Countertransference Management Research Articles

Changes in countertransference and changes in patient working alliance and outcome: An empirical study.

The American Psychological Association task force on empirically supported therapy relationships defined countertransference (CT) management (i.e., awareness of CT) as a "promising" element in psychotherapy research. The present study aimed to examine how changes in therapist CT and awareness of CT relate to therapy process and outcome. The data analysis was based on 41 treatments and used the core conflictual relationship theme to measure CT. We found that changes in therapists' Wishes from the relationship with the patient at the beginning of therapy were related to patients' working alliance and symptom changes at the end of treatment. Changes in therapist awareness of CT moderated the relationship between therapists' wishes from the therapy and patients' symptom changes during therapy. Last, we present a case study and discuss how awareness of CT can help the therapist handle the challenges that arise from it. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

상담자의 역전이 관리능력이 다문화 태도에 미치는 영향에서 자기성찰의 매개 효과

Objectives The purpose of this study was to investigate the mediation effect of self-reflection in the relationship of counselor's countertransference management and multicultural attitude. Methods To this end, an online survey data from 251 counselors was analyzed. The data were analyzed by reliablityanaysis, pearson correlation analysis, mediating analysis, and bootstrapping using the SPSS 22.0 and SPSS process macro program. Results First, it was confirmed that there was a statistically significant positive correlation between the self-reflection, counselor's countertransference management and multicultural attitude. Second, self-reflection was found to have a partial mediating effect as a result of examining the mediating effect on the counselor's countertransference management and multicultural attitude. The results confirmed that the counselor's countertransference had a direct influence on multicultural attitude with a partial mediating effect of counselor's self-reflection. Conclusions The results confirmed that the counselor's countertransference management had a direct influence on multicultural attitude with a partial mediating effect of self-reflection.

Development of a Family Therapist’s Countertransference Management Training Program and Verification of its Effectiveness

Development of a Family Therapist’s Countertransference Management Training Program and Verification of its Effectiveness

상담자의 불안정 성인 애착과 역전이 관리능력의 관계에서 마음챙김, 정신화의 순차적 매개효과

상담자의 불안정 성인 애착과 역전이 관리능력의 관계에서 마음챙김, 정신화의 순차적 매개효과

ADHD 아동의 부모상담에서 비효과적인 상담과정에 대한 근거이론 연구

The purpose of this study is to explore ineffective counseling processes with ADHD children’s parents and related barriers. Thirteen counselors who had counseling experience with ADHD children and their parents were recruited. Semi-structured interviews were conducted and data were analyzed using a grounded theory approach. As a result, nine categories and 20 subcategories were identified. Parents’ cognitive or emotional difficulties, family conditions that cause poor parenting, and insufficient social support were found as causal or contextual conditions. Low motivation for changes was identified as a central phenomenon which, in turn, generated negative responses to counseling and poor counseling alliance. Counselors’ competence, counter-transference management, and counseling facility were identified as intervening conditions. Based on these findings, implications to prevent potentially harmful counseling were discussed.

상담자의 다문화 상담 경험이 다문화 상담역량에 미치는 영향에서 역전이 관리능력의 매개효과

The purpose of this study was to investigate the mediation effect of countertransference management in the relationship of multicultural counseling experience and multicultural counseling competence. To this end, an online survey data from 251 counselors was analyzed. The research results are as follows. First, it was confirmed that there was a statistically significant positive correlation between the counselor's multicultural counseling experience, multicultural counseling competence, and countertransference management. Second, countertransference management was found to have a partial mediating effect as a result of examining the mediating effect on the counselor's multicultural counseling experience and multicultural counseling competence. The results confirmed that the counselor's multicultural counseling experience had a direct influence on multicultural counseling competence with a partial mediating effect of countertransference management.

아동상담사의 역전이 경험에 대한 주관성 연구

Objectives This study applied Q methodology to type the subjectivity of child counselors' countertransference ex-periences and identify the characteristics of each type in order to identify the subjective perceptions and charac-teristics of each type according to the countertransference experiences of child counselors.
 Methods To this end, a total of 143 statements were derived through literature research and in-depth interviews for a total of 26 days from March 20 to April 15, 2023, and a total of 25 child counselors were selected as the P sample and Q classification was conducted. . The collected data were analyzed using the PC-QUANL Program.
 Results As a result of the study, the types of child counselors' countertransference experiences were classified into a total of four types, with type 1 being the 'countertransference self-reflection type' who believed that they experienced inner maturity and growth as a human being, and type 2 being the 'countertransference type' as an expert. ‘Countertransference management ability type’, who thinks they have experienced the need for the ability to manage themselves, Type 3 is the ‘Countertransference Active Acceptance Type’, who thinks they have experi-enced acknowledging and accepting countertransference rather than denying it, and Type 4 is self-managed. The 'reverse transfer professionalism improvement type' was found to have experienced improvement in expertise by encountering problems.
 Conclusions Through the results of this study, we focused on the perception of child counselors' counter-transference experiences, classified and confirmed the structure of child counselors' subjective perception of countertransference, and provided information on accessibility and ways for child counselors to manage and pre-vent countertransference. We hope it will be used as relevant basic data.

