In intensive transactional analysis psychotherapy (ITAP), intensity is obtained with both technical expedients and the relational manner with the patient. In ITAP, the therapist modulates pressure and support commensurately to the patients' ego strength. In the present article, we contrast two clinical cases of young adults in which ego strength produced different therapy outcomes and processes. We present excerpts of the psychotherapy process that illustrates technical aspects of ITAP as well as the therapist's attitude that we describe as holding. We show quantitative therapy outcomes consisting of effects size values of changes in Clinical Outcome in Routine Evaluation—Outcome Measure scores in baseline, treatment, and follow-up phases and qualitative outcome evaluated with the Change Interview at the end of the therapy. In the patient with high ego strength, we observed a rapid improvement and a complete recovery at the end of the therapy, whereas the results of the patient with low ego strength were less consistent (more fluctuations in Clinical Outcome in Routine Evaluation—Outcome Measure scores including deterioration but good qualitative outcome). We conclude that quantitative and qualitative outcome data, together with process observations, are required to have a complete picture of therapy effectiveness. Moreover, we conclude that qualitative ego strength is not a limitation for the use of expressive therapy such as ITAP, but rather, it is an important variable that should be considered to dose confrontations and support.
Intensive Transactional Analysis Psychotherapy (ITAP) is a new therapeutic approach based on the integration of Transactional Analysis and brief psychodynamic approaches. ITAP is based on two key therapeutic tools—the intrapsychic triangle and the interpersonal triangle—which the therapist uses to focus patients’ attention on moment‐by‐moment therapy processes. The aim of the present study was to provide early empirical documentation of ITAP effectiveness. To this aim, six patients (four females, two males) were longitudinally evaluated using an A‐B‐A mixed quantitative and qualitative design, with evaluations at Baseline, Treatment and Follow‐up phases. Each patient received 16 50‐min weekly sessions of ITAP therapy over 4 months. For quantitative evaluations, patients filled out the Clinical Outcome in Routine Evaluation‐Outcome Measure (CORE‐OM) at each evaluation. Effects size values were estimated to evaluate quantitative changes comparing mean scores of Baseline, Treatment and Follow‐up phases. At the first follow‐up, the Change Interview was used to qualitatively evaluate patients’ perceived changes. In the quantitative data, four of the six patients reported a very good outcome, with large to very large effect sizes in Baseline versus Treatment and/or Baseline versus Follow‐up scores comparisons, whereas two patients reported variable fluctuations within the non‐clinical range of outcome scores. In the qualitative evaluations, all patients reported several moderately to extremely important perceived changes attributed to psychotherapy.
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