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QUALITATIVE

10.1177/1077800403251757
Corbin,
Morse /INQUIRY
DEALING/ WITH
June 2003
SENSITIVE TOPICS

ARTICLE

The Unstructured Interactive Interview:


Issues of Reciprocity and Risks When
Dealing With Sensitive Topics
Juliet Corbin
Janice M. Morse
University of Alberta
Qualitative research using unstructured interviews is frequently reviewed by institutional review boards using criteria developed for biomedical research. Unlike biomedical
studies, unstructured interactive interviews provide participants considerable control
over the interview process, thereby creating a different risk profile. This article examines
the interview process and literature for evidence of benefit and harm. Although there is
evidence that qualitative interviews may cause some emotional distress, there is no indication that this distress is any greater than in everyday life or that it requires follow-up
counseling, although the authors acknowledge distress is always a possibility. Essential
to preventing participant distress is the researchers interviewing skills and a code of ethics. When research is conducted with sensitivity and guided by ethics, it becomes a process with benefits to both participants and researchers. The authors conclude that qualitative research using unstructured interviews poses no greater risk than everyday life
and expedited reviews are sufficient.
Keywords:

qualitative research; interviewing; risk; ethics

Everyone agrees that among the highest duties of academics is to make


sure that the human beings they studyfellow citizens they probe,
query, prod, and palpateare treated with dignity and respect.
Shea (2000, p. 28)

This article grew out of a dialogue between the two authors regarding the
inconsistency with which institutional review boards (IRBs) review qualitative research proposals. Evidently, some review boards assess the risks as
Authors Note: This work was supported by an Alberta Medical Heritage Foundation
Visiting Scientist Award to Dr. Corbin and an Alberta Heritage Foundation for Medical
Research Senior Scholar Award and a Canadian Institutes of Health Research Senior
Scientist Award to Dr. Morse.
Qualitative Inquiry, Volume 9 Number 3, 2003 335-354
DOI: 10.1177/1077800403251757
2003 Sage Publications

335

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minimal because they do expedited reviews, thereby expediting qualitative


inquiry. Other IRB committees conduct full reviews applying the same criteria that they would to biomedical research. Their scrutiny extends beyond
issues of physical harm, confidentiality, and anonymity to include concerns
about the risks of psychological harm or emotional distress. In fact, some
IRBs are so concerned about the risks that they require researchers to develop
a priori strategies as a contingency should untoward effects occur, such as
identifying counselors for participant referral should the need arise.
IRBs are not alone in their apprehension. Many researchers have
expressed concern about the potential harm arising from unstructured interviewing (Cowels, 1988; Davis, 1990; Larossa, Bennett, & Gelles, 1981; Lee &
Renzitti, 1990; May, 1989; Munhall, 1988; Ramos, 1989; Rew, Bechtel, & Sapp,
1993; Smith, 1992). Despite the fact that our combined experience with doing
qualitative interviews totals almost 50 years and during that time weve had
no untoward incidents, we share the concern of these authors, and the possibility of causing possible harm remains as troubling to us as it does to others.
Yet our experience, which includes many years of conducting interviews on
sensitive topics, has been that participants react positivelyand in fact, many
are gratefulfor the interview experience. The purpose of this article is to
explore the risks and benefits of conducting unstructured interactive interviews on sensitive topics. The article begins with an examination of the interview process to ascertain if there are any components inherent in the interviews themselves that may produce harm. We then explore the literature for
evidence of the benefits or risks associated with qualitative interviews on sensitive topics. Finally, some suggestions are offered to IRB committee members
for reviewing research projects planning to use unstructured interactive
interviews to gather data on sensitive topics.

Potential Risks
What are the potential risks associated with unstructured interactive interviews when the topic of the research might be considered sensitive in nature?
Because participants are asked to tell their stories about some topic, they are
sharing personal, often intimate aspects of their lives. As such, there are certain risks associated with revealing matters of a personal nature. One risk is
that there might be a break in confidentiality/anonymity, with possible consequences of a social, financial, legal, or political nature. However, a break in
confidentiality is always possible when persons tell their secrets, even to
friends and relatives, and is less likely to happen in the research interview. In
the research situation, the risk of breaking confidentiality can be minimized
through scrupulous attention to record handling and the concealing of identifying information (Larossa et al., 1981). However, there can be no absolute
guarantee of confidentiality because records can be legally subpoenaed

