THE EFFECT OF GUIDED IMAGERY AND MUSIC ON STRESS MANAGEMENT

IN THE WORKPLACE

An Applied Doctoral Project submitted

by

ELLISHA C. WELLS

January 2020

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to

IE ASHFORD UNIVERSITY

Upon the recommendation of the Faculty and the approval of the Board of Trustees, this
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Applied Doctoral Project is hereby accepted in partial fulfillment of the requirements for the
degree of

DOCTOR OF PSYCHOLOGY
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Approved by:

_________________________________________
Dana Shelton, PhD
Committee Chair

Committee Members:
Jillian Skelton, PhD
Scott Burrus, PhD
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Ellisha Centrice Wells

2020
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 The Effect of Guided Imagery and Music on Stress Management in the Workplace

by

Ellisha C. Wells

Abstract

Stress is described as a dissonance within the individual that can lead to physical,

emotional, and mental strain (Lal & Singh, 2015). The negative impact of stress in the

workplace has led to high health costs with an estimated cost of $300 billion annually in the

United States (Buys, Matthews, & Randall, 2010; Smith, 2016). This study was a qualitative

descriptive study that gathered data from two groups: one group involved a guided imagery

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and music (GIM) stress management program known as the Healthy Employees and Leaders
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(HEAL) program; the other group was a survey group who completed the Workplace Stress

Survey and the Life Events and Stress Adjustment Scale (LESAS). The HEAL participants
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expressed stressors such as pressure in completing tasks, as well as different managerial

styles with respect to how those tasks should be completed. Other stressors included a

constant fear and worry of consequences for not completing tasks in a timely manner. The
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HEAL participants also shared that the HEAL program helped with those stressors, also

expressing that the program’s success in the workplace would be dependent on the marketing

of the program by management. Other permanent stress management methods suggested by

the HEAL participants included employee appreciation cookouts, more inclusive incentives,

and monthly sports outings that would promote team building among employees.

key words: stress, stress management, workplace stress, stressors, strain, music therapy,
guided imagery and music, meditation, yoga

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 ACKNOWLEDGMENTS

This was a journey that I almost did not take, but then I remembered how good the

Lord Jesus Christ has been to me despite the challenges I have gone through in my life.

There are several people whom I would like to thank, first giving all credit to the Lord Jesus

Christ for allowing the opportunity and giving me the strength to take on this journey.

Thank you to my family and friends, especially my mother Fontaine Wells, whose

love, prayers, and support have been the things that helped me through this part of my

academic journey, as well as her advice that, “Whatever field that you pursue, go to the

highest in that field.” I could not have done this without you as my number-one cheerleader.

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I want to thank my grandparents, the late Alton and Julia Wells, who raised me on the
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importance of education and that anything is possible if I set my mind to it. I love and miss

you both but know that you still live within me in spirit. I also want to thank my spiritual
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advisor, Reverend Dr. James Gallon, for not only helping me with my study but for his

guidance and influence on my relationship with Christ while I was on this journey.
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This ADP would not have been possible without the advice and guidance from my

Chair, Dr. Dana Shelton, who had become my “Mama Bear” throughout the entire ADP

process, even while she was facing a journey of her own. I am thankful also for my

committee members, Dr. Jillian Skelton and Dr. Scott Burrus, as well as my colleagues who

shared this journey with me, providing both motivation and accountability to get this ADP

done and completed. I could not have done it without any of you.

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 DEDICATION

This doctoral project is dedicated to my Lord and Savior Jesus Christ, as it is the

fulfillment of the promise I made to Him in 2013 at a time where I was content with only

having a master’s degree. I did not believe I was capable or strong enough to take on the

doctoral journey despite the challenges I had faced in my life at that time, but You showed

over and over again that I could do this, so I thank You again for being my help and my

strength. “My help cometh from the Lord which made heaven and earth” (Psalms 121:2,

KJV).

