Date of Award
Doctor of Philosophy (PhD)
College of Psychology
Cluster B, counseling, countertransference, personality disorders, therapy
Countertransference is one of several therapist variables that have been demonstrated to impact the quality of the therapeutic alliance. CT that is understood and managed by the therapist has the potential to serve as a tool in better understanding the patient, which puts the therapist in a better position to intervene therapeutically. CT that are emotionally charged can be more difficult to manage, and CT reactions tend to be especially emotionally intense when working with patients with Cluster B personality disorders (PDs). A better understanding of specific CT reactions to each Cluster B PD might aid in diagnosis and treatment and CT management, which may, in turn, contribute to more positive therapy outcomes. To date, no authors have specifically examined and compared the distinct CT presentations that are elicited from Cluster B personality diagnoses. The aim of this study was to examine whether the presentation of therapist CT differs systematically between Cluster B PD groups. A sample of psychologists and psychology trainees completed an online survey on their experience with a patient with a cluster B PD. Participants provided demographic information and completed the Level of Personality Functioning Scale to assess severity of the patient’s pathology as well as the Therapist Response Questionnaire to evaluate their CT response to the patient. ANOVAs revealed significant differences between PD groups on 3 of 8 TRQ CT variables and distinct CT presentations were identified for each PD group. Antisocial PD was associated with a low criticized/mistreated response; borderline PD was associated with a low disengaged, low criticized/mistreated, high parental/protective response; narcissistic PD was associated with a high disengaged, high criticized/mistreated, and low parental/protective response; and no associations were identified with histrionic PD. These results contribute to a developing framework of identifying specific CT associated with each Cluster B PD, which will be utilized to inform future treatment decisions and improve CT management on the part of the clinician.
Florence, S. A.
(2020). Understanding the Distinctive Presentations of Therapist Countertransference with Cluster B Personality Disorders. .
Available at: https://nsuworks.nova.edu/cps_stuetd/140