April 25, 2020
Countertransference is a term used by psychoanalysts primarily when applying it to psychotherapy relations. However, this term is pertinent and obliging when applied to both evaluative (Freedman et al., 1993) and professional roles (Greene & Feinberg, 1995). The psychoanalytic theory views countertransference as the reactions of analyst’s, their patient’s feelings, or thoughts basing upon their own unconscious or neurotic conflicts. In the contemporary view, therapists to encompass their total response towards their patients and not just those stemming from neurotic conflicts have used this concept.
A negative or bias countertransference situation can occur in a child evaluator scenario. The countertransference reactions exhibited by these children evaluators are not always a hindrance to the therapist. On the other hand, they provide an understanding of the child or adult under evaluation (Imura, 1991, p.110). In our case, the countertransference reaction leads to a bias situation in a child custody evaluation due to the fact that, difficult case circumstances or personal parent or child presentations elicited negative or positive reactions in an evaluator unconsciously. The results of these reactions are the distortions of perceptions, which could possibly lead to recommendations that are nonobjective or inapt. Mental health professionals conducting such evaluations undergo challenging, complex, risky, and stressful endeavors. Therefore, child custody evaluators (CCEs) major challenge is to be self-inspecting and hence realize when a meticulous bias interferes with an evaluation that is objective. All his problems would varnish once in the midst of his lovely children whom he adored and treasured (Imura, 1991, p.120).
Despair, rage, helplessness, intense anger, and abjuration of responsibility are some of the emotional expressions displayed parents undergoing CCEs, which are bound to affect the evaluation process. Vulnerability to counter-transference by custody evaluators occurs when the process of evaluation elicits feelings of past or present events. This clouds the judgment of the evaluator bearing in mind their marital conflicts, divorce, experience with their parents or even, his/her history for example, childhood sexual or physical abuse, domestic violence or even pregnancy cases (Strayhorn, 1982, p. 25). An example of a negative countertransference is as described below.
A Mr. Z, who presented himself as very angry during the CCE process, felt deeply resentful and thus, had to undergo an evaluation. On Saturday and Sunday, were his alternate over-nights with his two children aged 8 and 12, which he believed were preposterous since Ms. Z would not settle on him having additional custody periods. However, both of the parents did agree on the fact that, the children were requesting on spending more time with their father. In dealing with his anger and frustrations, the father decided to devalue the CCE process. This posed as a great challenge to the evaluator as he was taken aback by the criticalness of the father. He then developed a negative impression of the father.
Later on during group consultations, the evaluator of Mr. Z presented his negative impressions of the father and was tentative on recommending increased periods of paternal guardianship. From his consultation group, the evaluator was able to learn that, while the father was angry and very difficult, other sources of data from the evaluation process revealed that, he had a good relationship with his children. During those nights, he did not express any form of inappropriate ways due to his anger problems. As a result, the evaluator had to reflect on the presented evidence and realized that the father made him feel similar to the way his very negative, hostile, and demeaning father made him feel when he was young. The evaluator was able to understand this countertransference reaction and as a result, was better able to appreciate the strengths exhibited by the father. In addition, he became more objective in analyzing retrieved data and hence, formulated recommendations. It is evidential that, unresolved conflicts from the evaluator’s past may evolve as counter-transference.
Child custody evaluators work with material that is highly charged and emotional, which may at some point, interacts with their personal issues or past. Acknowledging that countertransference does exist is very important since it may influence the evaluator by compromising his/her objectivity. Therefore, the evaluator should maintain reaction awareness and seek apt consultation or supervision if it appears that such countertransference reactions might compromise his objectivity in providing recommendations suite the interests of the child. It is important to note that, countertransference reaction may affect the perception of the evaluator by influencing the perception of the parents under evaluation. According to Barsky and Gould (2002), they recommend that evaluators should maintain a personal log or self-check questionnaire in order to raise their awareness on how a particular case is affecting them.
