Questionnaires need testing of reliability and factor structure before clinical use or research in new languages or cultures. The aim of this study was to evaluate the Therapist Response Questionnaire (TRQ) in Sweden compared to corresponding factor analyses in USA and Italy. A national sample of psychotherapists (N=242) registered their countertransference with a single client using TRQ. The data were analyzed with confirmatory factor analysis (CFA) to test factor structures from previous studies, and exploratory factor analysis (EFA). The CFA did not verify the factor structure from the previous studies. The EFA extracted seven factors as the best solution: Helpless/Inadequate, Overwhelmed/Disorganized, Hostile/Angry, Parental/Protective, Disengaged, Special/Overinvolved, Sexualized. Analysis of convergent validity indicated that five of these could be considered equivalent to factors in the previous studies, and the remaining two were conceptually related to corresponding factors. Even though the factor structure was not confirmed by the CFA, the concordance was large, indicating a reliable self-report instrument with promising validity for measurement of complex aspects of countertransference. Common countertransference themes can inform psychotherapy supervision and education, give feedback to the therapist, and lay ground for a taxonomy for therapist reactions and feelings.

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Countertransference has mainly been studied in psychoanalysis from the perspective of the individual psychoanalyst, in case reports and theoretical papers, and to some extent in empirical research on a general level. There is a gap between knowledge about countertransference on the individual and the general level, as well as between empirical research and clinical practice. The aim of the present study was to examine common patterns in countertransference among individual therapists, using a person-oriented approach. By using a cluster-analytic statistical method with data on 219 individual therapists' countertransference (using the Therapist Response Questionnaire in relation to a particular psychotherapy), six groups of therapists with similar patterns in countertransference were identified: (1) over-engaged, (2) disengaged, (3) low intensity of countertransference, (4) high intensity in countertransference, (5) parental, and (6) sexualizing countertransference. Some identified patterns could be organized into opposites in dimensions: The level of intensity (low vs. high), and the experienced distance in the therapy (over-engaged vs. disengaged). The six patterns may represent prototypical patterns of reaction that could serve as self-knowledge for the therapist to counter different relational challenges in therapy. Limitations are the use of a cross-sectional design with only one patient per therapist, and the absence of a formal diagnostic procedure, which precludes any conclusions about the extent to which these patterns were due to therapist or patient characteristics.

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