Types of countertransference dynamics: An exploration of their impact on the client-therapist relationship

Tishby, Orya; Wiseman, Hadas

doi:10.1080/10503307.2014.893068

Cited by 37 publications

(36 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our results are broadly consistent with the literature that suggests clinicians have negative emotional responses to patients presenting as at risk for suicide ( 14 – 18 , 25 , 67 ), and deepen this literature by characterizing specific responses that associate prospectively both individually and in aggregate with suicide-related outcomes and clinician judgment of suicide risk. Further, our results extend the growing body of literature that supports the potential diagnostic specificity of emotional responses ( 5 , 6 , 34 , 44 – 48 , 50 , 53 – 56 ).…”

Section: Discussionsupporting

confidence: 83%

“…Countertransference, which emerges in the context of a therapeutic relationship with the patient, has been extensively addressed in the theoretical and qualitative clinical literature ( 2 – 4 ). The concept of countertransference has developed over the years since Freud (1910) classical definition of countertransference as the therapist’s own unresolved conflict-based reactions to the patient’s transference, which are unbeneficial to treatment ( 5 ) to a “total” view of countertransference as comprising all of a clinician’s emotional responses to a patient ( 6 ), an important source of information for understanding the patient’s dynamics. Following the growing body of quantitative empirical research on countertransference over the past three decades, several recent studies have provided quantitative empirical evidence supporting the relation of countertransference to treatment outcomes ( 2 , 7 – 9 ).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Emotional Responses to Suicidal Patients: Factor Structure, Construct, and Predictive Validity of the Therapist Response Questionnaire-Suicide Form

et al. 2018

View full text Add to dashboard Cite

BackgroundMental health professionals have a pivotal role in suicide prevention. However, they also often have intense emotional responses, or countertransference, during encounters with suicidal patients. Previous studies of the Therapist Response Questionnaire-Suicide Form (TRQ-SF), a brief novel measure aimed at probing a distinct set of suicide-related emotional responses to patients found it to be predictive of near-term suicidal behavior among high suicide-risk inpatients. The purpose of this study was to validate the TRQ-SF in a general outpatient clinic setting.MethodsAdult psychiatric outpatients (N = 346) and their treating mental health professionals (N = 48) completed self-report assessments following their first clinic meeting. Clinician measures included the TRQ-SF, general emotional states and traits, therapeutic alliance, and assessment of patient suicide risk. Patient suicidal outcomes and symptom severity were assessed at intake and one-month follow-up. Following confirmatory factor analysis of the TRQ-SF, factor scores were examined for relationships with clinician and patient measures and suicidal outcomes.ResultsFactor analysis of the TRQ-SF confirmed three dimensions: (1) affiliation, (2) distress, and (3) hope. The three factors also loaded onto a single general factor of negative emotional response toward the patient that demonstrated good internal reliability. The TRQ-SF scores were associated with measures of clinician state anger and anxiety and therapeutic alliance, independently of clinician personality traits after controlling for the state- and patient-specific measures. The total score and three subscales were associated in both concurrent and predictive ways with patient suicidal outcomes, depression severity, and clinicians’ judgment of patient suicide risk, but not with global symptom severity, thus indicating specifically suicide-related responses.ConclusionThe TRQ-SF is a brief and reliable measure with a 3-factor structure. It demonstrates construct validity for assessing distinct suicide-related countertransference to psychiatric outpatients. Mental health professionals’ emotional responses to their patients are concurrently indicative and prospectively predictive of suicidal thoughts and behaviors. Thus, the TRQ-SF is a useful tool for the study of countertransference in the treatment of suicidal patients and may help clinicians make diagnostic and therapeutic use of their own responses to improve assessment and intervention for individual suicidal patients.

show abstract

Section: Discussionsupporting

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Emotional Responses to Suicidal Patients: Factor Structure, Construct, and Predictive Validity of the Therapist Response Questionnaire-Suicide Form

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Two female clients were treated by the same therapist at a university counselling centre. They were selected from a sample of 67 clients and 27 therapists who participated in the Jerusalem–Haifa study on the ‘patient–therapist dance’ (Tishby & Wiseman, ; Wiseman & Tishby, ). In the larger sample, the clients were diagnosed with moderate depression and/or anxiety, and students in crisis or with symptoms of psychosis were excluded.…”

Section: Methodsmentioning

confidence: 99%

“…Thus, despite the promising implications for clinical training and supervision, it remains debatable whether the answers are there to be had, even using the best databases and designs available. We propose that rather than viewing the therapeutic relationship as composed of discrete client , therapist and treatment variables, it needs to be viewed as a fluctuating, evolving pattern, inseparable from the way it is actually experienced by both clients and therapists (Wiseman, Tishby, & Barber, ; Tishby & Wiseman, ). In their recommendations for future research on therapist effects, Baldwin and Imel () suggest attending to the relative contribution of therapists, patients and therapist–patient dyads in process‐outcome research.…”

mentioning

confidence: 99%

Relational Patterns and the Development of the Alliance: A Systematic Comparison of two Cases

