Assignment 2: Case study – Template and tips

Mediation enables co-parenting relationships

Assignment 2: Case study – Template and tips

Contents

Overview of the assignment………………………………………………………………………………… 2

Aim of the Case Study assignment…………………………………………………………………….. 2

Selecting a behaviour……………………………………………………………………………………… 2

Overview of structure…………………………………………………………………………………….. 3

General formatting notes………………………………………………………………………………… 3

Frequently Asked Questions…………………………………………………………………………….. 3

Assignment structure………………………………………………………………………………………… 5

HEADING: Reason for Referral………………………………………………………………………….. 5

HEADING: Assessment……………………………………………………………………………………. 5

SUBHEADING: Behaviour Description……………………………………………………………… 5

SUBHEADING: Behaviour Explanation……………………………………………………………… 6

HEADING: Intervention…………………………………………………………………………………… 7

SUBHEADING: Intervention goal…………………………………………………………………….. 7

SUBHEADING: Evidence-based research…………………………………………………………… 7

SUBHEADING: Intervention design………………………………………………………………….. 8

HEADING: Implementation and Evaluation………………………………………………………….. 8

HEADING: References…………………………………………………………………………………….. 9

HEADING: Appendix……………………………………………………………………………………….. 9

Overview of the assignment

Aim of the Case Study assignment

The ‘Case Study’ assignment gives you a chance to explore the basic structure and process through which a psychological problem (behaviour, emotion, thought, etc.) may be explored, understood, and addressed in a clinical setting. The assignment allows you to demonstrate your understanding of the motivations behind a particular behaviour, plan an intervention to change the behaviour, describe your implementation of the plan, and provide an evaluation of the outcome. We also want you to include an appendix containing a graph or figure and the support material you have made use of, most importantly including the data collection or behaviour tracking sheets you used.

There are three aims for the Case Study:

  1. To encourage you to self-reflect upon the motivations behind your own behaviours.
  2. To allow you to research and explore evidence-based methods for modifying a motivated behaviour.
  3. To introduce you to the basic process clinicians work through when attempting to understand and alter a motivated behaviour.

The key things we are looking for are:

  • Demonstration of your understanding of the sections of a clinical case study (putting the right information into the right sections).
  • Demonstration of an appropriate breadth of assessment of the various factors that may influence the chosen behaviour.
  • A clear logical flow through the sections. For example:
    • Your assessment (description and explanation) has to be about the behavioural problem

identified in your ‘reason for referral’ section.

  • Your intervention has to make sense given your assessment of the behaviour.
    • You need to implement and evaluate the actual plan you describe in your ‘intervention design’

section.

  • Adequate research justification of the intervention you have chosen.

Selecting a behaviour

We would like you to select a behaviour in yourself that you would like to change. It could be something you would like to do:

  • less than you currently do (for example, spend less time on your phone or watching television)
  • more than you currently do (e.g. exercise more, socialise more, drink more water)
  • differently than you currently do it (e.g. change sleep patterns, alter study/exercise routines)

The behaviour should be something that causes you a small amount of distress or frustration, but not something that is very challenging or overwhelming for you. For example, you may be dealing with difficult issues or psychological problems in your life, and we would NOT want you to work on these difficult issues for the assignment.

To pick an appropriate behaviour for the assignment:

  • Make a list of behaviours you do (or don’t do) that currently cause you some distress or frustration.
  • For each behaviour, rate how much distress it causes you on a scale from 1-5, where a rating of 1 or 2 would indicate a small amount of distress (e.g. a small problem you might publicly admit to on social media) and 4 or 5 indicate serious problems (e.g. that you might seek professional help for).
  • Pick a behaviour that is easily measurable that you have rated as a 1 or 2.

Overview of structure

Start with a cover page containing the usual information (name, student number, unit, etc.).

