bluuebunny/crossref_metadata_2025 huggingface dataset:
Norman Corwin's The Lonesome Train (Decca Recording) 1944
Authors: Dunaway David K
Published: April 2014

The Lonesome Train, the cantata for radio with words by Millard Lampell, music by Earl Robinson, and directed by Norman Corwin, probably originated in a dilapidated brownstone on lower Sixth Avenue in Manhattan: The Almanac House, a radical commune for music organisers in Greenwich Village, including Pete Seeger and Woody Guthrie. Corwin is widely regarded as a guru of thoughtful radio producers, a poet-laureate of radio. From 1936, when he helped create WQXR-FM in New York City (later, voice of the New York Times) to his death 75 years later, Norman Corwin managed to be simultaneously commercial, popular, and experimental. The series in which The Lonesome Train appears, ‘Columbia Presents Corwin,’ was made up of dramatised readings, interview excerpts, dramatisations of historical moments - oral and terrifying creativity in the art, as opposed to the craft, of radio. For historians, story can be an impediment to actual recollection of an event; the more times the story of an event is told, the less value is its factual recollection. But for the documentarian, the challenge is to discover a dramatic plot in a series of facts. Faced with a fact that may or may not be accurate, but which adds spice to the narrative, a documentarian will often make the imaginative leap to include what reaches the audience most directly. Craft and artistry, as well as intended audience, inflect such hard choices. The cantata is an uncommon form of documentary but an evocative one. The musical mix of orchestra and chorus (and banjo picker) must not overwhelm readings, interview actuality, and dramatisations; in this, Robinson and Corwin were original and innovative. The story is strong, dramatically simple; A man, a train, and his spirit moving across the land. The work engages the audience by its multiple voices, dialoguing with the narrator and one another, and its elegiac, Whitmanesque themes and music. Instead of being a linear, complex account of Lincoln’s funeral train, this program uses the historical record as a springboard for a fantastic voyage.
Reviewer DAVID K. DUNAWAY is a biographer of Pete Seeger, a DJ at KUNM-FM, Professor of Radio at San Francisco State University, and Professor of English at the University of New Mexico.
The Hospital Always Wins: Review 2
Authors: Boyd Michelle
Published: April 2014

This documentary raises crucial questions about our definitions of mental health and healing as well as the meaning of forgiveness. It also illustrates how an individual’s ability to extract themselves from the grip of institutional power is highly dependent on luck and money and privilege. Perhaps most importantly, this piece gives voice, in a complex, respectful manner, to Ibrahim and other schizophrenics whose struggles remain buried and ignored. One element that is missing from this story is an account of how race complicates this unequal power dynamic. Ibrahim is black… “Hospital’s” impact might have been even wider had it briefly considered how the assumption of black male criminality might have played a role in Ibrahim’s long confinement.
Michelle Boyd’s work explores how ethnographic research methods, creative nonfiction writing and audio documentary can be combined to deepen public understanding, empathy, and critical consciousness about racial injustice. Michelle teaches in the African American Studies Department at the University of Illinois, Chicago. She reviews The Hospital Always Wins, produced by Laura Starecheski for State of the Re:Union (US 2013). Duration: 53’05’’. The Hospital Always Wins was named among the best audio narratives of 2013 by Harvard University’s Nieman Storyboard.
The Case of "Sonia" Through the Lens of Dialectical Behavior Therapy
Authors: Geisser Sara , Rizvi Shireen L.
Published: April 2014

Scherb (2014) describes the case of Sonia, a 44-year-old woman with severe and complex presentation of borderline personality disorder, along with diagnoses of bipolar disorder, trichotillomania, borderline intellectual functioning, and obesity. At the end of 10 years of therapy with decreasing frequency, Sonia has made a dramatic recovery from almost all of her presenting symptoms. Scherb's therapeutic approach was based on Fernández-Álvarez's Integrative Psychotherapy Model, which incorporates behavioral, cognitive, and emotional components. In this commentary we look at Sonia's psychopathology and treatment through the lens of Dialectical Behavior Therapy, a highly developed treatment model that has shown impressive success in treating individuals with borderline personality disorder and that also combines behavioral, cognitive, and emotional components. A comparison of a DBT approach to Sonia's case with the approach Scherb actually employed reveals many similarities in proposed treatment strategies, as well as differences in the format and delivery of treatment.
An "Incurable" Schizophrenic: The Case of Mr. X
Authors: Karon Bertram P.
Published: April 2014

