Person-centred therapy with a client experiencing social anxiety difficulties: A hermeneutic single case efficacy design

Abstract

Background: Social anxiety is a chronic, debilitating psychological condition. Hermeneutic Single Case Efficacy Design (HSCED) is a legalistic mixed-method case study method for evaluating therapy efficacy in single cases. Aims: Using a case of Person-Centred Therapy (PCT) with a client experiencing social anxiety difficulties, we addressed the standard HSCED research questions of pre-post client change, causal role of therapy, and change processes. In addition, we explored adaptations to HSCED for ambiguous outcomes. Method: Based on a rich case record, affirmative and sceptic cases were constructed and adjudicated by three judges. Results: The judges held that the client changed considerably (but not substantially) and that therapy contributed considerably to client change. Change processes central to PCT were held to be active, as were client resources. Implications: The new procedures enabled judges to make sense of the ambiguous outcome data and can be further extended and developed. PCT can bring about considerable change in socially anxious clients.

Keywords:

• social anxiety
• Hermeneutic Single Case Efficacy Design
• person-centred therapy

Acknowledgements

We would like to thank the client and therapist, and the three judges, Marijke Moerman, Anja Rutten and Margaret Whitelaw, for their participation in this study.