After the cover page, the body of your assignment MUST be structured using the following headings and subheadings:

  • Reason for Referral
  • Assessment
  • Behaviour Description
  • Behaviour Explanation
  • Intervention
  • Intervention goal
  • Evidence-based research
  • Intervention design
  • Implementation and Evaluation
  • References
  • Appendix

What we expect in each of these sections is broken down for you in the rest of this document.

General formatting notes

  • Referencing:
    • References are essential in the ‘Evidence-based research’ section. They must be cited as per APA 7th

edition rules and listed in the reference list.

  • References are NOT required in ANY other section of the assignment. However, if you wish to include any other material that you have obtained from another source (e.g. if you decided to use a publicly available questionnaire or tracking sheet rather than making your own), you must also cite and reference that material according to usual APA rules.
  • Writing style:
    • Write in the third person (even though this is about you) and use a formal (i.e. academic) writing style, rather than casual language.
    • Write concisely in prose (do NOT use dot points to save space).
  • Formatting and word count:
    • Double-space your work!!!
    • The usual 10% rule applies for the word count (i.e. we will accept up to 2200 in length). The word count does NOT include the appendix, any graphs/figures, or reference list.
    • o   Carefully check the expected length/size of the various sections in the template.

Frequently Asked Questions

Can I pick a behaviour in someone else to change, rather than myself?

No! It would be unethical to do for the purposes of a university assignment. It needs to be a behaviour in yourself. However, if you are uncomfortable in disclosing certain personal information in your assignment, you may alter your personal information slightly (e.g. list your age as something close to but not your actual age).

Can I use other people as part of my intervention?

With their full consent, yes. For example, you may ask a friend or family member to monitor your adherence to your planned intervention, and to administer a reinforcer or punisher based on your behaviour.

I am seeing a psychologist for an existing problem. Can I base the assignment around the work I am doing with them?

We would prefer you NOT use a problem serious enough to warrant professional support for the assignment. However, you may do so as long as you recognise the risks and believe you can complete the assignment without becoming too distressed. Please speak with your psychologist about the assignment before deciding to go down this path and check in with them during your data collection and intervention.

Can I pick a ‘feeling’ or ‘emotion’ (e.g. anger or anxiety) that I want to change, rather than a ‘behaviour’? Yes, you may. However, note that it is often much easier to focus on a simple, observable behaviour for the assignment. Students that choose to measure and change a ‘feeling/emotion’ run the risk of confusing

feelings/emotions for behaviours in their writing, which loses them marks. If you want to go down this path, just make sure you are VERY clear in your writing when you are referring to internal subjective emotional/feeling states, vs externally observable overt behaviours that may be motivated by those internal states.

Can I use multiple components in my intervention?

Yes, but you would be better off just sticking to one component. Remember, a key thing we are looking for is the logical connection between your assessment, your intervention, and your evaluation of the success of the intervention. If your intervention contains multiple parts, it makes it very difficult to tease apart which parts of the intervention may have caused any observed change in the behavioural data. If you choose to include multiple parts to your intervention, make sure to clearly indicate what conclusion you can and cannot draw about the

intervention’s efficacy in your ‘Implementation and Evaluation’ section.

Who will see the personal information in my assignment?

Only the unit coordinator and the unit’s assignment markers will have access to your assignment. Any personal information presented in the assignments will be treated confidentially.

Assignment structure

The body of your assignment must contain each of the following headings/subheadings. Carefully follow the instructions in each section to understand what to put there.

HEADING: Reason for Referral

  • Approximate length: 1 paragraph

In a formal clinical case study, this section provides a detailed history for the client, as well as some background as to the reason they are seeking support, and a history of whether they have received any support for the problem in the past. This section is often quite brief. Aim for 1 paragraph (3-4 sentences) only for the assignment.

In the first sentence you want the client’s name, age, gender identity, how they came to be seeking assistance (in most cases this is just ‘self-referred’) and identification of the problem they are wanting to address. For example: “John is a 23 year old male, self-referred for concerns around lack of physical exercise”.

