How Parent–Adult–Child quietly shaped CBT, parts work, trauma therapy, and inner-child healing.
When you zoom out on today’s therapy landscape – CBT, DBT, schema therapy, Internal Family Systems (IFS), ego-state work, EMDR, inner-child work, a pattern appears.
Over and over again, clinicians are:
- Naming distinct “parts” or modes of self,
- Teaching people to observe and label states, and
- Helping them move into a more grounded, reality-based “adult” stance.
That’s exactly what Transactional Analysis (TA) was doing in the 1950s and 60s with its Parent–Adult–Child (P-A-C) model and its focus on scripts, life positions, and games. Some later models explicitly acknowledge TA as part of their heritage. Others arrive at similar territory from different theoretical roads. Either way, TA’s fingerprints are all over contemporary practice.
TA and CBT: Scripts, Beliefs, and the “Adult” as Cognitive Therapist
At first glance, Cognitive Behavioral Therapy (CBT) and Transactional Analysis look like distant cousins: one is known as “evidence-based,” the other as “60s humanistic psych.” However, dig deeper and there’s a lot of shared DNA.
Shared core ideas
Both CBT and TA:
- Emphasize the role of learned beliefs in distress.
- Aim to make automatic patterns conscious, then challenge or update them.
- Teach clients to adopt a more realistic, flexible stance toward themselves and others.
In TA, those deep patterns are called scripts and life positions (e.g., I’m not OK, you’re OK), shaped by early decisions and Parent/Child dynamics.
In CBT, they’re called core beliefs and schemas (“I’m unlovable,” “The world is unsafe”) driving distorted thoughts.
Not surprisingly, you see formal attempts to integrate TA and CBT:
- A classic paper, A Cognitive Behavioral Approach to Transactional Analysis, describes using behavioral techniques with TA concepts to create a combined framework for treatment.
- Contemporary clinicians write about TA enhancing CBT by mapping cognitions onto Parent/Adult/Child ego states, and using that to identify and reframe self-talk.
On the outcome side, TA training has been shown to improve emotion regulation and cognitive flexibility in groups like nursing students and adolescents, which are core CBT goals.
If CBT helps people think differently, you can think of TA as giving them a cast of internal characters to work with:
Critical Parent = harsh automatic thoughts
Adapted Child = shame and compliance
Adult = the internal CBT therapist, asking “What are the facts?”
Even when a CBT manual doesn’t mention Eric Berne by name, many clinicians are effectively doing P-A-C-informed CBT in practice.
DBT and TA: Emotion Regulation Meets Ego States
Dialectical Behavior Therapy (DBT) was formally developed by Marsha Linehan as a behavior-therapy approach for chronic suicidality and borderline personality disorder, drawing on behavioral principles and Zen.
DBT does not list TA as a primary influence. But you can see conceptual parallels:
- DBT teaches clients to observe emotions, thoughts, and urges as passing states.
- It emphasizes “wise mind” – a synthesis of emotional and rational mind that feels very close to TA’s Adult ego state.
- Interpersonal effectiveness skills often help clients move from reactive Child or punitive Parent dynamics into more Adult-to-Adult conversations.
Contemporary, comparative research also looks at DBT alongside TA:
- A 2023 study compared DBT and “transactional behavior analysis” groups for students with social anxiety. Both methods significantly improved cognitive emotion regulation; there was no significant difference in effectiveness, and authors suggested clinicians can use DBT or TA in conjunction with other treatments for this population.
That doesn’t prove DBT came from TA, but it does show:
- TA-based group work can function in the same “therapeutic neighborhood” as DBT.
- Both approaches are effective in emotion regulation, interpersonal patterns, and here-and-now skills.
In their practices, many clinicians informally combine them: they’ll use DBT skills (distress tolerance, mindfulness, emotion regulation) while using TA language (Parent–Adult–Child, games) to make the relational dynamics and inner voices explicit.
TA, Parts Work, and Ego-State Therapies
TA was one of the first accessible “parts” models in mainstream clinical work, and ego-state therapy, IFS, schema modes, and other parts models can be seen as its extended family.
Ego-state therapy: Federn, Watkins… and Berne
Ego-state therapy grew directly from psychoanalytic work by Paul Federn and was elaborated on by John and Helen Watkins, among others.
Historical reviews of ego-state theory explicitly note that:
- Ego-state therapy is a parts-based psychodynamic approach that treats inner “subpersonalities,” such as frightened child, controller, etc.
- Later authors list Eric Berne (TA) and Richard Schwartz (IFS) among key figures in the broader ego-state/parts line of work.
