Exhibition E 14.38 14.34 SD 3.63 3.59 Autonomy § 13.23 13.31 SD 3.85 4.53 Affiliation § 16.53 16.19 SD 3.26 4.36 Intraception x 19.34 16.72 SD 4.36 5.01 Succorance E 13.07 11.63 SD 4.38 4.65 Dominance §' 13.34 15.83 SD 3.70 5.02 Abasement § 12.50 13.66 SD 4.51 5.14 Nurturance E 17.42 15.22 SD 4.19 4.76 Change E 18.07 16.35 SD 5.13 4.88 Endurance i 9.92 12.65 SD 4.47 5.25 Heterosexuality § 15.38 16.01 SD 5.68 5.68 Aggression I 11.53 11.70 SD 4.56 4.73 45 Aliferis Music Achievement Test Results obtained reveal the percentile rank mean to be 74.6 with a standard deviation of 18.7. Scores ranged from the 24th to the 98th percentile rank. Individual raw scores for the three sections of the test (i.e., melodic, harmonic and rhythmic) are presented with the total raw scores and percentile ranks in Table 3. Affective Sensitivity Scale Results obtained reveal that the subjects responded more readily to adult, male, and dyad (two person) encounters. This is not surprising due to the facts that: most subjects worked with adult clients in the music therapy clinic; 5/6 of the subjects were female; and all subjects worked in dyad situations in the music therapy clinic. Means and standard deviations are presented by variable in Table 4. Teacher Ratings Ratings were based on a 100 point scale. Two separate ratings were given for each subject: (1) comprehen- sion of course material; and (2) leadership/participation in class required activities. Individual ratings, means and standard deviations are presented in Table 5. Work Performance Results for work performance were obtained from use of the Field Work Performance Report of the American Occupa- tional Therapy Association. The report consists of five areas: (1) data collection; (2) treatment planning; 46 Table 3. Individual Scores and Percentile Ranks for the Aliferis Music Achievement Test Melodic Harmonic Rhythmic Total Percentile Subject Score Score Score Score Rank 1 17 10 17 44 87 2 10 ll 18 39 80 3 23 16 18 57 98 4 20 10 18 48 92 5 16 8 16 40 82 6 24 12 18 54 96 7 17 9 16 42 85 8 ll 6 14 31 57 9 10 7 8 25 29 10 15 6 15 36 74 ll 12 6 19 37 76 12 9 6 9 24 24 13 7 6 16 31 57 14 10 7 18 35 71 15 18 3 16 37 76 16 13 10 15 38 78 17 15 7 16 38 78 18 20 12 19 57 98 19 11 9 11 31 57 20 15 10 17 42 85 21 17 6 13 36 74 22 6 6 17 29 49 23 22 14 15 51 94 24 15 7 20 42 85 25 15 8 14 37 76 26 17 6 18 41 83 E 14.88 8.38 15.80 39.07 74.6 SD 4.65 2.94 2.95 8.33 18.7 Table 4. Means and Standard Deviations for the Affective 47 Sensitivity Scale Variable Mean Standard Deviation Client 30.65 6.17 Interviewer 29.84 7.19 Adult 61.07 13.34 Child 10.65 2.78 Male 40.69 10.31 Female 31.03 5.75 Group 14.53 4.21 Dyad 57.19 11.44 Education 19.80 4.69 Health 11.53 4.16 Informal 8.15 3.05 Counseling 11.57 2.45 Psychotherapy 20.65 5.35 Total 71.73 14.49 48 Table 5. Individual Scores, Means and Standard Deviations for Teacher Ratings Course Leadership Subject Material Participation l 70 75 2 85 80 3 75 75 4 80 70 5 85 80 6 75 80 7 85 90 8 75 75 9 75 70 10 85 75 ll 70 70 12 80 75 13 80 75 14 85 85 15 80 75 16 65 70 17 80 80 18 85 90 19 75 70 20 70 70 21 70 65 22 85 85 23 90 90 24 85 75 25 85 75 26 80 80 Mean 79.03 76.92 SD 6.48 6.79 49 (3) treatment implementation; (4) communication skills; and (5) professional characteristics. Individual results, means and standard deviations are presented in Table 6. Academic Achievement The reported score for academic achievement was the actual cumulative grade point average for each subject. Individual GPAs, means and standard deviations are presented in Table 7. Agg Subjects age was recorded by years as of April 30, 1977. Individual ages, the mean and standard deviation are presented in Table 8. Data Analysis Three types of analyses were computed for this study. A forward stepwise and backward elimination multiple regres- sions were computed and compared in order to obtain five Optimum variables. A discriminant function analysis was computed in order to statistically distinguish between levels of clinical capability. A .05 alpha level was estab- lished for this research. All computations for analyzing the data in this study were done at Michigan State University Computer Center using the Control Data Computer NO. 6500 and appropriate SPSS programs. 