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Barbara Wheeler Oxford Handbook
Barbara Wheeler Oxford Handbook
Music therapy is a diverse field and music therapy research increasingly reflects that
diversity. Many methods and approaches are used to examine the various facets of music
therapy practice and theory. This chapter provides an overview of music therapy
research, and provides basic information about how research is conducted in this field.
Research methods in music therapy research are similar to those used in other healthcare
disciplines. A range of methods are reviewed and presented including; experimental
research and Randomized Controlled Trials, Participatory Action Research, Grounded
Theory, and Phenomenological methods.
Keywords: music therapy, music therapy research, research methods in music therapy, music therapy evidence,
medical music therapy
MUSIC therapy is a diverse field and music therapy research increasingly reflects that
diversity. Many methods and approaches are used to examine the various facets of music
therapy practice and theory. This chapter provides an overview of music therapy
research, and provides basic information about how research is conducted in this field.
Music therapy research is similar to research in other disciplines, but it has some unique
aspects. It has the same definition and purposes, as described below, and most of the
research methods that are employed are similar to those in other fields of health
research. The focus on music is distinctive from most other types of health research.
When the music, the therapist, and the client are included in the research process and
outcomes a unique perspective is gained.
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Definition of research
Bruscia (1995b) has defined research as “a systematic, self-monitored inquiry which leads
to a discovery or new insight which, when documented and disseminated, contributes to
or modifies existing knowledge or practice” (p. 21). Gfeller (1995) described research as
“a disciplined or systematic inquiry” (p. 29). She has also pointed to the importance of the
definition proposed by Phelps et al. (2005) that research is “a carefully organized
procedure that can result in the discovery of new knowledge, the substantiation of
previously held concepts, the rejection of false tenets, and the formal presentation of data
collected” (p. 3).
Quantitative research
Descriptive
We might ask, “How does X influence our client during the process of therapy?” where X
could be variations in the tempo, volume, tonality, or another aspect of an improvisation;
type of instrument used; or things that are happening in the client’s life outside of music
therapy. Examples of descriptive research in music therapy could include studies that are
based on surveys and questionnaires, single subject designs that rely on numerical data
to determine the results, and studies of groups of people that use quantitative measures
of outcomes but do not include a control group for comparison.
Experimental Research
We might ask, “Does X treatment work better than Y treatment?” X and Y could be music
therapy and movement therapy or music therapy in combination with physical therapy
versus music therapy alone. In experimental research, two or more treatment conditions
are compared and participants are randomly assigned to conditions so that no variables
outside of those that are being tested vary among conditions. Although it is not possible
to achieve strict control outside of a laboratory, these designs do as much as possible to
control all factors. These are standard experimental designs that answer questions about
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the effectiveness of music therapy and are often requested by those who determine what
therapy should be supported or paid for.
Qualitative research
Quantitative research
Examples of RCTs include two studies by Ghetti. In one (Ghetti 2011), of active music
engagement with emotional-approach coping to improve well-being in liver and kidney
transplant recipients, she evaluated the impact of music therapy under two conditions to
which the patients were randomly assigned. One group received music therapy with an
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One example is a study by Bensimon and Gilboa (2010), who studied Musical Presentation
(MP), a therapeutic tool in which members of a group present themselves through
musical pieces of their choice in and receive feedback from their peers, with the aim of
increasing their sense of purpose in life and self-consciousness. Rather than randomly
assigning (p. 723) participants to experimental and control groups, the researchers
assigned them to the groups based on the times at which they were available.
Nayak et al. (2000) investigated the use of music therapy as an aid in improving mood
and social interaction among people who have had traumatic brain injuries or strokes.
Although the original intention was to randomly assign participants to the different
groups that included an experimental group who received music therapy, a control group
who received art therapy, and a control group receiving standard care, this goal was not
achieved due to problems finding enough participants who met the criteria and were
willing to participate. The completed study compared music therapy to standard
treatment, but the condition to which participants were assigned was based on their
availability rather than random assignment. Without randomization of participants the
study design is considered to be much weaker because of the risk of bias.
In another type of exploratory study, data are collected but there is no control condition.
