Transference-Focused Psychotherapy (TFP) and Its Applications: The Initial Stage of Treatment, Interventions Repeated and Refined, and What Happens Over Time in the Therapy Model

Abstract

Transference-focused psychotherapy (TFP) proceeds in a deliberate way following the assessment and contracting phase. The TFP therapist expects to encounter confusing and confounding material reflecting the patient’s underlying pathology. The therapist manages this confusion by “naming the actors” or putting into words the most prominent affects identified and the associated experiences of self and others that emerge in early sessions. The TFP therapist focuses on the dominant object relations dyad and the expectable role reversal to follow. The therapist uses techniques of clarification, confrontation, and, eventually, interpretation, to expand exploration with the patient over time. Managing “affects storms” and encouraging probing of paranoid elements in the transference are central components of the early stages of treatment. TFP proceeds with the goal of integration of “all good” and “all bad” experiences over time; the patient’s improvement is measured by an increasing capacity for a nuance experience of self and others and the capacity for guilt.