50 we mm mm mm ma NH mv ma mm mm mm Ha we mm mm mm mm 0H Nv ma mm om ma m we mm mm mm ma m we on mm mm ma n be Hm mm on «N m mm pH me ma «a m we vm om Hm ma v mm mm mm mm on m om mm on om «N m om OH cm «a m a unflumflumuomnmnu maafixm coflumucmEOHmEH mcflccmam cowuomaaoo uomnnsm HMOOHmmmmoum cofiumOHOOEEOO ucmEummuB ucwsummua mumo uuommm OOGOEHOM lumm MHOS pamfim may now mcoflumw>ma Ohmpcmum UGO mammz .mmnoom HODOH>HOGH .0 manna 51 mv «N mm mm en en mv Hm mm mm Hm mm ov ma mm vm ma mm mm NH hm ma m Hm mm om mm ma ma om mm NH hm ma ma ma me am mm mm mm ma Hm ma me ow 5H 5H mm Hm mm Hm ma ma mm ma me 5H NH ma mv vN on vN mm OH mm NH om mm ha ma moaumwumuomumnu maaflxm COHDMOCOEOHQEH mcflccmam Gowuomaaoo womnnsm Hmcowmmmmonm cofiumOflGSEEOU unmEummHB unmEummHB mumn Ismssflusooc e wasps 52 mo.m mv.v ov.oa mm.v mm.¢ om mH.mm om.mH Hm.om om.m~ om.mH smog we em mm hm ma mm mm Hm mm mm mm mm mOHumflumuomumnu maafixm cowumucwEOHmEH mcficcmam OOHuOOHHOU uomnnsm Hmcofimmmmoum coflDOOficsEEoo ucmfiummua acmeummua mama AOODGHHCOUV m OHQOB 53 Table 7. Individual GPAs, Mean and Standard Deviation for Academic Achievement Subject Grade Point Average 1 2.83 2 3.54 3 3.65 4 2.95 5 3.22 6 3.05 7 3.46 8 2.88 9 2.95 10 3.40 11 3.24 12 2.71 13 2.61 14 3.73 15 2.71 16 2.39 17 3.50 18 3.25 19 3.33 20 2.80 21 2.74 22 3.27 23 3.98 24 3.79 25 3.72 26 3.20 Mean 3.18 SD .41 54 Table 8. Chronological Age of Subjects, Mean and Stan- dard Deviation Subject Chronological Age 1 24 2 20 3 21 4 22 5 25 6 22 7 21 8 20 9 27 10 22 11 21 12 23 13 22 14 22 15 21 16 23 17 21 18 22 19 35 20 21 21 22 22 22 23 35 24 21 25 21 26 22 Mean 23.00 SD 3.83 54 Table 8. Chronological Age of Subjects, Mean and Stan- dard Deviation Subject Chronological Age 1 24 2 20 3 21 4 22 5 25 6 22 7 21 8 20 9 27 10 22 ll 21 12 23 13 22 14 22 15 21 16 23 17 21 18 22 19 35 20 21 21 22 22 22 23 35 24 21 25 21 26 22 Mean 23.00 SD 3.83 55 Results Descriptive Data The subjects were divided into three groups signify- ing levels of clinical capability: Group 1 (low); Group 2 (moderate); and Group 3 (high). The descriptive statistics are presented by group classification in Table 9. Multiple Regression The use of a stepwise regression was employed to obtain five Optimum variables. In this procedure the com- puter selects the highest contributing variable in step 1. Moving down the variable list, the second variable chosen is the highest contributor to the dependent variable in combina- tion with the preceding variable. The variables are chosen in relationship to each other. The five Optimum variables are presented in Table 10. Backward elimination regression selects the least contributing variables and eliminates them from the regres- sion until the highest contributing variable remains. The last five variables in the regression are the Optimum con— tributors in the equation. Backward elimination regression for the five Optimum variables in presented in Table 11. The five Optimum variables are the same for both regression equations. Because of the small N (N = 26), the stability of the regressions is not good, however this procedure is useful in gaining insight to contributors to students clinical capabilities. 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Discriminant Function Analysis The appropriateness of discriminant function analysis for a small sample (N = 26) is dubious, however it is pos- sible to make divisions of clinical capability for the sample. The analysis serves to predict classification of subjects into levels of clinical capability according to the recorded data. The percentage of correct classification of the sample is obtained by comparing the predicted clas- sification to the recorded classification. Analysis for the twenty-one variables is presented in Table 12. Variables not in the equation were deleted by the computer because of insufficient tolerance levels. Prediction results are pre- sented in Table 13. Introducing the Edwards into the Analysis, it is possible to observe the differences of the sample in person- ality profile by group. Analysis for the Edwards is presented in Table 14. Prediction results (also including work per- formance) are presented in Table 15. 