The information gathered can help to determine whether the intervention can be carried
out as planned. Studies of this type are often shared in professional journals. It is
important that those writing them make it clear that, because they do not include any
type of control, it is impossible to say what caused the effects that are seen. These studies
are similar if not identical to what many clinicians do when they collect data on their
work about how their clients respond or change during and after therapy. It is important
for those involved with these designs to be aware of the limitations of such designs, and
also to consider the similarities with data collected in regular clinical work.
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Two studies of the Sing and Grow program for young children and their parents in
Australia used pre-experimental designs. Nicholson et al. (2008) assessed the impact of a
10-week program for marginalized parents and their children in promoting positive
parenting and child development. Williams et al. (2012) explored the impact on parental
well-being, parenting behaviors, and child development for parents of children with
disabilities and their children. Another example is of a music therapy program for women
coping with breast cancer (Wheeler et al. 2010), while a fourth is the evaluation of a
music therapy protocol to enhance swallowing training for people who have had strokes
and have dysphagia (Kim 2010). In all four studies, data were gathered on targeted
responses at several points and an evaluation of changes was made, but none of them
included a control group. The findings of such studies can be used to develop more robust
experimental procedures for future studies.
Meta-analysis
In a meta-analysis the researcher calculates a standard effect size1 for each study, giving
an indication of the size and variability of the phenomenon under investigation and
allowing the studies to then be compared among themselves across all measures and
variables. Meta-analyses have provided important information on the efficacy of music
and music therapy in medicine. Standley (2000) conducted the first of these in 1986 and
subsequently updated it several times. Standley (2002) later performed meta-analyses on
the effectiveness of music therapy with premature infants in neonatal intensive care units
and of music versus no music conditions during medical treatment of pediatric patients
(Standley and Whipple 2003).
Dileo and Bradt (2005) completed a meta-analysis of 184 studies involving music
(p. 724)
in medical treatment. They included all studies that had been conducted with a control
group that did not receive music. They included 47 dependent variables. The effects of
music and music therapy were reported for each dependent variable, grouped according
to 11 medical specialty areas: premature infants, fetal responses to music, pediatrics,
obstetrics/gynecology, cardiology/intensive care, oncology and terminal illness, general
hospital, surgery, rehabilitation, dementia, and dentistry.
Survey research
Survey research refers to:
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Wigram (2005) divided music therapy survey research into three categories: (a) surveys
of journals, (b) clinical surveys, and (c) surveys of training methods.
Surveys of journals, books, and other printed of web-based texts categorize the research
and other articles according to the purpose of the survey. They can alert the profession to
strengths and weaknesses, provide insight into where the research is happening, and
determine how research is divided among clinical fields. Recent examples of this type of
survey research include an analysis of music therapy journal articles by Brooks (2003)
and analyses by Aigen of journals and books (2008a) and dissertations (2008b). Roberts
and McFerran (2008) utilized both quantitative and qualitative methods for a content
analysis of how music therapy was reported in Australian print media over a 10-year
period.
Clinical surveys consider aspects of clinical practice, attitudes from both professionals
and clients, and information about where people work. Examples include such diverse
topics as: a survey of the use of aided augmentative and alternative communication
during music therapy sessions with persons with autism spectrum disorders (Gadberry
2011); a survey of repertoire and music therapy approaches employed by Australian
music therapists in working with older adults from culturally and linguistically diverse
groups (Baker and Grocke 2009); and a survey of the expectations of cancer and cardiac
hospitalized cancer and cardiac patients regarding the medical and psychotherapeutic
benefits of music therapy (Bruscia et al. 2009). In an extension of traditional survey
methods, Vega (2010) surveyed music therapists and also gave them a personality test
and a test of burnout to examine (p. 725) possible relationships between personality,
burnout level, longevity, and demographic variables among professional music therapists.
Surveys of training methods seek to learn more about music therapy practice, the
experiences and attitudes of music therapy students, to assess the effectiveness of
clinical training, and to explore competency requirements for music therapists.
