Papers by Michelle O'Reilly
The use of general descriptive names, registered names, trademarks, service marks, etc. in this p... more The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use.
A Practical Guide to Social Interaction Research in Autism Spectrum Disorders, 2017
In this chapter, O’Reilly and Lester highlight how a social constructionist perspective shapes th... more In this chapter, O’Reilly and Lester highlight how a social constructionist perspective shapes the way in which analysts might employ discourse analysis for the study of ASD. Specifically, they divide this chapter into three sections. First, they offer an overview of social constructionism, highlighting how the linguistic turn shaped how scholars have come to view and ultimately study language. Second, they highlight the usefulness of approaching the study of autism from a variety of discourse perspectives. A general description of six key approaches to discourse analysis is provided, offering examples of how these approaches are used in practice. Finally, they discuss how social constructionist and discourse analysis perspectives inform the study of autism. Throughout, case examples are used to illustrate the key points offered.
This chapter focuses on the concept of stigma as related to mental distress, as stigma has been o... more This chapter focuses on the concept of stigma as related to mental distress, as stigma has been of central concern to the field of mental health. The language and discourses of mental distress are intrinsically linked to stigma, prejudice, and discrimination, and our discussion focuses on the importance of stigma when presenting arguments about mental distress and language. It has been argued that the very notion of stigma is a complex and multidimensional one, which in turn creates challenges for researching its influence and impact. In this chapter, we consider the central theorists in terms of their contribution to the study of stigma and mental distress.
Using Naturally Occurring Data in Qualitative Health Research, 2018
In health research, there is an extensive literature regarding the benefits and challenges of evi... more In health research, there is an extensive literature regarding the benefits and challenges of evidence-based practice and how qualitative evidence fits within the broader need for research that underpins clinical decisions. The history and tensions regarding evidence and evidence-based practice are outlined in the chapter, with the contributions made by qualitative researchers emphasised. This is juxtaposed with a discussion of practice-based evidence and the contribution this has made in the field. Further, the chapter focuses on illuminating how naturally occurring data constitutes a form of evidence for the field of health.
Using Naturally Occurring Data in Qualitative Health Research, 2018
This chapter introduces the reader to the core concepts of qualitative research, defining the par... more This chapter introduces the reader to the core concepts of qualitative research, defining the paradigm and providing examples. The chapter introduces qualitative health research, drawing attention to some of the arguments that have been presented in the literature. This focus is on the usefulness of using qualitative approaches to examine health and healthcare.
Using Naturally Occurring Data in Qualitative Health Research, 2018
An often-underestimated, valuable source of naturally occurring data is that of media sources, su... more An often-underestimated, valuable source of naturally occurring data is that of media sources, such as television programmes, documentaries, newspapers, and magazines. Often in traditional textbooks these are positioned as secondary sources. We argue that they can be considered primary data, as well as naturally occurring data. This type of naturally occurring data is of interest for qualitative research, and in this chapter, we focus on the use of policy documents, medical notes, health guidelines, as well as other data sources such as police transcripts, court transcripts, and social care reports whereby health is invoked, to illustrate the value of analysing texts that occur naturally in the field of health.
