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Case Study – Methods, Examples and Guide

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A case study is a research method that involves an in-depth examination and analysis of a particular phenomenon or case, such as an individual, organization, community, event, or situation.

It is a qualitative research approach that aims to provide a detailed and comprehensive understanding of the case being studied. Case studies typically involve multiple sources of data, including interviews, observations, documents, and artifacts, which are analyzed using various techniques, such as content analysis, thematic analysis, and grounded theory. The findings of a case study are often used to develop theories, inform policy or practice, or generate new research questions.

Types of Case Study

Types and Methods of Case Study are as follows:

Single-Case Study

A single-case study is an in-depth analysis of a single case. This type of case study is useful when the researcher wants to understand a specific phenomenon in detail.

For Example , A researcher might conduct a single-case study on a particular individual to understand their experiences with a particular health condition or a specific organization to explore their management practices. The researcher collects data from multiple sources, such as interviews, observations, and documents, and uses various techniques to analyze the data, such as content analysis or thematic analysis. The findings of a single-case study are often used to generate new research questions, develop theories, or inform policy or practice.

Multiple-Case Study

A multiple-case study involves the analysis of several cases that are similar in nature. This type of case study is useful when the researcher wants to identify similarities and differences between the cases.

For Example, a researcher might conduct a multiple-case study on several companies to explore the factors that contribute to their success or failure. The researcher collects data from each case, compares and contrasts the findings, and uses various techniques to analyze the data, such as comparative analysis or pattern-matching. The findings of a multiple-case study can be used to develop theories, inform policy or practice, or generate new research questions.

Exploratory Case Study

An exploratory case study is used to explore a new or understudied phenomenon. This type of case study is useful when the researcher wants to generate hypotheses or theories about the phenomenon.

For Example, a researcher might conduct an exploratory case study on a new technology to understand its potential impact on society. The researcher collects data from multiple sources, such as interviews, observations, and documents, and uses various techniques to analyze the data, such as grounded theory or content analysis. The findings of an exploratory case study can be used to generate new research questions, develop theories, or inform policy or practice.

Descriptive Case Study

A descriptive case study is used to describe a particular phenomenon in detail. This type of case study is useful when the researcher wants to provide a comprehensive account of the phenomenon.

For Example, a researcher might conduct a descriptive case study on a particular community to understand its social and economic characteristics. The researcher collects data from multiple sources, such as interviews, observations, and documents, and uses various techniques to analyze the data, such as content analysis or thematic analysis. The findings of a descriptive case study can be used to inform policy or practice or generate new research questions.

Instrumental Case Study

An instrumental case study is used to understand a particular phenomenon that is instrumental in achieving a particular goal. This type of case study is useful when the researcher wants to understand the role of the phenomenon in achieving the goal.

For Example, a researcher might conduct an instrumental case study on a particular policy to understand its impact on achieving a particular goal, such as reducing poverty. The researcher collects data from multiple sources, such as interviews, observations, and documents, and uses various techniques to analyze the data, such as content analysis or thematic analysis. The findings of an instrumental case study can be used to inform policy or practice or generate new research questions.

Case Study Data Collection Methods

Here are some common data collection methods for case studies:

Interviews involve asking questions to individuals who have knowledge or experience relevant to the case study. Interviews can be structured (where the same questions are asked to all participants) or unstructured (where the interviewer follows up on the responses with further questions). Interviews can be conducted in person, over the phone, or through video conferencing.

Observations

Observations involve watching and recording the behavior and activities of individuals or groups relevant to the case study. Observations can be participant (where the researcher actively participates in the activities) or non-participant (where the researcher observes from a distance). Observations can be recorded using notes, audio or video recordings, or photographs.

Documents can be used as a source of information for case studies. Documents can include reports, memos, emails, letters, and other written materials related to the case study. Documents can be collected from the case study participants or from public sources.

Surveys involve asking a set of questions to a sample of individuals relevant to the case study. Surveys can be administered in person, over the phone, through mail or email, or online. Surveys can be used to gather information on attitudes, opinions, or behaviors related to the case study.

Artifacts are physical objects relevant to the case study. Artifacts can include tools, equipment, products, or other objects that provide insights into the case study phenomenon.

How to conduct Case Study Research

Conducting a case study research involves several steps that need to be followed to ensure the quality and rigor of the study. Here are the steps to conduct case study research:

• Define the research questions: The first step in conducting a case study research is to define the research questions. The research questions should be specific, measurable, and relevant to the case study phenomenon under investigation.
• Select the case: The next step is to select the case or cases to be studied. The case should be relevant to the research questions and should provide rich and diverse data that can be used to answer the research questions.
• Collect data: Data can be collected using various methods, such as interviews, observations, documents, surveys, and artifacts. The data collection method should be selected based on the research questions and the nature of the case study phenomenon.
• Analyze the data: The data collected from the case study should be analyzed using various techniques, such as content analysis, thematic analysis, or grounded theory. The analysis should be guided by the research questions and should aim to provide insights and conclusions relevant to the research questions.
• Draw conclusions: The conclusions drawn from the case study should be based on the data analysis and should be relevant to the research questions. The conclusions should be supported by evidence and should be clearly stated.
• Validate the findings: The findings of the case study should be validated by reviewing the data and the analysis with participants or other experts in the field. This helps to ensure the validity and reliability of the findings.
• Write the report: The final step is to write the report of the case study research. The report should provide a clear description of the case study phenomenon, the research questions, the data collection methods, the data analysis, the findings, and the conclusions. The report should be written in a clear and concise manner and should follow the guidelines for academic writing.

Examples of Case Study

Here are some examples of case study research:

• The Hawthorne Studies : Conducted between 1924 and 1932, the Hawthorne Studies were a series of case studies conducted by Elton Mayo and his colleagues to examine the impact of work environment on employee productivity. The studies were conducted at the Hawthorne Works plant of the Western Electric Company in Chicago and included interviews, observations, and experiments.
• The Stanford Prison Experiment: Conducted in 1971, the Stanford Prison Experiment was a case study conducted by Philip Zimbardo to examine the psychological effects of power and authority. The study involved simulating a prison environment and assigning participants to the role of guards or prisoners. The study was controversial due to the ethical issues it raised.
• The Challenger Disaster: The Challenger Disaster was a case study conducted to examine the causes of the Space Shuttle Challenger explosion in 1986. The study included interviews, observations, and analysis of data to identify the technical, organizational, and cultural factors that contributed to the disaster.
• The Enron Scandal: The Enron Scandal was a case study conducted to examine the causes of the Enron Corporation’s bankruptcy in 2001. The study included interviews, analysis of financial data, and review of documents to identify the accounting practices, corporate culture, and ethical issues that led to the company’s downfall.
• The Fukushima Nuclear Disaster : The Fukushima Nuclear Disaster was a case study conducted to examine the causes of the nuclear accident that occurred at the Fukushima Daiichi Nuclear Power Plant in Japan in 2011. The study included interviews, analysis of data, and review of documents to identify the technical, organizational, and cultural factors that contributed to the disaster.

Application of Case Study

Case studies have a wide range of applications across various fields and industries. Here are some examples:

Business and Management

Case studies are widely used in business and management to examine real-life situations and develop problem-solving skills. Case studies can help students and professionals to develop a deep understanding of business concepts, theories, and best practices.

Case studies are used in healthcare to examine patient care, treatment options, and outcomes. Case studies can help healthcare professionals to develop critical thinking skills, diagnose complex medical conditions, and develop effective treatment plans.

Case studies are used in education to examine teaching and learning practices. Case studies can help educators to develop effective teaching strategies, evaluate student progress, and identify areas for improvement.

Social Sciences

Case studies are widely used in social sciences to examine human behavior, social phenomena, and cultural practices. Case studies can help researchers to develop theories, test hypotheses, and gain insights into complex social issues.

Law and Ethics

Case studies are used in law and ethics to examine legal and ethical dilemmas. Case studies can help lawyers, policymakers, and ethical professionals to develop critical thinking skills, analyze complex cases, and make informed decisions.

Purpose of Case Study

The purpose of a case study is to provide a detailed analysis of a specific phenomenon, issue, or problem in its real-life context. A case study is a qualitative research method that involves the in-depth exploration and analysis of a particular case, which can be an individual, group, organization, event, or community.

The primary purpose of a case study is to generate a comprehensive and nuanced understanding of the case, including its history, context, and dynamics. Case studies can help researchers to identify and examine the underlying factors, processes, and mechanisms that contribute to the case and its outcomes. This can help to develop a more accurate and detailed understanding of the case, which can inform future research, practice, or policy.

Case studies can also serve other purposes, including:

• Illustrating a theory or concept: Case studies can be used to illustrate and explain theoretical concepts and frameworks, providing concrete examples of how they can be applied in real-life situations.
• Developing hypotheses: Case studies can help to generate hypotheses about the causal relationships between different factors and outcomes, which can be tested through further research.
• Providing insight into complex issues: Case studies can provide insights into complex and multifaceted issues, which may be difficult to understand through other research methods.
• Informing practice or policy: Case studies can be used to inform practice or policy by identifying best practices, lessons learned, or areas for improvement.

Advantages of Case Study Research

There are several advantages of case study research, including:

• In-depth exploration: Case study research allows for a detailed exploration and analysis of a specific phenomenon, issue, or problem in its real-life context. This can provide a comprehensive understanding of the case and its dynamics, which may not be possible through other research methods.
• Rich data: Case study research can generate rich and detailed data, including qualitative data such as interviews, observations, and documents. This can provide a nuanced understanding of the case and its complexity.
• Holistic perspective: Case study research allows for a holistic perspective of the case, taking into account the various factors, processes, and mechanisms that contribute to the case and its outcomes. This can help to develop a more accurate and comprehensive understanding of the case.
• Theory development: Case study research can help to develop and refine theories and concepts by providing empirical evidence and concrete examples of how they can be applied in real-life situations.
• Practical application: Case study research can inform practice or policy by identifying best practices, lessons learned, or areas for improvement.
• Contextualization: Case study research takes into account the specific context in which the case is situated, which can help to understand how the case is influenced by the social, cultural, and historical factors of its environment.

Limitations of Case Study Research

There are several limitations of case study research, including:

• Limited generalizability : Case studies are typically focused on a single case or a small number of cases, which limits the generalizability of the findings. The unique characteristics of the case may not be applicable to other contexts or populations, which may limit the external validity of the research.
• Biased sampling: Case studies may rely on purposive or convenience sampling, which can introduce bias into the sample selection process. This may limit the representativeness of the sample and the generalizability of the findings.
• Subjectivity: Case studies rely on the interpretation of the researcher, which can introduce subjectivity into the analysis. The researcher’s own biases, assumptions, and perspectives may influence the findings, which may limit the objectivity of the research.
• Limited control: Case studies are typically conducted in naturalistic settings, which limits the control that the researcher has over the environment and the variables being studied. This may limit the ability to establish causal relationships between variables.
• Time-consuming: Case studies can be time-consuming to conduct, as they typically involve a detailed exploration and analysis of a specific case. This may limit the feasibility of conducting multiple case studies or conducting case studies in a timely manner.
• Resource-intensive: Case studies may require significant resources, including time, funding, and expertise. This may limit the ability of researchers to conduct case studies in resource-constrained settings.

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• What Is a Case Study? | Definition, Examples & Methods

What Is a Case Study? | Definition, Examples & Methods

Published on May 8, 2019 by Shona McCombes . Revised on November 20, 2023.

A case study is a detailed study of a specific subject, such as a person, group, place, event, organization, or phenomenon. Case studies are commonly used in social, educational, clinical, and business research.

A case study research design usually involves qualitative methods , but quantitative methods are sometimes also used. Case studies are good for describing , comparing, evaluating and understanding different aspects of a research problem .

Table of contents

When to do a case study, step 1: select a case, step 2: build a theoretical framework, step 3: collect your data, step 4: describe and analyze the case, other interesting articles.

A case study is an appropriate research design when you want to gain concrete, contextual, in-depth knowledge about a specific real-world subject. It allows you to explore the key characteristics, meanings, and implications of the case.

Case studies are often a good choice in a thesis or dissertation . They keep your project focused and manageable when you don’t have the time or resources to do large-scale research.

You might use just one complex case study where you explore a single subject in depth, or conduct multiple case studies to compare and illuminate different aspects of your research problem.

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Once you have developed your problem statement and research questions , you should be ready to choose the specific case that you want to focus on. A good case study should have the potential to:

• Provide new or unexpected insights into the subject
• Challenge or complicate existing assumptions and theories
• Propose practical courses of action to resolve a problem
• Open up new directions for future research

TipIf your research is more practical in nature and aims to simultaneously investigate an issue as you solve it, consider conducting action research instead.

Unlike quantitative or experimental research , a strong case study does not require a random or representative sample. In fact, case studies often deliberately focus on unusual, neglected, or outlying cases which may shed new light on the research problem.

Example of an outlying case studyIn the 1960s the town of Roseto, Pennsylvania was discovered to have extremely low rates of heart disease compared to the US average. It became an important case study for understanding previously neglected causes of heart disease.

However, you can also choose a more common or representative case to exemplify a particular category, experience or phenomenon.

Example of a representative case studyIn the 1920s, two sociologists used Muncie, Indiana as a case study of a typical American city that supposedly exemplified the changing culture of the US at the time.

While case studies focus more on concrete details than general theories, they should usually have some connection with theory in the field. This way the case study is not just an isolated description, but is integrated into existing knowledge about the topic. It might aim to:

• Exemplify a theory by showing how it explains the case under investigation
• Expand on a theory by uncovering new concepts and ideas that need to be incorporated
• Challenge a theory by exploring an outlier case that doesn’t fit with established assumptions

To ensure that your analysis of the case has a solid academic grounding, you should conduct a literature review of sources related to the topic and develop a theoretical framework . This means identifying key concepts and theories to guide your analysis and interpretation.

There are many different research methods you can use to collect data on your subject. Case studies tend to focus on qualitative data using methods such as interviews , observations , and analysis of primary and secondary sources (e.g., newspaper articles, photographs, official records). Sometimes a case study will also collect quantitative data.

Example of a mixed methods case studyFor a case study of a wind farm development in a rural area, you could collect quantitative data on employment rates and business revenue, collect qualitative data on local people’s perceptions and experiences, and analyze local and national media coverage of the development.

The aim is to gain as thorough an understanding as possible of the case and its context.

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In writing up the case study, you need to bring together all the relevant aspects to give as complete a picture as possible of the subject.

How you report your findings depends on the type of research you are doing. Some case studies are structured like a standard scientific paper or thesis , with separate sections or chapters for the methods , results and discussion .

Others are written in a more narrative style, aiming to explore the case from various angles and analyze its meanings and implications (for example, by using textual analysis or discourse analysis ).

In all cases, though, make sure to give contextual details about the case, connect it back to the literature and theory, and discuss how it fits into wider patterns or debates.

If you want to know more about statistics , methodology , or research bias , make sure to check out some of our other articles with explanations and examples.

• Normal distribution
• Degrees of freedom
• Null hypothesis
• Discourse analysis
• Control groups
• Mixed methods research
• Non-probability sampling
• Quantitative research
• Ecological validity

Research bias

• Rosenthal effect
• Implicit bias
• Cognitive bias
• Selection bias
• Negativity bias
• Status quo bias

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What Is a Case Study?

Weighing the pros and cons of this method of research

Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."

Cara Lustik is a fact-checker and copywriter.

Verywell / Colleen Tighe

• Pros and Cons

What Types of Case Studies Are Out There?

Where do you find data for a case study, how do i write a psychology case study.

A case study is an in-depth study of one person, group, or event. In a case study, nearly every aspect of the subject's life and history is analyzed to seek patterns and causes of behavior. Case studies can be used in many different fields, including psychology, medicine, education, anthropology, political science, and social work.

The point of a case study is to learn as much as possible about an individual or group so that the information can be generalized to many others. Unfortunately, case studies tend to be highly subjective, and it is sometimes difficult to generalize results to a larger population.

While case studies focus on a single individual or group, they follow a format similar to other types of psychology writing. If you are writing a case study, we got you—here are some rules of APA format to reference.  

At a Glance

A case study, or an in-depth study of a person, group, or event, can be a useful research tool when used wisely. In many cases, case studies are best used in situations where it would be difficult or impossible for you to conduct an experiment. They are helpful for looking at unique situations and allow researchers to gather a lot of˜ information about a specific individual or group of people. However, it's important to be cautious of any bias we draw from them as they are highly subjective.

What Are the Benefits and Limitations of Case Studies?

A case study can have its strengths and weaknesses. Researchers must consider these pros and cons before deciding if this type of study is appropriate for their needs.

One of the greatest advantages of a case study is that it allows researchers to investigate things that are often difficult or impossible to replicate in a lab. Some other benefits of a case study:

• Allows researchers to capture information on the 'how,' 'what,' and 'why,' of something that's implemented
• Gives researchers the chance to collect information on why one strategy might be chosen over another
• Permits researchers to develop hypotheses that can be explored in experimental research

On the other hand, a case study can have some drawbacks:

• It cannot necessarily be generalized to the larger population
• Cannot demonstrate cause and effect
• It may not be scientifically rigorous
• It can lead to bias

Researchers may choose to perform a case study if they want to explore a unique or recently discovered phenomenon. Through their insights, researchers develop additional ideas and study questions that might be explored in future studies.

It's important to remember that the insights from case studies cannot be used to determine cause-and-effect relationships between variables. However, case studies may be used to develop hypotheses that can then be addressed in experimental research.

