Qualifying the Qualitative Social Work Interview

Contents: Introduction Part I Perspectives on Social Work Research: Cutting edge issues in social work research Is social work distinctive? Ways of knowing in social work Rereading The Jack Roller: hidden histories in sociology and social work William J. Reid: an appreciation. Part II Evaluation: Social work and the human services Evidence from qualitative evaluation Seeing the trees for the wood: the politics of evaluating in practice Evaluation for a learning organization? Part III Qualitative Research: Qualitative social work: a room with a view Qualitative research and outcomes in health, social work and education Ethics and the practice of qualitative research Constructing causal accounts in social work The consequences of qualitative social work research Unbroken voices: children, young people and qualitative methods. Part IV Research, Theory and Practice: The quality of mercy: the management of quality in the personal social services Game plans, buzzes and sheer luck: doing well in social work Practitioner evaluation at work Evaluating in practice Culture and the indigenisation of quality in Third World social research. Part V Service Users and Research: Consumer opinion and social policy: a research review Consumer evaluations of the personal social services Engaging the user: participation, empowerment and the rhetoric of quality Just inquiry? Research and evaluation for service users Users and practitioners' research Indexes.

This study explores foundations of qualitative social work research. A template-based review was completed on 100 articles from social work journals. Reviewers examined five things: (1) purpose or aims of research, (2) rationale or justification for work, (3) populations studied, (4) presence of four markers (addressing theory, paradigm, reflexivity, and power dynamics), and (5) implications presented. Results underscore exploratory nature of qualitative social work research; authors were most likely to use word explore and least likely to use term to describe their aims. The most common rationale given for research was a gap in literature (77%), followed by severity or extent of problem (50%). Authors emphasized perspectives of respondents, who were most likely to be social work practitioners (39%) or clients (28%). Among markers examined, authors were most likely to mention use of theory (55%) and a research paradigm (51%) and least likely to apply reflexivity (16%) or acknowledge power dynamics inherent in research (7%). Finally, authors were most likely to identify practice implications in their work (90%), followed by research (60%), theory (38%), and policy (29%). KEY WORDS: epistemology; qualitative methods; research methods; social work research; theory Social inquiry is shaped by epistemology of researcher, his or her underlying assumptions about process of knowing (Denzin, 2002). Epistemology may be seen as theories of knowledge that justify knowledge-building process that is actively or consciously adopted by (Carter & Little, 2007; Pascale, 2010). These assumptions guide our decisions about topics, research questions, theories, methods, analyses, and conclusions and help us evaluate knowledge contributions of published work (Carter & Little, 2007; Hesse-Biber & Leavy, 2011; Pascale, 2010). Koch and Hamngton (1998) recognized that bring to research product, data generated, a range of literature, a positioning of this literature, a positioning of oneself, and moral socio-political contexts (p. 882). Examining ways our social locations shape our process of knowing can help us understand why certain questions get asked and answered, examine how values shape observation (Pascale, 2010; Takacs, 2003, p. 37). Anastas (2004) noted that researcher's epistemology affects kind of scholarly work done, how one values scholarship and understands its political import, and how one situates oneself in relation to work. Marshall and Rossman (2006) noted importance of epistemological integrity, in which authors account for logical and compelling connections between genre, overall strategy, research questions, design, and (p. 55). Researchers demonstrate their engagement with work through explicit discussion of their research paradigm or inquiry tradition, which is fundamental for rigorous qualitative research (Anastas, 2004; Marshall & Rossman, 2006). Qualitative research should reveal a consistency and integrity of approach that is easily recognized by reader and reviewer (Padgett, 2009, p. 102). Given importance of epistemology to research endeavor, social work researchers must make explicit decisions made in process of inquiry if they are serious about contributing to knowledge base of profession. As Padgett pointed out, the burden of proof is on researcher (p. 102) to be accountable to readers regarding underlying assumptions and logic of our work. We focus our discussion on epistemology as research praxis that contributes to development of knowledge in our field. Our aim in this section of article is to discuss practice of epistemology to support social work researchers using qualitative methods to think and write more explicitly about foundations of our work. …

The present study assessed possible predictors of relapse while in treatment and treatment completion among marijuana-dependent adolescents (N = 59) in an intensive outpatient substance abuse treatment program. Comorbid depression was associated with an increased likelihood of relapse and a higher total number of relapses. As expected, relapse while in treatment was associated with a reduced likelihood of successfully completing the treatment program. Comorbid attention deficit hyperactivity disorder (ADHD) was also associated with a lower likelihood of successful program completion. These findings add to a slowly growing literature regarding adolescent substance abuse treatment, and may help clinicians identify marijuana-dependent adolescents at greater risk of relapse or noncompliance.

