Conflict, trauma and mental health: how psychological services in Northern Ireland address the needs of victims and survivors: interviews with victims and survivors (Report 4)

Aim
The aim of this qualitative part of the overall study was to seek insights from victims and survivors of the conflict who have accessed psychological therapies from organisations funded by the VSS.

Method
A semi-structured interview method was chosen to explore this research topic. The semi-structured interview questions, participant information sheet, consent form and invitation to participate can be found in appendices. The participants were recruited using purposive sampling (Sarantakos, 2005),whereby those participating were selected according to agreed criteria. The sampling frame for this selection was: 10 individuals who had experienced conflict-related trauma and attended VSS funded organisations for psychological therapy.

Participants
This study aimed to employ a stratified method; we asked three VSS funded organisations to select three service users who are no longer attending a VSS organisation for psychological therapy. In order to explore the convergences and divergences of experiences, we requested that organisations use their CORENET data to select participants based on a review of the service user's presenting problems post-treatment. Each organisation was asked to select: a) One service user who identified on their assessment form that the severity of their presenting problems (post-treatment) was causing minimal/mild difficulty. b) One service user who identified on their assessment form that the severity of their presenting problems (post-treatment) was causing moderate/severe difficulty. c) One service user who had an unplanned ending to treatment. Based on the interview findings, we believed that there were approximately, six service users selected from category 'a', three from category 'b' and one from category 'c'.

Thematic analysis
Thematic analysis was used to explore the perceptions of individuals who have been subject to conflict-related trauma and their experience of psychological therapy. Thematic analysis is widely used in qualitative studies and seen as a foundational method of qualitative analysis through the emergence of key themes (Braun and Clarke, 2006). Boyatzis (1998) confirms that this method can be used to construct meanings while also producing explorable observations.

Method of analysis
A coding structure was designed, and the data coded to anticipate emergent themes (Bazeley and Jackson, 2013). The themes and issues addressed in the interviews have been linked together under a category system (Burnard, 1991). In analysing the data patterns, differences, themes and sequences were initially identified. Collected data was then coded, conceptually organised, interrelated, analysed and evaluated. Methodological insights from Braun and Clarke (2006) and Burnard (1991) were used during open, focused and theoretical coding.

The limitations of the research
It is widely recognised that considerations of research quality, particularly in exploratory qualitative research, are essential. However, as this methodology explains, and as Oakley (2000) notes, the distinguishing mark of all 'good' research is the awareness and acknowledgement of potential error. An inherent aspect of the use of qualitative research methods which explicitly calls reliability into question is the small sampling when compared to quantitative methods. Although these narratives are illustrative of the experiences of victims and survivors, the themes that have emerged (when triangulated with other data) will potentially inform service provision and help to improve the quality of care for those who have experienced conflict-related trauma and are seeking psychological therapy.