Running head: RESEARCH PROPOSAL DRAFT

A Research Analysis of the Effectiveness of Group Therapy in Combination with Creative

Therapies on Individuals with Mental Illness

Aria Lynn Fonte, Dannicia Laws, Sam McDaniel, Maria Ouzounidis

University of South Carolina

RESEARCH PROPOSAL DRAFT 1

Abstract

Mental illness is a social problem in the United States, and people with mental illness

continue to be stigmatized and discriminated against. Many therapies and treatments have been

successful in lessoning the symptoms of mental illness. In our evaluation, we provide evidence-

based research and studies which focus on the positive effects of group therapy in combination

with creative therapies. Creative therapies include art therapy, music therapy, and dance therapy,

among others. Creative therapies are not a common treatment, but there are several studies

included in our research that support creative therapies being successful in lessoning symptoms

of mental illness. However, some of the research gathered by these studies have some flaws and

limitations. Our particular study evaluates the effects of group therapy in combination with art

therapy on patients with mental illness by using pre and post testing to track the patient’s

progress. From our research, we learned about the effectiveness of creative therapies on

individuals with mental illness based on evidence-based studies. We have concluded that more

studies need to be conducted to gain more knowledge on this theory.

RESEARCH PROPOSAL DRAFT 2

Introduction/Research Question1

The purpose for this study is to gain knowledge in what types and combinations of

therapies work best for individuals with mental illness, in order to provide the most effective

treatments. Many people diagnosed with a mental illness achieve strength and recovery through

participating in individual or group therapy (Mental Health America). Group therapy is a more

common treatment method for individuals with mental illness than creative therapies such as art,

music, dance, and theater, as they are not utilized as much. However, research has shown that

mentally ill individuals tend to be highly creative and talented, and that creative therapies have

shown to be highly effective treatments (Mental Health America).

Studies have also shown that creative therapies have been effective in the improvement

of mental health, social functioning, and quality of relationships with others (Mental Health

America). Hence, a combination of group therapy and creative therapy may be an even more

effective approach in alleviating the symptoms of mental illness. Each individual who suffers

from a mental illness may have an inner passion that is not acknowledged in group therapy

alone, so combining the two together may have even more beneficial outcomes. If all

individuals with mental illness were given the resources to participate in a creative talent that

they enjoy, it could not only help them in a therapeutic way, but also give them the self-

determination to pursue a potential career.

There are many individuals with mental illness who could benefit from creative therapy

services; however, many agencies do not provide these services. The program’s group therapy

and creative therapy services are expected to be effective when used together, since the therapies

are effective separately. By evaluating client’s symptoms over time, while they engage in both

1
Please note that edits have only been made from “The group would like to answer…” on.
RESEARCH PROPOSAL DRAFT 3

therapies, we can document improvement in the lives of our clients by identifying the positive

changes our clients have made. It is worthwhile to note that it is possible that the level of

effectiveness may vary for each client.

The group would like to answer the following research question: If individuals with

severe and persistent mental illness receive group therapy alone, or receive creative therapies,
such as music, art, theater, and dance, alongside psychosocial rehabilitative group therapy, which
will be more effective in improving the symptoms of individuals with mental illness, and have
the most beneficial outcome?
Commented [OO1]: I like your question, however is there
a specific mental illness and population on which you would
like to focus? Each mental illness may have varying
symptoms and you would have to test in a much larger
population. In addition, adults may react different from
children so in order to test this hypothesis, you would also
need a diverse sample of children and adults. Something to
think about. The question is still a bit broad. Think about
CIAO and how we were specific with our population.

By gaining further knowledge about the effectiveness of creative therapies utilized with

group therapy, social workers can develop evidence-based practices to better serve individuals

with severe and persistent mental illness. Understanding how beneficial utilizing creative therapy

in interventions would be, allows for more effective treatments. Answering the research question

would allow service providers to better serve their clients. By providing research and expanding

knowledge about various types of therapies and their effectiveness, social workers can develop

evidence-based practices. Understanding a lesser-known therapy, such as music therapy or art Commented [OO2]: This is repetitious. I think you are
saying the same thing here as you have in your first sentence
of this paragraph.
therapy, could reverse the negative effects on people and the community using evidence-based

practice.