One author described the key to recognizing countertransference during an evaluation process is by noticing when the evaluator starts to act atypically. Different styles of evaluations are applied by every evaluator when working with parents and children. A change in this characteristic approach considers the possible contribution of countertransference. Other aspects that reflect countertransference include things like sarcastic remarks to colleagues, defensive statements, unusually strong positive or negative feelings toward a parent, or dismissal of data (Wilson & Kniesl, 1996, p. 58). Some of the questions considered by evaluators in every case include, does this case evoke any feelings in the evaluator related to their personal history, which might lead them to identify with one parent, or perhaps be biased against one of the parents? Is the parent attempting to create a particular reaction in the evaluator, and how can this reaction or experience of the parent be used to learn about this parent’s capacity for relationships, their personality dynamics, or their experience in coping with their ex-spouse or the divorce? Does the evaluator feel a special desire to please one of the attorneys more than the other does and might this affect the recommendations? Might the evaluator have a potential gender, religious, or sex-role bias, which could lead to a nonobjective recommendation?
The Diagnostic and Statistical Manual of Mental Disorders, 4th edition text revision (DSM-IV TR) published in 2000, has been used by clinicians and psychiatrists in diagnosing psychiatric illnesses. The DSM-IV TR is covers all categories of mental health disorders for both adults and children. The manual is non-theoretical and focuses mostly on describing symptoms, statistics concerning which gender is most affected by the illness, the typical age of onset, the effects of treatment, and common treatment approaches. This manual is beneficial to mental health providers in better understanding the potential needs of their patient’s. It also helps them in assessing and diagnosis of the countertransference reaction in a more comprehensive evaluation process by using all the five dimensions (multiaxial approaches) presented. Consequently, giving the clinicians their client’s functioning level bearing in mind that, mental disorders affects many areas in their lives (American Psychiatric Association, 2000, p. 700).
- Axis I: Clinical Syndromes is an axis that fully describes the clinical symptoms causing the patient’s significant impairments. The different categories of disorders include adjustment, anxiety, and pervasive development disorders. For a depressed Mr. Z he has adjustment/situational disorders due to the major changes affecting his life. In order for the condition to be managed, he needs to adapt to the situation. He developed emotional and behavioral symptoms and thus, reacts to stressful events that have made him not function well. Adjustment disorder is also visible among the children because they are withdrawn and depressed. However, this condition does not last longer than six months, but if the problem lingers on, the need to visit a physician for evaluation will be highly recommended. For both parents and children, counseling will be helpful in managing the stressful situations (American Psychiatric Association, 2000, p. 701).
Such disorders should be dealt with immediately in order to reduce the chances of affecting the future life of the child. The two children became anxious and depressed, which led to them being tense, worried, and nervous at both school and home. Due to the father’s angry behavior, the children also started to develop them by being disobedient at school. The little boy started getting into fights with other boys while the girl decided to use other tactics that prevented her from going to school. The behavior of children in such conditions changes drastically. The uniqueness of family situation and resources affect how parents and children react to change and stress.
Adjustment disorders can be treated by first investigating the stressful events. One can also decide to seek psychological help to determine whether an individual is having an adjustment disorder or some other form of diagnosis. Psychologists help in alleviating and reducing the amount of stress one has through talking and sharing with professional mental health personnel. Thirdly, parents are advised to talk with their child concerning the stressful events affecting their children. This support and encouragement helps the child adapt and cope with the situation. For parents with marital problems, the best solution is to go and seek help from a marriage counselor.
- Axis II: Personality and Mental Retardation has been described as the axis with overlooked long-term problems in the actual presence of Axis I disorders. The relationship of the patient poses significant problems causing personality disorders like the antisocial and histrionic, which affect how the patient relates to the world. In areas such as self-care and interpersonal skills, mental retardation is characterized by intellectual impairment and deficits (American Psychiatric Association, 2000, p. 702).
