[Essay]
The Importance of Research in Educating About Music Therapy
By Barbara L. Wheeler
Abstract
In this essay, the author explores some ways in which music therapy research is important in educating people—music therapists and those outside of music therapy—about music therapy. There are different levels and types of research, and different levels are appropriate at different points in the development of music therapy in a country. However, some type of music therapy research is important for the development of music therapy in all cases and in all situations and all countries. The author suggests that music therapy research may be used to: (a) describe a situation, (b) identify and examine processes and causal factors, (c) provide evidence about outcomes, or (d) change a situation. Information on music therapy research for each purpose is provide. The article examines how all of these may be used to educate people about music therapy. It is suggested that music therapists in different countries have different needs for research and that one thing that leads to these variations is how highly developed music therapy is in the country.
Keywords: research; purposes of research
Music therapists conduct and read research for many reasons. One that has not been explored often is the potential role of research in helping to educate people about music therapy. My goal in writing this article is to examine some of the ways that research can help in this process, while also elaborating on purposes of music therapy research and sharing examples. As one who feels passionately about music therapy as well as research and education, this is an opportunity to bring them together. I hope that this will stimulate others to think about this topic, and that possibilities of using research to educate people about music therapy will become clear.
Music therapy research, which is important for the growth of music therapy, has many facets and has developed differently in various countries. This variety has implications for how music therapists from different countries, with different cultures, perspectives, needs, interests, and skills, can be involved with and benefit from research. I would like to explore here some ways in which music therapy research is important in educating people—music therapists and those outside of music therapy—about music therapy.
There are many reasons for doing research. For this article, I will elaborate on reasons given by Stige and Aarø (2012), who suggest that research may be done “to describe something (descriptive studies), … to identify and examine important processes and causal factors (explanatory studies), or … to learn something about the outcomes or effects of interventions and policies (evaluation studies)” (p. 237). These authors suggest also that a fourth reason to do research may be to change a situation.
The perspective that I will present here is that all of these purposes of research may be used to inform people about music therapy. Therefore, we will consider research to: (a) describe a situation, (b) identify and examine processes and causal factors, (c) provide evidence about outcomes, or (d) change a situation. We will look at how all of these may be used to educate people (music therapists and others) about music therapy.[1]
It seems that music therapists in different countries have different needs for research. Cultural considerations are certainly a part of this. Government and structural support for the provision of health care, including music therapy, vary greatly from country to country, with correspondingly different needs for and reliance upon research to justify the inclusion of music therapy. As an example, Bunt and Stige (2014) state: “In England and Wales, the National Institute for Health and Clinical Excellence (NICE) Guidelines for core interventions in the treatment and management of schizophrenia invite health care practitioners to ‘consider offering arts therapies to assist in promoting recovery, particularly in people with negative symptoms’” (pp. 135-136). The authors go on to state that a recent updated Cochrane review has influenced treatment guidelines in, for instance, Norway, where music therapy is strongly recommended. The provision of health care services that are paid by the government and delivered as a universal right to all citizens, as in Norway, also influences the provision of some types of health care, including music therapy, since not offering it to some could be considered unfair to those who did not receive it (B. Stige, personal communication, May 27, 2014).
Another thing that leads to these variations, from my experience, is how highly developed music therapy is in the country. It is my impression, from participation in public forums around the world and interactions with music therapy authors in relation to the books that I edited[2], that differences exist between countries where music therapy is established, and where it is new. Music therapists in countries where it is rather new and is in the early stages of development have little interest in conducting research. They are most concerned with what they perceive as more basic steps of the development of music therapy practice. Those involved in developing music therapy do not have the financial or personal resources to invest in research because so much is going towards the more basic aspects of development. Conversely, I have observed that music therapists in countries where music therapy is more highly developed will focus on research that may help in the next steps in the development of music therapy, whether that is providing evidence for the viability of music therapy or information on what occurs as part of the therapy. I think this applies, also, to music therapists in various parts of the same country (such as in different states or cities in the U.S.). In the U.S., although music therapy is relatively well known, we may experience a variation in the need to educate others depending upon how well music therapy is developed in a particular area or community. I experienced this when I moved to Louisville, Kentucky, in 2000, and was involved with others in the area to spread the word about music therapy in an area in which music therapy was not yet well developed. One of the things that I was asked for that could have been considered research was information (data) on how well music therapy worked with some of the people whom we treated. It was not enough to rely upon research done by others that showed that music therapy was effective. We were asked to provide our own data. Whether sharing others’ research or collecting data on my own sessions, I relied on music therapy research to educate others about music therapy and its potential.
