Jörg Frommer & David Rennie (Eds.) (2001). Qualitative Psychotherapy Research: Methods and Methodology. Lengerich, Pabst Science Publishers, 203 pages, ISBN 3-935357-74-5, 24.- Euro

Abstract: FROMMER and RENNIE present a stimulating, thought provoking collection of papers which are surprisingly well-integrated despite the diversity of methods and approaches discussed. In the first section of the book, various theoretical and conceptual bases for qualitative psychotherapy research are proposed and the location of qualitative research within a "double hermeneutic" is described. In the second section, an array of methods and approaches to research are described and evaluated. Although some of the methods proposed in this section contradict and undermine both each other and the conceptual/theoretical frameworks proposed in the first section, this is, nevertheless, a valuable and insightful text. Its focus on the negotiation and analysis of personal narratives in the sensitive setting of therapy raises issues of interpretation, pragmatics and ethics which are of great relevance for qualitative researchers more generally, and this book is highly recommended to anyone working in the field.

FROMMER and RENNIE's edited volume mainly consists of revised and expanded versions of papers presented at the First International Conference on Qualitative Psychotherapy Research in Düsseldorf, 1996. The conference and the book unite strands of research from the German speaking countries of Europe, North American and Britain. The book is organised into three sections: the first on methodology, the second on method, and the third (consisting of one chapter, written by the editors) a reflection on the book's contents. [1]

The first section of the book contains a focused series of discussions on the potential philosophical and conceptual bases of qualitative psychotherapy research. There are chapters by KVALE advocating the psychoanalytic interview and by FROMMER and LANGENBACH proposing psychoanalytic therapy (re-presented in the form of case studies) as vehicles and instruments for qualitative psychotherapy research. RENNIE then provides a lengthy and informative discussion of the potential status of grounded theory as a form of methodical hermeneutics. This discussion recommends grounded theory as a potential solution for the troublesome realism-relativism debate, arguing that its iterative, reflexive combination of interpretation and situated engagement with the data combines elements of both realism and relativism. Although appearing in the context of a book about qualitative psychotherapy research, these discussions are of interest to any qualitative researcher. The substantive focus of this research—two (usually) people, engaged together in a process of negotiation and naming with the goal of generating a narrative of the client's life with greater utility than the one which preceded it—foregrounds many issues which all qualitative researchers should consider, making this field a telling microcosm of qualitative research more generally. [2]

Linking grounded theory to DILTHEY's hermeneutics, RENNIE (pp.33f) reminds us (following GIDDENS and HABERMAS) that social science always involves a "double hermeneutic"—the interpretation of a world that is always already itself pre-interpreted, an attempt to divine meanings within an open ended mesh of processes wherein the participants themselves are engaged in a self-same process of meaning identification and generation. By extension, then, we could characterise qualitative research in psychotherapy as enacting what is at least a triple hermeneutic: the researcher creates a hermeneutic circle around and about a pre-existing hermeneutic circle created by the already-existing joint activity of clients and therapists. The therapeutic process itself creates meaning, with the explicit goal of extruding this (new) meaning elsewhere, onto other (typically spatio-temporally-deferred) situations and persons, so re-interpreting an interpretation. The situation is further complicated because "the understanding of therapy influences what is encountered in the research which, in turn, reflects back on the whole of the understanding of therapy and modifies it" (RENNIE & FROMMER, p.195). Issues of interpretation, reflexivity, emotional reactions and transference, realism, relativism, the partiality of perspectives and the subjectivity of researchers and readers, are all foregrounded by attempts to apply qualitative methods to the study of psychotherapy. It is within this triple hermeneutic, a spiral rather than a mere circle, that these issues gain particular relevance and force. [3]

The second section of the book focuses on method rather than methodology: how to do it, rather than (how to think about) what to do. But this is no collection of recipes in the style of an undergraduate textbook. Although the principal focus shifts to the mechanics of conducting qualitative psychotherapy research, issues of theory and epistemology are reiterated and integrated throughout. Research questions are focused around change processes (the "effective ingredients" of therapy, bridging between outcome and process measures), assimilation of problematic experiences, and a range of process-oriented examples. Data discussed include semi-structured interviews, therapy sessions and various forms of recall and reflection upon the therapeutic process. The chapter by STUHR and WACHHOLZ presents a psychoanalytically-oriented 12-year follow-up of client's subsequent views and memories of the therapist. Grounded theory is frequently adopted as a framework for analysis, with conversation analysis, discourse analysis, protocol (task) analysis and various more loosely-structured and defined methods also being explored. The penultimate chapter by FISCHER and colleagues at Duquesne University USA contains summaries of 20 postgraduate dissertations in this field conducted between 1973 and 1993. [4]

