Family Therapy and Qualitative Research

Journal of Marital and Family Therapy 1990, Vol. 16, No. 4, 357-373

FAMILY THERAPY AND QUALITATIVE RESEARCH*

Sidney M. Moon Deborah R. Dillon Douglas H. Sprenkle Purdue University

Qualitative research is becoming accepted by the scientific community as a viable way to explore and understand social science phenomena. The purpose of this paper is to describe the essential features of the qualitative research paradigm and to encourage further development of that paradigm in the field of family therapy. First, typical characteristics of qualitative research designs are deline- ated; these characteristics are illustrated with two extended examples from the qualitative research literature in the field of education. Next, possible applications of the qualitative paradigm to research issues in the field of family therapy are discussed. Finally, potential pitfalls that could inhibit the development of qualitative family therapy research are examined. It is hoped that this paper will serve as a stimulus for the development of qualitative research in the field of family therapy.

FAMILY THERAPY AND QUALITATIVE RESEARCH

A new research paradigm has begun to impact the social sciences. Drawing on traditions rooted in anthropology and sociology, the qualitative research paradigm provides an alternative to the quantitative research paradigm for exploring social science phenomena (Cook & Reichardt, 1979; Hoshmand, 1989; Howe, 1988; Lincoln & Guba, 1985; Smith, 1983). During the past decade, researchers and theorists in the field of education have refined and expanded the qualitative paradigm. Several textbooks have been written to guide the application of qualitative methods in educational environ- ments (Bogdan & Biklen, 1982; Goetz & LeCompte, 1984; Lincoln & Guba, 1985; Mer- riam, 1988), and qualitative studies have been published with increasing frequency in educational research journals (Alvermann, OBrien, & Dillon, in press; Dillon, 1989; Goldenberg, 1989; Hollingsworth, 1989; OBrien & Stewart, in press; Smith & Shepard, 1988). The purpose of this paper is to describe the essential characteristics of the qualitative research paradigm as it is developing in the field of education and to suggest possible applications of this paradigm to the field of family therapy.

'This article was accepted under the tenure of the previous editor. Sidney M. Moon, MS, is a Doctoral Candidate, Department of Educational and Psychoeduca-

tional Studies, School of Education, Purdue University, and Research Associate, Marriage and Family Therapy Program, Department of Child Development and Family Studies, Purdue Univer- sity, 523 Russell Street, West Lafayette, IN 47907.

Deborah R. Dillon, PhD, is Assistant Professor, Department of Curriculum and Instruction, School of Education, Purdue University, West Lafayette, IN 47907.

Douglas H. Sprenkle, PhD, is Professor and Director, Marriage and Family Therapy Program, Purdue University, 523 Russell Street, West Lafayette, IN 47907.

Correspondence concerning this article should be addressed to Sidney M. Moon, MS, at the above address.

October 1990 JOURNAL OF MARITAL AND FAMILY THERAPY 357

THE QUALITATIVE RESEARCH PARADIGM

What is qualitative research? Educational theorists have been wrestling with this question for more than a decade without achieving consensus (Firestone, 1987; Howe, 1988; Reichardt & Cook, 1979; Smith & Heshusius, 1986). However, out of the ferment of the educational version of the qualitative-quantitative debate some solid efforts to describe and define qualitative research in applied educational settings have emerged.

General Characteristics of the Qualitative Paradigm “All qualitative researchers in some way reflect a phenomenological perspective”

(Bogdan & Biklen, 1982). Researchers operating in the phenomenological mode attempt to understand the meaning of naturally occurring complex events, actions, and interactions in context, from the point of view of the participants involved. These researchers look for universal principles by examining a small number of cases intensively. Further, they are concerned with holistic understanding of phenomena. Although many different traditions of qualitative research exist (Jacob 1987,1988,1989; Hoshmand, 1989; Moon, in press), all of the traditions share these general characteristics.

As a first step in defining qualitative research, Goetz and LeCompte (1984) describe four continua which underlie all social science research:

Constructive.. .................... ..Enumerative Generative.. ..................... .Verificative

Inductive.. ...................... Deductive Subjective. ...................... .Objective

These continua imply different views of reality and of how reality is known-different epistemologies. Qualitative research is usually located closer to the constructive, generative, inductive, subjective, poles of these continua. Experimental resesarch typically is found toward the opposite end of each of the continua, nearer to the enumerative, verificative, deductive, and objective poles.

In their polarized expression, these continua differentiate the qualitative and quantitative paradigms. There is currently much debate in the educational community as to whether these two paradigms, and their associated methods, are compatible. Purists feel the qualitative and quantitative paradigms are incompatible because they make different assumptions about the nature of reality and have different research objectives (Lincoln & Guba, 1985; Smith, 1983; Smith & Heshusius, 1986). They believe the two paradigms can, and must, be kept separate.

Pragmatists, on the other hand, are more concerned with answering their research questions using the best methods possible. For the pragmatist, methods are paradigm- independent:

The attributes of a paradigm are not inherently linked to either qualitative or quantitative methods. Both method-types can be associated with the attributes of either the qualitative or quantitative paradigm. (Reichardt & Cook, 1979, p. 16)

Pragmatists also assert that “no incompatibility between quantitative and qualitative methods exists a t either the level of practice or that of epistemology and that there are thus no good reasons for educational researchers to fear forging ahead with ‘what works’ ” (Howe, 1988, p. 10).

