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Research Methods in
Clinical Psychology
Arlene Vetere, PhD
Your Relationship to Research
What is your experience of research?
What are your beliefs about research?
What is the role of research in systemic
clinical psychology practice?
Think of some research that has had an
impact on you, and why?
Discuss what criteria you used to judge the
usefulness of the research
Qualitative Research
Focus on understanding – meanings underlying
behaviour
Emphasis on description versus general, causal
explanations
Focus on participants’ representations of reality
Emphasis on subjectivity – recognition of
uniqueness of individuals and experience
Focus on small number of participants; data as
text, transcript, diaries, observation
Qualitative Research (cont’d)
Experience and behaviour should be viewed in
context and in its full complexity
Scientific process as generating “working
hypotheses” (compare with clinical practice)
Theorising as based upon emergence of
concepts versus imposition of prior theory
Variability of meanings over time and context
Close relationship between researcher and
participant
Criteria for Qualitative Research
Accessible – language, diagrams, presentation
Interesting and inspiring
Report draws reader in, fosters a sense of involvement
Reflective – shows evidence of self-appraisal:
1. On methods employed, findings, consideration of alternative methods, alternative interpretations possible
2. Reflections on researcher’s own stance, assumptions and possible biases
3. Context – indications of reflections on a variety of factors influencing the study and interpretation – prestige, constraints, demands, and so on
Criteria for Qualitative Research
(cont’d)
Participant’s voice – not just researcher’s
account but able to hear what participants
have to say
Collaborative – evidence that participants
were actively involved in the research
process, including initial consultation to the
research question
Reflexivity
Expectation that the researcher will make
explicit their ‘speaking position’ – their
interpretative framework
Expectation that they will reflect on this – in
supervision, with peers, in a research diary, in
a self-reflexive interview
What aspects of the researcher’s
interpretative framework have influenced the
research process and outcomes?
Self-reflexive Activity
Please reflect on the thoughts and feelings
you have had over the last few minutes in
relation to the material presented so far, and
the way in which it was presented….
Turn to your neighbour and reflect together
on how these responses can ‘get into’
research activity ie shaping the questions we
ask, how we ask them, how we meet
people….
Reflexivity: relevance to dissertation assessment
Position statement and personal reflections – the
outcome of the research analysis represents a dynamic
interaction between the researcher, participants and the
data, including the researcher’s interpretative
framework. What did you bring to the analysis? What
personal investment do you have in the topic? How
might they have shaped the way you interpreted the
data? Reflection on your emotional responses to the
data and to accounts from individual participants.
Reflect on the group analytic process. How have you
been affected by doing the research?
Quantitative cf Qualitative Research
Structured data vs unstructured data
Random sampling vs purposive/theoretical
sampling
Statistical analyses vs conceptual syntheses
Objective conclusions vs subjective
conclusions
Surveys, experiments vs focus groups,
interviews, observations
Generalisation to population vs generalisation
to theory
Critical Appraisal of Qualitative
Methods
Difficult to generalise
Lack of prescribed methods
Premature closure of text to further analysis
Focus on text loses performative aspects of language
Representativeness of research: sampling
Create new ‘truths’ or no ‘truths’
Weaker positioning for subjective methodologies
Repeatability and reliability issues
Qualitative Research Methodologies
Grounded Theory
Discourse Analysis
Rhetorical Analysis
Narrative Analysis
Interpretative Phenomenological Analysis
Conversational Analysis
Ethnography
Focus Groups & Delphi Study
Action Research & Participative Research
Mixed Methods
Genres of Psychotherapy Process
Research
Types of Question and Appropriate Methods:
1. Quantification
How frequent is a type of event? To what
degree or intensity is a property generally
present in therapy? What is typical?
Descriptive quantitative methods: surveys,
rating scales, category systems, descriptive
statistics
Quantification
Types of Question (cont’d)
Comparison:
Does a type of therapy, event, or phase of therapy have
more of something than another type, event or phase?
