Managing Countertransference

In this article, we review the history and definition of countertransference as well as empirical research on countertransference, its management, and the relation of both to psychotherapy outcome. Three meta-analyses are presented, as well as studies that illustrate findings from the meta-analyses. The first meta-analysis indicated that countertransference reactions are related inversely and modestly to psychotherapy outcomes (overall weighted effect r = -16, p = .002, 95% CI [-26, -06], k = 10 studies, N = 769 participants). The second meta-analysis suggested that countertransference management factors that have been studied to date play little to no role in actually attenuating countertransference reactions (r = -14, p = .10, 95% CI [-30, .03], k = 11 studies, N = 1065 participants). However, the final meta-analysis revealed that managing countertransference successfully is related to better therapy outcomes (r = .56, p = .000, 95% CI [.40, .73], k = 7 studies, N = 478 participants). We conclude by summarizing the limitations of the research base and highlighting the therapeutic practices predicated on research.