8 Designing Qualitative Research Article 2

Please read instructions thoroughly!

 This week, you will submit the annotation of a qualitative research article on a topic of your interest. Narrative, ethnographic, grounded theory, case study, and phenomenology are examples of types of research designs or approaches used in qualitative research. 

 An annotation consists of three separate paragraphs that cover three respective components: summary, analysis, and application. These three components convey the relevance and value of the source. As such, an annotation demonstrates your critical thinking about, and authority on, the source topic. 

• Before you read the full article and begin your annotation, locate the methodology section in the article to be sure that the article describes a qualitative study. Confirm that one of the types of qualitative research designs or approaches, such as narrative, ethnographic, grounded theory, case study, or phenomenology, was used in the study.
• Annotate one qualitative research article from a peer-reviewed journal on a topic of your interest.
• Provide the reference list entry for this article in APA Style followed by a three-paragraph annotation that includes:

  A summary
  An analysis
  An application as illustrated in this example

• Format your annotation in Times New Roman, 12-point font, double-spaced. A separate References list page is not needed for this assignment.

Qualitative Article

 Neale, J., Allen, D., & Coombes, L. (2005). Qualitative research methods within the addictions. Addiction, 100(11), 1584–1593. https://doi-org.ezp.waldenulibrary.org/10.1111/j.1360-0443.2005.01230.x 

An Example is attached

ADDICTION AND ITS SCIENCES

Qualitative research methods within the addictions

Joanne Neale, Debby Allen & Lindsey Coombes

School of Health and Social Care. Oxford Brookes University, Oxford,

UK

Correspondence to:

Joanne Neale

School of Health and Social Care

Oxford Brookes University

Jack Straw’s Lane

Marston

Oxford 0X3 OFL

UK

Tel: 0.1865 4 8 2 6 0 0

Fax: 03 865 4 8 5 2 9 7

E-mail: )neale@brookes.ac.uk

Suhmitted 24 March 2 0 0 5 :

initial review completed 19 April 2005:

linal version accepted 24 May 2005

BACKGROUND

In 1998. Fountain & Griffiths conducted a content anal-
ysis on papers published during 1 9 9 5 – 9 6 in three lead-
ing international drug publications: Addiction, Drug and
Alcohol Review and Addiction Research (Fountain & Grif-
fiths 1998). Of the 291 papers scrutinized, only 17 (6%)
reported on studies that had wholly or partially used
qualitative methods, fn Addiction, the proportion (at 2%)
was even lower. Addiction published just three qualitative
papers in 2004: Amos etal, (2004); Furst etal. (2004);
and Rhodes. Davis & Judd (2004). Such marginality
prompts uncomfortable questions, fs qualitative addic-
tion research only a minority interest.’ Are qualitative
analyses somehow less informative or less valuable than
quantitative investigations.’ Or do some addiction jour-
nals directly or indirectly militate against the publication
of qualitative research.’

It was with interest, then, that we received an invita-
tion to write a review of qualitative methods for Addiction.
Our brief was to produce a statement that would explain
what qualitative research is. highlight its strengths and
weaknesses, and outline some of the important principles
and processes involved in its undertaking. The offer pro-
vided reassuring evidence that Addiction does welcome
qualitative work and recognizes its importance. In
responding to our task, we hope that we have written a
paper that will especially interest and assist newcomers to
the qualitative field. For others, our intention is not to

offend by reporting what may sometimes seem obvious.
The aim is rather to offer a reminder that we need to see
a high standard of qualitative work appearing more often
in journals such as Addiction.

W H A T IS QUALITATIVE RESEARCH?

Qualitative research has been the historical bedrock of a
number of social science disciplines, such as anthropol-
ogy and history. However, interest in the approach has
grown in recent decades as more researchers in basic
disciplines and applied fields have adopted a qualitative
paradigm (Miles & Huberman 1994. p. 1). Within the
addictions, qualitative studies have been occurring regu-
larly since the 1920s. In fact. Feldman & Aldrich (1990)
suggest that Herodotus’ fifth-century account of mari-
juana use in Scythian purification rites is a very early
example of a qualitative ethnography. Over the years,
qualitative methods have provided drug researchers with
valuable techniques of scientific inquiry. In return, drug
taking has provided qualitative investigators with an
ideal arena in which to apply and develop their methods
(Fountain & Griffiths 1998).

Although defining qualitative research is not straight-
forward (see, for example: Denzin & Lincoln 1994: Lam-
bert, Ashery & Needle 1995), it is generally accepted that
qualitative researchers study phenomena in their natural
settings and their aim is to understand how people
account for, take action and otherwise manage their day-
to-day situations (Miles & Huberman 1994). As Rhodes
(2000) has argued, qualitative addiction research seeks
both to describe the social meanings that participants
attach to drug use and the social processes by which such
meanings are created, reinforced and reproduced. In par-
ticular, qualitative research focuses on exploring the
details of people’s lived experiences and on appreciating
why drug-using behaviours occur and how they are
understood in different contexts among different social
groups (Rhodes 1995).

