The Direct Approach to the Unconscious/Personal Integration Therapy Method in depression: therapeutic results and phenomenological foundation.

Abstract

Background: A growing body of empirical studies supports the relevance of intersubjective, narrative, and self-reflective processes in the genesis and treatment of depression. The results obtained in the psychotherapeutic process of the Direct Approach to the Unconscious Method in a Personal Integration Therapy (ADI/TIP Method) allow for the clarification and understanding of the psychic process of configuration of depression and its possibilities of reconfiguration. Aims: To investigate the maintenance of results obtained in participants submitted to the ADI/TIP Method; to understand how primary intersubjective bonds are configured; and to apprehend the processes that enable their reconfiguration. Methods: This mixed-methods study administered the Beck Depression Inventory at the beginning and at the end of the psychotherapeutic process to all participants. Subsequently, the Beck Depression Inventory–II (BDI-II) was administered to a selected group (n = 27) for longitudinal analysis, conducted three and six months after completion of the psychotherapeutic process. The nonparametric Friedman test was used, complemented by the Wilcoxon signed-rank test with Bonferroni correction for post hoc analyses. Qualitative data were collected throughout the psychotherapeutic process itself, and the evidenced content was analyzed through Psychological-Phenomenological analysis. Results: In the previous study, individual trajectory analyses indicated strong treatment effects at post-treatment. Across follow-up assessments, treatment gains showed partial attenuation but remained below baseline levels overall. Mean symptom reduction relative to baseline was 48.2% at 3 months and 52.7% at 6 months. The pattern of "Continuous Improvement" predominated over time, observed in 74.1% of participants, suggesting stabilization of results and consolidation of changes in the dynamics of meaning within lived- experience. Conclusion: Depressive illness cannot be reduced to a naturalistic psychophysical understanding, considering the structural unity and the self-formation process of the Human Person grounded in intersubjectivity. Phenomenological Psychology provides intelligibility to this phenomenon, and the ADI/TIP Method may contribute as an intervention tool for the understanding and treatment of depressive suffering.