Every year, millions of Americans suffer from either chronic or acute pain that results in tremendous healthcare cost, rehabilitation, and loss of work productivity. Pain is an unpleasant sensation associated with sensory and emotional experiences that can cause potential or actual tissue damage. One plausible solution to managing pain is the use of nonpharmacological modalities such as guided imagery. The purpose of this project was to determine if there was a difference in pain scores following pharmacological interventions and the use of guided imagery among postoperative same day surgical patients. Guided imagery is a nonpharmacological modality that uses pictures, music, and imaginary scenes to help heal the body in addition to using relaxation techniques and mental images for the management of pain. This project included the translation of evidence into practice using guided imagery on a 25-bed same day surgery unit (N = 34 patients), guided by Kolcaba's comfort theory. The findings of this project included using guided imagery for same day surgery patients who rated their pain greater than 4 on the traditional pain scale of one to ten, with one equaling no pain and ten equaling worst pain. The results of the evaluation showed a significant decrease in pain scores between premedication to postmedication (p < 0.001), premedication and postguided imagery (p < 0.001), and postmedication and postguided imaginary (p < 0.001). Guided imagery has been demonstrated to be efficient and cost effective methods to reducing pain. This project indicated that use of nonpharmacological and pharmacological interventions working together could be more effective for pain management in same day surgical patients.

Hypertension occurs in nearly 10% of pregnancies, and is associated with infant and maternal morbidity and mortality. Prior studies of non-pregnant adults have demonstrated the effectiveness of a variety of relaxation therapies in reducing blood pressure. A pilot randomized controlled trial was conducted, the purposes of which were 1) to provide preliminary evidence regarding the usefulness of guided imagery (GI) in reducing blood pressure in hypertensive pregnant women, and 2) to answer feasibility questions for a larger trial. Pregnant women with hypertension prior to 37 weeks gestation (n = 69) were randomized to either 15-minute periods of guided imagery (n = 34), or of quiet rest (QR) (n = 35), twice daily for four weeks or until delivery, whichever came first. Daytime ambulatory mean arterial pressure (MAP), systolic and diastolic blood pressures, anxiety, rest and GI use were measured weekly, to a maximum of four weeks. Sixty women completed at least one week in the study; 46.4% completed four weeks. Compliance was excellent. Intention to treat analysis was used. In the unadjusted analysis, women allocated to GI had significantly lower average daytime ambulatory mean MAP elevations from baseline to their last week of study participation than women allocated to quiet rest (GI: M = 1.58 mmHg, SD = 7.63; QR: M = 5.93 mmHg, SD = 6.55; t = 2.36, p = .02). However, the effect was no longer statistically significant (p = 0.14) when adjusted for baseline mean arterial pressure and gestation. There was no statistically significant difference in the numbers of women who were prescribed antihypertensive medication after randomization (GI: n = 16, QR: n = 13, X2 = 0.74, p = .46). There was also no evidence of an effect of guided imagery on anxiety. Nearly 90% (n = 26) of the guided imagery group indicated they would use it again, either in a subsequent pregnancy or during stressful life events. Given the ease of use, low cost, acceptability to women, and lack of risk of guided imagery, an adequately-powered randomized controlled trial is warranted.

This qualitative study sought to answer: How may I, as an artist, use art for my own transformation and healing? I am an artist and teacher living with chronic pain and fatigue and wanted to find healing through art and inspire others to do the same. During the three month study, I made artwork, reflected in my journal, and practiced guided imagery. The journal was used to reflect on my health, the creative process, and to record ideas generated through guided imagery. Findings showed that short term relief was provided during the act of creation, but no long-term relief was achieved. The primary conclusion was that I was able to use art for healing and transformation, but only after experimentation and reflection. By adapting the creative process to accommodate for my illness, I was able to include art making as part of a healthy life.

