I think this is a great research question and I look forward to heaing how you progress and what your findings are.

I will address question 3: perhaps the only way to tell if the interview and attention are having an impact on the depression (and they will!) would be to have a group where you do not have face to face contact except to present the packet and ask the participants to fill it out themselves.  If this is not feasable, then a series of telephone calls to guide them in filling out the forms.  OR make sure that the control group has equal time spent with the interviewer, but just leave out the positive intervention. That way the attention is controlled for.

John, thank you so much for your reply. Yes, I thought about doing a control group where I would see the same number of people for the same time period and we would just discuss whatever they wanted. The problem is that I have to type up all of the recorded interviews. Even with the experimental group it's going to take me an eternity to type up all of the discussions. I know that there are recorders that can trascribe spoken words numerically, but I'm working in French, and am not sure if this exists here. The other thing is that they're quite old and I am not even sure if that type of system could decipher what is being said.

I am wondering about your other proposition to simply do the tests with them at the programmed times without actually doing the interviews. Granted, I'm just a master's degree student, but it certainly seems to me that a lot can happen in 2 months time for an older person that could account for changes in test results. Again, I'm a beginner, but methodologically it seems to me that there could be lots of unaccounted bias in doing it this way. What are your thoughts on this ?

Thanks again so much for your help !

Holly

For issue 3: Could you prepare some kind of questionnaire that asks participants to answer the same kinds of questions you plan to ask in the interviews? That way you could gauge the difference between focusing thoughts on the positive aspects and working with the therapist.

For Issue 2: I would note that you will need to consider carefully what wording you will use with the PANAS, since if you ask them how they are 'feeling right now' for example, that will only pick up their immediate affective state rather than overall depression and mood.

In regards to issue 1: I would suggest that you ask people to talk about the particular difficult moments and then when you hear them say something that illustrates a positive quality or response on their part, ask them: 'what did you do at that point which helped you to cope?' or something along those lines… That way you are not pointing out the behaviour or traits themselves, but asking them to notice them. Just use questions to draw them out and make them think. You could also try something like: 'I am curious about how you responded to that… What do you think about how you responded there…?'

Re. question 1:

If you want to avoid orienting the discussions or being the one to point out the qualities, I recommend an interviewing technique called Clean Language. See:

Tosey, P., Lawley, J. and Meese, R. (2014) Eliciting Metaphor through Clean Language: An Innovation in Qualitative Research, British Journal of Management 25(3) · February 2014

and

Tosey, P. (2015) And what kind of question is that? Thinking about the function of questions in qualitative interviewing. Chapter 14 in Handbook of Research Methods on Human Resource Development. Editors, Saunders, M. N. K. & Tosey, P. Edward Elgar Publishing.

Topic 1: I agree to what has been said above, and would add: Try to use a reflective way of asking questions: i.e. let them tell their story, and reflect back what hey say: so you mean...., how did this make you feel,...., am I correct to say .....so that was a positive feeling...

They will mention positive things without noticing, and you can further develop form there. 

This is an ambitious project for a research study.  You are trying to identify difficult times and what helped these elderly patients overcome them at the same time you are trying trying to measure the impact of the interviews as an intervention.  As a former advisor, I'd say just do the interviews.  Once you graduate you will be able to use that information as a basis for future research.  Remember your goal is yes to do the research but also to graduate! 

Unless there is a specific reason to limit the interviews to the elderly in nursing homes, I'd pick a certain age group - say 65 to 75 - in various living places. 

Phenomenological interviewing would work well with your positive psychology approach.  (Lots of books and articles on Phenomenology - see link - check with a faculty member who uses that method) You could administer a geriatric depression scale and a questionnaire on life satisfaction to compare with the responses you get from the interviews.  Positive Psychology started with Dr. Seligman at the University of Pennsylvania in Philadelphia, PA.  Here's a link that lists all the tools they have developed.  When you do a thesis, it is recommended the tools connect well with the research approach.  http://www.ppc.sas.upenn.edu/ppquestionnaires.htm.  This group is also very helpful.