It may be helpful to be aware that different types of research may be appropriate and needed at different times—but I believe that some type of music therapy research is important for the development of music therapy in all cases and in all situations and all countries. I will explore this idea by examining the four reasons to do research, looking at when each may be useful in the development of music therapy. Although I will be presenting these as separate reasons and types of research, they are in reality not so distinct, and there are many crossovers from one type of research to another.
Before proceeding, I will provide a few definitions of research, which we will refer to in our discussion. My own preferred definition incorporates the influences of a number of scholars and colleagues, as published in my text Music Therapy Research (2nd Edition; Wheeler, 2005a, 2005b):
Research has been described as “a carefully organized procedure that can result in the discovery of new knowledge, the substantiation of previously held concepts, the rejection of false tenets that have been widely acclaimed, and the formal presentation of data collected” (Phelps, Ferrara, & Goolsby, 1993, p. 4). This organized plan, described by Gfeller (1995) as “a disciplined or systematic inquiry” (p. 29), is used to support or refute views held on “how and why things work the way they do” (Rainbow & Froelich, 1987, p. 10). Bruscia (1995) has given the following definition of research: “a systematic, self-monitored inquiry which leads to a discovery or new insight, which, when documented and disseminated, contributes to or modifies existing knowledge or practice” (p. 21). (Wheeler, 2005a, p. 3)
Purposes of Research
Research to Describe a Situation
While descriptive research is sometimes included as a category of research (Heller & O’Connor, 2002; Jackson, 2012; Madsen & Madsen, 1970/1978; Lathom-Radocy & Radocy, 1995), numerous music therapy publications that are not formal research are based on descriptions of music therapy sessions. Music in Therapy (Gaston, 1968) consists primarily of descriptions of clinical work. Therapy in Music for Handicapped Children (Nordoff & Robbins, 1972) and Creative Music Therapy (Nordoff & Robbins, 1977, 2007) include extensive clinical descriptions. More recent publications, such as The Music in Music Therapy: Psychodynamic Music Therapy in Europe: Clinical, Theoretical and Research Approaches, edited by DeBacker and Sutton (2014); Healing Childhood Trauma Through Music and Play, by Birnbaum (2013); and Developments in Music Therapy Practice: Case Study Perspectives, edited by Meadows (2011) are also based on clinical descriptions and analyses. Aigen (1995a), in one of the earlier writings about qualitative research in music therapy, suggested that some Nordoff and Robbins case studies may be seen as early examples of qualitative research. Aigen used the case of Edward (Nordoff & Robbins, 1977) as an example and points out ways in which the case characterizes an interpretive qualitative study. As an indication of the importance of clinical descriptions, in an analysis and comparison of the content of nine music therapy journals (through 2001), Brooks (2003) found that clinical reports, which were not research, were the most common contributions. The clinical descriptions listed here as well as many others are all used to inform and educate people about music therapy. The information conveyed is important to help people understand what occurs in a music therapy session.
