Standards of Integrity for Qualitative Music Therapy Research
EDITOR'S NOTE: This article was originally published in Journal of Music Therapy, vol. XXXV (3), 1998, 176-200, and is republished here with the kind permission from the author and the publisher American Music Therapy Association.
Positivism provides quantitative researchers with many philosophical comforts. In that world, truth is absolute rather than relative; reality is singular rather than plural; objectivity is attainable rather than delusional. There the purpose of research is clear: to discover and verify what is true and what is not true, based on standardized methods and universal levels of statistical proof. To leave that world of numeric certainty is to embark upon a search for human understanding where there are no reliable maps, no verified routes, and no valid passes. In the world of nonpositivistic, qualitative inquiry, the dilemmas are epistemological rather than methodological: without singularity of truth and reality, and little possibility for objectivity, how does one ever know anything with any certainty? There the challenges are experiential rather than technological: how does one human being gain access to, understand, and make meaning of another person's experience? There a researcher inevitably has to enter into interpersonal experiences and explore identity issues to drag the tiniest morsel of insight into consciousness. There the purpose of research is multifaceted: to enlarge our constructions of the world and to find and create individual meanings therein.
Fortunately, the shift from positivism to nonpositivism is very much like moving from the world of scientific knowing to the world of artistic knowing, a shift that most music therapists make quite regularly. As practitioners, we are familiar with the positivistic, linear terrain of science and the verification demands of the health community; as music therapists, we are familiar with the interpersonal terrain of clinical work, and as musicians, we are familiar with the artistic, nonlinear terrain of our art form. Because our work is both science and art, we already know that these terrains require different paths to knowing, as well as different ways of being as knower and beknown.
Aldridge (1996) points out that while there are fundamental differences between science and art, and between positivistic and nonpositivistic research, "both poles are necessary to express the life of human beings" (p. 93) and that consequently both are needed in music therapy research. Given the rich heritage of quantitative research and the scientific way of knowing we already have in music therapy, it is especially important for us to explore qualitative research and the artistic way of knowing about what we do. To do so requires that we acknowledge from the outset that positivistic and nonpositivistic research are not similar or even compatible. They have very different goals and methods, and mutually exclusive philosophical assumptions about the nature of truth, reality, and knowledge thereof. For detailed information on these differences, see Guba and Lincoln (1994), Aigen (1995), and Bruscia (l995d). These differences are so pervasive that they make the paradigms mutually exclusive; they cannot be reconciled or combined, and their differences cannot be ignored or minimized. Instead, what is needed is what Aldridge (1996) calls a tolerance of both perspectives, with neither taking predominance, and each contributing something unique and valuable to our understanding of music therapy (p. 104).
An area where such tolerance has to begin is in the understanding and acceptance of differences in standards of quality for research. Logically, one simply cannot impose standards for quantitative research onto qualitative research, no matter how intellectually tempting or convenient that would he. Reliability, validity, generalizability, and probability—the stalwarts of positivistic tradition—are simply irrelevant to the purpose, assumptions, and methodological problems of qualitative research. And conversely, standards for qualitative research make very little sense when imposed upon quantitative research.
Standards for qualitative research have been slow in developing, not because they are regarded as unnecessary or unimportant, but rather because they are very difficult to formulate. The main difficulty is that there are myriad philosophies that come together under the umbrella of nonpositivistic or qualitative research, each with significantly different positions on what it is possible to know, the ways in which it can be known, and the kinds of evidence that are needed to know that one knows it (see Cuba & Lincoln, 1994 and Ruud, 1996). Without universality on such matters (as there is in quantitative positivistic research), standards themselves become individual constructs based upon each researcher's beliefs about truth, reality, and knowledge thereof. As a result, there are as many qualitative standards as there are nonpositivistic epistemologies. This is certainly not a problem to be avoided or resolved—it is a fundamental condition of research.
Another difficulty in formulating standards is that there are so many approaches to methodology. Unlike in quantitative research, where there are standardized methodological designs, every qualitative design is unique to every study. The reason is that qualitative methodology always accommodates (rather than assimilates) the phenomenon and the participants as they present themselves to the researcher. Here again, the resulting diversity is not a problem, it is a fundamental condition of research.
A difficulty unique to music therapy standards is the addition of music to the research arena. Researching music brings unique and diverse perspectives to both epistemology and methodology in qualitative research. Music has its own epistemology: it is itself a way of knowing; it too encourages multiple constructions of truth and reality. Music also has its own methodology: it is itself a method of research; it too encourages the creation of unique methodology for every situation.
With this in mind, the purpose of this article is to enlarge our constructions about the integrity of qualitative music therapy research, by creating a set of standards that reflect the essentially artistic nature of our epistemology and methodology as therapists. Standards are here defined as ideals of quality towards which researchers strive as they design and implement a study. As such, they are values that a researcher espouses and constructs while engaging in the various phases and facets of inquiry. "Integrity" is what results from the researcher's devotion and adherence to these values.
Towards this purpose, relevant music therapy literature was surveyed to identify the ideals and values of research that: (a) have been directly expressed by qualitative researchers in their writings (see Table 1) and (b) can be inferred from the methodologies used in the research (see Table 2). As these ideals and values were identified, they were grouped according to commonalities in focus. No attempt was made to find points of agreement nor to resolve differences; instead, every ideal and value was regarded as equally valid in constructing a holistic picture. In this way, the resulting set of standards presents a range of ideals and values that may or may not be relevant, depending upon the research study and any aspect thereof. To repeat: the standards set forth here are constructs of the author which are intended for application only where relevant to the phenomenon, participants, and lived worlds under inquiry by the researcher. They are not meant to be universal or consensual. Once each value had been defined and differentiated from others in the same category, it was then interpreted using musical metaphors (see emphasized sections). The main question posed was: how would I, as a pianist, apprehend this quality or value in the process of preparing, interpreting, and performing a Chopin nocturne? In applying this musical metaphor to qualitative research: I as pianist am the researcher, the nocturne is the phenomenon being studied, Chopin is the participant, practicing or studying the nocturne represents gathering the data, interpreting what Chopin wrote is likened to analyzing the data, and performing the piece is likened to communicating the findings. My reason in using these metaphors is to show how our musical way of knowing can clarify and enhance our understanding of integrity in qualitative research, while also insuring that each standard is contextualized and understood from an artistic rather than strictly scientific point of view.
Upon analysis of the literature, four main areas of standards were discerned:
- Methodological integrity refers to those values that guide the researcher in designing and implementing the study.