Therapists use their education, skills, and training knowledge in helping their patients live lives that are rewarding, independent and healthy. On the other hand, many are reluctant to offer themselves the same care and understanding, which is important for both parties. Therapists need o attend to their needs in order to attain balance, renewal, and nurturance. When a therapist is burnout, the most common symptoms include frustration, depletion, fatigue, stress, hopelessness, emotional drain and exhaustion, cynicism, and helplessness. The importance of having therapeutic self-care practices is to be able to stimulate them in developing and instituting an ongoing practice despite of their age difference. It advocates the need and value of normalizing self-care for therapists.
Antisocial personality disorder is prevalent in the case of Mr. Z as they include longstanding patterns of disregard for other people’s rights. Individuals with such conditions experience angry outbursts that force them not to conform to societal norms. As a result, the result is numerous arrests and legal involvement. Limited insights to symptoms of this disorder have contributed to negative consequences and thus, the society is often blamed (Rotgers & Maniacci, 2006. p. 681).. The only treatment for this personality disorder is the long-term insight oriented therapy as associated to it by researchers, but the only major obstacle is getting individuals to commit to the treatment. The prognosis for this disorder is not good because it is characterized by failure of conforming to the norms of society. Secondly, the disorder lacks insight and the individuals see the world as having problems thus, rarely do they seek treatment (Rotgers & Maniacci, 2006. p. 682).
- Axis III: Medical Conditions comprise both medical and physical conditions that influence or even worsen the disorders of the above two axis. Examples of such cases include brain injuries and HIV/AIDS (American Psychiatric Association, 2000, p. 703).
Mr. Zs case is unique but common with many American families because of early marriages. Therefore, the medical conditions experienced by parents with similar situations include physical conditions worsening the antisocial and adjustment disorders. The most notable physical condition of Mr. Z is being angry. The evaluator was worried that the father would eventually translate the anger to his children, but this was not the case. In the presence of his children, he knew how to control his anger thus spending a lovely time with his family. However, this is a risky business because one is gambling with the lives of very young children. Parents should be there to guide and counsel their children and thus anger outbursts are not recommended options.
- Axis IV: Psychosocial and Environmental Problems encompass any social or environmental issues affecting Axis I and II disorders by accounting for them during assessment time. Divorce, unemployment, death of a loved one, or relocation is some of the issues to be noted (American Psychiatric Association, 2000, p. 704).
Divorce is one of the issues that prevail in the modern society in the world today. Children with divorced parents experience difficult times coping and engaging with peers. They have to take sides and hence resort to being loners. Depression then takes toll of their life leaving them confused and alienated from members of the society. Some of the children also form weird behaviors that include keeping to themselves both at home and school. This affects their school performance to an extent of them having very poor grades and no friends. They also do not engage in any extra-curriculum activities, which in turn affect their physical and mental states.
- Axis V: Global Assessment of Functioning is an axis that allows clinicians to rate the overall functioning level of the client. This assessment has been valuable for clinicians in better understanding how the other four axes interact and affect the life of individuals (American Psychiatric Association, 2000, p. 705).
Mr. Z is divorced from his wife, but he has been given two nights to spend with his children. He considers this time short and is seeking for additional time, which the wife refuses to grant and hence, they decide to handle the matter in court. By so doing, they are exposing their children to other societal issues not manageable for their young ages. Divorce matters and custody arrangements should be handled by parents outside court in order to save their children from experiencing psychological tortures in future.
This tool is important only for those with specialized training and possesses sufficient experiences having qualifications of diagnosing and treating mental illnesses. It is also used by clinicians for purposes of billing, when approving payment for treatment government and insurance carriers requires specific diagnosis. For every evaluation carried out by medical health professionals, a diagnosis must accompany the report to clarify to the court and other individuals regarding the mental state of the patient in question. If necessary, the children also need to undergo a thorough medical examination exercise that justifies there mental state and other physical aspects to the court.
