Case studies are in-depth investigations of a person, group, event, or community. Typically, data is gathered from various sources using several methods (e.g., observations & interviews).
The case study research method originated in clinical medicine (the case history, i.e., the patient’s personal history). In psychology, case studies are often confined to the study of a particular individual.
The information is mainly biographical and relates to events in the individual’s past (i.e., retrospective), as well as to significant events that are currently occurring in his or her everyday life.
The case study is not a research method, but researchers select methods of data collection and analysis that will generate material suitable for case studies.
Freud (1909a, 1909b) conducted very detailed investigations into the private lives of his patients in an attempt to both understand and help them overcome their illnesses.
This makes it clear that the case study is a method that should only be used by a psychologist, therapist, or psychiatrist, i.e., someone with a professional qualification.
There is an ethical issue of competence. Only someone qualified to diagnose and treat a person can conduct a formal case study relating to atypical (i.e., abnormal) behavior or atypical development.
Examples
Famous Case Studies
- Anna O – One of the most famous case studies, documenting psychoanalyst Josef Breuer’s treatment of “Anna O” (real name Bertha Pappenheim) for hysteria in the late 1800s using early psychoanalytic theory.
- Little Hans – A child psychoanalysis case study published by Sigmund Freud in 1909 analyzing his five-year-old patient Herbert Graf’s house phobia as related to the Oedipus complex.
- Bruce/Brenda – Gender identity case of the boy (Bruce) whose botched circumcision led psychologist John Money to advise gender reassignment and raise him as a girl (Brenda) in the 1960s.
- Genie Wiley – Linguistics/psychological development case of the victim of extreme isolation abuse who was studied in 1970s California for effects of early language deprivation on acquiring speech later in life.
- Phineas Gage – One of the most famous neuropsychology case studies analyzes personality changes in railroad worker Phineas Gage after an 1848 brain injury involving a tamping iron piercing his skull.
Clinical Case Studies
- Studying the effectiveness of psychotherapy approaches with an individual patient
- Assessing and treating mental illnesses like depression, anxiety disorders, PTSD
- Neuropsychological cases investigating brain injuries or disorders
Child Psychology Case Studies
- Studying psychological development from birth through adolescence
- Cases of learning disabilities, autism spectrum disorders, ADHD
- Effects of trauma, abuse, deprivation on development
Types of Case Studies
- Explanatory case studies: Used to explore causation in order to find underlying principles. Helpful for doing qualitative analysis to explain presumed causal links.
- Exploratory case studies: Used to explore situations where an intervention being evaluated has no clear set of outcomes. It helps define questions and hypotheses for future research.
- Descriptive case studies: Describe an intervention or phenomenon and the real-life context in which it occurred. It is helpful for illustrating certain topics within an evaluation.
- Multiple-case studies: Used to explore differences between cases and replicate findings across cases. Helpful for comparing and contrasting specific cases.
- Intrinsic: Used to gain a better understanding of a particular case. Helpful for capturing the complexity of a single case.
- Collective: Used to explore a general phenomenon using multiple case studies. Helpful for jointly studying a group of cases in order to inquire into the phenomenon.
Where Do You Find Data for a Case Study?
There are several places to find data for a case study. The key is to gather data from multiple sources to get a complete picture of the case and corroborate facts or findings through triangulation of evidence.
Most of this information is likely qualitative (i.e., verbal description rather than measurement), but the psychologist might also collect numerical data.
1. Primary sources
- Interviews – Interviewing key people related to the case to get their perspectives and insights. The interview is an extremely effective procedure for obtaining information about an individual, and it may be used to collect comments from the person’s friends, parents, employer, workmates, and others who have a good knowledge of the person, as well as to obtain facts from the person him or herself.
- Observations – Observing behaviors, interactions, processes, etc., related to the case as they unfold in real-time.
- Documents & Records – Reviewing private documents, diaries, public records, correspondence, meeting minutes, etc., relevant to the case.
2. Secondary sources
- News/Media – News coverage of events related to the case study.
- Academic articles – Journal articles, dissertations etc. that discuss the case.
- Government reports – Official data and records related to the case context.
- Books/films – Books, documentaries or films discussing the case.
3. Archival records
Searching historical archives, museum collections and databases to find relevant documents, visual/audio records related to the case history and context.
Public archives like newspapers, organizational records, photographic collections could all include potentially relevant pieces of information to shed light on attitudes, cultural perspectives, common practices and historical contexts related to psychology.
4. Organizational records
Organizational records offer the advantage of often having large datasets collected over time that can reveal or confirm psychological insights.
Of course, privacy and ethical concerns regarding confidential data must be navigated carefully.
However, with proper protocols, organizational records can provide invaluable context and empirical depth to qualitative case studies exploring the intersection of psychology and organizations.
- Organizational/industrial psychology research: Organizational records like employee surveys, turnover/retention data, policies, incident reports etc. may provide insight into topics like job satisfaction, workplace culture and dynamics, leadership issues, employee behaviors etc.
- Clinical psychology: Therapists/hospitals may grant access to anonymized medical records to study aspects like assessments, diagnoses, treatment plans etc. This could shed light on clinical practices.
- School psychology: Studies could utilize anonymized student records like test scores, grades, disciplinary issues, and counseling referrals to study child development, learning barriers, effectiveness of support programs, and more.
How do I Write a Case Study in Psychology?
