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

Abstract

This study is the second of a series of three, and represents an Italian replication of a previous UK -based case series (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 multiple sources of quantitative and qualitative evidence and judges evaluate these to conclude whether the client changed substantially over the course of therapy, and whether the outcome was attributable to the therapy. The therapist in this case was a white Italian man in the third year of training to become a psychotherapist, and the client, Penelope, was a 45-year old white Italian woman with mild depression and anxiety. The conclusion of the judges was that this was a mixed-outcome case: the client improved some aspects of her problems, without obtaining a complete and stable remission. Interestingly, this case presents a minimal correlation between empirical and proxy-rated indexes of depression and anxiety and answers to self reported questionnaires, raising the question of validity of self report measures with specific typology of client.