Conceptualizing the Complexity of Change in Psychotherapy: The Case of "Cora"

In this article we respond to the commentaries by Altman and Miller (2016), Bohart (2016), and Timulak and Keogh (2016) on our case of “Cora,” which involved over 121 psychotherapy sessions with a client with a history of severe relational trauma that had led to difficulty in forming close relationships, as well as a series of suicide attempts (Halvorsen, Benum, Haavind, & McLeod, 2016). The commentaries differ in their view of the value of Cora’s case, interpretations of the material, and methodological preferences. Together the commentaries illustrate the complexity of change in psychotherapy, how we need multifaceted approaches to understand change, and the challenges in writing up a case in this context. We call for further dialogue within the psychotherapy research community around the nature and implications of methodological choices arising from the conduct of case study research in this field.