The Evidence-Based Conceptual Model of Transactional Analysis: A Focused Review of the Research Literature

Abstract

This article presents a focused review of the research literature in transactional analysis (TA). TA was developed in the 1950s as a theory of human personality and social behavior and as a comprehensive form of psychotherapy, but there has not been any systematic research to test the empirical evidence for the efficacy of TA theory and practice. The aim of this study was to develop the conceptual model of transactional analysis on the basis of a systematic review of the actual, self-reported practice of international TA psychotherapists and on the evidence found in research. The article systematically reviews common conceptual components of TA and their empirical evidence by examining the common denominator and the empirical evidence for the central clinical phenomenon, etiology, therapeutic mechanisms, therapeutic competencies, outcomes, and synthesis. TA focuses on problems in ego states (operationalized as Parent, Adult, and Child) with distinctive behavioral functions of Controlling Parent, Nurturing Parent, Adult, Adapted Child, and Free Child. Individuals can develop long-term problems in their ego states, social functioning, and self-efficacy as the result of unfavorable messages from their social context (negative parental messages in early life, lack of developing mature coping mechanisms, intergenerational messages, negative stroke balance), script decisions (accepting or rejecting unfavorable messages via behavior, emotional disconnection, or cognitive styles), life events, and genetics/temperament. TA treatment intends to help clients by developing constructive ego states, improving social functioning, and stimulating a sense of self-efficacy. Research confirms that TA improves psychopathology, behavior, and general well-being thanks to improvement in ego states, self-efficacy, and social functioning. These effects are achieved by four evidence-based therapist competencies: creating a positive client-practitioner relationship, working with experiences in the present, etiological analysis (life scripts, injunctions, counterinjunctions), and therapeutic structure (treatment contracts, treatment stages, psychoeducation/didactics). Meta-analysis of 75 studies shows that TA has moderate to large positive effects on psychopathology, self-efficacy, social functioning, and ego states. This conceptual model shows that TA can be considered a bona fide and evidence-based treatment for a wide range of clients.