Applied Behavioral Sciences

Pragmatic Case Studies as a Source of Unity in Applied Psychology

Daniel B. Fishman and Stanley B. Messer Rutgers University

To unify or not to unify applied psychology: That is the question. In this article we review pendulum swings in the historical efforts to answer this question—from a comprehensive, positivist, “top-down,” deductive yes between the 1930s and the early 1960s, to a postmodern no since then. A rationale and proposal for a limited, “bottom-up,” inductive yes in applied psychology is then presented, using a case-based paradigm that integrates both positivist and postmodern themes and components. This paradigm is labeled pragmatic psychology and, its specific use of case studies, the Pragmatic Case Study Method (PCS Method). We call for the creation of peer-reviewed journal databases of pragmatic case studies as a foundational source of unifying applied knowledge in our discipline. As one example, the potential of the PCS Method for unifying different angles of theoretical regard is illustrated in an area of applied psychology, psychotherapy, via the case of Mrs. B. The article then turns to the broader historical and epistemological arguments for the unifying nature of the PCS Method in both applied and basic psychology.

Keywords: unity in applied psychology, case studies, positivism, postmodernism, philosophical pragmatism, pragmatic case study method, pragmatic case studies

Basic Versus Applied Psychological Research

The goal of basic psychological research is to describe and develop explanatory theories about the nature of human experience and behavior, whereas the goal of applied research is to aid the professional practice of solving psychosocial problems.1 Examples of the latter are anxiety and depression in individuals, treated by psychotherapy in the applied field of clinical psychology; poor student achievement and lack of character development in the schools, addressed by the applied field of school psychology; and neighborhood conflict and instability, addressed by the applied field of community psychology. Generally, then, the applied psy- chologist begins with a particular, real-world case, which involves a particular “client”— be it an individual, a family, a group, an organization, or a community—with a particular type of problem that takes place in the real-world life context of the client’s history and present situation.

Historically, following a positivist epistemology, applied psy- chology has been based upon theories emerging from basic re- search. In contrast, following a Pragmatic Case Study Method (PCS Method), we will argue that applied psychology should be based upon theories emerging from the rigorous study of applied psychology cases themselves. We will set forth this argument systematically below. We begin by providing some idea of the use of theory in the PCS Method and then illustrate it by presenting a clinical case.

The Case of Mrs. B.

Using Multiple Theoretical Perspectives Simultaneously

Sternberg, Grigorenko and Kalmar (2001) argued that unifica- tion in basic research can be enhanced by creating a psychology that is phenomenon-oriented rather than theory-based, that is multi- rather than monoparadigmatic, and multi- rather than mono- method. This vision in the basic research realm parallels the case study-based approach to knowledge that we call the PCS Method in the applied research realm. This method leads to a focus on theory as closely connected to actual cases in practice (Messer, 2011), rather than theory that makes reference only to the average client. The PCS Method thus offers a unifying view in which various theories and methods are conceptual tools with comple- mentary roles. That is, they can enhance the effectiveness of applied psychological interventions, like psychotherapy, rather than act as competitors for discerning the single, true theory and the single, true method.

These ideas are illustrated in the psychotherapy case of Mrs. B. (Messer, 2000), which highlights the capacity of the case study method to facilitate a multiparadigmatic approach in our effort to bring unity to applied psychology areas like psychotherapy. The example shows how an individual case (in Sternberg et al.’s terms, the phenomenon of interest) can embrace contrasting conceptual perspectives— called visions of reality (described below)—in such a way as to improve upon what could be achieved by any one of these conceptualizations alone. In other words, the case demon- strates the “value added” by the four visions working together.

1 This article is a shortened version of a chapter in Sternberg (2005). As such, it includes some of the original structure and wording of the original chapter.

Daniel B. Fishman and Stanley B. Messer, Graduate School of Applied and Professional Psychology, Rutgers University.

