Revisiting the benefits debate: does qualitative social work research produce salubrious effects?

McCoyd, Judith L.M. ; Shdaimah, Corey S.

A heated debate ensued on the pages of this journal regarding the "fit" of qualitative research and social work practice in response to Gilgun's (1994) famous "hand-in-glove" analogy (Bein & Allen, 1999; Padgett, 1998a, 1999; Pieper & Tyson, 1999). In a "reflexive spirit," Padgett (1998a) offered a caution that social work researchers should not confuse the roles or the goals of research with those of social work practice, even if the processes that they use might be a good fit. However, in a desire to avoid ethical impropriety that harms the research subject and the research (Padgett, 1999), many have apparently taken Padgett's cautionary words too far. Bein and Allen noted that "the qualitative researcher enters a human relationship that can be empowering to the interviewee" (p. 276). Refusing to acknowledge this process does not make it go away. It merely walls off an understanding of what may actually happen in the researcher-participant relationship and thus precludes reflection and the possibility of understanding the benefits and risks that may be a by-product of this relationship, particularly for participants. Confronting this possibility can enhance the benefits and mitigate the risks.

The NASW Code of Ethics requires all social workers to "critically examine and keep current with emerging knowledge relevant to social work and fully use evaluation and research evidence in their professional practice" (NASW, 2000, 5.02 [c]). This article contributes to the social work literature by examining whether qualitative interviews provide research participants with any benefits beyond the intended academic and practice use of such research. Drawing from our research findings, we argue that qualitative interviews have personal and political implications (both positive and negative) for research participants. As social work professionals, we must pay attention to these research dynamics (see NASW, 2000, 5.02 [j]) and disseminate knowledge about them (NASW, 2000, 5.02 [p]).

LITERATURE REVIEW

Social work literature about participation in qualitative research focuses on the difficulty of finding study participants, convincing them to speak with researchers, and understanding how to work with participants sensitively so as not to offend them (Fine, Weis, Weseen, & Wong, 2000; Lofland & Lofland, 1995; Padgett, 1998b, 2004). The primary discussion of the relationship in the literature revolves around the assertion that qualitative research is a good fit (Gilgun, 1994) because of the clinical social work skills that social workers bring to their research, coupled with a warning (Padgett, 1998a) not to confuse practice with research.

Concerns about conflating therapeutic efforts and research have long troubled both practitioners and researchers. The Belmont Report (National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, 1978) specifies that research-related informed consent procedures must include a statement that the activity is for purposes of research. The identification of any incidental benefits (and potential harms) that may accrue must be delineated with the stipulation that the primary activity is research. With the dawning of the practitioner-researcher movement (Bisman & Hardcastle, 1998; Bloom, 1997; Dangel, 1994; Raw, 1998; Thyer & Myers, 1998; Wakefield & Kirk, 1996, 1997a), more therapy was conducted in a manner that was intended to be both therapeutic and research oriented as the efficacy and effectiveness of various treatments were explored. Wakefield and Kirk (1997b) expressed concerns about this in connection with single-subject design in which the issue of informed consent about the A-B-A design may bias the outcome of the research and where conflicts among therapeutic goals, research goals, and ethical imperatives may occur. Padgett (1998a) explicated the differences between clinical practice and qualitative research in terms of paradigm, goals, education and training, relationship, and criteria for success.

A small but growing literature has begun to explore the relationship between the researchers and study participants, with a call for heightened reflexivity about the impact of the research on participants (Lofland & Lofland, 1995; Newman, Willard, Sinclair, & Kaloupek, 2001; Padgett, 1998b). That this discussion emerged from qualitative research is not surprising. Qualitative researchers "invite intimacy" (Birch & Miller, 2000). Furthermore, they provide a complex and attuned (if not broadly generalizable) understanding of the people and the phenomena they describe (Johnson & Waterfield, 2004; Lofland & Lofland, 1995; Padgett, 1998b). Ethical dilemmas may thus be more readily apparent in qualitative research because of the more intimate nature of the relationship between the researcher and the study participants. These include the effect of the research process on the participants, the impact of the research product on these same participants and others who are similarly situated, and the nature of power in the relationship itself (Fine et al., 2000). These potential dilemmas take on urgency in the qualitative research literature across a variety of disciplines (see, for example, Geertz, 1983; Padgett, 1998a; Punch, 1994). In disciplines that have linked professional cachet to the pursuit of evidence-based practice grounded largely in quantitative research, this discussion has not been as robust (Johnson & Waterfield, 2004).