상담자의 불안정 성인애착과 작업동맹의 관계

This study examined the moderated mediating effect of Focusing manner on the relationshipbetween counselors' insecure adult attachment, countertransference management, and workingalliance. The subjects of the study were 308 youth and adult counselor. As a result of thestudy, first, the significant partial mediating effect of countertransference management in therelationship between insecure adult attachment and working alliance was verified. Second, themoderating effect of focusing manner was found to be significant in the relationship betweenthe counselor's insecure adult attachment and countertransference management. Third, amoderated mediating effect of focusing manner appeared in the path from the counselor'sinsecure adult attachment to the working alliance through countertransference management. Thisstudy tried to confirm counselor's personal and professional characteristics that predict thequality of the working alliance, and discussed limitations and suggestions for the future study.

Retraction of Hill et al. (2015).

Reports the retraction of "Is training effective? A study of counseling psychology doctoral trainees in a psychodynamic/interpersonal training clinic" by Clara E. Hill, Ellen Baumann, Naama Shafran, Shudarshana Gupta, Ashley Morrison, Andrés E. Pérez Rojas, Patricia T. Spangler, Shauna Griffin, Laura Pappa and Charles J. Gelso (Journal of Counseling Psychology, 2015[Apr], Vol 62[2], 184-201). The following article is being retracted (https://doi.org/10.1037/cou0000053). This retraction is at the request of coauthors Hill and Gelso after the results of an investigation by the University of Maryland Institutional Review Board (IRB). The IRB found that the study included data from between one and four therapy clients of the Maryland Psychotherapy Clinic and Research Laboratory (MPCRL) who either had not been asked to provide consent or had withdrawn consent for their data to be included in the research. Baumann, Shafran, Gupta, Morrison, Rojas, Spangler, Griffin and Pappa were not responsible for obtaining and verifying participant consent but agreed to the retraction of this article (The following abstract of the original article appeared in record 2015-02322-001.) We investigated changes over 12 to 42 months in 23 predoctoral trainees during their externship training in a psychodynamic/interpersonal psychotherapy clinic. Over time, trainees increased in client-rated working alliance and real relationship, therapist-rated working alliance, client-rated interpersonal functioning, ability to use helping skills (e.g., challenges, immediacy), higher-order functioning (e.g., conceptualization ability, countertransference management), feelings about themselves as therapists (e.g., more authentic, more self-aware), and understanding about being a therapist (e.g., theoretical orientation, curiosity about client dynamics). In contrast, trainees did not change in engaging clients (return after intake or for at least 8 sessions), judge-rated psychodynamic techniques in third and ninth sessions across clients (although trainees used more cognitive-behavioral techniques over time in third but not ninth sessions), or changes in client-rated symptomatology. Trainees primarily attributed changes to graduate training, individual and group supervision, research participation, and working with clients. Implications for training and research are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Novice school counselors’ countertransference management on emotional exhaustion: The role of daily emotional processes

AbstractThe present study aimed to examine the role of daily emotional processes in the relationship between countertransference (CT) management and emotional well‐being in novice school counselors. We collected data for 7 consecutive days from 305 novice school counselors in South Korea. Multilevel mediation analyses revealed that novice school counselors with low CT management ability were less likely to be aware of their emotions, increasing their daily emotional exhaustion. In contrast, novice school counselors with a high level of CT management ability were more likely to engage in daily decentering and, in turn, were less likely to experience daily emotional exhaustion. Although emotional inhibition (lack of emotional awareness) significantly exacerbated emotional exhaustion over time, decentering was not related to emotional exhaustion over time. The practical and theoretical implications of this study are discussed.

Training community-based psychotherapists to maintain a therapeutic alliance: A psychotherapy practice research network study.

The goal of this study was to test the efficacy of training community-based psychotherapists who were part of a practice research network to be more attuned to their patients' experiences of the therapeutic relationship. We were particularly interested in the effect of therapist training on the congruence of alliance ratings with their patients. Forty psychotherapists who treated 117 patients were randomly assigned to receive either no training or training, whose learning objectives were to help therapists to develop and maintain a therapeutic alliance. The training included workshops and ongoing consultations to help the clinician to strengthen the therapeutic relationship with the use of mentalizing, attachment theory, countertransference management, and metacommunication. Therapeutic alliance and well-being outcomes were measured at each of six consecutive early psychotherapy sessions. We used the truth and bias model and response surface analysis within a multilevel modeling context to test hypotheses. There was a significantly faster rate of alliance growth in the training versus the no training condition when the alliance was rated by therapists, but not when rated by patients. Trained therapists experienced greater temporal congruence in alliance ratings with their patients compared to untrained therapists. Patient well-being outcomes improved in a session when trained therapists and their patients agreed in their positive alliance ratings in a previous session. This association not significant among untrained therapists. Training therapists in key interpersonally focused skills may lead them to be better attuned to their patients' experiences of the therapeutic relationship. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Trainee psychologists’ experiences of learning and conducting psychodynamic therapy via telepsychology

