Systematic Exploration of Countertransference Phenomena in the Treatment of Patients at Risk for Suicide

Soulié, Tess; Bell, Elliot; Jenkin, Gabrielle; Sim, Dalice; Collings, Sunny

doi:10.1080/13811118.2018.1506844

Cited by 16 publications

(31 citation statements)

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“…1). Data were extracted from ten studies (3/5/2 of low/intermediate/ high quality, respectively) and details of each study (Barzilay et al, 2018;Colson et al, 1986;Dressler, Prusoff, Mark, & Shapiro, 1975;Gillig, Hillard, Deddens, Bell, & Combs, 1990;Hawes et al, 2017;Perry, Bond, & Presniak, 2013;Rossberg & Friis, 2003;Soulié, Bell, Jenkin, Sim, & Collings, 2018;Yaseen et al, 2013;Yaseen et al, 2017) are available in Table 2.…”

Section: Resultsmentioning

confidence: 99%

“…Around 700 health professionals participated in the ten studies and their countertransference was measured from clinical encounters with 2247 patients. Patients came from outpatient/psychotherapeutic clinics (Barzilay et al, 2018;Perry et al, 2013;Soulié et al, 2018;Yaseen et al, 2013), psychiatric hospitals (Colson et al, 1986;Rossberg & Friis, 2003;Yaseen et al, 2013;Yaseen et al, 2017) and emergency wards (Dressler et al, 1975;Gillig et al, 1990). Countertransference was measured based on a mid-or long-term therapeutic relationship (Colson et al, 1986;Perry et al, 2013;Rossberg & Friis, 2003;Soulié et al, 2018;Yaseen et al, 2013;Yaseen et al, 2017) or on a single consultation (Barzilay et al, 2018;Dressler et al, 1975;Gillig et al, 1990;Hawes et al, 2017).…”

Section: General Description Of Studiesmentioning

confidence: 99%

“…Patients came from outpatient/psychotherapeutic clinics (Barzilay et al, 2018;Perry et al, 2013;Soulié et al, 2018;Yaseen et al, 2013), psychiatric hospitals (Colson et al, 1986;Rossberg & Friis, 2003;Yaseen et al, 2013;Yaseen et al, 2017) and emergency wards (Dressler et al, 1975;Gillig et al, 1990). Countertransference was measured based on a mid-or long-term therapeutic relationship (Colson et al, 1986;Perry et al, 2013;Rossberg & Friis, 2003;Soulié et al, 2018;Yaseen et al, 2013;Yaseen et al, 2017) or on a single consultation (Barzilay et al, 2018;Dressler et al, 1975;Gillig et al, 1990;Hawes et al, 2017). Five studies (Colson et al, 1986;Dressler et al, 1975;Gillig et al, 1990;Rossberg & Friis, 2003;Soulié et al, 2018) studied mainly cross-sectional associations between countertransference and suicidality and five studies (Barzilay et al, 2018;Hawes et al, 2017;Perry et al, 2013;Yaseen et al, 2013;Yaseen et al, 2017) examined countertransference as possibly related to future suicidal outcomes (Table 3).…”

Section: General Description Of Studiesmentioning

confidence: 99%

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Countertransference towards suicidal patients: a systematic review

et al. 2021

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Countertransference towards suicidal patients may blur healthcare professionals’ clinical judgment and lead to suboptimal decision-making. We conducted a systematic review of the quantitative studies on this topic. Following PRISMA guidelines, various databases were searched for studies measuring countertransference in healthcare professionals treating suicidal patients. Two authors independently performed screening and the quality of included studies was formally assessed. Ten studies were identified (3/5/2 of low/intermediate/high quality, respectively). Cross-sectional studies showed evidence for specific and adverse countertransference (e.g., disinterest, anxiety, overwhelming, rejection, helplessness or distress) towards suicidal patients. Furthermore, countertransference was prospectively associated with suicidal behavior and ideation in studies that explored this issue, but the meaning of this association remains to be clarified. Healthcare professionals’ characteristics (e.g. professional background, gender, personality traits) influenced countertransference. Suicidal patients elicit adverse countertransference, which should be addressed in clinical practice and through dedicated training.

