TILT – Therapeutic Innovations in Light of Technology
Research Review
Case Study & Online Th Case studies of one kind of online therapy or another have been vital and influential elements of the research literature for many years. Especially when interventions are new, case study methods offer an especially appropriate means of carrying out research that offers insight into what has been achieved in that specific instance. They do not, of course, tell us about what can be achieved in other cases, and even less so what is likely to be achieved across a broad range of specific instances – both of which require different kinds of outcome research with greater predictive power, like controlled trails – but insofar as a future case has similar characteristics, findings may be generalizable to some degree. The great strength of case studies, therefore, lies not so much in telling us what tends to happen, or what will happen, but what can happen. Before asking whether a specific intervention is, typically, effective it is vital to ask whether it is possible for it be effective – and that is what case studies are good for. Thus, they do not address questions like “does online therapy work?”, but rather “can online therapy work?”
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In the last ten or more years, case study methods have also evolved considerably, notably with the introduction of systematic case study methods (Stephen and Elliott, 2011, for example). When taken as a whole, a series of case studies with characteristics in common – such as their use of a specific technology – can then also form an evidence base of a quite different type than, say, a randomised controlled trial (RCT). The latter will tell us little about any individual other than, typically, change in quantitative measures of distress often recorded on some kind of psychometric indicator. The former, in contrast, will offer a far more rich and detailed impression of what happened, allowing much better assessment of what contributed to change, of problematic features of the intervention and so on. Initiatives like Fishman’s Pragmatic Case Studies in Psychotherapy (Fishman, 1999; 2000; and see http://pcsp.libraries.rutgers.edu/index. php/pcsp), Elliott’s Hermeneutic Single Case Efficacy Design (Elliott, 2001; 2002; Elliott et al, 2009) and others have been seen as offering an antidote to many of the problems associated