My general advise is to keep the proposal straight forward, simplify it, and focus on core basic information that will help you later develop a field of research on the topic if this is an area of interest for you.

http://www.amazon.com/s/?ie=UTF8&keywords=phenomenology&tag=mh0b-20&index=stripbooks&hvadid=3481637628&hvqmt=p&hvbmt=bp&hvdev=c&ref=pd_sl_366e5aw9q5_p

Hello to all,

I cannot tell you how much I appreciate your help with this. Your answers are really constructive.

For Sandra : Very good idea for the questionnaire on the interview content. Unfortunately it's not feasible for my research because the subjects are quite old (late 80s early 90's) and have great difficulties writing.

For the PANAS, I am using it in line with the CES-D depression scale where both cover the emotions felt during the prior week. You have pinpointed a difficulty with this choice : if the person happens to have some positive events during that week that have a positive impact on their mood, they may not come up as depressed. I have had to exclude a couple of subjects because of this. I should have used the Geriatric Depression Scale.

(Also as a reply to Lucienne) Yes, I used questions/formulations along the lines of what you both suggested. Reformulation and verification of what has been said are useful.

James : Thanks so much for the recommendations on the article/book on interviewing techniques. I will definitely look them up.

Corena : yes, I have taken into account those parasite variables.

Madelaine : Thanks for your comments. However, I can't just do the interviews and use the information once I graduate, because this is the research I have to do in order to get the Masters. Also, the goal of the research is to examine these aspects of depression and positive resssources specifically within the context of the nursing home. I'd be a pretty poor student if when doing a research project along the lines of positive psychology I didn't know who Seligman was...

Sincerely, thank you again for your input. It really has been of great help to me !

Best regards

H. Rougier

Good luck, Holly.  Didn't mean to insult you with the Seligman information.  I have found many who, unlike you, do not go back to the origins of Positive Psychology.  I can tell you doing both a qualitative study and an intervention study at the same time would challenge even experienced researchers.  That's a lot for a master's thesis.  

Thanks for your encouragement Madelaine. Yes, I most certainly do feel like I've taken on a lot.

Best!

Holly

In addition to what has already been said, I would like to point the following. Asking about qualities IS an intervention per se, so guiding them to think about the qualitites and skills they used may be the right thing to to considering your research question. 

Concerning the scales, I would use ALSO some positive psychology measure. The Depression and the PANAS come, as far as I understand, from the "non-positive" psychology, and you may not find effects as such, because you will be using two different epistemological approaches at the same time. 

Concerning the third question, it is true that an experimental study would have been best, and then you would have to check carefully on the control condition: no intervention? phone interview? written assignment? different intervention? intervention by a different interviewer? But, as was already implied, this would be more of a PhD and a postdoc at the same time! So, it may be enough to remember that you did not conduct a proper experiment and discuss the reasons (feasibility, resources) and the limitations of this choice. 

Best of luck with your research!

In addition to what has already been said, I would like to point the following. Asking about qualities IS an intervention per se, so guiding them to think about the qualitites and skills they used may be the right thing to to considering your research question. 

Concerning the scales, I would use ALSO some positive psychology measure. The Depression and the PANAS come, as far as I understand, from the "non-positive" psychology, and you may not find effects as such, because you will be using two different epistemological approaches at the same time. 

Concerning the third question, it is true that an experimental study would have been best, and then you would have to check carefully on the control condition: no intervention? phone interview? written assignment? different intervention? intervention by a different interviewer? But, as was already implied, this would be more of a PhD and a postdoc at the same time! So, it may be enough to remember that you did not conduct a proper experiment and discuss the reasons (feasibility, resources) and the limitations of this choice. 

Best of luck with your research!

Hello Georgios and thank you very much for your input.

Yes, it was my understanding as well  that exploring the positive qualities that allow people to overcome adversity is an intervention within the lines of positive psychology. You mention that I should include another positive psychology scale that would highlight the measured effects of this intervention. I do agree ! In fact that was one of the questions I asked (or thought I'd asked ?). So I truly would appreciate hearing your suggestions on which PP scale you think might best do this.

Thanks very much in advance for your suggestions....

