Sunday, 31 January 2016

qualitative research in psychology

I don't know about you but it often strikes me that most of the qualitative research one finds in clinical psychological doctoral dissertations and in psychology journals is without scientific merit. This demerit, it seems to me, has nothing to do with the researchers failing to do what quantitative researchers try to do. (Quantitative research is often without merit for quite different reasons.) If anything - and this is what I elaborate below - it comes from the qualitative researchers themselves asking questions and approaching their topic in a manner far too close to the forms of thought constituting and driving quantitative investigation. If one complains to such a researcher 'Oh but you'd need a much bigger sample to establish that with any reliability', the researcher will retort 'but I'm doing qualitative research, I'm here to build, rather than test, a model; I'm trying to develop valid concepts not to assert reliably true generalisations; please stop trying to foist your quantitative prejudices onto me'. To which the only apt response, often enough, is 'Well please stop framing your questions and answers in such a way as that only a quantitative approach could really do justice to them.' 

We do of course at other times meet with unthinking positivist critique of good qualitative research. I remember how, at a journal club meeting at the Institute of Psychiatry in London about thirteen years ago, in which we discussed an excellent qualitative paper by Josef Parnas on the essential structure of pre-schizophrenic self-disturbance, a young professor (who shall remain nameless) scoffed that the sample size of about seven people made rather worthless Parnas' investigation. It was embarrassing and demoralising how many of the students in the room tittered. Parnas who, despite being even grumpier than me, is a very perspicacious Danish psychiatric researcher, has not only published profound work on self-disturbance in the schizophrenic prodrome, but also extensive quantitative statistically rigorous research on diverse developmental, genetic, and neurological psychiatric concerns. The then head of the Institute (who shall also remain nameless) professed himself unable to grasp Parnas' phenomenological work but, given his knowledge of the quality of Danish scientist's rigorous quantitative research, could at least own that his failure to understand the value of the qualitative research may be his own.

To return to my theme: it seems to me that there really is a clear possible value to qualitative research, which is that it can help us reflectively unearth and articulate - give a voice to - what is otherwise the merely pre-reflectively grasped being or character or significance or meaning of some phenomenon. Imagine that we have an implicit grasp of the significance of something, or an implicit grasp that certain phenomena which looked at in various ways appear disparate nevertheless share something central. We might think this of schizophrenic symptomatology: looked at through the conceptual lens of a Mary Boyle or a Richard Bentall, one which accepts a phenomenological reduction of the condition into allegedly independently assayable behavioural and cognitive signs and symptoms - i.e. one which sees the concept of schizophrenia as a construct - the phenomenon falls apart and one now naturally questions whether or not 'schizophrenia' really means anything in particular. Nevertheless our intuition that here we meet with phenomena that are in some as-yet-unarticulated sense fundamentally alike might instead push us to reject the phenomenological reduction and instead pursue a qualitative investigation which would (a la Parnas) develop quite different terms with which to articulate the unitary lived character of schizophrenic experience. 

To develop my theme: For a qualitative investigation into the character of some phenomenon to be worthwhile, it must be the case that a) we actually do have to do with a phenomenon, of which b) we have an implicit grasp. The research makes the implicit grasp explicit. (It may also occasionally be more revolutionary than this, inviting us to question our unreflective grasp, suggesting a diversity which had previously been obscured by and assimilated in our thinking. I will leave this aside for now.) Essential to qualitative research, then, is that a) we do actually meet with phenomenon. But this is the first hurdle at which most qualitative studies that I've seen fall. They claim to be developing 'a model of' some or other phenomenon, but when you look at what this alleged phenomenon is it is something like 'the experience of being a nonagenarian insulin user' or 'the experience of visiting a relative in hospital' or 'the experience of being a gay Asian man in a European city' or what have you. And here it is not in the slightest bit obvious that we have here to do with any phenomenon at all. For why on earth should we imagine that there is any such thing as the experience of being a nonagenarian insulin user? Why should we even imagine that there is any such thing as the experience of being a nonagenarian, or the experience of being an insulin user? Maybe there are as many such experiences as there are nonagenarian insulin users - or perhaps even more than that, given the different experiences the same person may have on different days, and the different things that can be meant by that vaguest of terms 'experience' even on the same day. 