Education, Equity, Economy, 2021
Education, Equity, Economy, 2021
International Journal of Drug Policy, 2021
BACKGROUND The international growth of e-cigarette use has been accompanied by a corresponding co... more BACKGROUND The international growth of e-cigarette use has been accompanied by a corresponding concern that e-cigarettes will act as a 'gateway' to smoking and the use of other drugs. Taking these concerns as our point of departure, we explore the relationships between vaping and smoking among a cohort of young people. METHODS Qualitative longitudinal methods with a diverse sample of 36 14-18-year olds from the UK city of Leicester. A total of 66 depth interviews conducted across two phases separated by 6-12 months. The interviews were recorded, transcribed verbatim and thematically analysed. FINDINGS We highlight a complex 'tangle' of connections between substances/risk behaviours recounted to us by our adolescent study participants, including multiple and multilinear relationships between vaping and smoking. These findings problematise some of the core axioms of the notion of gateways as an explanatory model of causality and sequential connection between smoking and vaping. They also throw into question gateway logics more fundamentally. While many of our study participants themselves consciously invoked ideas of 'gateway effects', the accounts they produced repeatedly disrupted the logics of connection (between e-cigarettes and smoking; one set of behaviours and another) presupposed in gateway theory and our own early lines of questioning. Accordingly, we explore how cultural understandings of gateway effects are invoked by users in accounting for their vaping and smoking behaviours, noting the potential influence of these ideas upon the very processes they are understood to apprehend. CONCLUSION Our findings suggest there is a case to be made to reinforce the distinctiveness of tobacco and e-cigarettes in the life-worlds of young people to avoid naturalising a 'gateway' logic of connection that might ultimately inform the associative logic of young users themselves, and potentially the development of their usage careers.
The British Journal of Criminology, 2021
Worldwide, the COVID-19 pandemic has had a devastating impact on prisoners. The prison environmen... more Worldwide, the COVID-19 pandemic has had a devastating impact on prisoners. The prison environment and prisoner health put prison populations at a higher risk of contracting COVID-19. As a result, prison systems have adopted mitigation strategies to reduce the transmission of the virus into and within prisons. These strategies, however, have had an unintended impact on prisoners and their living conditions. In this article, we explore prisoners’ lived experiences of the pandemic in English and Welsh prisons, captured through correspondence with prisoners throughout 12 months of regime restrictions, from April 2020 to April 2021. Drawing on prisoner narratives, the analysis reveals how the restricted regime has exacerbated the pains of imprisonment and had a detrimental impact on prisoners.
Journal of Continuing Education in the Health Professions, 2019
Introduction: Diversity education is a mandatory requirement for all mental-health practitioners ... more Introduction: Diversity education is a mandatory requirement for all mental-health practitioners and health care professionals in the UK National Health Service. Wide variability exists in the development, delivery, and evaluation of diversity education across health care settings, with limited evidence to suggest the optimal approach for teaching this subject. This study aimed to explore the perspectives of patients with mental illness on how to better teach and evaluate diversity education in the National Health Service. Methods: A participatory research approach was used with five mental-health patient organizations. Forty-two patients with mental illness took part in three participatory workshops. Data were analyzed through template analysis. Results: The findings indicated that a focus on the nuances and dynamics of clinical relationships would be beneficial. Specifically, the relationship considered most important to examine with respect to diversity education was the "practitioner-self" relationship. Discussion: Reconstructing the relationship-centered care model with the addition of the practitioner-self relationship may be better suited to theoretically informing future developments in diversity education. Further research is needed to understand what educational approaches contribute toward a relationship-centered care outlook and how relationship building behaviors, particularly those relevant to the practitioner-self relationship are best developed in diverse settings.
Journal of Child Health Care, 2018
There is increasing interest in providing resilience-building interventions in low- and middle-in... more There is increasing interest in providing resilience-building interventions in low- and middle-income countries (LMIC), but limited evidence on how young people and their carers process mental health and related supports. The aim of this study was to establish stakeholders’ conceptualization of youth mental health in a disadvantaged area of Kenya through focus groups with 7 young people aged 14–17 years and their parents, 9 teachers and 11 practitioners or community leads. The four identified themes related to definitions of both mental well-being and mental health problems; a range of contributing factors related to identity resolution, parenting, poverty and social media; attribution of responsibility at different socio-ecological levels; and required awareness, supports and interventions at these levels. Stakeholders, notably young people, are thus essential in the development and planning of user-led and culturally appropriate interventions in LMIC.