Frequently, qualitative research and quantitative
research are described in oppositional terms (Martin &
Stenner 2004). Qualitative work is perceived as falling

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Qualitative research methods within the addietions 1585

within a ‘realist’ tradition, utilizing data that are ‘deep’
and ‘rich’ to explore ‘subjective understandings’ and ‘val-
ues’. In contrast, quantitative work is associated with a
more ‘positivist’ epistemology. employing ‘hard data’ to
focus on ‘objectivity’ and ‘fact’ (ibid.). Important differ-
ences between the two methods are evident. For example,
qualitative studies are typically less structured than
quantitative ones and tend to take more time to complete.
They generally yield much larger volumes of data from a
smaller number of individuals. Additionally, analysis is
more explicitly Interpretive, creative and personal
(Walker 1985).

Despite this, qualitative and quantitative studies can
usefully be undertaken together and it is therefore hetter
to see them as complementary rather than adversarial
approaches (McKeganey 1995). For example, qualitative
work can be performed as a preliminary to quantitative
research. This might involve using qualitative techniques
to provide background information on issues and con-
cepts to be investigated in a subsequent survey. Qualita-
tive methods can also supplement quantitative work.
Here, qualitative data might be used either to validate
findings from a quantitative study (‘triangulation’) or to
help build a wider picture of a particular phenomenon
under investigation. Thirdly, qualitative research can
complement quantitative work, for example hy exploring
complex phenomena or areas not amenable to quantita-
tive inquiry (Pope & Mays 1995).

DIVERSE TECHNIQUES AND
DATA SOURCES

In practice, qualitative research is an umbrella term that
is used to describe a variety of methodological
approaches. Space does not permit an exhaustive
account of what might be involved, but a brief review of
some of the main qualitative techniques and sources of
data that have been employed by drug and alcohol
researchers in recent years will illustrate some of the
diversity of the qualitative paradigm.

Techniques

Ethnography has played a particularly important role in
qualitative addiction research. The ethnographer seeks to
describe the lives of a group of people in a way that is
faithful to how they see it themselves (McNeill 1990,
p. 64). The intention is to understand the underlying
patterns of behaviour and meanings of a culture—
including the tacit rules, symbols and rituals that guide
group norms (Geertz 1973: Agar 1986, 1996). Ethnog-
raphers depend heavily on observation and, in some
cases, complete or partial integration into the society

being studied. They also often conduct in-depth inter-
views with community members and examine materials
or artefacts that are relevant to people’s everyday lives.

In the field of alcohol research, there is a very long
tradition of ethnographic studies that have mostly been
conducted by anthropologists working in remote regions
of the world (SIRC 1998), For example, Lemert examined
the relationship between drinking, alienation and cul-
tural change among North-west coast Native Americans
in the 1950s (Lemert 1958), More recently, Eher (2000)
explored female identities, roles, relationships and
sources of power in the context of women and drinking in
a Mexican community. Ethnographies of illicit drug use
have predominantly heen conducted in the United States
and one of the most often-quoted is a study of marijuana
users hy the sociologist, Howard Becker (1953), Becker
showed how social setting or context is a signilicant
determinant in how individuals become marijuana
users, as well as why they continue or desist from its use.

Other qualitative techniques (such as themed inter-
views, focus groups and open-ended questions inserted
into quantitative surveys) are conducted during one-off
contact with research subjects and have the advantage of
being less time-consuming and cheaper to conduct than
a full ethnographic study. Equally, their fiexibility enables
them to generate good-quality data on a wide range of
issues from a wide range of individuals. For example, Nyg-
aard etal. (2003) interviewed young people who had
been involved in drink driving episodes ahout their expe-
riences of drink driving and riding with drink drivers,
Beich, Gannik & Malterud (2002) Interviewed general
practitioners to explore the suitability of a screening-
based intervention for excessive alcohol use, and Lawrie
et al. (2003) interviewed pharmacy customers to ascer-
tain their views and experiences of using pharmacies that
provided needle exchange services.

A further qualitative technique that huilds upon the
interview approach and has been used hy addiction
researchers is narrative research. Here, those being stud-
ied are encouraged to tell their stories and these are then
analysed in terms of their form (e.g. structure of the plot)
and content (e.g. what happened). For example, Hilte
(2000) analysed women’s recovery from psychoactive
substance ahuse hy examining the main characters in
their accounts and hy exploring how characters’ actions
impacted on subsequent events. Not dissimilarly, McKeg-
aney et al. (1995) and Hughes (1998) have used personal
stories but combined them with projective techniques in
the form of vignettes and extended vignettes. These
involve presenting study participants with a character
and setting and asking them for responses to particular
events or moral dilemmas.