Some effects of the research process related to interviewing have been documented in other contexts. Ortiz (1995) suggested that positive mental health consequences occur as a result of using a Life History Method due to beneficial effects of validation and catharsis. He acknowledged the negative effects such as fear reactions and reliving trauma. Others confirm these findings for other narrative methods such as qualitative intensive interviewing. Pennebaker (2000) has found that the process of fully revealing a story of loss, even in written form, has positive effects on the immune system of the research participant. Furthermore, best practices literature regarding psychological processing after traumatic events identifies critical factors for healthy processing (Deahl et al., 2000; Everly & Mitchell, 1999; Parad, 1965; Sheehan, Everly, & Langlieb, 2004), which include an opportunity to tell the whole story to another human being who listens with unconditional positive regard--the stance ideally adopted by any qualitative researcher.

Some effects of the research process likely flow from the social context of the population that the researcher chooses to study. Punch (1986) referred to the populations typically studied by ethnography and participant observation as the "nuts and sluts," identifying the tendency of social scientists who study the "sociology of deviance" to focus on experiences that are outside the norm and thus "discreditable" and potentially stigmatizing (Goffman, 1959, 1963). This tendency to study people who are disenfranchised and stigmatized may yield different effects than the study of people who are accustomed to having greater societal power and "voice" (Kirby & Corzine, 1981). Even if stigmatized people do not accept the stigma, they are usually aware that others view them in this way, which can make open challenges to the dominant society difficult (Anspach, 1979).

Whereas much of the discussion outside of the social work context has focused on the therapeutic potential of qualitative research (Birch & Miller, 2000; Ortiz, 1995), this article contributes to the cross-disciplinary conversations about qualitative research generally and intensive interviewing specifically. The social work person-in-environment orientation reminds social work researchers to explore the political and social implications of social work activities, including research. It further challenges a discourse that focuses solely on the psychological risks and benefits to participants in research studies to the exclusion of other effects. Becker (2005) cautioned that focusing solely on psychological well-being (such as coping, insight, and symptom relief) risks masking social-structural problems as personal problems to which individuals must adjust and serves to maintain the status quo.

BACKGROUND

This article grew from our experiences as peer debriefers for each other's qualitative research study to enhance validity and rigor (Padgett, 1998b).We both identify with social constructionist epistemologies (Berger & Luckmann, 1966) and had research questions that explored processes and meaning-making that were not amenable to quantitative methods or observational modalities. We both conducted intensive interviewing using interview guides as the primary research method, relying on sensitizing concepts (Beeman, 1995) and conceptual frameworks (Miles & Huberman, 1994) that provided a flexible, narrative approach to the interviews.

METHOD

Underlying Studies

McCoyd, with a background in clinical perinatal social work, conducted intensive interviews with 30 women who terminated desired pregnancies because of fetal anomalies against a backdrop of ambivalent cultural messages regarding motherhood, disability, abortion, and loss (McCoyd, 2003a, 2007). Some interviews were conducted by e-mail (McCoyd & Kerson, 2006) and provided the opportunity for longitudinal data collection and extensive debriefing and member checking. McCoyd also conducted a focus group and interviews with perinatal social workers and physicians for triangulation. This is referred to as the "anomalies study."

Shdaimah, with a background in law, conducted 51 intensive interviews with 11 legal services lawyers and 30 indigent clients about their experiences as they used the legal system in a political, social, and economic climate perceived as indifferent to their lives and hostile to their claims (Shdaimah, 2005). Interviews lasted approximately 1.5 hours and were conducted in participants' homes or offices. Shdaimah debriefed participants at the end of the interviews and, sometimes, in follow-up correspondence. This is referred to as the "legal study."

