Just a quick post to share this article by Ron Chenail about writing up...it covers so many of the things we have been talking about recently but really puts the turbo on the creativity and number of options availalbe to us in writing up
HereThe Qualitative Report, Volume 2, Number 3, December, 1995(http://www.nova.edu/ssss/QR/QR2-3/presenting.html)
Some quotes to reinforce the points:
“I write in order to learn something that I didn’t know before I wrote it…not to write until I knew what I wanted to say, until my points were organized and outlined… this static writing model coheres with mechanistic scientism and quantitative research… It ignores the role of writing as a dynamic, creative process….(Richardson L. 1990)
“Writing-up qualitative research inevitably results in the emergence of new ideas and ways of viewing the data and hence plays a crucial role in the analysis process.”(Pitchforth et al. 2005)
Im learning the hard way at the moment about how to write results after a thrashing by a journal for a study titled Exploring How Trainees Manage Their Own Distress In-Session: An Interpersonal Process Recall Study
The review was very constructive, pushing me to write better, particularly suggesting that I integrate theory from the literature in my results rather than saving it all for the discussion..I confess to finding this quite difficult but after about 8 hours of mental struggle Ive found my results have really come to life in a much better way that before.before they were descriptive...now they kick arse? well..they are better but it's still a work in progress...here they are, completely unproofed and informatted..they are obviously out of context without the intro and method but I thought some of you writing at the moment might find it useful..
Results
The
Discrepancy Between Planned Content and In-Session Process
Watzlawick, Bavelas and Jackson (1967) differentiate
between content and process in therapy. The former is seen as the digital or
rational where messages are unequivocal and can be analysed easily. The latter
is analogue or emotional and messages as more subtle and hard to interpret. In
this study we saw the overwhelming majority of trainees become distressed when
faced with unexpected processes in the therapy room.
They described feeling as “lost”, “confused”, “unsure”, “floundering”, having a “mental blank” or unsettled.
Trainees recalled preparing well for
their sessions, including ‘reading books
and notes’, ‘revisiting the formulation’ and ‘making a number of session plans’ but felt that this preparation
did not necessarily equip them for what was occurring that moment in the room.
In-Session Interpersonal Difficulties
Many of the unexpected processes
involved interpersonal difficulties between trainee and client, including
clients who are seen as resistant, disengageing, attempting to assert control
or seeking direct advice.
Here a clients is seen as being
resistant to cognitive restructuring.
What
was I meant to say to that? In all the cognitive therapy books the person says,
“Wow! Now that you put it like that, I completely agree.”
Here a trainee becomes confused when a
client disengaged, despite a previously strong therapeutic relationship.
When
I said something that wasn’t an answer to her mind, you could tell she immediately disengaged. She stopped looking
at me and started playing with tissues. Whereas every other time she was
completely looking at me, very, very engaged.
One trainee described feeling “frozen” and “backing down” when a client was seen as overtly counteracting
explicit guidelines for homework tasks. In this case a couple were asked to
write on the same sheet, to facilitate a comparison of perceptions concerning
events. The trainee recalls the husband disagreeing.
“Can we have separate ones of these?” I went
“Oh! Okay! Yep”, agreeing to it because I was just so thrown by something that
I thought we’d really explicitly talked about.
Another trainee described feelings of
powerlessness in the face of a client who frequently requested direct advice.
It’s
an expectation of me to provide advice, it didn’t sit comfortably. I felt like
I was being trapped in a corner. She was putting me on the spot – trying to
nail me down kind of thing. I didn’t feel very comfortable [slight nervous
laugh]. I notice that I wave my hands around a lot more when I’m feeling scared.
Each of these examples suggest that
trainees had an expectation that client’s would follow therapy as described in
text books or in their own pre-session planning, as if what Bennet-Levy &
Thwaites (2007) calls declarative knowledge would be translated directly to
procedural (skills-in-action) without reflection on the interpersonal dynamics
at play in the room.
Complex or incongruous presentation
While trainees found interpersonal
interactions difficult they also had difficulty making sense of the complexity
of the client’s story.