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 TABLE OF CONTENTS

CHAPTER I: INTRODUCTION.............................................................................................. 1

Background of the Study .................................................................................................... 5

Justification Statement ........................................................................................................ 5

Purpose of the Study ........................................................................................................... 6

Importance of the Study ...................................................................................................... 7

Conceptual Framework ....................................................................................................... 9

Overview of the Project Approach ................................................................................... 10

Definition of Terms........................................................................................................... 12

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Assumptions, Limitations and Delimitations.................................................................... 13
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Assumptions................................................................................................................ 13

Limitations .................................................................................................................. 14
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Delimitations ............................................................................................................... 15

Summary ........................................................................................................................... 16
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CHAPTER II: REVIEW OF THE LITERATURE ............................................................... 18

Search Strategy ................................................................................................................. 18

Review of Related Research and Literature...................................................................... 19

Transactional Theory of Stress and Coping ................................................................ 19

Wan Hussin’s 3-D Stress Management Model ........................................................... 23

Stress ........................................................................................................................... 24

Stress Management and Types of Stress Management ............................................... 29

Current Stress Management Interventions in the Workplace ..................................... 29

Workplace Coaching as an Intervention Strategy ....................................................... 35

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 Current Issue with Stress Management in the Workplace .......................................... 37

Employees’ Perceptions of Workplace Stress ............................................................ 37

Music and its Relationship to Healing ........................................................................ 40

Guided Imagery and Music......................................................................................... 44

Health Benefits of Guided Imagery and Music .......................................................... 47

Guided Imagery and Stress ......................................................................................... 51

Summary ........................................................................................................................... 52

CHAPTER III: PROJECT APPROACH ................................................................................ 54

Study Approach ................................................................................................................ 54

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Type of Methodology Selected ................................................................................... 54
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Location of Study........................................................................................................ 55

Overarching Research Questions ...................................................................................... 55

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Population and Sample ..................................................................................................... 56

Instrumentation ................................................................................................................. 57
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Stress Management Intervention................................................................................. 57

Informed Consent Form .............................................................................................. 58

Incentive ...................................................................................................................... 59

Weekly Sessions ......................................................................................................... 59

Educational Materials ................................................................................................. 60

Data Collection ................................................................................................................. 61

Workplace Stress Survey ............................................................................................ 61

Life Events and Stress Adjustment Scale (LESAS) ................................................... 62

In-Depth Interviews .................................................................................................... 62

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 Data Analysis .................................................................................................................... 63

Interview Transcriptions ............................................................................................. 63

LESAS and Workplace Stress Survey ........................................................................ 63

Trustworthiness ................................................................................................................. 64

Credibility ................................................................................................................... 64

Transferability ............................................................................................................. 65

Dependability .............................................................................................................. 65

Confirmability ............................................................................................................. 66

Ethical Concerns ............................................................................................................... 66

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Privacy and Confidentiality ........................................................................................ 67
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Summary ........................................................................................................................... 67

CHAPTER IV: FINDINGS, EVALUATION OF FINDING, AND RECOMMENDATIONS

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................................................................................................................................................. 69

Sample............................................................................................................................... 69
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Assessments ...................................................................................................................... 70

Workplace Stress Survey ............................................................................................ 71

Life Events and Stress Adjustment Scale (LESAS) ................................................... 72

HEAL Program Assessment Survey ........................................................................... 73

Data Collection ................................................................................................................. 74

Data Analysis and Results ................................................................................................ 75

In-Depth Interviews (Pre-HEAL Program) ................................................................ 75

In-Depth Interviews (Post-HEAL Program) ............................................................... 78

Evaluation of Findings ...................................................................................................... 81

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 Recommendations ............................................................................................................. 85

Limitations of the Study.................................................................................................... 86

Implications for Theory and/or Practice ........................................................................... 86

Conclusion ........................................................................................................................ 87

References ............................................................................................................................... 89

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 LIST OF TABLES

Table 1 Search Terms ............................................................................................................ 19

