Week 7 Assignment

Outcome Research Design

A Best Kept Secret: Single-Subject Research Design in Counseling

Linda H. Foster1

Abstract Since the beginning of the counseling profession, there have been calls for counselors to support their effectiveness with clients in various counseling settings. Research methods that emphasize the individual do exist; however, professional counselors are reluctant to document their work through research. Single-subject research design methods help counselors report their client work and show effectiveness of counseling. More importantly, single-subject research provides counselors with a scientific method of inquiry to examine counseling techniques and ultimately help their clients.

Keywords counseling, counselor, education, efficacy, individual, practice, research, teaching, treatment

Received 7 June 2010. Revised 5 August 2010. Accepted 6 September 2010.

In response to demand to provide evidence of

the effectiveness of counseling (Astramovich,

Hoskins, & Erford, 2008; Lundervold &

Belwood, 2000; Sheperis & Miller, 2008), there

is a renewed interest in the professional counsel-

ing community appealing to counselors for more

research to provide evidence of the effectiveness

of therapeutic interventions (Foster, 2009;

Ray, Minton, Schottelkorb, & Brown, 2010;

Sharpley, 2007; Sheperis, Sheperis, & Simpson,

2010; Sheperis & Miller, 2008). Ray, Minton,

Schottelkorb, and Brown (2010) urged counse-

lors to conduct empirically based research in

order to comply with ethical codes not merely for

the sake of compliance but in order to contribute

to the professional knowledge base, thereby

enhancing client wellness. Nevertheless, there

appears to be a lack of enthusiasm for outcome

research by counselors in school counseling,

career counseling, and clinical counseling

(Foster, Watson, Meeks, & Young, 2002; Hinkle,

1992; Huber & Savage, 2009; Lundervold &

Belwood, 2000; McDougall & Smith, 2006;

Reisetter et al., 2004).

The intensive study of one individual, as in

the case of single-subject research, is appropri-

ate for professional counselors working with

individuals and couples. This idea is rooted

in the early 1900s when the individual case

study was widely recognized as the accepted

methodology for investigating emotional and

behavioral problems within the field of psy-

chiatry and psychology (Heppner, Kivlighan,

& Wampold, 2008). Barlow and Hersen

(1976, 1984) noted that study of the individual

1Mercer University, Atlanta, GA, USA

Corresponding Author:

Linda H. Foster, 3001 Mercer University Drive, Atlanta, GA

30341, USA

Email: foster_lh@mercer.edu

Counseling Outcome Research and Evaluation 1(2) 30-39 ª The Author(s) 2010 Reprints and permission: sagepub.com/journalsPermissions.nav DOI: 10.1177/2150137810387130 http://core.sagepub.com

was paramount for studying human behavior

change. They cited several advantages to this

case study approach including advancing clini-

cal innovation, development and refinement of

technical skills, among others. Studying the indi-

vidual and the effectiveness of the counselor’s

interventions can be accomplished with single-

subject research and also provide a culturally sen-

sitive research tool (Lundervold & Belwood,

2000; Sheperis et al., 2010).

Early case studies were not tightly controlled

and therefore as the professions of psychiatry

and psychology developed, more rigorous

methods of research regarding the efficacy of

therapy developed, but these methods relied on

group findings rather than individualist results.

There have been continued calls for outcome

research by professional counselors utilizing

an individual perspective, and fortunately

individualized research has been used since

the beginning of our profession. Barlow and

Hersen (1976, 1984) acknowledged the lack of

an adequate research method to document

individualist behavior change: dissatisfaction

with some of the early appraisal methods and

criticism of the measurement techniques led

researchers to investigate additional research

methods, and through the next several decades

the development and strengthening of applied

research methods continued.

