Practitioner Countertransference and Evaluation of Callous and Unemotional Trait Clients

Abstract

This on-line study evaluated whether the presence of callous and unemotional (CU) traits in a written case description affects practitioners’ countertransference (CT), appraisal of both global and specific client traits and other therapy-relevant variables. One hundred and fifty three mental health practitioners were randomly assigned to one of two groups: One group read a hypothetical case description of a client who did not present with CU traits (NCU Group) while the other group read the same case description as the NCU Group, but with the addition of CU traits (CU Group). The results demonstrated that the presence of CU traits not only was related to CT, but also to how much time and energy practitioners invested in treatment, their likelihood of referral, and their anticipated therapy effectiveness. Consistent with the halo effect, the global assessment of CU traits, and likability was also related to practitioners’ assessment of a more specific client trait. Last, practitioners indicated that the “likability” of likable clients had more influence on their assessment of clients and ratings of therapy-relevant variables than the “likability” of unlikable clients. Although practitioners who work with CU trait clients strive to effect change and reduce problematic behavior, they are confronted with the formidable task of forging an alliance with clients who are typically unresponsive to and disengaged from treatment. It is hoped that this study will prompt practitioners to examine and learn from their emotional responses to these difficult clients and expand their knowledge of CU trait clients so that they might better understand CU trait clients’ suffering, cultivate empathy, and effectively treat their pain.