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

Published in Transactional Analysis Journal 51(5) (April 2021)

Vos,J & van Rijn,B.


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.

Female therapists’ experiences of working with male clients who are sexually attracted to them

An exploratory study using a free association narrative interview method, published in Counselling Psychology Quarterly

Jasenka Lukac‐Greenwood, Biljana van Rijn First published: 12 February 2021


Sexual attraction between human beings is a pervasive phenomenon, impacting the process of psychotherapy, as well as other areas of social engagement. However, within ethical psychotherapy practice the experience of attraction could not lead to enactment without ethical misconduct or premature therapeutic termination. This qualitative study focused on female therapists’ experiences of working with male clients who were sexually attracted to them. It employed Hollway and Jefferson’s (2008) hybrid method ‘free association narrative interview’, which involved multiple unstructured interviews with five female participants. The results of the study suggested that participants’ experience differed depending on whether they felt reciprocal sexual attraction. On occasions when therapists were not attracted towards their clients, they struggled with unwanted sexual attraction because they feared having to reject their client and the retaliation this may entail. On such occasions, therapists expressed a sense of vulnerability, discomfort with power inequality and a sense of being at fault. Conversely, when therapists felt sexually attracted to their clients, they managed the dynamic by framing it within a context of loving as opposed to purely erotic feelings. The study suggests that working directly with sexual feelings is a challenge for female therapists, requiring personal development work, supervision and institutional support to address the complex interplay of individual, clinical and societal issues, which appear to play a part in this difficulty.

Link to article:
To cite this article:

Lukac-Greenwood,J, van Rijn,B.( 2021) Female therapists’ experience of working with male clients who are sexually attracted to them – an exploratory study using a Free Association Narrative Interview Method. Couns.Psychother Res.2021;00:1-13.

Activity preferences in psychotherapy: what do patients want and how does this relate to outcomes and alliance?

A new article published in Counselling Psychology Quarterly

Mick Cooper, Biljana van Rijn, Evi Chryssafidou & William B. Stiles

This study aimed to investigate (a) what clients’ within-treatment activity preferences were; (b) whether a match between preferences and psychotherapy approach predicted outcomes and alliance; (c) whether scores on preference dimensions, per se, predicted outcomes and alliance. Participants were 470 clients engaging in one of five approaches with trainee psychotherapists. We used the Cooper–Norcross Inventory of Preferences to identify clients’ within-treatment activity preferences; and multilevel modelling to examine the relationship between these preferences – and a match on these preferences – to outcomes and alliance. Clients had an overall preference for therapist directiveness and emotional intensity. We found no evidence of a preference matching effect. Clients who expressed a desire for focused challenge over warm support showed greater progress. Client preferences for focused challenge may be indicative of their readiness to change and indicate a positive prognosis. Further research should directly observe therapeutic practices and assess a range of client variables.

KEYWORDS: Aptitude-treatment interaction research; alliance; process research; experiential/existential/humanistic psychotherapy; integrative treatment models

Link to article: Routledge –
To cite this article:

Mick Cooper, Biljana van Rijn, Evi Chryssafidou & William B. Stiles (2021) Activity preferences in psychotherapy: what do patients want and how does this relate to outcomes and alliance?, Counselling Psychology Quarterly.

Reflective Practice and Personal Development in Counselling and Psychotherapy

Reflective Practice and Personal Development in Counseling and Psychotherapy. S. Bager-Charleson

Bager-Charleson, S. (2020) Reflective Practice and Personal Development in Counselling and Psychotherapy. Second Edition.  ISBN 9781526477491

A second edition of Reflective Practice and Personal Development in Counselling and Psychotherapy by Sofie Bager-Charleson is just out. My contribution consists of two updated chapters: Developments within reflective practice and Evaluating our practice.


Reflective practice is a vital part of your counselling and psychotherapy training and practice. This book is your go-to introduction to what it is, why it is important, and how to use different models for reflection and reflective practice to enhance your work with clients. It will support your personal development and professional development throughout your counselling training and into your practice.


Reflective practice: An overview
Personal development
Your support and development
Reflecting on relationships
Reflecting on practice with research
Emancipatory knowing
Developments within reflective practice by Biljana van Rijn
Evaluating our practice by Biljana van Rijn
The vulnerable researcher: Harnessing reflexivity for practice-based qualitative inquiry by Simon du Plock
How creative writing aids our professional transition by Jeannie Wright

More info at Sage

Working with Sexual Attraction in Psychotherapy Practice and Supervision

Biljana van Rijn & Jasenka Lukac-Greenwood (eds.) Working with Sexual Attraction in Psychotherapy Practice and Supervision. Routledge  ISBN 9780367250768

My latest book with Jasenka Lukac-Greenwood and published by Routledge will be available from 29 July 2020.