Therefore, Berne isn’t the only ancestor of ego-state work, but he is named in scholarly discussions of the evolution of ego-state theory, which gives TA a clear place in that lineage.
Internal Family Systems (IFS) and The Self vs. Parts
Internal Family Systems (IFS) conceptualizes:
- A core Self that is calm, compassionate, curious, and confident.
- Multiple parts (Managers, Firefighters, Exiles) with their own roles, fears, and strategies.
IFS emerges from systems thinking + multiplicity of mind; Schwartz doesn’t pitch it as “TA 2.0.” But if you set P-A-C next to IFS, the family resemblance is striking:
- Parent echoes many Manager / Protector functions (critical, controlling, or nurturing).
- Child overlaps with Exiles and playful parts.
- Adult has a lot in common with the Self that can witness, relate, and lead.
Scholars and clinicians writing on ego-state therapy explicitly group TA, ego-state therapy, and IFS together as approaches working with internal “parts” despite their different theoretical roots.
Schema modes: Healthy Adult, Parent, and Child
Schema therapy (Jeffrey Young) blends CBT, attachment theory, and experiential methods. Over time, it evolved into a “mode” model with distinct states:
- Child modes (e.g., Vulnerable Child, Angry Child)
- Parent modes (Punitive Parent, Demanding Parent)
- Coping modes
- And a central Healthy Adult mode
It’s hard not to hear Parent–Adult–Child echoing in that language. A book review in the American Journal of Psychiatry notes that Young’s schema therapy is historically situated among mid-20th-century developments, including TA, even though his primary influences were cognitive and attachment-based models.
Recent papers and conference materials explicitly discuss integrating schema modes with TA, analyzing their “general principles and distinctive features” and how they can be combined in clinical work.
So, even if schema therapy weren’t “born from” TA, the mode structure (Parent, Child, Adult) shows how strongly TA’s basic insight has permeated the ecosystem.
TA and Inner-Child Work
If you’ve ever sat with a client and talked about their “inner child,” you’re already in TA’s neighborhood.
Historically:
- Psychoanalysis and humanistic writers hinted at child-parts.
- But Transactional Analysis was one of the major movements that explicitly brought the idea of a “child inside” into mainstream awareness through the Child ego state.
- Modern inner-child literature often points directly back to TA
- Articles on “child ego state and inner child healing” state that the concept of the Child ego state originates from TA and describe working with that Child as essential to emotional repair.
- Therapists trained in TA write about listening to the inner child as listening to the Child ego state, with the Nurturing Parent and Adult learning to respond differently.
Contemporary authors on inner-child work now routinely note that inner-child approaches show up in TA, IFS, EMDR, schema therapy, Gestalt, and narrative therapy and reflect how widely the “parts + child” framework has spread.
In other words, when someone guides a client to talk to, comfort, or re-parent their inner child, they’re often using TA-shaped language, even if they’re calling it something else.
TA and Trauma Therapy: Ego States, EMDR, and Structural Dissociation
Trauma therapy has leaned heavily into parts language, and TA quietly helped set that stage.
Ego States and Trauma
In trauma work, ego-state models are used to make sense of dissociation, flashbacks, and apparently contradictory behaviors. Recent reviews of ego-state theory and therapy trace its origins to Federn and Watkins, then highlight how it became a leading approach in psychotraumatology for years.
Some trauma-focused papers explicitly list:
- Watkins & Watkins (ego-state therapy)
- Eric Berne (Transactional Analysis)
- Richard Schwartz (IFS)
These examples can be viewed as part of a shared “ego-state / parts” lineage used to help trauma survivors integrate fragmented self-states.
EMDR as a Form of Ego-state Psychotherapy
EMDR on its own is a structured bilateral stimulation protocol, but many EMDR clinicians integrate it with ego-state work:
- Articles describe EMDR as a “special form of ego-state psychotherapy,” explicitly linking it to Federn, the Watkins, Berne, and Schwartz.
The practical result:
- Therapists help clients identify different parts/ego states (frightened child, protector, critic).
- Then they process traumatic material within or between those states, often using EMDR.
TA’s simple, visual ego-state model is frequently used to teach this to clients quickly: Parent, Adult, Child become accessible handles for mapping dissociated or conflictual states.
TA Group Work as Trauma-Adjacent
TA group interventions have demonstrated:
- Improvements in self-esteem, emotion regulation, and interpersonal skills in vulnerable populations.
Those outcomes directly support the stabilization and resourcing phases of trauma treatment, even when the intervention itself isn’t marketed as “trauma therapy.”
