Training for Group Psychotherapists

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CHAPTER THREE THE INVESTIGATION

Introduction

In this investigation, the decision was made to utilise the qualitative research paradigm. It is suitable for this study since it permits an in-depth exploratory study of the experiential group. Therefore, in this section, the essential characteristics of qualitative research will be outlined. Thereafter, a description of the research design will be delineated. Finally, the research procedure followed in this investigation will be presented.

Qualitative Research Approach

Various techniques are now being used to conduct qualitative research (Denzin and Linclon, 1994). These are based on a range of theoretical perspectives that make different assumptions about the basis of scientific knowledge, use different procedures and have different aims. Defining qualitative research is therefore rather difficult. However, the definitions that follow do reflect certain characteristic features that are common across all qualitative research practices.
Defining Qualitative Research
Qualitative research is defined as being multi-method in focus, involving an interpretive, naturalistic approach to its subject matter (Denzin and Lincoln, 1994, p.2). This means that qualitative researchers study phenomena in their natural settings, attempting to make sense of or interpret these phenomena in terms of the meanings people bring to them. Qualitative research involves the studied use and collection of a variety of empirical materials – case study, personal experience, introspective life story, interview, observational, historical, interactional and visual texts – that describe routine and problematic moments and meaning in individuals’ lives.
This definition suggests an a priori approach, grounded in philosophical assumptions, i.e., the interpretive naturalistic approach, to qualitative research.
In addition, multiple sources of information and narrative approaches are available to the researcher in the process of gathering information.
Cresswell’s (1998, p. 15) definition relies less on sources of information, but it conveys similar ideas:
Qualitative research is an enquiry process of understanding based on distinct methodological traditions of inquiry that explore a social or human problem. The researcher builds a complex, holistic picture, analyses words, reports detailed views of informants, and conducts the study in a natural setting.
In summary, qualitative research is conducted in a natural setting, where in-depth, detailed information is gathered from the participant’s direct experience through various methods in order to build a complex and holistic picture of the topic under investigation.
Having defined some of the features, which characterize qualitative research, it might have become obvious that certain research questions and problems lend themselves more readily to qualitative research than others.
The rationale for using a qualitative research design in this study will be discussed in the section below.

The Appropriateness of a Qualitative Research Paradigm

The rationale for utilizing a qualitative approach is derived from the following premises:
v qualitative research provides the investigator with in-depth information while creating a context in which ethical principles are adhered to;
v the assumptions underlying qualitative research methods are congruent with those underlying systems concepts;
v it is consistent with the purposes of this study, with its emphasis on process research; and,
v qualitative research has been described in the literature as providing an important link in bridging the gap between research, theory and clinical practice (Moon, et al, 1990).
Qualitative Methods yield in-depth information
Within the context of group psychotherapy, participants tend to feel extremely vulnerable because of the risks involved. Therefore, the process of group psychotherapy/group interaction is in a strict sense very personal.
Given the above, a quantitative study’s methods of collecting data and reporting findings, would generalize information to the extent that subtle personal issues could be overlooked. However, by using qualitative methods, more specifically the open questions in in-depth interviews, this personal information could be captured. In addition, several ethical issues such as confidentiality, respect and the prevention of harm to the research participants would have been incorporated into the study.
Thus apart from facilitating sensitivity to the research participants and protecting their welfare, qualitative methods allow the researcher to focus the investigation and to provide information which is both meaningful and clinically relevant to a specific area of study (Baloyi, 2002).
Qualitative methods are compatible with the assumptions underlying systems theory
In addition, in line with this investigation, qualitative research methods may be more effective than quantitative methods in grappling with the full complexity of systems theory. Like systems theory, qualitative research emphasises social context, multiple perspectives, complexity, individual differences, circular causality, recursion and holism. Qualitative methods provide an avenue for examining the experience of family therapy from the perspective of the client rather than from the more typical research perspectives of the therapist and/or the researcher (Steier, 1985).
In keeping with the purpose of this study, a qualitative research design would provide a systematic, scientific way of looking at the context of group psychotherapy training holistically, with all of its « messiness » intact.
Emphasis on process-oriented research
Process research is a fairly new area of inquiry. Over the last few decades, process research has emphasised the study of change and ‘a smaller is better’ philosophy (Greenberg and Pinsof, 1986 in Moon, et al, 1990). The principles of process research as enumerated by Rice and Greenberg (1984 in Moon, et al, 1990) include criterion-based and theoretical sampling, pattern exploration, detailed descriptions and observations, process in context, a discovery-orientation, and clinical relevance. These sound very similar to those addressed by the qualitative methodologist.
Qualitative research may help answer the process researcher’s call for a context-specific microtheory of change because qualitative research is generative, inductive and constructive (Moon, Dillon, and Sprenkle, 1990). Hence, a qualitative approach would provide one way of studying such a rare and complex event (such as group psychotherapy training), in context across time.
Qualitative methods bridge the gap between research, theory and practice
According to Green (1989 in Moon, Dillon and Sprenkle, 1990), a perplexing problem for the field of family therapy during the past two decades has been the lack of integration between research, theory and practice. Although certain basic similarities exist between the methods of discovery in clinical work and research, Green (1989 in Moon, et al, 1990) argues that clinicians and researchers have tended to divide into two isolated camps, separated by a communication gap.
In agreement with the above argument, Moon and colleagues (1990, p. 367) state that: « Qualitative researchers could help reunite clinicians and researchers because qualitative methods are close to the world of the clinician. Qualitative researchers tend to ask the kinds of questions that clinicians are asking and to explore these questions in ways that are clinically meaningful. »
In summary, the qualitative approach to research was found to be suitable for this investigation for four primary reasons (as discussed in the above section). In addition, it corresponds with the aims of this investigation in that it permits the researcher to conduct an in-depth study, collect detailed information that is both meaningful and ethically sound. The decision to carry out a qualitative study carries a number of research implications. These are discussed in the section below.