In the United States, 43.8 million adults, approximately 18.5% of the adult population,

struggles with a mental illness. About 10 million of which have a serious mental illness that

prohibits their ability to complete major life activities (National Alliance on Mental Illness

(NAMI), n.d.). Lack of effective treatment has a significant impact on individuals’ and the

community’s health and well-being according to NAMI. Individuals with a severe mental illness

are more likely to be affected chronic medical issues; furthermore, various mood disorders are
RESEARCH PROPOSAL DRAFT 4

the third most common cause of hospitalization for youth and adults (NAMI, n.d.). Failing to

address the consequences of serious mental illness with more successful evidence-based

practices. Mental illness can also lead to suicide, which is the 10th leading cause of death in the

United States (NAMI, n.d.). These consequences of ineffectively treated serious mental illness

impact individuals and their families, affecting health and quality of life. Severe mental illness

has an economical effect as well, costing the country approximately $193.2 billion per year due

to lost income (NAMI, n.d.). Finding more successful treatments could reduce the repercussions

of serious mental illness and allow individuals to lead healthier and more productive lives. Commented [OO3]: Is there a particular population that
suffers more than another? Is there a way to further focus
your study on a specific population children? Adults?
Movement and Mindfulness: A Formative Evaluation of a Dance/Movement and Yoga

Therapy Program with Participants Experiencing Severe Mental Illness is an evaluation of the

use of dance/movement and yoga for individual with severe mental illness. Already, without the

inclusion of group therapy, the results show how movement-based psychotherapy, a form of

creative therapy, allows participants to learn useful life skills, including mindfulness and

breathing regulation, that were not as easily accessible in other psychosocial rehabilitative

groups. Participants were able to discover how to express themselves within their environment

(Barton, 2011). The ability to express oneself could be helpful in gaining coping skills and self-

assurance, useful abilities to improve symptoms of severe mental illness. Based on these results,

the group is confident in analyzing the effectiveness of various creative therapies with group

therapy. The group expects a combination of creative and psychosocial rehabilitative group

therapy to be more beneficial in improving severe mental illness symptoms. Commented [OO4]: Please revisit my comments on your
earlier introduction.
Literature Review