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(National Institute of Health, 1998). Only when there is no way of linking specific records with specific persons (not even by participant numbers or codes)
or no records of participationsuch as signed consent forms (although verbal informed consent is obtained)can one protect against the risk of a break
in anonymity (Lipson, 1994). Even then, when quotations or cases are used in
writing or presentations, the risk that someone might be able to recognize the
persons represented in the quotes or cases still remains (Larossa et al., 1981).
Going beyond the risk of breaks in anonymity, there is the risk that interviews on certain topics might arouse powerful emotions. According to Lee
and Renzetti (1990), it is possible for any topic, depending upon the context,
to be a sensitive one (p. 512). The authors suggested, however, that some topics have a higher probability of causing distress than others. These topics
include those that delve deeply into the personal life or experiences of persons. Also included are topics that explore deviant or illegal activities, expose
the vested interests of powerful persons or persons engaged in coercive or
domineering behaviors, and are of a meaningful religious nature (Lee &
Renzetti, 1990).
Despite the fact that certain topics are considered sensitive and more likely
to cause distress, this doesnt mean that the risks are of the same quality and
intensity as those associated with biomedical studies, hence requiring full
and rigorous reviews. The risks associated with unstructured interactive
interviews should not be compared to clinical trials that use experimental
drugs or treatments that may cause potentially disabling or even lethal side
effects. Although participants are informed of the risks before consenting to
the study, once persons enter a clinical trial they have little or no control over
the research process, often not knowing if they have been assigned to the
experimental or placebo group. Conversely, in qualitative research, especially those using unstructured interactive interviews, participants retain
considerable control over the process (Cassell, 1980). To make the assumption
that all interviews are potentially harmful takes away participant agency and
control over what is said, how it is said, or if anything is said at all about a
topic (Cassell, 1980; Ramos, 1989). As an interviewee recently told Corbin
before beginning the interview, I dont know if I have resolved all of the
issues. I think I have, but if it becomes too painful for me to talk about things, I
will stop the interview. Furthermore, being overly concerned about potential risks also implies that the distress aroused by talking to a researcher is
greater than that experienced when talking about the same subject to a family
member or friend. It is not unusual for persons to be overcome by grief and
begin to cry when talking about sensitive topics to family members and
friends. The difference between family and researchers is that family members and friends often dont want to hear about such matters and/or are
embarrassed by the storytellers emotional response.1 Researchers are more
likely to be interested in hearing the story and to empathize.

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Implied in IRBss criticism of distress associated with unstructured interviews is that it is better for participants not to talk about painful topics than to
talk about them and bring issues to a conscious level where they can be dealt
with. Much depends, of course, on the severity of the distress and how long it
lasts and if the distress is counterbalanced by the therapeutic effects of being
able to talk to a nonjudgmental person and perhaps even to gain some insight
and closure on unresolved issues. Naturally, there will always be persons
who have unresolved issues that haunt and torment them and persons who
are emotionally fragile. For these people, the distress aroused during an interview may not be counterbalanced by the opportunity to talk. However, emotionally fragile persons and those who dont feel they can talk about a problem usually dont volunteer to be interviewed. If asked to participate,
provided the request is made in such a manner that participants are allowed
to say no, those uncomfortable or distrustful of the interview process usually
refuse to participate. For example, Cowels (1988) interviewed persons one
month after the sudden violent death of a loved one. Her participants told her
that if she had asked them for interviews earlier they would have not consented. They were either too overcome by grief at the time or busy handling
their affairs. However, after one month they were willing and ready to talk.

THE NATURE OF UNSTRUCTURED


INTERACTIVE INTERVIEWS
Unstructured interactive interviews are shared experiences in which
researchers and interviewees come together to create a context of conversational intimacy in which participants feel comfortable telling their story
(Ramos, 1989). The nature of unstructured interviews makes them contrary to
what quantitative research is normally considered to bea process in which
distance and control are highly valued. At the start of an unstructured interview, participants are not always aware of the course that an interview might
take or what secrets they might divulge. Larossa et al. (1981) stated that in the
comfortable atmosphere of the home and when there is trust, information
that a participant might not have otherwise chosen to reveal might be so. The
authors implied that the stance of interviewer as a friend rather than an
impersonal professional crosses conversational trust boundaries and may
entice the participant into providing information that they might later regret.
It is this very essence of trust and conversational intimacy that creates both
the potential threats associated with unstructured interactive interviews and
at the same time makes them potentially therapeutic as well as essential as
data collection tools. What transpires when two (or more) people come
together to talk about a topic of relevance to each party? We turn next to examining the nature of interviews. It is our contention that the interviewing process and the control given to participants, especially in unstructured interac-

