Using mixed methods in feasibility studies: The example of brief transactional analysis psychotherapy for depression

Abstract

Introduction

Few guidelines exist on how to conduct Phase 1 feasibility studies in psychological therapies. It may be theoretically argued that small-size feasibility studies are best studied with mixed methods. The primary aim of this study was to examine the feasibility of using mixed methods in feasibility studies. The secondary aim was to systematically explore the feasibility of a 16-session treatment manual in transactional analysis psychotherapy (TAP) for depression developed in a prior Phase 0 study.

Method

Nine clients received therapy from three therapists, and sample characteristics were described using flowcharts and sociodemographic statistics. Interviews were conducted with clients and therapists to explore subjective experiences of changes and processes in therapy. Psychometric instruments measured the impact on mental health, quality of life and TAP-specific outcomes. Therapist learning effects were examined through self-reported TAP-specific competencies. The analyses included reflexive thematic analysis, descriptive statistics, t-tests and repeated measures ANOVA.

Results

The results indicated that the clients experienced important changes, such as self-insight, better coping strategies, self-confidence and boundaries, mainly attributed to TAP and facilitated by helpful factors in TAP. Significant differences were reported in outcome measures, and analyses indicated increased competency in TAP-specific skills. No negative side effects were mentioned.

Discussion

This study provides evidence for the feasibility of TAP for depression and the feasibility of using mixed methods in feasibility studies. Future researchers may want to use similar comprehensive mixed methods designs.