Abstract
In both graduate classrooms and field placements, social work student interns are increasingly taught empirically-supported, behaviorally-focused models as the primary way to engage in ethical practice. They are less prepared, however, to handle the personal impact of powerful psychodynamic processes active in therapeutic settings. In adolescent group treatment environments, the combination of novice therapists with dual-diagnosed, involuntary/mandated teens sets the stage for both behavioral and transference/countertransference issues to arise. Although supervision at the field setting is expected to ameliorate emergent issues, the behavioral and group-level focus of field supervisors may not be enough to identify and overcome deeper psychodynamic challenges. Student interns, as they provide professional treatment to their clients, may therefore have to self-navigate emotionally charged inter- and intra-personal conflicts and attempt to metabolize their own reactions to trauma and dysfunction. This paper presents a detailed post-treatment review of a student intern’s struggle to metabolize individual countertransference dynamics in a group setting in the service of a client, and provides supervisory insights on his approach to highlight the challenges and possibilities in such an environment.
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Notes
Providing case studies for academic journals has become an increasingly complex process due to barriers that may exist around requesting informed consent, the potential negative consequences of a client coming across their own material, legal issues around patient privacy, ethical implications of altering information for the sake of disguise, and composite cases that fail to reflect authentic activity (Aron, 2016; Seick, 2012). Protecting a client’s privacy and ensuring that there is no risk to their therapeutic progress must always be the foremost consideration when considering publication. It is important to note that permission to make process recordings for educational purposes had previously been given by the agency, and all exchanges were collected either in group settings or public areas; none would have been assumed to be rivate communications.
References
Agass, D. (2002). Countertransference, supervision and the reflection process. Journal of Social Work Practice, 16(2), 125–133. https://doi.org/10.1080/0265053022000033694.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Association.
Aron, L. (2016). Ethical considerations in psychoanalytic writing revisited. Psychoanalytic Perspectives, 13(3), 267–290. https://doi.org/10.1080/1551806X.2016.1228893.
Bemak, F., & Epp, L. (2001). Countertransference in the development of graduate student group counselors. Journal for Specialists in Group Work, 26(4), 305–318.
Bennett, S., & Rizzuto, C. (2011). Finding common ground: the perils of sameness and difference in the treatment of lesbian, gay and bisexual clients. In J. Berzoff (Ed.), Falling through the cracks: psychodynamic practice with vulnerable and oppressed populations (pp. 206–240). New York: Columbia University Press. https://doi.org/10.7312/berz15108.
Bernard, H. (2005). Countertransference: the evolution of a construct. International Journal of Group Psychotherapy, 55(1), 151–160. https://doi.org/10.1521/ijgp.55.1.151.56553.
Carpy, D. (1989). Tolerating the countertransference: a mutative process. International Journal of Psychoanalysis, 70, 287–294.
Cartwright, C., Barber, C., Cowie, S., & Thompson, N. (2018). A trans-theoretical training designed to promote understanding and management of countertransference for trainee therapists. Psychotherapy Research, 28(4), 517–531. https://doi.org/10.1080/10503307.2016.1252071.
Cartwright, C., Rhodes, P., King, R., & Shires, A. (2014). Experiences of countertransference: reports of clinical psychology students. Australian Psychologist, 49(4), 232–240.
Dewane, C. J. (2006). Use of self: a primer revisited. Clinical Social Work Journal, 34(4), 543–558.
Dane, B. O., & Simon, B. L. (1991). Resident guests: social workers in host settings. Social Work, 36(3), 208–213.
Fatter, D., & Hayes, J. (2013). What facilitates countertransference management? The roles of therapist meditation, mindfulness, and self-differentiation. Psychotherapy Research, 23(5), 502–513. https://doi.org/10.1080/10503307.2013.797124.
Foster, R. (1998). The clinician’s cultural countertransference: the psychodynamics of culturally competent practice. Clinical Social Work Journal, 26(3), 253–270.
Fox, R. P. (1998). The “unobjectionable” positive countertransference. Journal of the American Psychoanalytic Association, 46(4), 1067–1087.
