Bichsel, Lucy (5/12) Therapist personality, countertransference and the working alliance: The potential mediating effect of therapist mental activity in work with difficult patients (Lisa Wallner Samstag, Ph.D.; Nicholas Papouchis, Ph.D.; Kevin Meehan)
This study investigated the relationship between therapist emotional awareness, countertransference and mental activity in work with a difficult patient. This study also investigated the relationship between therapist introject and the working alliance, hypothesizing that therapist mental activity would mediate this relationship. Specifically, it was hypothesized that therapists with more hostile introjects would have poorer working alliances with their patients (Dunkle, 1996) and that therapist reflective mental activity would partially account for this relationship. Seventy-five psychology master's and doctoral-level students, social work students and psychiatry residents visited a website where they completed self-report measures assessing emotional awareness, introject, countertransference, and working alliance. They also engaged in a session recall writing task which was coded for type of mental activity using Bouchard et al.'s (2001) Mental States Rating System (MSRS). As predicted, emotional awareness was positively associated with therapist reflective mental activity. Reflective mental activity was also associated with Positive/Alliance-based countertransference with a moderate effect size. Reactive mental activity was found to be positively associated with Hostile/Mistreated countertransference and negatively associated with the working alliance, both findings with moderate effect sizes. Contrary to the study's central hypothesis, therapist introject was not found to be related to therapist mental activity or the working alliance. Limitations of this study and future directions for MSRS research are discussed.
