Messina Irene, Scottà Francesco, Marchi Arianna, Benelli Enrico, Grecucci Alessandro, Sambin Marco
Universitas Mercatorum, Rome, Italy.
Centro Psicologia Dinamica, Padua, Italy.
Front Psychol. 2021 Jun 9;12:618762. doi: 10.3389/fpsyg.2021.618762. eCollection 2021.
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.
在强化交互分析心理治疗（ITAP）中，强度可通过技术手段以及与患者的关系方式来实现。在ITAP中，治疗师会根据患者的自我强度相应地调整压力和支持。在本文中，我们对比了两名年轻成年人的临床案例，其中自我强度产生了不同的治疗结果和过程。我们呈现了心理治疗过程的节选内容，展示了ITAP的技术方面以及我们所描述的治疗师的“容纳”态度。我们展示了定量治疗结果，包括在基线、治疗和随访阶段常规评估-结果测量分数变化的效应量值，以及在治疗结束时通过改变访谈评估的定性结果。在自我强度高的患者中，我们观察到治疗结束时迅速改善并完全康复，而自我强度低的患者结果则不太一致（常规评估-结果测量分数的临床结果波动更大，包括病情恶化，但定性结果良好）。我们得出结论，需要定量和定性的结果数据以及过程观察，才能全面了解治疗效果。此外，我们得出结论，定性的自我强度不是使用如ITAP这样的表达性治疗的限制，相反，它是一个重要变量，在调整对抗和支持时应予以考虑。