Rather than participating in this debate, synthesists attempt to resolve it by stating that the two methodologies are neither incompatible nor compatible; instead, they are complementary:

Used separately, qualitative and quantitative studies provide different kinds of informa- tion. When focused on the same issue, qualitative and quantitative studies can triangu-

358 JOURNAL OF MARITAL AND FAMILY THERAPY October 1990

late-that is, use different methods to assess the robustness or stability of findings. (Firestone, 1987, p. 20)

Joanning, Newfield, and Quinn (1987) adopted this synthesist position in conducting their large scale, outcome study of families with a drug-abusing member.

Specific Characteristics of Qualitative Research Designs What are the common characteristics of qualitative research designs? How does one

actually carry out a qualitative study? How are qualitative studies different from quantitative ones? Figure 1 provides a brief summary of the key characteristics of qualitative research designs. Each of these characteristics is described below in some detail.

In order to make the discussion of the characteristics more concrete, two examples of actual studies from the educational research literature are woven into the description. The studies selected to illustrate the principles of qualitative research are from two different qualitative traditions. The first study, Dillon (19891, is an interpretive microethnography. Ethnography is a qualitative tradition rooted in anthropology (Dob- bert, 1984). Interpretive ethnographers are generally interested in exploring questions of culture and social interaction by totally immersing themselves in the context of a field setting over a long period of time (Erickson, 1986). The primary data-gathering techniques in interpretive ethnography are participant observation and interviewing. The purpose of Dillon’s study was to construct a description and interpretation of the social organization of one rural, secondary, low-track, English-reading classroom and to generate theory about what made the teacher in the observed classroom effective.

The second study, Smith and Shepard (19881, is from the phenomenological tradition. The phenomenological tradition is rooted in psychology. Researchers in the phenomenological tradition are primarily concerned with questions of belief and the structure of consciousness (Hoshmand, 1989). The primary data-gathering procedure in phenomenological research is the qualitative interview (Becker, 1986; Hoshmand, 1989). The purpose of Smith and Shepard‘s study was to explore the issues surrounding kindergarten teachers’ beliefs about, and use of, retention as a solution for academic unreadiness and incompetence in young children.

Theory. Like other research, qualitative research is informed by theory, either explicitly or implicitly. Ethnography is most frequently associated with the theoretical perspectives common to sociologists and anthropologists, such as structural functional- ism, symbolic interactionism, social exchange theory, and conflict theory (Goetz & LeCompte, 1984). Each of these perspectives addresses human interactions. Dillon’s (1989) ethnography was explicitly grounded on the theoretical underpinnings of symbolic interactionism (Blumer, 1969). This theoretical framework helped to guide the researcher in focusing on how students and teachers work together to create shared meaning through their communications and interactions.

Purpose and Questions. Qualitative researchers generally state the purpose for their research clearly and explicitly before beginning their research project. In most qualitative studies guiding research questions are developed in order to focus the data collection and analysis phase of the research, but it is anticipated that these questions may change during the course of the study (Lincoln & Guba, 1985). Qualitative research designs are thus more fluid, flexible, and responsive to data than most quantitative designs.

Qualitative research questions are also more open-ended and exploratory. The generic question qualitative researchers ask is “What’s going on here and why?“ Qualita- tive researchers attempt to approach their data without a priori assumptions, working to make “the familiar strange,” to see events in a new way before interpreting what


they see. They conduct their explorations in natural contexts and focus on looking at events and actions in a holistic, rather than a reductionistic, manner.

Dillon (1989) developed several “guiding questions” before beginning her data collection. These included: What is the nature of the social organization in the observed classroom? What verbal and nonverbal actions/patterns of action does the teacher dis- play as he interacts with students that have low reading ability? How does the context of the learning situatiodsocial organization influence the teacher’s actionslpatterns of action?

Participants and the Role of the Researcher. In qualitative research, subjects are called “participants.” The participants in qualitative research play a more active and egalitarian role than the subjects in a typical experimental study. In some cases the participant(s) may even become co-researchers and collaborators.

In ethnographic research the researcher usually assumes the role of participant observer, interacting with participants frequently over an extended period of time. This was the case in Dillon’s (1989) microethnography of a single classroom. During the exploratory phase of her study, Dillon states that she “started building the trusting, teacher-researcher and student-researcher collaborative relationships needed for ethnographic research” (p. 231). Dillon was in the classroom on a weekly basis during the exploratory phase of her research (six months) and on a daily basis during the intensive phase (three months). While there, she sat with students during class, participated in their activities, and talked with them informally before, during, and after lessons. She was an active and participating member of the classroom she was observing.

Since the researcher is the primary data collection instrument in most qualitative studies, it is important to make the researcher role clear and to make any known researcher biases explicit when reporting qualitative studies. Dillon’s (1989) study provides an example of this practice. She explicitly describes her role as a researcher and clearly delineates those aspects of her own background that she believes informed her perceptions, such as her familiarity with school settings and prior experience as a teacher.

