«Why N=1?»: Rethinking Evidence in Psychotherapy Research

Abstract

This presentation critically examines the epistemological status of case studies (N=1 designs) in psychotherapy research. While dominant evidence-based paradigms prioritise large-scale, quantitative methodologies, psychotherapy as a relational and context-dependent practice raises fundamental questions about the adequacy of such approaches for capturing clinical reality. Drawing on selected case material, the presentation demonstrates how in-depth single-case studies generate forms of knowledge that are not merely supplementary but constitutive of the field itself – particularly in illuminating unconscious processes, therapeutic dynamics, and transformations over time. Rather than treating case studies as lower in the hierarchy of evidence, it positions them as a primary site of knowledge…