We're Free: The Impact of a Rap Writing Music Therapy Intervention on Self-Esteem

of At-Risk Adolescents in a Public Middle School Setting

A thesis presented to

the faculty of

the College of Fine Arts of Ohio University

In partial fulfillment

of the requirements for the degree

Master of Music

Jessica L. Schlabach

May 2015

© 2015 Jessica L. Schlabach. All Rights Reserved. 2 This thesis titled

We're Free: The Impact of a Rap Writing Music Therapy Intervention on Self-Esteem of

At-Risk Adolescents in a Public Middle School Setting

by

JESSICA L. SCHLABACH

has been approved for

the School of Music

and the College of Fine Arts by

Kamile Geist

Associate Professor of Music

Margaret Kennedy-Dygas

Dean, College of Fine Arts

3

ABSTRACT

SCHLABACH, JESSICA L., M.M., May 2015, Music Therapy

We're Free: The Impact of a Rap Writing Music Therapy Intervention on Self-Esteem of

At-Risk Adolescents in a Public Middle School Setting

Director of Thesis: Kamile Geist

The negative behaviors displayed by adolescents who are at-risk can have detrimental effects on society. Developmentally appropriate, engaging treatments that adolescents enjoy may be the most successful as preventative interventions. The purpose of this study was to investigate rap writing as a possible treatment intervention to improve self-esteem of at-risk adolescents.

A convergent, mixed methods design was used to provide qualitative insight into quantitative results. Quantitative measures include the Rosenberg Self-Esteem Scale and a frequency count of low self-esteem behaviors. Qualitative measures included a thematic analysis of a post study questionnaire, a session transcription, and lyrics written by the participants. The results of this study suggest that rap writing had some positive effect on the self-esteem of three at-risk middle school boys. Participants perceived rap writing as a fun activity that increased confidence and satisfaction

Keywords: music therapy, rap writing, at-risk adolescents, self-esteem, hip hop, rap in therapy, hip hop in therapy 4 DEDICATION

To all the clients who led me on this unexpected journey discovering the therapeutic

importance of rap and Hip Hop.

5

ACKNOWLEDGEMENTS

First and foremost I would like to thank my thesis committee for their commitment to advising me through this process. Kamile Geist, Laura Brown, Richard

Wetzel, and Greg Janson, thank you for encouraging me to be my best and supporting me throughout this academic endeavor. To Cory Fletcher, for your support throughout this process even when completing this task felt impossible. I could not have completed this journey without your kind words and actions. Many thanks to my parents, John

Schlabach and Tina Wilson, and my sister, Kelly Schlabach, for always taking an interest in what I do. Thank you so much for your continued love and support. To my employer

Erin Spring for your understanding, and commitment to helping me complete graduate school and my thesis while working in the music therapy field. To my various extended family, especially Sarah Coffin and Sue Fletcher, for sharing your knowledge and advice throughout this process. Finally, I must thank the music therapists, and other clinicians, who have paved the way for Hip Hop in music therapy despite stigmas of the genre. 6 TABLE OF CONTENTS

Page

Abstract...... 3 Dedication...... 4 Acknowledgements...... 5 List of Figures...... 8 Chapter 1: Introduction...... 9 Problem Statement...... 12 Purpose Statement ...... 12 Research Questions...... 13 Definition of Terms ...... 14 Chapter 2: Review of Literature ...... 16 Need for Treatment...... 16 Importance of Adolescent Self-esteem...... 18 Types of Treatment...... 19 Rap Music as Music Therapy Treatment...... 24 Gaps in the Literature ...... 28 Chapter 3: Methods...... 30 Participants ...... 32 Music Therapy Sessions ...... 34 Data Collection and Analysis ...... 37 Data Organization...... 40 Validity and Reliability ...... 40 Chapter 4: Results...... 42 Research Questions...... 42 Quantitative Results...... 43 Qualitative Results...... 46 Comparison and Interpretation: Qualitative Interpretation of Quantitative Results...... 49 Chapter 5: Discussion...... 55 Expected Findings Related to Literature ...... 55 Unexpected Findings ...... 58 7 Theme of Freedom—Giving a Voice to the Voiceless...... 59 Limitations...... 62 Recommendations for Further Research ...... 64 Conclusion and Implications ...... 65 References...... 68 Appendix A: Ohio University Parental Consent Form...... 77 Appendix B: Letter of Introduction ...... 80 Appendix C: Assent Form ...... 81 Appendix D: Control Group Parental Consent Form ...... 82 Appendix E: Control Group Assent Form...... 84 Appendix F: Facility Letter of Support ...... 85 Appendix G: Rosenberg Self-Esteem Scale (Rosenberg, 1965) ...... 86 Appendix H: Rap Writing Prompts ...... 87 Appendix I: End of Study Questionnaire...... 88 Appendix J: Participant Written Rap...... 89 Appendix K: Lyrics and Lyric Discussion Prompts...... 90

8 LIST OF FIGURES

Page

Figure 1: Diagram for the Convergent Mixed Method Design……………………...….31

Figure 2: Rosenberg Self-esteem Scale Pre and Post-test Data………………….…...... 43

Figure 3: Mode of Low Self-esteem Behavior Frequency Count Data, Student B…..…45

Figure 4: Mode of Low Self-esteem Behavior Frequency Count Data, Student I……...45

Figure 5: Mode of Low Self-esteem Behavior Frequency Count Data, Student S……..46

9 CHAPTER 1: INTRODUCTION

Low self-esteem, low academic success, and negative life circumstances are daily struggles that plague at-risk adolescents and can contribute towards dropout. In the

United States, 7.4% of the population were considered high school dropouts in 2010

(Hansen, 2014; Kanu, 2014) and the National Center for Education Statistics reports the typical national average of dropout is 3.4%. Negative life circumstances outside of school, absences, not completing courses, and suspensions were cited as the highest reasons for not completing high school (Hansen, 2014; Kanu, 2014).

Academic failure and high-school dropout pose problems for schools, community, and the students (Druian & Butler, 1987; Freudenberg & Ruglis, 2007; Hansen, 2014;

Kanu, 2014; Moore, 2006; Olson-McBridge & Page, 2012; Slavin & Madden, 1989).

Low socioeconomic status, lack of academic success, familial problems, behaviors impeding academic success in the classroom, low self-esteem, or other negative life circumstances may contribute towards dropout (Druian & Butler, 1987; Freudenberg &

Ruglis, 2007; Hickman & Wright, 2011; Moore, 2006; Olson-McBridge & Page, 2012;

Slavin & Madden, 1989). However, at-risk youth need not be condemned to failure and can enhance their potential for success with proper therapeutic intervention (Moore,

2006). If at-risk youth are not provided with intervention and they fail, their behaviors and problems are often transferred to the community. Immediate risks of not providing intervention to at-risk youth include continued negative coping skills, emergent negative behaviors, and difficulty managing emotions appropriately. Long-term risks of allowing at-risk youth to fail include economic and health issues (Freudenberg & Ruglis, 2007;

Hansen, 2014; Moore, 2006; Stinson, 2009; Valdez, Lambert, & Ialongo, 2011). 10 Preventative intervention programs tailored to the specific needs of at-risk adolescents have the potential to support positive change for these adolescents, improve self-esteem, and ultimately keep them in school. Research has shown that engaging interventions provided in small groups with committed, supportive teachers and high academic standards are the most successful treatments with at-risk youth. Many of these types of treatments are best applied within the schools or in after school programs, and focus on holding these students to high academic standards (Brown, Kanny, & Johnson,

2014; Druian & Butler, 1987; Freudenberg & Ruglis, 2007). Holding at-risk students to higher standards and providing intervention within small groups with their peers, may lead to an increase in self-esteem. High self-esteem, or positive perceptions of self and others, may aid in the development of positive coping skills, positive peer relationships, and higher academic success. Low self-esteem, or negative perceptions of self and others, can contribute to increased anxiety, behavioral/emotional issues, and substance abuse

(Maccio & Schuler, 2012; Travis, 2012).

Arts involvement has shown significant and positive differences for at-risk students with low socioeconomic status. Arts involvement is related to better academic outcomes for at-risk youth and gives them an opportunity to regulate emotions, relate to peers, and engage in expressive activities (Cattrill, 2012; Coholic, 2011; Sutherland,

Waldman, & Collins, 2010). In fact, High school students who are at-risk and have low socioeconomic status who do not participate in the arts are more likely to drop out of school. Long-term involvement in the arts can also increase positive community involvement. Studies show that arts involvement for at-risk adolescents can improve 11 grades, increase college enrollment, and increase positive involvement in the community (Cattrill, 2012).

Music in particular can be a natural coping mechanism for adolescents and can be a beneficial tool when working with at-risk youth. Adolescents may use music to relax, relate to peers, and to distract themselves from problems (Crowe, 2012). Currently, many music-based treatments focus on music listening and drumming with goals of increasing self-esteem and building community (Crowe, 2012; Olson-McBride & Page, 2012; Stone,

2005; Wood, Ivery, Donovan, & Lambin, 2013).

Music based interventions implemented by social workers and other professionals have been successful with at-risk adolescents; music therapists also uses music in a therapeutic process to help adolescents improve self-esteem, develop problem solving skills, improve self-expression, and improve relationships to peers (Crowe, 2012; Gold,

Wigram, & Voracek, 2007a). Music therapists have the training to assess, treat, and evaluate the effect of the music in order to best accommodate the adolescents in need.

Creative and expressive interventions such as songwriting, drumming, improvisation, and lyric analysis are the most common music therapy interventions for adolescents (Clark,

Roth, Wilson, & Koebel, 2013; Gold, Wigram, & Voracek, 2007b; Solli, Rolvsjord, &

Borg, 2013). As music can be a natural coping mechanism for adolescents, it may be easier to engage them in treatment using the medium especially when using preferred genres and songs.

Rap music is a commonly preferred genre and may positively influence adolescent mood and behaviors (Gardstrom, 1999). The history, culture, and themes in rap music support the goals used in music therapy for adolescents. Rap is a genre that 12 originated amongst poverty and strife in the Bronx in the late 1970’s. Themes in rap music speak of life’s challenges, anger, and stressors (Decarlo & Hockman, 2004;

Elligan, 2004, 2012; Gardstrom 1999; Hara, 2012; Iwamoto, Creswell, & Caldwell 2007;

Travis, 2012). Rap has the potential to be particularly effective with adolescents due to its popularity with the age group and the accessible nature of the lyrics and themes.

Problem Statement

Currently, the national school dropout rate for high school students in the United

States poses a significant problem for schools and in the community. Many treatments are not addressing the needs of at-risk adolescents and students fail because over-burdened schools cannot provide appropriate intervention. Effective intervention must be provided for students who are at risk for academic failure or drop out. Early intervention provided prior to high school has the potential to have an impact on academic failure and/or high school dropout rate. Adolescent-preferred, effective interventions that engage and motivate the students to participate in treatment are needed for at-risk students. Problems displayed in school may be transferred to the community if not addressed before dropout.

If given the opportunity for proper intervention, these adolescents may have a better chance at succeeding in school, life, and contributing to society. Music as an intervention appeals to adolescent interests and can easily break down barriers or overcome adolescent resistance to other forms of non-arts based interventions.

Purpose Statement

The purpose of this study was to measure the effectiveness o f a rap writing, music therapy intervention on at-risk adolescent self-esteem. This study occurred in a middle school setting with at-risk youth as who may be at-risk for academic failure or 13 dropout due to low socioeconomic status, behaviors impeding academic progress, low academic success, and familial instability (Druian & Butler, 1987; Freudenberg & Ruglis,

2007; Hickman & Wright, 2011; Moore, 2006; Olson-McBridge & Page, 2012; Slavin &

Madden, 1989). The Rosenberg Self-Esteem Scale (Rosenberg, 1965) was used to measure self-esteem pre and post treatment sessions and low self-esteem behaviors were tracked through a frequency count video analysis. A post intervention questionnaire was administered to participants in order to capture their thoughts and opinions regarding the efficacy and value of the rap writing intervention. One session's data was transcribed for qualitative analysis as well as the lyrics written by the students. Rap music therapy sessions occurred over six weeks and included lyric analysis of rap music, group rap writing, and a final recording.

Research Questions

1. Does a rap writing intervention have an impact on self-esteem measured pre and

post-test for at-risk youth in a public middle school group setting?

2. Does a rap writing intervention have an impact on the number of low self-esteem

behaviors exhibited during music therapy sessions by at-risk youth in a public

middle school group setting?

3. What interactions arise between at-risk youth in a public middle school setting

and the music when participating in the rap writing music therapy intervention?