Further to the above, qualitative investigators have
used hoth community engagement and action research

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1586 ]oantie Neale et a\.

to give those heing studied a participatory role in the
research process. In these approaches, local people may
help to design the study, assist in conducting the research
and contribute to feeding the results hack into local
action. Both qualitative and quantitative components
can he involved. For example, local black and minority
ethnic community organizations across England have
heen involved recently in undertaking their own needs
assessment projects relating to drug prevention, educa-
tion and treatment issues (Winters & Patel 2003). In
Scotland, meanwhile, a study of community responses to
drug use in rural Lanarkshire resulted in local people ini-
tiating a breakfast club and homework club for children
living in an area badly affected by illegal drug use and
problem drinking (Parkin et al. 2001),

Lastly, rapid assessment methods provide a good
example of qualitative and quantitative approaches being
used together. Rapid assessment methods have been
developed to exploit diverse data sources and produce
quick, practically orientatated assessments in areas
where epidemiological systems are poor (Vingoe 2000).
The first rapid assessments occurred during the United
Nations Drug Control Programme missions to Vietnam
and Lebanon (Ingold 1994; Power 1996). More recently.
Fitch etal. (2003) have conducted a rapid assessment of
drug and alcohol use in Jersey. This study involved anal-
ysis of existing data sources, key stakeholder interviews/
focus groups, a community-recruited survey and
prevalence estimation of problem drug users. Its aim was
to inform the development of strategy performance
indicators and to make recommendations for change in
existing prevention, law enforcement and surveillance
activities.

Data sources

From the above, it is clear that qualitative techniques
involve collecting and analysing one or more types of
data. Moreover, just as qualitative and quantitative meth-
ods can profitably be used together, so two or more qual-
itative techniques and data sources can be used within
one study to complement, supplement and validate each
other. The main types of qualitative data are observa-
tions, interviews and documentary materials. A useful
summary of some of the respective advantages and disad-
vantages of each of these is provided by Creswell (2003,
pp, 186-187).

Observations can be gathered in various ways. For
example, researchers may engage in roles varying from a
non-participant to a complete participant. Equally, they
may take fieldnotes on the behaviour and activities of
individuals in an unstructured or semistructured way.
These notes can then be kept in the form of a diary, an
unfolding narrative or even personal letters, Bourgois’

direct observations of the lived experiences of homeless
heroin users in San Francisco provide an important
example of the power and value of this type of material
(Bourgois 1998a,b),

Interview data are usually collected in person or
sometimes by telephone. The interview format may he
structured, semistructured or unstructured and can
involve one interviewer and one respondent (one-to-one
interviewing) or be conducted in small groups (focus
groups). Because the researcher cannot be expected to
remember all the responses given to their questions,
interviews are generally audio-recorded and transcribed
verbatim. It is the interview transcripts that are later
analysed, increasingly with the assistance of computer
software packages, Neale (2002) provides a detailed
account of analysing semistructured interview data from
a study of non-fatal drug overdose using the computer
program WinmaxPro.

Documentary materials can include newspaper arti-
cles, books, reports, casenotes and audio-visual and dig-
ital media. Cooper (2004) analysed 297 medical articles
on opiate addiction in order to explore the relationship
between US health professionals’ theories of opiate addic-
tion’s aetiology and contemporaneous perceptions of opi-
ate addicts’ race/ethnicity, social class and gender.
Gilman (1998) used Usenet news groups on the internet
to gather information about routes into heroin addiction,
and Taylor et al. (2004) analysed video data produced by
filming drug injectors in their homes and other venues to
explore how injecting practices place individuals at risk of
HCV infection and the implications of this for harm
reduction.

WHY USE QUALITATIVE METHODS?

Having introduced something of the nature and diversity
of qualitative research, it seems important to review why
it might be used. Fundamentally, it has been argued that
quantitative methods are too narrow and too reduction-
ist for studying the social world (Martin & Stenner 2004),
Human beings are purposeful, goal-seeking, feeling,
meaning-attributing and meaning-responding creatures
(Hughes 1976, p, 24). Consequently, it is necessary to
understand how they perceive and interpret their envi-
ronment if their behaviour is ever to be interpreted use-
fully. Qualitative investigations facilitate this by enabling
the researcher to understand drinking and drug use from
participants’ perspectives.

Because of their capacity to explore and explain
human behaviour, qualitative methods have proved very
valuable in demystifying drug and alcohol use and
replacing stereotypes and myths about addiction with
more accurate information that refiects the daily reality

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Qualitative research methods within the addictions 1587

of substance users’ lives. In so doing, ethnographic
research has humanized the image of the drug taker and
drinker, improved general understanding of the everyday
context of drug use and drinking, and facilitated the
development of socio-eultural perspectives on substance
consumption. This has resulted ultimately in important
new theory, policy and practice.