A Shared Philosophy: Observing States, Choosing Adult
Across CBT, DBT, schema therapy, IFS, ego-state work, EMDR, and inner-child work, certain philosophical through-lines echo TA:
- Multiplicity is normal.
- TA: Parent, Adult, Child are all “you.”
- Parts models: we all have multiple parts or modes; that’s not pathology, that’s human.
- Naming states reduces shame and increases choice.
- TA: Once you can say, “That’s my Critical Parent,” you have some distance.
- CBT: Once you see a thought as “a thought,” you can challenge it.
- DBT/IFS: Once you notice a part or emotion, you can relate to it rather than from it.
- Adult/Wise/Healthy Self as inner leader.
- TA: Strengthen the Adult to mediate Parent and Child.
- Schema therapy: build a Healthy Adult mode to care for vulnerable child modes.
- IFS: help Self lead the system.
- Re-parenting and inner-child repair.
- TA: shift from Critical to Nurturing Parent, respond differently to the Child.
- Inner-child work: give the “child inside” what they didn’t get.
- Schema therapy & IFS: “limited reparenting,” Self or Healthy Adult caring for vulnerable parts.
So even when a training manual doesn’t put TA on the cover, many of the core moves in modern therapies look like refinements, extensions, or rediscoveries of what TA was already teaching:
You have different inner states. You can learn to see them. You can strengthen a grounded, compassionate “adult” self that leads with clarity instead of script.
Why It Matters to Recover TA’s Place in the Story
Bringing TA back into the conversation isn’t just about giving Eric Berne and his colleagues a gold star in the history of psychology. It remains clinically useful:
- Language: TA still offers one of the cleanest, most client-friendly vocabularies for parts work and communication patterns.
- Integration: You can layer TA onto CBT, DBT, trauma therapy, or IFS to give clients a simple “map” of their inner world.
- Ethics & dignity: TA’s emphasis on OK-ness (“I’m OK, you’re OK”) aligns with trauma-informed, dignity-centered care and modern parity/anti-stigma values.
In many ways, TA was a bridge between classical psychodynamics and today’s integrative, relational, trauma-aware therapies. It taught us that:
- Our inner conversations shape our outer relationships, and
- Cultivating a strong, steady Adult ego state (or Self, or Healthy Adult) is one of the most powerful ways we can heal, re-parent, and show up differently in the world.
Sources and Further Reading:
Transactional Analysis and Ego States
Berne, E. (1961). Transactional Analysis in Psychotherapy. New York: Grove Press.
- Murray, H. “Transactional Analysis Theory & Therapy: Eric Berne.” SimplyPsychology.
- “Transactional analysis.” Wikipedia. (updated 2025).
- Counselling Tutor. “What are Ego States?”
TA + CBT / Skills Work:
- Bergmann, L. H. (1981). “A Cognitive Behavioral Approach to Transactional Analysis.” Journal of Group Psychotherapy, Psychodrama & Sociometry.
- Angela Jullings. “Transactional Analysis & CBT Therapy.”
- Torkaman, M., et al. (2020). “The effect of transactional analysis on self-esteem.” Journal of Education and Health Promotion.
- Abbasszade, A., et al. (2025). “A transactional analysis training program on cognitive flexibility and emotion regulation in nursing students.” BMC Nursing.
DBT and Comparative Studies:
- Linehan, M. (2015). “The Course and Evolution of Dialectical Behavior Therapy.” Psychotherapy.
- Baharlou, F., et al. (2023). “Comparison the Effectiveness of Dialectical Behavior Therapy and Transactional Behavior Analysis…” Iranian Journal of Educational Sociology.
Parts / Ego-State / IFS / Schema:
- “Ego-state therapy.” Wikipedia.
- Leutner, S., et al. (2021). “The concept of ego state: From historical background to modern clinical practice.”
- Lawrence, M. “EMDR as a Special Form of Ego State Psychotherapy.”
- Schwartz, R. “Evolution of the Internal Family Systems Model.” IFS Institute.
- Edwards, D. (2022). “Using Schema Modes for Case Conceptualization in Schema Therapy.” Frontiers in Psychology.
- Temple, S. D. (2003). Review of Schema Therapy: A Practitioner’s Guide. American Journal of Psychiatry.
- “Integration of Schema Therapy and Transactional Analysis into Client Work.” Conference proceedings, 2025.
Inner-Child Work and TA:
- “What is the Inner Child?” Harley Therapy.
- “Child Ego State: Nurturing Your Inner Child for Emotional Healing.” The Wellness Institute.
- “Healing Your Inner Child with Ego States.” The Healing Nest.
- Lucy Hyde Therapy. “Listening to your inner child.”
- Nurick, J. “What Is Inner Child Work?”
