From my personal, professional interest to qualitative research methodology

My personal journey from a primary school teacher to special education, education psychology and therapies to a “multidimensional”, “holistic”, “transformative” rehabilitator, i.e. ‘conductive education teacher’ was long but direct. The focus on that ‘slice’ of the society which suffers a lot and struggles to find friendly and reliable professional help, evolved from an empathetic personality and a personal interest. Once I had learnt Conductive Education (CE), my mind slowly moved from a sceptical empiric dualist position increasingly towards a holistic one, where things can be looked at “in the round”. During studying CE at the International Peto Institute, Hungary, something very simple to the eyes but constructively so complex to the mind was unfolding in front of me. One very interesting thing I realised was that ‘Butterfly-effect’ (introduced first by Edward Lorenz in Does the flap of a butterfly’s wings in Brazil set off a tornado in Texas 1972 which highlighted that small variations of the initial condition of a dynamic system may produce large variations in the long term behaviour of the system) was real in terms of the holistic links between the various parts of the World. In the World we humans participate as part of the whole whilst functioning individually as a whole. The ‘whole’ builds up from many smaller “elements”. These elements can be found in the smallest and largest parts of our body and brain. Where, de facto, numerous simultaneous inputs can cause turbulence and change output, the overall system is able to accommodate such changes. Put simply, a global approach which is able to get in touch with the physically disabled person’s complex needs is more likely to bring about change in their condition than any other method. I thought I would find this approach in CE.

As a young professional in the field of rehabilitation I shortly realised that CE was very different from any traditional services as it takes for granted the use of pedagogy and deals with the person as whole and not only their physical needs but emotional, social and often any other needs as well. The new, unknown, professional position of the rehabilitation of the central nervous system damaged patients produces a professional loneliness and a sort of ‘professional racism’ for CE providers. The feeling of the loneliness and not being accepted, forced me into thinking harder about my own position and that of my fellow professionals. I noticed much misunderstanding about CE and I also found a colossal lack of adequate research in this area. All of these factors challenged me to look critically into the characteristics of CE again as experienced conductive education teacher and try to choose an adequate methodology to explore it.


“The holistic science includes more 'participatory methodology'. It validates the inner subjective experience as well as objective physical sense data. The worldview of wholistic science does recognize the intrinsic nature and value of the human inner life. With the scientific recognition of the inner life, the wholistic worldview permits a global view of the human being as a 'totality of body, soul and spirit.' Scientific discoveries of the interrelations of body, soul and spirit are reflected in a new educational paradigm. The new pedagogical methodology recognizes that the child's learning experiences and learning difficulties are global in nature. The global view of the child and the learning process can provide a secure theoretical and practical foundation for a holistic education that directs itself to educate the whole person for the whole of life." (Gerald Karnow, "Educating the Whole Person for the Whole of Life," Holistic Education Review vol. 5 no. 1 (Fall 1992): p. 64)

I suggest taking Karnow’s approach towards a better understanding of education of the person, and transfer it to the education of adults and hence to the rehabilitation of disabled people.

Thus, this methodology should fully support the alternative view of the self, which is responsive to issues of relationship, emotions and bodily functions etc. Such a concept would highlight the less visible aspects of the studied object as a result of the research.

An holistic way of thinking comes from the philosophical position of the researcher, which has an impact on the choice of methods used to gather and analyse data for the research. Martin Heidegger, the german philosopher, believed that one makes sense of the world by being in it, and not by being detached from it (Maggs-Rapport, 2001). “Dasein”, i.e. ‘being in the world’, is one of the main concepts of his hermeneutic phenomenology. Dasein is the experience of time and space. It is the experience of the whole without separation between the person and their life-world and where relationships are counted as part of the existance. Hermeneutic Phenomenology as research method, however, needs to be expanded.