Although the demographics of the participants in the anomalies study and the legal study varied, both populations shared a keen self-perception of stigma. For both studies, all interviews were transcribed verbatim except for the e-mail interviews, which were already in written form. All identifying information was removed from transcripts and from the e-mail interviews; names were replaced with pseudonyms (used here). We analyzed and coded our respective interviews and field notes independently using open coding and then organizing the open codes into themes.

Entering the research, we both were sensitive to the concerns about conflating practice issues with research and were careful to explain to participants that they were not acting in their roles as therapist or lawyer, respectively. We were also sensitive that we were asking study participants to speak about difficult, potentially stigmatizing topics. Our respective interview guides, therefore, closed with a solicitation of participants' input about their experience of the interview process to monitor possible harmful effects. From our peer debriefing we discovered that despite the differences in the demographics and our research questions, we often heard similar responses to these inquiries, best characterized by Katherine:

 I guess this could be my very last e-mail to you.
 I have enjoyed talking to you via the mail and
 it has been therapeutic I think for me to write
 my thoughts. So we have both gained something
 from all my ramblings.

After our initial response of self-congratulation, we began to see patterns suggesting that this was less about our skills as interviewers and more about the interview process and sought a deeper and more critical understanding of these types of unsolicited responses. This led us to return to our data with a new research question that is the basis for the analysis presented in this article: Are there salubrious (or harmful) effects from participation in qualitative studies involving intensive interviewing?

Working to debrief one another over the course of four years, we had intimate familiarity with the data in both studies, as well as with the decision points we each grappled with during the data analysis. Indeed, the research question emerged from our discussions of a code of "satisfaction" as it pertained to the research process that we found independently and unexpectedly. For the purpose of exploring our new research question, we returned to our respective data to explore emergent categories of salubrious and harmful effects of research participation, each rereading all of our interviews with an eye to recoding with this "lens" (Sands, 2004). We shared our new codes through written memos that included exemplars of each of these codes. We then met to discuss these codes, to situate them in the social context for each of our study groups, and to refine the common themes. Once we agreed on newly refined codes and their meanings through deliberation, we reread our respective interviews to code using our refined themes and actively searched our data for negative cases. From this final round of recoding, we found clusters or themes around which to organize the codes (Miles & Huberman, 1994): salubrious effects to the individual through storytelling; the importance of voice and bonding to stigmatized people and groups; and research as a bridge between people and groups who are stigmatized and mainstream society.

FINDINGS

Telling the Story: Validation, Cohesiveness, and Individual Salubrious Effects

Participating in a research study provides a chance for critical reflection. When asked how he found the interview, Martin, a lawyer, replied,

 Intriguing. I think it's always good to think of
 the way we inter-relate with our clients, what
 effect it has on them and how we can do that
 job better. I think if you stop asking questions
 you stop growing.

Another lawyer, unprompted, told Shdaimah, "You'd be surprised at how much our talks have made me re-evaluate our work. I've enjoyed our talks."

The lawyers, social workers, and physicians who participated in our respective studies often do not have the time or reason to stop and reflect on their busy practices, where they are typically overwhelmed with day-to-day tasks and triage. What motivated many of them in their career choices was an interest in working with the people they serve. For practitioner-participants who work with stigmatized groups, particularly those who are caring and openminded, participating in studies can be a welcome opportunity to reconsider their often beleaguered practices. They can consider modifications that potentially benefit their clients. Pete, in responding to a second recruitment notice of lawyers for the legal study, sent an e-mail to his colleagues. His tone was tongue-in-cheek, and his contorted grammar comes from a desire to respect confidentiality, but his message is serious:

 The experience of participating in this study is
 thought to be interesting and thought-provoking
 for both the attorneys and clients involved. It is
 thought to be a good opportunity to critically
 reflect on what we imagine we are accomplishing
 for and with our clients and how we
 go about doing that. It is thought to be highly
 recommended.

Reflection is not only valued by professionals. A legal study client-participant chided the researcher about her informed consent form, saying, "the 'no benefits' section is wrong and there is always a benefit in talking and learning about oneself" (Shdaimah field notes, interview with Lilly). We found that the opportunity to reflect is particularly valued when intensive interviews provide a forum in which an individual is encouraged to tell his or her whole story without a need to censor it to fit the audience.

