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Qualitative Research in Counselling and Psychotherapy
About This Book
The need to show how and why counselling works has led to an explosion of research activity, and a growing focus on research in counselling and psychotherapy teaching and practice. Yet this book, even now in its second edition, stands alone in addressing qualitative research in therapy.
Leading expert John McLeod helps readers through each stage of the research process, explaining techniques for gathering data, writing up the study and evaluating the findings. Each qualitative method is clearly described and critically assessed in terms of its own strengths and weaknesses. Examples from actual research studies are given to show how the methods work in practice. This new edition incorporates developments in qualititative research over the last ten years and includes eight new chapters, covering:
-interpretative phenomenological analysis (IPA)
-autoethnographic methods
-action research
-case study methods
For all those involved in research - whether as part of academic study or in practice -this book will be essential reading. As an introduction to qualitative methods, it is the perfect course text for all training programmes in counselling, counselling psychology and psychotherapy, and will also be of interest to those who work in areas such as psychiatry, clinical psychology and mental health nursing, or who provide counselling in other professional areas such as teaching, nursing and social work.
McLeod is Professor of Counselling, University of Abertay Dundee.
Frequently asked questions
Information
1
Qualitative research in counselling and psychotherapy: achievement and potential
Defining qualitative research
Exercise 1.1 Reflecting on forms of knowing
Box 1.1
Tracing the growth in qualitative research
The achievements of qualitative research in counselling and psychotherapy
- Clients report different outcomes from different types of therapy. Research into the outcomes of therapy is hugely important within the field, because clients, taxpayers, health service managers and other groups of people are vitally interested in knowing ‘what works’. Many hundreds of quantitative outcome studies have been published (for an overview of this literature, see Cooper 2008). For the most part, the results of this vast investment in scientific activity has yielded a puzzling finding–the equivalence paradox. Research seems to show that very different types of therapeutic intervention, when compared to each other in a fair test, appear to have the same level of success. A qualitative study carried out in Sweden by Thomas Nilsson, Martin Svensson, Rolf Sandell and David Clinton (2007) produced findings that begin to explain why the equivalence paradox exists, and what it means. Nilsson et al. (2007) interviewed clients who had received either CBT or psychodynamic therapy. Their analysis of the interview transcripts uncovered a great deal of interesting information about how these clients had experienced the therapy they had received, but in relation to the equivalence paradox two particular findings were particularly relevant. First, among the clients who reported that they had benefitted from therapy, quite different types of learning were described by those who had received CBT, compared to those who had received psychodynamic interventions. The CBT clients stated that what had changed was that they were now better able to deal with difficult situations and had taken control of their lives. By contrast, the psychodynamic clients said that what had changed was that they could understand themselves better, and could set limits and boundaries in their relationships with others. Both groups of clients had improved to the same extent in terms of symptoms of anxiety and depression, but had changed in different ways. Second, among the clients who had not been helped by therapy, those who had received CBT complained that they had been disappointed that their therapist had not allowed them to talk more extensively about their emotions and relationships (i.e., had been more like a psychodynamic therapist), while those who were disappointed with their psychodynamic therapy stated that what they had really wanted was someone who would provide structured problem-solving (i.e., a CBT therapist). When contrasted with the evidence accrued from quantitative outcome studies, the Nilsson et al. (2007) study opens up a more nuanced, and potentially more practically useful, account of therapy outcome, one that begins to uncover the ways in which the benefits of therapy are shaped by the interplay between the meaning systems of client and therapist around what is helpful.
