Mentioning the unmentionable – is no subject taboo in a group?

Mentioning the unmentionable – is no subject taboo in a group?

By Fiona Jack

As a qualitative researcher, I have on many occasions been asked to conduct research on sensitive or embarrassing topics, including conditions like diarrhoea, male and female incontinence, athlete’s foot and fungal nail problems, colostomy bags, sexually transmitted diseases and flavoured condoms to name but a few.

The first reaction when faced with these issues is to think: “it can’t be done”, or that the best approach would be a depth interview or an online panel, to spare everyone’s blushes and gain a more honest or truthful picture of the topic.  I’d argue, however, that almost any topic can be handled in a group discussion given the right circumstances, and that in most cases, a conducting groups will take you further in terms of new learning than other techniques can.

The development of a rapport between moderator and participants, and between the participants themselves in any qualitative group discussion is key to gaining real insights into behaviour and motivation, and this is especially true of sensitive topics.  The moderator must put people at their ease, give them permission to say what they really feel, not what they think they should say or feel, and make them want to reveal something about themselves.

Group dynamics are important in this context too.  In our experience, participants are much more willing to confide from the safety of a group of people who share the same problem than they are in a vacuum.  Group dynamics help people build on one another’s comments, and they are encouraged by the revelations of others to reveal something of themselves, which may not have emerged if interviewed in isolation.  I have over the years been party to some fascinating “confessions”, which are perhaps best left to the imagination!  It is amazing what people will tell you if they feel comfortable enough. (Maybe there’s a book here?)

Of course this kind of rapport can be built online, as is clear from the popularity of chat rooms and forums. However, the physical proximity of actually eyeballing someone in a small room, I would argue, allows a deeper intimacy to develop.  In addition, there is the element of body language, which gives an indication of unspoken feelings or moods.  A good researcher can tell from body language whether someone is bored or interested, being truthful or giving a sanitised version of the truth.  There is simply no substitute for being there, as despite great advances in technology, the nuances and subtleties of human behaviour can’t yet be picked up remotely.

Another key advantage of a face to face approach is the ability to use a range of techniques which enable participants to articulate more deeply held feelings and beliefs, than those which come to mind immediately.  Direct questions get direct, often highly rational answers.  It isn’t the ‘wrong’ answer, but it may only be a part of the bigger picture… and the bigger picture is what we need if we’re gain insights which go beyond the obvious.  Using techniques such as psycho-drawing or collage work never fail in my experience to uncover responses which go beyond the superficial and help take learning forward.

When dealing with sensitive subjects, it’s vital to ensure all participants are briefed adequately so they know the rules of engagement, so they won’t get a nasty shock when they arrive at the venue and are asked to taste a flavoured condom or discuss their bladder weakness or flatulence problems.  This has to start with recruitment, ensuring that the recruiter sets the scene well, reassures participants about confidentiality, anonymity and how any recordings will or won’t be used. They must be able to screen out anyone who would be uncomfortable with sniffing or licking a condom.

I have found that once the initial awkwardness is over, most people are more than happy to share their experiences, even about the most personal topics. Feedback we’ve had from participants when they’ve taken part in research about embarrassing topics, has often been that they’ve found the sessions therapeutic.  The most memorable example of this was a group of men in their 50’s talking about their incontinence problems – which some of them hadn’t shared with anyone before, even their partner! Whilst the therapeutic element isn’t the primary raison d’être, it represents an added benefit for the participant.  Set the research up properly, build rapport and confidence, think about appropriate techniques, and most subjects can best be approached in a group situation.

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