Etapas del procedimiento

Qualitative researchers come from different epistemological positions which in turn will determine how data is approached. For instance, an empiricist position, which seeks to make sense of the world through systematisation and classification of

observations, would adopt an approach to analysing data in accordance with this stance (e.g., grounded theory or interpretative phenomenological analysis). Alternatively, a social constructionist standpoint does not consider the world that we perceive and experience to be a true representation. Instead our perception is a reading of that world, and one that is socially influenced. Consequently, an approach would need to reflect this view e.g. narrative analysis (Willig, 2013).

The following sections will consider different approaches to qualitative analysis with respect to the current research:

2.3.7.1 Narrative Analysis.

Narrative psychology is concerned with the methods people use to bring

structure to experience. Narratives are stories, accounts of specific experiences (Willig, 2008. p133). People use narrative construction as a vehicle to make sense of a

constantly fluctuating world; to give meaning, and bring stability to disarray (Murray, 2000). Narratives are socially constructed and arise through everyday social interaction (Murray, 2003). Mattingly and Garro (2000. p1) assert that “narrative mediates between an inner world of thought-feeling and an outer world of observable actions and states of affairs.” Narratives provide a cohesive framework for people to link events, make sense and draw conclusions. The narrative is an active process that attributes agency to the characters within it. Our stories not only assist us to make sense of our daily lives but also offer a structure to our beliefs about ourselves. As a result, we create narrative identities that are linked to our social relationships (Murray, 2003). Murray (2003) argues that the world that we know is constructed through our personal narratives and we are shaped by our own stories and the ones of others. Consequently, he contends that narratives have ontological status.

Through narrative analysis, narratives are framed as a creative method of investigating and explaining realities. These realities are organised and constrained in time (Esin, 2011). Narrative research pays attention to the structure and form of the story. It focuses upon the variation between the features of narratives. Key to narrative research is an emphasis on an analysis that is systematic and well-defined. Findings should offer an understanding regarding the structure, function and “social and/or psychological implications” of the narrative (Willig, 2008. p133).

The interview is the main source of data material for narrative research (other forms of data, such as published memoires, are also collected) (Murray, 2003; Willig, 2008). The aim of the interview is to facilitate the participant to provide a rich and detailed narrative description of an experience. The life-story interview has been a particularly useful tool in enabling participants to offer information regarding their life history. However, narrative analysis strives to go beyond an account of a life-history. Narrative interviews aim to understand disruptions to life and support participants to disclose information about experiences that have caused change or disruptive episodes (e.g. illness) (Murray, 2003).

Due to the temporal element, narrative analysis was considered as a potential methodology for this programme of research. However, as investigating and

discovering structures in stories are central to narrative analysis, it was felt that this approach was not appropriate for the current programme of research. In addition, narrative analysis was not suitable as a means for conducting deductive testing on existing models.

2.3.7.2 Interpretative Phenomenological Analysis (IPA).

IPA aims to explore and understand how people make sense of the world from a personal and social stance. Central to the approach is ‘meaning’ and in particular, the subjective meanings people hold for certain experiences, events, and states (Smith & Osborn, 2003). IPA acknowledges that the world is perceived in different ways, and that this is dependent upon personality, experience and motivation (Smith & Osborn, 2004). The approach draws on phenomenological methodologies. Phenomenology, developed from Hurssel’s philosophy, does not focus upon abstract, general statements about the world but instead pays attention to how the world is experienced by people within specific contexts and times (Smith, 1996; Willig, 2008). Rather than an objective account, it emphasises the subjective. The phenomenological stance highlights the phenomena of the mind which arises from our engagement with the world in which we inhabit (Willig, 2008). Thus, IPA researchers are interested in the individual’s lifeworld, their personal perception, experiences, and interpretations of a phenomenon or

phenomena (Smith & Osborn, 2003). Through IPA, the researcher seeks to gain access to the participant’s world and assume an ‘insider’s perspective’ (Conrad, 1987 in Smith, 1996) of the object or event being studied (Smith, 1996).

The IPA analysis is viewed as an interpretation of the participant’s experiences. Although the aim of IPA is to explore and make sense of the other’s perspective, the role of the researcher’s own conceptions plays an active part in the interpretative processes of the research (Willig, 2008). Consequently, there is a double hermeneutic, or two-stage process, to the interpretation of the phenomenon under study. While the participant is attempting to understand their experiences, the researcher is also

attempting to understand the participant trying to understand their experiences (Smith & Osborn, 2003).

Although IPA can be used for broader theory or model development, the approach is more appropriate for standalone studies of experiences. Despite its

flexibility, the in-depth prescribed approach would have been unsuitable for the sample size of the current research, which was larger than typically used in IPA studies. The larger sample size, plus the longitudinal methodological approach, meant that the

prescribed approach to analysis would have been unmanageable. Additionally, similar to narrative analysis, IPA would not have been suited to deductive testing on existing models.

