What are case study methodologies?

Introduction

In research using case study methodology, the researcher seeks to obtain a thorough knowledge and present a clear picture of an individual, a program, or a situation. Sometimes the researcher obtains this information over a long period of time. With the goal of investigating a contemporary phenomenon within its real-life context, case studies may include observations, interviews, anecdotes, vignettes, direct quotes, audiovisual materials, psychological testing, documents and reports, analysis, and naturalistic summaries. The richness of detail from these multiple sources makes case studies fascinating. In addition, the researcher typically provides key issues to illustrate the complexity of the situation. Often, the researcher ends with lessons learned or implications that might be applicable to similar cases.

Case study research has advantages and disadvantages. Advantages include being well-suited for the study of certain phenomena, particularly psychological disorders. Also, case studies can provide compelling illustrations to support a theory and can inspire new therapeutic techniques or unique applications of existing techniques. Disadvantages include depending on what observers choose to include, as their choices may be biased. Also, subjectivity makes it easy to see what one expects to see, and the person or phenomenon chosen for the case study may not be representative.

Qualitative versus Quantitative Research

Case study research is considered a
qualitative experimental method. The term qualitative refers to the fact that researchers collect data in face-to-face situations by interacting with selected persons in a natural setting such as a school, a home, or a community.

A related type of qualitative research method is narrative research, but significant distinctions exist. Narrative research is chronological in focus and tells the story of an individual. Case studies, in contrast, focus on an issue, with the case selected to provide insight into that issue. Therefore, the focus in case study research is not predominantly on the whole person, as in narrative research, but on the issue illustrated by the case. Also, in case study research, the analytic approach involves a detailed description of the case, the setting within its environmental and cultural context, and a presentation that may or may not be chronological.

A contrasting type of research method is quantitative. Quantitative experimental designs typically study groups of individuals and rely on objective information. Correlation designs tell the association between two variables. Randomized, controlled experimental trials have control groups and can rule out the impact of extraneous factors that might account for findings. Case studies, in contrast, typically focus on the individual, rely on anecdotal information, and have no control groups. Case studies do not provide the arrangements that permit conclusions that are as clear as those available from experimentation. However, case studies can show the impact of treatment on one or a few individuals and can lead to scientific hypotheses. In case studies, researchers do not confine themselves to asking a limited number of questions as they would in a survey or randomized, controlled experimental study. Rather, researchers try to be open to learning from the individual or situation. Both qualitative research and quantitative research have value; which one a researcher uses depends on the specific research question.

For example, a researcher interested in studying do-not-resuscitate (DNR) orders may use different kinds of research designs, including correlation research, randomized experimental design research, narrative research, or case study research. An example of a correlation design would be a survey asking people how much they knew about DNR orders and how long they stayed in the hospital, to see if there is an association between length of hospitalization and knowledge of DNR orders. An example of a randomized experimental design could be a project in which the researcher randomly assigns people to one of two groups. One group would receive standard instructions about their upcoming elective surgery; the other group would receive the same standard instructions, plus additional information about DNR orders. After discharge, people in both groups might answer questions about their satisfaction with the hospital treatment. An example of narrative research could be for the experimenter to focus on one person who had experience with a DNR order, with the goal of telling this person’s story, chronologically. The DNR order might be a part of this person’s story. An example of case study research would be for the researcher to focus on one or several people who had experiences with DNR orders. The researcher would interview these people, asking specific and open-ended questions on the DNR aspects of their experience. The researcher might also, with permission, read the hospital charts and speak to hospital staff. The researcher might discern themes gleaned from reading transcripts of the interviews and other information, and develop theories or generalizations from these themes.

History

Modern social science case studies originated in the fields of anthropology and sociology. In the United States, case study methodology was most closely associated with the University of Chicago. In 1935, there was a public dispute between Columbia University scientists, who were championing quantitative experiments, and scientists at the University of Chicago. The outcome seemed to be in favor of Columbia University, and consequently, the use of case study methodology as a scientific research method declined. However, in the 1960s, researchers became increasingly concerned with the limitations of quantitative methods. Hence, there was a renewed interest in case studies.

Case study methodology is frequently used in the social sciences because of its popularity in psychology, medicine (case analysis of a problem), law (case law), political science (case reports), and education (instructional strategy). The fields of psychiatry and psychology have always depended on classical clinical cases to study different problems. Some important theories were developed from intensive one-on-one case studies of individuals.

