Development and validation of countertransference feeling and behavior awareness measures in an Italian and American clinician sample

Objective: Countertransference (CT) has been shown to interfere with therapy goals, and its management is crucial to desired treatment outcomes. As a first step, a clinician's awareness of their covert and overt CT reactions is critical to successfully managing CT. Research on CT awareness is scarce, however, mainly because of difficulties in empirically investigating and measuring this construct. In this study, we sought to develop and validate two instruments: one to measure CT feelings and one to measure CT behaviors. Method: We developed the Countertransference Feelings Awareness Measure and the Countertransference Behavior Awareness Measure, both composed of 12 items comprising 3 dimensions: dominant, hostile and distant. A sample of 245 Italian and 110 American clinicians participated in the research. Confirmatory factor analysis was conducted to verify the factor structure of the measures. Reliability and invariance analyses were conducted for both measures and both samples. Results: Factorial structure, reliability, and configural invariance across nationalities of both measures were confirmed. Conclusion: These tools should prove useful for future research, supervision, theoretical advances, and clinical application, allowing a deeper understanding of how clinicians' awareness of different elements of their CT experience impacts the outcome of therapy.