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tive types, allows for management of many of the so-called risks associated
with doing interviews.
There are several types of interviews. There are unstructured interactive
interviews, semistructured interviews, and structured interviews, the main
difference between them being the degree to which participants have control
over the process and content of the interview (Cassell, 1980; Fontana & Frey,
1998; Morse, 2002). Our concern in this article is with the unstructured interactive interviews. In unstructured interactive interviews, sometimes referred
to as open-ended or narrative interviews, participants are given considerable
control over the course of the interview. Researchers establish what will be
studied or what Spradley (1979) called a grand tour question. Participants
are asked to tell their story as they see it, feel it, experience it. As such, participants determine where to begin the narrative, what topics to include or
exclude, the order in which topics are introduced, and the amount of detail.
Although researchers play an active role in the unstructured interview process by means of focused listening, they are not the central actors. Rather, central to the process are the interviewees who are telling their stories. Some
researchers do respond, probe, or ask for clarification during the course of the
unstructured interview (Fontana & Frey, 1998; Rubinstein, 2002). Other
researchers wait until participants have concluded their stories before asking
for clarification, believing that any intrusion into the interview process has
the potential to alter its course (Schutz, 1992). Of course, researchers by virtue
of being there do influence the process. Participants are telling their story for
an audience, even if at the time of the interview there is only an audience of
onethe interviewer. Participants know that eventually their story will be
told to others. It is also presumptuous to imply that researchers exert no control over the interview process. Their status as researchers gives them a certain degree of power over the situation. However, unless a researcher is domineering or intrusive, the control is minimal. In fact, many researchers go to
great lengths to reduce status differences by sharing information about their
own lives and why they have an interest in the research (Thompson, 1995).
(See Table 1 for a comparison of degrees of control held by participants/
researchers for the different types of qualitative interviews.)
According to Kvale (1984), the very act of talking with another person that
shares a common interest, is genuinely interested in your viewpoint, and who
is not critical can be a richly rewarding experience. Unstructured interviews
are not interrogation sessions. No one is asking a series of questions to which
participants are expected to respond. Although unstructured interviews
share some characteristics with counseling, interviews are not counseling sessions either (Hutchinson, Wilson, & Wilson, 1994). This latter point is very
important. The purpose of unstructured interactive interviews is to provide
guidance but to gather information about topics or phenomena that happen
to be of interest to researchers and at the same time are significant events or
experiences in persons lives. Although it is possible for an interviewee to feel

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TABLE 1:

Dimensions of Participant Control Over Interviews in Three Modes of Interviewing

Dimensions

Unstructured

Semistructured

Quantitative/Closed-Ended

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Power relations Agenda is set by the participant


Researcher determines the struc- Researcher determines what inforthrough the stories/events they
ture of the interview and agenda mation will be gathered. Particichoose to tell. Researcher may
through the questions asked. The pant may respond or refuse to
enhance the data collection proparticipant controls the amount
respond.
cess by active listening and askof information provided in
ing questions.
responses.
Control over
interaction

Direction of
interaction

Pr

RP

R?

Participant has the control over


the pacing of the interview,
what will be disclosed (the
amount of detail, scope of the
interview, etc.), and the
emotional intensity.

Participant may withhold


Researcher has most of the control.
important information because
The participant may only choose
the relevant question was not
whether to respond (correctly or
asked, may answer in a perfunc- incorrectly) or to refuse to
tory manner, or fully cooperate.
respond (i.e., to comply, sabotage,
or not to play the game).

P?

Pr

Pr

R=P
Rp
(Initially the researcher may
(May be undermined by the
control the direction. This shifts
participant by withholding
as the participant becomes more information)
comfortable with the interview
and commences narration.)

Rp

Note: Uppercase indicates dominance; arrow indicates direction. R = Researcher; P = Participant. This table was adapted from Cassell (1980).

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that he or she has been coerced into being interviewed, consent forms make it
clear that persons are free to choose whether to participate. Furthermore, persons may withdraw from a study at any time without penalty. The topic of the
investigation is explained clearly before persons agree to be interviewed, and
once the agreement is made, researchers and participants together negotiate
the time and place to meet. Some participants may have told their entire story
before to family, friends, or even strangers. Other participants may have only
told their story in bits as events unfold, never before given the opportunity to
tell the entire story in one sitting (Morse, 2002). Some prospective interviewees are nervous about partaking in an interview, especially if they have never
participated in one before. But then, the same holds true for interviewers, particularly inexperienced ones.
Regardless of how many times individuals have told their story or how
experienced a researcher might be, each time an interviewer and an interviewee come together for the first time, it marks the beginning of a new relationship. The dynamic nature of qualitative interviews makes it impossible to
predict with certainty what will transpire. However, most interviews follow a
standard course. For purposes of this article, the interview process will be
explored in four phases: the preinterview phase, the tentative phase, the
phase of immersion, and the phase of emergence.
We take this opportunity to explicate the process of a typical unstructured interactive interview for the following reason. We want to demonstrate
to IRB committee members and other interested researchers that when
unstructured interviews are conducted with caring and sensitivity they present opportunities for reciprocity as well as risks. We dont mean to imply that
psychological risks are nonexistent. Rather, the risks are often contained
and mitigated by the benefits that participants receive by telling their stories.
The preinterview phase. Before an interview begins, the purpose of the interview is explained, even if this means repeating the material presented when
the interviewer first established an appointment with the participant. The
consent form is reviewed thoroughly. It is important to determine if the participant fully understands what being a research participant entails (Lipson,
1994). Once the researcher is confident that any concerns or questions about
confidentiality, anonymity, and so on are resolved, the participant is asked to
sign the consent form, and permission to tape record the session is sought and
obtained. Participants are reminded once more that they are free to withdraw
from the study at any time. This assurance is especially important if the interview referral was obtained from an agency or organization where participants receive service.
During the preinterview phase, there is often much small talk, especially if
the interview is being conducted in a place where participants might not feel
as relaxed as they would be in their own home, such as an agency or at a university. This is a time when the participant(s) and researcher assess each other
and begin to establish a degree of comfort and trust. This initial period is very

