TA Treatment of Depression: A Simplified Hermeneutic Single-Case Efficacy Design - The Case of “Giovanni”
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This study is inspired by previous case series replications of Hermeneutic Single-Case Efficacy Design which aim was to evaluate the effectiveness of a manualized transactional analysis treatment for depressive disorders and depressive personality. 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 ‘Giovanni, a 17-years old white Italian boy who attended sixteen session of transactional analysis psychotherapy with a white Italian woman specializing in psychotherapy with 2 years of clinical experience. The patient satisfied DSM-5 criteria for moderate major depressive disorder and generalized anxiety disorder.This is the second investigation which has evaluated the effectiveness of Transactional Analysis psychotherapy for depressed adolescents.
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American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author. https://doi.org/10.1176/appi.books.9780890425596
Barkham, M., Margison, F., Leach, C., Lucock, M., Mellor-Clark, J., Evans, C., Benson, L., Connell, J., Audin, K. & McGrath, G., (2001). Service profiling and outcomes benchmarking using the CORE-OM: Toward practice-based evidence in the psychological therapies. Journal of Consulting and Clinical Psychology, Vol 69(2), 184-196. https://doi.org/10.1037/0022-006X.69.2.184
Benelli, E., De Carlo, A., Biffi, D. & McLeod, J. (2015). Hermeneutic Single Case Efficacy Design: A systematic review of published research and current standards. Testing, Psychometrics, Methodology in Applied Psychology, 22, 97-133.
Benelli, E., Revello, B., Piccirillo, C., Mazzetti, M., Calvo, V., Palmieri, A., Sambin, M. & Widdowson, M. (2016a). TA Treatment of Depression: A Hermeneutic Single-Case Efficacy Design Study - 'Sara'. International Journal of Transactional Analysis Research, 7 (1), pp. 3-18. https://doi.org/10.29044/v7i1p3
Benelli, E., Scottà, F., Barreca, S., Palmieri, A., Calvo, C., De Renoche, G., Colussi, S., Sambin, M. & Widdowson, M. (2016b). TA Treatment of Depression: A Hermeneutic Single-Case Efficacy Design Study - 'Penelope'. International Journal of Transactional Analysis Research, 7 (1), pp. 19-34. https://doi.org/10.29044/v7i1p19
Benelli, E., Boschetti, D., Piccirillo, C., Quagliotti, L., Calvo, V., Palmieri, A., Sambin, M. & Widdowson, M. (2016c). TA Treatment of Depression: A Hermeneutic Single-Case Efficacy Design Study - 'Luisa', International Journal of Transactional Analysis Research, 7 (1), pp. 35-50. https://doi.org/10.29044/v7i1p35
Benelli, E., Moretti, E., Cavallero, G. C., Greco, G., Calvo, V., Mannarini, S., Palmieri, A. & Widdowson, M. (2017a). TA Treatment of Depression: A Hermeneutic Single-Case Efficacy Design Study - 'Anna'. International Journal of Transactional Analysis Research, 8(1), 3-20. https://doi.org/10.29044/v8i1p3
Benelli, E., Filanti, S., Musso, R., Calvo, V., Mannarini, S., Palmieri, A. & Widdowson, M. (2017b). TA Treatment of Depression: A Hermeneutic Single-Case Efficacy Design Study - 'Caterina'. International Journal of Transactional Analysis Research, 8(1), 21-38. https://doi.org/10.29044/v8i1p21
Benelli, E., Bergamaschi, M., Capoferri, C., Morena, S., Calvo, V., Mannarini, S., Palmieri, A., Zanchetta, M. & Widowson, M. (2017c). TA Treatment of Depression: A Hermeneutic Single-Case Efficacy Design Study - 'Deborah'. International Journal of Transactional Analysis Research, 8(1), 39-58. https://doi.org/10.29044/v8i1p39
Bohart, A.C., Berry, M. & Wicks, C. (2011). Developing a systematic framework for utilizing discrete types of qualitative data as therapy research evidence. Pragmatic Case Studies in Psychotherapy, 7(1): 145-155. https://doi.org/10.14713/pcsp.v7i1.1076
Cameron, I. M., Crawford, J. R., Lawton, K., et al. (2008). Psychometric comparison of PHQ-9 and HADS for measuring depression severity in primary care. Br J Gen Pract.;58(546):32-6. https://doi.org/10.3399/bjgp08X263794
Jane Costello, E., Erkanli, A., & Angold, A. (2006). Is there an epidemic of child or adolescent depression?. Journal of Child Psychology and Psychiatry, 47(12), 1263-1271. https://doi.org/10.1111/j.1469-7610.2006.01682.x
Crossman, P. (1966). Permission and Protection. Transactional Analysis Bulletin, 5, 152-4.
