Flying by the seat of your pants and magic behind doors: an interpretative phenomenological analysis of difficult decision making in clinical practice

Abstract

Introduction The process of decision making has been widely studied within different academic paradigms. Many theories and models have been developed from this research activity. However, there is a lack of in-depth research on individuals’ experience of decision making. The present research explores this topic with Clinical Psychologists. This group of professionals are trained to be expert in a specific discipline, which emphasises the need for making informed judgements and for justifying decisions. Objectives To provide an in-depth account of how Clinical Psychologists experience decision making in the context of clinical practice. To relate the analysis to theories and models of decision making and to research on factors thought to influence judgement and decision making. Method Semi-structured interviews were conducted with seven Clinical Psychologists. These were transcribed and analysed using Interpretative Phenomenological Analysis (IPA) methodology. Outcomes Elements of the decision making environment such as managing one’s conflicting beliefs and difficult emotions, responding to uncertainty and changeable scenarios and normative versus unique elements of one’s practice were elucidated in the analyses. The contribution of this work to research in decision making and the development of clinical practice are discussed.