The Narratives Which Connect…

Procedure

In this grounded theory research study, I have been through a complex and multifaceted process. The literature review showed that little was done connected to my research question. A part of my project became to give an answer to how this situation could be understood. The next step was to make a pilot study to prepare for the interviews and video observation of the therapists. This was a motivating process where coding and analysing was integrated in a theoretical sampling voyage.

Writing memos became a central activity in this period. In this process my project was reshaped and supplemented with some new ideas. It was for example supplemented with interviews with therapists that had particular experiences connected to a link between their own life and clinical experiences.

The next analytic process involved an analysis of the entire material to form categories and write new memos. All of the memos formed the basis for my categories and as part of my thesis.

The Case Studies

For the purpose of theoretical sampling, it was very useful for me to keep the idea of variation in my mind. My second participant was chosen because he was as different as I could think from my first. He was a very experienced family therapist with many years from child- and adolescent psychiatry and the last 20 years from a Family Counselling Office where he now was the leader. From my first participant I learned that I should not have the first interview before the video was ready. When he had made a video, he contacted me and we met for a first interview. After my analysis of my transcriptions and of the video and the comparison of the two, I prepared for the second interview. When this second interview was finished, I analysed all my material to select the next participant. Some important aspects from this therapist besides that he was very experienced were that he had never married, and in this sense, he did not live a traditional family life. He also underlined that therapy is a rather rational process where the therapist’s own personal and private experience should not influence the therapeutic process.

My third participant was a therapist of medium experience that I knew was a more traditional family man who was active in church and a dedicated therapist. I knew him as a former student (fifteen years ago). He worked in a family unit in child- and adolescent psychiatry. He has had this position for many years. I prepared the first interview with him and used the two former participants as background for this interview. Especially the questions about what working as a therapist has meant for his personal and private life was of special interest because I did not have much material from that area. I carried out the interview and got his video. The video was impossible to use and he had to make a new one. This was also without sound and impossible to use. He had to make a third. He did, and I could make my next interview with him.

One day I was surprised to get an e-mail saying that my first participant had made a video. She now worked part time in a Family Counselling Office and that she now could make a video more easily. I decided to analyse the video and I found it very interesting. I therefore decided to include her as a participant in my project. We agreed upon a new meeting and I analysed the two former interviews and the video and prepared the second research interview. I found some rather vague connections between the interview material and the video. However, I decided to test my ideas. She told me that my ideas were to the point in an astonishing way. She said: “It could have been me and my husband. We have been into therapy for almost two years with the same problems.” I then realised that I was about to miss some obvious topics. I had to find out what was happening when the therapist and the clients were in a parallel situation. What happened in therapy when the therapist for example was in a process of divorce when she or he met a couple that wanted to divorce? This is the method of constant comparison that influences the development of the research question. I had to include questions around parallel connections in my research.

With this background, I decided to invite the final full participant. She was a very experienced therapist that had worked many years in a Family Counselling Office and in child- and adolescent psychiatry for many years before that. I knew she had been married more than once and that she was described as a colourful therapist and person. I also wanted to ask her especially about how her clinical practice has influenced her personal and private life. This is the other side of influence between personal and private life and clinical practice.

I found out that I needed to supplement my material with stories about what I first called “obvious connections.” This is about what is going on in the therapy room when the therapist is part of the same kind of problems in her or his private life as the clients she or he works with. These topics are developed as “parallel connections” in this research project.

The Semi-Structured Interviews

If a questionnaire and the interview are structured, then participants may only answer these questions and may not bring forward other topics and stories that are relevant to them (Strauss and Corbin, 1998, p. 204).

I therefore chose to ask more open questions using a semi-structured format. Some of my questions were as open as possible so I could be connected to the participant’s own language and the participant’s genuine understanding of his or her own life experiences and clinical work.

The interviews were planned beforehand and the participants were asked to read through the questions when we met and before the interview started. The themes and the questions were based on several sources. They were based on my own experience and interest for the patterns that connect therapists’ clinical practice to their personal and private lives. The themes and the questions were also based on the pilot work, the literature review from my proposal, my experience as a family therapist and teacher in family therapy and from my knowledge of friends’ and workmates’ experience.

As previously stated, each therapist was initially a part of the constant comparison process and formed a separate case that helped form the interview for the next participant. The procedure was identical for the four full case participants. When collecting the data I conducted two semi-structured interviews, where the last one was based on my viewing a video of, and the theme analyses of, a first session of family therapy. All my semi-structured interviews were transcribed and analysed using coding procedures from Grounded Theory (Strauss and Corbin, 1998).

Grounded Theory Coding Procedures for the Semi-Structured Interviews

First, I used open coding on the interviews because I think about my research as an analytic process “… through which concepts are identified and their properties and dimensions are discovered in data” (Strauss and Corbin, 1998, p. 101). The aim of open coding is among others to keep the data collection process open to all possibilities in the early stages of analysis. The next step is to do axial coding of my transcribed interview material to help cluster and categorise the open codes.

In my first analytic work with my transcriptions, I used line-by-line open coding. Through the process of interviewing participants, I wrote memos. Memos are my interpretation and analysis and give direction and questions for further data collection. This process was the basis for developing concepts and categories. Memos are made between coding sessions and form the framework for the thesis. The thesis is based on the developed categories and “…the categories reflect the interaction between the observer and the observed” (Charmaz, 1995, p. 32).

Asking questions

Here are some examples of questions that I used to maintain as much openness as possible:

“Can you tell a story about a personal crisis or incident that influenced you in your work as a family therapist?”

“What was your experience with therapy before you started your training as a family therapist?”

“Can you tell me a story about how it came to be that you chose to work with family therapy?”

“Can you see any obvious connections between your own private experiences and what you do in family therapy?”

“What happened when you conducted a therapy session that was difficult for you?”

“Tell me what you think about what’s important for couples to develop a good relationship?”
Trying to avoid putting concepts and words in the mouth of the participant, I formulated for example a question about values or truth to one participant in the following manner (M=me, P=participant):

”M: If you are going to say something about, in a way, what you consider as truth, or what is right, or, I don’t know which word you would use. Some people talk about values…

P: … yes, values…

M: … right, there are many words, where you, in a way, have something such as truth and right in relation to what is a mistake or wrong or…do you have something like…?

P: … like head lines, yes…

M: … like main head lines?” (8, 220 – 224)

The participant chose the word ”head lines,” and I joined in on that way of designating the area. In this way, I tried to be as open as possible to the participant’s own value system and language (see Appendix 6 for an example of a semi-structured interview).

Process of semi-structured interviewing

The interviews were conducted in my office at Diakonhjemmet University College, in the participants own office, one in my home and one in a participants home. The interviews lasted between 70 and 100 minutes.

I had prepared in written form before the interview but I did not follow the interview guide slavishly. My intention was to keep an open mind and a curious approach.

When I was preparing the tape recorder before the interview started, I asked the participants to read my questions, just to get some flavour of what it was all about. All participants used this opportunity. Towards the end of the interview I glanced through to see if I had missed some important topics.