Researchers have sought information on a variety of topics. Stewart (2000) surveyed
music therapists from the United Kingdom to assess personal qualities of music
therapists, working models, support networks, and job satisfaction. Young (2009)
surveyed music therapy internship directors to examine the extent to which multicultural
issues were being addressed in internships in the United States and Canada; Gardstrom
and Jackson (2011) surveyed music therapy program coordinators for information on
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personal therapy for undergraduate students; and Hahna and Schwantes (2011) surveyed
music therapy educators regarding their views and use of feminist pedagogy and feminist
music therapy.
Applied behavior analysis (Hanser 2005) can be considered a type of single-case design
that includes specific designs and techniques, including reversal and multiple baseline
designs. These designs are applied in behavioral research to test a hypothesis about the
behavior of a single individual or group, examine the effect of a particular strategy, or
examine intra-subject changes over time under different conditions. Wlodarczyk (2007)
used a reversal design to examine the effect of music therapy on the spirituality of people
in an in-patient hospice unit. Using a multiple baseline design, de Mers et al. (2009)
looked at the effects of music therapy on challenging behaviors of young children in a
special education setting. These designs have been used frequently in music therapy, as
evidenced by Gregory’s (2002) finding of 96 examples of this design in an analysis of four
decades of the Journal of Music Therapy.
Longitudinal research
Longitudinal research provides information over a period of time (Ledger and Baker,
2005). According to Menard (2002), longitudinal research is when: (a) data are collected
for each individual unit for two or more distinct time periods; (b) the units are the same
from one time period to the next; and (c) the analysis of collected data involves some
comparison of data between or among time periods. The most commonly used
longitudinal designs (p. 726) are: (a) repeated cross-sectional studies what are carried out
regularly, each time using a different sample (or primarily different sample); (b)
prospective (panel) studies that collect information from the same people repeatedly over
a period of time (the preferred type); and (c) retrospective studies in which people are
asked to remember and reconstruct events and aspects of their lives (Ruspini 2002).
Several methods may be combined.
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Mixed methods research uses a range of research methods. This allows diverse
perspectives, methods, and data to generate the information that is desired (Bradt et al.
2013b; Creswell and Clark 2011). These methods are relatively new and in their very
early stages of development and expertise in music therapy research. Issues in combining
methods occur on pragmatic and philosophical/paradigmatic levels and are the subject of
numerous discussions and debates (K. Bruscia, personal communication, June 26, 2012;
Johnson and Onwuegbuzie 2004; Teddlie and Tashakkori 2003).
Examples of mixed methods research in music therapy include a study by Grocke et al.
(2009) in which they studied the effect of group music therapy on quality of life and social
anxiety for people who had a severe and enduring mental illness. Quantitative data were
gathered through several scales that measured the dependent variables, and qualitative
data were gathered through focus group interviews and an analysis of lyric themes. Barry
et al. (2010) studied the effects of creating a music CD on pediatric oncology patients’
distress and coping during their initial radiation therapy treatment. They collected
numeric and textual data for quantitative and qualitative analyses. Ridder (2005; Ridder
and Aldridge 2005) combined quantitative (including physiological measurements) and
qualitative approaches, using therapeutic singing, in case studies of individuals with
frontotemporal dementia.
Qualitative research
the varieties of social inquiry that have their intellectual roots in hermeneutics,
phenomenological sociology, and the Verstehen tradition. Many scholars use the
phrase qualitative inquiry as a blanket designation for all forms of social inquiry
that rely primarily on qualitative data (p. 727) (i.e. data in the form of words)… To
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call a research activity qualitative inquiry may broadly mean that it aims at
understanding the meaning of human action
Tesch (1990) listed 46 terms used to describe different types of research that is broadly
considered as qualitative research in the social sciences. The terms include: action
research, case study, clinical research, collaborative inquiry, content analysis, dialogical
research, conversation analysis, Delphi study, descriptive research, discourse analysis,
ecological psychology, ethnography, ethnomethodology, experiential psychology, field
study, focus group research, grounded theory, hermeneutics, heuristic research, holistic
ethnography, imaginal psychology, interpretive interactionism, life history study,
naturalistic inquiry, oral history, participant observation, phenomenography,
phenomenology, qualitative evaluation, symbolic interactionism, and transcendental
realism (p. 58).
