The psycho-social subject in 'evidence-based practice'

Abstract

In this paper I provide a theoretical outline, followed by two case examples, of a qualitative method, called the free association narrative interview, which produces evidence that is congruent with the kinds and contexts of knowledge that human service professionals use in their work. Following a critique of assumptions about what constitutes evidence in evidence-based practice and an argument for the use of experiential and theoretical, as well as empirical, ways of knowing, I focus on qualitative methods and the shortcomings of semi-structured interviewing as an alternative method for evidence-based practice. In particular I argue that the theory of the research subject and the research relationship that is assumed in most qualitative methods is misguided and affects the character of the evidence that can be produced. I outline an alternative theory of the (research) subject, a psycho-social subject, drawing on psychoanalytic concepts that emphasise unconscious conflict, defences against anxiety and the centrality of unconscious intersubjective dynamics in the research, as in other, relationships. Two examples follow. The first illustrates the transference and counter-transference dynamics in one of my research interviews, showing their importance for what information was produced. The second example demonstrates the use of experiential, empirical and theoretical knowledge in the analysis of data from an interviewee with agoraphobia. It illustrates how the paradigm of a psycho-social subject can produce a more complex account of people's behaviour. I conclude by arguing that the kind of evidence illustrated here, being congruent with the vicissitudes of most human service professionals' work with clients, could provide a model for evidence-based practice that is not only more appropriate but also helpful for professional development.