In phenomenological research, the role of the researcher is somewhat less involved with the participants than in ethnographic research but is more involved than in experimental research. The Smith and Shepard (1988) study is a good example of this middle position. In this study a team of four graduate students conducted the data collection phase of the research under the supervision of two senior researchers (the authors of the paper). Thus, the two primary researchers were one step removed from the actual data collection. They were intimately involved with the data only in its recorded form.

Sampling and Selection. Probabilistic sampling techniques are rare in qualitative research. Instead, a variety of criterion-based selection techniques are used to choose appropriate units of analysis and participants. Selection means that the researcher delineates the relevant unit(s) of analysis precisely, using criteria based on specific considerations, and then selects participants and/or phenomena for study that meet those criteria. Generally, qualitative researchers prefer to study a few cases intensively in their natural context. Often, only one case is selected for study. Various types of selection may be used, including convenience selection, comprehensive selection, quota selection, extreme-case selection, typical-case selection, unique-case selection, and reputational-case selection (Goetz & LeCompte, 1984). All of these selection methods are appropriate for research designs that focus on generalization to theory, rather than on generalization to populations (Yin, 1989).

Dillon (1989) used unique-case selection to choose the teacher and classroom for her study. She wanted to study a teacher of reading at the secondary level who was considered effective by his colleagues and the community. The participant teacher she


selected was Mr. Appleby, a white, middle-class, male from Rochester, New York, who was teaching low-reading-ability, predominately black students in rural Georgia. He had the reputation of being an unusually effective teacher.

Smith and Shepard (1988) used a combination of criterion-based selection techniques, including convenience selection, comprehensive selection, extreme-case selection, and unique-case selection. They used convenience selection to choose the school district for their study. The selected district had commissioned a quantitative, outcome- oriented policy study on grade promotion because no consistent policy existed in the district. In agreeing to do the quantitative policy study, the researchers also requested and received permission to conduct a qualitative, process-oriented study. The qualitative portion of the study provided the researchers with an understanding of social context that aided in the interpretation of the quantitative study and allowed them to pursue their own program of research on school policies.

Embedded in Smith and Shepard’s (1988) study were smaller units of analysis: teachers, schools, and classrooms. The teachers were chosen for interviews by comprehensive selection-40 of the 44 teachers in the district were interviewed. Six of the 26 schools in the district were selected for participant observation by extreme-and unique- case selection. Using extreme-case selection, two schools with high-retaining and three with low-retaining kindergartens were chosen for study. Using unique-case selection, one school that had a developmental kindergarten and a transition class was chosen. The reseachers then conducted participant observations in all of the kindergarten classrooms in the six selected schools. Finally, these researchers used comprehensive selection to examine as many documents as possible that were relevant to the purpose of the study, such as school policies on retention and pamphlets for parents on school readiness.

Data Collection. Typical data collection techniques in qualitative studies include both participant and nonparticipant observation, interviewing, and document analysis. Usually the data is recorded in some fashion. In early ethnographic research the typical recording mechanism was handwritten field notes. With the advent of modern technol- ogy, video and audio recording of data have become common. Usually, data is collected over a long period of time from a variety of sources. The researcher is considered one of the primary research instruments.

Participant observation was the primary data collection method in Dillon’s (1989) ethnography. However, Dillon also examined a variety of secondary data sources including: (a) transcripts of interviews with school officials, three key informants, and Mr. Appleby; (b) three questionnaires completed by Appleby; (c) and community, school, student, and teacher documents.

In Smith and Shepard’s (1988) study, multiple data sources and length of time in the field are also evident. The data collection phase of the project spanned a full year, “interweaving clinical interviews with teachers, participant observation of kindergarten classes and decision making events, analysis of documents and semistructured interviews with parents’’ (p. 310).

Use of a variety of data sources provides triangulation, a key concept in qualitative research. The term triangulation is thought to be a metaphor derived from radio triangulation, i.e., “determining the point of origin of a radio broadcast by using directional antennas set up at the two ends of a known baseline. By measuring the angle a t which each of the antennas receives the most powerful signal, a triangle can be erected and solved . . . to pinpoint the source at the vertex of the triangle opposite the baseline” (Lincoln & Guba, 1985, p. 305). In qualitative research triangulation refers to using multiple data sources, multiple data collection and analysis methods, and/or multiple investigators in order to increase the “trustworthiness” of findings (Lincoln & Guba, 1985). Triangulation and length of time in the field are two of the most important ways


that qualitative researchers enhance the reliability and validity of their findings (Goetz & LeCompte, 1984).

Data Analysis. Data analysis in qualitative research is inductive and recursive. It generally occurs throughout the data collection phase of the research rather than at the end of it. Field notes and transcripts are usually copied, read, coded, and categorized. The goal of the analysis is not to support a hypothesis but to generate rich descriptions of phenomena and discover theory (Glaser, 1978; Goetz & LeCompte, 1984; Miles & Huberman, 1984; Strauss, 1987).

