PATIENT PERSONALITY AND COUNTERTRANSFERENCE IN THE PSYCHOTHERAPY WITH ADOLESCENTS: TOWARD THE EMPIRICALLY DERIVED AND CLINICALLY USEFUL PROTOTYPES OF THERAPIST’S EMOTIONAL RESPONSES

Therapist’s emotional responses to the patient (or countertransference) can inform diagnostic assessment, as well as plays a crucial role in the psychotherapy process and outcome across different models of treatment. Although the clinical literature on countertransference phenomena in psychotherapy is rich, to date, little interest has been shown in empirical investigation of therapists’ emotional responses related to the adolescent patient’s personality. The aims of this study were to: 1) examine the stability of the factor structure and psychometric properties of the Therapist Response Questionnaire – Adolescent Version (TRQ-A; Satir et al. 2009); 2) investigate the relationship between therapists’ emotional responses and specific emerging personality patterns of adolescent patients; 3) provide the empirically derived prototypes of therapists’ emotional responses toward adolescent patients with particular personality styles/syndromes. A national sample of psychiatrist and clinical psychologists (N=177) completed the TRQ-A, as well as the Shedler–Westen Assessment Procedure–II-A (Westen et al., 2014) to assess personality patterns and syndromes regarding an adolescent patient currently in their care. Exploratory factor analysis (EFA) revealed six distinct countertransference scales that were conceptually coherent and psychometrically robust: hostile/devaluated, positive, bored/failing, overwhelmed/scared, overinvolved, and sexualized. These scales showed excellent reliability, as well as good validity. They were significantly associated with distinct personality styles/syndromes. Finally, the prototypes of therapist’s emotional responses in adolescent personality-disordered patients provided the empirically derived and clinically useful description of countertransference processes that strongly resemble clinical theories. The diagnostic and clinical implications of these findings are addressed.