Dissertation - World Federation of Music Therapy

scores are influenced by my negative attitude towards questionnaires like these – I
don’t feel they are illustrative of me and my process.” (INLA)
This does not mean that the scores are considered neither arbitrary nor dependent on
pure coincidence. But it means that caution is warranted when interpreting especially
high and low (or no) outcomes.
Validity problems in the questionnaires:
The participants’ critical comments included both problems connected to the
formulation of the questions (concept validity) and problems of how ‘processes of
change can be linked to therapeutic processes’ (internal validity, Smeijsters 1997 p.
29). Here are a few examples of concept validity comments: “What is ‘a long/short
walk’”? (SAAA); “Emotions are not addressed appropriately, and indicating QoL
with a number does not tell what actually has been going on.” (ESMA) Then follows
some examples of internal validity comments: “The questions don’t grasp the ”in-
betweens” - the movements up and down between more stable periods.” (ESMA);
“I cannot indicate that I was really low 4 days ago, but fine now (or the opposite). The
many changes within a week cannot be scored.” (ANHO)
The external validity of the findings presented in this study is unknown. The sample is
small, there is no control group, and the six participants cannot be identified as
representative in any way. The grounded theory presented in section 7.3 is limited to
this particular group of participants. Fundamentally the validity problems could only
have been minimized by the inclusion of a larger sample and a control group.
Changes in the scores of the six participants may be attributed to many other factors
than the music therapy. However, the combination of questionnaires and interviews
allowed the participants to comment on the scores and relate them to their actual
experience. This made it possible to see that the two participants who ‘changed the
least’ according to the questionnaire scores, actually experienced a lot of change
attributed to the music therapy, - changes that were inexpressible through the
questionnaires. The four participants whose scores showed major changes
(improvements) were allowed to comment on them, and they all validated the specific
changes when the researcher presented the pre–post–follow-up changes in the
interviews.
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