This chapter is based on the SPR Presidential Address delivered at the June 2001 meeting of the Society for Psychotherapy Research in Montevideo, Uruguay. In this paper, I outline Hermeneutic Single Case Efficacy Design (HSCED), an interpretive approach to evaluating treatment causality in single therapy cases. This approach uses a mixture of quantitative and qualitative methods to create a network of evidence that first identifies direct demonstrations of causal links between therapy process and outcome, and then evaluates plausible nontherapy explanations for apparent change in therapy. I illustrate the method with data from a depressed client who presented with unresolved loss and anger issues. The abridged version of the original article is followed by a commentary.
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