Countertransference in the treatment of patients with personality disorders: A longitudinal study.

IF 2.6 1区 心理学 Q2 PSYCHOLOGY, CLINICAL Psychotherapy Research Pub Date : 2024-11-01 Epub Date: 2023-11-14 DOI:10.1080/10503307.2023.2279645
R B Øvstebø, G Pedersen, T Wilberg, J I Røssberg, H S J Dahl, E H Kvarstein
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Abstract

Objective: This study examines how therapist emotional response/countertransference (CT) develops during treatment for patients with personality disorders (PDs) and how pre-treatment patient factors (severity of personality pathology, PD category, level of symptom distress) predict CT responses. Secondly, we explored associations between patient clinical outcome and CT.

Method: A longitudinal, observational study including 1956 patients with personality pathology treated at psychotherapy units within specialist mental health services. Therapists' emotional response was repeatedly assessed by the Feeling Word Checklist-Brief Version (FWC-BV) with three subscales-Inadequate, Confident, and Idealized.

Results: Levels of Inadequate CT were lowest and stable over time while Confident and Idealized increased over time. Greater severity of personality pathology and borderline PD predicted higher initial Inadequate, lower initial Confident and decreasing Inadequate over time. Antisocial PD predicted decreasing Confident. Number of PD criteria had higher impact on therapist CT than level of symptom distress. Clinical improvement was associated with decreasing Inadequate.

Conclusion: Therapists reported predominantly Confident CT when working with PD patients. More severe personality pathology, and borderline PD, specifically, predicted more negative CT initially, but the negative CT decreased over time. Patients who did not improve were associated with increasing Inadequate.

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反移情在人格障碍患者治疗中的作用:一项纵向研究。
目的:本研究探讨人格障碍(PD)患者治疗过程中治疗师情绪反应/反移情(CT)的发展,以及治疗前患者因素(人格病理严重程度、PD类别、症状困扰水平)如何预测CT反应。其次,我们探讨了患者临床结果与CT之间的关系。方法:一项纵向观察研究,包括1956名在专业精神卫生服务的心理治疗单位治疗的人格病理学患者。治疗师的情绪反应被反复评估的感觉词检查表-简要版本(FWC-BV)有三个子量表:不充分,自信,和理想化。结果:随着时间的推移,不充分的CT水平最低且稳定,而自信和理想化的水平随着时间的推移而增加。越严重的人格病理和边缘性PD预示着越高的初始不足,越低的初始自信和随着时间的推移而减少的不足。反社会PD预测自信心下降。PD标准的数量对治疗师CT的影响大于症状困扰程度。临床改善与不足减少有关。结论:当治疗PD患者时,治疗师报告的主要是自信CT。更严重的人格病理,特别是边缘性PD,最初预测更多的阴性CT,但随着时间的推移,阴性CT减少。没有改善的患者与不充分的增加有关。
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来源期刊
Psychotherapy Research
Psychotherapy Research PSYCHOLOGY, CLINICAL-
CiteScore
7.80
自引率
10.30%
发文量
68
期刊介绍: Psychotherapy Research seeks to enhance the development, scientific quality, and social relevance of psychotherapy research and to foster the use of research findings in practice, education, and policy formulation. The Journal publishes reports of original research on all aspects of psychotherapy, including its outcomes, its processes, education of practitioners, and delivery of services. It also publishes methodological, theoretical, and review articles of direct relevance to psychotherapy research. The Journal is addressed to an international, interdisciplinary audience and welcomes submissions dealing with diverse theoretical orientations, treatment modalities.
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