Clinical Crossroads: Countertransference, Ethics, and Premature Termination

Abstract

The literature extensively examines the clinical constructs of countertransference and premature termination through several theoretical orientations. It explores how countertransference is one of the most significant variables in successful therapy outcomes, and how premature termination is often an outcome of a poor therapeutic alliance stemming from the client’s insecure attachment to primary caregivers (Berg & Lundh, 2022; Westerling et al., 2019). However, few studies explore the interconnection of these two constructs and how clinicians process their countertransference when it interferes with their ability to provide effective treatment. Despite the gap in the literature, clinicians are bound to experience countertransference in their work with clients; thus, the literature must provide language to describe these experiences to lessen the feelings of guilt, shame, and uncertainty that tend to emerge through these processes. This clinical note aims to provide a review of these constructs through a case study to emphasize the clinical, ethical, and legal dilemmas clinicians encounter when they experience countertransference throughout the course of therapy. While experiences of countertransference are intimate and painful for the clinician, they are bound to happen; and it is the responsibility of the clinician to address them in the best interest of the client.