Adding Supporting Evidence and Eliminating Extraneous Bio-Medical Constructs from the Psychodynamic Case Study

Abstract

Skean’s (2005) case of “CG’ is an important addition to the case study literature on brief psychodynamic psychotherapy with difficult, treatment-resistant clients. It brings to life the clinical reality of this kind of work by combining a comprehensive description of the client’s problem, family history, current life-circumstances, and the process of therapy, with a clear theoretical framework that yields specific clinical interventions and interpretations. Three areas in which this case illustrates current problems in clinical practice or case study reporting are also discussed: (1) the underutilization of available documentation from other professionals involved in the case; (2) an overemphasis on describing the psychological problems of the client rather than the morally objectionable actions of those in positions of power and authority in the culture of the client and therapist; and (3) the intrusion of incongruent medical model language and recommendations for treatment despite the adequacy and ultimate effectiveness of the psychodynamic guiding conception of the case.