research summary

I have been trying to find funding to support research into the 6-Part Story Method for about three years from Spring 1998. In late 1999 my employer started to fund me (part-time, one day per week) and I started a PhD in October 2000 in the Clinical Psychology Department of the University of Hull.

Throughout the three years I made several applications to funding bodies (Dept of Health, NHS Executive, Medical Research Council) and finally in May 2001 won a 2-year Research Fellowship from the Northern and Yorkshire NHS Executive. This Fellowship, worth about £78,000, will pay for me full-time at my present salary, plus all course fees and travelling and conference expenses. It feels like a huge amount of money but it has also been a huge struggle to get here!

A summary of the study is below:

TITLE: The Validation of a Novel Assessment of Personality Disorder

AUTHOR: Kim Dent-Brown, Dramatherapist, HERCH NHS Trust, Specialist Therapies Service, Miranda House, Anlaby Road, HULL HU3 2RT.

Tel: 01482 617503. Email: kim@dent-brown.co.uk

BACKGROUND: The Six-Part Story Method (6PSM) was developed in Israel as a projective test to use in screening survivors of major trauma such as terrorist incidents. In this country it is being used by the author's team, a specialist assessment service for patients with personality disorders. The 6PSM involves the patient constructing and telling a fictional story. Interpretation of the story appears to reveal information about the teller's attitudes, concerns, thoughts and feelings. Despite its attractions to clinicians, the 6PSM has never been formally validated and this work needs to be done. The method undoubtedly produces much projected material. The question is: does this material tell us anything useful about the storyteller, or are the projections those of the interpreter?

AIMS: The aim of this study is to examine the reliability and validity of the 6PSM and its various methods of interpretation.

OUTLINE OF METHODOLOGY

SAMPLE: There will be three samples. (1) 30 clients referred to the specialist personality disorder service. (2) 30 non-personality disordered clients of the general mental health service. (3) 30 clinicians from the mental health service.

PROCEDURE: The 90 subjects will be interviewed by the researcher and a 6-part story elicited from them. They will also be asked to complete a psychotherapy screening tool (CORE) and a self-report tool looking at inter-personal problems (IIP). The clinician group will also receive training in the administration and interpretation of the 6PSM - this training will be given after they have produced their own stories. The clinician group will be asked to rate the stories in a number of ways, including one developed by the researcher which identifies reciprocal roles.

Members of the clinician group will be presented with stories blind as to the group membership or any other details about their authors. They will be asked to analyse the stories in a number of ways in an attempt to establish which - if any - methods produce the best inter-rater reliability. CORE and IIP results will be used to assess concurrent validity. The clients who produced the stories will also be asked to comment on the face validity of the interpretations. Test-retest reliability will be assessed with a sub-sample. The text of the stories produced will also be subjected to computer-based content analysis, looking at linguistic style, content, recurring themes, and any unexpected patterns within or between groups.

The following assumptions will be tested:

That there is some degree of test-retest and inter-rater reliability of the 6PSM

That raters can interpret client material without contaminating it with their own projections

That there are significant differences in the 6PSMs produced by the three groups.

That there is a degree of concurrent validity with the self-report questionnaires used.

That useful information on the nature and severity of symptoms can be inferred from the 6PSM

That content analysis of the text of the stories will reveal hitherto unexpected patterns

That authors express satisfaction with the face validity of the data educed from their stories

LIKELY IMPACT ON THE NHS

Projective tests are popular in mental health settings, but tend to be either dated forms restricted to Clinical Psychologists or to be applied in non-standardised and idiosyncratic ways. This study would produce the evidence base for the standardised application of an easily learned, quickly applied test which has already shown itself to be readily accepted by clients and staff.