[Research Voices: Qualitative Studies]

Say What You Say (Eminem): Managing Verbal Boundaries When Using Rap in Music Therapy, A Qualitative Study

By Helen Short

Abstract

This study identifies and describes considerations for managing verbal boundaries and the potential contraindication when using Rap in music therapy.

The literature review covers the small number of case studies documenting the use of Rap in music therapy. The method used was an in-depth qualitative interview of 8 music therapy experts from a range of countries and approaches, experienced in the use of Rap as an intervention. A combination of grounded theory and thematic analysis was used to analyse data. The results are placed in context of the literature review and draw upon a number of psychodynamic concepts in order to determine a set of themes that could further inform those music therapists using Rap as a clinical intervention.

The results display the flexibility with which Rap can be used to meet different levels of client need and how therapists’ boundary management allows this. The data contributes towards clarifying what informs music therapists when considering how to manage the potentially offensive material that may be introduced into the therapy space when using Rap and when it may contraindicate. The research could serve as a preparatory tool for those therapists new to the genre and its use within therapy.

Keywords: Rap, verbal boundaries, contraindication, qualitative study, adolescents, offensive material

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Introduction

Exploring how music therapists manage verbal boundaries when using Rap in music therapy is the central focus of this qualitative research. The literature on the use of Rap in music therapy is sparse consists mainly of case studies, most of which feature in the publication Therapeutic Uses of Rap and Hip Hop (Hadley & Yancy, 2011). The majority of work with rap in music therapy focuses on adolescents; of the 18 case studies found, 14 document the use of rap in individual and group work with at-risk[1] adolescents. For the purpose of this review “at risk” will be defined as being “in danger of negative future events” (McWhirter, McWhirter, McWhirter, McWhirter 1998, p.7) The clients in these case studies were from a variety of settings. The use of pre-composed, freestyled or improvised rap and rap song-writing is addressed in a variety of settings including youth shelters, schools and psychiatric hospitals in America, Australia, Canada and England. Please see the appendix 1 for characteristics of the case studies.

It is clear in the literature that the music therapists strongly advocate the use of rap in music therapy and I would say my stance as a researcher is a similar one. This will be considered throughout the research process.

Song Writing in Music Therapy

Prior to examining the literature documenting the use of rap as a specific song form, the function of song generally in music therapy requires some consideration. The literature is abundant with case examples of the use of song writing as therapy. Baker and Wigram (2005) list research focussed on the experiences of clients who have used songwriting within their treatment. Examples include the value of song-writing with children and adolescents who have cancer, blood disorders or are undergoing bone marrow transplants (for example Abad, 2003; Hadley, 1996). Positive benefits described with this client group include increased self esteem (for example Hadley, 1996) and a reduction in patients’ anxiety, anger and tension (for example Turry, 1999). Camilleri (2007) describes songs as containers for difficult and terrifying emotions; if using song writing as a therapeutic method, songs can absorb, hold and communicate the difficult transferred and projected feelings of the client, assisting in giving them an acceptable form and place in the patient's experience (Bion, 1962). She also describes songs as functioning as transitional objects (Winnicott, 1971) that may allow clients to internalise and retain the experience of the therapeutic relationship and process and therefore serving to link the inner and external world and help prepare the way for further development of self (Metzner, 1999). Rap could serve the same function.

O’Callaghan and Grocke’s 2009 paper describes lyric analysis research conducted in music therapy that reflects how song writing can enable clients to express what is believed to be important when enduring hardship or pathological conditions. They state that song-writing is a vehicle for vulnerable people to express what is important and reflect that analysis of lyrics in a music therapy setting can extend music therapists’ understanding of client’s lived experiences, which can increase clinician’s empathy, assessment and evaluation potentials.

Baker, Krout and McFerran-Skewes (2011) highlight the prominence of song-writing in music therapy. They highlight the importance of lyrics as an element of therapeutic song-writing and state “Music therapists typically utilise song writing with clients who have verbal capacities and who are interested in exploring their therapeutic needs through words’’ (p. 2). Their study deduced clients used song-writing to fulfill a range of agendas, of which pleasure and expression were prominent and music therapists use song writing to address a range of aims that are usually related to articulating the clients’ experience.

Background History and Characteristics of Rap

Taking the function of song into consideration, it is important to examine how characteristics of the Rap genre specifically can be of benefit when used as a therapeutic intervention for the purpose of this study. Rap is the music, beats and rhymes of Hip-Hop. The term Hip-Hop refers to urban youth culture composed of individuals from diverse racial, ethnic, social and economic backgrounds. Hip Hop grew out of political, economic, social and cultural conditions that existed in the Bronx, NY in the 1970’s.

Rap originated from African vocal traditions. Its earliest influences were the griots of Nigeria and Gambia (Toop, 1991), musicians and storytellers that sing the history of a village or tribe, improvising on current issues and events (Smitherman, 1997). Smitherman (1997) refers to the rapper as a “modern African Griot” who must be “lyrically. . . fluent, is expected. . . to speak the truth” (p. 4) and suggests Rap represents any kind of aggressive, highly fluent and powerful speech that serves the same purpose. Rap music is often seen as a way for poets and rappers to express cultural problems and issues facing the world, speaking for and to those voices that may have been suppressed by society (Viega, 2011; Chang, 2005; Kobin & Tyson, 2007). These qualities may lend an important function in music therapy in that by using Rap as a therapeutic intervention, clients might be encouraged to share their own "current issues" and a narrative of their own life events, truthfully and honestly. Whether Rap’s original function has been retained or distorted throughout the process of evolution has implications for how it might be used within the therapy space.

Rap’s Music comprises a number of elements that also may lend important functions in music therapy; the vocalist speaks lyrically in rhyme and verse, generally to an instrumental or synthesized beat and lyrics can often be complex, abstract and metaphoric increasing scope for expression. The vocal lines can also be sung but the pitch content is usually secondary to rhythmic content meaning vocal ability need not necessarily be to a high level to utilise the form. There are rhythmic and articulative features in the delivery of rap such as multiple rhythms, offbeat rhymes and flexibility of metre. Beat patterns are repeated to provide a predictable and grounding rhythm with the accompaniment in rap music typically consisting of a single two to four bar segment that repeats continuously throughout the song. The loop is an instrumental or melodic line that is repeated throughout and sampling involves the use of pre-composed music from another song. Elements are layered and occur simultaneously. All of these elements have the potential effect of creating both stability and reliability in the music.

As Rap evolved it split into subgenres including materialistic, political/protest, positive and spiritual Rap:

Table 1. Rap subgenres (Elligan, 2000, p. 28)

Sub-genre	Content
Gangsta	Violence, guns, misogyny and profane language.
Materialistic	Monetary wealth, possessions and women
Political/protest	Political issues, racism, sexism, equality and ethnic identity
Positive	Promotes value of education, responsibility and ethnic pride
Spiritual	Incorporates rap music with traditional gospel music to appeal to young African American men
Rap not otherwise specified	Various

Rap as a Therapeutic Intervention

Rap has been criticized as negatively influencing youth (Gonzales & Hayes, 2009). Elligan (2000) states “Gangsta Rap” focuses on violence, guns, misogyny and profane language. He argues that it promotes an antisocial message of violence, crime and sexism, despite the fact that gangsta rap artists state that their music simply reflects the reality of the circumstances of the inner city.

The literature demonstrates Rap possesses properties enabling its use as a therapeutic intervention. Elligan’s (2000) Rap Therapy and Tyson’s (2002) Hip Hop Therapy demonstrate the prescriptive use of Rap in therapy. Clients are encouraged to reflect on Hip Hop lyrics as they relate to their own life experiences (Tillie-Allen, 2005). Both approaches utilise chiefly the sub-genre of positive rap.

