Ethical Considerations

Any time there is involvement with human behaviour ethics are an integral part of the process (Figley, 2012). Ethical guidelines are necessary to clarify the conditions under which psychological research can take place (BPS, 2010). The guidelines aim to protect any research participants, the reputation of psychology and the psychologists (researchers) themselves (McLeod, 2007). Ethical principles underpin all research to ensure researchers carry out their studies in an open, honest way and with the protection of their participants in mind.

A request for ethical approval to carry out a small pilot study followed by a larger main study as part of a Professional Doctorate was submitted through the University of Derby, Nursing and Allied Health Professional Research Ethics Committee. Ethical approval from the University of Derby, Nursing and Allied Health Professional Research Ethics Committee was received on the 22 May, 2012 (Appendix F). In the case of insufficient participants volunteering to take part in the study in the first recruitment stage, a second request for ethical approval was submitted through the University of Derby, School of Health Research Ethics Committee. This was to ensure a second phase of recruitment outside the parameters of the initial approval, could take place without delay if required. Ethical approval with clarification and conditions was received on the 13 June, 2013 (Appendix G).

Clarification was also sought from the Research and Development Directorate as to whether ethical approval also needed to be gained through the National Health Service (NHS) Ethics Committee (Appendix H). This was because participants although working for private companies, may be working with clients referred from the NHS. Confirmation was received on the 13 August, 2012 that approval was not needed through the NHS Ethics Committee (Appendix I).

3.2.1.1. Sample size

An appropriate sample size for a qualitative study is one that adequately answers the research question (Marshall, 1996). Within the literature, IPA sample sizes are suggested merely as guidelines. When undertaking an IPA study and considering sample size, this should be influenced by the following elements: (i) the depth and variety of the data obtained, (ii) the degree of commitment to the level of analysis and reporting, and (iii) any organisational constraints one may be operating under (Eatough & Smith, 2006; Smith et al., 2009).

Unlike quantitative approaches which strive for generalisations and generate data using standardised measures, qualitative research methods generally adopt an idiographic approach without seeking to make generalisations (Dallos & Vetere, 2005). Whilst not opposed to making general claims for larger populations, IPA is committed to analysing a small number of cases which may lead to such generalisations (Smith & Osborn, 2003). Whilst this might be a limitation in substantiating theory, it allows for a richer depth of analysis (Smith et al., 2009). IPA was chosen for this study as its concern is to give a rich, detailed account of a participant’s personal experience, which should be about depth rather than breadth (Reid, Flowers & Larkin, 2005; Smith & Eatough, 2012). It has been suggested that less is more in IPA and that fewer participants examined at a greater depth, is more preferential to a descriptive analysis of many participants (Reid et al., 2005). Researchers are encouraged to choose a sample size sufficient enough to examine any similarities or differences, without being overwhelmed by data generated by larger sample sizes which can be particularly time consuming during analysis (Eatough & Smith, 2006).

Whilst there appears no definitive answer to sample size, published IPA studies have included a range of sample sizes between one and fifteen or more (Smith & Osborn, 2003; Reid et al. 2005; Eatough & Smith, 2006; Smith & Osborn, 2007; Smith & Eatough, 2012). Aiming for sufficient study data and using this as a

guideline, two to three participants were initially sought to take part in the pilot study and a further eight to twelve participants were sought for the main study.

3.2.1.2. Participant consent and withdrawal from the investigation

Decision to participate in the study was voluntary. This was to help ensure participants did not feel forced or coerced into helping with the research (Denscombe, 2007). A letter (Appendix J, K) explaining the purpose of the study was provided to participants as part of an information pack, containing the interview schedule (Appendix L), consent form (Appendix M) and support information (Appendix N, O). In particular, the letter drew attention to what participants were expected to do, how they could withdraw from the study and confidentiality issues. The letter included contact details of the researcher, to afford the opportunity to ask any general questions including potential risks or benefits.

Consent forms for tape recording the interview were supplied to participants for signing prior to conducting any interviews (Appendix M). Sufficient time and information concerning the study and taped interviews was given for participants to consider whether or not to participate in the study and change their minds as necessary (Lee, 2009). Participants were also offered a time-limited right to withdraw consent at any time during data collection and analysis, together with opportunities to review transcripts for quality assurance and withdraw any comments made during their interview, which they did not want to appear in the public domain.

3.2.1.3. Confidentiality

Participants in psychological research have a right to expect the information they provide to be treated as confidential and, if published, remain unidentifiable as theirs (BPS, 2010). Participants were provided with details of the specific circumstances in which confidentiality would have to be breached (Appendix J, K). Anonymity was ensured by supplying all participants with an identifiable reference number for use in place of personal details within the research study. Unedited

data transcripts were only seen by the researcher and the participant who provided the data. Any data used for any wider purposes such as peer review or university supervision was edited to maintain participant and/or their client’s anonymity.