- How therapists control the therapeutic agenda. Part of the legacy of Carl Rogers is the idea that counselling and psychotherapy are, or should be, fundamentally client-centred, in the sense of respecting and working with the way that the client defines his or her problem, rather than imposing an external, expert-drive perspective. There have been several qualitative studies that have challenged this idea by looking at what actually happens in conversations between clients and their therapists. One of the clearest and most convincing studies of this type was carried out in Holland by Kathy Davis (1986). In this study, an analysis was conducted of the conversation during the first meeting between a client (a young woman) and an experienced and highly regarded male therapist. The transcript of this session reveals that the client begins by describing the difficulties in her life (two young children, lack of contact outside the family, some tension with her husband). During the opening phase of the conversation, the therapist reflected back what the client was saying, and encouraged her to keep talking. As the session proceeded, however, the therapist introduced a gradual reformulation of the problem, redefining it as an issue around maintaining a façade and not being able to be open about feelings. Careful analysis of the conversational interaction was able to identify ways in which the therapist led the client into an agreement with his way of defining her problem. Davis (1986) comments that it took her a long time to be able to ‘see’ what had been happening in this session–on the face of it, what was in the transcript seemed to be an example of a typical good first meeting. It was only through detailed line-by-line analysis of the ways in which meaning was constructed and reconstructed through various conversational strategies that it became apparent that what was happening reflected a high level of therapist professional control of the interaction, in the direction of a therapeutically-tractable problem definition. Another study that arrives at a similar conclusion is Antaki, Barnes and Leudar (2007).
Exercise 1.2 Reading qualitative research
- Entering the lived experience of clients with different types of problem. One of the challenges of being a counsellor or psychotherapist involves entering the worlds of people who are struggling to cope with issues that the practitioner has not come across before in their personal or professional life. Good therapists are empathic and curious, and work collaboratively with clients in order to at least begin to understand the reality of their worlds. But it is also useful to draw on external sources of information. Qualitative research can be an invaluable source of insight into the experiences of people who are living with specific problems. For example, in the area of acquired brain and spinal cord injury, Andrew Sparkes and Brett Smith (2006) and Masahiro Nochi (1998, 2000) have explored the ways in which the person’s self-narrative can be changed for ever by a chance event, such as a sporting or industrial accident, and how people in this situation are eventually able to construct a new narrative and different relationships. For any therapist working with a client who is suffering from acquired brain injury, reading these qualitative studies will sensitise them to the possible ways in which their client may be thinking and responding, and the ways that other people may be relating to them. This kind of research does not look at the process or outcome of counselling or psychotherapy, but provides therapists with essential background information. Within the qualitative research literature, there are studies that have looked at the lived experience of people undergoing a wide range of health conditions and social problems. The findings of these studies represent an invaluable resource for the therapist, as a means of tuning in to the unique experience of individual clients and as a basis for designing interventions for groups of clients.
- What are the characteristics of good therapists? There have been a number of large-scale quantitative studies into the outcomes of therapy that have found that there are quite wide variations in the effectiveness of individual therapists who are randomly allocated clients of equivalent levels of problem severity. In particular, there appear to be a small number of therapists who are markedly more effective than their colleagues. What is it about these star performers that makes them able to achieve such high success rates? Thomas Skovholt and Len Jennings (2004; Jennings and Skovholt 1999) asked therapists in the region in which they worked to nominate those colleagues whom they regarded as ‘the best of the best’–the therapists to whom they would refer close friends and family members. Skovholt and Jennings (2004) then identified a set of ‘master therapists’, each of whom had been nominated by several colleagues, and invited them to take part in an in-depth interview that explored all aspects of their careers and their approach to their therapeutic work. What they found was that these master therapists were voracious learners. Even if they defined themselves as working within a sp...
Table of contents
- Cover Page
- Title
- Copyright
- Dedication
- Contents
- About the author
- Preface
- Acknowledgements
- 1 Qualitative research in counselling and psychotherapy: achievement and potential
- 2 The philosophical basis of qualitative research
- 3 Doing qualitative research
- 4 Phenomenological research
- 5 Ethnographic approaches to research in counselling and psychotherapy
- 6 Using grounded theory
- 7 Variants of grounded theory: thematic analysis, Interpretive Phenomenological Analysis, Consensual Qualitative Research, and ideal type analysis
- 8 Analysis of conversation and discourse
- 9 Narrative analysis
- 10 Personal experience methods: heuristic research and autoethnography
- 11 Using participation in inquiry to enhance practical knowing: action research
- 12 Qualitative case studies
- 13 The role of qualitative methods in outcome research
- 14 The concept of validity in qualitative research
- 15 Next steps: taking the research agenda forward
- References
- Index