Reading qualitative research

In recent years, qualitative research has emerged as an increasingly significant source of evidence for counselling and psychotherapy policy and practice. As a result, it is important for readers of qualitative studies to develop an appreciation of what kind of knowledge is made available, and not available, through this form of inquiry. The present paper offers a critical reflection on a series of qualitative studies published in the current issue of this journal. From a reader perspective, it is possible to identify a set of key themes: the capacity of qualitative research to address major issues within the field; contrasts between professional knowledge and other sources of evidence; the positionality of the author; the challenges associated with the accomplishment of contextuality; and, the struggle to determine the credibility and reliability of findings. The paper concludes by suggesting a shift in publication practice that might enhance the value and readability of qualitative articles.     

Culture and decision‐making: Investigating cultural variations in the East Asian and North American online decision‐making processes

Research in cross‐cultural psychology suggests that East Asians hold holistic thinking styles whereas North Americans hold analytic thinking styles. The present study examines the influence of cultural thinking styles on the online decision‐making processes for Hong Kong Chinese and European Canadians, with and without time constraints. We investigated the online decision‐making processes in terms of (1) information search speed, (2) quantity of information used, and (3) type of information used. Results show that, without time constraints, Hong Kong Chinese, compared to European Canadians, spent less time on decisions and parsed through information more efficiently, and Hong Kong Chinese attended to both important and less important information, whereas European Canadians selectively focused on important information. No cultural differences were found in the quantity of information used. When under time constraints, all cultural variations disappeared. The dynamics of cultural differences and similarities in decision‐making are discussed.     

The first interview: Anxieties and research on initiating psychoanalysis

A qualitative clinical study of preliminary interviews by the Working Party on Initiating Psychoanalysis (WPIP) of the European Psychoanalytic Federation suggests that the unconscious dynamics in first interviews are extraordinarily powerful and that they give rise to deep unconscious anxieties in both patient and analyst, with the corresponding defences against them. Furthermore, the group dynamics observed in the clinical workshops and in the research team doing the study suggest that both the anxieties and the defences are conveyed to these groups in the form of unelaborated ‘session residues’ provoking renewed anxieties and defences in them. These findings contribute to our understanding of what goes on in first interviews, but also raise interesting questions about the psychoanalytic research process in psychoanalysis and how confrontation with the unknown is dealt with in that context. Rather than as a means to avoid anxiety, method in clinical research can be seen as a way to help the research group to contain its reactions and to tolerate them until the group finds its way to further elaboration. These points are illustrated with a clinical case drawn from the study.     

The role of self‐image as a predictor of psychotherapy outcome

The present study examined the relationship between self‐image and outcome in psychotherapy. Patients (n = 170) received treatment‐as‐usual at a university clinic, and met diagnostic criteria for mostly anxiety and depression related disorders. Self‐image was measured with the Structural Analysis of Social Behavior (SASB‐I) introject pre and post‐treatment. Using multiple regression analyses, higher levels of Self‐ignore and Self‐blame pre‐treatment predicted a poorer treatment outcome in terms of symptoms (SCL‐90‐R) and interpersonal problems (IIP‐64), respectively. Increase in Self‐love and decrease in Self‐blame (pre to post) predicted reduced symptoms at post‐treatment, whereas decrease in Self‐attack and Self‐control, as well as increase in Self‐affirm, predicted reduced interpersonal problems. The results suggest that self‐image improvement may be important in order to achieve a good outcome in psychotherapy.     

The source of the truth bias: Heuristic processing?

People believe others are telling the truth more often than they actually are; this is called the truth bias. Surprisingly, when a speaker is judged at multiple points across their statement the truth bias declines. Previous claims argue this is evidence of a shift from (biased) heuristic processing to (reasoned) analytical processing. In four experiments we contrast the heuristic‐analytic model (HAM) with alternative accounts. In Experiment 1, the decrease in truth responding was not the result of speakers appearing more deceptive, but was instead attributable to the rater's processing style. Yet contrary to HAMs, across three experiments we found the decline in bias was not related to the amount of processing time available (Experiments 1–3) or the communication channel (Experiment 2). In Experiment 4 we found support for a new account: that the bias reflects whether raters perceive the statement to be internally consistent.     

Therapists’ experiences with internal representations of clients

Fourteen therapists were interviewed via telephone regarding their experience of “carrying around” their clients with them between sessions (i.e. internal representations, or IRs, of clients), a phenomenon about which little empirically based knowledge exists. Data were analyzed using consensual qualitative research. Findings indicated that overall, therapists have IRs infrequently, most often have IRs of clients struggling with severe or challenging presenting problems, and do receive some training about IRs. When describing a specific IR experience, therapists typically noted a strong therapy relationship, and stated that the IRs typically had specific triggers. The IRs generally consisted of feelings about the client, and typically consisted of thoughts about the client or the felt presence of the client. The IRs generally yielded positive effects, typically both personally and professionally, and were typically discussed with supervisors/consultants. Implications for research, training, and practice are presented.     

Amalia X: dialogical sequence analysis as a method in theory-based single case research in psychoanalysis

In this article, Dialogical sequence analysis (DSA) is introduced as a method in theory-based single case research. The structure of article is as follows: first, we will describe briefly the historical background of single case studies and their position as the foundation of psychoanalytic knowledge formation. Secondly, we will describe through Amalia X’s case how one psychoanalytic ‘specimen case’ has been used as a cornerstone for a comprehensive psychoanalytic process research model, the so called ‘Ulm model’. Amalia X is one of the most studied single cases internationally also outside psychoanalytic process study field. Thirdly, we will introduce the central theory and practice of DSA. Fourthly, in the last section of our article, we will show in practice how DSA can be used in the analysis of Amalia’s dream in the session 152.     

Meta‐Analysis of Anorexia Nervosa Counseling Outcome Studies From 1990 to 2015

This meta‐analysis of 92 anorexia nervosa counseling articles examined the effectiveness of counseling in reducing symptoms of anorexia nervosa at termination and the longest follow‐up assessments. Treatment‐as‐usual studies showed no effect to small effects at both posttest and follow‐up assessments, wait‐list studies showed small effects at posttest and medium effects at follow‐up, and single‐group uncontrolled studies showed medium to large effects at posttest and medium effects at follow‐up. Implications for research and practice are discussed.