What
I had sitting on that chair were three different session plans. What I did not
expect was for her to have all three as a presenting issue. “Ahh! Which one?!”
I got frazzled, there was a sense of urgency.
These stories were seen to “lack of
coherence and stability,”and trainess were unsure of how they related to the
presenting problem or how to integrate these experiences into their
formulations or treatment
Here a trainee is poised to intervene
with a client who has a history of social anxiety, only to discover that he is
telling the story of breaking up with his girlfriend.
I
was lost. I thought he was going to go and have coffee with this girl and
explore his feelings, so I thought we were testing predictions like, “It’ll be
awkward” and “It won’t be fun.” It became apparent that actually he was going
there to tell her he wasn’t interested. I was like like, “Riiiigggght. Now I’m
going to leave.”
Here a trainee finds it difficult to
make sense of seemingly incongruous reactions to a death in the clients life.
I’m
thinking, “What’s going on with you? This guy had died and you’re . . .
reacting with humour.’”He does impressions. He does impressions when asked
emotional questions.
The emotional reactions described by
students regarding both interpersonal processes and complex client
presentations reflect discomfort with what family therapists Anderson, H. &
Goolishian, H. (1992) call a ‘not-knowing’ position, an essential prerequisite
to curiosity (Palazzoli et al. 1980) that leads one to ask open-ended reflexive
questions of the client, rather than concern oneself with how to best
intervene. It would seem in both of these types of situations trainees are
momentarily “frozen’ or ‘baffled. Many also described feelings
of inadequacy at not knowing what to do next. ’
I
didn’t like that feeling. It felt like I was ineffective, like I’d lost
purpose, um, and I don’t see how that’s useful to the client.
One trainee described how her supervisor
helped her see that her negative judgments were related to her idea that
therapy had to be formal and technical, rather than natural and conversational.
I
was thinking “That part wasn’t special – it’s conversation” but my supervisor
today was going, “That – that’s therapy. That bit where you casually dismiss
that you re-framed that helost his job?
That’s therapy, What about the bits where I couldn’t fill in the sheets and do
the ABC and he’s like, “Yeaaahhh.”
In this example the trainee seem to have
misconstrued the collaborative nature of therapy, where meaning is contracted
through dialogue. (Overholser, 2011)
Activation
of Rudimentary Reflections
Bennett and Thwaites (xxxx) provide some
conceptual confirmation for the findings in this study, asserting that the
reflective system is activated when there is a mismatch between expectations
and reality. In their approach trainees are taught to focuss attention on the
problem at hand, develop a mental representation of it and engage in an active
cognitive proves of problem solving. However this occurs in supervision, as a form
retrospective of reflection on-action rather than in-session reflection
in-action (Schon)
While they were initially ‘taken aback’ Trainees describe how, in “what seems like a fleeting moment” or a ‘rush’
they are able to acknowledge the emotion they are feeling then struggle to engage
in a process of reflection (in my head I
was like “What the hell?”).
Three different strategies were then
described, each of which has been described here as rudimentary.
Referencing the expert
A significant number spoke about
mentally referencing a supervisor or perceived superior to help them decide how
to proceed. For one the supervisor operated as a “voice in your head going, you should do that”. For another it
served as a reminder of “what is the
right thing to do in terms of an intervention point-of-view”?
In some cases this strategy was seen as
helpful, particularly when their supervisor was trusted or open about their own
mistakes. For others comparisons with an “expert”
only exacerbated feelings of inadequacy.
He’d
have something meaningful to say, with his level of insight. Whereas I don’t
know what to do with her.
Attempts at transference
Despite the range of distressing
emotions experienced by trainees the majority described an ability to
acknowledge these emotions while they were happening in sessions. In some cases
trainees discussed how their own emotional response communicated to them the
emotional experience of their client.
“I was feeling lost, and I guess that’s
how she was feeling as well.”
“He’s probably feeling really upset and
really disappointed, too”
These reflections, while important, do
not yet mirror the complexities of transference dynamics, in terms of
recognising that interpersonal difficulties encountered with clients are
actually a potential tool for exploring complex unconscious processes (Gabbard,
2001).
