Hermeneutic Single Case Efficacy Design: Applying the Legal Model to Practice-Based Research on Counselling and Psychotherapy

Entry for 9 October 2006:

This is the summary of a grant prospectus that I have been working on for the past 10 days. This line of work was originally inspired by my dad, and he and I had several conversations about legal concepts of evidence and proof.


The randomised clinical trial (RCT) method for establishing the efficacy of psychotherapy and counselling is currently at the centre of intense scrutiny and controversy in psychiatry, clinical psychology and counselling. The proposed research would build on previous research in order to develop a case-based alternative Legal Model to complement the RCT, with the likely benefits of bridging the research-practice gap and providing more detailed understanding of the causal processes involved in psychotherapeutic change.

The strategy to be used will be to adapt concepts and procedures from legal theory and practice in order to develop more systematic, rigorous ways of interpreting causal processes in single treatment cases. Variations in how the legal model can be applied to evaluating psychotherapy efficacy will be tested over two clinical case replication series. First, 10 psychotherapy clients will be treated for Social Anxiety Disorder using a promising but untested treatment; second, a further 10 clients will be seen in a more general practice-based research protocol.

This project would make use of and help develop a new research clinic being created by the Counselling Unit. It would make sure of some of the strengths and resources there, including newly available and equipped research space and diverse research team of staff and postgraduate and research students. The requested grant funding would primarily be used to fund full-time MPhil and PhD students. The project would also involve collaboration with the University of Strathclyde’s Law School and with other Scottish universities (including University of Abertay, Glasgow Caledonia University, and others).

Objectives include (a) initiation of a Scottish therapy case database analogous to a body of case law; (b) development and testing of a new treatment for social anxiety; (c) testing and dissemination of practice-based research protocol for systematic case study research; and (d) development and dissemination of best practice guidelines for Legal Model-based systematic case study research in psychotherapy.