Discovery has been the aim of science since it was first practised, but how those discoveries are made has varied with the nature of the subjects being studied and the era in which they took place. Knowledge and understanding have taken many forms. In areas ranging from sociology and education to healthcare there has been a move towards qualitative paradigms since the World War II. Out of the quantitative – qualitative paradigm battles of the 1980s, qualitative researchers took their place at the table. Qualitative methods of data gathering and analysis have gained popularity. (N.K. Denzin 2009) “Qualitative research - according to A. Strauss and J. Corbin in Basic Qualitative Research (1998) – [we mean] any type of research that produces findings not arrived by statistical procedures or other means of quantification. It can refer to research about a person’s life, lived experiences, behaviour, emotions and feelings as well as about organisational functioning, social movements, cultural phenomena, and interaction between nations. Some of the data maybe quantified, as with a census, or background information about the people or objects studied.“

In addition to the measurable benefits of Conductive Education -Brittle N, Brown M, Mant J, McManus R, Riddoch J, Sackley C. at the School of Health Sciences, University of Birmingham, Edgbaston, Birmingham, UK. Short-term effects on mobility, activities of daily living and health-related quality of life of a Conductive Education programme for adults with multiple sclerosis, Parkinson's disease and stroke, Clin Rehabil.2008 Apr; 22(4):329-37) - I believe it is important to investigate research which might shed light upon the other possible benefits of the method, therefore, qualitative research methodology seemed to be a promising methodology to use. The key difference between quantitative and qualitative methods is flexibility. Qualitative methods allow greater spontaneity and adaptation to the interaction between the researcher and the study participant(s). The relationship is less formal than in quantitative research. Participants have the opportunity to respond more elaborately and in greater detail than is typically the case with quantitative methods. In turn, the researcher has a greater opportunity to study the possible variety of dimensions of lived experience of the participants without prejudging the format of the result, and can respond immediately to the answers by tailoring subsequent questions to information the participant has provided.
For more than a quarter of century narrative and dialogic methods have reshaped qualitative inquiry and can offer an alternative solution for scholars investigating the lived experience of the individual at a deeper level. Since CE is aiming to develop the physically disabled person as a whole in group setting, I consider that a combined use of narrative and dialogic methods could well facilitate the investigation the relationship between the cognitive, social, emotional and functional dimensions of the delivery.

Clandinin and Connelly in Narrative Inquiry: Experience and Story in Qualitative Research (San Francisco: Jossey-Bass Publishers, 2000), 3 define Narrative Inquiry as a method that uses the following field texts as data sources: stories, autobiography, journals, field notes, letters, conversations, interviews, family stories, photos (and other artifacts), and life experience. It implies that knowledge itself is considered valuable and noteworthy even when known by only one person. Donald Polkinghorne writes in Narrative Knowing and the Human Sciences (Albany: SUNY Press, 1988), 132. that Jerome Bruner, the american educational psychologist’s approach places the narrative in time, to “assume an experience of time” rather than just making reference to historical time. Thus narrative captures the emotion of the moment described, rendering the event active rather than passive, infused with the latent meaning being communicated by the teller.
Narrative ,therefore, could shed light onto a person’s lived experience and emotions.
John Dewey explains Narrative Inquiry in terms of the nature of experience. Dewey viewed experience as having both social and personal meaning, believing that people should be analyzed both as individuals and as part of a group or in a social context. In his view nothing and no one exists in isolation. His ideas directed me towards dialogic inquiry. In as much as the paricipants working in group setting have a similar experience of the delivery of CE, they are probably best placed give a view on the investigated dimensions and the link between them.
In David Bohm’s opinion, dialogue is a process of direct face-to-face encounter that insists on facing the corporeal lived experience. “It really means to break things up. It emphasizes the idea of analysis, where there may be many points of view, and where everybody is presenting a different one – analysing and breaking up. That obviously has its value…” in On Dialogue (London and New York, 1997) 6-7.
Richard Kearney in Strangers, Gods, and Monsters (Routledge, 2003) highlights the dialogic dimensions. It suggests that a narrative configuration of the self involves not only a relationship of self to self but also a relationship of self to other. This relationship of self to other maybe referred to as intersubjectivity – relation and response between the subjectivity of the self and subjectivity of the other. This is achieved through dialogue. Through dialogic inquiry we could gain knowledge of the participant’s lived experience in the group and the emotions involved ,giving them a chance to share their individual experiences and further discuss those subjects.

I conclude that a combined use of narrative and dialogic methods could well facilitate the investigation into the relationship between the cognitive, social, emotional and functional dimensions of the delivery of CE.


The research study raises ethical matters which need to be addressed.
At most universities, and certainly at LJMU, before beginning research we need to obtain ethical approval for our research.

