Doing Research in Counselling and Psychotherapy
Student Resources
Carrying Out a Systematic Case Study
The key messages of this chapter are:
- case study analysis makes a distinctive contribution to the evidence base for counselling and psychotherapy
- case studies are ethically sensitive, so need to be carried out with care and sensitivity
- it is important to be aware of how different types of research question require different case study approaches.
The following sources are intended to help you to explore issues covered in the chapter in more depth.
Methodological issues and challenges associated with case study research
Flyvbjerg, B. (2006). Five misunderstandings about case-study research. Qualitative Inquiry, 12, 219–245.
Essential reading – a highly influential paper that clarifies the value of case study methods
Fishman, D. B. (2005). Editor's Introduction to PCSP--From single case to database: a new method for enhancing psychotherapy practice. Pragmatic Case Studies in Psychotherapy, 1(1), 1–50.
The rationale for the pragmatic case study approach
Foster, L.H. (2010). A best kept secret: single-subject research design in counseling. Counseling Outcome Research and Evaluation, 1, 30–39
An accessible and informative introduction to n=1 single subject case study methodology
McLeod, J. (2013). Increasing the rigor of case study evidence in therapy research. Pragmatic Case Studies in Psychotherapy, 9, 382–402
Explores further possibilities around the development of case study methodology
Different types of therapy case study
Systematic case study that combines qualitative and quantitative information to explore a theoretically-significant case of apparent client deterioration. Case was drawn from dataset of a larger study
Brezinka, V., Mailänder, V., & Walitza, S. (2020). Obsessive compulsive disorder in very young children–a case series from a specialized outpatient clinic. BMC Psychiatry, 20(1), 1–8.
Example of how a series of n=1 case studies can be used
Faber, J., & Lee, E. (2020). Cognitive-Behavioral Therapy for a refugee mother with depression and anxiety. Clinical Case Studies, 19(4), 239–257.
A hybrid theory-building/pragmatic case study that seeks to develop new understanding of therapy in situations of client-therapist cultural difference. Clinical Case Studies is a major source of case study evidence – this study is a typical example of the kind of work that it publishes
Gray, M.A. & Stiles, W.B. (2011). Employing a case study in building an Assimilation Theory account of Generalized Anxiety Disorder and its treatment with Cognitive-Behavioral Therapy. Pragmatic Case Studies in Psychotherapy, 7(4), 529–557
An example of a theory-building case study focused on the development of the assimilation model of change
Kramer, U. (2009). Between manualized treatments and principle-guided psychotherapy: illustration in the case of Caroline. Pragmatic Case Studies in Psychotherapy, 5(2), 45–51
A pragmatic case study that also seeks to address important theoretical issues associated with the use of exposure techniques in CBT
McLeod, J. (2013). Transactional Analysis psychotherapy with a woman suffering from Multiple Sclerosis: a systematic case study. Transactional Analysis Journal, 43, 212–223.
A hybrid case study – mainly aims to develop a theory of therapy in long-term health conditions, but also includes elements of pragmatic, narrative and HSCED approaches. Good example of the use of the Client Change Interview in case study research
Powell, M.L. and Newgent, R.A. (2010) Improving the empirical credibility of cinematherapy: a single-subject interrupted time-series design. Counseling Outcome Research and Evaluation, 1, 40–49.
Example of a series of n=1 case studies
Stige, S. H., & Halvorsen, M. S. (2018). From cumulative strain to available resources: a narrative case study of the potential effects of new trauma exposure on recovery. Illness, Crisis & Loss, 26(4), 270–292.
A narrative case study based on client interviews
Kellett, S., & Stockton, D. (2021). Treatment of obsessive morbid jealousy with cognitive analytic therapy: a mixed-methods quasi-experimental case study. British Journal of Guidance & Counselling, 1–19.
Example of an n=1 case study of a single case. Useful demonstration of how this approach can be used to study non-behavioural therapy
Wendt, D. C., & Gone, J. P. (2016). Integrating professional and indigenous therapies: An urban American Indian narrative clinical case study. The Counseling Psychologist, 44(5), 695–729.
A narrative case study based on client interviews
Werbart, A., Annevall, A., & Hillblom, J. (2019). Successful and less successful psychotherapies compared: three therapists and their six contrasting cases. Frontiers in Psychology.DOI: 10.3389/fpsyg.2019.00816.
Combined narrative, theory-building and cross-case analysis, based on interviews with client and therapist dyads
Widdowson, M. (2012). TA treatment of depression: A hermeneutic single-case efficacy design study-case three: 'Tom'. International Journal of Transactional Analysis Research, 3(2), 15–27.
Example of an HSCED study that also includes elements of theory-building. Supplementary information on journal website includes full details of the Change Interview and judges’ case analyses. This open access journal has also published many other richly-described HSCED studies
Issues and possibilities associated with quasi-judicial methodology
Bohart, A.C., Tallman, K.L., Byock, G.and Mackrill, T. (2011). The “Research Jury” Method: The application of the jury trial model to evaluating the validity of descriptive and causal statements about psychotherapy process and outcome. Pragmatic Case Studies in Psychotherapy, 7(1),101–144.
Miller, R.B. (2011). Real Clinical Trials (RCT) – Panels of Psychological Inquiry for Transforming anecdotal data into clinical facts and validated judgments: introduction to a pilot test with the Case of “Anna”. Pragmatic Case Studies in Psychotherapy, 7(1), 6–36.
Stephen, S. and Elliott, R. (2011). Developing the Adjudicated Case Study Method. Pragmatic Case Studies in Psychotherapy, 7(1), 230–224.