“Thanks for Using Me”: An Exploration of Exit Strategy in Qualitative Research

Abstract

This article examines, through a synthesis of the literature and excerpts from a qualitative case study, the concept of exit strategy, specifically its relation to vulnerable populations (e.g., overweight adolescent boys) and potential impact on the researcher-participant relationship. The quality and duration of the researcher-participant relationship, along with rapport and trust building, are potential indicators for negotiated closure (i.e., exit strategy). Reframing this relationship as “participant-researcher” resituates vulnerable participants as foremost in such relationships. Given what is potentially at stake for participants in qualitative research, there is a moral and ethical imperative to enter into the dialogue of closure. Otherwise, participants may unwittingly serve as a means to an end, that is, as objects in the enterprise of qualitative research. Researchers, research supervisors, and human subject ethics committees are urged to establish protocols to guide how research relationships are ended within the context of qualitative methods, particularly with respect to vulnerable populations.

Keywords

exit strategy closure overweight adolescent boys vulnerable populations ethics

Lincoln and Guba (1985) identify that within naturalistic inquiry, the knower and the known are interactive and inseparable. Qualitative research therefore supports the importance of establishing a relationship with participants through building comfort, trust, and ultimately rapport between the participant and the researcher (Berk & Adams, 2001; Cutcliffe & Goward, 2000; Dickson-Swift, James, Kippen, & Liamputtong, 2006; Fontana & Fey, 1994; Irwin & Johnson, 2005). Trust and rapport are especially germane when studying sensitive topics (Corbin & Morse, 2003; Renzetti & Lee, 1993) and working with vulnerable populations (Moore & Miller, 1999).

Ethical issues (Robertson, 2000) and consequences (Lee & Renzetti, 1990) are associated with conducting qualitative research with vulnerable participants (Copp, 1986). Researchers are obligated to enact ethical approaches to ensure participant safety (Cutcliffe & Ramcharan, 2002; Frank, 2004; Orb, Eisenhauer, & Wynaden, 2000); establish researcher-participant boundaries, including the distinction between professional and researcher roles; understand the implications associated with the potential formation of friendships (Dickson-Swift et al., 2006); and ensure the personal safety of the researcher (Kenyon & Hawker, 1999; Paterson, Gregory, & Thorne, 1999). Although ethical dilemmas are often difficult to predict in qualitative research (Field & Morse, 1992), researchers who have invested little time considering ethical issues may have difficulty coping with unforeseeable issues as they arise (Batchelor & Briggs, 1994),

In light of the importance placed on establishing a relationship with participants (i.e., trust and rapport) and the associated ethical considerations of negotiating access with participants for data collection (Orb et al., 2000), equal emphasis regarding the closure of the relationship is warranted, as well as the ethical considerations therein. Such considerations are lacking in the research literature. This is an expository and reflective article about exit strategy and the limitations associated with this concept, especially as it is currently applied to the researcher-participant relationship involving vulnerable populations. Furthermore, a qualitative case study involving overweight adolescent boys illustrates the complexity of “ending” a study and proposes a theoretical shift from a researcher-participant to a participant-researcher relationship. “Thanks for using me asshole,” were the words one of the participants voiced when asked, “How would you feel if the researcher was gone today?”

Review of the Literature

Term Confusion in the Literature

Several terms have been used within the literature to describe concluding a research study. These terms include getting out (Iversen, 2009), leaving the field (Boynton, 2002; Cannon, 1992; Dickson-Swift et al., 2006; Iversen, 2009; Labaree, 2002; Stebbins, 1991), disengagement (Briggs, Askham, Norman, & Redfern, 2003; Iversen, 2009; Labaree, 2002 Snow, 1980), closure (Campesino, 2007; Snow, 1980), ending (Cutcliffe & Ramcharan, 2002; Read & Papakosta-Harvey, 2004), good-bye (Dickson-Swift et al., 2006; Robertson, 2000; Watson, Irwin, & Michalske, 1991), and exit (Booth, 1998; Cooper, Brandon, & Lingberg, 1998; McLaughlin, 2005; Reeves, 2010). Difficult for researchers is the array of terms that describe ending a research study. No one term or phrase within the literature fully describes the practices and processes to end a study.

