Master of Music Therapy, Appalachian State University, Boone, North Carolina, USA (2014)
Music Therapy Equivalency, Appalachian State University, Boone, North Carolina, USA (2013)
Bachelor of Music, Lawrence University, Appleton, Wisconsin, USA (2011)
Fellow of the Association for Music and Imagery (since 2014)
Board-Certified Music Therapist (MT-BC) (since 2014)
PhD student at the Doctoral Program in Music Therapy, Aalborg University, Denmark (since August 2018)
Music Therapist, Rockford Center Psychiatric Hospital, Newark, Delaware, USA
Lecturer, Creative Arts Therapy Department at Drexel University, Philadelphia, Pennsylvania, USA (2018)
Lecturer, Music Therapy Program at Appalachian State University, Boone, North Carolina, USA (2015-2016)
Treatment Effects of the Bonny Method of Guided Imagery and Music for Persons with Depression
Asst. Prof. Niels Hannibal, PhD, Doctoral Programme in Music Therapy, Aalborg University, Denmark
Prof. Dr. Cathy McKinney, PhD, Coordinator of the Music Therapy Program at Appalachian State University, USA
The World Health Organization (WHO, 2016) estimated that more than 300 million individuals worldwide are affected by depression and found that global rates are increasing. Together, depression and anxiety disorders account for a cost of $1 trillion USD annually. In the US, individuals with anxiety or depression were found to have a 60% higher mortality rate and died 7.9 years earlier than those without anxiety or depression (Pratt, Druss, Manderscheid, & Walker, 2016).
Bonny Method of Guided Imagery and Music (GIM) is a music-centered approach to exploring the self. Used in psychotherapy (Grocke, 2015; Ventre, 2002), it is an integrative therapeutic approach that can lead to a wide range of positive outcomes (for reviews, see McKinney & Grocke, 2016; McKinney & Honig, 2017) Case studies, qualitative research, and clinical practice have provided preliminary evidence that GIM is both appropriate and efficacious for individuals seeking treatment for depression (e.g. Chou & Lin, 2006; Summer, 2011; Trondalen, 2009-2010). Outcome research has provided further evidence that a series of GIM sessions has positive and lasting for depression, mood disturbance, and anxiety in a number of clinical and nonclinical populations (McKinney & Grocke, 2016; McKinney & Honig, 2017). A next step in research is to study the efficacy of GIM as treatment specifically for persons with depression.
This multi-phase research project is guided by the overarching aim of determining the efficacy of a series of individual Guided Imagery and Music (GIM) sessions in alleviating psychological symptoms of depression. The research project will be conducted in three phases: development of a treatment fidelity instrument for this project and for future GIM research, a randomized controlled trial of GIM for persons with depression, and a mixed-methods case study.
- The GIM Treatment Fidelity Assessment will be a descriptive, rather than prescriptive, tool grounded in the theory and process essential to GIM; it will provide a framework to achieve validity through consistent clinical practice while allowing for the client-centered flexibility necessary in a complex psychotherapy like GIM.
- The randomized controlled trial will occur in two clinical sites, and participants will be recruited through community mental health providers. The experimental condition will consist of 10 biweekly individual GIM sessions. The control condition will consist of a waitlist period equivalent to the time from pretest to follow-up for the experimental condition, followed by provision of six group music and imagery sessions to improve equity between groups. Dependent variables will include depression, anxiety, mood disturbance, and mental well-being, all of which will be measured at four time points: pretest, mid point, posttest, and 6-week follow-up. These variables will be measured using the Inventory of Depressive Symptomatology – Self-Report (IDS-SR; IDS/QIDS, 2017), Depression Anxiety and Stress Scale (DASS; Lovibond & Lovibond, 1995), Profile of Mood States (POMS; McNair, Loor, & Droppleman, 2003), and the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS; Tennant et al., 2007).
- An in-depth mixed methods case study will complement the quantitative arm of the project in order to provide a multidimensional description of the therapeutic process experienced by an individual with depression receiving a series of GIM sessions. This case study will weave together the client’s experience of change, their imagery and session content, and their quantitative outcome measures over time to provide a more complete understanding of their treatment process.
Primary research question: Is a series of Bonny Method of GIM an effective treatment for persons with depression?
