!#-,! TEAM BASED CASE STUDY RESEARCH FOR PRACTITIONERS AND STUDENTS. Aims. João Salgado University Institute of Maia, Portugal 15/02/18

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1 TEAM BASED CASE STUDY RESEARCH FOR PRACTITIONERS AND STUDENTS Contact: João Salgado University Institute of Maia, Portugal!"#$!$%$&'#%()*!&*'+,'-,!, Workshop Researching Psychotherapy Interaction Jyväskylä !#-,!,./0123'435678'2/'&61./153'439:78 438;<67'23'-313 ==>?@ABC'#D'(/257'2/',.1787!"#$%'EEB'FAA'CCC &'($%'EEB'FE?'GGH )*+,'-./0#$%'FCF'ECE'EH= 470;3I;7'+15/;7!"#$%'EEB'FAA'C>? 123'*#$%-:78@J532K3I7/8L18931D:;!0M7593NO/8'/9'444$*53'*$67 To invite practitioners/researchers/trainees to develop team- based case studies by clarifying how Aims Case studies support learning and needs of both trainees/ students and practitioners Using case study projects generate new knowledge, but also improve supervision, training, and clinical wisdom To explore some procedures available Main source: McLeod, J. (2010). Case study research in counselling and psychotherapy. London: Sage. 2 1

2 Case studies and the world of practice Case studies: Not studies based on single cases, but studies about that create a meaningful picture of a whole case. Few good quality cases studies are being published Pleas from academics calling practitioners to publish their cases Sources of resistance? Motivation Lack of time. But time to read, attend supervision, personal therapy, on- going training McLeod: research seen as not interesting, relevant for practice, something fulfilling someone s else agenda Ethical issues: difficulties in publishing client material 3 Potential contributions of case study research for practitioners and trainees Intensive, detailed observations of clinical material (e.g., videos, transcripts) + discussion + writing + publication supports Reflective learning Integration of theory and practice Moral and ethical implications coming from their work Contribution to the field and specific groupings Reputation and experience 4 2

3 But why case studies? Do psychology needs them? Until recently, quantitative studies were almost exclusively based on samples and groups. This kind of research does not tell us nothing about individual persons. It s not psychology it is demography (Lamiel) We need idiographic studies aiming at case study level New quantitative methods are quite promising Case studies, especially the ones with a qualitative component, give flesh and bones to scientific knowledge They bridge theory and real life They are important material for learning and future trainees They address important questions such as: Outcome (was therapy effective?); theoretical (is this theory applicable to this case?); pragmatic (what was more effective with this client?); experiential and narrative (what was like for the client?) 5 Why team- based? Single- authored case studies: the rule that needs to be an exception External validity requires external observations and contributions 6 3

4 A model for team- based practitioner research (McLeod) 7 Defining team- based study research team- based case study research involves a group of people (trainees or qualified practitioners) working together to plan a case study project, obtain ethical consent, collect and analyse data, submit their conclusions to external adjudication and prepare a case report for publication as an article, chapter or book, or dissemination through alternative media such as the Internet. (McLeod, 2010, p. 211) 8 4

5 Basic format McLeod s proposal: 4 to 6 members 6 to 18 months Working at least with one case, but extendable for multiple cases 3 hours meetings/month with exchange in- between (to be adapted to the geographical properties of the group) How to form a group? Shared interests, meetings in conferences, announcing the group in websites 5 stages 9 Stage 1: Convening the group 2 or 3 meetings Getting together; sharing interest and background experience; expectations and goals; rules, commitment to the group Case studies ideas Agreement over aims Scope of the 1 st case study project Allocation of tasks 10 5

6 Stage 2: Detailed planning 2 or 3 meetings Development of a research protocol, defining aims of the case study, data to be collected, methods of analysis, and getting ethical approval. Dealing with clients that may decline their permission afterwards. Possible combination of outcome and theory- building dimension 11 Stage 3: Collecting data Recording of sessions (audio, video)? Interviews (client, therapist)? Depending on the length of the process Don t start analysis before the end of the therapy Using the time to refine the starting point: more in- depth literature review, and write a draft of the method section 12 6

