Personality Organization Traits and Expected Countertransference and Treatment Interventions

Background: There is little empirical research on patients at the severe level of personality organization who generally need more clarifications of roles, tasks, boundaries, and supportive interventions, and often create increased problems with countertransference. The purpose of this study was to investigate the relationship between clinicians’ ratings of their new patients’ level of personality organization traits (i.e.: Defensiveness, identity integration, object relations, and reality testing) and degree of expected countertransference and treatment interventions. Method: We surveyed 509 Clinicians about their reactions to a recently seen patient. Results: We found that the more severe the level of personality organization traits: 1. The more expected need for ongoing clarification of roles and tasks throughout the course of treatment; 2. The more clinicians’ expectation of their patients being confused about boundaries; 3. The more expected negative countertransference; 4. The more expected need for supportive interventions. Conclusion: These findings point out the importance for clinicians to accurately assess and understand their patients’ level of personality organization in order to intervene appropriately regardless of theoretical orientation.