Why Research Ends

Snow (1980) states, “the researcher leaves the field when enough data have been collected to sufficiently answer pre-existing or emergent propositions, or to render an accurate description of the world under study” (p.102). However, many other factors beyond data saturation can precipitate the end of a study. Examples include completion of the research agenda, the world being investigated is no longer seen as problematic or interesting, heightened confidence by the researcher that he or she knows the world being studied, institutional constraints, resource and/or researcher exhaustion (Snow, 1980), the pressure of funding timelines (Russell, 2005), and intra/interpersonal factors such as conflict within a research team.

Emotional Impact

When working for extended periods of time in research settings and establishing deeper relationships with vulnerable populations, researchers can feel both relieved to end the relationship or concerned and distressed by ending such relationships (Iversen, 2009). When leaving the field, researchers can experience a range of emotions, such as a sense of unfinished business, anxiety, or pressure from participants (Snow, 1980), relief and happiness (Stebbins, 1991), guilt (Russell, 2005; Snow, 1980), the feeling of being emotionally overwhelmed (Dickson-Swift et al., 2006), depression, deflation, and lethargy (Boynton, 2002), and sadness (Watson et al., 1991). They might also experience feelings of shock, anger, emotional pain, and loss (Cannon, 1992). A researcher who does not experience strong emotions when nearing the end of an in-depth and emotionally charged study may not have fully immersed himself or herself within the research (Snow, 1980). Of course, the nature and topic of the research, its duration (time-limited or longitudinal), and the degree of established rapport can impact the researcher's emotional response to ending the researcher-participant relationship.

Moreover, the study duration coupled with intimate conversations between the researcher and the participant can foster emotional dependence for the participants (Cutcliffe & Ramcharan, 2002; Renold, Holland, Ross, & Hillman, 2008). Disengagement, therefore, can require careful consideration (Booth, 1998) and will likely vary depending upon the community, culture, and researcher (Labaree, 2002; Reeves, 2010). For instance, among a highly sensitive and vulnerable population, such as women living with or dying from breast cancer, ending the researcher-participant relationship can be strongly related to a fear of abandonment among such participants (Cannon, 1992). Ensuring participants are aware of the ending strategy when involved in a structured program can be helpful to them (Booth, 1998; Read & Papakosta-Harvey, 2004), and therefore it is important to discuss closure so that participants can prepare for transition and closure (Campesino, 2007). An undefined ending can also leave participants surprised or shocked (Iversen, 2009; Russell, 2005). Even in cases where the researcher conveys an ending strategy, participants may also resist this notion and desire ongoing communication and contact with the researcher post-research (Gregory, 1994).

The characteristics of a researcher, the connection formed with the participant during research, and the sensitivity of the research being conducted can influence the desire to maintain relationships post-research (Boynton, 2002; Cannon, 1992; Dickson-Swift et al., 2006; Iversen, 2009; Stebbins, 1991; Watson et al., 1991). Researchers may frame the continuing relationship in a professional capacity, that is, as researcher or counsellor (Booth; 1998; Cutcliffe & Ramcharan, 2002; Iversen, 2009). They may honour a personal commitment (Boynton, 2002) or express interest in maintaining a friendship (Cannon, 1992; Dickson-Swift et al., 2006; Stebbins, 1991). Some researchers maintain minimal, but regular, contact such as sending holiday cards (Dickson-Swift et al., 2006). Researchers might also stay connected to the field of study (post-research) because of a personal connection, social involvement, future research opportunities, or ethical obligations (Stebbins, 1991).

Ending Practices

Ending practices and/or rituals, which are definitive, are identified within the literature as cues and boundaries inherent in the process of ending the relationship with participants (Iversen, 2009). These have included plaques, books, and gift cards given at the end of a research study (Iversen, 2009), a social farewell thank you and gathering (Russell, 2005), letters of thanks (Cannon, 1992), an open invitation to participants for further dialogue, if desired (Booth, 1998; Cutcliffe & Ramacharan, 2002), and possibly a certificate of attendance and celebratory meal (Read & Papakosta-Harvey, 2004). The intent of the ending practices or rituals offered to participants is to signal the end of the research study. In this way, researchers recognize participants for their contributions to the study (i.e., their words and behaviours in the form of data). This is indeed the case with most qualitative research.

Summary

Given the efforts by the researcher to establish rapport and trust (i.e., an outcome of the researcher-participant relationship), it is inappropriate for the researcher to unilaterally declare the end of a study. Thus, rather than simply generating awareness about exit strategies or rituals for participants, it is morally and ethically incumbent among researchers to negotiate and co-create with participants a meaningful closure (Letherby, 2003).