Introduction
RESEARCH PROPOSAL DRAFT
“Creative group approaches are poorly represented in the literature, perhaps because
these approaches are not considered empirically supported or theoretically grounded” (Emond
and Rasmussen, 2012, p. 79). When group and creative therapy have been used together they
have been successful. However, there is a limited amount of literature available on these forms
of therapy combined and more research should be completed. One reason for this is may be that
group therapy has been used for much longer and although it has been proven to be effective
there are some deficiencies within the literature.
Group Therapy
Reaven et. al (2012) conducted a study to discover if children with Autism Spectrum
Disorder (ASD) have reduced levels of anxiety after receiving group cognitive behavioral
therapy. The study concluded that there was a “50% improvement rate obtained for participants”
(p. 417). Although the results of the study showed promising results, the study’s sample size was
very small and only included Caucasian children which makes it difficult to apply the
information to other populations. Also, after receiving the intervention many of the participants
still showed other symptoms in addition to anxiety. As a result, more research is needed as it
relates to group music therapy to determine if it is a more sufficient form of therapy.
A similar study was done by McConachie et al (2013) which incorporated both group
therapy and strategies for coping with anxiety in children with Autism Spectrum Disorder
(ASD); the results showed reduced levels of anxiety from the two groups (p. 730). However,
their findings did not provide enough validity because the participants all received multiple
anxiety diagnoses and needed additional forms of intervention. The intervention chosen did not
tailor to this factor and as a result the participants each responded differently, making it difficult
to generalize the treatments effectiveness.
5
Commented [OO5]: I would move this information to
your introduction.
Commented [OO6]: You need a citation here.
Commented [OO7]: I would remove this sentence.
Commented [OO8]: A study with how many children. I
would give a bit more detail. E.g., Reaven conducted a
quasi-experimental study with 50 Caucasian children to
determine if …………………. Following the intervention,
Reaven et al concluded that participants experienced a 50%
improvement rate in their anxiety.
Commented [OO9]: Ok I would also encourage you to
include this measure in your study as well if you focus on the
effect of creative therapies on ASD in children.
Commented [OO10]: Both of your studies in this section
focus on ASD, but your overall introduction discusses adults
and children in the U.S. with mental disabilities in general.
Although it is ok that you give overall statistics in the
introduction, I think that your introduction should end with
mental illness (or more specifically ASD) in children and its
affects. At this point I don’t know much about how many
people experience ASD and how it affects
Commented [OO11]:
Commented [OO12]: We need to know what the sample
size was.
Commented [OO13]: Are you saying here that the authors
found that the intervention produced symptoms that weren’t
present prior to their participation?
Commented [OO14]: I would remove this sentence and
make a stronger justification later for why music therapy (or
other creative therapies) might be better than solely group
therapy. Also, in other places you use the term creative
therapy as opposed to specifying. I say chose a term and
stick with it based on what type of therapy you plan to test.
Commented [OO15]: I am not sure what you are
concluding here. Let’s talk further.
Commented [OO16]: You may also want to find a good
study that does not have any major research-based flaws to
show that group therapy is a strong option, but it just may
need an additional component such as a creative therapy.
RESEARCH PROPOSAL DRAFT
Creative Group Therapy
Although there is not a large amount of literature about the use of creative and group
therapy combined, some studies have been proven successful. Eren (2015) reported that “During
the music therapy sessions, some improvements were observed in adolescents with ASD in areas
such as turn taking, eye contact, listening, self-expression, coordinated movement in the group”
(p. 212). Similarly to the previous study, LaGasse, A. B. (2014) studied if group music therapy
would improve physical and verbal communication skills in children with ASD. The results
showed that the communication skills of children that received music therapy greatly improved.
(p. 267-268). This research supports that group music therapy is an effective form of treatment
and that more literature related to this topic is needed.
According to a study by Bledin, Loat, Caffrey, Evans, Taylor, & Nitsun, (2016), data and
findings showed that it is very important to continue using group therapies in psychiatric
settings. Oftentimes, it may be seen as a costlier intervention, and thus may be subject to cuts in
budget. Budget cuts would then likely lead to higher recidivism of patients (Bledin, et. al., 2016,
p. 410). This study reached its conclusion by using what is referred to as the “Most Important
Event Questionnaire”, to assess which different aspects of group therapy patients considered
more beneficial. The component that seems to show the most limitations in studies on group
therapy is the methods of measurement. According to Caruso, Grassi, Biancosino, Marmai,
Bonatti, Moscara, Rigatelli, Carr, & Priebe (2013) “the factors important to the group experience
of patients are still poorly understood and are rarely measured,” (p. 1). This study led to the
formation of a method of measurement they referred to as the Ferarra Group Experiences Scale.
A study was conducted to determine five subscales that could be used to help measure
effectiveness of therapy. The limitation of using this particular study as possible guideline or
6
Commented [OO17]: Paraphrase more.
Commented [OO18]: This needs to be moved to the group
therapy section of your paper. Also, I think you should
reframe your argument a bit. As of now, I am unsure whether
or not group therapy is worth it because it is costly,
measurements are subpar, and studies have had limitations.
Remember, every study that highlights a gap, you will need
to attempt to fill some of those gaps with your study. As of
now, I need a justification why group therapy might be
profitable for alleviating the symptoms of mental illness and
what creative therapies might add beyond this. There are
several positions you can take: e.g., Group therapy is semi-
effective alone, but x studies show that adding creative
therapy might make it even more effective. I am concerned,
however, that adding other major limitations gives you more
work. i.e., you have introduced the fact that previous
measures may not be sufficient and the scale that may solve
our measurement problems has not been translated. This is a
study in itself (to test the instrument in a US population). In
addition, you talk about the costliness of group therapy. If it
is this costly already, it will be even more expensive to
implement group therapy + creative therapy. I feel that this
paragraph adds more work to your study. I would probably
eliminate this paragraph.
RESEARCH PROPOSAL DRAFT 7

framework for further study on the topic is its national relevance, as the Caruso, et. al. (2013)

study was conducted in Italy. Since our study will be conducted in the United States, cultural

difference would need to be taken into consideration. However, it still proves useful in showing

that much more research needs to be done in order to truly assess the effectiveness of group

therapy alone.