Check
the therapeutic relationship
Trainees also engaged in momentary
reviews of the therapeutic relationship, either checking whether the
relationship was strong enough to handle the difficult moment, or reviewing it
so as to make a choice between trying to re-establish rapport or continue with
the skills-based intervention. Relationships reviewed as strong made it “easier to say a lot of things” and
caused some easing of distress because “I
don’t really mind making mistakes in front of her.”
Engage in Self-talk
Self-talk was also a common strategy
used to try and get the session back on track after distressing events.
Trainees described talking themselves through fleeting reviews of their
formulation and treatment plans.
Just
trying to quickly re-formulate in my head how I could quickly change th direction of therapy to be still effective.
I’m
sort of not wanting to shut that possibility down but at the same time I do
sort of have a therapy plan which I went back to. I’m trying to make sure that
we take each session somewhere and that I use the time well.
This differs significantly from the kind
of complex inner conversations described by Rober et al. (2008) in his analysis
of work by more experienced therapists. Here the therapist can make mental room
for a conversation between multiple positions, including the interaction in the
room, client’s story and planning for action. This conversation is held
internally but at a distance, a process of constructive hypothesising about how
to respond in the moment (Rober, 2002).
Retreat
to Safety of Non-Directive Counselling
For many trainees, especially those who
lacked confidence in treatment techniques the next step after reflection was to
retreat to the safety of non-directive counselling.
I’m
supposed to be using some sort of technique and I don’t know what I’m doing.
I don’t have any strategy for her, CBT
or DBT or schema stuff– I have nothing to structure her thinking.
Skills used included listening,
affirming, summarising, reflecting or asking questions. For the majority of
trainees these basic counselling skills came more “naturally”
than skills that were seen as more interventive.
I
feel like being warm and being empathic towards a client are not things I have
to fake, and not things I have to remind myself to do. I suppose things that
I’m still less comfortable with, and still getting used to, are you know,
particular questioning techniques, or, you know, more sophisticated cognitive challenging
and things like that.
Using basic counselling skills in the
moment also served as a “coping
mechanism”, “buying time,” supporting a “facade of control” and the maintenance of a “professional stance.” For many therapists “surviving” the distressing moment was the goal.
Risk
Taking
Other trainees, however, decided to push
themselves ‘outside of their comfort
zones’and focus on intervention. Some were motivated to “take these risks” by “professional growth.’ Intervention did
not necessarily flow from a reconceptualization of the case or the formulation
based on the distressing experience but was instead described as an attempt to
‘push ahead’, be more ‘directed’
See! It
works! You’ve just got to talk. Now you
can get back to what you’re doing.” I’m pleased I did something. That it
actually went okay – that when I interrupted they both seemed to settle fairly
quickly – was a good reminder to me that when I do this it doesn’t actually
damage the relationship too much.
Arguably, despite the limitations, this
type of risk taking is critical to learning (Spellman & Harper, 1996).
Trainees who took risks, however, were careful to review the therapeutic
relationship first to see if it was secure. . Those trainees who felt it was less
seemed more tentative in their decisions and less likely to respond in a way
that might “challenge” the client.
Writing up your thesis or a paper is obviously one of the most critical stages of your research and one that gets too little attention....the key is DONT BE BORING BE CREATIVE!!! Noone wants to read a list of themes, massive amounts of quotes or unsynthesised analysis.......click on the links more info
simple introduction to key sections of a write up
Writing a qualitative research report
Philip Burnard PhD, RN (Professor of Nursing)
School of Nursing and Midwifery Studies, University of Wales College of Medicine, Heath Park, Cardiff, UK
Summary A research project in nursing or nursing education is probably only
complete once the findings have been published. This paper offers a format for
writing a qualitative research report for publication. It suggests, at least, the
following sections: introduction, aims of the study, review of the literature, sample,
data collection methods, data analysis methods, findings, discussion, conclusion,
abstract. Each of these sections is addressed along with many written-out examples.