Thus, ethnographic research conducted during the
1950s and 1960s questioned the prevailing medical
assumption that drug addiction was a disease and drug
users were passive, anxious and inadequate people.
Instead, it showed that drug addiction was a social expe-
rience that needed to he understood and that drug users
were normal self-determining Individuals who were par-
ticipating in a life-style that just happened to be deviant
(Faupel 1991: Stephens 1991), Similarly, anthropolo-
gists have questioned the high level of alcohol problems
associated commonly with tribal and village cultures,
arguing that while drunkenness may be common, alco-
hol addiction is actually rare (Leland 1976; Heath 1982),
Furthermore, the preoccupation with problem drinking
detracts from its more pleasurable and routinized aspects
(Levine .1981),

In terms of formulating new policy and practice, qual-
itative methods were employed in the 1990s in response
to the public health imperative to reduce HIV and other
blood-borne infections linked to injecting drug use. This
was in recognition of the fact that effective interventions
needed to be based on an understanding of the complex
risk behaviours and social factors involved in drug taking
(Leshner 1998), Accordingly, various qualitative tech-
niques were used to examine injecting practices and espe-
cially the social and cultural dimensions of needle
sharing (cf, McKeganey & Barnard 1992; Grund 1993),
The rich data resulting from this work were then used to
inform the expansion of crucial harm reduction services.

Qualitative research has also been making contribu-
tions to the expanding literature on drug treatment and
its effectiveness by exploring users’ views and experi-
ences of service provision. Here, the use of qualitative
methods is underpinned by the belief that treatment is
most likely to be effective when individuals feel positive
about and satisfied with the support that they receive.
For example, Neale (1998) investigated drug users’ opin-
ions of drug workers and other service providers while
Copeland (1997) examined the barriers drug users face
when attempting to access help. In the alcohol field,
Thom etal. (.1992) used open questions and free discus-
sion to generate qualitative material on patients’ percep-
tions and experiences of clinic and general practice-based
care for drinking problems. Meanwhile, Lock (2004)
conducted focus groups to explore patients’ views and
experiences of alcohol and brief intervention in primary
health care.

Further to the above, qualitative studies have always
been invaluable in accessing ‘hidden’ or ‘hard-to-reach’
populations. The illegality of much drug-related activity,
users’ erratic life-styles and/or the social stigma associ-
ated with substance misuse mean that addiction research
often concerns hidden populations (Power 1995), Quali-
tative techniques (such as interviewing or observing ven-
ues where drugs are sold, bought and consumed)
increase the addiction researcher’s knowledge of hidden
and hard-to-reach groups. Equally, feelings of trust and
rapport emerging during fieldwork can enable qualitative
researchers to permeate the complex social networks that
link substance users and their associates together. In
addition, qualitative researchers have developed innova-
tive sampling techniques to minimize the potential for
bias in their data. For example, snowball sampling is a
carefully staged process that involves the recruitment of
new respondents through referrals from earlier respon-
dents (see Kemmesies (2000) for a full description).

As indicated previously, qualitative research is also
important in identifying emerging trends in drug taking.
According to Clatts et al. (2002), institutionally derived
sources of data used to forecast changes in patterns of
drug abuse typically omit a number of hidden popula-
tions. In contrast, ethnographic research can identify
and track new and hidden drug-using groups as well as
new and hidden drug-taking practices. One reason for
this is that qualitative researchers are encouraged to go
where the data lead them (Belgrave, Zablotsky &
Guadagno 2002), Furthermore, qualitative data can pre-
serve the chronological flow of social processes, so help-
ing to identify precisely which events lead to which
consequences (Miles & Huberman 1994), Addiction
researchers have, in recent years, exploited this strength
by using qualitative methods to explore both the increase
in drug prevalence among young people as well as the
reasons underpinning this growth (Fountain & Grifliths
.1998),

Finally, qualitative techniques are highly effective in
researching sensitive and/or illegal activities—hence
substance use and misuse in general, but particularly
very sensitive drug-related issues. Providing evidence of
this, qualitative researchers have regularly elicited
detailed, personal information on drug dealing and
other drug-related criminal behaviour, injecting prac-
tices, parenting while drink- or drug-dependent and
high-risk sexual activity. Again, feelings of trust and rap-
port arising between the researcher and research partic-
ipants facilitate discussions about intimate information.
Similarly, qualitative researchers’ sensitivity to the social
and cultural specificity of their study population can fos-
ter an awareness and empathy that encourages those
being researched to disclose their vulnerabilities (Allen
2002),

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1588 Joantie Neale et al.

SOME GENERAL LIMITATIONS

Alongside the many strengths of qualitative work, there
are inevitable weaknesses. As Martin & Stenner (2004)
point out, qualitative techniques promise ecological
validity at the cost of the classic scientific requirements of
reproducibility and generalizability. In other words, more
opportunistic sampling techniques and the small num-
bers of individuals participating in qualitative work mean
that findings can never be generalized nor portrayed as
representative of drug users in general. Breadth and scale
are sacrificed in order to obtain a deeper and more
contextualized understanding of peoples’ lives and
experiences.

While this loss of scope is an acceptable compromise
for those committed to a qualitative paradigm, other
issues can provoke greater discomfort. One recurrent
problem is the lack of consensus about what exactly qual-
itative research is, compounded by the variety of
approaches—each with its own rules, aims and logic—
that can be adopted (Hammersley 1990). The lack of
clearly formulated procedures and conventions—partic-
ularly in respect of data analysis—means that qualitative
researchers do not only need to explain and justify their
techniques to those wedded to quantitative methodolo-
gies. They also need to explain and justify themselves to
other qualitative researchers.