4. What benefits are perceived by at-risk youth in a middle school setting after

participating in a rap writing music therapy intervention? 14 Definition of Terms

At-risk adolescents/youth—is defined as individuals who may be at-risk for academic failure or dropout due to low socioeconomic status, behaviors impeding academic progress, low academic success, and familial instability. The term at-risk only indicates an increased chance of failure due to negative life circumstances not a guarantee that the student will fail academically (Moore, 2006). At-risk youth may also deal with various issues such as cognitive or learning disability, a behavioral or emotional disorder, mental health issues, history of abuse or trauma, homelessness, familial dysfunction, and low self-esteem (Clark, Roth, Wilson, & Koebel, 2013; Freudenberg & Ruglis, 2007).

Beat—in this document, beat will refer to the music in the background that supports the lyrics. The beat may include repetitive and grounding rhythm (purposefully organized meter and beat patterns creating a predictability for the listener) and syncopation (to create a stronger sense of the downbeat for the listener and/or allow for change to make the lyrics and their meaning stand out) (Hara, 2012).

Hip Hop—is defined as the “the name of our culture and artistic elements” and more importantly “Hip Hop and Rap music are not the same things; that Rap is something we do, while Hip Hop is something we live, and the living of Hip Hop is ‘real’

Hip Hop” (KRS-One, p 63).

Hiphoppa(s)—is defined as one who believes in the truth, culture, and message of Hip Hop (KRS-One, 2009).

Low self-esteem behaviors—in this document, low Self-esteem behaviors include: avoiding tasks or giving up quickly, behavioral signs of regression (e.g. acting out), making excuses (e.g. this is stupid, I don’t like this anyways), self-critical comments 15 (e.g. I’m bad at this, everyone is better than me), withdrawing socially, emotional outbursts (e.g. crying, anger, frustration, excessive quietness), problems accepting praise or criticism, hyper concerned or sensitive of other’s opinions about themselves, and engaging in negative school attitudes (e.g. skipping class, disrespectful comments, negative comments regarding school) (American Academy of Pediatrics, 2004).

Rap—For the purpose of this study, rap music is defined as rhymed vocals that are spoken, or “rapped,” over beats of varying complexities, while portions of the chorus, or “hook,” may be sung. There are six categories of rap music which include Gangsta

Rap, Materialistic Rap, Political/Protest Rap, Positive Rap, Spiritual Rap, and Rap Not

Otherwise Specified (Elligan, 2012). Rap music contains repetitive and grounding rhythm that creates expectation for the listener. Syncopation of the beats, vocals, or instruments is also present in rap music, which emphasizes the downbeat or creates temporary disorientation within the music to highlight the meaning of the lyrics. All of the above techniques are purposefully layered within the music to highlight the meaning of the composition (Hara, 2012).

Self-esteem—is defined as a combination of perceived self-worth and the perception of how others view oneself (Travis, 2012).

16 CHAPTER 2: REVIEW OF LITERATURE

Students defined as at-risk for academic failure in the public schools are at a higher risk for high school failure or drop out. If these students fail or drop out of school, they can pose a risk to the community (Freudenberg & Ruglis, 2007; Hansen, 2014;

Moore, 2006; Stinson, 2009; Valdez, Lambert, & Ialongo, 2011). Early intervention prior to high school may serve as preventative treatment for academic failure/high school dropout. Current non-arts treatments that aim to increase self-esteem and positive peer interactions may decrease dropout rates. At-risk youth who participate in the arts involvement may have better academic outcomes and peer relations (Cattrill, 2012).

Music based interventions and music therapy treatment have addressed self-esteem and other social/behavioral issues. However, rap music interventions have increased therapeutic potential because the music contains particularly relevant themes to the lives and problems at-risk youth face such as marginalization, familial hardships, and academic failure (Tyson, Detchkov, Eastwood, Carver, & Sehr, 2012). Assisting students in analyzing and writing raps may help them gain confidence and relate to others within their classrooms and ultimately as members of society.

Need for Treatment

It is essential that schools focus on the issues of high school dropout instead of simply allowing students to fail. This passive involvement in the student's education is very damaging to the student and is a disservice to the community and ignoring or flunking students who are at-risk for academic failure is ineffective (Slavin and Madden,

1989). Freudenberg and Ruglis (2007) urge the community to think of high school dropout as a public health issue rather than just an educational problem. 17 The long-term benefits of preventing high school dropout can include reducing racial/socioeconomic gaps, reducing risky or unhealthy behaviors, and decreased healthcare costs. Effective programs to address behavioral, emotional, and social skills of at-risk adolescents may also serve as preventative healthcare (Freudenberg & Ruglis,

2007; Stinson, 2009). Short-term consequences to the individual often include difficulty managing emotions, poor coping skills, and “acting out” behaviors. Long-term consequences include economic, health related, and societal risks (Freudenberg & Ruglis,

2007; Hansen, 2014; Moore, 2006; Stinson, 2009; Valdez, Lambert, & Ialongo, 2011).

Specific risks to the community, if these students fail or dropout, include increased crime rates, unemployment, teenage parenthood, and poverty (Hansen, 2014; Moore, 2006;

Valdez, Lambert, & Ialongo, 2011).

The economic costs of associated risky behaviors may also rise if left unattended

(Moore, 2006; Stinson, 2009; Valdez, Lambert, & Ialongo, 2011). Specific economic benefits of intervention for at-risk adolescents derive from success and completion of education. Completing education can lead to better jobs, improved housing, healthier food choices, and improved medical care (Freudenberg & Ruglis, 2007). Treatment for at-risk youth to increase confidence and self-efficacy may decrease occurrences of repeat or future criminal activity (Hansen, 2014; Stinson, 2009) and therefore decrease costs in the judicial and correctional systems. In short, succeeding in education helps students feel more in control of their lives. This proactive angle can lead to better overall health and behaviors which can lower healthcare and judicial costs in the United States.

Freudenberg and Ruglis (2007) suggest framing high school dropout as a community health and economic issue. They specifically suggest taking a preventative 18 approach to rising health issues by using education, and perhaps therapeutic intervention, to improve high school completion rates and therefore improve the country’s overall health and wellbeing. This thesis proposes taking this a step further by addressing academic failure before it reaches its peak in high school via early intervention in the middle school years. Providing treatment as early intervention in middle school may further prevent academic failure and high school dropout.

There are several treatment methods currently in use, but unfortunately, the difficulty in breaking down boundaries set by adolescents is often a barrier to their effectiveness. At-risk youth may be resistant to therapy and test boundaries with clinicians (Decarlo & Hockman, 2004), but are more willing to engaged in therapies they enjoy (Ciardiello, 2003). Adolescents may prefer new and creative therapies to stereotypical verbal therapy where individuals are expected to process inappropriate behaviors and flaws, which can be intimidating and stigmatizing on its own to adolescents already facing hardship. It is important to assist at-risk youth in learning to manage emotions, improve coping skills, and manage negative behaviors. If adolescents work on developing these skills their academic performance and social relationships within the school setting may improve (Ciardiello, 2003; Decarlo & hockman, 2004).

Perhaps adolescents are not resistant, but we as therapist are failing to strive to engage them in treatment (Ciardiello, 2003).

Importance of Adolescent Self-esteem

Low self-esteem without intervention may result in behavioral/emotional issues, anxiety, decreased academic performance, and substance abuse. Because of the potential impact of low self-esteem, effective intervention is necessary. Low self-esteem can be a 19 perpetuating problem for at-risk youth and may result in problems in school and ultimately in the community. Improving self-esteem for adolescents may impact their academic success and potentially reduce dropout rates. Higher self-esteem promotes healthier coping and positive choices in at-risk adolescents. Improved self-esteem may result in higher academic success, positive coping skills, and positive peer relationships

(Maccio & Schuler, 2012; Travis, 2012).

Types of Treatment

Providing engaging and preferred treatments for at-risk adolescents is paramount to effectively treating at-risk youth. Therapists, social workers, and other related health professionals need to identify youth preferences in order to best treat them. Effective treatment may cut down on the potential economic, health, and community risks if at-risk youth are left to their own devices. Interventions beyond typical “talk therapy” must be explored in order to find the best treatment methods for at-risk youth.

Non-arts based treatments. Empowering, client preferred, group therapy is most successful with adolescents in residential treatment (Ciardiello, 2003). Treatments for at- risk youth focus on creating supportive environments, promoting initiative, fostering academic pride, and promoting success (Brown, Kanny, & Johnson, 2014; Druian &

Butler, 1987; Freudenberg & Ruglis, 2007).

Interventions to reduce dropout and improve academic achievement focus on school based intervention, mental health support, improving social environment within schools, and other specific health related goals (Freudenberg & Ruglis, 2007). Holding students to high, self-established goals, rather than focusing on school curriculum is a more successful support method for at-risk students. In fact, intensive, low student to 20 teacher ratio treatments focused on counseling rather than curriculum can be effective with at-risk youth (Brown, Kanny, & Johnson, 2014; Druian & Butler, 1987).

Intervention that increases academic engagement and fosters connections with teachers or adults leads to increased graduation rates (Freudenberg & Ruglis, 2007).

For instance, charter schools have been successful for at-risk youth by holding students to the same academic standards as their high achieving peers and focusing on structure with rigorous academics (Brown, Kanny, & Johnson, 2014). Programs where at risk adolescents are in charge of creating and managing their own programs with the assistance of mentors may also be successful in empowering at-risk youth (Meyer and

Bouchey, 2010). Despite treatment modality, effective methods of working with at-risk youth include strong leadership, dedicated teachers, maintaining rigorous academic standards for all students, promoting success for the students, and small ratio programs

(Druian and Butler, 1987). Many of these programs lack a creative outlet or alternative outlets for emotional expression. Programs containing the above elements in conjunction with a means for emotional and creative outlet have the potential to create more positive and lasting change than typical treatments.

Arts-based treatment. Arts-based treatment includes the use of music, theatre, dance, or visual art within a program. These treatments focus on at-risk youth participating in school related arts activities (such as band, choir, art classes, plays, dance class, etc.) Visual arts treatment focused on being mindful may foster social development, healthy coping skills, empathy for others, and promotes higher self- expression and self-esteem (Coholic, 2011; Sutherland, Waldman, & Collins, 2010). 21 Data collected from a twenty-year span showed that the majority of the youth participating in arts activities were from a low socioeconomic status. Catrill (2012) found that at-risk students with higher arts involvement showed better academic outcomes that those not involved in the arts. Specifically, these students had better grades (especially in science and writing) and higher rates of college enrollment. At-risk students participating in school-based arts activities were more likely to read the newspaper, be a member of service clubs, and be involved in the local community. If mere involvement in the arts can impact at-risk youth, perhaps including arts based therapy into formal treatment will enhance these results.

Music-based treatments. Music is often therapeutic for adolescents. Preferential music of adolescents may represent control, rebellion, and choice within their lives.

Adolescents may use music to relax, distract themselves from problems, cope with psychological pain, increase sensitivity to peers, relate to peers, and increase interest in potential musical skill (Crowe, 2012). The majority of music based activities for at-risk adolescents focus on music listening and drumming.

Building peer relationships and increasing self-esteem are common themes amongst these music-based treatments. Music listening treatments have shown that relatable lyrics increased self-disclosure and group participation (Olson-McBride & Page,

2012). Drumming treatments focused on using drum circles for healing, developing healthy relationships, building self-esteem, and a sense of community were the focus of the project (Stone. 2006; Wood, Ivery, Donovan, & Lambin, 2013). Most treatments using music focused mainly on music making and some discussion of the experience, as opposed to manipulating the music “in the moment” as the essential therapeutic element 22 (Olson-McBride & Page, 2012). However, unlike traditional music-based treatment, a music therapist possesses the training and flexibility to adjust the music and the intervention within the moment to best meet the developmental and emotional needs of the adolescent.

Current music therapy treatments. Current music therapy treatments expand beyond the music-making element to include assessment, treatment, and evaluation of effectiveness. These therapeutic strategies include drumming, improvisation, verbal reflection, and lyric analysis. Common music therapy goals for adolescents include, but are not limited to, improving self-esteem, developing problem solving skills, developing positive leisure activities, increasing emotional awareness, increasing self-expression, and decreasing anxiety.