Regards

Holly Rougier

Holly, first off, great research area. I have no doubt you will find rich findings. To answer your questions, I'll go in order to help me make sure I cover all areas:

Problem 1: Many researchers become tripped up on how to conduct a mixed method research, because a qualitative design is drastically different than a quantitative and then combining them together may become muddled. My suggestion is to look into one of two forms of mixed-method designs:

 - Mixed-Method Explanatory Sequential Design: This is where the use of your scale becomes the primary element and then your interview findings are used to explain the QN findings (thus the name). This allows a deeper exploration of the inter workings of the phenomenon you are researching.

 - Mixed-Method Exploratory Sequential Design: This is the reverse of the above, where your findings of your interviews sets the direction on how you analyze your scale results. One of the ways to do this is  to assessing your interview for emerging themes and use these as a way to code your participants to compare your scale results with.

As for preventing bias in your questioning, be sure to word your questions as if you were conducting a phenomenological qualitative design through the use of  HOW or WHAT (example: What has been most influential to help you manage your depression?) This cues the interviewee, but does not lead them. Written form is easiest, as long as the writing is legible, but it does not allow for free form or thought as a semi-structured verbal interview would be. Do what is most ideal, but I have always found that in person adds a depth you just can't find any other way.

Problem 2: The scale you've selected is strong, just be certain it has published evidence of validity and reliability. Without out that, even the best measure can be undermined. Georgios, is right, including other positive psychology scales would add strength to your research. Never pass up the opportunity to collect what you need and a touch more. Look at what scales others have used who have similar hypothesis to yours (part of the genius behind your lit review).

Problem 3: Every researcher brings a degree of bias to their work. Try to think of this as a lens in which a person looks through. To acknowledge the existence of this,, most researchers use two safeguards to strengthen their studies: bracketing and triangulation. Bracketing is where you acknowledge any potential bias (perspective) that exists before you conduct your research. Triangulation can be applied at two points, in the development of your interview questions and in the analysis of your findings. This is where you select individuals who are either experts or experienced (ideally both) in your field to soundboard with. Share your identified biases with them so they can help to determine if your research was malproportionally weighted in a certain direction.

Message me if you need any references or further guidance. I'd love to help in any way I can. Best wishes to you!

Fantastic Eliann ! Mixed methods research is a relatively new concept in France. You have just introduced me to two different approches in this area that  I've never heard of.  I will go the route of the Exploratory Sequential Design, because my sample isn't big enough to go the other way. Also didn't know the terms "bracketing" (though I've integrated it in my work) or "triangulation". Thanks also for the reminder on how best to formulate my questions.

Am still thinking about Georgios' suggestion to include another P.P. scale. I think measuring character strengths would be useful, but Seligman's VIA Character Strengths Profile is way too long for these older subjects. I am also feeling the "Meaning in Life" scale could be appropriate, though I've never used it and am not so sure about it's validity. Any suggestions ?

Thanks so much again for this very useful advice !

Holly

Very interesting project.  I have seen it today only.  I will study it in depth and then respond.  Keep in touch.   A blend of client centered therapy and psychoanalysis will help.  Best wishes.

Holly, I've added two references for you. The first is my primary resource for mixed-method design and the second is a reference providing the validation for a measure that may be helpful.  If there is anything more, just let me know.

Eliann - thanks for both these references. I plan on sharing the Mixed Method Design chapter with other students I know in my program, as we just don't have access to practical info on creating mixed methods methodology. thanks again!

Anirudh, looking forward to your reply. (I've already learned a lot from many others here.) Client centered therapy yes, but the psychoanalytical approach is not something I want to adopt. In France, the psychoanalytic approach is very "classic" and quite rigid. I don't really want to go into that minefield here...

George, I'm not quite sure if I understand your question. Could you clarify a bit ?

Thanks in advance

Holly

Dear George

Older people suffering from depression in nursing homes are often submerged in themes based around loss : the realisation that one's mind and body are deteriorating, loss of friends and family through death or inaccessibilty because they''re in nursing homes, loss of life control because they're dependant. (Ok, I could go but, II'll stop there.) At the same time, they are also reminiscent of the past. Because of their depression, there is a negative affective filter through which they are examining past events and memories.