Journal of interprofessional care, Jan 25, 2018
Children exposed to multiple adversities are at high risk of developing complex mental health and... more Children exposed to multiple adversities are at high risk of developing complex mental health and related problems, which are more likely to be met through integrated interprofessional working. Combining the expertise of different practitioners for interprofessional care is especially pertinent in low- and middle-income countries (LMIC) in the absence of specialist resources. The aim of this study was to work with practitioners who deliver care to vulnerable children in six LMIC (Turkey, Pakistan, Indonesia, Kenya, Rwanda, and Brazil) to understand their perspectives on the content of an interprofessional training programme in building resilience for these children. Seventeen participants from different professional backgrounds, who were in contact with vulnerable children were interviewed. A thematic analytic framework was used. Four themes were identified, which were the benefits of a tiered approach to training, challenges and limitations, perceived impact, and recommendations fo...
School Mental Health, 2018
The mental health of adolescents is a salient contemporary issue attracting the attention of poli... more The mental health of adolescents is a salient contemporary issue attracting the attention of policy makers in the UK and other countries. It is important that the roles and responsibilities of agencies are clearly established, particularly those positioned at the forefront of implementing change. Arguably, this will be more effective if those agencies are actively engaged in the development of relevant policy. An exploratory study was conducted with 10 focus groups including 54 adolescents, 8 mental health practitioners and 16 educational professionals. Thematic analysis revealed four themes: (1) mental health promotion and prevention is not perceived to be a primary role of a teacher; (2) teachers have limited skills to manage complex mental health difficulties; (3) adolescents rely on teachers for mental health support and education about mental health; and (4) the responsibility of parents for their children's mental health. The research endorses the perspective that teachers can support and begin to tackle mental well-being in adolescents. However, it also recognises that mental health difficulties can be complex, requiring adequate funding and support beyond school. Without this support in place, teachers are vulnerable and can feel unsupported, lacking in skills and resources which in turn may present a threat to their own mental well-being.
Adoption & Fostering, 2016
Adopted children tend to have high levels of emotional, behavioural and developmental need and ar... more Adopted children tend to have high levels of emotional, behavioural and developmental need and are more likely to present to a range of services, including Child and Adolescent Mental Health Services (CAMHS). Although research exploring adopted children's perspectives is growing, it remains limited. Furthermore, there has been little work to engage adopted children in research. Our project aimed to examine adopted children's viewpoints of mental health and services alongside those of their adoptive carers. Results indicated that although there were some similarities between carer and child perspectives, they also frequently differed. They provided different constructions of the problem but agreed that family relationships were strained. Some acknowledgement of the role of the school was offered and other external sources of support cited. Coping was considered to be complex and while some issues were analogous to ‘normal’ family life, much was inherent to the adoption status.
The Palgrave Handbook of Adult Mental Health, 2016
The evolution of both discourse analysis and conversation analysis (henceforth DA and CA, respect... more The evolution of both discourse analysis and conversation analysis (henceforth DA and CA, respectively) has been a progressive movement from their inception as an inductive focus and unmotivated interest in how language works and what it accomplishes. From their early beginnings, quite sophisticated structures and frameworks have been developed to understand how people use language in interactions to accomplish social actions. With this framework in place, more latterly attention has turned towards the possibility of how these principles might be usefully applied to different settings (we refer you to Chapter 1 of this volume — Lester & O’Reilly — for a good overview). With this second wave characterised by a greater focus on the real-world usefulness of CA and DA findings, there is an exciting opportunity for researchers using these methodologies to interrogate the nuances of institutional interactions in order to make recommendations for changes in practice. This chapter is situated within this cutting-edge movement, which is transposing the scientific rigour and credibility of CA and DA findings into real-world applied settings and evidence-based practice (see, e.g. Kiyimba, Chapter 2, this volume). In our contemporary culture, a primary concern for practitioners across a range of institutional contexts, and particularly within therapy and counselling, is to work within evidence-based models of care and demonstrate efficacy and cost-effectiveness of interventions. We therefore seek to demonstrate that both DA and CA have a great deal to offer the evidence base in this field. It is thus extremely timely and salient for this discussion to take place in a handbook such as this one.
