Observational Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 6, 2020; 8(13): 2787-2801
Published online Jul 6, 2020. doi: 10.12998/wjcc.v8.i13.2787
Case studies in psychotherapy training using Austria as an example
Ela Neidhart, Henriette Löffler-Stastka
Ela Neidhart, Henriette Löffler-Stastka, Department of Psychoanalysis and Psychotherapy, and Teaching Center – Postgraduate Unit, Medical University of Vienna/General Hospital of Vienna, Vienna 1090, Austria
Author contributions: Neidhart E was the guarantor and designed the study; Löffler-Stastka H provided critical revision of the article for important intellectual content.
Institutional review board statement: The study was reviewed and approved by the Ethikkommission der Medizinischen Universität Wien.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Henriette Löffler-Stastka, Department of Psychoanalysis and Psychotherapy, and Teaching Center – Postgraduate Unit, Medical University of Vienna/General Hospital of Vienna, Waehringer Guertel 18-20, A-1090, Vienna 1090, Austria. henriette.loeffler-stastka@meduniwien.ac.at
Received: March 9, 2020
Peer-review started: March 9, 2020
First decision: April 22, 2020
Revised: June 15, 2020
Accepted: July 1, 2020
Article in press: July 1, 2020
Published online: July 6, 2020
Abstract
BACKGROUND

Case studies (CS) are relevant for the development of theoretical and practical competencies in psychotherapy. Despite rapid progress in the development of methods and principles for establishing CS in the last three decades, research into the aims of CS, especially in training, or how CS are to be conducted is rare.

AIM

To elucidate the form and methodology of CS, the objectives of CS used in training institutions (TI), and if/how TIs handle therapist allegiance. Also, this preliminary investigation will suggest avenues for further research and attempt to establish certain guidelines.

METHODS

In order to counteract researcher bias and enlarge the question-pool, a focus group was established. The recorded and transcribed text was analyzed with Mayring’s method of qualitative content analysis, and the generated categories were formulated as questions. The resulting questionnaire with both qualitative and quantitative queries was sent out (after pre-testing) to all 39 Austrian TIs that provide professional psychotherapy training. The answers and text passages received were then also categorized with qualitative content analysis. Data analysis was discussed by a peer group consisting of three psychotherapists trained in differing schools of psychotherapeutic methods.

RESULTS

94% of Austrian institutes use CS as part of their psychotherapeutic training. Understanding of the term “case study” is inconsistent and has a wide variety of interpretations. CS serve mainly: (1) For observation of training/progress in therapeutic practice and knowledge/acquisition of the theory specific to each psychotherapeutic school; (2) To improve (self-)reflection capabilities; and (3) To expand theoretical knowledge. Most of the CS written are not accessible for students nor for the research community. More than two thirds of the CS take only the position of the author into account (the client’s position is not described). 15.5 % of the TIs do not consider researcher or therapist allegiance at all.

CONCLUSION

A more precise formulation of the term case study is needed in psychotherapeutic training. The training therapists play a key function, as they exemplify and teach how to deal with distorting factors. General guidelines as to how to conduct CS in training institutions would provide more direction to students, increase scientific rigor, and enhance synergistic effects.

Keywords: Case study, Psychotherapy training, Case study research, Therapist allegiance, Researcher bias

Core tip: Case studies are commonly used in psychotherapy training for theoretical and practical development of psychotherapeutic competencies. Yet there is hardly any research into if or how clinical case studies are used in training programs. This exploratory study gives the first glimpse into the training landscape in Austria, to our knowledge. Thirty-nine training institutes were investigated, and the results led to the conclusion that further research is necessary in order to define the term “case study” in psychotherapeutic training more precisely, create research-based guidelines for case studies, and deal with bias stemming from school and/or researcher allegiance.