The Pragmatic Case Study Method for Creating Rigorous and Systematic, Practitioner-Friendly Research

Psychotherapy case studies have the capacity to link directly to the work of practitioners because these studies are grounded in the same type of setting in which clinicians function, that of the single case. Not surprisingly, then, case studies have played a most important role in the development of a wide range of therapy models, like psychoanalysis, behavioral therapy, and client-centered therapy. However, until recently, case studies as a method of research have fallen into disuse because they have been viewed as subjective and journalistic. This situation has changed with the growth of the philosophical movement of postmodernism, which has encouraged pluralism in the social sciences, and in turn stimulated new approaches to the case study as a serious method for psychotherapy research. This paper reviews one such approach, the pragmatic case study method, which is grounded in the fast-growing "mixed methods" model in the social sciences that seeks new ways to integrate qualitative and quantitative research designs and data. This paper begins with an overview of the growing variety of types of psychotherapy research, indicating where case studies fit in and describing a new design that integrates the use of pragmatic case studies with randomized clinical trials. The paper then lays out the basic structure of the pragmatic case study, in the context of viewing therapy as a complex adaptive system and, in a related fashion, as an example of Peterson's (1991) "Disciplined Inquiry" model of professional practice. The paper next provides a more concrete idea of the pragmatic case study by summarizing guidelines for writing such a case study for this PCSP journal, and by describing the structure of a specific example of a pragmatic case study published in the journal, the case of Caroline by Ueli Kramer. Finally, the paper describes how the pragmatic case study can be integrated with other types of case study designs.