Which therapy is better for this disorder?
Quantitative experimental and quasi-experimental
designs: inferential statistics, RCTs, meta-analysis of
comparisons
Types of Question (cont’d)
Relationship
Which aspects of therapy vary together? What types of
event typically precede or follow another? What
predicts therapy process and outcome?
Bivariate and multivariate correlational methods;
sequential analysis; prediction research, path
analysis, meta-analyses of relational research
Types of Question (cont’d)
Method Quality
How well (reliably, validly) can an aspect or
event be measured by means of a particular
process or outcome measure?
Psychometric or measure development
research
Types of Question (cont’d)
Definition
What is the nature of a particular therapeutic
phenomenon? What defines or constitutes it?
Phenomenological research (IPA, theme
analysis), grounded theory, ethnographic
research
Types of Question (cont’d)
Description
What kinds of events or aspects exist in
therapy? What features, types or patterns do
these events or aspects have?
Naturalistic qualitative research (participant
observation), grounded theory, ethnography,
quantitative content, cluster, interaction
analysis
Types of Question (cont’d)
Interpretation
What is the meaning of a therapeutic event or
process? Why did it happen? How did it
develop?
Interpretative research (IPA), narrative case
study research, comprehensive process
analysis, task analysis, discourse analysis
Types of Question (cont’d)
Critique/Action
What is wrong with how things are now? How
could it be made better?
Feminist research, participant action research
Types of Question (cont’d)
Deconstruction
What implicit assumptions are made in this
research? Whose interests are served or
ignored?
Conceptual analysis, self-reflection, systematic
analysis and critique of typical practice,
discourse analysis, rhetorical analysis
Honing the Research Question
Think of a process moment in your practice
Develop a research question to explore it
further
What do you want to understand?
What would you learn?
How would it change your practice?
How would it benefit your client/s?
IPA: Theoretical Underpinnings
Phenomenology: explores in detail individual
personal and lived experience
Hermeneutics: a two-way interpretative
process – the double hermeneutic –
similarities and patterns
Idiography: analysis begins with a detailed
reading of a single case
IPA: Epistemological Position
Constructionist position
Focus on individual’s beliefs and experiences of topic
under study
The approach is phenomenological (ie how
individuals make sense of events or experiences
associated with topic under study)
(www.ipa.bbk.ac.uk)
IPA: Epistemological Position
The meaning that individuals give to events or
personal experiences becomes the focus of the study
The generation of meaning is an interpretative
process for both the individual and the researcher –
what might it mean for participants to have these
concerns in this context?
Language and context shape an individual’s
response to his or her understanding of events, or
personal experiences
IPA Analysis: Looking for Themes
Number the lines of the interview transcript, leave
wide margins and use double/triple spacing
Read the interview transcript many times, using right
side margin to note anything of interest (meaning and
context, and your responses to the text –
interpretative activity)
Use left side margin to annotate key words and
quotations for emergent themes (claims, concerns
and understandings – linguistic, descriptive and
conceptual: trying to represent your participants’
perspectives/experiences)
IPA Analysis: Looking for Themes
List all these emergent themes on a separate sheet and look for
connections, using your right side margin notes to help -
numeration, abstraction, function, contextualisation, polarisation
Make clusters of the emergent themes and give these sub-
themes a new name, etc. Do this first for each interview,
subsequently across all interviews
Then cluster the sub-themes into super-ordinate themes – give
them a name
Produce a table of themes ordered coherently: indicate where
sub-themes lie under super-ordinate/master-themes; indicate
where examples (quotations) can be found in the transcript
Theme Analysis: Practical
considerations
Development of semi-structured interview
Relationship between research interview and
therapeutic interview
Transcription and editing – para-lingusitic information
An ‘embarrassment’ of data
Take it slowly – risks of abstracting too quickly – strip
the data of meaning
Self-reflexivity – use right side margin notes to aid the
clustering process and development of themes
Interviewing more than one person – focus groups
Uses of IPA Research
Understand the experiences of particular groups of
people
Develop and evaluate services, therapeutic
interventions, and so on
Interpret the associative findings from conventional
quantitative research
Situate and understand people in their socio-cultural
contexts
Evaluate and reflect upon the role played by
therapeutic, institutional and legislative cultures
Re-evaluate existing theory
What is Thematic Analysis?