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ezzmzm em.N oN.m mN.m mv.N om mm.m oo.m Nm.w mm.m M hcoaumm mo.m oo.m oo.m mm.m om oo.mm mm.mm mo.om mo.om m zooms: pews unoEm>om£o¢ cams: mmmmmmmm AoNuzo mmuzo Amnzv mmuzo OHQOHHO> mmuoa msouw QDOHO QOOHU moozzmzsoeo mm omooe 74 oo.Nm oo.m mo.m mo.m om mo.om oo.oo mN.oo oo.Nm m mummaammmw mmomammw omnmmam> acooommmo me. me. mN. mm. mm mm.m mm.m mm.m oo.m m eoono>< nsmoo ooone mo.m no.N mo.v mm.m om moan mm.mm mo.me oo.oe oo.mm m Immaouomamnw monommmomcam mo.m om.m mm.m oo.v om om.mm oo.NN mm.mm oo.mm m mmmmxm comumcmcseaow ov.om mo.m oo.m om.mm om mm.mm mm.mm oo.mm mo.om m zOmzozz620mo2m zzoezomne mmmuzo mmuzo Amnzo monzo omnzmnm> mmuoa m macaw macaw macaw moozsmzzoeo mm omooe 75 Discussion The statistical results show that personality pro- file, music achievement, empathy skills, work performance, teacher ratings, academic achievement, and age as measured for this study are significant contributors to students clinical capabilities. When using all variables except personality profile and work performance, 96.2 percent of the sample was correctly classified for clinical capability. Further, it was shown that by introducing personality profile variables into the discriminant analysis, 100.0 percent of the sample was correctly classified. CHAPTER V SUMMARY, CONCLUSIONS, AND RECOMMENDATIONS Summary The purpose of this investigation was to identify measurable contributors to students clinical capabilities. Twenty-six senior music therapy students were used in this study. Experimentation took place during Spring term, 1977 at Michigan State University. Various tests and measures were administered to the subjects in order to obtain data for the following variables: personality profile; music achievement; empathy skills; work performance; teacher ratings; academic achievement and age. Testing was done on both individual and group basis by the music therapy super- visors. Subjects were video-taped with their clients during an actual music therapy session. Video-tapes were viewed and rated by the supervisors in accordance with the Student Practicum Evaluation Instrument (see Appendix C) in order to Obtain a score for clinical capability. A Stepwise Regression and a Backward Elimination Regression were computed to obtain five Optimum variables as a predictive measure. A Discriminant Function Analysis 76 77 was computed for prediction in levels of clinical capability based on the obtained data. The analysis was directed toward determining the following: (1) Whether personality profile as represented by the Edwards Personal Preference Schedule is a contributor to students clinical capabilities. (2) Whether music achievement as represented by the Aliferis Music Achievement Test is a contributor to students clinical capabilities. (3) Whether empathy skills as represented by the Affective Sensitivity Scale are contributors to students clinical capabilities. (4) Whether work performance as represented by the Field Work Performance Report is a contributor to students clinical capabilities. (5) Whether academic achievement as represented by the cumulative grade point average is a contributor to students clinical capabilities. (6) (a) Whether comprehension of course material as represented by Teacher Ratings is a contributor to students clinical capabilities. (b) Whether leadership/participation in required class activities as represented by Teacher Ratings is a con- tributor to students clinical capabilities. (7) Whether age is a contributor to students clinical capabilities. 78 Conclusions The conclusions drawn from this study apply only to the sample used in this investigation. Based on the results of this study and the statistical analysis of those results, the statistical hypotheses, stated in null form, are as follows (alpha level = .05): (1) Personality profile as represented by the Edwards Personal Preference Schedule will not be a contributor to students clinical capabilities. Rejected. (2) Music achievement as represented by the Aliferis Music Achievement Test will not be a contributor to students clinical capabilities. Rejected. (3) Empathy skills as represented by the Affective Sensitivity Scale will not be a contributor to students clinical capabilities. Rejected. (4) Work performance as represented by the Field Work Performance Report will not be a contributor to students clinical capabilities. Rejected. (5) Academic achievement as represented by the cumu- lative grade point average will not be a contributor to students clinical capabilities. Rejected. (6) (a) Comprehension of course material as repre- sented by Teacher Ratings will not be a contributor to students clinical capabilities. Rejected. (b) Leadership/Participation in required class activities as represented by Teacher Ratings will not be a contributor to students clinical capabilities. Rejected. 