Case Study Examples

There have been a number of notable case studies in the history of psychology. Much of  Freud's work and theories were developed through individual case studies. Some great examples of case studies in psychology include:

• Anna O : Anna O. was a pseudonym of a woman named Bertha Pappenheim, a patient of a physician named Josef Breuer. While she was never a patient of Freud's, Freud and Breuer discussed her case extensively. The woman was experiencing symptoms of a condition that was then known as hysteria and found that talking about her problems helped relieve her symptoms. Her case played an important part in the development of talk therapy as an approach to mental health treatment.
• Phineas Gage : Phineas Gage was a railroad employee who experienced a terrible accident in which an explosion sent a metal rod through his skull, damaging important portions of his brain. Gage recovered from his accident but was left with serious changes in both personality and behavior.
• Genie : Genie was a young girl subjected to horrific abuse and isolation. The case study of Genie allowed researchers to study whether language learning was possible, even after missing critical periods for language development. Her case also served as an example of how scientific research may interfere with treatment and lead to further abuse of vulnerable individuals.

Such cases demonstrate how case research can be used to study things that researchers could not replicate in experimental settings. In Genie's case, her horrific abuse denied her the opportunity to learn a language at critical points in her development.

This is clearly not something researchers could ethically replicate, but conducting a case study on Genie allowed researchers to study phenomena that are otherwise impossible to reproduce.

There are a few different types of case studies that psychologists and other researchers might use:

• Collective case studies : These involve studying a group of individuals. Researchers might study a group of people in a certain setting or look at an entire community. For example, psychologists might explore how access to resources in a community has affected the collective mental well-being of those who live there.
• Descriptive case studies : These involve starting with a descriptive theory. The subjects are then observed, and the information gathered is compared to the pre-existing theory.
• Explanatory case studies : These   are often used to do causal investigations. In other words, researchers are interested in looking at factors that may have caused certain things to occur.
• Exploratory case studies : These are sometimes used as a prelude to further, more in-depth research. This allows researchers to gather more information before developing their research questions and hypotheses .
• Instrumental case studies : These occur when the individual or group allows researchers to understand more than what is initially obvious to observers.
• Intrinsic case studies : This type of case study is when the researcher has a personal interest in the case. Jean Piaget's observations of his own children are good examples of how an intrinsic case study can contribute to the development of a psychological theory.

The three main case study types often used are intrinsic, instrumental, and collective. Intrinsic case studies are useful for learning about unique cases. Instrumental case studies help look at an individual to learn more about a broader issue. A collective case study can be useful for looking at several cases simultaneously.

The type of case study that psychology researchers use depends on the unique characteristics of the situation and the case itself.

There are a number of different sources and methods that researchers can use to gather information about an individual or group. Six major sources that have been identified by researchers are:

• Archival records : Census records, survey records, and name lists are examples of archival records.
• Direct observation : This strategy involves observing the subject, often in a natural setting . While an individual observer is sometimes used, it is more common to utilize a group of observers.
• Documents : Letters, newspaper articles, administrative records, etc., are the types of documents often used as sources.
• Interviews : Interviews are one of the most important methods for gathering information in case studies. An interview can involve structured survey questions or more open-ended questions.
• Participant observation : When the researcher serves as a participant in events and observes the actions and outcomes, it is called participant observation.
• Physical artifacts : Tools, objects, instruments, and other artifacts are often observed during a direct observation of the subject.

If you have been directed to write a case study for a psychology course, be sure to check with your instructor for any specific guidelines you need to follow. If you are writing your case study for a professional publication, check with the publisher for their specific guidelines for submitting a case study.

Here is a general outline of what should be included in a case study.

Section 1: A Case History

This section will have the following structure and content:

Background information : The first section of your paper will present your client's background. Include factors such as age, gender, work, health status, family mental health history, family and social relationships, drug and alcohol history, life difficulties, goals, and coping skills and weaknesses.

Description of the presenting problem : In the next section of your case study, you will describe the problem or symptoms that the client presented with.

Describe any physical, emotional, or sensory symptoms reported by the client. Thoughts, feelings, and perceptions related to the symptoms should also be noted. Any screening or diagnostic assessments that are used should also be described in detail and all scores reported.

Your diagnosis : Provide your diagnosis and give the appropriate Diagnostic and Statistical Manual code. Explain how you reached your diagnosis, how the client's symptoms fit the diagnostic criteria for the disorder(s), or any possible difficulties in reaching a diagnosis.

Section 2: Treatment Plan

This portion of the paper will address the chosen treatment for the condition. This might also include the theoretical basis for the chosen treatment or any other evidence that might exist to support why this approach was chosen.

• Cognitive behavioral approach : Explain how a cognitive behavioral therapist would approach treatment. Offer background information on cognitive behavioral therapy and describe the treatment sessions, client response, and outcome of this type of treatment. Make note of any difficulties or successes encountered by your client during treatment.
• Humanistic approach : Describe a humanistic approach that could be used to treat your client, such as client-centered therapy . Provide information on the type of treatment you chose, the client's reaction to the treatment, and the end result of this approach. Explain why the treatment was successful or unsuccessful.
• Psychoanalytic approach : Describe how a psychoanalytic therapist would view the client's problem. Provide some background on the psychoanalytic approach and cite relevant references. Explain how psychoanalytic therapy would be used to treat the client, how the client would respond to therapy, and the effectiveness of this treatment approach.
• Pharmacological approach : If treatment primarily involves the use of medications, explain which medications were used and why. Provide background on the effectiveness of these medications and how monotherapy may compare with an approach that combines medications with therapy or other treatments.

This section of a case study should also include information about the treatment goals, process, and outcomes.

When you are writing a case study, you should also include a section where you discuss the case study itself, including the strengths and limitiations of the study. You should note how the findings of your case study might support previous research. 

In your discussion section, you should also describe some of the implications of your case study. What ideas or findings might require further exploration? How might researchers go about exploring some of these questions in additional studies?

Need More Tips?

Here are a few additional pointers to keep in mind when formatting your case study:

• Never refer to the subject of your case study as "the client." Instead, use their name or a pseudonym.
• Read examples of case studies to gain an idea about the style and format.
• Remember to use APA format when citing references .

Crowe S, Cresswell K, Robertson A, Huby G, Avery A, Sheikh A. The case study approach .  BMC Med Res Methodol . 2011;11:100.

Crowe S, Cresswell K, Robertson A, Huby G, Avery A, Sheikh A. The case study approach . BMC Med Res Methodol . 2011 Jun 27;11:100. doi:10.1186/1471-2288-11-100

Gagnon, Yves-Chantal.  The Case Study as Research Method: A Practical Handbook . Canada, Chicago Review Press Incorporated DBA Independent Pub Group, 2010.

Yin, Robert K. Case Study Research and Applications: Design and Methods . United States, SAGE Publications, 2017.

By Kendra Cherry, MSEd Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."

Improving the Evaluation of Scholarly Work pp 65–80 Cite as

Case Research and Theory in Service Research

• Cristina Mele 4 ,
• Marialuisa Marzullo 4 ,
• Montserrat Díaz-Méndez 5 &
• Evert Gummesson 6  
• First Online: 09 November 2022

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Research methodology is a set of procedures that scholars follow to address their studies and ensure valid and reliable results. Choosing a suitable methodological approach is essential for the research process and represents one of the most challenging decisions for scholars. Case studies research assumes a key role in the debate between qualitative and quantitative methods. A manageable step forward to addressing complexity is offered by the narrative case study that interprets and makes sense of stories told by individuals. A further recent extension of case study research coming from the need to include two theoretical approaches that face complexity more systematically and structured: network theory and systems theory, led to the definition of case theory. Case theory offers higher validity and relevance by focusing on the outcome instead of details of the research process and techniques to augment reliability and rigor. Due to its characteristics, case theory is suitable to the service research and could contribute to new theoretical development.

• Case theory
• Narrative case
• Qualitative method
• Interpretive research

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Alam, M. K. (2020). A systematic qualitative case study: Questions, data collection, NVivo analysis and saturation. Qualitative Research in Organisations and Management: An International Journal, 16 (1), 15–31.

Google Scholar  

Andersen, P. H., Dubois, A., & Lind, F. (2018). Process validation: Coping with three dilemmas in process-based single-case research. Journal of Business & Industrial Marketing., 39 (1), 49–55.

Article   Google Scholar  

Antwi, S. K., & Hamza, K. (2015). Qualitative and quantitative research paradigms in business research: A philosophical reflection. European Journal of Business and Management, 7 (3), 217–225.

Azorín, J. M., & Cameron, R. (2010). The application of mixed methods in organisational research: A literature review. Electronic Journal of Business Research Methods, 8 (2), 95–105.

Benasso, S., Palumbo, M., & Pandolfini, V. (2019). Narrating cases: A storytelling approach to case study analysis in the field of lifelong learning policies. Italian Journal of Sociology of Education, 11 (2), 21–35.

Borghini, S., Carù, A., & Cova, B. (2010). Representing BtoB reality in case study research: Challenges and new opportunities. Industrial Marketing Management, 39 (1), 16–24.

Botturi, D., Curcio Rubertini, B., Desmarteau, R. H., & Lavalle, T. (2015). Investing in social capital in Emilia-Romagna region of Italy as a strategy for making public health work. In C. D. Johnson (Ed.), Social capital: Global perspectives, management strategies and effectiveness (pp. 197–219). Nova Science Publishers, Inc.

Bucic, T., Robinson, L., & Ramburuth, P. (2010). Effects of leadership style on team learning. Journal of Workplace Learning., 22 (4), 228–248.

Coffey, A., & Atkinson, P. (1996). Making sense of qualitative data: Complementary research strategies . Sage Publications, Inc.

Czarniawska, B. (2004). Narratives in social science research. Introducing qualitative methods . Sage Publications.

Denzin, N. K. (1989). Interpretive biography . Sage.

Dilthey, W. (1883). Introduction to the human sciences. In H. P. Richman (Ed.), W. Dilthey: Selected writings (pp. 157–263). London: Cambridge University Press

Dubois, A., & Araujo, L. (2004). Research methods in industrial marketing studies. In H. Håkansson (Ed.), Rethinking marketing: Developing a new understanding of markets (pp. 207–227). Wiley.

Durkheim, E. (1960). Montesquieu’s contribution to the rise of social science. In Montesquieu and Rousseau: Forerunners of sociology . Translated by R. Man- heim with a foreword by H. Peyre (pp. 1–64). University of Michigan Press.

Edmondson, A. C., & McManus, S. E. (2007). Methodological fit in management field research. Academy of Management Review, 32 (4), 1246–1264.

Eisenhardt, K. M., & Graebner, M. E. (2007). Theory building from cases: Opportunities and challenges. Academy of Management Journal, 50 (1), 25–32.

Fischer, M. (2015). Fit for the future? A new approach in the debate about what makes healthcare systems really sustainable. Sustainability, 7 , 294–312.

Flyvbjerg, B. (2006). Five misunderstandings about case-study research. Qualitative Inquiry, 12 (2), 219–245.

George, A. L., & Bennett, A. (2005). Case studies and theory development in the social sciences . MA, MIT Press.

Gillham, B. (2000). Case study research methods . Bloomsbury Publishing.

Gomm, R., Hammersley, M., & Foster, P. (Eds.). (2000). Case study method: Key issues, key texts . Sage.

Goulding, C. (2002). Grounded theory: A practical guide for management, business and market researchers . Sage.

Book   Google Scholar  

Gray, D. E. (2021). Doing research in the real world . Sage.

Gummesson, E. (2002). Relationship marketing and a new economy: It’s time for de‐programming. Journal of services marketing, 16 (7), 585–589.

Gummesson, E. (2007). Case study research and network theory: Birds of a feather. Qualitative Research in Organisations and Management, 2 (3), 226–248.

Gummesson, E. (2014). Service research methodology: From case study research to case theory. Revista Ibero Americana De Estratégia, 13 (4), 08–17.

Gummesson, E. (2015). Innovative case study research in business and management . Sage.

Gummesson, E. (2017). Case theory in business and management: Reinventing case study research . Sage.

Gummesson, E., Mele, C., & Polese, F. (2019). Complexity and viability in service ecosystems. Marketing Theory, 19 (1), 3–7.

Halkier, B. (2011). Methodological practicalities in analytical generalisation. Qualitative Inquiry, 17 (9), 787–797.

Harrison, R. L., III. (2013). Using mixed methods designs in the Journal of Business Research, 1990–2010. Journal of Business Research, 66 (11), 2153–2162.

Helkkula, A. (2010). Service experience in an innovation context . Hanken School of Economics

Helkkula, A., Kelleher, C., & Pihlström, M. (2012). Characterising value as an experience: Implications for service researchers and managers. Journal of Service Research, 15 (1), 59–75.

Hitt, M. A., Hoskisson, R. E., & Ireland, R. D. (1994). A mid-range theory of the interactive effects of international and product diversification on innovation and performance. Journal of Management, 20 (2), 297–326.

Johnston, W. J., Leach, M. P., & Liu, A. H. (1999). Theory testing using case studies in business-to-business research. Industrial Marketing Management, 28 (3), 201–213.

King, G., R. Keohane and S. Verba (1994) Designing Social Enquiry: Scientific Inference in Qualitative Research. Princeton, NJ: Princeton University Press

Knights, D., & McCabe, D. (1997). ‘How would you measure something like that?’: Quality in a retail bank. Journal of Management Studies, 34 (3), 371–388.

Lee, B., Collier, P. M., & Cullen, J. (2007). Reflections on the use of case studies in the accounting, management and organisational disciplines. Qualitative Research in Organisations and Management: An International Journal., 2 (3), 169–178.

Mathisen, L. I. N. E., & Chen, J. S. (2014). Storytelling in a co-creation perspective. In J. S. Chen, M. Uysal, & N. K. Prebensen (Eds.), Co-creation of experience value—A tourist behavior approach . CAB International (in Press).

Modell, S. (2010). Bridging the paradigm divide in management accounting research: The role of mixed methods approaches. Management Accounting Research, 21 (2), 124–129.

Närvänen, E., Gummesson, E., & Kuusela, H. (2014). The collective consumption network. Managing Service Quality, 24 (6), 545–564.

Neuman, S. B., & Dickinson, D. K. (Eds.). (2003). Handbook of early literacy research (Vol. 1, pp. 11–29). Guilford Press.

Nie, Y. (2017). Combining narrative analysis, grounded theory and qualitative data analysis software to develop a case study research. Journal of Management Research, 9 (2), 53–70.

Parlett, M., Hamilton, D. (1976) ‘Evaluation as illumination: A new approach to the study of innovative programs’. In D. A. Tawney (Ed.), Curriculum evaluation today: Trends and implications . Macmillan Education.

Patton, M. Q. (1990). Qualitative evaluation and research methods (p. 532). SAGE Publications, Inc.

Perry, C. (1998). Processes of a case study methodology for postgraduate research in marketing. European Journal of Marketing., 32 (9/10), 785–802.

Piekkari, R., Plakoyiannaki, E., & Welch, C. (2010). ‘Good’ case research in industrial marketing: Insights from research practice. Industrial Marketing Management, 39 (1), 109–117.

Pike, K. L. (1967). Etic and emic standpoints for the description of behavior. In D. C. Hildum (Ed.), Language and thought: An enduring problem in psychology (pp. 32–39). Van Nostrand.

Reis, H. T., & Judd, C. M. (Eds.). (2000). Handbook of research methods in social and personality psychology . Cambridge University Press.

Ridder, H. G. (2017). The theory contribution of case study research designs. Business Research, 10 (2), 281–305.

Riessman, C. K. (1993). Narrative analysis (Vol. 30). Sage.

Rossman, G. B., & Wilson, B. L. (1994). Numbers and words revisited: Being “shamelessly eclectic.” Quality and Quantity, 28 (3), 315–327.

Roller, M. R., & Lavrakas, P. J. (2015). Applied qualitative research design: A total quality framework approach . Guilford Publications.

Russo Spena, T., & Mele, C. (2019). Practising innovation in the healthcare ecosystem: The agency of third-party actors. The Journal of Business and Industrial Marketing, 35 (3), 390–403.

Saunders, M. N., & Bezzina, F. (2015). Reflections on conceptions of research methodology among management academics. European Management Journal, 33 (5), 297–304.

Siltaloppi, J., & Vargo, S. L. (2017). Triads: A review and analytical framework. Marketing Theory, 17 (4), 395–414.

Simons, H. (2014). Case study research: In-depth understanding in context. The Oxford handbook of qualitative research (pp. 455–470).

Sommer Harrits, G. (2011). More than method?: A discussion of paradigm differences within mixed methods research. Journal of Mixed Methods Research, 5 (2), 150–166.

Stake, R. E. (1995). The art of case study research . Sage Publications, Inc.

Stake, R. (1998). Case studies. In N. Denzin, Y. Lincoln (Eds.), Strategies of qualitative inquiry . Sage.

Stake, R. E. (2000). The case study and generalizability. In R. Gomm, M. Hammersley, and P. Foster (Eds.), Case study method. Key issues, key texts (pp. 19–26). Sage Publications.

Stake, R. E. (2013). Multiple case study analysis . Guilford press.

Taleb, N. N. (2007). Black swans and the domains of statistics. The American Statistician, 61 (3), 198–200.

Thyer, B. A. (2001). What is the role of theory in research on social work practice? Journal of Social Work Education, 37 (1), 9–25.

Tight, M. (2010). The curious case of case study: A viewpoint. International Journal of Social Research Methodology, 13 (4), 329–339.

Tsoukas, H., & Hatch, M. J. (2001). Complex thinking, complex practice: The case for a narrative approach to organisational complexity. Human Relations, 54 (8), 979–1013.

Turner, J. H. (2001). The origins of positivism: The contributions of Auguste Comte and Herbert Spencer. In Handbook of social theory (pp. 30–42). Sage Publications.

Weber, M. (1904). Die" Objektivität" sozialwissenschaftlicher und sozialpolitischer Erkenntnis. Archiv Für Sozialwissenschaft Und Sozialpolitik, 19 (1), 22–87.

Webster, L., & Mertova, P. (2007). Using narrative inquiry as a research method: An introduction to using critical event narrative analysis in research on learning and teaching . Routledge.