The majority of music therapy activities with adolescents include supportive activity interventions. These interventions can include musical skill building to increase self-esteem and relation to peers; musical ensembles to increase relation to peers, positive group behaviors, and attention to task; melodic or rhythmic improvisation to increase self-esteem, leadership, and group cohesion; therapeutic singing to increase self-esteem and peer relation; etc. Insight oriented music therapy intervention can include in depth songwriting for self-expression and self-esteem, instrumental improvisation for emotion regulation and self-expression, and lyrical analysis of preferred music for emotional insight and relation to peers (Crowe, 2012). A survey of music therapists conducted by

Clark, Roth, Wilson, & Koebel (2013) showed that forty percent of those who responded work with at-risk youth in school settings. Self-expression (39%), coping skills (38%), and self-esteem (28%) are the most common goal areas in music therapy sessions with at- 23 risk youth. Songwriting, drumming, improvisation, and lyric analysis are the four most common music therapy interventions. Sub-populations of at-risk youth may include juvenile offenders, bereaved youth, youth that have been abused or traumatized, youth with mental health issues, and youth with poor body image (Clark, Roth, Wilson, &

Koebel, 2013).

Music therapy intervention to increase self-esteem with adolescents is the second most frequently addressed goal in music therapy. Improving coping skills, increasing self-esteem, and increasing self-expression are common music therapy goals for at-risk adolescents or adolescents with a mental health diagnosis. Discipline-specific music therapy techniques may create more change than unspecified techniques when using improvisation and verbal reflection techniques in individual music therapy sessions

(Gold, Wigram, & Voracek, 2007b).

Examples of unique, program specific music therapy interventions may include making music videos, drumming, or improvisational techniques. At-risk students may report an increase in perceived peer support, increased motivation, increased self- confidence, and increased coping skills after participating in community hand drumming, call and response, and improvisation led by a music therapist (Snow & D’Amico, 2010).

Songwriting and music video production (including writing and video recording original compositions presented to family and friends) may provide an opportunity to develop social skills, increase self-expression, and increase empowerment (Smith, 2012).

Improvisation (structured and unstructured) may reduce psychiatric symptoms and behaviors in adolescents with possible psychiatric diagnosis (Gold, Wigram, & Voracek,

2007a). 24 Most importantly, music therapy can inspire empowerment and active participation in individuals needing mental health support, but participants must believe the music therapy interventions are meaningful in order to make positive change and to make connections to everyday life (Smith, 2012; Snow & D’Amico, 2010; Solli,

Rolvsjord, & Borg, 2013).

Rap Music as Music Therapy Treatment

Critical views of rap music. Rap music and Hip Hop originated in the Bronx in the late 1970’s amongst poverty and racism in the area. The genre eventually became popular and gained a wider audience presumably because the themes of discrimination, struggles of marginalization, and oppression resonated with audiences. The history and themes easily lend themselves to discussion and self-disclosure within peer groups (Hara,

2012).

Gardstrom (1999) interviewed 106 male adolescents ages twelve to seventeen of varying racial and ethnic backgrounds at a residential facility in Michigan. Seventy-three percent of respondents indicated that music positively influenced their mood and behaviors. Of these students, seventy-seven percent cited rap music as a preferred genre.

The lyrics in rap music are carefully positioned within the music to stand out. Rap lyrics can cause controversy due to the violence, profanity, and sexual references. However, while the majority of rap music contains drug references and may appear to condone drug usage, past researchers and individuals using rap music in their practices have argued these songs can be used as anti-drug messages (Diamond, Bermudez, & Schensul, 2009).

New genres of music tend to be controversial and are often accused of negatively influencing youth to the point that parents and politicians at times protest these genres. 25 Blues, Jazz, and Rock’ n’ roll were likewise criticized in the 1950’s for influencing teenage moral behavior and in the 1980’s heavy metal, hard rock, and rap were condemned by parents for influencing youth behavior. However, little evidence exists in support of these negatively perceived, genre-specific effects, despite heavy media publicity during their respective time eras (Gardstrom, 1999).

Despite similar negative criticism of rap music, the prevalent themes within most of the lyrics are overwhelmingly positive. The four most common themes within rap music include social criticism, social empowerment, humanistic values, and negative behavior criticism (Tyson, Detchkov, Eastwood, Carver, & Sehr, 2012). The historical, cultural, and themes within rap music create a natural space for therapeutic intervention.

The lyrics often have greater meaning and are an expression of the hardships in everyday life (Hara, 2012). We as therapists should not underestimate adolescents’ ability to understand that some messages in rap are negative, but encourage them to identify on what speaks to them individually and to focus on the positive messages of the music

(Iwamoto, Creswell, & Caldwell, 2007).

Rap music can support adolescent development and promote positive coping skill behaviors. At-risk adolescents may feel marginalized at times as a result of negative life circumstances. Rap music can help adolescents learn coping skills, improve self-esteem, and increase self-expression. Lyric analysis of the themes in rap music can provide opportunities to discuss impulse control, problem solving, social skills, anger management, abuse, etc. (Ciardiello 2003; Decarlo, 2013; Decarlo & Hockman, 2004;

Elligan, 2004; Lightstone, 2012a; MacDonald & Viega, 2012). Analysis can reveal 26 maladaptive coping mechanisms (within the rap music) while presenting a positive means of dealing with stressors (creating rap music) (Elligan, 2004; Evans, 2010).

Rap music, identity, and self-esteem. Developmentally, middle school students are entering an intense phase of identity formation. Incorporating student interests into the therapeutic setting can support positive identity formation and build self-confidence

(Brown, Kanny, & Johnson, 2014; Decarlo, 2013; Decarlo & Hockman, 2004; Elligan,

2004; McNeeley & Blanchard, 2009a; Viega, 2013). Discussions regarding the portrayal of self-worth, both negative and positive, can boost and clarify the positive aspects of self-esteem. Discussions of issues in rap music can include a good education, a healthier body image, and identifying strengths and talents. In fact, many rap songs can initiate conversations regarding self-worth and self-esteem because of heavy themes of rappers writing/singing about their accomplishments (Donnenwerth, 2012). Rap music can help at-risk youth find their voice through discussion, journaling, and rap-writing. Rap/Hip

Hop listening provides at-risk adolescents hope that their lives will improve and some adolescents find that listening to the genre makes them want to give back to their community (Travis & Bowman, 2011). Rap music has the potential to interest and engage students in treatment for their at-risk behaviors (Kobin & Tyson, 2006; Lightstone

2012a).

Current therapeutic uses of rap with adolescents. Rap music is a commonly preferred genre and may positively influence adolescent mood and behaviors (Gardstrom,

1999). In one study by Decarlo & Hockman (2004) preferences for rap in therapy over traditional group therapy were overwhelming. The authors theorized that this preference existed because the participants viewed the discussions as fun rather than work. Music 27 therapists can use this perception to their advantage in order to further engage and make adolescents aware of positive coping mechanisms (Crowe, 2012b; Travis, 2012).

At-risk adolescents that feel marginalized may relate to the counter-cultural themes and history of rap music (Lightstone, 2012b). The expression of life’s hardships in rap music may allow adolescents to feel open to relate their experiences to peers, which can accelerate the therapeutic progress (Decarlo, 2013; Decarlo & Hockman,

2004; & Elligan, 2004). When used therapeutically, rap music is used to process and deal with stressors in adolescent lives while teaching concepts through rap music. Students have preferred rap therapy over traditional therapy and levels of enjoyment, relaxation, impulse control, anger management, coping skills, and social relationships have been more effective with therapy with rap music than with traditional therapy (Decarlo &

Hockman, 2004). The high success rates of rap therapy are attributed to the accessible nature of rap music and the relevant themes (Decarlo, 2013).

Rap music is accessible and can act a medium to discuss the challenges of growing up (Elligan, 2004). In therapy, rap may be more appealing to adolescents that are less inclined to participate in traditional counseling because of the stigma of therapy or apprehension towards the counselor. Rap in therapy is often an enjoyable activity for adolescents and a means to encourage adolescents to discuss their lives (Gonzalez &

Hayes, 2009). Analyzing lyrics is the most commonly used method of rap in therapy

(Decarlo & Hockman, 2004; Evans, 2010). Discussing preferred music may lead to deeper disclosure from the adolescent or sharing writings (rap or otherwise) about their own lives. Eventually a therapist may be able to guide rap discussion to change the adolescents’ negative behaviors and lead them to insight into their behaviors and attitudes 28 (Evans, 2010). Discussion may lead to adolescents being open to writing their own raps about their lives and experiences (Ciardiello, 2003; Elligan, 2004; Gonzalez &

Hayes, 2009). Themes discussed by adolescents in conjunction with rap discussion and writing may include violence, drug/alcohol abuse, faith in God, relationship abuse, and faith in adversity/encouragement through difficult times (Ciardiello, 2003).

Currently, the majority of rap writing research has been conducted in social work and counseling practices. Music therapists are specifically trained to intervene within the medium of music (Gold, Wigram, and Voracek’s 2007b; Viega, 2013). That is, music therapists are able to make changes within the music to adapt to the adolescents’ needs in the moment.

Gaps in the Literature

Rap writing in music therapy is effective with at-risk youth, urban youth, and youth living in a low socioeconomic status. To date, most research has mainly focused on minority groups (Decarlo, 2013; Decarlo & Hockman, 2004). There is a need for rap research with varying age groups, diagnoses, cultures, and ethnic groups (Decarlo, 2013).

This study focused on Caucasian, middle-school aged males identified as at-risk youth.

Rap writing research barely skims the surface of the therapeutic potential of rap music and Hip Hop especially given the constant evolution of the genre (Iwamoto,

Creswell, & Caldwell, 2007). Research involving rap music in therapy must be ongoing and follow relevant trends in rap music. It is important to preserve the history and evolution of rap and hip-hop, while also expanding scholarly research involving the genre

(Aldridge & Stewart, 2005). There is also a lack of published music therapy research regarding rap writing in groups (Tyson, 2002). Further research with rap music or poetry 29 therapy should explore group cohesion and changes in behaviors (Olson-McBride and

Page, 2012). It is also important for properly trained professionals to implement rap writing research and other related treatments in order to increase the reputability of the intervention (Decarlo, 2013). 30

CHAPTER 3: METHODS

This study used a convergent mixed methods design to and measure the effectiveness of a music therapy rap writing intervention in a small group school setting on adolescent student self-esteem. Quantitative measures of self-esteem included pre and post-test data using the Rosenberg Self-esteem Scale (Rosenberg, 1965) for each of the three students and a frequency count of low self-esteem behaviors. Qualitative measures included a thematic analysis of the post treatment evaluation questionnaire (see Appendix

I), the written lyrics (see appendix J), and a session transcription of verbalizations and facial affect for the fourth music therapy session.

Convergent Design

This study was a case-oriented design that focused on explaining a phenomenon and its intricacies within a clinical setting. The researcher intended for the qualitative data to explain and inform the quantitative data results (Creswell, 2015; Teddlie &

Tashakkori, 2009). The researcher followed a mixed methods convergent design as described by Creswell (2015). This design allows for the best and most complete answer to the study’s research questions. This design compares quantitative and qualitative results and then merges the results to provide understanding of the problem from different perspectives. Quantitative results show general trends from collected data while qualitative results show deeper outcomes for individuals participating in the study.

Combining these techniques provides an opportunity to compare or confirm the two types of information and may provide a well-rounded understanding of the collected data

(Creswell, 2015). 31 For the mixed methods convergent design, the quantitative and qualitative data are collected as separate entities, at the same time, for the same event. Once both types of data are collected the results are separated, reported, and then compared to one another. The final step is to use the qualitative data to explain and provide insight into the quantitative data. A convergent design was chosen for this study because it has the ability to show multiple facets of the problem from several viewpoints (Creswell, 2015). The researcher wanted to provide a general picture of how the intervention generally affects adolescents, but also wanted insight as to why the intervention affected the students who participated in the rap writing intervention.

Figure 3.1: Diagram for the Convergent Mixed Method Design, (Creswell, 2015, p. 56).

Quantitative instruments and materials. The Rosenberg Self-Esteem Measure

(Rosenberg, 1965) was used to quantitatively measure self-esteem. The self-report, ten question scale measures positive and negative feelings about oneself and was given to the participants in a pre-post-test format (i.e. during an informational meeting prior to the study and after the final recording of the written rap). The measure is a Likert-type scale ranging from strongly disagrees (1) to strongly agree (5) (See appendix G). This results in 32 scores ranging from ten to forty on the scale with higher numerical scores indicating higher self-esteem (Blascovich & Tamaka, 1991; Rosenberg, 1965). A number of studies used the Rosenberg Self-esteem Scale with adolescents (Booth & Curran, 2010;

Ciarrochi, Heaven, & Fiona, 2007; Meyer & Bouchey, 2010; Wood, Ivery, Donovan, &

Lambin, 2013). The average reliability rating for the scale fell in a range of .77 to .88 and the test-retest correlation fell between.82 and .85 (Blascovich & Tomaka, 1991).