Mr. X, a schizophrenic, was evaluated by all his psychiatrists as “incurable” after several years of unsuccessful outpatient and two months of inpatient treatment, both with medications.  Electro-convulsive therapy (ECT) was strongly but pessimistically recommended.  He was not eating, not sleeping, and continuously hallucinating.  He began outpatient psychoanalytic therapy.  All medications were stopped.  After three days he began eating.  After four months he began working at an intellectually demanding job. After two years he could be assured that he would never be psychotic again under normal stresses.  But that was not good enough for him.  He kept raising new issues: problems in living, difficulties writing his first book, psychosomatic problems, problems in enjoying ordinary pleasures, marital problems, undoing problems he had caused his son.  The total treatment took 14 years.  More than 20 years after the completion of treatment the patient sent a note indicating his continued professional accomplishments and thanking the therapist for “giving me my life back.”
Psychotherapy Can Be Helpful for Schizophrenics
Authors: VandenBos Gary R.
Published: April 2014

Karon’s work with Mr. X reflects the model that he and I use generally in doing psychoanalytic psychotherapy with schizophrenic patients. In my experience, this work is frequently met with considerable skepticism and at times outright antagonism from the professional mental health community. In this commentary I explore 10  possible reasons for these negative reactions and why I believe the reactions are off target from the central clinical fact that Karon’s model has a track record of success. These reasons include such areas as the roles of diagnosis, medication, a detailed developmental history, the therapist’s distinctive personality and style, and the therapist’s level of activity in treating patients diagnosed as schizophrenic.
Karon's Case of "Mr. X" and the "International Society for the Psychological Treatments of Schizophrenia and Other Psychoses" (ISPS)
Authors: Silver Anne-Louise S.
Published: April 2014

This Commentary on the case study of Mr. X places Bertram Karon’s (2008) work in the contexts of (a) the current treatment of people suffering from psychotic disorders; (b) Karon’s historical connections with the ideas of such pioneering, humanistically oriented, psychodynamic psychiatrists as Frieda Fromm-Reichmann and Sándor Ferenczi; (c) the mission and work of the International Society for the Psychological Treatments of Schizophrenia and Other Psychoses (ISPS) and its U.S. chapter (ISPS-US); and (d) the ongoing struggle in psychiatry over the evidential legitimacy of the psychodynamic treatment of psychosis and schizophrenia. I conclude by pointing out that empirical details about process and outcome in the psychodynamic treatment of schizophrenia as documented in cases like Karon’s help to provide one source of such evidential legitimacy.
Deconstructing Demons: The Case of Geoffrey
Authors: Mohlman Jan , Cedeno Linda A. , Price Rebecca B. , Hekler Eric B. , Yan Grace W. , Fishman Daniel B.
Published: April 2014

Research in late life mental health has not kept pace with the rapidly aging population of the U.S.  Older adults (over age 65), more specifically the “baby boomer” cohort, are likely to pose unique challenges to mental health care providers.  This report describes the case of Geoffrey, a 66-year-old African American male who presented with a complex range of psychiatric conditions (e.g., major depressive disorder, social anxiety disorder, and a history of polysubstance dependence), and challenging life circumstances (e.g., limited financial and social resources, and poorly controlled medical illness).  Because Geoffrey also evidenced impairment in several cognitive domains (attention, memory, executive functions), a combined intervention of executive skills training (Sohlberg, Johnson, Paule, Raskin, & Mateer, 2001) and cognitive behavior therapy (CBT) was selected.  Furthermore, because time for conducting therapy was limited (fourteen, 90-minute sessions over a ten-week period), a “transdiagnostic” approach was taken to maximize efficiency.  Results suggest the utility of augmented, transdiagnostic therapies to achieve optimal response with older clients.  Although Geoffrey’s intervention progressed well, an event occurring late in treatment changed the course of therapy and led to an unexpected outcome.  Several noteworthy aspects of the intervention, including the relevance of Geoffrey’s case to the current aging trend in the U.S., the use of a combined transdiagnostic intervention, and aspects of the therapy process are discussed throughout.
Adapting Older Adults to Cognitive Behavior Therapy and Vice Versa: The Case of Geoffrey
Authors: Knight Bob G.
Published: April 2014

Mohlman et al.’s (2008) case history of Geoffrey makes a compelling case for adding training to improve cognitive functioning in older adults to enhance responsiveness to CBT.  They also provide by example a demonstration of therapist flexibility in working with older adults.  Along with attention to the influence of cohort differences and ethnic differences, the case provides a good model for what changes in working with older clients.
When Novice Therapists Meet Their First Patients: Reflections and Questions on Training in CBT
Authors: Huppert Jonathan D. , Carmeli Gil , Gilon Daniel
Published: April 2014

Hougaard et al.(2008) report a case series on a mixed individual and group treatment for social phobia, suggesting that the treatment is efficacious. As a group who has just embarked on a similar training program, we comment on their endeavor from the teacher/student perspective with an eye towards pedagogy in training students to conduct CBT. Thoughts and questions regarding the treatment, the patients, the therapists, and the outcomes are raised in order to highlight the potential that exists in such training models.
The Case of Ms. Q: A Demonstration of Integrative Psychotherapy Guided by "Core Clinical Hypotheses"
Authors: Ingram Barbara Lichner
Published: April 2014