Despite extensive research on telepsychology, less attention has been devoted to psychodynamic therapy (PDT), especially trainee psychologists’ experience of learning and conducting online PDT. Using inductive thematic analysis, this study explored the experiences of student psychologists learning and conducting PDT via video-based web platforms. Semi-structured interviews were conducted with 10 Australian trainee psychologists, all completing the psychodynamic component of their clinical psychology training. Interviews addressed participants’ experiences of online PDT learning and psychotherapy practice, generating five main themes: (1) technological barriers and their impacts, (2) overcoming telepsychology limitations through awareness and adaptation, (3) benefits of telepsychology, (4) effectiveness of psychodynamic telepsychology, and (5) experience of online psychotherapy learning. Participants reported that the paucity of sensory information, client resistance, distraction, problems maintaining therapy boundaries, supervisor opposition, and technological limitations made online PDT difficult to conduct and less effective than in-person treatment. However, some participants noted that the anxiety of commencing PDT delivery was reduced online, and that the ‘layer of separation’ assisted countertransference management. Notwithstanding its inherent limitations, online PDT was perceived to be relatively effective, but this requires specific training in adapting traditional psychodynamic techniques. Furthermore, PDT may be effectively learned online, but is an inferior alternative to in-person training.

The Mediating Effects of Self-reflection in the Influence of Supervsion Experiences on Countertransference Manangement Ability of Play Therapists

The purpose of this study is to verify the mediating effects of self-reflection in the influence of supervision experiences on countertransference management ability of play therapists. For this purpose, The Supervision Experience Questionnaire, Counselor Self-Reflection Scale, and Countertransference Factors Inventory(CFI) were used. The subjects of this study are 138 play therapists who have received the individual supervision at least three times. The results of this study can be summarized as follows. First, play therapists’ supervision experiences, the total score of Self-reflection and its sub-factors (self-understanding of counselor, counselor-client interaction), countertransference management ability had a positive correlation. Second, the total score of Self-reflection and its sub-factors (self-understanding of counselor, counselor-client interaction) had significant mediating effects on the relationships between play therapists’ supervision experiences and countertransference management ability. In conclusion, this study confirmed the mediating effects of self-reflection in the influence of supervision experiences on countertransference management ability of play therapists. Through this, the importance of the self reflection training in the play therapists’ supervision scene can be suggested.

The Mediating Effects of Self-reflection on the Influence of Self-efficacy on Countertransference Management Ability of Play Therapists

The Mediating Effects of Self-reflection on the Influence of Self-efficacy on Countertransference Management Ability of Play Therapists

Empirical support for the use and further study of the countertransference construct in the clinical care of patients with bipolar disorder.

We thank Andrew Shaw and colleagues for their recent paper1 inBipolar Disorders, highlightingthat theeffectivetreatment of patients with bipolar disorder requires a good therapeutic alliance,which is related to the clinicians' countertransference reactions and their management. The authorssuggestthat the integration of a psychodynamic approach into the biological paradigm in psychiatry might be helpful to increase countertransference awareness in clinicians, andpotentially improvingdyadic communication,resolution ofalliance ruptures, and treatment adherence. Theyalsomention that although the theoretical literature on countertransference is well developed, no good empirical studies exist that investigate the countertransferential responses experienced by mental health clinicians involved in the care of individualsduring acute phases of bipolar disorder. We would, however, like to add some examples of empirical evidence for the use (and further study) of the countertransference in the clinical care of these patients.

A structural analysis of variables related to therapeutic outcomes as perceived by music therapists and clients in guided imagery and music

This study examined the structural relationship between music therapists’ self-efficacy and countertransference management ability, and therapeutic outcomes perceived by music therapists and their clients regarding the working alliance they perceive in Guided Imagery and Music (GIM). The participants were 77 therapists and their clients. Our results indicated that therapists’ self-efficacy had a significant direct influence on their perceived therapeutic outcomes, and a significant direct and indirect influence on their perceived working alliance. Second, therapists’ self-efficacy did not directly influence the client-perceived working alliance, but significantly influenced the working alliance mediated by therapists’ countertransference management ability. Third, therapist- and client-perceived working alliances had a significant influence on their perceived therapeutic outcomes. Thus, the influence of therapists’ working alliance on therapeutic outcomes was similar for therapists and clients. However, the influence of client-perceived working alliance on therapist-perceived therapeutic outcomes was relatively lower than its impact on client-perceived therapeutic outcomes. Therefore, the self-efficacy, countertransference management ability, and working alliance of music therapists are critical variables in mediating therapeutic outcomes in GIM.