Observed low self-esteem behaviors (see definition of terms) were documented using frequency data collection from video of the rap writing sessions (American Academy of

Pediatrics, 2004).

Qualitative design. In this study, the researcher collected direct, observational qualitative data within the natural music therapy clinical setting. Benefits of conducting research in the clinical setting include: firsthand experience, knowledge of the clinical setting, increased awareness within the setting, and including the viewpoints and feelings of the research participants and supports the use of a convergent design (Creswell, 2015).

Thematic analysis was used to ultimately collect, organize, and bring meaning to the qualitative data. Using observational data, interviews, and transcriptions brings together many perspectives to achieve clearer understanding that supports the quantitative data

(Creswell, 2015; Patton, 2002). In this study, thematic analysis was conducted for the post-study questionnaire, lyrics written by the participants, and a verbalization/facial affect transcription of the fourth music therapy session.

Participants

This study was conducted in Southeastern Ohio in the foothills of Appalachia.

The local population is predominantly Caucasian and is a completely rural area. The 33 participants are a convenience sample from this area. The researcher has experience using the rap writing intervention with rural populations in this area. In the researcher’s experience, rap is a preferred genre of some adolescents and has been effective (and preferred) in music therapy treatment for this population and age group. The researcher is a Board-Certified Music Therapist with knowledge of appropriate music therapy interventions with any population and believes in the therapeutic potential of rap/Hip

Hop. It should also be noted that this study was facilitated/conducted by a Caucasian female researcher and the participating students were all male.

Recruitment. The researcher’s study was approved by Alexander Middle School

(see Appendix F) and the Ohio University Institutional Review Board before recruitment for the study began. The researcher and guidance counselor attempted to recruit an experimental and a control sample of individuals that fit the at-risk criteria who had a free period during the study time. However, none of the guardians for the control group returned consent forms to the researcher despite exhaustive efforts to obtain consent.

Therefore, the rap writing group was a purposive sample because a control sample could not be obtained.

Informed consent. The researcher drafted an introduction and research description letter, describing the benefits and risks of participating in the study. The letter

(see Appendix B) and the consent packets were distributed by the school's guidance counselor to parents and guardians of potential participants with the researcher’s contact information provided in the event that the guardians had any questions. All recruited individuals (including the experimental and control groups) received informed consent packets for their guardians to sign (Appendix A and Appendix D respectively). The three 34 participating students also signed their own assent form consenting to the study (see

Appendix C). All consent forms were collected and signed during the informational meeting a week prior to the start of the study.

Criteria for participation. The guidance counselor at Alexander Middle School compiled a list of appropriate participants for the rap writing intervention according to the definition of at-risk youth (see definition of terms). After consulting with the researcher, the guidance counselor identified eight students that met some or all of the following criteria: familial instability, acting out in the classroom, potential low self- esteem, academic struggles, could benefit from small group therapy, etc. Of the eight, identified students, three students/guardians returned consent forms.

Music Therapy Sessions

Environment. The rap-writing group occurred at Alexander Middle School in a group/meeting room outside the guidance counselor’s office and the door was closed during the group sessions to maintain confidentiality. The participants and the researcher sat around a circular table during the music therapy sessions.

Number of sessions and attendance. The study participants were three

Caucasian males enrolled in seventh grade at Alexander Middle School in Albany, Ohio.

Currently music therapy research with at-risk youth is increasing in community-based and school environments (Clark, Roth, Wilson, & Koebel, 2013). The sessions occurred for twenty minutes, once a week, for six weeks during an activity period designated for school meetings, clubs, and activities. The participants did not miss class or any activity meetings by choosing to participate in this study. During session four and session six only two out of the three participants were present. 35 Rap protocol. The rap writing protocol was adapted from techniques used in

Don Elligan’s Rap Therapy (2004). Elligan’s protocol used lyric analysis and themes within rap music to engage at-risk adolescents in therapy. Participants were asked to bring in preferred rap songs and discuss them with the therapist. The therapist helped highlight themes and meanings with the participant before assigning “homework” rap writing assignments (Elligan, 2004). Elligan’s process of using client preferred rap music and lyric analysis was used in the first few sessions of the study. The researcher began with prompts from McFerran’s (2012) songwriting techniques (Appendix H), but the songwriting was taken in a different direction almost immediately by the students. The researcher intended to have four stages of the rap writing protocol (lyric discussion, group rap writing, individual rap writing, and a final performance), but the students chose to write a rap as a group as opposed to writing their own individual raps. Therefore, the rap writing protocol comprised of three stages: lyric discussion, group rap writing, and final recording (Elligan, 2004; McFerran, 2012).

Lyric discussion. The lyric discussion phase occurred during the first week of the study. A week prior to the first session, during the informational meeting, the students were asked to name preferred artists and songs for the researcher to bring to the first session. The participating students easily listed songs/artists spanning country music, rap music, and popular music from the 1990’s and 2000’s. The researcher brought in three of the participants’ preferred songs to discuss: Numb by Linkin Park (Linkin Park, 2002),

Where is the Love? (Adams, et al, 2003), by The Black Eyed Peas, and Lose Yourself

(Mathers, Resto, & Bass, 2002) by Eminem. The students were handed lyric sheets to follow along with the words while a recording of the chosen songs were played. The 36 researcher facilitated a lyric discussion for “Numb” and “Lose Yourself” because of time and participant choice (Appendix K). The students brought up and discussed themes of being true to yourself, not being what other people want you to be, and briefly how music impacts their lives during this music therapy session. Students identified their favorite lines or phrases and asked questions about the songs, before the researcher needed to prompt the students with pre-prepared questions (Elligan, 2004).

Group rap writing. This phase was the longest and most involved phase of the study. The researcher presented three rap-writing options to the participants including a free form rap writing activity, a sampled chorus from an existing rap song with the option to write new verses, and a fill in the blank rap writing activity. The researcher allowed the students to choose which type of rap they wanted to write. The group chose to use the sampled chorus, so they could write their own lyrics for the verses. The researcher scribed the lyrics on a sheet of paper and read the lyrics back to the students as needed.

Prompts, brainstorming, and review of the lyrics were provided throughout the music therapy session by the researcher as needed.

A songwriting process adapted from McFerran (2012) was initially used with specific prompts and questions to engage participants in songwriting (see Appendix H), but the students quickly began suggesting lyrics and asking about backbeat options so the researcher allowed the rap writing process to be driven by the participants. Initially the researcher planned to present one week of rap writing as an example of the songwriting process, but at the end of the first group rap writing session the students specifically requested to work together as a group for the remainder of the music therapy sessions in order to perfect the rap that they started. Throughout the rap writing process the students 37 switched back and forth between writing lyrics and discussing what musical elements they wanted for the instrumental back beat. The students were given prompts and choices throughout and it appeared their peer interactions/facilitation of rap writing between themselves increased throughout (Elligan, 2004; McFerran, 2012).

Final recording. This phase occurred during the last week of the study. Initially the researcher intended on providing an amp, microphone, sampled beats, and speakers for a final performance for staff, but the students chose to produce a final recording instead. It took four attempts to complete a recording that satisfied the students. Each student received an audio CD recording of their rap at the end of the final session

(McFerran, 2012).

Data Collection and Analysis

Data summary. Quantitative data sources for this project included pre/post-test

Rosenberg Self-esteem Scale (Rosenberg, 1965) and videotaped music therapy sessions for self-esteem behavior analysis. Qualitative data sources for this study included a transcription of the fourth session, a post study questionnaire adapted from MacDonald and Viega (2012), and the rap written by the students. Each session was video/audio recorded in its entirety for quantitative and qualitative analysis. Only the researcher and a peer reviewer (for inter-observer agreement purposes) viewed the data.

Quantitative data approaches. During the informational meeting that took place prior to the study, students filled out the pretest Rosenberg Self-Esteem Scale (1965). The post-test Rosenberg Self-esteem scale was administered after the rap recording during the last music therapy session. The researcher handed the students a paper copy of the self- esteem scale to fill out for both the pre and post-test. Students wrote their names at the 38 top of their scales to avoid accidentally mixing the data. Post study, the participants’ responses to the Rosenberg Self-esteem Scale pre and post-test were documented in a spreadsheet for comparison of the scores and total scores (Rosenberg, 1965; Wood, et al.,

2013).

When the study finished, the researcher began the frequency count data, watching the middle ten minutes of each video for the number of low self-esteem behaviors presented by each student during the selected video segment. The researcher watched these segments a total of four times and a colleague watched for inter-observer agreement for a fifth viewing. The researcher waited a day or two in between most viewings of the data (to avoid accidental memorization of specific low self-esteem behaviors displayed by the participants) and the researcher could not see the previous count data. The frequency count was conducted by viewing the video data for low self-esteem behaviors.

The researcher watched the video segments four times and refined the definition as low self-esteem as needed (see definition of terms). The frequency count data was written in a notebook and covered before the next viewing so the researcher would not be influenced by the previously collected data. Frequency count data of two sessions were crosschecked by a peer reviewer for inter-observer agreement. The researcher used a formula of dividing the total number of agreements by the total number of agreements plus disagreements.

Qualitative data approaches. Qualitative data collection began after the quantitative data analysis was completed. The researcher did her best to organize and report the data objectively and without bias by systematically transcribing, reflecting upon, and describing the qualitative data (Moustakas, 1994; Patton, 2002). During the 39 study, the researcher verbally administered the post study questionnaire after the students completed their rap recording and filled out the post self-esteem scale.

The researcher already had a sense of two potential themes from watching video data for the frequency count and intuition is paramount to conducting some forms of qualitative analysis (Moustakas, 1994). Upon further reflection, the researcher and advisor decided one session should be fully transcribed for in depth, thematic analysis.

Despite only two of the participants being present during this session, this fourth session was chosen because it stood out as the most creative and appeared to best represent qualitative data that supported and provided insight into the quantitative data. This session appeared to contain the most interaction between participants including the most problem solving and the lowest number of low self-esteem behaviors. The fourth session also included the most insight into lyric choices and creative discussion of beat choices.

The researcher transcribed the session verbatim for participant verbalizations and facial affect and then conducted a thematic analysis of the transcription, the post study questionnaire, and the participant written lyrics. Thematic analysis involved looking for patterns within the qualitative data. The researcher then reduced the collected and transcribed data through these patterns into core meanings (Patton, 2002). As a final collation, the researcher conducted a thematic analysis for the themes of freedom, positive peer interactions, expression, and self-esteem comments (Hsieeh & Shannon,

2005; Krippendorff, 2012). The identified themes help explain the phenomena that occurred within the study (Patton, 2002). 40 Data Organization

The researcher saved all video and written data on an external hard drive specifically used for the thesis. Separate Excel sheets were kept for each type of data (i.e. pre/post-test data, frequency count, qualitative analysis, etc.). Qualitative data was initially kept in a notebook for free-writing/observational data, before a specific session was chosen and transcribed, along with the post study questionnaire, and coded for themes.

Validity and Reliability

The researcher attempted to rule out any other variables that might cause behavioral change other than the music therapy intervention to the best of her ability.

However, because this is a small study and there was no access to a control group or random selection, not all variables can be discounted. For example, internal validity cannot be accounted for through history, maturation, regression, selection, mortality, diffusion of treatment, compensatory/resentful demoralization, compensatory rivalry, or testing due to the feasibility nature of the study and the inability to obtain a random sample or a control group. However, internal validity was accounted for through instrumentation as the same instrument was used pre and post-test (Creswell, 2009;

Rosenberg, 1965). Portions of the data were cross-checked with a peer reviewer after the study to further ensure validity (Creswell, 2009; Patton 2002). The researcher also went to extensive measure to keep data collection consistent and methodical (see chapter four for more details).

The researcher will not generalize the results as this is a small study with a purposeful sample and the results cannot be generalized to at-risk adolescents as a whole. 41 Observational data collected in the natural clinical setting can provide the closest results to actual clinical work, but has a low level of generalization (Creswell, 2009;

Gold, Wigram, & Voracek, 2007b). Not generalizing the results will help ensure external validity. Qualitative data was checked for reliability by ensuring transcripts do not contain mistakes or assumptions, providing a clear definition of selected codes throughout, and cross-checking codes with a peer reviewer. Internal construct validity measures were accounted for by using rich, thick descriptions to convey findings and using an external auditor to help review the findings (Creswell, 2009; Moustakas, 1994;

Patton 2002).

