Newly qualified therapists' countertransference experiences when working with adult clients diagnosed with eating disorders : a thematic analysis

Abstract

This is a qualitative study investigating newly qualified therapists’ countertransference (CT) experiences when working with adult clients diagnosed with Eating Disorders (EDs). Literature review of this area has revealed that the experiences of newly qualified therapists’ CT are understated in the work with this client group. Therefore, to address this gap, eleven participants were recruited and interviewed using semi-structured interviews. Participants’ accounts were transcribed verbatim and were analysed using Thematic Analysis (TA). The analysis revealed five superordinate themes as follows: a) ‘Doubting Own Identity’; b) ‘Safeguarding the Client, the Self and the Work’; c) ‘Feeling “Chewed Through and Spat Out’; d) ‘It’s a Power Struggle!’ and e) ‘Being Equipped to Manage CT’. Each superordinate theme consisted of three subthemes. The research findings suggest that new therapists’ CT reactions may involve a temporary identification with their clients’ views of self and the world, often experiencing mental blocks and extreme anxiety around their own bodies. Findings further indicate CT responses of overprotecting, nurturing and rescuing clients, as well as strong physical reactions to clients’ fragile physical appearances. New therapists’ CT reactions further included feeling consumed, worn-out and frustrated both during therapy and in their private lives. New therapists participating in this study experienced a battle for power between themselves and their clients. Lastly, findings emphasise the essential role of CT in therapy with this client group. This study accentuates a need for increased awareness around the importance of CT amongst new therapists working with clients with EDs whilst informing training and NHS services to address potential tensions. The study’s limitations, relevance to Counselling Psychology and suggestions for future research are presented.