Countertransference management and effective psychotherapy: Meta-analytic findings.

Abstract

In this article, we review the history and definition of countertransference, as well as empirical research on countertransference, its management, and the relation of both with psychotherapy outcome. Three meta-analyses are presented, as well as studies that illustrate findings from the meta-analyses. The first meta-analysis indicated that countertransference reactions are related inversely and modestly to psychotherapy outcomes (r = −.16, p = .02, 95% CI [−.30, −.03], d = −0.33, k = 14 studies, N = 973). A second meta-analysis supported the notion that countertransference management factors attenuate countertransference reactions (r = −.27, p = .001, 95% CI [−.43, −.10], d = −0.55, k = 13 studies, N = 1,065). The final meta-analysis revealed that successful countertransference management is related to better therapy outcomes (r = .39, p < .001, 95% CI [.17, .60], d = 0.84, k = 9 studies, N = 392 participants). In all meta-analyses, there was significant heterogeneity across studies. We conclude by summarizing the limitations of the research base and highlighting the therapeutic practices predicated on research.

“Meeting Someone at the Edge”: Counselors’ Experiences of Interpersonal Stress

“…Therefore, it seems critical for counselors to pay special attention to how they are managing challenging client and relational dynamics. Counselors’ ability to cope with difficulties that arise during the counseling process influences their effectiveness (Hayes, Gelso, Goldberg, & Kivlighan, 2018). Macdonald and Mellor‐Clark (2015) suggested that clinicians who are more aware of the challenges and uncertainty in their work and their professional limitations are better able manage the difficulties that arise in their work with clients.…”

Facilitative interpersonal skills performance test: Psychometric analysis of a German language version

“…Further evidence for the importance of therapists' interpersonal skills has been derived from research on negative therapy processes (see Binder & Strupp, 1997, for a review) and, more recently, in research on ruptures in the therapeutic alliance . Difficulties in the interpersonal process have been found to be linked with negative therapy outcomes, such as dropout , and to difficulties in therapists' interpersonal behavior (e.g., acting out of countertransference reactions; Hayes, Gelso, Goldberg, & Kivlighan, 2018) or in their internalized relationship models (Steel, Macdonald, & Schroder, 2018). Consequently, developing therapists' interpersonal abilities has been proposed as a priority for psychotherapy training; further, evidence suggests that such trainings are effective Muran, Safran, Eubanks, & Gorman, 2018).…”

Countertransference feelings and personality disorders: A psychometric evaluation of a brief version of the Feeling Word Checklist (FWC-12)

“…An instrument such as the FWC-12 can also help therapists become more aware of their feelings. Several studies have demonstrated that therapists' feelings are related to patient outcomes (7,20). For therapists to become aware of this phenomenon, it must be given attention.…”

“…Although the concept of CT originally derives from psychoanalytic theory, several current psychotherapeutic approaches regard the therapist's emotional reactions as an important aspect of the therapeutic process (5)(6)(7). However, empirical work on CT has historically been sparse compared to the enormous amount of theoretical literature written about the phenomenon.…”