The mixed methods analysis maintained a simple design by not mixing the quantitative and qualitative data collection too early or combining the parallel analysis with any other types of data analysis. The meta-inference data was not described, analyzed, or combined too early when initially analyzing the data (Teddlie & Tashakkori,

2009). 42 CHAPTER 4: RESULTS

Research Questions

The original research questions were as follows: What is the effect of rap writing music therapy sessions on self-esteem measured pre and post-test for select adolescents in a middle school public school group setting? What are the self-esteem behaviors exhibited during music therapy sessions for select adolescents in a middle school (public school) group setting? What are the perceived benefits of the rap writing intervention after music therapy sessions from select adolescents who participated in music therapy sessions?

However, once the study was conducted the following research questions better fit the purpose of the study: Does a rap writing intervention have an impact on self-esteem measured pre and post-test for at-risk youth in a public middle school group setting?

Does a rap writing intervention have an impact on the number of low self-esteem behaviors exhibited during music therapy sessions by at-risk youth in a public middle school group setting? What interactions arise between at-risk youth in a public middle school setting and the music when participating in the rap writing music therapy intervention? What benefits are perceived by at-risk youth in a middle school setting after participating in a rap writing music therapy intervention? The word “impact” replaced

“effect” and the word “what” replaces “does” in order to accurately represent the exploratory nature of the data collected. The third question was added to represent the unexpected thematic findings in the study that were not represented in the original research questions. 43 Quantitative Results

These results address impact of self-esteem as discussed in the first research question. The pretest was administered at the end of the informational meeting and the post-test was administered after the final recording of the written rap and the post study questionnaire at the end of the last music therapy session. A higher total score on the

Rosenberg Self-Esteem Scale indicates a higher perceived self-esteem. Two of the three students showed an increase in their pre/post-test Rosenberg Self-Esteem Scale scores.

Student B showed an increase on the self-esteem scale from 24 to 29, while Student I showed an increase from 15 to 21. The third participant, Student S, scored 17 on the pre- test, but was absent on the last day of the study, so no post-test data could be collected from this student.

Rosenberg Self-Esteem Pre and Post-Test Data Student S was absent Post during the post test data collecon

Client S Pre 17

Post 21

Client I Pre 15

Post 29

Participating Students Pre

Client B 24

0 5 10 15 20 25 30 35

Total Rosenberg Self-Esteem Scale Score

Figure 4.1 Rosenberg self-esteem pre and post data 44 These results address the impact on low self-esteem behaviors as discussed in research question two. Low self-esteem behaviors generally decreased for Students B and

I, but increased for Student S. The mode was used to report frequency count because it most accurately reflected the average count (specifically the repeating numbers) of low self-esteem behaviors per session after data analysis was completed. The low self-esteem behaviors frequency count numbers varied slightly at first, so the researcher chose to count responses to a single prompt as one behavior to refine the definition and make the frequency count more consistent. A peer reviewer watched two out of the six video segments for inter-observer agreement. For the video of the second session the researcher counted five low self-esteem behaviors while the peer reviewer counted four behaviors, for inter-observer agreement of eighty percent. For the video of the fifth session, the researcher counted three low self-esteem behaviors while the peer reviewer counted two behaviors, for inter-observer agreement of sixty-six percent. The researcher used a formula of dividing the total number of agreements by the total number of agreements plus disagreements.

45 Student B 10 8 6 4 2 Behaviors 0 12-Nov 19-Nov 26-Nov 3-Dec 10-Dec 17-Dec

Number of Low Self-Esteem Number Session Date

Figure 4.2. Mode of low self-esteem behavior frequency count data, Student B

Student I 10 8 6 4 2

Behaviors 0 12-Nov 19-Nov 26-Nov 3-Dec 10-Dec 17-Dec Session Date Number of Low-Self Esteem Number

Figure 4.3. Mode of low self-esteem behavior frequency count data, Student I

46 Student S 10 8 6 4 2 Behaviors 0 12-Nov 19-Nov 26-Nov 3-Dec 10-Dec 17-Dec

Number of Low Self-Esteem Number Session Date

Figure 4.4. Mode of low self-esteem behavior frequency count data, Student S

Qualitative Results

As a convergent mixed methods design, the quantitative and qualitative data are compared and/or related in order to find meaning, interpret the results, and explain phenomena in the quantitative data (Creswell, 2015; Teddlie & Tashakkori, 2009). The lyrics written by the students, verbal and facial affect transcriptions of one session, and the post study questionnaire were selected for thematic analysis. Through the process of reviewing the written initial reactions of the researcher, knowledge of session content from viewing video data while conducting the frequency count, and reflection, the following four themes were identified: positive self-esteem statements, positive peer interaction, expression, and freedom. A peer reviewer coded a segment of the verbal/facial affect transcription looking for the four themes to achieve some level of inter-observer agreement. The following themes and results address the peers interactions and perceived benefits as discussed in research questions three and four. 47 However, the impact of self-esteem (as discussed in research questions one and two) are also addressed in these qualitative results.

Positive self-esteem statements. The theme of positive self-esteem statements was most prevalent in the session transcription and post study questionnaire. Student B and Student I both stated that they felt more confident and more satisfied when asked how the rap writing program helped them. However, the students were not able to articulate exactly how the program helped them. During the session transcription, Student

I and S both applauded (impersonating the potential audience) when discussing how the song should end. Of note, Student S stated “just a little bit of applause because I think everybody else [listening] will applaud” potentially indicating increased confidence. All students expressed interest in wanting to share their recording with others by gifting a CD or posting the recording on YouTube.

Positive peer interactions. The theme of positive peer interactions was most prevalent in the session transcription and did not appear in the lyrics or post study questionnaire that often. Throughout the session transcription, the students initiated discussion with one another about the lyrics and musical choices. One interaction of note occurred when Student I stated “I’m sayin’ all the ideas, let’s hear your ideas!” and gestured to Student S. Student S then said “My ideas are more on the beat.” The students offered constructive criticism of written lyrics and were able to problem solve when they disagreed about lyrics or musical choices throughout the study. Also, in the post study questionnaire the students repeatedly stated “working as a team” was an aspect of the rap writing program that they enjoyed. Student B stated that he “feels satisfied with all my 48 friends now” when prompted with how the program helped him, but he did not elaborate on how the program helped him in this way.

Expression. The theme of expression was most prevalent in the session transcription, but also appeared in the post study questionnaire. Expression was defined as any statements or actions regarding music decisions, reasoning for lyric choices, or personal disclosure. Out of all the participants, Student I was most interested in creating rap music and at times disclosed why he chose certain lyrics. Student S preferred to make beat and musical choices throughout the writing process. He specifically wanted the backbeat music to be “upbeat” and “happy.” Expression of music choices and disclosure was most prevalent in the fourth session (which contributed to the researcher choosing this session to transcribe after initial viewings). Furthermore, Student I repeatedly stated he liked “making his own music” during the post study questionnaire. Student B’s responses and comments were least prevalent for the theme of expression. However, during the recording of the written rap Student B helped decide who should rap the verses, helped critique recordings, and agreed to rap help the chorus, which was a dramatic shift from previous sessions.

Freedom. The theme of freedom was prevalent in the lyrics written by the students and some of the session transcription, but was not included in the post study questionnaire. Sample lines containing this theme include “I’m free from these chains that are holding me back” and “Tired of people telling me what to do, now I’m free.”

Some interactions in the session transcription involved this theme, but most were related to writing the lyrics such as Student I mentioning that being free from chains that are holding him back “is [his] life every day.” However, later in the session transcription 49 choosing the title of the rap was discussed. After reflecting, Student S suggested “I’m free” and Student I quickly suggested the collective “we’re free” instead. Student S also specified that “we’re free” (the title of the rap) should be emphasized and repeated at the end of the rap.

Comparison and Interpretation: Qualitative Interpretation of Quantitative Results

As a mixed methods convergent design, the quantitative and qualitative data are compared or related in order to find meaning and interpret the results (Creswell, 2015) and to find meta-inferences within the results (Teddlie & Tashakkori, 2009). In this study, low self-esteem behaviors decreased for two out of the three participants (Student

S’s increase in low self-esteem behaviors which will be addressed in the discussion).

Also, the participant scores on the Rosenberg Self-esteem Scale increased for the two out of three participants that were present for both the pre and post-test evaluation. So in general, the quantitative data shows that self-esteem increased for two out of the three participants. Three of the themes (positive peer interactions, positive self-esteem statements, and expression) found in the qualitative thematic analysis best support the quantitative findings. The remaining theme, freedom, requires a more creative interpretation and will be addressed in the discussion (Teddlie & Tashakkori, 2009).

Positive self-esteem statements. Positive self-esteem statements were prevalent in the post-study questionnaire when the students discussed perceived benefits of participating in the study. The students stated they felt more confident and satisfied as a result of the rap writing intervention which supports the increase in self-esteem recorded in the quantitative data. During the transcribed session, Student S and Student I agreed that the audience listening to the performance/recording would applaud afterwards. They 50 also expressed interest in sharing their composition via YouTube and briefly discussed wanting to make a music video to accompany the rap which indicated they were satisfied with their final product. Unfortunately, there was not enough time in the study or parental permission to include a music video as a part of the study. These statements indicate pride in their work and may illustrate the overall increase in self-esteem found in the quantitative results.

The two students present for the post study questionnaire repeatedly stated that they felt more confident as a result of participating in the program. Student B stated that the program made him happy. Student I repeatedly mentioned the opportunity to “make our own music” as a benefit of the study along with feeling more confident. The researcher found Student B’s progress throughout the study particularly interesting.

Student B initially was resistant to participate stating that he felt good about himself and just wanted to get out of class. He also stated that he did not like rap music, was a

“country boy”, and presented with difficulty reading and writing (as observed in the pre- test/post-test data collection). Despite these challenges, he eventually contributed a few lyrics, made some decisions regarding the beat, and rapped on the final recording. His ratings on the self-esteem scale increased, his low self-esteem behaviors decreased throughout, and he provided the most insight into how the study helped during the post study questionnaire. According to Student B, the rap writing intervention made him happy, made him feel more confident, and more satisfied with his friends despite all the therapeutic challenges he presented at the beginning of the study.

Perhaps, the opportunity to create their own music and express themselves through the medium of rap led to an increase in self-esteem. In general, as the 51 participants became more involved in the creative process their low self-esteem behaviors decreased. This theme is the most obvious and supportive of the quantitative results because of the straightforward benefits mentioned by the students in the post study questionnaire (e.g. increased happiness, increased confidence, and increased satisfaction in general and with friends).

Positive peer interactions. Positive peer interactions were prevalent in the video transcriptions and the post-study questionnaire. As music therapy sessions progressed, the number of constructive conversation regarding the process of writing lyrics and choosing the beats increased. For example, during the transcribed session Student I often checked in with Student S regarding lyric decisions and Student S did the same with decisions regarding the beat.

In the post study questionnaire, Student B and Student I both stated that they felt more satisfied (Student B specified he felt more satisfied with his friends) and working as a team as a benefit of participating in the study. This is significant, because during the informational meeting at the beginning of the study Student I stated that he “barely had any friends”, yet by the end of the rap writing program he was working well and interacting with other students in the group.

Perhaps the opportunity to interact with their peers in a supportive environment helped the students feel more confident in expressing their thoughts and opinions, which led to an increase in self-esteem and a general decrease in low self-esteem behaviors.

Previous research suggested that working in a small group with their peers and supportive staff may lead to better intervention outcomes. The researcher was impressed that within the creative medium of rap writing, no disputes occurred during the creative process that 52 needed to be redirected or solved by the researcher. This is particularly important since the students were initially referred to the rap-writing program because of behaviors within the classroom impeding academic success. The participants worked together to problem solve disputes when writing lyrics or making suggestions for the beat with less and less facilitation from the researcher. Perhaps the students’ work together informs their choice of pronouns within the written lyrics. While this theme was not obvious in the lyrics, the students repeatedly chose to use the expressive pronoun “we” as opposed to “I” when writing the lyrics, suggesting a collective approach to overcoming the struggles mentioned in the lyrics as opposed to an individual journey.

Expression. The theme of expression appeared most in the session transcription and the post-study questionnaire. Throughout the rap writing intervention the students became more confident in expressing their choices and opinions about composing the rap. Students focused on different aspects of writing the rap over the course of the study.

Student I wrote a majority of the lyrics while Student S showed an interest in making creative choices regarding the beat.