Correspondence concerning this article should be addressed to Daniel B. Fishman, Graduate School of Applied and Professional Psychology, Rut- gers University, 152 Frelinghuysen Road, Piscataway, NJ 08854-8020. E-mail: [email protected]

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Review of General Psychology © 2013 American Psychological Association 2013, Vol. 17, No. 2, 156 –161 1089-2680/13/$12.00 DOI: 10.1037/a0032927

156

Note that the presentation of Mrs. B.’s case is not meant as a model of a full PCS Method case study. Unlike the description of Mrs. B., which is designed to illustrate a particular point about the simultaneous use of multiple theoretical perspectives, a full PCS case has several sections that incorporate Peterson’s (1991) com- ponents of best practice, such as a guiding conception, quantitative and qualitative assessment, a case formulation and intervention plan, the course of intervention, monitoring, and outcome. For examples of model pragmatic case studies in the area of psycho- therapy, see the journal Pragmatic Case Studies in Psychotherapy (http://pcsp.libraries.rutgers.edu; Fishman, 2005).

The Case

Mrs. B is a 45-year-old married Jewish woman who has been feeling poorly for some time, with frequent crying spells, a lack of interest in people and activities, a wish to run away from it all, and a depressive disorder diagnosis. Two months ago, Mrs. B. learned from her 16-year-old daughter that the daughter had been sexually molested over a 2-year period by her older brother when they were younger. Mrs. B. feels that she can’t tell her husband about it and is reluctant to confront her son for fear that revealing this infor- mation will “destroy the family.”

Other significant background stressors include Mrs. B.’s hus- band’s loss of his job a year ago and being unable to find other regular employment, and her variety of medical problems, includ- ing constant, intractable pain from lupus, arthritis, and collagen vascular disorder; high blood pressure; a history of the removal of one breast and chemotherapy for cancer; and being overweight as a result of her medications.

Mrs. B. is well regarded at work, seems to take pleasure in the challenges there, and is striving to advance herself by taking workshops in her area of expertise. She tends to miss some days at work due to her medical condition but is able to take work home. She is engaging to be with and, despite her many problems, conveys a degree of strength and perseverance under very adverse circumstances. She has hobbies in the artistic realm that also give her pleasure.

Case Analysis

We will examine this case using what have been called the four visions of reality. These correspond with the tragic, comic, roman- tic, and ironic genres of literature that have been elaborated upon by the literary critic Northrop Frye (1957), applied to psychoanal- ysis by Roy Schafer (1976), and to different forms of psychother- apy by Messer and Winokur (1984) and Messer and Woolfolk (1998). Therapists may adopt one or more of these visions of reality, which determine the angle of regard of the therapist at different points along the way in therapy.

The tragic vision. In terms of content, the tragic vision would highlight the irreversible features of Mrs. B’s life condition. She has reared her children and can undo little of whatever damage has accrued from the sexual contact between them. She must struggle with the attendant guilt of not having noticed, or not wanting to notice, what was happening at the time. Moreover, her medical condition is chronic and is slated to worsen.

From the point of view of therapeutic process and technique, the tragic view calls for exploration, reflection, and contemplation,

which is most typical of psychoanalytic and humanistic ap- proaches. However, the tragic view, in isolation from the leavening provided by the other visions of reality, can lead to an overly gloomy and pessimistic therapeutic stance. The danger here is in subtly encouraging the client to wallow in her angst leading to passivity, which would allow opportunities for action to pass her by.

The comic vision. As in comic drama, one might view the content of Mrs. B’s problems as situational obstacles to be over- come through direct action. The problems can be framed as mal- adaptive interpersonal interactions between her and her children, and her and her husband, which are potentially ameliorable. Sim- ilarly, her husband’s employment and business woes can be ap- proached in a problem solving mode that could improve Mrs. B’s mood and reduce her anxiety. Ways can be proposed to improve her physical condition as well.