These characteristics are evident in Dillon’s (1989) description of her data analysis techniques. She first describes her data analysis techniques and then explains her specific application of those techniques:

I collected and analyzed the data simultaneously using the constant comparative method (Glaser & Strauss, 1967). The constant comparative method, a procedure that combines inductive behavior-category coding with simultaneous comparison of all incidents observed, was used with all data. My daily analysis procedure consisted of fleshing out, reading, and rereading field notes; listening to and transcribing audio and video tapes; looking for patterns of actiondmeanings in the data; and reflecting on the data by writing theoretical memos (Glaser, 1978) or analytic insights. I continued this process as I collected data, looking for incidents that confirmed or disconfirmed my initial assertions about the social organization of the classroom. (p. 235)

At the end of the data collection phase of her research, Dillon made three copies of her field notes and transcripts. She then coded and categorized the written records until she was satisfied that the assertions, categories, and instances she had developed accurately reflected the data. Next, she asked Mr. Appleby to read and comment on her categoriza- tions. Finally, she had an independent rater code portions of the data to determine interrater reliability on the coding scheme she had developed for the field noteltranscrip- tion incidents and the video tape incidents. Smith and Shepard (1988) used a similar procedure to analyze their data.

Results. The results of such an analysis are usually termed “assertions.” The major assertion that emerged from Dillon’s (1989) study was “that the social organization in the observed classroom was constructed jointly by Appleby and his students; Appleby assumed the role of translator and intercultural broker during student and teacher interactions” (p. 237).

Four empirical assertions emerged from Smith and Shepard’s (1988) study. One of these was that teachers’ beliefs about retention vary along a continuum from enuiron- mentalism (development of school readiness is amenable to influence from the environment) to nativism (development of school readiness cannot be readily influenced by the environment because it is a function of internal, organismic processes). Using this continuum, Smith and Shepard developed a taxonomy of four types of teachers based on the degree of nativism in a teacher’s beliefs about retention.

Reporting. A thorough report of a qualitative research study should include discussion of the following components of the study: (a) the theoretical framework that informed the study, (b) the purpose of the study, (c) the guiding research questions and any changes that occurred in these questions as the study progressed, (d) the research tradition and/or design employed, (el selection techniques, (0 the participant(s1, setting(s), and context(s1, (g) researcher role(s) and potential biases, (h) data collection and analysis strategies, (i) findings, and (i) discussion and interpretation of the findings. Inclusion of these elements enhances what Lincoln and Guba (1985) have called the “trustworthiness” of qualitative studies; in other words, inclusion of these elements enables the reader to make reasonable judgments about the extent to which the author’s conclusions are valid and transferable.


However, inclusion of these elements is not enough to make a report trustworthy or credible. Attention must be paid to reliability and validity issues throughout the design and implementation of the study in order for the final report to be trustworthy (Goetz & LeCompte, 1984; Lincoln & Guba, 1985; Yin, 1989). Further, a well-written and credible report is one in which a convincing story is told, a story that causes readers to say, “Yes, these eventstactions occurred and I now understand why they might have occurred and what they mean.”

Developing a qualitative research report takes considerable writing skill. Since one of the goals is to create a rich description of the phenomena investigated from the perspective of the participants involved, qualitative reports tend to be lengthy. Dillon’s (1989) study was 32 journal pages long; Smith and Shepard’s (1988) was 26 pages. It is difficult to condense qualitative studies to more typical journal article lengths without destroying the holistic, contextual, rich description that is the hallmark of such research.

APPLICATIONS TO THE FIELD OF FAMILY THERAPY RESEARCH

In spite of the many differences between the fields of education and family therapy, the two areas have one important thing in common-they tend to be interventionist. For this reason, the qualitative research movement in education appears to be somewhat more applicable to the field of family therapy than earlier developments in the fields of sociology and anthropology. The purpose of this section is to suggest possible applications for the educational version of the qualitative paradigm to researchable issues in the field of family therapy.

Congruence with Systems Theory Within the field of family therapy, a call has been issued for new research methodolo-

gies that are consistent with systems theory (Andreozzi, 1985; Keeney & Morris, 1985; Kinston & Loader, 1988; Schwartz & Breunlin, 1983; Schwartzman, 1984; Steier, 1985; Tomm, 1983). Durkin (1987) suggests that “specifically systemic methodology” (p. 30) is needed for research on systemic phenomena. Pinsof (1981) believes that there is a need to “bring our data analysis procedures into line with the conceptual reality of family or systemic therapy” (p. 737). The new epistemologists claim that traditional research methods are inadequate to contribute to knowledge about how systems operate and change because traditional methods are derived from linear, reductionist paradigms (Hazelrigg, Cooper, & Borduin, 1987). However, the new epistemologists have not yet identified research methods that are consistent with their world view (Gurman, 1983; Gurman, Kniskern, & Pinsof, 1986; Shields, 1986a, 1986b; Tomm, 1983).