Table 2 Frequency Table for Demographics ......................................................................... 70

Table 3 Summary Statistics Table for Age and Time with Company ................................... 70

Table 4 Workplace Stress Survey Descriptive Statistics ....................................................... 72

Table 5 Descriptive Statistics for LESAS ............................................................................... 73

Table 6 Descriptive Statistics for HEAL Program Assessment Survey ................................ 74

Table 7 Pre-HEAL Participant Interview Codes ................................................................... 77

Table 8 Post-HEAL Participant Interview Codes .................................................................. 80

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Table 9 RQ1: Themes and Sample Responses ...................................................................... 82
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Table 10 RQ2: Themes and Sample Responses .................................................................... 83

Table 11 RQ3: Themes and Sample Responses .................................................................... 84

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Table 12 RQ4: Themes and Sample Responses .................................................................... 85
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 LIST OF APPENDICES

Appendix A: Informed Consent .............................................................................................. 95

Appendix B: Informed Consent Form Revised For Survey Data Only .................................. 98

Appendix C: Workplace Stress Survey................................................................................. 101

Appendix D: Life Events and Stress Adjustment Scale........................................................ 102

Appendix E: Workplace Stress Interview ............................................................................. 104

Appendix F: Guided Meditation Script for Stress Management .......................................... 105

Appendix G: Healthy Employees and Leaders Assessment ................................................. 106

Appendix H: Permission to Use or Modify an Existing Instrument ..................................... 108

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Appendix I: Organizational Permission Form ...................................................................... 109
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Appendix J: Use of Public Domain Music in a Dissertation Screen Clip ............................ 110

Appendix K: Public Domain Music Website Screen Clip .................................................... 111

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Appendix L: HEAL Program Yoga Poses and Instructions ................................................. 112

Appendix M: Solicitation E-mail to Study Participants (HEAL Program) .......................... 114

Appendix N: Solicitation E-mail for Survey Only Participants............................................ 115

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 CHAPTER I: INTRODUCTION

Stress is a state of physiological dissonance in the body that can affect an individual

physically, emotionally, and mentally. Stress is defined in terms of its physiological and

physical effects on an individual, and can create mental, physical, and emotional strain (Lal

& Singh, 2015). The workplace is one of the greatest causes of stress in everyday life (Carr,

Kelley, Keaton, & Albrecht, 2011). Workplace stress has been considered to be a major

work-environment problem in organizations (Ladegård, 2011). Typically, stress can help an

individual stay focused, energetic, and alert but can become dangerous after a certain point

(Carr et al., 2011). Stress can have physical, psychological, and occupational consequences,

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which can include a weakened immune system, mental health issues, and increased
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absenteeism (Wan Hussin, 2008). After a certain point, however, stress can affect an

individual’s relationships and productivity (Carr et al., 2011).

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There are two types of stress, the first being acute stress. Acute stress is often short-

lived and the result of unexpected stressors (Carr et al., 2011). The second type of stress,
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known as chronic stress, is more debilitating. Chronic stress is an ongoing state of

physiological agitation from an unresolved issue or situation (Carr et al., 2011). There are

three areas that influence chronic stress as perceived in the workplace: job demands,

individual differences, and social demands. Job demands refer to the intrinsic task

requirements, levels of uncertainty, time pressure, and the rate, amount, and difficulty of

work (Carr et al., 2011). Individual differences refer to the various characteristics of

individuals in the workplace that ultimately have an effect on human behavior, as well as

individuals’ reactions to stress. Individual differences are further divided into two classes of

variables: heredity and environment. Heredity accounts for inborn differences such as the

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individual’s physical health (Carr et al., 2011). Environment, on the other hand, is more

acquired and develops over time. Finally, the third area that influences chronic stress is

social demands. Social demands refer to an individual’s perception of his or her social-

network support needs. Having too much stimulation can lead to stress, while having too

little may leave the individual feeling isolated and lonely (Carr et al., 2011).