Student I immediately expressed his opinion in sessions and appeared to enjoy expressing his opinion during the lyric discussion. He flourished almost immediately once the rap writing began and he could barely contain his ideas. Student I even once stated “Do you have another brain? Cause I have a whole lot more ideas!” He was able to control his impulses and as sessions progressed he checked in with other students to try to help them express their opinions. For instance, during the session transcription he turned to Student S and said, “Yeah, I’m coming up with all the ideas. Let’s hear your ideas” and gestured towards Student S. 53 During this same session, Student S responded to Student I stating, “my ideas are more on the beat.” Student S was excessively quiet the first few sessions and only responded to prompts by nodding or quietly expressing his opinion. As sessions progressed he began to openly express his opinions on the beat supporting the music. He wanted the music to match and support the lyrics as he repeatedly stated the beat should sound happy and upbeat. He also requested Spanish guitar and adding spaces to highlight important words within the written lyrics (specifically the word free). Using the music to highlight the meaning of the lyrics is a common practice in rap and hip hop music (Hara,

2012).

Student B was initially hesitant to participate in sessions or express his opinion when prompted. He often deflected making any decisions by stating “I don’t really like rap music” or simply agreeing with other client opinions. Over the course of the study

Student B slowly expressed some opinions such as disliking certain aspects of the beat, wanting to change words that repeated too often, etc. Student B was most resistant to rapping, but eventually agreed to rap a part of the lyrics on the final recording despite initially refusing to sing/write any lyrics during the first few sessions.

While this study lacked the ability to explore the meaning behind the all the student written lyrics, Student I at times provided insight into his lyric choices. He stated he liked the line “free from these chains that are holding me back” because that described how he feels every day. The researcher believes that it was a combination of the creative medium of rap music and increasing positive peer interaction that led to an opportunity for students to express themselves. This is supported by the post-study questionnaire where Student I cited making music as what helped him feel more confident and satisfied 54 with himself. The students appeared to feel safe expressing their opinions in the supportive and creative environment. This opportunity to express themselves the free, creative environment of rap writing may have led to the increase in self-esteem documented by the quantitative data. 55

CHAPTER 5: DISCUSSION

The results of this study help fulfill a need for more research for successful intervention to increase self-esteem for at-risk youth. Some of the following findings were unexpected and surprised the researcher, while other findings supported previous research with adolescents, successful interventions, and/or rap in therapy. All of the results, unexpected and expected, helped lead the researcher to discover a theme of freedom throughout the study, which is discussed here because of its importance in tying the results of the study together and making meaning of all the compiled results.

Limitations and implications for further research show a need for lengthier studies and more mixed methods research.

Expected Findings Related to Literature

As expected, rap music was a preferred genre for two out of three of the group participants (Gardstrom, 1999). In this study, rap writing served as an intervention that broke down barriers with the adolescents and focused on therapy that the participants enjoyed in order to best engage the students in treatment. As reported in the literature review, adolescents are more inclined to participate in an intervention when they perceive the intervention as fun (Decarlo & Hockman, 2004). In general, self-esteem improved for participating students corroborating with previous research findings that show that groups based on non-academic goals (such as improving self-esteem or peer interaction within the school environment) may be more successful with at-risk adolescents (Ciardiello,

2003; Olson-McBride & Page, 2012). 56 Adolescents and small groups. This study included a low student to teacher ratio and peers working together, which may have led to a more successful benefits for the participating at-risk adolescents (Druian & Butler, 1987; Freudenberg & Ruglis,

2007). Participating students stated in the post study questionnaire (and to the guidance counselor) that working together as a team was a benefit of the project. The participants in this study stated that they enjoyed participating in the rap writing intervention and their involvement increased throughout. Previous research called for studies observing changes in behaviors and group cohesion. This study observed a general decrease in low self- esteem behavior and discussed the results of positive peer interactions between participants (Olson-McBride & Page, 2012).

Empowering adolescents. Empowering, client preferred, group therapy is most successful with adolescents needing treatment (Ciardiello, 2003; Decarlo & Hockman,

2004). In this study, the researcher facilitated the rap writing intervention, but the participants were ultimately in charge of the content and the direction of the rap writing.

It should also be noted that the rap writing protocol was changed when the students requested to work in a group as opposed to individually, providing another opportunity for empowerment within the study. In previous research, allowing participants to be in charge of their own program created a sense of empowerment for youth (Meyer and

Bouchey, 2010).

Hear our voices. After conducting this study, the researcher realized that the method and results were very similar to the findings of the “Hear Our Voices” program at

Temple University. That program provides a creative outlet for the children to express their perceived hardships in life through music therapy rap writing (MacDonald & Viega, 57 2012). Each round of the fourteen-week program includes songwriting, creating a CD, and a CD release party. Students involved in a particular round of the program, naming themselves The Little Saints, showed a range of preferred music from rap, Hip-Hop, to country. The authors point out that the children displayed some disruptive behaviors, but the lyrics the children wrote were insightful and socially conscious. Like the current study, the Hear Our Voices program was geared towards student strengths and focused on writing about themes that were important to the participants (MacDonald & Viega, 2012).

Similar to the findings in the post-study questionnaire, The Little Saints perceived the work required within the group as fun and an empowering way to express their thoughts and feelings. The Little Saints reported that making music and being a part of a group allowed them to feel included and feel more confident. The facilitators of the

“Hear Our Voices” study believed having an opportunity to interact within the rap and

Hip Hop music helped facilitate interaction and connection within the group (MacDonald

& Viega, 2012).

This study reflects current rap in therapy research that rap writing provides an opportunity for at-risk student voices to be heard (Lightstone, 2012b; Macdonald &

Viega, 2012; Viega, 2013). In this study, the lyrics written by the students were insightful and surprisingly deep given the short span of the study and the length of the song. Their written lyrics discussed the hardships of everyday life (Hara, 2012).The qualitative results also indicated a sense of freedom through expression in rap music (Lightstone,

2012b). Since many at-risk youth are marginalized by negative life circumstances, the opportunity to express themselves freely can be incredibly powerful and gives a voice to the voiceless. 58 Unexpected Findings

The most surprising finding to the researcher in this study was the participating students choosing to write the rap as a group as opposed to writing individual raps. While this finding supports previous research that working in small group work is beneficial, the researcher assumed students would want to produce their own rap composition and come out of the study with an individual product. This could be attributed to one or two students initially wanting to do less writing/creative work in the project, but all students contributed creatively to the rap. As a result of their choice, more interactions occurred between the students. This also led to creative problem solving between the students and ultimately the theme of positive peer interaction within the study. However, these results may also reflect results of previous research in which small groups with supportive staff were successful (Maccio & Schuler, 2012; Travis, 2012).

Adolescent interpretation. The researcher was also surprised by the students’ interpretations of how the study helped them as described in the post-study questionnaire.

The researcher expected non-informative, yes or no answers or the students indicating that the rap writing did not help them in any way. That the students provided interesting and more complex answers to the post-study questionnaire and provided some insights into how the study helped them surprised the researcher. For instance, two of the students responded that the study made them feel more confident and one student stated the study

“made him feel more satisfied with his friends.” The students also responded very quickly and even interrupted the researcher halfway through asking “if they would recommend the program to their peers” with a resounding and confident “yes.” Perhaps this unexpected insight is an extension of the expression results that shows giving 59 students a voice through rap writing may give them the confidence to express true feelings about the benefits of the activities in which they participate.

Given the surprising responses of the participants regarding the benefits of the study, the researcher followed up with the guidance counselor after the study and asked if she saw any general impact of the study for the students. According to the guidance counselor, the students enjoyed spending time in a small group and all three students mentioned to her that they really enjoyed the rap-writing program. In fact, Student I had asked more than once when they would be able to participate in the program again. The guidance counselor also stated she has not seen a difference in behaviors and there were no significant differences in academic performance for the students. However, the guidance counselor mentioned she would be open to helping facilitate further projects of this nature and indicated to the researcher that she was extremely pleased with student participation and their enthusiasm.

Theme of Freedom—Giving a Voice to the Voiceless

The theme of freedom was most prevalent in the lyrics written by the students and in the session transcription. Freedom is not only a finding of this study, but the theme of freedom encompasses a deep importance and therapeutic potential for rap writing, and

Hip Hop, as a genre. The following descriptions are meta-inferences based on this theme

(Teddlie & Tashakkori, 2009).

Freedom emerges. The subject of freedom emerged during the process of the students writing and composing this rap. The theme of freedom quickly emerged in the lyrics written by the students and was initiated by the students. The lyrics told the story of someone (most often referred to as “him” or “he” by the students when writing the lyrics, 60 indicating that the students may relate to this character) climbing out of a pit and heading to a city in order to be free. It was implied that this central character had endured struggled by lines such as “started from the bottom now we’re up at the top”, “I’m free from these chains that are holding me back,” and “Tired of people telling me what to do, now I’m free.” This struggle of the male character in the lyrics into freedom is reminiscent of two of the common themes in rap including social empowerment and negative behavior criticism (Tyson, et al, 2012). The word free was initiated by the students and became the central theme of their composition and the word was later included in title.

Freedom through expression. Repeatedly, the students stressed that the beat backing up their lyrics needed to sound upbeat and not sad. Perhaps through the process of writing, collaborating, and composing the students felt a sense of freedom through rap writing and the opportunity for expression. This idea is supported by the quantitative results and the post study questionnaire. The students stated the felt more confident, that they enjoyed working together, and they feel more satisfied. All students present for the pre and post self-esteem scale reported a higher self-esteem post-test.

The results suggest that the opportunity to express their thoughts, feelings, and opinions in a validating medium led to improved self-esteem in the students. Rap music and its history give participants an opportunity for positively experiencing a sense freedom. The researcher believes the participants may have related so strongly to the theme and idea of freedom because historically rap music has been an opportunity for the voiceless to find a voice (Lightstone, 2012b; Viega, 2013). The participants’ responses to how the study affected them were confident and strong. They appeared to want to convey 61 how the study helped them and appeared passionate about their responses of how writing raps made them happy, confident, and satisfied.

Hip Hop: The potential. Rap writing barely skims the surface of the therapeutic power of Hip Hop (see definition of terms). While the rap written by these participants tells the story of struggles at-risk adolescents may face in their day to day lives, studies and intervention with more lyric and beat composition contain an opportunity for more transformative power. For instance, “We’re Free” tells the story of a male (or males) climbing up from the bottom of a pit and finding freedom. This is an incredibly powerful image yet, there is little to no insight into the struggles or adversity the students faced. In depth studies using the core ideals of Hip Hop provide insight into the struggles along with the transformation of Hip Hop composition (Viega, 2013). Viega (2013) contains songs and an album with titles such as “Butterfly Wings” and “Rising from the Ashes” which, even in the title, clearly indicate transformative power and moving through adversity and towards positive change (Viega, 2013).

Hip Hop: The philosophy. KRS-One, a Hop Hop scholar, speaks to the incredible potential of Hip Hop which parallels the importance of Hip Hop in music therapy. He highlights the importance of self-knowledge and the courage it takes to be yourself. That these are some of the true aspects of Hip Hop (KRS-One, 2013) and that true Hip Hop culture and truth can be transformative (KRS-One, 2013; Viega, 2013).

KRS-One defines Rap (the brand) as the videos, the MTV culture, celebrities, etc. that represent the commercialization of Hip Hop. Unfortunately this commercialized Rap product is often confused with the spirit and culture of Hip Hop (KRS-One, 2009; 2013).

In fact, Viega (2013) calls for a Hip Hop perspective in music therapy that aligns with the 62 beliefs of Hip Hop culture and advanced clinical training/education within the subject in order to be serve students who would benefit from the Hip Hop perspective (Viega,

2013).

The researcher was conflicted after conducting the study and compiling/analyzing the results between calling the intervention a rap writing intervention or a Hip Hop writing intervention. After discussing and reflecting upon this issue with a rap/Hip Hop music therapy colleague, the researcher decided this intervention was truly a rap writing intervention, but held the potential (with longer and more frequent sessions and opportunities for working in-depth with the music and lyrics) to be a transformative Hip

Hop writing intervention.

Limitations

Music therapy sessions. The length and number of rap writing sessions limited the potential of the study. The researcher felt rushed at times during the twenty minute sessions and felt if the sessions were longer there would be more time to write, explore, and expand the rap/Hip Hop writing portion of the study. The researcher feels that the quality of the facilitation of the rap writing was sacrificed in order to meet all the requirements of the methodology and data.