The objective of the intervention is to lower depression levels and raise positive affect. There is an existential element to this intervention that appeals to me. At this point in life for them, and especially because of their depressive state, the future is mainly about death. But even people who have lead very hard lives have had moments in the past where they have succeeded in overcoming certain challenges. The positive psychology element of the intervention is intended to help them focus specifically on the personal strengths they have that enabled them to get over these moments. Reexamining  these positive aspects of themselves would be therapeutic for depressed subjects. Anyway, that's my hypothesis.

holly

Holly, it should be 'In line with normative psychology' instead of 'in line with positive psychology'.

 I also regard the project very ambitious.  My concern is that we should use correct terminology.  When we study 'what should be' as  in clinical psychology it comes under Normative Psychology.  And when we study 'what is' as in Experimental Psychology it comes under Positive Psychology.  I am further studying the project undertaken by Holly so that I may be able to contribute my views purposefully.

Interesting study. I wish you good luck.

With regard to your question " ideally I should only guide them to see these aspects themselves." Consider socratic dialougeas help to guide them.

Wish you the best

Rico

Thank you George. It's always encouraging when one is just starting out to hear some positve feedback.

Anirudh, I am looking forwarding to hearing more from you as I am open to getting different viewpoints (and any help I can get on my research!). Though not a professional on the subject, I feel I've delved quite a bit into the positive psychology approach. In my opinion it can seem pretty "normative" in its own way.

In France, I have not been exposed to "Normative psychology". For me when one asserts "what is" as you say, we are already within the normative realm (as opposed to constructivism for example.) But again, I'm not an expert in this area, so I'll wait to hear your reply on this.

Best,

Holly

I don't understand Anirudh Kumar Satsangi's answer. Holly is not about to study the "should". It is an clinical intervention to promote flourishing by discovering strenths. Therefore it is correct to subsume it under the umbrella of positive psychology according to Selgiman and Rashid.

Thanks for your support Rico. I have just spent some time looking into socratic questioning and how it might be useful for my interviews.

As far as Anirudh's comments go, I like to hear back from him so he can explain his reasoning.

Good day !

Holly

Hi Carole,

Story telling is exactly what takes place during these interviews. The initial guidance involves helping the older person to pinpoint the story that exemplifies their strengths during adversity. After that, the story is really their own. For example, one lady told a WW2 story of how she lived in the free zone in France under the German occupation. She was pregnant, her husband was a resistant and she didn't  where he was. She had to make her way back into occupied territory in order to be with her family when she delivered. She was quite frightened and had to muster up a lot of courage to do this. Yes, there are potentially lots of great stories to tell....

In passing, I will just mention that I am still waiting on Anirudh's feedback...

Thanks for your suggestion Carole.

Holly

Hi Holly,

Those scales seem good- widely used and on the shorter side. One way you could distinguish the results in the intervention from effects of the therapeutic relationship would be to add in control participants...ask them questions in a half hour interview but nothing focusing on overcoming adversities like you're doing in the intervention. 

Hello again Carole,

I can't really comment on normative psychology, because as I said, I hadn't heard of it before. When I hear this term, the first thing that comes to mind is Abnormal Psychology, where the goal is to pin down limits concerning what is "normal" from what is "abnormal". In any event, this kind of thinking is not the focus of the research I'm working on. (DSM thinking if you are familiar with the DSM.)

When you say "the intervention is the therapeutic relationship", in a way, you're making a very good point. For the intervention I'm doing,  the question is, what exactly is the factor that makes depression decrease and positive affect increase : is it the therapeutic relationship or is it the effect of the intervention which focuses on recalling positive ressources from the past that have enabled people to get over challenges in their lives (the intervention)? This question, among others, is why I have sought out help from researches on this website.

I don't really understand what you mean when you say :

"I wonder if being too reductive can obscure the ways things work relationally i.e. the challenge will be sustaining the 'positive' outcomes of the study through positive relationships."

In any event, you're very right that aspects concerning relationship building - listening, being kind, etc. - are very important elements in helping someone get over depression.

But this is a research project. The goal is to try and figure out which factors really have an impact.

Hope I was clear enough for you in my explanations ...