7 Stage 4: Analysing the case 4 to 6 meetings Individual analysis + sharing it with the group The end- point: assembling the case record and analysis and sending it to external adjudicators. How to do it? Several possibilities (later) 13 Stage 5: Writing up the case 2-4 meetings Different roles and contributions Future of the group 14 7

8 Advantages Exploration of the personal meaning in greater detail Discussions foster reflection and new perspectives Refining personal knowledge Enhancing practice: The tension between what was done and what the researcher thinks it should be done can be generative 15 Beyond the general format: Principles and specific procedures for the research project 16 8

9 Some general principles Step- by- step approach Enabling everyone to make a contribution Pursue consensus Consider alternative interpretations and justify your options Seek external validity involving external members 17 Some available models to structure the group Consensual Qualitative Research (C. Hill) Ward Method Significant events approach Comprehensive Process Analysis (R. Elliott) Task Analysis (L. Greenberg & L. Rice) Quasi- judicial structures The co- operative inquiry 18 9

10 1. The material is first selected in broad domains, previously determined. Consensual qualitative research (C. Hill) 2. Then, an open- ended grounded theory approach is used to generate categories. Every member independently analyses the data, and then all share the information. 3. The emerging categories are discussed, until a consensus is reached. 4. An auditor analyses (an adjunct member of the team) reviews and sends back the feedback to the group, on a regular basis. 19 The Ward method Initiated by Anthony Ward, for teams of architects Iterative approach to consensus building designed to maximize the potential benefits of working in groups while minimizing the risks often associated with group dynamics. (Schielke et al., 2009) Each member produces a draft plan and presents it to the group Rule: no one expresses a positive or negative critique of anyone else s ideas the focus is creating an understanding of each others ideas A record of each session is kept The process continues until enough convergence is achieved, in order to write a final agreed version of the case

11 Significant events approach Identification of significant events associated with clinical change. Involves a very complex set of procedures. The major ones are: 1. A strategy for identifying significant events 2. To describe the step- by- step sequence, as these events unfold, tracking therapist and client processes. Multiple parallel processes can be tracked 3. Associating within- session processes to postsession outcomes and to posttherapy outcomes. Different specific methods: Comprehensive Process Analysis (Elliott) open- ended qualitative exploration of the change process Task Analysis starting with a clinical problem or issue and its end state in an optimal change process, determining the necessary steps leading to change. 21 Other possible methods Quasi- judicial structures The co- operative inquiry model (collaborative inquiry, participatory inquiry): based on action research. There is a cycle of reflection and action from what has been learned. No specific analytic procedures the group improvises along the process

12 Combination of methods It is possible to arrange specific combinations of these and other methods in order to establish a specific strategy for the group and its research questions 23 Today s workshop: Analysing Gloria s session with Carl Rogers Description: Team- based analysis of 10 minutes of the session Based on the Ward Method Informed by Significant Events Approach selecting significant events and relating them in a meaningful way And informed by Grounded Theory bottom- up creation of categories of analysis Steps: Convening the group and setting up research questions (pre- prepared) Watching 10 minutes of the video Gloria Films: Session with Carl Rogers Individual analysis of the transcript Group discussion (Ward Method) Articulating a report Tervetuloa! 24 12

13 Kiitos! 25 Practice Team- based research of Gloria s session with Carl Rogers 26 13

14 Time schedule 13.45: Orientation : Convening the group : Video (excerpt) : Establishing subgroups Individual work BREAK : Group discussion (Ward method) : New individual analysis and preliminary conclusions 27 Activities during this workshop and their relation with usual stages in team- based case analysis Stage 1: Convening the group: Brief introduction (each member) Stage 2: (Detailed) planning: Setting up research questions (pre- prepared + discussion) Setting up the general procedures of analysis (pre- prepared + discussion) [Stage 3: Collecting data: Gloria Films: Session with Carl Rogers] Stage 4: Analysing the case. Ward Method + Comprehensive Process Analysis [Stage 5: Writing up the case] 28 14