Although we understand the power of social desirability effects (Loftand & Lofland, 1995), qualitative interviewing ideally solicits the participant's perspective while eschewing judgment. Our impressions were that participants felt relief as a result of openly discussing stigmatizing and traumatizing events. The participants in our studies reported many beneficial effects identified by the psychological literature regarding full disclosure and trauma processing.

 Talking about it with you has helped, although
 I still have bad days, just being able to express
 how I feel and not have to worry about making
 someone else feel bad has helped a lot. (Erin)

 I'm glad I was able to participate and that it was
 a success. It was a healing process for me and
 I'm glad I participated. (Jenna)

For some participants, storytelling and disclosure are part of an ongoing struggle and talking to researchers is just one part of a larger coping process.

 The one thing that I learned is that for me to stay clean I have to
 talk about what is going on with me. 'Cause if I don't--my disease
 is very cunning, it'll use anything to make me use (bitter
 laugh).You know? I don't know if you're familiar with addiction or
 not but it'll use anything to make me use. And I just don't want to
 do that no more. So I'm always talking about me. That's why I didn't
 have a problem with doing this interview with you (laughs).
 (LaTonya)

Full disclosure of the story to a nonjudgmental person clearly had a powerful salubrious effect, especially for people who experience stigma.

Stigma and Voice: Becoming Part of a Critical Mass

All of those interviewed (anomalies group, legal services clients, and legal services lawyers) are stigmatized groups. For the anomalies study, the stigma was attached to the termination of desired pregnancies within the context of the U.S. abortion debate and the stigmatizing condition of having conceived an anomalous fetus. For the legal study of clients, the stigma was related to economic status and the need to use legal services and, for many, the kinds of problems that led to their legal troubles, such as charges of child abuse and neglect or homelessness. Legal services lawyers experienced the stigma of contagion (Goffman, 1963) and of marginalization within the legal community because of the deviant nature of their practice (Scheingold & Sarat, 2004; Shdaimah, 2006).

Furthermore, our participants felt strongly that their respective stigmas were undeserved:

 Being a drug addict even if you're clean or not ... it's almost
 like you're discriminated against ... I was in a program before and
 then when my son died I had like a breakdown.... It took me four
 months to get back into a program. You know but I think especially
 in my case where I am someone who really wants the help and who had
 been clean for a couple of years, I don't think they should use
 that to discriminate against you. Because it's a disease, just like
 cancer. And they don't discriminate against someone who has cancer,
 but yet they would against someone who is, you know, is an addict
 or an alcoholic. So I don't think that's fair. (Janet, a legal
 services client)

Participants reported feeling appreciative of the opportunity to join in the research study to amplify their voices and to be part of creating a critical mass challenging stigma and smoothing the way for others.

 Thanks again for doing this work and giving those of us who have
 terminated a "voice" somewhere. I do hope genetics counselors and
 perinatal social workers make some positive changes. (Joan)

 It has been a good thing for me to go back and think about aspects
 of our termination that I haven't thought of in a while. It's also
 been rewarding to know that my responses may go to help others in
 my same shoes some day. (Olina)

As the quotes indicate, participants hoped that their voices would inform the service providers who worked with them, as well as help others in similar situations to feel a sense of solidarity in the face of the isolation customarily experienced by people who are discreditable.

Participants never explicitly stated that they expected us to disseminate the findings, but this expectation is part of the motivation for participation in this type of research. Our participants made this clear from their desire to prioritize confidentiality and from discussion during the interviews in which they asked who would read the results of the research. This points to an added advantage to research participation; it offers an avenue for participants to contribute to challenging stigma without bearing the risks associated with "coming out" that are inherent in other forms of challenge such as public speaking or direct political engagement.

