About PCSP

About PCSP

Pragmatic Case Studies in Psychotherapy (PCSP) is a peer-reviewed, open-access journal and database. It provides innovative, quantitative and qualitative knowledge about psychotherapy process and outcome, for both researchers and practitioners.


1) To generate a growing database of systematic, rigorous, and peer-reviewed therapy case studies across a variety of theoretical approaches. These cases can serve:

A) as a source of guidance on individual cases for practicing clinicians.

B) as a research base for qualitative and quantitative cross-case analysis by researchers and theorists. This research base can be employed (a) to derive and test theory-based hypotheses about therapy process and change mechanisms; (b) to develop pragmatic, evidence-based, "best practice" guidelines for addressing particular types of cases; (c) to explore effective ways to combine qualitative and quantitative information; and (d) to compare, contrast, and/or integrate different theoretical approaches as applied to the same clinical facts in individual cases.

C) as a way to enhance the knowledge value of cases employed in quantitatively oriented therapy research involving either groups of therapy patients (e.g., efficacy research) or single-case research designs.

D) as a resource in therapist training, for both students, academic educators, and supervisors.

2) To pilot-test the special advantages of online, case study journals in applied psychology generally by exemplifying in detail their ability to make large amounts of qualitative and quantitative, peer-reviewed information particularly timely, accessible, searchable, and pragmatically and theoretically valuable.

3) To act as a vehicle for progress in therapy case-study method through the process of example, critical dialogue, and cross-case analysis.


In recent years, there has been a vigorous, renewed interest by applied psychology researchers and scholars in case studies of therapy -- and other psychosocial interventions -- whose process and outcome are systematically described with "thick" qualitative detail (see sample list of references below). These authors have been drawn to the case study from a variety of theoretical and applied perspectives, such as cognitive-behaviorism, psychoanalysis, phenomenology, hermeneutics, humanistic psychology, life-history, personology, and program evaluation. In spite of this diversity, these authors have offered converging rationales for restoring the case study to its former prominence as a vehicle for systematically reporting clinical observations, exploring theory, and documenting advances in professional effectiveness.

Furthermore, these authors have developed a variety of similar guidelines for improving the reliability and generalizablity of the case study's content. For example, Elliott, Fischer, and Rennie (1999) recently reported the following guidelines that emerged from a consensus-seeking process among psychotherapy researchers: "owning one's perspective," involving specification of factors like the author's theoretical orientation, personal anticipations, and values, and the role these play in the research design and conceptual analysis; "situationing the sample," by describing relevant contextual data about the subjects involved; "providing reliability checks," by the use of multiple qualitative analysts and/or a research "auditor"; and "grounding in examples." This latter guideline is analogous to reporting significance tests in quantitative research, in the sense that both types of research practices form the empirical basis of the logic for supporting conclusions about the phenomena being studied.

We believe that the scholarship, sophistication, vitality, and pragmatic import of this recent work in case study method, along with the power of electronic publishing and searchable databases, permits the field of professional psychology to take a ma jor leap forward towards the integration of theory, research and practice. Our aim is to maintain the clinical richness and creativity of the case study method while generating a database that permits cross-case comparisons and more generalized rules of psychotherapeutic practice.

Drawing on major themes in the new applied case research models, Fishman (1999, 2000, 2001) uses the term "pragmatic case study" to refer to systematic, qualitative case studies that capture the logic, process, and outcome of professional practice. Such case studies also include, where feasible and theoretically consistent, intake and outcome data on standardized quantitative measures to place an individual patient in normative context.

Fishman has illustrated the nature and theoretical and practical value of pragmatic case studies through article series in two journals: one involving 8 cases studies in forensic psychology (Fishman & Delahunty, 2003, 2004); and one involving 6 case studies in program planning & evaluation, and community psychology (Fishman & Neigher, 2003, 2004). In each of these series, there are complementary articles on case study method and cross-case comparisons. Broad-based, pragmatic case studies as applied to the arena of psychotherapy are the guiding model for the cases in PCSP. The location of pragmatic case studies within the larger psychotherapy research field is described below.

