The manifestation and management of staff countertransference on a pediatric AIDS team

The authors discuss the countertransference reactions that arise in staff who work in a hospital outpatient clinic with children with HIV and AIDS. Countertransference feelings such as guilt, anger, and helplessness can be easily aroused when working with a young, impoverished, dying population. Factors that precipitate these feelings and their manifestations are discussed, as well as the antitherapeutic effects of acting on one's countertransference. Psychodynamic explanations are offered for some of the more salient countertransference reactions. Finally, suggestions are made for management of countertransference, such as strong team leadership, ongoing support groups, and redefinition of therapeutic objectives.