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

Different types of therapy case study

Bloch-Elkouby, S., Eubanks, C. F., Knopf, L., Gorman, B. S., & Muran, J. C. (2019). The difficult task of assessing and interpreting treatment deterioration: an evidence-based case study. Frontiers in Psychology, 10, 1180. 

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), 18. 

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), 239257.

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), 529557

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), 4551

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, 212223.

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, 4049. 

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), 270292. 

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, 119. 

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), 695729. 

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), 1527. 

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