There may be a myriad of reasons for the

lack of outcome research but one reason

mentioned by Lundervold and Belwood (2000)

is the perception that counseling and research

are antithetical. Other reasons suggested in

professional literature include a lack of knowl-

edge and training in research methods, legal and

ethical considerations regarding minors, time

constraints, and not surprisingly, a lack of

confidence (Fairchild, 1993; Fairchild & Zins,

1986; Myrick, 1997). Hinkle (1992) asserted the

absent outcome research is due, in part, to the

lack of practical methodologies and overreli-

ance on statistical rather than clinical signifi-

cance. Sheperis and Miller (2008) agreed that

clinical significance is more interesting, appro-

priate, and useful to counseling practitioners than

statistical significance. Therefore, single-subject

research design (SSRD) methodologies are better

suited for counseling practitioners to document

their work and provide evidence of the effective-

ness of counseling. Increasingly, SSRDs are

being promoted because of the applicability to

practice settings and the ability to easily incorpo-

rate into a client’s treatment (Ray et al., 2010;

McDougall & Smith, 2006; Sharpley, 2007).

Consequently, the focus of this article is to assist

counseling professionals and counselor educa-

tion students in gaining an understanding of the

usefulness of SSRD methodology.

SSRD Description

Simply defined single-subject research metho-

dology allows for the study of one individual

or one group that is treated as a single entity

(Foster, 2009). More formally defined, SSRD

examines variables that may change over time

within an individual subject (Heppner et al.,

2008). An essential feature of single-subject

research is systematic, repeated, and multiple

observations over time of a client, dyad, or group.

Client behaviors measured may range from overt

to covert behaviors (e.g., self-mutilation or

self-defeating thoughts). SSRD allows counse-

lors to research behaviors and interventions with

an individualized focus.

SSRDs, also known as time series designs or

equivalent time series designs, are quasi-

experimental designs. Unlike true experimental

designs, they do not use a formal control

group. Rather, they use the subject as his or her

own experimental control. SSRD examines

the change in a client’s or group’s behavior

(dependent variable) following a counselor’s

intervention (independent variable). As an exam-

ple, the counselor can use SSRD to determine

whether a change occurred in a client’s stress

level, but the possibility exists that other variables

also influenced the change. A simple A-B design

cannot unequivocally prove that the counselor’s

intervention was responsible for the change. The

counselor’s intervention may have been responsi-

ble for the observed change, but there may be

other extraneous conditions that also influenced

the client’s change. In research parlance, the

researcher cannot eliminate or rule out threats

to the internal validity. The practical or clinical

Foster 31

significance may outweigh the lack of statistical

significance if the client improves. In order to

determine whether the client change was due

solely to the counselors intervention, the inter-

vention must be replicated a second time. Repli-

cation should only be used if a return to the

baseline would not endanger the client.

Although professional counselors have been

resistant to conduct outcome research, SSRDs

can offer professional counselors a method to

evaluate, document, and communicate their

work to clients as well as provide needed data

to enhance evidence-based practice. De Los

Reyes and Kazdin (2008) noted evidence-

based practice encompasses many disciplines

from medicine and education to psychology

and counseling and beyond. Researchers offer

SSRD as a method to carefully explore charac-

teristics of therapeutic relationships (see Foster

et al., 2002; Heppner et al., 2008; Hinkle, 1992;

Lundervold & Bellwood, 2000; McDougall &

Smith, 2006; Ray et al., 2010; Sheperis & Miller,

2008). Many professionals have already adopted

SSRDs including special education teachers,

school psychologists, and therapeutic recreation

therapists because of the low data collection

costs, lack of complicated statistics, and ability

to assess individualized interventions (De Los

Reyes & Kazdin, 2008; Foster, 2009).

Heppner, Kivlighan, and Wampold (2008)

have long touted the benefits of using SSRDs.

The simplicity of SSRDs can be used to test new

theories or interventions or can be used to dis-

cover new information which can be very helpful

with clients. Many professionals (e.g., school

counselors, therapeutic recreation therapists,

special education teachers, and school psycholo-

gists) use SSRDs because of low data collection

costs and ease of uncomplicated statistics and

individualized approach. Additionally, for pro-

fessional counselors who work within a managed

care environment, providing evidence of effec-

tiveness or outcome research is a prime reason for

utilizing SSRDs (Sheperis & Miller, 2008).

