TA Treatment of Depression: three
case study research – Liliana, MD, Bia
G. C. Cavallero, E. Berdini, E. Moretti, F. Vulpiani
Scuola di Analisi Transazionale – SIFP Roma
These studies are part of an Italian series of systematic
replication of Hermeneutic Single Case Efficacy Design (HSCED) aiming to
support the efficacy of Transactional Analysis treatment for depression.
A rich case record with quantitative and qualitative data
was collected for each case and analysed by two teams of researchers in order
to develop arguments either for or against 1) the claim that a change occurred,
2) the role of therapy in change, 3) mediator and moderator factors of change.
Finally, a panel of independent judges came to a verdict about the quality of
the outcome and the factors of change.
Qualitative data includes Change Interview at the end of
the therapy (CI) and Helpful and hindering Aspect of Therapy (HAT).
Quantitative data include instruments for: depression (PHQ9), distress (CORE),
anxiety (GAD7) and Personal problems (PQ).
All patients fulfilled DSM criteria for Major Depression
and received 16 sessions of a manualized transactional analysis treatment
(Widdowson, 2013), tailored in accordance with their personality traits as
diagnosed with SWAP and Psychodynamic Diagnostic Manual.
The first case presents Liliana, a 67 years old Italian
female with severe Major Depression (severe) and histrionic and narcisistic
personality traits. Her PQ described emotional problems due to divorce from her
husband after 33 years of marriage, feeling of lloneliness, helplessness,
inability to handle daily life, lack of interest anddifficulty in managing
The second case presents MD, a 37 years old Italian female
with mild Major Depression (mild) and dependent and histrionic (SWAP)
personality traits. Her PQ described longstanding problems about relationship,
loneliness, feeling of inadequacy and guilt.
The third case presents Bia, a 44 years old Italian female
with mild Major Depression (mild) in comorbidity with anxiety disorder and
dependent and histrionic personality traits. He PQ described desperation for
being unable to have chidren, difficulties in relationship with the partner,
feeling of guilt for the choices made in the past, fear for the future, job
The three cases showed a mixed to good outcome as for RCI
index and clinical cut off in quantitative measures (PHQ9, CORE, GAD7, PQ), and
a good outcome in qualitative patients’ accounting of therapy (HAT, CI),
supporting the claim that TA Therapy for depression may be effective.
The patients’ personality characteristics (SWAP), theirs
experiences of the therapists and theirs perception of their own change (CI)
and theirs perceptions of helpful and hindering aspects of the therapies (HAT)
are presented and discussed in respect of developing and refining the
theoretical model of TA treatment for depression.
– Widdowson, M. (2013) Transactional Analysis for Depression Stage One Treatment Manual. Unpublished Manuscript, University of Salford.
– Novellino, M. (2003) L’organizzazione depressiva, in L’approccio clinico in analisi transazionale. Francoangeli, Milano