“In many ways, this process of obtaining to negotiate our inquiries works against the relational negotiation that is part of narrative inquiry. However, as an institutional requirement, obtaining ethical approval is necessary. This places inquires in a catch-22 position.”
Clandinin and Connelly in Narrative Inquiry: Experience and Story in Qualitative Research (San Francisco: Jossey-Bass Publishers, 2000) 170

“For decades, oral historians have promulgated high ethical and professional standards, including their ethical requirement to obtain informed consent prior to conducting an interview and a signed legal release at the conclusion of the interview. … A humanities-based, interpretive inquiry model…would stand alongside a revised biomedical model. A radical rethinking would produce an inclusive, ethically empowering model that would be applied to all forms of inquiry.”
Norman K. Denzin in Qualitative Inquiry under Fire, Left Coast Press Inc, California, 2009) 297

“Indeed, ethical research is perhaps best understood as part of an ongoing dialogue which not only precedes the investigation but, while participants and researchers alike my contribute to the ‘conversation’ for a short time, will also continue after it. Greenop Darren, LJMU, 2008

I am at the stage of obtaining ethical approval for my proposed research and, like many other qualitative researchers, I simply try to follow the format of the given form and fill out the required sections. However, during this exercise I have come across some difficulties. To me, one of the biggest concerns is how to outline narrative and dialogic interviews. I would be more interested in what the participants will say rather than giving them suggestions as to what to talk about. The ethical form requires an outline in advance I look for guidance on the subject of obtaining ethical approval in case of narrative and dialogic inquires.

Comment

As you often say to me, “You took the words right out of my mouth”!Sitting, standing or kneeling on plinths is a pet subject of mine too. One which until now I have not really discussed with anyone.I have done all of these today, the standing, the kneeling and the sitting on plinths. Not because of my age, although I do now belong to the older generation of conductors, but because of what you described as “health and safety” regulations. It was the only way to do my work so I could stay in one piece. The only way to do my work so the client felt safe too.The broader issue here however is giving consideration to the private space which is our client’s. Whether they are on a plinth or on a chair, standing or walking, they have a space around them which we need to respect. We must respect the fact that although we enter that space to help clients achieve their goals we must be careful not to encroach on their personal space unnecessarily.There is a very fine balance between keeping our own bodies healthy while giving the help needed for our clients to achieve their aims and at the same time keeping our distance. This is what we learn through experience.Yes, we had a rigid training at the Petö Institute. We were told not to sit on plinths. We were told lots of other things too which took us a long time to understand and interpret in our own individual ways.Years of experience allow us to become flexible. The experiences give us confidence in our movements and behaviour in the presence of our clients. Through experience and observation we learn when we can enter that personal space and when we can not, and we also learn how best to do it.If I need to sit on a plinth to do my work properly I will do it, respectfully keeping my distance.If I want to sit down because I am tired, or because I want to talk to my clients at the same level, the plinth isn’t the place for me. I can pull up a ladder back chair for these purposes, there are always plenty of them about.Thanks for this posting Laci, it gave me lots to think about at work this week and opened up some interesting discussions with my clients. I expect I will report on them at a later date on my own blog.Susie
22 June 2009

To sit or not to sit that is the question...

This little ‘sitting’ thing has grown into a big dilemma in my mind throughout many years of CE experiences working in different places and countries. Now I have decided what it is I believe and I have decided that I will stick to my own ideas whatever the absolute truth is.
The question is: to sit or not to sit on the plinth during CE delivery. Well, I will answer it first as I learnt it and then, think about it twice. This little problem has different angles from which to approach it. During my training at the Peto Institute, Hungary, I was taught not to sit on the plinth in any circumstances because the plinth belonged to the client’s personal territory and it was his/her personal education tool and this we highly appropriated in the conductive education system. Parallel to this I worked as a teacher at the State Institute of the Motor Disabled, Budapest, where there was a CE department and where I met great, enthusiastic, passionate older generations of conductors who learnt from Andras Peto himself. I learnt a lot from these conductors and it was here that I feel I was “made” into a conductor.
Some of these conductors were, interestingly, occasionally sitting on the plinth during lying programs or when clients were also sitting on it in order to facilitate them. When I asked them why they were doing so they would tell me I would learn why after 20 years of service. Their answers were, of course, indications of their own state of health.
Since I am graduated from Peto Institute, I worked in different CE environments in Hungary, Germany, Singapore, USA and in the UK. I met many different points of views. At the majority of places it was taken for granted that to sit on the plinth was OK in any circumstances and there was just no need to open up a discussion about it. In my opinion the worse has happened here in the UK when one of my former colleagues sat on the plinth when it was being used as a table with children sitting around it.
So after many years of experience, I decided to put this little thing in its rightful place. On the one hand, I highly appropriate the philosophy of CE and I try most of the time not to sit on the plinth, however, as the older conductors led me to imagine, there are some very questionable parts of this philosophy from the point of few of a conductors’ health.
Just imagine how unhealthy it is to lean forward and maintain this position for longer periods of time while facilitating, when the client is on a low plinth or when the client is very heavy and you actually propose to lift parts of his body in this position. The health and safety based manual handling book says that you must avoid such movements. Unfortunately, I know of many conductors of my age, or older, who have been sentenced to follow a career other than CE because of terrible spine or other CE related health conditions.
A couple of years ago I did a short search to find out what has been written in our training books or what can be read about it on the Net.

