Sounds indeed like it might be a lot of fun on all sorts of levels.  Would
only be epistemologically problematic if one bought into the view
that the RCT is essentially positivist on the lines of the Vienna lot -
don't know a lot about this, but am trying to move away from the
dichotomised position of research methodologies... presumably its the way
in which one intends to contextualise (or, alternatively, reduce) the
knowledge gleaned from the rct that signals the epistemology... and if one
intends to embed the findings of the rct within a narrative around the
implication of the findings then it might be argued there is no
conflict...? what do you think?
Bernadette Bartlam
Research Fellow
Keele University

On Wed, 14 Nov 2001 08:59:33 -0000 Trish Greenhalgh
<[log in to unmask]> wrote:

> The notion that one can do RCTs of narrative techniques is an interesting
> one.  I did a commentary on the JAMA paper which Charlotte refers to. I
> don't think I had the last word on the topic but the authors of the JAMA
> paper emailed me and said my assessment had been fair.  At one stage we
> were planning to work towards a bigger trial along the lines of what they
> did, but I think everyone got cold feet.  Not sure still whether this line
> of research is epistemologically sound!  Any commments?  Here's the url of
> my editorial.
> http://www.bmj.com/cgi/content/full/319/7205/270
>
>
> Trisha Greenhalgh
> Professor of Primary Health Care
> University College London
> Room 410, Holborn Union Building
> Highgate Hill, London N19 3UA
> Tel 00 44 20 7288 3246
> Fax 00 44 20 7281 8004
> [log in to unmask]
>
> -----Original Message-----
> From: Researching and evaluating the use of narrative in health and
> related fields [mailto:[log in to unmask]]On
> Behalf Of C&F Charlotte Burck
> Sent: 12 November 2001 09:42
> To: [log in to unmask]
> Subject: Re: Using the time between between consultations
>
>
> Dear Judith
> I wanted to respond to your idea about asking people to write, and
> wondered if you know about the research in the USA on the effect of
> writing on symptom reduction.
> JAMA (1999) Effects of writing about stressful experiences on symptom
> reduction in patients with asthma or rheumatoid arthritis. Journal of
> the American Medical Association 281: 1304-1309. They have shown that
> asking patients to write about stressful events in their lives, not
> necessarily about their illness / pain, had an effect on their immune
> systems.
> This technique of asking people to write has also been incorporated into
> work with families that struggle with chronic illness, and there is a
> good article called:
> Chronic Illness: Trauma, Language, and Writing: Breaking the Silence. by
> Peggy Penn. Family Process. Vol 40. No 1 2001, which offers ideas about
> narrative, listening and the use of writing which could be applicable in
> a consultation process - this article pays attention to the relational
> aspects of managing pain and illness, ie the effects on everyone in the
> family.
> Charlotte Burck
> Family Therapist
>
> -----Original Message-----
> From: Judith Norman [mailto:[log in to unmask]]
> Sent: 10 November 2001 11:30
> To: [log in to unmask]
> Subject: Using the time between between consultations
>
>
> "Using the time between consultations" sounds as though it has huge
> potential.
> So far my experience has been that many people need to be handed a
> specific
> sheet of paper with some sort of written question/s posed on it and
> space for
> them to write their response. Seems very directive but gives more likely
> response
> than a verbal request. Not sure why - ?They think I don't seriously mean
> the
> request otherwise? ?They forget?
>
> Am planning to introduce patient-held notes for the Pain Clinic but
> would like
> ideas from anyone. Thought of starting small, and evolving as I get the
> feel
> of it. Have certainly reaped rich pickings from the material received on
> my
> initial Pain Clinic Questionnaire which they mail back before the first
> consultation.
> Saves a huge amount of beating about the bush asking the wrong questions
> on
> the day.
>
> What sort of things would you be asking people to mull over in between
> consultations
> Nigel? Examples always inspire me.
> Judith

----------------------
Bernadette Bartlam
Research Fellow
Centre for Social Gerontology
School of Social Relations
Keele University
Keele
Staffordshire.  ST5 5BG

Tel: 44 (0) 1782 621111  Ext.  7038
Fax: 44 (0) 1782 584069

E-mail: [log in to unmask]