Countertransferential reactions of therapists as a function of dependency and self-criticism: a schema-theory perspective

In describing a supervision model for Schema-Focused Cognitive Therapy (Young, 1990), Greenwald and Young (1998) suggest supervisors guide the supervisee in examining the role of his/her own schemata in the therapy process. Surprisingly, no known research has examined the role of self-schemata in therapists and how therapists' schemas might influence countertransference. Viewed from a social cognitive perspective, therapist and client engage in a social relationship in which both individuals make interpretations of therapy experiences based on activation of personal constructs. Clients' affect, behavior, and presenting issues act as stimuli to be filtered through the therapist's schemata. Certain kinds of client material may cause a therapist's personal constructs or schemata to become activated, thereby influencing the therapist's responses in therapy. Research on therapist expertise suggests that "healthy perspective on their sense of importance" and "strong relationship skills" are essential qualities of effective therapists (Jennings & Skovholt, 1999, p.7). Therefore, it seems plausible that therapists' management of dependency and self-criticism schemata (c.f., Blatt, 1974; Beck, 1983) plays some role in therapists' overall efficacy. While most research has explored associations between these self-schemata and cognitive vulnerability to depression, more recent investigations are exploring how these schemas may be related to personality disorders, selection of romantic partners, and the therapeutic alliance. This dissertation examined countertransference from a schema theory perspective, specifically, therapists' affective, behavioral, and cognitive reactions to clients' dependency and self-critical issues, as a function of therapists' own dependency and self-criticism schemata. Fifty therapists listened to audiotaped vignettes of clients illustrating dependency and self-criticism issues. Affective measures included degree of warmth and anxiety felt toward each client. Behavioral measures included verbal responses made to each client. Cognitive measures included therapists' recall of information presented in the vignettes and beliefs regarding clients' treatment outcome and goals. Linear regression analyses suggest therapists' dependency schemas predict therapists’ tendency to provide verbal responses that discourage exploration of dependency-oriented issues. This study also suggests therapists’ dependency schemas are associated with a tendency to under-recall dependency - oriented client material and belief that dependency issues should receive less focus in treatment. Implications for training, supervision, and future research directions are discussed.