15 General organization of the workshop Aims: To explore how does it work for you joining a research group working based on the Ward Method and informed by Grounded Theory To create a brief learning experience about the personal value of team- based case analysis Material: Gloria Films Session with Carl Rogers (first 9 minutes of the session) video and transcript Depending on the interests, several research questions are proposed. You can chose one of the topics and join a group. Other questions may be also explored. Ward Method: to understand everyone s perspective Grounded Theory: leaving behind any previous theoretical background. Starting by looking closely at the phenomena, and creating your own categories of analysis 29 Discussion (Ward method) Background: Unforced consensus may result in an interpretation that is deeper, richer, and more thorough, precise, and realistic than one generated by a single individual. As an additional benefit, participants in consensus decision- making processes are also likely to feel that their perspectives were represented and to feel positively about the process. However group dynamics leading to inequalities in participation and interpersonal influence, tendencies toward groupthink Rule: no one expresses a positive or negative critique of anyone else s ideas the focus is creating an understanding of each others ideas 30 15

16 Ward method: Rules (1) Each collaborator should be invested in a successful outcom (2) the process should reliably offer a rewarding, constructive experience to each collaborator (3) power should be shared equally among members (4) each collaborator s experience should be treated as equally valid (5) criticism (both positive and negative) should be discouraged (6) the group should have its own meeting place (to facilitate a sense of group identity) (7) collaborators should have shared understandings of project- relevant language (i.e., share a common language system), and (8) the rules governing the process should be defined and agreed to by all at the beginning of the project, during the initial orientation phase. 31 Suggested questions What are the clinical problems raised by Gloria and how did Rogers respond? What the first exchanges tell us about the clinical problems? Is there any change process undergoing in those 9 minutes? If so, how would you describe the moment- by- moment interactions that feed specific changes? 32 16

17 Convening the group Introducing yourself (1 minute) name job previous background on practice or research expectations for this workshop : Organizing the workshop activities : Convening the group : Watching the first 10 minutes of the video : Forming subgroups by deciding the research questions you want to work with Initial instructions for the analysis + individual analysis + short individual report to share with the group BREAK : Group discussion (Ward Method) : Reaching common points and articulating a brief report 34 17

18 Watching the video Gloria Films: Session with Carl Rogers 35 Forming groups Suggested questions What are the clinical problems raised by Gloria and how is Rogers dealing with them? What the first exchanges tell us about the clinical problems and how is Rogers dealing with that? Is there any change process undergoing in those 9 minutes? If so, how would you describe the moment- by- moment interactions that feed specific changes? 36 18

19 Instructions to the individual work SELECTING PASSAGES Read the material, and select important passages. Write down its importance ANALYSING PASSAGES For each passage, write down your specific thoughts about that passage. Avoid, as possible, to be theoretically, top- down, driven. Pursue bottom- up understanding: What is happening here? How can I describe this passage? What seems more relevant?) When analysing clinical problems, follow questions such as why is this passage relevant for the problem? What does it say about it? When analysing change, select passages involving change. Follow questions such as Why do I say that change is happening here? What is changing here? When analysing the interaction between Rogers and Gloria or the change processes taking place, also pay attention to: (1) changes taking place during the interaction; (2) to the sequence of events and how they might have an effect afterwards (immediately or later, in the session) ANSWERING THE INITIAL RESEARCH QUESTION After concluding the previous analysis, try to synthesize your findings by articulating an answer to your research question 37 Discussion (50 minutes) One facilitator, and one co- facilitator Takes notes, +manages the conditions of the discussion Each one presents her/his view. The others do not express positive or negative feedback, and do questions in order to better understand the perspective at stake. Each one may take notes of the ideas that seem interesting to integrate in one s own personal view +/- 1 hour of discussion 38 19

20 Individual round (15 minutes) Rewrite your personal perspective about the case 39 Preliminary conclusions How was this experience, to you? What did you learn, if anything? How do you see team- based efforts? And the Ward method? Do you want to share again your view and get in touch with others? 40 20