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important and should never be hurried for it sets the tone for the forthcoming
interview. It is the beginning of a temporary but important human connection
that will intensify and grow over the course of the interview. It is also the
period in which the groundwork for reciprocity (Schoenberg, 2002) is established: An interview is an exchange. The participants sometime share intimate information, but the researcher gives something in return: a sense of
presence or of being with the participant in the story.
Reciprocity extends beyond being there with the participant. Participants,
in agreeing to participate in a study, usually do so because they want something in return even though they themselves might not be consciously aware
what this is. Sometimes they want validation that they are recovering or are a
good person despite what might have happened to them. Sometimes they
desire information, such as about an illness or possible services. Often they
need to unburden and there is no one else to whom they can turn to tell their
story. A frequent reason cited by persons for consenting or requesting to participate in a study is the hope that telling their story will help others. Some
people just have a need to talk. Talking helps them to sort things out, make
sense out of events, or conquer fear or shame. Sometimes persons want to see
how a stranger reacts to their story before they tell it to someone closer to
them. Usually, there is no overt or spoken contract between participant and
researcher about what the exchange will be. However, a conscientious
researcher will try to discern what it is participants are seeking, then if possible provide that either during the interview or once its over. (See footnote 3
for a further discussion on this topic.)
The tentative phase. The preinterview phase gradually gives way to the
interview itself, though the movement between the two phases is often not
discernable. Participants dont just start out telling intimate details of their
lives; they work up to the story as they begin to trust the investigator (Mishler,
1999). There may be some testing of interviewer response as participants
wonder what and how much can be told. Unstructured interactive interviews
provide the opportunity for participants to construct their stories, reliving
past experiences during the course of the narration. As they shape the story,
participants take into account their own emotional responses to what is being
revealed as well as the verbal and nonverbal responses of the interviewer and
adjust their storytelling accordingly. As trust builds, gradually more of the
story unfolds. As with any good novel, the narration begins with background
information about the persons lives and the events leading up to the event of
interest. Slowly, the layers of a participants life are peeled back, exposing the
self to varying degrees, thereby moving the narration into the next phase.
The immersion phase. Unstructured interviews dont necessarily follow a
strictly linear pattern. They vary in quality and duration. Some participants
are more introspective, thoughtful, and tell their stories better than others,
choosing to reveal more of themselves by expressing their inner thoughts and

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feelings. Other persons tend to limit their conversation to the factsfirst this
happened, then this, then that. In a good interview, both participant and interviewer gradually become immersed in the unfolding drama of the story. To
ease any tension or to gather thoughts, participants sometimes take side trips
to talk about topics unrelated to the research or stop talking for a few
moments to gather their thoughts or think something through. Participants
may move back and forth in time and between events and sometimes even
contradict themselves. These contradictions do not necessarily negate the
story. Rather, they are indications that by telling their stories, participants are
trying to make sense out of significant events in their lives, a clarity that might
have eluded them until they sat down to talk. At certain points in the narration, depending on the nature of the interview, the telling might become distressful to the participant, the story provoking feelings of deep loss and grief,
anger, or despair. An interviewee might cry or become too overwhelmed to
go on. Usually when this happens, a sensitive interviewer stops the narration
until the participant regains composure. Although researchers might not
have encountered the same loss or have undergone the exact experience,
many researchers have also experienced sorrow, loss, anger, and despair.
Therefore, during these intense and distressful moments, researchers often
connect with participants at a very deep level. They too are caught up in the
story and share feelings of loss, grief, and/or anger with participants. At the
same time, experienced qualitative researchers are able to step back and provide the empathy and support that participants might need to work through
troubling experiences. Much of this is done in silence, the researcher sitting,
being there for the participant.
Once a participant regains composure, he or she is usually given a choice
about whether to continue with the topic, change to another topic, or terminate the interview, perhaps making arrangements for the participant to
return at some later date. A good interviewer never leaves the interview with
the participant in a distressed state but uses this period to take the participant
on to the fourth stage. As stated by Smith (1992), to interview and then leave
someone in emotional distress without adequate support or safeguards is
morally wrong (p. 102).
Phase of emergence. In the fourth and final phase, the interview shifts to a
less intense emotional level. The topics that are discussed might be just as relevant to the story but are of a less emotional and sensitive nature. As in the
preinterview phase, the interviewee might ask personal questions of the
interviewer or talk about events in his or her past. For example, toward the
end of a recent intense interview conducted by Corbin, the interviewee took
the researcher out into the backyard to look at the garden and the new retainer
wall that had been built. After that, they shared tea and cookies and talked
about the holidays before finally concluding the session.2
The phase of emergence is the time that without fear of influencing the narrative flow, the researcher can provide information, advice, or validation.3

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This is not to say that after the tape recorder is turned off and the interviewer
is ready to go that the interview is necessarily finished. Sometimes, a participant takes this opportunity to reveal some extremely relevant information or
secret. In fact, this often leaves investigators scrambling to get out their pen
and paper or turn the tape recorder back on. Although one might interpret
this delayed action in many different ways, one might also consider this one
more piece of evidence that the interviewee is really in control of what information, how much information, and when that information is delivered.4
It is important to remember that qualitative interviews also can be very
demanding of researchers. They become involved in the story and reach out
in empathy to participants. In a way, they become part of that story. As stated
by Kleinman and Copp (1993), we assume that field researchers selves and
emotions are always implicated in the research (p. 52). Because interviews
can be so intense for participant and researcher, it is important that both
achieve a level of comfort and readiness before they part (Booth & Booth,
1994).
These authors experiences with unstructured interactive interviews have
been positive, however we represent only a sample of two and a biased one at
that. The concern at this point is with other researchers experiences and what
they have written about the emotional distress and issues of reciprocity and
risks. We turn now to the literature regarding risks of benefits of interviews in
general.