Research Design

The decision to make use of a qualitative research paradigm has many implications for research design: it has a variety of consequences for sampling, data collection and analysis. In developing a research design, the researcher must consider whether the aims of the research are mainly exploratory, descriptive or explanatory (Terre Blanche and Durrheim, 1999). Since the focus of this research is exploratory in nature, a brief description of such a study will be provided.
Exploratory study
Exploratory studies are used to make preliminary investigations into relatively unknown areas of research. They employ an open, flexible and inductive approach to research as they attempt to look for new insights into phenomena. In other words, exploratory studies generate speculative insights, new questions and hypotheses. Exploratory research designs should detail how the researcher plans to collect information and where he/she would look for this information (Flick, 1990).
In terms of this investigation, it implies that core aspects such as sampling, data collection and data analysis, would have to be discussed. These core aspects of the study are discussed in the following section.
The aim of this investigation was to generate hypotheses about the effectiveness of the use of an experiential group as a reliable and valid tool for training in group psychotherapy. Further objectives included exploring the merits of an experiential approach to training in group psychotherapy, and identifying factors that could potentially aid/hinder trainee development. Thus, the group members are the subjects of the study while the training is the object of the investigation. In the section below, the variables of the study and the research procedures followed will be presented. The Variables of the Study
In line with the aims of the study, the research variables are as follows:
v group psychotherapy as described in the literature
v group psychotherapy training
v individual trainees’ subjective reports of the experiential group
The Principles of Group Psychotherapy as described in the Literature
Since the findings from the literature in relation to the principles of group psychotherapy (as they manifest in group interaction) have been discussed in the previous chapter, they will not be repeated in this section. However, a synopsis of the key themes extracted from the literature will be discussed in conjunction with the research findings
Group Psychotherapy Training
The training for a Masters degree in Clinical Psychology at UNISA ran over two academic years. The group from which the research participants were chosen for this study was selected in 1998. This group of individuals met once a week on a Thursday (in 1999) for approximately two hours for group psychotherapy training. In the second year of training (2000), they also met for approximately two hours but on a Monday morning. The training took place within the format of an experiential group.
Trainee’s Subjective Reports
Information regarding the trainee’s subjective experience of the group psychotherapy training would be elicited by executing the proposed research procedure as described later in this chapter.
The Sample
Sampling involves decisions about which people, settings, events, behaviours and /or social processes to observe (Terre Blanche and Durrheim, 1999). Since this study utilises a qualitative, exploratory research design and is concerned with detailed in-depth analysis, typically one is not required to draw large or random samples. Instead, a purposeful (i.e. non – random) sampling procedure was considered an appropriate means of selecting the research participants for this investigation. Hence, the sample includes all the trainees who had already completed the Masters program in Clinical Psychology at UNISA in the academic years 1999 – 2000. They were completing the internship program, at the time of the interviews. The group comprised of nine individuals, all of whom had been invited to participate in this investigation.
The Group Composition
The demographic information pertaining to the group members is as follows:
The original group comprised of ten members, three males and seven females. One of the male members had failed in the first year (1999) of training. Consequently he had to exit the group. The group was heterogeneous. It comprised of two White males, one Black male, five White females and two Indian females. All the group members resided in the Gauteng Province during the course of the training. The ages of the group members ranged from the youngest being approximately 24 years of age, to the oldest member being about 40 years old.
None of the group members was in full-time employment for the duration of the training. Their previous work histories varied. Some were unemployed (i.e. they were students). A number of the group members fell into the lower middle class socio-economic category. Five group members were married in their first year of training, while four individuals were single. In the second year one individual was separate