3.2.1.4. Protection of participants

Health care research can require stringent ethical approval, especially if the research involves vulnerable patients. The ‘traditional Hippocratic moral obligation of medicine, is to provide net medical benefit to patients with minimal harm, that is

beneficence with non-maleficence’ (Gillon, 1994:185). This moral obligation also

applies to participants when conducting research, the aim of which must be benefit over harm. It is essential that a researcher considers what constitutes a benefit for their research, may not necessarily be a benefit for research participants. ‘Key processes and outcomes for the professional doctorate relate to research knowledge and skill generated from and within a practice setting, by the practitioner as opposed to an independent researcher’ (Lee, 2009:146). Whilst this may bring the benefits of insider knowledge, it is not without its potential problems and researchers might struggle with role conflict (Brannick & Coghlan, 2007). Although there is a commonality that affords access that may be ‘closed’ to outsiders (Costley, 2010), dual roles can also result in role confusion when the researcher responds to the participants or analyses the data from a perspective other than that of researcher (Asselin, 2003).

Consideration was given to risks to the participant’s personal social status, privacy, personal values and beliefs, personal relationships and adverse effects of the

disclosure of sensitive material (BPS, 2010). An example of risk within this study

might include concern being raised over a participant’s professional practice when talking about their experiences of working with a vulnerable client group. This concern could lead to disclosure of unprofessional practice by the researcher and an onward investigation against the participant. Within research, the obligation to provide net benefit to participants also, ‘requires us to be clear about risk and probability when we make our assessments of harm and benefit’ (Gillon,

1994:185). Researchers must ensure that those taking part in research, are protected from physical and mental harm and will not be caused distress (McLeod, 2007). Potential risks were explored and discussed by the researcher with research supervisors within doctoral supervision. Participants were provided with clear guidance on what would happen should this occur within the study information pack and reminded of this before and after their interview took place. Ethical approval was applied for after the risks of the research study had been considered and addressed, in order to minimise the chances of this.

The research study excluded persons under the age of twenty one and those otherwise incapable of giving consent. The age of twenty one was chosen to reflect the minimum higher education training requirements needed to become a qualified therapeutic therapist. Participants were offered access to emotional support in case of distress, whether during or following the research study interview and each participant was asked to nominate designated contacts (Appendix M). In the case of any distress during the interview, participants were informed their interview would be stopped and their nominated person contacted for immediate support. This ensured clear boundaries between the researcher’s dual role of researcher and psychological trauma therapist.

After the interview, participants were orally debriefed by the researcher in line with recommendations in the Code of Human Research Ethics (BPS, 2010) and reminded that they had the right to withdraw. Due to the majority of interviews taking place over the telephone (which may have offered some form of protection or detachment for participants), an overt approach to support participants was taken by the researcher by asking participants whether they would like their nominated support contacted. This was to minimise potential for unexpected, emotional distress arising out of the interview. Information and local contact numbers were given in the participant information pack for support during both office working hours and out of hour’s services (Appendix N, O). Participants were advised that should they need advice with regard to any issue arising from participation in the study they would be signposted to a suitably qualified

professional who could assist them. Throughout the doctoral process, the researcher was supported by their university and clinical supervisors.

3.2.1.5. Data protection

The Data Protection Act (Parliament, 1998) regulates the processing of information relating to individuals including the obtaining, holding, use and disclosure of such information. The Act requires anyone who processes personal data must comply with its principles and ensure personal data is used fairly and lawfully; for limited, specifically stated purposes; used in a way that is adequate, relevant and not excessive; accurate; kept for no longer than is absolutely necessary; handled according to people’s data protection rights; kept safe and secure and not transferred outside the United Kingdom without adequate protection (Parliament, 1998). Furthermore, the Act gives individuals rights of access in relation to personal data which affords participants asking for copies of personal data collected by a researcher (Research Ethics Guidebook, 2015).

In order to comply with the Data Protection Act (Parliament, 1998), participant anonymity was ensured by supplying all participants with an identifiable reference number for use in place of personal details within the research study. As the study developed, these were replaced with pseudonyms to aid the reader. Any identifiable details, including consent forms, were held separately from the tape recorded interviews by the researcher in a secure filing cabinet. Electronic data was password protected. Upon completion of the research study, any identifiable paperwork or taped interviews will be held securely by the researcher for a period of five years, after which time they will be destroyed.