Monitoring variation to Guided Imagery and Music (GIM): Development of the GIM Treatment Fidelity Instrument

Introduction: The Bonny Method of Guided Imagery and Music (GIM) is a complex music therapy method that practitioners use in varied and individualized ways. To improve validity in a quantitative GIM research study and to build knowledge about clinical uses of GIM, we developed a process to monitor variation within GIM sessions.

Method: According to recommendations for complex intervention research, we undertook a process to develop a system to monitor variation to the GIM method that was focused on maintaining consistency of process and function of the GIM method. A team of GIM researchers, practitioners, and primary trainers identified elements of the GIM method and developed an instrument designed to capture variations in a GIM session. The instrument was piloted in 28 individual GIM sessions.

Results: The final version of the GIM Treatment Fidelity Instrument contained 17 items organized into four categories, and included a manual to provide additional clarity for each item. Pilot-testing confirmed that the instrument captured adequate detail for monitoring treatment fidelity and was efficient to use.

Discussion: The GIM Treatment Fidelity Instrument comprises the central part of a comprehensive process to monitor treatment fidelity in GIM research and has the potential to improve implementation and reporting of GIM research. Utilization of this process may help GIM researchers and therapists generate knowledge about implicit decision-making within GIM practice. This descriptive approach to monitoring treatment fidelity may also provide a model for research related to other complex music therapy approaches.