Quantitative methods have long predominated the field of psychological research. More recently however, there has been a recent surge in the use of qualitative methods. Whether used alone or in combination with quantitative methods in a mixed method design, qualitative methods offer huge potential to contribute to the field of mental health services research. It is especially effective in retrieving rich perspective data from the individual, which complements the objectivity of quantitative data to create a better understanding of the subject matter. However, it must be kept in mind that qualitative research methods aren’t substitute for quantitative methods and both are needed.
Qualitative methods are informed by a social constructionism paradigm, suggesting reality is a social and psychological construction rather than an objective truth (Gergen, 1985). Constructionists view knowledge and truth as created, not discovered by the mind (Schwandt, 2003). Qualitative researchers deem the target of psychological research to be understanding behaviours and phenomenon from the point of view of those being studied (Bryman ; Burgess, 1994). This approach adopts naturalistic designs to study phenomenon as they occur without external constraint or control (Lincoln ; Guba, 1985). Qualitative methods provide a ‘thick description’ or depth of understanding to complement findings derived from quantitative methods, extract the perspective of those being studied, investigate issues that haven’t been well studied and create conceptual theories or test hypotheses. Qualitative methods adhere to many of the same principles of scientific rigour as quantitative methods, but often differ with respect to study design, data collection and data analysis strategies. Palinkas (2014) states the most common techniques for data collection are individual semi-structured interviews, focus groups, document reviews, and participant observation. Strategies for analysis are usually inductive, based on principles of grounded theory or phenomenology. Rigorously applied qualitative methods offer great potential in contributing to the scientific foundation of mental health services research.
The quantitative approach to psychological research has been dominated by a positivist paradigm of which is very different to social constructionism, that assumes there is an objective reality that can be revealed through experimental and correlational procedures to discover causal relationships and predict behaviour (Ponterotto, 2005). A quantitative researcher attempts to fragment and delimit phenomena into measurable or common categories that can be applied to all subjects or wider and similar situations (Winter, 2000). (Kuhn, 1970) suggests qualitative methods in mental health services research have long been regarded as being “unscientific”, unlike quantitative methods. He believes this is largely due to a lack of understanding of and experience with scientific methods. This viewpoint began to shift over the last two decades with the recognition that qualitative methods could offer more in terms of an understanding of the need for and delivery of mental health services, than was available from the use of quantitative methods alone (Hohnmann, 1999). Since, qualitative methods have been used in mental health services research, both alone or in mixed method designs (Palinkas et al, 2011). Evidence suggests qualitative and quantitative research complement each other in mixed method designs for convergence, complementarity, expansion, development, and sampling. It can be said that qualitative research is needed to identify the characteristics of phenomena and quantitative research is needed to control phenomena and to predict outcomes. Similarly, Trow (1957) argued that no single technique could claim to a monopoly on inference, and the past decade has witnessed an increasing interest in combining methods. Stenbacka (2001) also comments on how qualitative and quantitative methods work together to create good quality research. He states quantitative study has a “purpose of explaining” and qualitative study has the purpose of “generating understanding”.
A profound strength of using qualitative methods is that they are ideal for eliciting the perspectives of those being studied which is most fundamental for generating understanding.
According to Sofaer (1999), “Qualitative methods allow people to speak in their own voice, rather than conforming to categories and terms imposed on them by others”. By eliciting participant perspectives, qualitative methods serve to enhance the validity of data being collected because it enables the investigator to compare their own perception of reality with the perception of those who are being studied. Interpretive phenomenological analysis (IPA) is a qualitative method and is phenomenological in that it is purely concerned with individual subjective reports rather than formulation of objective accounts (Flower et al, 1999). The aim of IPA is to explore in detail the processes through which participants make sense of their own experiences, by looking at the respondents account of the process they have been through and seeking to utilise an assumed existing universal inclination towards self-reflection (chapman & smith, 2002). IPA is particularly relevant to health psychologists (smith et al, 1999) as they have stirred away from a simple biomedical model of disease and illness. Health psychologists realise the importance of understanding patients’ perceptions of an interpretation of their bodily experiences and the meaning to which they assign to them (Leventhal et al, 1984). Quantitative methods could not retrieve this kind of data which conveys the usefulness of qualitative methods. Brocki and Wearden (2006) undertook a systematic literature to identify published papers in the area of health psychology employing IPA. They found that IPA seems applicable and useful in a wide variety of research topics. Another example of the usage of IPA more particularly within clinical psychology includes Rhodes’ (1991) ethnography of an emergency psychiatric unit; a descriptive account of the way in which clinicians reported making treatment decisions, their beliefs about how decisions should be made, and barriers to making treatment decisions. Additionally, another instance IPA is used is displayed by Lee et al (2006) who gave youths in foster care an opportunity to voice their experiences with mental health services and specific providers. The rich data obtained from these studies may not have been possible without the interpretive and
