THE RELATIONSHIP BETWEEN MUSIC THERAPISTS‟ SPIRITUAL BELIEFS AND CLINICAL PRACTICE A Dissertation Submitted to the Temple University Graduate Board In Partial Fulfillment of the Requirements for the Degree DOCTOR OF PHILOSOPHY By Roberta Stewart Kagin August, 2010 Examining Committee Members: Cheryl L. Dileo, Advisory Chair, Music Education and Therapy/Music Therapy Kenneth E. Bruscia, Music Education and Therapy/Music Therapy Christine Anderson, Music/Voice and Opera Ed Flanagan, External Member, Music Studies/Jazz © by Roberta Stewart Kagin 2010 All Rights Reserved ii ABSTRACT The Relationship Between Music Therapists’ Spiritual Beliefs and Clinical Practice Roberta Stewart Kagin Doctor of Philosophy Temple University, 2010 Doctoral Advisory Committee Chair: Cheryl Dileo This study examined the relationship between music therapists‟ spiritual beliefs and their clinical practices. A survey was sent to 4243 members of the Certification Board for Music Therapy, using an electronic program, SurveyMonkey. There was a return rate of 32%. The survey contained two parts; Part I was the Music Therapy Questionnaire, and Part II was the Spiritual Involvement and Beliefs Scale (SIBS). Data were analyzed using a combination of Kruskal-Wallis Anova, Mann-Whitney U, and Spearman Rho correlation tests to analyze both the relationships as well as significant variations in responses between the survey questions and the SIBS scores. Research questions focused on the relationships between the music therapists‟ spirituality scores (SIBS) and their demographics, their reported spiritual beliefs and practices, and their clinical practices. Statistical analyses revealed significant differences in the relationship between SIBS scores and gender, age, and years of professional experience; however, there were no significant differences between SIBS scores and education level, regions of AMTA, or client populations served. Significant correlations were found between SIBS scores and music therapists‟ personal appraisal of their own spirituality, their use of music as a iii spiritual experience, the use of music in their own personal practice, and their belief in the importance of some type of contemplative experience in their own personal lives. Further statistical analyses also revealed significant correlations between music therapists‟ SIBS scores and the following clinical practices: 1) the role of spirituality as a sustaining force in their music therapy career, 2) their spiritual ideals as exemplified in their work, 3) attention to their own spirituality in their role as a music therapist, 4) their spiritual growth as a music therapist, 5) the classifying of their work as a spiritual endeavor, 6) their choice of music therapy as a profession. Additional positive correlations were found between music therapists‟ SIBS scores and the reported influence of spirituality on their choice of population, their comfort in addressing clients‟ spiritual needs when they are similar to their own, and their comfort in addressing clients‟ spiritual needs when they are different from their own. iv ACKNOWLEDGEMENTS The author wishes to acknowledge the support and encouragement of the administration, faculty, staff, and music therapy students of Augsburg College in the completion of this degree, especially Boyd Koehler, librarian. Friends and family members who have given continual support and encouragement are too numerous to name individually, but a few deserve special recognition, including Craig Alexander, the Bill Bowen family, Julia Mensing, Gretchen Alaniz, Dr. Carl and Mary Kagin Kramer, Edwin Kagin, Katie Lindenfelser, and Barbara Hays. The graduate students and alumni from Temple University have been continually supportive and encouraging. Special guidance has been received from life-long mentors Drs. Charles T. Eagle, Les Pugh, and Clive Robbins. Sabbaticals from Prospect Park United Methodist Church and Augsburg College have provided the necessary time to focus on this research. Statistical support has been received from Steve Ozanne, Marc Isaacson, and Dr. Milo Shields. Kevin Alexander and Betti Iwanski provided needed computer assistance. Temple University faculty, including Drs. Cheryl Dileo, Ken Bruscia, Darlene Brooks, Ken Aigen, Christine Anderson and Ed Flanagan have provided expert guidance and direction. The author would like to give special thanks to Dr. Cheryl Dileo, who approaches all of her teaching and advising with a commitment to excellence in music therapy research and a genuine love for her students. Her constant attention to details, as well as her personal and academic assistance with numerous revisions and editing has been exemplary and greatly appreciated. Without the author‟s constant spiritual connection to the field of music therapy, this project would never have happened. It is the belief in music to transcend, inspire, motivate, to create a bond between and among humans, and to support health and quality of life, which has continued to motivate me throughout my personal and professional life. v TABLE OF CONTENTS ABSTRACT ....................................................................................................................... iii ACKNOWLEDGEMENTS .................................................................................................v LIST OF FIGURES ........................................................................................................... ix LIST OF TABLES ...............................................................................................................x CHAPTER ONE ..................................................................................................................1 INTRODUCTION ........................................................................................................... 1 Religion and Spirituality in Healthcare ....................................................................... 4 Definitions of Spirituality ............................................................................................ 4 The Relationship between Spirituality and Healthcare ............................................... 9 How Spirituality is Assessed ..................................................................................... 16 Complexities Involved in Assessments ..................................................................... 20 Ethical Issues Regarding Spirituality in Medicine .................................................... 21 CHAPTER TWO ...............................................................................................................25 RELATED LITERATURE ........................................................................................... 25 Music and Spirituality ............................................................................................... 25 Spirituality and Music Therapy ................................................................................. 26 Pioneering Approaches to Music, Therapy, and Spirituality ..................................... 30 Music Therapy Methods used to Address Spiritual Issues in Clinical Populations .. 35 Spiritual Beliefs of Musicians/Music Therapists....................................................... 52 Education/Training in Spirituality and Music Therapy ............................................. 54 Music Therapists‟ Spiritual Beliefs and How They Influence Music Therapy Practice56 vi CHAPTER THREE ...........................................................................................................60 RESEARCH METHOD ................................................................................................ 60 Participants ................................................................................................................ 60 Materials .................................................................................................................... 60 Procedure ................................................................................................................... 62 Analysis of Data ........................................................................................................ 64 CHAPTER FOUR ..............................................................................................................65 RESULTS...................................................................................................................... 65 Research Question #1: The Relationship between Music Therapists‟ Spirituality Scores and their Personal and Work Information ...................................................... 70 Research Question #2: The Relationship between Music Therapists‟ Spirituality Scores and their reported Spiritual Beliefs and Practices .......................................... 76 Research Question #3: The Relationship between Music Therapists‟ Spirituality Scores and their Clinical Practice regarding Spirituality........................................... 80 Survey Comments...................................................................................................... 88 CHAPTER FIVE ...............................................................................................................90 DISCUSSION ............................................................................................................... 90 The Relationship between Spirituality Scores and Demographic Data ..................... 91 The Relationship between Music Therapists‟ Spirituality Scores and Their Reported Spiritual