Pergamon The Arts in Psychotherapy, Vol. 23, No. 3, pp. 277-280, 1996

Copyright 0 1996 Elsevier Science Ltd Printed m the USA. All rights reserved

0197-4556/96 $15.00 + Ml

PI1 SO197-4556(96)00019-6

BOOK REVIEW

Music Therapy Research: Quantitative and Qualitative Perspectives

Barbara L. Wheeler (Ed.)

(Phoenixville, PA: Barcelona Publishers, 1995, 602 pages, $45, paperback)

This book is the first of its kind to give such a broad overview of quantitative and qualitative re- search methods used in music therapy. It is divided into four parts. Part One gives an overview of issues, such as the boundaries of music therapy research, the status of music therapy research, implications of the quantitative-qualitative dichotomy and ethicalpre- cautions.

In her introductory chapter Barbara Wheeler men- tions an important topic that arises in many discus- sions: “The needs of clinicians must influence re- search if the research is to be relevant to clinical prac- tice.” To me, the “if” in this sentence is important. Of course, research questions should arise from clini- cal practice. However, outside clinical practice there are health insurance companies from which questions arise, such as: “Does it work?“. Although limited, reductionistic effect studies can respond to this im- portant question. Wheeler also describes attitudes of researchers to whether it is possible to combine quan- titative and qualitative research.

Kate Gfeller focuses on the misfit between experi- mental research and clinical significance. Basic train- ing competencies developed by both the American Association for Music Therapy and the National As- sociation for Music Therapy in her opinion do not guarantee the development of research capabilities. She sums up several other phenomena that obstruct relevant clinical research, such as the need to com- plete a research program in the time required and to publish.

Kenneth Bruscia, who sees the separation between researchers and clinicians as a cause of the mismatch between research and clinical practice, at the same time advises that precautions be taken to make certain that a more clinical point of view does not hide the differences that exist between research and clinical practice. Research, as defined by him, is a “system- atic, self-monitored inquiry,” which is different from clinical work.

Cheryl Maranto in her chapter delves into impor- tant ethical questions, such as the ability to give in- formed consent, autonomy and privacy of the clients.

Part Two is completely committed to quantitative research. Carol Prickett sets out the pros and cons of quantitative research. Her argument that quantitative research is unable to offer holistic descriptions re- sembles the arguments used by qualitative research- ers. She thinks quantitative research cannot be under- taken when variables have yet to be defined. Quali- tative researchers think differently, saying that defining and isolating variables is impossible. She writes that “They are not concepts which are limited to any one style of research.” It would be interesting to ask if she thinks these concepts hold also for quali- tative research. Can her statement be linked to Bruscia’s point of view, expressed in Part One, that, although quantitative and qualitative research para- digms are mutually exclusive ways of thinking, there can be converging directions, road signs and rules?

In Part Two Bruscia describes research questions in quantitative research. It can be used to determine

277

278 BOOK REVIEW

the frequency of a phenomenon, to develop reliable and valid measurement instruments, to calculate cor- relations between variables, to determine the constitu- ent elements of a variable (factor), to map changes in time, to make comparisons between groups of vari- ables, to make before and after comparisons and fi- nally to determine interaction between variables.

In Suzanne Hanser’s and Wheeler’s chapter pre- experimental, true-experimental and quasi-experi- mental designs are illustrated with examples from mu- sic or music therapy. Some of these examples show that with quantitative research a researcher can get strong, but superficial data. The research findings give little insight into the complex processes that occur in a human being when suffering, nor in the therapeutic processes during receptive or active music therapy.

In another chapter Hanser gives examples of ap- plied behavior analysis in single-subject research. It becomes clear that quantitative researchers them- selves are aware that sometimes it is impossible to use experimental group designs. They developed reversal, multiple baseline and multi-element de- signs to overcome these problems. Qualitative re- searchers on the contrary see the obstructions of the quantitative method as an argument to adopt the quali- tative paradigm.

Wanda Lathom-Radocy and Rudolf Radocy give an overview of descriptive research methods, such as the survey, ex post facto research, quantitative case studies and developmental studies.

