BLOQUE TEMÁTICO 5 ¿D E DÓNDE PROVIENE EL AGUA QUE INGERIMOS ?

Impact of my role as researcher

As a trainee clinical psychologist, I was situated in the professional realm also occupied by the group facilitators. There is therefore a great likelihood that I will have been identified with the facilitators in the minds of the participants, and indeed there was much evidence in the interviews that this was the case. For example, one participant assured me that ‘you and [one of the facilitators] are just the right people for us.’ Such an identification will likely have had a significant influence on the content and process of the participant interviews, particularly given the participants’ positioning of themselves as grateful receivers of the help offered by the ‘expert’ facilitators, and the concerns expressed about the power of the facilitators to end their membership of the group. In addition, it appeared that some

participants confused me with the facilitators for at least part of the interview: many referred to 'you' when talking about the facilitators. Again, this raises similar issues with regard to how this may have influenced the accounts participants gave of their experience of the group.

Research process

Wilkinson (2002) points out that when disempowered people participate in research, their marginalized position in society can be reflected in the relationship between researcher and researched. As a result, she argues, while it is essential to include the views of individuals with dementia when undertaking research, it is important to recognise the potential for these inherent power inequalities to be played out. It is important, therefore, to consider ways in which the powerlessness of the participants in this study relative to myself could have been replicated in the research relationship, and the potential impact of this on the research process and findings.

My possible identification with the facilitators who had the power to grant or withhold membership of the group, discussed above, may be regarded as one aspect of this unequal relationship. Given the power differential between the participants and me, consideration should be given to the degree to which the participants felt able and were enabled to express their views and concerns in my interviews with them. This may have been impacted on further by the influence of social desirability and the tendency for people receiving help to evaluate that help positively (Solomon et al, 2001). Both these factors may have been further mediated by participants’ difficulties with speech and memory. Yet there is evidence in the interviews that the process was a positive experience for the participants, in which they felt listened to and empowered to speak. One participant likened the experience of being heard in the group with her experience of being interviewed: ‘the same thing you are doing to me here now - to get my voice and to put it in those words that I have said.’ Another thanked me ‘for listening.’ However, there is also evidence of the participants wanting to flatter and reassure me. I was assured by one participant who had confused me with the facilitator that I

Chapter Four: Discussion

‘was doing a marvellous thing.’ Each of these aspects of the research process should be held in mind when interpreting the study’s findings.

The issues regarding inequalities of power have implications for all research with individuals with dementia. However, they are perhaps particularly an issue in research that is inherently and explicitly linked to service provision and therefore to the professionals providing the service. It could be considered whether participants would have felt more empowered to be critical had they been attending a group that was not professionally-led, and where there was therefore no confounding of the facilitator and researcher roles and the power relationships inherent in them. However, a number of participants did express some difficulties and frustrations with the group experience. There is therefore evidence that it was possible for at least some of the participants to be critical at least some of the time.

Finally, it is important when considering the research process to return to the issue of consent. Despite the care taken during the consent process, described in Chapter 2, it could be argued that the degree to which participants actually gave their consent to participate in this study entirely freely remains open to question. Given certain participants’ feelings of dependency on the facilitators and their concern that they may curtail their membership of the group, it may be that they felt pressured to take part in the study when invited to by the facilitators. In this case, it might have been better for me, as a person unrelated to the group, to carry out the consent process. The original decision that the facilitators should obtain consent from their group members was made on the assumption, however, that familiarity with the person seeking their consent would make it easier for participants to raise objections or ask questions. It is unclear in this case how the relative benefits and disadvantages of the consent process used influenced members’ participation in the study and thus the results obtained.