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Case Studies in Counselling and Psychotherapy: An Introduction by John McLeod

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This content provides a comprehensive overview of case study research, covering its historical context, rationale, principles, practicalities, and various applications, particularly within psychotherapy research. It emphasizes the value of case studies in capturing complexity, unfolding processes over time, and understanding contextual influences.

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okay um

well i thought i'd um i'd i'd kind of

give an overview

uh of uh some of my

kind of thoughts about all this and then i've

i've

i've i'm already aware of um

questions from emily and

from uh edis and

um so i mean we can have more questions but

but

i mean the questions that have been sent

to me already

kind of fit quite well i think with a

discussion because emily's kind of at

the beginning of planning

yeah and he just i think you've got

all the data so you're the writing

it's kind of the other end of it isn't

it analyzing and writing

yeah um so anyway i think

if i um

uh i i think if if if

mick gives me or maybe i've already got

everybody's email addresses anything

that comes up

in terms of suggested reading and stuff

i can send it at the end

and if it's if there's going to be a

version of this

on the on your kind of departmental

whatever website then

we can figure out how to put recommended

reading up there

later yeah okay that'll be brilliant

john and john story i should have said

at the start thanks so much for doing

this i'm very incredible yeah

so nice

it's a nice thing to do you know as an

alternative to being locked in the house

and never have anybody to speak to

really so

um so i think just

uh i thought i'd talk about kind of

very briefly background to case study

research the kind of rationale for

principles and practicalities and so

forth just to kind of set the scene

i think the the um

uh the background is that i

i think i mean case study inquiry and

case study knowledge

is just so basic

in so many disciplines in kind of

medicine and management studies and law

and so on and i think one of the

problems in psychology

is that when the when the

kind of experimentalists took over and

then the

the kind of quantitative researchers

took over

uh case studies got marginalized and so

we're in a process

of rediscovering case studies but

but i think one of the things to keep in

mind about the kind of

general interest across all the social

sciences and humanities and

case studies is that there is a a massive

massive

um mainly untapped potential knowledge

about how to do case study inquiry

out there um if we can kind of look

outside of psychology or look beyond psychology

another thing is i mean my own interest

i don't know how i particularly got

interested in this but

i mean i was one of these people who was

like a consumer of therapy

for many years um uh while i made a living

living

as a psychology lecturer it wasn't until

fairly late in life that i got

trained uh as a counselor

and i used to teach um personality

uh psychology on a psychology degree

and i became uh particularly interested in

henry murray so henry murray is

i think best known as being the co-designer

co-designer

of the thematic appreception technique

with tat

and in my psychology degree i mean

remember i'm really

old you know i'm kind of even much older

than mick

so um this was a long time ago when i

did psychology again we were taught

about projective techniques and i'd always

always

thought protective techniques were

actually a pretty good thing and i was

interested in money

but then as i somehow as i was teaching

some of murray's ideas i became more aware

aware

that it was all based on case study research

research

and i managed to actually

have some communication in a meeting

with murray before he died and

i think that really kind of

crystallized an interest in case studies

and i think

the kind of rediscovery of case studies

within psychology and then most recently

with more recently within psychotherapy

research owes a lot to money that's not

and then i think i mean there was a period

period

when i was working in dundee and in

glasgow there was mick

and there was also robert elliott and

there's a lot of

kind of really useful collaboration

going on and

robert elliot was really interested in

case study methodology robert and i

managed to get

a grant from esrc years and years ago to run

run

um a kind of seminar

uh a series of seminars on case study

methodology with

kind of big-name people coming over from america

america

and stuff and that kind of fed into

the book which you'll be familiar with

my case study reception counseling and psychotherapy

psychotherapy

and the um i was kind of really looking

at the book

um in preparation for today

and i thought yeah that's okay but

it at the time it was really hard to

write it

there was not actually that many case studies

studies

to draw upon and literature to draw upon

and since then i've started

sort of constantly um asked sage

if i can do a new addition

and they have not wanted me to do a new addition

addition

on basic commercial grounds that sells about

about

like 10 copies a year and um

so anyway um so that's some of the

background from

my perspective i think another thing is

that i think my best research book

is a book called doing research in

counseling and psychotherapy

and in that i um

i i'm basically trying to construct an

argument which

i don't think anybody has ever caught

on to because i don't think i made it

clearly enough but i i think i think

i've all

i've thought for a long time that there

are kind of five

different kinds of therapy products that people

people

need to learn to do so

one is a literature review i mean like

publishable products like a paper you

need to

know what to do to produce a literature

review paper you need to

know what to do to do some sort of outcome

outcome

evaluation paper you know sort of

naturalistic pre-post design

outcome evaluation you need to know how

to do

uh qualitative research like ground

theory and ipa

you need to know how to do it

autoethnography and

also case study research and

it's like i think because i think that

one of the

things that's holding us back as a

discipline in terms of our relationship

with research

is that uh people get trained you know

people do masters and doctorates and things

things

and they become competent in one of

these methodologies

and they when they then write things uh

um they're not drawing and publishing

things they don't they're not drawing

upon an

appreciation of the other methodologies

so um so

we may come back to this later

uh in terms of um

some of the implications for that

let me highlight just not to be

mysterious i mean i think one of the

implications of that

is that case studies um

are as you we all know already

you know those of you who interested in

writing a case study or doing a case study

study

study uh it's quite a complicated and

intricate and ethically sensitive thing

to do

and um it's

it's the kind of thing that's probably

easier to do

later in your career when you've got

cases that you might want to write up

and things like that but if you haven't had

had

training earlier on in

case study methodology then it's it's very

very

difficult to kind of uh know how to go

about it and i mean in the past i used

to do

quite a lot of workshops and so on case

study methodology

and quite you know there'd be

practitioners who would come

and they would say you know they'd

always want to write up their own cases

but they they didn't even know where to

start and they didn't know how to

negotiate their score consent

and things like this so i i'm a great

believer in

case study um inquiry

being part of basic training um

so the the kind of rationale

for if we could move on then to the kind

of rationale for doing

case study research i think that

it's each methodology like

you know outcome research quantitative

research quality research so on

has got its own strengths and

limitations and the particular

contribution or strengths of quality of research

research

the kind of distinctive thing about

quality research is that

it's good at capturing complexity

yeah so you can you're not just looking

at say

empathy if you're looking at empathy

you're looking at how that kind of

interacts with

other things that are going on within

the process of therapy and therapeutic relationship

the second distinctive thing about case

study research

is that allows you to look at how things

uh unfold over time yeah so

that you know you're looking at a case

from beginning to end and there's either

stages or phases or something

there's some sort of change happening so

case studies are good at that

and the final thing is that um

case studies are good at kind of

learning about how the context affects therapy

therapy

so if you if you're doing a big randomized

randomized

trial uh like 100 or more

clients you can you know like the school study

study

you can kind of say a bit about the

context but

but given all the other things

have to be reported uh and and kind of

measured and so on there's not much

space to write our context but whereas

when you do

a case study um there's always

the the context completely hits you in

the face because

it's like when does the case begin

and when does the case end is the case

only about what goes

on in the therapy session well

it's mainly maybe about that but

probably you've also got information about

about

how the client came into therapy

and how the the kind of culture and

society they live in are affecting the

process and therapy

so so it's a kind of context sensitive

methodology the

um so that's part of the rationale for

it the other rationale

is that it's um if you

it kind of fits in with other

things you know it can that it then

slots into different

kind of research tasks or different bits

of a research program so

i mean a number of you're interested in

theory building and uh

case study research is really uh

really good at developing theory i won't

say more about that because i'm sure

we'll come

back to that but basically

interesting therapy theories are kind of

complex and you know like causal

