Single case experimental design : an overview

Background: In health related research, it is critical not only to demonstrate the efficacy of intervention, but to show that this is not due to chance or confounding variables. Content: Single case experimental design is a useful quasi-experimental design and method used to achieve these goals when there are limited participants and funds for research. This type of design has various advantages compared to group experimental designs. One such advantage is the capacity to focus on individual performance outcomes compared to group performance outcomes. Conclusions: This comprehensive review demonstrates the benefits and limitations of using single case experimental design, its various design methods, and data collection and analysis for research purposes.

Humming as a mean of communicating during meal time situations : A Single Case study involving a women with severe dementia and her caregiver

Objective: ‘Music Therapeutic Caregiving’, when caregivers sing for or together with persons with dementia during morning care situations, has been shown to increase verbal and nonverbal communication between persons with dementia and their caregivers, as well as enhance positive and decrease negative emotions in persons with dementia. No studies about singing during mealtimes have been conducted, and this pilot project was designed to elucidate this. However, since previous studies have shown that there is a risk that persons with dementia will start to sing along with the caregiver, the caregiver in this study hummed such that the person with dementia did not sing instead of eat. The aim of this pilot project was threefold: to describe expressed emotions in a woman with severe dementia, and describe communication between her and her caregivers without and with the caregiver humming. The aim was also to measure food and liquid intake without and with humming. Method: The study was constructed as a Single Case ABA design in which the ordinary mealtime constituted a baseline which comprised a woman with severe dementia being fed by her caregivers in the usual way. The intervention included the same woman being fed by the same caregiver who hummed while feeding her. Data comprised video observations that were collected once per week over 5 consecutive weeks. The Verbal and Nonverbal Interaction Scale and Observed Emotion Rating Scale were used to analyze the recorded interactions. Results: A slightly positive influence of communication was shown for the woman with dementia, as well as for the caregiver. Further, the women with dementia showed a slight increase in expressions of positive emotions, and she ate more during the intervention. Conclusion: Based on this pilot study no general conclusions can be drawn. It can be concluded, however, that humming while feeding persons with dementia might slightly enhance communication, and positive expressed emotions in persons with dementia. To confirm this, more studies on group levels are needed. Because previous studies have found that caregiver singing during caring situations influences persons with dementia positively it might be desirable to test the same during mealtime.

Diagnosis and treatment of an obsessive-compulsive disorder following traumatic brain injury: A single case and review of the literature

A 27-year-old patient with traumatic brain injury and neuropsychiatric symptoms fitting the obsessive-compulsive disorder was investigated. Brain CT-scan revealed left temporal and bilateral fronto-basal parenchymal contusions. Main Outcome Measure was the Yale-Brown Obsessive Compulsive Scale at pre- and post-treatment and at 6 months follow-up. The combination of pharmacotherapy and psychotherapy resulted in lower intensity and frequency of symptoms. Our case illustrates the importance of a detailed diagnostic procedure in order to provide appropriate therapeutic interventions. Further studies are needed to guide the clinician in determining which patients are likely to benefit from a psychotherapeutic intervention in combination with pharmacotherapy.

Using Single-Case Participatory Action Research as a Methodology to Explore Appalachian Summer Camp Communities

Community educators have long known the value of direct experience in the learning process. Participatory action research extends this philosophy to the realm of research. This article examines the value of involving front line camp staff, members of the camp community in Appalachia as practitioner researchers with university scientists in studying the type and conditions of transformative learning in young adult camp staff. A young adult who was a camp community member assisted the researchers with methodology, data analysis, data interpretation, and dissemination of findings. This resulted in a more accurate, richer, and thicker description of the camp community member’s transformative learning experience. The benefits of involving practitioner researchers are examined, as well as promising practices for conducting participatory action research in community education environments.