Barton (2011) conducted an evaluation of the use of dance/movement and yoga for

individuals with severe mental illness. Already, without the inclusion of group therapy, the
results show how movement-based psychotherapy, a form of creative therapy, allows
participants to learn useful life skills, including mindfulness and breathing regulation. These
therapies were not as easily accessible in other psychosocial rehabilitative groups. Participants
Commented [OO19]: What mental illness specifically?
Was this study with children or adults? You want these
studies in some way lend themselves to the population in
which you will test. I think that even if you chose a specific
disorder you can still use studies like these to support the
efficacy of using creative therapies. You can do this by
saying that the symptoms are similar between the disorders
that are being discussed in these studies and the disorder
which you are addressing in your study.

were able to discover how to express themselves within their environment (Barton, 2011). The

ability to express oneself could be helpful in gaining coping skills and self-assurance, and could

provide useful abilities to improve symptoms of severe mental illness. Based on these results, the

group is confident in analyzing the effectiveness of various creative therapies along with group

therapy.

Within the literature, a basis was also found for the necessity of this group's research

question and study. “Despite the long-standing popularity of creative activity groups with mental

health patients, there has been a lack of measurement evidencing a positive relationship between

participation in such groups and improved mental health” (Caddy, Crawford, & Page, 2012, p.

327). This particular study was able to find significant empirical data that there is a correlation Commented [OO20]: I would phrase this differently.
Simply state the purpose of the study and the outcomes.
between creative activity groups and improved mental health. This was studied over a period of

five years. This study, however, is only just the tip of the iceberg. Now that documented

evidence of effectiveness of creative group therapies has been shown, the research must go
RESEARCH PROPOSAL DRAFT 8

further and uncover more nuanced and specific details. For instance, this study was focused on

one single private hospital facility, limiting its sample set. The research in this study also

suggested that more comparative work between group creative therapy and group talk therapy

specifically, such as the group’s proposed study, needs to be conducted. Research also found a

possible link between group musical therapy and improved mental health (through enhanced

quality of life, social enrichment, self-esteem, spirituality, and psychiatric symptoms of

participants, and how they experienced the intervention) (Grocke, Bloch, Castle, Thompson,

Newton, Stewart, & Gold, 2014). Through this particular study, results displayed enhanced self-

esteem and quality of life among individuals with severe mental illness who participated in group

music therapy. However, this study is also limited by a small sample size and short term study

timeframe. Upon deeper reading into a systematic review of the literature on clinical and cost

effectiveness of different therapies, there was a lack of sufficient and comparable data that a

meta-analysis could not be compiled (Uttley, Stevenson, Scope, Rawdin, & Sutton, 2015). Commented [OO21]: Not sure how this adds to the
argument. I think you should eliminate.
Research was attempted but fell short due to lack of sufficient and adequate data on the subject.

This displays a need for further detailed and quality research of the effectiveness of group

therapies as compared to creative therapies (music therapy, art therapy, etc.), in improved mental

health among individuals with severe mental illness. Commented [OO22]: Your research is focused on group
therapies vs group therapies + creative therapies right?
Conclusion

Based on the literature that has been reviewed, there is a need for more research that

utilizes both group therapy and creative therapy. Much of the existing information about these

types of therapy has been influential. However, many of these studies have included some flaws

that affect the outcome such as study design and sampling method. New knowledge on this

subject would help people with mental illness learn to apply creativity, learn new coping skills,
RESEARCH PROPOSAL DRAFT 9

as well as improve their social independent living skills. This proposed study is the best way to

investigate our question because it will include both male and female participants with an Commented [OO23]: Any particular age group? Were
studies that you reviewed male and female?
improved method of measuring the impact of combining group and creative therapy on severe

mental illness. The group expects that through further studies, a combination of creative and

psychosocial rehabilitative group therapy will show to be more beneficial in improving severe

mental illness symptoms.