Similar therapeutic uses of Rap lyrics in music therapy are not limited to certain sub-genres. Many people identify with Rap as its lyrical expression represents the realities of their lives and struggles (Elligan, 2011). McFerran (2011b) describes how her clients identified and understood the frustrations behind behaviour described in Gangsta Rap and gained benefit from sharing their surrounding feelings. Viega (2011) highlights the element of truthfulness and reality in the social and historical context of Rap that enables clients to explore reality and facilitates authentic lyrical expression. Lightstone (2004) found that major themes discovered in the lyrics closely paralleled verbal self-expression in psychotherapy Compton-Dickinson’s (2011) client initially communicated fantasy in Rap but eventually a connection with real emotions and situations was made . She suggests Rap as a culture-specific genre was “a life-sustaining form of musical expression, similar to the roles of African-American spirituals during slavery” (p. 12) for her client. The literature also demonstrates Rap can engender the therapeutic process for those clients who are reluctant to engage (Lightstone, 2004). It can bridge culture and facilitate the therapeutic alliance (Cobbett, 2009).

The expressive nature of the lyrics in Rap can be utilised by those clients who may not be comfortable using traditional instruments since the style combines vocal and instrumental music. Likewise, in certain instances, those clients who may not be comfortable improvising vocally, would still be able to utilise the form, especially given the musical components are simple enough so that no one needs musical skill or competence to master it. The music of Rap reflects and supports the lyrics, a useful feature which could enable the use of Rap by the therapist as a vehicle to reflect and support the contributions of the client. O’Brien (2011) describes Rap as an ideal musical landscape to set words to that provided the maximum impact of the message communicated. She describes the music of rap as supportive, approachable and flexible. It has been documented by Frisch-Hara (2011) that its form, namely the stability, predictability and familiarity inherent in the repetitive elements of the music, can provide a holding and containing function. She also believes that the loop and responsorial element within rap can be experienced as supportive mirroring, the earliest interaction between caregiver and infant.

Challenges Associated with Rap in Music Therapy

Elligan (2011) identifies Rap as a potentially difficult genre to work with stating “its use in therapy may be uncomfortable. . . challenges may include unfamiliarity on the part of the therapist with Rap. . . word choices of certain artists. . . sexist lyrics” (p. 31). Whilst the evidence of Rap as a therapeutic intervention is of abundance within the literature, the simultaneous struggles of using Rap in music therapy receive less attention. It was apparent in the literature that issues regarding boundaries arose however. Several music therapists documented instances when offensive language had been introduced into the therapy space and described their management of boundaries regarding verbal content.

The material indicates that language allowed into the therapy space varied widely. It seems there are similarities in reasoning regarding why offensive language is allowed despite differing backgrounds. When language was prohibited, this often depended on clients and settings, boundaries are not defined however. This is one of the most interesting unknowns to arise in this literature review.

There were instances when therapists chose not to limit offensive material. McFerran (2011b), describes a group session where clients composed a Rap with particularly violent themes. Instead of prohibiting the music, McFerran, a predominantly humanistic therapist, decided to trust the group process as the members seemed to appreciate freedom of expression. There is a deficit in the literature addressing how offensive language could negatively affect group processes. Compton-Dickinson, a cognitive-analytic (integrative) therapist and Frisch-Hara (2011), a psychodynamically informed therapist, describe refraining from censoring offensive words as they were used to convey strong feelings and so that that resonant issues can be addressed.

Likewise there were instances when therapists restricted offensive language; in 3 settings the use of lyrics and language considered offensive was not permitted and therefore eliminated from the therapy space. Rio and Tenney (2002) describe encouraging a client to write a Rap without expletives and with more positive thinking as his use of expletives was mimicking words he was exposed to as a gang member. There is a deficit of examples illustrating similar limiting of language as part of a therapeutic intervention.

Also indicated in the literature is the potential contraindication when using Rap; Compton-Dickinson (2011) highlights the assumption that antisocial tendencies and aggression would prevail in Rap amounting to “offence paralleling rather than correcting behaviour” (p.10). Other literature enables thinking about this; Elligan (2011) identifies instances when the use of Rap would not be beneficial, suggesting that Rap Therapy is contraindicative for those individuals whose “strict interpretation of Rap lyrics may not allow them to comprehend multiple meanings” typically presented and those “. . . having difficulty changing their cognitive style of interpreting their presenting issue” (p. 38). I suggest this could also apply within music therapy, nowhere in the literature is this highlighted. Elligan (2004) suggests another contraindication, that certain Rap artists glorify becoming a thug or “Gangsta.” Frisch-Hara (2011) contests this, suggesting that although some artists advocate violence, this is not a function of Rap’s music and the genre should not be contraindicated and that when Gangsta Rap is referred to, we should question and address this therapeutically.

Study Aims

I was led to question further how the prohibition and encouragement of offensive lyrical content when using Rap can be helpful and/or harmful. The aims of this study are to determine considerations that inform music therapists when managing verbal boundaries and instances when Rap should not be used. Research in this area could further inform therapists using Rap.

Methodology and Proposal

Participants

The sample of participants was purposive and consisted of 8 music therapists considered experts in the use of Rap in music therapy, chosen deliberately as they possess relevant characteristics for the question being considered (Brown & Lloyd, 2001). All participants have worked with a diverse client group in a range of settings. All are academic experts and established practitioners; each has at least 7 years of experience.

Each participant had written case studies documenting the use of Rap covered in the literature review. This population was chosen because I felt it would be beneficial to understand the “experts’’ reasoning for the management of boundaries. Having used Rap and practised for a considerable length of time, they could also be considered qualified for discussing the hypothetical management of boundaries and potential contraindication.

The selection of the participant population was systematic; 2 therapists from Britain, 2 from Australia, 3 from America and 1 from Canada were recruited in order to gather an internationally representative sample[2]. The sample included participants whose clinical training and experience is influenced by a variety of models including music-centred, psychodynamic and humanistic music therapy in order to obtain a holistic picture of considerations regarding the research question within the field as a whole, not limited to certain approaches.

Method of Recruitment

Participants were contacted via personal email to ascertain whether it would be feasible to interview them. Most potential participants had been contacted previously and asked permission to use their unpublished material. As a result, many were aware of the nature of my research. Participants were informed of the purpose of my study via an information sheet and consent was obtained via a consent form.

Ethical Considerations

Prior to interview participants were advised they would be asked to discuss clients and clinical work and any information disclosed would be classed as data and potentially used.

Participants were given the option to be identified or remain anonymous in the final report on the consent form. All chose to be identified and are named in data characteristics. Informant Validity (Robson, 1993) was built into the research process enabling participants to verify interpretations and context, avoiding misrepresentation and enhancing understanding when necessary.

Discussion of offensive material and questioning subjective clinical practice could have felt awkward for participants. This was handled sensitively using my judgement as primary researcher; I took the lead from participants as to which language to articulate explicitly and ensured I objectively questioned personal subject matter.

Data was stored securely using encrypted files on a laptop and external hard drive located in a locked cupboard to which only the principal researcher had access. Throughout data collection and analysis anonymity and confidentiality was maintained; a coding system enabled identification of data without naming participants.

Data Collection

This study identifies and describes how and why music therapists subjectively tailor their clinical approaches considering the management of verbal boundaries and potential contraindication when using Rap in music therapy. This involved the qualitative research of experiences and events. Qualitative research methods are particularly well suited to the study of music therapy. Quantitative methods are useful in demonstrating the efficacy of music therapy (Lightstone, 2004) but since the aim of this study was to understand the meaning and processes involved in individualised clinical approaches, qualitative methods were best suited (Silverman, 2006).

The method of data collection was a semi-structured interview (Robson, 1993) consisting of a set of pre-determined questions, probes and prompts. Although it was strictly ensured each question was addressed in order to not limit the reliability and objectivity of the study, the order was modified based on the researcher’s perception of what seemed appropriate during interview; the wording or specific nature of a question was changed if necessary. Additional questions were included or existing questions removed when appropriate depending on the participant (Robson, 2008). This was according to the specific responses of each participant in order to not interrupt flow, encourage fluidity and therefore enhance and maximise the potential of each response.