Classic SSRD Designs

SSRDs involve a concentrated focus and study

on an individual or a single group over time to

determine the effects of an intervention. SSRDs

begin with the repeated measurement of a

dependent variable and systematically move

to the application and withdrawal of an indepen-

dent variable. The individual or single group

functions as the control for this experimental

research design.

SSRDs are also identified with a variety of

other names such as small-N designs, within

subject comparisons, single-case experimental

designs, and time series designs (Hadley &

Mitchell, 1995; Heppner et al., 2008). Time

series designs can also involve the study of only

one individual or a single through multiple

observations. Again, the dependent variable is

of interest as to whether it increases or decreases

in response to the independent variable. Some of

the threats to internal validity of time series

designs include instrumentation, testing, and

pretest treatment interaction (Sheperis & Miller,

2008). One of the more serious threats to a time

series design is history or maturation. Heppner

et al. (2008) suggested using a simple inter-

rupted time series design which allows for the

researcher to detect maturational changes that

can occur prior to initiation of treatment.

Another concern using time series design is an

appropriate length of time for collection of data

or the number of data points collected. Hadley

and Mitchell (1995) offered guidance regarding

time sampling keeping in mind the purpose of

the data collection. Their suggestions include

whole-interval time sampling (i.e., for increas-

ing behaviors), partial-interval time sampling

(i.e., to decrease behavior), and momentary time

sampling (i.e., occurrence of behavior only).

Although there may be questions and concerns

about using SSRDs or time series designs, they

are considered very useful in examining

relationships in settings such as counseling and

are practical for counselors to use in conducting

research with their clients. Moreover, these

designs have been cited as useful in program

evaluation as well.

SSRDs can take several forms including

A-B design, A-B-A design, A-B-A-B design,

B-A-B design, A-B-C-D design, and the multi-

ple baseline design. Although there are many

useful variations in SSRDs descriptions of three

32 Counseling Outcome Research and Evaluation 1(2)

classic designs and examples are provided: A-B,

A-B-A-B, and multiple baseline.

A-B Design

The initial phase of any SSRDs begins with

a baseline or pretreatment phase known as

Phase A. It is during this phase that repeated

measurement or observation gives the researcher

a quantifiable condition. The A phase can also be

thought of as the pretesting phase and also has

been coined simple phase change (Sheperis &

Miller, 2008). The B phase is designated as the

period of time when treatment or the intervention

is delivered along with continued measurement

or observation (see Figure 1). An examination

of the two phases ends this experiment. Infer-

ences are then drawn from a visual examination

of the graphed data and researchers look for

changes in trends or patterns (Lundervold &

Belwood, 2000; Sheperis & Miller, 2008).

However, Sharpley (2007) noted that researchers

may be restricted from using A-B design because

of the inability to concretely demonstrate the

effectiveness of an intervention. The most signif-

icant drawback in using the simple A-B design is

the lack of control for internal validity threats

such as extraneous variables. Extraneous vari-

ables such as holidays, crisis, illness, and so on

cannot be discounted in affecting the results,

thereby affecting internal validity. In order to

alleviate concerns over the internal validity,

researchers may implement a second A phase.

It is assumed that a return to the original baseline

will strengthen the inferences noted in the first

treatment phase, thereby creating a more robust

experiment (Sharpley, 2007).

One example of using an A-B design with a

client might involve thought-stopping interven-

tions. During the treatment Phase A, the coun-

selor and client would explore the frequency,

intensity, and duration of negative self-talk.

Baseline Treatment

Phase A = Sessions 1-5 Phase B = Sessions 6-12

C lie

nt ’s

le ve

l o f d

is tre

ss

Number of Sessions with Counselor

Foster 33

The client would be asked to chart their own

behavior, so there might be some discrepancies

in actual reporting. After a designated baseline

period of charting behaviors, the client and

counselor would examine the data and discuss

possibilities for intervention. This process

might take a few weeks during which the client

would continue to chart their negative self-talk.

