Countertransference, Defense Mechanisms, and Vicarious Trauma in Work With Sexual Offenders.

Abstract

This study aimed to examine the associations between countertransference induced by sex offenders, defense mechanisms, and manifestations of vicarious trauma in forensic psychiatrists and psychologists. A cross-sectional study using a mixed-methods design was performed with 56 Brazilian forensic psychiatrists and psychologists from October 2016 to May 2017. Countertransference, defense mechanisms, and vicarious trauma were assessed with the Assessment of Countertransference Scale, the Defense Style Questionnaire-40, and the Trauma and Attachment Belief Scale (TABS), respectively. Qualitative data analysis based on grounded theory was also performed to explore the influence of sex-offender assessments on the experts' personal and professional lives. Positive and moderate correlations were found between feelings of indifference and the Other-Safety TABS subscale (rho .43, P < .01) and between immature defense mechanisms and TABS total score (rho .45, P < .01). Qualitative data revealed changes in the professionals' identity, worldview, and beliefs related to safety and trust. Specific maladaptive coping strategies, such as feelings of indifference and immature defenses, during the assessment of sex offenders were associated with manifestations of vicarious trauma in forensic psychiatrists and psychologists. These findings indicate the need for awareness and care about the forensic expert's mental health.