The Palgrave Handbook of Child Mental Health, 2015
In this chapter, we utilise a discourse perspective to explore ways in which parents manage thera... more In this chapter, we utilise a discourse perspective to explore ways in which parents manage therapeutic alignment in family therapy. As therapy is an activity which relies heavily on the use of language (McLeod, 2001), we use a language-based analytic approach to explore child mental health, particularly as discourse analysis is most appropriate for looking at family therapy processes (Roy-Chowdhury, 2003). In this chapter, we present a case for the deliberate temporary exclusion of children in the initial stages of a series of therapeutic sessions. The purpose of this temporary exclusion is to provide opportunities for therapists to engage in active solution-focused alignment with parents in order to provide a foundation and set boundaries for later work with the whole family. We also argue that while this initial session with parents is taking place, the child could be otherwise engaged in a session of their own so that the child’s perspective and expectations are also managed effectively.
Journal of Family Therapy, 2015
Systemic family therapy promotes a systemic reframing of individual problems to an understanding ... more Systemic family therapy promotes a systemic reframing of individual problems to an understanding of the familial processes influencing family functioning. Parents often attend therapy identifying their child as the key problem, which raises issues of accountability and blame. In this article, we explored the discursive practices used by parents for constructing themselves as 'good parents'. Using the basic principles of conversation analysis and discursive psychology, we analysed actual therapeutic sessions and found that parents used a range of strategies to display their good parenting. This included directly claiming to be a good parent, illustrating how they act in their child's best interests, showing that they parent in appropriate ways and by making appeals to scientific rhetoric. It was concluded that family therapists have a challenging task in managing competing versions of events and we discussed implications for practice. Practitioner points • Parents tend to blame their children for the problems experienced and this blaming tends to be done in front of the children during the therapy. • By being explicitly aware of the discursive strategies parents employ in therapy, therapists can reflect on how to manage these challenging conversational practices. • Conversation analysis may serve as a tool to support reflection, as therapists examine their own interactions during the therapy.
Communication and Medicine, 2015
The opposing positions of the social model of disability and the biomedical framework of impairme... more The opposing positions of the social model of disability and the biomedical framework of impairment have created tensions regarding what constitutes ‘normality’. In this article, we drew upon focus group data of parents, professionals, and people with autism, to explore how the dilemmatic tensions of normality and abnormality and of disability and ability were managed. Our findings illustrate how the boundaries of normality in relation to autism are blurred, as well as how the autistic identity is fluid. The members of the focus group invoked their epistemic rights to assert their positions and delicately considered the limitations of the rhetoric of cure. Our findings have implications for professionals working with families of children with autism, specifically as they aim to maintain a balance between providing sufficient support and not being intrusive, and we show how a medical sociology can facilitate an understanding of autism as a social category.
Qualitative Psychology, 2014
The study utilised a conversation analysis approach to closely examine family therapy talk, as th... more The study utilised a conversation analysis approach to closely examine family therapy talk, as this has the benefit of illuminating the discursive strategies used by all parties. • Parents used a range of strategies to display their good parenting, including illustrating how they act in their child's best interests. • This can present challenges for therapists as they work to reframe the difficulties systemically, without engaging in blame.
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Papers by Michelle O'Reilly
Sample: The data were audio-visual recordings of child mental health assessments with 28 families. These are typically one-off appointments, with a minimum of two mental health professionals. Each lasted approximately one and a half hours with at least one parent and child from each family attending. This resulted in 2520 minutes of data.
Methodology: We will use CA to interrogate the data and explicate the use of ‘obviously’.
The case of obviously: From initial readings of the data it seems that ‘obviously’ is embedded in sequences of preference organisation (Pomerantz, 1984) performing different interactional actions dependent upon its position and this is something we would like to understand better. The flexibility of ‘obviously’ can occur by both its syntactic position in turn-organisation and the way that it is indexically referent within the interactional context. By undertaking a data session we anticipate that this will help to widen our understanding of ‘obviously’ within assessment interactions. The institutional setting of this data-set could be particularly relevant to the use of ‘obviously’. Members orient to the specifics of the child mental health assessment and using the item ‘obviously’, may indicate a proposed shared understanding of progressivity. This is something that the data session could interrogate.