Welch, C., Piekkari, R., Plakoyiannaki, E., & Paavilainen-Ma¨ntyma¨ki, E. (2011). Theorising from case studies: Towards a pluralist future for international business research. Journal of International Business Studie, 42 , 740–762.

Westerman, M. A. (2011). Defenses in interpersonal interaction: Using a theory-building case study to develop and validate the theory of interpersonal defense. Pragmatic Case Studies in Psychotherapy, 7 (4), 449–476.

Woodside, A. G., & Wilson, E. J. (2003). Case study research methods for theory building. Journal of Business & Industrial Marketing, 18 (6/7), 493–508.

Yin, R. K. (2003). Case study research (3rd ed.). Sage Publications.

Yin, R. K. (Ed.). (2004). The case study anthology . Thousand Oaks.

Yin, R. K. (2014). Case study research design and methods (5th ed.). Sage Publications, Inc.

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CLINICAL CASE STUDY article

“a child’s nightmare. mum comes and comforts her child.” attachment evaluation as a guide in the assessment and treatment in a clinical case study.

• Department of Developmental and Socialization Psychology, University of Padova, Padova, Italy

There is a gap between proposed theoretical attachment theory frameworks, measures of attachment in the assessment phase and their relationship with changes in outcome after a psychodynamic oriented psychotherapy. Based on a clinical case study of a young woman with Panic Attack Disorder, this paper examined psychotherapy outcome findings comparing initial and post-treatment assessments, according to the mental functioning in S and M -axis of the psychodynamic diagnostic manual. Treatment planning and post-treatment changes were described with the main aim to illustrate from a clinical point of view why a psycho-dynamic approach, with specific attention to an “attachment theory stance,” was considered the treatment of choice for this patient. The Symptom Check List 90 Revised (SCL-90-R) and the Shedler–Westen Assessment Procedure (SWAP–200) were administered to detect patient’s symptomatic perception and clinician’s diagnostic points of view, respectively; the Adult Attachment Interview and the Adult Attachment Projective Picture System (AAP) were also administered as to pay attention to patient’s unconscious internal organization and changes in defense processes. A qualitative description of how the treatment unfolded was included. Findings highlight the important contribution of attachment theory in a 22-month psychodynamic psychotherapy framework, promoting resolution of patient’s symptoms and adjustment.

Introduction

Attachment theory in Bowlby’s (1969/1982 , 1973 , 1980 , 1988 ) and Ainsworth’s (1963 , 1967 ) tradition postulates that an individual’s experience of early parental care contributes to the development of internal representations of self and others as safe and available. This theory offered the clinicians a scientific grounded model, which postulated and empirically demonstrated the origin of psychopathology in early separation experiences and in adverse emotional experiences ( Oppenheim and Goldsmith, 2007 ; Cassidy and Shaver, 2008 ). The most recent literature endorses that attachment theory is consonant with all assessment and treatment approaches which evaluate childhood experiences as an important contributor to adult functioning (e.g., Wallis and Steele, 2001 ; Blatt and Levy, 2003 ; Diamond, 2004 ; Bakermans-Kranenburg et al., 2005 ; Buchheim et al., 2007 ; Zegers et al., 2008 ; Buchheim and George, 2011 ). Throughout the case formulation and the planning of treatment, attachment theory has also the potential to provide-at least-a useful foundation for defining the target of change in psychotherapy (e.g., features of internal working models or attachment patterns), understanding the processes through which change occurs (e.g., through the development of a secure base and exploration of working models; e.g., Fonagy, 1999 , 2001 ; Cozzolino, 2002 ; Parish and Eagle, 2003 ; Mallinckrodt et al., 2005 ; Wallin, 2007 ; Fosha, 2009 ; Holmes, 2010 ; Siegel, 2010 ). As Bowlby originally stated, while reconsidering classical attachment theory, Davila and Levy 2006 , p. 990) stressed “five key tasks for psychotherapy: (a) establishing a secure base, which involves providing patients with a secure base from which they can explore the painful aspects of their life; (b) exploring past attachments, which involves helping patients explore past and present relationships, including their expectations, feelings, and behaviors; (c) exploring the therapeutic relationship, which involves helping the patient examine the relationship with the therapist and how it may relate to relationships or experiences outside of therapy; (d) linking past experiences to present ones, which involves encouraging awareness of how current relationship experiences may be related to past ones; and (e) revising internal working models, which involves helping patients to feel, think, and act in new ways that are unlike past relationship.” Despite the increasing interest in the relevance of attachment theory as a framework to understand the unfolding of psychodynamic treatment, there is a gap between the proposed theoretical frameworks and the empirical measures of attachment used in the assessment, and only few studies addressed the interplay between attachment pattern measures, and their implication for unfolding and outcome in a psychoanalytic oriented treatment ( Buchheim and Kachele, 2001 ; Dahlbender et al., 2004 ; Buchheim, 2005 ; Lis et al., 2008 , 2011 ; Isaacs et al., 2009 ).

Interpersonal problems, adult attachment, and emotion regulation have been increasingly studied across adult anxiety disorders. Literature linked attachment and separation in infants and preschool children to separation anxiety disorder, agoraphobia, and panic attacks later in life, underlining how insecure attachment can lead to an increased risk for attachment psychopathology and subsequent social and emotional maladjustment/attachment and separation anxiety/school or work phobia/attachment correlations ( Routh and Bernholtz, 1991 ). Of all the forms of anxiety, separation anxiety seems to be the one which is most likely to be associated with an anxious attachment style, because sufferers are by definition highly sensitive to real or perceived threats to relationships ( Main et al., 1985 ). Separation anxiety would appear to be a core form of anxiety associated with panic attack disorder and with attachment problems ( Hazan and Shaver, 1987 ; Bartholomew and Horowitz, 1991 ; Eng et al., 2001 ). Dysfunctional and not good-enough parenting and hereditary factors appear to play a role in generating early separation anxiety. However, the child’s anxiety itself may generate overprotective parenting ( Manicavasagar et al., 1999 , 2009 ) which, in turn, could make children approach their caregivers both in response to dangerous external stimuli and to caregiver’s permanent monitoring availability and attentiveness; moreover, overprotecting or over responsive parents could obstacle the expression of the explorative system, even when a “secure base” is provided ( Pacchierotti et al., 2002 ). Although attachment theory suggests that anxious attachment styles are mostly associated with risks of developing anxiety disorders, neither all anxious attached patients develop panic attack disorder, nor all secure attached patients do not develop it: the latter is a weird and rare condition because, theoretically, secure early relationships with adults are the basis for the development of a sense of control and predictability accounting for normal subjects’ tendency not to interpret ambiguous internal stimuli as threatening ( Shear, 1991 ).

Based on a clinical case study of a young woman with Panic Attack Disorder- Matilde-, this paper examined psychotherapy outcome findings comparing initial and post-treatment assessments, according to the mental functioning in S and M -axis of the Psychodynamic Diagnostic Manual (PDM; PDM Task Force, 2006 ) 1 . The patient’s choice is motivated by this “rare combination”: a PAD patient with secure attachment. The first aim of this paper was to provide incremental usefulness to the picture of the patient’s idiographic and intra-subjective features, using a multi- method assessment based on (1) two performance-based attachment measures – the Adult Attachment Interview (AAI; George et al., 1984 / 1985 / 1996 ), and The Adult Attachment Projective Picture System (AAP; George and West, 2001 , 2012 ), (2) the Shedler–Westen Assessment Procedure (SWAP–200; Westen and Shedler, 1999a , b ), and (3) a self-report symptom scale, the Symptom Checklist 90 Revised (SCL-90-R; Derogatis, 1983 ; Funder, 1997 ; Meyer et al., 1999 ; Ozer, 1999 ).The second aim was to describe how Matilde’s assessment findings – and more specifically attachment pattern analysis – could represent useful guidelines for the unfolding of a psychoanalytic therapy with a supportive approach, in an attachment theory framework ( Misch, 2000 ).

We hypothesized that the AAI, the AAP, the SCL-90-R, and the SWAP–200 would help in focusing on the most relevant dimensions of patient’s psychological functioning which make a meaningful diagnosis ( Barron, 1998 ; Shedler and Westen, 2007 ) at the beginning and at the end of treatment. Attention was directed to the interplay between modification of overt symptoms and behaviors, and changes in personality functioning and adaptation; more specifically, we focused on patterns and complexities in the patient’s internal organization and interpersonal functioning ( Shectman and Harty, 1986 ; Peebles-Kleiger, 2002 ; Bram, 2010 ). A reduction in psychopathological symptoms and an improvement in mental functioning according to the PDM M -axis and S -axis were expected at the end of the therapy.

Clinical Case Presentation: Matilde

Matilde was a pleasant 20-year-old young woman, who looked younger than her age. She was a self-referred patient, and was assessed for a high level of anxiety at a university-based psychology-training clinic 2 . Matilde had a diagnosis of Panic Attack Disorder in Axis I (DSM-IV; American Psychiatric Association [APA], 1994 ), and no diagnosis in Axis II. Although she was a 2-year student at the Medical School with outstanding results, she felt “ anxious, confused, and insecure, ” “ I do not know if this Faculty is good for me, maybe Biology would be better, or Pharmacy … I do not know really, I am so confused; I do not understand what is happening to me …. I am no more sure about anything. ” Insecurity caused her quite severe crying crises, pervasive anxiety, and some physical symptoms, such as psychomotor agitation and tachycardia. She had taken light tranquilizers in the last 3 months. She felt unable to control or understand her present distress. Since she started University, her life had been totally busy with studying, leaving no time or desire to engage in social relationships. She did not talk about any actual satisfying relationships. The only “ friends ” she kept in touch with were schoolmates from high school, with whom she shared school topics. She had never had a boyfriend, and felt very uncomfortable talking about romantic or sexual topics. Matilde moved away from her small native town to attend University, and she was sharing an apartment with other students next to the Medical School. She went back home to her family during University vacations. She came from an intact family, which she was very proud of. She had a 10-year-old sister, Sarah, to whom she was very attached. Sarah was described as very different from Matilde: very funny, an ironic with a lot of energy. They spent a lot of time playing together, and Matilde was unconcerned about her worries when she was with Sarah. Matilde describes her childhood with some enjoyment and unconcern while her present appears very worrying, uncertain and without any source of protection and soothing. Matilde supports a good relation with her mother, although the father is described as rigid and very involved in practical duties.

Approach to the Case: Procedure and Instruments

At the initial assessment phase Matilde underwent three interview sessions, two test sessions and one feedback session. In particular, Matilde’s evaluation involved the administration of the AAI and the AAP, the SCL-90-R, and the SWAP–200. All results were integrated with clinical interview contents to formulate a case conceptualization, according to specific dimensions of the PDM. In the feedback session, a once-a-week psychodynamic psychotherapy with a supportive approach was proposed to and accepted by Matilde. The therapy lasted 22 months. At treatment conclusion Matilde accepted to be re-administered the AAP and the SCL-90-R. Based on the last three sessions also the SWAP–200 was re-administered. All the tools administered were scored and interpreted by independent judges 3 . A brief description of used tools follows after timetable of administration (Table 1 ).

TABLE 1. Timetable of administered tools.

Symptom Checklist 90 Revised ( Derogatis, 1983 ) is a 90-item self-report questionnaire scored on a five-point Likert scale of distress from 0 (none) to 4 (extreme), indicating the rate of occurrence of symptoms during the time reference ( Derogatis et al., 1973 ). It is intended to measure symptom intensity on 10 different dimensions: somatization (SOM), obsessive–compulsive (O–C), interpersonal sensitivity (I-S), depression (DEP), anxiety (ANX, hostility (HOS), phobic anxiety (PHOB), paranoid ideation (PAR), psychoticism (PSY), and sleep difficulties (SLEEP). A Global Severity Index (GSI) of distress is calculated. According to the Italian Manual, an intensity raw score higher than one was qualified as penetrating in the clinical range. The internal consistency coefficient alphas for the nine symptom dimensions ranged from 0.77 for Psychoticism, to 0.90 for Depression. Test–retest reliability coefficients ranged between 0.80 and 0.90 after 1 week of therapy. The few validity studies of the SCL-90-R demonstrate levels of concurrent, convergent, discriminant, and construct validity comparable to other self-report inventories ( Derogatis, 1983 ).

The Shedler–Westen Assessment Procedure ( Westen and Shedler, 1999a , b ) is a set of 200 personality-descriptive statements developed for clinicians to assess adult personality traits and pathologies ( Shedler and Westen, 1998 ). Starting from clinical interviews, the assessor is asked to describe the patient by arranging the statements into eight categories, from those that are not descriptive (assigned a value of “0”) to those that are highly descriptive (assigned a value of “7”) for each of the 200 personality-descriptive variables. The instrument is based on the Q-sort method that requires clinicians to arrange items into a fixed distribution ( Block, 1978 ). The SWAP–200 could be interpreted at a nomothetic as well as at an idiographic level. Nomothetic interpretations are carried out following two profiles. The first is the PD-T score profile of the 10 Personality Disorders included in DSM–IV (paranoid, schizoid, schizotypal, antisocial, borderline, histrionic, narcissistic, avoidant, dependent, obsessive); the Q-T profile covers 11 dimensions (psychological health, dysphoric, antisocial, schizoid, paranoid, obsessive, histrionic, narcissistic, avoidant, depressive high functioning, emotional dysregulation, dependent, hostile). Both PD-T and Q-T profiles include a score on a Healthy Functioning scale. Inter-rater reliability coefficients range from 0.70 to 0.80. Support for the validity of the SWAP–200 is derived from its ability to predict relevant variables in expected ways, including family psychiatric history, history of abuse, social, and school functioning, violence, suicidal behaviors and attempts, attachment status, and eating disorder diagnostic groups ( Westen and Muderrisoglu, 2003a , b ). Idiographic narrative case description is also included in the SWAP–200 (e.g., Lingiardi et al., 2006 ). Both levels were used to assess Matilde. Moreover, the SWAP–200 ( Westen and Shedler, 1999a , b ) is one of the instruments listed by PDM work-group members to be used to measure the dimensions of the M -axis.

The Adult Attachment Interview ( George et al., 1984 , 1985 , 1996 ; Hesse, 2008 ) is an about 1 h audio-recorded semi-structured interview that explores an adult’s mental representations of attachment, guiding the individual through a series of questions about past and present relationships with each parent and attachment-relevant events during childhood. The AAI focuses on the assessment of the attachment internal working model ( Bowlby, 1969/1982 ) and assumes developmental continuity of the attachment system along life. AAI final attachment classification is evaluated on two different set of scales (1) Experience Scales that evaluate for example Loving, Rejecting, Neglect, Role Reversal, Pressure to achieve and (2) State of Mind Scales that assess Coherence, Metacognitive Processes, Lack of Recall, Passivity of Discourse, Idealization, Anger, Derogation attitudes toward caregivers, Unresolved mourning or trauma, Feared loss of one’s own child. Starting from these scales, each interview is classified in one of the primary attachment patterns: secure/autonomous, dismissing/avoidant, and preoccupied/entangled or “cannot classify.” Where applicable, the “unresolved” pattern with respect to loss, trauma, or abuse could be scored. Multiple scoring is allowed (e.g., F/DS). AAI validation rests on more than 25 years of developmental and clinical research ( van IJzendoorn and Bakermans-Kranenburg, 2008 ). Rigorous psychometric testing and meta-analyses of the AAI demonstrate its stability, and discriminant and predictive validity in both clinical and non-clinical populations. In a recent meta-analysis of 61 clinical samples ( van IJzendoorn and Bakermans-Kranenburg, 2008 ), strong associations were found between psychiatric diagnoses (i.e., anxiety disorders, borderline personality disorder) and attachment insecurity.

The Adult Attachment Projective Picture System ( George and West, 2001 ) is based on a standardized set of seven drawn pictures divided in Alone and Dyadic stimuli 4 . The pictures describe major attachment events, potential threat of separation, illness, solitude, death, and abuse. The stimuli are: child at window (window); departure; bench; bed; ambulance; cemetery; and child at corner (corner). Individuals are asked to make up a story for each image in which they describe what is going on in the picture, what led up to the scene, what the characters are thinking or feeling and what might happen next. The responses are audiotaped for transcription and verbatim analysis. The AAP assesses attachment in the Bowlby-Ainsworth tradition ( West and George, 2002 ; George and West, 2012 ). The AAP Coding System, leads to four adult attachment classification patterns, – secure/autonomous, dismissing, preoccupied, unresolved – as they were traditionally assessed in the AAI, even if no multiple scoring is allowed. The AAP also assesses attachment personal elements that individuals may exclude from conscious awareness. Attachment classification using the AAP is determined by evaluating patterns of responses using a set of seven scales grouped under three major categories: discourse, content, and defensive processing. These dimensions evaluate the attachment story content related to the hypothetical characters portrayed in the stimuli, to defenses, and to self-other boundaries in narrative discourse ( George and West, 2001 , 2012 ). Discourse codes evaluate personal experience. Content codes include agency of self and connectedness for alone pictures, and Synchrony for dyadic pictures. Finally, the AAP codes for defensive exclusion, segregated systems, deactivation, and cognitive disconnection ( Bowlby, 1980 ). They represent different degrees of “protection” from dangerous distressful events. Segregated systems describe a mental state in which painful attachment-related memories are isolated and blocked from conscious thought and rooted in experiences of trauma or loss through death ( Bowlby, 1980 ). Deactivating defensive processes are defined as attempts to dismiss, cool off, or shift attention away from attachment events, individuals, or feelings in response to the picture stimuli. Cognitive disconnection processes literally disconnect the elements of attachment from their source, thus undermining consistency and the capability of holding in one’s mind a unitary view of events, emotions, and the individuals associated with them. The most recent review of AAP reliability and validity was published in George and West (2012) . AAP–AAI convergence for secure versus insecure classifications was 0.95 (κ = 0.75, p = 0.000); convergence for the four major attachment groups was 0.89 (κ = 0.84, p = 0.000; George and West, 2001 , 2012 ; West and George, 2002 ). The AAP has also been shown to be useful in studying the neurobiological and emotional expression correlates of attachment in non-clinical and clinical samples ( Buchheim and Benecke, 2007 ; Buchheim et al., 2007 , 2008 , 2009 ; Fraedrich et al., 2010 ) as well as in single case studies ( Lis et al., 2011 ).

