Steff Revell, one of our MSc students has been using the Helpful Aspects of Therapy (HAT) form to study Adventure Therapy. She contacted me yesterday to ask, “how you analyze the helpful/hindering events part of your HAT questionnaire.” She’s given permission for me to post my reply here:
The Helpful Aspects of Therapy (HAT) Form generates lovely qualitative descriptions of significant therapy events. These data tend to be informative, lively and information-dense. There are lots of different ways to analyze HAT data:
First, if it's a new therapy or population that hasn't been studied in this way before, it may make sense take an open-ended approach and do an open coding (one aspect of Grounded Theory) of the descriptions, just to see what emerges.
Second, it's useful to know that HAT forms generate a fairly specific range of types of information:
(1) Descriptions of helpful things that happened in the therapy (=Processes)In Grounded Theory terms (following the Elliott-Hill interpretation), these 4 kinds of information are called "domains", and can be useful for organizing your analyses into smaller collections of meaning units that are easier to analyze.
(2) Descriptions of helpful reactions the informant had to the therapy (=Effects)
(3) Descriptions of previous states of affairs or events that explain why the informant found something helpful (=Context)
(4) Descriptions of hindering processes, effects or contexts (this is much this common, so processes, effects & contexts can be grouped)
Third, a couple of different content analysis systems have been developed for HAT data, one for generally analyzing the kinds of therapeutic effects generated (The Therapeutic Impacts Content Analysis System, Elliott et al., 1985); the other specific to individual experiential therapy (Elliott et al., 1988). If the relevant variables in the therapy you are studying match the variables measured in these content analysis measures, you could train yourself and a couple of other folks to use them to rate your HAT data.
Fourth, because HAT are often pretty information-dense a more intensive, interpretive discourse approach to qualitative analysis can used, particularly if you're bringing a particular theoretical interest to your study, such as relational or emotion processes. I've done a small demonstration project illustrating this approach (Elliott & Schnellbacher, 2007), if it sounds useful.
Fifth, a related discourse analytic approach is to identify partiicular kinds of events of interest and study how informants construct descriptions of them. I did this for insight event descriptions in Elliott (2007).
References: [unpublished documents available from me by request]
Elliott, R. (2006). Decoding Insight Talk: Discourse Analyses of Insight in Ordinary Language and in Psychotherapy. In L G. Castonguay & C.E. Hill (Eds), Insight in Psychotherapy (167-185). Washington, DC: APA.
Elliott, R., Kemeny, V., Clark, C., Morehouse, V., Norgard, T., San Gregory, A. & Van Tassel, J. (1988). Helpful Aspects of Experiential Therapy Content Analysis System (Version 2.0). Rating manual, Department of Psychology, University of Toledo.
Elliott, R., Reimschuessel, C., Sack, N., Cislo, D., & James, E. (1984). Therapeutic impacts content analysis system - 1984 version. Rating Manual, Department of Psychology, University of Toledo.
Elliott, R., & Schnellbacher, J. (June, 2007). Relational and Emotion Processes in First Sessions of Process-Experiential Therapy: An Interpretive Discourse Analysis of Clients’ Accounts of Significant Events. Paper presented at meeting of Society for Psychotherapy Research, Madison, WI.