The result was strange. There was no such rule written down anywhere. Nothing to say that you are not allowed to sit next to your client. So, I decided the following that I wish to declare state now:
I totally believe in the philosophy of CE. However, we need to enjoy it responsibly. If the plinth functions as a bed or a tool on which people sit or work I would consider sitting on if it is easier for me to facilitate in this way. This is not supposed to mean that I am looking for the first opportunity to sit on the plinth ‘because I am tired’ and also not supposed to mean that I put my shoes into the client’s face, etc., but it means that I have to be confidentially responsible for my own health as well as that of my client.
Why am I posting this now? Things have changed in my professional life and turned full circle so that I am now working with freshly graduated conductors. They now tell not to sit on the plinth. Why? For all the same reasons I was told before. It feels like I am looking into a mirror. I see myself a decade ago when I was also 'fighting' for all of those things I was taught. They are great people and I assume great professionals too. Still, I think they do not yet have the kind of independence or the confidence that one acquires through years of experience. This confidence often brings with it flexibility and the ability to move beyond different boundaries. I strongly sense the rigid training effects behind the issue. We all know that. It is really so sweet to discuss such things.
Similar situations have occurred on official university research registration documents. I called clients patients. I had to do this for several different reasons. The freshly graduated conductors started to tell me that the clients were not patients but participants. :)

Between Satisfaction and Pleasure

Passion lives somewhere between two very positive emotions – satisfaction and pleasure. We often do not distinguish between these two similar emotions. A massage or a bottle of red wine produces the positive emotions of pleasure, however, satisfaction points to something much deeper. Buddha suggested that the things that seen to lead to real satisfaction have something of investment quality to them, such as building a house, creating a child, or writing a book. Some people experience this feeling of satisfaction and passion they produce. Mihaly Csikszentmihalyi a psychologist who interviewed thousands of people of all ages and asked them to describe their highest moments of satisfaction. According to Csikszentmihalyi, when people experience their highest moments of satisfactions and are experiencing ‘flow’, they describe the psychological components as: ‘The task is challenging and requires skill’, ‘We concentrate’, ‘There are clear goals’, ‘We get immediate feedback’, ‘We have deep, effortless involvement’, ‘There is a sense of control’, Time stops’.
Interestingly, none of these components are about the experience of pleasure per se. Rather, when we are absorbed in flow, it is about total engagement and a loss of self-consciousness. In other words, when we are wrapped up in flow we are investing in building emotional capital that we can draw on to sustain our passion and therefore our energy. In contrast, to seeking the immediate rewards of pleasurable experience, to build your emotional capital you need to pay attention to the elements of the flow experience that fuel your passion and produce your most rewording satisfactions. People whose motivations are intrinsic exhibited more interest, excitement, and confidence, as well as greater persistence, creativity, and performance than those who motivated largely by external demands and rewards. Passionate people are productive, persistent, high performers. These people look for creative challenges. They also display a constant energy for discovering how things can be done better. One thing is sure, if you have passion for what you do, then what you do is powerful. I saw conductors to have that power, passion when I enrolled Peto Institute in the early nineties. They absorbed me into ‘flow’ several times and that was an extraordinary experience. Then, later, I missed them for long. It felt like; they would have died out. I worked at different work places where individuals were strongly fighting for their individual aims and somehow they lost energy, concentration, effort, but most importantly self control on human strength. It made me really happy to meet someone again, in last November, who was young, powerful and passionate - somwhere between satisfaction and pleasure. Even more happy now, I have been working with some of those....

