Countertransference feelings and personality disorders: A psychometric evaluation of a brief version of the Feeling Word Checklist (FWC-12) (original) (raw)
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Background: The Feeling Word Checklist (FWC) is a self-report questionnaire designed to assess therapists' countertransference (CT) feelings. The primary aim of the study was to evaluate the psychometric properties of a brief, 12-item version of the Feeling Word Checklist (FWC-BV). The second aim was to validate the factor structure by examining the associations between the FWC-BV factors, patients' personality pathology and therapeutic alliance (TA). Methods: Therapists at 13 different outpatient units within the Norwegian Network of Personality Disorders participated, and the study includes therapies for a large sample of patients (N = 2425) with personality pathology. Over a period of 2.5 years, therapists completed the FWC-BV for each patient in therapy every 6 months. Statistical methods included exploratory (EFA) and confirmatory (CFA) factor analysis. Internal consistency was estimated using Mc Donald's coefficient Omega (ω t). The Structured Clinical Interview for DSM-IV-Axis II (SCID II) and Mini International Neuropsychiatric Interview (MINI) were used as diagnostic instruments, and patient-rated TA was assessed using the Working Alliance Inventory (WAI-SR). Results: Factor analyses revealed three clinically meaningful factors: Inadequate, Idealised and Confident. These factors had acceptable psychometric properties. Most notably, a number of borderline PD criteria correlated positively with the factors Inadequate and Idealised, and negatively with the factor Confident. All the factors correlated significantly with at least one of the WAI-SR subscales. Conclusions: The FWC-BV measures three clinically meaningful aspects of therapists' CT feelings. This brief version of the FWC seems satisfactory for use in further research and in clinical contexts.
Psychotherapy Research
Objective: Recently, studies have reported systematic relationships between the therapists' emotional response/ countertransference (CT) during therapy and a variety of patient characteristics, speaking to the communicative potential of CT. Within an RCT assessing the role of transference work (TW) in psychodynamic therapy, we investigated whether therapist CT was related to patients' pre-treatment interpersonal problems, degree of personality pathology and motivation for psychodynamic therapy. Secondly, we explored if these relationships depended on whether the therapists used TW or not in sessions. Method: One hundred outpatients were treated with psychodynamic psychotherapy (with or without TW) for one year. Their therapists' emotional reactions after sessions (CT) were assessed with the Feeling Word Checklist-58 (FWC-58). Results: Four subscales of the FWC-58; Inadequate, Confident, Disengaged and Parental feelings were differentially predicted by patient characteristics. Some of the associations depended on treatment condition such that degree of PD pathology was associated with therapists feeling more inadequate in the non-TW-group. Patients' motivation for treatment was associated with less disturbing CT feelings, such as Inadequate and Disengaged CT (the latter especially in the TW group), and feeling more Confident CT. Conclusion: Patient factors predict therapists' emotional countertransference differently depending on whether therapists use transference work in psychodynamic therapy. Trial registration: ClinicalTrials.gov identifier: NCT00423462.
Psychiatric symptoms and countertransference feelings: An empirical investigation
Psychiatry Research, 2010
The main aim of this study was to examine the relationship between patients' psychiatric symptoms and therapists' countertransference reactions. Additionally, we wanted to examine the relationship between symptom improvement and countertransference reactions. Eleven therapists completed the Feeling Word Checklist 58 for each patient admitted to a day treatment program. Forty-two patients met the inclusion criteria. The patients completed the Symptom Checklist-90 Revised (SCL-90R) upon admission and at discharge. The study revealed several specific and significant correlations between the therapists' countertransference reactions and the patients' self-reported symptoms. At the end of treatment, notable findings included negative correlations between higher patient scores on the symptom dimensions and the therapists' feelings of being important and confident, and positive correlations between higher patient scores on the symptom dimensions and the therapists' feelings of being bored, on guard, overwhelmed and inadequate. Symptom change was positively correlated with positive countertransference feelings and negatively correlated with negative countertransference feelings. The study revealed that the patients' levels of self-reported symptoms were significantly associated with the therapists' countertransference feelings. This empirical study confirmed findings from the clinical literature of a specific relationship between symptom improvement and countertransference reactions.
Patient personality and therapist countertransference
Current opinion in psychiatry, 2015
The purpose of this review is to provide a comprehensive and critical examination of the empirical literature about the relation between patient personality and therapist countertransference. The therapist's countertransference can play a crucial role in psychotherapy outcomes, especially in the treatment of personality disorders. The therapist's emotional responses to patients can accomplish the following: inform the clinician about the patient's personality, impact therapy outcome, influence patient resistance and elaboration, mediate the influence of the therapist's interventions and influence therapeutic alliance. In the last years, several studies have empirically demonstrated the presence of a specific pattern of therapist responses that are related to different patient personality disorders. Other works showed how the effects of the therapist's technique depend on the emotional context in which they are delivered and in particular countertransference exper...
International Journal of Environmental Research and Public Health
Countertransference (CT) responses during therapy sessions can be understood as the therapist’s emotional reactions towards the patient. Within adolescents’ psychotherapy, little is known about the effects of the therapists’ feelings on treatment outcome. The Feeling-Word Checklist—28 (FWC-28) is a self-report questionnaire designed to evaluate the therapist’s in-session feelings during therapy with younger patients. The aim of the study was to evaluate the psychometric properties of the clinician-rated FWC-28 and explore the associations between the CT-subscales and therapeutic alliance. Data were collected from a randomized controlled trial in which 11 therapists specialized in child and adolescent psychotherapy treated 16- to 18-year-old patients (n = 62) with major depressive disorder in outpatient clinics. The patients received psychodynamic psychotherapy treatment over 28 sessions. Therapists rated their emotional responses towards their patients on FWC-28 after sessions 3, 12...
Psychotherapy (Chicago, Ill.), 2014
Countertransference can be viewed as a source of valuable diagnostic and therapeutic information and plays a crucial role in psychotherapy process and outcome. Some empirical researches have showed that patients' specific personality characteristics tend to evoke distinct patterns of emotional response in clinicians. However, to date there have been no studies examining the impact of patients' symptomatology on the association between their personality and therapists' responses. This research aimed to (a) investigate the relationship between patients' symptom severity and clinicians' emotional responses; and (b) explore the possible mediated effect of symptom severity on the relationship between patients' personality pathology and countertransference responses. A sample of psychiatrists and clinical psychologists (N = 198) of different theoretical orientations completed the Shedler-Westen Assessment Procedure-200 and the Therapist Response Questionnaire on a ...
American Journal of Psychotherapy, 2013
The Feeling Word Checklist-24 (FWC-24) is a self-report questionnaire comprising 24 feeling words measuring therapists' emotional reactions towards patients. The aim of this study was to evaluate the psychometric properties in FWC-24in individual therapy with adolescents. Therapists (Nϭ41) in four outpatient clinics filled in the FWC-24 (Nϭ410) after each session with a teenage client (age range 13 to 18 years). We examined whether an underlying factor structure exists in FWC-24.