The Evidence-Based Conceptual Model of Transactional Analysis: A Focused Review of the Research Literature

This article presents a focused review of the research literature in
transactional analysis (TA). TA was developed in the 1950s as a
theory of human personality and social behavior and as a comprehensive
form of psychotherapy, but there has not been any
systematic research to test the empirical evidence for the efficacy
of TA theory and practice. The aim of this study was to develop
the conceptual model of transactional analysis on the basis of a
systematic review of the actual, self-reported practice of international
TA psychotherapists and on the evidence found in
research. The article systematically reviews common conceptual
components of TA and their empirical evidence by examining the
common denominator and the empirical evidence for the central
clinical phenomenon, etiology, therapeutic mechanisms, therapeutic
competencies, outcomes, and synthesis. TA focuses on
problems in ego states (operationalized as Parent, Adult, and
Child) with distinctive behavioral functions of Controlling Parent,
Nurturing Parent, Adult, Adapted Child, and Free Child.
Individuals can develop long-term problems in their ego states,
social functioning, and self-efficacy as the result of unfavorable
messages from their social context (negative parental messages in
early life, lack of developing mature coping mechanisms, intergenerational
messages, negative stroke balance), script decisions
(accepting or rejecting unfavorable messages via behavior, emotional
disconnection, or cognitive styles), life events, and genetics/
temperament. TA treatment intends to help clients by developing
constructive ego states, improving social functioning, and stimulating
a sense of self-efficacy. Research confirms that TA improves
psychopathology, behavior, and general well-being thanks to
improvement in ego states, self-efficacy, and social functioning.
These effects are achieved by four evidence-based therapist competencies:
creating a positive client-practitioner relationship, working
with experiences in the present, etiological analysis (life
scripts, injunctions, counterinjunctions), and therapeutic structure
(treatment contracts, treatment stages, psychoeducation/didactics).
Meta-analysis of 75 studies shows that TA has moderate to
large positive effects on psychopathology, self-efficacy, social
functioning, and ego states. This conceptual model shows that TA
can be considered a bona fide and evidence-based treatment for
a wide range of clients.