- Personal integrity refers to values a researcher needs in shaping his/her identity in the role of inquirer.
- Interpersonal integrity refers to qualities a researcher needs to interact with others meaningfully during the inquiry.
- Aesthetic integrity refers to qualities of beauty that the researcher imparts to the study itself.
Table 1: Ideals of Quality Expressed in Writings on Qualitative Research
| Confirmability (Objectivity) | Data and findings can be upheld by another researcher (Lincoln & Guba, 1985). |
|---|---|
| Transferability (External validity, generalizability) | Findings can be applied to other participants, settings, or situations (Lincoln & Guba, 1985); one case study is typical of several cases (Smeijsters, 1996). |
| Dependability (Reliability) | Data and findings are obtained consistently (Lincoln & Guba, 1985; Smeijsters, 1996). |
| Credibility (Internal validity) | Methodology is appropriate to study (Lincoln & Guba, 1985); the goals and predicted outcomes of the clinical case study are consistent with the data and findings (Smeijsters, 1996); the musical and "onmusical behavior of the participant are consistent with one another (Smeijsters, 1996). |
| Construct validity | Interpretive categories and findings are appropriate representations of data. Also referred to as "accuracy" (Aigen, 1996a) and groundedness (Amir, 1996; Glaser & Strauss, 1967). Descriptions of the data are consistent with one another: when made by independent observers, or with different methods of data collection, or in different theoretical frameworks (Langenberg, Frommer, & Langenbach, 1996: Smeijsters, 1996). Musical findings are consistent across different methods of analysis (Lee, 1994). |
| Ontological authenticity | The study leads to enlarged constructions (Guba & Lincoln, 1989). The research is of value, meaning, and interest to the audience (Aigen, 1995, 1996a). |
| Educative authenticity | The study increases understanding of others (Guba & Lincoln, 1989). |
| Catalytic authenticity | The study leads to action (Guba & Lincoln, 1989). |
| Tactical authenticity | The study empowers participants to act (Guba & Lincoln, 1989). |
| Personal authenticity | Researcher is aware of what is important about study, acts in a way that is consistent with that awareness, and takes responsibility for own awareness and actions (Bruscia, 1996). |
| Ethical | The human rights of the participants are respected fully, through safeguards which are extrinsic and/or intrinsic to the paradigm (Guba & Lincoln, 1994). Extrinsic safeguards include external review boards (Maranto, 1995); intrinsic safeguards include self-inquiry, consultation with other researchers, or collaboration with the participants (Bruscia, 1995c). Aigen (1995) underlines the importance of equality in the researcher-participant relationship. |
| Primacy of the lived world | 'The researcher focuses on phenomena as they are lived in the real world, and as experienced by human beings in context, prior to explanations and interpretations of any kind (Giorgi, 1975). Topics of research should be connected to the living clinical reality of music therapy (Aigen, 1995). |
| Musical integrity | Musical phenomena are studied and described in ways that are indigenous to music (e.g., musical analysis of scores and recordings), rather than in ways that are indigenous to verbal phenomena (Ansdell, 1995; Lee, 1994, 1996). |
| Artistry | Research is an artistic process and art is a process of research (Aldridge, 1996; Kenny, 1996). |
| Expressivity | Researchers use various expressive modalities and techniques in reporting the study, in order to convey the essence of the phenomenon, the richness of the data, and the potential implications of the findings. Essentially, this involves metareflecting upon, translating, and re-presenting the data so that the audience can experience the phenomenon on both affective and cognitive levels (Baur-Morlok, 1996; Kenny, 1996). |
| Usefulness | The study has "potential for application, relevance, interestingness, or the degree to which it is compelling for its intended audience" (Aigen, 1996a, p. 25). |
Table 2: Methods Recommended By Qualitative Music Therapy Researchers
| Optimal sampling | The researcher searches for data samples which will produce typical examples of the phenomenon, as well as maximum variations. The samples are selected as the research proceeds, and criteria for selection may vary as data are analyzed. (Bruscia, 1995a; Lincoln & Guba, 1985). |
|---|---|
| Prolonged and persistent observation | The researcher invests sufficient time in observing the phenomenon and participants, and engaging them repeatedly until the aims of the study have been accomplished (Lincoln & Guba, 1985). |
| Data comparisons | The researcher compares data sets within and between participants, researchers, phenomena, modalities (e.g., musical data, verbal data) (Bruscia, 1995b); also called "triangulation" (Lincoln & Guba, 1985). Analysis by constant comparison: A strategy for interpreting the data which begins by developing categories to describe initial cases, analyzing relationships between these categories, generating hypotheses or theoretical constructs based upon these relationships, and then continually modifying and refining both the categories and constructs on the basis of subsequent cases (Goetz & LeComte, 1981). |
| Contextualizing | The researcher identifies the many different personal perspectives, professional orientations, organizational systems, physical environments, and conditions impinging upon the study (Bruscia, 1995b). |
| Interpersonal analysis | The researcher examines roles and relationships between every individual and group involved in the research study (Bruscia, 1995b). |
| Appraisal | The researcher continuously evaluates and relines every aspect of the research process (Bruscia, 1995b): also called "metacritical evaluation" in phenomenological research (Forinash & Gonzalez, 1989). |
| Bracketing | A phenomenological technique also referred to as "epoche" in which the researcher acknowledges and reports his/her own perspective on the phenomenon or participants, and then attempts to suspend or hold in abeyance any preconceptions or biases that might influence the gathering, analyzing, or interpreting of the data (Aigen, 1995; Forinash, 1995). |
| Perceptual description | After "bracketing" his or her own perspective, the researcher describes the phenomenon and participant as they appear, that is, as faithfully as possible to what is perceptually present and clearly manifest, without interpretation of any kind. Usually, a perceptual description provides "factual" information about the client, the client's life, and the actual events that took place in the research or therapy session (Forinash, 1995; Forinash and Gonzalez, 1989). |
| Notational devices | The researcher develops ways of visually re-presenting music that occurred within the research or therapy session. Such devices may be designed to facilitate its analysis or to communicate to the reader the essential nature of the music created or experienced by the participant and researcher (Bergstrom-Nielsen, 1993; Langenbcrg et al., 1996; Lee, 1994, 1996). |
| Personal engagement | The researcher contributes data on him/her self to the study by: experiencing the same phenomenon under investigation as the participant, empathizing with participant's experience of the phenomenon, recreating the data of participants in the same or different modality, or exploring one's own personal reactions to the data (Bruscia, 1995b, 1995c). Phenomenological reflection: The researcher studies the perceptual descriptions of the data to uncover what meanings they might have within the life world of the participant (i.e., the participant's ontology) and to the researcher (i.e., the semantic or referential meaning of the data) (Amir, 1990; Forinash, 1995; Forinash &Gonzalez, 1989). |
