Countertransference responses mediate the relationship between patients' overall defense functioning and therapists'...

Area of Science:

• Psychology
• Psychotherapy Research
• Clinical Psychology

Background:

• Understanding the interplay between therapist techniques, countertransference, and patient functioning is vital in psychotherapy.
• Previous research suggests therapist responses can influence patient outcomes, but the mediating role of countertransference requires further investigation.

Purpose of the Study:

• To investigate the relationship between therapists' supportive/expressive intervention level (ESIL), therapists' countertransference (CT), and patients' overall defense functioning (ODF).
• To test the hypothesis that CT mediates the relationship between patients' ODF and therapists' ESIL.

Main Methods:

• 65 psychotherapy sessions were analyzed using the Psychodynamic Interventions Rating Scale and Defense Mechanisms Rating Scale.
• Clinicians' countertransference was assessed using the Therapist Response Questionnaire.
• Participants included 65 clinicians and 65 patients, many with personality disorders.

Main Results:

• Four types of CT (parental, positive, criticized, overinvolved) fully mediated the relationship between patients' ODF and therapists' ESIL.
• No mediation effects were found for other CT types (overwhelmed, helpless, sexualized, disengaged).
• Therapeutic orientation did not influence the mediation pathways.

Conclusions:

• Both positive and negative countertransference feelings play a critical role in the dynamic between therapist interventions and patient defense functioning.
• These findings highlight the importance of therapist self-awareness regarding countertransference in clinical practice.