After this we would like to see some further information about the client, including:

  • Their living arrangements (e.g. “Lives at home with her parents, older brother, and younger sister”)
  • Do they work/go to uni, etc.
  • Whether they have sought professional help for the problem before.

HEADING: Assessment

In a clinical case study, the assessment component is often the largest and most comprehensive section. The better you understand a behaviour, the more able you are to plan an intervention that will accurately target it.

We are not expecting a highly detailed or comprehensive assessment component here as you have not been taught how to go about this process at a professional clinical level. As you are the ‘client’ here, we are also not expecting you to engage in the kinds of formal assessment procedures such as interviews, behavioural observations, or psychometric tests, that are often used to assess behaviour in clinical settings.

However, we DO want to see a clear understanding of the range of factors that you need to explore in order to understand the CURRENT FUNCTION AND CONTEXTUAL FACTORS behind the chosen behaviour. To help you structure this, we want you to write your assessment section using the following two sub-headings:

SUBHEADING: Behaviour Description

  • Approximate length: 2-3 paragraphs

Here you need to describe the problem behaviour (or lack of behaviour) in detail, to gain a rich understanding of where, when, and how often the behaviour occurs. Things you will need to cover in your description include:

  • How often does the behaviour occur? Is the motivation behind the behaviour stronger or weaker at different times? (frequency and magnitude)
  • Are there specific times or situations in which this behaviour does and does not occur? Does it only occur around certain people, at certain times of year, or after certain events (what are the ‘antecedents’ to the behaviour)? What happens for the client after the behaviour occurs (i.e. what are the ‘consequences’ of the behaviour for the client)? (contextual information)
  • When did the behaviour first emerge (i.e. how long has this been an issue for the client)? Has the behaviour remained constant/regular since it started, or have their been periods where it gets better or worse? If it has fluctuated, what contextual factors may have related to this fluctuation? (history and time-course information)

Do NOT write this section in point form or using bullet points. Rather, present the information in normal paragraphs.

The description of the behaviour must be driven by the information you have collected/measured. In most clinical settings you would obtain much of this information directly from the ‘client’ through your clinical conversations with them. However, with non-verbal clients or clients who are unable to reflect rationally upon their behaviours (e.g. young children, clients with moderate or severe intellectual disability), you often have to obtain this information through direct observation (e.g. observing the client at school, at home, etc.) and from friends, relatives, teachers, or care workers.

Write most of your description section as if you had been gaining this information by talking to your client. For example: “John reported that he has struggled with setting up a good exercise routine ever since he started uni”.

SUBHEADING: Behaviour Explanation

  • Approximate length: 1-2 paragraphs

In this section you should construct a ‘theory’ explaining why this problem behaviour (or lack of behaviour) is occurring for the ‘client’? This is a narrative that takes all the information you collected in your assessment of the behaviour and constructs a story to try to explain why your ‘client’ has this behavioural issue – what are the factors that are maintaining the behaviour?

Examples of possible explanations might be:

TypeDescriptionExample
Environmental factorsOne or more life factors, situations, responsibilities, or stressors is preventing better behaviour.John wants to exercise more but uni and childcare responsibilities mean he has little time to instigate a regular exercise routine.
Problems with knowledge or beliefThe client lacks information required in order to change their behaviour.John wants to exercise more but doesn’t know about the different kinds of exercise routines he                                                                             could try.                                                                                                                                                   
 The client has false/irrational beliefs about the problem behaviour.*People tell John he should exercise more but he doesn’t really believe exercise is important.
Associations (reinforcers and Punishers)Negative associations with preferred behaviour (dislikes, past negative experiences, etc.) which de-motivates   preferred behaviour*                                                                                                                                                                     John hasn’t enjoyed exercising in the past;
 Desire for preferred behaviour is present, but motivation for problem behaviour is stronger.John likes watching tv more than exercising; John will fail his uni course if a regular exercise routine prevents him from studying.
Lack of skillThe client knows what they need to do to change the behaviour, but doesn’t know ‘how’ to do it.John wants to play badminton to exercise, but has never learnt how to play badminton.

