Child Life Work and Qualitative Research: A Perfect Match

ACLP Bulletin | Winter 2019 | VOL. 37 NO. 1

Jenny Chabot, PhD, CCLS
Ohio University, Athens, OH

As a graduate student in the 1990’s, I fell in love with qualitative research. My first introduction was reading Barrie Thorne’s Gender Play: Boys and Girls in School (1993), detailing her ethnographic research focusing on fourth and fifth graders in their world of the classroom and school playground, and how intersections of race, socio-economic class, and gender help shape childhood experiences. As I read on, I could see myself on those playgrounds with the kids, could remember back to my own experiences playing with friends in school, and remember who controlled the cool spaces, and who was ostracized from their peers and why. I could vividly picture the playgrounds Thorne described, feeling the dirt at my feet as I smacked the ball around the pole in the tetherball pit. The idea that I could feel so connected to people’s stories was powerful, and that feeling has never left me. I did not know research as a process could be this fascinating. As I was assigned and read more qualitative research throughout graduate school, it brought me into the living rooms and the work and play spaces of adults, families, and children. To borrow from the movie Jerry Maguire, qualitative research “… had me at hello.”

As I began teaching child life students and integrating qualitative research as a process into my classes, I realized the power of capturing the voices of child life specialists, patients, siblings, and parents and caregivers in my scholarship. I wanted my students to fall in love with this research methodology, and I encouraged this by discussing my experiences doing this kind of research. As I taught the key concepts and methods of qualitative research, the powerful connections between the skills of qualitative researchers and the skills, roles, and responsibilities of child life professionals began to clearly unfold. For this Research Corner article, I would like to discuss some of those research concepts and essential skills and how they connect so well to the daily work of child life.

The clinical skills of a child life specialist fit beautifully with the skills necessary for a qualitative researcher, including being able to sharply observe your surroundings (observation).

The clinical skills of a child life specialist fit beautifully with the skills necessary for a qualitative researcher, including being able to sharply observe your surroundings (observation). Daily, as child life professionals, you help patients and their families understand the world of healthcare by stimulating sensory experiences. As a qualitative researcher, you utilize all of your senses during your observation of people in their natural setting, so you can teach children to do what you know so well. In both realms, you record in detail what you are witnessing—doing so objectively—yet you are also called upon to interpret what you are seeing, to help others gain an understanding of what is going on in the setting you are studying. In child life work, you do this every day. You are acute observers of body language, watching for subtle aspects of non-verbal communication, as you work to interpret what a child may be thinking, worrying about, and questioning. In your work, you are called to interpret what a child could be thinking or feeling to medical and other psychosocial team members, so observation is an essential skill in your daily work and these skills mirror the work of a qualitative researcher.

Skilled observers also work to learn the language of the people they are studying, as you do in child life. You build on your awareness and gather details of children’s and family’s lives. In child life, you capture the dailiness of each patient’s and family’s experiences, and this is what we do as qualitative researchers. You immerse yourselves in these settings to help build trust and rapport, and work to foster an in-depth and rich understanding of their lives as patients.

My first attempt at qualitative research was for my doctoral dissertation. I was a graduate assistant in student affairs throughout my doctoral program. I began to witness the difference in the experiences of two women in our office who were trying to become parents. One was heterosexually married, very open about her path towards parenthood, sharing updates and her excitement, and she became pregnant. The other woman was in a lesbian relationship, and was not open about her own path. She had disclosed to me that she was dealing with infertility as she attempted to become a parent via donor insemination. Observations of real-life experiences can often lead to a research study (the beauty of grounded theory), whether qualitative or quantitative. As both women shared their experiences of parenthood, it began to become glaringly obvious how different their paths to parenthood were: One was openly excited and sharing, and the other was not quite ready to “out” herself in her workplace while having to be incredibly intentional in her goal to be a mom. This led to me interviewing 10 lesbian couples who became parents together in the context of their current relationships, and who utilized donor insemination. To learn more about the parenting process for these families, I was invited to a lesbian mom’s support group in my community, where I was able to introduce myself and share my research idea. What I learned from these women, and as I completed two focus groups and interviews with each couple, was that there were issues surrounding the intentionality of their path to parenthood, including legal issues and decisions about who would attempt pregnancy first, how to navigate the often complex process, and many other aspects of navigation. As a researcher viewing this topic through the privileged lens of heterosexuality and as a non-parent, I had a lot of work to do to understand the language of my participants. I carry these early experiences with me every day in my work, to remember the importance of doing my best to understand what and whom I am researching.