| Self-inquiry | The researcher uses various techniques to systematically examine "his or her own personal experiences, concerns, needs, reactions, thoughts, feelings, beliefs, and so forth, with regard to the research study, and in particular those aspects that are susceptible to personal influence" (Bruscia, 1995c, p. 430). |
| Consultation with experts | The researcher consults with other qualified professionals to: guide the decision-making process, facilitate the self-inquiry process, and to help integrate the personal and professional perspectives of the researcher (Bruscia, 1995b, 1995c); also called "peer debriefing" (Lincoln & Guba, 1985). |
| Collaboration with participants | The researcher seeks the advice and assistance of the participants in order to: insure the significance, relevance, safety, and ethics of the study; to better understand the lived world of the participant and how it affects his/her participation in the research study; and to better understand the data from the participant's perspective (Bruscia, 1995b, 1995c); also called "member checking" (Lincoln & Guba, 1985). |
| Stepwise replication | The researcher has another researcher conduct a parallel inquiry, using the same method with different samples (Guba, 1981). |
| Grounding | Based on the work of Glaser and Strauss (1967), the researcher returns "to the original data (as gathered in their original contexts) to determine whether the codes, categories, or constructs that have been developed through various stages of data processing are in fact relevant and appropriate" to the original data (Bruscia, 1995b, p. 419). The process is sometimes referred to as "recontextualizing" the data after it has been "de-contextualized." A variation of this is to check the adequacy of the final interpretations against data that was gathered previously but left unanalyzed specifically for this purpose (Lincoln & Guba, 1985). Another method is the "negative case analysis" (Lincoln & Guba, 1985). |
| Audit | Towards the end of the study, the researcher asks another qualified researcher to conduct an independent review of every step in the research process, and to evaluate the trustworthiness of the data and interpretations (Lincoln & Guba, 1985). |
| Reflexive journal | The researcher keeps a diary of personal thoughts, feelings, reactions, and concerns as they arise during the research study (Bruscia, 1995c; Lincoln and Cuba, 1985). |
| Field journal | The researcher records significant or interesting events, observations, or insights that occur in collecting or analyzing the data (Bruscia, 1995b). This may include a log of day-to-day research activities, and a log of every methodological decision or change (Lincoln & Guba, 1985). |
| Expressive devices | The researcher uses a variety of expressive forms and media to report the findings, including images, metaphors, allegories, symbols, poems, artwork, soliloquies, myths, stories, case studies, video and audiorecordings, etc. (Aigen, 1995; Bruscia, 1995b; Kenny, 1996). |
| Thick description | The researcher provides sufficient information for the reader to make the necessary comparisons to apply the research to other situations (Lincoln & Guba, 1985). |
Methodological Integrity
A researcher has methodological integrity when demonstrating the qualities of responsiveness, completeness, and fidelity in the design and implementation of the study. These qualities overlap and influence one another reciprocally.
Responsiveness
Responsiveness is evidenced when the researcher is continually sensitive to the phenomenon, participants, and environment under study, delimiting and gathering data in ways that allow the phenomenon and participants to unfold spontaneously and easily, in a natural and supportive environment. Such responsiveness requires that the researcher use methodology that is both appropriate and flexible.
Appropriateness of method.
The researcher uses methods of data collection that are appropriate to the purpose of the study, the participants, the phenomenon under investigation, and the setting. Specifically, the researcher selects sources of data, determines the research setting, engages the participants, selects and gathers the data in ways which: (a) accomplish the purpose of the study as relevant to the needs of the participants, phenomenon and setting; and (b) enables and assists the participants and/or phenomenon to unfold as naturally and comfortably as possible.
When I set out to learn how to play a Chopin nocturne, I have to organize my practicing according to the technical and interpretive demands of the nocturne, my own abilities, my practice schedule, and the target date/or completion. Many decisions are involved. What should I do before I sit down at the piano? When I begin to practice, what should I do first, sightread the entire piece, read it over and over until I fluent, start memorizing the notes from the very beginning, or go immediately to the technical challenges? Should I practice the entire piece each session, or break it down? How should I break it down, by sections, by difficulty, by hands? When should I schedule lessons? When should I listen to existing recordings? Should I tape myself playing it? Should I play it for friends to hear their reactions? I need to develop a learning plan based on the challenges I face.
Flexibility of method.
After designing the study, and beginning to gather the data, the researcher must remain open to adapting the methodology as needed, based on (a) how easily and comprehensively the phenomenon is revealing itself, and (b) how well the participants are engaging in and reacting to the research process. Gathering data always provides information not only about the phenomenon and the participants, but also about the appropriateness and effectiveness of the researcher's procedures. Aldridge (1996) likens designing a qualitative study to jazz improvisation: "We have to try [things] out, rather than sit around for ever discussing what will be the best way. We can only find out by trying it out to see what works, and then comparing our best way with others with common purposes" (p. 18). Thus, methodology always emerges as and according to how the study unfolds.
The more I practice, the more I understand the challenges of playing the nocturn. I become increasingly aware of how I should and should not practice it. When I practice inappropiately, I have to undo what I learned. As I master each part of the piece, the others become easier, because what I am really mastering is my method of learning it As time goes on, my notion about the piece and it's performance requirements change, and my practicing changes accordingly. The way I practice has to be responsive to the challenges of the piece, as well as to my own characteristics as a pianist and learner, as I am discovering them.
Fidelity
Fidelity is the extent to which a researcher, mindful of the focus and limits of the study, makes sure that the methodology remains "faithful" to the phenomenon: (a) as it unfolds in the lived world, (b) as reported or manifested by participants, and (c) as experienced by the researcher in relation to that world.
When practicing, I have to be sure to learn the correct notes and to observe all the markings in the score. I do not want to make any mistakes in reading the score itself. When I am forming an interpretation of the Chopin nocturne, I want to be faithful to what Chopin actually wrote, and I want to be sensitive to what he implied in the way he wrote it. I try to imagine how he intended it to sound. The best way to do this is to play through and actually make the score come alive in real sound. I have to understand the nocturne as it sounds, and as it unfolds in time, rather than how it looks. I have to relive the lived sound experience of Chopin; and to do that, I have to hear, at least imaginatively, what Chopin himself heard. Then I will be able to hear the living meanings and relationships that are stored in the still-life score; it is like hearing what is latent in what is visually manifest.
