Abstract

Objective: The aim of this work was to investigate the relationship between therapists’ techniques (supportive/expressive intervention level – ESIL), therapists’ countertransference (CT) and patients’ defense level of functioning (ODF). We hypothesized that CT could play a mediating role in the relationship between patients’ ODF and therapists’ ESIL. Method: 65 psychotherapy sessions were rated by two different raters each with the Psychodynamic Interventions Rating Scale and the Defense Mechanisms Rating Scale. Clinicians used the Therapist Response Questionnaire to provide information on their CT. The 65 sessions referred to 65 clinicians (25 = females, 40 = males; 38 = psychodynamic, 27 = cognitive). More than half of the patients (n = 40; 61.5%) had a diagnosis of personality disorder. Among clinical disorders the most frequent were mood (n = 12) and anxiety disorders (n = 11). Five patients had no diagnosis. Results: Four CT responses (parental; positive; criticized; overinvolved) completely mediated the relationship between patients’ ODF and therapists’ ESIL, while no effect resulted in relation to overwhelmed, helpless, sexualized and disengaged CTs. No effect of theoretical orientations on mediation pathways was found. Conclusion: Both positive and negative CT feelings seemed to play a crucial role in the relationship between therapists’ interventions and patients’ ODF.

摘要

目的：这项工作的目的是调查治疗师的技术（支持性/表达性干预水平 - ESIL）、治疗师的反移情（CT）和患者的防御功能水平（ODF）之间的关系。我们假设 CT 可以在患者 ODF 和治疗师 ESIL 之间的关系中发挥中介作用。方法： 65 次心理治疗课程由两个不同的评估者分别使用心理动力学干预评定量表和防御机制评定量表进行评定。临床医生使用治疗师反应问卷来提供有关其 CT 的信息。65 次会议涉及 65 名临床医生（25 = 女性，40 = 男性；38 = 心理动力学，27 = 认知）。超过一半的患者（n = 40; 61.5%）被诊断为人格障碍。在临床疾病中，最常见的是情绪（n  = 12）和焦虑症（n  = 11）。五名患者没有确诊。结果：四个 CT 反应（父母；积极；批评；过度参与）完全介导了患者 ODF 和治疗师 ESIL 之间的关系，而对不堪重负、无助、性化和脱离接触的 CT 没有影响。没有发现理论取向对中介途径的影响。结论：积极和消极的 CT 感觉似乎在治疗师干预与患者 ODF 之间的关系中起着至关重要的作用。