With respect to technique, within the comic vision one would approach Mrs. B. with a sense of optimism and can-do. Cognitive behavior therapy might treat her depression through cognitive restructuring, her relationship with her husband through assertive- ness training, and her medical problems through behavioral stress reduction techniques like mindfulnesss, appropriate diet, and an exercise regimen. However, the limitations or danger in this ap- proach is to induce expectations for cure in the client that are unrealistic, leading to disappointment.

The romantic vision. Resonating with humanistic psycho- therapy, the romantic vision emphasizes the creative, fulfilling, and adventurous aspects of life, even if there are temporary set- backs. In Mrs. B’s case, she has artistic interests that can be capitalized on to help her live a more satisfying life. Regarding the process of therapy, Mrs. B. can be helped to strive to fulfill her potential in the work sphere and to develop her artistic talents as expressions of her true self. Her inner life of fantasies and day- dreams can be explored with the view of encouraging her to see herself as a complex, striving individual who is not defined solely by her illnesses or her current life condition. She can be helped to live more in the moment than in the past.

The danger in a one-sided emphasis on the romantic vision is of overplaying the creative possibilities and ignoring the client’s and life’s realistic limitations. Clearly, not all fantasies can be realized nor all aspirations fulfilled.

The ironic vision. With particular centrality in psychoanalytic therapy, the process or technique of therapy within the ironic vision calls for the therapist to be skeptical of all he or she sees and hears from the client. Things may not be as bad as they seem for Mrs. B., but they are not infinitely malleable. One should not be too readily persuaded to side with Mrs. B’s position or with that of her husband, her children, or her boss. What might seem at first blush like a clear case of fate conspiring against Mrs. B. may turn out to be her bringing things on herself, for example, by doing too much for others, by not standing her ground, and even by not attending to her illnesses in an optimal way.

Within the ironic vision, nothing should be taken at face value or for granted. The liability of the ironic stance is that its unremitting skepticism and confrontation can lead to accusatory interpretations (Wile, 1984) and client self-criticism (Andrews, 1989).

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157PRAGMATIC CASE STUDIES AS A SOURCE OF UNITY

Orchestrating the Visions

As we have suggested above, the application of each life vision to therapy has its plus side and minus side. What is the pragmatic value of taking all four visions into account? By being aware of the four visions and keeping them in mind simultaneously, the thera- pist does not allow the therapy to tilt too much toward the impli- cations of one to the exclusion of the others. To do so might well turn out to be detrimental to the individual client. Taking into account contrasting and even contradictory theoretical perspec- tives—as conceptual tools— can surpass what can be achieved using only one perspective and can keep the treatment in proper balance for the individual client. This aspect of the PCS Method thus offers a unifying view in which various theoretical outlooks can be coordinated and complementary. Thus, as mentioned above, treating theories as complementary conceptual tools, rather than as competitors for a single truth, can enhance the effectiveness of applied psychological interventions, like psychotherapy.

Historical and Epistemological Considerations in the Search for Unity in Applied Psychology

This pragmatic approach to therapy, illustrated by the case of Mrs. B., is a new “bottom up” approach to unity in applied psychology. It emerges from a search for a third way out of psychology’s present “culture wars” between modern/positivist and postmodern/constructivist visions of psychology. These cul- ture wars undermine unity in applied psychology and draw re- sources away from practical problem-solving (i.e., directed toward today’s pressing psychological and social issues). Because many readers will not be familiar with these culture wars, a brief over- view will provide some helpful context (Fishman, 1999).

The “Modern,” Positivist Vision of Unity as a Foundation for Applied Psychology

Positivism assumes that a natural science-derived experimental model can lead psychology to discover a fundamental set of underlying, unifying, “context-free,” “value-free” quantified laws of human behavior and experience. According to this way of thinking, a proper applied psychology should be built upon these underlying laws, and thus the validity of any applied psychology venture is dependent upon the experimental validity of these laws. Therefore, the place to begin in developing a positivist applied psychology, for example, one about psychotherapy, is with efforts to discover such laws.