A few points to keep in mind:

  • For most behavioural problems there is a combination of explanatory factors that together maintain the problem behaviour. So feel free to identify multiple possible causal factors if you need to.
  • For most of the causal explanations listed above, the client does have the desire to change the behaviour but there is something else stopping them from doing so. However for the two possible causes identified with *, the client is not currently motivated to change the behaviour. You want to think about this when planning your intervention (are you trying to change their motivation, or allow expression of an existing motivation).

In a clinical context, even after a comprehensive assessment process we may still not be 100% certain of the explanation for a problem behaviour. What we want you to do is come up with the most accurate and complete explanation for the behaviour that you can, based on the information you have collected about the ‘client’. This last point is very important… your explanation MUST be consistent with, and driven by, the information in your ‘behaviour description’ section.

HEADING: Intervention

This is where you research and plan out the intervention you are going to implement to try to change the problem behaviour. We want you to structure this section using the following subheadings:

SUBHEADING: Intervention goal

  • Approximate length: Very short (1-2 sentences)

A clear description of the goal – the preferred behaviour or change in behaviour that the ‘client’ wants to implement through the intervention. You need to be specific in describing the new behavioural goal, so that you are able to tell from your measurements whether you have been able to reach your goal or not. So be specific around how often, or for how long, the new behaviour should be seen in order for the intervention to be considered successful.

An example might be: “John would like to be exercising for a minimum of 5 hours each week.”

SUBHEADING: Evidence-based research

  • Approximate length: 3 paragraphs

A brief research review exploring evidence-based interventions for addressing the problem behaviour (you must include AT LEAST FIVE references in this section). This must end with a clear statement of which approach was selected for use in this case and why.

Most importantly, this needs to be driven by your behavioural explanation. To get you started, here are some possible intervention ideas you could research and explore, based on the same categories you used to explore the causes of the problem behaviour:

CauseDescriptionExample intervention options to explore
Environmental factorsIntervention should address the environmental factor(s) so as to remove the block stopping the preferred behaviour.Time management strategiesScheduling/timetabling/prioritisingFinancial management/savings plans/loansGaining support/assistance from othersReducing commitments/responsibilities
Problems with knowledge or beliefIf client simply lacks information, intervention should systematically   provide that information.                                                                                                                                                                    Structured educational program
 If client has false/irrational beliefs, intervention should challenge thoseIdentifying and challenging thought errorsKeeping a ‘thought diary’ to assist in thought challenging Exposure to information that challenges/argues against their unhelpful viewpoints
Associations (reinforcers and punishers)To boost motivation for the preferred behaviour…Contingent reinforcement: Reward the preferred behaviour
To reduce motivation for the problem behaviour…Contingent reinforcement: Punish the problem behaviourNon-contingent reinforcement: Find another way to satisfy the need driving the problem behaviour
Lack of skillThe client needs to learn how to perform the preferred behaviourPsychological skills (communication/social skills, conflict resolution skills, anger management, emotion regulation)Practical/motor skills (computer skills, sports, musical instruments, driving a car, fixing a leaky sink, etc.)

SUBHEADING: Intervention design

  • Approximate length: 2-3 paragraphs

Once you have selected a general approach for the intervention from your literature research, you need to describe in detail what your intervention will be, how it will be carried out (including things like timeframe, data collection methods, any equipment or resources needed), and how the intervention and data collection procedures will enable you to evaluate the effectiveness of the intervention.

This section should include the following information:

  • The research design (i.e. simple baseline, reversal, or multiple baseline) that you will use to structure your data collection and test the success of your intervention. Please note:
    • Case study research designs were discussed in detail in the week 4 eLectures… please revise that

material. You MUST base your assignment on one of these designs.