Interest in qualitative research in music therapy began in the mid-1980s, when some
music therapists started to consider the limitations of quantitative research in capturing
important aspects of the music therapy experience (Wheeler and Kenny, 2005). All around
the world music therapists started to explore the use of qualitative methods in their
research. In the US, Aigen (1991) set the stage for the consideration of qualitative inquiry
by music therapists in his doctoral dissertation, The Roots of Music Therapy: Towards an
Indigenous Research Paradigm, as he considered historical influences on music therapy
research from the philosophy and theory of science and critiqued what he called the
received view from a position of process, clinical realities, creativity, and research
methodologies (Wheeler and Kenny 2005). In Australia in the early 1990s, O’Callaghan
was researching the experience of palliative care patients using grounded theory method
and content analysis by examining the text of their songs created in music therapy
(O’Callaghan 1996). Earlier in the US, Forinash (1992) used phenomenology to consider
the experience of improvisation in Nordoff-Robbins music therapy sessions. In Germany
at the same time Langenberg (Langenberg et al. 1992) and her colleagues used
hermeneutic inquiry to understand which aspects of the therapeutic process were helpful
for the client. The First International Symposium for Qualitative Research in Music
Therapy was held in 1994, offering music therapists who were using qualitative methods
in their research an opportunity to share and collaborate (Langenberg et al. 1996). This
symposium was followed by similar gatherings, continuing until 2007.
Since the mid-1990s the number of qualitative studies has increased (see Aigen 2008a,b).
This chapter will focus on some of the qualitative research methods that have been used
by music therapists.
Many qualitative studies use naturalistic inquiry (Aigen 2005; Ely et al. 1991; Lincoln and
Guba 1985), with the research being carried out in the settings that researchers want to
understand, with the researcher’s self experience and observation as the primary vehicle
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Phenomenological inquiry
Phenomenology is defined as: “A philosophy or method of inquiry based on the premise
that reality consists of objects and events as they are perceived or understood in human
(p. 728) consciousness and not of anything independent of human
Hermeneutic inquiry
Hermeneutics refers to the “art, theory, and philosophy of interpreting the meaning of an
object” (Schwandt 2001, p. 115). The hermeneutic circle involves a constant analytic
movement between the phenomena of interest and the structures (theories) developed in
order to better understand the phenomenon. Theories are therefore tentative and
evaluated against the data, further refined, and then reapplied to the data. The goal of
hermeneutic research is to engage deeply in the circle of understanding in order to
develop insightful and plausible interpretations of events.
Langenberg and her colleagues (Langenberg 1988; Langenberg et al. 1992, 1993)
developed a psycho-analytically based method using what is called the resonator function
to help observers gain access to the hidden meaning of an improvisation through a series
of steps in which they listen to and respond to an improvisation by a client. Their system
involves having a number of observers listen to a recording of a music therapy session
and write down descriptions of the improvisation. They then follow a number of steps to
compare and interpret the information and, finally, analyze the results in a process of
hermeneutic circling in relation to clinical data from the client’s case history.
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Rolvsjord 2007, p. 50
(p. 729)Others who have used hermeneutic inquiry in music therapy research include
Bonde (2005), who employed a hermeneutic framework for understanding Bonny Method
of Guided Imagery and Music (BMGIM) sessions; Gardstrom (2004), who used
phenomenological and hermeneutic inquiry to investigate meaning in clinical music
improvisation with troubled adolescents; Luce (2008), who studied music therapy
students’ epistemological development and how that influences their education and
clinical training; and Jackson (2010), who explored responses to client anger in music
therapy by examining cases, as units of data, through a process of hermeneutic
phenomenological reflection.
Grounded theory
Grounded theory is defined as:
a general approach of comparative analysis linked with data collection that uses a
systematically applied set of methods to generate an inductive theory about a
substantive area with the purpose of discovering theory from data. The researcher
focuses on one area of study, gathers data from a variety of sources, and analyzes
the data using coding and theoretical sampling procedure.
Amir 2005
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procedure to investigate how cancer survivors described the experience and perceived
outcome of therapy using BMGIM.