It is not clear whether those who wrote or read the early publications referred to above considered them to be research. In perusing some, I do not find the authors referring to clinical descriptions as research. However, looking at the extent to which they possess the characteristics of research as presented above (e.g., some present “a carefully organized procedure that can result in the discovery of new knowledge, the substantiation of previously held concepts, the rejection of false tenets that have been widely acclaimed, and the formal presentation of data collected” [from the Phelps, Ferrara, and Goolsby, 1993, definition that was cited]; or “a systematic, self-monitored inquiry which leads to a discovery or new insight, which, when documented and disseminated, contributes to or modifies existing knowledge or practice” [Bruscia’s 1995 definition]), an argument could be made to consider them as research. In my opinion, though, it is a mistake and an incorrect understanding of the definition of research to consider all clinical reports to be research, as this may limit our sights as we consider areas in which research is needed and may be valuable. Some issues when considering whether clinical reports are types of research are presented below.
A major difference between a case study as descriptive research and a clinical report on a client is the purpose. To be considered research, the purpose would be to describe the case with a plan to learn something from it that might apply, or be developed to apply, elsewhere. In the case of a clinical description that is part of treatment, but not research, the purpose is to document or describe the case in order to communicate something to others or for further treatment. Such a clinical treatment description would generally not use specific data analysis methods, although a music therapist might measure behavior before, during, and after treatment to determine whether change is occurring. The essential aspects of case study research, according to Smeijsters and Aasgaard (2005), are: (a) the use of a research method that requires all data to be observed and analyzed; (b) the use of various forms of data collection and analysis; (c) data analyses that are checked by members and peers; and (d) data analyses that are informed by multiple perspectives (p. 441).
Both qualitative and quantitative methods can inform a case study that is considered research. Playin’ in the Band (Aigen, 2002) is a case study of a 7½-year music therapy experience with an adult who had developmental delays and was nonverbal, through which Aigen illustrates the use of improvisation in popular music styles. This is an example of a descriptive qualitative study and also of a case study that would be classified as research. Another example of a qualitative case study is “The Therapeutic Potentials of Creating and Performing Music with Women in Prison: A Qualitative Case Study” (O’Grady, 2011), a grounded theory study based on post-performance interviews that the researcher conducted with seven women who were in prison and her session notes. A descriptive analysis of YouTube® music therapy videos by Gooding and Gregory (2011) is an example of a quantitative study that describes a situation. The researchers analyzed YouTube® videos that were viewed frequently for quality and also to see whether they demonstrated competencies set forth in the Professional Competencies of the American Music Therapy Association (2013).
Describing what occurs is important at all stages of the development of music therapy. An accurate description of a music therapy session, including the music, the therapist’s interventions, and the client’s responses is essential to understanding what occurs. But when music therapy is new in a country or in the early stages of development, describing and reporting what occurs in a session may be a part not only of the clinical process but may also add to the information that is available about the viability of music therapy. Using information in this way could be an example of what is done clinically being used to advocate for music therapy. For example, if a music therapist has previously relied upon a subjective report of what occurs in the session as a way of helping others understand music therapy—perhaps saying something such as “The client responded with sensitivity and caring to the therapist’s interventions,” a clearer description would be a step in understanding the process better. If the therapist said, “The client responded to the therapist’s steady drumbeat by looking at the drum briefly, then reaching his right hand out to touch the drum,” it would provide more information and potentially help the therapy process as well as others’ understanding of what was occurring. Beyond that, if the therapist said, “The therapist played the drum with a steady rhythm of 60 beats per minute, moderately loud, and the client looked at the drum for approximately 3 seconds, then reached his right hand out to touch the drum for approximately 1 second,” it provides additional information. While each of these provides clinical information, we can also see that they might be considered systematic in that the therapist (now therapist-researcher) is systematically observing and then measuring, and the clearer description may lead to a discovery or new insight. Looking at it as a part of the research process, the therapist may document the interventions by writing down the changes in these areas (i.e., seconds looking at or touching the drum) and later sharing them as part of a conference presentation (disseminating). These basic steps—which may or may not be correctly considered to be research—might be just what is needed when music therapy is new in a country and therapists are working to help others understand and accept it.