From Single Case to Database in Psychotherapy Research

There is a very well established tradition in psychotherapy research for evaluating the comparative efficacy and effectiveness of different types of clinical interventions across groups of similar kinds of patients. (For examples of efficacy research, which is experimentally based, see Nathan & Gorman [2002]; and for an example of effectiveness research, which is naturalistically-based, see Seligman [1996].) The late Kenneth Howard and his colleagues (e.g., Howard, Moras, Brill, Zoran, Martinovitch, & Lutz, 1996;) call this tradition "treatment-focused" research, because it views the intervention model and procedures as the basic unit of analysis.

Howard and his colleagues have pioneered and developed an alternative, complementary approach, which they call "patient-focused research," because it views the individual case as the basic unit of analysis. More specifically, working in this paradigm, Howard et al. began by developing a common, omnibus, psychometrically established database of quantitative indicators normed on large numbers of patients and the general population, including a summary mental health index (MHI) score. For the patient sample, these measures were collected at intake, during therapy, and at follow-up. Then, by administering the same quantitative measures to a new client, a patient's psychometric intake profile could be matched to a group of similar patients in the database, and that group could be used to generate the expected course of therapy over time on the MHI score for that patient. The resultant feedback of how the patient is doing over time is of important practical use to the practitioner, supervisor, and case manager. At follow-up, patients' information goes into the database, adding to the power of the database, which can be employed for research trends across groups of patients. Howard's group has successfully pilot-tested their paradigm and continue to develop it (Grissom, Lyons, & Lutz, 2002).

One major goal of Pragmatic Case Studies in Psychotherapy (PCSP) is to expand the Howard model into the qualitative sphere, adding the capacity to look in process detail at cases that are normatively contextualized with quantitative measures like Howard's. In addition, PCSP is interested in other case study paradigms that focus on qualitative data per se. Specifically, while we expect many of the cases to be quantitatively contextualized, we anticipate other cases where quantitative measures are not feasible or where the author argues that quantitative data are not compatible w ith the theoretical model employed in the case. We believe that having such cases side by side with those that are quantitatively contextualized will stimulate constructive discussion and exploration of the potentials and limits of quantification in researching therapy.

In order to facilitate comparison among cases, it is important to strive for a common framework and structure embodied in common headings -- within each case. The editors of PCSP have chosen to begin their project with a framework developed by Donald Peterson (1997) titled "Disciplined Inquiry." This model has been chosen because it can accommodate (a) a wide array of different theoretical approaches, such as cognitive behavior therapy, psychodynamic therapy, humanistic therapy, and family systems; (b) the whole continuum defined by highly manualized treatment models at one end, highly individualized therapy at the other end, and some type of synthesis in the middle (e.g., Davison, 1998; Kendall, Chu, Gifford, Hayes, & Nauta, 1998; Persons, 2003); (c) and a variety of models of how the most effective practitioners in many fields actually function (e.g., the models of Schön's [1987] "reflective practitioner" and Stricker & Trierweiler's [1995] "local clinical scientist").

Briefly, Disciplined Inquiry requires the practitioner to lay out his or her "guiding conception" of therapy," as informed by published research and the practitioner's clinical experience. This guiding conception is then employed to create an individualized assessment, formulation, and treatment plan for the client. Interventions are next carried out -- with appropriate monitoring and feedback -- until termination, follow-up, and a concluding evaluation. (For a more detailed description of this Disciplined Inquiry, see Instructions for Authors.)