Freud, S. (1910). The origin and development of psychoanalysis. The American Journal of Psychology, 21(2), 181–218. https://doi.org/10.2307/1413001.
Gabbard, G. (2001). A contemporary psychoanalytic model of countertransference. Journal of Clinical Psychology, 57, 983–991. https://doi.org/10.1002/jclp.1065.
Ganzer, C. (2007). The use of self from a relational perspective. Clinical Social Work Journal, 35, 117–123.
Garran, A. M. (2013). Lessons learned: racial enactments in the treatment process. Journal of Social Work Practice, 27(3), 305–317.
Geller, S., & Greenberg, L. (2002). Therapeutic presence: therapists’ experience of presence in the psychotherapy encounter. Person-Centered & Experiential Psychotherapies, 1(1–2), 71–86. https://doi.org/10.1080/14779757.2002.9688279.
Gelso, C., & Hayes, J. (1998). The psychotherapy relationship: theory, research, and practice. New York: John Wiley & Sons.
Gendlin, E. (1978). Focusing. New York: Bantam Books.
Gitterman, A., & Germain, C. B. (2008). The life model of social work practice: advances in theory and practice (3rd ed.). New York: Columbia University Press.
Gordon, R., Gazzillo, F., Blake, A., Bornstein, R., Etzi, J., Lingiardi, V., McWilliams, N., Rothery, C., & Tasso, A. F. (2016). The relationship between theoretical orientation and countertransference expectations: implications for ethical dilemmas and risk management. Clinical Psychology and Psychotherapy, 23(3), 236–245. https://doi.org/10.1002/cpp.1951.
Hayes, J. (2004). The inner world of the psychotherapist: a program of research on countertransference. Psychotherapy Research, 14(1), 21–36.
Hayes, J., Gelso, C., & Hummel, A. (2011). Managing countertransference. Psychotherapy, 48(1), 88–97.
Hayes, J. A., Gelso, C. J., Goldberg, S., & Kivlighan, D. M. (2018). Countertransference management and effective psychotherapy: Meta-analytic findings. Psychotherapy, 55(4), 496–507. https://doi.org/10.1037/pst0000189.
Heydt, M., & Sherman, N. (2005). Conscious use of self: tuning the instrument of social work practice and cultural competence. The Journal of Baccalaureate Social Work, 10(2), 25–40.
Hoag, M. J., & Burlingame, G. M. (1997). Evaluating the effectiveness of child and adolescent group treatment: a meta-analytic review. Journal of Clinical Psychology, 26(3), 234–246.
Kabat-Zinn, J. (2013). Full catastrophe living: how to cope with stress, pain and illness using mindfulness meditation (Revised ed.). UK: Hachette.
Kautz, S., & Piotrowski, M. (2019). Reconsidering graduate training and clinical practice: the importance of psychodynamic thinking. Psychoanalytic Social Work, 26(2), 106–141.
Knott, H. (2016). Countertransference and projective identification revisited and applied to the practice of group analytic supervision. International Journal of Group Psychotherapy, 66(1), 323–337. https://doi.org/10.1080/00207284.2016.1149408.
Kurland, R., & Salmon, R. (2005). Group work vs. casework in a group: principles and implications for teaching and practice. Social Work With Groups, 28(3–4), 121–132. https://doi.org/10.1300/J009v28n03_09.
Lee, E. (2017). Working through countertransference: navigating between safety and paranoia for a client with complex trauma history and borderline personality organization. Psychoanalytic Social Work, 24(2), 75–95. https://doi.org/10.1080/15228878.2017.1336104.
Leszcz, M. (2018). The evidence-based group psychotherapist. Psychoanalytic Inquiry, 38(4), 285–298. https://doi.org/10.1080/07351690.2018.1444853.
Linehan, M. (2015). DBT skills training handouts and worksheets (2nd ed.). New York: The Guilford Press [Kindle Edition].
McTighe, J. P. (2011). Teaching the use of self through the process of clinical supervision. Clinical Social Work Journal, 39, 301–307.