After informing respondents that preliminary findings had been presented at a professional workshop in Florida (McCoyd, 2003b), participants replied:

 Good to hear that the people in Orlando listened to what we had to
 say through you. If it helps just one of them to understand a
 little more what it is like for anyone in our shoes, it will make a
 difference to some poor woman. (Katherine)

 Thank you so much for the opportunity to express some of my
 thoughts on this taboo topic. I hope that with people like you
 researching and bringing this subject out in the open, women &
 their partners will not feel alone when faced with this painful
 decision. (Carole)

Alice, a lawyer who read an article that Shdaimah published (2006), described her response to academics who criticize the work of legal services lawyers without having a true understanding of their day-to-day practices, relationships with clients, and dilemmas:

 I read your draft article for Cause Lawyering and was simply blown
 away by it! It ... deals so well with the issues that I feel when I
 read the academic articles on "empowering clients," community
 lawyering etc. It is the first piece that says what I think and try
 to express--the contradictions and realities--and also expresses
 the compassion and caring that are integral to the client--attorney
 relationship but isn't usually discussed as part of the analysis.
 Anyway, I love it and want to share it with the world.

Having one's story joined confidentially with others' and brought into the mainstream to challenge perceptions about stigmatized groups is another salubrious effect of social work research.

Bridging: Connecting for Action

Research can be empowering for populations who are stigmatized because they are asked to participate as experts. Attuned research can and should situate participants in the role of expert by the way researchers conceptualize the research, frame the questions, and treat study participants (Shdaimah Stahl, & Schram, 2007). This is one strategy for mitigating harmful effects. Both study groups were explicitly told that we hoped to learn from them to help others who are similarly situated, and this resonated for many. Study participants were encouraged to see themselves the way researchers see them: as advocates, guides, and experts. This strategy combats stigma that accrues when participants are viewed as victims or as somehow "at fault." Some participants were eager to participate, not so much to reflect on their own experience but to use their expertise to educate others, particularly on topics that many people are reluctant to discuss openly because of stigma.

 I'm so glad that I can participate in this study. This topic is
 somewhat "taboo" and if I can do even a small bit like this to help
 with educating others, I want to. (Joan)

Participants in both studies were eager to share concrete advice, encouragement, and support for others who might find themselves in similar situations. Justin, a legal services client, was concerned that we would not have sufficient time for him to provide all the information he considered important: "I would like to explain more details because I'm sure it would be a good point for me and you to know." When urged to provide as much detail as he could and reassured that if we ran into a time problem, we could continue the interview another day, he was clearly relieved; "I do appreciate it." Frances provided advice that she wanted to see passed on to health care providers. When McCoyd thanked her for her completeness and thoughtfulness, she ended with this:

 On behalf of people who have faced poor prenatal diagnosis and had
 to make gut-wrenching decisions about their babies' lives, I want
 to thank YOU for doing this study. Through your work and others like
 it, I hope we gain the recognition and support we need and deserve,
 so that no other parent has to struggle alone and in silence with
 the confusion, pain, and fear. (Frances)

We have come to understand this as part of a bridging function between groups isolated by stigma, and the broader society. The researchers elicit and then carry nuanced stories from stigmatized groups into the "mainstream world," while simultaneously serving to connect mainstream culture to those groups. Bridging creates a dialogue that allows researchers access to participants' experience, while also creating opportunities for participants to get their perspectives into mainstream society and politics.

In his research with crack dealers, Bourgois (2003) described how research can be used to illuminate social injustice (including stigma) and advocate for change. In the chapter "Violating Apartheid in the United States," he underscored the divide between people who are isolated because of socioeconomic status and the role that he hoped his research would play in chipping away at this divide.

 When I discussed with Ray [a crack dealer who participated in
 Bourgois's study] and his employees my desire to write a book of
 life stories "about poverty and marginalization" that might
 contribute to a more progressive understanding of inner-city
 problems by mainstream society they thought I was crazy and treated
 my concerns about social responsibility with suspicion. (p. 46)

Bourgois described how, as time went on and they developed relationships, his study participants began to view him as an important bridge to mainstream society. He wrote:

 About halfway through my research, the main characters in this
 book, with whom I have developed deeper relations, began following
 the details of my writing habits and urging me to make speedier
 progress.... For example, when I came down with a debilitating
 tendonitis in my wrists and forearms ... Caesar and Primo became
 genuinely worried and disappointed. I realized that our
 relationships had developed an almost psychotherapeutic dimension.