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Section: Resultsmentioning

confidence: 99%

Section: General Description Of Studiesmentioning

confidence: 99%

Section: General Description Of Studiesmentioning

confidence: 99%

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Countertransference towards suicidal patients: a systematic review

et al. 2021

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“…Encounters with suicidal individuals (i.e., individuals who present with suicide attempts and/or ideation) are consistently reported by mental health professionals to be highly stressful (Berman, Stark, Cooperman, Wilhelm, & Cohen, ; Deutsch, ; Jahn, Quinnett, & Ries, ; Roush et al, ). Documented emotional responses to suicidal patients include feelings of anxiety, incompetence, frustration, anger, as well as helplessness, discouragement, sadness, and guilt (For recent reviews see Ellis, Schwartz, & Rufino, ; Soulié, Bell, Jenkin, Sim, & Collings, ). Therapists' negative reactions to patients often occur as early as the beginning of therapy (Perry, Bond, & Presniak, ).…”

Section: Introductionmentioning

confidence: 99%

Associations between clinicians' emotional responses, therapeutic alliance, and patient suicidal ideation

et al. 2019

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Background Mental health clinicians frequently experience intense negative emotional responses to suicidal patients, which have been related to treatment outcome. This study examines the therapeutic alliance as a mediator of the relationship between clinicians' negative emotional responses at the initial encounter and patients' suicidal ideation (SI) concurrently and 1 month later. Methods We assessed 378 adult psychiatric outpatients (62.7% female; mean age = 39.1 ± 14.6 years) and their 61 treating clinicians. Following the initial encounter, self‐report questionnaires assessed clinicians' emotional responses to their patients, patients' and clinicians' perception of the therapeutic alliance, and patients' SI. The SI was reassessed 1 month after the initial visit. Multilevel mediation analyses were performed. Results Patients' (but not clinicians') perception of the therapeutic alliance mediated the relationship between clinicians' negative emotional responses to patients and patients' SI 1 month following the initial visit (indirect effect estimate = 0.015; p < .001). Conclusions The association between clinicians' negative emotional response and patients' prospective SI appears to be transmitted, at least partly, through the patients' perception of the poorer early quality of the therapeutic alliance. Thus, clinicians' awareness and management of their emotional states appear essential both for the identification of suicidal risk and to enhance therapeutic alliance and treatment outcomes.

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“…We employed robust qualitative methods to engage first-hand and in-depth with distressed/suicidal internet users in an area more often explored using survey methods (e.g. [ 17 , 18 ]). Participants were recruited from three differing sources, thus increasing diversity and the transferability of findings, and resulting in a substantial dataset of over 50 interviews.…”

Section: Discussionmentioning

confidence: 99%

Online help for people with suicidal thoughts provided by charities and healthcare organisations: a qualitative study of users’ perceptions

Biddle

Derges

Goldsmith³

et al. 2020

Soc Psychiatry Psychiatr Epidemiol

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Purpose Internet use is common among people with suicidal feelings and a considerable amount of suicide help material is available online. Despite attempts to promote formal help sites (e.g. governmental and charity sector) in internet search results, users' evaluation of these sites is lacking. This study, therefore, aimed to explore distressed users' perceptions of formal online help and their experiences of using this in times of crisis. Methods In-depth interview study of 53 adults reporting suicide-related internet use. Results While highly valued in relation to general mental health problems, formal sites were not perceived to meet the different needs of those experiencing suicidal thoughts, and did not engage individuals in crisis. Sites were criticised for being impersonal, dispassionate, too focused on information-giving, and lacking solutions that were novel or sensitive to reasons why an individual may choose to seek help online. Most participants criticised the tendency for sites to signpost to offline services as their primary response. Participants desired immediacy and responsive online help incorporating 'live chat', self-help tools, opportunities to interact with others and lived-experience content. Positive accounts of seeking online help described sites incorporating these features. Conclusions Formal online help services should be reappraised to ensure they meet users' needs for immediacy and responsive help to capitalise upon the opportunity available for suicide prevention.

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Systematic Exploration of Countertransference Phenomena in the Treatment of Patients at Risk for Suicide

Cited by 16 publications

References 50 publications

Countertransference towards suicidal patients: a systematic review

Countertransference towards suicidal patients: a systematic review

Associations between clinicians' emotional responses, therapeutic alliance, and patient suicidal ideation

Online help for people with suicidal thoughts provided by charities and healthcare organisations: a qualitative study of users’ perceptions

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