Risk of Harm
Brzuzy, Ault, and Segal (1997) stated that some of their interviewees
reported a lack of concentration and anxiety in anticipation of being interviewed. The authors also stated that some interviewees experienced emotional distress while being interviewed and had nightmares after recounting
their experiences. However, the authors did not state for how long the nightmares occurred or if any of the participants required counseling services.
Interestingly, two of the coauthors of the article were also informants in the
study, prompting them to sit down with the primary researcher to talk about
their experiences during the interview along with the risks. What the authors
sought to bring out in their article was the potential for revictimizing participants by having them recount their stories. The authors implored researchers
to be sensitive to participants emotional state and aware of the ethical considerations when doing research on female victims of trauma. They also suggested that researchers make contact with participants 1 to 2 days following
an interview to determine if there are any distressing effects still lingering.
During parts of the interview when his interviewees were confronting,
reliving, or remembering traumatic events in their lives, Wong (1998) noted
that the interviewees showed emotional frustration, behavioral outbursts of

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pain, sadness, and grief. Yet despite this, he noted that most of the women
said that they enjoyed the interviews. Wong added that the sessions enabled
women to vent their anger and relive memories while laughing at their
mistakes.
While exploring perinatal loss, Kavanaugh and Ayres (1998) asked the
participants for their reaction to the interview after its completion. The
authors pointed out how difficult it is to evaluate participants reactions
merely by noting their verbal responses. Their experience with studying loss
has led them to suggest that a more accurate indication of degree of distress
can be obtained through a review of field notes for number of attempted contacts, canceled appointments, and characteristics of the interview and setting.
The authors described how one interviewee cried during the interview but
stated afterward that being able to talk about the loss of her baby was helpful.
However, the same woman was 40 minutes late for a subsequent interview.
The woman also cried during the second interview but wanted to continue.
She stated that although a memory or conversation could prompt sadness,
sometimes there was no identifiable reason for her sorrow. The woman went
on to say, sometimes it [answering painful questions] helps you to think and
get over it (Kavanaugh & Ayres, 1998, p. 93).
Turnbull, McLeod, Callahan, and Kessler (1988) conducted a survey that
examined married couples responses to stressful life experiences and related
psychopathology. A general population sample of 1,755 respondents was
used. Data were collected through two interviews. In the first, a screening
instrument administered by lay interviewers was used to identify respondents with psychiatric problems. Those participants with problems were
interviewed a second time by a mental health professional to gather diagnostic information. As part of the first data-gathering process, interviewers were
asked to rate participants reactions to the interviews. Of the 1,755 participants, only 45 were rated as being distressed by the interviews. Overall, more
participants expressed enjoyment with having the opportunity to talk than
were distressed by it. Reasons given for distress were concern about the
spouses reaction to respondents participation, the length of the interview,
and certain questions on the questionnaire. The uncomfortable questions pertained to recent painful or embarrassing events in participants lives. The
researchers acknowledged that one of the problems with the interviewer rating is that they applied only to the time of the interview. The researchers did
not know how long the distress persisted. The only possible measure available to the researchers to measure long-term distress was participant willingness to participate in a second interview. Of the 45 participants who were
rated as distressed in the first interview, 22 were eligible to participate in the
second. Of those, 12 refused to participate in a second interview, 9 consented,
and 1 moved away. However, even among the 12 who refused to participate
in a second interview, the reasons for refusal were mixed. Four reported not
having enough time, 4 were concerned about their spouses reaction, and

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only 4 refused without explanation. The researchers concluded that the distress caused by the first interview was minor and short-lived. In the second
interviews, which were conducted by clinicians, the interviewers were told
that they could do whatever seemed appropriate to handle distress in participants should the need arise. Most clinicians reported that respondents
enjoyed the interviews and that they were never called on to use their clinical
skills.