From this perspective, we can see that even rudimentary description or descriptive studies can provide a basis for understanding what music therapists do. When I presented on music therapy research in other countries a number of years ago (in the late 1990s) and spoke with music therapists from those countries, it was often not clear to me why they classified what they did as research, since it frequently did not seem to match what is included in any of the definitions of research as presented here. It seemed to me at that time that they considered almost anything that they did—including descriptions of clinical work—to be research. My perception is that this has changed. I base this on what I read in the music therapy literature, where I do not see people describing clinical work as research unless it includes some additional levels of analysis that would clearly put it into the realm of research. I do not know if this means that my earlier perceptions of what people called research were not accurate, if things really have changed in terms of what people classify as research, or if there is another explanation.
Research to Identify and Examine Processes and Causal Factors
Music therapists want and need to learn many things about what occurs in music therapy. This information is important to help music therapists understand their work, as well as to be able to inform others about this work, both of which are aspects of educating about music therapy. This may be described as explaining, or identifying and examining, processes and causal factors.
One way to learn more about what occurs in music therapy is through research that explores music therapy processes and helps to elucidate aspects of music therapy. Some of this is qualitative research. One of the things that precipitated the development of qualitative research in music therapy was clinicians’ frequent reporting that research was not relevant to their work. Aigen (1995b) wrote about this when he described the evolution of his doctoral research, titled The Roots of Music Therapy: Towards an Indigenous Research Paradigm (Aigen, 1991), which provided a strong argument for the need for qualitative research. He said:
We begin with the “real world” problem that is at the source of the study, namely: There has been, and continues to be, a schism between researchers and clinicians in music therapy. Clinicians have continually observed that the research base of the field has been of limited applicability and relevance to actual clinical work. (pp. 470-471)
Within the American context, many qualitative methods have been used to learn about the process of music therapy. Ahmadi (2011) examined the role that music plays as a coping mechanism for patients with cancer, finding that the lyrics of certain music could help the patients obtain a balance in their feelings as they dealt with this disease. Muller (2008) used phenomenological inquiry to investigate the music therapist’s experience of being present to clients and discovered both client and therapist themes that helped to elucidate this experience. Studies that explore how musical process is related to clinical process and decision-making include Turry’s (2010) examination of the relationship between lyrics and music in improvised songs created within the context of a Nordoff-Robbins music therapy session with an adult who had been diagnosed with non-Hodgkin’s lymphoma. Viega (2013) developed a songwriting intervention model for teens who had experienced trauma and who identified with Hip Hop culture. In his research, he related musical process to developmental and psychological processes, from protecting vulnerability to expressing abandonment to self-love. Aigen (2009) illustrates how musical decisions (temporal, melodic, harmonic) are connected with specific clinical goals arguing, “to analyze music is to analyze human experience… the structure of human experience in music is homologous with the structure of music itself” (p. 265). Ghetti (2012) used qualitative document analysis and philosophical inquiry to study music therapy as procedural support for invasive medical procedures. She analyzed 19 articles to develop a working model of music therapy as procedural support. In this model, “the music therapist engages in a reflexive process of continually assessing the patient’s responses in order to refocus the intervention lens … to positively influence outcomes” (p. 3).
A number of quantitative methods can also be used for these purposes. Surveys, which gather information on a subject of interest, are an important type of quantitative research that can be used to learn about what occurs in music therapy. Recent surveys have looked at clinical practices and training needs for people with autism spectrum disorder (Kern, Rivera, Chandler, & Humpal, 2013); the use of aided augmentative and alternative communication during music therapy sessions with persons with autism spectrum disorder (Gadberry, 2011); parents’ use of music in the home for children with autism spectrum disorder (Thompson, 2014); participant experiences of members of a therapeutic chorale for persons with chronic mental illness (Eyre, 2011); music therapy educators’ views on and use of feminist music therapy pedagogy (Hahna & Schwantes, 2011); and music therapy students’ practicum experiences in hospice and palliative care settings (Pitts & Cevasco, 2013).
Quantitative research methods in addition to surveys are also possible. Additional research that provides information on what occurs in music therapy includes a study by LeGasse (2013) on the influence of an external rhythm on oral motor control in children and adults, and a study by Kalas (2012) on joint attention responses of children with autism spectrum disorder to simple versus complex music. Results of experimental research studies, including randomized controlled trials (RCTs), discussed below, can also be used to inform the profession.