What counts as a theme?
A rich description of the data set, or a detailed
account of one particular aspect?
Inductive (bottom-up) versus theoretical
(deductive/top-down) thematic analysis?
Semantic or latent themes?
Epistemology: essentialist/realist versus
constructionist thematic analysis?
The many questions of qualitative research and their
inter-relationships?
Phases of Thematic Analysis
Familiarise yourself with your data: transcribing,
reading and re-reading, noting initial ideas
Generating initial codes: coding interesting features
of the data in a systemic way across all the data,
collating data relevant to each code
Searching for themes: Collating codes into potential
themes, gathering all data relevant for each potential
theme
Reviewing themes: checking if themes work in
relation to the coded extracts and the entire data set,
generating a thematic ‘map’ of the analysis
Phases of Thematic Analysis
Defining and naming themes: ongoing analysis to
refine the specifics of each theme, and the overall
story the analysis tells, generating clear definitions
and names for each theme
Producing the report: the final opportunity for
analysis. Selection of vivid, compelling extract
examples, final analysis of selected extracts, relating
back from the analysis to the research question/s and
the relevant theoretical and research literature,
producing a scholarly report of the analysis
Braun and Clarke, 2005
Grounded Theory
Simultaneous involvement in data collection
and analysis phase of the work
Creation of analytic codes and categories
developed from the data, not preconceived
hypotheses (creating categories early in the
research shapes subsequent data collection;
categories reflect interaction between
observer and observed)
The development of middle range theories to
explain behaviour and processes
Grounded Theory (cont’d)
Memo-making ie writing analytic notes to
explicate and fill out categories
Theoretical sampling ie sampling for theory
construction, to check and refine emerging
categories, disconfirmation
Delay of the literature review
Grounded Theory: line-by-line coding
What is going on?
What are people doing?
What is the person saying?
What do these actions and statements take
for granted?
How do structure and context serve to
support, maintain, impede or change these
actions and statements?
Activity: What is Discourse?
Think of a time in your childhood, and
Think of now……
What discourses about health and well being
were current then and now?
How have they changed?
What has changed?
DISCOURSE: A Definition
DISCOURSE - constellation of shared ideas/beliefs (explicit or implicit) which map out how areas of experience are to be seen and what is to be done
DOMINANT DISCOURSES - any given culture and parts of it contain dominant shared assumptions or discourses e.g. discourse of ‘mental illness’
Discourse Analysis: basic tenets
Language is seen as constitutive
People struggle in language over the nature
of events
People use language to construct versions of
the social world
Discourses are the constructs, often derived
from wider social and cultural repertoires,
used to present accounts
Some discourses more dominant in society
than others
Discourse Analysis
Discourse analysts ask particular kinds of questions
about language:
What action does this piece of talk perform?
What accounts are individuals trying to construct in
interaction with each other?
How do these accounts change as contexts change?
What are the limitations and consequences of the
discourses that individuals use?
Activity: Text Extract
With a colleague, ‘free associate’ to the
text
Reflexivity: ask yourself – why am I
reading this text this way?
What do you think is the ‘function
orientation’ of the text?
How is the text organised rhetorically?
Steps in Discourse Analysis
Selection of text: selection of themes;
selection of dialogue – both content and form
Analysis: construction; variability; function
Maintaining self-reflexivity
Rhetorical Analysis
Focus on action rather than cognition
Conversation as argument – justification and
criticism
Issues of accountability and agency
Rhetorical Analysis (cont’d)
“unhappy incidents”
Recipient design
Use of “facts”
Extreme case formulation
Use of vagueness
Category entitlement
Use of common sense maxims
Rhetorical Analysis:
Questions to ask of the extract
How do the identified discourses position
Jim/May in the interaction, and how does
he/she position themselves in relation to
them?