Agency/Program Description

Bridges Clubhouse is an agency that directly provides services in Cayce, South Carolina

(https://clubhousesofmhasc.org/, https://mhascclubhouses.files.wordpress.com/2016/03/bridges-

brochure-march-2016.pdf). It is associated with the larger non-profit organization Mental Health

of America South Carolina (MHASC) as a program to enact their shared mission to assist

individuals with severe and persistent mental illness. The agency strives to assist individuals

diagnosed with mental illness with independent living through day treatment. This includes

developing various skills and healthy self-care practices through psychosocial rehabilitative

groups and skill development groups. Psychosocial rehabilitative groups include topics such as

self-care, care of the home, creative coping skills, and budgeting and time management. The

ultimate goal for individuals receiving services is to live independently and with strong coping

skills in order to successfully maintain recovery. Bridges Clubhouse teaches multiple skills

within their various skill development groups including self-care enhancement, daily living and

life skills, therapeutic socialization and social skills, decision-making and problem solving,

empowerment, and recovery as a way to develop and enrich their client’s abilities to
RESEARCH PROPOSAL DRAFT 10

independently live. The agency also organizes transportation for clients from their home to the

clubhouse when requested by using Logisticare (March, 2016).

Treatment occurs Monday through Friday. Clients arrive at 8:30am and immediately begin

socializing and interacting with peers. During the morning meeting, they discuss current events,

popular culture, etc. After a short break, clients begin Life Skills for an hour and fifteen minutes.

Life skills encompasses practicing intellectual, social, and emotional skills to assist in

community functioning such as budgeting, time management, self-care, and creative coping

skills. For the next hour, clients will have Psychoeducational Group, which educates clients

about different severe mental illnesses, managing symptoms, self-advocacy, etc. Clients are

given a free lunch before Wellness/Skills Groups begins. Skill Groups occur for approximately

forty-five minutes and consists of activities such as canteen, computer technology, kitchen,

maintenance, and transitions. These groups teach individuals how to prepare and serve food,

operate a cash register, navigate e-mail and the Internet, practice food safety, perform skills

related to cleaning and managing a home, and utilize available resources, all with the purpose of

preparing clients to live and work independently. After another short break, everyone reunites in

the communal area to summarize what was learned and appreciated throughout the day. Before

leaving at 3:30pm, clients have the opportunity to practice Life Skills for another hour and

fifteen minutes (Bridges Clubhouse, 2016).

Bridges Clubhouse serves adult males and females. Clients must be at least 22 years old and

have a diagnosable mental illness that is severe and persistent. Some clients will have a dual-

diagnosis of mental illness and substance abuse. The agency serves individuals of all sexual

orientations, races, and religions and does not discriminate. Clients attend voluntarily and are

sometimes referred by case managers. Additionally, individuals should be willing, able, and
RESEARCH PROPOSAL DRAFT 11

determined to participate in groups and activities and to reach individual goals. The agency does

not release the rates of specific client characteristics such as race, gender, and age to the public.

The exact costs of services are not disclosed to the public either. Costs are discussed with

clients privately during intake. Bridges Clubhouse bills for treatment services and the only

additional cost is transportation, if needed. Services can be paid through SC Healthy Connections

Insurance (Medicaid) or out-of-pocket (Bridges Clubhouse, 2016).

Mental Health America South Carolina (MHASC) is a non-profit organization associated

with Bridges Clubhouse. It is dedicated to advocating and providing services for individuals with

a mental illness in addition to educating all South Carolinians. The organization hopes to raise

public awareness, diminish stigma, and encourage wellness. MHASC provides service through

client support in partnership with Bridges Clubhouse (Mental Health of America South Carolina,

n.d.).

Logic Model Commented [OO24]: You may want to combine these

boxes as one image. As of now, I cannot read your model.