As previously stated, stress can have consequences on the human body. Wan Hussin

(2008) stated that there are physical, psychological, and occupational consequences of long-

term stress. Physical consequences include the impact of stress over a prolonged period of

time and can include the weakening of the immune system, making the individual more

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susceptible to illness (Wan Hussin, 2008). Some physical ailments include cardiovascular
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disease, ulcers, diabetes, hypertension, high cholesterol, and gastrointestinal disorders. Stress

is always directly associated with emotional difficulties and behavioral problems (Wan
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Hussin, 2008). With this said, when too much demand is placed on the body, it does not

have the ability to relax and therefore enjoy life. When the body’s ability to relax is greatly
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affected, the individual becomes open to phobias, anxiety, panic attacks, and other

psychiatric disorders (Wan Hussin, 2008). Lastly, occupational consequences to stress

include the individual’s inability to cope with life’s stressors, leading to reduced productivity,

absenteeism, and increased mistakes while on the job. Occupational consequences are

always directly related to both physical and psychological consequences of long-term stress

in the workplace, also creating financial losses for both the individual and the organization

(Wan Hussin, 2008).

As there have been conventional methods that serve to help alleviate perceived stress

in some form, there is also the power of music and music therapy as a healing medium.

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Music has been used since the ancient times to enhance well-being as well as reduce pain and

suffering (Kemper & Danhauer, 2005). It is also ubiquitous among all human cultures, ages,

and ethnic backgrounds. Music therapy is recognized as an allied health profession that uses

the power of music to facilitate therapeutic processes (Kemper & Danhauer, 2005). These

therapeutic goals include the restoration, maintenance, and improvement of both physical and

mental health. Even without the presence of a professional music therapist, many individuals

listen to or play music to help manage stress, anxiety, and pain in the clinical setting. Music

serves to have different effects on the individual based on the individual’s characteristics,

which include age, culture, medical conditions that can affect hearing, musical aptitude, and

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personal experience (Kemper & Danhauer, 2005). Also, the characteristics of the music
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(e.g., tempo, pitch, harmony), the delivery of the music (e.g., headphones or live), setting

(e.g. being alone or in a group), and participation (e.g., active or passive) should be put into
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consideration of the personal experience.

Helen Bonny (1986) described music therapy as the systematic application of music
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to bring change in an individual’s emotional and or physical health. In this approach, the

focus is more on music’s functional use rather than the aesthetic and entertainment aspects.

Effective music therapy is dependent on the music therapist as well as an understanding of

how music can serve in a healing capacity (Bonny, 1986). With this said, there are several

characteristics of music that contribute to its healing capability, the first being that music is

non-verbal. While verbal communication is linear and limited to one level of

communication, music is multi-dimensional and can move across verbal barriers and provide

meaning on several levels at the same time (Bonny, 1986). Music also evokes emotional and

physiological responses, where music can influence an individual’s mood state and rhythmic

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balances that are desired in good health. Another characteristic of music that contributes to

its healing capacity is its ability to stimulate symbolic representation. As images (e.g.,

kinesthetic, emotional, or visual) are part of the treatment of various diseases, carefully

selected music can enhance the flow of imagery and renewal of memories (Bonny, 1986).

Finally, the sensory stimulation of music can create the sensation of other senses. Other

senses such as taste, touch, vision, or smell can be enhanced when an individual deeply

listens to music (Bonny, 1986).

The primary approach for this proposed study was the use of guided imagery and

music. Guided imagery and music (GIM) are known as an in-depth approach to music

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psychotherapy where music is used to generate an unfolding of inner experiences
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(McKinney, Antoni, Kumar, Tims, & McCabe, 1997). Guided imagery and music were

created by Helen Bonny in the 1970s following research at the Maryland Psychiatric Center,
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where research showed that music produced an altered state of consciousness for therapeutic

purposes (Perilli, 2012). Guided imagery has been used as a therapeutic process where the
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individual invokes a comforting image to connect with psychological processes outside of

conscious awareness for the purpose of achieving specific health goals, including managing

stress, anxiety, and depression (Watanabe et al., 2006). The Bonny Method of Guided

Imagery and Music (BMGIM; also known as GIM) uses music-facilitated metaphors as a

way to explore an individual’s inner universe and ultimately develop a new self-image

(Perilli, 2012). In essence, music serves as a catalyst to evoke imagery for both accessing

and working through emotional processes.