A further weakness of qualitative research is the
potential for bias and misrepresentation. The integrity
and honesty of drug users’ responses to interview
questions are often doubted, along with their ability to
recall events and emotions. Such concerns are, of
course, equally relevant to those conducting quantita-
tive surveys. Indeed, the trust and rapport fostered
during qualitative research can help respondents to
give more accurate accounts. That notwithstanding, it
is still the case that interviews and observation intrude
as foreign elements into the social setting they would
describe. Therefore, the particular dynamics of any
given researcher/respondent interaction can create as
well as measure attitudes (Webb etal. 1966). For exam-
ple, the respondent may simply report those beliefs and
behaviours that he or she feels the researcher wishes to
hear.

Finally, qualitative methods have some very practical
limitations. Data collection, processing and coding all
tend to be labour-intensive and thus demanding from a
resource point of view. Similarly, analysing the vast
amounts of material produced requires a high degree of
organizational skill. Even 40 in-depth interviews or a few
days of observation can produce such a large volume of
information that it is easy for the unskilled and/or inex-
perienced researcher to become dangerously adrift on a
seemingly endless sea of unstructured materials.

ADDRESSING THE PRACTICALITIES

Because qualitative data commonly concern aspects of
everyday life, there is a dangerous assumption that any-
one and everyone can do qualitative research with little
or no prior training. In this section, we highlight what we
consider to be some important features of undertaking
good qualitative work within the addictions. For simplic-
ity we have separated the processes of planning, data-
gathering, analysis and dissemination. In reality, we
appreciate that these activities tend to occur simulta-
neously. We also recognize that many of the ingredients
of a good qualitative study mirror those we would advo-
cate for quantitative research. We none the less include
them here for coherence.

Planning

Before selecting and piloting a research method or meth-
ods, the literature should have been reviewed and one or
more clearly defined research questions or hypotheses
formulated. If the aim of the study is to achieve reproduc-
ihility and generalizahility, qualitative methods should be
rejected in favour of suitable quantitative techniques. If
ecological validity and practical and personal relevance
are sought, the next stage is to decide on the type/s and
amount of qualitative data to be collected. While large
sample sizes and rigorous sampling techniques tend to be
inappropriate for qualitative work, materials and respon-
dents must still be selected objectively and sufficient data
should be collected to ensure that all aspects of the
research issue are explored (Morton-Williams 1985).

As with quantitative research, a parallel planning
stage involves thinking through and addressing any
potential ethical issues. Obtaining formal ethical
approval—perhaps from a university or NHS Local
Research Ethics Committee (LREC)—is usually advised,
but can take weeks or months. This can result in lost time,
which is both frustrating and costly. If formal ethical
approval is needed this should be sought as soon as is
practically possible. Even if formal ethical approval is not
required, procedures should be developed for dealing
with issues relating to consent, confidentiality, respon-
dent identification and payment/compensation (for an
interesting discussion on paying drug users to participate
in research see McKeganey, 2001).

As a final precursor to data collection, access to the
data field must be negotiated. This involves the researcher
contacting those who will be directly or indirectly
involved in the research: drug users, professionals and
members of drug users’ family and friendship networks,
etc. To convince others that participation In the study is
worthwhile, the researcher has to be clear ahout what
exactly is being investigated and why. Sometimes this can

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Qualitative research methods within the addictions 1589

be explained successfully in one brief telephone conver-
sation. On other occasions, multiple strategies may be
required (for example, phone calls, letters, meetings,
posters and information sheets).

Data collection

For data collection to progress smoothly, researchers
need to be confident about using their chosen research
methods and happy to answer any questions regarding
the study. They should also enter the field fully
equipped—with recording devices working, consent
forms prepared and information sheets packed. For per-
sonal safety reasons, addiction researchers are wise to
carry an identity card and mobile phone. Similarly, they
should notify colleagues of their approximate where-
abouts and expected times of return.

Alongside these very practical issues, researchers
have to be alert to the more subtle dynamics of gathering
qualitative data. For example, they are advised to dress
so that study participants feel at ease and, if interview-
ing or focus groups are involved, they need to consider
where and when these will occur and even how people
will sit so that eye contact and observation of facial
expressions are permitted without forcing constant con-
frontation (Morton-Williams 1985). Researchers must
also be alert to participants’ non-verbal cues and ensure
that they do not themselves react in ways that could
infiuence others’ responses (for example, by expressing
surprise or horror).

In order to generate the most reliable data, the sub-
jects of qualitative research must be reassured that their
anonymity will be protected at all times and that they can
speak and behave honestly and openly Oones 1985a). To
this end, the researcher must construct a system of cod-
ing respondents so that each Interview can be docu-
mented without any real names or places being disclosed.
In addition, the researcher must win the trust and confi-
dence of all study participants through regular reassur-
ances of confidentiality and a non-judgemental attitude.
While this is an important aspect of any research, it is
critical when investigating drug users who may have very
real concerns about the illegality, danger and stigma
associated with much of their hehaviour.