79 (7) Age will not be a contributor to students clinical capabilities. Rejected. Use of the Edwards Personal Preference Schedule is questionable because it is an ipsative measure. This was not originally a consideration. When introduced to the dis- criminant analysis only eight of the fifteen personality characteristics proved to be significant contributors to students clinical capabilities. Therefore, only 53.33 percent of the measure is useful for this sample. The total Aliferis Music Achievement Test proved a significant contributor at the .05 level of confidence. However, within the test structure, harmony is shown to be the most powerful discriminant variable for the sample. This phenomenon was not anticipated and is felt to be contri- butable to the musical training of the adjudicators. It is questionable whether this phenomenon would occur if the adjudicators were versed in therapeutically related fields (i.e., occupational therapy, recreational therapy, etc.), rather than being music therapists. Empathy skills, as represented by the total Affective Sensitivity Scale, are significant at the .01 level of confidence. This phenomenon is quite understandable in respect to the necessity of acquired or learned interpersonal communication skills involved with therapy techniques. Sensitivity response of the therapist toward the client is a useful facilitator in therapy sessions. Work Performance as measured for this study, is significant at the .000 level Of confidence. In respect 80 to the dependent measure, rating work performance requires direct observation of the subject conducting therapy sessions. Because work performance is a measure of clinical capability, the measure should not be considered a contributor to the acquisition of clinical skills. This was not originally a consideration. Academic achievement as represented by cumulative grade point average is significant at the .01 level of confidence. Grade point average is considered as a measure of what has been gained or learned through curriculum. It is important to note that grade point average may be representative of textbook comprehension but is not necessarily a measure of practical application. The variable of course material as represented by Teacher Ratings is similar to that Of grade point average in reflecting what has been learned or acquired in a text- book sense. However, this variable only pertains to music therapy techniques. Therefore, it is more valid than cumula- tive grade point average. Leadership/Participation in required class activities is reflective of practical appli- cation and therefore is more closely associated with the dependent variable in respect to needed observation for rating. By employing the use of multiple regression analysis to Obtain five optimum variables (Tables 10 and 11), it was possible to account for 51 percent oftflmatotal variance (multiple R). Certain aspects of interpersonal relationships, 81 skills, and the combination thereof, tend to be abstract and defy measurement. It is questionable whether the remaining 49 percent can be accounted for until further research provides a means for more applicable measurement in this area. Recommendations for Future Research Based on the findings of this research, it is recom- mended that: (l) The study be repeated with the following changes: (a) Minimize the number of independent variables by using measures that allow for a total score to reflect the measure as a whole. (b) Maximize the size Of the sample to a minimum Of twenty subjects per variable. (c) Employ the use of adjudicators from thera- peutically related fields other than music therapy. (2) Further research should be designed to eXpand the population to various educational institutions. (3) Further research should be designed to expand the population to various geographical locations. It is strongly recommended that more research be done in identifying measurable contributors to students clinical capabilities in the field of music therapy. There is a lack of well controlled experimental research in this area. Such research may provide the basis for a diagnostic measure in the selection of students entering the field, as 82 well as a means to counsel students in ascertaining their vocational skills. APPENDICES APPENDIX A SESSION PLANNING SHEET APPENDIX A SESSION PLANNING SHEET Client's Name Date: Short Term Goals: (immediate session goals) 1. Long Term Goals: 1. Inapprcpriate Behavior to be Modified: 1. ApprOpriate Behavior to be Reinforced: l. 2. 