This case study describes the treatment of a married mother—Ms. Q—in her mid-thirties who sought help for making major life decisions that involved her marriage, career, obligations as a parent, and self-development. A model and method for conducting theoretically integrated therapy as described in the author’s book, Clinical Case Formulations (Wiley, 2006), is illustrated through case formulation charts and narrative discussion of the choice points in therapy with Ms. Q. The treatment integrated clinical hypotheses from five theoretically differentiated categories: existential/spiritual (issues of choice, responsibility, commitment, meaning and creativity); psychodynamic (conflicting inner parts, immature “self,” and unresolved guilt and abandonment fears from past relationships); cognitive (faulty schemas about responsibility, parenting, and marriage); behavioral/learning (conditioned emotional responses and lack of skills in decision making, emotional regulation, and marital communication); and social/cultural/environmental (family systems factors, issues of culture and gender, and need for appropriate work environment.)
Individualizing Exposure Therapy for PTSD: The Case of Caroline
Authors: Kramer Ueli
Published: April 2014

In therapy for chronic posttraumatic stress disorder (PTSD), prolonged exposure (PE) to stimuli associated with an original trauma experience is considered a state-of-the-art treatment method. The present case report outlines the use of  Foa and Rothbaum’s (1998) manual for this type of treatment in the year-long, 40-session treatment of Caroline, an adult female victim of child sexual abuse. The manual was supplemented by Caspar’s (1995, 2007) Plan Analysis technique for individualized case formulation and treatment planning, along with Caspar’s concept of the Motive-Oriented Therapeutic Relationship (MOTR). As indicated by standardized, quantitative measures, by changes in the client’s behavior patterns, and by the client’s subjective report, the treatment was very effective. An analysis of the therapy process illustrates the importance of a combination of manual-based procedures with individualized case formulations and interventions. The case is discussed in the context of enhancing the cognitive-behavioral treatment of PTSD.
Manualized Psychotherapies in the "Real World"
Authors: Muller Katherine L
Published: April 2014

Manualized psychotherapies, especially those that are cognitive-behavioral in nature, are becoming an increasingly important part of everyday clinical practice. While this development is exciting, it also poses certain challenges. In this context, Kramer (2009) describes a modified application of Foa and Rothbaum’s Prolonged Exposure (PE; Foa & Rothbaum, 1998) with Caroline, a 26-year-old woman with a history of depression and posttraumatic stress disorder (PTSD). Kramer pairs this manualized cognitive-behavioral psychotherapy with an enhanced case conceptualization and treatment plan utilizing Caspar’s Plan Analysis approach (Caspar, 2007). This commentary reviews the case, evaluates the application of PE, and offers suggestions for future use of manualized treatments in "real world" clinical settings.
Using Case Studies to Develop Theory: Roadmap to a Dialogue
Authors: Fishman Daniel B.
Published: April 2014

This issue’s target article by William Stiles (2009) presents a general paradigm that explains how the "logical operations" of deduction, induction, and abduction can be applied to case-study-level observations in order to build, test, and refine applied psychology theories in areas like psychotherapy. Stiles’ paradigm is exemplified in the development of his own "assimilation model" of psychological change across many types of successful therapy. The subsequent commentaries, written by nine well-known psychologists representing a wide diversity of perspectives and expertise, fall into three general categories. These include illustrations of the usefulness of Stiles paradigm, and critiques of the Stiles paradigm as either being "insufficiently grounded" in mainstream scientific method and philosophy of science, or being "too grounded" in traditional science and not open to new philosophical developments in the areas of moral theory, pragmatic approaches to truth, and methodical hermeneutics. Because of the richness of the issues raised here, publication of further dialogue between Stiles and the commentators is planned for 2010.
Lurching Toward Theory: The Case of Case Study Research in Conflict Mediation
Authors: Kressel Kenneth
Published: April 2014

William Stiles (2009) makes a cogent argument for the value of case study methods for building practice relevant theory in psychotherapy. My use of case study methods in the domain of conflict mediation, an area of professional practice in which more traditional empirical methods have largely failed to answer questions of most interest to practitioners, well illustrates many of Stiles’ points. Although mediation has more delimited objectives than psychotherapy and is practiced by many individuals with little if any mental health training, its practitioners face the same challenge of exerting influence in situations of considerable tension, ambivalence, and unpredictability. Stiles’ argument for the case study as a theory building device resonates most strongly with my own experience in three major ways: (1) The value of the case study for connecting theory to practice; (2) the capacity of the case study to capitalize on problematic or unique experiences; and (3) the ability of case studies to generate the kind of rich observations that allow theories to be productively modified and adapted.  I illustrate these points by describing my gradual movement towards a theory of expert mediation practice in a series of case study investigations in three diverse domains: divorce mediation in a family court; the management of conflict in a university medical center; and the mediation of conflict among scientists by ombudsmen-mediators at The National Institutes of Health.
Forensic Evaluations Advance Scientific Theory: Assessing Causation of Harm
Authors: Goodman-Delahunty Jane , Foote William E.
Published: April 2014