Both AAI and AAP show individual strengths in measuring attachment patterns, but their combined use increments their overall usefulness. The AAI, the golden standard measure of adult attachment ( Bakermans-Kranenburg and van Ijzendoorn, 1993 ), focuses on the assessment of the representational model and coherence of mind, and assumes developmental continuity of the attachment system, evaluating abuse and loss in one’s personal history. The AAP, based on the Bowlby–Ainsworth tradition ( West and George, 2002 ; George and West, 2012 ), assesses current views of self, attachment figures, and expectations about the productiveness of attachment relationships, elucidating how current experience activates attachment accomplishment, disappointment, and trauma from the past ( West et al., 1995 ; George and West, 2012 ). The AAP is also more trauma sensitive and underscores defense patterns (e.g., Hesse, 2008 ; George and West, 2012 ). The combined use of the AAI and the AAP gives the chance to portray a complex image of the patient’s attachment pattern, providing a detailed narrative about life attachment activators such as separation, fear, solitude, and danger, shedding light on the unconscious defensive mechanisms and exploring the accessibility of attachment figures during the life-span (e.g., Hesse, 2008 ; George and West, 2012 ). The SCL-90-R contributed to get Matilde’s self-evaluation of symptoms.

Assessment Findings

Results from DSM-IV diagnosis, SCL-90-R and SWAP–200 during the assessment phases are described in Table 2 . Results from attachment tools are reported below and AAI subscales are shown in Tables 3 and 4 .

TABLE 2. Results from SCL-90-R and SWAP–200 in assessment phase.

TABLE 3. AAI experience scales.

TABLE 4. AAI state of mind scales.

Matilde’s AAI was scored F2/Ds3, secure with features of dismissing or some restriction in feelings of attachment (F2 = free somewhat dismissing or restricted in attachment; DS3 = dismissing restricted in feelings with some evidences of Lack of Memories; George and Solomon, 1996 ; see Tables 3 and 4 ). Matilde secure pattern was so defined because she was able to explore his or her thoughts and feelings about childhood experiences, with fresh speech, humor and forgiveness, without becoming angrily or passively overwhelmed while discussing them. Generally, Matilde appeared to be aware of the nature of experiences with her parents and of the effects of such experiences on her present state of mind and on her personality. Nevertheless, she remained a little bit restricted in her emotional expressions, preferring to rationalize. State of mind scales tapped a dismissing feature, showing a slight tendency to idealize parents and some lack of memories. Further information about Matilde derived from a qualitative analysis of the AAI. She did not report any severe illness, traumatic or abuse experience. However, separations caused her some distress, but she felt always supported and listened by her mother. She described herself as a very calm girl but, during early childhood, she was very shy and very worried about separation: “ I became very agitated when I did not see my parents, when they were not there, when they were away from home, ” “ Once we were at the lake. I was on the one side of the road and my parents were on the other side. Some people passed and so I could not see my parents anymore. I did not see them anymore and I began to scream .” However, she remembered that during her summer camp experience, when there were no well-known friends or schoolmates: “ I felt the distance from home, I felt lost and confused … I was very happy to go back home. The bus journey to go back home was very stressful,” “I do not like changes. I am worried about changes. ”

She described the relationship with her mother as: affectionate, playful, reciprocal, supportive, and protective. When she was asked to recall a specific example in respect with “supportive relationship” she reported that “ I gulped a small toy and it remained caught in my throat. I had to be taken to the hospital. I was very agitated, I screamed that I was frightened of dying. Mammy was very supporting … I mean comforting. ” She was able to identify a specific episode, but in a superficial and not qualitative consistent manner ( Grice’s qualitative maxim ): the adjective-descriptor (supportive) of relationship with her mother was supported with a second generalized positive descriptor (comforting). The adjectives she chose to describe the relationship with her father were: always affectionate, playful, formal ( “home rules had to be respected, for instance times for lunch and dinner” ), respectful ( “Nothing escaped from him; his words had always a weight” ), and important. Such aspects were more linked to father’s role as a parent and to school achievement: “I felt very bad about his criticism.” Matilde felt closer to her mother than to her father, from whom she felt more detached. Moreover, during school years she always felt a little bit anxious and agitated about school achievement and completion. Beside all these difficulties, she always felt supported and sustained by her mother, and at the end she demonstrated herself as very forgiving toward her father’s severity. When asked to imagine the possibility of being separated from her child, Matilde reported to feel “ a big void, a big feeling of lost, of mourning, a big pain, an absence of being complete ” and the three wishes about this child when he would be 20-years old were: “ to be able to choose, to have a clear reasoning, not being confused, and to be able to be autonomous. ”

Matilde was judged as secure on the AAP (F): she showed, at the representational level, a flexible and organized thinking about attachment situations and relationships ( Bowlby, 1969/1982 ). She was confident that she could rely on attachment figures to achieve care, safety and protection and, when alone, she could access internalized attachment relationships ( George and Solomon, 1996 , 1999 ). In response to two of the alone stimuli – Window and Cemetery- as a secure individual, she demonstrated the ability to think (i.e., Internalized Secure Base) and to take constructive action. She also used flexible defensive processes to integrate attachment feelings and events. Using these resources she was able to re-organize her attachment-related feelings, also in the few cases (Bed and Cemetery Stories) when she became disorganized by feelings of loss and danger. From the pattern of story responses it appears that Matilde, above all other response qualities, genuinely valued and represented the capacity for integration of self and relationships. The responses to the Alone pictures demonstrated Matilde’s internal resources, such as the potential availability and responsiveness of attachment figures. As a representative example of this attitude the Cemetery picture (a man stands by a gravesite headstone) story is reported.

“A gentleman who had a bad day or felt sad or depressed or undervalued because of an episode that happened during the day and goes and visits his father … he feels reassured because he found a place where to think about his life by himself and then he will go back home and will be able to reconsider what happened from a different point of view.”

In Cemetery, Matilde reveals the intensity of feelings of pain associated with loss: she tries to deal with them through some form of uncertainty and desire to withdraw (cognitive disconnection). These forms of organized defensive mechanisms keep Matilde’s attachment system activated but they cannot prevent her from becoming dysregulated, as evidenced by painful attachment-related feelings of loss represented by the appearance of a them where no clear distinction is made between life and death (“he goes and visit his father”). A segregated system (spectral domain) was activated by the picture features, which portray a man visiting a grave. However, Matilde was able to depict the man as engaged in some kind of “thinking.” The man is able to “reconsider what happened from a different point of view.” This process belongs to Internalized Secure Base, and portrays Matilde’s ability to clearly differentiate between the living and the dead. The Dyadic picture stimuli portray attachment-caregiving dyads. The responses to Dyadic picture stimuli demonstrate Matilde’s representation of the self and other in attachment situations when attachment figures are present and accessible, but they also demonstrate the use of attachment figures to quell the attachment anxiety aroused in the scenes depicted in the cards. Bed picture (a child and woman sit opposite to each other on the child’s bed) could be a representative example.

“A boy had a nightmare during the night and his mother woke up eh … now he is scared and he would like to be close to his mum … the mum is trying to soothe him and she will be able to do it … the boy will come back to sleep quietly … (Anything else?) no.. maybe the bad dream was … was about the fact of staying alone without his mom … and now … he wants his mom first!”

In Matilde’s story, the child signals his attachment need after a “nightmare” (segregated system in AAP) and the mother is able to provide a contingent and soothing answer, containing the potential breakdown of the attachment system and resolving the segregated system. Both AAI and AAP classified Matilde as secure with somewhat dismissing or restricted feelings in attachment without elements of unresolved abuse or trauma. However, both tools detected some shortcomings about fears of separation and danger. The AAI was not able to draw attention in an exhaustive way to how Matilde experienced abandonment fears and felt scared without the presence of her parents. Instead the AAP clearly depicted this nuance, under a secure pattern, showing that her attachment was threatened by painful attachment-related feelings of loss, and by a nightmare (in Bed picture), a signal of danger. In both tools she demonstrated her ability to re-organize herself, but these disturbing feelings kept being alive underneath her reorganized secure pattern.

Case Formulation Based on PDM Axes

S -axis – Matilde had a diagnosis of DSM-IV ( American Psychiatric Association [APA], 1994 ), and showed a slightly High Functioning profile with Obsessive, Schizoid-Avoidant and Dysphoric characteristics, in both PD and Q factors in SWAP–200. Matilde’s SCL-90-R symptom profile revealed depression, anxiety, obsessive–compulsive, and somatization scores in the clinical range (Table 2 ).

M -axis – this Axis describes nine dimensions, which systematize the capacities that contribute to an individual’s personality and overall level of psychological health or pathology.

Capacity for regulation, attention, and learning

In the clinical interview, she said, “ I lost control of my body and thinking. ” She appeared in a profound state of crisis and she appeared to be unable to cope with it and with connected feelings of anxiety and distress. She (a) adhered rigidly to daily routines and became anxious or uncomfortable when they were altered, (b) had trouble making decisions and was indecisive or vacillated when faced with choices, (c) was overly concerned with rules, procedures, order, organization, and schedules: all obsessive strategies which would interfere with processes that support attention and learning from experience. However, according to Bowlby, being secure at both AAI and AAP means that Matilde had basic capacities for regulation. Matilde appeared to believe in the seeking of proximity and support as effective ways in regulating distress, in particular in AAP Dyadic pictures. However, at the moment of assessment, she was not able to recur to her internalized security patterns, showing how an emotional regressive crisis was rising up. Although Matilde subjectively felt unable to cope with it and was very frightened by it, according to the AAP and AAI, the dysregulation appeared momentary and not prolonged. It seems she was still functioning as she described herself in the early childhood memory, when she could not see her parents and she got anxious at the thought of being lost. However, her basic secure attachment suggests that, thanks to the therapy, she could re-establish her capacity of self-regulation, a secure person’s basic characteristic.

Capacity for interpersonal relationships

Although she was excessively devoted to work and productivity, compromising leisure and relationships, her secure attachment pattern at the AAI and AAP indicated that Matilde had a positive representation of available adults who can offer protection, support, care, and comfort in threatening and stressful situations. The AAP supported also her potential ability to be connected with other relational systems such as partners and peers, almost in a concrete manner, since she was able to tell stories in which she described specific connections with friends and other people in general. However, her agency, connectedness, and synchrony were at the moment “quite silent” in her everyday life. She needed help to regain these resources.

Quality of internal experiences

In AAI and AAP she felt reassured by (her) mother’s proximity, soothing, and comfort. However, episode and story plots clearly indicated some separation anxieties and worries in respect to changes, which she faced using dismissing defense mechanisms. AAP clearly depicted how under a secure pattern, her attachment was threatened by painful attachment-related feelings of loss and danger. Until that moment, such feelings were isolated and blocked from conscious thought. Even if she was able to deal with these experiences in childhood thanks to her mother’s comfort, her fear of loss connected to the fear of being alone and unprotected seem to re-emerge We hypothesized that she was having trouble in coping with new adolescence-through-young adulthood tasks, such as the adult separation-individuation process. According to the SWAP–200, she experienced a sense of personal dissatisfaction, poor self-regard, low self-esteem, lack of confidence, and chronic self-criticism. Her unrealistically high standards together with her expectation of being “perfect” above all in her achievements, made her feel guilty, depressed and despondent, with negative self-regard toward others, and the world at large.

Affective experience, expression, and communication

According to the SWAP–200, Matilde tended to defend herself via the inhibition of emotion expression, by means of abstract thinking and intellectualized terms, and appeared unable to recognize her wishes and impulses. Apparently, intellectualization and disavowal defenses (above all rationalization) led her to the avoidance of expressed conflict and emotions – both positive and painful. This emotional constriction resulted in a bottled up affect being channeled into panic attacks. The SWAP–200 stressed the risk of recurrent episodes of overt anxiety, tension, nervousness, and irritability and difficulty in acknowledging or expressing underlying feelings of anger and resentment. The AAP and AAI confirmed that underneath this block of affection there was a rich and positive affective state she had internalized during childhood life experiences. However, although not so rigid, her present affective state of constriction and inhibition was consistent with the rigid attempt to neutralize affect using deactivating defenses in the AAP. The emotions, which were bottled up in the segregated system, surely carried a negative and overwhelming emotional tone, which at the moment she was unable to deal with.

Defensive patterns and capacities

The SWAP–200 indicated the extent to which Matilde tended to defend her from expressing emotions, by abstract thinking and intellectualized terms. Although her defenses were at a mature-neurotic level, they were not solid enough to allow her to avoid the recourse to symptoms and anxiety. From an attachment viewpoint-AAP-Matilde shows a different picture underneath. Here defenses appeared organized and flexible, but in order to keep a regulated attachment she relied more on deactivation than on cognitive disconnection ( George and West, 2012 ).

Capacity to form internal representations

Matilde was able to form internal representations of self and others, and her experiences were symbolized mentally. However, in the current state of distress, some emotions and conflicts were expressed somatically through her somatic symptoms and panic attack episodes.

Capacity for differentiation and integration (ego strength, self-cohesion, stability of reality testing). Overall, her AAP stories and her narrative in the AAI revealed that she was able to look realistically at herself, people, and relationships. Also during the clinical interview, a solid, stable and good child image emerged, but was not integrated with an adolescent and adult image: Matilde’s ego was fragile and was shattered by a large number of symptoms, her self-image was damaged and not well integrated; moreover, she looked younger than her age and never talked about sexuality or intimate relationships.

Self-observing capacities

Matilde did not demonstrate good self-observation capacities. Her level of current distress, extension of intellectualization and rationalization defenses, avoidant and constricted emotional style did not allow for an adult and mature emotional insight.

Capacity to construct or use internal standards and ideals. SWAP–200 showed how she currently set unrealistically and childish high standards for herself and how she appeared intolerant of her own human defects.

Therapeutic Stance and Therapy Guiding Conception

Matilde looked younger than her age and did not talk about sexuality or intimate relationships and we supposed that she did not undergo a true adolescent process. Looking at her secure attachment pattern, the therapist hypothesized that the present state of dysregulation and symptomatic picture is transitory and derived from the new young adulthood tasks she has now to deal with during her transition toward adulthood, such as moving to University. From a psychoanalytic as well as an attachment-oriented viewpoint, we hypothesized she was not able to face adolescent and adult separation-individuation processes. According to attachment theory, attachment relationships foster integration of attachment with relationships in peer behavioral systems during adolescence and adulthood: these include friendships and romantic relationships ( West and George, 1999 ; Allen, 2008 ; George and Solomon, 2008 ; George and West, 2012 ). Psychoanalytic theories also agree that the individual needs to face adolescence as a separation-individuation process, where adolescents need to acquire an individual separate self-identity through identification with parents and separation from childhood ties. The AAP and AAI were taken into account, making the therapist sensible to specific topics concerning separation, loss, and loneliness, able to reactivate and unleash childhood attachment-related memories of fear of being lost and completely alone during treatment itself. Matilde needed to explore this topic with a therapist who would represent for her, in the transference, a secure parent similar to the one she had already experienced in her life via her mother’s supporting stance. In particular, the therapist expected that supportive psychotherapy would integrate the “segregated” themes locked in Matilde’s experience: she might then be able to consciously accept and deal with her blocked emotions and affects, as to regainenjoyment of life and satisfaction in the relationship with significant figures, re-finding the haven of safety of self and others that she had experienced in her childhood.

The clinical case formulation suggested for Matilde a therapeutic approach in the context of a “partial rapprochement” between attachment theory and psychoanalytic individual psychotherapies as the best solution ( Skean, 2005 ; Slade, 2008 ; Steele et al., 2009 ). This intervention would include: (a) The use of therapeutic relationship and alliance as vehicles for a “secure base” constitution, in order to observe and understand the client’s interpersonal behavior ( Spence, 1982 ; Binder et al., 1987 ; Dozier et al., 1994 ; Slade, 2008 ; Steele et al., 2009 ); (b) Relationships with the self and others (internal and external), in terms of personality functioning but also from client’s transference and therapist’s counter-transference points of view of ( McWilliams, 1999 ; Skean, 2005 ); moreover, patient’s real or transferential relationships and past-present pattern of emotional responses and behaviors were examined ( Gabbard, 2009 ). However, a particular emphasis was put on the supportive versus insight-oriented modes of therapy ( Skean, 2005 ), because Matilde needed: (a) to reduce physical and psychical symptoms ( S-Axis ; Gabbard, 2009 ), and reestablish a consistent level of functioning ( Dewald, 1971 ; Ursano and Silberman, 1996 ; Douglas, 2008 ); (b) to strengthen her fragile ego. Her defenses were at a mature-neurotic level, but were not solid enough to stop the recourse to symptoms and anxiety ( PDM: Defenses; Capacity for Differentiation and Integration ), (c) to change her self-definition, improving self-esteem, and getting a more integrated perception of the self, ( PDM: Qualiy of internal experiences; Capacity for Differentiation and Integration ); (d) To function better in everyday life investing lessin achievements and study matters ( Dewald, 1971 ; Ursano and Silberman, 1996 ; PDM: Rehabilitation ); (e) to improve her coping skills and to learn consistent strategies to manage her painful internalized feelings ( PDM: Capacity for regulation, attention, and learning ); (f) to increase her capacity to express affects both on the positive and negative aspects evidenced by AAI and that were consciously often inhibited and not acknowledged (PDM: Affective Experience, Expression, and Communication) ; (g) to encourage more consistent ways of relating to others ( PDM: Capacity for Intepersonal Relationships; Misch, 2000 ). In addition, her concrete and intellectualized thinking (SWAP–200) made also difficult for her to deal with interpretations, suggesting again the need of a more supportive approach.