Chlan, Heiderscheit, and their colleagues conducted an RCT to determine whether patient-directed music could reduce anxiety while patients were on ventilator support. This study and related investigations have led to several publications presenting different aspects of the research, several of which could be placed in different categories of research purposes. The main presentation of the results of the RCT (Chlan et al., 2013) is classified under the next purpose, research to provide evidence about outcomes. Studies and articles that can be considered as research to identify and examine processes and causal factors include an article with exemplars from two patient cases (Heiderscheit, Chlan, & Donley, 2011), about which they say, “the case examples illustrate the importance and necessity of engaging a music therapist not only in assessing the music preferences of patients, but also for implementing a music listening protocol to manage the varied and challenging needs of patients in the critical care setting” (p. 239), thus serving to examine some of the processes that occurred during the study. Another article (Heiderscheit, Breckenridge, Chlan, & Savik, in press) explores the music data for the study through a secondary analysis, using a descriptive design to illustrate and discuss music preferences of the group that received patient-directed music. The article outlines the scope, depth, and patterns of these preferences. They also published an article on the development of a tool for music preference assessment that was used in the study (Chlan & Heiderscheit, 2009). The tool, which allowed the music therapist to collect consistent information throughout the study and ensured treatment fidelity, can be considered broadly also as research to identify and examine processes.
Research to Provide Evidence About Outcomes
A traditional use of research is to provide evidence about how well music therapy works or, in other words, how effective it is. This is part of evidence-based practice, defined as the “conscientious, explicit, and judicious use of current best evidence in making decisions about care of individual patients. The practice of evidence based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research” (Sackett, Rosenberg, Gray, Haynes, & Richardson, 1996, p. 71). Evidence-based practice (EBP) represents the combined use of (a) systematic reviews of the scientific literature, (b) practitioner experience and opinion, and (c) patient or client preferences and values for making clinical decisions and treatment and intervention planning. An essential part of EBP is using the evidence to educate people about the results.
Quantitative experimental research is important to provide evidence for music therapy. This is often done through randomized controlled trials (RCTs), generally considered to be the best way to show the effects an intervention or treatment. RCTs are important throughout the scientific world and are considered by many to be the gold standard of research methods.
Before I define and discuss RCTs, I would like to point out that there is an active discussion in music therapy and other disciplines related to how appropriate it is to use RCTs as evidence for music therapy (Edwards, 2005; Otera, 2013). Many do not feel that providing evidence for how well something, including music therapy, works is an important—or certainly not the most important—reason for doing research or that RCTs can capture the important aspects of what actually occurs in music therapy. Some who embrace qualitative music therapy research are among those who feel that RCTs should not be emphasized, and that what they help us to learn is not as important as are some other aspects of music therapy. Some music therapists argue that it does not make sense to conduct RCTs of music therapy interventions, since music therapy involves a relationship, there are so many possible uses of music, and music therapy sessions are individualized and seldom follow a standard set of procedures or protocol. It is important to realize that these alternate viewpoints exist, particularly when we see emphasis placed on the value of RCTs.
In an RCT, participants are assigned to two or more conditions, one of which is the treatment of interest (e.g., music therapy) and another that is a no contact control group. Often an additional group receives the standard treatment that is offered in the facility or for the condition. Participants are assigned randomly to conditions, meaning that each person has an equal chance of being assigned to each condition. The different groups or conditions then receive different interventions and the outcomes are measured. Since the conditions were identical (or at least not systematically different) other than the treatment that is of interest, any differences that are found are thought to be due to the intervention that was received. Participants are randomly selected from a larger group, with those who participate in the experiment itself being called the sample and the larger group, the population. Because they have been randomly selected, those in the sample are assumed to be typical of those in the larger population with whom the results of the research are to be used, so that the results of the experiment can then be applied, or generalized, to the larger population of interest.
