This article is published in the book:

"Psych 101 -
What you didn't learn in nursing school."


by Kathi Stringer
Paperback: 320 pages
ISBN-13: 978-0615193137
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Treatment Team
Countertransference Awareness

Written by Kathi Stringer

An effective therapeutic alliance is supported on the foundation of the treatment team’s countertransference awareness and management. If left unmonitored or unidentified, it can lead to staff burnout, resentment, and turnover. Certainly, a disturbing element is the drop in staff moral and emotional plasticity. The by-product of ineffective countertransference management from the team as a collective can lead to a “domino-effect” of patient’s unresponsiveness and uncooperation.

These motivating factors from countertransference necessitate implications to consider the teams resources, skills, history and capacity to function synergistically and effectively. For example, perhaps staff had a difficult patient and the remnants of resentment or unresolved conflicts are still emotionally engaged and then ‘transferred” to the new patient. As Paris (1993) states, “The countertransference response may reflect unresolved issues in the team’s history of working with a certain kind of patient.” We see here how countertransference history is important and must be acknowledged. Equally important is the task of introducing and reviewing of new or contemporary therapeutic skills coupled with the teams resources. And finally, the team’s capacity to therapeutically meet the treatment needs of the unit’s caseload and demands. Any variation in the parameters of the teams resources, skills, history and capacity can dynamically affect countertransference reactions to the patients. In other words, depending on the measures of the above independent properties the team may react different countertransferentially to the patient population at any one time.

Keep Tools Sharp

As every successful and competitive industry acknowledges, one criteria is certain, and that is the tools of the trade must be continually be sharpened to keep from becoming dull. These savvy companies survive through savings or profits or a combination of both. Dull tools make for poor productivity. A sharp tool can boost effectiveness while cutting downtime. This will create dual pockets, one for profits and the other for savings. If mental health providers would give serious consideration to creating a position in the staff hierarchy, therapeutic tools would remain on the competitive edge.

This newly created position would belong to a full time facilitator and the duties would be similar to the duties of a patient group facilitator with the exception of being professionally targeted. The facilitator would bring in new ideas while mobilizing dull skills to the surface and reintegrating them into fresh creative methods. This would boost the treatment team’s spirit, moral and confidence towards themselves and the patient. Paris states, “The treatment staff, both individually and collectively, need to feel that their therapeutic contributions are acknowledged, respected, and valued.”