TA Treatment of Depression: A Hermeneutic Single-Case Efficacy Design Study


This study is the sixth of a series of seven and belongs to the second Italian systematic replication of findings from previous series that investigated the effectiveness of a manualized transactional analysis treatment for depression through Hermeneutic Single-Case Efficacy Design. The therapist was a white Italian woman with 10 years of clinical experience and the client, Beatrice, was a 45-year old white Italian woman who attended sixteen sessions of transactional analysis psychotherapy. Beatrice satisfied DSM 5 criteria for Major Depressive Disorder, Anxious Distress, with Dependent and Histrionic Personality Traits. The judges evaluated the case as a good outcome: the depressive and anxious symptomatology clinically and reliably improved over the course of the therapy and these improvements were maintained throughout the duration of the follow up intervals. Furthermore, the client reported significant change in her post-treatment interview and these changes were directly attributed to the therapy.

Key words

Systematic Case Study Research; Hermeneutic Single-Case Efficacy Design; Transactional Analysis Psychotherapy; Major Depressive Disorder; Anxious Distress; Dependent Personality Traits; Histrionic Personality Traits.


This Hermeneutic Single-Case Efficacy Design (HSCED) is the sixth of a series of seven, and belongs to an Italian systematic replication of findings from previous case series (Widdowson 2012a, 2012b, 2012c, 2013, 2014; Benelli, 2016a, 2016b, 2016c, 2017a, 2017b, 2017c) and is conducted under the auspices of the project ‘Transactional Analysis meets Academic Research in order to become an Empirically Supported Treatment: an Italian two-year plan for publishing evidence of Transactional Analysis efficacy and effectiveness into worldwide recognized scientific journals’, funded by the European Association for Transactional Analysis (EATA). Previous publications have widely described the rationale for supporting by HSCED the accumulation of evidences of efficacy and effectiveness for those models of psychotherapy that are emerging or marginalized (Benelli, De Carlo, Biffi & McLeod, 2015) and specifically how this is important for recognition of TA and inclusion within the acknowledged treatments for common mental disorders (i.e., depression, anxiety and personality disorders) (Widdowson 2012a, 2012b, 2012c, 2013, 2014; Benelli, 2016a, 2016b, 2016c, 2017a, 2017b, 2017c).
The aim of this study was to investigate the effectiveness of the manualised TA treatment of depression (Widdowson, 2016) applied to a major depressive disorder in comorbidity with anxious distress. The quantitative primary outcomes investigated were depressive and anxious symptomatology, the secondary outcomes were global distress and client-generated personal problems, which were analysed both quantitatively and qualitatively.
The present study analyses the treatment of ‘Beatrice’, a 45-year-old Italian woman with diagnosis of major depressive disorder in comorbidity with anxious distress, dependent and histrionic personality disorder.

Ethical Considerations

The research protocol follows the requirements of the ethical code for Research in Psychotherapy of the Italian Association of Psychology, and the American Psychological Association guidelines on the rights and confidentiality of research participants. The research protocol has been approved by the Ethical Committee 9 (1), 42-63 https://doi.org/10.29044/v9i2p42
International Journal of Transactional Analysis Research & Practice Vol 9 No 2, December 2018 www.ijtarp.org Page 43
of the University of Padua. Before entering the treatment, clients received an information pack, including a detailed description of the research protocol, and they gave a signed informed consent and written permission to include segments of disguised transcripts of sessions or interviews within scientific articles or conference presentations. Patients were informed that they would have received therapy even if they decided not to participate in the research and that they were able to withdraw from the study at any point, without any negative impact on their therapy. All aspects of the case material were disguised, so that neither the client nor third parties are identifiable. All changes are made in such a way that does not lead the reader to draw false conclusions related to the described clinical phenomena. Finally, as a member checking procedure (Lincoln & Guba 1985), that is a qualitative research technique wherein the researcher compares her understanding of what an interview participant said or meant with the participant to ensure that the researcher’s interpretation is accurate, the final article in English language was presented to the client, who read the manuscript, amended it, and confirmed that it was a true and accurate record of the therapy and gave her final written consent for its publication. […]


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