Qualitative research may provide a partial answer to the search for research methods that are congruent with systems theory because the qualitative research paradigm is isomorphic with the cybernetic underpinnings of the field of family therapy (Hoshmand, 1989). This isomorphism should come as no surprise, for the field of family therapy grew from phenomenological roots. For instance, Bateson was a trained anthropologist who conducted ethnographic research among the Iatmuls of New Guinea during the 1930s (Bateson, 1958; Kobayshi, 1988). It was from his work with the Iatmuls that Bateson first developed his cybernetic systems perspective (Bateson, 1958; Bateson, 1972; Kobayshi 1988).

In addition, early developments in the field of family therapy in the 1950s had a decidedly qualitative character. At several centers around the United States small teams of researchers observed therapy sessions through one-way screens, developed tentative hypotheses, and then tested these hypotheses in subsequent therapy sessions (Eider, Dare, & Szmukler, 1988; Gurman, Kniskern, & Pinsof, 1986; Hoffman, 1981; Schwartzman, 1984; Wynne, 1983). Out of this phenomenological, inductive, clinical


methodology, the first theories of family therapy gradually emerged. These early family therapy researchers were intuitively applying an informal version of constant comparison (Glaser & Strauss, 1967; Grove, 1988). The constant comparative method is considered by qualitative researchers to be one of the best methods available for the discovery of “grounded theory,” richly elaborated theory that is grounded in empirical data (Gla- ser, 1978; Glaser & Strauss, 1967; Goetz & LeCompte, 1984).

More recently, researchers in the field of family therapy have had difficulty grappling with the complexity of family therapy; they have tended to handle complexity by simplifying it. Their research efforts have focused on presenting symptoms and terminal outcomes in identified patients rather than addressing the multiple perspectives and recursive interactions suggested by systemic family therapy theory (Bednar, Burling- ame, & Masters, 1988; Gurman, Kniskern, & Pinsof, 1986; Schwartzman, 1984; Tomm, 1983).

As noted by Steier (1985), qualitative research methods may be more effective than quantitative ones in grappling with the full complexity of systems theory. Like systems theory, qualitative research emphasizes social context, multiple perspectives, complexity, individual differences, circular causality, recursion, and holism. Qualitative methods provide an avenue for examining the experience of family therapy from the perspective of the client rather than from the more typical research perspectives of the therapist and/or researcher (Kuehl, Newfield, & Joanning, 1990; Newfield, Kuehl, Joanning, & Quinn, in press).

Because the qualitative paradigm emphasizes social contexts, it may help to answer the feminist call for a greater appreciation for contextual issues in systemic therapy (Taggart, 1985). As Todd and Stanton (1983) have noted, “life and research are inevitably messy,” (p. 14). Research is especially “messy” in a field like family therapy which is concerned with complex, systemic change in human beings. Qualitative research designs may provide a systematic, scientific way of looking at therapy holistically, with all of its “messiness” intact.

Process Research Process researchers have also called for a new research paradigm:

Our conviction is that a new style of research paradigm is called for, one that will make use of intensive analysis for discovering the internal structure of the interactions of therapy while using some more extensive method for verification of some of the basic processes of therapeutic change. (Rice & Greenberg, 1984, p. 8)

The principles of process research as enumerated by Rice and Greenberg (1984) include criterion-based and theoretical sampling, pattern exploration, detailed descriptions and observations, process in context, a discovery-orientation, and clinical relevance. These principles sound very similar to those addressed by qualitative methodologists (Goetz & LeCompte, 1984; Yin, 1989).

Process research is a young area of inquiry (Greenberg & Pinsof, 1986). Over the last decade, process research has emphasized the study of change and a smaller is better philosophy (Greenberg & Pinsof, 1986). Qualitative research may help answer the process researcher’s call for a context-specific microtheory of change (Greenberg & Pinsof, 1986) because qualitative research is generative, inductive, and constructive (Goetz & LeCompte, 1984). Elliott (1984) notes that “significant change events are both infrequent and highly complex” and thus “should be studied closely and comprehensively when they are encountered” (p. 251). Qualitative research designs provide one way of studying rare and complex events in context across time.

Process researchers also need a “conceptually focused sampling procedure that is directly linked to some type of proximal outcome” (Gurman, Kniskern, & Pinsof, 1986,


p. 600); such sampling procedures are common in qualitative research. Process researchers have found the frequencylaggregate approach to data analysis to be inappropriate and ineffective (Greenberg & Pinsof, 1986); qualitative research can aid the shift to a focus on patterns of change because pattern discovery is what generative qualitative research methods are designed to accomplish (Glaser & Strauss, 1967; Glaser, 1978; Strauss, 1987). Qualitative methods are also suited to the earlier, discovery-oriented stages of programmatic research for the purpose of developing the sophisticated measurement instruments that Gurman, Kniskern, and Pinsof (1986) believe are necessary for quantitative process research.

Outcome Research Since outcome research is by definition verificative, it might appear a t first glance

that qualitative methods have no place in family therapy outcome research. Giirman and Kniskern’s (1978a) fourteen criteria for evaluating family therapy outcome research clearly encourage controlled, experimental research methods. Hence, it may seem incon- gruous to suggest using qualitative designs and methods in outcome research.

