Etapas del procedimiento de oposición

The decision to use a mixed methods approach within this programme of research was pragmatic. The rational for using this approach, as opposed to a

monomethod (single approach) will be discussed. First, the strengths and weaknesses of quantitative and qualitative research will be considered, as an understanding of the merits and limitations of these strategies supports the “fundamental principle of mixed research” (Johnson & Turner, 2003, p.299). This principle claims that researchers should mix methods and approaches in a manner that results in “complementary strengths and non-overlapping weaknesses” (ibid).

2.3.5.1 Quantitative research.

Fundamentally, quantitative research affords a framework for examining cause- and-effect relations (Mulhall, Alexander, & Le May, 1998). Quantitative research practice is well established, and this is considered one of its main strengths (Yilmaz, 2013). The methods of analysis are well-developed and, by typically ensuring that the data results are not dependent upon the researcher undertaking the analysis, generate objectivity to the study. A key strength is that the quantitative paradigm allows a standardised, objective comparison of situations or phenomena to be made (Punch, 2013). Additionally, research findings can be generalised, quantitative predictions can be offered, and hypotheses can be tested (Johnson & Onwuegbuzie, 2004).

Alternatively, many of the characteristics which are considered the strengths of quantitative research, have also been cited as weaknesses (Choy, 2014). Dudwick, Kuehnast, Jones and Woolcock (2006) argue that, by reducing research to numbers, quantitative methods are unable to meaningfully capture many important features of people and communities (e.g. identities, beliefs, perceptions). Additionally, as most questionnaires and surveys are designed in isolation from the population to which they will be administered, they may be influenced by the biases of the researcher. According to Johnson and Onwuegbuzie (2004), due to a “focus on theory or hypothesis testing rather than on theory or hypothesis generation (confirmation bias)” the researcher may not capture certain phenomena (p.19). Knowledge produced may also be too general to be applied to particular contexts or individuals (Johnson & Onwuegbuzie, 2004).

2.3.5.2 Qualitative research.

‘Meaning’ is fundamental to qualitative research. A strength of this approach is that, through exploring and interpreting people’s experiences of events, and how they make sense of the world, qualitative researchers may obtain an in-depth understanding of complex psychosocial matters (Marshall, 1996; Willig, 2013. p9). Qualitative research favours methods, such as in-depth interviews and, consequently, can capture real-life experiences (Denzin & Lincoln, 2000). It is useful for depicting complex phenomena, provides a means to understanding how people make sense of ‘constructs’ (e.g. self-esteem) and offers a way to explore dynamic processes (i.e. recording

successive patterns and change) (Johnson & Onwuegbuzie, 2004). As qualitative researchers may be sensitive to changes that arise during a study, they are able to shift the focus of the research accordingly (ibid).

Like quantitative approaches, qualitative approaches also demonstrate

limitations. For example, due to small samples that are not randomly selected, findings cannot typically be extrapolated to a broader population (Dudwick et al., 2006). The nature of qualitative analysis is interpretative and may be subject to the idiosyncrasies and biases of the researcher (Dudwick et al., 2006; Johnson & Onwuegbuzie, 2004). In addition, different researchers examining the same data may conclude with different interpretations (Dudwick et al., 2006). Testing theories and hypotheses are more

problematic, data collection and analyses are generally more labour intensive (Johnston & Onwuegbuzie, 2004), and “because qualitative data cannot control for other

mitigating factors or establish the counterfactual, it is hard (but again, not impossible) to make compelling claims regarding causality on the basis of qualitative data alone.” (Dudwick et al., 2006).

In summary, both quantitative and qualitative methods demonstrate strengths and weaknesses. Consequently, it is argued that the mixture of different methods, known as ‘triangulation’ (applying the strengths of a methodological approach to balance the weakness of another), can help to mitigate limitations (Rao & Woolcock, 2003)

2.3.5.3 The decision to use a mixed methods approach.

In relationship to the current programme of research both quantitative and qualitative methods will be considered, as well the decision to employ a mixed method approach.

Although consideration was given to using a quantitative design, it was judged inappropriate to meet the requirements of the current programme of research. To enable research findings to be generalised, quantitative research requires large representative samples (Yilmaz, 2013). However, the sample size within the current study was considered too small to ensure statistical power for a quantitative study design. In addition, participant attrition rates are generally high within a longitudinal research design. For example, in a review of 32 longitudinal studies, Plano Clark et al. (2015) found 40% or higher attrition rates. Given the high probability of attrition, it was reasoned that a quantitative paradigm was unsuitable.

Alternatively, qualitative research is directed at the individual’s frame of reference of the world (Yardley, 2000). Instead of hypothesis testing on larger participant groups, qualitative researchers focus on a comparatively small number of participants’ personal views and experiences (Smith, 2015. p2). Given the focus of inquiry, obtaining in-depth data from small samples, a qualitative approach was

considered appropriate for data collection amongst both service users and clinicians for the current programme of research. It was also felt that in-depth one-to-one interviews may be in line with previous psychological treatments and therefore, participants may be more responsive. Yardley, (2000) proposed that the relationship and interaction between the investigator and interviewee can be aligned to traditional clinical practice such as clinician-client relationships. In particular, the reciprocal reactions (e.g. personal and ethical issues), and the effects of these reactions, that occur in the dynamic between the interviewer and interviewee are of central importance within a qualitative paradigm. Yardley (2000) concludes that qualitative methodologies provide a complementary approach to quantitative methods and can offer novel insights in areas such as health and illness.

The corroboration of different approaches increases confidence regarding research conclusions (Onwuegbuzie & Leech, 2004). In addition, if findings diverge then interpretations and conclusions may be adjusted accordingly. However, the aim of mixed methods is not validation but to increase knowledge (ibid). It was therefore felt that, if used as an embedded approach (an approach that provides a supporting role to the primary methodological research approach), quantitative findings may corroborate (or not) qualitative data. In addition, it may also demonstrate clinically meaningful change in beliefs about voices, schemata, voice severity and voice relating. Clinically meaningful change signifies a change in score from atypical (e.g. a score that is typical

of a clinical population) to one that is in line with a “normal” population (Jacobson, Follette, & Revenstorf, 1984). Consequently, the research programme employed a mixed method approach. It was considered that quantitative data, collected in parallel to qualitative data, would provide a more complete understanding of the research and validate qualitive findings. Quantitative methods may support qualitative methods, which were given priority for this research.