Brief Outline of the Therapy Unfolding

As expected, during the first months of therapy Matilde showed a high symptomatic picture. She appeared very distressed and confused, with a sense of failure, of inability to reach her standards. Long boring and intellectualized descriptions of daily routines and of University achievement, anxiety, uncertainties and doubts about her achievements were her main topics. The therapist acted as a secure attachment figure ( Parish and Eagle, 2003 ; Mallinckrodt et al., 2005 ), as a caregiver who offered security and soothing to Matilde’s distress. She worked actively helping Matilde to contain anxiety, shame, and anger ( Winston et al., 2004 ). The therapist, very slowly and respecting her defenses, tried to reduce Matilde’s anxiety, to increase her self-esteem and hope, and to make her more aware about herself as a person, and not only as a student who had to achieve some standards. She begun anyway to talk about how she could count on her mother, the only person that always helped her when she felt anxious and distressed. This finally opened a window on her family and her separation difficulties during childhood, and she started to tellhow she felt alone and how much she needed her mother’s soothing, how much difficult it was to face her first experience of a 2-week summer camp, as well as to begin elementary school, middle school, and high school. She also admitted that anyway with her mother’s help she was able to face these separations. She began to recognize, following therapist’s verbalizations, that at that time she was beginning a new kind of “school-experience,” similarly to the situation at present. In parallel with this initial understanding of her fear of facing changes and separation, all symptoms increased, especially anxiety symptoms. “ It is a nightmare ” were her words. She told the therapist that she called mommy every morning and evening but it was not enough. She felt lost and alone. The episodes reported by Matilde at this phase of the therapy were very similar to the ones she reported in the AAI, and the ways she dealt with the present separation from her mother were similar to the ones she previously used during her childhood: going concretely to her mother to be soothed and supported. Moreover, she used the same words she previously used in the two AAP stories where segregated systems were unleashed but resolved. It could be hypothesized that in the transference with the therapist Matilde’s attachment system was activated and “seen in action” ( George and West, 2012 ). As she said during the AAI, it was always difficult for her to deal with changes. Now in the transference with the therapist she was reliving her fears, the same fears she experiencedin childhood, the ones that were unleashed at the beginning of the University andthat she was able to face only through anxiety and obsessive symptoms. It was difficult for her to connect this experience with the new separation experience from home and from herself as a child, now that she had to face University and all the complex processes connected with entering adulthood. In the transference with the therapist she was reviving an acute separation anxiety and she was also unconsciously angry at the therapist’s impossibility to help her. The therapist tried unsuccessfully to interpret and to connect this profound regression with Matilde’s previous separation anxieties. Words were not useful. Wallin (2007) supports that “ what patients are unable to explain with words, tends to be evocated, enacted or incorporated ” ( Zaccagnini and Zavattini, 2009 ). The working alliance showed for the first time some ruptures, and the risk of treatment disruption itself became a subject of discussion ( Appelbaum, 2005 ; Colli and Lingiardi, 2009 ). Matilde’s alliance rupture style was characterized by the presence of withdrawal maneuvers: emotional disengagement from the therapist, skipping from topic to topic, responding in an overly intellectualized fashion, and very short answers ( Safran and Muran, 2000 ). In such a moment of regression, she really needed a concrete comfort and physical contact with her mother. The therapeutic stance was not enough for her; she decided that the best way to deal with the situation was to go back home. Matilde went home, “ to be near to her family. ” Coming back to her parents represented for her the haven of safety she described in her AAP. Parents were still used as attachment figures during early, middle and late adolescence and also during young adulthood ( Fraley and Davis, 1997 ), especially under conditions of extreme stress ( Huntsinger and Luecken, 2004 ; Kamkar et al., 2012 ). She stayed home with her family for 3 weeks. When she came back, she appeared less anxious and more integrated: little by little, Matilde was more able to feel the setting as a place where exploration of her personal life and new experiences could be initiated, shared, and enjoyed. She was able to develop positive feelings toward the therapist ( Misch, 2000 ). She began to integrate positive and negative feelings in life events, becoming more and more flexible, increasing her ability to tolerate changes and learning to find new solutions to life schedule. She reached some goals toward adulthood and began to find real friends, also far from home, and to spend energy in different activities (e.g., organization, church, neighborhood, etc.). She loved challenges and she felt pleasure in realizing her goals and in pursuing long-term ambitions. A boyfriend appeared. The symptoms disappeared. She continued to use a great amount of razionalization in order to explain some affective aspect of her experiences. from the point of view of attachment, she mantained a tendency to change the topic when she approached emotional issues using displacement defenses in order not to deal with her core difficulties. The therapeutic goal of accomplishing a true adolescent process was also achieved. A solid and good child image was now more integrated with an adolescent and adult image. Some developmental tasks were reached on the way toward adultood (friendship and romantic relationship). The therapist discussed with Matilde the fact that some shortcomings were still present in her personality functioning, but both agreed that she wished now to try to go on with her life by herself. As Freud (1966) suggested, the aim of psychotherapy at a developmental age is to help the patient to proceed along his or her developmental lines. Now Matilde managed to integrate some issues concerning the developmental step of adolescence and young adulthood and she wished to try new experiences by herself.

Follow-Up Findings

Results from DSM-IV diagnosis, SCL-90-R, and SWAP–200 in the follow-up phase are described in Table 5 .

TABLE 5. Results from SCL-90-R and SWAP–200 in follow-up phase.

The AAP was scored secure, but without any segregated systems. As a representative example of some new attitudes, Matilde’s stories for Window and Departure pictures are reported.

Window (a child looks out a window): a girl who woke up eh … parents are not there, they are at work and she knows she is alone at home. She is quiet. She is looking out of the window thinking about her mom and the fact she will come back home in the afternoon. She is thinking about who she can invite in … who can … can keep … her company. She is quiet, excited by the day without parents (What might happen next?) she will find someone … a … a friend … a neighbor … finally she will have fun (Anything else?) No.

Matilde tells one of the most common AAP stories for the Window picture: a typical home-related scenario in which a little girl needs to manage her solitude. The girl is “ quiet ” although she is alone home. So, Matilde is not threatened by the girl’s loneliness, but she is somehow able to enjoy the possibility of being alone. The absence of segregated systems demonstrates the absence of dysregulating events, which could have led to her being alone (her parents are just working) and of girl’s traumatic reactions. More specifically, the girl is depicted “ thinking about her mom, ” activating her ability to internalize the secure base and being “ content in solitude. ” In fact, this connection with the thought of her mother’s coming back in the afternoon keeps the girl regulated and lets her also think about something specific to do alone: “ she looks out of the window thinking about who she can invite in … who can keep … her company. ” The little girl can recall the affiliative system (“ friend ”) to handle her loneliness. Her ability to think makes Matilde confident and envisages the possibility of changing things in the immediate future (“ she invited friends ”). From a developmental point of view, Matilde is now a late adolescent-young adult: she is prone to consider also peers and friends as a secure base to refer to in moderately distressful situations.

Departure (an adult man and woman stand facing each other with suitcases positioned nearby): a woman is going to leave for a business trip and she is saying goodbye to her husband … he took her to the station … she was already planning what she needed to do during the trip … yes during this period of work … he is quiet and he thinks about their relationship, about how they enjoy to be together, what he would do without … in these few days without his wife…however … she will leave and he will spend a few dull days … (Anything else?) No.

In Departure, Matilde is able to tell a typical AAP story, which portrays a couple at the train station. The husband thinks about their relationship and he feels that his days will be dull without his wife. Matilde’s story suggests togetherness and a goal-corrected partnership. She portrays the husband as involved in a contingent, reciprocal and mutually engaging relationship.

Qualitative Clinical Evaluation at the End of Therapy

Matilde did not have any DSM-IV diagnosis in Axis I and her personality functioning resulted carachterized by obsessive high functioning features (PDM S -axes, SWAP–200). She had no more panic attacks accompanied by strong physical arousal, and her experiences were now more mentally symbolized. Her SCL-90-R final symptom profile revealed a magnitude within the normal range. Only two symptomatic distress levels, obsessive–compulsive, and anxiety, still penetrated the clinical range, but their intensity had diminished compared to the assessment phase.

Her self-image improved: she now experienced a sense of personal satisfaction, sufficient self-esteem and self-confidence (PDM M -axes). The “negative-stressful” components of her affective world were still present but the level of self-blame, and emotional constriction greatly diminished. She was now less inhibited and became more spontaneous in expressing emotions, and also anger. Matilde still showed a pattern of Mature-Neurotic defenses and an absence of primitive defenses. Rationalization, intellectualization, undoing, and displacement were the mostly used defenses, but were now more flexible, less pervasive and she was able to avoid recourring to symptoms and anxiety. The AAP confirmed a flexible use of defenses and reduction in thereliance on dectivation defenses; however, her kind of defense structure still did not allow neither an emotional insight about her motivations and behaviors, or psychological mindedness.

Matilde remained secure in her attachment pattern, changing her defensive approach through a more integrated and coherent one, in which no more segregated systems or disregulation were present: she was now able to use again her self-regulation capacities autonomously (PDM M -axes). Her attachment adolescent crisis was resolved; she was out of her “nightmare.” She still seemed naïve and used an excessive part of her mental energy to keep emotions and feelings at bay, showing a limited ability to appreciate metaphor, analogy, or nuance. In the context of a supportive stance, comprising a secure and holding environment and an atmosphere based on emotional safety, she was able to work on her fear of loss and changes allowing her internalized attachment status to reach an adult structure. She was now able to deal with adult tasks using her internalized parental figures, thinking about how they could protect her. Matilde now found pleasure, satisfaction, and enjoyment in everyday-life activities. Her underneath security pattern now re-emerged allowing her to maintain a loving relationship, and to engage and keep long-standing and intimate friendships and relationships (PDM M -axes). She now set less unrealistically high personal standards and she was now able to find meaning in belonging and contributing to a wider community (e.g., organization, church, neighborhood, etc.). Table 6 shows Matilde’s qualitative picture at baseline and at follow up.

TABLE 6. Qualitative Matilde’s picture of features at baseline and at the end of psychotherapy.

This clinical case study highlighted the importance of assessing patient’s idiographic and intra-subjective features ( Hilliard, 1993 ). The nature of the clinical case perspective requires a rich diagnostic process that includes both a nosographic approach (such as DSM-IV) and a more multifaceted point of view to assess the specific patient’s psychological functioning ( Barron, 1998 ; Shedler and Westen, 2007 ). There have been few studies investigating the psychotherapy process in supportive therapies ( Orlinsky et al., 2004 ), and very few studies were devoted to inserting also the contribution of validated measures of attachment. Slade (2008) endorsed that, although attachment theory terms have been incorporated in the present psychoanalytic theory, only few therapists have really integrated core elements of the attachment perspective in their clinical thought. Above all, few of them inserted measures of attachment and their strategies to understand the therapy unfolding ( Rockland, 1989 ; Porcerelli et al., 2011 ). Assessing attachment means more than just determining a patient’s attachment classification status. The benefit from the inclusion of attachment assessment to a multi-method approach is the chance of using results to elucidate the patient’s representational and defensive patterns related to attachment activation ( Bowlby, 1980 ).

This paper tried to illustrate a clinical case where results from attachment tools together with PDM assessment could help to give a more integrate picture and to form and inform the unfolding of the therapy. The incremented validity about symptoms and attachment internal working models evaluation added a specific qualitative contribution to each tool (e.g., SCL-90-R gave the self perception of symptomatology and SWAP–200 the clinical perception of it; AAI and AAP increased biographical information and defense mechanism, respectively). The paper presented a case formulation in which a psychodynamic approach was integrated with an attachment theory framework both in the assessment and post-assessment phases and with a “ supportive psychotherapy approach. ” The secure attachment status, as derived from the AAI and the AAP, helped to structure Matilde’s therapy, adding information to the therapeutic intervention: Matilde’s secure attachment resulted helpful to establish a therapeutic plan, to facilitate the therapeutic alliance and the answer to the therapy, and to help her to face her symptoms and internal difficulties ( Douglas, 2008 ; Steele and Steele, 2008 ). The AAP and AAI were taken into account, making the therapist sensible to the specific topics concerning separation and loss, which were reactivated throughout treatment. Matilde needed to explore them in the context of a “ safe haven, ” the same context she had previously experienced in her life with her mother’s supporting stance. On her side, the therapist recreated and maintained a well knownholding environment, affective mirroring and personal warmth ( Markowitz, 2008 ) and an atmosphere based on emotional safety ( Crits-Christoph and Connolly, 1999 ; Skean, 2005 ). She provided Matilde with the secure base she temporary lost, a starting point from where the exploration of painful experiences in her present life could finally begin. This gave her the possibility to recall some hidden memories, leading to self-exploration ( Parish and Eagle, 2003 ; Mallinckrodt et al., 2005 ; Holmes, 2010 ). The “supportive approach” and the role of attachment framework turned out to be a key factor in the assessment and in the development of an effective therapeutic relationship with Matilde. Within a psychoanalytic framework, through the unfolding relationship with the therapist, Matilde brought her interpersonal world into the treatment room and allowed the therapist to experience aspects of her structuring of reality ( Crits-Christoph and Connolly, 1999 ; Skean, 2005 ). The conclusion of the therapy showed a more integrated picture, where symptoms were no more outstanding and Matilde seemed to be out of her big “nightmare” and ready to face her life tasks in a more integrated and young-adult way. The post-treatment AAP confirmed that Matilde was able to integrate these issues of separation and loss. She was a very defensive neurotic patient blocked at latency, and showed some shortcomings related to the separation-individuation process ( Mahler et al., 1975 ) both from a psychoanalytic and from an attachment point of view.

The treatment helped Matilde to make a developmental step toward maturity: “from childish features to adolescent ones, reaching the capacity of (emotionally) exploring the possibility of living independently from parents (…) because they know that they can turn to parents in case of real need” ( Allen and Land, 1999 , p. 322). The therapist was both an “attachment figure” that helped Matilde to face new experiences, as well as a transference object ( Dozier et al., 1994 ). Matilde’s development resulted in increased abilities in managing the goal-corrected partnership with each parent, in which behavior is not determined only by adolescent’s current needs and wishes, but also by recognition of the need to manage certain set goals for the partnership ( Bowlby, 1973 ).

As all clinical case studies, this study suffered from some limitations ( Hodkinson and Hodkinson, 2001 ): results are not generalizable in the conventional sense; it looks expensive, if attempted on a large scale and the complexity examined is difficult to represent simply and briefly. Furthermore, clinical case studies results stronger when researchers’ expertise and intuition are maximized, but this raises doubts about their “objectivity”: this type of research is easily subjected to criticisms by those who do not like the messages that they contain; and finally it cannot answer a large number of relevant and appropriate research questions that future studies could address (e.g., in this sense, it could be highly valuable for future research to compare PAD patients with different attachment styles). However, this particular case study could be considered an original and extremely valuable one, because it is grounded in “lived reality.” This helps us to understand complex inter-relationships between diagnosis, measures and their clinical application, facilitating the development of conceptual/theoretical issues and the exploration of unexpected and unusual situations, such as PAD in a secure attached patient. As regards the choice of this patient, the present paper can provide “provisional truths, in a Popperian sense” ( Hodkinson and Hodkinson, 2001 ): it represents the best account of such assessment and treatment in the current literature, and it should stand, until contradictory findings or better theories are developed.

Conflict of Interest Statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

• ^ The PDM was developed to describe “the depth as well as the surface of emotional, cognitive, and social patterns” (p. 1) of an individual’s functioning, as to improve the diagnosis and treatment of psychological disorders. PDM comprises three areas: personality patterns (Axis P ), mental functioning ( M -axis), and symptoms ( S -axis). Our attention focused mainly on mental functioning or M -axis, “a microscopic look at mental life” (p. 8), although some attention was paid to symptoms and concerns or S -axis.
• ^ The patient self-referred to a psychodynamic service, where therapists are trained to use an Operationalized Psychodynamic Diagnosis approach during consultation sessions, preferring free or “per area” clinical sessions to interviews (e.g., SCID).
• ^ The self report SCL-90-R was digitally computed. Inter-reliability reached Cohen’s k = 1 for AAI and AAPs final classifications; 0.93 for AAI subscales; 0.85 for AAP codings; 0.72 for SWAP–200 final scales.
• ^ (1) Neutral (children playing ball); (2) child at window (alone); (3) departure (dyad); (4) bench (alone); (5) bed (dyad); (6) ambulance (dyad); (7) cemetery (alone); (8) child in corner (alone).

Ainsworth, M. D. (1963). “The development of infant-mother interaction among the Ganda,” in Determinants of Infant Behavioral , ed. B. M. Foss (New York: Wiley), 67–104.

Ainsworth, M. D. (1967). Infancy in Uganda: Infant Care and the Growth of Love . Baltimore, MD: Johns Hopkins University Press.

Allen, J. P. (2008). “The attachment system in adolescence,” in Handbook of Attachment: Theory, Research and Clinical Applications, 2nd Edn, eds J. Cassidy and P. R. Shaver (New York: Guilford Press), 419–435.

Allen, J. P., and Land, D. (1999). “Attachment in adolescence,” in Handbook of Attachment Theory Research and Clinical Application , eds J. Cassidy and P. R. Shaver (New York: Guilford), 319–335.

American Psychiatric Association [APA] (1994). Diagnostic and Statistical Manual of Mental Disorders , 4th Edn, Washington, DC: American Psychiatric Association.

Appelbaum, A. H. (2005). Supportive Psychotherapy. Arlington, VA: American Psychiatric Publishing, Inc.