sequences and so on that you're

interested in

and um you can really

get better understanding them back kind

of map them on to

cases i think another thing is

uh another part of the rationale for

case study research is it's practical

knowledge um that

uh i mean obviously there's been huge

loads of stuff written about the

so-called research practice

gap you know like practitioners don't read

read

uh research studies um i don't

particularly like the notion of a gap

but anyway

but the um but practitioners

are more likely to read case studies

because the case study has got

a story and it's a memorable story and you're

you're

working with cases so the case a case study

study

lets you say oh here's how somebody else

might have worked with

a client like mine and so forth

another uh way that case study research

uh fits in is is

um kind of early research on a topic

or hard to

study topics doing preliminary research

on it

so that for example if you've got a new

um intervention or new technique

um it's pretty unlikely anybody's going

to give you

the money or give you ethical approval

to do a big randomized

trial on it um but you can publish

uh you can analyze single cases and

build up an evidence base

and so forth and then i think a kind of

final way that case studies kind of fit in

uh is is

this side sometimes called the double

helix randomized control

trial i saw a randomized controlled

child that's got a sort of spiral of

collecting the quantity of data and

stuff but then woven around is another spiral

spiral

of qualitative research and

case study research which clearly is

what is

going on in your um school study and i

think that

it it makes um

randomized trials much more kind of interpretable

interpretable

and kind of communicates like if you've

if you've got a kind of numbers

but you you know a paper

on your outcome results there's just

phone numbers

it's fine for other researchers but

practitioners will think what does this

mean but if you can present

case studies it um it's a good way of

communicating and

kind of also deepening your

understanding so these are

these are i think some of the what i

would call rationale for case studies

and i think that

met probably not in roehampton because

roehampton is

kind of very much

in my view psychology and psychotherapy

together but i mean

people doing research in

other types of psychology department get

a hard

time for want to do case studies yeah

so um i think it's important to have a

kind of clear rationale

for how how it fits in

then i just want to say a little bit

about the

principles and in

um in

chapter two of the case study book

there's a kind of list of principles

um i can't remember if it says this

in that chapter but i i have never come

across a case study

that fulfills all these principles yeah

um and it's not

you just can't do it but but here but i

would just

let me just go through what i think are

the key things to be thinking about

the first thing is ethics ethical

approval and so on and i think that

the um quite apart

from all of the

um you know the reasons that we understand

understand

for being working ethically and

confidentiality and

whatever um i think another aspect

of it is certainly for me

and other people who i know have done

case studies that

at the end of the day um

it's important to have a kind of moral

confidence in what you're doing

i mean i have case studies that i have

not published

because i've just not felt this is right

that even though the person has

signed bits of paper saying that they

give ethical consent and so forth

to me at the point of putting it all together

together

it's just it's like it's too still too

recognizable as somebody you know like

too recognizable by somebody who would

know them well

and it's too sensitive and things like that

that

so i think the ethics are important

the second thing that's important is

a rich data set i mean

robert elliot's hermeneutic

design has got kind of a whole kind of

specification for what being a rich data set

set

interviews with a client and um

quantitative process and outcome data

and so on and so forth

and i think the the more

data that you've got the more types of

data that you've got

the more you're able to triangulate and

and come

to you know to have some sort of confidence

confidence

in conclusions that you offer

the next thing is um multiple

analysts like a team approach to

analyzing it or

that consider multiple interpretations

or multiple

perspectives on the data so that if you

if you look at freud's

case studies early psychoanalytic case studies

studies

hugely fascinating still influential

but almost entirely um

biased by his pre-existing assumptions

and so on um and

i think that the we'll talk a bit more

about how this

happens this multiple analysts later but

i think this is a really important

thing and you can either highlight it in

the way you write up study or it can be

kind of in the background depending on

what you want to do

i think it's important to if possible to

include the client's perspective

most case studies published at the moment

moment

do not include the client's perspective

i mean i read a lot of case studies and

at the end of a lot of them i think well

that was really interesting

that was fascinating what did the client

think would the client have

recognized any of this that you've

written about yeah

so uh i think and of course the interview

interview

like a an end of therapy interview like

robert elliott's change interview is good

good

but actually you can if you've recorded sessions

sessions

particularly the closing sessions where

you're kind of reviewing things with the

client is often

like the client's version or some

account from the client

and then the final kind of principle

is the um

is is some sort of time series analysis

uh so if you go to the kind of broader

case study literature and other disciplines

disciplines

this is kind of what everybody is does

that's the sort of common

um feature case study analysis

of time series analysis and whether you

just call it like stages and within the

unfolding of the therapy or whether you

look for causal sequences

which is a kind of micro time series um

this is kind of a pretty basic thing to do

and then it i've

tried to kind of

argue that that kind of maps onto four different

different

types of case study research and

they can be combined in all sorts of

ways i mean people

have researched questions and research

skills skills that allow them to combine

these things in different ways

but i think it's helpful to just

differentiate between kind of almost

like ideal types

or pure types of case studies so one is

narrative which is based on

the client's story and usually based on

interviews with clients and sometimes

diaries that clients keep

and then there's the pragmatic case studies

studies

as pioneered by dan fishman in his

journal pragmatic case studies and psychotherapy

and that is essentially the therapist's

story so that's the therapist saying

like i have this approach to therapy

have this model

uh or um conceptualization of therapy

and here's how it plays out in a case so

you can

you know it's a it's a tremendously good

way of

communicating to colleagues

you know what what a particular

approach to therapy or model of therapy

might look like and then there's

outcome oriented case studies

that are trying to answer the question

was therapy

effective what did i have a good outcome

or a poor outcome in this particular case

case

and that is quite often linked to

um you know kind of early wave of

research we've got a new intervention and

and

you know we want to be able to show

whether it works or not

and there's kind of two versions of our

commodity therapy there's the kind of old

old

behavioral n equals one single subject design

design

um and then there's the uh robert elliott's

elliott's

hermeneutic single case efficacy design and

and

the um the single case efficacy design

is um is

is actually a really important moment

in the development of psychotherapy

case study research because the thing

about it

is it refers to a different

logic and a different disciplinary

framework which

art bohar also describe

as judicial or quasi-judicial

so what they're saying is that you gather

gather

the evidence so it's like a court case

you gather the evidence

and in a court case you've got the

prosecution and the defense

and then an h sched study

you've got somebody arguing was it a

good outcome case and somebody arguing

no it wasn't a good outcome case and

then that was a good outcome had nothing

to do with the therapy

and then you've got a kind of judicial

process where they

argue it out now that is

to me this that's also what henry murray did

did

in the 1930s which then

got a bit lost but that

is some version of that

is for me how you bring in

multiple analysts and multiple

perspectives right

so the i've never understood

why robert only

really applied that to

answering the question was it a good

outcome case because

you can equally well apply a judicial perspective

perspective

to um and different sort of questions of

what was most helpful in that case

or does this case give

support a particular theoretical model

or or does it not support

particular theoretical models so um

sorry i'm just pausing there

because in within that category of

outcome oriented cases

there was there's a kind of

methodological innovation that i think is

and then i think we've talked about

theory building research so there's

these four types of

pragmatic narrative uh outcome oriented

and um theory building

research and then i'd just like to

finish off by

kind of highlighting what i think some

the in other words when you get down to

doing case study research

what are the what are the big hurdles

i think what it always takes a lot of

time and effort to study

the case so you want to invest that time

carefully so you need to have a reason for

for

choosing a case so

um there's

many different kind of reasons for

uh choosing a case and um

if you're like i think some of you are

at least if you're operating within a

bigger study

you've got a reason for choosing a case

because a case

would be a representative of

the clients who dropped out therapy or a

case would be

a representative of

clients who reported in an interview