Procedure

All group members were contacted telephonically to invite them to participate in the investigation. They had been given information about their role in the study, and the proposed method of investigation. Initially, all the invitees agreed to participate except for one. In addition, none of the participants objected to the manner in which the data would be collected and/or recorded. In the end, only five members agreed to participate. One member contacted the researcher telephonically in order to excuse herself. She reported that she had been busy and therefore could not grant an interview. Another member promised to contact the researcher at his convenience but claimed that, for practical reasons, it had not been possible for him to participate. The remaining two members were not contactable.
The members who finally participated were required to provide written consent to meet the ethical requirements of informed consent. They agreed to participate out of their own free will, with the assurance that their identity would remain confidential. Pseudonyms were assigned to each participant.
The participants also completed a questionnaire, which was designed to yield demographic information and provide data in relation to previous experience with groups. The primary methods of data collection will be discussed in the section below.
3.5.1 Data collection
There is widespread agreement that the data should be valid, that is, the data should capture the meaning of what the researcher is observing. Many qualitative researchers argue that social phenomena are context-dependent, and that the meaning of the topic/subject the researcher is investigating depends on the particular situation an individual is in. Qualitative researchers seek validity in the degree to which the researcher can produce observations that are believable to her/himself, the subjects being studied and the eventual readers of the study (Terre Blanche and Durrheim, 1999, p.36).
Decisions relating to data collection have been guided by sound principles of qualitative methodology (as discussed in the above section), the researcher’s interest in increasing her understanding of group process, her knowledge of group interactions, subjective experience of the group psychotherapy training (in UNISA’s Clinical Psychology Masters program) and by the principles of group psychotherapy as described in the literature.
In an attempt to develop a coherent research design, the researcher favoured qualitative methods of data collection i.e. observation and interviewing, because they permitted rich, and detailed observations of a few cases. In addition, these methods would allow the researcher to build an understanding of the (experiential) training in group psychotherapy by observing the subjective impact of the training on the trainee, as it manifested in the context of the group setting.
The decision to collect the data for the study via a client-centered interview, and open-ended questions in a semi-structured questionnaire remained unchanged. The client-centered interview was taped , while the responses to the questionnaire were recorded on the instrument. The goal of data collection had been to gather information in order to extrapolate themes from the responses based on the individual member’s subjective experience of the group.
Interviews
A client-centered interview is considered an appropriate method of collecting data for this investigation since it is compatible with the exploratory nature of this study.
A client-centered interview is a form of an exploratory interview in that it is open, non-threatening and has little structure.
The aim of a client-centered interview within the therapeutic context is to obtain a typical sample of the client’s behaviour and to allow the client/interviewee to explore his emotions and his experiential world as he sees fit or from his own frame of reference. Thus, the client-centered interview would provide the researcher with a sample of an internal representation of the participant’s emotional experiential world. It would also reveal information about the way in which the participant perceives and conceptualizes the experiential training which he/she had received in group psychotherapy (Rogers, 1970).
During the investigation, each participant was interviewed for approximately half an hour. The initial arrangement to videotape the interviews was changed for practical reasons. It had been difficult to arrange a suitable time for all participants to be interviewed in consecutive order. Therefore, in order to standardize the research procedure, the format was changed. Consequently, the interviews were recorded on audiotapes.
