Interpretation And Understanding In Research Practice






Joy Higgs, Margo Paterson and Elizabeth Anne Kinsella


Psychotherapy deals with the uncertainties and particularities of people’s lives and situations. The selection of approaches to investigate these phenomena cannot be restricted to objective and context-free options; people’s lives are subjective, contextualised and personally experienced. Many human sciences research approaches exist that can access, deeply study and richly portray the human world. One of these is hermeneutics. The aim of hermeneutics is understanding rather than explanation. The types of questions people may consider through an hermeneutic perspective are varied, and draw attention to human being and understanding with a focus on the role of interpretation of these phenomena. Some examples of hermeneutic situations might include: What does the community expect from psychotherapy? How do people feel about their psychotherapy experiences? In what ways do clients and families benefit from psychotherapy? In this paper we examine philosophical hermeneutics as an approach that is structured around the particular questions and purpose of a specific research project and we provide an example to illustrate what hermeneutics can reveal. We present hermeneutics as a credible, rigorous and creative approach to investigations into the human life world, one that is flexible, adaptable, and justifiable in the contexts of evidence-based as well as client-centred practice.

About Hermeneutics
Hermeneutics is the theory and practice of interpretation. The name ‘hermeneutics’ is derived from Hermes, the legendary Greek messenger who bore knowledge and understanding between the gods and mortals. In the 17th century, hermeneutics became associated with the interpretation of texts, particularly in the context of Biblical studies (Crotty, 1998). A number of theologians and philosophers (Dilthey, 1988; Gadamer, 1975; Heidegger, 1962; Ricoeur, 1976; Schleiermacher, 1977) since that time have developed variations of hermeneutic philosophy and subsequent methodologies. Schleiermacher (1977) has been acknowledged as the founder of modern hermeneutics, moving beyond the illumination of Biblical text to the illumination of human understanding. Dilthey (1988) later broadened the field of interest of hermeneutics beyond the individual to include cultural systems and organizations.

Hermeneutic inquiry uncovers “meanings and intentions that are, in a sense, hidden in the text” (Crotty, 1998: 91). Hermeneutics involves firstly accessing or creating texts about the phenomenon being interpreted. The term text is important here; in hermeneutics it can refer to any aspect of the phenomenological world being interpreted. In research these aspects might be represented via written texts, oral and video recordings, interview texts, images, actions, and other modes of communication and recording that illustrate the phenomenon being investigated. The extension of hermeneutics beyond the interpretation of existing written texts to the interpretation of human action arose from the argument by Ricoeur that human action and text have a number of similar features (Ricoeur 1976). “Human behaviour becomes a text analogue that is studied and interpreted in order to discover its hidden or obscured meaning” (Leonard, 1989:52). Having formulated the texts the next phase involves the interpretation of the texts; this provides the means for understanding the phenomenon under investigation (Crotty, 1998).

In this paper we focus on the work of Gadamer – often referred to as philosophical hermeneutics (Gadamer, 1976) – who further developed Heidegger’s hermeneutic phenomenology. Gadamer related hermeneutics to the philosophy of historical understanding, and asserted the linguistic character of human reality (Palmer, 1969). According to Gadamer, hermeneutics lies at the centre of modern philosophical problems such as the “relationship of language to being, understanding, history, existence, and reality” (Palmer, 1969: 43). From a hermeneutic perspective, language is central to understanding as it “shapes our expectations and our dealings with things in the world” (Bontekoe, 1996: 123).

A key aspect of using a hermeneutic approach to inquiry is the recognition that basic philosophical assumptions inform our interpretations and our assumptions about what we are seeing and how we are making sense of what we see. There are three key philosophical assumptions or constructs that inform hermeneutics as an approach to interpretation, understanding and knowledge creation.

1 Fusion of Horizons
Hermeneutics refers to the shared understandings that we come to have with each another (Koch, 1999) and this shared understanding occurs through language and dialogue. This view is translated into the Gadamerian metaphor of a ‘fusion of horizons’ whereby different interpretations of the phenomenon are brought together through dialogue to produce shared understanding in a professional practice or in a research encounter. Through a fusion of horizons whether this be the historical horizon of the past and the current horizon of the present, or the different perspectives and experiences of a clinician and a client, or a researcher and a research participant, there is a bridging of the gap between the familiar and the unfamiliar. In this way the researcher comes to a deeper understanding of other perspectives or co-participants in the research come to a shared understanding.

2 Dialogue of Questions and Answers
One of the identifying aspects of Gadamer’s (1975/1981) hermeneutic approach is the use of question and answer. Knowledge is constructed through dialogue; meaning emerges through a dialogue or hermeneutic conversation between the text and the inquirer (Koch, 1999). A “unique characteristic of hermeneutics is its openly dialogical nature: the returning to the object of inquiry again and again, each time with an increased understanding and a more complete interpretive account” (Packer, 1985: 1091). Gadamer equated “the metaphor of dialogue with the logic of question and answer” (Koch, 1996: 176).

