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

Abstract

This study is the first of a series of three, and represents an Italian systematic replication of previous UK findings (Widdowson 2012a, 2012b, 2012c, 2013) that investigated the effectiveness of a recently manualised transactional analysis treatment for depression with British clients, using Hermeneutic Single-Case Efficacy Design (HSCED). The various stages of HSCED as a systematic case study research method are described, as a quasi-judicial method to sift case evidence in which researchers construct opposing arguments around quantitative and qualitative multiple source evidences and judges evaluate these for and against propositions to conclude whether the client changed substantially over the course of therapy and that the outcome was attributable to the therapy. The therapist in this case was a white Italian woman with 10 years clinical experience and the client, Sara, was a 62-year old white Italian woman with moderate depression and three recent bereavements, who attended sixteen sessions of transactional analysis therapy. The diagnosis is based on the new DSM-5 criteria that allow differentiation between Depression and Bereavement. The conclusion of the judges was that this was a good-outcome case: the client improved early over the course of the therapy, reported positive experience of therapy and maintained the improvement at the end of the follow-up.