Hypertension occurs in nearly 10% of pregnancies, and is associated with infant and maternal morbidity and mortality. Prior studies of non-pregnant adults have demonstrated the effectiveness of a variety of relaxation therapies in reducing blood pressure. A pilot randomized controlled trial was conducted, the purposes of which were 1) to provide preliminary evidence regarding the usefulness of guided imagery (GI) in reducing blood pressure in hypertensive pregnant women, and 2) to answer feasibility questions for a larger trial. Pregnant women with hypertension prior to 37 weeks gestation (n = 69) were randomized to either 15-minute periods of guided imagery (n = 34), or of quiet rest (QR) (n = 35), twice daily for four weeks or until delivery, whichever came first. Daytime ambulatory mean arterial pressure (MAP), systolic and diastolic blood pressures, anxiety, rest and GI use were measured weekly, to a maximum of four weeks. Sixty women completed at least one week in the study; 46.4% completed four weeks. Compliance was excellent. Intention to treat analysis was used. In the unadjusted analysis, women allocated to GI had significantly lower average daytime ambulatory mean MAP elevations from baseline to their last week of study participation than women allocated to quiet rest (GI: M = 1.58 mmHg, SD = 7.63; QR: M = 5.93 mmHg, SD = 6.55; t = 2.36, p = .02). However, the effect was no longer statistically significant (p = 0.14) when adjusted for baseline mean arterial pressure and gestation. There was no statistically significant difference in the numbers of women who were prescribed antihypertensive medication after randomization (GI: n = 16, QR: n = 13, X2 = 0.74, p = .46). There was also no evidence of an effect of guided imagery on anxiety. Nearly 90% (n = 26) of the guided imagery group indicated they would use it again, either in a subsequent pregnancy or during stressful life events. Given the ease of use, low cost, acceptability to women, and lack of risk of guided imagery, an adequately-powered randomized controlled trial is warranted.

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The effectiveness of guided imagery as an enhancement to the Systematic Training for Effective Parenting (STEP) program was explored during a shortened 8-week program using three parent groups of elementary-age students matched for parent training experience and couple participation: a) an imagery-modified STEP group (STEP-Im, n = 14); b) a traditional STEP group (STEP, n = 14); and c) a drop-out comparison group (n = 10). Guided imagery consisted of centering exercise(s) for focus and concentration; structured imagery of Adlerian concepts; and open-ended role-assumption imagery for clarifying personal values, the perspectives of others, and concept practice.

Several studies have investigated the psychosocial impact of breast cancer, however, there is a paucity of research examining interventions geared towards breast cancer survivors. This study investigated the effects of group music psychotherapy on improving the self-concept of breast cancer survivors. Eleven breast cancer survivors where randomly assigned to one of two treatment groups - group music psychotherapy or a cognitive behavioral based support group. Pre and post intervention comparisons were made using the Body Image After Breast Cancer Scale and the Tennessee Self-Concept Scale on measures of identity, role performance, self-esteem, and body image. After ten weeks, results from the Wilcoxon U test indicated participants in the music psychotherapy group significantly improved on measures on identity, family role relationships, self-esteem, and body image. Furthermore, as compared to participants in the cognitive behavioral support group, participants in group music psychotherapy improved on measures of identity, role relationships, and body image. Implications and suggestions for further research are discussed. / Music Therapy

The Bonny Method of Guided Imagery and Music (GIM) is an individual form of music psychotherapy known for facilitating profound and embodied music and imagery experiences. GIM theorists have argued that the use of music and imagery can facilitate a mind-body interaction, leading to powerful experiences that affect all facets of a person's being. But this interaction has not been directly examined in GIM, despite the need to understand its nature and risks. This gap in research is due to the inherent limitations of the two major paradigms used in this field: quantitative research cannot account for unique individual responses to phenomena, while qualitative research is not predictive in the same way as quantitative, positivistic research. This study used a new research approach, neurophenomenology, in order to link participants' descriptions of qualitative music and imagery experiences with electroencephalographic (EEG) data, providing context for the brain data while also illuminating the neurological effect of imagery experiences. The music and imagery session used a guided imagery script which focused on six different kinds of imagery experiences (Affect, Body, Interaction, Kinesthetic, Memories, Visual) and was pre-recorded over two different classical musical pieces selected from the GIM literature. Four participants each underwent individual music and imagery sessions using the pre-recorded script and music while having simultaneous EEG data collected. Afterward, participants viewed a video of their sessions with the researcher and described their imagery experiences during a phenomenological interview. The contents of the transcribed interviews were coded into phenomenological categories concerning the congruence of image with guiding cue, imagery modality, stability of imagery, awareness of guiding and music, and awareness of altered state of consciousness (ASC). Meanwhile, consultants performed coherence analyses on the EEG data, examining relationships between major regions of the brain according to both guiding condition and frequency ranges of brain waves. The researcher integrated the phenomenological and EEG data for each participant, and then across cases to determine patterns of subjective experience and brain response. Each participant demonstrated distinctive styles of reported imagery experience with brain responses, ranging from minimal emotional involvement with alertness, to drowsy, disjointed body sensory imagery, to drowsy, disconnected emotional imagery, to a deeper exploration of consciousness with a consistent ASC. Cross-case comparisons of the integrated data showed that 1) the ASC involves both physical relaxation and ongoing focus on the imagery experience; 2) imagery generates brain activity in the same regions that would process information from similar real-life experiences; 3) beta and gamma frequencies played a significant role in how participants maintained an ASC and made meaning out of the imagery. Implications of these and other conclusions from the separate examination of EEG and phenomenological data are discussed. / Music Therapy