that the goals forms were really helpful

for them and then another case where the client

client

thought that the ghost forms were utter

and total waste of time

and so on right so first thing

is to kind of um sometimes

you just start with a case um

but you um

you it it's kind of a bit more

reassuring if you've got some idea

of how the case fits into a kind of broader

broader

um kind of population of cases

and the other thing is that it's

kind of difficult to know

what it's a case of until you've read

the case

you see what i mean so you can you can

you can pick up a case of somebody who's

dropped out

of uh young people's therapy

and you say right i'm going to analyze

this in terms of dropbox but when you

read the

case you think it's not actually

a dropout case it's just a case of

failure to communicate

the decision to finish or something like

that right

so there's always a bit of um

kind of uh emily and i have had a

bit of email correspondence about this i

think there's a bit of kind of

uh if at all possible checking out on

what's in

the cases that might be available to you

and what would be

an appropriate case um

the um

another practical difficulty is if

you're doing a study where you're

actually trying to set up a

case series you're actually planning to

do a case series

or recruit potential cases

by which i mean asking the client at the

beginning if

in principle they give approval for you

to do a case study

then you've always got to recruit more

than you need

i mean um a few years ago one of my phd students

students

kiel sophia bala mutsu was interested in

looking at metfor in therapy cases

and i think she started off with

five cases and

ended up with one and i mean

this was because people got to a point

of of like no i couldn't i couldn't bear

anybody to be analyzing this or writing

about it's too personal

and things like that so the fact that

she started off with five and ended up

with one was a tribute

to the authenticity of the ethical

process that was going on there

but it was deeply scary for her

as a phd student would she have anything

to write about

at the end of the day right so these are

that that's another kind of practical difficulty

difficulty

i think there are issues around

um writing

case studies and i think it's

important to um

to kind of um to look

carefully at the journal where you would

be positioning your case study where

you'd be submitting your

case study because they've each got a

rather different

structures um even if they're all

that all journals at the moment i would say

say

are interested and willing to publish

case studies that are multi-method

rich data set case studies uh

they've got some sort of rigorous hopefully

hopefully

team-based system analysis they'll all

publish things like that

but they tend to have different ideas

about what the paper should

look like and how long it should be in

the um

i think another thing is um

the the introduction to um

a case study paper is sometimes

uh a trick we'll come back to that later

um but it's um

for example that you're

uh you you're publishing a case study

of a young person who's dropped out

therapy so you can

um there's a literature on that

in your introduction of

you know how many clients i mean there's

a there's

a massive literature on dropout therapy

to start with and then there's a sub

literature on young people dropping out therapy

therapy

and then there's maybe some studies at

least at least

yeah on interviews with young people but

the and you can kind of do all that but

at the end of the day

your argument is then to really

understand this

phenomenon we've got to look at a

case-by-case level

what are you saying are you saying this

is the first case study ever

on that or are there other case studies

and that is that's painfully difficult

to establish

because case studies are

um you know to actually search the literature

literature

on that um and then

the um there's the

question of uh how you would

assemble a research team and our

research team would function but i gotta feel

feel

going to come back to that in relation to

possibly uh what emily's planning to do

or maybe edis as well

so anyway these are some kind of

opening remarks so probably stuff you

all know already

so what mick you're going to facilitate

this a bit so we could either go into

kind of what edith's

questions that she's already thought

about in emily's questions or

we could open up to other questions what

do you

i think that's fantastic john and you

know you're saying that people already

know that but that's the

clearest the most coherent introduction

to case studies

uh i've heard is brilliant what i

suggest is um let's just open it up to

questions and dialogue

um who wants to go first emily or edith

or or really whoever has got questions i

think he's just raised so much i'm sure

we've got

well about just over 45 minutes so yeah

yeah okay who'd like to go first

should i go first yeah okay um

so yeah i had a question just about

ethics um

so i think it was just so you can alter the

the

characteristics of the client and to

kind of disguise who they are

um when you're describing them um

but i suppose i was also thinking do you

have any suggestions for trying to

disguise the results and i know

it might be quite difficult because they

are being probably including

um yeah results for direct quotes from

what young people have said

so yeah do you have any suggestions for

yeah how how that part of the results

could be disguised in some way or

what to think about i think that the

i think it's really important to take it

very seriously

yeah um

i think that it's important to have

um ethical consent

you know traditional ethical consent

like an informed consent

form and an information sheet and things

like that

um you know as you would in any research

yeah but the the the trouble with

the when um somebody consents

for their data to be included in a in a

study of

multiple participants or mult you know uh

then their own individual story gets

hidden doesn't it

so it's numbers it's hidden in a big

data set but even quotes

are short quotes like participant one or

participant two

and things like that and they don't really

really um

you can you can edit them so that the

kind of contextualizing

and individual kind of identifiable things

things

are not in there but

um when you're doing a case study then you

you

are um it's like

it's a whole storyline isn't it and even little

little

quotes of you know that

session um where we talked about goals

was the most helpful thing in the whole

therapy i mean that's like an innocuous

statement but actually within

the whole story it might make it just a

little bit more

identifiable and personal and things

like this

so the

the best thing is to get

permission is to ask the client to

read the case study and get their

permission are you okay about this

right but i i i've

tried that and it's actually

it i'm not i i think

i think there are some situations where

there's been some sort of collaborative

process about creating the case analysis

and things that's involved the client

where that's kind of

a kind of easy next step but

i haven't really had that situation

the i mean like the

the anyway the bit

and to kind of go back to client out of

the blue

several months later i mean after they

filled in the original

things say by the way i'm going to write

up your story in detail would you have a

look at it

it's just it's kind of it's a bit intrusive

intrusive

in itself yeah so i think

that's probably not a good thing to do

unless you know there's a kind of style

of research that's very much

you know working with service users and

clients and things but if

if you're not doing that then maybe it's

too intrusive to go back

so the other thing i would say is

um to to have somebody

independent just read it as an ethical consultant

consultant

okay right and actually i

i would go further than that and say

even if the client has given permission

you know i've read the paper i would still

bring in an ethical consultant because

and i think there's examples of this in

my case study books

of a client will give say i want

everybody to know

about how i overcome my childhood sexual

abuse and things like that

and you know publish it i want everybody

to know about this

i want my voice to be heard but they

don't know

they don't really have a sense of what

the public

impact of that might be and it's one of

our jobs is to kind of look after them

yeah and i think that as the researchers say

say

you or mick as the kind of principal researcher

researcher

you've got too much of an interest in

publishing the case

right so it's a matter of finding

somebody else in the department and just

saying like

just go through as if you were

an advocate for the client and tell me

what you think about this yeah so that

would be my

uh that would be my advice um

if you i think i think one of the things

in the emails i sent you was to

encourage you to read

case studies yeah i mean maybe not right now

now

because you're obviously doing your

proposal on things but

but one of the things to look for when

you're reading case studies

is just it's the ethics

you just skim case like look at the

ethics bit and

there's there's there isn't a standard practice

practice

right um

going back to the thing about uh okay a

little bit more about disguising the client

client

something that i thought i might talk

about at the end if we've got some time

it's about case study meta analysis

yeah and

uh i'm working with a colleague we're

interested in

what integrative therapy actually is

okay so we decided to collect

up all the published case studies of

integrative therapy

and do a meta-analysis of different

forms of psychotherapy integration yeah

and i was talking to somebody about this

and i said to her

oh we've included your case study yeah

and and she said oh that's interesting

so she said how are you analyzing all

these case studies and so

i said well we're starting off by just

listing you know the ages of the clients

their gender

and you know how what their presenting

problem was and the exam we're looking at

the model of integration and stuff and

she starts to laugh

and i said what what's going on he said well

well

to disguise that client i changed their sex

sex

right so i mean i'm just saying this is