The data session may also explore the syntactic positioning of its usage. For example it is sometimes used as turn-initial component within an insertion sequence which may function to mitigate against a dispreferred response. In these occurrences either a subsequent question or continuation of talk from the speaker was suspended for the period of the insertion turn unit, with the insertion often positioned after a cut-off of the initial turn. The apparent function of making an 'obviously' initiated insertion could be a useful focus for the session.
In this corpus of institutional mental health data the term 'obviously' appears to function within its sequential environments to manage the interactionally constructed nature of that which was newsworthy (Maynard, 2003) or interestingly as not newsworthy at all. This is something that we would like to explore within the data session.
Conclusion: Interlocutors usually demonstrate a preference to orient their topic to that which is out of the ordinary or treated as not already known, and where this does not occur such utterances are likely to be treated by recipients as accountable. In the case of 'obviously', the data session can explore the range of ways it is employed by its members and the functions it serves in this particular institutional setting.
Context: Drawing from a larger corpus of data, we focused on 105 hours of group therapy talk. During these sessions, children with autism and their behavioral and/or occupational therapist engaged in play-based activities aimed at facilitating the development of social skills and appropriate behaviors in a group context. The therapists used a social skills curriculum, ‘Superflex...A Superhero Social Thinking Curriculum’ (Madrigal & Winner, 2008), which included a shared vocabulary for talking about problematic behaviors. Like many developmental disorders, autism has been positioned as a disorder to be named and understood most often by professionals. Much of the research focused on autism and therapeutic interventions has assumed that the researchers and trained professionals themselves know exactly what it means to behave ‘appropriately’ or ‘inappropriately’, thereby entitling ‘experts’ to speak for and even teach the person with autism how to behave (Biklen et al., 2005). Donnellan, Hill, and Leary (2010) noted that in the professionalization of the “interactions with people with autism, we have trained professionals, parents and others to interpret what happens in terms of simple, binary views of behavior (i.e., good/bad or positive/negative)” (p. 2).
Quite often, children with autism exhibit behavioral challenges that are constructed as socially inappropriate and identified as needing to be ‘remedied’ or ‘fixed’. The interactions between therapists and children with autism within their behavioral therapy sessions, then, are one of the main sites within which specific behaviors are identified as ‘problematic’ or ‘acceptable’, and the boundaries of ‘normality’ and ‘abnormality’ negotiated. These boundaries are often accounted for and reframed by both the child and therapist.
Analytical Approach: For our investigation, we employed the analytic approach of conversation analysis. Conversation analysis provides a modality to examine in detail how cultural norms of behavior are attended to in institutional talk. It provides a mechanism to explore the practices used by individuals with different epistemic positions and how they are able to employ specific social actions to secure membership to particular categories.
Analytic Focus: The focus for analysis was on the key social actions used to establish appropriateness and inappropriateness, and behavioral normality and abnormality. More specifically, we attended to the lexical items related to the Superflex curriculum, as these items were used to position particular behaviors as acceptable or unacceptable and were open to challenges from the children themselves.
Within the therapy sessions, both the therapists and children often spoke about the superhero character, Superflex, as capable of defeating a group of ‘unthinkables’ – which were those characters representing social and behavioral problems. For example, the therapists often referred to ‘Glassman’, who was a ‘common unthinkable’, when talking about making a small problem into a big problem that resulted in a meltdown or an ‘earth shattering reaction’. ‘Superflex’ was described as being capable of defeating ‘Glassman’ and preventing him from making small problems into big problems. ‘Glassman’ then marked the meltdown as inappropriate, while ‘Superflex’ marked the appropriate or desired behavior, providing a contrast between two dichotomous positions. Thus, with a broad focus on how behaviors were constructed as appropriate or inappropriate within this setting, we attended to how the lexical items (i.e., Superflex and the unthinkables) functioned to mark: 1) what was considered an appropriate versus inappropriate behavior; 2) who was accountable for changing the inappropriate behavior; 3) what was responsible for causing the inappropriate behavior; and 4) who had the right to name a behavior as appropriate or inappropriate.