Phase I: Development of treatment fidelity assessment
Aim: Develop an instrument to measure treatment fidelity for GIM in the treatment of depression that captures
- The essential process of GIM
- Clinically indicated modifications
Phase II: RCT
- In individuals with depression, does a series of GIM sessions reduce severity of depression in comparison to a control group?
- In individuals with depression, does a series of GIM sessions reduce severity of anxiety in comparison to a control group?
- In individuals with depression, does a series of GIM sessions reduce severity of mood disturbance in comparison to a control group?
- In individuals with depression, does a series of GIM sessions improve mental well-being in comparison to a control group?
Phase III: Case study
- How does the client experience change in their lived experience of depression over the course of a series of GIM sessions?
- How and to what extent are the three following factors related:
- the client’s experience of change in their lived experience of depression,
- the client’s imagery and session content, and
- the client’s quantitative outcome measures of depressive symptomatology?
Chou, M.-H., & Lin, L.-F. (2006). Exploring the listening experiences during Guided Imagery and Music therapy of outpatients with depression. Journal of Nursing Research, 14(2), 93–102.
Grocke, D. (2015). Introduction. In D. Grocke, & T. Moe (Eds.), Guided Imagery and Music (GIM) and music imagery methods for individual and group therapy, 19–30. Philadelphia, PA: Jessica Kingsley.
Lovibond, P. F., & Lovibond, S. H. (1995). The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety inventories. Behaviour Research and Therapy, 33(3), 335–343.
McKinney, C. H., & Grocke, D. E. (2016). The Bonny Method of Guided Imagery and music for medical populations: Evidence, effectiveness and vision for the future. Music & Medicine, 8(2), 18–25.
McKinney, C. H., & Honig, T. J. (2017). Health outcomes of a series of Bonny Method of Guided Imagery and Music sessions: A systematic review. Journal of Music Therapy, 54, 1–34. doi:10.1093/jmt/thw016
McNair, D. M., Lorr, M., & Droppleman, L. F. (2003). Profile of Mood States II. New York, NY: Multi-Health Systems.
Pratt, L. A., Druss, B. G., Manderscheid, R. W., & Walker, E. R. (2016). Excess mortality due to depression and anxiety in the United States: results from a nationally representative survey. General Hospital Psychiatry, 39, 39-45.
Rush, A. J., Trivedi, M. A., Carmody, T. J., Ibrahim, H. M., Markowitz, J. C., Keitner, G. I., . . . & Keller, M. B. (2005) Self-reported depressive symptom measures: sensitivity to detecting change in a randomized, controlled trial of chronically depressed, nonpsychotic outpatients. Neuropsychopharmacology, 30(2), 405–416.
Rush, A. J., Gullion, C. M., Basco, M. R., Jarrett, R. B., & Trivedi, M. H. (1996). The inventory of depressive symptomatology (IDS): Psychometric properties. Psychological Medicine, 26(3), 447–486.
Simmons, C. A., & Lehmann, P. (2013). Strengths and psychotherapy. In C. A. Simmons & P. Lehmann (Eds.), Tools for Strengths-Based Assessment and Evaluation (pp. 1–18). New York, NY: Springer.
Summer, L. (2011). Music therapy and depression: Uncovering resources in music and imagery. In A. Meadows (Ed.), Developments in music therapy practice: Case study perspectives (pp. 486–500). Gilsum, NH: Barcelona Publishers.
Tennant, R., Hiller, L., FIshwick, R., Platt, S., Joseph, S., Weich, S., . . . Stewart-Brown, S. (2007). The Warwick-Edinburgh Mental Well-Being Scale (WEMWBS): Development and UK validation. Health and Quality of Life Outcomes, 5(63).
Trondalen, G. (2009–2010). Exploring the rucksack of sadness: Focused, time-limited Bonny Method of Guided Imagery and Music with a female executive. Journal of the Association for Music and Imagery, 12, 1–20.
Ventre, M. (2002). The individual form of the Bonny Method of Guided Imagery and Music (BMGIM). In K. E. Bruscia & D. E. Grocke (Eds.), Guided Imagery and Music: The Bonny Method and beyond (pp. 28–35). Gilsum, NH: Barcelona Publishers.
World Health Organization. (April 13, 2016). Investing in treatment for depression and anxiety leads to fourfold return. http://www.who.int/mediacentre/news/releases/2016/depression-anxiety-treatment/en/. Accessed May 20, 2017.