Leveraging single-case experimental designs to promote personalized psychological treatment: Step-by-step implementation protocol with stakeholder involvement for a single-case outpatient clinic

Abstract

Our objective is to implement a single-case experimental design (SCED) infrastructure in combination with experience-sampling methods (ESM) in addition to the standard diagnostic procedure of a German outpatient research and training clinic. Extending the idea of routine outcome monitoring, the SCED infrastructure introduces intensive longitudinal data collection, individual effectiveness measures, and the opportunity for systematic manipulation to push personalization efforts further. It aims to empower psychotherapists and patients to evaluate their own treatment (idiographic perspective) and to enable researchers to analyze open questions of personalized psychotherapy (nomothetic perspective). Organized around the principles of agile research, we plan to develop, implement, and evaluate the SCED infrastructure in six successive studies with continuous stakeholder involvement: In the project identification phase, a business model for the SCED infrastructure is developed that describes its vision in consideration of the context (Study 1). In the project development phase, the infrastructure's prototype is specified, encompassing the SCED procedure, ESM protocol, and ESM survey (Study 2 and 3). During the optimization phase, feasibility and acceptability are tested and the infrastructure is adapted accordingly (Study 4). The evaluation phase includes a pilot implementation study to assess implementation outcomes (Study 5), followed by actual implementation using a within-institution A-B design (Study 6). The sustainability phase involves continuous monitoring and improvement. We discuss to what extent the generated data could be used to address current questions of personalized psychotherapy research. Anticipated barriers and limitations during the implementation processes are outlined.