this is kind of you know you change the

occupation you change

where they might live but sometimes you

would change

things like that because the that

in a sense the kind of scientific guts

of the paper

is some sort of therapy process that

you're analyzing

what i mean and to to keep

the client safe which is the primary

responsibility that we all have you know

to work as ethical as ethically as we can

can

sometimes you may have to sacrifice

other things

yeah so you may have to sacrifice

demographic information you may have to sacrifice

sacrifice

there may be an absolutely wonderful

description of a change episode in

therapy but it's too

personal so you can't include that

you've got to find another one that's

not as powerful

so i mean so i think i'm just trying to

give you a flavor

of the sort of choices that are around

does that kind of make sense now that

that's that's really helpful

next question next question i mean and

it can be either general questions about

case studies or specific to

i've got loads but i want to give other

people's face jasmine

oh yeah hi john and my name is jasmine

sorry that i was late this morning okay

yeah mine but i couldn't get there for

nine sorry about that

um so um yeah just a couple of questions

really and apologies if you've already

kind of touched on this and i missed it

um i'm an ipa researcher predominantly

in thematic analysis so i don't know

um um one of my duties uh claire who's here

here

um we were discussing what actually

constitutes a case

and is there any way that a setting

could be considered as a case so and how

that might work so for example

an iap service for example could be the case

case

or um but i don't know what data would

necessarily look like but

but maybe the um the participant

interviews or the transcripts

um well i don't know how that would work

exactly but we were thinking about a

particular interest in

the setting being seen as the case so

the charitable organization

or the iap service or the well whatever

and does that make sense at all yeah oh absolutely

absolutely

yeah yeah yeah yeah yeah in in

the there's there's a much bigger i mean

compared to

like in my book the case study research

book it's all about

therapy cases you know a client seeing a therapist

therapist

and i was aware

that there was a much bigger literature

on organizational cases

and i i didn't want to muddy the water

so i just kept that out but i would

bring that in

my wife and i we're working on

a case study of a training course as a case

case

so our uh our rationale

is the to this

the the literature on therapy training

is very fragmented

and and kind of not particularly helpful

and our argument

is that actually the

the the use of a training intervention

say like a personal development group an

experiential group

for students you it doesn't make any sense

sense

just study that on its own or it does but

but

but actually to understand what's going

on you need to see it in the context

of the university course so

i don't know we've not submitted it yet

so maybe

journals will just throw it out but but

i completely agree and um

and i think i think that there are

i think that um

studies of therapy clinics or agencies

or i have

centers or whatever it's going to be voluntary

voluntary

sector counseling organizations

is really really timely because there's

been a couple of i don't know if this is

where you're coming

coming from on this but there's been a

couple of

studies and reviews

two or three studies reviews some of them

them

actually using app data that are found

that um i mean like david clarke

the you know

i better be careful what i say about

david clarke but anyway the founder of iact

iact

i think believed that all the research

on iab would show that cbt was better

than everything else

yeah this has not come to pass

and what his most recent um

analyses of like thousands and thousands

of iaf clients

is that some ayat centers do much better

than others

even when you factor in kind of

demographic characteristics of the

population in that area and things like that

that

um social deprivation health problems

and things like this

and but that's as far as he's got and

and there's very few studies of what

is going on in um

say for example ayat centers that are

getting great results

versus ones that are not getting great results

results

is this is this what you're interested

in well we would note we were thinking

about disclosure of suicide

um and in some charitable organizations

hi claire um that um they have a very different

different

uh confidentiality agreement and kind of non-disclosure

non-disclosure

and encourage the um the disclosure of

suicide so it's more around that actually

actually

um thinking about that being a very

bespoke setting um so i think samaritans

historically had that

and then they had to change it but um

claire's working a different um charity

at the moment

and um just seeing that as a very kind

of a bespoke

um into yeah um this perspective

really um whether how yeah

how you would negotiate that within a

there's a the classic book

is robert yin y-i-n uh

case study methods or something like

that it's on its umpteenth edition

published by sage and it i don't it's got

got

like therapy research in our therapy

clinics or anything but it's

it's just full of examples of that kind

of thing

organizations how to organizations

different organizations

how they kind of kind of uh does the

organizational culture

the procedure the hierarchy hierarchical

aspects of it how does that affect the

way they do different things

i mean endless studies of schools and

so on like that so there's a there's a

big literature

but yin yin kind of condenses it all

into kind of here's some options for how

to design a study like that

okay thank you very much

i'll try and i'll try and

i'll try and i made a note there's a

there's a woman in america called john cook

cook

who was interested in um

she's a kind of trauma therapist and she

she was interested in why some

uh services in america

embraced emdr and others didn't

so i mean so she had a case study design

where she had one case

of a clinic that had really trained

everybody in the mdr

another clinic that the mdr was the work

i think this is a really helpful kind of research

research

yeah yeah a bit more deeply thank you

very much

john can i bring you guys jasmine john

can i bring you on to the topic of combining

combining

different methods and kind of case study

methods because i think that's one

question that

a lot of people working on case studies

here have

is particularly i guess if you're asking

a question like um

you're wanting to test a particular

model or look at a particular theory

around why people drop out or how

school based counseling is working uh or

whether goals are important

is it legitimate to combine say theory

building case studies with narrative

case studies or should people be

sticking to

just one method um

i don't know if i would i don't know if

it is a method you see what i mean

i'm very uncertain about the difference

between words like method and methodology

methodology

and approach and things like that but

but let's

be specific yeah right

the um if you take theory building

case research yeah the

um the clearest

example uh

the best example we've got of theory

building case research

is bill stiles endless studies on the

assimilation model

right so um

bill's argument is that you need to have

uh you need to have data that's relevant

to the theory and you need to be able to

analyze that

data in relation to the concepts of

theory so he's got his

assimilation coding scheme and things

like that so you

you have a case all you need is

recordings of sessions and then you can

then you can um apply the

the kind of assimilation analysis and so forth

forth

now in most of these cases

the uh and most of the papers have been produced

produced

out of that that there's a very

thin narrative right the story of what

was going on for the client

is very briefly described okay

um and uh

in the earlier papers they did the story

of the client the client's experience

and to some extent therapist experience

were a bit more

uh in the foreground but as they

they got more and more focused on sort

of like

the minutiae of the theory that they

were testing out case by case they kind

of lost some of that and it became

very much this um

uh sort of conceptual uh

working at this conceptual level with

the case material

so that's one example another example

would be um there's

three at least three cases by

clara hill and two cases by her group

and one case by somebody else inspired

by them

on immediacy in therapy

um which are

sort of beautifully described and analyzed

analyzed

multi-method case studies and

um clara is

she was she came up with this

idea which is i think such a good idea

she said well

we all talk about immediacy uh but what

is immediacy there's hardly any

literature on immediacy

so let's just see what happens in cases

so these cases are

um i've got a lot of

analysis of immediacy episodes

you know where the therapist is talking

about this is what i feel now that sort

of thing

uh and in in the transcript and

kind of clients ratings of these

episodes and things like that

but at the same time you can in each of

these cases

you if you're not particularly

interested in the technical analysis

of immediacy you can read it as an

immediacy story you know you can get the client's

client's

experience it's a kind of there's enough

narrative woven through

and then a third example

would be the paper by

uh quinn can't remember her first name

published in psychotherapy research a

few years ago

so she was interested in therapy

with people who'd had um

men who had seizures psychogenic

seizures like epileptic

seizures that weren't epilepsy and these

these are this is horrifically difficult

thing i mean it messes up your whole life

life

and you go around all the hospital

consultants and no one can help because

you end up seeing psychotherapists so

she said well what

what happens in these therapies so she

interviewed three

clients and their therapist so it was a

narrative study

the whole thing is a rich narrative of

their stories and so forth

but then at the end um

there's there's a kind of thematic

thematic [Music]