How are ‘worry’ discourses (interpretive
repertoires) promoted/undermined?
How are blame and responsibility dealt with?
What alternative versions are being
constructed in the text?
NARRATIVES: Some definitions
LANGUAGE AS ACTIVE - language is used actively, strategically to persuade, influence, justify - present oneself in preferred ways
DOMINANT DISCOURSES - any given culture and parts of it contain dominant shared assumptions or discourses e.g. discourse of ‘mental illness’
DISCOURSE - constellation of shared ideas/beliefs (explicit or implicit) which map out how areas of experience are to be seen and what is to be done
NARRATIVES/STORIES – they help organise, make sense of, give coherence to experiences over time; they connect the past, present and future
NARRATIVES: Some Definitions (cont’d)
SELF - distributed, fragmented across different contexts - questions idea of a unitary self or personality
POWER - dominant groups in any given culture have the power to produce and maintain/reproduce dominant culturally shared ideas – discourses
PROBLEM-SATURATED TALK - ways of talking about difficulties can shape problematic systems
NARRATIVE ANALYSIS
Assumptions: Self narrations are both constructions and claims of identity
Types: Life story method; sequence of core narratives; emplotment and genres; poetic and metaphor approach
Identifying the narrative: look for markers eg “I’ll give you an example…”,
or, through its structure eg act (what), scene
(where/when), agent (who), agency (how),
purpose (why)
The story: agent uses instrument to take action to achieve goals
“There is no other way for us to describe lived time other than through narrative” (Ricoeur, 1984)
NARRATIVE as PERFORMANCE
Relationship between the teller and the listener
Power – who asks the questions and for what purpose?
Intentions of the story teller – to convince, justify, explain, persuade, amuse and so on
Co- construction – prompting, editing, encouraging, validating, disagreeing and so on
Connecting with shared stories – cultural, literary, religious and so on
Narratives can be seen to vary on a number
of important dimensions….
ELABORATIVE vs. CONSTRICTIVE/pre-emptive
e.g. you are always selfish and everything you do is...
FRAGMENTED vs. COHERENT
e.g. well I suppose my mother was... sort of kind... but she did let me down a lot and... at the end of the day she was OK but I don’t really care anyway, I’ve kind of forgotten about it...
REFLEXIVE vs. CONCRETE
e.g. I have no idea why she used to hit me, she’s just a cruel personality I suppose
CONSTELLATORY vs. DIFFERENTIATED
e.g. he stole some money and he just couldn’t be trusted with anything, I think he would let his friends down, even his family, he had no respect for anything...
NARRATIVE ANALYSIS: Interpretative decisions
Its co-construction
Its cultural context
What problems it solves for the narrator
Psychological processes – change processes
Narrative as performance: look at positioning of self and others (links with discourse analysis)
Its intended purpose: why is it being told in this way? Here? Now?
Turning points
NARRATIVE ANALYSIS: Life Story Method
Accounts are constructed/translated by the analyst from the text
Plot-lines are contrasted across the interviews
Particular attention is paid to points where expected story-lines are disrupted
Stories of restitution or reparation; chaotic or frozen stories
NARRATIVE ANALYSIS
Life Story Method and Sequence of Core Narratives:
Examination in relation to structure, style, content and form
Plot lines are contrasted across the interviews
Thematic connections between narratives within interviews
Emplotment and Genres:
Influenced by Ricoeur’s narrative theory ‘canonical narrative forms’
What cultural genres are drawn on by the person to present their self account eg The Quest, as a form of agency
ATTACHMENT REPRESENTATIONS:
The layers of attachment
PROCEDURAL MEMORY: memory for how we do things: embodied,
rate of talk, expressed affect, relationship with interviewer – cf.
systemic patterns / process (R)
SENSORY MEMORY: visual images, smell, touch, auditory (R)
SEMANTIC MEMORY: cognition, beliefs, attitudes (L)
EPISODIC MEMORY: narratives, stories, inter-connected
experiences (L and R )
INTEGRATIVE MEMORY: reflection, meta-cognition, on-going
monitoring of our speech and thought.. (L and R)
Right Brain – Implicit Left Brain - Explicit
ACTIVITY: Transcript process analysis
Structure – how well ordered is the interview, relationship with interviewer?