Analytically, therefore, we considered how these lexical items functioned to delineate the fluid boundaries between abnormality and normality. Further, we noted how the ‘unthinkable’- and ‘Superflex’-marked turns were constructed to elicit a change in the children’s behavior and interrupt ‘inappropriate’ behaviors. With Superflex coupled with individual strategies specific to the child’s preferences (e.g., deep breathing, drawing to calm down, walking away for a while), the children were offered alternative ways of responding and/or calming to the unexpected, strategies which they themselves had participated in constructing and practicing with their therapists. In this way, these lexical items functioned to shift what behaviors were allowable within the interactional space.
Concluding Thoughts: While autism is the most widely researched childhood mental health disorder (Wolff, 2004), the majority of this research has centered on identifying etiologies and developing therapies/interventions. Relatively little research has examined how therapies aimed at teaching social behaviors are actualized in the talk between therapists and children with autism. As such, this research offers new insights related to how such therapies function to construct the boundaries around appropriateness and inappropriateness, and highlights the interactional delicateness of marking someone’s behavior as “good” or “bad” and illustrates the value of using CA in an applied way in these settings.
Child mental health assessments and therapeutic interventions, like other forms of institutional talk, are characterised by question/answer sequences. Mental health professionals work with children and their families to elicit information regarding the presence or absence of a diagnosable condition and work through the intervention process. To enable us to explore knowledge elicitation, problem presentation and children’s epistemic status at the point of assessment and intervention, we draw upon two complementary data sets. First, we utilise naturally-occurring video-recordings of child mental health assessments from a child and adolescent mental health service in the UK. Second, we draw upon naturally-occurring video-recordings of children with autism working in social groups with therapists at a paediatric clinic in the US. The integration of these data provides us with a mechanism for exploring the initial problem presentation and negotiation of epistemic status at the assessment stage, the first encounter with mental health services, as well as the reconfiguration of problems during an intervention (e.g., social group interventions).
For our study, we employed the method of conversation analysis to explore the sequential nature of how epistemic rights and responsibilities are negotiated between children and professionals. The distribution of rights and responsibilities in terms of what participants can accountably know, how they know it, whether they have the right to describe it and in what terms are directly implicated in the organised practice of speaking (Heritage & Raymond, 2005). Epistemic status is relative and relational in that the epistemic status of an individual is relative to that of others and will vary (Heritage, 2012). Given children’s half membership status in institutional contexts (Hutchby & O’Reilly, 2010), this detailed, nuanced methodology has potential to reveal insights into the organisation of children’s talk and their epistemic rights. Research in therapy indicates that children easily disengage from a therapeutic modality (O’Reilly & Parker, 2012) and may resist professionals’ attempts to access their mental health experiences, which hinders the progressivity of the on-going therapeutic activity (Hutchby, 2002).
Across our data, children were positioned as knowledgeable, claiming some type of knowledge about the behaviors that led to their referral for assessment or participation in an intervention. Children’s expertise, however, was treated as variable and their presentation of problems incomplete, and, at times, even inaccurate. Often their claims were challenged, negotiated, and redefined by professionals. More specifically, this aspect of knowledge elicitation and problem presentation occurred sequentially and within an institutional frame of adjacency pairs. Professionals directed their questions regarding service attendance mostly to the children directly, treating children as potentially knowledgeable regarding their own issues. Recipient responses included claims to technical medical knowledge through the use of mental health concepts, claims to lay descriptions of problems or claims to insufficient knowledge. These question/answer adjacency pairs characterised the institutional goals of assessments and interventions as the professional negotiated a conceptualisation of the child’s reports regarding their epistemic claims to experiential knowledge. Preliminary analysis reveals that the professionals’ questions designed to elicit information were presented in a number of formats with specific qualities: 1) a temporal quality – concerned with time 2) a reflective quality, typically with the lexical item ‘you said’ 3) an emotive quality – orienting to an evidencing of feelings, 4) descriptive quality – pursuing knowledge of a specific issue or event and, 5) in the form of tags. It is through these question/answer sequences that the progressivity of the encounter is achieved and the management of knowledge entitlements negotiated.
