Grounded Theory methods in child psychotherapy research

Abstract

This article considers the place of qualitative research in psychoanalysis and child psychotherapy. It discusses why research methodology for many years occupied so small a place in these fields, and examines the cultural and social developments since the 1960s which have changed this situation, giving formal but also qualitative methods of research much greater significance. It reflects on the different pressures to develop explicit research methods which arise both from outside the psychoanalytic field, as a condition of its continued professional survival, and from within it, where its main aim is the development of fundamental psychoanalytic knowledge. It suggests that the conduct of mainly quantitative research into treatment outcomes is largely a response to these external pressures, whilst the main benefits to be gained from the development of qualitative research methods, such as Grounded Theory, are in facilitating the knowledge-generating capacities and achievements of child psychotherapists themselves. The paper describes Grounded Theory methods, and explains how they can be valuable in the recognition of hitherto unrecognised meanings and patterns as these are made visible in clinical practice. Finally, it briefly describes three examples of completed doctoral studies, all of which have added significantly to the knowledge-base of child psychotherapy, and which demonstrate how much can be accomplished using this method of research.

Keywords:

• Grounded Theory
• normal science
• clinical research
• qualitative methods
• development in child psychotherapy

Notes

1. A valuable exception was the special issue of the International Journal of Psycho-Analysis, edited by David Tuckett, devoted to ‘Clinical facts’ (IJPA, 1994).

2. As Fonagy and Target (2003: 3–4) have put it, ‘The psychology that Freud discovered and elaborated has enjoyed considerable success as an explanatory framework. This is because its few basic assumptions and propositions are open to endless revision and refinement, and, arguably, because the clinical procedure that provides its evidential base offers a unique perspective on the human mind’. While they urged psychoanalysts and child psychotherapists to adopt research methods compatible with mainstream psychology, they also urged developmental psychologists to learn from the subtlety and complexity of psychoanalytic descriptions and explanations, which their book indeed describes. While there are ‘more psychoanalytic theories than we need’, there are also ‘unique features to each body of theory’ (Ibid.: 2).

3. Hinshelwood (2013) has attempted to show that it is possible in rigorously conducted clinical research to subject psychoanalytic theories to the Popperian test of falsifiability. For a commentary on his arguments see Rustin (2014).

4. John Forrester and Laura Cameron’s research on the presence of psychoanalysis in Cambridge University in the 1930s has revealed its unexpected influence within scientific circles, but this does not seem to have advanced its scientific status very much. Several of their papers can be accessed at http://www.people.hps.cam.ac.uk/index/teaching-officers/forrester

5. Demands to return to educational ‘basics’ and to return to a more traditional curriculum have been made by conservative educationalists from the 1970s onwards, in the first instance by the authors of the Black Papers. These arguments have had a considerable influence on the educational policy of successive governments. On this history see Ball (2013).

6. The Tavistock Clinic Karnac book series includes many examples of edited collections of papers which report developments in these various sub-paradigms of child psychotherapy theory and practice. Even though most of these make little reference to formalised methods of research, one should surely see these collections as the reports of a successful ongoing child psychotherapy research programme. Indeed given its evidential basis in clinical practice, one can equally view the development of the whole corpus of psychoanalytic theory as the outcome of a multi-faceted research programme. It is important that the designation of ‘research’ should not be confined to those practices which conform to the norms of clinical psychology, which often provides the implicit model of scientific legitimation in this field, but should respect the outcomes of the ‘normal science’ of psychoanalytic clinical practice.

7. Grounded Theory and IPA are comparable in their prescription of methods of line-by-line or segment-by-segment coding, and thus to a degree may be interchangeable methods for analysing data. However they differ in so far as the objective of Grounded Theory is the development of theory, while that of IPA is more the elucidation of actors’ own understanding of a situation. Grounded Theory emerged from sociology, a strongly theoretical discipline, IPA from psychology, which has usually adopted a more minimalist theoretical approach to its objects of study.

8. However, the existence of data-sets reporting treatments of significant numbers of cases, where both the sample of cases and treatment methods have been standardised to provide a degree of uniformity and comparability, is a valuable resource for fundamental psychoanalytic research. It is noteworthy that the IMPACT study has already given rise to the adoption of its Short Term Psychoanalytic Psychotherapy model of treatment within child psychotherapy training, since it was found (even in advance of the outcome data from IMPACT being known) that this treatment protocol was especially appropriate for working with adolescent patients. Another researcher (Creaser, 2016) using this data has been comparing audio transcripts of clinical sessions with the post-facto written notes made by the therapists, on which clinical researchers have hitherto mainly relied.