Bakermans-Kranenburg, M. J., and van Ijzendoorn, M. H. (1993). A psychometric study of the adult attachment interview: reliability and discriminant validity. Dev. Psychol. 29, 870–879. doi: 10.1037/0012-1649.29.5.870

CrossRef Full Text

Bakermans-Kranenburg, M. J., Van Ijzendoorn, M. H., and Juffer, F. (2005). Disorganized infant attachment and preventive interventions: a review and meta-analysis. Infant Ment. Health J. 23, 191–216. doi: 10.1002/imhj.20046

Barron, W. J. (1998). Marking Diagnosis Meaningful. Enhancing Evaluation and Treatment of Psychological Disorders. Washington, DC: American Psychological Association. doi: 10.1037/10307-000

Bartholomew, K., and Horowitz, L. M. (1991). Attachment styles among young adults: a test of a four-category model. J. Pers. Soc. Psychol. 61, 226–244. doi: 10.1037/0022-3514.61.2.226

Binder, J. L., Henry, W. P., and Strupp, H. H. (1987). An appraisal of selection criteria for dynamic psychotherapies and implications for setting time limits. Psychiatry 50, 154–166.

Pubmed Abstract | Pubmed Full Text

Blatt, S. J., and Levy, K. N. (2003). Attachment theory, psychoanalysis, personality development, and psychopathology. Psychanal. Inq. 23, 102–150. doi: 10.1080/07351692309349028

Block, J. (1978). The Q-Sort Method in Personality Assessment and Psychiatric Research. Palo Alto, CA: Consulting Psychologist Press.

Bowlby, J. (1969/1982). Attachment and Loss, Vol. 1, Attachment . New York: Basic Books.

Bowlby, J. (1973). Attachment and Loss , Vol. 2, Separation: Anxiety and Anger . New York: Basic Books.

Bowlby, J. (1980). Attachment and Loss , Vol. 3, Loss: Sadness and Depression . New York: Basic Books.

Bowlby, J. (1988). A Secure Base. New York: Basic Books.

Bram, A. D. (2010). The relevance of the rorschach and patient-examiner relationship in treatment planning and outcome assessment. J. Pers. Assess. 92, 91–115. doi: 10.1080/00223890903508112

Pubmed Abstract | Pubmed Full Text | CrossRef Full Text

Buchheim, A. (2005). Inaccessible attachment: a paradox? Personlinch. Theor. Therap. 9, 155–164.

Buchheim, A., and Benecke, C. (2007). Mimisch-affektives verrhalten bei patientinnen mit angststörungen während des adult attachment interviews: Eine pilotstudie. Psychother. Psychol. Med. 57, 343–347. doi: 10.1055/s-2006-952030

Buchheim, A., Erk, S., George, C., Kächele, H., Kircher, T., Martius, P.,et al. (2008). Neural correlates of attachment trauma in borderline personality disorders: a functional magnetic resonance image study. Psychiatry Res. 30, 223–235. doi: 10.1016/j.pscychresns.2007.07.001

Buchheim, A., and George, C. (2011). “Attachment disorganization in borderline personality disorder and anxiety disorder,” in Disorganization of Attachment and Caregiving , eds J. Solomon and V. George (New York: Guilford Press), 343–383.

Buchheim, A., George, C., and Kächele, H. (2007). “My dog is dying today: attachment narratives and psychoanalytic interpretation of an initial interview,” in Attachment and Sexuality, eds D. Diamond, S. J. Blatt, and J. D. Lichtenberg (Hillsdale, NJ: The Analytic Press), 161–178.

Buchheim, A., Heinrichs, M., George, C., Pokorny, D., Koops, E., Henningsen, P.,et al. (2009). Oxytocin enhances the experience of attachment security. Psychoneuroendocrinology 34, 1417–1422. doi: 10.1016/j.psyneuen.2009.04.002

Buchheim, A., and Kachele, H. (2001). Adult attachment interview of a patient with a borderline personality organization: a single case study integrating attachment and psychoanalytic perspective. Personlich. Theor. Therap. 5, 113–130.

Cassidy, J., and Shaver, P. R. (Eds.). (2008). Handbook of Attachment: Theory, Research, and Clinical Applications , 2nd Edn, New York: Guilford Press, 3–27.

Colli, A., and Lingiardi, V. (2009). The collaborative interactions scale: a new transcript-based method for the assessment of therapeutic alliance ruptures and resolutions in psychotherapy. Psychother. Res. 19, 718–734. doi: 10.1080/10503300903121098

Cozzolino, L. (2002). The Neuroscience of Psychotherapy: Building and Rebuilding the Human Brain . New York: Norton & Company.

Crits-Christoph, P., and Connolly, M. B. (1999). Alliance and technique in short-term dynamic therapy. Clin. Psychol. Rev. 19, 687–704. doi: 10.1016/S0272-7358(98)00079-8

Dahlbender, R. W., Buchheim, A., and Doering, S. (2004). OPD and AAI: integrative diagnostics of structure, conflict and attachment representation. Personlinch. Theor. Therap. 8, 251–261.

Davila, J., and Levy, K. N. (2006). Introduction to the special section on attachment theory and psychotherapy. J. Consult. Clin. Psychol. 74, 989–993. doi: 10.1037/0022-006x.74.6.989

Derogatis, L. R. (1983). SCL-90-R Administration, Scoring Procedures Manual-I . Towson, MD: Clinical Psychometric Research, 14–15.

Derogatis, L. R., Lipman, R. S., and Covi, L. (1973). The SCL-90: an outpatient psychiatric rating scale-preliminary report. Psychopharmacol. Bull. 9, 13–28.

Dewald, P. A. (1971). Psychotherapy: A Dynamic Approach . New York: Basic Books, Inc.

Diamond, D. (2004). Attachment disorganization: the reunion of attachment theory and psychoanalysis. Psychoanal. Psychol. 21, 276–299. doi: 10.1037/0736-9735.21.2.276

Douglas, C. J. (2008). Teaching supportive psychotherapy to psychiatric resident. Am. J. Psychiatry 165, 445–452. doi: 10.1176/appi.ajp.2007.07121907

Dozier, M., Cue, K. L., and Barnett, L. (1994). Clinicians as caregivers: the role of attachment organization in treatment. J. Consult. Clin. Psychol. 62, 93–800. doi: 10.1037/0022-006x.62.4.793

Eng, W., Heimberg, R. G., Hart, T. A., Schneier, F. R., and Liebowitz, M. R. (2001). Attachment in individuals with social anxiety disorder: the relationship among adult attachment styles, social anxiety, and depression. Emotion 1, 365–380. doi: 10.1037/1528-3542.1.4.365

Fonagy, P. (1999). Pathological attachments and therapeutic action. Paper to the Developmental and Psychoanalytic Discussion Group, American Psychoanalytic Association Meeting , Washington, DC.

Fonagy, P. (2001). Attachment Theory and Psychoanalysis. New York: Other Press.

Fosha, D. (2009). “Healing attachment trauma with attachment (... and then some!),” in Clinical Pearls of Wisdom: 21 Leading Therapists Offer their Keyinsights , ed. M. Kerman (New York: Norton), 43–56.

Fraedrich, E., Lakatos, K., and Spangler, G. (2010). Brain activity during emotion perception: the role of attachment representation. Attach. Hum. Dev. 12, 231–248. doi: 10.1080/14616731003759724

Fraley, R. C., and Davis, K. E. (1997). Attachment formation and transfer in young adults’ close friendships and romantic relationships. Pers. Relat. 4, 131–144. doi: 10.1111/j.1475-6811.1997.tb00135.x

Freud, A. (1966). Normality and Pathology in Childhood. London: Hogart Press.

Funder, D. C. (1997). The Personality Puzzle. New York: W. Norton.

Gabbard, G. O. (2009). Textbook of Psychotherapeutic Treatments. Arlington, VA: American Psychiatric Publishing, Inc. doi: 10.1176/appi.books.9781585623648

George, C., Kaplan, N., and Main, M. (1984). Adult Attachment Interview (Unpublished manuscript). Berkeley: University of California.

George, C., Kaplan, N., and Main, M. (1985). Adult Attachment Interview , 2nd Edn (Unpublished manuscript). Berkeley: University of California.

George, C., Kaplan, N., and Main, M. (1996). Adult Attachment Interview, 3nd Edn (Unpublished manuscript). Berkeley: University of California

George, C., and Solomon, J. (1996). Representational models of relationships: links between caregiving and attachment. Infant Ment. Health J. 17, 198–216. doi: 10.1002/(SICI)1097-0355(199623)17:3<198::AID-IMHJ2>3.0.CO;2-L

3.0.CO;2-L" target="_blank">CrossRef Full Text

George, C., and Solomon, J. (1999). Attachment Disorganization. New York: Guilford Publications.

George, C., and Solomon, J. (2008). “The caregiving system: a behavioral systems approach to parenting,” in Handbook of Attachment: Theory, Research, and Clinical Applications, 2nd Edn, eds J. Cassidy and P. R. Shaver (New York: Guilford Press), 833–856.

George, C., and West, M. (2001). The development and preliminary validation of a new measure of adult attachment: the adult attachment projective. Attach. Hum. Dev. 3, 30–61. doi: 10.1080/14616730010024771

George, C., and West, M. (2012). The Adult Attachment Projective Picture System. New York: Guilford Press.

Hazan, C., and Shaver, P. (1987). Romantic love conceptualized as an attachment process. J. Pers. Soc. Psychol. 52, 511–524. doi: 10.1037/0022-3514.52.3.511

Hesse, E. (2008). “The adult attachment interview: protocol, methods of analysis, and empirical studies,” in Handbook of Attachment: Theory, Research, and Clinical Applications, 2nd Edn, eds J. Cassidy and P. R. Shaver (New York: Guilford Press), 552–598.

Hilliard, R. B. (1993). Single-case methodology in psychotherapy process and outcome research. J. Consult. Clin. Psychol. 61, 373–380. doi: 10.1037/0022-006x.61.3.373

Hodkinson, P., and Hodkinson, H. (2001). The Strengths and Limitations of Case Study Research. Paper Presented to the Learning and Skills Development Agency Conference. Making an Impact on Policy and Practice , Cambridge.

Holmes, J. (2010). Exploring in Security: Towards an Attachment-Informed Psychoanalytic Psychotherapy . New York: Routledge.

Huntsinger, E. T., and Luecken, L. J. (2004). Attachment relationships and health behavior: the mediational role of self-esteem. Psychol. Health 19, 515–526. doi: 10.1080/0887044042000196728

Isaacs, M. B., George, C., and Marvin, R. S. (2009). Utilizing attachment measures in child custody evaluations: incremental validity. J. Child Cusotdy 6, 139–162. doi: 10.1080/15379410902894882

Kamkar, K., Doyle, A., and Markiewicz, D. (2012). Insecure attachment to parents and depressive symptoms in early adolescence: mediating roles of attributions and self-esteem. Int. J. Psychol. Stud. 4, 3–18. doi: 10.5539/ijps.v4n2p3

Lingiardi, V., Shedler, J., and Gazzillo, F. (2006). Assessing personality change in psychotherapy with the SWAP–200: a case study. J. Pers. Assess. 86, 23–32. doi: 10.1207/s15327752jpa8601-04

Lis, A., Mazzeschi, C., Di Riso, D., and Salcuni, S. (2011). Attachment, assessment and psychological intervention: a case study of anorexia. J. Pers. Assess. 93, 434–444. doi: 10.1080/00223891.2011.594125

Lis, A., Mazzeschi, C., Salcuni, S., and Di Riso, D. (2008). Attachment and Personality in Clinical Settings: Assessment and Treatment Issues . Madrid: EditorialPsimàtic.

Mahler, M. S., Pine, F., and Bergman, A. (1975). The Psychological Birth of the Human Infant: Symbiosis and Individuation . New York: Basic Books.

Main, M., Kaplan, N., and Cassidy, J. (1985). Security in infancy, childhood, and adulthood: a move to the level of representation. Monogr. Soc. Res. Child Dev. 50, 66–104. doi: 10.2307/3333827

Mallinckrodt, B., Porter, M. J., and Kivlighan, D. M. Jr. (2005). Client attachment to therapist, depth of in-session exploration, and object relations in brief psychotherapy. Psychother. Theory Res. Pract. Train. 42, 85–100. doi: 10.1037/0033-3204.42.1.85

Manicavasagar, V., Silove, D., Marnane, C., and Wagner, R. (2009). Adult attachment styles in panic disorder with and without comorbid adult separation anxiety disorder. Aust. N. Z. J. Psychiatry 43, 167–172. doi: 10.1080/00048670802607139

Manicavasagar, V., Silove, D., Wagner, R., and Hadzi-Pavlovic, D. (1999). Parental representations associated with adult separation anxiety and panic disorder-agoraphobia. Aust. N. Z. J. Psychiatry 33, 422–428. doi: 10.1046/j.1440-1614.1999.00566.x

Markowitz, J. C. (2008). How “supportive” is internet-based supportive psychotherapy? Am. J. Psychiatry 165, 534. doi: 10.1176/appi.ajp.2007.07121853

McWilliams, N. (1999). Psychoanalytic Case Formulation. New York: Guilford Pubblications, Inc.

Meyer, G. J., Finn, S. E., Eyde, L. D., Kay, G. G., Kubiszyn, T. W., Moreland, K. L.,et al. (1999). Benefits and Cost of Psychological Assessment in Healthcare Delivery: Report of the Board of Professional Affairs Psychological Assessment Work Group, Part I . Washington, DC: American Psychological Association.

Misch, D. A. (2000). Basic strategies of dynamic supportive therapy. J. Psychother. Pract. Res. 9, 173–189.

Oppenheim, D., and Goldsmith, D. F. (2007). Attachment Theory in Clinical Work with Children. New York: Guilford Press.

Orlinsky, D. E., Ronnestad, M. H., and Willutzki, U. (2004). Fifty years of psychotherapy process-outcome research: Continuity and Change, in Bergin and Garfield’s handbook of psychotherapy and behavior change , 5th Edn, ed. M. Laambert (New York: John Wiley and Sons).

Ozer, D. J. (1999). “Four principles for personality assessment,” in Handbook of Personality: Theory and Research, 2nd Edn, eds O. P. John and L. A. Pervin (New York: Guilford Press), 671–686.

Pacchierotti, C., Bossini, L., Castrogiovanni, A., Pieraccini, F., Soreca, I., and Castrogiovanni, P. (2002). Attachment and panic disorder. Psychopathology 35, 347–335. doi: 10.1159/000068597

Parish, M., and Eagle, M. N. (2003). Attachment to the therapist. Psychoanal. Psychol. 20, 271–286. doi: 10.1037/0736-9735.20.2.271

PDM Task Force. (2006). Psychodynamic Diagnostic Manual (PDM) . Silver Spring, MD: Alliance of Psychoanalytic Organizations.

Peebles-Kleiger, M. J. (2002). Beginnings: The Art and Science of Planning Psychotherapy . Hillsdale, NJ: The Analytic Press.

Porcerelli, J. H., Cogan, R., and Bambery, M. J. (2011). The mental functioning axis of the Psychodynamic diagnostic manual: an adolescent case study. J. Pers. Assess. 93, 177–184. doi: 10.1080/00223891.2011.542724

Rockland, L. H. (1989). Psychoanalytically oriented supportive therapy. J. Am. Acad. Psychoanal. 17, 451–462.

Routh, D. K., and Bernholtz, J. E. (1991). “Attachment, separation and phobias,” in Intersections with Attachment , eds J. L . Gewirtz, W. M. Kurtines, and J. L. Lamb (Hove: Psychology Press), 295–310.

Safran, J. D., and Muran, J. C. (2000). Negotiating the Therapeutic Alliance: A Relational Treatment Guide . New York: Guilford Press.

Shear, M. K. (1991). The concept of uncontrollability. Psychol. Inq. 2, 88–93. doi: 10.1207/s15327965pli0201-23

Shectman, F., and Harty, M. K. (1986). “Treatment implications of object relationships as they unfold during the diagnostic interaction,” in Assessing Object Relations Phenomena, ed. M. Kissen (Madison, CT: International Universities Press), 279–303.

Shedler, J., and Westen, D. (1998). Refining the measurement of Axis II: a Q-sort procedure for assessing personality pathology. Assessment 5, 333–353. doi: 10.1177/107319119800500403

Shedler, J., and Westen, D. (2007). The Shedler–Westen assessment procedures (SWAP): making personality diagnosis clinically meaningful. J. Pers. Assess. 89, 41–55. doi: 10.1080/00223890701357092

Siegel, D. J. (2010). The Mindful Therapist: A Clinician’s Guide to Mind Sight and Neural Integration . New York: W. W. Norton & Company.

Skean, K. R. (2005). The case of “CG”: balancing supportive and insight-oriented, psychodynamic therapy with a client undergoing intense life stresses. Prag. Case Stud. Psychother. 1, 1–18. doi: 10.14713/pcsp.v1i3.860

Slade, A. (2008). The Implications of Attachment Theory and Research for Adult Psychotherapy: Research and Clinical Perspectives . New York: Guilford Press.

Spence, D. P. (1982). Narrative Truth and Historical Truth. New York: Norton.

Steele, H., and Steele, M. (2008). Clinical Applications of the Adult Attachment Interview. New York: Guilford Press, 69–96.

Steele, H., Steele, M., and Murphy, A. (2009). The adult attachment interview: a clinical tool for facilitating and measuring process and change in psychotherapy. Psychother. Res. 19, 633–643. doi: 10.1080/10503300802609698

Ursano, R. J., and Silberman, E. K. (1996). “Psychoanalysis, psychoanalytic psychotherapy, and supportive psychotherapy,” in The American Psychiatric Press Synopsis of Psychiatry, eds R. E. Hales and S. C. Yudofsky (Washington, DC: American Psychiatric Association), 969–989.

van IJzendoorn, M. H., and Bakermans-Kranenburg, M. J. (2008). “The distribution of adult attachment representations in clinical groups: a meta-analytic search for patterns of attachment in 105 AAI studies,” in Clinical Applications of the Adult Attachment Interview, eds H. Steele and M. Steele (New York: Guilford Press), 69–96.

