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This study is the third of a series of three, and represents an Italian systematic replication of previous UK findings (Widdowson 2012a, 2012b, 2012c, 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, Luisa, was a 65-year old white Italian woman who attended sixteen sessions of TA therapy. Luisa satisfied DSM-5 criteria for severe adjustment disorder, with moderate depression and mixed deflected humour and anxiety, for which she had been taking medications and homeopathic treatments for over a year. The conclusion of the judges was that this was a good-outcome case: the client improved over the course of the therapy, reported a positive experience of therapy and maintained this improvement at the end of the follow-up.
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