Data collection. Low self-esteem behaviors needed a clearer definition as the frequency count was difficult and the low self-esteem behaviors the students displayed didn’t always match the definition. Also it was hard to quantify certain behaviors that lasted for an extended duration of time (e.g. excessive quiet, crossing arms/disengaged behavior, etc.) and further studies should account for frequency and duration of measured behaviors. Student S’s low self-esteem data rose during the study, however this could be 63 attributed to the measure of the low-self-esteem behavior “quiet.” The researcher was not able to time the length of the quiet behavior, which may have informed, and altered,

Student S’s data. He was quiet most of the first three sessions, only answering prompted questions and remaining quiet the rest of the sessions.

The low self-esteem data may have been skewed by the written data collection

(the Rosenberg Self-Esteem Scale) falling within the ten minute video segments. The students complained about reading/signing the permission forms and reading/answering the Rosenberg Self-esteem Scale. One or two of the students may have reading comprehension deficits that affected attitudes towards the scales. For instance, Student B showed significant increases in negative attitudes when writing/reading during the study and this affected his low self-esteem behaviors frequency count scores. Student absences during the study and particularly during the final session also affected the pre and post- test data and the frequency count data.

Gender differences. The researcher is aware the gender differences may have had an impact on the study. The female researcher facilitated the study with three middle school aged adolescents. The only time gender was addressed was when the participating students assured the researcher that the character in the written rap was a male because

“everyone here is a guy. [small pause] Except her [pointing to the researcher].” Aside from this moment, the researcher did not perceive any effect due to the differences in gender between the researcher and participants. She attempted to come across open and honest with the participants in order to connect with them and used music/rap writing as the creative medium and therapeutic tool in order to connect with the students. 64 Validity and reliability. The peer reviewer found it hard to cross check and code for positive peer interactions because she could not infer the tone of the comments from the transcription. Therefore, agreement was lower for the theme of positive peer interactions because the researcher knew how the students delivered comments, but the peer reviewer could not hear the intent or inflection of the comments. This also applied to the theme of freedom. The peer reviewer had no prior knowledge of the lyrics, so agreement was lower for this theme because the peer reviewer did not know the context of the conversation given the rap lyrics (since freedom was so prevalent within the written lyrics). In future research, the researcher should either choose more aspects of the session to transcribe (beyond just the verbalizations and facial affect), have the peer reviewer listen to the audio or watch the video while coding the transcription, or transcribe more sessions for coding analysis for research and review purposes.

Recommendations for Further Research

The researcher believes that this study was a success and it is worth investigating rap writing interventions and in depth Hip Hop interventions with more elaborate research. Further research would benefit from a larger group to increase the amount of data or multiple groups of a similar size to recreate the results of this study. Ideally, future rap research would have a control group to add validity and reliability to the study and provide an opportunity for a quasi-experimental design. This study would also benefit from more sessions over a longer duration of time to add more depth to the study and to provide an opportunity to gain insight into the student lyric and beat choices.

The MacDonald and Viega (2012) study included opportunities for flexibility and allowed for musical decisions to occur in the moment at the whim of the children 65 involved in the study. In the “Hear Our Voices” program students had free creative range to write their music and were able to write as inspiration struck. This study would benefit from an increased unstructured protocol that expands on the participants’ willingness to work back and forth between the lyrics and the beat as they felt motivated.

While this creates more work and requires more energy from the facilitator, past researchers have found allowing for maximum creative potential increases the participants’ engagement and devotion to the music (MacDonald & Viega, 2012).

Further studies and research designs that combine the in depth methods of Hip

Hop with some quantitative methods should be attempted. For instance, Hip Hop composition sessions lasting for forty-five minutes, twice a week over a semester (with a control group) including opportunities to write their own lyrics and compose their own beat would provide an opportunity for maximum creative involvement for the participants. Using a mixed-methods design along with an expanded study would allow for more insight from participants and staff while still maintaining the quantitative nature of a study.

Most importantly, more valid and reliable studies using rap writing in music therapy should be conducted due to the power of the genre to provide a voice for marginalized youth and to bring legitimacy to using the genre therapeutically. The more legitimacy professionals can bring to the genre through research, the more individuals in need can benefit from the messages and expressive freedoms found in rap writing.

Conclusion and Implications

There is a need for successful treatment for at-risk adolescents so they do not drop out of school and transfer their behaviors to the community (Druian & Butler, 1987; 66 Freudenberg & Ruglis, 2007). Adolescents are resistant to typical, verbal processing based treatment at times because of stigmas (Ciandiello, 2003; Decarlo & hockman,

2004). Music therapy and rap writing/Hip Hop composition is an opportunity to meet at- risk adolescents where they are and incorporate their interests, opinions, and preferences into treatments (Lightstone, 2012b; Macdonald & Viega, 2012).

So far, studies involves rap in therapy have primarily been strictly qualitative or quantitative in nature. More mixed methods studies should be conducted in order to provide qualitative insight into quantitative results (Creswell, 2015). This type of research can also incorporate client opinions and insights, while methodically demonstrating if the intervention is successful. Mixed methods research will show if rap writing is effective as well as how and why it is effective. This study supports further research into the benefits and potential success of rap in therapy as an effective, and preferred, medium for at-risk adolescents.

This was a preliminary study. The researcher’s ultimate intention is to further strengthen external validity by accounting for interaction of setting and treatment, and interaction of history and treatment by conducting additional studies in the future

(Creswell, 2009). The current study indicates that rap in music therapy can improve self- esteem with male, middle school aged adolescents within a small group. The qualitative results also indicate that rap in music therapy can be a powerful and freeing therapeutic medium. This study showed a rap writing intervention is feasible, but more research is needed with more populations and on a larger scale. Similar studies with more participants, a control group, longer duration, and in depth Hip Hop therapy may indicate a stronger level of effectiveness. 67 This study focused on rap writing and barely skimmed the surface of the potential of the therapeutic potential of Hip Hop (KRS-One, 2009). To truly understand the importance of Hip Hop in therapy we must return to KRS-One and the philosophical views on Hip Hop. He stresses believe in the true, transformative power of the genre and having faith in its ability to create positive chance. “We must first believe that we exist if we are to develop ourselves into a strong Hip Hop community capable of raising our collective quality of life. […] Hip Hop is made up of real people and real events. We must explore the facts of OUR experiences as Hiphoppas in search of achieving the Truth about ourselves as Hiphoppas” (KRS-One, 2009, p. 61).

68

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77 APPENDIX A: OHIO UNVERSITY PARENTAL CONSENT FORM

Title of Research: The Effects of Rap Writing on Adolescent Self-Esteem

Researchers: Jessica L. Schlabach, MT-BC

You are being asked permission for your child to participate in research. For you to be able to decide whether you want your child to participate in this project, you should understand what the project is about, as well as the possible risks and benefits in order to make an informed decision. This process is known as informed consent. This form describes the purpose, procedures, possible benefits, and risks. It also explains how your child’s personal information will be used and protected. Once you have read this form and your questions about the study are answered, you will be asked to sign it. This will allow your child’s participation in this study. You have been given two copies so you can keep one for yourself.

Explanation of Study Therapeutic activities, such as rap writing, that provide meaningful connection to experiences in the real world will help develop positive coping skills and therefore benefit the community. Studies have shown that adolescents can benefit from using rap music therapeutically and sometimes describe rap music as preferable over other genres because the themes within the music relate to their lives. Despite the genre’s controversial nature due to violent themes and inappropriate language, other rap music also contains positive themes that support improving anger management, impulse control, coping with stressful life events, etc. Rap music is also a “free-form” creative medium that empowers adolescents by providing choices within a beat structure. In fact, because the music contains relevant themes and allows for maximum creativity it has been called the “perfect therapeutic medium” for adolescents If you agree to allow your child participate, you will be asked to allow the researcher (a board certified music therapist) to audio and video record group music therapy sessions led by the researcher. The guidance counselor, the principal, and the Review Board at Ohio University have approved the study. Your child will participate in six music therapy sessions that include discussing their favorite music, writing a rap song in a group, and each child writing their own individual rap that will be performed and recorded (within the group setting) on the final session date. Your child should not participate in this study if they have any intellectual or physical disabilities that will prevent them from effectively discussing their preferred music in a group or writing original lyrics. The music therapist or guidance counselor will be present in all sessions to assist children participating in writing original material in a group and individually. Your child’s participation in the study will last six weeks and occur from (start date) to (end date) during school hours. These sessions will not take away from your child’s schoolwork.

78 Risks and Discomforts No risks or discomforts are anticipated. Your child will be encouraged to discuss their favorite music in a group, but will not be asked or forced to say anything they are uncomfortable sharing with the music therapist or the group. Your child’s preferred music will be screened for profanity/explicit content and adapted as needed for appropriate use in the therapy session.

Benefits This study is important to science/society because: 1. This research will add to a body of research available to music therapists, and other professionals working with adolescents. 2. This research could demonstrate benefits of music therapy, specifically the use of rap music, and how it can help adolescents. 3. Families/Caregivers will have an opportunity to be informed of music therapy and the use of rap music and how it can help adolescents. Individually, your child may benefit in the following ways: 1.) Improved self-esteem 2.) Improved peer interaction 3.) Improved coping skills

Confidentiality and Records Your child’s study information will be kept confidential by the researcher/the guidance counselor and no one outside of the research team (myself, my advisor, and two other committee members) will be knowledgeable of your child’s participation or see the video/audio recordings. The Guidance Counselor will share any information from school records pertinent to research (i.e. IEP, past behavior problems, etc.) if needed. Audio/Video recordings, and any other information pertaining your child, will be destroyed in January of 2016. Additionally, while every effort will be made to keep your child’s study-related information confidential, there may be circumstances where this information must be shared with: * Federal agencies, for example the Office of Human Research Protections, whose responsibility is to protect human subjects in research; * Representatives of Ohio University (OU), including the Institutional Review Board, a committee that oversees the research at OU; The researcher also has an obligation to report any comments/behaviors that indicate your child may harm themselves or others or if any abuse is indicated.

Compensation As compensation for your child’s time/effort, your child will receive a CD recording to take home of their written and performed raps.

79 Contact Information If you have any questions regarding this study, please contact myself, Jessica L. Schlabach, MT-BC at [email protected] or Kamile Geist, MA, MT-BC, Music Therapy Research Advisor at [email protected] or (740) 593-4249.

If you have any questions regarding your child’s rights as a research participant, please contact Chris Hayhow, Director of Research Compliance, Ohio University, (740)593-0664 or [email protected]

By signing below, you are agreeing that: • you have read this consent form (or it has been read to you) and have been given the opportunity to ask questions and have them answered; • you have been informed of potential risks to your child and they have been explained to your satisfaction; • you understand Ohio University has no funds set aside for any injuries your child might receive as a result of participating in this study; • you are 18 years of age or older; • your child’s participation in this research is completely voluntary; • your child may leave the study at any time; if your child decides to stop participating in the study, there will be no penalty to your child and he/she will not lose any benefits to which he/she is otherwise entitled.

Parent Signature Date

Printed Name

Child’s Name

Version Date: [insert 10/17/2014]

80

APPENDIX B: LETTER OF INTRODUCTION

Dear Student,

Hello! My name is Jessica Schlabach and I am a graduate student at Ohio

University in the field of music therapy. I am currently working on my thesis for my master’s degree and I am looking for middle schools students to participate in this study.

You are receiving this letter because you fit the criteria for my study and I was hoping you would be willing to participate. My research is focused on using rap music for building self-esteem. I want to see if rap can affect change in self-esteem and how you feel about the rap activities. I hope to begin my research soon. Please return this signed form to the guidance counselor as soon as possible.

Thank you for considering participating in my study. If at any time you wish to withdraw from the activity you may do so without consequence. I have received IRB approval for working with human subjects. If you have any questions please feel free to contact me at [email protected]. I look forward to meeting you and hearing about your music preferences!

-Jessica L. Schlabach, MT-BC

Board Certified Music Therapist

81

APPENDIX C: ASSENT FORM

Title of Study: The Effects of Rap Writing on Adolescent Self-Esteem

My name is Jessica Schlabach. I am trying to learn about how rap writing can help your self-esteem (that is, how you feel about yourself). I also want to know if you enjoy talking about and writing your own raps is helpful and enjoyable in your life. I want to know this because I think a lot of people would be interested in knowing how rap music can help adolescents like yourself. If you would like, you can be in my study.