In practice, of course, the fieldwork encounter can
never be planned completely. Humans behave in diverse
and unpredictable ways and quafitative researchers must
adapt their style to the particular individual/s they are
with and to the shifts and developments occurring during
the interactions experienced Qones 1985a). This requires
fiexibility and accommodation, alongside an abiUty to
remain focused on the stated research topic. A competent
qualitative researcher will follow-up interesting leads and
seek clarifications when issues seem unclear; yet they will

always maintain a basic level of control over the fieldwork
situation.

Frequently, however, the effects of drink or drugs com-
plicate the addiction researcher’s task. Subjects’ compre-
hension may he limited, their memory confused and their
powers of expression poor. Sometimes, they will convey
very little. Sometimes, they will talk at great length.
Occasionally, it may be necessary to terminate an inter-
view because a respondent is too intoxicated to talk
coherently. At other times, the repetitive respondent may
need to be guided gently on to another question. Any par-
ticipant who becomes upset should be allowed time for
composure and given the opportunity to withdraw from
the study. Researchers should also be in a position to pro-
vide information on local sources of professional support
if this is needed.

In order to provide a robust description of the sample,
as much information as possible must he kept on people
who were approached but refused to participate in the
study and on people who began to participate but with-
drew part-way through. Researchers should also write
detailed fieldnotes immediately after any data collection
episode. Such fieldnotes will include subjective opinions
and contextual information to supplement all of the
other data collected. Those who help with any aspect of
data gathering must always be thanked for their time and
effort. Similarly, they need be told what will happen to the
research findings and given feedback when this is
desired.

Analysis

Qualitative research is generally based on the analysis
documentary materials, interview transcripts and
detailed fieldnotes. Because these data tend to be unstruc-
tured, the researcher must impose order and structure on
them in order to generate meaning and significance
(Morton-Williams 1985). Increasingly, this process of
ordering and structuring is being undertaken with the
assistance of computer software packages such as NVivo,
MAXqda, Atlas.ti, Nud*ist, HyperRESEARCH and Qual-
rus. These packages do not ‘analyse’ the data for the
researcher. They simply enable materials to be ordered
and sorted more quickly and systematically than is gen-
erally possible by hand.

The analysis itself is a highly personal activity (fones
1985b). The technique/s adopted within any particular
study will probably relate to the nature and amount of
data collected, the aim/s of the project, the analytical
skills and interests of the researcher, as well as the time
and resources available. There is plenty of scope for llexi-
bility. Despite this, procedures must always be systematic,
rigorous and complete. All the material collected should
be reviewed and re-reviewed thoroughly. If the data are

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1590 Joanne Neale et al.

analysed superficially or randomly, only random and
superficial (rather than valid and meaningful) flndings
can ever result.

There are various accepted techniques of methodi-
cally analysing qualitative data, such as thematic analy-
sis, constant comparative method, analytical induction,
narrative analysis, grounded theory, deviant cases, con-
tent analysis and framework. While it is not possible to
examine each of these here, the following are common
processes: (i) afflxing codes to the data; (ii) noting down
reflections; (iii) sorting and sifting through the material
to identify important phrases, patterns, and themes; (iv)
isolating emergent patterns, commonalities and differ-
ences; (v) producing a small set of generalizations that
cover the consistencies discerned in the data; and (vi)
confronting those generalizations with a formalized body
of knowledge in the form of constructs or theories (Miles
& Huberman 1994),

According to Miles & Huberman (1994), these vari-
ous processes are underpinned by three concurrent
activities; (i) data reduction (selecting, focusing, simplify-
ing, abstracting and transforming raw data, as well as
making decisions about which parts will provide the ini-
tial focus); (ii) data display (organizing the information,
for example by assembling it into matrices, graphs, net-
works and charts); and (iii) conclusion drawing/verifica-
tion (interpreting the data by noting regularities,
patterns, explanations, causal flows and propositions, as
well as testing the provisional conclusions for their plau-
sibility and contirmability).

Dissemination

As findings emerge, researchers will wish to identify suit-
able audiences for dissemination. Written research out-
puts might appear in reports, books, practitioner
magazines and peer-reviewed journals. Given the wide
range of possible audiences and publications that might
be targeted, it would be odd to find Addiction selected on
every occasion. Indeed, this would suggest a lack of
awareness of all the other high quality drug, health,
social science and policy journals in circulation.

Although Addiction does not stipulate a maximum
number of words, conciseness (as is the case with many
scientific journals) is prioritized. Because of their focus on
description and explanation, qualitative papers tend to be
longer than quantitative ones. Their greater length may
be one reason why it can be difflcult to get them published
in some journals. It is not impossible to write up qualita-
tive work succinctly, but it does require a clear focus and
a willingness to omit some of the hard-earned contextual
detail.

As with quantitative studies, there are a number of
important conventions in writing up qualitative work.

For example, authors should relate their flndings to the
existing literature, provide a clear description of the
research setting, discuss the sampling strategy adopted,
comment on the research methods employed and
acknowledge any obvious study limitations. Equally, they
should explain the analytical strategies employed. All too
often, authors blithely state that the data were analysed
using a particular approach (most commonly grounded
theory) without providing any indication of how this was
achieved. At the very least, researchers should document
the processes through which the themes, concepts and
categories they identify were derived from their raw
materials.

