When Is Transference Work Useful in Psychodynamic Psychotherapy? Main Results of the First Experimental Study of Transference Work (FEST)

Abstract

This article presents the main results of the First Experimental Study of Transference (FEST). The background of the study, as well as the aims, main hypotheses, and methods are described. The participants were 100 patients who were randomized to psychodynamic psychotherapy of one year's duration, with transference work or without transference work. The analyses of the effects of psychodynamic psychotherapy with transference work versus psychodynamic psychotherapy without transference work are presented. The two treatments were equally effective, but analyses of moderators revealed differential effects. Patients with low quality of object relations (QOR) and/or presence of personality disorder showed specific positive effects of transference work. Female patients responded better than men. Further analyses included mechanisms of change and three-way interactions among factors, with an impact on outcome. We also found that (1) insight was a mediator of change, and (2) that the specific effects of transference work were influenced by interaction of object relations and alliance, but in the direct opposite direction of what is generally maintained in mainstream clinical theory. For patients with more mature object relations and high alliance, a negative effect of transference work was observed.

Interaction Structures in Psychodynamic Psychotherapy for Adolescents

“…Fifth, we could assess the outcome only in terms of problem levels. However, the psychodynamic technique may be related to other mechanisms, such as affect regulation, tolerance, and insight, which may have roles in symptom reduction [ 53 ]. Moreover, long-term follow-up is necessary because the literature suggests that the effects of psychodynamic treatments increase during follow-up [ 1 ].…”

Therapists’ Experiences of Psychodynamic Therapy with and without Transference Interventions for Adolescents with Depression

“…The therapists experienced it as superfluous to use TI in therapy with adolescents that were relatively high-functioning or had no personality pathology. Higher relational functioning might suggest that less is activated in the transference [ 26 , 27 , 28 , 30 ]. Research on adults indicates that moderate levels of TI can be useful in therapy with patients who have personality problems, as well as those who have serious and chronic difficulty in establishing stable and meaningful relations.…”

“…Systematic research on specific interventions in psychodynamic therapy with adults has revealed that some patients profit more from working with transference than others according to various patient characteristics [ 26 , 27 , 28 , 29 , 30 ]. Transference interventions (TI) seem to have specific positive effects on long-term functioning in patients with personality problems, as well as serious and chronic difficulties in establishing stable and meaningful relations [ 26 , 27 , 28 , 30 ]. Patients with higher relational functioning seem to benefit from low to moderate levels of TI, but they have difficulty with high levels of TI [ 26 , 27 ].…”

“Like I’m Talking to a Real Person”: Exploring the Meaning of Transference for the Use and Design of AI-Based Applications in Psychotherapy

“…Transference can also act as a form of resistance and as an obstacle to treatment by keeping the patient from feeling like they can discuss certain ideas or topics, or a strong negative transference can make it hard for the patient to attend sessions regularly or even cause them to terminate the treatment (for an overview of the different effects of transference and ways of working with it, see Fink, 1997 ; Corradi, 2006 ; and Fink, 2007 , esp. chapter 7; for empirical studies of its usefulness, see Marmarosh, 2012 ; Hersoug et al, 2014 ; Suszek et al, 2015 ; Ulberg et al, 2021 ).…”