Byrne suggests that:

qualitative interviewing is particularly useful as a research method for accessing individuals’ attitudes and values – things that cannot necessarily be. . . accommodated in a formal questionnaire. Open ended and flexible questions…provide better access to interviewees’ views, interpretation of events. . . experiences and opinions (cited in Silverman, 2006, p. 114.)

This method of data collection was chosen over a survey, questionnaire, fixed alternative, scale or structured interview as it allowed the researcher to pick up on and investigate themes that emerged in each interview, informing subsequent research.

The use of open ended questions encouraged flexibility, active listening and the building of a rapport with participants. They enabled the testing of limits of participants knowledge, allowed a truer assessment of what participants really believe and produced unanticipated answers (Robson, 2008), enriching the data collected. Face-to-face interviews where possible and interviews using Skype rather than telephone aided the development of a rapport with participants and enabled the researcher to pick on non-verbal cues which helped in understanding the response of participants.

The structure of the interview consisted of:

• A set of questions with alternative s
• ubsequent items depending on the responses obtained
Suggestions for probes and prompts
• A sequence for the questions which may be subject to change during the course of the interview (Robson, 2008)

Questions enquired about participants’ experiences and beliefs surrounding the research areas. Participants were asked to discuss aspects of their clinical work retrospectively. Analysis of the case studies was undertaken in order to develop relevant lines of enquiry. Several key areas relating to the research question were identified; the therapists stance and reasoning regarding the use of offensive language and Rap, the introduction of Gangsta Rap into the therapy space, considerations regarding the therapeutic relationship, stylistic and cultural connotations of the genre and therapists opinions and experience of potential contraindications when using Rap. These were the areas that were explored initially. Questions were intended to be unbiased and non-directional. The interview questions are located in the appendix 2.

The method of engagement was post-factum since participants have already engaged the phenomenon and the researcher is interested in studying the resulting materials. The enquiry will be naturalistic since material has taken place in a real-life setting and will be retrospectively researched (Ansdell & Pavlicevic, 2001).

Brown and Lloyd (2001) state “qualitative researchers seek a small and detailed sample to produce a plausible and coherent explanation of the phenomena under study” (p. 271). For these reasons it was decided that 8 would be the optimum number of participants.

A pilot interview with a recently qualified music therapist who has used Rap with clients preceded data collection. This enabled the identification of any issues regarding the interview; timings were monitored to ensure correct length of interview and the suitability of the interview questions in terms of ease of understanding and relevance were determined. This also enabled any key lines of enquiry that could have been neglected to be identified and subsequently incorporated into the interview.

A brief description of the interview was included in an information sheet sent to participants prior to data collection but specific research questions were not sent as this could have produced responses that were less spontaneous and authentic.

Data Analysis

This study employed qualitative research methods based on procedures of thematic analysis described by Braun and Clarke (2006) incorporating grounded theory techniques described by Strauss and Corbin (1998). In my attempt to discover how music therapists manage verbal boundaries I required research techniques that provided procedures for the analysis of qualitative data. I wanted strategies that would be flexible but systematic (Robson, 2008) as I believed this would be necessary when managing the large amount of potentially diverse data I obtained. I wanted to use techniques that provided answers firmly grounded in the data and offered insight and enhanced understanding). This was the rationale for using grounded theory techniques.

Strauss and Corbin (1998) state that grounded theory procedures exist to help provide standardisation and rigour to the process. However “these procedures were not designed to be followed dogmatically but rather to be used creatively and flexibly by researchers as they deem appropriate” (p. 13) This informed my decision to design an analysis technique that incorporated some aspects of grounded theory and ignored others and combines their use with thematic analysis techniques.

Braun and Clarke (2006) state that “thematic analysis provides a flexible and useful research tool which can potentially provide a rich and detailed. . . account of data” (p. 78) and a method which reports experiences, meanings and reality of participants. This was in line with my research objectives. Grounded Theory aims to generate a theory to explain what is central in the data, an objective that was not in line with that of the research project. This was also part of the rationale for using main concepts of Thematic Analysis as opposed to Grounded Theory.

Analysis of data according to thematic analysis is less rigorous and time-consuming than methods employed in grounded theory which demand a demand a detailed theoretical and technological knowledge of the approach. Therefore owing to the time limitations and scale of this project, thematic analysis techniques were more accessible and most appropriate for analysis of the complete data.

The purposive sampling of participants was undertaken according to the grounded theory technique of theoretical sampling whereby “the persons interviewed . . .are chosen to help the researcher formulate theory” (Robson, 2008, p. 193).

Eight participants were pre-selected; this opposes the general approach of grounded theory method which is to keep the field of a study open and decide within the process, whether “theoretical saturation” (Glaser & Strauss) has been achieved. It was thought that given the population sample was purposive, this would contribute towards providing a holistic picture in line with considerations regarding the research question within the field as a whole, not limited to certain approaches.

The data collection process incorporated grounded theory techniques as described below:

Alternation of data collection and analysis: Data collection and analysis occurred in alternating sequence. Analysis drove collection somewhat; each interview was transcribed immediately and analysed for themes that could enhance and inform subsequent data collection. Throughout data collection the participants, given they are experts in the study field, and given the sparse amount of literature available, informed my research considerably. This was the rationale for using an iterative process.

Since the research objective was not to establish core categories in line with Grounded Theory (Strauss & Corbin, 1998) but to report experiences, meanings and reality of participants, a single coding technique was used in favour of open, axial and selective coding used in Grounded Theory.

Throughout data collection, data was analysed according to the following thematic analysis techniques described by Braun and Clarke (2006):

Identification of themes and initial coding: Initially a general coding scheme was used; a response was analysed and a preliminary code assigned to discover significant themes. As data collection progressed, each interview was coded and the coding scheme reviewed and refined in an iterative fashion. Since the sample size was small, an apparently significant theme could be represented by only one participant. Therefore themes were not selected according to prevalence, rather according to whether they captured something important in relation to the research question. Coding was be done by analysis of paragraphs of data.

Once gathered and transcribed verbatim, thematic analysis was used to analyse and report patterns within the data.

Searching for themes: A final review of coding took place. Codes were collated into potential themes and data relevant to each theme gathered and organised. Although only a small sample of 8 participants were selected, this produced a large volume of data in relation to the scope of the research project which required careful organisation and categorisation. For some extracts several codes were applicable and therefore data could be assigned to several themes. Many preliminary themes and subthemes were identified which interlinked and overlapped. Several thematic maps were constructed and the map that provided the best representation of the data in relation to the research question was selected. As described earlier, those themes considered most significant, as opposed to prevalent by the researcher were selected. An example of an intermediary thematic map is as follows:

 

Revisiting of literature: Themes were cross-referenced against those prevalent themes identified in the literature review in order to place data in context and provide a comparison for viewpoints expressed.

Reviewing themes: Themes were reviewed to check they worked in relation to the coded extracts and entire data set. They were refined so there are clear distinctions between themes with the researcher identifying four overarching components relating to the use of rap in the data. Final data extracts were selected for each theme. Where ideas were duplicated in the data extracts, extracts were selected to produce a balanced representation of data from the participant sample. A final thematic map was constructed.

Defining and naming themes: Clear definitions and names for themes were determined. The ‘story’ that each theme told was identified and the way in which each theme fitted into the broader ‘story’ and in relation to the research question was considered.

A final report provided an account of what the data displayed. Evidence of themes was supported by carefully chosen extracts and an argument in relation to the research question was made (Braun & Clarke, 2006).

Reflexivity and Considerations Regarding Objectivity

Before data collection it was necessary to identify any aspects of the protocol that may affect the objectivity of the research and should be monitored throughout the research process. In the qualitative research process, subjectivity and inter-subjectivity require careful handling to avoid constraining the data and research process. In this study, the researcher served as the instrument of data collection and analysis. Aigen (1995) states “what you do as a qualitative researcher reflects directly who you are” and that research findings “reflect the values, emotions, skills and experiences of the researcher” (p. 296). This could be considered subjective and a limitation of the data analysis method and is particularly relevant when considering the thematic analysis and grounded theory techniques employed in data analysis. A reflexive approach to the research process, in which a critical self-reflection of the ways in which the researcher’s social background, assumptions, positioning and behaviour impact upon the research process and how the researcher constructed their findings, was adopted. This ensured that these attributes, rather than skew the data, interacted with the field of study to determine the data and went towards providing insight into the researcher’s individual process (Finlay & Gough, 2003).