To be faithful to Chopin's intent, I seek out any comments or recommendations Chopin made about the nocturne or how to play his works, and I listen to how other pianists, especially Chopin experts, have interpreted the nocturne. I also take lessons and consult a teacher.
Completeness
Completeness is evident when the researcher gathers sufficient data to provide a holistic perspective on the phenomenon, participants, and setting, given the focus and purpose of the study. Specifically, the researcher continues to select data sources and engage the phenomenon and participants until: (a) the data reveals both variation and consistency, breadth, and depth: and as a result, (b) the constructs or potentials of the researcher and/or participants have been enlarged.
Variation is apparent when the researcher finds exceptions, inconsistencies, controversies, and deviations in the data which lead to an enlarged perspective on the phenomenon; consistency is apparent when the researcher finds regularities, repetitive patterns or themes in the data which reveal what appears to be typical of or essential to the phenomenon, participants, or setting. Be aware that regularities are not necessarily better or more valuable than variations. In qualitative research, relative frequency is not a criterion for knowledge. Higher frequency is not necessarily stronger evidence of fact than lower frequency and conversely, lower frequency is not necessarily weaker evidence. Thus relative frequency does not determine facticity and probability of occurrence does not determine the significance of a fact.
I do not perform the nocturne until I have learned it thoroughly and completely. I practice every aspect of it sufficiently. I have memorized every note and marking that Chopin wrote, and I have made decisions regarding everything that various editors have added to or omitted from the original score I can play the entire piece with technical accuracy and fluency, at the desired tempo. I have checked the way I play it against the score, and against the performances of other-pianists. I have noted the consistencies and inconsistencies therein. Because the nocturne is frequently played and interpreted in a certain way does not signify that I should play it the same way, or that these agreements signify Chopin's intent. As a result of these explorations of similarities and differences between sources of data, I have a clear concept of my own interpretation in relation to the score, to Chopin's intent as I understand it, and to other interpretations by other pianists. I am ready to present it to an audience as my personal rendition of the nocturne as I believe Chopin wanted if to sound.
Interpersonal Integrity
These standards deal with the values a researcher demonstrates when relating to every person involved in the study, including its readership. It is important to note that while a quantitative researcher values objectivity and strives to relate to participants as a neutral, distant, and respectful observer, the qualitative researcher values intersubjectivity, and strives to relate to participants as an involved, authentic, and respectful human being. A quantitative researcher seeks to eliminate subjectivity from the process by operation&zing and thereby reducing both researcher and participant to measurable variables. A qualitative researcher tries to learn from intersubjectivity, allowing both participant and self to be fully who they are as coexperiencers of the phenomenon within the context of their relationship. "Qualitative research is the study of interaction and interexperience, as it seeks to explicate the various gaps and bridges that exist between human beings and which make it possible to understand one another's behavior and experience" (Bruscia, 1995d, p. 396).
Three values are essential to the study of human beings in relation to one another: situatedness, clarity of voice, and respectfulness.
Situatedness
Situatedness is the ability of a researcher to situate the participants and him/herself in their own respective lived worlds, both past and present, as well as in the shared and immediate lived world of the research study itself. Three layers are involved: situating the participants, situating the self, and situating the participants and self in relation to one another.
Situating participant,
At the first layer, a researcher makes continual efforts to observe, study, and understand the participants within the context of their own personal and cultural identities and backgrounds, thereby situating them in relation to the phenomenon under investigation within their own lived worlds. This layer is an acknowledgment of the mutual embeddedness of the participants and phenomenon in ecological contexts that originate from outside of the study hut enter into all aspects of the study (Aigen, 1996a, 1996b; Kenny, 1996).
For me to understand the nocturne as it was conceived, I have found out how it fits info Chopin's life and works, and put all of that into a historical context. What was happening in the world of Chopin at the time it was written? How did the nocturne develop as form? How did Chopin contribute to its development? How many nocturnes did Chopin write before this one, and how were they related? How did audieces at the time regard such short pieces, and under what circumstances were they performed? How would the nocturne have sounded on the pianos in those days? What were performance practices during the early 1800s? How did Chopin describe the nocturne and its place in the world of music, and especially his own works?
Situating the researcher
At the second layer, the researcher is aware of and takes responsibility for determining his/her own situatedness in relation to the participants, phenomenon, and research study. Essentially, this layer deals with the embeddedness of the researcher in his/her own lived world, past and present. Since this layer deals with both intrapersonal and interpersonal issues, it has been placed under standards for personal integrity, and defined according to a previous work (Bruscia, 1996) as "authenticity of context."
I bring who I am as a pianist and person to everything I do with this nocturne: how I practice it, whether I enjoy it, whether I want to perform it, why I want to perform it, etc. I have certain attitudes and feelings about Chopin, this nocturne, my ability to play it, and the ways I learn best, all of which have an impact on the outcome. I also have a history of how many Chopin works I have played, how many nocturnes I know, how long I have studied piano, etc. All of these parts of me are poured into my playing of the piece.
Situating participants and self in thestudy.
At the third layer, the researcher studies and acknowledges the physical, emotional, and interpersonal environment in which the study takes place, and thereby situates the participants, the phenomenon, and the self in relation to one another within the shared lived world of the study. This layer is an acknowledgment of the mutual embeddedness of participants, researcher, and phenomenon within the specific ecological context of the study itself.
When I play the nocturne, I have to take into account the room or auditorium and all of its properties, the occasion or context for my playing, who the listeners are, the musical background of the audience, the quality of my piano, my physical and emotional state at the time, whether I am nervous or calm, and how well I know the nocturne.
Clarity of Voice
While situating participants and self allow the researcher to understand the context in which each person gives voice to his/her experience, clarity of voice involves identifying each person's voice. Clarity of voice is evident when the researcher (a) differentiates the roles and voices of all individuals involved in the study, as they have been situated in relation to one another, and (b) communicates in the final document whose voice is being expressed: the researcher's, the participant's, the consultant's, or that of anyone else involved in the study. This requires that self be differentiated from others to the extent possible, recognizing that all interactions and communications in the study have been cocreated by the individuals involved, and that the researcher has a privileged position as author of the final report.