Wallin, D. J. (2007). Attachment in Psychotherapy. New York: Guilford Press.

Wallis, P., and Steele, H. (2001). Attachment representations in adolescence: further evidence from psychiatric residential settings. Attach. Hum. Dev. 3, 259–269. doi: 10.1080/14616730110096870

West, M., and George, C. (1999). Abuse and violence in intimate adult relationship: new perspectives from attachment theory. Attach. Hum. Dev. 1, 137–156. doi: 10.1080/14616739900134201

West, M., and George, C. (2002). Attachment and dysthymia: the contributions of preoccupied attachment and agency of self to depression in women. Attach. Hum. Dev. 4, 278–293. doi: 10.1080/14616730210167258

West, M., Rose, S. M., and Sheldon-Keller, A. (1995). Interpersonal disorders in schizoid and avoidant personality disorders: an attachment perspective. Can. J. Psychiatry 40, 411–414.

Westen, D., and Muderrisoglu, S. (2003a). Assessing personality disorders using a systematic clinical interview: evaluation of an alternative to structured interviews. J. Pers. Disord. 17, 351–369. doi: 10.1521/pedi.17.4.351.23967

Westen, D., and Muderrisoglu, S. (2003b). Reliability and validity of personality disorders assessment using a systematic clinical interview: evaluation of an alternative to structured interviews. J. Pers. Disord. 17, 350–368.

Westen, D., and Shedler, J. (1999a). Revising and assessing Axis II: I. Developing a clinically and empirical valid assessment method. Am. J. Psychiatry 156, 258–272.

Westen, D., and Shedler, J. (1999b). Revising and assessing Axis II: II. Toward an empirically based and clinically useful classification of personality disorderds. Am. J. Psychiatry 156, 273–285.

Winston, M. D., Rosenthal, R. N., and Pinsker, H. (2004). Introduction to Supportive Psychotherapy. Arlington, VA: American Psychiatric Publishing, Inc.

Zaccagnini, C., and Zavattini, G. C. (2009). Introduzione a D. J. Wallin, Psicoterapia e Teoria dell’Attaccamento. Bologna, Il Mulino, 7–21.

Zegers, M. A., Schuengel, C., Van, I. M. H., and Janssens, J. M. (2008). Attachment and problem behavior of adolescents during residential treatment. Attach. Hum. Dev. 10, 91–103. doi: 10.1080/14616730701868621

Keywords : assessment, attachment, psychodynamic supportive therapy, outcome research, clinical case study

Citation: Salcuni S, Di Riso D and Lis A (2014) “A child’s nightmare. Mum comes and comforts her child.” Attachment evaluation as a guide in the assessment and treatment in a clinical case study. Front. Psychol. 5 :912. doi: 10.3389/fpsyg.2014.00912

Received: 21 May 2014; Accepted: 30 July 2014; Published online: 20 August 2014.

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Copyright © 2014 Salcuni, Di Riso and Lis. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Silvia Salcuni, Department of Developmental and Socialization Psychology, University of Padua, via Venezia 12, 35100 Padova, Italy e-mail: [email protected]

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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This study was conducted to analyze the principal efficacy between the first year students (Cohort 8) and the second year students (Cohort 7) of the Masters Educational Leadership University Program. The principal efficacy can be measured via analyzing the responses obtained across the various items of the questionnaire exploring areas of time management, enthusiasm, organizational management, policies and several more. For this reason, the foremost research question is as follows:

Is there a significant difference in the mean efficacy scores for cohort 7 and cohort 8?

It was therefore hypothesized that the principal efficacy of cohort 7 is greater that cohort 8 as shown below: Ho: u1=u2

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The topic of the paper is murder, and its mission is to discuss the crimes of Jeffrey Dahmer and relating this crime with the three categories of crime causation. Murder is the deliberate taking of another person life. Murder can be first-degree and second-degree murder where in the first degree both the intention and the killing is planned (Brown et al, 2010). This paper will also discuss how Jeffery Dahmer killed people deliberately out of ill will.

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Article Evaluation

A. Introduction

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9.1 You use the symbol H0 for which hypothesis?

Null hypothesis

9.2 You use the symbol H1 for which hypothesis?

Alternative hypothesis

9.3 What symbol do you use for the chance of committing a Type I error? 9.4 What symbol do you use for the chance of committing a Type II error? β 9.5 What does 1 - α represent? confidence level 9.6 What is the relationship of α to a Type I error? it is the significant level 9.7 What is the relationship of β to a Type II error?

If the null hypothesis is false, then the probability of a Type II error is called β

9.8 How is power related to the probability of making a Type II error?

When the power is decreased, then the chances of you making an error is decreased

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Erie Railroad v Tompkins was a fairly simple case in which the Supreme Court was called upon to give an interpretation as to the application of state common law over federal common law in cases of diversity jurisdiction. In addition, the case is celebrated for its empowerment of the state common law as it clearly denied Congress the power to set federal common law, an action it perceived as unconstitutional.

Federal Court’s obligation to state court decisions prior to Erie Railroad v Tompkins

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- Sample mean can be calculated using the following formula: μ=x=1 Nxi , where xi is mass of sample.

The mean is equal

x=130i=130xi=14.87 ounces In a set of observations, median is a value of variable that have half of the number of observations below it and remaining half above it (Agarval, 43). To set median it is necessary to arrange data in ascending or descending order. As the number of samples is even (N=2p) the average of p-th and (p+1)-th is median. In our case median is equal to 14.8 ounces.

Standard deviation can be calculated as (Bajpai, 129)

σ=i=1Nxi-μ2N=0.541 ounces σN=0.54130=0.099 ounces

It is possible to find numbers –x and x, between which lies mass of soda with probability 95 % (1-α).

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Fleming and Sturdy (2011) describe the managerial regime in a call centre. Please read their case description closely.

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I choose the following 3 hypothesis to test: - Marriages where the man is older than the woman will be perceived as being more satisfying than marriages where the woman is older than the man. - There will be a positive association between perceived level of relationship satisfaction and optimism. - There will be a positive association between perceived level of relationship satisfaction and relationship longevity

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• Knowledge Base
• Methodology
• Case Study | Definition, Examples & Methods

Case Study | Definition, Examples & Methods

Published on 5 May 2022 by Shona McCombes . Revised on 30 January 2023.

A case study is a detailed study of a specific subject, such as a person, group, place, event, organisation, or phenomenon. Case studies are commonly used in social, educational, clinical, and business research.

A case study research design usually involves qualitative methods , but quantitative methods are sometimes also used. Case studies are good for describing , comparing, evaluating, and understanding different aspects of a research problem .

Table of contents

When to do a case study, step 1: select a case, step 2: build a theoretical framework, step 3: collect your data, step 4: describe and analyse the case.

A case study is an appropriate research design when you want to gain concrete, contextual, in-depth knowledge about a specific real-world subject. It allows you to explore the key characteristics, meanings, and implications of the case.

Case studies are often a good choice in a thesis or dissertation . They keep your project focused and manageable when you don’t have the time or resources to do large-scale research.

You might use just one complex case study where you explore a single subject in depth, or conduct multiple case studies to compare and illuminate different aspects of your research problem.

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Once you have developed your problem statement and research questions , you should be ready to choose the specific case that you want to focus on. A good case study should have the potential to:

• Provide new or unexpected insights into the subject
• Challenge or complicate existing assumptions and theories
• Propose practical courses of action to resolve a problem
• Open up new directions for future research

Unlike quantitative or experimental research, a strong case study does not require a random or representative sample. In fact, case studies often deliberately focus on unusual, neglected, or outlying cases which may shed new light on the research problem.

If you find yourself aiming to simultaneously investigate and solve an issue, consider conducting action research . As its name suggests, action research conducts research and takes action at the same time, and is highly iterative and flexible. 

However, you can also choose a more common or representative case to exemplify a particular category, experience, or phenomenon.

While case studies focus more on concrete details than general theories, they should usually have some connection with theory in the field. This way the case study is not just an isolated description, but is integrated into existing knowledge about the topic. It might aim to:

• Exemplify a theory by showing how it explains the case under investigation
• Expand on a theory by uncovering new concepts and ideas that need to be incorporated
• Challenge a theory by exploring an outlier case that doesn’t fit with established assumptions

To ensure that your analysis of the case has a solid academic grounding, you should conduct a literature review of sources related to the topic and develop a theoretical framework . This means identifying key concepts and theories to guide your analysis and interpretation.

There are many different research methods you can use to collect data on your subject. Case studies tend to focus on qualitative data using methods such as interviews, observations, and analysis of primary and secondary sources (e.g., newspaper articles, photographs, official records). Sometimes a case study will also collect quantitative data .

The aim is to gain as thorough an understanding as possible of the case and its context.

In writing up the case study, you need to bring together all the relevant aspects to give as complete a picture as possible of the subject.

How you report your findings depends on the type of research you are doing. Some case studies are structured like a standard scientific paper or thesis, with separate sections or chapters for the methods , results , and discussion .

Others are written in a more narrative style, aiming to explore the case from various angles and analyse its meanings and implications (for example, by using textual analysis or discourse analysis ).

In all cases, though, make sure to give contextual details about the case, connect it back to the literature and theory, and discuss how it fits into wider patterns or debates.

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Psychology Case Study Examples: A Deep Dive into Real-life Scenarios

Peeling back the layers of the human mind is no easy task, but psychology case studies can help us do just that. Through these detailed analyses, we’re able to gain a deeper understanding of human behavior, emotions, and cognitive processes. I’ve always found it fascinating how a single person’s experience can shed light on broader psychological principles.

Over the years, psychologists have conducted numerous case studies—each with their own unique insights and implications. These investigations range from Phineas Gage’s accidental lobotomy to Genie Wiley’s tragic tale of isolation. Such examples not only enlighten us about specific disorders or occurrences but also continue to shape our overall understanding of psychology .

As we delve into some noteworthy examples , I assure you’ll appreciate how varied and intricate the field of psychology truly is. Whether you’re a budding psychologist or simply an eager learner, brace yourself for an intriguing exploration into the intricacies of the human psyche.

Understanding Psychology Case Studies

Diving headfirst into the world of psychology, it’s easy to come upon a valuable tool used by psychologists and researchers alike – case studies. I’m here to shed some light on these fascinating tools.

Psychology case studies, for those unfamiliar with them, are in-depth investigations carried out to gain a profound understanding of the subject – whether it’s an individual, group or phenomenon. They’re powerful because they provide detailed insights that other research methods might miss.

Let me share a few examples to clarify this concept further:

• One notable example is Freud’s study on Little Hans. This case study explored a 5-year-old boy’s fear of horses and related it back to Freud’s theories about psychosexual stages.
• Another classic example is Genie Wiley (a pseudonym), a feral child who was subjected to severe social isolation during her early years. Her heartbreaking story provided invaluable insights into language acquisition and critical periods in development.

You see, what sets psychology case studies apart is their focus on the ‘why’ and ‘how’. While surveys or experiments might tell us ‘what’, they often don’t dig deep enough into the inner workings behind human behavior.

It’s important though not to take these psychology case studies at face value. As enlightening as they can be, we must remember that they usually focus on one specific instance or individual. Thus, generalizing findings from single-case studies should be done cautiously.

To illustrate my point using numbers: let’s say we have 1 million people suffering from condition X worldwide; if only 20 unique cases have been studied so far (which would be quite typical for rare conditions), then our understanding is based on just 0.002% of the total cases! That’s why multiple sources and types of research are vital when trying to understand complex psychological phenomena fully.

In the grand scheme of things, psychology case studies are just one piece of the puzzle – albeit an essential one. They provide rich, detailed data that can form the foundation for further research and understanding. As we delve deeper into this fascinating field, it’s crucial to appreciate all the tools at our disposal – from surveys and experiments to these insightful case studies.

Importance of Case Studies in Psychology

I’ve always been fascinated by the human mind, and if you’re here, I bet you are too. Let’s dive right into why case studies play such a pivotal role in psychology.

One of the key reasons they matter so much is because they provide detailed insights into specific psychological phenomena. Unlike other research methods that might use large samples but only offer surface-level findings, case studies allow us to study complex behaviors, disorders, and even treatments at an intimate level. They often serve as a catalyst for new theories or help refine existing ones.

To illustrate this point, let’s look at one of psychology’s most famous case studies – Phineas Gage. He was a railroad construction foreman who survived a severe brain injury when an iron rod shot through his skull during an explosion in 1848. The dramatic personality changes he experienced after his accident led to significant advancements in our understanding of the brain’s role in personality and behavior.

Moreover, it’s worth noting that some rare conditions can only be studied through individual cases due to their uncommon nature. For instance, consider Genie Wiley – a girl discovered at age 13 having spent most of her life locked away from society by her parents. Her tragic story gave psychologists valuable insights into language acquisition and critical periods for learning.

Finally yet importantly, case studies also have practical applications for clinicians and therapists. Studying real-life examples can inform treatment plans and provide guidance on how theoretical concepts might apply to actual client situations.

• Detailed insights: Case studies offer comprehensive views on specific psychological phenomena.
• Catalyst for new theories: Real-life scenarios help shape our understanding of psychology .
• Study rare conditions: Unique cases can offer invaluable lessons about uncommon disorders.
• Practical applications: Clinicians benefit from studying real-world examples.

In short (but without wrapping up), it’s clear that case studies hold immense value within psychology – they illuminate what textbooks often can’t, offering a more nuanced understanding of human behavior.

Different Types of Psychology Case Studies

Diving headfirst into the world of psychology, I can’t help but be fascinated by the myriad types of case studies that revolve around this subject. Let’s take a closer look at some of them.

Firstly, we’ve got what’s known as ‘Explanatory Case Studies’. These are often used when a researcher wants to clarify complex phenomena or concepts. For example, a psychologist might use an explanatory case study to explore the reasons behind aggressive behavior in children.

Second on our list are ‘Exploratory Case Studies’, typically utilized when new and unexplored areas of research come up. They’re like pioneers; they pave the way for future studies. In psychological terms, exploratory case studies could be conducted to investigate emerging mental health conditions or under-researched therapeutic approaches.

Next up are ‘Descriptive Case Studies’. As the name suggests, these focus on depicting comprehensive and detailed profiles about a particular individual, group, or event within its natural context. A well-known example would be Sigmund Freud’s analysis of “Anna O”, which provided unique insights into hysteria.

Then there are ‘Intrinsic Case Studies’, which delve deep into one specific case because it is intrinsically interesting or unique in some way. It’s sorta like shining a spotlight onto an exceptional phenomenon. An instance would be studying savants—individuals with extraordinary abilities despite significant mental disabilities.

Lastly, we have ‘Instrumental Case Studies’. These aren’t focused on understanding a particular case per se but use it as an instrument to understand something else altogether—a bit like using one puzzle piece to make sense of the whole picture!

So there you have it! From explanatory to instrumental, each type serves its own unique purpose and adds another intriguing layer to our understanding of human behavior and cognition.

Exploring Real-Life Psychology Case Study Examples

Let’s roll up our sleeves and delve into some real-life psychology case study examples. By digging deep, we can glean valuable insights from these studies that have significantly contributed to our understanding of human behavior and mental processes.

First off, let me share the fascinating case of Phineas Gage. This gentleman was a 19th-century railroad construction foreman who survived an accident where a large iron rod was accidentally driven through his skull, damaging his frontal lobes. Astonishingly, he could walk and talk immediately after the accident but underwent dramatic personality changes, becoming impulsive and irresponsible. This case is often referenced in discussions about brain injury and personality change.

Next on my list is Genie Wiley’s heart-wrenching story. She was a victim of severe abuse and neglect resulting in her being socially isolated until she was 13 years old. Due to this horrific experience, Genie couldn’t acquire language skills typically as other children would do during their developmental stages. Her tragic story offers invaluable insight into the critical periods for language development in children.

Then there’s ‘Little Hans’, a classic Freudian case that delves into child psychology. At just five years old, Little Hans developed an irrational fear of horses -or so it seemed- which Sigmund Freud interpreted as symbolic anxiety stemming from suppressed sexual desires towards his mother—quite an interpretation! The study gave us Freud’s Oedipus Complex theory.

Lastly, I’d like to mention Patient H.M., an individual who became amnesiac following surgery to control seizures by removing parts of his hippocampus bilaterally. His inability to form new memories post-operation shed light on how different areas of our brains contribute to memory formation.

Each one of these real-life psychology case studies gives us a unique window into understanding complex human behaviors better – whether it’s dissecting the role our brain plays in shaping personality or unraveling the mysteries of fear, language acquisition, and memory.

How to Analyze a Psychology Case Study

Diving headfirst into a psychology case study, I understand it can seem like an intimidating task. But don’t worry, I’m here to guide you through the process.

First off, it’s essential to go through the case study thoroughly. Read it multiple times if needed. Each reading will likely reveal new information or perspectives you may have missed initially. Look out for any patterns or inconsistencies in the subject’s behavior and make note of them.

Next on your agenda should be understanding the theoretical frameworks that might be applicable in this scenario. Is there a cognitive-behavioral approach at play? Or does psychoanalysis provide better insights? Comparing these theories with observed behavior and symptoms can help shed light on underlying psychological issues.

Now, let’s talk data interpretation. If your case study includes raw data like surveys or diagnostic tests results, you’ll need to analyze them carefully. Here are some steps that could help:

• Identify what each piece of data represents
• Look for correlations between different pieces of data
• Compute statistics (mean, median, mode) if necessary
• Use graphs or charts for visual representation

Keep in mind; interpreting raw data requires both statistical knowledge and intuition about human behavior.

Finally, drafting conclusions is key in analyzing a psychology case study. Based on your observations, evaluations of theoretical approaches and interpretations of any given data – what do you conclude about the subject’s mental health status? Remember not to jump to conclusions hastily but instead base them solidly on evidence from your analysis.