Two flnal issues are specific to writing up qualitative
work. The flrst is a tendency to over-rely on the use of
quotations. Verbatim comments are an ideal way of
bringing to life a particular point or issue. However, they
should be used sparingly to illustrate key flndings. Papers
that string together quotation after quotation with little
comment in between suggest that the data have not been
analysed rigorously. The second issue relates to anonym-
ity. Qualitative researchers who have promised their
research subjects confldentiality must remember that
this extends into publication. Because qualitative
research is often based on detailed information collected
from a small number of individuals in a particular loca-
tion, identities can be revealed inadvertently. Due care
must therefore be taken to ensure that privacy is never
violated nor reputations harmed.

CONCLUSIONS

This review began with three rather troubling questions.
Is qualitative addiction research only a minority interest,’
Are qualitative analyses somehow less informative or less
valuable than quantitative investigations,’ and do some
addiction journals militate directly or indirectly against
the publication of qualitative research,’ We return to
these questions below.

Even in this brief review, we have identifled numerous
examples of qualitative addiction research. The examples
cited are illustrative rather than representative, but
reveal that there is both a long history and a strong, con-
temporary presence of international qualitative work
within the addiction fleld. Qualitative addiction research
is, in other words, mainstream. That said, we have
revealed how conducting qualitative work is generally
labour and resource intensive, Sufflcient time and money
must be allocated to all the key stages of negotiating
access, securing ethical approval, recording and tran-
scribing materials in full, and systematically and
rigorously analysing all data collected. Cutting cor-
ners invariably results in under funded and/or overly

© 2005 Society for the Study of Addiction Addictkm. 100, 1584-1593

Qualitative research methods within the addictions 1591

amhitious programmes of work that yield unreliable and
invalid tindings.

In short, qualitative research—and particularly eth-
nographies involving lengthy periods of time collecting
very detailed data from one particular drug-using subcul-
ture—cannot be seen as a cheaper, quicker or easier
alternative to undertaking a quantitative inquiry. On the
contrary, qualitative techniques often appear economi-
cally uncompetitive at the side of their quantitative coun-
terparts. Furthermore, quantitative studies tend to he
more suited to producing the kinds of ‘hard’ statistical
data demanded in today’s climate of measurable targets
and performance indicators. As a result qualitative stud-
ies are often not the preferred option of research funders,
policy-makers and service planners/commissioners.
Given that they are less likely than quantitative research
to be undertaken in the first place, it is not surprising to
Iind that they are poorly represented in the puhlished
literature.

Despite this, we hope that we have shown that the
strengths of qualitative addiction research are many and
diverse. They have helped us to understand and demystify
drug taking, dispel unhelpful myths and stereotypes
about drug users, build and develop theories of addiction
and formulate and evaluate drug policy and practice.
They have also had particular advantages in studying
hidden and hard-to-reach groups, identifying emerging
trends in drug consumption and researching particularly
sensitive drug issues. In addition, qualitative techniques
have played an important role in complementing quanti-
tative research by helping to interpret, illuminate, illus-
trate and qualify empirically determined statistical
relationships (Walker 1985, p. 22).

We conclude that qualitative analyses are no less
informative or valuable than other forms of investigation.
They simply answer different questions and in different
ways. However, we emphasize that the success of qualita-
tive research is heavily dependent upon the expertise—
but also the interpersonal skills—of those undertaking
the work. Good qualitative researchers will understand
how to select the techniques and data sources that are
most appropriate to answering the question/s being
posed. Equally, they will know how to put participants at
their ease, establish a sense of trust and rapport and probe
and respond flexibly to interesting and unexpected issues
without losing sight of the stated research aims and
objectives.

Like all research techniques, qualitative methods have
limitations. To minimize these, qualitative researchers
must always sample study participants carefully, be wary
of invoking socially desirable responses, never generalize
from their findings and disseminate their data in ways
that are accessible to as wide an audience as possible.
They must also provide detailed, but jargon-free accounts

of their methods of data collection and analysis. Collec-
tively, these strategies should help to ensure that qualita-
tive work is given the credibility and support it deserves
by research funders. policy-makers, practitioners, aca-
demics (of all methodological persuasions) and journal
editors.

Finally, we turn to the question of whether some
addiction journals directly or indirectly inhibit the publi-
cation of qualitative research. A charge of direct discrim-
ination could be made if journals had an explicit policy of
not publishing qualitative work or if editors/reviewers
consciously or subconsciously dismissed qualitative
research as inadequate or inferior. Indirect discrimina-
tion might occur if journals demanded such a formulaic
structure that it was virtually impossible to write up qual-
itative studies in the required format. Without adequate
information (qualitative or quantitative) on these issues,
we can offer no answers. In any case, the proposed ques-
tion is unhelpful—being likely only to aggravate those
whom qualitative researchers would be better advised to
convince.