Examples

Some famous case studies in psychology are Anna O., Little Hans, and Little Albert. Anna O. was the pseudonym given by Viennese physician Josef Breuer to Bertha Pappenheim, a patient he treated from 1880 to 1882 in Vienna. She suffered from severe complaints, including paralysis, memory loss, mental deterioration, nausea, and disturbances of vision and speech. The symptoms first appeared when she was nursing her dying father, who had always pampered her. Her symptoms had no physical or organic cause and thus were diagnosed as hysteria. Much to Breuer’s surprise, Anna O.’s symptoms cleared up when she talked to Breuer about emotionally charged experiences from her past. Breuer and the Viennese psychoanalyst Sigmund Freud, thirteen years later, wrote a famous paper about her treatment. Since then, psychiatrists and psychoanalysts have included this information in discussions of hysteria, acknowledging that the case study of Anna O. is part of the prehistory of psychology and psychoanalysis.

Little Hans, a five-year-old boy, had phobias of horses, streets, and trucks. He feared leaving the house and abandoning his mother. Gathering information from detailed letters from Hans’s father, a physician who had attended lectures on psychoanalysis, and from his own limited interviews with Hans, Freud wrote a case study on Hans, describing Hans’s sexual oedipal desire for his mother. Freud believed that the case study of Little Hans demonstrated the therapeutic potential of a verbal approach for treating children as well as adults. This case study is also the first recorded instance of psychoanalytic supervision, because Freud treated Hans by advising Hans’s father on steps to take.

Little Albert (his surname remains unknown) has been termed the most famous baby in the history of psychology. As an eleven-month-old boy, Albert liked to play with toys and initially showed no fear of a live white rat. To illustrate behavioral principles, John B. Watson, noted as the founder of behaviorism, on several occasions struck a loud gong while the baby was playing with a white rat. Soon, Little Albert reacted with fear whenever he saw the white rat. Further, his fearfulness and crying generalized so that he cried when he saw other white furry things, including a rabbit, a fur coat, and even a Santa Claus mask. Watson called Little Albert’s fear a conditioned response and concluded that adult fears, anxieties, and phobias develop from similar conditioning experiences. The case study of Little Albert illustrates behavioral principles in action. The case studies of Anna O., Little Albert, and Little Hans are seminal in the field of psychology.

Some famous case studies about individuals receiving psychological treatment are described in Case Studies in Psychotherapy (1989), edited by Danny Wedding and Raymond J. Corsini. The editors include one example of psychoanalysis that involved more than eight hundred therapy sessions spanning more than seven years, illustrating how a skilled therapist managed problems such as personal vacations, sexual misbehavior, and suicide attempts. Among the other case studies in this volume are illustrations of cognitive therapy for a depressed professional woman and illustrations of existential therapy for an obese woman who was anxious about death.

Case studies occupy an important place in mental health. They are useful for developing hypotheses about clinical problems and exploring innovative treatments. The problems for which case studies are appropriate are those related to exploratory studies (for example, generating new theories), or to critical and unusual cases. Case study methodology is less fit to test a theory.

Bibliography

Breuer, Josef, and Sigmund Freud. “Fräulein Anna O.” Studies on Hysteria. Vol. 2 in The Standard Edition of the Complete Psychological Works of Sigmund Freud. Ed. and trans. J. Strachey. London: Hogarth, 1955. Print.

Coolican, Hugh. Research Methods and Statistics in Psychology. 5th ed. New York: Routledge, 2013. Print.

Creswell, John W., et al. “Qualitative Research Designs: Selection and Implementation.” Counseling Psychologist 35.2 (2007): 236–64. Print.

Franklin, Ronald D., David B. Allison, and Bernard S. Gorman, eds. Design and Analysis of Single-Case Research. New York: Psychology, 2014. Print.

Kazdin, Alan E. “Drawing Valid Inferences from Case Studies.” Methodological Issues and Strategies in Clinical Research. Ed. Alan E. Kazdin. 3d ed. Washington: American Psychological Association, 2003. Print.

Sternberg, Robert J., Henry L. Roediger, and Diane F. Halpern. Critical Thinking in Psychology. New York: Cambridge UP, 2007. Print.

Wedding, Danny, and Raymond J. Corsini, eds. Case Studies in Psychotherapy. 5th ed. Belmont: Thomson, 2008. Print.

Willig, Carla. Introducing Qualitative Research in Psychology. 3rd ed. New York: McGraw-Hill, 2013. Print.

Wilson, Barbara A. “Single-Case Experimental Designs.” Choosing Methods in Mental Health Research: Mental Health Research from Theory to Practice. Ed. Mike Slade and Stefan Priebe. New York: Routledge, 2006. Print.

Yin, Robert K. “Case Study Methods.” Handbook of Complementary Methods in Education Research. Ed. Judith L. Green, Gregory Camilli, and Patricia B. Elmore. Mahwah: Erlbaum, 2006. Print.