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 Background of the Study

Effective stress management techniques appear not to be implemented in the

workplace, resulting in increased perceived stress in employees. This perceived stress leaves

the negative impact of high health care costs due to absenteeism and turnover, with an

estimated cost of $300 billion annually in the United States (Buys et al., 2010; Smith, 2016).

Stress management in the workplace is of importance because a positive and effective

approach may promote a healthier organization in the long-term. Workplace stress continues

to be pervasive and results in economic and social costs for employees, the employees’

families, organizations, and governments (Buys et al., 2010). When an employee is

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negatively impacted by long-term stress, the consequences affect both the employee and the
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employer, who have to adjust to the negative impact. Employees feel that stress prevention

is an area of concern with employers, including stress prevention training and provisions of
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safety programs that address workplace stress (Buys et al., 2010).

Justification Statement
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The proposed study had the potential to reduce employee absenteeism and turnover

due to an alleviation of employees’ (both managerial and non-managerial) perceived stress

levels. The proposed changes may then have the potential to improve organizational

productivity and effectiveness. The general problem was that workplace stress is a major

problem leading to health problems in employees (Ladegård, 2011). The specific problem of

this study is that employees are working in unhealthy stress environments and are being

given coping mechanisms from the company only to have the employee to return to the same

environment with no real environmental changes (Giga, Cooper, & Faragher, 2003), resulting

in the need of a permanent stress management intervention. The proposed study is a step

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toward finding a potential permanent stress management intervention that could be

implemented across multiple industries in the workplace.

Purpose of the Study

The purpose of this action research qualitative study was to explore how using a

proposed intervention called Healthy Employees and Leaders (HEAL), which was developed

for employees working in the retail industry, reduces stress. If the program was successful,

employers could use the HEAL program to design more permanent stress management

interventions across job types. It is with the hope that the HEAL program may help

employees modify or change behaviors when they are faced with workplace stress and learn

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positive coping strategies in the workplace. It was also the hope that employers would be
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open to a potential permanent stress management intervention across multiple industries.

It was best that the methodology for this proposed study be a qualitative study, with
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the research design being action research. The proposed study required employee

perceptions and inputs about current stress management methods, perceived stressors, and
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the idea of an intervention that featured guided imagery and music. The study also required

the implementation of a stress management intervention involving guided imagery and

music. It was critical to gather data on personal perspectives on areas surrounding the overall

topic of stress in the workplace. The gaining of personal perspectives allowed the researcher

to understand viewpoints outside of what could appear to be apparent about the workplace, as

well as what already had been implemented (if anything) to alleviate and/or address the

problem.

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 Importance of the Study

Currently, the negative impact of long-term stress in the workplace is costing

employers $300 billion in annual health care costs (Buys et al., 2010; Smith, 2016). While it

is a common issue, stress is a topic that it is very little understood and a problem that has

negative effects on more than just the individual (Kumar & Jain, 2012). It can have a

negative impact on both the individual and the organization in which the individual works,

affecting several areas of the body. Stress has been conceptualized into three different

perspectives: as a stimulus, as a response, and as a psychodynamic (Pestonjee, 1999). These

perspectives have a basis in Lazarus and Folkman’s transactional theory, describing the

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relationship between the individual and the environment. Lazarus and Folkman’s
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transactional theory is one that will provide a theoretical basis for stress management in the

workplace. Workplace stressors have been known to cause reduced productivity, high
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employee turnover, and frequent tardiness and absenteeism (Williams & Cooper, 1998). Job

stress is a threat to employee health, where 40% of North American workers report that work
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is stressful, with 25% reporting that work is the main source of stress (Calogiuri et al., 2016).