Clearly, the results of a single case study lack the ability for deductive generalization to other similar situations that is found in a group study. However, in line with the Howard et al. model, collections of case studies develop the capacity for inductive generalization to other, similar settings. This capacity can come about by organizing case studies of patients with similar target goals and similar intervention approaches into databases. For example, consider the application of cognitive behavior therapy to a phobia in a middle-class, professional Latina woman who has associated depressive symptoms, marital difficulties, and alcohol problems. Or consider family therapy with a poor, White teenager who is also a single mother of a child with attention deficit disorder. A write-up of either case is limited in terms of the number of case situations in the future to which it will apply. This limitation is due to large contextual differences that can occur between any one case and any other case that is randomly drawn out of a heterogeneous case pool.

However, as cases in the database grow, they begin to sample a wide variety of contextually different situations in which the target problem can occur and a wide variety of intervention approaches for that problem. Therefore, as the number of cases in the database rises substantially, the probability increases: (a) that there exist specific cases in the database that are pragmatically relevant to a new target case in terms of both the nature of the target problem and the intervention approach employed; and (b) that there are groups of cases that are contextually similar enough to inductively create general guidelines for working with and theoretically understanding such cases. (Note that this "case-based reasoning" [e.g., Fishman, 1999, 2003] is similar to the use of the Westlaw and Lexis databases in the legal profession.) To accomplish (a) and (b) involves a capacity for appropriate case-finding and for performing cross-case analyses where the units of study are in a large database with detailed qualitative data. These tasks seem only feasible with the online capacities of a journal like PCSP.

In sum, we have three broad goals for PCSP. First, the journal should be a vehicle for progress in therapy case study method through the process of example and critical dialogue. Second, the journal should be a vehicle for creating a growing database of systematic, rigorous, and peer-reviewed therapy case studies, which can serve as a systematic knowledge resource for practicing clinicians, for researchers and theorists, and for therapy educators and students. Finally, we view PCSP as an opportunity within the field of applied psychology generally to prove the special advantages of online journals in their ability to make large amounts of qualitative, peer-reviewed information particularly timely, accessible, searchable, and pragmatically and theoretically valuable.


(* references specifically cited in the text)