At this point the qualitative researcher may say 'Well actually Dr Gipps I'm precisely not assuming that there is an experience that I'm investigating. If you look properly at my title you'll see that I'm undertaking at 'a qualitative investigation into the experiences of relatives attending a hospital for psychiatric patients'. At this point, however, I want to say 'Ok but, aside from the question of whether this really counts as scientific research: if we can all be fairly sure from the get-go - just from our ordinary experience and understanding of what it is to live a human life - that people will be having different experiences here - why are you looking at the experience of just seven people?' Once again, there is no phenomenon being studied here. There are instead a variety of different experiences of a situation. The unity resides in the object (the hospital) not in the experiences of the object. In fact, given that this object is where the only unity lies, we ought to note as well that the abstract titular talk of 'a hospital' is itself misleading. There is nothing in the research which suggests that the experiences of these visitors can be generalised to other hospitals, and nothing that suggests that it is distinct to this hospital either. What the 'research' paper ought to be called is 'An inquiry into what seven people who visited relatives in St Barts hospital on 7th November 2009 were inclined to say on that day about how they found coming to St Barts.' The only thing still wrong with that title is the word 'inquiry' which is better suited, I would suggest, to legal, journalistic or scientific contexts rather than to unstructured interviews. (When a journalist or lawyer conducts an inquiry into something, it really is just into that one thing - in particular when we are asking ourselves 'what actually did go wrong here?')

I just mentioned generalisation, and ought to immediately acknowledge that qualitative research is not, or at least ought not to be, itself in the business of generating generalisations. Someone might say 'I'm just generating some nicely fleshed-out concepts, you quantitative researchers can now go off and find out how widely they are instantiated in reality'. However this once again, I believe, just misunderstands the criticism. The criticism is not that qualitative research ought but fails to generate generalisable claims. It most certainly ought to be in the business of investigating the being of some phenomenon, and not be considering how widely that phenomenon obtains. The criticism is instead that, given that we don't have an intuition that we meet with a phenomenon here, but instead are looking at a tiny sample of a range of different phenomena which are only contingently related through sharing, in the vaguest possible sense, the same object, the only possible way in which what is being done could be of interest or have significance would be if it were reliably generalisable. 

Why is this? It is because knowledge, and not only understanding, is sometimes useful. Qualitative research at its best develops understanding for us. It isn't in the business of delivering knowledge of what happens to obtain, but rather helps us better grasp what we already know to obtain. But in the contexts considered above, in which we are given an insight into what a few people's experience of visiting the hospital was like, any new understanding we develop is probably irrelevant - unless we were, say, doing therapeutic work with that individual - and the only thing that would here be relevant would be knowledge.

By all means, please have a look at the experience of visitors to your hospital, and listen to what they say, and make your service better given that feedback. That is highly important work. It may be more valuable than doing research. But - it is not research. There's no honest reason to dress it up as 'An investigation into the experience of visitors to a day hospital': that's just hyperbole, the driver of which is probably the misperception of the desirability of scientific over non-scientific ways of spending one's time and developing as a professional.

Finally a comment on the idea of 'developing a model of...'. The word 'model' is not clearly defined and so I don't want to get stroppy about it. However in the qualitative arena I'd rather go with 'an understanding of...' since the word 'model' often carries connotations of either a prototype or of a representation of how something works. Qualitative research, however, gives us 'whats' and 'whys', not 'hows'. Talk of models by qualitative researchers is, it seems to me, yet another way in which they too closely ape the procedures and forms of representation of quantitative research and, in the process, make themselves vulnerable to losing sight of what can be of real and distinctive value in the process of trying to grasp the qualities that make a phenomenon what it is.