The only way a researcher can study another person is to experience that person's behavior within an interpersonal context. At all times, it must be understood that the researcher's experience of the participant's behavior is only his or her own, not only because he or she can never know the participant's experience of that behavior directly or fully, but also because no other researchers can ever experience the participant's behavior in the same way, within the same interpersonal context, or in any matter other than the researcher's own idiosyncratic way of experiencing other people (Bruscia, 1995d. p. 395).
I recognize the differences in roles between composer and performer, while also realizing how interdependent our voices are. I realize that the composed role is to select and organize the sounds and thereby create a piece of music while the performer's role is to bring these sounds to life. Thus, Chopin's voice (however and wherever situated in his own world) has to be heard through my voice (however and wherever situated in my world). I have to re-present what Chopin presented in another presentational context. In our situatedness together I cannot alter or modify what Chopin wrote, but at the same time, I must exercise all liberties and responsibilities of a performer with regard to interpretation.
It is imperative for me to understand my role and voice as an interpreter of Chopin's voice; Chopin provided the texture, but it is I who color the various strands as I hear they need to blend. It is I who decide which tones in the chord are to be highlighted or subdued, based on my own sensibilities on the piano I am playing. Chopin provided a wide range of possibilities from which to choose. Sometimes I hear hidden voices embedded in his textures that beckon my ear to be heard. I realize that, as a performer he too recognized and utilized the rights of the perfomer to give other composers' music his own personal sounds and voicings.
Chopin provided the melody and harmony, but it is I as performer who articulates and shapes the phrases as I feel them in my own body, and according to my own breath patterns. To be authentic, I cannot play them any other way, fully recognizing that Chopin must have played them differently given his body. Chopin provided a tempo marking, but it is I as performer who sets my own tempo within Chopin's range of possibilities; I also will take liberties in maintaining it. My rubato is only mine, as only it can be; at the same time, it is always within Chopin's divisions of the beat and measure.
I take responsibility for how I have calmed, voiced, phrased, and energized the nocturne within the stipulations that Chopin gave. My liberties and his stipulations are diffferentiated whenever I explain or discuss my interpretation or performance of the piece.
I also have to face the reality that I can never hear it the way Chopin heard it; I can never determine or replicate the way Chopin played it or the way he intended it to be played. It will help me to listen to how other pianists, especially the great ones, have heard and interpreted what Chopin wrote, but here again I will never be able to play it the way anyone else plays it, no matter how much I empathize with them. I am not Chopin or Rubinstein or Horowitz, and I can never be them or play like they do: I am myself, and the best I can do is to play the nocturne according to my understanding of it. Inevitably, I will have to play what I think Chopin intended in my own way, on my own piano, with my own body. Ultimately, fidelity will require not only being faithful to the score and composer, but also being jaithful to my own musical identity in relation to them. When I perform it, I have to help the audience hear how my conception and style have shaped what Chopin intended and wrote.
Respectfulness
A researcher always strives to honor the human tights of every individual involved in the research study. At the very least, this requires an adherence to personal and professional codes of ethics regarding research and clinical practice, and ongoing consultation with other qualitative researchers, therapists, ethical review boards, and the participants themselves.
I make sure that I am considerate of others whenever I play the piano or perform the Chopin nocturne. I honor Chopin and the nocturne when I represent them; I would never misrepresent what Chopin wrote or bastardize the nocturne in any way. I always try to be truthful about myself as a pianist; I do not misrepresent myself in the program notes or recital notices. When I practice, I respect the piano and myself; I am also considerate of those who can hear me practicing. When I perform, I respect the audience and the critics!
Personal Integrity
Personal integrity concerns the values a researcher follows when defining his/her role, responsibilities, and identity in relation to the study. The two main areas are authenticity and caring.
Authenticity
As suggested above, qualitative researchers strive to be fully who they are within the context of the research study, both personally and professionally. In doing so, they face two main challenges: knowing who they are and then acting accordingly. When these challenges are met, the researcher has "authenticity" (Bruscia, 1996). More specifically, authenticity is the ability of the researcher to bring into awareness whatever is possible and relevant regarding oneself and the study, to act in a way consistent with that awareness, and to take responsibility for both what is and what is not in awareness, and for all actions taken (Bruscia, 1996, p. 82). There are several areas of authenticity to consider, each defined by how aware and responsible the researcher is in relation to a particular aspect or phase of the study.
Authenticity of intent.
The researcher is really doing "research" with a clear notion of how research is different from clinical assessment, therapy, theory construction, or expository writing. The researcher therefore fulfills all the role responsibilities of a researcher, and represents him/herself to participants and consumers as a researcher.
Authenticity of paradigm.
The researcher is really doing "qualitative" research, operating from a nonpositivistic point of view, using methodology that fits that view, and representing him/herself as such. The researcher is aware of the epistemology underlying his/her approach to research, and takes action and responsibility accordingly.
Authenticity of focus
The researcher is in fact studying what s/he set out to study. The focus and purpose of the study are what the researcher has decided, represented, and communicated them to be, and there are no ulterior motives that have been left undisclosed.
Authenticity of context (also included under "Situatedness")
The researcher makes continual efforts to bring into awareness how his/her own identity and background may be affecting the research process. This layer is an acknowledgment of the researcher's embeddedness in personal, cultural, and professional contexts existing prior to the study, but being brought into the study. Personal issues are those which stem from the physical and psychological characteristics of the researcher, or his complete personal identity (see Bruscia, 1996). Cultural issues are those which stem from the researcher's group identity and background, such as race, gender, nationality, past and present community membership, group identifications, etc. (Aigen, 1996b; Kenny, 1996). Professional issues are those which stem from our background, skills, philosophies, and values about music therapy, research in general, and all aspects of the study itself (Bruscia, 1996).
Authenticity of method
The researcher is aware of methodological options and constraints in qualitative research, and takes full responsibility for making all decisions with regard to gathering, processing, and interpreting the data.
Authenticity of findings.
The researcher authentically seeks new insights and discoveries in addition to confirmations of personal constructs. The researcher is therefore open to reaching findings that are unanticipated as well as anticipated, unwanted as well as wanted, and unflattering as well as flattering.
Authenticity of communication
The researcher accurately communicates, within reasonable limits, everything about the study that is essential for the consumer to know in order to engage the data and findings. In communicating about the study, the researcher attempts to maintain clarity of voice, as discussed above.
