Counselling for sight loss: using case study methodology to develop a practice model

Aim/Purpose: It is well documented that acquired sight loss negatively impacts on identity and can lead to depression, suicidal ideation, social isolation and loneliness. With an aging demographic, the prevalence of acquired sight loss is rising. Nearly two million people in the UK are blind or partially sighted. There is growing recognition of the need to provide emotional support for people with sight loss. However, little is known about effective counselling interventions for this client group. Case studies have the potential to play an important role in the development of theory and practice, particularly in relation to this specific client group.

Design/Methodology: Findings will be presented from the analysis of a single case study in which the client was a 70 year old woman who had experienced sudden and irreversible post operative sight loss. She received six sessions of counselling from a sight impaired counsellor working within a pluralistic framework. The client completed the CORE outcome measure and a goals scale at each session, along with process measures. Sessions were recorded and transcribed. A change interview was conducted at the end of session six. This data set were analysed by an inquiry team, using a modification of Elliott's quasi judicial hermeneutic single case study efficacy design. Ethical approval was obtained from the University Research Ethics Committee to conduct this study, and the client engaged in an informed consent process at the beginning and end of her therapy.

Results/Findings: The case analysis is briefly presented, in terms of the outcome of the counselling and the therapeutic processes that contributed. Results indicated that this case had a positive outcome, with the client reporting that she felt more hopeful and less lonely at the end of session six. The implications of this study for practitioners seeking to counsel sight impaired clients are discussed.

Research Limitations: The key weakness of this study is that a limited range of data were collected from the client, who represents only one among several patterns of sight loss. Further systematic case studies with a wider range of sight impaired clients are needed to determine the generalisability of the findings.

Conclusions/Implications: The study provides an example of systematic case study research, and places this approach within the context of the development of a practice framework for a specific client group. Systematic case study research has potential to make a substantial contribution to the research literature, and to deepen our understanding of issues presented by specific client groups.