Overall, many of the children moved to resist the claims that others (e.g., parents) made about their behavioral problems, using their diagnostic labels to make a case for why they behaved as they did. The ‘cause’ of their problematic behaviours was typically located outside of their personhood, thereby resisting the idea of a ‘disorder’ as being the primary cause for their problematic behaviors. Through our analysis, we highlight how the positioning of the child as ‘knowledgeable’ and ‘an expert on who you are’ served to reframe who had the right to claim that a story told about an ‘inappropriate behaviors’ was accurate or inaccurate and complete or incomplete. Further, we point to how positioning a child’s account as valid, mental health professionals left open the possibility that children were competent participants in their own care.
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(IAPT) the Government emphasises the need for evidence based practice. Juxtaposed with the desire for evidence, however, has been the creation of complex ethical frameworks which have allegedly created barriers to this goal (Gittner et al, 2010; Togerson and Dumville, 2004).
Internationally randomised control trials are viewed as the ’gold standard’ (Hansson, 2006) with a preference for quantitative evidence. Although the usefulness of some qualitative methods has gained recognition, the use of conversation analysis (CA) in NHS research is only just starting to gain momentum. Typically experts in CA tend to be academics, rather than NHS practitioners. Subsequently there are challenges to academics gaining access to NHS data. In this paper we present a model of collaborative working between NHS professionals and academics to source funding, gain ethical approval and produce clinically relevant research. In framework we utilise a research example from a Child and Adolescent Mental Health setting. We describe the hurdles we overcame in demonstrating the value of CA to the NHS. These include, obtaining finance from NHS funding sources, the ethics process, negotiating the necessary long-term data storage, and managing the practical clinical implications of recording naturally occurring data. We pay particular attention to the need for good relationships with clinical staff and the sequential management of informed consent. By presenting data relating to clinical openings we explore how clinical professionals translate the reality of CA research to families within the child psychiatry setting. We conclude that despite the hurdles of doing NHS based research, CA makes a valuable contribution to the evidence base. For this to be successful, academics need to be mindful not to just use clinical professionals as a portal to data but develop strong mutually beneficial partnerships in order that data can be disseminated in a meaningful way.""
1) Parents answer for them (with/without a relevant pause)
2) The child is positioned as answering the question incorrectly (or inadequately) as the parents display disagreement
3) The child fails to answer the question or uses strategies such as ‘I don’t know’
Half-membership is arguably counter-productive to the inclusive, equitable ethos of family therapy and these finding have wider implications for practice.
Mixing methods, however, transcends the simple quantitative/qualitative divide and issues of mixing methods within one approach are also salient. Mixing data collection approaches, or analytical methods within the qualitative approach raises issues and challenges for researchers in similar ways and it is important that these are not ignored within the wider debate.
While broadly social constructionist in nature, the ontological concerns raises problems about combining two qualitative approaches together. Notably combining artificial data collection methods with natural data causes murmurs within the qualitative academic community. In this paper I address some of the practical and ontological challenges that researchers should address in the decision making process.
Clients/young people:
Make explicit the honesty and flag it up using phrases like ‘to be honest’
Make ‘God’ orientations that suggests ‘God’ as the ultimate witness in a way that adds credibility to their statements
Express belief or disbelief
Clients:
Cite witnesses
In conclusion, specific honesty orientations are prevalent both within family therapy and interviews. In this paper we explore how credibility and accountability get managed and investigate the importance of being believed.