미술치료사의 집단미술치료 경험이 ‘역전이 관리능력’에 미치는 영향

미술치료사의 집단미술치료 경험이 ‘역전이 관리능력’에 미치는 영향

Associations between countertransference reactions towards patients with borderline personality disorder and therapist experience levels and mentalization ability.

Objective This exploratory study locates countertransference as a pan-theoretical concept, comprising of thoughts, feelings, and behaviors expressed or experienced by therapists toward their patients. It aims to understand the patterns of countertransference experienced in working with borderline personality disorder. Associations between countertransference reactions and therapist-related variables of experience and mentalization ability are also examined.Method Psychotherapists (n = 117) completed the Therapist Response Questionnaire to assess patterns of countertransference experienced with a representative patient diagnosed with borderline personality disorder. They also completed a measure of mentalization ability that examined self-related mentalization, other-related mentalization, and motivation to mentalize.Results The profile of responses across eight countertransference dimensions is discussed, with the most strongly endorsed reactions being positive/satisfying, parental/protective, and helpless/inadequate. More experienced therapists reported less negative countertransference reactions in select dimensions. Therapists’ self-reported ability to reflect on and understand their own mental states was negatively correlated with a range of difficult countertransference experiences. There were few associations between their ability to make sense of others’ mental states, the motivation to mentalize, and the strength of their countertransference reactions.Conclusion The implications for countertransference management as well as therapist training and development are highlighted.

Countertransference types and their relation to rupture and repair in the alliance

Background Ruptures in the alliance are co-constructed by clients and therapists, reflecting an interaction between their respective personality configurations [Safran, J. D., & Muran, J. C. (2000). Negotiating the therapeutic alliance: A relational treatment guide. Guilford Press]. In order to work effectively with ruptures, therapists should be aware of their own feeling states, acknowledging the subjectivity of their perceptions [Safran, J. D. (2002). Brief relational psychoanalytic treatment. Psychoanalytic Dialogues, 12(2), 171–195. https://doi.org/10.1080/10481881209348661]. Lack of such awareness may be a product of countertransference (CT), which has been shown to be inversely related to outcome. However, when effectively managed, CT contributes to positive outcome [Hayes, J. A., Gelso, C. J., Goldberg, S., & Kivlighan, D. M. (2018). Countertransference management and effective psychotherapy: Meta-analytic findings. Psychotherapy, 55(4), 496–507. https://doi.org/10.1037/pst0000189]. Objectives: The present study examined the associations between types of CT and therapists’ reports of ruptures and resolutions. Method: Data were collected from 27 therapists, who treated 67 clients in yearlong psychodynamic psychotherapy. CT patterns were assessed based on therapists’ Core Conflictual Relationship Themes with their parents, which were repeated in narratives about their clients [Tishby, O., & Wiseman, H. (2014). Types of countertransference dynamics and their impact on the client–therapist relationship. Psychotherapy Research, 24(3), 360–375. https://doi.org/10.1080/10503307.2014.893068]. Results: Negative CT patterns were associated with more ruptures and less resolution. Positive patterns predicted resolution when the therapists repeated positive patterns with parents, but predicted ruptures when they tried to “repair” negative patterns with the parents. These results point to the importance of therapists’ awareness of their CT in order to deal effectively with ruptures and facilitate resolution.

상담자의 성인애착과 역전이 관리능력의 관계에서 정서인식 명확성과 자아탄력성의 매개효과

The purpose of this study is to investigate the relationship among adult attachment, countertransference management ability, emotional clarity and ego-resilience. And to examine the mediating effects of emotional clarity and ego-resilience on the relationship between adult attachment and countertransference management ability of counselor. This study was conducted on 209 counselors with four or more counseling experiences. For these purposes, 209 counselors working for center in universities, public counseling center, center in school, centers for youth and other centers are were selected for survey. The mediated model was analyzed based on adult attachment, countertransference management ability, emotional clarity and ego-resilience. Collected data were treated by the SPSS 25.0 and AMOS 25.0. The results of the study were as follows. First, counselors anxiety attachment, avoidance attachment, countertransference management ability, emotional clarity, and ego-resilience were found to have significant correlation. Second, emotional clarity and ego-resilience were found to have a complete mediating effect in the path of anxiety attachment and avoidance attachment affecting countertransference management ability. Third, emotional clarity and ego-resilience were mediating variables, and sequential double mediation effect was confirmed. Also, the direct path of adult attachment to countertransference management ability was not significant and was completely double mediated. This study provides a way for counselors who have difficulty in countertransference management in counseling.