Trauma-focused treatments for posttraumatic stress disorder (PTSD), such as Prolonged Exposure (PE) therapy and Cognitive Processing Therapy (CPT), are effective and supported by various Clinical Practice Guidelines; however, drop-out rates for the treatments are as high as 40% within clinical programs. One promising solution is delivering the evidence-based psychotherapies (EBPs) three or more times per week within an intensive outpatient program (IOP) for PTSD. The present study examined the feasibility and effectiveness of a relatively low-resourced PTSD IOP within a larger PTSD program at the Veterans Healthcare Administration. The intensive program offers two tracks (2 week or 4 week) grounded in the massed delivery of PE and CPT. Over a 12-month period, 351 veterans completed an assessment for PTSD and 172 started within one of the local PTSD programs (e.g., weekly, IOP, or residential). Results of the study demonstrated that the IOP is an acceptable (i.e., 87.3% completion rate) and effective (e.g., PTSD Checklist for Diagnostic and Statistical Manual [DSM-5] [PCL-5] decrease effect size d = 1.80) treatment option. There was also adequate demand for the program (e.g., 37.2% of patients engaged in care with the PTSD programs started the IOP), and the program was implemented with fidelity to the design. Taken together, the results of this study demonstrate that this low-resource IOP model is a promising approach to improve completion rates within the continuum of care for the treatment of PTSD. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Digital features like virtual reality have hardly been used in the framework of data collection in qualitative social work research. Virtual reality holds specific promise because it allows the immersion of participants in a situation and has the potential to strengthen the ecological validity of data. In this light, we examined the use of a virtual reality serious game in qualitative in-person interviews in the framework of a prevention-oriented HIV social research project. We designed and developed an immersive virtual reality serious game, and integrated it into 24 problem-centred in-person interviews. The integration was feasible, and the virtual reality serious game was well accepted. It prompted participants to elaborate their lived experiences more extensively and in depth. Participants subsequently recalled episodes they had not mentioned before, complemented their narratives and brought up new topics. The atmosphere became less formal, and participants were even more communicative. The use of virtual reality seems to have the potential to open up new perspectives, broaden epistemic possibilities and complement the qualitative methods used to investigate, in particular, verbal and non-verbal communication and interaction processes. From an ethical perspective, the use of virtual reality should be well reflected upon regarding possible after-effects for the participants.

Background Waiting to be admitted to treatment poses a significant barrier to substance use recovery. Such delays occur when service demands exceed treatment capacity. One issue that contributes to this problem is clients missing scheduled appointments (i.e., no-shows) because it typically leaves time that could be used to counsel others in need. Methods This research utilized Lean methods, which encompass approaches for improving process efficiency by reducing waste (i.e., work that does not add value to a product or service), to reduce intake appointment no-shows and admission wait-time within an intensive outpatient substance use treatment program in Fort Bend County, Texas; hence, this study involved mapping the client admission process, analyzing it for causes of inefficiency, and developing and implementing countermeasures (i.e., solutions) to address the issues identified in order to improve performance. Results By implementing enhanced appointment reminders, posting admission process information online, and transferring financial eligibility tasks to nonclinical staff, intake appointment no-shows were reduced from 24% to 17%, and admission wait-time was reduced from 14 to 9 days. Conclusions This case report provides a detailed example from which other outpatient substance use treatment programs can learn to streamline their admission process with little to no additional resources.

