Shigeru Iwakabe

From single-case studies to practice-based knowledge: Aggregating and synthesizing case studies

Abstract Recent developments in case study methodology reflect a rising interest that clinicians and researchers share in building a clinically useful and empirically sound knowledge base from single-case studies. The present article describes three types of single-case studies (clinical, experimental, systematic) and examines their potential contributions to psychotherapy research. It then lays out three ways in which single-case studies can be aggregated and synthesized to enhance clinical understanding: (a) a case database that allows clinicians to efficiently search for relevant cases, (b) a metasynthesis of single-case studies that integrates common themes across similar cases, and (c) an individual case comparison method in which closely matched cases are compared to identify both therapeutic and hindering processes.

Psychotherapy Integration in Japan

Psychotherapy in Japan is a relatively new area of practice growing rapidly in the last 10 years, especially in the area of education as the problems associated with school-aged children such as bullying and truancy became one of the major social challenges. The majority of Japanese psychotherapists practice approaches developed in North America and Europe, and Jungian theory has been influential to Japanese psychotherapists. Psychotherapy integration in Japan often take a form of cultural integration that takes two routes: adjusting and modifying technical procedures in the western psychotherapy to suit Japanese client population and developing theoretical concepts that are more in agreement with Japanese culture and its underlying worldview. Psychotherapists in Japan emphasize the importance of a non-talking cure, or silent processes and often employ nonverbal tasks such as drawing and sandbox. They have also developed innovative theoretical constructs that emphasize the importance of healthy dependence between mother and child.

Making a case for case studies in psychotherapy training: A small step towards establishing an empirical basis for psychotherapy training

The evidence debate in psychotherapy pays little attention to developing an evidence base for training practices. Understanding effective training requires an examination of what makes training work. This article examines the role of case studies in psychotherapy training. This has not been articulated explicitly or researched systematically in spite of its cardinal importance. An analysis of the role of case studies in psychotherapy training is presented. Reading, watching, or hearing about cases can offer novice psychotherapists access to a closed world; access to psychological theory in action; access to whole courses of therapy; access to different approaches; access to significant moments; access to the therapeutic relationship; access to a wide range of client types; access to working in different contexts; and the opportunity of identifying with therapists and clients. Writing or presenting cases offer students the opportunity of: learning to integrate information into a relevant whole; being in the ‘hot seat’; learning to give appropriate feedback; assessing the validity of interpretations, inferences, and interventions; adapting methods to suit the client; and learning to collaborate with other professionals. The paper presents directions for future research into psychotherapy training, specifically proposing an international survey of training practices at psychotherapy training institutions.

Corrective emotional experience in an integrative affect‐focused therapy: Building a preliminary model using task analysis

OBJECTIVE The present study constructed a preliminary process model of corrective emotional experience (CEE) in an integrative affect-focused therapy. METHOD Task analysis was used to analyse 6 in-session events taken from 6 Japanese clients who worked with an integrative affect-focused therapist. The 6 events included 3 successful CEEs and 3 partially successful CEEs for comparison. RESULTS A rational-empirical model of CEE was generated, which consisted of two parallel client change processes, intrapersonal change and interpersonal change, and the therapist interventions corresponding to each process. Therapist experiential interventions and therapist affirmation facilitated both intrapersonal and interpersonal change processes, whereas his relational interventions were associated with the interpersonal change process. The partially successful CEEs were differentiated by the absence of the component of core painful emotions or negative beliefs in intrapersonal change process, which seemed crucial for the interpersonal change process to develop. CONCLUSIONS CEE is best represented by a preliminary model that depicts two parallel yet interacting change processes. Intrapersonal change process is similar to the sequence of change described by the emotional processing model (Pascual-Leone & Greenberg, ), whereas interpersonal change process is a unique contribution of this study. Interpersonal change process was facilitated when the therapists active stance and use of immediacy responses to make their relational process explicit allowed a shared exploration. Therapist affirmation bridged intrapersonal change to interpersonal change by promoting an adaptive sense of self in clients and forging a deeper emotional connection between the two.

Learning and difficult experiences in graduate training in clinical psychology: A qualitative study of Japanese trainees’ retrospective accounts

This study examined the experiences of Japanese clinical psychology trainees in their graduate school with the aim of identifying factors that might enhance or hinder their learning and professional development. We analyzed the interview data obtained from 17 clinical psychologists using grounded theory approach. Two major category groups were generated: Developing as a Clinician and Difficulties. The primary positive learning experiences in Developing as a Clinician were labeled “Hot Learning,” in which trainees acquired professional knowledge and skills through close interpersonal engagement with clients, peers, faculty, and supervisors. In contrast, Difficulties involved trainees’ negative experiences resulting in feelings of self-doubt and incompetence. These experiences occurred in close but sometimes conflicted interpersonal contexts, where trainees felt evaluated in a manner incommensurate with the support they received. We found that the quality of interpersonal relationships, which provided the context for optimal learning for trainees, was paramount to the definition of positive versus difficult learning experiences. Implications for therapist training, professional development and future research are discussed.