Instead, we pose two challenges. First, those who are
undertaking qualitative addiction research should have
confidence in the scientilic rigor and value of their meth-
ods and not hesitate in writing up their data for any jour-
nal that will reach their target audience. Secondly,
addiction journals should adopt policies and practices
that will potentially encourage more qualitative submis-
sions. This might include a statement welcoming articles
based on qualitative research, not being too prescriptive
about the structure and length of papers, ensuring that
qualitative work is always reviewed by those with quali-
tative expertise, commissioning publications from those
known to be undertaking valuable qualitative investiga-
tions and setting an approximate per annum quota of
journal space for qualitative contributions.

Acknowledgements

The authors wish to acknowledge Griftith Fdwards for
commissioning this review and three anonymous refer-
ees for their helpful comments on an earlier draft.

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1

8

Annotated Bibliography

Author Name

Walden University

RSCH 8110/7110/6110: Research Theory, Design, and Methods

Instructor Name

Due Date

Annotated Bibliography

A
utism researchers continue to grapple with activities that best serve the purpose of fostering positive interpersonal relationships for children with autism. Children have benefited from therapy sessions that provide ongoing activities to aid their ability to engage in healthy social interactions. However, less is known about how K–12 schools might implement programs for this group of individuals to provide additional opportunities for growth, or even if and how school programs would be of assistance in the end. There is a gap, then, in understanding the possibilities of implementing such programs in schools to foster the social and mental health of children with autism. The six articles I selected for this assignment present research on different types of therapeutic programs that have been used to promote social interactions in children with autism.

Annotated Bibliography

Wi
mpory, D. C., & Nash, S. (1999). Musical interaction therapy – therapeutic play for children with autism. Child Language and Teaching Therapy, 15(1), 17–28.

https://doi.org/10.1177/026565909901500103

Wi
mpory and Nash provided a case study for implementing music interaction therapy as part of play therapy aimed at cultivating communication skills in infants with autism spectrum disorder (ASD). The researchers based their argument on films taken of play-based therapy sessions that introduced music interaction therapy. To assess the success of music play, Wimpory and Nash filmed the follow-up play-based interaction between the parent and the child. The follow-up interactions revealed that 20 months after the introduction of music play, the child developed prolonged playful interaction with both the psychologist and the parent. The follow-up films also revealed that the child initiated spontaneously pretend play during these later sessions. After the introduction of music, the child began to develop appropriate language skills.

Si
nce the publication date for this case study is 1999, the results are dated. Although this study found that music interaction therapy is useful, emerging research in the field has undoubtedly changed in the time since this article was published. Wimpory and Nash wrote this article for a specific audience, including psychologists and researchers working with infants diagnosed with ASD. Their focus means that others beyond these fields may not find the findings applicable to their work.

I
am interested in the role of music in therapy to foster social and mental health in children with ASD. Therefore, Wimpory and Nash’s research is useful to me for background information on the implementation of music into play-based therapy in infants with ASD. Wimpory and Nash presented a basis for this technique and outlined its initial development. Therefore, their case study can be useful to my research when paired with more recent research on the topic.

Conclusion

For the Week 10 Application assignment, include a one-paragraph conclusion that presents a 

synthesis

 of the six articles you annotated.

�An introduction paragraph is a helpful addition to your annotated bibliography to tell your reader about your topic of interest and the general context of your topic.

An introduction paragraph is not required for the Week 6 and Week 8 Application assignments.

An introduction paragraph is required for the Week 10 Application assignment; this single paragraph should provide context for why you selected the six research articles that you did.

�Each APA style-formatted reference entry should be followed by a three-paragraph annotation that includes (a) a summary of the source, (b) an analysis of the source, and (c) an application of the source.

�The first paragraph of the annotation is a � HYPERLINK “https://academicguides.waldenu.edu/writingcenter/assignments/annotatedbibliographies/summary” ��summary� of the source.

The summary should present the (a) main findings of the study, (b) primary method(s) of the study, and (c) theoretical or conceptual basis of the study.

�The second paragraph of the annotation is an � HYPERLINK “https://academicguides.waldenu.edu/writingcenter/assignments/annotatedbibliographies/critique” ��analysis� of the source.

The analysis should explain the strengths and limitations of the source.

�The third paragraph of the annotation is an � HYPERLINK “https://academicguides.waldenu.edu/writingcenter/assignments/annotatedbibliographies/application” ��application� of the source.

The application should (a) justify how the source is applicable to your research interest, (b) describe how the source’s method is applicable to your research interest, and (c) indicate how the source might help to guide your future research on the topic.

In this paragraph, it is acceptable to use the � HYPERLINK “https://academicguides.waldenu.edu/writingcenter/scholarlyvoice/first” ��first person� (I, me, my) in your writing.

��A conclusion is not required for the Week 6 and Week 8 Application assignments.

A conclusion is required for the Week 10 Application assignment; this single paragraph should present a � HYPERLINK “http://academicguides.waldenu.edu/writingcenter/evidence/synthesis” ��synthesis� of the six research articles you annotated.