As a basis for psychological theory construction, Stiles (2009) proposes connecting theory and practice in single, qualitative case studies as an alternative to group-experimental approaches. In this paper, we apply Stiles’ model to determine the causation of psychological injuries within individual cases in forensic settings—in other words, to develop a theory of causation within individual forensic cases. The specific example considered is that of a sexual harassment complainant. This is a case-based context in which the dimensions of the case study are framed by the referral questions of the retaining counsel and by the law in that jurisdiction. Forensic evaluators in sexual harassment and other workplace discrimination cases may use a three-stage model to assess the status of the sexual harassment plaintiff before the alleged harassment, during those events, and following harassment incidents. By examining the complainant’s status at these three times, the forensic examiner can more accurately develop a theory relevant to a particular complainant for determining legal causation and for distinguishing between symptoms or problems compensable by the defendant and those which are a result of other life events. Using Stile’s formulation, this model also demonstrates the use of deductive, inductive and abductive logic in the evaluation process to more effectively build and test theories relevant to the forensic issues.
Case Studies and Non-Abstractionist Theorizing
Authors: Yanchar Stephen C.
Published: April 2014

Case studies offer a unique methodological resource for studying human practices in real-world settings and have the potential to facilitate non-abstractionist theorizing that may be especially useful to practitioners. Stiles’ contribution regarding deduction, induction, and abduction in theory development—via case study methods—raises important, but often ignored, issues and suggests several ways that cases can facilitate this practically-oriented theoretical work.
The Logic of Case-Study Methodology
Authors: Held Barbara S.
Published: April 2014

The question of how we deploy logic in developing and justifying scientific theories of any sort is an important one.  In this commentary, I consider William Stiles’ (2009) arguments about the logical operations that are deployed especially in theory-building case-study research in psychotherapy.  My commentary contains three sections, defined by three sets of distinctions:  (a) the distinction between description and explanation in theory building, (b) the distinction between theory building and theory justification, and (c) the distinction between nomothetic and idiographic approaches to theory building in case-study methodology.
Capturing (and Communicating) Complexity: Adapting CBT for Clients with Multiple Diversity
Authors: Bedoya C. Andres , Safren Steven A.
Published: April 2014

Due to the increasing diversity of the U.S. population, practitioners of cognitive-behavioral therapy (CBT) and other evidenced-based psychotherapies are often called on to adapt interventions for use with their diverse clients. There are few tools available to guide what steps are needed to culturally adapt interventions, yet such a framework is needed to move the field forward. In this context, Glassgold (2009) describes her use of gay-affirmative psychotherapy, utilizing adapted CBT interventions and other psychotherapeutic techniques with “Felix,” a Latino gay male client. This commentary uses the case of Felix as a point of departure to add to the discussion of cultural competence as it relates to a client from two minority groups (Latino ethnicity and gay sexual orientation). At the same time, we discuss some of the psychotherapeutic interventions employed by Glassgold and how they relate to merging evidenced-based treatment with traditional psychotherapeutic techniques and the adaptations needed when working with sexual minority and ethnic minority clients.
The Use of Cognitive-Behavioral Therapy to Promote Authenticity
Authors: Pachankis John E.
Published: April 2014

Glassgold’s (2009) case study offers an excellent example of combining LGB-specific empirical findings with established treatments that have been shown to work for the general treatment-seeking population. In doing so, she helps her client, Felix, take a stand about who he is as a gay man and thus move towards a more authentic self.  I focus this commentary on 1) the potential hazards of masculine ideology on gay male development, 2) the use of cognitive-behavior therapy (CBT) to promote our gay clients’ authenticity in the face of challenges to healthy sexual orientation development, and 3) the need for empirical tests of the integration of LGB-specific research findings into established treatment approaches. Although the field still awaits controlled trials of affirmative approaches to LGB-specific clinical issues, this should not stop clinicians from drawing on the relevant empirical work to facilitate successful treatments of our LGB clients’ presenting issues. Glassgold’s approach serves as an excellent example of the integration of this research into a cognitive-behavioral conceptualization of anxiety and panic.
"Back to the Future" Therapy: Its Present Relevance, Promise, and Implications
Authors: Farnsworth Jacob , Sewell Kenneth W.
Published: April 2014

Palgi and Ben-Ezra (2010) describe an intriguing approach to the treatment of acute stress responses in persons whose memory for a recent traumatic event has not yet consolidated -- an approach they call "Back to the Future" therapy (BFT). The present article examines BFT on several dimensions: theoretical fidelity, applicability, and potential for empirical investigation. BFT shows considerable promise as a treatment for a subset of persons who experience a traumatic stressor. The greatest challenges now for users of BFT include both identifying persons most likely to benefit from BFT, and systematically evaluating the effectiveness of the approach.
The Role of Religion and Spirituality in Olav's Treatment and Recovery: Commentary on an Exemplary Case Report
Authors: Richards P. Scott
Published: April 2014