[Music]

interpretation of the key features of

these stories

which she puts forward

as the beginnings of a theory of therapy

for people with psychogenic seizures

right so i'm just saying that the

in this in my view um

theory building is it can be

it can be mixed in these different ways yeah

yeah

and if you had if one of the tiles on

the screen was bill

styles he would probably disagree with

that because he believes in his

he believes in a very pure kind of

theory building research

um which is i know why he's arguing that

because he's he doesn't believe that within

within

the psychotherapy field we're taking

theory seriously enough and if we did

take theory seriously enough this is

what we do we do what he does

but i'm just saying well that

isn't really going to work for everybody

does that kind of make sense

yeah so i think it's like it's then

it's then a matter of thinking

uh what kind of paper would i like to produce

produce

or you know given the data i've got

i mean for example my guess is that you

um this is uh

probably emily's research isn't it the

interviews with young people

are not going to be as rich as quinn's interviews

interviews

with these um you know men who'd had

uh psychotherapy in australia for

psychogenic seizures

so you're not going to be able to do

something like that you're going to have to

uh you're gonna have to do something

else along with

it you're gonna have to analyze the

transcripts because this is

this is the other big source of evidence

that you've got is it well you've got

the measures

you've got measures you've got the

transcripts and there must be

there must be fascinating clues in the transcripts

transcripts

of the client's ambivalence about

therapy or

whether the therapist is picking these

up or not who knows

yeah um so it's going to be more like a

clara hills study

so i mean it's going to be some narrative

narrative

but some other stuff yeah yeah if i could say otherwise if you

yeah if i could say otherwise if you just

just if you produce if you write

if you produce if you write if you do three of your clients

if you do three of your clients and produce an analysis of three

and produce an analysis of three fairly thinly you know shortish

fairly thinly you know shortish interviews reviewers general reviewers

interviews reviewers general reviewers are gonna say well this is like a

are gonna say well this is like a half-baked qualitative study

half-baked qualitative study yeah uh why don't you just have what

yeah uh why don't you just have what happened to

happened to clearly you've got load other interviews

clearly you've got load other interviews with

with clients that dropped out so why don't

clients that dropped out so why don't you just analyze them

you just analyze them so if you want to do k yes so i'm just

so if you want to do k yes so i'm just saying i think my understanding of

saying i think my understanding of you know what's available to you uh is

you know what's available to you uh is probably going to be um the clara hill

probably going to be um the clara hill type

type bit of both yeah

bit of both yeah that's so helpful john yeah i don't know

that's so helpful john yeah i don't know whether somebody

whether somebody maybe working in the ethos data or

maybe working in the ethos data or sophie would like to kind of talk a

sophie would like to kind of talk a little bit about

little bit about what they're specifically thinking of

what they're specifically thinking of doing just to get john's

doing just to get john's maybe kind of concrete views on how you

maybe kind of concrete views on how you might go about doing that

chess for instance yeah no i'm i'm happy to

to um so i'm looking at doing a theory

um so i'm looking at doing a theory building

building case study i don't have any interviews

case study i don't have any interviews unfortunately

unfortunately it's um with two um young people with

it's um with two um young people with on the spectrum and with asd

on the spectrum and with asd and one of my questions i suppose was

and one of my questions i suppose was around

around um kind of the initial

um kind of the initial overarching metaphor or

overarching metaphor or theory in that i want it to be very much

theory in that i want it to be very much related to kind of

related to kind of humanistic face of of the counseling

humanistic face of of the counseling but also i want to try and incorporate

but also i want to try and incorporate theory around kind of autism and social

theory around kind of autism and social emotional processing

emotional processing difficulties or differences and um sense

difficulties or differences and um sense of self and to make it

of self and to make it yeah to make it relevant to

yeah to make it relevant to that population and to represent that i

that population and to represent that i suppose i suppose my question is would

suppose i suppose my question is would you be able to

you be able to combine maybe from

combine maybe from your point of view and kind of

your point of view and kind of merge those or um theories

merge those or um theories um together in in a sense yeah

um together in in a sense yeah well what what data do you have

well what what data do you have um so i have um i have

um so i have um i have the m session recordings um

the m session recordings um for and each of the um

for and each of the um young boys say it's around i think 10 to

young boys say it's around i think 10 to 12

12 10 to 12 sessions each um

10 to 12 sessions each um and it is quite rich in kind of what's

and it is quite rich in kind of what's coming out and there are definitely

coming out and there are definitely um elements which are appealed to

um elements which are appealed to something which is more autism specific

something which is more autism specific but also

but also i can see kind of the um benefit of the

i can see kind of the um benefit of the humanistic um approach

humanistic um approach for them within that if that makes sense

for them within that if that makes sense so

so yeah i don't know i i just don't know

yeah i don't know i i just don't know whether it would be

whether it would be um feasible to do that or whether that

um feasible to do that or whether that would be kind of

would be kind of against the more purest theoretical

against the more purest theoretical um standpoint that you were

the way you're talking about that it's like the

like the somebody going to criticize what you're

somebody going to criticize what you're doing i'm not quite sure

doing i'm not quite sure why why would they what's the

why why would they what's the what are you kind of arguing against

what are you kind of arguing against here well i'm not quite clear what your

here well i'm not quite clear what your concern is so

concern is so i suppose yeah um i suppose my concern

i suppose yeah um i suppose my concern is that

yeah with kind of coming in with something

something that is theory based um

that is theory based um and having that kind of metaphor i

and having that kind of metaphor i suppose doesn't need to be

suppose doesn't need to be something that's

concrete or i i feel like going in more with kind of already kind of combining

with kind of already kind of combining those two

those two ideas and and like around the school

ideas and and like around the school base humanistic counselling and

base humanistic counselling and something that's more asd specific

something that's more asd specific that would already be kind of going in

that would already be kind of going in with that

with that kind of bias and assumption obviously i

kind of bias and assumption obviously i have listened to the recordings but

have listened to the recordings but i don't know i think yeah um yeah okay

i don't know i think yeah um yeah okay i think that the um

i think that the um i don't know if i'm understanding you

i don't know if i'm understanding you correctly i think what

correctly i think what you're describing is

you're describing is i think one of the kind of fundamental