In all this journey of analysis remember one thing: every person is unique and so are their experiences! So while theories and previous studies guide us, they never define an individual completely.

Applying Lessons from Psychology Case Studies

Let’s dive into how we can apply the lessons learned from psychology case studies. If you’ve ever studied psychology, you’ll know that case studies offer rich insights. They shed light on human behavior, mental health issues, and therapeutic techniques. But it’s not just about understanding theory. It’s also about implementing these valuable lessons in real-world situations.

One of the most famous psychological case studies is Phineas Gage’s story. This 19th-century railroad worker survived a severe brain injury which dramatically altered his personality. From this study, we gained crucial insight into how different brain areas are responsible for various aspects of our personality and behavior.

• Lesson: Recognizing that damage to specific brain areas can result in personality changes, enabling us to better understand certain mental conditions.

Sigmund Freud’s work with a patient known as ‘Anna O.’ is another landmark psychology case study. Anna displayed what was then called hysteria – symptoms included hallucinations and disturbances in speech and physical coordination – which Freud linked back to repressed memories of traumatic events.

• Lesson: The importance of exploring an individual’s history for understanding their current psychological problems – a principle at the heart of psychoanalysis.

Then there’s Genie Wiley’s case – a girl who suffered extreme neglect resulting in impaired social and linguistic development. Researchers used her tragic circumstances as an opportunity to explore theories around language acquisition and socialization.

• Lesson: Reinforcing the critical role early childhood experiences play in shaping cognitive development.

Lastly, let’s consider the Stanford Prison Experiment led by Philip Zimbardo examining how people conform to societal roles even when they lead to immoral actions.

• Lesson: Highlighting that situational forces can drastically impact human behavior beyond personal characteristics or morality.

These examples demonstrate that psychology case studies aren’t just academic exercises isolated from daily life. Instead, they provide profound lessons that help us make sense of complex human behaviors, mental health issues, and therapeutic strategies. By understanding these studies, we’re better equipped to apply their lessons in our own lives – whether it’s navigating personal relationships, working with diverse teams at work or even self-improvement.

Challenges and Critiques of Psychological Case Studies

Delving into the world of psychological case studies, it’s not all rosy. Sure, they offer an in-depth understanding of individual behavior and mental processes. Yet, they’re not without their share of challenges and criticisms.

One common critique is the lack of generalizability. Each case study is unique to its subject. We can’t always apply what we learn from one person to everyone else. I’ve come across instances where results varied dramatically between similar subjects, highlighting the inherent unpredictability in human behavior.

Another challenge lies within ethical boundaries. Often, sensitive information surfaces during these studies that could potentially harm the subject if disclosed improperly. To put it plainly, maintaining confidentiality while delivering a comprehensive account isn’t always easy.

Distortion due to subjective interpretations also poses substantial difficulties for psychologists conducting case studies. The researcher’s own bias may color their observations and conclusions – leading to skewed outcomes or misleading findings.

Moreover, there’s an ongoing debate about the scientific validity of case studies because they rely heavily on qualitative data rather than quantitative analysis. Some argue this makes them less reliable or objective when compared with other research methods such as experiments or surveys.

To summarize:

• Lack of generalizability
• Ethical dilemmas concerning privacy
• Potential distortion through subjective interpretation
• Questions about scientific validity

While these critiques present significant challenges, they do not diminish the value that psychological case studies bring to our understanding of human behavior and mental health struggles.

Conclusion: The Impact of Case Studies in Understanding Human Behavior

Case studies play a pivotal role in shedding light on human behavior. Throughout this article, I’ve discussed numerous examples that illustrate just how powerful these studies can be. Yet it’s the impact they have on our understanding of human psychology where their true value lies.

Take for instance the iconic study of Phineas Gage. It was through his tragic accident and subsequent personality change that we began to grasp the profound influence our frontal lobes have on our behavior. Without such a case study, we might still be in the dark about this crucial aspect of our neurology.

Let’s also consider Genie, the feral child who showed us the critical importance of social interaction during early development. Her heartbreaking story underscores just how vital appropriate nurturing is for healthy mental and emotional growth.

Here are some key takeaways from these case studies:

• Our brain structure significantly influences our behavior.
• Social interaction during formative years is vital for normal psychological development.
• Studying individual cases can reveal universal truths about human nature.

What stands out though, is not merely what these case studies teach us individually but collectively. They remind us that each person constitutes a unique combination of various factors—biological, psychological, and environmental—that shape their behavior.

One cannot overstate the significance of case studies in psychology—they are more than mere stories or isolated incidents; they’re windows into the complexities and nuances of human nature itself.

In wrapping up, I’d say that while statistics give us patterns and trends to understand groups, it’s these detailed narratives offered by case studies that help us comprehend individuals’ unique experiences within those groups—making them an invaluable part of psychological research.

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Behaviourism

How would you solve these behaviour issues without using behaviourist techniques?      

Room Profile

Non-traditional classroom with no desks and a high-risk environment with very expensive equipment and supplies.

Class Profile

• Class of 30 grade 9 students consisting of 6 girls and 24 boys.
• Because it’s a pandemic year, students don’t get their choice of electives so only 3 students actually chose this class as their elective
• 16 designations total
• 6 IEPs - ranging from needing written instructions to having to keep them at your side and a close eye on them for the safety of the student and those in the classroom
• No EA or student aide help
• 2.5 hour class every day for 10 weeks

Description of Behaviours

Every other word uttered by students is a swear and they are incredibly disrespectful toward themselves, each other, the teacher, and the physical environment. One student is so keen on being in the room that they won’t let the teacher talk without interrupting with questions. Three other students keep talking to their neighbours and distracting them regardless of how many times the teacher waits for silence (which ends up about 25 minutes the first time on the first day). Two students refuse to put their phones away claiming they can be on them because of their IEPs; however, they cannot. One student won’t sit down and is physically throwing things around the classroom. This student’s IEP specifies that the teacher has to make sure they are seated very close to them and not to let the student “get away” with anything.

The teacher works on respectful language and discusses code switching, specifically how the classroom has different norms and behavioural expectations than outside of school and students must “switch” to adhere to these expectations when in the classroom. Emails are sent home about language use. The teacher also sits the class down for a minimum of 30 minutes each day to discuss appropriate behaviour and language in class (this continues for the first three weeks of the quarter as behaviour does not change enough to do any curriculum work). The teacher has the class come up with the following list of disciplinary measures increasing in severity:

• 1st offense: Verbal warning
• 2nd offense: Verbal warning and student moved from current location
• 3rd offense: Student sent outside of classroom
• 4th offense: Student sent outside and email home
• 5th offense: Student sent to office and email home
• 6th offense: Student removed from class      

The space is split into two parts, the classroom area and performance area. Students are not to use the performance area due to the pandemic and cleaning load of the janitors. The teacher puts tape lines on the carpet to distinguish the classroom space, but these are ignored. Emails are sent home detailing necessary classroom boundaries for the health and safety of students in the space. Chairs are put up above the lines with signs on them noting the boundaries, but these are also ignored. Emails are again sent home and administration is notified. Despite all these efforts, the behaviour persists.          .

Second week

The principal comes in to talk to the class. The behaviour continues, but the teacher notes that the use of language has gotten better.

The teacher pulls five senior students out of their classes for one day and divides the class into separate, carefully curated, groups. The teacher also arranges for a peer-tutor to come work with one student, and another is sent to the support room. Two other students are sent to the construction shop to work with the shop teacher. Everyone is successful for one hour. However, the behaviour continues when everyone is back in the classroom together. The teacher removes the students from the classroom and goes into library space with the librarian and vice principal present.

Fourth week

The Library is booked this week so the class is moved primarily outside, as it is safer to be outside during the pandemic anyway. Little to no actual classwork has happened so far.

Traditional classroom with table groups, reading area, teacher desk, and three computer stations

• Class of 30 grade 6 students consisting of 10 girls and 20 boys
• 10 designations total
• 6 IEPs - ranging from needing written instructions to having to keep them at your side and a close eye on them for the safety of the student and others in the classroom

Students exhibit a wide array of disruptive behaviours. The majority of the class is running around, yelling at each other, using disrespectful language or derogatory terms to address one another, and throwing papers and materials across the room. When the teacher tries to address the students, only a handful pay attention and listen for instructions. When the teacher asks for silence, some of the students keep talking to each other, while others keep interrupting the teacher and moving around the classroom. One student with a designation refuses to stop playing games on his phone, claiming he can use it because of his IEP accommodations; however, this student’s IEP specifies that the student should be seated very close to the teacher and to not let him “get away with anything.” Despite the teacher’s efforts, the majority of students won't remain silent or still, mocking the teacher whenever they speak. It takes the teacher 25 minutes to get the students' attention and for them to be relatively quiet. The lesson is not effective since most students tend to be distracted and off-task.

The teacher works on respectful language and discusses code switching, specifically how the classroom has different norms and behavioural expectations than outside of school and students must “switch” to adhere to these expectations when in the classroom. Emails are sent home about language use and respectful behaviour. The teacher also sits the class down for a minimum of 20 minutes each day to discuss appropriate behaviour and language in class (this continues for the first three weeks of the quarter as behaviour does not change enough to do any curriculum work). The teacher has the class come up with the following list of disciplinary measures increasing in severity:

Students are not to use the computers due to the pandemic and cleaning load of the janitors. The teacher puts tape lines on the carpet to distinguish the classroom space, but these are ignored. Emails are sent home detailing necessary classroom boundaries for the health and safety of students in the space. Chairs are put up above the lines with signs on them noting the boundaries, but these are also ignored. Emails are again sent home and administration is notified. Despite all these efforts, the behaviour persists.

The teacher pulls five students out of their classes for one day and divides the class into separate, carefully curated, groups. The teacher also arranges for a peer-tutor to come work with one student, and another is sent to the support room. Two other students are sent to the library to work with the librarian. Everyone is successful for one hour. However, the behaviour continues when everyone is back in the classroom together.

The teacher decides to move the class outside as it is safer to be outside during the pandemic anyway. Little to no actual classwork has happened so far.

Behaviourism on Station 12?

Congratulations Earthling!

As one of Earth’s top teacher candidates, you have been selected to take a tour of Station 12, one of the most advanced elementary schools on Mars! As your friendly Martian tour guide, I’ll be showing you how our education system has advanced to be one of the best in the galaxy! In honesty, our progress is all thanks to you, and your fellow Earth-dwellers. You see, about 50 years ago, we received a time capsule from Earth containing tons of interesting information, sounds, and images! In addition to learning about Justin Bieber, apparently one of Earth’s greatest poets, we learned all about Behaviorism and the perils of dehumanizing our young learners through rewards and punishments. Anyways, that’s enough jibber-jabber, where are my Martian-manners! Let’s go check out Station 12 and you can see for yourself!

As you enter Station 12, you immediately notice the absence of any shiny trophy cases that commonly adorn the lobbies of schools on Earth. You think to yourself: “I guess Martians truly don’t offer rewards for certain behaviours, at least in terms of athletics.” Noticing your curiosity, your friendly Martian turns to you and says, “We don’t use any objective forms of rewards or punishments in our classrooms! We understand that if a student receives a reward or punishment for their behaviour, they may not develop intrinsic motivation for learning.”

As you continue to walk through the hallways of Station 12, you get glimpses of different classroom environments and teaching practices. Interestingly, you don’t notice any signs of grades, stars, or points systems being used in the classrooms. On the surface, the students also seem to be completely engaged and intrinsically motivated.

As you round the next corner, your tour guide invites you into a classroom where students are just about to return from recess and continue working on their independent research projects. As the students enter the classroom on time, the teacher is giving them a big, gleaming smile. After the students are settled, you begin walking around the classroom and learning about their projects. You discover that one student is learning about Earth and another about the gravity on the Moon. The students are at different stages of their projects and some are still deciding on their topics. You overhear one student inform the teacher that they have decided to study the constellations closest to Mars. As an avid astronomer, the teacher excitedly says, “I think that is a wonderful choice!” Just then, a student enters the classroom 10 minutes late from recess. The teacher lets out a quick “hmm” and shows the slightest suggestion of a frown. Your Martian tour guide turns to you and says, “Did you see that!? No detention for arriving late to the classroom!” Before you can respond, you notice another student beginning to get distracted from their work. You watch as the teacher walks over to a student sitting beside them and, with a warm smile, says, “Great job! I’m so happy you are working hard today and staying focused. I am so proud!” Interestingly, you notice the distracted student begin working again. Another student approaches the teacher and says, “I’ve decided to change my topic to the gravitational pull of the Moon!” Hearing this, the teacher says, “That's a clever idea!” and offers them a quick wink and a warm smile as the student bounces away, seemingly happy with the interaction. Just as you’re about to leave the classroom, you watch as another student explains to the teacher that they have decided to research Emily Carr and the emotions her paintings surface in both humans and Martians. Just as you exit the classroom, you watch the teacher scrunch their noise ever so slightly and say, “Oh. Okay. That’s a good choice,” before immediately moving their attention to another student.

As you leave the school, your Martian tour guide turns to you and says, “So!? What do you think? Pretty impressive, eh? We learned from the time capsule and don’t use any forms of rewards or punishments!” Before you can respond, you are awoken by one of your friends. You’re in EPSE 308 and it’s your turn to discuss your perspectives on Behaviourism. Good luck, Earth-dweller!

Possible Discussion Questions

• In the classrooms on Station 12, you were informed that there were no objective forms of rewards or punishments for students' behaviour. Did you notice any subtle (maybe even unconscious) forms of behaviourism?
• As a teacher candidate, you may be motivated to cultivate a classroom environment that fits your needs and values as a teacher. In this case study, the teacher did this by encouraging students to attend class on time, stay engaged in their work, and pick topics that they themselves deemed worthy. Are these subtle forms of behaviourism more or less harmful, compared to more tangible and objective rewards and punishments? Explain your reasoning.
• As a future teacher, how might you become more aware of your subconscious values and goals for your classroom? How will you manage them in your classroom?
• What do you see as the pros and cons of behaviourism?

Dear Colleague

I can’t imagine you have an answer to this question, but you seem to have been thinking a lot about how to motivate your students and when it comes to this, I’m at a total loss! I thought I had it all figured out, but no – my plan to motivate my students has totally backfired. Help!

I’m teaching seventh grade language arts for the first time this year, and one goal of mine going into this term was to encourage my students to become independent readers. Well, lucky for me, the school librarian, Ms. Daniels, had a program set up this year to do just that! You see, there’s a new book coming out at the end of the year – it’s the latest in a series of young adult novels that’s all the rage right now. Vampires, wizards, a dystopian world – this series has got it all. Anyway, the school librarian KNOWS that this book will be a hot commodity the moment it’s released. When the last in the series came out, she had about fifty holds on it the second she entered it into the library catalogue!

Ms. Daniels devised a system to encourage independent reading. It’s simple: each time a student reads a book from the library – any book – they fill out a worksheet to reflect on it and show they’ve read it. It's just a few questions, asking for a brief plot summary, something they liked about the book, something it made them think about – things like that. Anyway, each time a student hands in a worksheet on a book they’ve read, they get a point, or points, depending on the length of the book. You get one point if you read a book that’s at least 100 pages, two if you read a book that’s at least 200 pages, three if it’s more than 300 pages – you get the idea. The student in the school who has the most points at the end of the year wins a copy of that new young adult novel that everyone wants. It’s bound to fly off the shelves and be sold out for weeks, so they’ll be one of the first to get it!

Well, since I’m teaching language arts this year, I thought I’d supplement Ms. Daniels' competition with some extra motivation – to really get my students wanting to read. After all, not every student in my class is a fan of this series. So, I told my class that for every reading worksheet they hand in to the librarian, they'll also get a bonus mark they can add to their final assignment for the year. It would never change their grade significantly, but hopefully just enough to get them reading. Simple, right?

It all seemed to be going smoothly at first. In the beginning, Bilal was the student who was gaining the most points. He's a high achiever and has always been an avid reader, so that wasn't surprising. But then I had some unexpected runner-ups. A few students who were otherwise struggling in my class, Andy and Sobiga, started gaining more points, and fast! They were giving Bilal a run for his money.

At first, I was thrilled! But that all changed on Friday afternoon. Bilal and Andy had been close friends all term, but on Friday during class, they seemed to have a falling out. Then Bilal lingered after the bell to talk to me. Bilal declared: "Andy is cheating!" When I asked him what he meant, he explained: "He doesn't actually READ any books! He just looks at summaries online to fill out those worksheets!"

To add to my stress, I heard the next day that students in the neighbouring seventh grade class, taught by Mr. Chu, were complaining that my students had an unfair advantage over them because of the bonus marks I had promised. Mr. Chu has even gotten several calls from parents who felt that my students have an advantage over theirs.

As you can see, my plan to encourage reading has gone totally awry! What should I do now? And, most importantly, how can I motivate my students to read?

Ms. Mahmoud

Potential Reflection Questions

1. Identify and provide examples of the types of behaviourism used in the case study (positive reinforcement, negative reinforcement, positive punishment, negative punishment).

2. Going beyond the events described in this scenario, what are possible pros and cons of this teacher’s choice to establish a reward system to encourage reading?

3. What suggestions would have for this teacher and the librarian to encourage reading without relying on behaviourist strategies?

4. Assuming Bilal's allegations about Andy are true, how might you deal with this situation? What might be contributing to Andy's behaviour? How could this issue have been prevented?

Additional resources

• https://www.alfiekohn.org/article/reading-incentives/
• https://www.thisamericanlife.org/713/made-to-be-broken/act-two-11

When re-using this resource, please attribute as follows:

This UBC EPSE 308 Behaviourism Open Case Study was developed by Benjamin Dantzer, Lee Iskander, and Sharmilla Miller and it is licensed under a under a Creative Commons Attribution 4.0 International License

Post Image: Educators .co.uk, CC BY 2.0 via Wikimedia Commons