In his 2004 paper, Lightstone highlights that choosing a research topic is in itself subjective and Moustakas (1990) states “the task of the initial engagement is to discover an intense interest, a passionate concern that calls out to the researcher” (p. 27). The research area chosen was inspired by an article that demonstrated the use of Rap as a valuable intervention in music therapy. In addition, although popular music had been both a personal and professional interest, the researcher had thus far neglected to engage with Rap as a popular music style. A new-found interest in political, social, historical and musical aspects of the genre, not only in it’s relation to music therapy, had been stimulated leading to the selection of the genre as a focus for the research.

Following analysis of the literature, the participants could be described as advocates of the use of Rap and this could affect findings to some extent. Ensuring the research questions were as objective and unbiased as possible helped produce objective data.

Regarding the data collection technique, Robson (2006) highlights that a lack of standardisation with qualitative interviews can raise concerns about reliability and biases are difficult to rule out. A disadvantage when using open ended questions is the risk of loss of control of the researcher during the interview and a subsequent failure to address relevant questions. Data collection required careful execution in order to maintain consistency and objectivity. The pilot interview assisted with this. Reflexivity appreciates that research is co-constituted and is a joint product of the participants, researcher and their relationship. Instead of minimising the researchers presence, “subjectivity in research is transformed from a problem to an opportunity” (Finlay & Gough, 2003, p.5). It is hoped that by using qualitative interviewing techniques in an attempt to build rapport and make a link between experiences, allowed the interaction of my own position and interests with those of the participants to produce a rich and varied data set.

In terms of data analysis, since themes selected were those considered most significant by the researcher, as opposed to those most prevalent, this was a subjective process led by the researcher as the instrument of data collection and analysis. In reflexivity it is acknowledged that meanings are negotiated in particular social contexts so that one researcher will unfold a different story to another (Finlay & Gough 2003). Taking this into consideration, both the data extracts selected and themes constructed inevitably were influenced by the researcher’s interests and background in popular music, interest and training in a psychodynamic approach to music therapy and interest in each participant’s approach and practise. It is hoped that using these influences introspectively in the data analysis process served as a springboard for interpretations and more general insight rather than skew the data.

Strauss and Corbin (1998) state “in every piece of research there is an element of subjectivity” and that “researchers should take appropriate measures to minimise its intrusion into their analyses” (p. 43). Regarding data collection and analysis, the researcher maintained a reflexive, self-aware approach, handling elements of subjectivity and inter-subjectivity using methods specific to qualitative research as a way to enhance, rather than constrain the data produced.

Findings

Thematic analysis outlined 3 themes (with subcategories) relating to the management of verbal boundaries when using pre-composed and improvised rap in music therapy and 1 relating to the potential of rap to contraindicate. Themes 1 to 3 capture how, why and when music therapists limit the use of potentially offensive language in rap that is presented in the therapy space and theme 4 encapsulates instances when therapists think rap should not be used.

Table 2 outlines participant and data characteristics from which the themes were derived.

Table 2. Participant characteristics. Client grioups discussed: Adolescents "at risk."[3]

Participant/ Code	Nationality	Years Qualified	Model/ Approach	Setting
Andrea Frisch-Hara/AFH	American	20	Psychodynamic	Inpatient hospital, SEBD[4] school
Florence Ierardi/FI	American	27	Psychodynamic/ Humanistic	Short-term juvenile detention facility (inpatient), after-school program
Mike Viega/MV	American	8	Music-centred	Various inner-city
Aaron Lightstone/AL	Canadian	13	Music-centred	Urban youth shelter (outpatient), residential addictions treatment centre
Katrina McFerran/KM	Australian	15	Eclectic/ Humanistic	Mainstream schools
Emma O’Brien/EO	Australian	16	Eclectic/ Humanistic	Early psychosis setting (inpatient), various
Steve Cobbett/SC	British	7	Integrative	SEBD school
Stella Compton – Dickinson/SCD	British	17	Cognitive analytic (Integrative)[5]	High secure hospital (inpatient)

Theme 1. Factors Influencing the Management of Verbal Boundaries in Music

Theme 1 examines the management of potentially offensive material presented within the rap that clients introduce into the space. Sub-theme 1.1 considers how the therapist’s individual response to the material might influence the boundaries that they put in place. Sub-theme 1.2 considers the way in which the client is using the language and in part how the therapist interprets this use of language as a means to communicate via the rap medium in informing the therapist of instances and ways in which offensive material should be limited. Sub-theme 1.3 addresses the way in which management of boundaries relate to the function of the rap created which determines the extent of the offensive language incorporated. Therapists also direct clients to the quality and aesthetic of the material created as a means to manage the type and amount of offensive language included.

These subthemes relate directly to the processes and interventions surrounding music that is presented or created by the client within the therapy space. The rap lyrics may stimulate a response in the therapist who may decide to accept or limit material according to this response. They may also tailor their intervention as relates to the language in the music in accordance with what they believe the client is revealing about their internal world, patterns of behaviour and relating or culture. The function and desired outcome of the improvised and original material can impact upon management of offensive language.

1.1 Therapist Response to Offensive Language

1.1.1 Acceptance of Language to Establish Trust

Seven therapists felt they need to demonstrate they can withstand the extreme offensive language often presented at the beginning of therapy in order to develop the therapeutic relationship and begin the therapy process. They accept content however abusive it may be and refrain from censoring. In discussion of the impact of managing offensive language upon the therapeutic relationship when undertaking individual therapy in a youth treatment centre, AL expressed:

At the beginning of a relationship, I want the person to feel accepted and that their expression is acceptable to me, even if it’s problematic in making me feel uncomfortable and then once the therapy relationship is established and they trust me . . . then when stuff is problematic, when there’s a b**tch and a mother f**ker, I can challenge them on it.

SC, drawing upon his work with adolescents in schools for children with social, emotional and behavioural difficulties and pupil referral units (for those pupils removed from mainstream primary and secondary schools), also described the initial emotional impact of the music which could leave him feeling “abused” and “scared” and explained:

I’m almost used to that kind of rapping appearing at the beginning . . . there’s certainly something around them needing to project that into me and see me survive and contain it for them . . . quite often the content of Rap will change over time . . . so that they will start to introduce more vulnerable sides of themselves into their lyrics.

Five therapists described reconsidering this in a group context if the client’s expression was potentially offensive or damaging to another person. Six described difficulty staying with the material; one strategy suggested was the use of supervision.

1.1.2 Countertransference

Six therapists highlighted the potential of the offensive language in rap to evoke strong countertransference reactions. MV discussed his work with adolescents who have experienced adverse circumstances or trauma and have developed emotional or behavioural disorders as a result. In describing the counter transferential response to the “evocative” lyrics often presented in rap provided a powerful analogy using Albert LeBlanc’s (1982) metaphor of “the gate” whereby the ear shuts things out:

If you listen to Jay Z’s ‘99 Problems’, the main hook is “I got 99 problems but a b*tch aint one” that’s going to close someone’s gate real fast . . . they pin-point it as one thing and that’s not what’s happening in the song at all, that song’s . . . got so many different levels of his cultural experience . . . I started working with the counter transference and moving past my own stuff in order to become more connected to the time and place of the world I live in.

He stated that in his work with rap and young people, moving past his own counter transference allowed him to take a more “strength- based” approach that fostered the “empowerment, self efficacy . . . authenticity . . . things that come from free-styling lyrics.”

FI, talking generally about her response to offensive language in rap when it’s presented in the therapy space, described checking her reaction “to see if it’s clinically justified” when limiting language. KM contradicted this, stating she rarely experiences strong reactions to offensive language. She does not consider countertransference “that useful a construct” in her work as she’s “much more focussed on the client.” Therapists’ familiarity with the genre can influence and help manage countertransference.