Delgadillo, J., McMillan, D., Leach, C., Lucock, M., Gilbody, S., & Wood, N. (2014). Benchmarking routine psychological services: a discussion of challenges and methods. Behavioural and cognitive psychotherapy, 42(01), 16-30. https://doi.org/10.1017/S135246581200080X
Elliott, R. (2002). Hermeneutic Single-Case Efficacy Design. Psychotherapy Research, 12(1), 1-21. https://doi.org/10.1080/713869614
Elliott, R., Partyka, R., Wagner, J., Alperin, R., Dobrenski, R., Messer, S. Margherita., Watson, J.C., & Castonguay, L. G. (2009). An adjudicated hermeneutic single-case efficacy design study of experiential therapy for panic/phobia. Psychotherapy Research, 19(4-5), 543-557. https://doi.org/10.1080/10503300902905947
Elliott, R., Shapiro, D. A., & Mack, C. (1999). Simplified Personal Questionnaire procedure manual. Toledo, OH: University of Toledo.
Elliott, R., Slatick, E., & Urman, M. (2001). Qualitative change process research on psychotherapy: Alternative strategies. Psychologische Beiträge, 43, 69-111.
Elliott, R. (2015). Hermeneutic Single Case Efficacy Design. In Strauss, B., Barber, J. P., & Castonguay, L. (Ed.). Visions in psychotherapy research and practice: Reflections from the presidents of the society for psychotherapy research. (pp. 188-207). New York, NY; Abingdon. Routledge.
Ernst, F. H., Jr. (1971). The OK corral: The grid for get-on-with. Transactional Analysis Journal, 1(4), 33-42. https://doi.org/10.1177/036215377100100409
Erskine, R. & Zalcman, M. (1979). The racket system: a model for racket analysis. Transactional Analysis Journal, 9, 51-9. https://doi.org/10.1177/036215377900900112
Evans, C, Connell, J., Barkham, M., Margison, F., Mellor-Clark, J., McGrath, G. & Audin, K. (2002). Towards a standardised brief outcome measure: Psychometric properties and utility of the CORE-OM. British Journal of Psychiatry, 180, 51-60. https://doi.org/10.1192/bjp.180.1.51
Evans, C., Margison, F., & Barkham, M. (1998). The contribution of reliable and clinically significant change methods to evidence-based mental health. Evidence Based Mental Health, 1(3), 70-72. https://doi.org/10.1136/ebmh.1.3.70
Goulding, R. & Goulding, M. (1976). Injunction, decision and redecision. Transactional Analysis Journal, 6, 41-8. https://doi.org/10.1177/036215377600600110
Jacobson, N. S., & Truax, P. (1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59(1), 12-19. https://doi.org/10.1037/0022-006X.59.1.12
Kerr, C. (2013). TA Treatment of Emetophobia - A Systematic Case Study - 'Peter'. International Journal of Transactional Analysis Research, 4:2, 16-26. https://doi.org/10.29044/v4i2p16
Kahler, T. (1975). Drivers: the key to the process of scripts. Transactional Analysis Journal, 5, 280-284. https://doi.org/10.1177/036215377500500318
Karpman, S. (1968). Fairy tales and script drama analysis. Transactional Analysis Bulletin, 7(26), 39-43.