A number of positivist psychologists and other social science theorists have searched for a grand unifying theory. One of the most compelling is that of the psychologist and physician James G. Miller (1978), who tried to show that a general theory of living systems—including biological, psychological, and social sys- tems— could be constructed. Miller’s book, Living Systems, is an 1102-page tour de force that demonstrates the conceptual and functional parallels among seven levels of systems: the cell, the organ, the individual organism, the group, the organization, the society, and the supranational system. Miller laid out 19 critical subsystems within each of the seven systems, which created 134 categories of knowledge and 186 hypotheses for further testing. Although Miller was able to fit vast amounts of the published

research literature from biology and each of the social sciences into his 134 knowledge categories and 186 hypotheses, and al- though his book was something of a sensation at the time of its publication, we rarely hear it mentioned today. When it is cited, it is more for its detailed presentation of system concepts not because of new data in support of its empirical hypotheses. One explana- tion for the failure of Miller’s vision to have a long life in the history of psychology’s unification efforts is that it took place in the middle of a postmodern period of increasing diversity, plural- ism, and perspectivism in psychology, as discussed further below. In this light, Miller’s grand systems theory integration of all social science knowledge is today viewed as one of a number of different possible paradigmatic perspectives, but not the one “true” integra- tion accepted by all. Suffice it to say that if grand systems like Miller’s are not successful, a positivistically derived applied psy- chology is not likely to be viable.

The “Postmodern,” Constructivist Alternative

Starting in the early 1960s and inspired by continental philos- ophy, the postmodern, constructivist, epistemological paradigm has arisen as an alternative to positivism. In contrast to positivism, postmodern epistemology contends that psychosocial knowledge must be constructed through naturalistic observation, not discov- ered experimentally. It is intrinsically subjective, perspectival, context bound, evaluative, fragmented, nonfoundational, and re- flective of multiple realities (Denzin & Lincoln, 2000; Fishman, 1999; Gergen, 2000).

Starting in the 1930s, and continuing into the 1970s, positivism was also being challenged from within its ranks by Anglo Amer- ican, “postpositivist” philosophical ideas:

Popper, Kuhn, Quine, Feyerabend, and Wittgenstein all sound a similar theme, emphasizing the limitations if not the impossibility of objective, scientific knowledge because of our embeddedness in the logical, cultural, cognitive, and linguistic preconditions of that knowledge—preconditions that change according to historical and cultural context. For Popper, these preconditions include the de- ductive theoretical principles that we simply have to assume with- out being able to prove them; for Kuhn, these preconditions are scientific paradigms; for Quine and Feyerabend, they are webs of belief; and for Wittgenstein, they are language games (Fishman, 1999, pp. 87– 88).

Pragmatic Psychology as a “Third Way” in Applied Psychology

Postmodernism’s fragmenting, dialectical epistemological chal- lenge to positivist-inspired models certainly rules out straightfor- ward unity in basic psychology in J. G. Miller’s sense—and by logical extension, in applied psychology. For if basic researchers cannot come to an agreement on the underlying laws of human behavior, there is no resulting foundation from which applied psychology can deductively derive technologies for the effective amelioration of human problems.

However, we believe our pragmatic adoption of multiple visions can offer a “third” way. In a complementary and integrative manner, it draws on the insights of both postmodernism and positivism to create a unifying framework for applied psycholog- ical research. Pragmatic psychology is an applied psychology

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158 FISHMAN AND MESSER

model that is grounded in philosophical pragmatism—first devel- oped in the late 19th century by such thinkers as William James, Charles Peirce, and John Dewey (Menand, 2002), and later elab- orated upon by such postmodern thinkers as Richard Bernstein, Richard Rorty, and Stephen Toulmin. James and Dewey’s philo- sophical pragmatism is founded upon a social constructionist the- ory of knowledge, which is why it has been embraced by a number of postmodern thinkers. One of pragmatism’s organizing themes is the concept of contextualism:

The world is seen as an unlimited complex of change and novelty, order and disorder. Out of this total flux we select certain contexts; these contexts serve as organizing gestalts or patterns that give mean- ing and scope to the vast array of details that, without the organizing pattern, would be meaningless or invisible (Lilienfeld, 1978, pp. 9).

