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Psychology: Research and Review

Table 13 Case Study Evaluation-tool (CaSE) purpose-based evaluative framework for systematic case studies. Recommended responses: open-ended questionnaire

From: Appraising psychotherapy case studies in practice-based evidence: introducing Case Study Evaluation-tool (CaSE)

1 Representative cases (purpose: typicality)

The studied phenomenon

  • What is the studied phenomenon or ‘conceptual type’ (e.g, clinical condition, therapeutic technique, patient’s symptoms)? There is generally one specific phenomenon.

  • Is the studied phenomenon sufficiently distinguished from other kinds of (potentially similar) phenomena?

Patient data

  • Are patient characteristics relevant to the wider clinical population? (e.g. is there a good match between symptoms and experiences?)

  • What is the rationale for choosing this patient?

  • Does the patient present any unique or deviant characteristics? (e.g. symptoms that are not representative of the studied clinical condition)

The clinical discourse

  • Is there a detailed clinical narrative in the form of therapist reflections and observations?

  • Does the case move from the particularity of the patient to a more general (theoretically abstract) claim about the studied phenomenon?

Research

  • Is there a sufficient review of literature on the studied phenomenon?

  • Does the case refer to other cases and/or studies that replicate their findings?

Case purpose

  • Does the case demonstrate the typical characteristics of the studied phenomenon?

  • Does the case provide findings relevant for the broader clinical population?

  • Can the case contribute to psychotherapy theory?

2 Descriptive cases (purpose: particularity)

The studied phenomenon

  • What phenomena are studied in the case (e.g. clinical condition, therapeutic technique, patient’s symptoms)? There can be multiple phenomena.

  • Does the case present events and processes common to clinical practice? (e.g. therapeutic relationship difficulties)

Patient data

  • Are patient characteristics described in detail, with particular attention to uniqueness, subjectivity and meaning of “lived experiences”?

  • Does the case narrative convey interpersonally sharable statements, ruminations, metaphors?

  • Is the patient clearly positioned within their cultural and psycho-social context?

The clinical discourse

  • Does the case convey the process behind therapist’s practical decisions in the consulting room?

  • Does the case provide ‘know-how’ knowledge on how practitioners can deal with clinically salient issues and situations?

  • Does the therapist provide a reflexive account on how their views and theoretical assumptions might impact the therapeutic relationship and clinical decision-making?

Research

  • Does the case include patient’s self-assessment? (e.g. through self-report measures and dialogic exchange)

  • Does the case include excerpts of dialogue between therapist and patient?

Case purpose

  • Does the case provide a relational understanding (with which readers can empathise) of the studied phenomenon?

  • Does the case narrative sufficiently portray ‘real analytic practice’ rather than ‘ideal models’? (e.g. by demonstrating disparity between clinical theory/research and practice)

  • Can the case contribute to psychotherapy training and practice?

3 Unique cases (purpose: deviation)

The studied phenomenon

  • What phenomena are studied in the case (e.g. clinical condition, therapeutic technique, patient’s symptoms)? There can be multiple phenomena.

  • Does the case explain how the studied phenomena are different or unique from the established theory/research? (e.g. the patient’s experience of transference is different from the experiences of transference across a broader clinical population)

Patient data

  • Are patient characteristics described in detail, with particular attention to uniqueness, subjectivity and meaning of “lived experiences”?

  • What is the rationale for choosing this patient?

The clinical discourse

  • Does the case convey a detailed description of therapeutic interventions and their effectiveness?

  • Does the therapist provide a reflexive account on how their views and theoretical assumptions might impact clinical decision–making, particularly in terms of their understanding of the uniqueness/deviation in the case?

  • Does the case include sufficient considerations as to the cause of the deviation/uniqueness in patient’s clinical condition or symptoms?

Research

  • Does the case convey more than one theoretical and/or research perspective? (e.g. clinical assessment by multiple practitioners or data analysis by multiple researchers)

  • Are there considerations of alternative explanations to the observed deviation/uniqueness of the case? (e.g. by referring to other published case studies or research)

Case purpose

  • Does the case provide insight into a novel phenomenon? (e.g. by describing unique patient symptoms or experiences)

  • Does the case provide novel theoretical knowledge in relation to unique/deviant phenomenon? (E.g., by developing a new therapeutic technique)

  • Can the case contribute to psychotherapy theory, training and/or practice?

