Written By: Dr. Paul Rhodes, Senior Lecturer, Clinical Psychology Unit, Sydney University
Clinical Psychology has long prided itself as being based on the scientist-practitioner model and has relied, at least in part on the randomised control trial and other forms of quantitative research to establish its stature among the helping professions as trustworthy and accountable. This is a critical feature in our identity as a profession, especially given the fact that there is so much potential for poor guidance and even abusive practice when working therapeutically with vulnerable people. Despite the importance of quantitative research, however, focusing exclusively on outcomes and evidence brings the risk of ignoring many other important questions that can be best explored through qualitative and mixed methods. What in-session processes or interactions contribute towards change? What types of personal narratives are involved in recovery? How can research support community-based participatory initiatives? Can “unconscious processes” be externalised and understood? Qualitative methods, such as conversational analysis, interpersonal, process recall, narrative inquiry and participatory action can all contribute to the field, adding the process to the content, filling in the lived experiences that underlie the outcomes, and by doing so deepen a field that has contributed so much to the helping professions. Certainly this is becoming more recognized in the field, albeit perhaps slower here in Australia than has been the case in the United Kingdom and United States.
In my own experience as an academic I have been involved in both randomised control trials and a host of studies using qualitative methods. As a family therapist I am influenced by models informed by post-structuralism, including Post-Milan systemic therapy, narrative therapy and brief solution-focussed therapy but have still found that they are amenable to the operationalisation and manualisation process required for quantitative investigation. In the past four years, however, since become a full time academic I have focused more on qualitative methods, developing an interest group (QRIP: Qualitative Research in Psychology) in the Psychology Department and taking on many students using these methods. There have been a few difficulties along the way, but as I reflect on them I can see that they have been my own, rather than those necessarily created by my more quantitative colleagues. The key to enhancing the recognition of these methods has not been to secretly disparage those who are more interested in stats and numbers but instead to recognise that some of their concerns about qualitative methods have been justified. In particular the key has been to ensure that studies are designed with appropriate methods to establish rigour, that they are multi-staged studies relying on more than one qualitative method, that sometimes processes are linked to outcomes through mixed method design and that the process of data analysis is always clearly explained as logical and predictable. This is not to imply that there have not been occasions where it has been important to insist on certain non-negotiables when it comes to qualitative research; that sometimes smaller numbers of participants are better than big numbers, that participation of “subjects” can sometimes be a good ethical choice, that lived experience does not have to be generalisable to be important.
I have taken some of my inspiration from a series of articles written by Glenn Larner, a Sydney -based author and clinicians and Editor of the Australian and New Zealand Journal of Family Therapy. In his 2003 paper, Integrating Family Therapy in Child and Adolescent Mental Health Practice: An Ethic of Hospitality he writes the following: Derrida (2001: 16–17) recently said: ‘ethics is hospitality’. He is talking about the right to asylum of refugees forced into migration, a sensitive political issue in recent times. Ethos is Greek for home or abode, and ‘ethics’ means a relationship to others who require assistance and taking in. Derrida’s suggestion is that to be in one’s home requires welcoming the stranger. This ethic of hospitality towards what is different is what defines the ‘familiar’: to be ‘at home with oneself’ depends on accommodating the other. Hospitality is a positive cultural enactment, a reaching out to the stranger that allows the possibility for understanding, growth and integration; where hospitality is refused, the potential for misconstruction, hostility and conflict exists.” In this article Glenn talks about how family therapists need to adopt this ethic if they are to introduce their practice into more medically-oriented clinical settings. I have taken it, however, as relevant to my current journey as a qualitatively-oriented academic in a field where quantitative research has been priveleged. They key point in this quote for me is that we need to be at home with our own research values and preferences before we can enter into respectful interactions with others. I am convinced that as qualitative researchers there is a great risk that we can be perceived as precious and arrogant if we are not to engage with our colleagues from this perspective.