A Qualitative Study of Therapists’ Experiences of Countertransference when Working Therapeutically with Children and Families.

Abstract

The concept of countertransference (CT) originated within psychoanalysis in the 1900s and is considered an important therapeutic tool in psychodynamic therapies today. With increasing emphasis on the therapist’s role in the therapeutic relationship and on treatment outcomes, CT is increasingly being talked about and recognised in other therapeutic disciplines. While there is ongoing debate about the definition of CT, it is generally understood to be the emotional, cognitive, physiological and behavioural reactions therapists experience in response to clients within the therapeutic relationship. There is evidence that CT is a process that is common to all therapists, regardless of theoretical perspective, training or years of experience. CT is considered to affect the therapeutic relationship, working alliance and treatment outcomes in both individual and family therapy. Importantly, how CT is managed by therapists is critical in determining therapeutic progress and outcomes. Significantly less research examining the nature of CT in family therapy has been undertaken. This may be due to early attempts by researchers and practitioners in family therapy to differentiate the field from psychodynamic paradigms and to assume a position in which the therapist remains emotionally neutral. However, it is believed that the role CT plays in family therapy is equivalent, if not larger, due to the increased number and complexity of relationships. This thesis is a qualitative exploration of therapists’ understanding and experiences of countertransference (CT) when working therapeutically with children and families in New Zealand. In particular, this study examined the family behaviours, therapist sensitivities and therapy situations that triggered CT in therapists and the nature of the reactions associated with these. It also investigated the strategies therapists use to manage their CT, as well as the impacts they perceive CT has on themselves, their clients, the therapeutic relationship and treatment outcomes. Fourteen therapists (11 clinical psychologists, 1 psychiatrist and 2 psychotherapists) were recruited for this study. The study sought therapists working in all modalities, who had worked with children and families within the last 18 months, and for a period of at least two years. Twelve identified as female and two as male. The therapists were interviewed using a semi-structured interview format about their experiences of CT when working with children and families. The data from the interviews were analysed using the process of thematic analysis.