The temporal evolution of nonverbal synchrony in outpatient psychotherapy: An aggregation of single-case studies

Objective: The authors quantified nonverbal synchrony—the coordination of patient's and therapist's movement—in a random sample of same-sex psychotherapy dyads. The authors contrasted nonverbal synchrony in these dyads with a control condition and assessed its association with session-level and overall psychotherapy outcome. Method: Using an automated objective video analysis algorithm (Motion Energy Analysis; MEA), the authors calculated nonverbal synchrony in (n = 104) videotaped psychotherapy sessions from 70 Caucasian patients (37 women, 33 men, mean age = 36.5 years, SD = 10.2) treated at an outpatient psychotherapy clinic. The sample was randomly drawn from an archive (N = 301) of routinely videotaped psychotherapies. Patients and their therapists assessed session impact with self-report postsession questionnaires. A battery of pre- and postsymptomatology questionnaires measured therapy effectiveness. Results: The authors found that nonverbal synchrony is higher in genuine interactions contrasted with pseudointeractions (a control condition generated by a specifically designed shuffling procedure). Furthermore, nonverbal synchrony is associated with session-level process as well as therapy outcome: It is increased in sessions rated by patients as manifesting high relationship quality and in patients experiencing high self-efficacy. Higher nonverbal synchrony characterized psychotherapies with higher symptom reduction. Conclusions: The results suggest that nonverbal synchrony embodies the patients' self-reported quality of the relationship and further variables of therapy process. This hitherto overlooked facet of therapeutic relationships might prove useful as an indicator of therapy progress and outcome. (PsycINFO Database Record (c) 2015 APA, all rights reserved)

Nutritional intervention program in elite athletes: single case design research with one professional basketball player

The American College of Sports Medicine argues that sports performance is improved with optimal nutrition (ACSM position stand, MSSE 2009, Mar; 41(3):709-31). However, scientific evidence shows that professional athletes do not achieve nutritional recommendations (Farajian et al, IJSNEM 2004 Oct; 14(5):574-85; Shroeder et al EJSS 2004 Jun 4 (2):1; Nogueira & Da Costa, IJSNEM 2004; 14:684-697) Objectives: a) describe the nutritional practices of one professional basketball player b) carry out a long term nutritional intervention to adapt his diet to current recommendations.

Therapeutic Assessment for an individual with Binge Eating Disorder: A single-case time-series design .

Therapeutic Assessment (TA) is a treatment approach that combines psychological assessment and psychotherapy. The study examines the efficacy of this approach with an individual with Binge Eating Disorder. A replicated single-case time-series design with daily measures is used to assess the effects of TA and to track the process of change during the TA. The individual experienced inconclusive benefits after participation in TA. Significant change occurred in all variables measured, though none of the changes occurred in the hypothesized direction. Further research is needed to determine if TA is an effective treatment for individuals diagnosed with Binge Eating Disorder.

A metacognitive contextual intervention to enhance error awareness and functional outcome following traumatic brain injury: A single-case experimental design

Very few empirically validated interventions for improving metacognitive skills (i.e., self-awareness and self-regulation) and functional outcomes have been reported. This single-case experimental study presents JM, a 36-year-old man with a very severe traumatic brain injury (TBI) who demonstrated long-term awareness deficits. Treatment at four years post-injury involved a metacognitive contextual intervention based on a conceptualization of neuro-cognitive, psychological, and socio-environmental factors contributing to his awareness deficits. The 16-week intervention targeted error awareness and self-correction in two real life settings: (a) cooking at home: and (b) volunteer work. Outcome measures included behavioral observation of error behavior and standardized awareness measures. Relative to baseline performance in the cooking setting, JM demonstrated a 44% reduction in error frequency and increased self-correction. Although no spontaneous generalization was evident in the volunteer work setting, specific training in this environment led to a 39% decrease in errors. JM later gained paid employment and received brief metacognitive training in his work environment. JM's global self-knowledge of deficits assessed by self-report was unchanged after the program. Overall, the study provides preliminary support for a metacognitive contextual approach to improve error awareness and functional Outcome in real life settings.

