Abstract
Background and Aims: Countertransference has the potential to negatively impact therapeutic processes and outcomes and these risks are likely increased within forensic settings. To date, the interaction of patient and therapist factors in countertransference has largely been ignored. The purpose of this study was to explore the countertransference interaction hypothesis through the lenses of therapist schemas and therapist-measured patient interpersonal behaviours within the context of forensic settings. It was hypothesized that the interaction between patient and therapist factors would influence therapists’ experience of countertransference. Methods: Sixty therapists from a range of forensic settings completed an abbreviated version of the Young Schema Questionnaire, the Therapist Response Questionnaire, and the Chart of Interpersonal Reactions in Closed Lived Environments. A series of regressions were conducted to explore whether therapists’ disconnection schema, patient withdrawal-gregariousness and their interaction, predicted therapists’ experience of countertransference. Results: While no significant main effects were found, a significant interaction effect was found predicting therapists’ experience of being helpless/inadequate, hostile/angry and disengaged. Simple slopes analysis suggested that when therapists have a high disconnection schema score, the effect of a patient’s level of withdrawal-gregariousness on helpless/inadequate or disengaged feelings were not significant, however when a therapist has a low disconnection schema, the more withdrawn (and less gregarious) a patient is, the more likely they are to feel helpless/inadequate and disengaged. Further, when therapists have a low disconnection schema score, the effect of patient withdrawal-gregariousness on hostile/angry feelings was not significant, however when the therapist has a high disconnection schema score, the less withdrawn (and more gregarious) a patient is, the more likely they are to feel hostile/angry. Discussion: This research provides partial support for the countertransference interaction hypothesis and points to a complicated picture of countertransference which should consider the interaction of patient and therapist factors. Several limitations, clinical implications and future research directions are discussed.