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Case Study Designs in Music Therapy

David Aldridge (Ed.)(2005). Case Study Designs in Music Therapy. Jessica Kingsley Publishers. Paperback 1-84310-140-8, 2004, 304 pages.

Reviewed by Felicity Baker, PhD, University of Queensland, Brisbane, Australia.

br2005_60The number of case study research published in music therapy journals such as the Nordic Journal of Music Therapy, is ever increasing so it is timely that a book on case study design has been added to Jessica Kingsley Publisher’s music therapy literature list. While Bruscia’s Case Studies in Music Therapy (1991) and Hadley’s Psychodynamic Music Therapy: Case Studies (2003) provide a rich pallet of clinical work with individuals that the clinician can absorb, Aldridge’s new text Case Study Designs in Music Therapy, is the first of its kind to focus on the art and science of case study design. Unlike Bruscia’s and Hadley’s texts, the authors in Aldridge’s text inform the reader of the potential benefits of case study design, the research methods by which they engage in, and what outcomes were found when the authors themselves applied case study design to address their own research questions.

I admit to having limited experience in using case study research – having used it only within my own doctoral study – and I was therefore interested in this book as a means of expanding my knowledge and understanding of what case study research could achieve and how I might go about using it again in the future. I can say without a doubt that the book certainly achieved this for me. When I reflect back to my own research training, I remember reading the case study design texts by Yin (1994) and Gomm, Hammersley & Foster (2000) – also mentioned by the authors within Aldridge’s text – and my memories of trying to make sense of them in relation to music therapy. How much I would have benefited from Aldridge’s text if it had existed back then!

Several of the chapters within this text were highly descriptive in articulating complex methods of data collection and analysis to answer predefined research questions. The strength of this book is that the chapters do this across a broad range of clinical populations. Ridder’s chapter on mixed designs particularly impressed me as it was an easy to follow and informative chapter showing how quantitative data combined with pattern matching can result in understandings of clinical phenomena. Ridder critiques the “paradigm wars” of positivist versus constructionists arguing that music therapy researchers should take a “pragmatic stance” by using both quantitative and qualitative methods (when appropriate) to answer a question instead of “modulating the questions so they fit a certain criteria” (p.193). In keeping with this, she goes on to explain her strategies for “describing” the effects of music therapy rather than “proving” these effects (p.192) suggesting that the outcomes from these case studies can lead on to larger scale outcome based studies.

Gudrun Aldridge’s chapter explains the “Narrative Case Study Approach” and how she used it to study the development of melody within music therapy. She describes the phases of therapeutic narrative analysis using tables and figures to illustrate the complexity. Much of her chapter really challenges the reader’s thinking – for example, her discussion about the debate between subjectivity and objectivity challenged me to think when she wrote “We are indeed subjects reaching out to an objective world, but this separation is not apparent in music therapy. The music, as object in the world, is performed by the subjects.” Aasgaard’s chapter discusses and illustrates case study research using naturalistic enquiry and multiple data resources. Aasgaard suggests that his method of enquiry suits his desire to find out “who does what, where, when and with whom?” (p.69). The unique aspect of this chapter is that Aasgaard treats a song (rather than a person or group of people) as the cases. Each song has a life and a story to tell in where it is created, performed, who hears the songs and what happens to them. Like Ridder, Aasgaard begins with clear research questions that are addressed in a clearly explained and systematic case study method.

Petra Kern’s chapter details a series of case study research with children who are on the autism spectrum. This chapter is particularly informative as it reports on the application of three case study designs: 1. an ABAB withdrawal design, 2. an alternating treatment design, and 3. a multiple baseline design. The strength of this chapter lies in its transparency of how the research questions link together with the selected case study designs, making it easy for the reader to consider research questions that may be relevant to his or her own clinical area. Like Kern, Cochavit Elefant’s chapter on case studies of girls with Rett’s syndrome is also highly useful in clearly explaining the research method. Elefant is particularly good at explaining a highly complex research design – single-case, multiple-probe, in an understandable manner. Within her chapter, Elefant raises the important issues of validity, reliability, and intra and inter-observer reliability. In her discussion of her design, Elefant draws to the reader’s attention, the advantages and limitations of the multiple-probe design and some of the ethical issues that it addresses and creates. The final chapter of the book by Aldridge, presents some guidelines for case study design research in music therapy which the beginning music therapy researcher will undoubtedly find useful. He concludes the chapter by providing a checklist of questions that should be answered before beginning any research.

In Ridder’s chapter, she purports that a distinction must be made between case reports, case studies, and case study research. While she quite clearly describes case study research in her chapter, this is not the case in all the chapters within the book, with those of Grocke and Griessmeier describing case studies rather than case study research. It may be that these authors did use a case study design however this method was not articulated within their chapters – perhaps the authors were not provided with a clear brief of what to include in their chapters? That said, both Grocke’s and Griessmeier’s chapters are well constructed and informative chapters within themselves but perhaps don’t belong in this book. The same can be said for Wigram’s chapter. In this case, Wigram’s chapter comprises a series of studies of vibroacoustics which Aldridge himself suggests illustrate the value in conducting a series of small studies to build knowledge – however these are not case studies. These three chapters are not in line with the remaining contents of the book – there is inconsistency here.

In conclusion, there is plenty of content within the remaining chapters to give the novice researcher an overview of music therapy case study research. It is well written, easy to read, and for a research methods book, quite an enjoyable (bedtime) read. I highly recommend this text as a prescribed text for courses where music therapy research methods are being taught. Students need concrete examples of case study research specifically in music therapy, and this book provides a range of different case study approaches for them to carefully study.

References

Bruscia, K. (1991). Case Studies in Music Therapy. Phoenixville, PA: Barcelona Publishers.

Hadley, S. (2003). Psychodynamic Music Therapy: Case Studies. Phoenixville, PA: Barcelona Publishers.

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