2.3.7.3 Grounded Theory.

Grounded theory is a methodological approach that is used to examine action and interaction and their associated meanings (Frost, 2011). It is a general methodology for facilitating the generation of theory. From a theoretical stance, the aim of grounded theory is to provide a descriptive structure from which to make sense of the

phenomenon being studied. It identifies, makes links and ascertains relationships between categories in order to develop theory (Willig, 2008). Theory is developed and grounded within a logical, systematic approach to data collection and analysis (Strauss & Corbin, 1994). It uses an inductive approach whereby during the research process, theory evolves from the interaction of data collection and analysis (Strauss & Corbin, 1994). Charmaz (1996) states “grounded theory methods explicitly unite the research process with theoretical development” (pp.). In addition, grounded theory challenges existing attitudes that divide qualitative approaches as only intuitive and indistinct and quantitative as rigorous and systematic (Charmaz, 1996).

Although often used qualitatively, grounded theory can be used as a mixed methods approach. It has been used in a range of areas such as clinical psychology, social work and nursing (Frost, 2011). It is appropriate for investigating “individual processes, interpersonal relations and the reciprocal effects between individuals and larger social processes” (Charmaz, 1996). Despite its suitability for analysing large quantities of semi unstructured qualitative data (Lawrence et al., 2013), grounded theory was considered not apt for a longitudinal design, as used in the current programme of research. The present study aimed to recruit two population groups, service users and clinicians, with a single set of interviews being conducted with clinicians and multiple interviews with service users. Consequently, this would contradict the grounded theory approach of constant comparison. In addition, contrary to theoretical sampling, it was intended that the sample group would remain the same over the data collection period.

2.3.7.4 Thematic Analysis.

Thematic Analysis (TA) originated as a method for coding and developing themes (Braun & Clarke, 2014). Despite several variations, Braun & Clarke’s (2006) method for conducting TA is the version that is most frequently used (Braun & Clarke, 2014). This paper will now refer to Braun and Clarke’s (2006) method for TA.

TA is a flexible approach that is used within a variety of disciplines, often with a health focus (Braun & Clarke, n.d.; Braun & Clarke, 2014). Its flexibility supports researchers to systematically investigate, analyse and report patterns of meaning, or themes, across data sets without being bound to a theoretical position. In this respect, TA is distinct from other qualitative analytic approaches as its sole purpose is to offer a structure for analysis (Braun & Clarke, 2013). TA does not espouse a particular

theoretical position, epistemology or ontology; instead, it can be used across a variety of theoretical and epistemological methods. Consequently, within psychology, it is suitable for both constructionist and essentialist paradigms and can be applied to most research questions (Braun & Clarke, 2006; Braun & Clarke, 2013). Despite its lack of theoretical constraints, TA still has the capacity to offer a rich and in-depth description of the data (Braun & Clarke, 2006) and is suitable to use with both small and large data sets (Braun & Clarke, 2013). TA can be used as a bottom-up approach, whereby themes are

identified from within the data set; a top-down approach with the data used as a means to explore theory; or a combination of both. It may be used with data in a range of ways, from a critical to experiential stance (Braun & Clarke, 2013).

Braun & Clarke (2006) provide a clear explanation of, and framework for conducting, TA. Their approach involves a systematic six-phase procedure: familiarisation with the text; development of initial codes; looking for themes;

evaluating possible themes; demarcating and labelling themes; and creating the report (Clarke & Braun, 2014).

The TA method has been criticised as to its validity. It has been referred to as merely a “realist, descriptive method, and a method that lacks nuance, subtlety, or interpretative depth” (Braun & Clarke, 2014. p1). Although TA can be used within a realist or descriptive manner, Braun and Clarke argue (2014) that it is not limited to just this. Braun and Clarke’s (2006) version of TA uses a robust and systematic coding framework that helps the researcher to identify patterns across the body of data. Hence, TA can support a range of research designs, from a thorough and complex analysis; research outside of academia; or more of an applied research approach (Braun & Clarke, 2014). The authors, however, have acknowledged that the interpretative power may be reduced when not applied to an existing theoretical framework. In addition, it lacks specific guidance for research requiring a high level of interpretative analysis (Braun & Clarke, 2013).

Rationale for using TA.

The current research examining service users’ experience with voices over time required an approach that was flexible with regard to data collection, analysis and sample size. TA was therefore considered an appropriate method. Due to this flexibility, it was suitable for a longitudinal design, and it allowed for both a deductive testing of existing models and an inductive, experiential exploration of the data set.

2.3.7.5 Template Analysis.

Template analysis (a version of TA) is a qualitative approach for thematically organising and analysing data (King, 2004). It has been described as particularly useful for use within applied qualitative psychological research (Brooks & King, 2012). A template of codes is developed from textual data. The template is organised to denote the connections between themes which is represented within a hierarchical framework (King, 2004).

Rationale for using template analysis.

As an approach, template analysis is flexible and can be adapted to the

requirements of the research project. In respect of the current programme of research, and in particular the analysis of clinicians’ data, two main features specific to this method meant that it was judged a fitting approach. Firstly, template analysis

emphasises across case data analysis as opposed to within case data analysis (Brooks & King, 2012). This was considered valuable in attempting to understand clinicians’ views as a group. Secondly, themes can be defined prior to analysis (known as “a priori” themes) (ibid). This meant that, where appropriate, the interview schedule was used to inform the development of the template. Consequently, template analysis was used as a method to analyse clinicians’ data.