In other words, to understand and cope with the world, we take on different conceptual perspectives as we might put on different pairs of glasses, with each providing a different perspective. The pragmatic “truth” of a particular perspective does not lie in its correspondence with “objective reality” because that reality is continuously in flux. Rather, pragmatic truth lies in the usefulness of the perspective in helping us to solve particular problems and achieve particular goals in today’s world.

How are these problems and goals to be selected, defined, articulated, and addressed? The social constructionist epistemol- ogy of postmodernism proposes that human problems and goals are not “given” by the natural world, and thus they cannot be discovered through rational thought, as moral objectivists claim, or through natural science as others such as evolutionary psycholo- gists (e.g., Pinker, 1997; Wilson, 1999) claim. Instead, these prob- lems and goals represent the multiple purposes, intentions, desires, interests, and values of individuals and groups (R. B. Miller, 2004).

Developing Applied Psychology Knowledge Through Peer-Reviewed Journals of Pragmatic Case Studies

In sum, philosophical pragmatism holds that applied knowledge is not “given” by nature, but rather is constructed in specific human contexts to solve particular problems, ideally as democrat- ically agreed upon by relevant stakeholders. Building on this way of thinking, pragmatic psychology proposes that in deciding on what should be the basic unit of knowledge in applied psychology, we should start from the point at which knowledge is ultimately applied. That end point is the single, contextually situated case, because the ultimate purpose of applied psychological knowledge is to improve the condition of actual clients within the complexi- ties of their reality, whether the “client” be an individual, family, group, organization, or community.

It has been argued that knowledge of a single case lacks “ex- ternal validity,” that is, the capacity to generalize to other situa- tions, which one can do deductively within the positivist paradigm via the group experimental study. Nevertheless, single case studies contain the potential to inductively generalize across settings (Fishman, 1999). This can occur by organizing case studies of clients with similar target goals and similar intervention ap- proaches into computerized databases. It is true that any single case study is limited by the particular contextual differences that can occur between any one case and any other case that is ran-

domly drawn from a heterogeneous case pool. However, as cases in the database grow and include a wide variety of contextually different situations and types of interventions, the probability increases for the accumulation of more and more comparable cases.

An informative example of a large database of cases guiding practitioners’ decision-making is that of case law within the U.S. legal system. To facilitate decision-making in a target case based upon past case precedents, the legal practitioner (prosecuting at- torney, defense lawyer, judge, etc.) can go to at least two huge databases of cases and related materials in the United States: Lexis and Westlaw. Each contains tens of thousands of legal cases that can act as precedents. (For the parallel between these databases and the case study approach in applied psychology, see Fishman’s [2003] “Psycholegal Lexis Proposal”).

In light of the above, pragmatic psychology, through the PCS Method, calls for the creation of peer-reviewed “journal- databases” of systematic case studies (Fishman, 2000, 2001). To create such databases at the highest level of scholarship, quality standards have been established for the information associated with case studies, including both quantitative data (e.g., Jacobson & Truax, 1991); qualitative data (e.g., Elliott, Fischer, & Rennie, 1999; Fishman, 1999; McLeod, 2010); and “mixed methods” strategies for integrating both types of data (e.g., Teddlie & Tasha- korrie, 2009). Being online, the journal databases would be able to accommodate, first, a large number of “thickly described” cases and, second, easy accessibility to search the considerable amount of qualitative and quantitative material in the cases. To accommo- date the developing “bootstraps” nature of case study knowledge, the databases would be structured like a wheel:

The hub of the wheel would consist of articles of two types: (a) those that address epistemological, theoretical, methodological, logistical, economic, political, and ethical issues in the develop- ment of insightful and useful, systematic case studies in the prob- lem area; and (b) substantive cross-case analyses of groups of individual cases already published in the database. The spokes of the wheel would each consist of particular databases of types of cases within the content area, embodying the issues and applied usefulness associated with practice in the content area (Fishman, 2001, p. 299).