Benefits
Hutchinson et al. (1994) listed seven possible benefits of qualitative interviews. They stated that interviews (a) serve as a catharsis, (b) provide selfacknowledgement and validation, (c) contribute to a sense of purpose, (d)
increase self-awareness, (e) grant a sense of empowerment, (f) promote healing, and (g) give voice to the voiceless and disenfranchised. Honeycutt (1995)
described interviews as informal, unorthodox, lay interventions. He stated
that happily married couples view oral histories as a means of informing
other couples that despite the high number of divorces, happy marriages are
possible. On the other hand, unhappily married couples use interviews as an
emotional release and a reference point for understanding their relationship.
Ortiz (2001) reported that he was surprised to discover after initial interviews
with wives of professional athletes that the sessions took on a therapeutic
value. Participating in interviews gave the wives an opportunity to express
pent-up feelings and in the process, experience emotional ventilation and in
some cases self-transformation.
People tell their stories to be heard (Frank, 2000). Although illness may be
demoralizing, people use storytelling as a way of re-moralizingwhen life
is hard, telling serves a recuperative role in that it enables persons to gain
some distance from what is threatening. Furthermore, Lipson (1994) stated
that though sometimes there is uncontrolled crying and struggling to regain
control during and after interviews, there appear to be no ill effects.

A CASE FOR SKILL AND ETHICS


In this review of the literature there is no documentation that interviews
have caused long-term harm or that participants required referral for followup counseling. In fact, even though participants experienced some degree of
emotional distress during and immediately afterward, the anecdotal evidence suggests that interviews are more beneficial than harmful. Yet, it
remains that no one can predict what will be said in the course of an unstructured interview, the feelings it will provoke, or any long-lasting effects. Much
depends on the ability of the interviewer to judge and respond to the emo-

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tional state of the participant (Kavanaugh & Ayres, 1998). Also important is
having a code of ethics to guide the entire research process from framing the
question, to choosing a population, to writing up and presenting the findings
(Munhall, 1988). Thus, we make a case for skill and ethics.

Interviewing Skill
Interviewing is a skill, one thats not readily learned in the classroom,
although some disciplines, such as social work and psychological counseling
and nursing, provide interview training skills that may be transferred to
research interviewing. Interviewing skill seems to develop with experience.
A good interviewer must be able to establish rapport and trust (Schoenberg,
2002), gather information without controlling the flow of information, and
record it accurately (May, 1989). First interviews by novices are often awkward, with the interviewer injecting comments and questions more often
than necessary, usually because of discomfort with pauses and silences in the
conversation. Fortunately, while reading transcripts of their interviews, most
novices are able to see the errors in their approach, and in subsequent interviews there is less input from the researcher. Sensitivity, on the other hand, is
more of a personality trait than a skill. It too is a necessary ingredient for interviewing that aims to minimize the distress of participants. Sensitivity cant be
learned from a textbook but must be fostered and developed through interaction with others. Other qualities of a good interviewer include authenticity,
credibility, intuitiveness, receptivity, and reciprocity (Rew et al., 1993).
Several authors provide guidelines for minimizing the distress associated
with interviews. Interviews must be adapted to the needs of respondents,
including the need for pacing, taking breaks, postponing painful discussions,
and terminating interviews should they become too distressful (Kavanaugh
& Ayres, 1998; McSherry, 1995). In cases where the discussion becomes too
painful, it might be necessary to abandon a topic based on cues from the participant. In painful interviews, it is important that participants be able to
choose the words with which to tell their stories. Participants want to get the
story right and sometimes ask for copies so that they might read what they
said. Even before beginning a study, researchers should clarify the ethical
principles that will guide the research and respect the interests of participants. Booth and Booth (1994) believed that rapport and trust are two-way
processes and that it is important to give as well as receive information. Also
relevant is setting aside ones own values and standards for judging, overlooking such things as how participants keep house. Most important is delivering what one promises and pacing the withdrawal from the research relationship in accordance with participants readiness.
Unstructured interactive interviews are exhausting for the researcher.
Booth and Booth (1994) reported feeling tired and exhausted from the strain

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of sharing the anguish of participants, thus bringing out the importance of


researchers looking out for and caring for themselves as well as for
participants.

Using a Code of Ethics


Ethics are acquired through discourse and reflection on ones own and
others experiences and as part of professional development within the context of ones culture. Ethics provide the basis for conduct in research (Davis,
1990; Munhall, 1988; Punch, 1986). (See also Mishlers [1986] important work
on co-constructing realities and interviews as conversations and ethics.)
Although IRBs set standards, they are not on site to enforce those standards.
IRBs rely on researchers to act within a code of ethics to protect the rights of
their research participants (Smith, 1992). Rosenblatt (1995) made the point
that the interactive nature of qualitative research that requires direct contact
between participants and researchers can actually prevent researchers from
engaging in the ethical self-delusion that can occur when researchers have little contact with participants. This is because researchers and participants
actually co-construct ethical realities during the course of the interviews.
Cieurzo and Keitel (1999) argued that qualitative research is an unfolding and
emerging process, therefore participants cannot be fully informed about all
the potential consequences of the research or even all the particulars that will
be covered. Lipson (1994) listed several ethical issues related to qualitative
research. These are discussed in the following.
Informed consent. Participants must fully understand what it means to participate in terms of risks and benefits. Fully understanding can pose difficulties when there are cultural differences and language barriers. It is the responsibility of the researcher to make certain that participants understand their
rights, especially the right to not participate or to withdraw from the research
at any time. But cultural differences and language are not the only barriers.
Brody, Gluck, and Aragon (1997) conducted an interview study with undergraduate students that asked about their experiences with participating in
psychology experiments in their university. In the course of their study they
discovered that most of the participants had only a limited understanding of
the purpose of a signed consent.
Deception or covert research. Although carrying out covert research is rare
today, Lipson (1994) stated that the issue is not so much one of either deception or covertness. She placed covertness on a continuum and stated there are
times when it is easier to go ahead and gather certain data when making
observations rather than interrupting a situation to ask for consent, thereby