RCTs are used to evaluate interventions in a wide range of disciplines, including medical interventions and drug trials. Evidence about the effectiveness of music therapy is needed, and well-designed RCTs are generally accepted as the ideal way to acquire this evidence. As Bradt (2012) stated in the conclusion of an article that provides information on conducting high quality RCTs: “The demands for evidence of treatment efficacy and effectiveness are placing increased pressure on the field of music therapy. Music therapists are being asked by their employers, as well as the healthcare industry, to present research that supports their claims of treatment benefits” (p. 146).
Ghetti’s research provides two examples of RCTs. In one (Ghetti, 2011), she evaluated the impact of active music engagement with emotional-approach coping to improve well-being in liver and kidney transplant recipients under two conditions to which the patients were randomly assigned. One group received music therapy with an emphasis on emotional-approach coping, which uses emotional expression, awareness, and understanding to facilitate coping with significant life stressors, while the other group received music therapy without the emphasis on emotional-approach coping. In another RCT, Ghetti (2013) evaluated the use of music therapy emphasizing emotional-approach coping on preprocedural anxiety in adults receiving cardiac catheterization. Another RCT (Albornez, 2011) evaluated the use of group improvisational music therapy on depression in adolescents and adults with substance abuse.
RCTs would be on the far end (along with some other methods and designs) of any continuum of the difficulty of conducting research studies, as it is difficult to design and carry out an RCT. Music therapists conducting RCTs often have funding for their research, although an RCT can be carried out without funding.
While quantitative experimental studies fit naturally as research that provides evidence about outcomes, qualitative research tends to focus on aspects of music therapy other than outcomes, so it is not as easy or as logical to find qualitative research in this category. Meta-synthesis is a qualitative method that is related to the quantitative method of meta-analysis in that it pulls together a number of research studies and makes broader conclusions from them. Solli, Rolvsjord, and Borg (2013) performed a meta-synthesis on the experiences of consumers in recovery-oriented practice that can be considered as providing evidence about outcomes.
I often speak with reporters who are writing and producing shows about music therapy. A number of years ago, they were happy for me to share positive clinical examples to help the public learn about music therapy. More recently, though, they nearly always want to hear of research that supports the use of music therapy. I am sure that this is part of the focus on evidence-based practice, but it has certainly changed the tone of such interviews. Because of this change, it is important for music therapists to be aware of the research that supports our work and able to talk about the results as a way of educating others. This obviously accentuates the value of RCTs in providing evidence for the effectiveness of music therapy.
Music therapists who are in situations or countries that are not ready to conduct RCTs can still benefit from understanding RCTs and their relationship to evidence-based practice. They will be able to draw on research done by others that supports music therapy, often through RCTs, to provide support for music therapy interventions in their situation or country. Music therapists who want to rely on what has been learned through research do not need to conduct all of the research themselves! Learning to read research and then drawing on it for one’s own situation is important.
Research to Change a Situation
A fourth reason for doing music therapy research, according to Stige and Aarø (2012), is to change a situation. Research done for any of the three purposes described so far—to describe something, to identify and examine processes and causal factors, or to learn something about the outcomes or effects of interventions and policies—can all lead to changing a situation, so we might assume that the purpose of most music therapy research is to help to change a situation. Indeed, the main reason that we do research for any of these purposes is probably to help to understand and improve our clinical interventions, thus helping to change the client’s (problematic) situation. So we should not assume that we must do an entirely different type of study in order to use research to change a situation.
Keeping this in mind, we can also look at research that focuses more overtly on changing a situation. One way of working to change a situation is to focus on social justice. Music therapists as well as other creative arts therapists have made social justice a focus of their work, and a special issue of Arts in Psychotherapy, published in 2012 (see Sajnani & Kaplan, 2012), focuses on social justice and includes articles on this topic by music therapists Vaillancourt (2012) and Curtis (2012). Here, we will discuss several research approaches that may aim to change a situation: action research, ethnographic inquiry, arts-based research, and feminism and other types of critical inquiry.