Imagery – what visual, sensory material is there?
Semantic – what are the concepts, generalisations about relationships made?
Episodes – what are the stories told, how coherent are these?
Integration – how is material from the above brought together, what evidence is there of insight, reflection on self and others
Engagement and therapy: How would you position yourself, approach, think about, feel about, fantasise about starting to work with this person?
Focus Group Analysis (IPA)
Concerns and experiential claims: summarise
and sort into emergent patterns
Positionality: perspectives and stance
Roles and relationships: references to other
people
Organisations and systems: how are they
described?
Stories: structure, genre, temporal reference,
imagery and tone
Focus Group Analysis (IPA)
Language use: metaphor, idiom, euphemism,
pattern, context and function
Return to emergent themes: what
experiences are being shared? How are they
making things meaningful? What are they
doing as a group? Consensus issues?
Conflict? How managed/resolved?
Integration of multiple focus groups:
commonalities and differences, connection to
theories and explanations
Evidence Based Practice:
Hierarchies of evidence Level 1: Single RCT or meta-analysis of RCTS
Level 2a: At least one well designed controlled study without
randomisation
Level 2b: At least one other well designed quasi-experimental
study
Level 3: Evidence obtained from well designed non-
experimental descriptive studies, eg case studies, correlation
studies
Level 4: Expert committee reports or opinions and/or clinical
experiences of respected authorities
Participant Observation Methodologies
Participant observation as a continuum of roles:
The complete participant
The participant as observer
The observer as participant
The complete observer
Ethics and involvement
Reactivity and demand characteristics
Social facilitation
Approaches to Structured Observation
Elliott’s (1991) Five Stage Process of Decision-Making
Stage One: Perspective of the observation study
1. Is researcher a trained observer eg in use of reliable coding scheme?
2. Or an expert participant eg a psychotherapist or supervisor?
3. Or an index participant with expertise eg psychotherapy client or supervisee?
Approaches to Structured Observation
Stage Two: Focus of the observation
Which element of the behavioural process is studied:
Is it the client or client system?
The psychotherapist or their agency?
Or the rated quality of their relationship? (interaction of participants)
Approaches to Structured Observation
Stage Three: What kind of behaviour or process variables are to be studied?
Content, or what is said, meant or expressed (as ideas or themes)
Action/intention (behaviours, tasks, response modes)
Style, or how it is done, said or expressed (duration, frequency, intensity, mood, para-linguistic, non-verbal behaviour)
Quality, or how well it is done, said or expressed (accuracy, skilfulness, appropriateness)
Approaches to Structured Observation
Stage Four: Selected useful units of study
Idea unit (sentence, single expressed idea)
Interaction unit (a speaking turn, a response to the other)
Topic or task unit (episode, series of actions or speaking turns)
Scene unit or occasion (eg time limited interaction)
Interpersonal unit (relationship between two people)
Institution unit, or organisation, system of relationships
Person (self history, sets of beliefs, organisational involvement)
Approaches to Structured Observation
Stage Five: Sequential phase, what happened before, during, after the unit of process
Context or antecedents, what led up to the process eg previous behaviours, speaking turns
Process or behaviours eg particular process observed at given level or unit
Effects or consequences, eg psychotherapy outcomes
Comprehensive Process Analysis
CPA (Elliott, 1989) was developed to analyse both
individual events and themes across events, focusing
on four areas of understanding:
Expanding key or peak responses in an event eg
exploring implied meanings within a response
The context out of which the event arises, and that
gives it meaning, eg what had been happening before
or after the event, nature of the therapeutic alliance,
background features of client and therapist, client’s
preferred ways of coping, cultural attunement of the
therapy,......