Qualitative research grounded in a social constructionist epistemology troubles the assumption, integral in positivist research, that a researcher can be neutral and apolitical. In fact, many scholars are drawn to constructionist epistemologies because they situate the research process as a site of ontological resistance and social change. This essay explores the politics of voice and representation in anti-oppressive qualitative research. Using an example from one author's research on stigma management among formerly incarcerated women, and the particularly pernicious stigma women faced if they had engaged in sex work, we detail the benefits and pitfalls of either re-presenting research participants in their exact words or changing participants' words, a process we refer to as re-languaging. Drawing upon philosophical and social scientific scholarship on the "crisis of representation" in qualitative research and recent scholarship and news articles about human sex trafficking, we underscore the powerful political effects of language. We argue that researchers' choices about language are neither inherently liberatory nor oppressive, but they are always political. We call for a more reflexive scholarly dialog on voice in qualitative social work research and press scholars to explicitly engage the question of whom and what we represent when we claim to represent marginalized others.

Qualitative research methods are advancing from individual analysis levels to dyadic and above to present multiple facets of reality, coinciding well with micro (individual), mezzo (family and groups) and macro (communities and society) levels in social work (SW) practices. Complex units (CU) comprise two groups with several members in each group, with each CU member having a perspective on the studied phenomenon; some perspectives are in congruence, others not. However, methodological approaches to the analysis of CUs are lacking. Based on the naturalistic–constructivist paradigm, this methodological article aims to present a Complex Unit Interviews Analysis (CUIA) approach that can be used in qualitative SW research. It includes a four-phase circular procedure: Phase 1—full analysis (i) familiarisation, (ii) coding, (iii) identifying themes; Phase 2—selective analysis of how a theme plays out in a CU (i) vertical analysis (across interviews within each CU group) and (ii) horizontal analysis (between groups of a CU); Phase 3—refining themes by analysis across CUs; Phase 4—conducting Phase 2 and Phase 3 for each theme identified in Phase 1. CUIA is illustrated using a family study case that presents multiple facets of a phenomenon’s reality by combining individual perspectives to form a CU perspective within SW and familial contexts.

Mayo Medical Center Brain Injury Outpatient Program: treatment procedures and early outcome data.

Introduction: Research has shown that combining different evidence-based PTSD treatments for patients with PTSD in an intensive inpatient format seems to be a promising approach to enhance efficiency and reduce generally high dropout rates. Objective: To assess the effectiveness of an intensive six-day outpatient trauma-focused treatment for patients with PTSD. Method: Data from 146 patients (89.7% female, mean age = 36.79, SD = 11.31) with PTSD due to multiple traumatization were included in the analyses. The treatment programme consisted of six days of treatment within two weeks, with two daily individual 90-minute trauma-focused sessions (prolonged exposure and eye movement desensitization and reprocessing), one hour of exercise, and one hour of psychoeducation. All participants experienced multiple traumas, and 85.6% reported one or more comorbid psychiatric disorders. PTSD symptoms and diagnoses were assessed with the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5), and self-reported symptoms were assessed with the PTSD Checklist for DSM-5 (PCL-5). Results: A significant decline in PTSD symptoms (CAPS-5 and PCL-5) from pretreatment to one-month follow-up (Cohen's d = 1.13 and 1.59) was observed and retained at six-month follow-up (Cohen's d = 1.47 and 1.63). After one month, 52.4% of the patients no longer met the diagnostic criteria for PTSD (CAPS-5). The Reliable Change Index (RCI) shows that 73.9% of patients showed improvement on the CAPS-5 and 77.61% on the PCL-5. Additionally, 21.77% (CAPS-5) and 20.0% (PCL-5) showed no change, while 4.84% (CAPS-5) and 2.96% (PCL-5) showed symptom worsening. Discussion: The results show that an intensive outpatient trauma treatment programme, including two evidence-based trauma-focused treatments, exercise, and psychoeducation, is effective for patients suffering from PTSD as a result of multiple traumatization. Subsequent research should focus on more controlled studies comparing the treatment programme with other intensive trauma treatments and less frequent routine treatment.