Action research, related to practices labeled as participatory research, thematic research, collaborative research, mutual inquiry, community-driven research, and emancipatory research (Stige, 2005, p. 404), focuses directly on changing a situation. According to Greenwood and Levin (2007):
[Action research] is a research strategy that generates knowledge claims for the express purpose of taking action to promote social analysis and democratic social change. … AR aims to increase the ability of the involved community or organization members to control their own destinies more effectively and to keep improving their capacity to do so within a more sustainable and just environment. (p. 5)While all definitions of action research do not speak so directly of social change, Stige (2002) focuses on the researcher’s social responsibility by presenting participatory action research, which he says includes three dimensions of the researcher’s social responsibility: “(a) research for change, (b) participatory influence, and (c) empowerment” (p. 277).
Action research is in the early stages of development in music therapy (see Stige, 2002, 2005), and much of the action research that has been conducted has investigated community music therapy. Stige and Aarø (2012) say:
The participatory and activist quality of community music therapy suggests that we also do research because we want to change a situation, not only because we want to describe, explain, or evaluate it. Research is linked to the accountability of a profession, and in community music therapy this is interpreted in a broad way to include and emphasize accountability to participants and community members. (p. 237).
One relevant study is by Elefant (2010), who conducted a participatory action research project with individuals who were part of a choir for people with severe physical disabilities. Her project, which suggests the importance of considering empowerment and social change when designing research so as not to risk ignoring critical voices among participants and thus contributing to preserving the status quo, helped the choir members to make their voices heard. Another example is Stige’s (2002, Chapter 4) research with Upbeat, a group of people with intellectual disabilities who were involved in a collaborative process to develop a more inclusive life in the community. This was one of the earlier examples in the music therapy literature of research that linked music therapy to social change.
Ethnographic inquiry, defined by Stige (2005) as “a scholarly approach to the study of culture as lived, experienced, and expressed by a person or a group of people” (p. 392), can focus on promoting change. Examples of this in Goffman’s work are summarized by Stige:
In Goffman’s work [in the 1940s], ethnographic approaches are no longer restricted to the study of a specific culture or to a subculture linked to a given locality. Instead, broader cultural themes are examined. Goffman, who did fieldwork examining the communication conducted in a community in the Shetland Islands, used the same observations as part of a more general argument about the dramaturgical principles of social life (Goffman, 1959/1990). Similarly, after 1 year of participant observation at St. Elizabeth’s Hospital in Washington, DC, his agenda when writing Asylums (Goffman, 1961/1991) was not to describe the specific culture of this specific place, but to discuss it as an example of total institutions and closed communities comparable to monasteries, prisons, army camps, and boarding schools. (p. 394)
Ethnographic research in music therapy has developed in recent years. Several examples are related to community music therapy. Stige (2010) studied participation in a festival that was started by music therapists several decades ago, focusing on ways in which adults with intellectual disabilities could participate. Ansdell (2010) explored what happens with a group of people in West London who get together to create and perform music. Pavlicevic (2010) documented the rich ethnographic context in and around a children’s choir in South Africa. Each of these provides information and a perspective that can contribute to change.
A different form of ethnographic research, an autoethnography, “seeks to unite ethnographic (looking outward at a world beyond one’s own) and autobiographical (gazing inward for a story of one’s self) intentions” (Schwandt, 2001, p. 13). Woodward (2013) explores, through an autoethnography, “the nature, impact, and process of change of two dynamic cultural forces—mine and the culture in which I lived and worked” (p. 11) through an autoethnographic study of her experiences in Bosnia and Herzegovina as leader of a small multi-ethnic team in what she states “aims toward a deeper understanding of my own culpability … and what implications this may have for arts-based fieldwork practice in post conflict regions” (p. iii).
A number of researchers (Finley, 2008, 2011; Kay & Kaiser, in press; Leavy, 2009; Viega, 2013) emphasize the potential for arts-based research to address social justice issues.