CE research

A konduktiv pedagogia tudomanyos vizsgalatara keszulve, osszeszedve gondolataimat, el kellett dontenem, hogy mibe is kezdjek. Nehany dolog a kezdetektol fogva vilagosan, komoly teret nyerve elmemben, eloretolakodva arra "kenyszeritett", hogy ne hagyjam ki oket, vagy bele se fogjak "holmi" kutatasba. Megis, szamtalan dolog befolyasolja ilyen helyzetekben dontesunket. A tajekozottsag, olvasottsag jol jon(ne) ilyenkor, de azzal kerulunk legkevesbe kozelsegbe, amit nem ismerunk:), tehat sokszor tenyleg a tanulasban es kutatasban is a szerencse legalabb akkora szerepet jatszik - meglatasom szerint- mint barmely biologiai jellegu kiserleti kutatasban. Azzal tobbe, kevesbe tisztaban vagyok, hogy amiota a konduktiv pedagogia rendszerevel talalkoztam (1991), egyre tagulo holisztikus felfogasban elek. Azzal viszont kevesbe szembesultem, hogy masok egeszen tavol lehetnek ettol a nezoponttol. Egyszeru megfogalmazasban barki lehet holisztikus, ellentetben a professzionalis valosaggal: kevesen akadnak, akik tokelyre kepesek ezt a napi viszonylatra is munkassagukban 'redukalni'. Minden, mindennel osszefuggesben all. Igen. Ezt azonban nagyon nehez a dolgok melyere hatolva, a dolgok osszesegere alkalmazni a hetkoznapi valosagban. A komplexitast meg lehet ismerni, akademikusan tanulni, megis; semmi egyeb nem vezet a totalis megerteshez jobban, mint a tapasztalati praxison keresztuli megismeres. Ennek a nezetnek es eletfelfogasnak kialakulasahoz jelentosen jarult hozza a Peto Intezeti kepzesem, az akkori kepzesi modell ( elmelet es praxis egyensulya szamomra), valamint akkori eletformam: szaktanari tanitas a Mozgasserukltek Allami Intezeteben, sok es mindenfele onszorgalombol vegzett gyakorlat a Peto Intezet szamtalan csoportjaban + termeszetesen a kotelezo kepzesi gyaklorlatok es tanorak. Itt mindefelekeppen megjegyzendo nehany kollega emberfeletti, vagy inkabb abszolut sallangmentes, nyiltszivu emberi szolgalata; a tudas feltekenyseg nelkuli, emberbarati atszarmaztatasa. Ha neveket kezdenek el sorolni, akkor ez az oldal mara nem fejezodne be, s ha valakit veletlenul kihagynek a sorbol, akkor nagyon nehezen esedezhetnek bocsanatert. Tobben ugy lenditettek at valoszinutlen, nem aposztrofalt krizis, vagy tanulohelyzeteken, hogy eszre sem vettek (vehettek) dialogusuk nagyszeruseget. Megis engedtessek meg kulonos tekintettel arra nezve, hogy nelkuluk aligha valhattam volna konduktorra, hogy Makkai Erzsebet es Horvath Jantje nevet es faradhatatlan munkassagukat emlithessem az elsok kozott...

A holisztikus, komplex eletfelfogas, a kulonbozo elethelyzetek ismerete, iskolak, rehabilitacios intezetek mindennapi praxisa, nehany elottem es ismeretemben vegzett kutatas es azok eredmenyei, ugymond predesztinaltak arra, hogy valasszak. Ez szamomra fekete-feher uggye nott. Valasszak kutatas egy uj iranyban, vagy nem kuatas kozott... folyt. kov.

I met with this just recently

Sorry, I have never found who wrote this bit but I felt to share it because I feel it is so truth.

“…when Freire talked of love, he suggested it was an energy that extended to a love for all humanity, an energy that fuelled the determination to sustain action for social justice: ‘Love is an act of courage, not fear …a commitment to others …[and] to the cause of liberation’ (1972:78). His belief was that the process of dialogue, so central to the transformative project, could not exist ‘in the absence of a profound love for the world and for people’ (1993:70).”

We need our risks

They want us to avoid risks, however, WE NEED our risks at CE: because this is the only way to learn orthofunction...