Clinicians’ Emotional Reactions toward Patients with Depressive Symptoms in Mood Disorders: A Narrative Scoping Review of Empirical Research
Abstract
:1. Introduction
1.1. Mood Disorders
1.2. Working with Depressive Symptoms in Patients with Mood Disorders
1.3. Countertransference and Therapist Subjective Reactions
1.4. Aims of the Present Review
2. Methods
3. Results
3.1. Comparison between/among Different Diagnostic Groups
3.2. Clinician’s Response to Patient’s Characteristics
3.3. Countertransference and Psychotherapy Elements, Process, and Outcome
3.4. Clinicians’ Responses to Suicidal Patients
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Measure Name | Description | Items/Factors/Subscales |
---|---|---|
Psychotherapy Process Q-set (PQS) Jones [82] | Q sort 100 items It is applied to recorded single session. Clinical judges sort items into nine categories from 1 (least characteristic) to 9 (most characteristic). | The items are divided into three categories that describe or attempt to capture the following areas:
|
Countertransference Behavior Inventory (CBI) Friedman & Gelso [84] | Observational rating 21-items Designed for supervisors to assess perceived countertransference behavior during therapy sessions, rating reactions to a particular patient in a given therapy session. 5-point Likert scale ranging from 1 (to little or no extent) to 5 (to a great extent). | Exploratory factor analysis identified two factors:
|
Assessment of Clinician’s Subjective Experience (ACSE) Pallagrosi et al. [76] | Clinician self-report 46 items measuring subjective experience during clinical interaction with patients. Each item refers to a specific phase of the visit: “at the beginning”, “in the course of” or “at the end”. 5-point Likert scale ranging from 0 (not at all/never) to 4 (extremely/always). | Principal component analysis identified five subscales.
|
Experience and Attitude Scale (EAS) Brody & Faber [45] | Clinician self-report 25 items Assesses the overall experience in psychotherapy (15 items) and attitudes towards their own emotional reactions in therapy (10 items). Clinicians rate the intensity or frequency of their reactions. 5-point Likert scale ranging from 1 (not at all/hardly ever) to 5 (very much so/very often). | The authors used only the subscale on the therapist’s attitudes toward their emotional reactions. Items were not summed, analyzing all 10 items separately. The aspects assessed by the items are as follows:
|
Feeling Word Checklist (FWC) Røssberg et al. [79] | Clinician self-report 58 items Therapists rate degree they have experienced different feelings toward the patient. 5-point Likert scale ranging from 0 (nothing) to 4 (very much). Note that some shorter versions (28- and 24-item versions) use a 4-point Likert scale ranging from 0 (nothing/not at all) to 3 (very much). | Principal component analysis identified four subscales:
|
Impact Message Inventory (IMI) Kiesler [73] | Clinician self-report 90 items Measures distinctive internal reactions (referred to as impact messages) that the therapist experiences to the full range of interpersonal behaviors indexed along the circumference of the interpersonal circle. 4-point Likert scale ranging from 1 (not at all) to 4 (very similar). | Items are clustered into four subscales:
|
Stress Appraisal Scale (SAS) Carpenter & Suhr [74] | Clinician self-report 36 items Investigates the therapist’s feelings about entering a therapeutic relationship with a patient listened to in an audiotaped interview. 4-point Likert scale ranging from 1 (very untrue of me) to 4 (very true of me) by rating how accurate each statement is of the therapist’s reactions. | Items are grouped into four subscales, which in turn are clustered into three primary categories.
|
Therapist Positive Feeling Index (TPFI) Stiles [87] | Clinician self-report 6 items The TPFI is part of the Session Evaluation Questionnaire. It assesses the emotional expression of the therapist. The original version of this subscale begins with the stem ‘‘Right now I feel,’’ but was changed in the included study to, ‘‘To what extent did the therapist express feelings of __ during the session.’’ This stem is followed by the five bipolar adjectives that are rated on a continuum from 1 to 7 by a coder. | A total score is calculated using the mean rating on the following bipolar adjectives.
|
Therapist Response Questionnaire (TRQ) Zittel Conklin & Westen [83] | Clinician self-report 79 items Assesses CT patterns in a psychotherapeutic setting on a wide range of cognitive, affective and behavioral responses therapists have to their patients. 5-point Likert scale ranging from 1 (not true) to 5 (very true). | The English version revealed an eight-factor structure [88]:
|
Therapist Response Questionnaire—Suicide Form (TRQ-SF) Yaseen et al. [90] | Clinician self-report 10 items Assesses clinicians’ responses to suicidal patients after a single encounter. It includes five items derived from the TRQ [83], two items from the WAI [91] and three items developed de novo. 5-point Likert scale ranging from 0 (not at all) to 4 (extremely). | Three subscales have been identified and validated by Barzilay et al. [92] and adopted by Michaud et al. [93]:
|
Vignettes Rating Scale (VRS) Brody & Faber [45] | Clinician self-report 20 items Assesses the extent to which the clinician imagined that actually working with the patient described in a clinical vignette would generate a variety of feelings and reactions. 5-point Likert scale, with response options ranging from 1 (much less than usual) to 5 (much more than usual). |
Three different aspects of countertransference:
|
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Stefana, A.; Fusar-Poli, P.; Gnisci, C.; Vieta, E.; Youngstrom, E.A. Clinicians’ Emotional Reactions toward Patients with Depressive Symptoms in Mood Disorders: A Narrative Scoping Review of Empirical Research. Int. J. Environ. Res. Public Health 2022, 19, 15403. https://doi.org/10.3390/ijerph192215403
Stefana A, Fusar-Poli P, Gnisci C, Vieta E, Youngstrom EA. Clinicians’ Emotional Reactions toward Patients with Depressive Symptoms in Mood Disorders: A Narrative Scoping Review of Empirical Research. International Journal of Environmental Research and Public Health. 2022; 19(22):15403. https://doi.org/10.3390/ijerph192215403
Chicago/Turabian StyleStefana, Alberto, Paolo Fusar-Poli, Cristina Gnisci, Eduard Vieta, and Eric A. Youngstrom. 2022. "Clinicians’ Emotional Reactions toward Patients with Depressive Symptoms in Mood Disorders: A Narrative Scoping Review of Empirical Research" International Journal of Environmental Research and Public Health 19, no. 22: 15403. https://doi.org/10.3390/ijerph192215403