After an agreed upon intervention, the client

would enter the treatment B phase and

implement the intervention. The client would

then begin to chart their progress using the

intervention. Again at the end of a determined

period, the client and counselor would examine

the data and evaluate the effectiveness of the

intervention. There could be other extraneous

variables that influence the effect of the inter-

vention, but the goal is to alleviate the client’s

distress.

A-B-A Design

The A-B-A design is an extension of the A-B

design which adds another baseline period. The

addition of another baseline creates a return to

baseline by removing the intervention also

known as the independent variable. It is

expected that the return to the second baseline

would result in a condition similar to the first

baseline, therefore allowing for a stronger infer-

ence regarding the effectiveness of the interven-

tion/interventions. Removal of an intervention

(which may have been successful) can result in

a deterioration of the client’s well-being in order

to return to the baseline. Although this design

strengthens the relationship of the variables, it

could result in deleterious effects for the client.

If the interventions are successful, the client

gains insight and hopefully generalization

of the intervention/interventions will occur in

other situations. Although a change occurs, the

counselor cannot be certain the intervention

alone caused the change, as there may be other

extraneous conditions influencing and affecting

the outcome. In order to fully demonstrate that

the counselor’s intervention was responsible,

replication would be accomplished through a

further extension of the A-B design. The design

would then become an A-B-A-B design. If the

intervention was not successful and a return

to baseline would not endanger the client, the

process can begin and the treatment phase may

consist of different interventions.

A-B-A-B Design

One method to resolve the internal validity

problem is the use of the A-B-A-B design also

known as a reversal design. This design is

simply a replication of the A-B design using

two baselines and two treatment phases. Using

the A-B-A-B design allows the researcher to

make a stronger statement regarding the inter-

nal validity and minimize extraneous variables.

The A-B-A-B design is an extension of the

A-B design wherein baseline and treatment

phases are repeated therefore it becomes a four

phase design. The initial baseline period is the

time of data gathering (A1) and a treatment

phase (B1). It then returns to a second baseline,

A phase is followed by another treatment

B phase (i.e., A2 and B2). The assumption

underlying the A-B-A-B design is that the

removal of the intervention in B1 will return the

subject to a level similar to the baseline A1 (Heppner et al., 2008). The idea is that a repli-

cation of intervention used in B1 will result

in reinforcement of the causal relationship

shown during the first A1 and B1 phases. This

greatly increases the ability of the counselor

(researcher) to infer the effectiveness of the

intervention.

The A-B-A-B design might be useful for a

child who has difficulty staying seated during

the school day. First, the counselor might act

as the observer and collect data to illustrate the

amount of time that the child is out of his or her

seat. During the course of counseling, questions

are asked to determine whether the out-of-seat

behavior serves a particular function. Several

reasons may be the root of the problem ranging

from avoidance of work that is too difficult, as

attention-seeking behavior, or because school-

work is not challenging. Understanding the

cause of the out-of-seat behavior is important

in order to develop the treatment plan. If the

clinician finds the child is feeling inadequate,

three treatment components might be used:

34 Counseling Outcome Research and Evaluation 1(2)

(a) modifying (i.e., decreasing) the complexity

of the work; (b) providing direct skill instruc-

tion, or (c) providing brief breaks contingent

upon completed work. A treatment plan would

be developed with the child, teacher, parents,

and counselors to determine what might be the

best intervention. If a token reinforcement is

used, it helps to make sure the reinforcement is

something desirable to the child. After complet-

ing the treatment plan, the Phase B treatment

would begin. Again observations and measure-

ment of the out-of-seat behaviors would begin.

In order to see whether changes occurred

because of the treatment, the intervention

would be removed with a return to the baseline

phase. If the treatment was responsible for

changes in behavior, the child’s behavior would

return to the level seen in the first baseline

period. This design would be implemented with

caution to ensure the child’s safety. The Phase A

baseline period would again be examined and a

second phase B treatment would begin.