I have decided to learn this nocturne and to perform it. My primary motivation is to play it the way it deserves to be played, however I am also aware of other personal motives that I might have in learning and performing this piece. I would like to take pride in my playing, and I would like the audience to enjoy my playing. I also want them to know that I am a good pianist, and that I play the Chopin nocturnes particularly well. I am aware of what resources, shortcomings, and biases I bring to this task, and I take responsibility for how I have utilized or managed them. I am aware of what I did and did not do in studying this piece, I stand behind all the decisions I have made as an interpreter and I take complete responsibility for the quality of my performance. When I perform the piece, I try to get the audience to appreciate the piece for its own sake and within its original context, while also presenting my own personal perspective on it within the present performance setting.
Caring
No research study can have integrity or quality if a researcher does not care—about the participants, the phenomenon, the study, the audience, and one's own being as a person and professional. It seems odd that we all know this at a very deep level, but for some reason, its significance and meaning have not been acknowledged in our research standards. Pirsig (1974) says that caring and quality are "internal and external aspects of the same thing. A person who sees Quality and feels it as he works is a person who cares. A person who cares about what he sees and does is a person who's bound to have some characteristics of Quality" (p. 275). We can certainly detect this interdependence in the world of music.
I love practicing and playing the piano. It brings me great joy. I decided to study this nocturne, because I feel a real affinity for it and for Chopin's piano works. I genuinely care about how well I play it; I want my interpretation and performance to be beautiful. I want to do justice to it as a work of art, and to my own integrity as a pianist. If I get tired of the piece, or if I get bored playing the piano, I will not be able to do justice to the nocturne as a work of art; nor will I maintain my integrity as a pianist. Either I am going to care and do my very best, or I should give it up altogether.
Aesthetic Integrity
Aesthetic integrity is evident when the researcher has approached the study as an artistic process, and has imparted qualities of art to the study itself. In so doing, the researcher will value four main qualities: creativity, enlightenment, structural beauty, and expressive beauty.
Creativity
The process of doing qualitative research is a creative one, that is, it goes beyond the mere act of discovery to include the creation of new possibilities. As such, creative research involves: (a) an immersion into how a phenomenon presents itself and the possibilities therein, (b) an apprehension of the essential nature of the phenomenon as it appears, (c) the discovery of new possibilities for experiencing it, (d) an evaluation of the potential implications of these possibilities, (e) the selection of those unrealized possibilities that enhance our knowledge or construction, (f) the creation of a new experience of the phenomenon, and inevitably, (g) a change in the phenomenon itself.
The more I immerse myself in the nocturne, the more I understand its essence as sound, and its core meaning as experience. I begin to recognize the understanding I do have of it, and this deepens my experience of each phrase and nuance. This enables me to move with more freedom within the limits of the music and myself to experiment with the shapes and nuances of the melody, and with the elasticity of the pulse. I try out as many possibilities as I can imagine. I try new ways of practicing; I try new pianistic techniques; I try out different colors, phrasings, tempi, rubati, and dynamics. I try out different approaches to interpretation.
I like some ways of stretching the music and myself, and dislike others. Some work, others do not. I try to get a sense from inside, which ones fit and which ones go beyond the piece and me. I recognize what is within our limits, and how we can be challenged beyond them. I begin to hear new and unheard things, to imagine new sounds and meanings, and I begin to experience the nocturne on another level, and in different places in my heart and body. I begin to know how far I can go within it, and it within me; but more importantly I have expanded the possibilities for how I can experience the nocturne, and how the nocturne can be experienced. I have created new musical phenomena. I have moved the nocturne from the past into the present, and projected new possibilities for it in its future and mine.
Enlightenment
For qualitative research to have any value, the process has to be a creative one, and the outcome has to enlighten us in some way. The ultimate goal of research is to move us beyond our past and present experiences of a phenomenon to new constructions of what the phenomenon can be when we experience it differently. Thus, what a creative research study creates is some form of enlightenment. An enlightening study is one that helps the researcher, participants, and/or audience to develop an expanded consciousness, new insights and understandings, more varied and informed perspectives, enlarged constructions, more vivid values, more deeply felt experiences, clearer connections, greater creativity, more significant meanings, and greater appreciation. These are all forms of enlightenment.
Two points are important to make. The kind of enlightenment sought in qualitative research goes beyond the cognitive realm to include felt experience, and therein all other facets of the human being. To be enlightened is more than an intellectual enterprise, it is more than science. Enlightenment incorporates all forms of human experience, including the affective, physical, and spiritual. It is for this reason that enlightenment is considered an aesthetic outcome; it requires an artistic way of knowing in addition to the scientific; it exceeds the intellectual in the same way that music does.
Second, enlightenment always involves a reciprocal transformation: being enlightened about a phenomenon changes the researcher, and the researcher's enlightenment changes the phenomenon. By immersing into a phenomenon and exploring different ways of experiencing it, the researcher and phenomenon act upon and are acted upon by one another. They are mutually transformed.
Trying so many things with this piece, and deciding which ones I will implement has been very enlightening. The creative process of learning and playing this piece has expanded my understanding, not only of this piece, but of Chopin, and my own piano playing. I am more aware now of what is essential and what is not when I play the piano, and particularly this nocturne. I perceive the values expressed by Chopin in this piece, about music and the life of human experience. My possibilities for experiencing Chopin and this nocturne have been expanded. I have been enlightened by these experiences, and I have been changed by the process of practicing, interpreting, and perfoming this.
With every enlightenment about Chopin, the nocturne, and myself, I have also changed the nocturne. It has been changed and expanded by my interpretation and performance. Others hear something in the nocturne that they have not heard before—me. I am now a part of the nocturne in their perception of it, and this has changed what the piece means to them. Together, the nocturne and I have created something new within each other, and within all those who hear me play it.
Relevance
Research is relevant when it is meaningful, beneficial, useful or valuable in some way. It is intrinsically relevant when those involved in the study (e.g., participants, researchers, consultants, etc.) find their participation in the research process itself to be meaningful, or when they benefit from its findings or outcomes. It is extrinsically relevant when the audience or readership find the results of the study (as it was communicated by the researcher) to have important implications for their lives or work. Another way of thinking about relevance is that research is by nature service-oriented. Whatever a researcher discovers or learns as a result of the study should be of some value or service to self and others.
What I have learned from studying and interpreting this piece has been valuable to me. I can apply what I have learned from practicing it to other things in my life, musical and otherwise. The process of interpreting Chopin and the nocturne have implications about my interpretations of other things in my life, musical and otherwise. My performance of the piece has taught me something about how I perform in similar situations. Overall, my experiences with this piece have improved me as a pianist, a musician, and person, and as a learner, interpreter, and performer; in fact, they have been therapeutic to me.