Contribution à la validation du modèle cognitif du trouble obsessionnel- compulsif : le rôle des expériences de l’enfance et des états affectifs

Depuis une vingtaine d’années, le modèle cognitif basé sur les interprétations (Groupe de recherche sur la cognition dans le trouble obsessionnel compulsif [OCCWG], 1997, 2001, 2003, 2005) représente le modèle psychologique de l’étiologie et du maintien du TOC le plus étudié au plan empirique. Cependant, peu de recherches ont porté sur les deux postulats importants du modèle touchant respectivement le développement des croyances liées à l’obsessionnalité et la contribution des états affectifs au maintien des interprétations et des croyances (réactivité cognitive). L’objectif de cette thèse est de contribuer à la validation empirique de ces postulats. Fondé sur un devis corrélationnel dans un échantillon de participants mixte (participants troubles obsessionnels-compulsifs et participants non cliniques), le premier article étudie les liens entre les expériences de l’enfance et la présence de croyances obsessionnelles chez l’adulte. Deux modèles alternatifs sont comparés qui représentent d’une part un lien spécifique, et d’autre part un lien non spécifique entre les expériences de l’enfance et les croyances obsessionnelles adultes. Les résultats suggèrent la présence à la fois de relations spécifiques et non spécifiques entre les expériences de l’enfance et les croyances adultes. Les expériences de l’enfance et les domaines de croyance obsessionnels qui montrent des liens spécifiques sont ceux relatifs à la responsabilité, à la perception du danger, et au perfectionnisme. En contrepartie, les expériences de l’enfance relatives à la perception de danger et dans une moindre mesure la sociotropie, apparaissent étroitement liés à la plupart des domaines de croyances adultes (intolérance à l’incertitude, surestimation du danger, importance et contrôle des pensées). Dans la seconde étude, nous nous intéressons à la mesure et l’analyse longitudinales de la réactivité cognitive telle qu’elle s’exprime dans l’environnement naturel de huit participants troubles obsessionnels-compulsifs de type ruminateur. Par le biais de huit protocoles à cas uniques intensifs, l’analyse de contingence entre les scores quotidiens d’humeur (4 états émotionnels cotés par participant) et d’interprétations (une interprétation idiographique des intrusions par participant) permet d’établir une mesure de l’importance de la réactivité cognitive chez chaque participant. Ces résultats sont ensuite analysés du point de vue des postulats principaux de deux modèles spécifiques de la réactivité cognitive (modèle de l’Infusion de l’affect [Forgas, 2008] et modèle de l’Humeur comme intrant [Meeten & Davey, 2011]. Ainsi, les analyses intra-individuelles répétées trans-comportements) et interindividuelles (trans-participants) permettent d’illustrer le rôle proximal déterminant des stratégies de traitement de l’information (traitement systématique; traitement superficiel; traitement altéré) employées par les participants. En résumé, les résultats obtenus dans ces deux études fournissent des données utiles à la poursuite de la validation du modèle des interprétations du TOC. Dans la première étude, l’identification de liens spécifiques entre les EE et les croyances obsessionnelles soutient la séquence étiologique postulée, alors que l’identification de liens non spécifiques suggère que d’autres trajectoires étiologiques peuvent être pertinentes. Dans la seconde étude, l’analyse longitudinale et naturaliste des covariations humeur – interprétations se révèle d’abord féconde à identifier les phénomènes de réactivité cognitive postulés dans le modèle des interprétations. Ensuite, en conformité aux modèles intégrés de la réactivité cognitive, l’analyse des liens entre cette réactivité et les stratégies privilégiées de neutralisation des participants permet d’identifier le rôle clé des différentes stratégies de traitement de l’information dans la réactivité cognitive.

Contribution à la validation du modèle cognitif du trouble obsessionnel- compulsif : le rôle des expériences de l’enfance et des états affectifs