Book Description

Working with Sexual Attraction in Psychotherapy Practice and Supervision addresses some of the challenges associated with sexual attraction in psychotherapy practice and supervision, as well as within services, and helps therapists, supervisors, and managers to navigate them with openness and self-reflection.

The book focuses on practical and applied issues, using a relational humanistic-integrative theoretical approach as a backdrop for understanding. Split into three parts, it deals with issues related to clinical practice, supervision and ethical issues. Chapters support in-depth exploration in all three arenas of practice and are completed by editors providing a reflective summary.

Enriched with case examples and research written by senior relational practitioners, the book will be beneficial to therapists, supervisors, and service managers in the field of psychotherapy.

Table of Contents

Part 1. Clinical Practice: Sexual attraction in the therapy room; 1.1 Let’s talk about sex: Female therapists’ experiences of working with male clients who are sexually attracted to them; 1.2 Mapping the ‘Erotic’ in the therapeutic relationship; 1.3 The Meaning of the Asking; 1.4 Gender Identity & Sexual attraction in the therapeutic encounter. A Transgender perspective; 1.5 Editor’s summary and reflection of the themes related to practice issues;

Part 2.Sexual attraction and Sexual Identity in Supervision; 2.1 The Supervisory Dimension; 2.2 The Comfort and disturbance of Forbidden Conversations: Sexuality and Erotic Forces in Relational Psychotherapy Supervision; 2.3. Sexual Orientation in the supervisory relationship: Exploring Fears and Fantasies when different sexual orientations are present in the client/therapist and/or supervisory dyad; 2.4. Editor’s Summary and reflection on sexual attraction and orientation in supervision;

Part 3. Ethics: Preventing and dealing with transgressions; 3.1. Sexual Transgressions and Transgressing Gender and Sexuality; 3.2. Firefighting. Managing sexual ruptures and transgressions within counselling and psychotherapy services; 3.3. An ethical container for erotic confusion; 3.4. Editor’s Summary and reflection on ethical practice and prevention of transgressions.

Available for pre-order:


‘If ever there was a text to help us navigate the treacherous waters of sexual and erotic material within therapeutic and supervisory relationships, this is it! With scholarship, clinical wisdom and not a little courage, Van Rijn and Lukac-Greenwood have brought together a collection of new essays that offer invaluable insights into the complexities of acknowledging and working with issues of sexual attraction in therapy and clinical supervision. Drawing on a wide range of theoretical ideas as well as some fascinating clinical material, they and their contributors encourage psychotherapists and other psychological practitioners to reflect openly and deeply on their practice and to engage more fully with the personal, ethical and relational issues that emerge from working with sexuality in the consulting room. 
This is a brave, timely and thought-provoking book: I will certainly be recommending it to all my colleagues and trainees.’
Rosemary Rizq, PhD, Professor of Psychoanalytic Psychotherapy, University of Roehampton.

‘Kudos to Jasenka Lukac-Greenwood and Biljana van Rijn for this remarkable collection of essays taking up the complex and compelling challenges of working with the vital and disturbing forces of eros and sexuality as they come alive within the therapeutic process. Writing within the humanistic/relational traditions, each author, while speaking in a personal voice, addresses questions of far-reaching theoretical and clinical concerns. This book is quite unique in speaking to the emergence of sexual dynamics within supervisory relationships as well as the therapeutic. This is a book that will bear multiple readings and will be an invaluable resource to practitioners, supervisors, educators and trainers.’
William F. Cornell, Independent Psychotherapist and Consultant, Pittsburgh, PA. Author and Editor of Routledge series, “Innovations in Transactional Analysis”

‘This is an impressive book about sexual dynamics in the therapeutic encounter. It is multi-layered and rich -with a welcomed relational humanistic-integrative framework on personal as well as socio-cultural constructs about self and sexuality. It is a must-have for all therapists, I can’t recommend it enough!’
Dr Sofie Bager-Charleson, Senior Fellow (SFHEA), Director of Studies (Management) MPhil/PhD in Psychotherapy, Metanoia Institute.

‘Addressing what, for many, is a complex and frightening area to understand and work with, this book offers a frank, thought-provoking, and encouraging approach to many of the concerns that therapists struggle with when it comes to working with sexual attraction in the therapy room.
A welcome addition to the library of students and experienced therapists alike, the reader will find a host of stimulating and well-argued papers. Each of which gives voice to how within a relational humanistic-integrative perspective, the emergence and development of sexual dynamics in the therapeutic encounters can be thought about, engaged with, and drawn upon for maximum therapeutic benefit.’

Heather Fowlie
Faculty Head – Psychotherapy and Counselling, Metanoia Institute.