i think one of the kind of fundamental tensions in um qualitative research

if you compare it let's just say you compare it with

compare it with um a quantity

um a quantity how a quantitative you sound to me like

how a quantitative you sound to me like qualitative researcher

qualitative researcher yeah um but if you think just briefly

yeah um but if you think just briefly what a quantitative researcher might do

what a quantitative researcher might do right

right i mean this is purely hypothetical right

i mean this is purely hypothetical right but

but a quantitative researcher with a

a quantitative researcher with a humanistic

humanistic background might say that

background might say that um that what they would be

um that what they would be interested in is they'd want to measure

interested in is they'd want to measure something wouldn't they

something wouldn't they so what could you measure that would be

so what could you measure that would be relevant to

relevant to a humanistic understanding of these

a humanistic understanding of these cases in terms of the transcript you

cases in terms of the transcript you could measure

could measure experiencing level yeah and you could

experiencing level yeah and you could measure um kind of

measure um kind of adequacy or level of

adequacy or level of empathic responding yeah

empathic responding yeah so you you you've got coding systems for

so you you you've got coding systems for that so you can work your way through

that so you can work your way through the transcript and code it for that and

the transcript and code it for that and you could have an independent code that

you could have an independent code that you do

you do integrate reliability and things like

integrate reliability and things like this yeah

this yeah and so you'd have some quantitative data

and so you'd have some quantitative data yeah so the

yeah so the if we just put that to one side a

if we just put that to one side a qualitative researcher

qualitative researcher is wanting to be more open yeah

is wanting to be more open yeah you know more kind of discovery oriented

you know more kind of discovery oriented but

but a quality receptor still has

a quality receptor still has some ideas in their head about things

some ideas in their head about things yeah so the

yeah so the um i think there are

there's many ways of dealing with this one is to at one end i would say one end

one is to at one end i would say one end of a continuum

of a continuum would be a phenomenological research

would be a phenomenological research where you try to bracket off what's in

where you try to bracket off what's in your head

your head and your assumptions and keep asking

and your assumptions and keep asking what is happening here what is happening

what is happening here what is happening here

here and kind of describe so you get this

and kind of describe so you get this sort of hugely

sort of hugely rich description of things yeah

and on the other end of the scale is um would be something like

is um would be something like clara hill's consensual qualitative

clara hill's consensual qualitative research

research where you you decide on um

where you you decide on um things you'd be uh interested in

things you'd be uh interested in domains that you'd be interested in yeah

domains that you'd be interested in yeah so

so clara hill faced with your cases might

clara hill faced with your cases might say

say well empathy is um

well empathy is um is kind of uh of interest

is kind of uh of interest because somebody on the autism spectrum

because somebody on the autism spectrum it might be difficult to be empathic

it might be difficult to be empathic with them it might be for them to

with them it might be for them to appreciate your empathic response to

appreciate your empathic response to things

things so from a consensual quality of research

so from a consensual quality of research you'd say right let's look at the

you'd say right let's look at the transcript

transcript and identify all the episodes within the

and identify all the episodes within the therapy

therapy there's somehow empathy episodes right

there's somehow empathy episodes right but then to look at them with an open

but then to look at them with an open mind

mind yeah to be um

yeah to be um to be kind of um

to be kind of um uh you know to have a research team and

uh you know to have a research team and have different perspectives on it and

have different perspectives on it and things and just see what's there

things and just see what's there you know to be more like

you know to be more like phenomenologists

phenomenologists um so i mean in some i mean

um so i mean in some i mean years ago i was really interested in

years ago i was really interested in narrative ideas about therapy

narrative ideas about therapy and so forth and i did some

and so forth and i did some case studies of therapy transcripts

case studies of therapy transcripts and i didn't describe it like this at

and i didn't describe it like this at the time but basically

the time but basically i was interested in how the client told

i was interested in how the client told their story

their story yeah so i would read through

yeah so i would read through and i'll just make notes in the

and i'll just make notes in the in the margin about this seems to be

in the margin about this seems to be this kind of mode of storytelling

this kind of mode of storytelling and this is you know this is this is a

and this is you know this is this is a story it's got lots of metaphors in it

story it's got lots of metaphors in it and i would gradually

and i would gradually sort of chunk the the transcript

sort of chunk the the transcript into episodes that i would then try to

into episodes that i would then try to think

think um these episodes

um these episodes there's a different type of episode as

there's a different type of episode as we go through you see where there's a

we go through you see where there's a shift in this

shift in this third so that's there's

third so that's there's there's many many different ways of

there's many many different ways of doing that yeah um

doing that yeah um but i think stick to one

but i think stick to one and specific kind of well i think the

and specific kind of well i think the um

the um sticking to the one specific thing

thing you mean like that sort of quality of

you mean like that sort of quality of analysis that i was

analysis that i was describing i i meant kind of one one

describing i i meant kind of one one kind of clear theory um

is is kind of doing a kind of variant of interpretative phenological analysis

of interpretative phenological analysis right um and

i really really like ipas and i think what ipa

what ipa does is allow you to be a

does is allow you to be a phenomenologist and describe things

phenomenologist and describe things say like this is why i looked at the

say like this is why i looked at the material and this is what

material and this is what hit me this is what seemed to be there

hit me this is what seemed to be there but it allows you to go to town on

but it allows you to go to town on theoretical interpretation of it as well

theoretical interpretation of it as well so basically

so basically to me at least in an ipa paper

to me at least in an ipa paper the findings or results section is

the findings or results section is is a lovely kind of thematic description

is a lovely kind of thematic description of what was there say in the interviews

of what was there say in the interviews and then in the discussion section

and then in the discussion section the the author or authors can can

the the author or authors can can kind of uh i've got then they've kind of

kind of uh i've got then they've kind of that's the space where you say well this

that's the space where you say well this is how it relates to

is how it relates to um humanistic ideas this is where it

um humanistic ideas this is where it relates to theories of autism and stuff

relates to theories of autism and stuff like that

like that yeah um

yeah um [Music]

