Post the to forum your thoughts about the current research

Hi Ashman,

It was good to read your post about research ethics. I hadn’t considered self-governing and self-regulating aspects of research into psychotherapy before so I found that thought provoking.

In terms of looking at research into ethics, it is interesting that there does not seem to be a huge body of research into this important area. As McLeod (2015) asserts: ‘Most of the literature on research ethics is written from a philosophical perspective, and consists of rational argument interspersed with occasional case examples.’ (70)

McLeod (2015) highlights two studies into research ethics. One of these was by Biddle et al (2013) which focused on how people who had suicidal tendencies felt after taking part in research interviews. The other by Flory and Emanuel (2004) which looked at the issue of informed consent.

According to McLeod (2015), it is these two areas of research ethics that have primarily been the focus of research: ‘[…] there has been a fair amount of research into how participants feel about ethical procedures. […] other studies have explored the extent to which participants understand informed consent procedures.’ (70)

Both the Biddle et al (2013) and Flory & Emanuel (2004) studies are easily accessible online.

Biddle et al (2013) explain that ‘Concern exists that involving vulnerable individuals as participants in research into suicide and self-harm may cause distress and increase suicidal feelings. Actual understanding of participants’ experiences is however limited, especially in relation to in-depth qualitative research.collected.’ (70). In order to research this, they collected data from four different studies of individuals with self harm or suicidal tendencies. They report the following results, limitations and conclusions of this research:

‘Results: Most participants experienced a change in well-being. Between 50% and 70% across studies reported improvement, many describing the cathartic value of talking. A much smaller group in each study (18-27%) reported lowering of mood as they were reminded of difficult times or forced to focus on current issues. However, most anticipated that their distress would be transient and it was out- weighed by a desire to contribute to research. An increase in distress did not there- fore necessarily indicate a negative experience.

Limitations: There was no follow-up so the long-term effects of participation are unknown. Scores and post interview reflections were collected from participants by the researcher who had conducted the interview, which may have inhibited reporting of negative effects.

Conclusions: These findings suggest individuals are more likely to derive benefit from participation than experience harm. Overprotective gate-keeping could prevent some individuals from gaining these benefits.’ (14)

Flory and Emanuel (2004) provide the following context to their study:

‘Available data suggest that prospective research participants may frequently not understand information disclosed to them in the informed consent process. Little is known about how understanding can be improved.’

They found the following worrying results:

‘Although not conclusive, available data suggest that research participants may frequently not understand disclosed information. For example, approximately 30% of participants in a cross-section of oncology clinical trials believed that their treatment had already been proven to be the best treatment for their cancer. In a randomized trial of β-blocker drugs to prolong the lives of patients with history of myocardial infarction, 44% of research participants interviewed did not know that they were assigned to treatment or placebo by chance. Many other studies suggest that similar shortfalls in understanding are widespread.’

Other research into ethics that I am aware of centres around researcher allegiance/researcher bias and has usefully highlighted the prevalence of this (Cooper, 2010). Highlighting the existence of this is useful because it allows other researchers to attempt ways in which researcher allegiance can be mitigated and it also provides clarity over the validity of results of studies pitting one form of therapy against another.

Clearly research into ethics is crucial to the field of psychotherapy. It is vital that before we conduct research, we are aware of the ways in which individuals may be affected by it and the ways in which we can avoid any harm being caused. It seems that more research is urgently needed into the area of informed consent if, as Flory & Emanuel (2004) argue, ‘Little is known about how understanding can be improved’. It is of paramount importance that clients engaging in psychotherapy research understand what they are embarking upon. Bond (2015) stipulates that ‘Ethics require that the researcher […] ensures that all participation in the research is truly voluntary and offered on the basis of freely given and informed consent’ (104-5). Other research such as that conducted by Biddle et al (2013) into ethics is clearly useful in terms of allowing future valuable studies to be conducted. McLeod (2015) makes this point:

‘The findings of such research can represent a valuable resource for researchers […] in helping to persuade gatekeepers and research supervisors around types of ethical action that should or should not be pursued.’ (70)

References:

Biddle L, Cooper J, Owen-Smith A, Klineberg E, Bennewith O, Hawton K, Kapur N, Donovan J, Gunnell D (2013) ‘Qualitative interviewing with vulnerable populations: Individuals’ experiences of participating in suicide and self-harm based research’ published in ‘Journal of Affective Disorders 145, 356-362, 2013’ [accessed on 19/10/15 at www.griffith.edu.au/__data/assets/pdf_file/0005/541814/volume9-suicide-research.pdf]

Bond, T in Vossler, A and Moller, N in (2015) ‘The Counselling and Psychotherapy Research Handbook’ Sage, London

Cooper, M (2012) ‘Essential Research Findings in Counselling and Psychotherapy; The Facts are Friendly’ Sage, London

Flory, J and Emanuel, E (2004) ‘Interventions to Improve Research Participants Understanding in Informed Consent for Research: A Systematic Review’ published in The Journal of the American Medical Association (October 6, 2004, Vol 292, No. 13) [accessed on 19/10/15 at jama.jamanetwork.com/article.aspx?articleid=199537]