3 The Hermeneutic Circle
Gadamer used Heidegger’s metaphor of the hermeneutic circle “to describe the experience of moving dialectically between the parts and the whole” (Koch, 1996: 176). In professional practice, and in research practice, the interpreter becomes part of this circle moving repeatedly between interpretations of parts of the text and interpretations of the whole text, representing an emerging understanding of the phenomenon. Through the hermeneutic circle the interpreter attempts to understand “the whole through grasping its parts, and comprehending the meaning of the parts divining the whole” (Crotty, 1998: 92). Using the concept and practice of the hermeneutic circle, the inquirer recognizes that the phenomenon or object of comprehension is understood as a whole because its parts are integrated and comprise it. At the same time inquirers recognize how the whole contextualizes each of the parts, seeking to illuminate the phenomenon within its context. The process involves an examination of the parts, examining each component before it is reintegrated into the whole (Bontekoe, 1996).

Gadamer (1975/ 1981) emphasized the need for interpreters to acknowledge their biases and prejudices (pre-judgements), and to recognize themselves as historically situated and shaped by traditions as part of the interpretive process of hermeneutics. He argued for the universality of the hermeneutical problem; the idea that situated interpretive activity lies at the heart of all quests for understanding.

An example of hermeneutics as a contemporary approach to inquiry
This section reports on a hermeneutic investigation carried out by Paterson and Higgs (2005) which sought to explore the relationship between reasoning and judgement in occupational therapy (OT). The specific phenomenon investigated in this research was professional practice judgement artistry (PPJA), a construct developed by Paterson and Higgs (2001) to explore the cognitive, meta-cognitive, and humanistic aspects of artistry in professional practice decision-making. The terms professional judgement, reasoning, practice decision-making are related terms. It is beyond the scope of this paper to debate the semantic and functional differences in their meaning; hence we will use them as associated rather than synonymous terms to reflect the multiple terms used by the research participants. The principal research question in this study was: “How can the term Professional Practice Judgement Artistry be understood in relation to OT professional practice?” We note at this point that, while the project was conducted in an OT practice setting, the research phenomenon of making practice judgements occurs across professions and is pertinent (within its different context) to psychotherapy.

A Hermeneutic Approach
We contend that professional practice entails judgement artistry beyond the simple application of technical knowledge and findings of evidence-based practice research, that PPJA can be best understood through an interpretive lens and that hermeneutics is an interpretive approach that is useful for coming to understand complex aspects of professional practice.

A reference group of 8 internationally recognized OT educators and researchers was identified from four countries: Australia, Canada, New Zealand, and the UK. Each of the reference group members had published in the area of OT professional decision-making and had established connections with OT practice communities.
The 53 participants included OT practitioners and workplace plus academic educators with approximately equal numbers of academics and practitioners.

Research activities
The construction of texts arose from two processes: focus groups and interviews. Participants were asked to describe how they conceptualised their judgement processes and to detail their observations of expert reasoning in others. During the focus groups the researchers identified individuals who made particularly interesting and insightful comments in the focus group and invited them to participate in individual interviews to elaborate more deeply on the focus group discussion and to consider more fully the phenomenon and dimensions of PPJA. As a result 3 practitioners and 3 educators from each country (n=24) agreed to participate in semi-structured interviews (one interview per participant) which facilitated a deeper understanding of PPJA. The texts (transcriptions) generated in the focus groups and interviews were treated as equally important and were thus combined in the various stages of text interpretation to enable a better understanding of the phenomenon of PPJA.

Participants shared insights about their experiences of recognizing, articulating and justifying to students how professional decision making operated in action. The transcripts of these sessions served as one set of texts for this interpretive inquiry. Utilising the Gadamarian strategies of fusion of horizons, dialogue through questions and answers, and the hermeneutic circle, the inquiry process was enacted through a series of what we have termed hermeneutic spirals.

Spiral 1 – Identifying and collating first text set
Initially we entered the hermeneutic spiral by clarifying our pre- judgements concerning PPJA and its components (professional judgement and practice artistry). What did the various terms and practices mean to us? How had we experienced them? This was the first attempt to make sense of the term we had created and the phenomenon it represented by seeking to understand the horizons we had created for ourselves through past learning, research, and practice experience. We reflected upon potential sources of interpretation and identified three text sets based upon: (a) reflection on, and clarification of, our own assumptions and pre-judgements about PPJA (b) a review of the literature which produced a set of collated texts containing existing concepts and ways of understanding the dimensions of PPJA and (c) texts comprising transcriptions from focus groups and individual interviews with OT educators and practitioners who discussed their experiences of PPJA.