Published accounts of the processes associated with ending a study or leaving the field are lacking in the literature (Delamont, 2004; Iversen, 2009; Labaree, 2002; Snow, 1980), especially accounts wherein initial ending strategies are altered throughout the course of a project (Iversen, 2009). This gap is particularly evident when considering the sensitivity of ending a research study with vulnerable groups (Iversen, 2009; Robertson, 2000).

In part, this dearth reflects a researcher-centric focus in the literature. To date, the literature about understanding the dynamics involved in ending research has emphasized the emotional strain experienced by researchers, the role of stakeholders (e.g, institutions and funding organizations) in determining closure, and the obligation some researchers feel to define new relationships with participants. However, the powerful words voiced by the adolescent participants in the following case study reveal the potential emotional investment participants make regarding their research involvement. Hence, meaningful dialogue with participants, rather than a directive from researchers, to identify the ending of the participant-researcher relationship and not the researcher-participant relationship is warranted. The well-being, protection, and safety of participants necessarily include negotiated safe closure.

Case Study: Overweight Adolescent Boys and the Closure Experience

This case study is the partial graduate work of Zachary Morrison, a University of Lethbridge graduate student. “Through Their Voices: Experiences of Overweight and Obese Adolescent Boys” was an exploratory qualitative study privileging the voices and day-to-day experiences of overweight and obese adolescent boys. The purpose of the study was to gain insight into the quality of life of this population, knowledge that was missing from current literature.

“Through Their Voices” was conducted in a Canadian city of 60,426 residents (2008). The sampling criteria were fourfold: boys, aged 14 to 20 years, assessed by parents or professionals as overweight or obese, and not involved in an obesity treatment program. Three of the boys were “nominated” by physicians and other health-related care providers who were cognizant of the boys' obesity, for example, through body mass index. The other boy was nominated by his parents.

Participants met bi-weekly for a variety of group activities (e.g., movies, video games, and dinner) as well as interview sessions at community locations (e.g., coffee shops and the community college). In addition, each participant met individually and regularly with the researcher. The intent of the group activities was to develop trust and rapport among the participants and the researcher. One-on-one interviews were conducted, and they focused on exploring the daily lives of the participants. These interviews were about the boys (n=4) and not about their weight. The group activities (observations) and person-centered interviews (N=16) were held over a five month period, and included 55 face-to-face contact hours. In addition, there were also 25 non face-to-face contact hours with the participants, for example, through text messages, emails, and phone calls. The research study received ethical approval from the University of Lethbridge Human Subject Research Committee. All participants and their parents signed consent forms.

Participants are identified within the data through acronyms, based on their sports and leisure interests, for example, EO (Edmonton Oilers), NY (New York), MB (Motor Bike), and GP (Guitar Player). This approach not only contributed to the anonymity of the participants, but offered each participant an identity within the findings. Throughout the case study, the participants are referred to by their acronym.

Building Trust and Rapport

Given the sensitivity of weight and obesity, including the potential vulnerability of the participants, the researcher worked diligently to ensure appropriate activities were provided, a safe research environment was established, and participants' individual interests were met. This was achieved through attentive listening and observing, with a sincere interest in each of the participants. The goal was to establish trust and rapport as recommended by the qualitative literature. Constant attention was given to organizing activities that met everyone's schedule, choosing locations acceptable to all the participants, planning activities that everyone agreed to, and ensuring participants felt respected and had an equal opportunity within the group. Such efforts resulted in a participant-directed group, which empowered the participants and created an opportunity for individualism as each boy influenced group decisions.

As soon as the participants understood that the researcher was “there” for them, they were much more willing to enter into a dialogue about their lives. Once trust was gained, the researcher did not have to ask questions; the participants would simply share their thoughts, whether personal or not. Such intimacy within the interview process did not happen quickly, rather it required several months and many hours at both the group and one-on-one levels of engagement.

Ending: The Researcher

Given the frequency and nature of engagements with the participants, the researcher felt as if he was poised to “let them down” once the study approached completion because the research relationship closely resembled a mentorship bond. Knowing each of the boys personally made the notion of ending each relationship particularly difficult. The boys had their own daily life challenges, and the researcher felt that their bond benefited the boys, bringing fun, enjoyment, and camaraderie to each participant. Nevertheless, the research study was required to come to completion based upon pre-established research timelines. Funding, as well as time considerations within the graduate studies program, dictated these timelines. Although parents and participants acknowledged the research timelines, they regularly expressed the desire for their time together to continue post-research. Ending rituals (e.g., thank you cards, a final group gathering, thank you phone calls from the Thesis Supervisor to parents and participants, and personal gifts to each participant with an inscribed “thank you” from the lead researcher) were planned, similar to those noted within the literature.