The first author (Daniel B. Fishman) has pilot-tested the devel- opment of different elements of such journal-databases in a variety of applied psychology areas, including demonstrating the logic of the approach in school psychology (Fishman, 1999, chapter 9); editing a special journal issue of such case studies in forensic psychology (Fishman, 2003, 2004); and editing another in a com- bination of school, community psychology, and organizational psychology (Fishman & Neigher, 2003, 2004). In addition, since 2005, through the Graduate School of Applied and Professional Psychology at Rutgers University, we have developed a scholarly journal, Pragmatic Case Studies in Psychotherapy (http://pcsp .libraries.rutgers.edu; Fishman, 2005). PCSP is a peer-reviewed, quarterly, open access, online, international, trans-theoretical jour- nal of both case studies and case method articles, the latter paral- leling component (a) in the hub of the wheel above. With an editorial board of 65 members, PCSP’s acceptance and visibility are reflected in its 4,000 subscribers and, through the end of 2012, the publication of 163 articles, which have been accessed by readers through more than 280,000 electronic hits.

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159PRAGMATIC CASE STUDIES AS A SOURCE OF UNITY

In addition, our latest project (Fishman, Dattilio, Edwards, and Messer, 2013) involves demonstrating how, via a mixed-methods paradigm, the group-based, quantitative knowledge from a ran- domized clinical trial (RCT) in psychotherapy can be integrated with individualized, qualitative knowledge from case studies drawn from the RCT. The logic and structure of this project, which are generic for all areas of applied psychology, contribute to unifying applied psychology by showing how knowledge from systematic psychotherapy case studies can be unified from the “bottom up” with the results of group experimental research. As a final aspect of integration, Fishman (2012) has recently shown how pragmatic case studies can be integrated with four other models of systematic case study research that McLeod (2010) has identified, including those that focus on theory-building, the ad- judication of truth claims about psychotherapy outcome and its connection to psychotherapy process, the narrative experience of the participants, and single-case experimental designs.

Summary and Conclusion

In going from unification via the individual therapy case of Mrs. B. to Miller’s grand unification of the social sciences and biology—are we talking about the same discipline?! Yes, we believe that these two examples dramatize the difference between a top-down versus a bottom-up approach to unity in applied psychology. We have argued that although the advent of postmod- ern, postpositivist, and pluralistic perspectives in psychology have undermined the top-down, positivist approach to unification rep- resented by Miller’s model, a “third way” to such unity is possible via a bottom-up strategy that draws upon both positivist and postmodern elements and themes. This is the PCS Method, which proposes the creation of peer-reviewed journal databases of sys- tematic case studies in applied psychology areas like psychother- apy, allowing for unifying themes and theoretical generalizations within areas to emerge inductively through cross-case analysis. Paralleling the technique of meta-analysis for reviewing and eval- uating the results of group-based, quantitative studies, a method for such cross-case analysis is emerging under the name “meta- synthesis” (Iwakabe & Gazzola, 2009; Timulak, 2007). In line with this, some psychologists (e.g., Bromley, 1986, and R. B. Miller, 2004) have begun to translate the logic and quality stan- dards from the “case law” tradition in the judicial system to the task of generalizing across applied psychology case studies. (Also related to this goal is Fishman’s [2003] “Psycholegal Lexis Pro- posal,” mentioned above.)

An important strength of the PCS Method from a unifying point of view is its resonance with parallel efforts in the basic research arena by authors such as Sternberg and colleagues (Sternberg & Grigorenko, 2001; Sternberg, Grigorenko, & Kalmar, 2001), using examples from the areas of prejudice and intelligence. These authors start with phenomena—that is, the behavior and experi- ences of individuals in specific situations that can be captured in case examples—and then develop multiple, complementary theo- ries for explaining such phenomena in a “converging,” unifying way. In other words, the ontological reality of what psychology as a discipline addresses are cases, that is, individual instances of the history of people’s lives and their ongoing and changing percep- tions, cognitions, emotions, behaviors, personalities, relationships, and positions in organizational and cultural contexts. In contrast,

psychology’s generalizations and theories are human constructions designed as conceptual tools to help us understand and manage this reality; our generalizations and theories are not the reality itself.