4 Critical cases (purpose: falsification/confirmation)

The studied phenomenon

  • What is the studied phenomenon in the case (e.g. clinical condition, therapeutic technique, patient’s symptoms)? There is generally one specific phenomenon.

  • Does the case seek to test an existing theory/research about the studied phenomenon? (e.g. testing the effectiveness of a well–established therapeutic intervention)

Patient data

  • Are patient characteristics described in detail?

  • Is the patient clearly outlined within their cultural and psycho-social context?

  • What is the rationale for choosing this patient?

The clinical discourse

  • Does the case link therapist narrative and observations with the theoretical/research considerations?

  • Does the case convey a detailed description of therapeutic interventions and their effectiveness?

Research

  • Does the case convey more than one theoretical and/or research perspective? (e.g. clinical assessment by multiple practitioners or data analysis by multiple researchers)

  • Does the case show how the theory/research that is being tested accounts for the clinical observations in the case?

  • Does the case provide a sufficient explanation on why their chosen theory/research is more appropriate than another?

  • If the case falsifies an existing theory/research, are there sufficient sample considerations? (e.g. the case may be unique and therefore the original theory/research still stands)

Case purpose

  • Does the case examine an existing theory/research successfully? (e.g. by showing whether a theory is effective with a specific patient)

  • If the case falsifies an existing theory/research, does it offer any novel suggestions or revisions to the falsified theory/research?

  • If the case confirms an existing theory/research, does it rule out alternative explanations for the tested hypothesis? (e.g. to show that a therapeutic intervention is effective, the positive effects of other variables like medication may need to be ruled out)

5 Exploratory cases (purpose: hypothesis generation)

The studied phenomenon

  • What phenomena are studied in the case (e.g. clinical condition, therapeutic technique, patient’s symptoms)? There can be multiple phenomena.

  • Is the case discovery-led, in the sense that it explores data as it emerges?

  • Does the case contain new hypotheses about the studied phenomena?

Patient data

  • Are patient characteristics described in detail?

  • Is the patient clearly outlined within their cultural and psycho-social context?

The clinical discourse

  • Does the case link therapist narrative and observations with the theoretical/research considerations?

  • Does the case narrative explore the ‘how’ and ‘what’ questions in relation to patient experiences and treatment processes?

  • Does the case identify complex processes and mechanisms in the treatment and link them to theory?

Research

  • Is there a sufficient review of literature of the studied phenomenon?

  • Does the case convey more than one theoretical and/or research perspective? (e.g. clinical assessment by multiple practitioners or data analysis by multiple researchers)

  • Does the data converge? Are different/conflicting findings reported?

Case purpose

  • Does the case convey more than one set of outcomes?

  • Does the case indicate future research trajectories?

  • Can the case contribute to psychotherapy theory, training and/or practice?

6 Transferable cases (purpose: generalisability)

The studied phenomenon

  • What is studied phenomenon (e.g. clinical condition, therapeutic technique, patient’s symptoms)? There is generally one specific phenomenon.

  • Is the studied phenomenon explicitly defined and differentiated from other kinds of (potentially similar) phenomena?

Patient data

  • Are patient characteristics described in detail?

  • Is the patient clearly outlined within their cultural and psycho-social context?

  • Does the patient present characteristics typical of the studied phenomenon? Is there sufficient information (clinical, theoretical) to link the patient with the studied phenomenon?

The clinical discourse

  • Is there a detailed clinical narrative in the form of therapist reflections and observations?

  • Does the case shed light on specific characteristics of the therapeutic process? (e.g. the development of therapeutic alliance)

  • Is the case narrative theme-focused? (e.g. the case identifies specific treatment patterns across different sessions)

  • Is there a clear description of the therapeutic process, usually involving a session-by-session description?

Research

  • Is there a sufficient review of literature on the studied phenomenon?

  • Does the case involve a specific therapeutic, theoretical and research framework, and is the framework made explicit by the researchers?

  • Is there a clear description of the research process? (e.g. step-by-step description of data analysis procedures)

Case purpose

  • Does the case provide information about common or specific psychotherapy processes?

  • Can the case be compared to and aggregated with other psychotherapy case studies on the basis of its studied phenomenon and formulation?