This study is the first of a series of three, and represents an Italian systematic replication of previous UK findings (Widdowson 2012a(Widdowson , 2012b(Widdowson , 2012c(Widdowson , 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.
This study is the seventh of a series of seven and belongs to the second Italian systematic replication of findings from previous series that investigatedthe effectiveness of a manualized transactional analysistreatment for depressionthrough Hermeneutic Single-Case Efficacy Design. 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 ‘Margherita’, a 56-years old white Italian woman who attended sixteen session of transactional analysis psychotherapy with a white Italian woman therapist with 5 years of clinical experience. The patient satisfied DSM-5 criteria for moderately severe major depressive disorder with anxious distress, and SWAP 200 criteria for traits of depressive, dependent, avoidant and hostile personality typeswith a high level of functioning.
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