Depuis une vingtaine d’années, le modèle cognitif basé sur les interprétations (Groupe de recherche sur la cognition dans le trouble obsessionnel compulsif [OCCWG], 1997, 2001, 2003, 2005) représente le modèle psychologique de l’étiologie et du maintien du TOC le plus étudié au plan empirique. Cependant, peu de recherches ont porté sur les deux postulats importants du modèle touchant respectivement le développement des croyances liées à l’obsessionnalité et la contribution des états affectifs au maintien des interprétations et des croyances (réactivité cognitive). L’objectif de cette thèse est de contribuer à la validation empirique de ces postulats. Fondé sur un devis corrélationnel dans un échantillon de participants mixte (participants troubles obsessionnels-compulsifs et participants non cliniques), le premier article étudie les liens entre les expériences de l’enfance et la présence de croyances obsessionnelles chez l’adulte. Deux modèles alternatifs sont comparés qui représentent d’une part un lien spécifique, et d’autre part un lien non spécifique entre les expériences de l’enfance et les croyances obsessionnelles adultes. Les résultats suggèrent la présence à la fois de relations spécifiques et non spécifiques entre les expériences de l’enfance et les croyances adultes. Les expériences de l’enfance et les domaines de croyance obsessionnels qui montrent des liens spécifiques sont ceux relatifs à la responsabilité, à la perception du danger, et au perfectionnisme. En contrepartie, les expériences de l’enfance relatives à la perception de danger et dans une moindre mesure la sociotropie, apparaissent étroitement liés à la plupart des domaines de croyances adultes (intolérance à l’incertitude, surestimation du danger, importance et contrôle des pensées). Dans la seconde étude, nous nous intéressons à la mesure et l’analyse longitudinales de la réactivité cognitive telle qu’elle s’exprime dans l’environnement naturel de huit participants troubles obsessionnels-compulsifs de type ruminateur. Par le biais de huit protocoles à cas uniques intensifs, l’analyse de contingence entre les scores quotidiens d’humeur (4 états émotionnels cotés par participant) et d’interprétations (une interprétation idiographique des intrusions par participant) permet d’établir une mesure de l’importance de la réactivité cognitive chez chaque participant. Ces résultats sont ensuite analysés du point de vue des postulats principaux de deux modèles spécifiques de la réactivité cognitive (modèle de l’Infusion de l’affect [Forgas, 2008] et modèle de l’Humeur comme intrant [Meeten & Davey, 2011]. Ainsi, les analyses intra-individuelles répétées trans-comportements) et interindividuelles (trans-participants) permettent d’illustrer le rôle proximal déterminant des stratégies de traitement de l’information (traitement systématique; traitement superficiel; traitement altéré) employées par les participants. En résumé, les résultats obtenus dans ces deux études fournissent des données utiles à la poursuite de la validation du modèle des interprétations du TOC. Dans la première étude, l’identification de liens spécifiques entre les EE et les croyances obsessionnelles soutient la séquence étiologique postulée, alors que l’identification de liens non spécifiques suggère que d’autres trajectoires étiologiques peuvent être pertinentes. Dans la seconde étude, l’analyse longitudinale et naturaliste des covariations humeur – interprétations se révèle d’abord féconde à identifier les phénomènes de réactivité cognitive postulés dans le modèle des interprétations. Ensuite, en conformité aux modèles intégrés de la réactivité cognitive, l’analyse des liens entre cette réactivité et les stratégies privilégiées de neutralisation des participants permet d’identifier le rôle clé des différentes stratégies de traitement de l’information dans la réactivité cognitive.

The influence of national culture on communication practices : a case study on Malaysian organisation