First-person research
First-person research is defined by Bruscia (2005b) as “any method in which researchers
or participants gather data from themselves, using processes such as introspection,
retrospection, self-perception, self-observation, self-reflection, self-inquiry, and so
forth” (p. 379). One of the most well known types of first-person research is heuristic
research (Moustakas 1990), in which a person studies his or her own responses as a way
of understanding a phenomena. Bruscia suggests that the following situations may occur
in first-person research: the researcher studies self, the researcher studies self and
participants, participants study themselves, and co-researchers study themselves.
Baines (2000) reported on a pilot study for a program to “develop a cost effective group
music therapy program that prioritized the requests of the consumers as the process for
development, thereby readily incorporating consumer concerns and hopefully meeting
consumer needs” (p. 54). A survey to assess the program was jointly developed by staff
and consumers (clients), thus incorporating elements of participatory action research. A
later report (Baines and Danko 2010) provided follow-up survey data supplemented by
information from interviews with consumers.
There are varied examples of action or participatory action research in the music therapy
literature. One is Stige’s (2002, Chapter 4) research with Upbeat, a group of people with
mental challenges who were involved in a collaborative process to develop a more
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inclusive life in the community. Another is by Baker (2007), who used action research to
evaluate a problem-based learning activity with students who were doing their first year
of clinical training, emphasizing developing clinical reasoning skills. McFerran and Hunt
(2008) used an action research process in a program to help adolescents cope with grief
and loss in several situations. Rickson (2009) worked collaboratively with team members
to facilitate their use of music with children who have special education needs and
included action research in her consulting.
Most of the case studies in the book about Community Music Therapy, Where Music
Helps (Stige et al. 2010), are ethnographically informed music therapy research exploring
how the effects of music and musicking are linked to human interaction in context.
Ansdell (2010) (p. 731) explored what happens with a group of people in West London
who get together to create and perform music. Pavlicevic (2010) documented the rich
ethnographic context in and around a children’s choir in South Africa. Stige (2010)
studied participation in a festival that was started by music therapists several decades
ago. In each of these cases, the researcher employed ethnographic research methods to
study the people, the events, and the process of collaborative music making.
Arts-based research
Austin and Forinash (2005) have defined arts-based inquiry as “a research method in
which the arts play a primary role in any or all of the steps of the research method. Art
forms such as poetry, music, visual art, drama, and dance are essential to the research
process itself and central in formulating the research question, generating data,
analyzing data, and presenting the research results” (p. 458). Only a small number of
arts-based research studies have been done in music therapy. Ledger and Edwards (2011)
reviewed the arts based research conducted in music therapy and queried why music
therapists have not engaged more enthusiastically in arts-based research. They suggested
that music therapy researchers may be reluctant to adopt arts-based research practices
due to a desire to insure that music therapy research is accepted as scientific and
scholarly among other health care research. They also wondered whether music
therapists may have used arts creation within their research approaches but have not
highlighted this for various reasons, some of which might be related to the quest for
recognition as a scientific and scholarly discipline.
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Schenstead (2012) conducted a heuristic arts-based self-study through which she took an
in-depth look at the intricacies of the personal improvisational process using her primary
instrument, the flute. She improvised on stories and poetry that she had written and
wrote about her experiences in a journal that became the main source of data. The
journal was analyzed using an arts-based method and the findings took on the form of a
performance piece in which she perform the stages of my process using a synthesis of
poetry, artwork, music, and personal reflections. A final meta-reflection of the entire
project presents a philosophy explaining the dynamics of the intrapersonal relationship.
EBP has received increased attention in music therapy as it has become apparent that by
meeting the standards of EBP music therapy increases the opportunity to be accepted
and funded. This is not without controversy and the issues surrounding the
implementation of the evidence-based approach to music therapy have been elaborated
(Abrams 2010; Edwards 2005b) The Cochrane Library and Cochrane reviews are an
important source of information on EBP, and a number of Cochrane reviews have been
done in music therapy, with the largest number in recent years.
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Research on music
Bonde (2005) suggests that researching music includes “any method within music
therapy in which researchers gather data concerning the relationship between music—
improvised or composed, recorded or performed live—and client experiences and
behavior” (p. 489) and that “the focus may be on material properties of music (stimulus
or effect); on intentional properties of music (description, analysis, and interpretation of
meaning); or on musical processes (interactions and relationships)” (p. 489). These may
include studies of nonmusical or musical responses.
