Clinical Psychology

Clinical Psychology
Clinical psychology aims to reduce psychological distress and to enhance and promote psychological well-being by the systematic application of knowledge derived from psychological theory and data? (British Psychological Society Division of Clinical Psychology, 2001). To this end clinical psychology has distinguished itself from other helping professions by an enduring reliance on its foundation of scientific research.
Within scientific research there is always a strong debate between those that prefer quantitative methods and those who prefer qualitative ones. proponents of quantitative methods have built the standards in experimental research and in researches performed on a large number of subjects and which use sampling criteria and statistical analysis techniques. On the other side, the qualitative method uses procedures of qualitative nature both at the level of collecting the data as well as the level of analyzing them (Tagliapietra, Trifan, Raineri &ump; Lis, 2009). The gathering data procedures include: interviews, group discussions, observations, journals; while the analysis procedures include coding, categorizations and systematic confrontation between the categories and their dimensions. Such research is often defined as an explorative one, opposite to ?classical? scientific research aiming to confirm / disconfirm initial hypothesis. Among the qualitative methods used in the scientific research we can list: Focus Group, Speech Analysis, Conversation Analysis, Grounded Theory and Phenomenological Interpretative Analysis (Tagliapietra, Trifan, Raineri &ump; Lis, 2009).

This tension between an emphasis on a positivist science base and an emphasis on therapy and professional issues runs through many debates in clinical psychology also. Thus, on the one hand, clinical psychology has often seemed wedded to quantitative research methods drawing on an implicit naively realist epistemology and yet, on the other hand, many commentators note the similarities between the kinds of analysis undertaken in qualitative research and the judgements practitioners have to make in making sense of clinical material (Good and Watts, 1995).

According to Barker and Pistrang (2002) the main advantages of using qualitative methods in clinical context in comparison to the quantitative research are: i) they avoid the simplifications imposed by quantification, since some things cannot be easily expressed numerically. That is, they enable more complex aspects of experience to be studied and impose fewer restrictions on the data or the underlying theoretical models than quantitative approaches. ii) They allow the researcher to address research questions that do not easily lend themselves to quantification, such as the nature of individual experiences of a psychological condition (e.g., eating disorders) or event (e.g., being a victim of crime). iii) They enable the individual to be studied in depth and detail. iv) the raw data are usually vivid and easy to grasp: good qualitative research report makes the participants come alive for the reader. In general, the reports of qualitative studies are often more readable than those of quantitative studies v) Qualitative methods are good for hypothesis generation, and for exploratory, discovery-oriented research. They permit a more flexible approach, allowing the researcher to modify his or her protocol in mid-stream. The data collection is not constrained by pre-existing hypotheses. vi) qualitative self-report methods usually give more freedom to the participant than structured quantitative methods. For example, open-ended questions give interviewees a chance to respond in their own words and in their own way. vii) Since the data collection procedures are less constrained, the researchers may end up in the interesting position of finding things that they were not originally looking for or expecting (Barker and Pistrang 2002).
Gibson, Timlin, Curran, &ump; Wattis, (2004) states that within clinical and health services research, qualitative approaches view the world more subjectively, acknowledging that the researcher is part of what is researched, focusing on meanings and understanding of experience, rather than on what can be reduced to quantitative measures. They can develop new ideas through induction from data, rather than confirming or refuting hypotheses. Qualitative methods have improved our understanding of the experiences of people with dementia and, if used alongside clinical trials, could be used to improve the relevance of outcomes to patients, compliance and user involvement. They could also possibly generate new measures of efficacy and effectiveness in severe dementia

Qualitative researches have a number of contributions in clinical psychology for example qualitative researches are said to have a contribution in different theoretical developments in clinical psychology and other related fields. According to Burman et, al. (1998) critical qualitative research has begun to have a moderate influence on the development of theory and practice in clinical psychology (e.g. Parker et al, 1995), for example, offering new insights into how therapeutic practitioners might understand cultural and gender identities. Some important work here has been conducted by the psychiatrists Pat Bracken and Phil Thomas who have developed the notion of ?postpsychiatry? (Bracken and Thomas, 2005). Thomas has also been involved with innovative work into the experience of hearing voices which is partly based on qualitative research into the voice-hearing experience and has led to therapeutic innovations very much in tune with other developments in the field like the Hearing Voices Movement (Romme and Escher, 2000). Some qualitative researchers have also used post-Structuralist ideas in their research to explore the embodied nature of the experience of voice-hearing, focusing on the work of the Hearing Voices Network (Blackman, 2001).