Inputs Activities

Conducting research in Subjects will be

which subjects will either interviewed and evaluated
be involved in group by mental health
therapy alone or group professionals before and
therapy combined with art after therapies begin
therapy, a form of creative Subjects will also be
therapy surveyed
Subjects will positively
Art therapy, possibly grow in result of the
and eventually creative combination of group
therapies as well, are therapy and art therapy
moreOutcomes
highly valued as Outputs
in terms of quality of
an effective, evidence- life, social enrichment,
Art therapy’s
based value as an
intervention
effective intervention for health/wellness,
useful for some psychiatric symptoms,
individuals affected
individuals with serious
by a
and persistent mental spirituality, and self-
severe and persistent esteem
Impact
illness
mental is emphasized
illness
RESEARCH PROPOSAL DRAFT
Methods
Research Design
The research design for this study will include survey research, qualitative research, and
pre/post testing. Participants will be patients with mental illness from several mental health
agencies located in Columbia, SC. About 25 participants from each agency who are engaging in
group therapy, and who agree to engage in art therapy in combination with group therapy, will be
used for this study. These participants will be pre-tested on their symptoms using a likert scale.
Afterwards, they will engage in art therapy for a period of two weeks, and then be post-tested to
compare the results. This will help determine if any progress has been made with reducing the
patient’s symptoms.
The research design will also include qualitative interview questions administered by
therapists that work with the participants. The therapists will track their patient’s progress by
asking them open-ended questions to determine if art therapy in combination with group therapy
is more beneficial to reducing the patient’s symptoms compared to group therapy alone.
One weakness of this research design is that the sample size is not very big and is located
in only one city. Another weakness is that it does not take into consideration different types of
mental illnesses, and just groups them into one category. There are many different symptoms for
certain mental disorders so that may cause measurement errors in the data. Also, it does not take
into consideration whether or not patients included in the study are taking their medication. This
may also cause measurement errors in the data.
One strength of this research design is that it uses mixed methods to gather data, which
increases our findings. The research design is also feasible considering the amount of time that it
will take to gather the data (two weeks).
12
Commented [OO25]: How many agencies?
Commented [OO26]: Why did you pick art therapy, you
need some justification here.
Commented [OO27]: Describe very briefly what these
things consist of e.g. painting? I am curious to know what
the intervention looks like.
Commented [OO28]: If you will conduct the study as
proposed, you might consider giving a pre and post after
group only therapy and pre and post after art therapy, but as
written in your literature review it seems as if elements of art
therapy will be incorporated into a group therapy session. If
this is not the case, then I say expand on the methods in the
literature review e.g., group therapy followed by art therapy
OR elements of art therapy incorporated into group therapy.
Also will you be comparing two groups?
Commented [OO29]: This is a huge limitation. How is
group therapy conducted in the real world? Are there people
with various disorders being treated in one type of group
therapy? For example, including people with PTSD in a
group of individuals with psychosis may not be the best
treatment strategy because the treatment would likely be
targeted.
Commented [OO30]: Absolutely. See the last comment.
Are the symptoms for each of these disorders the same? If
not, how can you reliably measure the success of the
intervention. I suggest either using one disorder OR testing
only among people with mental illnesses that have similar
symptoms e.g. anxiety, frustration, etc.
Commented [OO31]: Think you should chose different
language here.
Commented [OO32]: Is this consistent with
RESEARCH PROPOSAL DRAFT 13

The research design is suitable to the agency setting because it uses participants who are

patients at these mental health agencies.

This research design is the best option because it uses both qualitative and quantitative

research, which gives us more information to rely upon. Qualitative data gathered by therapists

can give us a deeper understanding of the patient’s symptoms and progress, while quantitative

data can help support the results of the qualitative data. Also, using pre and post testing helps Commented [OO33]: See your text for further
justification for why it is beneficial to use a mixed methods
design.
determine a patient’s progress, which is key to answering our research question.

Data Collection/Measurement

Variables. In this current study, the dependent variable will be the symptoms of the

patients. The independent variable will be the group therapy versus group and music therapy Commented [OO34]: Can you give some examples? If
you chose one disorder, you can list the most common. See
the articles that you chose in your literature review to see
combined that the participants will receive. The control group will be the group of participants what symptoms they measured and scales they used.

that only receives group therapy. Our goal is to observe if group and music therapy combined

can create a beneficial side effect on people with mental illness.

Measures.

Appendix A

The participants will be asked the following questions: 1) “What part of group and music therapy

did you enjoy most?”, 2) “Do you think that it made you feel better, worse, or the same in any

way? If so, in what way?”, 3)”Are you still having similar symptoms to the ones you had before

completing group and music therapy?