[Music] thank you yeah the

thank you yeah the yeah okay

thank you yeah that's that's that's been really helpful thank you

really helpful thank you i've got some more

what other question i've got a few other questions i think it seems central but

questions i think it seems central but sophie did you want to ask me yeah i was

sophie did you want to ask me yeah i was just wondering in terms of doing um

just wondering in terms of doing um theory building case studies we've had

theory building case studies we've had discussions in supervision about having

discussions in supervision about having a research question or not

a research question or not um and um i know

um and um i know some case studies don't and theory

some case studies don't and theory biblically because i know bill styles

biblically because i know bill styles writes that you know you shouldn't

writes that you know you shouldn't necessarily

necessarily have a research question because what

have a research question because what you're doing is testing the theory

you're doing is testing the theory um but we've sort of landed on a kind of

um but we've sort of landed on a kind of having a really

having a really research questions just about testing

research questions just about testing the theory as a kind of focus but i

the theory as a kind of focus but i guess

guess um yeah i just wanted to ask what your

um yeah i just wanted to ask what your thoughts were on that

well go on what what is your research question

question so how does goal orientation practice

so how does goal orientation practice impact therapeutic change

impact therapeutic change um so it's about testing the theory that

um so it's about testing the theory that goal orientated practice

goal orientated practice impacts therapeutic change that's the

impacts therapeutic change that's the theory that i'm going to be testing

theory that i'm going to be testing right um

i would i i would push you more on that yeah um and

i think i think bill styles has forgotten

forgotten that there was a time when the

that there was a time when the assimilation model didn't exist

assimilation model didn't exist right so there was a time when he

right so there was a time when he and david shapiro and others were

and david shapiro and others were sitting there with these

sitting there with these cases from the sheffield psych therapy

cases from the sheffield psych therapy study and thinking

study and thinking what is going on how do we understand

what is going on how do we understand the process of change so they didn't

the process of change so they didn't have an assimilation model and then they

have an assimilation model and then they came up with an assimilation model

came up with an assimilation model but before

but before they formulated the assimilation model

they formulated the assimilation model they had

they had ideas right and

ideas right and so this is for where i would push you i

so this is for where i would push you i mean not now i'm not trying to put you

mean not now i'm not trying to put you on the spot

on the spot now in this meeting but to maybe think

now in this meeting but to maybe think about this

about this later is if if you

later is if if you it it's almost like it's similar to

it it's almost like it's similar to researcher reflexivity

researcher reflexivity right what are your pre-existing

right what are your pre-existing assumptions what are your

assumptions what are your pre-understandings that you have

pre-understandings that you have so what what would be your kind of

so what what would be your kind of implicit or rough and ready or

implicit or rough and ready or preliminary

preliminary theory of um of

theory of um of how goals conversations

how goals conversations and goals forums and so on operate

and goals forums and so on operate yeah right um

yeah right um and because that is

and because that is and and i would i would i i think it's

and and i would i would i i think it's worth spending a lot of time on that

worth spending a lot of time on that right because then when you

right because then when you when you're faced with the horrific

when you're faced with the horrific complexity of the cases

complexity of the cases you've got a list of things right

you've got a list of things right so i mean here would be my this would be

so i mean here would be my this would be an example from me

an example from me right because this is something that is

right because this is something that is um

um i'm genuinely interested in right

i'm genuinely interested in right i believe i believe in goals forms

the process of formulating a goal and then having a weekly conversation of

then having a weekly conversation of some

some type of goal is facilitative

type of goal is facilitative right so my model would be

right so my model would be that goals talk of some kind

that goals talk of some kind you know around the goals forum uh

you know around the goals forum uh would lead to some kind of

would lead to some kind of new understanding event or closer

new understanding event or closer mutuality

mutuality connection connectedness or thing

connection connectedness or thing right so i'd be looking for that but

right so i'd be looking for that but the the thing that really intrigues me

the the thing that really intrigues me is

is hannah odley's research from norway

hannah odley's research from norway right

right which is like completely the opposite

which is like completely the opposite it's like therapists who have very

it's like therapists who have very subtle

subtle goals agent you know agency-oriented

goals agent you know agency-oriented conversations

so maybe then part of my theory would be well that is helpful

well that is helpful so is there is there things as described

so is there is there things as described with oddly's research that's visible in

with oddly's research that's visible in the case

the case yeah and then is

yeah and then is how do these fit together is it possible

how do these fit together is it possible and this is kind of hard but if you

and this is kind of hard but if you could answer this

could answer this i'd be really interested in it is it it

i'd be really interested in it is it it does

does does the fact that in the sample you've

does the fact that in the sample you've got the cases you've got that there is

got the cases you've got that there is this formal goals call

this formal goals call conversation does that seem to inhibit

conversation does that seem to inhibit these other sorts of things that oddly

these other sorts of things that oddly is describing

is describing yeah so anyway that's just the

yeah so anyway that's just the beginnings

beginnings of a preliminary theory of goals

of a preliminary theory of goals yeah and if you have that

yeah and if you have that beside you as you and colleagues

beside you as you and colleagues hopefully are analyzing the cases

hopefully are analyzing the cases then you can look for these things you

then you can look for these things you can say no that was

can say no that was that's stupid that doesn't turn up

that's stupid that doesn't turn up anywhere

anywhere right or it needs to be phrased in a

right or it needs to be phrased in a different way or defined in different

different way or defined in different way

way or really exciting here's something

or really exciting here's something that wasn't in our

that wasn't in our previous discussions that's like here

previous discussions that's like here and in the data and it's a surprise and

and in the data and it's a surprise and i think

i think so i think i think that let me give you

so i think i think that let me give you we're kind of running out of time a bit

we're kind of running out of time a bit but let me give you another example

but let me give you another example which of something which i don't think

which of something which i don't think there's enough attention to and i've got

there's enough attention to and i've got my ideas about that but if you look at

my ideas about that but if you look at the task analysis research

the task analysis research by um uh

by um uh mainly les greenberg and uh pasqual

mainly les greenberg and uh pasqual leone and

leone and people like that in canada

people like that in canada uh and the trouble with it it's kind of

uh and the trouble with it it's kind of embedded within the

embedded within the wonderful world of emotion focused

wonderful world of emotion focused therapy and things so

therapy and things so other people are not paying enough

other people are not paying enough attention to it but

attention to it but you one of the things you're looking at

you one of the things you're looking at is a sort of goal clarification

is a sort of goal clarification task you could say right but if you

task you could say right but if you think about how they're

think about how they're they they're looking at they're not

they they're looking at they're not looking at that sort of task they're

looking at that sort of task they're looking at other tasks like

looking at other tasks like um

exploring an unclear felt sense of things right

things right but their starting point

but their starting point is they all sit around the table and

is they all sit around the table and think right just on the basis of our

think right just on the basis of our experience as therapists

experience as therapists what do we think the task sequence is

what do we think the task sequence is going to look like

going to look like so they get a kind of a priori um

so they get a kind of a priori um starting point and then

starting point and then they look in you know quantitatively and

they look in you know quantitatively and qualitatively

qualitatively at episodes task episodes

at episodes task episodes and see whether uh

and see whether uh that's valid or not

that's valid or not and you know you say well anyway you

and you know you say well anyway you just see what i'm getting

just see what i'm getting at i think so i think so is it about

at i think so i think so is it about sort of having i mean you have the

sort of having i mean you have the theory as a starting point but you pick

theory as a starting point but you pick out also your own assumptions based on

out also your own assumptions based on the theory and you kind of test

the theory and you kind of test it's almost like you have a specific set

it's almost like you have a specific set of assumptions that you're testing and

of assumptions that you're testing and also looking at if there's something

also looking at if there's something that's not

that's not in that that comes up in the data it

in that that comes up in the data it might yeah

might yeah absolutely i think i think the the

absolutely i think i think the the i think i think to me one of the

i think i think to me one of the one of the the kind of deeply sad

one of the the kind of deeply sad aspects of psychotherapy research

aspects of psychotherapy research uh more and more in recent years is it's

uh more and more in recent years is it's not discovery oriented

not discovery oriented [Music]