Two examples of research are used by Wheeler in the next chapter to illustrate the distinction between problem statement, subordinate questions, the general hypothesis, specific predictions and operational defi- nitions of the variables. These distinctions are surely helpful in training the researcher to develop a topic.

The same holds true for Maranto’s chapter on re- viewing the literature. This part of the research pro- cess often is neglected in research literature because much attention is given to statistical procedures and designs. For starting researchers knowing where to find databases and how to use them is very important. Wheeler in a subsequent chapter gives guidelines for designing and implementing the research study.

Part Two is closed by two chapters of Anthony Decuir and Michael McGuire. Decuir’s is an intro- duction to descriptive and inferial statistics. He also refers to computer programs. McGuire’s is an outline of the research report, tools for writing, aspects of the writing process and content and format based on the APA Publication Manual. When reading Part Two

many interesting questions and thoughts came up, es- pecially about the connection or disconnection be- tween quantitative and qualitative research.

Part Three is about qualitative research. Kenneth Aigen puts forward his belief that qualitative and quantitative approaches differ fundamentally in their axioms and cannot be equally useful in the domain of music therapy. He categorizes methods of quali- tative research, using the foci developed by Tesch, into “Establishing categories and their connections,” “Discerning patterns, ” “Discerning themes” and “Interpreting.’ ’

In another chapter Aigen gives examples of Natu- ralistic Inquiry and Hermeneutics in music therapy research. The examples he chooses to illustrate quali- tative research in music therapy seem to be limited. Because Grounded Theory is no part of the Inter- pretative-descriptive research type, it has been omit- ted. Two of four examples chosen by Aigen belong to the Nordoff-Robbins school of music therapy. Another example is taken from Langenberg’s re- search and Bruscia’s method of self-inquiry also has been selected. Although the categorization is very well done and useful, the examples could be more representative.

Phenomenology in one separate chapter is de- scribed by Michele Forinash as a search for meaning and relevance. Whereas the quantitative researcher wants to prove whether music therapy works, the phe- nomenologist wants to understand what meaning it has for the participants. Forinash gives three examples of phenomenological music therapy research: Mytho- poeic Music Therapy by Gonzalez, a Phenomenologi- cal Analysis of the Nordoff-Robbins Approach by herself and Discovering Meaning in Improvised Songs by Amir. Because these examples share the same institutional context (New York University), the same argument can be applied that in the future a more representative overview of qualitative research should be developed. What I appreciate is that she gives attention to research methods and their stages. She describes Protocol Analysis, Imaginative Listen- ing, Perceptual Description and Phenomenological Reflection.

Bruscia, in four chapters, gives an extensive and systematic introduction into the process of doing qualitative research. Main features of this process are described, such as not following an established pro- cedural sequence, including the researcher’s personal experience, and the interaction between researcher and participant. Bruscia uses an inner and outer circle

BOOK REVIEW 279

to describe the procedural steps. The inner circle may start at defining the focus, then to contextualize, to design, to gather data, to process data, to record, to communicate and again start a focus. It is also pos- sible to follow another sequence.

Several steps of the outer circle resemble specific techniques used in qualitative research. For instance, “to consult” resembles “peer debriefing,” “to jour- nal” resembles writing memos, and “to collaborate” resembles the so-called “member check.” It seems to me that several steps of the inner circle can be com- pared to steps in quantitative research. Of course, the way these steps in qualitative research are fulfilled differs strongly from quantitative research. In Brus- cia’s own words: “Notice how familiar the issues are but how different the approaches to them are.”

Each step of the inner and outer circle is described in detail in separate chapters and paragraphs. Focus- ing means: selecting a topic (discipline or profes- sional), targeting the phenomena (events, experiences, materials or persons), limiting the scope (singular, idiographic, nomothetic) and formulating the purpose of the study. Purposes are distinguished as follows: holistic description, definition of essence, analysis, theory building, interpretation, re-creation, critique and self-exploration.