1.1.3 Limitations of Therapist

Five therapists described needing to recognise limitations regarding tolerance levels to work effectively with rap. This could relate to the nature and frequency of offensive language and stylistically aggressive delivery. AL, during his first experience of the use of Rap in therapy, considered him self an “outsider” to the Hip Hop culture. In describing one challenge he faced with managing verbal boundaries in a multi-cultural setting, he stated feeling reluctant to impose his own culture onto the individuals he worked with but was also conscious that some of the content that was being presented left him feeling uncomfortable. He referred directly to the genre to help him determine boundaries:

Afrikaa Bambata, one of the founders of Hip Hop . . . [talks] about how…Hip Hop should always be very positive and people who bring a lot of misogyny and negativity into it have hijacked the original intention of the art form. That made me realise that because there is misogynistic lyrics in Hip Hop are by no means universally accepted by the Hip Hop community and as an outsider am in position to not accept it either.

1.2 What the Client is Communicating

1.2.1 Mask/Defence Against Vulnerability

Two therapists suggested clients sometimes use offensive language as a mechanism defending against their true feelings therefore censoring material would be detrimental. SC, describing his experience and approach to working with at-risk young people stated he would not put a boundary on offensive language and explained:

In terms of the violence and the abusive content, I think sometimes it’s like a false persona they are trying to present to me around them needing to appear very strong and that’s to do with their vulnerabilities and needing to protect themselves . . . I think it would be counter-productive to make an issue of it.

He later suggested that often, gradually, the defensive use of the offensive content in Rap may decrease:

And quite often the content of Rap will change over time in their therapy so that they will start to introduce more vulnerable sides of themselves into their lyrics.

Similarly SCD, talking about her work in a forensic institution, discussed her therapeutic technique. She described focussing on the therapeutic process, acknowledging the emotions of patients but possessing the therapeutic skills to understand and be aware of the psychodynamic processes that might be occurring:

If they’re singing about what a crap, s**t, f**ked up place it is, it’s a view, but it’s one that one would question, because that’s their projection onto the organisation and you have to work with it and get them to take responsibility because they’re in that institution because they’ve done something wrong

1.2.2 Testing of Boundaries

All therapists highlighted clients may use offensive language to shock or test and recognised this behaviour as non-specific to rap. AFH described her work with adolescents in both and inpatient hospital program and special education school setting for children with emotional and behavioural issues. Relating to explicitly sexual or violent content in the pre-composed and improvised rap that clients brought to the sessions, she described thinking about how the material is being used, as clients may be trying to “share something vicariously” and therefore it would not be appropriate to censor material. They may also be using it in a provocative way:

Why were they [the client] sharing it, was it the shock value? . . . .That’s a normative adolescent thing, to shock the adult. That’s been pretty much done in every generation of Pop music.

In this instance it may be appropriate to manage the offensive language. EO, relating to her work with a young man as part of a group for young people experiencing early psychosis, suggested when offensive language in rap is being used to test and lacks meaning, it is appropriate to enforce boundaries:

If the swearing was purposeful and sort of within context, I would probably just go with it but if it’s that sense that they’re just trying to test you and see how far you go, I’d want to let him know that it wasn’t going to shock me but that it also wasn’t going to impress me.

1.2.3 Limitations of Self-expression

Four therapists considered instances when clients might be dissuaded to use offensive language in rap and encouraged to better express themselves. SCD, talking her group work in a forensic institution, described working closely with the MDT and within the boundaries of the setting in which verbal, emotional and physical abuse are not acceptable. Subversive activity was not encouraged or tolerated so that the group did not become split off from the rest of treatment. She explained that therefore in the group, clients were not being verbally abusive but expressing themselves the way they need to, however:

If they [clients] have limited language because they often have limited educational capacity (though not always) . . . they may not have yet found the right word. So the words we would think about, it might be a four letter word and a rude word and that was something we would reflect on. They may then with help and group process find a better word that was more expressive

Three therapists suggested clients might lack motivation to better articulate themselves and in these instances, the use of offensive language should be questioned. KM, when talking about the use of offensive language in improvised rap by clients in her work in schools stated:

If I feel as if it’s a way of hiding or it’s just being slack and, that they could be stretched to express themselves more clearly, then I might ask “do you need to use it?

1.2.4 Cultural Use of Language

Three therapists described clients’ use of offensive language as a “secondary behaviour”[6] inherent in the culture of the client group or their national language, aside from the genre.

SC, referring to his work with improvised and composed rap in a school for children with social, emotional and behavioural difficulties, explained:

I have very basic rules of safety, they’re not allowed to hurt me or themselves or damage the equipment or anything like that but I do turn a blind eye to swearing because they swear all the time.

KM referred to the prevalence of “swearing” in Australian culture and the language of adolescent clients she works with. As a result she considered its use as less significant and felt it unnecessary to enforce boundaries. EO also described experiencing “swearing” as part of the language in Australian culture.

1.3 Purpose of Music Making

1.3.1 Music Stays Within Therapy

If improvised rap is staying within the therapy space, management of boundaries is less-restrictive to allow for creativity and free emotional expression. MV described an example when working with adolescents in a secure setting in which clients were motivated to attend music therapy and participate in the rap-writing process. Clients used explicit language but their primary focus on the music and creative process informed his decision to not impose constraints:

They were creating a song and they were so invested in the craft of it and for me that’s so key ... certain things stayed in there, and for me that was remaining within the craft of Rap and Hip Hop and I was like “okay.”

1.3.2 Music for Performance/End Product

KM and EO stated when original rap ultimately would be performed or recorded, offensive language would be limited or omitted. This is negotiated and clients have a degree of autonomy. EO explained that informing a client that a song will be performed may have an effect on their use of offensive language, as may structural boundaries which arise naturally as part of the song-writing process:

Once you enter into song-writing you have to let the client know that this is a song that will be sung which can impose limits. The song in its very nature has natural boundaries. It has expectations of verse, chorus or a Rap has expectations of the rhythm that you hear or there has to be some kind of hook that comes back, there needs to be some kind of flow within the Rap so the song itself creates a boundary.

KM exemplified with her client who had composed a rap with offensive language as part of a song-writing project for young adolescents. Boundaries needed to be put in place as the rap was going to be recorded, but she wanted the client to retain autonomy:

I spoke to him and said “look if the swearing’s on it, it won’t be able to go on the CD..do you want to take the swearing out and make a new recording or do you want to keep it as it is and we could make a single and keep it as a track that we only give out to people who are old enough?” . . . “ he ended up recording 2 versions . . . .that was his decision.

1.3.3 Therapist as Producer

Music-centred therapists described adopting the role of record producer as part of their approach when working with rap. They manage verbal boundaries in an indirect, non-persecutory way by encouraging clients to consider their language by focussing on the aesthetic of the rap created and their strengths as artists. AL discussed rap song-writing with an individual client. He felt it important that the client be freely expressive in his lyrics but that it was necessary to question their repeated use of certain potentially offensive material and referred to the quality of the lyric-writing in order to do this:

The third or fourth song in a row had some disturbing misogynistic content in it so then I’m challenging him on it, you know “where are you going with this? Why do we need to say this again?” So it’s almost like my role as a music therapist was analogous to the role of a record producer.

Theme 2. Influence of Therapy Context and Characteristics Upon the Use of Rap

Theme 2 examines how the context and nature of the therapy might influence the extent to which therapists are required to manage verbal boundaries when offensive material is presented in rap. This theme relates to 3 core characteristics of music therapy that might influence the nature of the intervention provided: the needs of the client or client group (see 2.1), the boundaries embedded within the culture of the setting (see 2.2) and whether the therapy is in an individual or group context (see 2.3).

Therapists tailor their interventions and management of verbal boundaries in accordance to core characteristics of the therapeutic work identified here as the requirements of the client relating to therapy aims and reasons for referral, rules of the setting which may impact or require integration into the therapeutic work and whether interventions focuses on the individual client or are shaped according to group process.

