The impact of countertransference awareness on counselling sessions outcome

Aim: For the psychodynamic approach, being aware and managing countertransference are core therapeutic competencies. Research has demonstrated the negative effect of the unmanaged countertransference on outcomes of all kind of psychotherapy. We focused on the relationship between countertransference when measured by therapists and external observers and its impact on session quality. Methods: We analyzed 69 counseling sessions, held by 23 in-training psychotherapists with 23 patients. We used the Therapist Response Questionnaire and three external observers (who used the Countertransference Behavior Measure) to measure psychotherapists’ countertransference. We rated the session impact perceived by patients and psychotherapists using the Session Evaluation Questionnaire and by patients through the Session Impact Scale. Results: Psychotherapists’ and observers’ ratings of countertransference correlated but on different dimensions. Moreover, considering the Countertransference Behavior Measure and the Therapist Response Questionnaire as predictors of session quality, only countertransference behavior scores of the external observers were able to predict the evaluation of the session impact. Discussion: These results indicate that an external evaluation is able to grasp aspects of countertransference that a psychotherapist is probably not aware of and therefore have a negative impact on the session. The awareness of countertransference and its management have a significant impact on the perceived session quality. From a methodological point of view, it is necessary to adopt various perspectives to investigate countertransference. Future research should confirm these results on a sample of experienced psychotherapists.