While reviewing the literature, we sought to understand the way various authors were interpreting key concepts (ie clinical reasoning, professional decision making, professional artistry, professional judgement) related to PPJA. Four key questions emerged through this process which would become, at a later stage, a focus for a fusion of horizons between the voices of the text and the voices of the researchers.
1. What is PPJA?
2. Why is PPJA needed or valuable?
3. What is the nature of PPJA in OT practice?
4. How is PPJA developed in individual practitioners?

The next step involved conducting focus groups with all participants and interviews with 23 of the participants. Since the construct PPJA was unfamiliar to the target group, they were asked to speak about their experiences with the more familiar terms of clinical reasoning, and professional artistry and professional judgement. Through discussions of clinical reasoning the groups were able to transition into exploration of their experiences of professional judgement.

Spiral 2 – Exploring horizons, and a dialogue with questions and answers
Arising from the interpretation of the texts in spiral 1 we returned to address the principal research question. Hermeneutic cycling, involved moving between parts of the data and the emerging picture of the phenomenon, and this stage began a process of bringing the horizons of the participants into the analysis.
The hermeneutic process of questioning the texts and responding to emerging responses with more questions was beneficial in bringing a deeper interpretation and conceptualization to the research. Rather than limiting the inquiry to planned boundaries, the horizons of the research itself were reconfigured in response to the hermeneutic process and the emerging interpretation of the texts.

Spiral 3 – Fusion of horizons
We used hermeneutic analysis to focus on the more elaborate answers that had emerged from Spiral 2 and to fuse the participants’ and researchers’ viewpoints and thereby moved toward a bigger picture.

Spiral 4 – Fusion of horizons – Spiralling back to the whole
The goal was to interpret the significance of the emerging themes in light of the primary research question. The main themes identified at this stage were:

Table: Key Dimensions and Elements of PPJA in OT

A model was constructed to portray the interpretation of PPJA arising from the emergent themes and responses to the research questions.

Spiral 5 – Hermeneutic circle – Returning to the whole, engaging in dialogue
The “final” spiral illustrated as Figure 1 involved returning to the whole interpretation created of PPJA in a critique of the model produced against existing literature. The model was presented for critique to other reference group members, the doctoral research supervisors, and key researchers and scholars in the fields of clinical reasoning, professional decision-making and professional artistry. The model was refined on the basis of their reflections and critique.

Outcomes of using this hermeneutic approach
The rationale for using a hermeneutic approach was to illuminate the phenomenon of PPJA in Occupational Therapy practice and to identify the key factors (both external and internal to the practitioner) that characterize the phenomenon of PPJA in OT practice. The understanding of PPJA that resulted was developed as being: the capacity of professional practitioners to make highly skilled, micro-, macro- and meta-practice judgements that are optimal for the circumstances of the client and the context. The hermeneutic process informed the development of a 3-part model (Paterson, Higgs, & Wilcox, 2005, 2006) which generated four “dimensions” of the PPJA: professionalism; multi-faceted judgment; practice artistry; and reflexivity. Without an emphasis on human interpretation through attention to the fusion of horizons, dialogue, and the hermeneutic circle these dimensions would likely not have been revealed but rather would have remained tacit and invisible.

In this paper we have explored the use of hermeneutics as a research approach. We used the example of a particular study which set out to interpret and understand professional reasoning processes of expert therapists in 4 countries. We conclude that hermeneutics offers a fruitful though underutilized approach to inquiry in the human sciences (see also Kinsella, 2006). It has much to offer contemporary psychotherapists wishing to pursue significant, yet frequently overlooked, interpretive understandings of phenomena in professional practice and research.

Thanks to Ron Chenail, Editor of The Qualitative Report journal for giving permission to reprint Figure 1 in this manuscript.

Dr A M Higgs is the Strategic Research Professor in Professional Practice and the Director of The Education for Practice Institute at Charles Stuart University. Her primary role is the advancement of practice-based education through collaborations in research, scholarship, student supervision and education. She has produced over 20 books in in her fields of expertise in professional practice, practice knowledge, clinical reasoning, qualitative research and professional education.

Dr Margo Paterson is a Professor in the School of Rehabilitation Therapy and the Director of the Office of Interprofessional Education and Practice at Queen’s University, Kingston Ontario, Canada. Her research has focused on understanding the nature of collaborative practice including inter-professional education and professional reasoning. She is interested in understanding theory-practice integration to ensure best practice.

Dr Elizabeth Anne Kinsella is Associate Professor in the School of Occupational Therapy, Faculty of Health Sciences and in the Faculty of Education at the University of Western Ontario, Canada. Her work considers knowledge practices in research and practice with a particular focus on epistemologies of practice, the health professions, ethical issues in professional life, reflection, reflexivity and professional knowledge.

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Image: Treppe zu stilleben by Rupert Ganzer