Despite its critical role in clinical suicidology, empirical evidence on the nature of countertransference (CT) to patients at risk for suicide (PRS) is lacking. This study aimed to provide a systematic description of CT phenomena to PRS. Psychiatrists, psychologists and psychotherapists completed the Therapist Response Questionnaire (TRQ) online, with reference to a PRS. Factor analysis (n = 267) yielded a seven-factor structure, including 1) entrapped/rejecting, 2) fulfilled/engaging, 3) aroused/reacting, 4) informal/boundary crossing, 5) protective/overinvolvement, 6) ambivalent/inconsistent, and 7) mistreated/controlling. On average, clinicians reported that CT dimensions tended to not apply to them, except for the positively connoted factor. Our findings suggest that patients at risk for suicide elicit specific dimensions of CT. We offer two alternative interpretations of clinicians' CT endorsement patterns.
In light of Government endeavours to transform New Zealand's (NZ) mental health system and services, this short communication reports on secondary qualitative data on barriers to positive outcomes in treatment of patients at risk for suicide (PRS) from the unique multi-disciplinary perspective of 12 positively inclined clinicians. According to grounded theory, interview data were collected and analysed iteratively until we reached data saturation. We present these data in two categories, distal barriers, that is those emanating from the context of practice, and proximal barriers, that is those emanating from clinicians themselves. Overall, the 12 clinicians interviewed converged in describing experiencing the NZ mental health system as interfering rather than supporting their clinical endeavours with PRS, and NZ clinical training as partially failing to prepare them for clinical suicidology. Despite limitations due to the secondary nature of these data, this short communication provides insights into the subjective experience of positively inclined clinicians, a unique professional group, in relation to a health challenge of national importance, and invites consideration that positively inclined clinicians might represent a valuable source of information in relation to improving suicidal patients' care in NZ.
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