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"Research on the couch": developing and appraising case studies in clinical practice



The workshop consisted of two parts: 1) an exploration of the significance of case studies in clinical practice, and 2) a new form of appraisal through Case Study Evaluation-tool (CaSE), which seeks to strengthen the position of case studies in the evidence-based practice. Through Freudian, Jungian and other classic psychoanalytic heritage, psychoanalytic case studies became home to mental phenomena that are difficult or impossible to study in a decontextualized manner. Detailed and intricate case narratives allow clinicians to gain an in–depth understanding of specific mental experiences across concrete clinical populations. But psychological experiences and their representation in psychoanalytic, and later, psychotherapy, case studies soon fell under pressing scrutiny. Critics quickly pointed out that it is difficult to generalize from single case studies, and, more importantly, that is difficult to differentiate between observations of clinical reality (what might be called the epistemic psychic reality) and therapist observations (altered by scientific biases and counter/transference processes). The growing demands of evidence-based practice deemed case studies as lacking in evidence, unstandardized, and unappraisable. The second part of the workshop challenged these claims by proposing a new approach to evidence and appraisal through Case Study Evaluation-tool (CaSE). CaSE Checklist and Framework approaches have been demonstrated with a worked example of a published psychoanalytic case study.
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