reflexive nature of the qualitative method. Smith (2010) argues that the reflexivity involved in IPA is a key strength and useful, as it allows researchers to use their own experience-based interpretation to add value and clarity. Another useful attribute of qualitative methods is that they are often found to be especially useful during initial stages of research because they enable investigators to acquire some understanding of issues, to obtain “pilot data”, or when there is too little previous research or absence of theory to allow for identification of hypotheses to be tested. Examples of such use include an exploration of the experiences of providers who have encountered immigrant patients in their services daily. Additionally, to reflect on areas where difficulties may arise and how these are managed in mental health services (Sandu et al, 2012). Moreover, an exploration of wraparound services for youth with serious emotional disturbance (Mendenhall et al., 2013). Dorsey et al (2014) used qualitative methods as part of a pilot project effort to tailor an existing engagement intervention for use in implementing trauma-focused cognitive behavioural therapy with a small group of foster parents to identify any population-specific areas of adaptation to the engagement intervention. Such exploration can be used to develop new theories or conceptual frameworks or to expand upon existing ones and to generate new hypotheses that may be tested using quantitative methods. This is known as the grounded theory of which originates from symbolic interactionism and suggests meaning is negotiated and understood through interactions with others in social processes (Blumer, 1986). Strauss (1967) first proposed that researchers should engage in simultaneous data collection and analysis, which has become routine practice in qualitative research. Grounded theory can also be used to develop valid and reliable quantitative methods by identifying the content and form of questions to be asked and by identifying the target population through observation and interviews. For
instance, Byng et al (2008) used qualitative methods to generate provisional hypotheses, ready to be tested using the analytic induction process, that were derived both from themes emerging during initial coding of interview transcripts and by examining the matrix of obvious patterns. Grounded theorists share a conviction with many other qualitative researchers that the usual canons of “good science” should be retained but require redefinition in order to fit the realities of qualitative research and the complexities of social phenomena. These scientific canons include significance, theory-observation compatibility, generalizability, consistency, reproducibility, precision, and verification (Gortner and Schultz, 1988). Charmaz & Bryant (2011) comment that grounded theory is primarily a method of data analysis, with profound implications for collecting data that have largely remained unaddressed. For example, Allen (2003) comments there a lack of rigour within the use of grounded theory due to careless interview techniques and the introduction of bias. However, this can be avoided where by interviews should be guided to avoid leading questions and the introduction of bias. On the other hand, a real advantage of GT is identified by Glaser (2002) who comments on the fact that analysis starts as soon as data collection begins in the first interview if the researcher identifies concepts that are striking at that time. Further credible usage of qualitative methods in mental health services research lies with the evaluation of process. Such methods are frequently used in evaluation research to explain how a program or intervention operates. Harris et al (2012) used qualitative methods to help understand why Early Intervention in Psychosis services are effective by exploring the personal experiences of a small sample of services users. Similarly, Byng et al. (2008) used qualitative methods to conduct a process evaluation of a complex intervention for shared care in mental health.
A downfall of qualitative methods is that they have been known to lack validity and reliability in comparison to quantitative methods. Mays & Pope (1995) suggest firstly, that qualitative research is merely an assembly of anecdote and personal impressions, strongly subject to researcher bias. Secondly, they argue that qualitative research lacks reproducibility-the research is so personal to the researcher that there is no guarantee that a different researcher would not come to radically different conclusions. Similarly, Wagstaff and Williams (2014) argues that the interpretive, flexible nature of qualitative methods conflicts with the idea of truthfulness and replicability and can change the outcome of studies through bias, and therefore may not do well in acquiring valid, reliable psychological research. However, the aim of validity checks in this context is not to prescribe to the ‘singular true account’ but to certify credibility of the final account and aim for trustworthiness within research (Osborn & Smith, 1998). Mays and Pope (1995) also comment on a criticism of qualitative methods and their lack of generalisability. They suggest qualitative methods tend to generate large amounts of detailed information about a small sample. Despite a rich nature of information being produced, if it is not applicable to a wider population, it can only be useful to a certain extent. Yin (1994) defended the position that case studies do lead to building theories applicable in the world at large. In conclusion, it is agreeable to state that qualitative methods offer enormous potential to contribute to the field of psychological research particularly when using IPA to gain the perspective of individuals to contribute to the bigger picture of research. Qualitative complements quantitative methods, whether used in combination with quantitative methods in a mixed method design or alone. However, it should be noted that qualitative methods cannot replace quantitative methods. Qualitative research can enable a researcher to achieve a deeper understanding of a process and therefore develop better instruments for measuring process and outcome, more efficiently target potential study participants, enhance the
external validity of the findings, and also account for any unexplained findings of an analysis of quantitative data. Eisner (1991) summarises the usefulness of a good qualitative study, and how it can help us “understand a situation that would otherwise be enigmatic or confusing