However, as Gurman and Kniskern (1978b) themselves have pointed out, a t least three of their own criteria suggest the inadequacy of conventional research designs and outcome measures to establish the conceptual adequacy of family therapy outcome studies. Gurman and Kniskern’s (1978b) discussion of such factors as the need to assess interactional and relationship variables, to tap multiple dimensions and perspectives on change, and to balance insider and outsider perspectives all point to an appropriate place for qualitative methods in family therapy outcome research. Indeed, qualitative and quantitative methods have been used in tandem for over a decade in educational evaluation research (Cook & Reichardt, 1979; Filstead, 1979; Patton, 1980), and at least one major family therapy outcome study has combined the two paradigms to provide different views of the same issues (Joanning, Newfield, & Quinn, 1987).

Qualitative methods provide contextual data that can enrich the interpretation of quantitative outcome studies. For example, Jacobson, Schmaling, and Holtzworth- Munroe’s (1987) two-year follow-up of a component analysis of behavioral marital therapy (BMT) contained both a traditional, quantitative, before-after, experimental study (Kerlinger, 1986) and a qualitative, structured interview study. The quantitative portion of the study revealed that differences between treatments which had emerged at the 6-month follow-up, and disappeared by the 1-year follow-up, did not reappear at the 2-year follow-up.

From the qualitative portion of the study the researchers were able to generate tentative hypotheses as to why the treatment gains had slipped away. These hypotheses, in turn, were used to develop and pilot an expanded version of BMT which includes booster sessions to extend the effects of the initial treatment. Thus, theory generated by the qualitative portion of an outcome research project helped BMT researchers to interpret quantitative results and create a treatment modification that can be tested by future researchers. The work of Jacobson et al. (1987) clearly illustrates the complemen- tarity of the quantitative and qualitative paradigms and the need for both types of research in some outcome studies.

Qualitative researchers may also help create a better balance in the family therapy outcome research literature. In the past, outcome research has focused primarily on pragmatic types of therapy, especially behavioral approaches (Gurman, Kniskern, & Pinsof, 1986). Very little research has been conducted on “aesthetic” therapies (Allman, 1982; Keeney & Sprenkle, 1982). Contextual, humanistic, and multigenerational therapies all received “effectiveness untested zeros in Gurman, Kniskern and Pinsof s (1986) most recent tabulation of outcome research on family therapy. This lack of balance in the outcome research literature may be due, in part, to the lack of fit between quantitative,

October 1990 JOURNAL. OF MARITAL AND FAMILY THERAPY 365

experimental methodology and the aesthetic approaches to therapy. Qualitative methods are the logical research expression of aesthetic approaches to family therapy, just as quantitative methods are the logical research expression of pragmatic approaches to family therapy. Both approaches to family therapy are needed (Keeney & Sprenkle, 1982), and both approaches to family therapy research are needed.

Discovery-Oriented Research Another promising area for qualitative research in the field of family therapy is in

answering the emerging call for more discovery-oriented research (Gurman & Kniskern, 1981; Gurman, Kniskern, & Pinsof, 1986; Keeney & Morris, 1985; Mahrer, 1988). In a recent critique of state-of-the-art family therapy research, Bednar, Burlingame, and Masters (1988) outlined five developmental phases of scientific maturation and asserted that the field of family therapy has paid insufficient attention to the two earliest stages: astute observation and development of descriptive taxonomies. Qualitative methods are particularly useful in the early stages of scientific maturation. They can provide researchers with useful tools for observation, description, and taxonomy development.

Many of the pioneers of family therapy have recognized the value of qualitative research for discovering theory implicitly, if not explicitly. Reference has already been made to the qualitative, theory-generating work of the pioneers of family therapy in the 50s, but there are also recent examples of family therapy researchers who have used qualitative research methods to discover theory. For example, the Brief Therapy Center in Palo Alto, California, began its work in the mid-seventies using a qualitative approach. Therapists worked as a team, taking turns conducting and observing therapy sessions, studying audio tapes, and discussing results. Their goal was to see what could be accomplished in a limited time period-no more than ten sessions. Their data analysis methods included live observations of therapy sessions through a one-way mirror, “detailed study’’ of audio tapes, and “extensive discussion and efforts to generalize’’ (Fisch, Weakland, & Segal, 1988, p. 10). In other words, they conducted informal qualitative research.

Science in the service of discovery and invention has been common in clinical family therapy research. Such science can be seen in Alexander’s (1973) development of the concepts of supportive and defensive communication styles among families of delin- quents and in Patterson and Chamberlain’s (1988) development of the concept of nonco- operation after “prolonged immersion in videotaped sessions with families that failed to respond to treatment” (p. 202).

Similarly, Selvini’s (1986a, 1986b) development of the concept of psychotic family games is an example of theory discovered through informal, qualitative, clinical research. Anderson’s (1986) response to Selvini’s research, however, points out a major problem with existing clinical research in the field of family therapy-it is too informal. As a result, needed detail is lacking. The reader is left wanting to know more about the research methods used and how the data were analyzed and interpreted. If clinical family therapy researchers would begin to conceptualize and report the qualitative portions of their research as suggested in the section on “reporting” presented earlier in this paper, then concerns about evidence for claims of efficacy (Anderson, 1986) might be laid to rest and family therapists would have a better basis for deciding whether to accept or refute new clinical theories.