The reason is that what I hear and experience in the nocturne is intrinsic to music and yet beyond music. I hear the energy of life in its rhythm, the breath of a feeling in its melody, and the beauty of the universe in its harmony and textures. Living in the music is living life itself, for both me as performer and the audience as well. And when we live in the music together, the nocturne provides us with a unitive experience that connects Chopin, performer and listener to human life and the universe beyond. Therein lies the growth and healing of human experience.
I hope that my playing has brought new life to the nocturne and to the audience. It is important for me to have expanded the music experiences of the audience, and therefore their life experiences. It would be meaningful to me if I contributed something worthwhile to the listener's understanding of music and life. I would also be honored if other pianists gained something from my performance. Perhaps my interpretation of the nocturne will help them in their understanding of music and life, and this will in turn help them to bring the unitive experience to their audiences.
Structural Beauty
A research study has structural beauty when its form and design reflect economy, clarity, cohesion, harmony, balance, and wholeness. There is economy in method and clarity of communication between researcher, participants, and audience. There is harmony between the methodology, phenomenon, and participants. The findings are consonant with the data; they all fit together beautifully. The final report communicates the essence of the study in a coherent way. Every part of the study has a meaningful place in relation to other parts, and all the parts form a meaningful and cohesive whole. The study is beautiful in itself.
I respect the structures inherent in the nocturne and Chopin's compositional style, and I use those structures to give my own interpretation organizational clarity, stylistic congruence, balance and continuity. My interpretation has external and internal consistency, and this is evident in my performance. My performance is seamless and seemingly effortless. In short, the piece, my interpretation, and my performance all fit together to form a meaningful and beautiful "gestalt."
Expressive Beauty
The research report gives a poignant, imaginative description of the participants, their experiences with the phenomenon and the setting, and the researcher's experience of the study. The researcher uses appropriate media to communicate the essence of the study to the audience (e.g., prose, narrative, music, art, metaphor, images, etc.). The research document is an aesthetic work to behold and appreciate in itself, and in music therapy, it presents the most significant moments of music created or experienced by the researcher and participants.
My interpretation and performance of the piece have poignance. When I play the nocturne, I bring to life some of the beauty that Chopin poured into it. In addition, my playing in itself has beauty: my tone qualities are colorful and imaginatively blended; my melodic phrases have the ebb and flow of human experience, my rhythms resonate the musical energy of life; and my stage presence communicates my commitment to the experience without distracting the audience from the music.
Concluding Remarks
In closing, I would like to share a few insights gained in reviewing the literature and creating this set of standards. The most striking realization has been that unlike other sets, these standards hold researchers accountable not merely for methodology, but for their entire way of being and interacting within the study. With this, the focus of accountability also expands. Professional peers are no longer the only important arbiters of quality. Given these standards, researchers have to hold themselves accountable not only to the scholarly community, but to themselves, the phenomenon, the participants, and all other parties involved in the study. In short, qualitative research standards are not merely concerned with how procedures enhance the truth value or the trustworthiness of findings for the scholarly community, they are also concerned with who the researcher is when interacting with every person and element involved in the study.
The implications are significant. Quality is no longer definable merely in terms of external standards which are imposed upon the researcher by others. Given the present standards, the researcher has to establish and uphold his/her own individual standards as well, and sometimes these individual standards are by necessity different from those imposed by others. Thus quality requires holding oneself accountable to one's own values within the context of values operating within the entire research community. One cannot assume that either self-imposed or other-imposed values are superior. We understand this quite well within an aesthetic context.
Chopin did not write the nocturne to accommodate his critics, the aesthetic level of his audience, or the technical limits pianists at the time. Similarly, I cannot shape my interpretation and performance of the nocturne according to how my audience or critics would prefer for me to play it. The integrity of a work of art cannot be defined externally, that is, only by audience reaction. There is something of value that has to abide within the work itself, a quality that the composer and performer impart to the work, that will eventually define its value and relevance to the audience. Chopin had to be true to his own standards of composition, just as I have to meet my own standards of performance. Then and only then is it possible for Chopin's nocturne and my performance of it to meet the standards of others who were not involved in its presentation.
With this changed perspective, even the criteria of trustworthiness established by qualitative researchers (Lincoln & Guba, 1985) begin to smack of over-dependence on the perception of others. To what extent should a researcher hold him/herself solely responsible for the audience's perception of what is credible and not credible, transferable and not transferable, confirmable and not confirmable, dependable and not dependable? How does the researcher determine when to take responsibility for the skepticism of others? Does the failure of the audience to trust the findings make the research or researcher untrustworthy? Does the failure of an audience to find the research relevant, make the study irrelevant? Given the emphasis on multiple constructions of truth and reality in qualitative research, yes-no answers to these questions do not seem appropriate.
A benefit that comes from shifting the locus of accountability for research is that more options are now available for establishing and improving its integrity. Most of the present quality standards can be achieved through both intrinsic means (i.e., using aspects or elements within the study or paradigm) and extrinsic means (i.e., through assistance from agents outside of the study). Thus, in qualitative research, safeguards of integrity can be found within the researcher, the phenomenon, the participant, or the paradigm, or they can be found outside of the study, with other professionals and review committees. Thus, just as the arbiters of quality have expanded, so have its agents and safeguards.
Finally, the present standards have opened two new horizons for research. The first is the acknowledgment that aesthetic factors influence the quality of our knowing. It is no longer possible to divorce truth from beauty in research. They are inseparable within the human experience, they are inseparable within the music experience, and they are inseparable in the music therapy experience. How can they be separate in research on music therapy?
Related to this, the second new horizon is the acknowledgment of the humanness of the researcher and the intrapersonal determinants of quality. How a researcher relates to various aspects of self is a crucial concern when a researcher is a personal instrument of inquiry, and when the focus of inquiry is another human being. Subjectivity and intersubjectivity are not new freedoms, they are new responsibilities which profoundly influence the quality of our knowing.
To deny who we are in order to understand who we are simply makes no sense. One must be at least human to understand humans. ... Qualitative research is a process wherein one human being genuinely attempts to understand something about another human being or about the conditions of being human, by using approaches which take full advantage of being human (Bruscia 1995b, p. 426).
References
Aigen, K. (1995). Principles of Qualitative Research. In B. wheeler (Ed.), Music Therapy Research: Quantitative and Qualitative Perspectives (pp. 283-311). Gilsum, NH: Barcelona Publishers.
