The Narratives Which Connect…

The Single Case Study and Paradigm Cases

A paradigm case is according to Benner ”… a clinical episode that alters one’s way of understanding and perceiving future clinical situations. These cases stand out in the clinician’s mind; they are reference points in their current clinical practice” (Benner, 1984, p. 296).

A paradigm case in this frame of reference consists of narratives that link personal development and clinical practice and that have been of great importance for the clinician’s development and present practice. During the interviews, I asked participants for narratives that represented their points of reference in which they linked their personal life to clinical practice and explained the connection between them.

The concept of the paradigm case is closely linked to qualitative research and represents a… “nonexperimental qualitative sociological method that employs an exhaustive examination of cases… (Vidich and Lyman, 1998, p. 74). A paradigm case is a case that is based on experience and that is a part of the clinician’s clinical competence. Some paradigm cases are simple and can be told as stories that students (and others) can incorporate in their knowledge to deepen and expand their practice. “However, many paradigm cases are too complex to be transmitted through case examples or simulations…” (Benner, 1984, p 9).

While the Grounded Theory analysis “pooled” the data to form concepts, hypotheses and categories, the case study model was intended to help look at each full participant in turn to pull out specific, illustrative examples of the narratives which connect.

Ethical Issues and Anonymity

The project plan for this research project was presented to the Research Ethics Committee at the Tavistock and Portman NHS Trust, and approved by them (Appendix 3). All of the participants have given me their permission to use their stories by signing a written consent (Appendix 2) and they have been given the opportunity to comment on my use of them and even withdraw if they are uncomfortable with the use in this thesis.

A letter describing my research program and requesting participation was sent to them after an initial oral enquiry from me. This letter emphasized that my sampling criteria will meet gender, multi-educational background, experience, age and systemic training. I encouraged potential participants to thoroughly discuss the ethical, the personal and the professional implications of participating before submitting to the research.

The audio tapes and the video tapes are stored and locked up in a safe at Diakonhjemmet University College according to the rules given by the Data Inspectorate (Datatilsynet) in Norway. Transcripts are also stored on my computer and here saved in a way that requires a password. All material that can be attached to a therapist or a client will be deleted when the project has finished.

This research concentrates on the family therapist’s private and professional life. Their clients also play an important part in this research process. However, when the clients’ stories appear they form a background or a connection for the therapist’s stories. The client’s stories are never in the forefront in this research. Nevertheless, the clients’ anonymity is of great importance and is taken care of in this research.

Norway is a small country and the numbers of family therapists are relatively small. The participants in this research project have met me with generosity and an open mind and they have chosen to tell me many important private and personal stories. That means that it is of the greatest importance that the participants keep their anonymity. In this thesis, I have done everything possible to cover my participants in a way that makes it impossible to recognise any of them by reading about their background and personal stories.

A research process that involves the participant’s personal and private lives as well as their professional practice may influence them as well as the researcher in significant ways. This research process invites both the participants and myself as researcher to enter into reflections and documentations that demand respect and responsibility for the stories that are told and the clinical practice they let me be a part of. The analysis and the presentations of the participants’ narratives will be treated as valuable material presented in a fashion that shows respect for each therapist’s integrity and that does not cross their personal boundaries, as defined by them.

All participants were reminded that all narratives and all videos were to be considered as their property and that they had the right to withdraw at any time. They were also told that they would be shown how their material came to be analysed before the thesis was completed.

A research project and a research process has many ethical implications. It is, however, not possible to “fully identifying all the implications” (Wren, 2000, p. 84). For example, a research process may also be punctuated as interventions.

Self-reflexivity issues

The lack of interest in and work with the links between a family therapy students personal and private life and her or his process of becoming a family therapist is a main starting point for this research project.

My own ideas about the importance of understanding the connections of the patterns, which connects the therapist’s personal and private lives with their clinical practice, appeared as a premise which I built on. Colleagues and friends also confirmed the idea that interesting connections between a psychotherapist’s personal and private life and her or his clinical practice are important. However, I did not have any specific or particular ideas about special areas or topics of special importance or of special interest, and hence why I selected GT.

In the period when I was planning this research project, I went to the grocery store. There I met a researcher I knew a little beforehand. She asked me what I was doing for the time being, and I told her about my research proposal. She spontaneously said: “You have the right age and experience. You could not have done that twenty years ago.” I had not considered that aspect of my project at that stage. However, I came to realize that a relationship of trust and confidence was essential for the research process. One of the participants commented on this aspect after an interview by referring to another researcher that he felt tried to “pump him.” That researcher did not get much from him, he said.

The Family Therapy community in Norway is fairly small and transparent. This makes these research issues very sensitive. I have been in the family therapy field for many years, both as a clinician and as a teacher. My background and competence will therefore be a part of what I observe and part of my analyses.

I decided not to include people I had as friends or students or clinicians I have been supervising. However, these guidelines should not exclude me from important contributions to my project. With one exception, I have followed these guidelines.

To further gain self-reflexivity I have also invited a colleague and doctoral student to interview me about my project plans and my own ideas and experience with patterns that connects a systemic family therapist personal and private life with hers or his professional life. I subjected this interview to theme analysis.