TA Treatment of Depression: A Simplified Hermeneutic Single-Case Efficacy Design - The Case of “Margherita”

Abstract

This study is the seventh of a series of seven and belongs to the second Italian systematic replication of findings from previous series that investigatedthe effectiveness of a manualized transactional analysistreatment for depressionthrough Hermeneutic Single-Case Efficacy Design. We address problems and difficulties emerged in previous case series, such as: spending time in training a group of people to conduct the hermeneutic analysis, organizing the involvement of external judges to give the final adjudication, and dealing with inconsistencies between quantitative and qualitative data. For these reasons, this study suggests a simplified method to conduct the hermeneutic analysis that require one person only, maintaining its validity. Therefore, we integrated hermeneutic design with the pragmatic case evaluation methodology in order to follow pre-defined criteria in analysing qualitative material. Furthermore, we present a way to use the Script System to detect changes in depressive symptomatology and depressive personality. We tested this approach to HSCED in the case of ‘Margherita’, a 56-years old white Italian woman who attended sixteen session of transactional analysis psychotherapy with a white Italian woman therapist with 5 years of clinical experience. The patient satisfied DSM-5 criteria for moderately severe major depressive disorder with anxious distress, and SWAP 200 criteria for traits of depressive, dependent, avoidant and hostile personality typeswith a high level of functioning.

Imagery-based Cognitive Therapy for Patients with Persistent Depressive Disorder: A Hermeneutic Single-Case Efficacy Design

“…The third step of HSCED includes drawing a general conclusion according to the information obtained. There are three methods to evaluate the strength and validity of positive and negative evidence: 1-reviewing by reviewers [7], 2-the simple method [20], and 3-mixed-method [7] (which is a combination of the first two methods). In this study, the simple method of hermeneutic analysis based on 56 Bohart criteria was used to reach a conclusion.…”

“…For quantitative analysis, the percentage of recovery was obtained by deducting the pre-treatment target problem (A0) from the post-treatment target problem (A1), dividing by A0 (formula below). According to this formula, a 50% or more change in a case study is considered significant [38]: ΔA% = (A0 -A1) / A0 Clinical significance was analyzed according to the cut-off score [20]. Also, qualitative tools included Helpful Aspects of Therapy (HAT) [39], Change Interview (CI) [9], Therapist Session Notes Questionnaire (TSNQ) [9], and Bohart criteria [21].…”

How Outcome Measures Could Support Transactional Analysts in Clinical Practice to Improve Treatment Trajectories, Manage Risk, Minimise Client Drop-Out Rates and Support Clinical Supervision.

“…Case study researches using OMs to track client responses to TA treatment have also made important contributions to the sound evidence base of TA clinical practice and effective treatment of mood disorders (Gentelet and Widdowson, 2016;Widdowson, 2011Widdowson, , 2012Widdowson, , 2013Benelli, Revello, Piccirillo, Mazzetti, Calvo, Palmieri, Sambin, and Widdowson. 2016;Benelli, Scotta, Barreca, Palmieri, Calvo, de Renoche, Colussi, Sambin, and Widdowson, 2016;Benelli, Boschetti, Piccirillo, Quagliotti, Calvo, Palmieri, Sambin, and Widdowson, 2016;Benelli, Moretti, Cavallero, Greco, Calvo, Mannarini, Palmieri, and Widdowson, 2017;Benelli, Filanti, Musso, Calvo, Mannarini, Palmieri and Widdowson, 2017;Benelli, Procacci, Fornaro, Calvo, Mannarini, Palmieri, and Zanchetta, 2018;Zanchetta, Farina, Moreno and Benelli, 2019;Zanchetta, Picco, Revello, Piccirillo and Benelli, 2019).…”