With the above in mind, we suggest that there is a strong argument that cases are the basis of unity in all of psychology, not just in applied psychology; and that it would be worthwhile for the field to further explore the rationale and implications of this line of thinking. One of those implications would be the development of case study-based journals in basic psychology. These would create rigorously and systematically descriptive databases, along with associated theories acting as “conceptual tools” as illustrated in the case of Mrs. B. Such descriptive databases are now present and foundational in such fields as botany, zoology, and molecular biology, but sorely missing in psychology, both basic and applied. In short, we have argued in this article that, to paraphrase the old Chinese saying, the long journey to unity in applied psychology (and perhaps in basic psychology also) starts with a single, indi- vidual case.

References

Andrews, J. D. W. (1989). Integrating visions of reality: Interpersonal diagnosis and the existential vision. American Psychologist, 44, 803– 817. doi:10.1037/0003-066X.44.5.803

Bromley, D. B. (1986). The case study method in psychology and related disciplines. Chichester, UK: Wiley.

Denzin, N. K., & Lincoln, Y. S. (Eds.). (2000). Handbook of qualitative research (2nd ed.). Thousand Oaks, CA: Sage.

Elliott, R., Fischer, C. T., & Rennie, D. L. (1999). Evolving guidelines for publication of qualitative research studies in psychology and related fields. British Journal of Clinical Psychology, 38, 215–229. doi: 10.1348/014466599162782

Fishman, D. B. (1999). The case for pragmatic psychology. New York, NY: NYU Press.

Fishman, D. B. (2000). Transcending the efficacy versus effectiveness research debate: Proposal for a new, electronic “Journal of Pragmatic Case Studies”. Prevention & Treatment, 3, Article 8. Retrieved from http://journals.apa.org/prevention/

Fishman, D. B. (2001). From single case to database: A new method for enhancing psychotherapy, forensic, and other psychological practice. Applied & Preventive Psychology, 10, 275–304. doi:10.1016/S0962- 1849(01)80004-4

Fishman, D. B. (2003). Background on the “Psycholegal Lexis Proposal”: Exploring the potential of a systematic case study database in forensic psychology. Psychology, Public Policy, and Law, 9, 267–274. doi: 10.1037/1076-8971.9.3-4.267

Fishman, D. B. (2004). Integrative themes: Prospects for developing a “psycholegal lexis.” Psychology, Public Policy, and Law, 10, 178 –200. doi:10.1037/1076-8971.10.1-2.178

Fishman, D. B. (2005). Ed.’s introduction to PCSP—from single case to database: A new method for enhancing psychotherapy practice. Prag- matic Case Studies in Psychotherapy, 1(1), 1–50. Retrieved from http:// hdl.rutgers.edu/1782.1/pcsp_journal

Fishman, D. B. (2012). Ed.’s introduction: Combining pragmatic case studies within a single case experimental design. Pragmatic Case Stud- ies in Psychotherapy, 8, 245–254. Retrieved from http://hdl.rutgers.edu/ 1782.1/pcsp_journal

Fishman, D. B., Dattilio, F. M., Edwards, D. J. A., & Messer, S. B. (2013). Case studies within clinical trials: Integrating qualitative and quantita- tive methods. Manuscript submitted for publication.

Fishman, D. B., & Neigher, W. D. (2003). Publishing systematic, prag- matic case studies in program evaluation: Rationale and introduction to

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be di

ss em

in at

ed br

oa dl

y.