Careful consideration must be given to using

this design because of the application and

withdrawal of interventions. The attempt of this

design is to provide evidence of the causal

effect of the independent variable. The assump-

tion of the clinician–researcher is that the

independent variable caused the change in the

dependent variable in Phase B1 and that

removal of the intervention would result in a

similar baseline period. If indeed the second

baseline phase closely resembled the first

baseline phase, this would strengthen the causal

relationship between the independent and

dependent variables and decrease the threats

to internal validity (Frankel & Wallen, 2009).

Ethical concerns are also addressed because the

problem of leaving the client without an inter-

vention is avoided.

Heppner et al. (2008) noted several limitations

of the A-B-A-B design: (a) a lack of reporting of a

statistical test (i.e., a quantitative value such as

a t test of F test); (b)carryover effects which

could be that the effects of the intervention are

irreversible and cannot be withdrawn; and (c)

potentially undesirable or unethical withdrawal

of an effective treatment. An alternative to the

A-B-A-B design is the multiple baseline design.

Multiple Baseline Designs

A multiple baseline design is basically a series

of A-B designs that are replicated in several

ways: (a) with the same individual across dif-

ferent behaviors known as multiple baseline

across behaviors; (b) with the same individual

across different settings known as multiple

baseline across settings; or (c) with the same

behavior across different individuals known

as multiple baseline across subjects. In the

multiple baseline across behaviors, there is a

baseline and treatment phase for two or more

different behaviors of the same subject. In a

multiple baseline across settings, there is

baseline and treatment phase for two or more

settings in which the same behavior of the

same subject is measured. Finally, the last

multiple baseline design known as multiple

baseline across subjects consists of a baseline

and treatment phase for the same behavior for

two or more subjects (Miltenberger, 1997).

Multiple baseline designs strengthen the

supposition that an intervention caused a beha-

vior change but still do not allow for statements

of causality (Polaha & Allen, 1999). This

may be one of the reasons for the lack of use

of multiple baseline designs by counselors.

Despite numerous examples of the use of mul-

tiple baseline designs cited by several authors,

multiple baseline design is not being used by

counseling professionals (Hadley & Mitchell,

1995; Heppner et al., 2008; Miltenberger,

1997). Heppner et al. (2008) found that the use

of multiple baseline research design is rarely

cited in counseling literature in contrast to

numerous citations found in clinical psychology

literature. Professional counselors may find this

design helpful especially for clients that are exhi-

biting a specific problematic behavior in more

than one setting such as in the home and at work.

Heppner et al. (2008) provided a good

example of a multiple baseline design. A coun-

selor may want to examine the effectiveness

of an intervention on family communication.

The counselor may determine two identifiable

behaviors such as (a) the amount of time after

dinner the husband and wife spend talking, and

(b) the amount of time after dinner the parents

Foster 35

spend talking with the children. During the

baseline A phase, the interaction time would be

measured for both of these. An intervention is

developed by the counselor and client to increase

communication between the spouses with the

assumption that the control would be communi-

cation between parents and children. The

intervention is implemented and the counselor

might expect that there would not be a difference

in the parent–child communication because no

intervention was implemented. Next step would

be to implement an intervention for parent–child

communication and the counselor would expect

that communication would increase. Other

targeted behaviors could also be addressed

over successive time periods to assess other

interventions.

Multiple baseline designs can be used with

individuals, couples, groups, or classrooms;

however, this type design is rarely seen in the

journals of counseling research. It is primarily

used in behaviorally oriented journals although

is gaining acceptance by the counseling profes-

sion. Acceptance by the counseling profession

may be due, in part, to the versatility of this

design with one individual across different

behaviors, settings, or for the same behavior

with several individuals. There are advantages

to using multiple baselines due to the generali-

zation of behaviors that may occur across

settings. The usefulness to counselors is the

ability to show clients their progress using a

visual reference. Another relevant and important

advantage for counselors is the ability to provide

outcome research and evidence of accountability

in managed care settings (Sheperis, Gardner,

Erford, & Shoffner, 2008; Sheperis & Miller,

2008).