Comprehensive Process Analysis
Important features of the event, eg therapist action,
interpretation and style, and client expression of
thoughts and feelings
Impacts of the event eg understanding, changes in
mood and beliefs, anticipated changes, etc
Helpful Aspects of Therapy/Supervision
Questionnaire
Immediately following a therapy or supervision
session, identify one helpful event, and rate it 1-5 on
a Likert scale (least to most helpful)
Write a brief description of the helpful event, and say
why it was helpful
Identify one unhelpful event and rate it 1-5
Write a brief description of the unhelpful event and
say why it was unhelpful
Rate the overall helpfulness of the session, 1-5, least
to most helpful
Helpful Aspects of Therapy/Supervision
Questionnaire (cont’d)
Again, using 5 point scales, each event can
be rated on the following nine areas:
Personal insight
Problem clarification
Problem solution
Understanding about others
Helpful Aspects of Therapy/Supervision
Questionnaire (cont’d)
Increase in understanding
Reassurance
Sense of relief
Involvement in the therapy/supervision
Personal contact with the therapist/supervisor
Publishability Guidelines: Quantitative &
Qualitative Research
Explicit scientific context and purpose
Appropriate methods
Respect for participants
Specification of methods
Appropriate discussion
Clarity of presentation
Contribution to knowledge
Publishability Guidelines: Qualitative
Research
Owning one’s perspective
Situating the sample
Grounding in examples
Providing credibility checks
Coherence
Accomplishing general vs specific research
tasks
Resonating with readers
“Trustworthiness” Criteria for a
Qualitative Research Dissertation
Rationale for the research question
Methodology
Persuasiveness
Reflexivity
Coherence
Relevance/pragmatic use
Respondent validation
Face/Ecological validity
Concurrent/contextual validity
Triangulation
Independent audit
Presentation of evidence/rhetorical power
Internal coherence
Transparency and reflexivity
Generativity
Validation/Credibility Checks
Sensitivity to context:
Relevant theoretical and empirical
literature
Socio-cultural setting
Participants’ perspectives
Ethical issues
Empirical data
Yardley, 2000
Validation/Credibility Checks
Commitment and rigour:
Thorough data collection
Depth/breadth of analysis
Methodological competence/skill
In-depth engagement with topic
Yardley, 2000
Validation/Credibility Checks
Transparency and coherence:
Clarity and power of your argument
Fit between theory and method
Transparent methods and data
presentation
reflexivity
Yardley, 2000
Validation/Credibility Checks
Impact and importance:
Practical/applied
Theoretical
Socio-cultural
Further research
Yardley, 2000
Validation/Credibility Checks
A few references….
Braun V and Clarke V (2013) Successful Qualitative Research: A practical guide for beginners. London: Sage
Bryman A (2006) Integrating quantitative and qualitative research: how is it done? Qualitative Research, 6, 97-113
Bryman A (2007) Barriers to integrating qualitative and quantitative research. Journal of Mixed Methods Research, 1, 8-22
Burck C (2005) Comparing qualitative research methodologies for systemic research: the use of grounded theory, discourse analysis, and narrative analysis. Journal of Family Therapy, 27, 237-62
Dallos R and Vetere A (2005) Researching Psychotherapy and Counselling. McGraw Hill/Open University Press
A few more references….
Harper, D and Thompson A (2012) (Eds)Qualitative Research Methods in Mental Health and Psychotherapy. Chichester: Wiley Blackwell
Lyons E and Coyle A (2007) Analyzing Qualitative Data in Psychology. London: Sage
Robson C (2011) Real World Research. Third Edition. Oxford: Blackwell
Smith J (2008) Qualitative Psychology: A practical guide to research methods. Second Edition. London: Sage
Smith J, Flowers P and Larkin M (2009) Interpretative Phenomenological Analysis: Theory, method and research. London: Sage