Discovery-oriented qualitative research can also be used to answer questions about training and supervision issues. For example, a recent qualitative study examined the ingredients necessary for “excellent” family therapy workshops (Heath, McKenna, & Atkinson, 1988). Using reputational-case selection, these family therapy researchers chose 14 experts for indepth interviews. Then they inductively categorized the responses


of the exptrts into clusters. The results of their study included assertions about the skills, content, and contexts essential for excellent training workshops.

Bridging Research, Theory, and Practice A perplexing problem for the field of family therapy during the past two decades

has been the lack of integration between research, theory, and practice (Andreozzi, 1985; Olson, 1976; Schwartz & Breunlin, 1983; Wynne, 1983). Although certain basic similarities exist between the methods of discovery in clinical work and research (Green, 19891, clinicians and researchers have tended to divide into two isolated camps, sepa- rated by a communication gap (Gurman, Kniskern, & Pinsof, 1986; Schwartz & Bruen- lin, 1983; Wynne, 1983).

Qualitative research could help reunite clinicians and researchers because qualitative methods are close to the world of the clinician. Qualitative researchers tend to ask the kinds of questions that clinicians are asking and to explore these questions in ways that are clinically meaningful.

An example of the potential of qualitative research for building bridges between clinicians and researchers is Greenberg‘s programmatic research on intrapersonal conflict resolution (Greenberg, 1979, 1980, 1984a). Guided by Gestalt theory, Greenberg selected splits as the focus ofhis investigations. In Gestalt therapy people are conceptual- ized as systems that function most effectively when the component parts are working in harmony. Splits are a Gestalt term for aspects of the personality that are not in harmony. In order to clarify the features of a split and develop a formal definition of its structure, Greenberg selected a number of samples of tapes of therapeutic events that included splits for qualitative analysis. Three types of splits were identified in this phase of the research (Greenberg, 1979).

Next, Greenberg (1980) used a qualitative research methodology called task analysis (Greenberg, 198413; Safran, Greenberg, & Rice, 1988) to examine the characteristics of successful resolutions of conflict splits in therapy. After three cycles of analysis, Greenberg developed a detailed model of successful therapeutic resolutions of conflict splits using the Gestalt two-chair technique (Greenberg, 1984a). The model maps the behavioral and internal client processes that typically occur in each chair before, during, and after resolution of the conflict. The model also indicates the therapist behaviors that are most likely to facilitate an effective resolution of the conflict at each stage of the process. Such programmatic, qualitative, clinical research is likely to be meaningful to clinicians because it provides specific guidance for helping clients.

Applications of task analysis to the investigation of therapeutic processes (Green- berg, 1984a; Greenberg & Johnson, 1988; Safran, Greenberg, & Rice, 1988) also illustrate the versatility of qualitative research. Whereas ethnographies focus on macrophe- nomena like culture, task analysis focuses on microphenomena like therapeutic events, client cognitive and affective processes, and therapist behaviors. Similarly, task analysis demonstrates that research conducted from within the qualitative paradigm can employ quantitative tools.

POTENTIAL PITFALLS

Given all of the above congruences and opportunities, why has the field of family therapy, like the field of family studies (LaRossa & Wolf, 19851, seemingly been reluctant to adopt the qualitative research paradigm? There are a number of possible explanations. Several observers feel that the shift that occurred in the field between the fifties and sixties turned attention from theory to methodology, from qualitative to quantitative research approaches, and from cybernetic to positivist epistemology (Eider, Dare, & Szmukler, 1988; Schwartzman, 1984; Wynne, 1983). In Schwartzman’s (1984) words,


the field “self-corrected back toward the positivist context of American social science” (p. 230). Eider, Dare, and Szmukler (1988) believe the shift occurred because of the links that developed between the early family therapists and psychologists trained in traditional research methods. Perhaps the field’s very closeness to qualitative data and phenomenological epistemology has served to obscure rather than to highlight the potential value of the qualitative research paradigm for the field.

Whatever the reasons, it is important for family therapists to be aware of the problems they may encounter if they decide to undertake qualitative research projects. These problems include:

1. Methodolatry. As Gurman and Kniskern (1978b) pointed out over a decade ago, worship of traditional methodology is a strong factor mitigating against reflective and innovative science. Qualitative researchers have a different perspective on many traditional research concepts, including objectivity (Lincoln & Guba, 1985; Locke, 1989; Peshkin, 19881, sampling (Bogdan & Biklen, 1982; Yin, 19891, data analysis (Bogdan & Biklen, 1982; Goetz & LeCompte, 1984; Yin, 1989), and reliability and validity (Goetz & LeCompte, 1984; Lincoln & Guba, 1985; Locke, 1989). Positivists in particular may misunderstand qualitative research because of these differences.

2. F l u . Qualitative research design is in flux. Terms and concepts are sometimes poorly defined. Methods are still being invented (Miles, 1990; Strauss, 1987; Yin, 1989). There is some disagreement on vocabulary and research standards (Brown, 1988). Thus, there is need for clear communication and careful explanation if qualitative terms, methods, and techniques are to be understood by scientists trained in a different tradition.

