Dimensions of activity in countertransference and therapist reactions: Therapist reactions during sessions with depressed patients

Abstract

Objectives: This paper presents the interaction structure between the therapist's countertransference and the patient's affect based on identified dimensions of how therapists feel and react during sessions with depressed patients. Methods: 639 sessions were audio-recorded and rated by trained raters. These recordings were obtained from the Munich Psychotherapy Study and analyzed with the PQS, the AREQ, and the TRQ/CTQ. Results: Seven components with good to excellent internal consistency (Cronbach α =.745-.902) were found and labeled Hostile Feelings, Positive, Disengaged, Overwhelmed and Encroaching Feelings concerning countertransference and therapists' emotional reaction, while the therapist's behavior was scored on separate dimensions. The middle and final sessions reveal significant correlations between a patient's positive affect experience and positive countertransference. Conclusions: The confirmed pattern implies not only that a positive affect is related to a positive countertransference reaction, but also that a positive countertransference entails a positive affect. The fact that this pattern could be accounted for only during the middle and the last sessions indicate that the working alliance is not fully established at the beginning of the treatment.