3. 4. Reinforcement for Appropriate Behaviors: Activities, Techniques and Sources: Therapist: Supervisor: 83 APPENDIX B SESSION EVALUATION SHEET APPENDIX B SESSION EVALUATION SHEET Client's Name: Date: Materials Used: Activities Used: Observation and Evaluation of Implemented Session Goals: Progress of Client in Relation to Long Term Goals: Therapist: Supervisor: 84 APPENDIX C STUDENT PRACTICUM EVALUATION INSTRUMENT APPENDIX C STUDENT PRACTICUM EVALUATION INSTRUMENT l. Sequential presentation of materials and activities. 1 2 3 2. Use of varying and appropriate music activities. 1 2 3 3. Use of communication that is therapeutically suited for the client. 1 2 3 4. Pacing of session in respect to client's ability. 1 2 3 5. Client involvement throughout the session. 1 2 3 6. Appropriateness of nonmusic activity for therapy. 1 2 3 7. Overall evaluation of the session. 1 2 3 Student: Score: Supervisor: 85 APPENDIX D SURVEY QUESTIONNAIRE FOR CONTENT VALIDITY 86 MICHIGAN STATE UNIVERSITY ”MOI!!!“ MW'W'WC James F. McQuiston. R.M.T. Route 3 Ellisville. Ms. 39937 August 10. 1977 I am writing you in respect to a current research project at Michigan State University. The purpose or the pro- ject is the determination of some important goals, that attain- ment of which seem to be reasonably easy to measure. for stu- dents in a clinical practicum.setting. The purpose of your re- sponse is to establish content validity for a Student Practicum Evaluation Instrument. . In agreement with Robert F. Unkefer. Chairman of Music Therapy at Michigan State University, the attached ques- tionnaire is being sent to all N.A.M.T. approved colleges and universities. For your convenience. I have enclosed a pre- addressed and stamped envelope. Thank you for your time and consideration in this matter. Sincerely. . , fag—«7‘. 722321447» Jane 7 ‘ Quiston ert Pf Unkeier‘ 87 In the clinical practicum at Michigan State University, the following six items were found to be: (1) measurable by an Objective format; and (2) some of the most important goals for this setting. As an educator or supervisor in the field of music therapy, do you agree that these six items are important goals to be used in a clinical practicum for under- graduate senior music therapy students? (Please circle comment.) 1. To sequentially present materials and activities in a session. yes no 2. To use varying and appropriate music activities in a session. yes no 3. To use a form of communication that is therapeutically suited for the client. yes no 4. To pace the session in respect to the client's ability. yes no 5. To have the client involved throughout the session. yes no 6. To make sure that non-music activity (when used) is apprOpriate for therapy. yes no By use of the reverse side of this sheet, your comments and/or suggestions are invited. APPENDIX E LIST OF INDEPENDENT VARIABLES APPENDIX E LIST OF INDEPENDENT VARIABLES Edwards Personal Preference Schedule Achievement Affiliation Nurturance Deference Intraception Change Order Succorance Endurance Exhibition Dominance Heterosexuality Autonomy Abasement Aggression Aliferis Music Achievement Test Melody Harmony Rhythm Total Affective Sensitivity Scale Client Interviewer Adult Child Male Female Group Dyad Education Health Informal Counseling Psychotherapy Total Field Work Performance Report Data Collection Communication Skills Treatment Planning Professional Characteristics Treatment Implementation Total Teacher Ratingg Course Material Leadership/Participation Academic Achievement Cumulative Grade Point Average 59.9. 88 BIBLIOGRAPHY BIBLIOGRAPHY Anderson, Harry E., Jr., and Jantzen, Alcie C. "A Predic- tion of Clinical Performance." 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