Schattner

Tishby

Wiseman

2016

Clin Psychology and Psychoth

Self Cite

View full text Add to dashboard Cite

The interaction of client and therapist relational patterns may be a key factor in the development of the therapeutic alliance and might potentially impact client outcome. Therapeutic practice will likely be improved if therapists are more aware of their own relational patterns and the ways these interact with their clients' relational patterns. Striving for this awareness should probably be a main focal point for therapists throughout their careers, in their training, supervisions and personal therapies.

show abstract

“…Countertransference has been shown to be multi-faceted (e.g., Tishby & Wiseman, 2014), but there is evidence that it is at least partly based in the therapist's own emotional patterns as well as being related to what the patient brings to therapy (e.g., Holmqvist, HansjonsGustafsson, & Gustafsson, 2002). However, there is far less empirical consideration of how patients experience their therapists' emotions.…”

mentioning

confidence: 99%

Patients’ experiences of clinicians’ crying during psychotherapy for eating disorders.

Tritt¹,

Kelly²,

Waller³

2015

Psychotherapy

View full text Add to dashboard Cite

Many psychotherapists cry in therapy sessions. Those clinicians who do cry see it as likely to have a positive impact on the therapy or to have no impact, and therapist personality characteristics have not shown reliable associations to crying in therapy. However, it is not known how patients experience therapists' crying, or whether the patient's view of the therapist's characteristics is related to that experience. This study used an online survey, recruiting 202 patients with eating disorders, 188 of whom had received therapy for an eating disorder, and 105 of whom had experienced a therapist crying. Retrospective data from those 105 individuals indicated that therapists' crying tended to be seen positively, but that perception was influenced by the patients' perceptions of the demeanor of their therapist and their understanding of the meaning of the crying. While they need to be extended to other disorders, these findings suggest that therapists' crying needs to be understood in the context of the therapist's perceived characteristics and demeanor, rather than being assumed by therapists to be positive or to have no impact on the therapy.Keywords: Psychotherapy; therapist; patient; crying IMPACT OF CLINICIANS' CRYING 3 Patients' Experiences of Clinicians' Crying during Psychotherapy for Eating DisordersPsychotherapy has a tradition of focusing on the inner world of the patient. However, the inner world of the therapist is also important, as it interacts with that of the patient. Such interaction appears in many forms in the literature, including constructs such as transference/countertransference and the therapeutic alliance. Therefore, regardless of therapeutic orientation, it is important to consider the therapist's reactions to the client during the session (e.g., Gelso & Hayes, 2007;Gilbert & Leahy, 2007;Summers & Barber, 2010).This study addresses one specific reaction -the therapist crying in the session, and the impact of that experience on the patient.Emotional experience in the therapy session and how it can disrupt therapy if unattended are key elements of therapists' reactions. This concept is not limited to the psychodynamic construct of countertransference. For example, Waller (2009) has hypothesised that cognitive-behavioral therapists who experience higher levels of anxiety are less likely to implement core behavioral techniques, making them less effective.Following a series of small-scale reports in the literature, Blume-Marcovici, Stolberg and Khademi (2013) surveyed a large number of psychologists and trainees (N = 684) regarding one specific emotional marker -the therapist crying in therapy. In this relatively diverse group of clinicians, using a variety of therapeutic approaches with a wide range of patients, they reported that over 70% of the therapists reported ever having cried in therapy (with 30% having done so in the past four weeks). Pope, Tabachnick and Keith-Spiegel (1987) found a slightly lower lifetime rate for therapists' crying (56.5%), but these findings represent a ...

show abstract

Types of countertransference dynamics: An exploration of their impact on the client-therapist relationship

Abstract: A preliminary analysis of two psychodynamic therapies, one with good outcome and one with poor outcome, showed that CT types could be reliably rated.

Cited by 37 publications

References 38 publications

Emotional Responses to Suicidal Patients: Factor Structure, Construct, and Predictive Validity of the Therapist Response Questionnaire-Suicide Form

Emotional Responses to Suicidal Patients: Factor Structure, Construct, and Predictive Validity of the Therapist Response Questionnaire-Suicide Form

Relational Patterns and the Development of the Alliance: A Systematic Comparison of two Cases

Patients’ experiences of clinicians’ crying during psychotherapy for eating disorders.

Contact Info

Product

Resources

About