Countertransference in successful and unsuccessful cases of psychotherapy.

Hayes, Jeffrey A.; Nelson, Dana L.; Fauth, James

doi:10.1037/a0038827

Cited by 43 publications

(42 citation statements)

References 17 publications

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“…According to this conception, CT being useful or a hindrance to treatment depends on the degree to which therapist understands his or her CT reactions and uses them to better understand the patient. CT is an inevitable (evident in all therapists) reaction originating in the therapist's own and unresolved personal conflicts and/or unconscious vulnerabilities, and triggered by both transference and nontransference material brought in session by the patient (Hayes, Nelson, & Fauth, 2015). CT is a subset of therapist overall reactions.…”

Section: Countertransference: Origins and Definitional Issuesmentioning

confidence: 99%

Patient personality and psychotherapist reactions in individual psychotherapy setting: a systematic review

Stefana

Bulgari

Youngstrom

et al. 2020

Clin Psychology and Psychoth

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Despite the importance of psychotherapists' subjective experiencse working with patients with mental issues, little is known about the relationship between therapists' emotional reactions and patients' personality problems. The present study is a systematic review of quantitative research on the association between patients' personality pathology and psychotherapists' emotional, cognitive and behavioural reactions in individual psychotherapy setting. A systematic database search (from January 1980 to August 2019) supplemented by manual searches of references and citations identified seven relevant studies. Significant and consistent relationships were found between therapist reactions and specific personality traits or disorders. In general, odd and eccentric patients tend to evoke feelings of distance and disconnection;

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Section: Countertransference: Origins and Definitional Issuesmentioning

confidence: 99%

Patient personality and psychotherapist reactions in individual psychotherapy setting: a systematic review

Stefana

Bulgari

Youngstrom

et al. 2020

Clin Psychology and Psychoth

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“…Using the Gelso and Hayes (2007) framework, Hayes et al (2015) interviewed 18 therapists and drew these conclusions about CT origins, triggers, manifestations, effects, and management strategies: Origins consisted mainly of the therapist's unresolved personal and professional issues. Triggers were client resemblance to therapist or to others, differences between client and therapist, client behaviors, and client characteristics Manifestations were pleasant feelings (warmth, caring, compassion), unpleasant feelings (anger, worry, selfdoubt), cognitions (confusion, misconceptualization), and behaviors (colluding, working too hard, relaxing boundaries).…”

Section: Research On Countertransferencementioning

confidence: 99%

Characterizing Clinical Genetic Counselors’ Countertransference Experiences: an Exploratory Study

Reeder

Veach

MacFarlane

et al. 2017

Journal of Genetic Counseling

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Countertransference (CT) refers to conscious and unconscious emotions, fantasies, behaviors, perceptions, and psychological defenses genetic counselors experience in response to any aspect of genetic counseling situations (Weil 2010). Some authors theorize about the importance of recognizing and managing CT, but no studies solely aim to explore genetic counselors' experiences of the phenomenon. This study examined the extent to which clinical genetic counselors' perceive themselves as inclined to experience CT, gathered examples of CT encountered in clinical situations, and assessed their CT management strategies. An anonymous online survey, sent to NSGC members, yielded 127 usable responses. Participants completed Likert-type items rating their CT propensities; 57 of these individuals also provided examples of CT they experienced in their practice. Factor analysis of CT propensities tentatively suggested four factors: Control, Conflict Avoidance, Directiveness, and Self-Regulation, accounting for 38.5% of response variance. Thematic analysis of CT examples yielded five common triggers: general similarity to patient, medical/genetic similarity, angry patients, patient behaves differently from counselor expectations, and disclosing bad news; six common manifestations: being self-focused, projecting feelings onto the patient, intense emotional reaction to patient, being overly invested, disengagement, and physical reaction; five CT effects: disruption in rapport building, repaired empathy, over-identification, conversation does not reach fullest potential, and counselor is drained emotionally; and three management strategies: recognizing CT as it occurs, self-reflection, and consultation. Results suggest CT is a common experience, occurring in both "routine" and emotionally complex cases. Training programs, continuing education, and peer supervision might include discussion of CT, informed by examples from the present study, to increase genetic counselor awareness and skills for managing the phenomenon.

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“…In poor outcome case, the analyst was not able to deepen the patient’s understanding of her psychic life, and the analyst’s interventions were general and not clearly enunciated. Hayes et al. (2015) found that countertransference reactions were evoked, in successful and unsuccessful cases alike, when therapists’ unresolved personal and professional issues were activated by their perceptions of patient characteristics and behaviors.…”

Section: Introductionmentioning

confidence: 99%

Successful and Less Successful Psychotherapies Compared: Three Therapists and Their Six Contrasting Cases

2019

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Despite the general effectiveness of bona fide psychotherapies, the number of patients who deteriorate or fail to improve is still problematic. Furthermore, there is an increased awareness in the field that the therapists’ individual skills make a significant contribution to the variance in outcome. While some therapists are generally more successful than others, most therapists have experienced both therapeutic success and failure in different cases. The aim of this case-series study was to deepen our understanding of what matters for the therapists’ success in some cases, whereas other patients do not improve. How do the patients and their therapists make sense of and reflect on their therapy experiences in most successful and unsuccessful cases? Are there any distinctive features experienced by the participants at the outset of treatment? To explore these issues, we applied a mixed-method design. Trying to keep the therapist factor constant, we selected contrasting cases from the caseloads of three therapists, following the criterion of reliable and clinically significant symptom reduction or non-improvement at termination. Transcripts of 12 patient interviews and 12 therapist interviews (at baseline and at termination) were analyzed, applying inductive thematic analysis and the multiple-case comparison method. The comparisons within the three therapists’ caseloads revealed that in the successful cases the patient and the therapist shared a common understanding of the presenting problems and the goals of therapy and experienced the therapeutic relationship as both supportive and challenging. Furthermore, the therapists adjusted their way of working to their patients’ needs. In non-improved cases, the participants presented diverging views of the therapeutic process and outcome. The therapists described difficulties in the therapeutic collaboration but not how they dealt with obstacles. They tended to disregard their own role in the interactions and to explain difficulties as being caused by the nature of their patients’ problems. This could indicate that the therapists had difficulty in reflecting on their own contributions, accepting feedback from their patients, and adjusting their work accordingly. These within-therapist differences indicate that taking a “third position” is most needed and seems to be most difficult, when early signs of a lack of therapeutic progress appear.

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Countertransference in successful and unsuccessful cases of psychotherapy.

Cited by 43 publications

References 17 publications

Patient personality and psychotherapist reactions in individual psychotherapy setting: a systematic review

Patient personality and psychotherapist reactions in individual psychotherapy setting: a systematic review

Characterizing Clinical Genetic Counselors’ Countertransference Experiences: an Exploratory Study

Successful and Less Successful Psychotherapies Compared: Three Therapists and Their Six Contrasting Cases

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