SSRD Application Models

Sheperis and Miller (2008) used Data-based

Problem Solver (DBPS) model to help connect

clinical practice and research methods. DBPS

utilizes four phases: problem identification,

problem analysis, problem solution, and problem

evaluation. These four phases closely resemble

stages of the counseling process and can be used

as to think about the A-B design description as

well. The A phase or baseline is the period of time

in which no intervention or treatment is applied

and might be most commonly known to profes-

sional counselors as the rapport building stage.

As the counseling relationship is developed and

trust gained, the identification of the client’s

problem begins and research can provide

evidence of the effectiveness of treatment.

Another useful way to connect the counseling

process and research is to use the skilled-helper

model (Egan, 2007). First, in Egan’s model,

Stage 1 is ‘‘The Current Picture’’ of a client’s life

or situation (i.e., defining the problem). This

stage allows for relationship building between

counselor and client and begins the discovery

and clarification of problems, issues, and/or

concerns. This stage of discovery leads to the

assessment of the troublesome factors.

Data collection during this time investigates

the frequency, intensity, and/or duration of the

client’s problem. The client’s issue, concern, or

problem is categorized as the dependent

variable. The dependent variable can consist

of behaviors, emotional reactions, physiological

responses, personality traits, and thoughts.

Heppner et al. (2008) also suggested that

system characteristics (e.g., communication

patterns, cohesion, involvement) can also be the

dependent variable when researching groups,

families, or couples. It is during this period that

the professional counselor continues forming a

relationship and gathering information from the

client about their distress. Using the basic

sequence of who, what, where, when, how, and

why to help evaluate the client’s functioning

during the baseline Phase A period, the depen-

dent variable is measured (i.e., frequency, inten-

sity, or duration). Clients may even be unaware

of their level of their distress and measurement

can improve recognition of problematic beha-

viors (i.e., either overt or covert). A common

feature of SSRD is the repeated measurement

of the dependent variable over time. For

example, if a client engages in self-defeating

thoughts, the counselor might suggest measuring

the thoughts on a weekly, daily, or even hourly

basis to create the baseline. It should be noted that

the measurement during the Phase A relies on the

client’s self-report. It might be helpful for the

36 Counseling Outcome Research and Evaluation 1(2)

counselor to provide the client with a tally sheet

or some type form to complete during the Phase

A. Although self-report can be considered a

limitation in research, there are advantages.

Some of the advantages include ease of use, little

training required for the client, and SSRDs

are compatible with phenomenological views

(Heppner et al., 2008). On the other side, disad-

vantages to self-reporting can be the distortions

(either intentional or unintentional) by the client.

It is from this baseline that the counselor and

client examine the distress and move into the

working stage to create strategies or a treatment

plan to help the client.

Egan’s second stage is referred to as ‘‘The

Preferred Picture,’’ which allows the client to

explore options to create a better future (Egan,

2007). The working alliance between counselor

and client develops alternatives to alleviate the

client’s distress. It is during this stage of coun-

seling that counselor and client work together

to create realistic and challenging goals along

with moving into Stage 3 ‘‘The Way Forward’’

to develop strategies to accomplish goals

(Egan, 2007). This working stage develops into

the treatment B phase wherein interventions are

applied to the client’s situation. The counselor

continues to work with the client as the inter-

ventions are tried and plans for being successful

are reviewed. Assessment of the client’s func-

tioning occurs again during this phase to deter-

mine the effectiveness of the interventions. The

interventions are considered the independent

variable that can be manipulated or controlled.

An assessment of the intervention is then

compared to the baseline phase, allowing both

the client and the counselor to determine

whether the intervention was effective.

Discussion

The usefulness of SSRD as a tool for counselors

is multifaceted. First and foremost, the ease

with which SSRDs can be adapted into a

counselors’ practice is easily accomplished.

The low cost of data collection and the lack

of complicated statistics also create a user-

friendly tool for conducting outcome research.