Interviewing skills are essential in qualitative research: asking relevant, open-ended questions that are not leading. Again, this is a skill of child life work, as you ask questions of patients and families that are created with thought. The questions you ask are done with great care, to ensure they are developmentally appropriate, sensitive, yet probing so you can help patients understand the healthcare experience. It is not a far leap to take these kinds of interview skills and translate them to the world of research, where carefully crafted questions are an integral part of solid research design. You probe for further information, as do qualitative researchers needing additional clarification for a question posed to participants.

Facilitating focus groups, another tool used in qualitative research, is also not a far leap from child life work. Many of you facilitate a number of groups, including sibling support groups, bereavement groups, and parent advisory teams. This is a tool already familiar in your child life profession. In order to successfully facilitate focus groups, you need to be a skilled moderator, knowing how to sensitively handle tougher topics, making sure every participant has a voice, and ensuring participants feel safe. As child life professionals, you already are skilled moderators as you advocate for children’s voices to be heard, making sure they feel safe in the healthcare environment. Having a plan is important (just like you do in planning child life interventions), as is ensuring that participants understand their role in a research study (as you do every single day helping children to understand their role in their own healthcare experience).

Case studies are often done in qualitative research, providing an in-depth look at a particular family, phenomenon, community, or institution. We delve deep in case studies and you delve deep in understanding the children and families you work with in child life. You consistently ask yourselves, “What can I learn from this family?” in the same way I ask, “What can I learn from this study?” to advance and/or validate lived experiences.

Ethnography, a form of qualitative research, often uses case studies to place us at the center of who/what we are researching. Is this not what child life workers do every single day? You place yourself at the center of your patients and their families to learn and understand their story—so critical in the daily work you do. A great example of an ethnographic study that is relevant to child life work is a book I assign in my qualitative research class, Annette Lareau’s (2011) Unequal Childhoods: Class, Race, and Family Life. Lareau shares very detailed case studies of families she and her research team spent time with, exploring the roles that race, socio-economic class, and gender have within each family system she studies. I challenge anyone to read this book and not reflect back on your own childhoods, comparing yourself to the different families highlighted. The children and their families Laureau spends time with (often staying at their houses for days at a time) are the children you work with in your various, diverse healthcare settings, so this book resonates well with child life students, as it provides a cross-section of the diversity of family life throughout the United States. Actress, director, and producer Sarah Polley’s (2012) documentary on her own family experiences, Stories We Tell, is another interesting glimpse of ethnography using a case study, told through the lens of Polley’s siblings and parents as they examine the history of their family and explore the question that has existed throughout the timeline of their family: Who is Sarah’s biological father? Although not an actual research project, Stories We Tell is a fascinating introduction to the unfolding stories of families that occurs in qualitative research.

In critical ethnography research, we take on the role of an advocate, finding ways to empower those who are often powerless by telling their stories as accurately as possible, without exploitation of their participation. We work to gain entry as trusted researchers in the same way you work to gain entry to the lives of patients and their families: We are the gatekeepers of doing our work in non-exploitative ways and with integrity. Advocacy on behalf of children and families, and creating a safe, trusted environment, are at the heart of child life work—a perfect partnership of these skills.

What I have discussed here is a small piece of qualitative research and is just a glimpse of the complex work you do in child life. However, I hope it serves as a tool to get your creative juices flowing and to begin your interest in this kind of rich, fulfilling research. Reflect on the stories of your patients and their families that need to be told and put in the context of the research process (with proper institutional IRB approval, of course—essential in all research), so that their voices are heard. Find ways to utilize qualitative research to capture the aspects of your work that can be difficult to measure: emotions, rituals, routines, feelings, behaviors, and meaning of experience, to name a few. Child life professionals have direct access to the stories of patients and their families, and sharing these voices in the research format creates a powerful partnership that can only advance what we know about patient and family experiences.

REFERENCES

Lareau, A. (2011). Unequal childhoods: Class, race, and family life, with an update a decade later (2nd ed.). Berkeley, CA: University of California Press.

Polley, S. (Writer & Director). (2012). Stories we tell [Motion picture]. Canada: National Film Board of Canada.

Thorne, B. (1993). Gender play: Boys and girls in school. New Brunswick, NJ: Rutgers University Press.

Membership

ACLP Connect