Countertransference and therapeutic alliance in the early stage of adult psychodynamic psychotherapy. 2015

Diogo de Bitencourt Machado, and Stefania Pigatto Teche, and Catherine Lapolli, and Beatriz Franck Tavares, and Laura Sigaran Pio de Almeida, and Giovana Barreto da Silva, and Pedro Vieira da Silva Magalhães, and Cláudio Laks Eizirik
Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.

OBJECTIVE The primary objective of this study was to assess the relationship between countertransference (CT) and therapeutic alliance (TA) during the early stages of psychodynamic psychotherapy. A secondary objective is to assess associations between CT and variables related to therapist and patient and between CT and other patient variables investigated, which were defense mechanisms, symptomology and functionality. METHODS This was a cross-sectional study that enrolled 30 patients treated by 17 different therapists at the psychotherapy clinics of two psychiatry centers. Assessments of each patient-therapist pair were conducted between their fourth and 10th sessions. RESULTS The CT distance domain exhibited a moderate negative correlation with TA, particularly its sub-dimension representing the patient's capacity for work in therapy. Moderate positive correlations were observed between CT distance and the splitting defense mechanism and between CT closeness and suppression defenses, in addition to moderate negative correlation between CT indifference and the fantasy defense mechanism. Another finding was higher scores for CT indifference in association with socioeconomic classes D and E. CONCLUSIONS The quality of CT may provide a source of information about TA. A high degree of CT distance represents a low level of TA, particularly with relation to the patient's working capacity, although presence of the splitting defense mechanism can affect CT, to the extent that it constitutes a confounding variable. The concept of CT is useful to psychotherapists, providing a source of information about the patient's internal world and about certain elements of therapy, such as the quality of TA, which is important for good treatment results.

UI MeSH Term Description Entries
D008297 Male Males
D011369 Professional-Patient Relations Interactions between health personnel and patients. Contacting Clients,Pharmacist-Patient Relations,Professional Patient Relationship,Client, Contacting,Clients, Contacting,Contacting Client,Pharmacist Patient Relations,Pharmacist-Patient Relation,Professional Patient Relations,Professional Patient Relationships,Professional-Patient Relation,Relation, Pharmacist-Patient,Relation, Professional-Patient,Relations, Pharmacist-Patient,Relations, Professional-Patient,Relationship, Professional Patient,Relationships, Professional Patient
D003379 Countertransference Conscious or unconscious emotional reaction of the therapist to the patient which may interfere with treatment. (APA, Thesaurus of Psychological Index Terms, 8th ed.) Countertransference, Psychology
D003430 Cross-Sectional Studies Studies in which the presence or absence of disease or other health-related variables are determined in each member of the study population or in a representative sample at one particular time. This contrasts with LONGITUDINAL STUDIES which are followed over a period of time. Disease Frequency Surveys,Prevalence Studies,Analysis, Cross-Sectional,Cross Sectional Analysis,Cross-Sectional Survey,Surveys, Disease Frequency,Analyses, Cross Sectional,Analyses, Cross-Sectional,Analysis, Cross Sectional,Cross Sectional Analyses,Cross Sectional Studies,Cross Sectional Survey,Cross-Sectional Analyses,Cross-Sectional Analysis,Cross-Sectional Study,Cross-Sectional Surveys,Disease Frequency Survey,Prevalence Study,Studies, Cross-Sectional,Studies, Prevalence,Study, Cross-Sectional,Study, Prevalence,Survey, Cross-Sectional,Survey, Disease Frequency,Surveys, Cross-Sectional
D005260 Female Females
D006282 Health Personnel Men and women working in the provision of health services, whether as individual practitioners or employees of health institutions and programs, whether or not professionally trained, and whether or not subject to public regulation. (From A Discursive Dictionary of Health Care, 1976) Health Care Professionals,Health Care Providers,Healthcare Providers,Healthcare Workers,Health Care Professional,Health Care Provider,Healthcare Provider,Healthcare Worker,Personnel, Health,Professional, Health Care,Provider, Health Care,Provider, Healthcare
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D012959 Socioeconomic Factors Social and economic factors that characterize the individual or group within the social structure. Economic and Social Factors,Social Inequalities,Social Inequality,Social and Economic Factors,Socioeconomic Characteristics,Factors, Socioeconomic,High-Income Population,Land Tenure,Standard of Living,Characteristic, Socioeconomic,Factor, Socioeconomic,High Income Population,High-Income Populations,Inequality, Social,Living Standard,Living Standards,Population, High-Income,Socioeconomic Characteristic,Socioeconomic Factor,Tenure, Land
D013997 Time Factors Elements of limited time intervals, contributing to particular results or situations. Time Series,Factor, Time,Time Factor

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