The Case of Olav (Stalsett, Engedal, & Austad, 2010) offers in-depth insight from a spiritually and existentially informed psychodynamic perspective of how religious and spiritual issues may be intertwined with psychopathology. This case report also shows how psychological and spiritual interventions can be used in an integrative manner to help patients with severe long-term psychopathology. Ultimately the case provides convincing quantitative and qualitative evidence that an in-depth working through of Olav's pathological inner representations of self and God were instrumental in his psycho-spiritual healing and recovery.
Autobiographical Memory Narratives in Psychotherapy: A Coding System Applied to the Case of Cynthia
Authors: Singer Jefferson A. , Bonalume Laura
Published: April 2014

Recent cognitive and psychodynamic oriented therapies have converged on the powerful role that narrative processing plays in psychotherapy. Although previous coding systems have examined specific aspects of memory narratives, there are no comprehensive methods for coding segments of clinical evaluations or psychotherapy sessions that zero in on the unit of a briefly recounted autobiographical memory narrative.   The present single case study aims to introduce and to demonstrate the Coding System for Autobiographical Memory Narratives in Psychotherapy (CS-AMNP; Singer & Bonalume, 2008) with a young female client whom we  call "Cynthia."  We applied this autobiographical memory narrative approach to the diagnostic interview of Cynthia in evaluation for psychotherapy and compared predictions based on its results to the clinician’s report of Cynthia's actual therapeutic outcome.  This study demonstrates the utility of the coding system for personality assessment and case conceptualization in the service of ongoing treatment.  In addition, implications of this coding system for future research, clinical practice, and training are discussed.
Using Systematic Case Studies to Investigate Therapist Responsiveness: Examples from a Case Series of PTSD Treatments
Authors: Edwards David J.A.
Published: April 2014

This article highlights the emerging literature on therapist responsiveness in psychotherapy and examines several concepts used to identify dimensions of responsiveness. Some methodological obstacles are identified to studying responsiveness in a systematic manner, and several examples of existing responsiveness research are reviewed.  It is argued that meaningful theory on responsiveness has emerged from research methods that are qualitative and interpretive and that the writing of systematic case studies can be of particular importance since only the presentation of a case unfolding over time can disclose some of the more complex aspects of therapist responsiveness.  Examination of a series of systematic case studies of the treatment of posttraumatic case disorder in South Africa was used to derive a model for guiding therapist responsiveness with respect with what to focus on at a particular phase of the therapy within a particular session.  Material from the cases is used to illustrate aspects of the model related to building social support for the client and promoting emotional processing of trauma memories.
Case Studies Help Us Read Between the Lines of Manual-Driven Therapy
Authors: Eells Tracy D.
Published: April 2014

Edwards’ (2010) article illuminates the benefits of systematic case series analysis in exploring metacompetencies such as therapist responsiveness.  These benefits are unique contributions of systematic case analyses since the situational and temporal contexts provided by cases are  lost in group comparison research such as randomized clinical trials.  For this reason, the two approaches triangulate well with each other, in the sense described by Edwards.  Aggregation of findings from multiple cases facilitates generalization.  Edward’s systematic case series of PTSD treatments demonstrates one important and pragmatic way in which this generalization can be accomplished.  I discuss Edward’s approach to studying therapist responsiveness in light of methodology, theory-building, training, and case formulation.
A Promising Strategy for Critically Evaluating Case Studies: Introduction to an Issue on the Adjudicated Case Study Method
Authors: Fishman Daniel B.
Published: April 2014

This introduction is designed to orient the reader to the 11 articles that comprise this issue of PCSP. The theme of the articles is an exploration of the adjudicated case study method. The  rationale for this approach is first outlined below. This is followed by a brief description of the three different types of adjudicated case study methods presented and illustrated by specific case studies in this issue. These include: Ronald B. Miller's "Panels of Psychological Inquiry" model; Arthur C. Bohart's "Research Jury Method"; and Robert Elliott's "Hermeneutic Single Case Design" model. This article series ends with a commentary by Susan Stephen and Robert Elliott on issues that cross cut the three models, with the implications of these issues for improving the overall adjudication method.
Contrasting Two Clients in Emotion-Focused Therapy for Depression 1: The Case of "Tom," "Trapped in the Tunnel"
Authors: Watson Jeanne C. , Goldman Rhonda N. , Greenberg Leslie S.
Published: April 2014