2.1 Client Needs

Six therapists consider therapy aims when judging the extent to which they limit offensive language. Two therapists described their roles involving helping clients recognise and regulate emotions and suggested removing chaos could prevent this. In the context of working within a forensic institution, in which clients’ index offences characteristically involve a violation of boundaries, SCD explained:

The whole point is they have to be able to recognise their own emotions and work with them rather than acting out their emotions impulsively and harming someone. Nothing so far as I’m concerned, would have happened that was therapeutic if I’d put constraints on which words they used within the Rap.

Conversely therapists described instances when not restricting offensive language could hinder or contradict therapy aims. FI, when talking about her work in an after school club with mainstream primary school children, stated that because of the high level of structure and boundaries within the institution, often clients “expected limits and were confused when they didn’t have [them]”. One strategy was to offer alternative songs or lyrics (MV and FI).

2.2 Boundaries Within the Setting

Seven therapists described negotiating whether there should be a differentiation between the rules of the therapy session and those of the setting. AL explained that the potentially offensive material that was being used in the context of improvised rap conflicted with the strict policy that prohibited swearing and offensive language in the youth shelter in which he was working. He suggested a compromise for the purpose of the therapeutic work:

I negotiated with the administration of the shelter that in the sessions I was going to not allow them to swear but if they wanted to swear whilst they were rapping and that’s how they were going to express themselves then I’m not going to shut that down.

MV described a general understanding that when working in certain institutions it was necessary to adhere to the rules that were in place regarding potentially offensive material, as not to develop an “us vs. them” culture between client and therapist and other staff of the institution.

Contradicting this, in her work with young men part of a community music therapy program KM described choosing not to adopt the “educative strategies” and “teacher mentality” approach of colleagues when managing violent lyrics. She was aware some of her clients were reverting to substance use and aggression and felt that their music reflected that. She decided to accept what they were bringing with a predominantly humanistic approach. She felt limiting offensive language would be inappropriate for her clients who could view her as “another adult . . . telling them what to do and who didn’t understand that life on the streets was really like that and they were reflecting their world” as a result.

2.3 Group or Individual Work

If rap is used in a group context, this influences how all therapists manage boundaries. If one person’s use of offensive language could potentially damage another or stimulate uncomfortable feelings or conflict, this is addressed. Interventions are not rap specific, rather a general approach. Working within the context of Australian culture, where she described "swearing" amongst Australian adolescents as prevalent, KM highlighted the importance of sensitively handling content when working with a culturally diverse group:

Some people, especially from different cultural traditions, find swearing offensive so if I find that the swearing is coming into the songs, I usually check that out with the whole group . . . and have a good discussion.

Theme 3. Familiarity With the Rap Genre

Theme 3 considers how the therapist’s knowledge of the rap genre may influence the way in which they manage verbal boundaries when rap is presented by clients. This encompasses the extent to which therapists are familiar with the style and aesthetics of the genre (see 3.1), language and culture of rap (see 3.2) and role models (see 3.3) that are presented in the therapy space. These factors impact upon how therapists interpret the way in which the rap is being delivered, the meaning of the offensive language presented and how they view the artists clients are aligning themselves with.

These sub-themes connect in that they all relate to stylistic, cultural, political and historical aspects of rap as a musical genre that by default may become present in the therapy space via the introduction of pre-composed or improvised rap by the client. The level of therapists’ familiarity with these aspects prior to the therapeutic work could influence verbal boundaries put in place.

3.1 Familiarity With Style/Aesthetics

When referring to adolescents’ potential capacity for emotional expression, AL highlighted the importance of understanding stylistic connotations of rap when managing boundaries as clients may imitate a particular artist. Feelings expressed in an angry delivery for example may not be congruent with clients’ true feelings and this is important to recognise:

Teenagers, they’re going to want to sound like the artists they look up to. So chances are, if they really look up to an artist like Eminem or Tupac . . . but they’re not really an angry person, they’re lyrics for the first part of the therapy are going to sound very angry anyway. And as a therapist it can be tricky to figure out “is this person really giving me their genuine expression or imitating the Rap artists that they like?” And that’s something that complicates work in Hip Hop and that you won’t necessarily find working in other genres or freely improvised music.

3.2 Familiarity With the Language and Culture of Rap

The use of language in rap is often metaphorical and not literal. Therapists can reduce their own preconceptions by recognising the complexity of the genre; lyrical content often has multiple meanings beyond that which the offensive language may suggest. MV explained:

Rap is poetry and you have to respect it on the same level . . . it’s complex music. . . and when people listen to it one level they just hear certain words . . . and they dismiss it but . . . there’s so much going on; cultural references, personal things.

Conversely, when referring to potentially offensive material as part of the aesthetic of the genre, AL emphasised the importance of the subtle cultural nuances of the language, stating that even if a word is inherent in the lyrical style of rap, boundaries often still require consideration:

If you listen to hip hop, the N word can often be part of the aesthetic but there’s definitely some pretty clear boundaries on who can use that word . . . you do have to be careful . . . especially in a group situation and if it’s someone who’s not black who’s using the term.

3.3 Familiarity With Role Models

Similarly, owing to negative social and cultural connotations, considering pre-composed rap, therapists should be familiar with artists clients bring to sessions and what they represent. This will avoid preconceptions and aid understanding of what the client is communicating. MV reflected upon how certain rappers originally “at risk”, by sharing their life experience, could inspire clients:

Russell Symmonds . . . Sean Combs, these people…created franchises . . . their own companies, they had nothing…[they are] saying be self-sufficient, be your own person, share about your life experience . . . Jay-Z . . . had to accomplish it through adverse experience . . . in an environment where crack-cocaine ruled . . . .people like Biggy Smalls, Tupac, all these people that are perceived negatively [are] saying “I’m going from the negative to the positive.

Theme 4. Contraindication

The final theme considers factors that indicate rap as contraindicative and as such an unsuitable therapeutic intervention. This might be the case when clients associate themselves with rap artists that are considered negative role models (see 4.1), become overstimulated by the music of rap (see 4.2), use the fantasy element of certain rap genres to avoid confronting the difficult situations that led them to therapy or use rap in an anti-social or destructive way (see 4.3). A summary of the themes is below.

These themes convey factors associated with rap that impact not upon how the lyrical content is managed, rather its presence or prohibition in the therapy space; rap is used or responded to by clients in a way that is unhelpful or counter-productive and therefore should not be incorporated into therapeutic intervention.

4.1 Negative Role Models

FI highlighted the importance of therapists, when considering pre-composed rap, recognising the potential for certain artists that client bring to the therapy space to serve as negative role models and managing this appropriately:

It seems perfectly acceptable . . . for [some] younger . . . Rappers . . . to have criminal charges, go to jail for a while, then they get out and are just as popular as before . . . they were using drugs or being violent or they were found with a gun . . . in some cases those things are topics for discussion . . . it’s always best to use our clinical judgement about this.

4.2 Overstimulation

The potential of rap’s music, such as the energy of the deep bass and rhythms, to over-stimulate clients was described by 3 therapists. Two noted this was not unique to rap. AFH, talking of her work with adolescents in a variety of settings described needing ‘to keep people feeling safe and to move the therapeutic process along’ and explained:

If the music is so stimulating that you feel like therapeutic work isn’t happening then you’ve got to deal with it but that comes up in other ways . . . with adolescents . . . with issues of volume . . . choice of instrument.

AL, in the context of addressing the potential for clients experiencing psychosis or dissociative experiences to become “caught up” in the energy of rap, emphasised that this aspect relates more to the patient’s condition:

If you’re going to contraindicate hip hop, then you’re probably also going to contraindicate heavy metal and rave music and other kinds of music that are inherently loud and pumping and high energy.