As the era of accountability continues,

counselors can adopt SSRDs to create outcome

research needed to provide effectiveness of

counseling interventions. In order to encourage

more research in the counseling profession,

new ways of thinking about research must be

promoted. The counseling profession is still a

relatively new profession in relation to other

helping professions and as such strives to gain

recognition and provide evidence of the

effectiveness of counseling interventions, and

this can be accomplished through more empha-

sis on outcome research. Case studies were

early individualized research methods and

have evolved from uncontrolled methods to a

more scientific and controlled approach.

Since professional counselors generally focus

on individual clients it seems appropriate to

continue developing and implementing indivi-

dualized research evaluating the outcome of

our counseling practice (Heppner et al., 2008;

Sheperis et al., 2008).

A common goal of counseling outcome

research must be to help facilitate an under-

standing of human behavior. It is generally

accepted that SSRD is a useful tool for examin-

ing change within a single individual and is

ideal for describing individualist idiosyncrasies

(Heppner et al., 2008). Providing a visual

representation to the client will likely provide

evidence of the problematic behavior and

possibly provide reinforcement for the inter-

ventions (if successful). Visual representations

for both client and counselor are considered

more user-friendly and reinforce the clinical

significance of interventions (Sheperis & Miller,

2008). Alternatively, it can also provide useful

material for the counseling session by an investi-

gation of who, what, why, and how a specific

intervention did or did not work.

Early in counselor education programs,

outcome research must be promoted for several

reasons. First, accreditation of counselor educa-

tion training programs is one of the many steps

involved in creating a profession. In a classic

article by Klatt (1967), steps in the formation

of any profession include development of a

systematic body of knowledge, requiring

specific training. Council for Accreditation of

Counseling and Related Educational Programs

Foster 37

(CACREP) ensures that accredited counselor

education programs adhere to a systematic

curriculum, promoting standardized preparation

of future counselors (CACREP, 2009). Huber

and Savage (2009) suggest by promoting

research as a core value in graduate counselor

education programs, the identity of clinicians

as researchers would be strengthened. A final

point for consideration is the importance of

the ethical responsibility incumbent on the

counseling profession to provide interventions

and techniques that are effective, and the

documentation of our effectiveness can be

provided through research (American Counseling

Association [ACA], 2005).

Conclusion

SSRD has been called the best kept secret in

counseling (Lundervold & Bellwood, 2000).

Single-subject research can become an avenue

for counseling professionals in all settings, as

well as students and counselor educators to

evaluate their practice of counseling. In order

to promote the use of SSRD, counselor educa-

tion programs must be diligent in preparing

students to become producers of research

rather than consumers only. Likewise, counsel-

ing professionals must also answer the call to

provide the necessary outcome research pro-

viding evidence of counseling’s effectiveness.

Caveats include responsibility for adequate

training and attention to ethical considera-

tions; nevertheless SSRDs are easily incorpo-

rated into any counseling practice setting.

SSRD is only one of many research designs,

which can be used to enhance the counseling pro-

fession, our identity, our practice, and ultimately

and most importantly our client’s wellness.

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of

interest with respect to the authorship and/or

publication of this article.

Funding

The author(s) received no financial support for

the research and/or authorship of this article.

References

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code of ethics. Retrieved from http://www

.counseling.org/Resources/CodeOfEthics/TP/

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Bio

Linda H. Foster, PhD, LPC, received her under-

graduate degree from Samford University, her mas-

ter’s and education specialist degree in Community

Counseling from the University of Alabama in Bir-

mingham, and her PhD in Counselor Education at

Mississippi State University. Her areas of research

include professional identity of counselors, clinical

supervision of school counselors, counselor educa-

tion faculty dynamics, job satisfaction, leadership

styles and personality types among counselor educa-

tors and use of single subject research methods by

counselors. Dr. Foster has presented at local,

regional, national and international conferences on

professional identity, credentialing, research and

other professional counseling issues.

Foster 39