  • It is strongly recommended that you use a ‘simple baseline’ design. This involves collecting baseline measurements of the problem behaviour for approx. 1 week, then continuing those measurements for a further week while you implement your intervention, then comparing the data between the two.
    • Make sure to specify the timeframes of the sections of the design (e.g. 1 week or baseline, 1 week for intervention?)
  • How the behaviour will be measured over the baseline and intervention periods
    • Include mention of any equipment (phone apps, tracking sheets, etc.) you will use.

·        Procedural description of the intervention

  • Similar to the ‘Procedure’ part in the ‘Method’ section of a psychological report, you need to describe exactly what you will do in your intervention in enough detail so that someone could replicate your intervention after reading this section.
    • Include mention of any equipment you will use.

HEADING: Implementation and Evaluation

  • Approximate length: 2-3 paragraphs

Here you will describe your results and conclusions from your intervention. This section can be kept quite short,

but must include the following information…

Firstly, a brief account of when the intervention was carried out. This should include the start and end dates and number of days for both the baseline and intervention sections of data collection. It might start with something like: “Baseline measurement of the problem behaviour commenced on [date] and ran for 7 days. …”.

Secondly, an evaluation of the intervention’s success through comparison of the data collected between the baseline and intervention periods. Describe your data using counts, totals, or basic describe statistics (e.g. means) ONLY. We are NOT expecting statistical analysis of your collected data! You simply need to establish whether the data appears consistent with the behavioural goal you intended to achieve. An example might start with something like: “The average time spent exercising during the 7 day baseline period was 1.5 hours. This raised to 4 hours during the intervention week. While this suggests the intervention was successful in motivating behavioural change, the goal of 5 hours exercise during the intervention week was not reached.”

Thirdly, a critical analysis of any problems with your implementation. This should explore whether the intervention was implemented according to plan, any problems, errors, missed data recordings, etc. Note that you will not be marked down for any errors or problems in your intervention. What we want to see is your critical analysis of how well the intervention was implemented.

Finally, end the section with some suggestions for future improvements – a brief exploration of possible changes to the intervention plan that may have resulted in stronger results. These could be informed by your critical analysis of problems with your implementation, but could also consider other ways to alter the intervention to further reinforce any behavioural changes.

HEADING: References

Reference list in APA format, starting at the top of a new page.

HEADING: Appendix

There are two things you MUST include in your appendix:

  • A graph showing the comparison in measurements between the stages of your design (e.g. between the baseline and the intervention stages)
    • The graph should be formatted according to APA 6th edition rules, identified as ‘Figure 1’, with

clear labels on its axes.

  • Make sure to refer to the figure in your written work (typically in the ‘Implementation and Evaluation’ section).
  • The raw behavioural measurement data you collect during your baseline and intervention phases
    • We want to see how you chose to track and measure your data, and what the results looked like. The easiest and most common way to do this would be to simply include a copy of any completed data tracking sheets you made use of. Alternatively, you can include a table listing all of the data point you collected.
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Table of Contents Executive Summary                                                                                                   3 Introduction                                                                                                                5 Examination of the Chosen Health Issue in the Context of Lambeth                        5 Application of Health Inequality Framework and Analysis of Determinants: Psychotropic Drug Use in Lambeth                                                                           6 Exploration and Discussion of Strategies to Manage Psychotropic Drug Use in Lambeth                                                                                                                        7 Conclusion                                                                                                                  8

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Solution: Mirror therapy in patients post stroke

Title: Scenario 1, Mirror therapy in patients post stroke Part 1 : Summary Ramachandran and colleagues developed mirror therapy to treat amputees’ agony from phantom limbs. Patients were able to feel their amputated limb without experiencing any pain by presenting them a mirror image of their healthy arm. Since then,

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