The range of methods that are presented reflects both the inherent eclecticism of the therapeutic enterprise and the variety of research questions it throws up. Given such variety, there are, inevitably, contradictions: some of the methods proposed could undermine aspects of the philosophical and conceptual positions set out in the first section of the book, whilst other methods conflict between themselves. For example, the cognitivism of some methods (most obviously protocol analysis) sits uneasily with the constructionism endorsed by discourse and conversation analytic approaches. In the chapter by ELLIOT, SLATICK and URMAN these are presented alongside each other as alternative research methods. STILES and ANGUS contribute a chapter on client's therapeutic assimilation of problematic experiences where they note that "the words the client and therapist use in talking about a theme may change as the problematic experiences are assimilated" (STILES & ANGUS, p.116). They also observe that metaphors deployed in therapist-client interaction "may change or grow," reflecting degrees of therapeutic success. The troublesome consequences of these acute, but presumably uncontroversial, observations for methods such as discourse analysis are not explored. There is, nevertheless, a surprising sense of coherence to this section, the focus upon a particular field of applied psychology (in its broadest sense) highlighting a range of shared concerns. One implicit theme is the perennial (for qualitative researchers) problem of interpreting and representing the views of others without doing violence to them, but without yielding to an atheoretical mindless empiricism. Conversely, a theme raised in McLEOD and BALAMOUTSOU's chapter on qualitative narrative analysis, but which rarely receives explicit attention elsewhere, concerns the ethics of reproducing (large sections from) transcripts when publishing research findings. [5]

As in the first section of the book, many of these issues have much wider relevance. Discourse analysis has high face validity, but a more considered reflection may reveal that its empiricist focus on the situated and occasioned interactions within a transcript can draw attention away from the broader, temporally-organised patterns of talk which might be discerned across numerous transcripts. Discourse and conversation analysis can uncover and deconstruct interesting patterns of social interaction within relatively short sequences of particular therapy sessions, but the relevance and meaning of such patterns to the entire psychotherapeutic enterprise can only be revealed by relating them back to the broader context in a part-whole fashion. The methodological (and for some variants of discourse analysis, epistemic) relativism of the method problematises, however, any such Gestalt process. Whilst this is clearly an issue for the application of discourse analysis to psychotherapy research, it is also relevant wherever the method is applied to topics or situations where subjectivity and agency are foregrounded. The ethics of quoting at length from transcripts is another issue that qualitative researchers in general might wish to discuss—especially perhaps in FQS, since part of the rationale for its online existence is that the electronic format permits publication of substantial data sets in a way that paper journals cannot manage. In short, there is much to consider in this section of the book, and many interesting ideas that may eventually run into opposition with each other are not developed to a point where this may happen. However, in this case at least, such contradictions and omissions seem to be illustrative of a healthy subordination of abstract debates to a sophisticated research praxis driven by applied questions and issues rather than philosophical disagreement. [6]

The final section of the book is a single chapter by the editors called "Reflections," wherein they pre-empt reviews such as this one by conducting the task themselves. Their sensitive, thoughtful discussion identifies three emergent themes: the issue of the researcher's own subjectivity; the fact that qualitative psychotherapy research is mostly piecemeal rather than programmatic; and problems which arise because of the time and resources needed to produce good quality qualitative research. Yet again, these issues are clearly of concern to qualitative researchers generally, and the discussions are both informed and thought provoking. There is, however, an attempt in this section to re-frame the preceding text and impose upon it coherence around methodical hermeneutics. Not only might this artificially foreclose some debates, but it also goes somewhat against the eclectic spirit of the rest of the book. For this reviewer, this was the only unsatisfactory aspect of the book. This is a minor complaint, however; overall, this is an informed, detailed, sensitive stimulating and thought-provoking collection. [7]

John CROMBY is a lecturer in Psychology in the Department of Human Sciences, Loughborough University England. Previously he worked as a researcher in medical settings. His research interests include social constructionist and critical psychologies, their application in applied settings, and possible overlaps between constructionism and current developments in neuroscience.

Department of Human Sciences
Loughborough University
Loughborough Leicestershire
LE11 3TU, England

Cromby, John (2002). Review: Jörg Frommer & David Rennie (Eds.) (2001). Qualitative Psychotherapy Research: Methods and Methodology [7 paragraphs]. Forum Qualitative Sozialforschung / Forum: Qualitative Social Research, 3(4), Art. 6, http://nbn-resolving.de/urn:nbn:de:0114-fqs020464.

Forum Qualitative Sozialforschung / Forum: Qualitative Social Research (FQS)

ISSN 1438-5627

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