Case Report: Individualization of Intensive Transactional Analysis Psychotherapy on the Basis of Ego Strength

In intensive transactional analysis psychotherapy (ITAP), intensity is obtained with both 84 technical expedients and the relational manner with the patient. In ITAP, the therapist 85 modulates pressure and support commensurately to the patients’ ego strength. In the 86 present article, we contrast two clinical cases of young adults in which ego strength 87 88 produced different therapy outcomes and processes. We present excerpts of the 89 psychotherapy process that illustrates technical aspects of ITAP as well as the therapist’s 90 attitude that we describe as holding. We show quantitative therapy outcomes consisting 91 of effects size values of changes in Clinical Outcome in Routine Evaluation—Outcome 92 93 Measure scores in baseline, treatment, and follow-up phases and qualitative outcome 94 evaluated with the Change Interview at the end of the therapy. In the patient with high 95 ego strength, we observed a rapid improvement and a complete recovery at the end of 96 the therapy, whereas the results of the patient with low ego strength were less consistent 97 (more fluctuations in Clinical Outcome in Routine Evaluation—Outcome Measure scores 98 including deterioration but good qualitative outcome). We conclude that quantitative and 99 100 qualitative outcome data, together with process observations, are required to have a 101 complete picture of therapy effectiveness. Moreover, we conclude that qualitative ego 102 strength is not a limitation for the use of expressive therapy such as ITAP, but rather, it is 103 an important variable that should be considered to dose confrontations and support.