 Caesar: [grabbing my arms and twisting them] don't be giving up
 on us, Felipe.... You're our role model here.... I ain't lettin' you
 leave us until I get something in writing with our name on it, as a
 lifetime reference. (p. 47)

Bourgois's (2003) bridge goes two ways. Many of the clients in the legal study were unfamiliar with academic degrees and were eager for the researcher to share information. Some asked what a doctorate or a dissertation was (having read the consent form). Many in the anomalies study asked about how the research would be reported, and even more wanted to discuss the political implications of the research in the context of the abortion debate and its various stakeholders. Participants wanted to know what motivated us to study them, they wanted to talk politics, and they wanted to ask questions. They actively used the researcher to connect their experience to mainstream understandings of their circumstances. Participants also wanted to learn about other participants' experiences. Providers seemed curious about what clients had to say and vice versa; in this way the researcher provided another bridge between different populations.

Although participants' desire to share information was perhaps reflective of an existing understanding of themselves as experts, advocates, or helpers, participation in research can help to reinforce this. This then creates a forum for fostering political consciousness that should not be discounted, particularly among stigmatized groups wherein understanding is tenuous and may mediate other messages such groups receive from the broader society. Participants in both studies were eager to change what they saw as unfair or unjust treatment of people similarly situated and expressed the hope that the bridge we provided and our connection to academic and professional audiences would help provide access for their understanding to be considered.

 I was wondering if when you get your paper done if you could send
 me a copy of my portion or the entire piece, I would consider it an
 honor, plus I would really like to see how my thoughts combined
 with yours looks on paper. Maybe it will inspire me to go into the
 legal field as well. I also wanted to say I hope I inspired you
 with our conversation especially about [Child Protective Services]
 and how their complaints need to be investigated before they open a
 case and break apart more families--good loving ones. (Carolyn)

 I am happy that I am given a chance to have my story heard and that
 my story will help mothers who are and will be faced with the
 toughest decision in their lives. (Deirdre)

This is where research that may have collateral therapeutic benefits goes beyond the limitations of therapy. Research creates a bridge where participants and researchers can build relationships to connect the individual experience to a larger context. Attuned participants and researchers can amplify or provide a stage for the voices of individuals who may not otherwise have access to audiences such as practitioners, policymakers, or academics who are in a position to advocate for change. Researchers also provide a bridge among groups separated by stigma.

DISCUSSION

We assert that a number of salubrious personal and societal results accrue when research is done within an epistemological framework that acknowledges the experiences of participants and situates participants as expert knowers. We identify three salubrious effects that fall into categories similar to Ortiz's (1995): (1) the validation of being understood and of having one's story heard in full without judgment; (2) the chance to have one's story joined with others in such a way as to create a "voice" on a topic of shared experience, and (3) the knowledge that findings will be published and communicated to providers, policymakers, and the public. The latter often gives stigmatized groups hope that their experience will be brought into mainstream culture in a way that allows them to be heard, understood, and destigmatized. Researchers must guard against a paternalistic notion that they are "giving" voice or providing empowerment. Ideally, researchers accurately capture, reflect, and communicate the experiences of participants; however, they are not giving participants something.

Members of stigmatized groups may not know how to challenge stigma or where to direct such challenges. Researchers can help to articulate a framework that allows participants to see their stories contextualized. This then creates opportunities for developing a political understanding of the place of similarly situated (and stigmatized) people in society and moves the individual to see how what has been viewed as a personal problem or failing is, perhaps foremost, a societal issue. This revelation opens avenues for challenging societal injustice rather than accepting the shame of stigma.

We have claimed that researchers and participants create a relationship and that the power of the relationship can have significant personal and societal implications. Any powerful relationship that may give rise to positive effects can also produce negative effects. It is unethical to ignore this possibility. We have documented positive effects stemming from this relationship because this is what was reported to us. It is possible that negative consequences went unreported for several reasons. The first is due to social desirability bias; participants generally want to please and are reluctant to offend by reporting discomfort or other negative outcomes. The second is due to selection bias; people who voluntarily participate in research studies may represent individuals for whom such participation is more likely to be positive than adverse and who choose to participate precisely because they see the research and their participation in it as beneficial. Our findings may be skewed by this aspect of qualitative interviewing because we found that participants in the anomalies study and in the legal study expressed gratitude for the opportunity to tell their stories. These limitations, however, do not diminish the intensity of our participants' reported experiences of benefits. The overwhelmingly positive responses are not anomalous; similar findings have been reported in other studies of reactions to research participation (Newman et al., 2001).