If you decide you want to be in my study, you will need to do the following: • Fill out a ten question scale before and after the study about how you feel about yourself and verbally answer six questions for the researcher after the study about what you liked/disliked about the treatments. • You will participate in six music therapy sessions that include discussing your favorite music, writing a rap song in a group, and writing you own individual rap that will be performed and recorded (within the group setting) on the final session date. • These sessions will occur Wednesdays at 8:00 am at Alexander Middle School in the Guidance Counselor suite. • The Guidance Counselor will share any information from school records important to the study with the researcher if needed.. You will be video and audio recorded during the sessions, but these videos will only be seen by myself and my advisor. The recordings will be destroyed in January of 2016. • The researcher has an obligation to report any comments/behaviors that indicate you may harm yourself or others or if any child abuse is indicated.

Your parents or guardian have to say it’s OK for you to be in the study. After they decide, you get to choose if you want to do it too. You will only have to meet with me about 7 times for thirty minutes and this study will not cut into school time. If you don’t want to be in the study, no one will be mad at you. If you want to be in the study now and change your mind later, that’s OK. You can stop any time. You can email me if you have questions about the study or if you decide you don’t want to be in the study any more. I will give you a copy of this form in case you want to ask questions later.

Agreement I have decided to be in the study even though I know that I don’t have to do it. Jessica Schlabach has answered all my questions.

Signature of Study Participant: ______Date:

Signature of Researcher: ______Date: 82 APPENDIX D: CONTROL GROUP PARENTAL CONSENT FORM

Title of Research: The Effects of Rap Writing on Adolescent Self-Esteem

Researchers: Jessica L. Schlabach, MT-BC

You are being asked permission for your child to participate in research. For you to be able to decide whether you want your child to participate in this project, you should understand what the project is about, as well as the possible risks and benefits in order to make an informed decision. This process is known as informed consent. This form describes the purpose, procedures, possible benefits, and risks. It also explains how your child’s personal information will be used and protected. Once you have read this form and your questions about the study are answered, you will be asked to sign it. This will allow your child’s participation in this study. You have been given two copies so you can keep one for yourself.

Explanation of the Study If you agree to allow your child participate, you will be asked to allow the school guidance counselor to administer a short, ten question self-esteem scale to your child. Their scale results will be compared to a group of children receiving a treatment intervention. This scale will be taken once in a study hall period and they will not be pulled out of class.

Risks and Discomforts No risks or discomforts are anticipated.

Benefits This study is important to science/society because: 1. This research will add to a body of research available to music therapists, and other professionals working with adolescents. 2. This research could demonstrate benefits of music therapy, specifically the use of rap music, and how it can help adolescents.

Confidentiality and Records Your child’s study information will be kept confidential by myself/the guidance counselor and no one outside of my research team (myself, my advisor, and two other committee members) will be knowledgeable of your child’s participation. Additionally, while every effort will be made to keep your child’s study-related information confidential, there may be circumstances where this information must be shared with: * Federal agencies, for example the Office of Human Research Protections, whose responsibility is to protect human subjects in research; * Representatives of Ohio University (OU), including the Institutional Review Board, a committee that oversees the research at OU;

83 Compensation There is no compensation for their brief participation.

Contact Information If you have any questions regarding this study, please contact myself, Jessica L. Schlabach, MT-BC at [email protected] or Kamile Geist, MA, MT-BC, Music Therapy Research Advisor at [email protected].

If you have any questions regarding your child’s rights as a research participant, please contact Chris Hayhow, Director of Research Compliance, Ohio University, (740)593-0664 or [email protected]

By signing below, you are agreeing that: • you have read this consent form (or it has been read to you) and have been given the opportunity to ask questions and have them answered; • you have been informed of potential risks to your child and they have been explained to your satisfaction; • you understand Ohio University has no funds set aside for any injuries your child might receive as a result of participating in this study; • you are 18 years of age or older; • your child’s participation in this research is completely voluntary; • your child may leave the study at any time; if your child decides to stop participating in the study, there will be no penalty to your child and he/she will not lose any benefits to which he/she is otherwise entitled.

Parent Signature Date ___

Printed Name

Child’s Name

Version Date: [insert 10/17/2014]

84

APPENDIX E: CONTROL GROUP ASSENT FORM

Title of Study: The Effects of Rap Writing on Adolescent Self-Esteem

My name is Jessica Schlabach. I am conducting a research study with adolescents your age. If you would like, you can briefly help me with my study.

If you decide you want to be in my study, you will need to do the following: • You will complete a ten question scale given to you by the guidance counselor asking how you feel about yourself now and once again in six weeks.

Your parents or guardian have to say it’s OK for you to be in the study. After they decide, you get to choose if you want to do it too. You will only have to meet with the guidance counselor twice for about ten to fifteen minutes in order to complete the scale. If you don’t want to be in the study, no one will be mad at you. If you want to be in the study now and change your mind later, that’s OK. You can stop any time. You can email me if you have questions about the study or if you decide you don’t want to be in the study any more.

I will give you a copy of this form in case you want to ask questions later.

Agreement

I have decided to be in the study even though I know that I don’t have to do it. Jessica Schlabach has answered all my questions.

Signature of Study Participant: ______Date:

Signature of Researcher: ______Date:

85 APPENDIX F: FACILITY LETTER OF SUPPORT

86

APPENDIX G: ROSENBERG SELF-ESTEEM SCALE (ROSENBERG, 1965)

Below is a list of statements dealing with your general feelings about yourself. Please indicate how strongly you agree or disagree with each statement.

On the whole, I am satisfied with myself. • Strongly Agree I feel that I'm a person of worth, at least • Agree on an equal plane with others • Disagree • Strongly Agree • Strongly Disagree • Agree • Disagree At times I think I am no good at all. • Strongly Disagree • Strongly Agree I wish I could have more respect for • Agree myself. • Disagree • Strongly Agree • Strongly Disagree • Agree • Disagree I feel that I have a number of good • Strongly Disagree qualities • Strongly Agree All in all, I am inclined to feel that I am a • Agree failure. • Disagree • Strongly Agree • Strongly Disagree • Agree • Disagree I am able to do things as well as most • Strongly Disagree other people • Strongly Agree I take a positive attitude toward myself. • Agree • Strongly Agree • Disagree • Agree • Strongly Disagree • Disagree • Strongly Disagree I feel I do not have much to be proud of. • Strongly Agree • Agree Scoring: • Disagree Items 2, 5, 6, 8, 9 are reverse scored. • Strongly Disagree Give “Strongly Disagree” 1 point, “Disagree” 2 points, I certainly feel useless at times. “Agree” 3 points, • Strongly Agree “Strongly Agree” 4 points. Sum scores • Agree for all ten items. Keep scores • Disagree on a continuous scale. Higher scores • Strongly Disagree indicate higher self-esteem

87

APPENDIX H: RAP WRITING PROMPTS

Adapted from McFerran (p. 175, 2012)

1.) Introduction to rap writing—What do you think makes a good song?

2.) Brainstorming Themes/Topics—What do we all have in common? What issues do

we want to communicate with this song?

3.) Brainstorming Lyrics—What ideas do you have about this theme/topic? Word,

phrases, sentences, etc.

4.) Selecting Ideas—Which of these idea should we use? What doesn’t fit?

5.) Selecting Song Format—What format of song should we use? Fill in the Blank,

Pre-composed chorus, or free style.

6.) Creating Lyrics—How we make these words into a song? What phrases/words

should be in the chorus, verses, etc.

7.) Creating Style—Are any of these lyrics sung or are they all rapped? Is there body

percussion or beat boxing in this song?

8.) Choosing a Beat—Which beat should this song be performed over?

9.) Performance—Who will perform this rap? Will we perform together, assign parts,

or is one person performing.

88

APPENDIX I: END OF STUDY QUESTIONNAIRE

Adapted from MacDonald & Viega (p. 168, 2012)

1.) How did you feel about the program?

2.) What did you enjoy about the program?

3.) Has the program helped you in any way?

4.) What would you change?

5.) Would you recommend the program to your peers?

6.) What else would you like to say about the program?

89

APPENDIX J: PARTICIPANT WRITTEN RAP

We’re Free

Drop the Beat Started from the bottom now we’re up at the top Started from the bottom now we’re here, now stop Started from the bottom now we’re making ears pop Drop the Beat Started from the bottom of a pit now we’re here Put your hands up and wave them like you just don’t care Put your hands up and wave them like you just don’t care Gonna get out of here, gonna hit the city Tired of people telling me what to do, now I’m free (free, free, free)

I’m free from these chains that are holding me back We’re hitting the city, gonna crash it up Pop, pop, pop, it’s at the top. I’m gonna keep on climbing until I get to the top. Gonna drop that beat, gonna shake that city.

Drop the Beat Started from the bottom now we’re up at the top Started from the bottom now we’re here, now stop Started from the bottom now we’re making ears pop

90

APPENDIX K: LYRICS AND LYRIC DISCUSSION PROMPTS

"Numb"—Linkin Park

I'm tired of being what you want me to be Feeling so faithless, lost under the surface Don't know what you're expecting of me Put under the pressure of walking in your shoes (Caught in the undertow, just caught in the undertow) Every step that I take is another mistake to you (Caught in the undertow, just caught in the undertow)

Chorus: I've become so numb, I can't feel you there Become so tired, so much more aware I'm becoming this, all I want to do Is be more like me and be less like you

Can't you see that you're smothering me, Holding too tightly, afraid to lose control? 'Cause everything that you thought I would be Has fallen apart right in front of you. (Caught in the undertow, just caught in the undertow) Every step that I take is another mistake to you. (Caught in the undertow, just caught in the undertow) And every second I waste is more than I can take.

Chorus

20 And I know, I may end up failing too. 21 But I know, You were just like me with someone disappointed in you.

Chorus X2 ______Questions for Thought: 1.) Which lines do you like or dislike? 2.) What do you think of the lines “I'm tired of being what you want me to be”? Have you ever felt this way? 3.) What do you think of the line “I'm becoming this, all I want to do Is be more like me and be less like you”? Have you ever felt this way? 4.) Does this song end happy, sad, or angry? Does the singer come up with a solution or move forward? 5.) What themes do you see in the lyrics? 6.) What do you think is the most important message in this song? 91

"Lose Yourself"—Eminem

Look, if you had one shot, or one opportunity To seize everything you ever wanted. one moment Would you capture it or just let it slip? Yo

His palms are sweaty, knees weak, arms are heavy There's vomit on his sweater already, mom's spaghetti He's nervous, but on the surface he looks calm and ready To drop bombs, but he keeps on forgetting What he wrote down, the whole crowd goes so loud He opens his mouth, but the words won't come out He's choking how, everybody's joking now The clock's run out, time's up, over, bloah!

Snap back to reality, Oh there goes gravity Oh, there goes Rabbit, he choked he's so mad but he won't give up that easy, no He won't have it, he knows his whole back's to these ropes It don't matter, he's dope He knows that but he's broke He's so stagnant, he knows When he goes back to his mobile home, that's when it's Back to the lab again, yo This whole rhapsody He better go capture this moment and hope it don't pass him

Chorus You better lose yourself in the music, the moment You own it, you better never let it go You only get one shot, do not miss your chance to show This opportunity comes once in a lifetime yo You better lose yourself in the music, the moment You own it, you better never let it go You only get one shot, do not miss your chance to show This opportunity comes once in a lifetime yo (You better)

No more games, I'ma change what you call rage Tear this roof off like two dogs caged I was playing in the beginning, the mood all changed I've been chewed up and spit out and booed off stage But I kept rhyming and stepped right into the next cypher Best believe somebody's paying the pied piper All the pain inside amplified by the fact 92

That I can't get by with my 9 to 5 And I can't provide the right type of life for my family Too much for me to wanna Stay in one spot, Success is my only other option, failure's not Mom, I love you, but this trailer's got to go I cannot grow old in Salem's lot So here I go it's my shot. Feet, fail me not, this may be the only opportunity that I got

[Hook:] You better lose yourself in the music, the moment You own it, you better never let it go You only get one shot, do not miss your chance to show This opportunity comes once in a lifetime yo You better lose yourself in the music, the moment You own it, you better never let it go You only get one shot, do not miss your chance to show This opportunity comes once in a lifetime yo (You better)

Questions for Thought:

1.) Which lines do you like or dislike? 2.) What do you think of the lines “You better lose yourself in the music, the moment You own it”? What do you think this means? 3.) What do you think of the line “I was playing in the beginning, the mood all changed I've been chewed up and spit out and booed off stage But I kept rhyming and stepped right into the next cypher.” What do you think this means? 4.) Does this song end happy, sad, or angry? Does the singer come up with a solution or move forward? 5.) Do you think it’s possible to “do whatever you set your mind to?” 6.) What themes do you see in the lyrics? .

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