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altering the course of events. When deciding how to proceed in such


instances, the researcher must rely on his or her code of ethics to judge the propriety of using information gathered in this manner. Perhaps the best way to
proceed is to obtain post hoc consent to use the information as data. In making
judgments, the safety and integrity of participants always comes first. When
there are potential risks along these lines, data collection must give way to the
rights of participants.
Researcher responsibility to informants, sponsors, and colleagues. Researchers
have a responsibility to maintain confidentiality, to keep appointments, and
to provide for the personal safety and well-being of participants. There is also
the responsibility to publish findings and to do justice to participants and
their cultures.
Risks versus benefits. The benefits of research to participants should outweigh the risks. Beyond emotional risks, the researcher should be aware of
any social, political, legal, and economic complications that might result from
having participated in research and take measures to safeguard against these.
Reciprocity and intervention. Although researchers do give back to participants in a variety of ways (e.g., giving information, writing letters, making
phone calls, etc.), problems can arise when participants make requests that go
beyond the social norms. Although a request might not be considered unethical from the cultural or social perspective of the participant, it might be unethical according to a researchers standards. Again, only the researcher can
make a decision of how to act under these conditions, responding to a participants request according to his or her code of ethics.
One cant talk about ethics without talking about the issue of exploitation.
Usually this term refers to power and status differences, with some researchers believing that the balance of power tends to be in favor of the researcher
(Thompson, 1995). We disagree with this latter point and hold the view that
during qualitative research, especially that using the unstructured interactive
interview, the balance of power is in the hands of participants. One could
argue that all research exploits participants to some extent and that researchers stand to benefit more than individual participants from any given
research project. Careers are built on research, status is enhanced, and in some
cases, there is even financial compensation in the form of grants. Yet, the issue
is more complicated than it appears at first glance. There is reciprocity
between researcher and participant, as noted earlier in this article, with each
gaining something from the experience. In addition, there are benefits to society in the form of professional knowledge development. These benefits are
not undervalued or overlooked by participants, who often consider the
opportunity to participate in research as the opportunity to give back indirectly to society.

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SUMMARY AND CONCLUSIONS


The issue of whether qualitative unstructured interviews meet the guidelines for expedited reviews by IRBs is complex, with no simple answer. We
ourselves have not encountered any situations that have provoked undue
distress or lasting harm, at least that we are aware of. There is considerable
reporting in the literature that research participants find unstructured interview validating and offering opportunities for introspection and growth
(Frank, 2000; Honeycutt, 1995; Hutchinson et al., 1994; Ortiz, 2001). Even
when signs of distress are reported, researchers have not provided any evidence of lasting harm (Brzuzy et al., 1997; Kavanaugh & Ayres, 1998; Turnbull
et al., 1988; Wong, 1998). That is not to say that harm has never happened or
that the potential is not there. However, it appears to be a rare occurrence,
most likely because potential participants have the right to refuse to participate in the study and do control the course of unstructured interviews
through what they choose or not choose to reveal.
In regards to IRB reviews, we do not believe that it is justified to hold
unstructured interviews up to the same rigid criteria as biomedical studies.
With the latter, the threat of lasting physical damage, psychological consequences, and even death is very real, especially with drug studies, whereas
we could not locate a single reported case of lasting psychological harm from
studies using unstructured interviews. However, we acknowledge that even
a single case of long-lasting psychological harm would provide evidence for
more stringent IRB review of qualitative studies, and we are open to reports of
this nature.
As it now stands, who benefits from a full IRB review of qualitative proposals using the same criteria that are applied to biomedical studies? Is it the
participant, who can then be assured that the interview or observation will
cause no harm? Or is it the institutions or researchers, who are then absolved
if something untoward occurs? The uncertain course of research using
unstructured interviews means that no one can anticipate what will happen
or how the participant will respond emotionally when recalling and reliving
their experiences. Depending on the person and the situation, any recalled
event may be distressful to some persons. Perhaps we have forgotten that
such distress should be considered within the context of what is being
revealed and ask: Is the manifestation of distress normal and of a nature
that one might find in everyday life? That is to say, is it no greater than what
would occur if the story were being told to family members or friends?
Before concluding, we would like to offer some suggestions that IRB committees might use when reviewing studies planning to use unstructured
interviews to gather data on sensitive topics. We phrase the suggestions as
questions. Answers to the questions might make it easier for committees to
expedite their reviews.