4.3 Fantasy as Avoidance of True Feelings/Situation

FI suggested the fantasy element present in certain rap sub-genres of Rap, that clients bring in the form of pre-composed or improvised rap, may encourage unrealistic goals or aspirations for certain clients, serving as a distraction from reality or the hopelessness they may experience in their day to day lives and hindering authentic expression of feelings:

Many . . . don’t seem to have plans for the future . . . because of what’s going on around them . . . their losses and perhaps the trauma they’d grown up with . . . when they talk about the future it’s always about a big fancy house or a big fancy car . . . perhaps they don’t see themselves as having the skills or the tools to get to a more positive future without having that fantasy.

A strategy was to introduce pre-composed rap that described more realistic positive aspirations that could be discussed and drawn from.

4.4 Antisocial Tendencies vs. Authentic Expression

Clients could misinterpret offensive language used for authentic expression in rap and use it in an anti-social way. In addressing in general the potential for Rap to contraindicate, AFH stressed that, considering the offensive material presented, “it’s the way somebody’s using it. I think any decent clinicians are going to be aware of this.” She illustrated:

The famous example is that Rap where they go “f**k the Police”. Now a lot of kids, at least in the States, if they’re minorities and they grew up in poor neighbourhoods the police are not their allies so in the context of the session, that’s a great way of getting to that issue. But if it’s . . . ”f**k the police, f**k the teachers, f**k you” then it has to be dealt with.

SCD, talking of her work in a forensic institution, described the need to negotiate clear boundaries, in the form of ground rules, with the group and emphasised the need to determine whether clients’ musical self expression was considered creative or destructive. Her view was that if expression is “destructive, and if there’s no aesthetic content, there’s a potential contraindication” and boundaries should be examined.

Discussion

This study has confirmed, extended what is already known from the literature and revealed new areas for consideration regarding the research questions. The specific approach, interpretation of how the offensive language in Rap was being used and emphasis on certain musical and verbal interventions was often influenced by the theoretical stance the music therapist adopts. However it was observed that overall therapists described similar experiences, thought processes and reasoning informing boundary management.

Factors Influencing the Management of Verbal Boundaries in Music

Therapist Response

Already mentioned in the literature (Frisch-Hara, 2011), accepting without judgement offensive language presented by clients was highlighted as crucial. Little has been written regarding management of offensive language in psychotherapy but following supports this: “effective . . . [psycho]therapists refrain from placing social conformity above the personal interests of patients” (Firestone, 1990, p.634). Psychodynamic oriented therapists framed this within processes of projection and containment in the data whilst humanistic and music-centred therapists described withstanding the material to develop trust.

Offensive language can provoke strong reactions (Frisch-Hara, 2011). Strong feelings stimulated in the therapist, for example anxiety or fear, may be a representation or duplication of feelings that the client is experiencing in their daily existence or as a result of their own anxiety or ambivalence surrounding the therapeutic process. Some therapists used this within the frame of countertransference, others took a similar approach but did not term it countertransference. For those considering it important, opinions differed as to whether this was a vital tool, necessary to recognise or an obstruction when managing boundaries.

Philips (n.d.) states “it is part of the adolescent’s developmental project to find and expose the inevitably very real limitations of the adults he is involved with . . .” (p.4). Frisch-Hara (2011) suggests gender, class and race issues rap raises for therapists must be personally explored The research confirms rap is used by clients to test limitations; this is a pertinent consideration with therapists describing material they encountered relating to similar issues as personally volatile. She also highlights difficulty in tolerating the sometimes aggressive delivery of rap for therapists; this is confirmed in the data. Awareness of these limitations is a must. Supervision and a better understanding of rap can assist with these issues. Language limitations varied according to the therapist’s stance.

Ruud (1997) suggests therapists should be aware of their musical identity. I suggest this is essential when using rap; although therapists may be resistant to offensive statements from clients, they may not have been exposed to a genre that serves as a vehicle for the direct presentation of honest and potentially disturbing feelings and this could affect what they are able and prepared to tolerate.

What the Client is Communicating

Therapists described clients using offensive language in rap to conceal their true feelings. This could be considered in relation to Storr’s (1979) idea that “civilised life demands that we all develop a mask or persona” and that social life would be impossible if we were unable to. He suggests that with “with our intimates we should be able to shed the mask and risk being our vulnerable emotional selves without constraint” (as cited in Tyler, 1998, p. 61). Given clients discussed were “at risk” and had potentially experienced adverse circumstances, it is possible that the genuine emotional worlds of clients may be suppressed in favour of a more superficial, defensive persona which conceals a more fragile inner world that may be to difficult to expose and think about. The client may perceive the therapist and process as threatening to their defensive state which they utilise as a form of protection. As the therapeutic relationship and process develops, clients may feel safer in removing the mask to reveal more authentic emotional states and ways of being. SCD later highlighted this use as context dependant and “a tricky, subjective issue” as it “may not be defensive but emotive and real” to clients (personal communication, 28 April, 2011). Another interpretation could be that this type of defensive use of offensive language could be associated with the anxiety or ambivalence that might be felt by clients at the beginning of therapy, in response to a new and unfamiliar situation and relationship. Indeed such feelings may also be present or reappear throughout the therapeutic process.

Featuring consistently was the apparent use of explicit material to shock and test therapists. This is not unique to rap and can be understood in relation to Erikson’s stage of identity formation: adolescents are confronted by the need to re-establish boundaries for themselves, conducting a series of behavioural experiments "of the 'I dare you' and I 'dare myself” variety" (1959, p.126) and monitoring reactions. Many therapists described challenging the use of offensive language in this instance In her example of the client “testing” her, EO likens her provision of boundaries as an intervention to that of the “good enough mother” (Winnicott, 1965). This provides one good example of the flexibility with which rap can be used to meet different levels of need and how exactly therapists use the genre to do this.

The data acknowledged a re-educative element where clients were motivated to improve their language and maximise their potential when composing rap. There was a subtle difference between this and management of offensive language viewed as inherent to clients’ language that would be ignored in favour of more serious issues that required addressing.

Purpose of Music Making

Music-centred therapists or those using specific song-writing techniques described client-centred management of boundaries that indirectly encouraged clients to address their use of offensive language by focussing on the creation and quality of rap and their song-writing abilities. This could be an important technique for all therapists composing rap with clients, especially those adolescents with a tendency to resist therapy, regardless of their theoretical stance.

Influence of Therapy Context and Characteristics Upon the Use of Rap

Boundary management as with all therapy is context dependent. The setting and the individual pathology inform therapists how to use boundaries. The literature identified instances when settings stipulated therapists’ management of boundaries. In the data, therapists described instances when it was appropriate to emphasise that authentic expression in rap should take precedence over the rules of the setting. In contrast, instances when therapists felt it necessary, considering the pathology and needs of the client, to adhere to the rules of the setting were also described. After validating his data, MV emphasised the influence of the American education and health systems which is primarily behavioural and based on short-term care as an external factor (personal communication, 13 April, 2006). Frisch-Hara encourages the therapist using rap to strive for clinical autonomy (2011). My research demonstrates this should be handled carefully.

Therapists were conscious of the severity of language and its potential to “open things up” or be personally volatile for members in a group therapy context and this informed interventions. Careful consideration of language and subject matter of rap was used in relation to the pathology and specific needs of clients.

Familiarity With the Rap Genre

Music-centred therapists stressed the importance of a deeper understanding of rap in informing boundary management. The complex use of language and style and aesthetics of the genre have implications for metaphoric and personal meanings communicated by clients and subsequent therapist interventions. Rap and its connotations can be used to understand the whole person. McFerran (2011a) references Ruud’s (1997) description of the function of musical affiliation as allowing for the “performance of identity” (p. 182). Researching and understanding the meaning of rap to the individual and culturally can assist the therapist in understanding the client’s problems and guiding the client in discovering and making sense of their own problems as well.

Adolescents may “use idols from the musical world to try out different identities, which are then presented to others to obtain some sort of reaction” (Ruud, 1997, p.9). Rap artists could serve as role models with teenage clients mimicking artists of their preferred genre. A knowledge of artists presented and subsequent exploration with clients can aid clinicians’ understanding of what it means for clients to identify with an artist. One recommendation is that training courses encourage students to become familiar with rap and gain a deeper awareness of the complexities of the genre in order to avoid misunderstanding or facilitate further understanding of material presented by clients in the therapy space.

