Countertransference in Forensic Patients with Psychosis: Associations with Symptomatology, Inpatient Violence, and Psychopathic Personality Traits

Virgilio, Patrizio Di; Page, Louis De; Titeca, Pierre

doi:10.1080/24732850.2021.1874975

Cited by 1 publication

(1 citation statement)

References 24 publications

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“…Patients presenting with antagonistic (ANT) traits and disorders can also impact the experience of the mental health care providers delivering the treatment. For example, ANT forensic and adolescent patients are more likely to evoke negative countertransference in their mental health service providers (Di Virgilio et al, 2021; Tanzilli & Gualco, 2020; Tanzilli et al, 2017), which may be related to the tendency for ANT individuals to behave coldly toward others in interpersonal interactions and to perceive others as behaving more coldly toward them (Vize et al, 2022). Additionally, qualitative research suggests that providers working with community adult patients with antagonism-based diagnoses may be especially prone to feeling vulnerable and incompetent (Warner & Keenan, 2022).…”

Section: Antagonism and Treatment Experiencesmentioning

confidence: 99%

Surveying veterans affairs mental health care providers on experiences working with veteran patients with antagonistic clinical presentations.

Hyatt¹,

Sleep²,

Asamsama³

et al. 2024

Psychological Services

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We surveyed N = 84 mental health care providers (i.e., psychiatrists, psychologists, social workers) working across two Veterans Affairs health care sites about their experiences working with Veteran patients with antagonism-based clinical presentations (e.g., callous, aggressive, grandiose features), as well as negative affect-based clinical presentations (e.g., depressive, anxious, self-conscious features). Providers reported on aspects of these clinical interactions, including assessments and interventions used, treatment outcomes, interpersonal experiences, and training and preparedness to treat this type of presentation in the future. Compared to treatment experiences with patients with predominant negative affect, providers reported that treatment experiences with antagonistic (ANT) patients tended to be shorter (d = −.60), less effective at improving psychological functioning (d = −.61), more emotionally draining (d = 1.03), and more often marked by relationship ruptures (instance of ≥1 rupture = 72.6% vs. 15.5%). Providers also reported less professional training to treat antagonism (d = −1.56) and less preparedness to treat ANT patients in the future (d = −1.81). These results highlight the important role of patient characteristics in providers' experiences and underscore the need for more training and resources to support mental health providers working with ANT patients. Impact StatementIn this study, mental health care providers reported that compared to Veteran patients with predominant negative affect, clinical interactions with antagonistic Veteran patients tend be shorter, more emotionally draining, and less effective at reducing target symptoms. Providers also reported less training to treat antagonistic patients and less preparedness to treat them in the future, highlighting the need for resources and training in evidence-based antagonism treatment.

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