Barlow, D.H. (Ed.). (2001). Clinical handbook of psychological disorders, third
edition: A step-by-step treatment manual
. New York: Guilford Press.
Bromley, D.B. (1986). The case study method in psychology and related
. Chichester: John Wiley.
Clement, P.W. (1999). Outcomes & incomes: How to evaluate, improve, and
market your psychotherapy practice by measuring outcomes
. New York:
COMPASSS Research Group (COMParative methods for the Advancement of
Systematic cross-case analysis and Small-n Studies). (2004). COMPASSS
is a research group bringing together scholars and practitioners who share
a common interest in theoretical, methodological and practical
advancements in a systematic comparative case approach to research
which stresses the use of a configurational logic, the existence of multiple
causality and the importance of a careful construction of research
populations. The web site of COMPASSS is http://www.compasss.org
*Davison, G.C. (1998). Being bolder with the Boulder model: The challenge of
education and training in empirically supported treatments. Journal of
Consulting and Clinical Psychology, 66
, 163-167.
Davison, G.C. & Lazarus, A.A. (1994). Clinical innovation and evaluation:
Integrating practice with inquiry. Clinical Psychology: Science and Practice,
D'Zurilla, T. J., & Nezu, A. M. (1999). Problem-solving therapy: A social
competence approach to clinical intervention (2nd ed.).
New York:
Edelson, M. (1988). Psychoanalysis: A theory in crisis. Chicago: University of
Chicago. Edwards, D. A. (1998). Types of case study work: A conceptual
framework for case-based research. Journal of Humanistic Psychology, 38,
*Elliott, R. (2001). Hermeneutic single-case efficacy design: An overview. In
K.J. Schneider, J.F.T. Bugenthal, and J.F. Pierson (Eds.), The handbook of
humanistic psychology
, 315-326. Thousand Oaks, CA: Sage.
Elliott, R., Fischer, C.T., & Rennie, D.L. (1999). Evolving guidelines for
publication of qualitative research studies in psychology and related fields.
British Journal of Clinical Psychology, 38,
*Fishman, D.B. (1999). From single case to database: Resolving the
"manualized treatment" versus "case formulation" dilemma. Panel discussion
presented at the annual conference of the Association for Advancement of
Behavior Therapy. Toronto, Canada.
*Fishman, D.B. (2000). Transcending the efficacy versus effectiveness
research debate: Proposal for a new, electronic "Journal of Pragmatic Case
Studies." Prevention & Treatment, 3, Article 8. Available on the World Wide
Web: http://journals.apa.org/prevention/volume3/pre0030008a.html.
*Fishman, D.B. (2001). From single case to database: A new method for
enhancing psychotherapy, forensic, and other psychological practice.
Applied & Preventive Psychology, 10
, 275-304.
*Fishman, D.B. (2003). Background on the "Psycholegal Lexis Proposal":
Exploring the potential of a systematic case study database in forensic
psychology. Psychology,Public Policy and Law, 9, 267-274. |
*Fishman, D.B. & Goodman-Delahunty, J. (Eds.). (2003, 2004). Pragmatic
psychology and the law, parts 1 and 2. Special Section of Psychology,
Public Policy, and Law,Volume 9
, No. 3/4; and Volume 10, No. 1.
Fishman, D.B., & Neigher, W.D. (Eds.). (2003, 2004). Systematic case
studies in program evaluation, parts 1 and 2. Special section of Evaluation
and Program Planning, Volume 26
, No. 4; and Volume 27, No. 1.
Fishman, D.B., & Messer, S.B. (2004). Case-based studies as a source of
unity in applied psychology. Chapter in R.J. Sternberg (Ed.), The Unification
of psychology: Prospect or pipedream?,
37-59. Washington, D.C.:
American Psychological Associaton.
Franklin, A. J. (1999). Invisibility syndrome and racial identity development in
psychotherapy and counseling African American men. Counseling
Psychologist, 27,
Freeman, A. (2002). Modifying therapeutic homework for patients with
personality disorders. Journal of Clinical Psychology, 58, 513-524
Goldfried, M. R. (1995). Toward a common language for case formulation.
Journal of Psychotherapy Integration, 5,
Goldman, R. & Greenberg, L.S. (1995). A process-experiential approach to
case formulation. In Session: Psychotherapy in Practice, 1, 35-36, 42-51.
*Grissom, G.R., Lyons, J.S., & Lutz, W. (2002). Standing on the shoulders of
a giant: Development of an outcome management system based on the
dose model and phase model of psychotherapy. Psychotherapy Research,
Haaga, D.A.F. (1999). Major depression with anger attacks: The case of
Mary. Cognitive and Behavioral Practice, 6, 271-273.
Hayes, S.C., Barlow, D.H., & Nelson-Gray, R.O. (1999). The scientist
practitioner: Research and accountability in the age of managed care
