Bradshaw (1998) - Case Study Flashcards
What is significant about this case study?
It shows how scientific research proceeds and established CBT as a treatment
Who was carol?
A 26 year old student with an upper class background in her first year of uni who had no history of psychotic illness
Was carol her real name?
No, it was a psuedonym to protect her identity
How did she know she had schizophrenia?
She began to experience auditory hallucinations and had delusions, she then withdrew from people and acted bizarly
What type of schizophrenia was she diagnosed with?
Undifferentiated type
What was her global assessment functioning score before treatment?
30/100
What anti psychotic drug did she take alongside CBT?
Thorazine but she still couldn’t function independently before the CBT
What is triangulation?
Pooling all data from research methods to look for trends and themes
What was the aim of the case study?
To investigate how CBT can be used to treat a woman with schizophrenia
It was a prospective case study which means
they tracked her progress over 3 years and followed up her progress 6 months after therapy and again after a year
What scales were her sypmtoms measured on?
- Role functioning scale (RFS)
- Global Attainment scale (GAS)
- Hospitalisation
- Global Pathology Index
What is the role functioning scale?
a score for her ability to work, socialise and live independently
What is the global attainment scale?
goals she was able to meet
What is hospitalisation?
The amount of times she was hospitalised
What us the global pathology index?
an 8 point scale measuring symptoms
What was stage 1?
Where she developed a relationship with her therapist by taking walks, they found they both had an interest in softball
How did Carol describe her condition?
“I’m no good, I can’t do anything, I’ll always be this way”
What was stage 2?
Where Carol was taught about CBT and her disorder, they set goals and discovered methods of coping with stress
What was stage 3?
The treatment stage where she learnt to manage stress, had to record her day, build coping strategies and focused on her fears e.g social situations where they challeneged her beliefs
How were her fears of relapse challenged?
She had anxiety and depression over fears of relapse which were challenged by creating a stress thermometer, scheduling activites, planning sleep patterns, exerising and dieting
What impact did the therapy have on Carol herself?
She became more confident of her stability and could talk about the impact of schizophrenia as if gave her low self esteem and made her critical of herself
How did they try and boost her self esteem?
They taught her to identify 3 positive events in her life each day, no matter how minor the event was and she had to think of positive words to describe them and herself
What happened in the ending phase?
She had to develop plans to maintain treatment without the therapist but writing cue cards with coping strategies on
Did Carol improve?
Yes, on all measures and even after a year these were still present
How did her GPI improve?
Year 1 - 6
Year 2 - 4
Year 3 - 1
How did her GAS improve?
19.85 at pre test, 80.15 in year 3
How did her RFS improve?
6 in pre test, 27 in year 3
What did the increase in her GAS show?
Her treatment goals had been attained as she started a college course and took on a volunteer job
What did the increase in RFS show?
She had few symptoms present and reported little distress
Was she ever re hospitalised?
No
How does Bradshaw and Roseborough (2004) give the study credibility?
They did a meta analysis of 22 patients, 86% improve their psychosocial functioning, 82% had reduced severity of symptoms
What is a major weakness of the case study?
That CBT wasn’t used alone so there is no guarantee that it was the CBT that produced the improvement, lacks internal validity
How is it hard to generalise to other sufferers?
She is female and it presents itself different in men, she had undifferentiated type which isn’t the only type and someone else may not build the rapport she built
How could the study be replicable?
The CBT therapy follows a standard procedure and the measures of functioning are all well established tools and the same measures were used 4 times overall, test retest reliability
What is the main application?
It has helped promote the use of CBT and lower dependency on anti psychotic drugs
How is the data more valid?
It is both quantitative and qualitative providing objective and detailed results
How were ethics respected?
She has a pseudonym, although it could be said that she wasn’t well enough to give informed consent
What are case studies?
Involves studying individuals or small groups with some kind of unique characteristic or experience, often uses triangulation
What type of data is usually gathered in a case study?
qualitative and quantitative as brain scans might take place as well as observations
When are case studies particularly useful?
When dealing with unique situations