The objective in this paper is to present a case drawn from a series of randomized clinical trials (RCT) comparing brief (16-20 sessions), emotion-focused therapy (EFT) the process experiential approach with client-centered therapy and cognitive-behavioral therapy in the treatment of depression.  A case comparison method that triangulates data from clients’ histories, in-session process, post-session questionnaires, and post-therapy outcome measures was used to increase understanding of those factors that contribute to successful and unsuccessful outcomes.  The case comparison method examines the role of the working alliance, clients’ emotional processing, clients’ and therapists’ interpersonal processes, and clients’ cognitive processing, as well as the specific changes that clients report immediately following their sessions that have been found to be related to therapeutic outcomes.  The method is illustrated with two examples one a poor outcome case and the other a good outcome case The poor outcome case of "Tom" is presented in this article, and the good outcome case of "Eloise" is presented in the next article by Goldman, Watson, and Greenberg (2011). These two cases extend and build on the cases presented by the authors in their book Case Studies in Emotion-Focused Treatment of Depression: A Comparison of Good and Poor Outcome (Watson, Goldman, & Greenberg, 2007), in which six clients, three good outcome and three poor outcome, were compared and contrasted using the case-comparison method.
Contrasting Two Clients in Emotion-Focused Therapy for Depression 2: The Case of "Eloise," "It's Like Opening the Windows and Letting the Fresh Air Come In"
Authors: Goldman Rhonda N. , Watson Jeanne C. , Greenberg Leslie S.
Published: April 2014

This paper presents a good-outcome case of "Eloise," an individual drawn from the York II Depression study and treated with emotion-focused therapy (EFT) (Goldman, Greenberg, & Angus, 2006). Using the case comparison method, this study considers data from an observer-rated measure of emotional processing during therapy, the client's perceptions of change as measured by post-session and post-therapy questionnaires, the therapist's perceptions of change as measured by post-session reports, and post-therapy interview data, to form an understanding of factors that contributed to change. Eloise's case study is designed to compare and contrast with Watson, Goldman, and Greenberg's (2011) case study of Tom, a poor-outcome case drawn from a similar RCT. The Eloise and Tom case studies extend and build upon the cases presented by the authors of Case Studies in Emotion-Focused Treatment of Depression: A Comparison of Good and Poor Outcome (Watson, Goldman, & Greenberg, 2007), which consist of three good outcome and three poor outcome clients compared and contrasted using the case-comparison method.
Theory Development via Single Cases: A Case Study of the Therapeutic Relationship in Psychodynamic Therapy
Authors: Messer Stanley B.
Published: April 2014

The goals of this paper are (a) to demonstrate how study of the therapeutic alliance in single cases of psychodynamic therapy can exemplify and instantiate theoretical concepts and lead to the development or refinement of psychotherapy theory, research and practice, as illustrated in the case of Ron and in Hans Strupp's classic analyses of pairs of comparable successful and unsuccessful cases; (b) to point out methodological challenges of case studies as a source of reliable and valid data; and (c) to illustrate the greater influence of clinical case studies compared to research reviews of the psychotherapy literature on the practitioner.
Defenses in Interpersonal Interaction: Using a Theory-Building Case Study to Develop and Validate the Theory of Interpersonal Defense
Authors: Westerman Michael A.
Published: April 2014

I investigated interpersonal defense theory, an interpersonal reconceptualization of defense processes, using the theory-building case study approach. Close examination of patient-therapist interaction during a psychotherapy session provided support for tenets of the theory. The analyses of the clinical material also elucidate some of the key concepts of interpersonal defense theory. Those concepts include a new way of conceptualizing the nature of problematic interpersonal behavior, which offers a novel approach to understanding patients' contributions to the alliance and transference phenomena. The analyses also clarify ideas from the theory about how defensive behavior on the part of one individual affects how the other person in a relationship behaves. These ideas lead to a new approach to countertransference, point away from common formulations of the self-fulfilling prophecy concept, and offer a novel response to the question of why dysfunctional processes persist. In addition to considering these substantive matters related to interpersonal defense theory, I also consider methodological issues related to the theory-building case study approach. The analyses presented illustrate the process of simultaneously examining whether multiple tenets from a theory are supported by observations on a single case, a crucial part of the theory-building case study approach that can make unique contributions to validating theories. I also discuss the role played by case formulations in the process of determining whether observations conform to theoretical tenets, which is an aspect of the logic of theory validation that has not been considered previously in the literature on the theory-building case study approach.
Empathy and Otherness: Humanistic and Phenomenological Approaches to Psychotherapy of Severe Mental Illness
Authors: Pienkos Elizabeth , Sass Louis A.
Published: April 2014

In this commentary, we respond to Atwood’s (2012) article, "Psychotherapy as a Human Science: Clinical Case Studies Exploring the Abyss of Madness," by highlighting some of the theoretical ideals that guide Atwood’s writing and his therapy work.  In particular, we consider how these case studies fit into the larger paradigm of humanistic psychology, and how this perspective informed Atwood’s work with his clients, providing him with the understanding and empathy that facilitated the therapeutic healing he describes.  We also consider the different, but complementary, idea in phenomenological psychiatry of "radical otherness," which suggests the fundamental impossibility of complete empathy, and how this can be therapeutic, particularly when treating cases of schizophrenia.  Finally, we discuss the contributions of phenomenology to the understanding of schizophrenia, and its implications for treatment.
The Many Complexities in Treating and Studying Narcissism
Authors: Levy Kenneth N.
Published: April 2014