The purpose of this study was to describe clinician-observed, naturally occurring temper tantrums in preschoolers ages 2 to 5.5 diagnosed with severe behavior problems. Participants were 24 mother-child dyads enrolled in an intensive outpatient treatment program. Clinicians timed and observed 330 temper tantrums, rated their intensity, and recorded occurrence of 16 behaviors, tantrum precipitants, and interventions; parents completed the Achenbach Child Behavior Checklist pre- and posttreatment. Data were analyzed using descriptive statistics, Pearson chi square, paired t tests, and generalized linear modeling. Mean tantrum duration was 3.4 minutes (range = 0.2 to 26.5 minutes); most tantrums were low in intensity. Noncompliance precipitated 52% of tantrums. Aggressive behaviors were more likely to occur early in tantrums, with distress behaviors occurring later. Parent surveys indicated perceptions of behavioral improvement but no change in tantrum behavior. Study findings corroborate those of previous studies using retrospective parent reports.

Change in “resolved plans” and “suicidal ideation” factors of suicidality after participation in an intensive outpatient treatment program

The objective of this report was to describe an efficacious treatment of an adult with long-standing anorexia nervosa (AN). A 50-year-old woman with an over 7-year history of AN and comorbid major depression had been treated unsuccessfully with numerous psychotropic medications, manualized cognitive behavior therapy, and an intensive outpatient treatment program before referral. After treatment with mirtazapine, she gained weight and her depression improved. A 9-month follow-up revealed a maintenance of these benefits. Mirtazapine may be useful for older, chronically ill patients presenting with AN and comorbid depression.

This case report of a veteran with a history of multiple traumatic brain injuries, posttraumatic stress, and chronic pain highlights the MossRehab Institute for Brain Health (MRIBH) model of care: a collaborative, interdisciplinary, intensive outpatient treatment program. Unique to this case was the severity of symptomatology and the concerted engagement by the clinicians, who fully tailored and adjusted their approaches based on team rounds and daily exchanges. The client's main concerns of headaches, difficulty sleeping, difficulty with memory and cognition, depression, anxiety, posttraumatic stress, anger, and chronic musculoskeletal pain were addressed and significantly improved within three weeks. The outcome of this case is promising and suggests that the highly individualized and collaborative interdisciplinary approach provided at MRIBH is particularly beneficial for veterans with chronic TBI and PTSD and can provide a roadmap for the treatment of specific clinical scenarios.

Greetings to readers as we start a new year for Qualitative Social Work. Last year saw an increase in papers to the Journal and as our readership continues to grow, the value of qualitative research for social work is confirmed. However, there is no room for complacency and if we are to ensure that the Journal continues to thrive, it is important to remain abreast of changes in the world of qualitative research and social research more generally. So, this brings me to consider the issue of innovation in this new year editorial. For readers familiar with writing or reviewing grant applications, claims by academics that their work is novel or innovative are all very familiar. As Taylor and Coffey described in 2009, pressures stemming from funding councils and publishers encourage academics to state and indeed over-state the cutting edge nature of their work. Writing in 2015, it seems that claims to innovation are now endemic and if we examine the mission of the UK’s major social science research funding council – the Economic and Social Research Council (ESRC) – the word innovation is never far from the Council’s funding calls, strategy statements or impact case studies. In the Council’s research funding guide, applicants must pay attention to impact, innovation and interdisciplinarity. The Council’s conceptualisation of innovation is broad, to include: ‘innovative or even untested methods’, through to research which challenges ‘existing paradigms in respect of research ethics’ (ESRC, 2015). So what exactly is meant by innovation and to what extent is new invention better than old? In response to the latter question, critics differ in their opinion. For example, there are those who consider that innovative methods simply represent the latest fads, leaving unresolved the long-standing challenges in qualitative research (Travers, 2009). The problem of fad is that where we fetishise the novel we may inadvertently recast tried and tested methodologies as dated, or at worse obsolete. Traditional ethnography and conventional methods of qualitative interviewing have been so vital to our understanding of the social world, we must resist casting such methods as old hat (Wiles et al., 2011). Critics have also argued that claims to innovation are frequently overstated and can amount to little more than Qualitative Social Work 2016, Vol. 15(1) 3–10 ! The Author(s) 2016 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/1473325015619822 qsw.sagepub.com