3. Scarcity. At the current time there is a scarcity of scientists who are well-trained in qualitative methodology. Only a few universities offer any coursework at all in qualitative research design, and almost none have well-developed programs. Train- ing has proceeded primarily by networking and internships. Hoshmand (1989) has developed a proposal for integrating the teaching of qualitative research design into graduate research training programs, but it is likely to take at least a decade for her recommendations to become standard fare in family therapy doctoral programs.

4. Time and effort. Qualitative research is time and labor intensive. It does not lend itself well to the “publish or perish environment prevalent a t many universities.

5 . Funding and publication. Both journals and funding agencies are often biased in favor of traditional science (Shannon, 1989). As a result, the qualitative researcher may have trouble securing funding and getting published. “Systemically oriented researchers. . . must meet funding agency research guidelines based on one paradigm and attempt to incorporate methodology relevant to family therapy based on another” (Joanning, Newfield, & Quinn, 1987). The publication problem is exacerbated by the length of most qualitative research reports. Journals with restrictive space requirements may reject qualitative studies on the basis of length. Further, standardized criteria for evaluating qualitative inquiries are only just beginning to emerge (Lin- coln & Guba, 19901, and there are few reviewers knowledgeable enough about qualitative research reports to review qualitative manuscripts adequately for journal editors.

6. Limitations of the qualitative paradigm. It is essential that family therapy researchers conducting qualitative studies understand the limits of the qualitative paradigm. For example, researchers must be aware of cognitive limitations on naturalistic data processing, such as the tendency of the human mind to select data in such a way that it confirms tentative hypotheses and the tendency of first impressions to endure even in the face of considerable contrary data (Lauer & Asher, 1988; Sadler, 1981). In addition, researchers using qualitative methods must understand that their work


often gains validity at the expense of generalizability (Goetz & LeCompte, 1984), and they must expect to work hard in order to be able to document their findings (Strauss, 1987).

7. Ethics. Fundamental ethical issues like informed consent and risk-benefit equations take on a different cast in qualitative research. For example, anonymity is often impossible to maintain, and risks may be hard to determine in advance due to the open-ended, exploratory nature of the research process. In addition, the “private and intimate nature of the family imposes unique constraints and raises distinctive ethical issues for investigators using qualitative methods” (LaRossa, Bennett, & Gelles, 1981). Guidelines for ethical behavior in qualitative family therapy research are needed.

SUMMARY The qualitative research paradigm appears to be a useful one for family therapy

research. The field of qualitative research is still in its infancy. Family therapists are

Figure 1 Characteristics of Qualitative Research Designs

THEORY Theoretical frameworks inform qualitative studies, either explicitly or implicitly.

QUESTIONS Tend to be open-ended, discovery-oriented. Often are modified as the study proceeds. Focus on understanding holistic complexity and context.

SAMPLING Many types are possible, including probabilistic sampling. However, small samples which are deliberately chosen because they fit research goals (criterion-based selection) or will help elaborate developing theory (theoretical selection) are the most common methods. Tendency to look intensively at a few cases rather than broadly at many cases. Emphasis on individual differences and context. Selected to enhance generalization to theory rather than to populations.

ROLE OF THE RESEARCHER Often a participant observer. Develops close, even collaborative, relationship with participants. Intentionally subjective. Handles subjectivity by making researcher role($ and biases explicit.

DATA COLLECTION Both interactive and noninteractive methods are used. Data are visual or verbal rather than numerical. The most common methods are participant observation, nonparticipant observation, unstructured interviews, structured interviews, and document analysis. Methods of recording include fieldnotes, video tapes, and audio tapes. Data analysis usually occurs simultaneously with data collection.

DATA ANALYSIS: Again, several methods are possible. The most fundamental ones are analytic induction and constant comparison. Both are generative methods that involve looking closely and recursively at social science phenomena in order to discern patterns. Data like field note transcripts are coded using elaborate coding systems (see Strauss, 1987). Constructs and concepts emerge from the analysis of the observed data rather than being imposed on it a priori. The researcher is the primary data analysis instrument and so needs intimate, first- hand knowledge of the data. Time and labor intensive.

RESULTS Usually take the form of theoretical assertions, discovered theory, or categorical systems (taxonomies) that have emerged from the data collection and analysis.

REPORTING Good writing skills are essential. The goal is to recreate the reality studied. Studies take a lot of space to write up. Many qualitative studies end up as books. No standard conventions have been developed for reporting the raw data or the data analysis.

RELIABILITY AND VALIDITY Trustworthiness and credibility are established by a number of specific strategies, including prolonged engagement, persistent observation, triangulation, negative case analysis, constant comparative analysis, thick description, dependability audits, confirmability audits, reflexive journals, and participant critiques of research reports. Sources: Bogdan & Biklen (1982), Goetz & LeCompte (1984), Lincoln & Guba (1985).


uniquely equipped to be at the forefront of the movement to develop more effective qualitative research designs and methods because the epistemological foundations of the fields of qualitative research and family therapy are congruent and because so much of the generative, clinical research that has already been carried out by family therapy researchers is qualitative in nature.

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Family Therapy and Qualitative Research