[Music] and in other words people have a theory

and in other words people have a theory or they measure things and that's all

or they measure things and that's all you get and

you get and and i'm thinking this is this is

and i'm thinking this is this is absolutely

absolutely this is not real and i'm thinking any

this is not real and i'm thinking any research that i've done

research that i've done i've always learned such a lot because

i've always learned such a lot because you've got to really

you've got to really immerse yourself in something and really

immerse yourself in something and really engage in it so i think

engage in it so i think i think it's really important to have

i think it's really important to have that space for just

that space for just um kind of

um kind of new new insights yeah

new new insights yeah um i think anyway

um i think anyway john can i sneak in one last question

john can i sneak in one last question before we finish just because i think

before we finish just because i think it's a really important one and you

it's a really important one and you mentioned it a few times

mentioned it a few times it's about teams um you've talked about

it's about teams um you've talked about kind of working as a team

kind of working as a team but everybody here is pretty much doing

but everybody here is pretty much doing research

research within a doctorate where getting

within a doctorate where getting together a kind of big team

together a kind of big team where more than one person can work on

where more than one person can work on the analysis in depth

the analysis in depth is probably going to be fairly limited

is probably going to be fairly limited so what's your kind of

so what's your kind of what are the concrete i know you

what are the concrete i know you mentioned a bit about judges but can you

mentioned a bit about judges but can you say a little bit more about concrete

say a little bit more about concrete ways in which people can bring in that

ways in which people can bring in that triangulation

triangulation within the concept of a um yeah

within the concept of a um yeah doctoral study right um

okay we're going to finish after this because i've got to go off

because i've got to go off right but we'll just if we just have

right but we'll just if we just have another three or four minutes

another three or four minutes right the first thing is that

right the first thing is that if you don't have a team if you don't

if you don't have a team if you don't have other people looking at it

have other people looking at it you're going to miss things right

you're going to miss things right so i've got a case which i've done

so i've got a case which i've done workshops with

workshops with around the world many many workshops

around the world many many workshops different groups of

different groups of therapists and trainees and things like

therapists and trainees and things like this

this and which i give people the case

and which i give people the case materials and get them to

materials and get them to kind of work in teams on it and every

kind of work in teams on it and every time

time i do that new insights into the case

i do that new insights into the case come up

come up so i am 110 convinced

so i am 110 convinced that a solo analysis is not

that a solo analysis is not is going to miss things and i think i

is going to miss things and i think i think one of the

think one of the big mistakes in the the h scad

big mistakes in the the h scad group strathclyde i think i know why

group strathclyde i think i know why they've done this but

they've done this but the original h skates that robert did

the original h skates that robert did had

had teams right separate affirmatives and

teams right separate affirmatives and skeptic teams who have battled away

skeptic teams who have battled away and now it's like one student does an

and now it's like one student does an affirmative analysis and does a skeptic

affirmative analysis and does a skeptic analysis all from within their own head

analysis all from within their own head it's not nearly as convincing and rich

it's not nearly as convincing and rich and so forth

and so forth so i am absolutely not just

so i am absolutely not just this is not just kind of bactinian

this is not just kind of bactinian dialogical this is like my

dialogical this is like my personal experience

personal experience of kind of a dialogical approach this

of kind of a dialogical approach this really makes a difference

really makes a difference so at the moment there's three basic

so at the moment there's three basic models

models of this there's

of this there's and okay i'm also convinced that

and okay i'm also convinced that you need a framework if you're going to

you need a framework if you're going to do this at all

do this at all in the when i was working in oslo

in the when i was working in oslo we worked on several case studies and

we worked on several case studies and nobody

nobody would would kind of follow my

would would kind of follow my ideas of having a structure and we spent

ideas of having a structure and we spent bloody months on these things

bloody months on these things that didn't need to take months right

that didn't need to take months right so a structure helps you to make use of

so a structure helps you to make use of your time so there's three models one is

your time so there's three models one is the h sched model of you

the h sched model of you all these things you start with a case

all these things you start with a case book all the data

book all the data is in a big book right um

is in a big book right um which everybody's got the same thing

which everybody's got the same thing like transcripts of sessions

like transcripts of sessions measures interviews whatever

um so in the eight sched you've got maybe

maybe two or three people or maybe just a

two or three people or maybe just a couple of people that are the

couple of people that are the affirmatives and skeptics they read this

affirmatives and skeptics they read this and then they present the argument of

and then they present the argument of here's why it's good outcome case here's

here's why it's good outcome case here's why it's poor outcome case

why it's poor outcome case and you kind of glare at each other this

and you kind of glare at each other this is all this can be very dramatic

is all this can be very dramatic and fun and competitive and things

and fun and competitive and things you go away and each group says we're

you go away and each group says we're going to show these bastards they're

going to show these bastards they're wrong so they have a rebuttal

wrong so they have a rebuttal and so on and then you have a judge

and so on and then you have a judge or judges who look at all this and say

or judges who look at all this and say right

right on the basis of what the affirmatives

on the basis of what the affirmatives and the skeptics have

and the skeptics have said this is what you know we think

said this is what you know we think we've got like a 75

we've got like a 75 confidence that it's a good action case

confidence that it's a good action case or whatever

or whatever and and you can you can weave in there

and and you can you can weave in there like what were the helpful factors in

like what were the helpful factors in the therapeutics doesn't have to be just

the therapeutics doesn't have to be just an outcome question but now i have done

an outcome question but now i have done that

that in a meaningful way and abertay they do

in a meaningful way and abertay they do this every

this every year in a meaningful day in a one-day

year in a meaningful day in a one-day workshop

workshop right where all this happens in a day

right where all this happens in a day and you go back and forwards

and you go back and forwards things like this i mean clearly at the

things like this i mean clearly at the moment we can't have

moment we can't have workshops like that can we so it's got

workshops like that can we so it's got to be kind of online and things

to be kind of online and things so that's one model and then in a model

so that's one model and then in a model like that

like that the fellow students are the co-analysts

the fellow students are the co-analysts and somebody like mick or me is the

and somebody like mick or me is the judge

judge yeah i think you mentioned this in an

yeah i think you mentioned this in an email

email you can i think to have a professor

you can i think to have a professor as a co-analyst alongside you

as a co-analyst alongside you is like not good use the professor's

is like not good use the professor's time

time and also introduces power dynamics which

and also introduces power dynamics which is i'm not going to be there if it's

is i'm not going to be there if it's just colleagues

just colleagues you know side by side arguing about

you know side by side arguing about material or discussing material

material or discussing material but then the the

but then the the um the um

um the um that somebody else uh is

that somebody else uh is is the ultimate judge interestingly

is the ultimate judge interestingly there's been a couple of experiments

there's been a couple of experiments where the judges

where the judges have been lay people and lay people are

have been lay people and lay people are actually able to make a decision about

actually able to make a decision about this

this uh but whether you know which analysis

uh but whether you know which analysis is more

is more uh convincing um

so that's that a version of that is clara hill's consensual qualitative

is clara hill's consensual qualitative research where

research where you don't have it's not quasi-judicial

you don't have it's not quasi-judicial you've got a group

you've got a group working on things so you say to them

working on things so you say to them like what are the helpful processes or

like what are the helpful processes or what's the change

what's the change process within this case

process within this case or how do you make sense of this case in

or how do you make sense of this case in terms of humanistic

terms of humanistic ideas or you know what

ideas or you know what is useful or not useful goal or

is useful or not useful goal or exploration process whatever questions

exploration process whatever questions so the questions are decide the group

so the questions are decide the group works on this

works on this and the the professor or some other

and the the professor or some other person

person is the auditor of that so it's similar

is the auditor of that so it's similar kind of hierarchical

kind of hierarchical thing the group works on it and then

thing the group works on it and then presents

presents the the findings to somebody else

the the findings to somebody else who says yeah this kind of makes sense

who says yeah this kind of makes sense you've arrived this looks good or i'm

you've arrived this looks good or i'm not convinced by that could you take

not convinced by that could you take that back again

that back again and then the third version

and then the third version is a bit weird but is

is a bit weird but is works tremendously well it's called the

works tremendously well it's called the word method

word method bill styles came up with the word method

bill styles came up with the word method and

and um kate smith albert

um kate smith albert did a case study based on word method so

did a case study based on word method so again you have a case book

again you have a case book and you decide on the questions you want

and you decide on the questions you want answered and

answered and say and then i was involved in this

say and then i was involved in this study

study with kate smith there was three of us so

with kate smith there was three of us so we each went away

we each went away with the casebook with questions came

with the casebook with questions came back

back and we presented our each individual

and we presented our each individual analysis

analysis of the case right and the others just

of the case right and the others just sat

sat and listened no conversation about it

and listened no conversation about it you just listen

you just listen you take notes and things and then you

you take notes and things and then you go away and you produce another analysis

go away and you produce another analysis of the case

of the case in which you take account of the other

in which you take account of the other perceptions you know the other members

perceptions you know the other members of the team and you come back

of the team and you come back and you've converged you've converged a

and you've converged you've converged a bit because you've had the other views

bit because you've had the other views and usually with we just had three

and usually with we just had three iterations of that and we arrived at

iterations of that and we arrived at something that we were

something that we were happy with and ward

happy with and ward the ward method is this a new zealand

the ward method is this a new zealand architect who said this is the way his

architect who said this is the way his architectural practice designs buildings

architectural practice designs buildings they each come up with a different

they each come up with a different design

design they just present the design to each

they just present the design to each other they listen to each other go away

other they listen to each other go away come back a week later with another

come back a week later with another design and things like this

design and things like this and it's it's a bit strange

and it's it's a bit strange in um

to do it because it's very disciplined you don't have any

you don't have any kind of sight discussions about the

kind of sight discussions about the meaning of therapy and whatever else you

meaning of therapy and whatever else you just

just get on with it so at the moment i would

get on with it so at the moment i would say there's these three

say there's these three uh main versions of it

uh main versions of it and the other thing that i would say

and the other thing that i would say just kind of maybe the final point about

just kind of maybe the final point about these

these is the team then

is the team then includes the principal investigator

includes the principal investigator you know whoever's gonna write it up say

you know whoever's gonna write it up say sort of emily

sort of emily uh with her case and um

uh with her case and um they are almost certainly doing more

they are almost certainly doing more work

work than the other members of the team

than the other members of the team because they've got more at stake

because they've got more at stake and they're drawing it all together yeah

and they're drawing it all together yeah um and i think it just has to be like

um and i think it just has to be like that i've never

that i've never seen it operate as a sort of complete

seen it operate as a sort of complete kind of democratic thing because it's

kind of democratic thing because it's just

just just the realities of life is you need

just the realities of life is you need somebody to be the coordinator and

somebody to be the coordinator and finally produce a written version of it

finally produce a written version of it but during the dialogue and during the

but during the dialogue and during the discussion there isn't

discussion there isn't the sort of difference between people

the sort of difference between people it's like everybody's ideas are

it's like everybody's ideas are are equal um

are equal um that's it

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YouTube Transcript:Case Studies in Counselling and Psychotherapy: An Introduction by John McLeod

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YouTube Transcript:
Case Studies in Counselling and Psychotherapy: An Introduction by John McLeod