The purpose of this study was to solicit information from Fellows of the Association for Music and Imagery concerning their use of the method known as Guided Imagery and Music (GIM). Modifications to the individual and group forms of GIM that were created by Helen Bonny in the 1970s have been reported in the literature over the past 30 years, but the prevalence of these practices is unknown. Based on distinctions provided by Bruscia (2002a), an anonymous electronic survey was designed to gather data on the extent to which original and modified forms of GIM found in the literature are currently practiced. In addition, data were gathered on the basic demographics of GIM fellows, as well as characteristics of their clients and their delivery of GIM treatment. Results indicated that the original Bonny Method practices were frequently used by a majority of GIM fellows. All of the modifications included in the survey were also practiced, although less frequently than original Bonny Method practices. T-tests and ANOVAs were computed to identify significant differences between GIM fellows' use of practices, and, their demographics and delivery of GIM treatment. Pearson correlations were computed to identify significant relationships between GIM fellows' use of practices and their clients' characteristics. A number of significant results were found and discussed. Results of factor analyses indicated that the boundary distinctions between the original Bonny Method and modified practices as articulated by Bruscia (2002a) are reflected in GIM fellows' frequency ratings for these practices. It is recommended that the GIM community adopt a system for distinguishing boundaries between practices, conduct research to determine where Bonny Method and modified practices are learned and for what purposes they are used, and to use this information to inform GIM training and practice. / Music Therapy

The purpose of this study was to identify predictors of responsiveness to the Bonny Method of Guided Imagery and Music (BMGIM), as measured by the Responsiveness to Guided Imagery and Music scale (RGIM). It was hypothesized that when combined, Sense of Coherence (SOC), state trait anxiety (STAI), classical music experience (CME), gender, and/or age would account for a significant amount of variance in responsiveness to BMGIM. Sixty volunteer participants were recruited from the general population. They all attended one research session where they participated in a group Guided Imagery and Music (GIM) experience. Prior to the group GIM experience, participants completed a demographic questionnaire (including a CME measure), the Spielberger State Trait Anxiety Inventory (STAI), and the SOC scale. After the group GIM experience, participants completed the RGIM scale. Once data collection was completed, the reliability and construct validity of the RGIM was examined. Exploratory factor analyses revealed that the RGIM contained five distinct factors: (a) Ability to Relax (AR), (b) Ability to Image to Music (AIM), (c) Responsiveness to Music and Guiding (RMG), (d) Comfort with Self-Disclosure (CSD), and (e) Meaningfulness of the Experience (MOE). These were the dependent (criterion) variables in this study. Before analyzing the data, the researcher ran diagnostics to check for assumptions of regression. Correlational statistical techniques were used to identify significant relationships between variables, and three sets of exploratory multiple linear regressions were used to identify which combinations of variables were the most accurate predictors of RGIM factors. Results of the first multiple regression showed that together, SOC, classical music experience, and age are predictors of "Ability to Image to Music," "Responsiveness to Music and Guiding," and "Meaningfulness of the Experience." Results of the second multiple regression showed that together, state anxiety, classical music experience, and age are predictors of "Ability to Image to Music," "Responsiveness to Music and Guiding," and "Meaningfulness of the Experience." Results of the third multiple regression showed that together, trait anxiety, classical music experience, and age are predictors of "Responsiveness to Music and Guiding." A number of other significant and non-significant results were found and are discussed. Limitations of the study as well as recommendations for future research, clinical practice, and education/training are presented. / Music Therapy