Furthermore, qualitative research are claimed to have enormous contributions in intervention studies in a variety of ways. For example, some researchers have used qualitative methods to design an intervention for subsequent testing (DeJoseph, Norbeck, Smith, &ump; Miller, 1996). Many other researchers have addressed conceptual and methodological issues surrounding an intervention. In these approaches, data typically are obtained through focus groups or individual interviews and used to identify the needs of a target population and/or acceptable ways to implement an intervention. Researchers also have conducted qualitative studies of interventionists? records or logs to describe patient problems and nursing interventions or to improve understanding of the nature of an intervention in its natural context (Jennings-Sanders &ump; Anderson, 2003; Lawler, Dowswell, Hearn, Forster, &ump; Young, 1999 as cited Schumacher et, al. 2005).). Others have used qualitative methods to enhance their understanding of research participants who dropped out or did not adhere to the intervention (Jolly et al., 2003 as cited Schumacher et, al. 2005).

Qualitative research also plays important roles in developing effective practice for clinical psychology and public health interventions. Qualitative findings are often the first type of evidence available relating to innovations and contextual constraints relating to existing practice (Thomas 2000). Indeed for some topics, qualitative data gathering may be the only type possible. In line with this, Thomas (2000) suggest that in clinical psychology, qualitative researches can be useful in the following circumstances: (1) Topics for which there is little or no previous research. (2) Implementation of social policies and changes where the use of Randomized Controlled Trails or other types of ?experiments? is not possible. (3) To complement quantitative data gathering. For instance, provide data about unanticipated impacts of interventions. In some instances qualitative procedures may uncover information not obtainable using quantitative methods (4) a preliminary research phase that assists the design of subsequent quantitative research. Qualitative evidence may often be the ?best available? evidence until quantitative research is carried out (Thomas 2000). In addition, researcher have conducted qualitative interviews following an intervention study to elucidate the content and interpersonal processes of the intervention, to elicit participants? experiences of having received the intervention, to evaluate the intervention, or to explain study findings (Gamel, Grypdonck, Hengeveld, &ump; Davis, 2001). In these studies, sequential research designs, in which qualitative inquiry precedes or follows the intervention study, are most common (Schumacher et, al. 2005).

Researchers also have conducted qualitative studies of interventionists? records or logs to describe patient problems and nursing interventions or to improve understanding of the nature of an intervention in its natural context (Jennings-Sanders &ump; Anderson, 2003; Lawler, Dowswell, Hearn, Forster, &ump; Young, 1999 as cited Schumacher et, al. 2005).). Others have used qualitative methods to enhance their understanding of research participants who dropped out or did not adhere to the intervention (Jolly et al., 2003 as cited Schumacher et, al. 2005). Critical qualitative researchers have also offered new perspectives in the area of child sexual abuse and there is now a broad array of approaches. New perspectives have led to alternative therapeutic interventions and innovative approaches to the training of professionals involved with child protection (Warner, 2003).

According to Gibson, et, al. (2004), the integration of qualitative research into intervention studies is a research strategy that is receiving increasing attention across disciplines recently. Although once viewed as philosophically incongruent with experimental research, qualitative research is now recognized for its ability to add a dimension to intervention studies that cannot be obtained through measurement of variables alone. (Featherstone, 1998 as cited in Gibson, et, al. 2004) further state that, qualitative methods have a wide scope of use within clinical trials. They can address issues such as informed consent and randomisation. They can allow those undertaking treatments and their carers to share their own experiences of the benefits and impacts that drug treatments bring, perhaps particularly relevant in severe dementia. Beyond the clinical trial, they can explore reasons for inequity of access to treatment (Gardner , Chapple &ump; Green, 1999). Because of the respect shown to the participants? views, qualitative research can be useful in improving the design of randomised controlled trials, and in improving recruitment (Featherstone, 1998). Because they do not have to decide in advance which rating scales to use, qualitative methods in drug evaluation can increase the likelihood of discovering new kinds of information about the experiences of patients and those who care for them.

In summary, quantitative research method as a research tool has an several contribution in the field of clinical psychology. Opportunities are unlimited in rehabilitation to describe and interpret phenomena via qualitative study. The qualitative research method is needed in addition to or concurrently with the quantitative perspective in improving the practices of clinical psychology. Using qualitative methods in clinical practices has several advantages compared to the quantitative methods. Moreover qualitative method as a research tool has been proven by different researchers that it contributes in development of new theories and new treatment approaches in clinical psychology.

Clinical Psychology 9.2 of 10 on the basis of 1284 Review.