Assessing objective countertransference: A comparison of two different statistical procedures in three different samples

The Impact Message Inventory-Circumplex (IMI-C): Exploring the Aversiveness Component of Therapists' Covert Reactions to Patients' Interpersonal Communications

The Impact Message Inventory-Circumplex (IMI-C) is a two-dimensional measure of patient-induced countertransference. Surprisingly, in a replication study of its circumplex structure, Hafkenscheid and Timmerman could retrieve a third dimension, in addition to the basic dimensions of Affiliation and Control. They tentatively interpreted this preliminary third dimension as representing 'reactance' (oppositional and uncooperative patient behaviours), with 'active' and 'passive' as polarities. This provisional interpretation was no more than plausible and was partly speculative. Therefore, a more systematic empirical approach to the meaning embedded in the third dimension is required. The present empirical study tests the hypothesis that the preliminary third dimension might represent aversiveness rather than reactance. A panel of IMI-C users (N = 100) independently judged all 56 items of the instrument in terms of the general (i.e., without taking a specific patient in mind) emotional undertone enclosed in the item formulations using a forced choice three point scale format: 'positive emotional undertone' (+), 'neutral' (o) and negative (aversive) undertone (-). Overall, IMI-C users appeared to evaluate the formulations of items constituting the preliminary third dimension as intrinsically more aversive (negative emotional connotation), compared to the group of IMI-C items not included in this preliminary third dimension. However, the original octants of the IMI-C could be discriminated in terms of aversiveness as well. Anyhow, clinical interpretations of IMI-C profiles may benefit from an examination of the aversiveness component, enclosed within the items and octants themselves, irrespective of the specific patients judged with the instrument.

Countertransference and Psychological Assessment: Direct and Indirect Exposure

Countertransference (CT) is usually conceptualized as emerging in the course of psychotherapy. This study explores whether CT manifests itself in the context of assessment and if the modality of exposure to participants (interviewer and observer) affects the intensity and nature of CT. Evaluators either led (direct exposure) or observed (indirect exposure) a 6-hour interview with a subject focusing on attachment and personality. Interviewers and evaluators then completed a measure of CT, the Therapist Response Questionnaire for a total of 43 subjects. Results show significant CT reactions for both interviewers and observers that were globally as intense in both conditions, although lower positive/satisfying and helpless/inadequate CTs were reported by observers. Moreover, intraclass correlations suggest that interviewers' and observers' CT reactions toward the same interviewee show an important degree of similarity. These results highlight the presence of CT in assessment contexts and support the existence of an objective part to CT reactions.

A trans-theoretical training designed to promote understanding and management of countertransference for trainee therapists

OBJECTIVE

There is evidence that awareness of countertransference (CT) in combination with a conceptualization of CT facilitates its management. This study examines the impact of a trans-theoretical training designed to make the construct of CT accessible to trainee therapists in programs oriented towards cognitive-behavioral therapy. The training aimed to enhance trainees' awareness, understanding, and management of CT.

METHOD

Academics at five New Zealand universities introduced the training into their curriculum. Five academics and 54 clinical psychology trainees evaluated it, responding to open-ended questions on the impact of the training on awareness, understanding, and management of CT. They also rated the training's effectiveness.

RESULTS

The majority of trainees reported increased awareness and conceptualization of CT. They rated the training as useful for professional practice and reported increased commitment to monitoring CT. Academics also observed trainees' increased awareness and understanding of CT and openness to discussing it. Trainees and academics were less confident in trainees' abilities to manage CT in clinical practice, although trainees reported gains in this area.

CONCLUSIONS

The training appeared to enhance awareness and conceptualization of CT, processes that support its management. However, future research into training models needs to examine the impact on CT management in clinical practice.

The Impact Message Inventory-Circumplex (IMI-C): a replication study of its circumplex structure in a Dutch sample

The 56-items Impact Message Inventory-Circumplex (IMI-C) has been developed to describe the interpersonal styles of target persons in terms of the 2-dimensional interpersonal circle, divided in 8 subscales (octants). The IMI-C is based on the assumption that a target person's interpersonal styles can validly be measured by assessing the internal (cognitive and emotional) reactions of the IMI-C respondent (e.g., therapists), interacting with the target person (e.g., psychotherapy patients). This replication study tested the circumplexity of a computer-delivered Dutch IMI-C. The computer-delivered Dutch IMI-C approached circumplexity in a large clinical sample (N = 812) of psychotherapy and psychiatric patients, after removing 3 items from the Submissive octant scale. These 3 items clearly disturbed the IMI-C circumplex structure. It is concluded that, even with the inevitable problem of nested data, circumplexity was approached sufficiently to justify the interpretation of the IMI-C at the octant level, provided that the 3 troublesome Submissive items are removed from the calculations of octant scores. Our replication test of the Dutch IMI-C circumplexity might be an impetus for researchers in the United States to invest in the further validation of the original American version.