In a paragraph about processing data, Bruscia gives 18 distinct processing tasks. Most of them, like get- ting a sense of the whole, segmenting, eliminating redundant data, coding, relating, regrouping and syn- thesizing, are general to qualitative research using content analysis. Others, like interpreting (uncovering latent meaning) and theorizing (to form constructs and conceptual schemes), are specific to different catego- ries of qualitative research as described by Aigen. Bruscia’s analytic and systematic framework will be of great help, not only for music therapists but for every researcher in the arts therapies.

In the chapter about the human side of the re- searcher, Bruscia chooses a psychodynamic approach. What struck me was the sentence: “I have found that there are many parallels in what personal qualities are required to find and stay on track in life and to find and keep one’s focus in research, and that the very same issues and problems interfere.” This demon- strates that doing research is a human undertaking. As in life, a researcher has to take the risk of going into insecurity and not hiding him or herself behind pro- cedures. Also being as human as possible is a prereq- uisite to study other human beings. I have wondered why for a long time it was taken for granted that an

“objective” attitude should be the one and only right means to study human life. Bruscia’s and Aigen’s chapters help us to criticize this seemingly immovable “law” of science.

Part Three differs from Part Two in being more limited in describing concrete designs and techniques of qualitative research. Perhaps this is because quan- titative research has been more established and devel- oped than qualitative research. To work with the qualitative in a research or training program, more information about procedures will be needed.

Part Four contains one chapter about philosophical inquiry and one about historical research. Aigen de- scribes several procedures, such as clarifying terms, exposing and evaluating underlying assumptions, re- lating ideas and using argument. He convinces the reader that clarifying terms in music therapy discus- sions should be one of the most important concerns, for instance, defining musical improvisation as being a replica, analogy or metaphor. He gives further examples of training and treatment philosophies, ex- amples of the search for integration of different theo- ries into one, examples of ontological, epistemologi- cal, axiological, ethical and aesthetic issues. In one separate paragraph Aigen uses his own dissertation as an example of a philosophical study. This study shows in a very systematic way the process of rea- soning that brought him to his qualitative research paradigm. What is exciting is that Aigen, in this chap- ter, meta-communicates about his own study, thus making explicit how his thinking took place.

In the final chapter Alan Solomon defines histori- cal research as gaining knowledge about the past by systematically studying the evidence of the past. His- torical research can concentrate on the music thera- pist’s biography, places, institutions and ideas. Solo- mon discusses the important distinction between pri- mary and secondary sources and gives examples of different sources of evidence. He gives procedures by which the credibility and accuracy of evidence can be assured.

There are several appendices at the end of the book: Supplementary Materials to Ethical Precautions, Statistical Formulas and Examples, a glossary of terms, and a name and subject index.

Music Therapy Research has the character of an introduction into research. Although most of the in- formation for quantitative researchers is general and well-known, the chapters give a good introduction to the subject and show also how this kind of research has been used in music therapy. Therefore the book is

280 BOOK REVIEW

a bridge between research methodology and music therapy.

While the quantitative researchers raise questions within their paradigm and find solutions within the same paradigm, the criticism of qualitative research- ers to quantitative research leads them to reject it. Although qualitative researchers claim that music therapy needs a distinct research paradigm, when reading their reflections they come across mostly as general qualitative research procedures and music it- self comes a bit short.

Each author used those research studies with which he or she is acquainted. This is justifiable because the intent of the authors is to illustrate research methods. However, some research studies that have an impor- tant impact on the scientific credibility of music therapy are missing. This holds for quantitative as well as qualitative research findings.

There is no discussion between quantitative and qualitative researchers. The book is an introduction

into each paradigm, as travelling into two separate worlds.

The authors succeeded well in writing a book that gives a very good overview of research methods to be used in music therapy research and training. The book is easy to access and should be used at each training institute where research training on a masters or PhD level is of concern. Its solidity makes it an important handbook for every music therapist who is interested in or wants to study research methodology applied to music therapy.

Henk Smeijsters, Ph.D. Director of Research

Music Therapy LaboratoryHogeschool Nijmegen Head of Studies

Music Therapy Training Program-Hogeschool Enschede

The Netherlands