To measure the dependent variable, which is the level of symptoms of the patients while

receiving therapy, we will provide them with a post-test to complete. This will allow us to

analyze their results and determine if their symptoms have reduced. The independent variable,

which is the group and music therapy that will be used, will be measured through a survey that
RESEARCH PROPOSAL DRAFT 14

guardians of the participants will complete. It will explain what the different therapies used

consist of and ask whether signs of improvement have been observed. This study will measure a

combination of both duration and magnitude. The study will test how long therapy must be

received in order to have positive effect on participants that are actively involved. The magnitude

of the study will be uncovered by discovering to what extent both group and music therapy can

be utilized in order to bring about promising results as it relates to reducing problematic

symptoms in people who have mental illness.

Cultural Sensitivity. It is common for many people who have mental illness to

experience multiple symptoms. We would be sensitive to this while conducting our study by

making it clear to our participants as well as their guardians that we understood if they had

difficulty completing the study as a result of experiencing severe pain or symptoms.

Source of Data. We will use records from different mental health settings about the

history of our participants in order to get a deeper understanding of their symptoms and how it

relates to our study. We will then conduct interviews with the participants to get a better Commented [OO35]: Ok this was not mentioned before.

understanding of how group and music therapy is affecting them. Lastly, we will directly observe

the participants to see if their symptoms become better over time.

Collection of Data. Trained psychiatrist who are not apart of the study will collect the Commented [OO36]: How many?

data. We will not collect the data in order to avoid creating any bias toward the data. Also, we

will not allow therapist who are working with participants to directly collect data because in

order to avoid social desirability biases which could occur if participants know the therapist want

certain results. The therapist would collect paper surveys and the questions would be qualitative. Commented [OO37]: Good.

How the therapy has helped, Asking them what their experience was like, their mental state at

this point.
RESEARCH PROPOSAL DRAFT 15

Sample Design

For this particular study, the group concluded that a non-probability sampling method

would be most appropriate. Particularly, in this case, quota sampling would be used, because in

order to obtain the data needed the sample set must consist entirely of individuals living with

severe mental illness. Therefore, the participants will be drawn by random selection within

different mental health facilities across Columbia, in order to build as diverse and representative

of a sample subset within this population. 25 participants will be randomly selected from facilities Commented [OO38]: Spell out when it is the first word of
the sentence. I am still unclear whether you are collecting 25
participants total or 25 from each agency?
such as Bridges Clubhouse, Three Rivers Behavior Health, University of South Carolina Campus
Commented [OO39]: This is not non-probability
sampling.
Counseling, and Palmetto Health Richland Springs to participate in the randomly assigned

intervention-study groups. Participants will be slightly skewed due to the voluntary nature of the Commented [OO40]: Above you seem to list a quazi-
experimental design (e.g., pre-post). However, it is sounding
more at this point like a randomized control trial. See your
study; some initially randomly selected participants may choose to opt out and some participants text and revise as needed.

may not be capable of participation due to medical related restrictions. Non-probability sampling Commented [OO41]: You say randomly selected above
which would not be representative of non-probability
sampling.
is the best choice in this case because it is most useful in testing the effectiveness of different types

of interventions, which is the ultimate purpose of this study. Quota sampling is necessary in this

particular study because these interventions, for their purpose, are only relevant to a certain subset

of the population (that is, individuals with severe mental illness). Therefore, in order to find the

most useful and accurate data on this topic, the sample set must be selected within this specific

subset. One of the advantages of this sampling design is that it is relatively easy to obtain. It is also

much less expensive, and it is more adequately representative of a specific population. One of the

disadvantages of this sampling method is that it is not entirely randomized, and therefore may Commented [OO42]: You state above that this is
randomized.
contain unchecked bias or sampling errors. Since it is a type of non-probability sampling, it also

has the disadvantage of lack of generalizability. A final limitation of this sample is that, due to

feasibility, it studies only within the Richland area. However, this would be an introductory study; Commented [OO43]: Exploratory?
RESEARCH PROPOSAL DRAFT 16

if significant results were found within the Richland area alone, it would then lead to a push and Commented [OO44]: Not clear

more funding for more robust and extensive studies.

