TA Treatment of Depression - A hermeneutic single-case efficacy design study - 'Linda' - a mixed outcome case

Hermeneutic Single-Case Efficacy Design (HSCED) is a systematic case study research method involving the cross-examination of mixed method data to generate both plausible arguments that the client changed due to therapy and alternative explanations. The present study is the fourth article of a case series which has investigated the process and outcome of transactional analysis psychotherapy using Hermeneutic Single-Case Efficacy Design (Elliott 2002). The client, Linda, was a 45 year old white British woman with mild depression who attended nine sessions of therapy. The conclusion of the judges was that this was a mixed-outcome case: whilst the client improved over the course of therapy and was positive about her experience of therapy, her changes did not last when she experienced considerable stressful events during follow-up. Linda provided a detailed and idiosyncratic description of the aspects of the therapy which were most helpful for her. A cross-case comparison with other cases in this series suggests several interesting features which are worthy of further investigation. Specifically, the use of a shared theoretical framework and an egalitarian therapeutic relationship were helpful. As with other cases in this series, the client experienced positive changes in her interpersonal relationships suggesting that this outcome of TA therapy warrants further investigatio

TA treatment of depression: A hermeneutic single-case efficacy design study - case two: 'Denise'

Hermeneutic Single-Case Efficacy Design (HSCED) is a systematic case study research method involving the cross-examination of mixed method data to generate both plausible arguments that the client changed due to therapy and alternative explanations. The present study uses HSCED to investigate the outcome of short-term TA psychotherapy with a woman with severe depression. The objective of the research was to investigate the effectiveness of short-term TA therapy for the treatment of depression and to explore and identify key aspects of the TA therapy process and associated factors promoting change amongst effective cases. To enhance rigour and to address potential for researcher allegiance, independent psychotherapy researchers have adjudicated the case and offer a verdict on outcome. The conclusion of the adjudicators is that the client changed substantially, and that these changes were substantially due to the effects of therapy. Additional rigour was introduced into the HSCED approach for this 2nd case through the use of a more stringent classification of change, an increased reliable change index score, a higher standard of proof, the use of two teams to develop the affirmative and sceptic cases, and the addition of a third judge

TA treatment of depression: A hermeneutic single-case efficacy design study - 'Peter'

Hermeneutic Single-Case Efficacy Design (HSCED) is a systematic case study research method involving the cross-examination of mixed method data to generate both plausible arguments that the client changed due to therapy and alternative explanations. The present study uses HSCED to investigate the outcome of short-term TA psychotherapy with a young man with severe depression. The objective of the research was to investigate the effectiveness of short-term TA therapy for the treatment of depression and to explore and identify key aspects of the TA therapy process and associated factors promoting change amongst effective cases. To enhance rigour and to address potential for researcher allegiance, independent psychotherapy researchers have adjudicated the case and offer a verdict on outcome. The conclusion of the adjudicators is that the client changed considerably-substantially, and that these changes were substantially due to the effect of therap

Case study research methodology

Commenting on the lack of case studies published in modern psychotherapy publications, the author reviews the strengths of case study methodology and responds to common criticisms, before providing a summary of types of case studies including clinical, experimental and naturalistic. Suggestions are included for developing systematic case studies and brief descriptions are given of a range of research resources relating to outcome and process measures. Examples of a pragmatic case study design and a hermeneutic single-case efficacy design are given and the paper concludes with some ethical considerations and an exhortation to the TA community to engage more widely in case study research

Transactional analysis psychotherapy for a case of mixed anxiety & depression : a pragmatic adjudicated case study – ‘Alastair’

Using an original method of case evaluation which involved an analysis panel of over 80 Italian psychologists and included a lay case evaluation, the author has investigated the effectiveness of transactional analysis psychotherapy for a case of mixed anxiety and depression with a 39 year old white British male who attended 14 weekly sessions. CORE-OM (Evans, Mellor-Clark , Margison, Barkham, Audin, Connell and McGrath, 2000), PHQ-9 (Kroenke, Spitzer & Williams, 2001), GAD-7) Spitzer, Kroenke, Williams & Löwe, 2006, Hamilton Rating Scale for Depression (Hamilton, 1980) were used for screening and also for outcome measurement, along with Session Rating Scale (SRS v.3.0) (Duncan, Miller, Sparks, Claud, Reynolds, Brown and Johnson, 2003) and Comparative Psychotherapy Process Scale (CPPS) (Hilsenroth, Blagys, Ackerman, Bonge and Blais, 2005), within an overall adjudicational case study method. The conclusion of the analysis panel and the lay judge was unanimously that this was a good outcome case and that the client’s changes had been as a direct result of therapy. Previous case study research has demonstrated that TA is effective for depression, and this present case provides foundation evidence for the effectiveness of TA for depression with comorbid anxiety