160 FISHMAN AND MESSER

the special section. Evaluation and Program Planning, 26, 421– 428. doi:10.1016/S0149-7189(03)00059-4

Fishman, D. B., & Neigher, W. D. (2004). Publishing systematic, prag- matic case studies in program evaluation: Collateral on a “promissory note”. Evaluation and Program Planning, 27, 105–113. doi:10.1016/j .evalprogplan.2003.07.001

Frye, N. (1957). Anatomy of criticism. New York, NY: Athenaeum. Gergen, K. J. (2000). The saturated self. New York, NY: Basic Books. Iwakabe, S., & Gazzola, N. (2009). From single case studies to practice-

based knowledge: Aggregating and synthesising case studies. Psycho- therapy Research, 19, 601– 611. doi:10.1080/10503300802688494

Jacobson, N. S., & Truax, P. (1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychologv, 59, 12–19.

Lilienfeld, R. (1978). The rise of systems theory: An ideological analysis. New York, NY: Wiley.

McLeod, J. (2010). Case study research in counselling and psychotherapy. Thousand Oaks, CA: Sage.

Menand, L. (2002). The metaphysical club: A story of ideas in America. New York, NY: Farrar Straus & Giroux.

Messer, S. B. (2000). Applying the visions of reality to a case of brief therapy. Journal of Psychotherapy Integration, 10, 55–70. doi:10.1023/ A:1009470427889

Messer, S. B. (2011). Theory development via single cases: A case study of the therapeutic relationship in psychodynamic therapy. Pragmatic Case Studies in Psychotherapy, 7, 440 – 448. Retrieved from http://hdl .rutgers.edu/1782.1/pcsp_journal

Messer, S. B., & Winokur, M. (1984). Ways of knowing and visions of reality in psychoanalytic therapy and behavior therapy. In S. B. Messer & H. Arkowitz (Eds.), Psychoanalytic therapy and behavior therapy: Is integration possible? (p. 63–100). New York, NY: Plenum Press. doi: 10.1007/978-1-4613-2733-2_5

Messer, S. B., & Woolfolk, R. L. (1998). Philosophical issues in psycho- therapy. Clinical Psychology: Science and Practice, 5, 251–263. doi: 10.1111/j.1468-2850.1998.tb00148.x

Miller, J. G. (1978). Living systems. New York, NY: McGraw-Hill. Miller, R. B. (2004). Facing human suffering: Psychology and psychother-

apy as moral engagement. Washington, DC: American Psychological Association. doi:10.1037/10691-000

Peterson, D. R. (1991). Connection and disconnection of research and practice in the education of professional psychologists. American Psy- chologist, 40, 441– 451. doi:10.1037/0003-066X.40.4.441

Pinker, S. (1997). How the mind works. New York, NY: Norton. Schafer, R. (1976). A new language for psychoanalysis. New Haven, CT:

Yale University Press. Sternberg, R. J. (Ed.). (2005). Unity in psychology: Possibility or pipe-

dream? Washington, DC: American Psychological Association. doi: 10.1037/10847-000

Sternberg, R. J., Grigorenko, E. L., & Kalmar, D. A. (2001). The role of theory in unified psychology. Journal of Theoretical and Philosophical Psychology, 21, 99 –117. doi:10.1037/h0091200

Teddlie, C. B., & Tashakorrie, A. (2009). Foundations of mixed methods research: Integrating quantitative and qualitative approaches in the social and behavioral sciences. Thousand Oaks, CA: Sage.

Timulak, L. (2007). Identifying core categories of client-identified impact of helpful events in psychotherapy: A qualitative metaanalysis. Psycho- therapy Research, 17, 305–314. doi:10.1080/10503300600608116

Wile, D. B. (1984). Kohut, Kernberg, and accusatory interpretations. Psychotherapy: Theory, Research, Practice, Training, 22, 793– 802. doi:10.1037/h0085571

Wilson, E. O. (1999). Consilience: The unity of knowledge. New York, NY: Vintage.

Received April 4, 2013 Accepted April 9, 2013 �

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161PRAGMATIC CASE STUDIES AS A SOURCE OF UNITY