In some sections, alternative approaches are suggested. The aim of the paper is to
help the neophyte researcher to structure his or her report and for the experienced
researcher to reflect on his or her current practice. References to other source
material on qualitative research are given.
c 2004 Elsevier Ltd. All rights reserved
The Qualitative Report, Volume 2, Number 3, December, 1995 (http://www.nova.edu/ssss/QR/QR2-3/presenting.html)
The following are just of the many ways data can be arranged and presented: Natural - The data are presented in a shape that resembles the phenomenon being studied. For instance, if the data are excerpts from a therapy session, present them in a sequential order or in an order that re-presents the flow of the session itself. Most Simple to Most Complex - For sake of understanding, start the presentation of data with the simplest example you have found. As the complexity of each example or exemplar presented increases, the reader will have a better chance of following the presentation. Erving Goffman's work is a good example of this style. First Discovered/Constructed to Last Discovered/Constructed - The data are presented in a chronicle-like fashion, showing the course of the researcher's personal journey in the study. This style is reminiscent of an archeological style of presentation: What was the first "relic" excavated, then the second and so forth. Quantitative-Informed - In this scheme data are presented according to strategies commonly found in quantitative or statistical studies. Data are arranged along lines of central tendencies and ranges, clusters, and frequencies. Theory-Guided - Data arrangement is governed by the researcher's theory or theories regarding the phenomenon being re-presented in the study. For instance, a Marxist-informed researcher might present data from a doctor-patient interview in terms of talk which shows who controls the means for producing information in the interaction, talk which illustrates who is being marginalized, and so forth. In clinical qualitative research, this approach is quite prevalent as clinicians organize the data in terms of their understandings of how doctor-patient, or nurse-patient, and therapist-client interact. Narrative Logic - Data are arranged with an eye for storytelling. Researchers plot out the data in a fashion which allows them to transition from one exemplar to another just as narrators arrange details in order to best relate the particulars of the story. Most Important to Least Important or From Major to Minor - Like the journalistic style of the inverted pyramid, the most important "findings" are presented first and the minor "discoveries" come last. Dramatic Presentation - This one is the opposite of the inverted pyramid style. With the dramatic arrangement scheme, researchers order their data presentation so as to save the surprises and unforeseen discoveries for last. No Particular Order Order - As it sounds, data are arranged with no particular, conscious pattern in mind, or the researcher fails to explain how or why the data are displayed the way they are.
Conversations: On Writing Qualitative Research
Author(s): Donna E. Alvermann, David G. O'Brien, Deborah R. Dillon
Source: Reading Research Quarterly, Vol. 31, No. 1 (Jan. - Feb. - Mar., 1996), pp. 114-120
Published by: International Reading Association
Stable URL: http://www.jstor.org/stable/748242
Accessed: 07/11/2010 17:32
Im writing up one of the studies I have been doing with a student at the moment for publication and thinking about how to do it in a way that isn't just a collection of themes and quotes..god knows that can be pretty boring...
The general principle is creativity..its NOT a report
“I write in order to learn something that I didn’t know before I wrote it…not to write until I knew what I wanted to say, until my points were organized and outlined… this static writing model coheres with mechanistic scientism and quantitative research… It ignores the role of writing as a dynamic, creative process….(Richardson L. 1990)
Writing also involves analysis
“Writing-up qualitative research inevitably results in the emergence of new ideas and ways of viewing the data and hence plays a crucial role in the analysis process.”(Pitchforth et al. 2005)
Here ten tips:
1. Add a case study which focuses on how the overall results are exemplified
2. Include longer sections of the transcript or other forms of data
3. Include a pictorial diagram of the results so long as it doesnt clean them up too much
4. Present theoretical triangulation in detail....how each theory informed coding
5. Write a section "What Was Most Unexpected"
6. Include a reflective piece about the impact on you, the researcher
7. Blend your quotes into the actual text rather than make them separate
8. Ask the participants at the end (in a focus group) how they want to be represented
9. Ask them about Implications for the discussion
10. Its an art not just a science!
What ideas do you have? Got any examples you want to share?
Good Book: Wolcott HF. Writing Up Qualitative Research. California: Sage Publications 2001.