As aforementioned, the health care costs due to stress-related health problems cost

$300 billion annually. Also, employers’ productivity and effectiveness are negatively

impacted due to absenteeism and employee turnover. Workplace stress is estimated to

contribute to 40% of all job turnover (Jarman, Martin, Venn, Otahal, & Sanderson, 2015).

The study presented can provide a potential avenue toward preventative and management

methods toward alleviating stress in the workplace. Also, this study can potentially bring

awareness to the effectiveness or ineffectiveness of current stress management techniques

and support their effectiveness based on theories. It is important to discuss the theories and

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or theoretical frameworks behind stress management because they influence the current state

of which employers handle stress in the workplace.

Current approaches to handling workplace stress involve different coping strategies

(e.g., emotional and transforming), as well as learning to thrive in a sustainable yet

productive manner. This includes employees having an attitude of working harder and

tougher but with the consequence that it becomes unsustainable over time and places a

burden on the individual (Walinga & Rowe, 2013). There are short term coping strategies in

which employees often participate, but overall, these can worsen the costs of stress. These

coping strategies include working while ill (presenteeism) and putting in longer hours while

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at work (Aronsson, Gustafsson, & Dallner, 2000; Worrall & Cooper, 2004). There is a need
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for a stress management intervention that can promote reduced health costs to address

workplace stress as well as teach employees a healthier coping strategy.

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This potential study or project would have importance because stress and stress

management in the workplace is a topic that is not only common but has been a challenge.
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Most organizations implement stress management techniques in the workplace; but in most

cases, employees become recuperated only to come back into the environment that

contributed to the stress (Buys et al., 2010). Employers are suffering from increased health

care costs and reduced productivity from employees suffering from stress-related illnesses.

Stress prevention techniques or interventions have the potential to aid employees’ perceived

stress in the workplace. Examining more into stress prevention and management techniques

in the workplace could lead employers into a positive direction of helping employees, which

then has the potential to reduce health care costs, absenteeism and employee turnover, and

increase overall productivity.

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 Stress prevention techniques or interventions have the potential to aid employees’

perceived stress in the workplace. Examining more into stress prevention and management

techniques in the workplace could lead employers into a positive direction of helping

employees, which then has the potential to reduce health care costs, absenteeism, and

employee turnover, and increase overall productivity. Stress is a common enemy in the

workplace, therefore this study was a starting place as to how to combat or alleviate it. This

applied doctoral project had importance surrounding the industries it could ultimately help.

Although the study focused on the retail industry; it is with the hope that the results of the

study might provide a potential resolution to organizations in multiple industries.

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Conceptual Framework
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The fundamental basis of Lazarus and Folkman’s transactional theory was that the

interaction between an individual and his or her environment created felt stress for the
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individual (Perrewé & Zellars, 1999). Lazarus and Folkman (1987) discussed two central

approaches to their transactional theory, cognitive appraisal and coping. Cognitive appraisal
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describes how humans evaluate what happens to them from the standpoint of its significance

to their well-being (Lazarus & Folkman, 1987). There are two types of cognitive appraisal:

primary and secondary. Primary appraisal concerns itself with the motivational relevance of

what is currently happening, whether it is germane to the individual’s well-being (Lazarus &

Folkman, 1987). Furthermore, there are three types of primary appraisal with stress: the

harm already experienced, the harm that is anticipated (threat), and the potential challenge of

mastery or gain (Lazarus & Folkman, 1987). There is the addition of the benefit appraisal to

take the emotional aspect into consideration. A secondary appraisal is described as a crucial

supplement to primary appraisal. This is such because the harm, threat, challenge, and

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benefit presented in the primary appraisal is dependent on how much control individuals

think they can exert over outcomes (Lazarus & Folkman, 1987). Coping, on the other hand,

serves as a meditator along with a cognitive appraisal of short-term emotional reactions.

