Languages of Science and the Problem of Applied Clinical Knowledge: A Mixed Methods Appraisal of Eells' Case Formulation Research

Abstract

This article is a methodological commentary on Eells' (2010) summary of his research on case formulation. It draws attention to an epistemological tension between a positivist and a qualitative/hermeneutic paradigm. I argue that the kinds of questions researchers are most concerned with in the field of case formulation are ones with direct relevance for practice and that an exclusively positivist paradigm is problematically suited to answer these, an observation that emerges from a consideration of Eells account of his research. While Eells' account of his case-based strategy is initially positivist in intent, the introduction of a hermeneutic approach opens the field up considerably. I conclude (a) that a "mixed methods" paradigm, which integratively and rigorously combines quantitative and qualitative methods and which has recently been called a "third research paradigm," offers a particularly attractive epistemological framework for planning research on case formulation that can directly guide and improve practice; and, following from this point, (b) that the meaning and direction of Eells' research can be enhanced by explicitly conceptualizing it within such a mixed methods paradigm.Keywords: psychotherapy case formulation; mixed methods research; therapist responsiveness; positivist vs. interpretive methods; quantitative vs. qualitative methods; case studies __________________________________________________________________________There are large similarities between the kind of problems presented to researchers by case formulation, the focus of Eells' (2010) research, and by therapist responsiveness during treatment, the focus of my (Edwards, 2010) contribution to this PCSP issue. In both areas, practitioners engage in complex behaviors that involve moment-to-moment decision making in response to an ongoing flow of data in the form of the behavior of or information provided by the client. In assessment and case formulation, which Eells examines, the focus is on gathering information in order to develop an understanding of the client's problems in terms of their severity, developmental history, precipitants, and current maintaining factors, a process aptly summarized in Figure 8 of Eells ' (2010) article. In my contribution to this PCSP issue, the focus is on the treatment phase of posttraumatic stress disorder (PTSD) and the challenge of:

Integração entre pesquisa empírica e prática clínica psicanalítica: um estudo ilustrativo

“…A tradição clínica sustenta-se em teorizações minuciosas sobre o encontro terapêutico. Estudos de casos empíricos sistemáticos mantém essa tradição, porém agregam diversos elementos que implicam conjugar subjetividade e objeti-vidade e adotar procedimentos metodológicos mais rigorosos desenvolvidos do ponto de vista das ciências empíricas (Dattilio et al, 2010;Edwards, 2010;Serralta et al, 2011).…”