Case study - Lavarenne et al. (2013)

Question 1

Define the term “ego boundary”.

Answer 1

The concept that individuals can distinguish between self and not-self/reality and fiction

Question 2

Define the term “weak ego boundary”.

Answer 2

A person fearing that they will break apart, be annihilated or wishing to be a part of someone else

Question 3

What was the aim of the Lavarenne et al case study?

Answer 3

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

Question 4

What was the methodology of the Lavarenne et al case study? (2 points)

Answer 4

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

Question 5

What was the procedure of the Lavarenne et al case study? (3 points)

Answer 5

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

Question 6

What were the names of the 6 members of the Thursday group in the Lavarenne case study?

Answer 6

Brett
Earl
Deena
Dan
Dillon
Andy

Question 7

What are Brett’s qualities and what did they find about him? (4 points)

Answer 7

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

Question 8

What are Earl’s qualities and what did they find about him? (4 points)

Answer 8

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

Question 9

What are Deena’s qualities and what did they find about him? (3 points)

Answer 9

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

Question 10

What are Dan’s qualities and what did they find about him? (3 points)

Answer 10

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

Question 11

What are Dillon’s qualities and what did they find about him? (2 points)

Answer 11

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

Question 12

What are Andy’s qualities and what did they find about him? (3 points)

Answer 12

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

Question 13

What was the conclusion of the Lavarenne et al case study? (2 points)

Answer 13

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

Question 14

How generalisable is the Lavarenne case study? (4 points)

Answer 14

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

Question 15

How is the Lavarenne case study reliable? (2 points)

Answer 15

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

Question 16

How is the Lavarenne case study not reliable? (2 points)

Answer 16

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

Question 17

How applicable is the Lavarenne case study? (3 points)

Answer 17

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

Question 18

How valid is the Lavarenne case study? (4 points)

Answer 18

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

Question 19

How ethical is the Lavarenne case study? (3 points)

Answer 19

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