In this commentary I examine conceptual and methodological issues in Dr. Riordan's (2012) presentation of three cases treated using Mitchell’s integrative model that combines aspects of Kernberg and Kohut's technical stances in the treatment of narcissism.  Riordan proposes that Mitchell's integrative model provides a useful blend of Kernberg's focus on defense and Kohut's focus on empathy. He then provides case material to illustrate the benefits of Mitchell’s model.  In discussing Riordan's paper, I focus on approaches to the case study method and present technical advances in Kernberg's approach that I believe address the concerns articulated by Riordan.  These issues are examined in the current context of evidence-based practice.
Exposure Therapy -- What Is It That We Are Selling?
Authors: Ramnero Jonas , Folke Fredrik
Published: April 2014

This discussion is a response to Muller and Schultz’s (2012) thoughtful commentary on our case series on treating Body Dysmorphic Disorder (BDD) in this issue of the Pragmatic Case Studies in Psychotherapy. We join Muller and Schultz in their dedication to exposure treatment. We  elaborate on their perceptive comments on what exposure is, and how it is presented, applied, and implemented most effectively, in the context of  BDD specifically. We conclude by briefly exploring some of the complexities of the theory underlying exposure therapy.
Values-Focused Exposure and Response Prevention in the Treatment of Comorbid Schizophrenia and Obsessive-Compulsive Disorder: The Case of "Mr. H"
Authors: Golden Ashleigh , Holaway Robert M.
Published: April 2014

We describe a subgroup of individuals with comorbid diagnoses of paranoid schizophrenia and obsessive-compulsive (OCD) disorder.  It is proposed that traditional exposure and response prevention (ERP) may need to be altered given the unique characteristics of this subgroup.  We suggest that providers may approach treatment for OCD from within the context of a patient’s delusion.  The case study of "Mr. H," a veteran of the U.S. military diagnosed with schizophrenia and OCD, is described.  We propose that attenuating or eliminating obsessions and compulsions may not result in the achievement of a goal stemming from a delusional belief, but may contribute to an increased sense of mastery and independence.
Considerations for Modifying Exposure and Response Prevention: The Cases of Mr. H and Angela
Authors: Austern David , Farber Tanya , Marinchak James
Published: April 2014

Exposure and response prevention (ERP) is considered the gold standard treatment for obsessive-compulsive disorder (OCD). However, when comorbidity or other clinically relevant issues arise, the standard ERP protocol may require modification. Golden and Holaway's (2013) case of "Mr. H" and Pontes and Pereira's (2013) case of "Angela" offer excellent examples of clients presenting with these clinical challenges.  Our commentary addresses some of the concerns raised by these authors by bringing in the emerging field of Distress Tolerance (DT) research.  Using examples from the authors’ cases, along with relevant research, we suggest that clinicians who wish to modify ERP consider the proposed alterations carefully by simultaneously thinking more broadly and more specifically about the psychopathology present. In addition, we stress the necessity of various forms of continual outcome monitoring.
The Anxiety Disorders Clinic for Children and Adolescents (TADCCA) at Aarhus University in Denmark
Authors: Thastum Mikael
Published: April 2014

This article serves as an introduction to the two case studies in this issue of PCSP.  The first is the single case of "Erik," a 12-year-old boy with cognitive difficulties and multiple anxiety disorders who was seen with his family in a cognitive behavioral therapy group program designed for children with anxiety problems. The second case study is one of the total group of six families in which Erik was participating; as such it includes a summary of Erik's case in the context of the other five who participated. The group was conducted by a combination of a senior doctoral clinical psychologist and eight students. They were part of a training clinic, called The Anxiety Disorder Clinic for Children and Adolescents (TADCCA), in the Educational and Research Clinic of the Department of Psychology at Aarhus University in Aarhus, Denmark. This article describes the background and context of the TADCAA in which the two case studies took place.
Sara, A Social Phobia Client with Sudden Change After Exposure Exercises in Intensive Cognitive-Behavior Group Therapy: A Case-Based Analysis of Mechanisms of Change
Authors: Jensen Vicki L. , Hougaard Esben , Fishman Daniel B.
Published: April 2014