Studies that focuses on nonmusical responses include one by Elefant (2002, 2005), who
used a single case multiple baseline, time series, within-subjects design to investigate
whether songs in music therapy intervention could enhance the communication skills of
seven girls with Rett syndrome. Ridder’s research (2005; Ridder and Aldridge 2005)
studied the use of therapeutic singing with individuals with frontotemporal dementia.
This is presented under mixed methods research. They also viewed nonmusical
responses, as do the examples of RCTs by Ghetti (2011; 2013) and Gattino et al. (2011);
the exploratory studies by Bensimon and Gilboa (2010); Nayak et al. (2000); Williams et
al. (2012); Wheeler et al. (2010); and Kim (2010) among others. The fact that so many
examples of research on nonmusical responses have been presented in this chapter
highlights that a great deal of music therapy research has focused on nonmusical
responses or outcomes by music therapists.
There are also numerous examples of research on musical responses. The work
(p. 733)
Historical research
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Historical research is defined as “the systematic study of the past practices, materials,
institutions, and people involved in therapeutic applications of music” (Solomon and
Heller 1982). Historical research is a way of preserving the history of music therapy that
people in the future will know of what led to that point. Historical research topics cover a
wide range.
Several studies of music therapy pioneers, including Ira Maximillian Altshuler (Davis
2003), Willem van de Wall (Clair and Heller 1989), and James Leonard Corning (Davis
2012), have been published. Historical uses of music in hospitals, and the development of
the profession of music therapy for hospital patients has been researched (e.g. Edwards
2007, 2008; Taylor 1981). Reschke-Hernández (2011) examined the history of music
therapy treatment interventions for children with autism.
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Theory development has always been a part of the research work in music therapy. Sears
(1968) suggested three processes in music therapy: experience within structure,
experience in self-organization, and experience in relating to others, still provides a basis
for the thinking of many about what music therapy does. Kenny (1989, 2006) organized
her ideas into a formal theory and found a language to reflect her understanding of the
music therapy process in what she termed The Field of Play.
Music therapy theory has continued to develop. Working to develop theory for the music
therapy as procedural support for invasive medical procedures, Ghetti (2012) used
qualitative document analysis to examine the literature in this field. She integrated
findings from 19 primary sources to formulate a theoretically grounded working model.
Robb (2012) suggests that music therapy research is moving from being outcomes-based
to theory-based and that (p. 734) the attention that is now being paid to theory “offers
one way to advance our understanding of the complex interactions between music,
clients, and the education or health care environment” (p. 5).
Research publications
Eight music therapy journals are published regularly in English, many by music therapy
associations of their countries, and include varying amounts of research. In order of the
dates on which they commenced publication (and which are listed), they are: Journal of
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Music Therapy 1964 (US); Canadian Journal of Music Therapy 1973; Music Therapy
Perspectives 1982 (US); British Journal of Music Therapy 1987; Australian Journal of
Music Therapy 1990; Nordic Journal of Music Therapy 1992 (representing all of the
Nordic countries and now an international journal); New Zealand Journal of Music
Therapy 1994; and Voices: A Worldwide Forum for Music Therapy 2001 (on-line:
<www.voices.no>).
Several people have reviewed music therapy research in the past decade, primarily
through analyses of journal articles. Brooks (2003) examined 1521 articles from nine
music therapy journals over a 37-year period, looking for trends and types of article and
comparing them across journals. She tallied the numbers of research articles classified in
the categories of quantitative, qualitative, clinical, historical, philosophical/theoretical,
and professional.2 (p. 735) The number of articles published in each of these journals is,
of course, related to the length of time that the journal has been published and the
number of issues a year. Brooks found quantitative research articles to be the
predominant category across all journals, with 542 articles. She found 55 historical
articles and 136 philosophical/theoretical articles.
Edwards (2005a) reviewed eight journals for content and trends, and also examined the
number of articles from one journal that were referenced in other journals. This was in
order to reveal the extent to which music therapists showed awareness of each others
work across the international community. To examine how many articles from one journal
were cited by authors writing in other journals, she reviewed papers from the Journal of
Music Therapy (JMT) from 1964–2003 and the British Journal of Music Therapy (BJMT)
from 1995–2003. She found no papers from either the New Zealand Journal of Music
Therapy or the Canadian Journal of Music Therapy to have been cited in JMT during the
publication period reviewed. Citations from the BJMT appeared in eight papers in JMT,
five of which were authored by music therapists from countries outside the United States.