Ending: The Participants

At the “end” of the study, the researcher felt strongly that he had an obligation to continue the relationship with each of the participants. This sense of obligation was rooted in the enjoyment the boys experienced during the study. Through numerous passing conversations, the participants and their parents felt that continuing the relationship was both a positive and needed outcome of the project. However, the one-on-one time expected by each participant and their parents steadily grew throughout the project, and thus became unsustainable. This post-research, extensive one-on-one time was not anticipated at the onset of the study. In fact, clear understanding of the situation was only realized once participants were directly asked during an interview to give their opinion on ending the researcher-participant relationship.

This question was not anticipated at the beginning of the case study. However, as relationships were established with the researcher and amongst the boys, there was an emergent sense that closure of this study would become difficult. Indeed, participants and parents wanted to continue contact post-research. The following textual excerpt reveals the strength of the bond established between the boys and the researcher.

Researcher: “How would you feel if we stopped hanging out as of today?”

Participant EO: “I'd be fucking pissed.”

Participant NY: “Thanks for using me asshole.”

Participant GP: “That would suck … huh. I enjoy hanging out with you guys.”

Participant MB: “Like have you discussed breaking up with anyone else yet?”

Researcher: “No.”

Participant MB: “I don't think you should do that.”

Researcher: “No?”

Participant MB: “I really don't think you should.”

Researcher: “Why?”

Participant MB: “Because it will be like a bomb shell being dropped on them.”

Researcher: “Really?”

Participant MB: “I fear it.”

Researcher: “Like what gives you that impression?”

Participant MB: “I don't know, it just does. I know Participant GP says this is fun, and Participant EO says, this is the most fun he's had forever.”

Following the interviews, which revealed the boys' feelings about ending the research, the researcher had informal conversations with each of the boys' parents. The parents echoed the boys' feelings, validating that this experience was positive for their sons, and the parents felt the relationships with the researcher and the group should continue.

Ending: The Study Project

Although ending rituals were indeed considered, very limited time within the scope of the overall research timeline was allotted to the process of closure with the participants. Considerable attention was directed to ethics (i.e., the Human Subject Research Committee, noting that once data collection was complete, the study would end), funding timelines, the time constraints of data collection/data analysis for graduate work, as well as the need for bringing the study to a successful closure (both meeting expectations of funding and saturation of the data). As a result of the relatively quick exit, each boy lost a group where he felt safe, a group where he had fun, and a place where he fit in. As Participant GP observed, “I enjoy hanging out with you guys.” But, it was not just the group that the boys lost, it was also the participant-researcher relationship. As Participant NY voiced, “You're a buddy. You're a friend. You're somebody who we can trust, feel that we possibly go to. A mentor.” Participant GP commented, “It is fun hanging out with you playing guitar and stuff.”

Participant MB expressed it best by asking, “Have you discussed breaking up with anyone else?” His words capture the potential impact that would be felt when ending this relationship, that is, breaking up. For example, Participant EO became angry as a result of the researcher-directed closure, and he lashed out through an email. This prompted consultation regarding the situation with the Chair of the University's Human Subject Research Committee. Discussion resulted in strategies to assist the participant in working through his emotions, which lead to a follow-up telephone conversation with EO's parents and the suggestion to have EO access local support systems such as Big Brothers and High School Counsellors. In fact, the Thesis Committee members now more fully recognize the importance of negotiated closure, but also the potential need for sustainable emotional support as part of the closure process with vulnerable populations. Open lines of communication among all involved were an important strategy to appropriately manage this unpredictable research project scenario, a strategy recommended in the literature (Batchelor & Briggs, 1994).

Discussion

A research study ends for a variety of reasons (Russell, 2005; Snow, 1980). The terms and approaches within the literature associated with the process of ending research are vague and varied (Booth, 1998; Boynton, 2002; Briggs et al., 2003; Campesino, 2007; Cannon, 1992; Cooper et al., 1998; Cutcliffe & Ramcharan, 2002; Dickson-Swift et al., 2006; Iversen, 2009; Labaree, 2002; McLaughlin, 2005; Read & Papakosta-Harvey, 2004; Reeves, 2010; Robertson, 2000; Snow, 1980; Stebbins, 1991; Watson et al., 1991). Exit, a consideration often neglected, under reported, or given less consideration in the literature (Delamont, 2004; Iversen, 2009; Labaree, 2002; Snow, 1980), is further complicated by term confusion. This creates difficulty for qualitative researchers who are searching for strategies about ending research, an important consideration, especially when thinking about the participant-researcher relationship.