Each participant was first asked to describe his/her experience of the group, which had met once a week for group psychotherapy. Thereafter, the interview questions were formulated in relation to the respondent’s description of that experience. In addition, since the aim of the research was to generate hypotheses about the use of an experiential group as a medium of training in group psychotherapy, the participants’ experiences with each group member (including the facilitator) and, their perceptions of group dynamics and group processes were also explored.
Audiotapes
Audiotapes were used to record the interviews. The information recorded on these tapes provided the text for data analysis (content analysis). The data collected was transcribed in order to facilitate accurate analysis of information. Complete transcripts will be available upon request.
The Semi-Structured Questionnaire
The information from the questionnaire would give the researcher an indication of the participant’s self-reflexive competencies, i.e. his/her experiential understanding of group process, theoretical understanding of group psychotherapy and the skills required in order to function as an effective group facilitator.
A literature search was conducted to find a questionnaire that would serve as a suitable measuring instrument for this investigation. However, the available instruments were inadequate for the research requirements of this study. Subsequently, a questionnaire was designed to ensure that the measuring instrument was compatible with the investigation’s research requirements. The initial questionnaire consisted of twenty-three questions. It was subsequently scaled down to a sample of ten questions. The questionnaire was constructed, based on information obtained from the literature describing the principles of group psychotherapy.
In order to remove researcher bias, the questionnaire was standardized by means of a pilot study.It was administered to three psychologists working at UNISA’s Psychology Department. Two of these psychologists are clinicians; the other is a researcher. The responses from the two clinicians were similar, while those of the research psychologist differed vastly from the clinicians. The clinical psychologists’ responses were related to the actual content of the questionnaire in terms of the wording of the questions, the construct validity and the structuring of information. Their suggestions were taken into account and incorporated into the final questionnaire. The research psychologist on the other hand, had offered suggestions that were related more to the paradigm through which the research findings would be analysed, and to the research methodology.
3.5.2. The Analysis of Data
According to Terre Blanche and Durrheim (1999, pp 39-41) issues regarding data analysis should be carefully considered when designing a study, since the aim of data analysis is to transform information (data) into an answer to the original research question. A careful consideration of data analysis strategies will ensure that the design is coherent, as the researcher matches the analysis to a particular type of data, to the purposes of the research and to the research paradigm. Qualitative techniques begin by identifying themes in the data and relationships between these themes.
The data, which would appear on the transcripts, would be analysed by means of a qualitative content analysis.
Content Analysis
Content analysis comprises both a mechanical and an interpretive component (Breakwell, et al, 1995). The mechanical aspect involves physically organizing and subdividing the data into categories while the interpretative component involves determining which categories are meaningful in terms of the questions being asked. The mechanical and interpretative components are inextricably linked by cycling back and forth between the transcripts and the conceptual process of developing meaningful coding schemes. Qualitative content analysis tends to be more subjective and less explicit about the processes by which interpretation of the target material occurs (Henwood and Pidgeon in Breakwell, et al, 1995). The emphasis is on meaning rather than on quantification.
Initially, the system of classification may be derived from the research question and the topic guide used by the moderator during process facilitation. Additional conceptual tools may arise from a closer examination of the data as whole. Coded segments may include long exchanges, phrases or sentences. The transcripts are cut and then sorted. Codes can also be developed to signal useful quotations and to provide a descriptive overview of the data. The aim is to be able to find quotations to illustrate particular themes or strands of meaning within the transcript. With this form of content analysis, the aim is not normally to put numbers to the data (Breakwell, Hammond, & Fife-Schaw, 1995).