Application of redecision therapy in executive coaching workshops: Part 2 - a qualitative exploration of participants’ changes

This is the second paper of three and describes an investigation into the way that executive coaching as a growing field of organisational development can be based on transactional analysis theory and methods. Twelve participants who had attended a coaching workshop based on Goulding & Goulding’s (1979) redecision therapy approach completed a follow-up Change Questionnaire adapted by the first author from material by Elliott et al (2001) and responses were analysed using thematic analysis (Braun & Clarke 2006). Participants reported experiencing a wide range of personal growth experiences, positive interpersonal change and growth in their business, managerial and leadership skills as a result of participating in the work-shops. Limitations are described including the possible impact of the transferential artefact of wanting to please the workshop facilitator. The thematic analysis findings suggest that such an approach can provide an effective framework for executive coaching workshops

Avoidance, vicious cycles, and experiential disconfirmation of script: Two new theoretical concepts and one mechanism of change in the Psychotherapy of depression and anxiety

This article presents an argument for the clinical and empirical relevance of case study material. Drawing on a series of systematic case studies based in Stiles 19s (2007) model of theory building, the author proposes adding the concepts of avoidance and vicious cycles to standard transactional analysis and offers case material to illustrate the usefulness of doing so. Avoidance and vicious cycles are proposed as key mechanisms in the maintenance of the client 19s problems, specifically depression and anxiety, but also in relation to other presenting problems. The article also proposes experiential disconfirmation as an active change mechanism in transactional analysis therapy whereby the therapist actively challenges the client 19s life script and promotes change at an experiential level. These concepts forge links between several transactional analysis concepts and provide a unifying framework for a range of TA therapy approaches

Application of redecision therapy in executive coaching workshops: Part 1 – the workshop

First in a series of three, this paper describes how the redecision approach (Goulding & Goulding 1979) has been applied over many years within executive coaching workshops internationally. The potential controversy about using a therapeutic approach in a business context is addressed, participant profiles and leadership characteristics are described, the impact of the group environment is considered, and the links between working on ‘problems’ and Berne’s (1961) stages of cure are explained. The stages of working are related to those described by Goulding & Goulding (1979) and supplemented with material from McNeel (1999-2000) and Allen & Allen (2002). This paper describes the interventions that are evaluated qualitatively by Widdowson & Rosseau (2014) and that will be further evaluated quantitatively in the future

An inquiry into the experience of the dyslexic transactional analysis psychotherapist

Dyslexia causes difficulties in reading, writing, and information processing and is known to impair academic performance unless adaptations are made to the teaching and learning environment. This article explores some of the ways currently practicing transactional analysts who are dyslexic recall and understand their experiences from the earliest recognition of their difference in being dyslexic, through their training, and into their current work life. The authors have investigated the impact of having dyslexia on the training and practice of five transactional analysis psychotherapists using a qualitative approach. The participants were interviewed and the data analyzed using thematic analysis. The results indicate further research would be beneficial to facilitate a deeper understanding of the impact of dyslexia and to facilitate appropriate support for both trainees and qualified psychotherapists

Quantitative and qualitative outcomes of transactional analysis psychotherapy with male armed forces veterans in the UK presenting with post-Traumatic stress disorder

This paper presents findings from a two-year research project conducted within a live-in residential charity setting in the UK, examining clinical outcomes of TA psychotherapy among 15 male armed forces veterans presenting with severe PTSD (post-traumatic stress disorder) and other comorbid disorders. Outcomes were measured for short-term (24 sessions) and long-term (52 sessions) transactional analysis (TA) treatment using the quantitative CORE-OM (Evans, Mellor-Clark, Margison, Barkham, McGrath, Connell & Audin, 2000), PHQ-9 (Kroenke, Spitzer & Williams, 2001) and GAD-7 (Spitzer, Kroenke, Williams & Löwe, 2006) questionnaires and the qualitative Change Interview (Elliott, Slatick, & Urman, 2001, as cited in Frommer & Rennie, 2001). Quantitative findings show that positive Reliable Change on global distress, depression and anxiety has taken place within both the short-term and long-term treatment groups with some clients achieving Clinically Significant Change on these measures. Qualitative findings arising from thematic analysis (Braun & Clarke, 2006) indicate that a broad spectrum of therapist factors and psychotherapy process factors within the TA therapy delivered were beneficial for this particular client group. The negative influence of a number of psychosocial factors on the veterans' well-being is also discussed based on numerical data and interview responses. Overall, these results suggest that TA psychotherapy can be effective in the treatment of PTSD among combat veterans