Case study - Lavarenne et al. (2013) Flashcards
Define the term “ego boundary”.
The concept that individuals can distinguish between self and not-self/reality and fiction
Define the term “weak ego boundary”.
A person fearing that they will break apart, be annihilated or wishing to be a part of someone else
What was the aim of the Lavarenne et al case study?
To investigate how 6 out-patients use a single 45-minute group open-ended unstructured psychotherapy session to provide firm boundaries which support them with Sz
What was the methodology of the Lavarenne et al case study? (2 points)
Case study approach - in-depth idiographic approach to triangulate the psychotic thoughts and emotions experienced by the patients through observation and interview
Longitudinal design - focused on a long-established therapy group where pre-doctoral psychology interns had trained since 1997
What was the procedure of the Lavarenne et al case study? (3 points)
Weekly 45-minute sessions with the ‘Thursday Group’ led by 3 therapists with 6 patients
The therapists qualitatively recorded and coded psychotic, manic or depressed thoughts and behaviours
Data had been recorded for 7 years - patient attendance ranged from 3 months to 2 to 22 years
What were the names of the 6 members of the Thursday group in the Lavarenne case study?
Brett
Earl
Deena
Dan
Dillon
Andy
What are Brett’s qualities and what did they find about him? (4 points)
Nationality: Irish-Catholic, Caucasian
Disorder: Sz
Main finding:
+ He gave out a Christmas card and calendar to group members
+ Card served as a social process to link and connect the group
+ Reinforced the group boundary and helped to solidify his
What are Earl’s qualities and what did they find about him? (4 points)
Race: African American
Disorder: Sz
Main finding:
+ Rejected gifts from Brett
+ Has an underlying fear of being annihilated
+ Accepting it may have triggered fragmentation fears
What are Deena’s qualities and what did they find about him? (3 points)
Occupation: Master’s student
Disorder: Sz affective disorder
Main finding:
+ Reported having nightmares - psychiatrist suggested she be tested for sleep apnoea
+ Fragile Ego boundary - her focus between being awake and asleep is blurred
What are Dan’s qualities and what did they find about him? (3 points)
Struggles with control of space - becomes angry
He was silent for 6 months when he joined - now he doesn’t stop talking
His ego boundary is extremely fragile- showed the group burns on his arms he had got from being distracted while cooking
What are Dillon’s qualities and what did they find about him? (2 points)
Likes time for himself and does not enjoy relatives coming to stay at his home over Christmas
Indicates:
+ Fragile ego boundary
+ Limited tolerance to personal space and closeness
What are Andy’s qualities and what did they find about him? (3 points)
A sexually repressed and very competent mother
She often helps her daughter and relatives with homework after school each day
Self-sacrificing behaviours enable her to deal with her fragile Ego boundaries
What was the conclusion of the Lavarenne et al case study? (2 points)
All 6 members of the group had fragile ego boundaries, expressed in various ways
The group served as ‘an auxiliary Ego-structuring mechanism’ to offer a stabilising force and promote psychological growth and stronger Ego defences
How generalisable is the Lavarenne case study? (4 points)
Low generalisability due to unique and small sample population
The small sample of 6 patients in total - 4 males and 2 females
Both genders included but the sample population is predominantly androcentric and consists of a unique population of Sz psychotic patients experiencing grandiose delusions
Makes it difficult to generalise the findings to other patients - not representative for those experiencing less severe psychosis or other disorders like AN
How is the Lavarenne case study reliable? (2 points)
Multiple researchers recording data as part of a long-established therapy group - the observations made by 3 therapists ensure consistency, increasing inter-rater reliability
Data obtained can also be compared to 7 years of records strengthening the reliability
How is the Lavarenne case study not reliable? (2 points)
Case studies are unusual by nature - low reliability as replicating them exactly is unlikely
The group session was not videotaped or audio-recorded - other researchers cannot validate the claims made, reducing reliability
How applicable is the Lavarenne case study? (3 points)
Findings could be used by other psychologists to provide a new understanding and insight into group psychotherapy
Sigman (1996):
Patients who had participated in group therapy for more than 2 years had decreased their hospitalisation days by more than 50%
Relevant application in real-life settings when providing group therapy for psychosis Sz patients
How valid is the Lavarenne case study? (4 points)
Case studies use the qualitative approach, yielding rich, insightful data - increased internal validity
Case studies are subjective to the researchers’ interpretation - researcher bias could influence the findings
Little control over extraneous variables like:
+ Mood
+ Drug medication side effects
Difficult to establish cause and effect between group therapy sessions and promoting psychological growth
How ethical is the Lavarenne case study? (3 points)
The group session was not videotaped or audio-recorded - confidentiality of patients was protected, reinforcing the ‘safe & trusted container’ created
Allowed participants to explore innermost feelings in a safe and trusted place - ‘the container’
Sharing fantasies with other Sz patients could reinforce the delusions, meaning patients could internalise the fantasies of others in the group