Boston: Allyn and Bacon.
Hersen, M. (2002). Rationale for Clinical Case Studies: An editorial. Clinical
Case Studies, 1
, 3-5.
Hilliard, R.B. (1993). Single-case methodology in psychotherapy process and
outcome research. Journal of Consulting and Clinical Psychology, 61, 373-
Hoshmand, L.T. & Polkinghorne, D.E. (1992). Redefining the science-
practice relationship and professional training. American Psychologist, 47,
*Howard, K.I., Moras, K., Brill, P.L., Martinovich, Z., & Lutz, W. (1996).
Evaluation of psychotherapy: Efficacy, effectiveness, and patient
progress. American Psychologist, 51, 1059-1064.
Kanfer, F.H., & Schefft, B.K. (1988). Guiding the process of therapeutic
Champaign, Illinois: Research Press.
Kazdin, A.E. (1981). Drawing valid inferences from case studies. Journal of
Consulting and Clinical Psychology, 49,
Kazdin, A. E. (1993). Evaluation in clinical practice: Clinically sensitive and
systematic methods of treatment delivery. Behavior Therapy, 24, 11-45.
*Kendall, P.C., Chu, B., Gifford, A., Hayes, C., & Nauta, M. (1998).
Breathing life into a manual: Flexibility and creativity with manual-based
treatments. Cognitive and Behavioral Practice, 5, 177-198.
Klumpner,G.H. & Frank, A. (1991). On methods of reporting clinical material.
Journal of the American Psychoanalytic Association, 39
, 537-551.
Lazarus, A. A. (2002). .Client readiness for change, cultural concerns, and
risk taking: A multimodal case presentation. Clinical Case Studies, 1, 39-48.
Levine, M. (1980). Investigative reporting as a research method: An analysis
of Woodward and Bernstein's "All the President's Men." American
Psychologist, 35
, 626-638.
Mahoney, M. J. (2003). The postmodern self in psychotherapy. Journal of
Cognitive Psychotherapy, 7,
McWilliams, N. (2004). Psychoanalytic psychotherapy: A practitioner's guide.
New York: Guilford.
Messer, S.B., & McCann, L. (in press). Research perspectives on the case
study: Single-case method. In J.S. Auerbach, K.N. Levy, & C.E. Schaffer.
Relatedness, self-definition, and mental representation: Essays in honor of
Sidney J. Blatt
. New York: Routledge Press.
Miller, R.B. (2004). Facing human suffering: Psychology and psychotherapy
as moral engagement.
Washington, DC: APA.
*Nathan, P.E., & Gorman, J.M. (Eds.). (2002). Aguide to treatments that
work, 2nd edition.
New York: Oxford University Press.
Ogilvie, D.M. (2003). Fantasies of flight. New York: Oxford Press.
Persons, J.B. (1989). Cognitive therapy in practice: A case formulation
ach. New York: W.W. Norton.
*Persons, J.B. (2003, November 22). Empiricism, mechanism, and the practice
of cognitive-behavior therapy. Presidential address to the annual
convention of the Association for Advancement of Behavior Therapy.
*Peterson, D.R. (1997). Educating professional psychologists: History and
guiding conception.
Washington, DC: American Psychological Association.
Runyan, W. M. (2003). From the study of lives and psychohistory to
historicizing psychology: A conceptual journey. Annual of Psychoanalysis,
Schneider, K.J. (1999). Multiple-case research: Bringing experience-near
closer. Journal of Clinical Psychology, 55, 1531-1540.
*Schön, D.A. (1983). The reflective practitioner. How professionals think in
. New York: Basic Books.
Sechrest, L., Stewart, M., Stickle, T.R., & Sidani, S. (1996). Effective and
persuasive case studies.
(Product # PN-20). Cambridge, MA: The
Evaluation Center @ HSRI.
*Seligman, M.E.P. (1995). The effectiveness of psychotherapy: The
Consumer Reports study. American Psychologist, 50, 965- 974.
Shapiro, M.B. (1961). The single case in fundamental psychological research.
British Journal of Medical Psychology, 34
, 255-262.
Spence, D. P. (1993). Traditional case studies and prescriptions for improving
them. In N.E. Wilson (Ed.) Psychodynamic treatment research: A
handbook for clinical practice
. New York : Basic Books.
Stake, R.E. (2000). Case studies. In N.K. Denzin & Y.S. Lincoln (Eds.).
Handbook of qualitative research, 2nd ed.,
435-454. Thousand Oaks, CA:
Stiles, W.B., Shapiro, D.A., Harper, H., Morrison, L.A. (1995). Therapist
contributions to psychotherapeutic assimilation: An alternative to the drug
metaphor. British Journal of Medical Psychology, 68, 1-13.
*Stricker, G., & Trierweiler, S.J. (1995). The local clinical scientist: A bridge
between science and practice. American Psychologist, 50, 995-1002.
White, R. (1975). Lives in progress. New York: HBJ.
Yalom, I. & Elkins, G. (1977). Every day gets a little closer: A twice told
. New York: Basic Books.
Yin, R.K. (2002). Case study research: Design and methods, 3rd ed.
Thousand Oaks: Sage.