Protection of Human Subjects

Voluntary Participation. The individuals involved will be well-informed regarding the Commented [OO45]: Good.

voluntary nature of the research. The subjects will be given information packets, to be signed

then copied if desired, about their rights and protections while the research is conducted. In terms

of voluntary participation, the packet will include the following statement, “Participation in both

therapies, art and group, as well as the interviews and evaluations is entirely voluntary. If at any

point during the research you no longer wish to continue, you have the right to stop. Be aware,

however, that information collected thus far will continue to be used by the research team. Please

make any research conductor aware if you decide to stop participating.” Through this, subjects

will be knowledgeable about their right to discontinue participating during the study.

Informed Consent. The research team will also inform the subjects about the entirety of Commented [OO46]: Good.

the study. Although the subjects will be familiar with group and possibly art therapy, the

information packet will include thorough information about what each type of therapy consists of

and their purposes. The packet will also provide the subjects with details about how data will be

collected and measured through interviews, scales, and evaluations by mental health

professionals. Additionally, subjects will be given information about where, when, and how long

the study will be conducted. Lastly, subjects will be informed of the purpose of the study. This

section will ensure the subjects’ rights of informed consent are protected.

Risks v. Benefits. Along with the detailed information about the process of each therapy, Commented [OO47]: What would be some of the risk of
this type of study?
we will include any possible risks and benefits. One example within the packet is explaining how

group therapy may help them develop support networks; however, there is no guarantee of
RESEARCH PROPOSAL DRAFT 17

privacy in terms of the other members attending (American Psychological Association (APA),

n.d.). All possible advantages and disadvantages of each therapy will be stated within the

information packet. The research team will also include the possible benefits or risks regarding

the findings of the study. The subjects will be aware that the research may discover a more

effective, evidence-based intervention or an ineffective intervention that does not support

positive progress.

Anonymity and/or Confidentiality. Finally, subjects have the right to anonymity and/or

confidentiality. The research team will be protecting the subjects’ identities with confidentiality

rather than anonymity. This is simply to keep all mechanisms of measurement, such as

interviews, together with their respective subject so researchers can gain a complete

understanding of their experience with each therapy. The team will use codes as identifiers and Commented [OO48]: Identifiers on what? Surveys?
Consent forms? Please clarify.
the key legend to the codes will be safely protected with encryptions. The information packet

will make subjects aware of, as well as protect, their right for confidentiality. It will explain what

confidentiality means and how the research will protect it. The packet will also discuss how

subjects must protect the confidentiality of their fellow participators as well. Although this

cannot be guaranteed, which will be outlined in the “Risks v. Benefits” section, subjects will be

aware of their right to be protected and their duty to protect confidentiality of others. This final

section of the information packet will ensure the subjects are aware that their confidentiality is

protected.
RESEARCH PROPOSAL DRAFT 18

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American Psychological Association. (n.d.). Psychotherapy: Understanding Group Therapy.

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Barton, E. J. (2011). Movement and Mindfulness: A Formative Evaluation of a

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Emond, S., & Rasmussen, B. b. (2012). The Status of Psychiatric Inpatient Group Therapy: Past,

Present, and Future. Social Work With Groups, 35(1), 68-91. Commented [OO49]: Make sure your references are
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references if you include it for one.
RESEARCH PROPOSAL DRAFT 19

Eren, B. (2015). The Use of Music Interventions to Improve Social Skills in Adolescents with

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LaGasse, A. B. (2014). Effects of a music therapy group intervention on enhancing social skills

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Couteur, A. (2013). Group therapy for anxiety in children with autism spectrum disorder.

Autism, 1362361313488839.

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march-2016.pdf

Mental Health America. (n.d.). Mental Health Treatments. Retrieved January 31, 2017, from

http://www.mentalhealthamerica.net/types-mental-health-treatments

Mental Health America of South Carolina. (n.d.). Retrieved January 15, 2017, from

http://www.mha-sc.org/whatwedo.php

National Alliance on Mental Illness. (n.d.). Mental Health By The Numbers. Retrieved January

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RESEARCH PROPOSAL DRAFT 20

Reaven, J., Blakeley-Smith, A., Culhane-Shelburne, K., & Hepburn, S. (2012). Group cognitive

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