This case study deals with Sara, a 37-year-old social phobic woman who suffered from a primary fear of blushing as well as comorbid disorders, including obsessive-compulsive disorder, generalized anxiety disorder and spider phobia. The client was treated in an intensive, one-week group cognitive-behavioral therapy program in an educational university clinic in Aarhus, Denmark. She achieved a remarkable and durable change in her longstanding social phobia after two in-session behavioral experiments conducted during the third and fourth days of the program. After treatment, the client was interviewed about her sudden gain, and she read and commented on the case study report. The primary aim of the study was to investigate the micro-level mechanisms of change for this particular client, and thereby illustrate the prospects of pragmatic case studies in meticulous process research focusing on one of the most intricate problems in psychotherapy: how does treatment work.
"Cool Kids" in Denmark: Commentary on a Cognitive-Behavioral Therapy Group for Anxious Youth
Authors: Perini Sarah J. , Wuthrich Viviana M. , Rapee Ronald M.
Published: April 2014

Two case studies by Lundkvist-Houndoumadi and Thastum (2013a, 2013b) describe the use of the Cool Kids cognitive behavioral therapy program for anxious children and their parents, which was conducted at their Clinic at the University of Aarhus in Denmark. In providing our reactions to these two fascinating and illuminating articles, we first familiarize readers with the Cool Kids program, including both its nature, range, and evidence base. This is followed by a discussion of some relevant issues and complications in doing therapy with anxious children that are illustrated by these case studies, including the motivation of both anxious children and their parents; the therapeutic role of exposure to anxious situations; a modular approach to accommodate individual variation; group versus individual format; directly addressing parental anxiety problems; and the cost-effectiveness of treatment.
Introduction: International Research Ethics Education
Authors: Millum Joseph , Sina Barbara
Published: April 2014

NIH's fogarty international Center has provided grants for the development of training programs in international research ethics for low- and middle-income (LMIC) professionals since 2000. Drawing on 12 years of research ethics training experience, a group of Fogarty grantees, trainees, and other ethics experts sought to map the current capacity and need for research ethics in LMICs, analyze the lessons learned about teaching bioethics, and chart a way forward for research ethics training in a rapidly changing health research landscape. This collection of papers is the result.
Evaluating International Research Ethics Capacity Development: An Empirical Approach
Authors: Ali Joseph , Kass Nancy E. , Sewankambo Nelson K. , White Tara D. , Hyder Adnan A.
Published: April 2014

The us national institutes of health, Fogarty International Center (NIH-FIC) has, for the past 13 years, been a leading funder of international research ethics education for resource-limited settings. Nearly half of the NIH-FIC funding in this area has gone to training programs that train individuals from sub-Saharan Africa. Identifying the impact of training investments, as well as the potential predictors of post-training success, can support curricular ***decision-making, help establish funding priorities, and recognize the ultimate outcomes of trainees and training programs. Comprehensive evaluation frameworks and targeted evaluation tools for bioethics training programs generally, and for international research ethics programs in particular, are largely absent from published literature. This paper shares an original conceptual framework, data collection tool, and detailed methods for evaluating the inputs, processes, outputs, and outcomes of research ethics training programs serving individuals in resource-limited settings. This paper is part of a collection of papers analyzing the Fogarty International Center's International Research Ethics Education and Curriculum Development program.
Fogarty Research Ethics Training Programs in the Asia-Pacific: The Merging of Cultures
Authors: Pratt Bridget , Van Cassandra , Trevorrow Emily , Loff Bebe
Published: April 2014

In-depth interviews were undertaken with nine principal investigators and 16 former trainees from eight FIC programs recruiting trainees from the Asia-Pacific to assess the impact of training. Incorporation of new knowledge into teaching, research, and medical practice; advanced training; and ethics committee participation were the most common outcomes identified. When attempting to implement ethics activities post-training, trainees often had to contend with opposition from more senior staff. Approaches that enhanced the cultural relevance of program content were identified as necessary, including comparing/contrasting non-Western principles and religions with Western bioethics, using region-specific case studies, and integrating clinical and research ethics. Best practices associated with program and trainee success included selecting more senior trainees clustered within Asia-Pacific institutions, offering a variety of degree and nondegree options, and post-training mentorship and networking support. This paper is part of a collection of papers analyzing the Fogarty International Center's International Research Ethics Education and Curriculum Development program.
Twelve Years of Fogarty-Funded Bioethics Training in Latin America and the Caribbean: Achievements and Challenges
Authors: Saenz Carla , Heitman Elizabeth , Luna Florencia , Litewka Sergio , Goodman Kenneth W. , Macklin Ruth
Published: April 2014

The landscape in research ethics has changed significantly in Latin America and the Caribbean over the past two decades. Research ethics has gone from being a largely foreign concept and unfamiliar practice to an integral and growing feature of regional health research systems. Four bioethics training programs have been funded by the Fogarty International Center (FIC) in this region in the past 12 years. Overall, they have contributed significantly to changing the face of research ethics through the creation of locally relevant training materials and courses (including distance learning), academic publications, workshops, and conferences in Spanish, and strengthening ethics review committees and national systems of governance. This paper outlines their achievements and challenges, and reflects on current regional needs and what the future may hold for research ethics and bioethics training in Latin America and the Caribbean.