Is countertransference a valid source of clinical information? Investigating emotional responses to audiotaped psychotherapy sessions

Abstract

The study aimed to test whether countertransference reactions contain valid information about the patient. The authors examined whether a significant part of the variance in emotional, cognitive, and motivational responses to recorded therapy sessions is attributable to the patient. Six student raters listened to 605 audiotaped sessions of 81 patients with major depression treated by 19 therapists and indicated their reactions using a modified version of the Countertransference Questionnaire. The relative amount of variance in countertransference reactions due to differences between patients, ranging from 2% to 16%, was significant for most of the countertransference dimensions. Reactions were influenced by type of treatment and severity of depression but not by comorbid personality disorder or interpersonal problems. The relative amount of variance due to differences between raters was large, averaging at 23%. The authors conclude that—albeit having a relatively low “signal-to-noise ratio” in raters without psychotherapy training—countertransference reactions contain valid clinical information.

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

“…One is to have therapists fill out self-report questionnaires [13,15]. The other is to have an external observer evaluate recorded material from sessions [16][17][18]. An advantage of self-reports is their quantitative nature; they can be distributed to many therapists, and one can subsequently aggregate large amounts of data enabling identification of common patterns of feelings [9].…”

Negative feelings toward borderline patients: Are layperson emotional reactions disorder-specific?

“…We believe that understanding this distinction between structural impairment in general and BPD specifically is important for several reasons. First, emotional reactions to patients have been shown to contain important clinical and diagnostic information (Löffler-Stastka et al, 2019). Identifying the cause of negative emotional reactions in dimensional rather than categorical terms could redirect our discussions about differential indication as well as about research foci.…”

Experience of Managing Countertransference Through Self-Guided Imagery in Meditation Among Healthcare Professionals

“…For example, clinicians working with patients with narcissistic personality disorder reported feeling devalued and criticized by the patients; experiencing anger, resentment, and dread; and finding themselves distracted, avoidant, and wanting to terminate the treatment (32). Research has additionally revealed statistically significant variance in therapists' emotional reactions attributable to patients' specific personality pathologies (32)(33)(34)(35). On the other side, patients are often aware of, and may directly experience, manifestations of countertransference or other behaviors, such as unresponsiveness, sarcasm, and confrontation (36).…”