Researcher Bias, Ethics and Credibility

Researcher Bias
Like all research, qualitative research is biased. A biased interpretation is one that leans too much on preconceptions (including institutional or cultural norms), and not enough on observation (Stiles, 1993).
Investigators cannot eliminate their values and preconceptions, but they can work to make them permeable. The qualitative approach to the problem of bias is thus to increase investigators’ – and readers’ – exposure to the phenomenon by, for example using intensive interviews, thick descriptions, and triangulation; responsible searching for negative instances; and repeatedly seeking consensus through peer debriefing and other elements of good practice. It is argued, that closer engagement with participants or text, in which interpretations are iteratively stated and refined, promotes a dialectical process by which the observations tend to permeate and change the investigator’s initial views.
This response to observer bias represents a sharp departure from the traditional scientific view that the possibility of bias invalidates a research finding (Stiles, 1993).
Since the purpose of this study is to review the relevant literature in order to describe the principles of group psychotherapy and then to compare the subjective experiences of trainee group psychotherapists with the findings from the literature, the researcher would have to exercise caution in making interpretations based on the research findings. Therefore, the researcher would also have to be wary of the pressure to observe what the theory dictates, exclusively. Consensus of participant’s responses could also reflect conformity to the theory and may not necessarily reflect actual experiences of phenomena.
One rejoinder is that yes, preconceptions may influence results, but in the end, this is a weak effect. It is strongly believed that, as Stiles (1993) describes it: « Despite our biases, we do in fact disconf irm our expectations all the time. Our ability to be surprised, to change our minds, to come to new understanding, demonstrates our initial biases are not immutable. »
Ethics
The qualitative researcher’s investment in uncovering the insider’s view of a situation may present ethical considerations not often confronted by researchers who are dedicated to maintaining an impartial stance with their study participants. The foregoing validity criteria are vulnerable to distortion by investigators’, participants’, and readers’ expectations and values. For example, (participant) self-disclosure and uncovering could reflect selective perception, selective reporting, or self-fulfilling prophecies (Stiles, 1993).
In addition, in surveys and other types of quantitative research, informed consent is routinely given at the beginning of the project and extends across the length of data collection. Although an indepth interview also typically involves informed consent at the beginning of the project, the participant may reveal sensitive material during the course of the interview that was not anticipated at the time of the original agreement. The participant reserves the right to have any of the material withdrawn from the recorded version of the interview. As previously discussed, the research participants were required to sign a document in which they agreed to participate in this study out of their own free will with the assurance that their identity would remain anonymous. This agreement also ensured that confidentiality could be maintained to the extent that the identity of the participants would remain anonymous, thus ensuring that the subjects of the study would be protected.
A second ethical consideration is the fact that there may be considerable role ambiguity for researchers and practitioners in clinical settings. As part of the interview process, participants take the interviewer into their confidence and may seek and experience therapeutic effects during the interview process. The researcher is no longer an « objective outsider » but considered a confidant and potentially a therapist. Qualitative researchers are advised to recognise their limitations and to give careful forethought to the limits of their involvement with participants (Fiese and Bickham, 1988).
During this investigation, the researcher did find herself in an ambiguous position, in that she simultaneously had 2 roles i.e. that of UNISA trainee and research observer. However, this did not appear to have an adverse effect on the participants in the study, nor did it pose problems for the investigation itself, as this dual role is compatible with the epistemological assumptions of the research paradigm used in this study.
Credibility
In this study, it is proposed that, in addition to those mentioned above, some steps can be taken to establish credibility. As a first step, some of the assumptions about group psychotherapy training, personal and therapeutic preconceptions regarding group psychotherapy, and research can be examined. This is included in the discussion on methodology, so the reader, knowing a bit more about the researcher and the underlying principles of this study, can make better sense of the claims that would be made. Another way to address credibility would be to look at the visibility of the data. Visibility refers to the extent others have access to the actual data of a study. Visibility will be addressed by providing transcripts from the interviews. By having access to the original data, readers can evaluate the accuracy of the research claims and see how interpretations are made (Moon, Dillon, and Sprenkle, 1990).

Conclusion

In this chapter, the research design and procedures followed have been discussed. It was found that a qualitative research paradigm is suitable for this study since it is compatible with the aims of this investigation. In addition, since it allows for an in-depth exploratory investigation, the qualitative research paradigm also yields a rich source of information, which is reliable, has contextual validity and is ethically sound. In the next chapter, an analysis of the research data will be presented and discussed.

TABLE OF CONTENTS
Abstract
Acknowledgments
Table of contents
I.    INTRODUCTION
1.1. The Motivation for this study
1.2. Aim of the study
II     LITERATURE REVIEW
2.1. Introduction
2.2. Defining a group
2.3. Training for Group Psychotherapists
2.4. A Brief Historical Overview of Group Psychotherapy
III.   METHODOLOGY
3.1. Introduction
3.2. Qualitative Research Approach
3.3. The Appropriateness of a Qualitative Research Paradigm
3.4. Research Design
3.5. Research Procedure
3.6. Researcher Bias, Ethics and Credibility
3.7. Conclusion
IV.    RESULTS AND DISCUSSION
4.1. Introduction
4.2. The Analysis of the Data
4.3. Interpretation of the Research Findings
4.4. Discussion of Research Findings
4.5. Summary and Conclusions
V.   CONCLUSION
FINAL REMARKS
REFERENCES
APPENDIX

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