Aigen. K. (1996a). The Role of Values in Qualitative Music Therapy Research. In M. Langenberg. K. Aigen, & J. Frommer (Eds.) Qualitative Music Therapy Research: Beginning Dialogues (pp. 9-33). Gilsum. NH: Barcelona Publishers.
Aigen, K. (1996b). The researcher's cultural identity. In M. Langenburg, K. Aigen & J. Frommer (Eds.) Qualitative Music Therapy Research: Beginning Dialogues (pp. 165-176). Gilsum, NH: Barcelona Publishers.
Aldridge, D. (1996). Music Therapy Research and Practice in Medicine: From Out of the Silence. London: Jessica Kingsley Publishers.
Amir, D. (1990). A Song is Horn: Discovering Meaning in Improvised Songs Through a Phenomenological Analysis of Two Music Therapy Sessions with a Traumatic Spinal-cord Injured Young Adult. Music Therapy 9(1), 62-81.
Amir, D. (1996). Experiencing Music Therapy: Meaningful Moments in the Music Therapy Process. In M. Langenberg, K. Aigen, & J. Frommer (Eds.) Qualitative Music Therapy Research: Beginning Dialogues (pp. 109-129) Gilsum, NH: Barcelona Publishers.
Ansdell, G. (1995). Music for Life: Aspects of Creative Music Therapy with Adult Clients. London: Jessica Kingsley.
Baur-Morlok, J. (1996). Translations. In M. Langenberg, K Aigen, & J. Frommer (Eds.) Qualitative Music Therapy Research: Beginning Dialogues (pp. 233-238). Gilsum, NH: Barcelona Publishers.
Bergstrom-Nielsen, C. (1993). Graphic Notation as a Tool in Analyzing and Describing Music Therapy Improvisations. Music Therapy, 12(1), 40-58.
Bruscia, K (1995a). The Process of Doing Qualitative Research. Part I: Introduction. In B. Wheeler (Ed.) Music therapy research: Quantitative and Qualitative Perspectives(pp. 389-400). Gilsum, NH: Barcelona Publishers.
Bruscia, K (1995b). The Process of Doing Qualitative Research. Part II: Procedural Steps. In B. Wheeler (Ed.) Music therapy research: Quantitative and Qualitative Perspectives(pp. 401-427). Gilsum, NH: Barcelona Publishers.
Bruscia, K (1995c). The Process of Doing Qualitative Research. Part III: The Human Side. In B. Wheeler (Ed.) Music therapy research: Quantitative and Qualitative Perspectives (pp. 429-446). Gilsum, NH: Barcelona Publishers.
Bruscia, K (1995d). Differences Between Quantitative and Qualitative Research Paradigms: Implications for Music Therapy. In B. Wheeler (Ed.), Music therapy research: Quantitative and Qualitative Perspectives (pp. 65-78). Gilsum, NH: Barcelona Publishers.
Bruscia, K (1996). Authenticity Issues in Qualitative Research. In M. Langenberg, K Aigen, & J. Frommer (Eds.), Qualitative Music Therapy Research: Beginning Dialogues (pp. 81-107). Gilsum, NH: Barcelona Publishers.
Forinash, M. (1995). Phenomenological Research. In B. Wheeler (Ed.), Music therapy research: Quantitative and Qualitative Perspectives (pp. 367-387). Gilsum, NH: Barcelona Publishers.
Forinash, M., & Gonzalez, D. (1989). A Phenomenological Perspective of Music Therapy. Music Therapy, 8(1), 35-46.
Giorgi, A. (1975). An Application of Phenomenological Method in Psychology. In A. Giorgi, C. Fischer, & E. Munay (Eds.) Duquesne Studies in Phenomological Psychology (pp. 82-101). Pittsburgh, PA: Duquesne University.
Glaser, B., & Strauss, A. (1967). The Discovery of Grounded Theory. Chicago: Aldine.
Goetz, J., & LeComte, M. (1981). Ethnographic Research and the Problem of Reduction. Anthropology and Education Quarterly, 12, 51-70.
Cuba, E. (1981). Criteria for Assessing the Trustworthiness of Naturalistic Inquiries. Educational Communication and Technology Journal, 29, 75-92.
Cuba, E., & Lincoln, Y. (1989). Fourth Generation Evaluation. Newbury Park, CA: Sage.
Cuba, E., &Lincoln, Y. (1994). Competing Paradigms in Qualitative Research. In N. Denzin & Y. Lincoln (Eds.) Handbook of Qualitative Research (pp. 105-117). Newbury Park, CA: Sage Publications.
Kenny, C. (1996). The Story of the Field of Play. In M. Langenberg, K Aigen, & J. Frommer (Eds.). Qualitative Music Therapy Research: Beginning Dialogues (pp. 55-78). Gilsum, NH: Barcelona Publishers.
Langenberg, M., Frommer, J., & Langenbach, M. (1996). Fusion and Separation: Experiencing Opposites in Music, Music Therapy, and Music Therapy Research. In M. Langenberg, K. Aigen, & J. Frommer (Eds.) Qualitative Music Therapy Research: Beginning Dialogues (pp. 131-160). Gilsum, NH: Barcelona Publishers.
Lee, C. (1994). Lonely Waters: Proceedings of the International Conference on Music Therapy in Palliative Care. Oxford: Sobell Publications.
Lee, C. (1996). Music at the Edge: The Music Therapy Experiences of a Musician With AIDS. New York: Routledge.
Lincoln, Y., & Guba, E. (1985). Naturalistic Inquiry. Newbury Park, CA: Sage Publications.
Maranto, C. D. (1995). Ethical Precautions. In B. Wheeler (Ed.) Music Therapy Research: Quantitative and Qualitative Perspectives (pp. 79-93). Gilsum, NH: Barcelona Publishers.
Pirsig, R. (1974). Zen and the Art of Motorcycle Maintenance. New York: Morrow Quill.
Ruud, E. (1996). Interpretation and Epistemology in Music Therapy or How to Deal With Competing Claims of Knowledge. In M. Langenberg, K Aigen, & J. Frommer (Eds.) Qualitative Music Therapy Research: Beginning Dialogues (pp. 225-232). Gilsum, NH: Barcelona Publishers.
Smeijsters, H. (1996). Qualitative Single-case Research in Practice: A Necessary, Reliable and Valid Alternative for Music Therapy Research. In M. Langenberg, K. Aigen, & J. Frommer (Eds.) Qualitative Music Therapy Research: Beginning Dialogues (pp. 35-53). Gilsum, NH: Barcelona Publishers.
