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A Model of Dance/Movement Therapy for Resilience-building in People Living with Chronic Pain: A Mixed Methods Grounded Theory Study A Dissertation Submitted to the Faculty of Drexel University by Minjung Shim in partial fulfillment of the requirements for the degree of Doctor of Philosophy June 2015 © Copyright 2015 Minjung Shim. All rights reserved. ii Like the five loaves of bread and two fish of a little boy, I dedicate this dissertation to the gracious hand of God. May He bless this humble offering to be broken and shared to feed amd nourish others. I also dedicate this work to my parents Gunho Shim and Youngsook Oh whose unconditional love, sacrifice, and support enabled me to achieve all I have accomplished and will accomplish in my life. iii Acknowledgments The Study Participants: First, I thank the thirty-six participants of this study who shared their stories and dance with me. They are living examples of resilience, and I am honored to have had the opportunity to learn from each one of them. I hope and believe that the lessons we learned from them will help bringing hope and resilience to many others. My Advisor: I would like to express my sincere appreciation for my advisor Dr. Joke Bradt. Dr. Bradt’s steadfast support and guidance have been invaluable over the years and I feel incredibly privileged to have had her as my advisor. Without her patient guidance, teaching, insightful ideas, thorough feedback and long hours of work, this dissertation could not have been completed. I cannot adequately express my thanks for her enthusiasm and care in helping me obtain not only my degree, but succeed in all my endeavors. For all her support and mentoring throughout my PhD journey, I am truly grateful. Dissertation Committee Members: I give my heartfelt thanks to my dissertation committee members. Without a doubt, I am most fortunate to have had an outstanding team of gifted and dedicated scholars and educators who made unique and valuable contributions to this dissertation process. I thank Dr. R. Burke Johnson for his teaching and guidance in designing this innovative research study. His knowledge and expertise in various aspects of research methodology and process was immeasurably helpful in making this dissertation a distinctive work. Dr. Johnson’s teaching helped me to expand the horizon of my perspective on research and empowered me to build my identity as a researcher. I am very thankful to Dr. Susan Gasson for the critical role she has had in this research process. There were numerous occasions where I was feeling lost and stumped about the direction of my research, but inevitably, a meeting with Dr. iv Gasson would bring me much clarity and confidence, and reinvigorated my enthusiasm for research. I appreciate her dedication to take extensive amounts of time to sit down with me to teach grounded theory step-by-step. I give many thanks to Dr. Sherry Goodill. The knowledge and resources she has taught and shared with me over the years truly became a foundation for this dissertation work and were applied throughout the entire dissertation process. Her teaching has profoundly influenced me in building my theoretical and clinical framework as a dance/movement therapist and my aspiration for medical DMT. I am grateful for her feedback and advice during the designing of the intervention and the model building process. I also wish to thank Dr. Richard Jermyn for giving me insightful suggestions during the proposal stage and helping me to conduct and recruit participants for the study at Rowan University NeuroMusculoskeletal Institute. I am thankful for the funding provided by Rowan School of Osteopathic Medicine music medicine program, which helped me to finish this dissertation project. Faculties at Drexel CAT program: I would like to thank the faculty members and staff in the Creative Arts Therapies program of Drexel University. I learned that it really takes a village to raise a PhD scholar! Thank you, Drs. Nancy Gerber, Elizabeth Templeton, Seran Schug, Donna Kaiser, Girija Kaimal, Francis Bonds-White, Katherine Fisher, Maureen Davis, and David Flood. Everything I was taught in and out of the classroom contributed to building and shaping this dissertation and my emerging identity as a scholar and researcher. A special thank you goes to my supervisor Anne Margrethe Melsom for her encouragement. I want to also express my gratitude to and staff Robin Johnson and Debra Karlan for their kindness and care. PhD Colleagues: I wish to thank Gioia Chilton, Liesbet Manders, and Marsha Cohen- Liebman, for being wonderful companions throughout my journey in this inaugural doctoral v program. The talents and experiences you bring and being the persons you are all came together to create a rich learning environment for me. I also thank Donna Radl for her friendship and help with formatting this dissertation. Friends and Supporters in Korea: My dearest friends, Nameun Song, Moonyoung Choi, Bohyun Yoo, Jiyeon Kim, and Soyoung Shim, I thank you for your support and encouragement during my PhD process and your friendship throughout my life. I would like to express my deep gratitude to reverend Myoungkyung Lee, and Changseon Lee for their mentorship in my life. Many thanks to U-oh Chun, Jooyeon Lee, Gahee Kim, Jeonjin Lee, Jiyeon Yoo, Yoojin Choi, Bokhee Lee, Eunhee Kim, and my faith community at Ewha Womans University dance alumni fellowship for their partnership in prayer and support. I am grateful for the DMT community in Korea and Heekyoung Nam for being a good friend and companion on this path less traveled. Friends in Philadelphia: Being a full-time international PhD student, especially writing a dissertation, can be an extremely lonely and challenging experience. My “Philly friends” deserve my big thank you for their care and moral support in this process. My special thank you goes to Amy Yu who has been the biggest cheerleader throughout my PhD journey. Thank you for your belief in me and always being there for me. Your help and support in the final stage of this work was crucial. Haelim Suh, I am grateful for having your company during this PhD journey. My PhD years would have been so lonely without you. Another big thank you to Brenda Chadambura, Shikata Mudakha, Jihye Kim, Maria Choy, Janet Lee, Sueen Noh, and Julie Yoon, for their prayer and support, and for helping me to emerge out of my ‘dissertation cocoon’ to share moments of laughers and convivial conversations. I also owe a deep thank you to Bonnie vi and Steve Choi for opening up their home to me upon my arrival and helping me to resettle in Philly again. I appreciate your care and friendship over the years. Staff at Stephen and Sandra Sheller 11th Street Family Health Services: I would like to thank Dr. Patricia Gerrity, Lindsay Meeks Edwards, and the staff at 11th Street for welcoming me to their community and providing me with help and support to carry out this research. Staff at Rowan University School of Osteopathic Medicine: I am grateful for Barbara Thomson and Kathy Kupiec for their kindness and help throughout the research process. Marian Chace Foundation, Ki-een Dance and Art Foundation, and Global Bridge of Sharing: This research and my education were partly supported by the funding provided by these organizations. I am grateful for their financial support. My Family: My deepest and most important thanks go to my family. Without their love, support, and prayers, it wouldn’t have been possible for me to accomplish this intense process of learning, growth and transformation. THANK YOU! vii TABLE OF CONTENTS LIST OF TABLES ....................................................................................................................... XV LIST OF FIGURES………………………………………….…………………………………XVI ABSTRACT ................................................................................................................................ XIX CHAPTER 1: INTRODUCTION .................................................................................................... 1 1.1 Problem Statement ..................................................................................................................... 1 1.2 Purpose Statement ...................................................................................................................... 2 1.3 Method Statement ...................................................................................................................... 4 CHAPTER 2: REVIEW OF THE LITERATURE .......................................................................... 6 2.1 Chronic Pain ............................................................................................................................... 6 2.1.1 Definition and Epidemiology .................................................................................................. 6 2.1.1.1 Defining pain ....................................................................................................................... 6 2.1.1.2 Acute versus chronic pain .................................................................................................... 7 2.1.1.3 Pain Epidemiology ............................................................................................................... 8 2.1.2 Common Theories and Models of Pain ................................................................................... 8 2.1.2.1 Biomedical model of pain .................................................................................................... 8 2.1.2.2 Gate control theory
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