National culture is deeply rooted in values, which are learned and acquired when we are young (2007, p. 6), and „embedded deeply in everyday life. (Newman & Nollen, 1996, p. 754). Values have helped to shape us into who we are today. In other words, as we grow older, the cultural values we have learned and adapted to will mould our daily practices. This is reflected in our actions, behaviours, and the ways in which we communicate. Based on the previous assertion, it can be suggested that national culture may also influence organisational culture, as our „behaviour at work is a continuation of behaviour learned earlier. (Hofstede, 1991, p. 4). Cultural influence in an organisation could be evidenced by looking at communication practices: how employees interact with one another as they communicate in their daily practices. Earlier studies in organisational communication see communication as the heart of an organisation in which it serves, and as „the essence of organised activity and the basic process out of which all other functions derive. (Bavelas and Barret, cited in Redding, 1985, p. 7). Hence, understanding how culture influences communication will help with understanding organisational behaviour. This study was conducted to look at how culture values, which are referred to as culture dimensions in this thesis, influenced communication practices in an organisation that was going through a change process. A single case study was held in a Malaysian organisation, to investigate how Malaysian culture dimensions of respect, collectivism, and harmony were evidenced in the communication practices. Data was collected from twelve semi-structured interviews and five observation sessions. Guided by six attributes identified in the literature, (1) acknowledging seniority, knowledge and experience, 2) saving face, 3) showing loyalty to organisation and leaders, 4) demonstrating cohesiveness among members, 5) prioritising group interests over personal interests, and 6) avoiding confrontations of Malaysian culture dimensions, this study found eighteen communication practices performed by employees of the organisation. This research contributes to the previous cultural work, especially in the Malaysian context, in which evidence of Malaysian culture dimensions of respect, collectivism, and harmony were displayed in communication practices: 1) acknowledging the status quo, 2) obeying orders and directions, 3) name dropping, 4) keeping silent, 5) avoiding questioning, 6) having separate conversations, 7) adding, not criticising, 8) sugar coating, 9) instilling a sense of belonging, 10) taking sides, 11) cooperating, 12) sacrificing personal interest, 13) protecting identity, 14) negotiating, 15) saying „yes. instead of „no., 16) giving politically correct answers, 17) apologising, and 18) tolerating errors. Insights from this finding will help us to understand the organisational challenges that rely on communication, such as during organisational change. Therefore, data findings will be relevant to practitioners to understand the impact of culture on communication practices across countries.

Resilience in critical infrastructures : the case of the Queensland electricity industry

The reliability of Critical Infrastructure is considered to be a fundamental expectation of modern societies. These large-scale socio-technical systems have always, due to their complex nature, been faced with threats challenging their ongoing functioning. However, increasing uncertainty in addition to the trend of infrastructure fragmentation has made reliable service provision not only a key organisational goal, but a major continuity challenge: especially given the highly interdependent network conditions that exist both regionally and globally. The notion of resilience as an adaptive capacity supporting infrastructure reliability under conditions of uncertainty and change has emerged as a critical capacity for systems of infrastructure and the organisations responsible for their reliable management. This study explores infrastructure reliability through the lens of resilience from an organisation and system perspective using two recognised resilience-enhancing management practices, High Reliability Theory (HRT) and Business Continuity Management (BCM) to better understand how this phenomenon manifests within a partially fragmented (corporatised) critical infrastructure industry – The Queensland Electricity Industry. The methodological approach involved a single case study design (industry) with embedded sub-units of analysis (organisations), utilising in-depth interviews and document analysis to illicit findings. Derived from detailed assessment of BCM and Reliability-Enhancing characteristics, findings suggest that the industry as a whole exhibits resilient functioning, however this was found to manifest at different levels across the industry and in different combinations. Whilst there were distinct differences in respect to resilient capabilities at the organisational level, differences were less marked at a systems (industry) level, with many common understandings carried over from the pre-corporatised operating environment. These Heritage Factors were central to understanding the systems level cohesion noted in the work. The findings of this study are intended to contribute to a body of knowledge encompassing resilience and high reliability in critical infrastructure industries. The research also has value from a practical perspective, as it suggests a range of opportunities to enhance resilient functioning under increasingly interdependent, networked conditions.

Organisational challenges in understanding and implementing effective buiness continuity management strategies in a complex and critical organisation : an airport case study

With the increasing complexity of modern day threats and the growing sophistication of interlinked and interdependent operating environments, Business Continuity Management (BCM) has emerged as a new discipline, offering a strategic approach to safeguarding organisational functions. Of significant interest is the application of BCM frameworks and strategies within critical infrastructure, and in particular the aviation industry. Given the increased focus on security and safety for critical infrastructures, research into the adoption of BCM principles within an airport environment provides valuable management outcomes and research into a previously neglected area of inquisition. This research has used a single case study methodology to identify possible impediments to BCM adoption and implementation by the Brisbane Airport Corporation (BAC). It has identified a number of misalignments between the required breadth of focus for a BCM program, identified differing views on specific roles and responsibilities required during a major disruptive event and illustrated the complexities of the Brisbane Airport which impede the understanding and implementation of effective Business Continuity Management Strategies.