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Consideration of the researchers skills. Have the researchers (or the interviewers they will hire) reported receiving any training in qualitative research
especially in the techniques of interviewing? That is, have they taken a
course(s) that specifically enables them to learn the skills they will need to
conduct an interview in a manner that does not provoke distress and that
enables them to recognize signs of distress and take measures to diffuse it if
necessary?
Doing qualitative research has become trendy, and a qualitative piece is
often included as part of a larger quantitative study. This is not to say that
quantitative researchers dont know how to conduct interviews but that they
may not have the intensive training and feedback that qualitatively trained
researchers receive as part of their programs. The question for the IRB committees would be where and how was the researcher and interviewers trained
to do interviews.
Level of risks varies with the topic of the interview. Not all studies using
unstructured interactive interviews are likely to generate the same degree of
distress in participants. Certain topics are more likely to arouse distress than
others, such as spousal abuse and those that explore major illness and loss or
that are incriminating or embarrassing. When dealing with sensitive topics, it is important for IRBs to determine if the researchers considered the
potential that strong emotions might be aroused by the research. Also, have
the researchers built into their proposals procedures for evaluating and terminating an interview should participants become severely distressed? For
example, have researchers stated that interviewers will remain with the participants until they reach a stable emotional state? Have the researchers
assembled a list of local counselors that can be given to participants should
distress arise during or after the interview? Have the researchers made provisions to call participants several days or even a week after the interview to
determine if there is any lingering distress?
In the end, the onus of responsibility for protecting the rights of participants lies not so much with IRB committees as with researchers who are ultimately alone with participants in the research situation. Unstructured interactive interviews involve reciprocity as well as risks. Without skill in doing
interviews and a strong code of ethics to guide them, researchers cannot carry
out their mission, which is to collect valuable data while protecting the rights
of participants. With skill and ethics, dignity, respect, and concern will automatically follow.

NOTES
1. When the authors speak of everyday life risks, they are referring to the level of
emotional distress often experienced by persons when they tell their stories to family
members and friends. Contrary to researchers, family members and friends often dont

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want to hear the story and/or are embarrassed by the intensity of the emotional
response.
2. It is important to point out that not every interview ends with tea and cookies, nor
should it. What is being brought out here is that sometimes participants need time at
the end of an interview to come out of their deep emergence in their story. This coming out is especially important if the narration is about a sensitive topic that is difficult
and emotional for the participant to talk about. It is important that researchers recognize participants need time to get over their emotional response. In other words, it is not
a matter of taking your information and running. Part of the time allotted for an interview includes time given to participants to go through the phase of emergence so as not
to abruptly cut off the intimate context of storytelling.
3. The provision of information, feedback, or validation at the conclusion of an interview is not to be confused with counseling. It must be kept in mind that during interviews two or more human beings come together for a temporary interaction. Similar to
other human beings in a social context, they often exchange information that might
benefit the other and/or offer validation about behavior. Often interviewers have information about places and things that might be considered useful to the participants.
Also, participants sometimes have information related to the topic of inquiry that
might be useful to the researcher but that is not part of the narrative. There is no reason
why researcher and interviewee cant share information or give validation just as two
other human beings might do. The important thing is to not interrupt the narrative discourse but to wait until the storytelling comes to a natural ending.
4. This four-phase description of the interview process primarily reflects the experience of these authors. We do not state that there is anything new in these phases for
researchers who do unstructured interviews. However, not all persons on institutional
review board committees are qualitative researchers and therefore may not know how
these are conducted. Also, we want them to know that there are many styles of interviewingand variations within thesebut all are invariably conducted with sensitivity and caring. Although researchers are gathering data, they remain attuned to participants emotional and physical state. If they notice distress, researchers take action to
mitigate that distress (Ramos, 1989). During the most intensely emotional periods, participants are given the freedom and time to cry, vent, and express anger if necessary.
They can stop talking until theyve regained composure or stop completely. This again
is not to be confused with counseling but is an empathetic and caring response that
might occur between any two human beings.

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Juliet Corbin, D.N.Sc, is a senior scientist at the International Institute for


Qualitative Methodology at the University of Alberta. She collaborated with
Anslem Strauss for many years, coauthoring Unending Work and Care
(1988), Shaping a New Health Care System (1990), and Basics of Qualitative Research: Grounded Theory Procedures and Techniques (1998).
Her research interests are in the areas of chronic illness, the sociology of work,
and the professions.
Janice M. Morse (Ph.D. [Nurs.], Ph.D. [Anthro], D.Nurs [Hon], FAAN) is
the scientific director of the International Institute for Qualitative Methodology, Canadian Institutes of Health Research senior scientist, Alberta Heritage
Foundation for Medical Research senior health scientist, professor, faculty of
nursing, University of Alberta, and the 1997 Sigma Theta Tau Episteme Laureate. She has published extensively in the areas of comfort, suffering, and
qualitative methods and serves as coeditor of International Journal of Qualitative Methods and editor of Qualitative Health Research. She has
authored, coauthored, or edited 14 books, including Read Me First: A Users
Guide to Qualitative Analysis (2002) with Lyn Richards, The Nature of
Evidence in Qualitative Inquiry (2001), Completing a Qualitative Project: Details and Dialogue (1997), and Critical Issues in Qualitative
Research Methods (1994).

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