These biases shed light on potential negative consequences that stem from the research relationship. Researchers who do not acknowledge the power of the research relationship (as distinct from the power of the research process itself) are blind to potential consequences, positive or negative. Thus, they will not anticipate them, and they will not consciously explore this possibility and mitigate possible negative consequences. Our attention to respectful relationships with our participants and our view of them as experts may have mitigated the potential negative effects of objectification inherent in being a research "subject."

Perhaps more compelling is the ethical concern that the end of the research relationship on completion of data collection will be experienced as a loss. Researchers continue with their research project, and then move on. Participants are left behind, uncertain of the value of their contribution and possibly feeling dismissed or rejected. It might take years for studies to be published or to enter into policy or treatment arenas, and even when and if this occurs, participants are unlikely to be aware of these developments. Researchers cannot practically continue the relationship with all (or any) participants. To the extent that researchers are able to provide some follow-up to participants, our experience shows that this is appreciated. The risk of harm from the end of the research relationship needs to be more fully explored, and social work literature on "termination" might provide guidance for managing the conclusion of the research relationship.

Another implication of these findings is for practitioners who feel that they must protect clients from researchers. For instance, lawyers from the legal study wanted to ensure that clients would be treated respectfully and would be compensated for their time. The anomalies study researcher had difficulty getting past gatekeeper medical and social work professionals expressing concerns about the privacy of their patients. On gaining access directly to patients, she found them eager to participate. Practitioners often cite privacy issues and concerns about harm as reasons for hesitation about cooperating with research efforts. Our findings should encourage practitioners not to accept or reject research participation for clients unreflectively but to assess the safety and possible benefits of such participation.

CONCLUSION

Although the debate in this article has been framed in the context of qualitative research, the same questions can and should be asked regarding any social work research that strives to be respectful, sensitive, and concerned with social justice. In this article, we focus on findings from qualitative studies. Nevertheless, quantitative and mixed-method research also involve participant investment in the research process and, often, engagement with a researcher. Consequently, quantitative research may have many of the same effects on participants when they are fully engaged in the research process.

We do not intend to conflate therapeutic goals with research. Yet we found that our participants often used the language of therapy when reflecting on their research participation. In the spirit of qualitative research and social work, we must give their experience credence. Exploring the basis for these responses is useful for understanding the experience of participating in social work research. It may also provide useful guidelines for researchers in how to share the goals of their research more fully with participants. Researchers should not let legitimate concerns about conflating research and intervention (for example, Franklin, 2006, on the danger of underestimating risks) prevent them from open and honest discussion of the collateral risks and benefits that derive from the researcher-participant relationship and the research process.

Our findings from the anomalies study and the legal study indicate that participants experienced positive effects from research participation. These effects included validation, destigmatization, a sense of making a contribution, and enhanced political awareness. The participants may have experienced some negative effects from participating in the research; however, we found none, possibly because of our attention to their expert status and conscientious debriefing about their research experience. Researchers must consider these possibilities to enhance the positive effects and mitigate the negative effects. To do otherwise is unethical.

Original manuscript received June 19, 2006

Final revision received December 5, 2006

Accepted January 25, 2007

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Judith L. M. McCoyd, PhD, LCSW, QCSW, is assistant professor, School of Social Work, Rutgers University, The State University of New Jersey, 327 Cooper Street, Camden, NJ 08102-1519; e-mail: jmccoyd@rci.rutgers.edu. Corey S. Shdaimah, PhD, LLM, is assistant professor, School of Social Work, University of Maryland, Baltimore. Dr. McCoyd would like to thank the American Association of University Women for a Dissertation Fellowship grant in the 2002-2003 year. Drs. McCoyd and Shdaimah thank the participants of the Rutgers University Qualitative Working Group for comments on a draft of the manuscript and thank the three anonymous reviewers for very helpful comments on this article.