Kroenke, K., Spitzer, R. L., Williams, J. Margherita. (2001). The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. ;16(9):606-13 https://doi.org/10.1046/j.1525-1497.2001.016009606.x
Kroenke, K., Spitzer, R. L., Williams, J. Margherita., et al. (2007). Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection. Ann Intern Med.;146(5):317-25. https://doi.org/10.7326/0003-4819-146-5-200703060-00004
Lingiardi, V., & McWilliams, N. (2015). The psychodynamic diagnostic manual-2nd edition (PDM‐2). World Psychiatry, 14(2), 237-239. https://doi.org/10.1002/wps.20233
Llewelyn, S. (1988). Psychological therapy as viewed by clients and therapists. British Journal of Clinical Psychology, 27, 223-238. https://doi.org/10.1111/j.2044-8260.1988.tb00779.x
MacLeod, R., Elliott, R., & Rodger. (2012). Process-experiential/emotion-focused therapy for social anxiety: A hermeneutic single-case efficacy design study, Psychotherapy Research, 22:1, 67-81, https://doi.org/10.1080/10503307.2011.626805
Murray, C. J., Vos, T., Lozano, R., Naghavi, M., Flaxman, A. D., Michaud, C., ... & Aboyans, V. (2012). Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. The lancet, 380(9859), 2197-2223. https://doi.org/10.1016/S0140-6736(12)61690-0
O'Reilly-Knapp, M., & Erskine, R. G. (2010). The script system: An unconscious organization of experience. Life scripts: A transactional analysis of unconscious relational patterns, 291-308. https://doi.org/10.4324/9780429476686-13
Richards, D. A. and Borglin, G. (2011). Implementation of psychological therapies for anxiety and depression in routine practice: two year prospective cohort study. Journal of Affective Disorders, 133, 51-60. https://doi.org/10.1016/j.jad.2011.03.024
Seligman, L. D., & Ollendick, T. H. (1998). Comorbidity of anxiety and depression in children and adolescents: An integrative review. Clinical Child and Family Psychology Review, 1(2), 125-144. https://doi.org/10.1023/A:1021887712873
Spitzer, R. L., Kroenke, K., & Williams, J. Margherita. (1999). Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Journal of the American Medical Association . Nov 10; 282:18, 1737-44. PMID 10568646. https://doi.org/10.1001/jama.282.18.1737
Spitzer, R. L., Kroenke, K., Williams, J. Margherita., & Löwe, Margherita. (2006). A brief measure for assessing generalized anxiety disorder: the GAD-7. Archives of Internal Medicine. https://doi.org/10.1001/archinte.166.10.1092
Wall, J. M, Kwee, J. L, Hu, M. & McDonald, M. J. (2016). Enhancing the hermeneutic single-case efficacy design: Bridging the research-practice gap. Psychotherapy Research. https://doi.org/10.1080/10503307.2015.1136441
Westen, D. & Shedler, J. (1999a). Revising and assessing Axis II: I. Developing a clinically and empirically valid assessment method. American Journal of Psychiatry, 156, 258-272.
Westen, D. &Shedler, J. (1999b). Revising and assessing Axis II: II. Toward an empirically based and clinically useful classification of personality disorders. American Journal of Psychiatry, 156, 273-285.
Widdowson, M. (2012a). TA Treatment of Depression - A Hermeneutic Single-Case Efficacy Design Study - 'Peter'. International Journal of Transactional Analysis Research, 3:1, 1-11. https://doi.org/10.29044/v3i1p3
Widdowson, M. (2012b). TA Treatment of Depression - A Hermeneutic Single-Case Efficacy Design Study - 'Denise'. International Journal of Transactional Analysis Research, 3:2, 3-14. https://doi.org/10.29044/v3i2p3
Widdowson, M. (2012c). TA Treatment of Depression - A Hermeneutic Single-Case Efficacy Design Study - 'Tom'. International Journal of Transactional Analysis Research, 3:2, 15-27. https://doi.org/10.29044/v3i2p15
Widdowson, M. (2013). TA Treatment of Depression - A Hermeneutic Single-Case Efficacy Design Study - 'Linda' - a mixed outcome case. International Journal of Transactional Analysis Research, 4:2, 3-15. https://doi.org/10.29044/v4i2p3
Widdowson, M. (2014). Transactional Analysis Psychotherapy for a Case of Mixed Anxiety & Depression: A Pragmatic Adjudicated Case Study - 'Alastair'. International Journal of Transactional Analysis Research, 5:2, 66-76. https://doi.org/10.29044/v5i2p66
Widdowson, M. (2016). Transactional Analysis for depression: A step-by-step treatment manual. Abingdon: Routledge. https://doi.org/10.4324/9781315746630