Holly

Hello Sabrina,

I was writing to Carole at about the same time you were writing your reply to my post. Thanks very much for giving me feedback on the scales I've chosen. Yes, I think you're very right, that adding a control group is essentiel. However, in order to really ascertain that it is not just the therapeutic alliance that is the primary effect, I think I would have to do the same amount of time with the control group as with the experimental group. It's just not the same playing field if you spend 30 mn with the control group and 120mn with the experimental group.

But your post really confirms for me that I have to have a control group. The problem I have is, that as a student, it's really hard for me to type up all these conversations. And that has to be done. Do you know of a software (not too outrageously expensive I hope !) that converts spoken word directly from a recorder to a computer ?

THAT would help me enormously !

Thanks very much in advance....

Holly

PS: How lucky you are to be doing your studies at UC Santa Barbara....

Dear Anirudh

I do hope that you will follow up with a reply to some of the suggestions you have made. I have to admit I have a hard time understanding when someone says a research project should be based on x or y factor and then doesn't explain why. So, still waiting on your feedback...

Holly

Dear Holly,

Considering the population you are studying and the goals you are trying to achieve, I would suggest increasing the time for your individual interviews to one hour to enable building rapport with each participant and give each individual time to tell you their story in response to the questions in your research study.  The elderly have much to say and will take time to say it to a willing listener.  The researcher requires patience and a good ear to guide the conversation and capture the nuggets that will ultimately contribute to your findings.

Creating your interview questions will be one of the most important parts of your project and I suggest doing a pilot to see how well they work.  It is worth the time invested to tweak the questions and polish them until they flow for your participants.

For mixed methods data analysis, Dedoose is an inexpensive software you may want to check out and might find very useful.  I found it to be fairly intuitive for the narrative analysis of the stories my participants told in my dissertation research.

Best wishes to you in your study!  

Hello Gloria,

Please forgive me for not replying sooner. I did not know I'd gotten another reply. (I just happened to look back on the question.) I agree with you that more time will be needed for the interviews and of course that the questions are key. I have done a pilot interview which revealed a number of glitches I hadn't thought of and which also enabled me to feel more at ease in the interview process.

I also checked out the Dedoose website and may very sign up as it looks very good. This is particularly helpful as I have almost no background support on mixed methods.

Thanks very much for your help.

Holly

Dear Carole,

Firstly, thanks for the references. I will definitely be using the mixed methods article you gave a link for. Currently, I have no practical guide to doing research this way, so it will be very useful for me. I hadn't seen the "onion" image to breaking down research approaches.

At the risk of taking up too much space, I'm going to go into some detail here. Because I've painted myself into a research corner and can use any help I can get.

My initial goal of testing a variation on Seligman's "3 good Things" exercise from the positive psychology approach seemed really ideal with this sample of older people. It's never been done before  in France and there is to my knowledge only 2 other studies that have done something similar (German and Hong Kong study). I had variations on the exercise (one group would write 15mn per day on the 3 good things, another would write on difficult experiences in the past and the qualities, strengths the person had to overcome those difficulties. A final control group would write 15mn per day on a neutral topic.) AT this point, the methodology was experimental and more quantitative.

The nursing home where I'm doing the study is located in the Cévennes area of France which is very Protestant and has particular traditions and values that set it apart. The people are far more reserved. They found the idea of writing about the good things that happened to them during day way too strange. Also, there were physical limitations (many can't write because of arthritis or cognitive limitations). I wanted to keep my sample to people with a Mini Mental State of minimum 20. But there were too few subjects who met all the criteria.

So I had to radically change the methodology. The exercise now is to focus on difficult past experiences and the qualities, strengths the interviewee can identify that helped him or her to overcome them. The approach is much more qualitative and exploratory with 4 interviews of 30 - 45mn spaced out over 2 weeks. The control group is to spend the same amount of time talking with other subjects on any topic of their interest. At the same time, I wanted to keep the experimental measures to see if there would be a reduction in depression levels and an increase in affect (pre and post tests immediately after the intervention and 6 weeks later : CES-D depression scale, Positive and Negative Affect Scale, Diener's Satisfaction with Life Scale)

After doing a pilot example with one subject, I saw that the results were positive and that it was therapeutic for the person. I also so that there is no way to distinguish if the results are due to the intervention (focus on positive strengths in overcoming adveristy) or if the results came about because of the therapeutic relationship created during the interviews. Other than the Strengths Inventory (VIA) test, which is way too long for these subjects I don't know of any other test that would permit me to isolate the intervention as the active variable producing results.