In the case study presented, overweight and obese adolescent boys constituted a vulnerable population. The participants formed a strong attachment with a researcher. Not recognizing closure as a negotiated reality within the context of trust and rapport building placed the participants at risk for harm. Participant MB experienced closure as “breaking up.” “Breaking up” suggests the end of an intimate relationship and the possibility of emotional impairment therein. Reflecting back on the project timelines, the researcher recognizes that it was inadequate to engage in recruitment for 10 months, and then engage in five months of intense trust and rapport building with the participants individually and as a group, only to conclude the research relationship with a few token ending rituals. This lack of consideration toward the participant-researcher relationship was disconcerting for the researchers, because the participants deserved not only a voice regarding their day-to-day lives but also a voice to indicate how the participant-researcher relationship should end. Respecting the participant-researcher relationship does not necessarily end once data are collected, but once the participants and the researcher mutually agree to a closure process that is amendable to all parties. The participants' experiences and those of the research team should serve as a reminder about the potential for unpredictable ethical dilemmas (Field & Morse, 1992) for qualitative researchers working with vulnerable participants.

Currently the literature reflects ending practices and/or rituals that are pre-determined by the researcher to symbolize the end of a participant's involvement in a research study (Booth, 1998; Cannon, 1992; Cutcliffe & Ramacharan, 2002; Iversen, 2009; Read & Papakosta-Harvey, 2004; Russell, 2005). Newly defined relationships can continue between the participant and the researcher post-research (Boynton, 2002; Cannon, 1992; Dickson-Swift et al., 2006; Iversen, 2009; Stebbins, 1991; Watson et al., 1991). Nevertheless, missing from the literature is a participant-centred perspective about conducting a research study. Involving participants in the authentic co-creation of access (Orb et al., 2000) and an appropriate ending are moral and ethical imperatives. Researchers, research supervisors, graduate students, and human subject ethics committees are urged to establish protocols to guide how a research relationship is ended (Dickson-Swift et al., 2006) and to consider these protocols a priority (McLaughlin, 2005). In fact, and as a consequence of this case study, the University of Lethbridge Human Subject Research Committee now requires researchers to outline their “exit strategy” for termination of their studies. Of note is that participants may have difficulty disengaging from a project, especially when there is intense or lengthy contact between researcher and participant and where matters of the heart are involved (University of Lethbridge, n.d., p. 10).

Conclusion

Researcher-declared exit strategies may cause harm to participants. Researchers engaging vulnerable participants in sustained contact for the purposes of trust and rapport building are obligated to engage them in meaningful dialogue around closure. Although the participant-researcher relationship requires closure, sustainable emotional support may be advised, particularly with some vulnerable populations. Closure, practiced as a morally and ethically informed process and embedded in the participant-researcher relationship, is enacted throughout the duration of the study.

Unforeseeable ethical dilemmas arise despite thoughtful preparation. Open lines of communication, particularly among supervisors and researchers, are one method to effectively manage unpredictable issues (Batchelor & Briggs, 1994). The change in university policy was a positive outcome from this case study, an outcome from the open lines of communication between supervisor and graduate student.

Future Directions

Ending a research relationship under the auspices of bringing a study to a close is a vital component of an ethics submission. Moreover, how such closure is enacted with participants necessarily entails their meaningful participation and input. Closure, as a concept and process, is positioned as researcher-centric in the literature and warrants further critical analysis.

Footnotes

Acknowledgements:

Funding for this research project was provided by the Alberta Centre for Child, Family and Community Research. The research team would also like to thank the Advisory Committee members for their time and guidance on the project: Dr. Geoff Ball, Associate Professor, Department of Pediatrics, University of Alberta and Director, Pediatric Centre for Weight and Health, Stollery Children's Hospital, Edmonton, Alberta; Judith Down, Director, Alberta Centre for Active Living; Marcia Stodalka, Community Dietitian, Alberta Health Services; Catherine Morrison, Manager, Alberta Children's Hospital, Alberta Health Services; and Dr. Don Flaming, Nursing Program Coordinator, Medicine Hat College.

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