Position of the researcher

I am a 29-year-old white British female, and I have worked in the field of clinical psychology for five years with a range of client groups. In both clinical and research contexts, I am an advocate of viewing the client/participant as a ‘person-in-context’, and am critical of the traditional perspective in mental health services which is based on symptoms and diagnoses, rather than contexts and experiences. One of the issues I have with such a reductionist perspective is that those who cannot be ‘fitted’ into predefined categories can slip through

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gaps between services, which I have observed in clinical practice. I have a strong interest in exploring alternative or additional means by which activities with therapeutic effect may be made accessible to people with mental health difficulties, particularly those for whom traditional services are unsuitable. Whilst working on an inpatient acute assessment unit, I noticed that it was often engagement in simple everyday tasks, rather than a session with the psychiatrist or psychologist, which seemed to have the greatest impact upon someone’s functioning in the short-term, and so became interested in how everyday tasks such as reading may be employed to enhance mental health and well-being.

The appeal of reading for this purpose is not only its apparent simplicity but also its creative quality, since I am also interested in how engagement with artistic creations (e.g. music, literature, film) can reveal insights around emotional experiences both for creator and audience. My interest in the relationship between arts and mental health developed when I was doing my Masters dissertation, which looked at how people perceive and understand schizophrenia through cinematic portrayals in contemporary North American film.

Conducting this research illustrated that others’ stories can potentially be extremely useful in helping people understand what it is like to live with emotional distress, and perhaps be better able to make sense of it.

With this context in mind, I contacted The Reader Organisation, and through initial

discussions with staff/reading about past projects/participation in RGs, I begun to reflect on the potentially powerful emotional effects of reading literature in a group. This then made me wonder about comparisons between RGs and psychological therapy, and whether the former may be therapeutic for people with mental health difficulties. Particularly, I was interested in the experience and meaning of participation from the perspective of the individual member, and how this related to how people understand their lives.

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2.7 Reflections on methodology

The first thing that struck me during this process was the welcoming and approachable nature of staff and group members during the recruitment and data collection stages. It seemed that the friendliness that I experienced was exemplary of the general atmosphere of RGs, and made me wonder whether this would be identified by participants in their own experience. The accounts that participants shared with me were varied and fascinating and, at times, I found it difficult to keep in mind and follow up all of the curiosities elicited in me during the interviews. This experience highlighted to me both the vast amount of interest and

experiences that participants had to share, and the value of IPA as a methodology, in terms of enabling me to get to know participants and explore their stories.

As mentioned previously, the interviews varied in length and richness, which seemed partially attributable to variations in wellness among participants. It seemed important to comment on this, since mental health will fluctuate over the period of time in which someone attend RGs, so the current time point reflects a snapshot of this period; while some participants may be relatively well, others may be less so. A related reflection was the potential blurring of my dual roles as researcher and clinician, since it sometimes felt difficult not to respond as a clinician and resist the urge to help, especially with participants who seemed less well. From a clinical perspective, I found myself fascinated with one particular participant, but wondered how this might affect the interview and analysis. For example, I was aware that, if

unchecked, my interpretations of this individual’s account could run the risk of straying into clinical territory, akin to the hypothesising process that occurs during formulation, and therefore aimed to remain mindful of this during the analysis stage.

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3.0 Analysis

This chapter outlines the sample, and provides an overview of the main findings. I then present the master themes and subthemes, alongside participant quotes (notation details in Appendix O), to illustrate their relation to the data. The chapter concludes with reflections on the analysis.

3.1 Participants

Eight interviews were analysed. Participants were three females and five males, aged 30 to 58. Participants had attended reader groups (RGs) for at least nine months, averaging at approximately 21 months. Table 3.1 displays basic demographic information, with fuller ‘pen pictures’ in Appendix P. All identifying data has been changed.

Table 3.1

Participant Demographics

Participant number Pseudonym Age Mental health problem (MHP)

1 Olivia 30 Depression, low self-esteem,

anger

2 Nadia 42 Bipolar disorder

3 Alfie 53 Depression

4 Liz 56 Depression

5 Jim 58 Depression

6 Ian 44 Anxiety, depression, substance

misuse

7 Hassan 42 Anxiety, depression,

Asperger’s Syndrome

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3.2 Overview of master themes

The aim was to explore participants’ experiences of being in RGs. Interpretative

phenomenological analysis (IPA) resulted in five master themes, each containing three/four subthemes (Table 3.2). Appendix Q presents the results in further detail, including

superordinate themes and associated participants.

Table 3.2.

Table of Master Themes and Subthemes Master theme Subthemes

1. Literature as an intermediary object

 Attunement to text, self, other

 Literature eliciting self-reflection in safe environment

 Testing ground for new ways of being 2. Boundaries and

rules of engagement

 RG as separate (protected) space

 Structure and unplanned happenings

 RG as unpressured/failure-free

 Acceptance and non-judgement 3. Self as valued,

worthy, capable

 Fulfilment of otherwise unaccomplished endeavours

 Sense of potential through (enjoyable) learning and achievement

 Opportunity for contribution/involvement 4. Community and

togetherness in relational space

 Interpersonal self-efficacy counteracting social difficulty

 Attachment to others fosters trust and belonging

 RG as collective experience/venture 5. Changing view of

self, world, others

 Re-appraising self as normal

 Psychological flexibility

 Connecting past and present self