Neuman, K., & Friedman, B. (1997). Process recordings: fine tuning an old instrument. Journal of Social Work Education, 33(2), 237–243. https://doi.org/10.1080/10437797.1997.10778867.
Norton, C. (2011). Developing empathy: a case study exploring transference and countertransference with adolescent females who self-injure. Journal of Social Work Practice, 25(1), 95–107. https://doi.org/10.1080/02650530903525991.
Ornstein, E., & Ganzer, C. (2005). Relational social work: a model for the future. Families in Society, 86(4), 565–572.
Phillips, A. (2011). The pleasures of working with adolescents. Psychodynamic Practice, 17(2), 187–197. https://doi.org/10.1080/14753634.2011.562698.
Rooney, R. (2009). Strategies for work with involuntary clients (2nd ed.). New York: Columbia Press.
Santorelli, S. (1999). Heal thyself: Lessons on mindfulness in medicine. New York: Random House.
Schore, J. R., & Schore, A. N. (2014). Regulation theory and affect regulation psychotherapy: a clinical primer. Smith College Studies in Social Work, 84(2–3), 178–195.
Schore, J. R., & Schore, A. N. (2008). Modern attachment theory: the central role of affect regulation in development and treatment. Clinical Social Work Journal, 36(September), 9–20.
Seick, B. (2012). Obtaining clinical writing informed consent versus using client disguise and recommendations for practice. Psychotherapy, 49(1), 3–11.
Thomas, H., & Caplan, T. (1999). Spinning the group process wheel: effective facilitation techniques for motivating involuntary client groups. Social Work with Groups, 21(4), 3–21.
Thompson, K. L., Hannan, S. M., & Miron, L. R. (2014). Fight, flight, and freeze: threat sensitivity and emotion dysregulation in survivors of chronic childhood maltreatment. Personality and Individual Differences, 69, 28–32. https://doi.org/10.1016/j.paid.2014.05.005.
Tishby, O., & Vered, M. (2011). Countertransference in the treatment of adolescents and its manifestation in the therapist-patient relationship. Psychotherapy Research, 21(6), 621–630. https://doi.org/10.1080/10503307.2011.598579.
Tishby, O., & Wiseman, H. (2014). Types of countertransference dynamics: an exploration of their impact on the client-therapist relationship. Psychotherapy Research, 24(3), 360–375. https://doi.org/10.1080/10503307.2014.893068.
Toseland, R. W., & Rivas, R. F. (2017). An introduction to group work practice (8th ed.). Boston: Pearson.
van Breda, A., & Feller, T. (2014). Social work students’ experience and management of countertransference. Social Work/Maatskaplike Werk, 50(4), 469–484.
Werkmeister Rozas, L. (2021). Introducing self. In J. Logan, van B. Eeden-Moorfield, & S. Browning (Eds.), Constructing Authentic Relationships in clinical practice: working at the intersection of therapist and client identities. New York: Routledge.
Yalom, I., & Leszcz, M. (2005). The theory and practice of group psychotherapy (5th ed.). New York: Basic Books.
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Both authors contributed to the study conception and design. Process recordings were collected by Kurt Roggendorf and supervisory observations provided by Lisa Werkmeister Rozas. The first draft of the manuscript was written by Kurt Roggendorf and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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The “student intern” is the second author of this paper, who provides his permission. Prior permission to use process recordings for educational purposes had been obtained from clients’ parents by the agency. All client-related information has been genericized and no specific diagnoses or unique client characteristics have been provided. All process-recorded exchanges were collected either in group settings or public areas; none would have been assumed to be private communications. It is relevant to note that the analysis of the case is based on the intern and his own struggles and insights related to the client’s behaviors, not the client’s interpretation.
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Rozas, L.W., Roggendorf, K.S. Metabolizing Countertransference in an Adolescent Group Treatment Internship. Clin Soc Work J 51, 198–210 (2023). https://doi.org/10.1007/s10615-023-00864-4
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DOI: https://doi.org/10.1007/s10615-023-00864-4