Furthermore, coping has two functions: to change the terms of the person-environment

relationship, known as problem-focused coping, and to regulate emotional distress, known as

emotion-focused coping (Lazarus & Folkman, 1987).

Overview of the Project Approach

It was appropriate that this study was a qualitative action research study. Action

research is primarily defined by its research design, consisting of three recurring stages:

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inquiry, action, and reflection (Kemmis & McTaggart, 2005). In the inquiry stage, both the
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researcher and participants identify a shared practical problem as well as a method to address

that problem collectively. Research is then used to provide accurate empirical knowledge of
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the problem, including its nature, causes, and consequences (Mackenzie, Tan, Hoverman, &

Baldwin, 2012). Implementation of an intervention is executed as part of the action phase of

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action research, with defined roles for both the researcher and the participant. Finally, the

reflection stage involves the observation of the effects of the action as well as the results of

the action research on the situation (Mackenzie et al., 2012). The primary purposes of action

research that seemed appropriate for this study included improving and developing a better

understanding of practice, introducing innovation and facilitating change, and simultaneously

generating and testing theory (Titchen, 2015). This followed the three stages of action

research.

The research design for this study was an action research study that included a guided

imagery and music (GIM) program that hoped to provide relaxation to employees within the

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retail industry. The music with meditation program was known as the Healthy Employees

and Leaders (HEAL) program geared for participants who work in the retail industry. The

HEAL program was created as a stress prevention and management intervention for retail

participants. The program provided a stretching and relaxation session along with a guided

imagery session (Watanabe et al., 2006). The stretching and relaxation session lasted ten

minutes, and the remaining 20 minutes were composed of the guided imagery session,

totaling 30 minutes. The 30-minute sessions were conducted weekly over the course of six

weeks, totaling six sessions. During the course of the HEAL program, participants received

materials to promote ongoing guided imagery and music relaxation on their own outside of

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the weekly sessions.
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Prior to the start of the HEAL program, participants were given an informed consent

form that described the study. Also, there was an assessment that measured employees’
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(both managerial and non-managerial) perceived stress. The assessment used for this part of

the study was the Workplace Stress Survey, a 10-item survey scored on a Likert scale. Also,
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considered was an assessment created by the researcher, known as the Life Events and Stress

Adjustment Scale (LESAS). Another assessment was conducted at the end of the HEAL

program to measure any changes in employees’ perception of workplace stress. Interviews

before the program were conducted with participants, were transcribed for this study. As part

of the planning process of the HEAL program, potential participants were recruited through

snowball sampling to discuss their willingness to participate in the program.

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 Definition of Terms

Terms that were featured in this applied doctoral project included the following:

Bonny Method Guided Imagery and Music (BMGIM, or GIM: The use of music-

facilitated metaphors as a way to explore an individual’s inner universe and ultimately

develop a new self-image (Perilli, 2012).

Management employee: Employees who are in a management role within the

organization.

Music therapy: An allied health profession that uses the power of music to facilitate

therapeutic processes (Kemper & Danhauer, 2005).

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New age music: A combination of mostly instrumental pieces creating sounds of a
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soothing, romantic, mood-elevating and sometimes sensual nature for general relaxation

(New World Encyclopedia, 2015).

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Non-management employees: Employees who are not in a management role within

the organization.
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Relaxation techniques: Refer to the variety of methods and manipulations used to

reduce stress, muscle tension, and anxiety in the body (Spine-Health, 2018).

Stress: A state of physiological imbalance in the body (Wan Hussin, 2008).

Stress management: Refers to interventions used at three different points in the stress

process: primary (preventative), secondary (coping), and tertiary (rehabilitative; Glazer &

Gasser, 2016).

Stress: Any event or situation that puts a demand on the individual (Carr et al., 2011).

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