Case Studies - Bradshaw

• Case Studies AO1

  • In-depth detailed studies on unique clinical Ps, small groups of Ps, or clinical hospitals to collect data that can't be studied experimentally
  • Collects quant and qual data on P using triangulation such as observations on the Ps symptoms, interviewing the P about their symptoms, and experiments with the Ps
  • Longitudinal so study P over a long period of time, so can compare the Ps behaviours and see changes over time
  • Can collect both primary data on P by observing or interviewing them, or secondary data by reding their clinicians medical notes
• Case studies :) Eco val

  Documentation of the experience of a clin P and disorder, symptoms and experience of treatment in their natural environment, so researchers haven't had control and behaviour is genuine. T/f case studies of clin Ps have high external validity, Ps behaviour is naturally occurring and can be generalised to everyday clinical disorders
• Case Studies :) Rich qual data

  Uses trigangulation - range of methods such as interviews with the P about their symptoms, observations of their behaviour, and reading medical notes. T/f increasing validity of the data collected on the patients experiences using the case study method
• Case studies :( Researcher Bias

  Researcher may become too involved with patient, so will lose objectivity, analysing and recording data in a subjective way. T/f reducing reliability of the data as wont get consistent findings if repeated
• Case studies :( Unique case

  Variables not controlled in case study, and case study is unique so researchers wont find same patient with same clinical symptoms again. T/f cannot establish reliability of the findings on the clinical disorder as the study cannot be replicated
• AIM

  To look at how CBT was used to treat a woman with schizophrenia, including its effectiveness. Study of an attempt to use psychotherapy to treat schizophrenia where drug treatment has previously been preferred - there has been little evaluation of the use of CBT for schizophrenia
• PROCEDURE P1

  • Longitudinal case study on Carol, tracking her progress over 3 years of CBT and following up on progress 6 months and 1 year after the therapy
  • Measures the effectiveness of CBT on 4 scales:

  1. Psychosocial functioning measured by Role-Functioning scale
  2. Attainment of treatment goals measured by goal-attainment scale
  3. Hospitalisations measured by number of hospital visits
  4. Development of therapeutic relations
• PROCEDURE P2

  Stage 1 - development of rapport (socialisation)

  • 15 min to 1 hour CBT seshs. Therapist disclosed own problems and interests to encourage Carol to talk - found both interested in softball.
  • 3 months to develop rapport through genuineness, respect and empathy. Self-disclosure promoted discussion of difficulties.

  Stage 2 - understanding CBT

  • 2 months to help Carol understand CBT (including education about schiz and treatments) + establish goals
  • Emphasised that schiz involves biological vulnerability to stress and focused on improving stress coping mechanisms
• Procedure P3

  Stage 3 - treatment

  • 1st year ('early phase') focused on managing stress + anxiety. If parents asked her to do anything her hallucinations and delusions increased. Would cope with stress by withdrawing.
  • Weekly activity schedule helped her cope with loss of daily structure, and she was asked to record what she did during the day so could review with therapist and try diff strategies.
  • Did behavioural activities to increase lvls of activity, and meditation to manage stress
• PROCEDURE P4

  • Middle phase of treatment was 16 months of building more cognitive strategies to help cope with stressful situations. Focus was on social situations, impact of schiz on her, and dealing with fear of relapse
  • End phase of 3 months focused on thoughts about end of treatment + plans to maintain treatment without therapist. E.g. cue cards written out with strategies + reviewed daily