So you see, I'm in a bit of a quandry here. If you or anyone else has some suggestions on how to help, I would be very, very grateful indeed !

Holly

Hello again to you,

Yes, I would have been in really big trouble if I didn't have the answers to those questions before starting my research. In fact, I talked about these aspects at the beginning of this post.

Rationale/purpose : French nursing homes all now have psychologists. (This is a very good thing ! I'm surprised that in the US we have social workers taking on both roles). There are very high rates of depression among residents. Psychotherapy in the classic sense isn't feasible because the psychologist can't meet the need. However, shorter interventions might prove very useful in this context. I made the link to positive psychology interventions which might reduce  depression levels in this population. They are also potentially feasible for the psychologist to implement. Internationally, very little research has been done in this area and in France it's absolutely novel. (My master's thesis director who is also a professor of research methodology had never heard of Positive Psychology research...)

Hypotheses : I'm doing this quickly because I have to get back to studying for my exams : PP intervention (interviews) will lower depression levels and increase positive affect. The tests being used measure these aspects. None of this is statistically valid because the sample is too low (4 to 6 experimental subjects and an equal number of controls); I'm alone on this and as it is, the transcriptions for these interviews are going to be a nightmare. (This is why if anyone could tell me of a recording system that transfers data directly to computer it would be a godsend for me. Otherwise I have to do it myself and pay someone to help.)

There's also the qualitative exploratory approach to analyzing the interview content. Ideally, once Iget all this data transcribed, a thematic content analysis will be done. What kind of strengths will they identify ? Because they are depressed, will they have problems identifying strengths ? Is the fact that the interviews focus on exploring positive strengths sufficient to help them to do so ? What difficult life experiences will they identify ? Etc...(An aside : I admit I feel ill at ease analysing the qualitative aspects because I have to do it in French. The French are masters at "philosphizing" qualitative analyses.  Ok, it's beside the point !)

I hope I have been sufficiently clear. It is always helpful to review the objectives of the research.

Best and thanks again for your feedback !

Holly

Dear Carole,

Thanks very much for the references for the transcription. No, our university doesn't provide voice recognition software, so I will look into what you've given me.

Granted, I will get immersed in the data by directly typing the  experimental interviews. But typing around 8 hours of conversation on any topic (the control group) won't improve my life much !

Also, thank you for the references. I had one but not the other two.

People have been so generous with trying to help me. Thanks again so much for your helpful input.

Holly

PS : Be careful when you use the verb "jouir" in French. There's a sexual connotation there !

Hi Holly,

You can consider the use of picture-based scales. For example questionnaires with pictures in place of text... 'smiley faces'; " unhappy"; "happy" etc. This type of method is used by psychologists and researchers in situations were reading ability might create barriers. 

Best Wishes.

Hi Holly, Regarding problem #3, if you have a casual conversation with 4 control subjects, that does not involve the intervention, you can compare the results to the experimental group to see if there is a difference. This would resolve that problem.

Hello Nana & John,

Nana, if I understand correctly, you're proposing that I use a picture-based scale to measure depression/affect pre-post intervention ? Thank you for the suggestion, but I am already using scales that have very good discrimination (CES-D, PANAS).

John : of course, that's the whole point of the control group. But I really thank you for your input because I think maybe unconsciously I was kind of thinking that simply by spending time talking about any subject with the control group, their scores would improve simply by the fact that they are very lonely and their mood would improve due someone who is taking the time to really listen to them. I shouldn't necessarily assume that. Your post puts me onto a new idea about the control group : it's not "controlled" enough if I simply offer them the possibility of discussions  on the topic of their choice - specifically because they have identified me as someone able to deal with their psychological problems (in which case they would be more willing to open up to me in this area). In order to really create a "clean" control group I should come up with a minimum of neutral direction for their interview time. I'll really have to re-think this. Thanks for putting me on the right track of thought !

Best

Holly

Holly