The lack of awareness and citation of authors from other countries is a concern for the
internationalization of the discipline of music therapy.
Page 18 of 35
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Aigen examined qualitative articles and chapters (2008a) and qualitative dissertations
(2008b) published from 1987–2006. He found 92 articles and book chapters, 55 doctoral
studies, and six books to have been published during that period. In the period from
1987–1990, two articles and chapters and two dissertations (or doctoral theses) were
published; from 1991–1994, five articles and chapters and seven dissertations; from
1995–1998, 20 articles and chapters and seven dissertations; from 1999–2002, 31 articles
and chapters and 13 dissertations; and from 2003–2006, 34 articles and chapters and 23
dissertations. This clearly represents a large increase in qualitative research in music
therapy, beginning in the mid-1990s.
Another discussion is about how well the requirements for rigorous control in conducting
RCTs can match with what actually occurs in a music therapy session. As Bradt (2012)
says, “One of the major concerns expressed by music therapists about the use of RCTs is
the claim that the treatments used in RCTs suffer so severely from the required
standardization (p. 736) that they become irrelevant to clinical practice” (p. 136). One
way to address this concern is to use a treatment manual, which contains guidelines for
the treatment approach being investigated but does not provide a rigid set of procedures
to use. Rolvsjord et al. (2005), who developed a manual for an RCT investigating resource
oriented music therapy, say:
Our pragmatic solution… has been to produce a manual with open descriptions of
principles that emphasize contextual and collaborative aspects. The manual thus
focuses upon underlying assumptions and values informing a contextual approach
to resource-oriented music therapy, rather than describing specific actions,
techniques, or procedures. In this way we hope to have avoided that the
manualization should limit the possibilities for each therapeutic process to be
Page 19 of 35
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tailored to match the individual client. We also think that the principles, if
practiced with competence and not only adherence, have left enough space for the
collaborative therapeutic process to develop relatively freely.
(p. 28)
Another issue is the quality of music therapy research. As research has been reviewed for
Cochrane Reviews and the quality evaluated on a number of criteria, it has become
apparent that many music therapy studies are not of high enough quality to be included.
Bradt (2012) said, “Reviews of the music therapy research literature indicate a need for
increased scientific rigor in the design and conduct of RCTs” (p. 146). “It is important
that music therapists contributing to our evidence base through RCT research are
prepared to design trials that meet current methodological standards and, equally
important, are able to respond appropriately to those design aspects (e.g. blinding of the
participants) that are not feasible in music therapy research” (p. 121).
The positive side of this is that it providing guidance for music therapy researchers in
raising the quality of the studies, leading to more studies that meet criteria for inclusion.
This applies primarily to RCTs, and it seems that the number of RCTs about music therapy
research is increasing.
Challenges to music therapy research that are not specific to RCTs have to do
(p. 737)
with whether music therapy clinicians and others use the research that has been done.
This has been an ongoing challenge for music therapy research (see Wheeler 2005, p. 6).
Waldon (2015) surveyed US music therapists for information on the extent to which they
engage in research-related activities or whether they perceive barriers to integrating
Page 20 of 35
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Along with the challenges confronting music therapy research and researchers, there is a
great deal of development and extension work that builds the profession and increases
our knowledge within the profession as well as our visibility to others. Music therapy
research draws from various traditions of inquiry, selecting the method as relevant to the
questions being asked, and doing it with increasingly high quality. All of this brings music
therapy closer to achieving an integral connection between theory, clinical practice, and
research that Gaston (1968) suggested should form a tripod, each necessary in order for
the other to stand.
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Notes:
(1.) An effect size is the difference between means in standardized units, or the number
of standard deviations by which the means differ.
(2.) Since the focus of this chapter is music therapy research, clinical and professional
articles are not included in this summary, although they were part of Brooks’ (2003)
analysis.
Barbara L. Wheeler
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