Contraindication

Therapists were in agreement that contraindications are similar to other aspects of music therapy but aesthetics of the genre can give clues as to whether or not rap might be contraindicative. The data suggests therapeutic skills are required to manage this.

FI described two important aspects specific to rap that could potentially contraindicate. First, already exemplified in the literature (Compton-Dickinson, 2011), therapists should recognise clients could use the “fantasy” element often incorporated in the subject matter as an unconscious avoidant strategy. One strategy to avoid this was to offer alternative lyrics or introduce pre-composed rap without this element. Second, clients could identify with negative role models. This is supported by Erikson (1959) who, when referring to the potential of adolescents to fall into a state of "role confusion", states patients may;

Choose a negative indentity . . . .based on . . . those..roles which . . . had been presented as most undesirable or dangerous and yet also as most real (p.141) [and adopt] a total identification with that that one is least supposed to be [rather] than . . . struggle for a feeling of reality in acceptable roles which are unattainable with the patient’s inner means.” (p.142)

This is particularly pertinent considering client groups addressed in this study.

Frisch (1990) notes the tendency of adolescent patients with problematic behaviour to “use the music in a destructive manner” and states the therapist “must make a distinction between nonverbal expression and “acting out” (p.22). In the data she discusses this in direct relation to the use of offensive language in rap, confirming the same distinction must be made when managing boundaries.

A new theme is the potential for rap’s music to over stimulate. This is not unique to the genre as adolescent clients can use other genres or improvised music to over stimulate in other ways. Respondents did not detail how they managed this, partly because this was outside the remit of the study. All therapists were in agreement that rap should not be contraindicated any more than other genres or styles of music.

Limitations

Although systematic selection of participants produced a range of models and countries, similarities and differences are not acknowledged; further consideration is beyond the scope of this study.

During data collection, interviews naturally became less standardised and more fluid. Interviews lasted between 30 minutes and 1 hour depending on participants circumstances; scheduling, taking into consideration international time differences, influenced this.

Interviewing depends on subjective impressions and validation is influenced by the researcher’s ability to continually check, question and theoretically interpret the findings (Brinkman & Kvale, 2009). Throughout interview, I endeavored to verify meanings and interpretations. On-the-spot decisions made about which aspects of participants answers’ to follow up and interpret could have affected data collection (Brinkman & Kvale, 2009). Informant validity helped moderate this; data in the themes were further enhanced when necessary.

The researcher was the instrument of data collection and analysis and ideally data analysis would have been a shared process to allow control for inter-researcher reliability. Owing to resource constraints, this was not possible therefore supervision was used as a type of triangulation and a control to counteract biased and selective interpretations. As stated in the methodology, in order to position herself within the research and provide insight into the research process, the researcher maintained a critical stance in regards to her personal background, ambitions and interests. Using these influences introspectively in the data analysis process served as a springboard for interpretations and more general insight as opposed to skew the data.

The amount of data collected was large considering the scope of the project; selection and construction of themes was complex. Ideally more would have been included; another limitation of qualitative research in general is that data has to be lost. Upon reflection, a smaller sample might have enabled more detailed analyses of data. It was the intention of the researcher to focus and produce a rich and meaning data set; it is hoped this was

The researcher was immersed to a high degree in the large volume of data. I avoided becoming overwhelmed and maintained a systematic and rigorous approach by returning to the data many times and using supervision to discuss emerging themes, ensure my analysis was unbiased and to help consolidate ideas. The complete data set was reviewed each time a validating or contradictory finding emerged.

Data analysis was a long and challenging process since interpretations had alternative explanations and categorisations were interchangeable. This confirms the data as rich in meaning.

Future Research

To maximize potential, data relating to pre-composed and improvised rap was considered. Future research could focus specifically on boundary management relating to one or the other. Likewise, owing to the scale of this project, clinical work with groups and individuals was not distinguished. Both would allow a deeper and richer analysis. Research focussing more narrowly on any of the themes identified in this research could produce more specific and detailed results.

A similar study using client groups other than adolescents could produce different data. Equally, a study with a larger, globally representative sample with a wider range of experience (perhaps undergraduates, newly trained therapists and non-academics) and whose practise is influenced by a variety of models could be conducted.

A similar qualitative study with clients who have used rap in music therapy could be undertaken, the sample purposive and incorporating a variety of ages, cultures, backgrounds and nationalities.

In Lightstone’s 2004 qualitative study clinical improvisations were recorded and lyrics analysed to determine therapeutic potential. A similar study could be conducted whereby analysis focuses on offensive material incorporated. Instances where boundaries required consideration could be documented. Follow-up interviews with clients exploring their relationship with rap, social and cultural history, background and other factors represented by themes discovered in this research could be included.

It would be interesting to see how results differed by conducting an anonymous global survey using a questionnaire, fixed alternative, scale or structured interview.

Conclusion

This study has been an attempt to explore how music therapists manage verbal boundaries when using rap in music therapy and the potential contraindications. Analysis of the data, placed within the context of the sparse amount of literature available, produced several main findings.

There have been instances when music therapists have needed to consider boundaries regarding lyrical content. The therapist’s response informs boundary management. Responses are similar despite the range of nationalities and approaches; theoretical understanding is influenced by the model of music therapy adopted, although there is some cross over. Prevalent is the acknowledgement that rap can evoke strong reactions and that the therapist is aware of this in order to respond appropriately. Supervision and familiarity with the genre can help.

Understanding what the client is communicating can assist boundary management. How and why adolescents use offensive language can be informed by knowledge of adolescent behaviour and clients’ history and social and cultural context. The purpose of the rap produced often affects the offensive language therapists allowed in the therapy space. When the music is to be heard by others or the focus is the craft of the rap and the client as song-writer, boundaries arise naturally. As with all therapy, external factors require consideration; the client’s needs, the setting and whether the therapy is individual or group work all have an influence on how boundaries are managed.

Familiarity with the genre, specifically with stylistic and cultural connotations, aesthetics, complex use of language and artists, is essential in managing boundaries appropriately. Contraindications are similar to other aspects of music therapy but aesthetics of the genre can indicate whether rap might be contraindicative. This can be informed by knowledge of clients’ history, social and cultural context and pathology. An overarching feature displayed several times in the data is flexibility with which rap can be used to meet different levels of need and how therapists’ boundary management allows this.

The data hopefully contributes towards clarifying what informs music therapists when considering how to manage the offensive material introduced within rap and when rap may contraindicate. The analysis shows clearly a cross-over in approaches despite different training backgrounds. The themes determined could direct music therapists as to factors requiring consideration regardless of their model; individual ways of working could influence what therapists choose utilise from the findings.

Lightstone described difficulties deciding how to manage boundaries during his 2004 study owing to a lack of literature and music therapy mentors who had used Rap. It is not the purpose of this research to serve as a guide but more a preparatory tool for those therapists new to the genre and its use within therapy. I suggest that boundary management and assessment of whether rap could be contraindicative will necessitate spontaneity and informed clinical judgement rather than adherence to a rule book. It is hoped that the research may be of some interest to the profession and other therapists working with adolescents, rap and other popular genres to which the ideas that have emerged may apply.

Notes

[1]For the purpose of this review “at risk” will be defined as being “in danger of negative future events” (McWhirter et al. 1998, p.7) The clients in these case studies were from a variety of settings.

[2]This was the breadth of nationality of the music therapists of the case studies analysed.

[3]For the purpose of this study “at risk” will be defined as being “in danger of negative future events” (McWhirter et al. 1998, p.7).

[4]Specialist educational setting for children with emotional and behavioural difficulties.

[5]See Compton Dickinson, S. (2006).

[6]This refers to a concept by Rogers (1995) who distinguishes between primary behaviours that should be challenged and worked on and secondary ones that should be ignored.

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Appendices

• Appendix 1 Table of Case Study Characteristicsts (pdf, 100KB)
• Appendix 2 Interview Questions (pdf, 74KB)