Arts-based research is defined as,
A research method in which the arts play a primary role in any or all of the steps of the research method. Art forms such as poetry, music, visual art, drama, and dance are essential to the research process itself and central in formulating the research question, generating data, analyzing data, and presenting the research results. (Austin & Forinash, 2005, p. 458)
Finley (2011) makes the social justice aspect evident by labeling the research that she speaks of as critical arts-based inquiry. Leavy speaks of the ability of the arts to communicate emotional aspects of social life:
For example, theatrical representations of the experience of homelessness, the experience of living with a debilitating illness, or surviving sexual assault can get at elements of the lived experience that a textual form cannot reach. Furthermore, the dramatic presentation connects with audiences on a deeper, more emotional level and can thus evoke compassion, empathy, and sympathy, as well as understanding. In this way, arts-based practices can be employed as a means of creating critical awareness or raising consciousness. This is important in social justice-oriented research that seeks to reveal power relations (often invisible to those in privileged groups), raise critical race or gender consciousness, build coalitions across groups, and challenge dominant ideologies. (p. 13)
Musical performance, of course, could be substituted for dramatic presentation in the above. Leavy goes on to suggest that arts-based practices can be useful in studies involving identity work, in which research often involves “communicating information about the experiences associated with differences, diversity, and prejudice” (p. 13). It is clear that arts-based research has numerous possible uses in seeking change.
Vaillancourt’s (2009, 2011) research, titled Mentoring Apprentice Music Therapists for Peace and Social Justice Through Community Music Therapy: An Arts-Based Study, is an example of an arts-based study that seeks social justice. In stating the purposes of her research, Vaillancourt was clear about the connections to change (social justice, peace) that she was seeking when she said:
I am searching for equations between music, music therapy, CoMT, peace, social justice, Music Therapists for Peace, leadership, mentoring, and apprenticeship. My questions then become: Is there a link/how to link/where is the link between these concepts? In what ways does CoMT relate to and connect to peace and social justice? (2009, p. 4)
Feminism and other types of critical inquiry also seek to change a situation. Critical inquiry is related to critical theory, associated with philosophers from the Frankfurt School that was established around 1930. Kincheloe and McLaren (2000) define critical social theory as concerned with “issues of power and justice and the ways that the economy, matters of race, class, and gender, ideologies, discourses, education, religion and other social institutions, and cultural dynamics interact to construct a social system” (p. 281). Feminism is one type of critical inquiry and has been important for some music therapy researchers and scholars (see, e.g., Curtis, 2000; Edwards, 2006; Hadley, 2006; Hahna, & Schwantes, 2011; Rolvsjord, 2006). Curtis (2012) provides a broad examination, including from a feminist perspective, as she examines the “diverse nature and scope of social justice … from such varied perspectives as: feminist music therapy, community music therapy, peace activism, and participatory action research, as well as multicultural and empowerment approaches to music therapy” (p. 209). In another type of critical inquiry, Baines (2013) connects Anti-Oppressive Practices to feminism and critical theory, pointing out ways in which music therapists can benefit from this awareness and relating some past research to Anti-Oppressive Practices.
Conclusion
With each possible focus of music therapy research comes opportunities to use research to educate about music therapy. I urge music therapists to take research seriously, whether this means learning to read and apply research studies to their clinical work, conducting research studies using any of a number of methods and designs, or utilizing research for change and to educate others. All are potentially exciting and rewarding uses for music therapy research, and involvement in them will add to the music therapist’s credibility, knowledge, and skill.
Acknowledgement
The author thanks Carolyn Kenny, Katrina Skewes McFerran, Brynjulf Stige, and Michael Viega for feedback on and information for this article.
Notes
[1]This final point, that music therapy research may be used to educate people about music therapy, was initially suggested to me as a separate purpose for doing research by Carolyn Kenny (personal communication, December 22, 2012).
[2] Music Therapy Research: Quantitative and Qualitative Perspectives (Wheeler, 1995) and Music Therapy Research (Wheeler, 2005b),
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