Follow specified case study guidelines provided by a journal or your psychology tutor. General components of clinical case studies include: background, symptoms, assessments, diagnosis, treatment, and outcomes.
Interpreting the information means the researcher decides what to include or leave out. A good case study should always clarify which information is the factual description and which is an inference or the researcher’s opinion.
1. Introduction
- Provide background on the case context and why it is of interest, presenting background information like demographics, relevant history, and presenting problem.
- Compare briefly to similar published cases if applicable. Clearly state the focus/importance of the case.
2. Case Presentation
- Describe the presenting problem in detail, including symptoms, duration,and impact on daily life.
- Include client demographics like age and gender, information about social relationships, and mental health history.
- Describe all physical, emotional, and/or sensory symptoms reported by the client.
- Use patient quotes to describe the initial complaint verbatim. Follow with full-sentence summaries of relevant history details gathered, including key components that led to a working diagnosis.
- Summarize clinical exam results, namely orthopedic/neurological tests, imaging, lab tests, etc. Note actual results rather than subjective conclusions. Provide images if clearly reproducible/anonymized.
- Clearly state the working diagnosis or clinical impression before transitioning to management.
3. Management and Outcome
- Indicate the total duration of care and number of treatments given over what timeframe. Use specific names/descriptions for any therapies/interventions applied.
- Present the results of the intervention,including any quantitative or qualitative data collected.
- For outcomes, utilize visual analog scales for pain, medication usage logs, etc., if possible. Include patient self-reports of improvement/worsening of symptoms. Note the reason for discharge/end of care.
4. Discussion
- Analyze the case, exploring contributing factors, limitations of the study, and connections to existing research.
- Analyze the effectiveness of the intervention,considering factors like participant adherence, limitations of the study, and potential alternative explanations for the results.
- Identify any questions raised in the case analysis and relate insights to established theories and current research if applicable. Avoid definitive claims about physiological explanations.
- Offer clinical implications, and suggest future research directions.
5. Additional Items
- Thank specific assistants for writing support only. No patient acknowledgments.
- References should directly support any key claims or quotes included.
- Use tables/figures/images only if substantially informative. Include permissions and legends/explanatory notes.
Strengths
- Provides detailed (rich qualitative) information.
- Provides insight for further research.
- Permitting investigation of otherwise impractical (or unethical) situations.
Case studies allow a researcher to investigate a topic in far more detail than might be possible if they were trying to deal with a large number of research participants (nomothetic approach) with the aim of ‘averaging’.
Because of their in-depth, multi-sided approach, case studies often shed light on aspects of human thinking and behavior that would be unethical or impractical to study in other ways.
Research that only looks into the measurable aspects of human behavior is not likely to give us insights into the subjective dimension of experience, which is important to psychoanalytic and humanistic psychologists.
Case studies are often used in exploratory research. They can help us generate new ideas (that might be tested by other methods). They are an important way of illustrating theories and can help show how different aspects of a person’s life are related to each other.
The method is, therefore, important for psychologists who adopt a holistic point of view (i.e., humanistic psychologists).
Limitations
- Lacking scientific rigor and providing little basis for generalization of results to the wider population.
- Researchers’ own subjective feelings may influence the case study (researcher bias).
- Difficult to replicate.
- Time-consuming and expensive.
- The volume of data, together with the time restrictions in place, impacted the depth of analysis that was possible within the available resources.
Because a case study deals with only one person/event/group, we can never be sure if the case study investigated is representative of the wider body of “similar” instances. This means the conclusions drawn from a particular case may not be transferable to other settings.
Because case studies are based on the analysis of qualitative (i.e., descriptive) data, a lot depends on the psychologist’s interpretation of the information she has acquired.
This means that there is a lot of scope for Anna O, and it could be that the subjective opinions of the psychologist intrude in the assessment of what the data means.
For example, Freud has been criticized for producing case studies in which the information was sometimes distorted to fit particular behavioral theories (e.g., Little Hans).
This is also true of Money’s interpretation of the Bruce/Brenda case study (Diamond, 1997) when he ignored evidence that went against his theory.
References
Breuer, J., & Freud, S. (1895). Studies on hysteria. Standard Edition 2: London.
Curtiss, S. (1981). Genie: The case of a modern wild child.
Diamond, M., & Sigmundson, K. (1997). Sex Reassignment at Birth: Long-term Review and Clinical Implications. Archives of Pediatrics & Adolescent Medicine, 151(3), 298-304
Freud, S. (1909a). Analysis of a phobia of a five year old boy. In The Pelican Freud Library (1977), Vol 8, Case Histories 1, pages 169-306
Freud, S. (1909b). Bemerkungen über einen Fall von Zwangsneurose (Der “Rattenmann”). Jb. psychoanal. psychopathol. Forsch ., I, p. 357-421; GW, VII, p. 379-463; Notes upon a case of obsessional neurosis, SE, 10: 151-318.
Harlow J. M. (1848). Passage of an iron rod through the head. Boston Medical and Surgical Journal, 39, 389–393.
Harlow, J. M. (1868). Recovery from the Passage of an Iron Bar through the Head. Publications of the Massachusetts Medical Society. 2 (3), 327-347.
Money, J., & Ehrhardt, A. A. (1972). Man & Woman, Boy & Girl: The Differentiation and Dimorphism of Gender Identity from Conception to Maturity. Baltimore, Maryland: Johns Hopkins University Press.
Money, J., & Tucker, P. (1975). Sexual signatures: On being a man or a woman.