Parents given custody of their children ought to be mentally fit and financially stable to support them Mr. Z is proven to have the capability of taking care of his two children and has a san mind that befits raising young children. Doctors evaluating and diagnosing the clients on behalf of the evaluator collaborate in gathering as much information as is required in order to avoid any inconveniences that will later on affect the lives of their clients. The two young children in the case presented should be considered because, they are not of age, and thus, they need to be protected by the system and given the best care.
There are other forms of negative countertransference discussed by other authors, which include trauma cases in patients. Trauma is a condition that needs to be invigilated and cared for because, it involves the functioning of the brain. In class, other forms of countertransference situations include schizophrenia, which is mostly associated to the elderly people of the community. For patients suffering from trauma, major problems linked to the condition include rage, hostility, and anger. Counterhostility is one of the contertransference patterns linked to trauma patients. Moderate positive, admiring, apprehensive, overprotective, aggressive, erotic, distrustful, derogatory, and competitive are other examples of countertransference.
Identification, observation, and feedback are some of the common interventions for counter-transference used by medical professionals during their evaluation process. In the presence of countertransference reaction, evaluators are counseled against terminating the new founded relationship with the parent or child. Rather, the evaluator experiencing the countertransference should be assisted supportively by other group members in identifying his or her feelings and behaviors and recognizing the occurrence of the phenomenon. In order to improve the existing therapeutic relationship, evaluators need to offer their group members feedback about the relationship progression (Rotgers & Maniacci, 2006. p. 683). Evaluative and consultative sessions can be helpful for the evaluators after their CCEs encounter with the patient, in which, both they and group members observing the interactions, discuss and compare the exhibited behaviors in the relationship. Importantly, an evaluator who is helped identifying his own countertransference when dealing with a particular patient will be in a better position of recognizing and managing this on his or her own when they encounter other patients later on who evoke similar personal reactions.
The effects of countertransference on the patient and group members is important to recognize. If not managed properly, the phenomena can also affect the entire therapeutic environment. This is because; the rest of the therapeutic community of patients and group members may perceive the relationship to be positive or negative It is essential to facilitate group awareness and education programs regarding these phenomena in order to help ensure high quality of therapy and preserve the integrity of the therapeutic, evaluator-patient relationship.
Projective testing techniques resulting from standardized measures such as the Rorschach and the Thematic Apperception Test (TAT) provide useful data for evaluating several types of mental disorders. These test results are useful for disability evaluation if corroborated by other evidence, including other results from psychological tests, and obtained information in the course of the clinical evaluation, from treating and other medical sources, other professional health care providers, and nonmedical sources. Any inconsistency between test results and clinical history and observation should be explained in the narrative description.
Supervision is the best technique for a child custody evaluator to use for coping, assessment, and evaluation of countertransference conditions. He should be able to set a certain amount of time for each child in order to get relevant information concerning the father. The evaluator can decide to use observation as a tactical method of understanding how the children and father relate to each other. These two methods are widely used by evaluators and thus come up with a solution that is not biased. Countertransference is a condition that should be managed by evaluators in a professional way in order to reduce the chances of having to favor one side or judging according to past situations and events.
The child welfare department also comes in during such situations and therefore, grilling is expected. Parents are supposed to be available at all times to ease the process of evaluation and hence help the department in solving the issue in a timely manner. Child custody evaluators experience many challenges during countertransference but act professionally and consult other group members over possible solutions. This has been helpful in accommodating and evaluating the different situation they encounter. They are allowed to visit the father and children during their bonding session in order to determine the relationship existing between them. This is an avenue to ask questions by touching on sensitive subjects in way not likely to suggest that any fishy thing is being conducted. However, it should be noted that, the two children are at a very tender age of enquiring things. The parents should therefore develop a culture of being sincere and open with their children about their present situation. This builds a strong relationship and trust is gained, which is important for any long-term relationship to survive (Greer, 2004, p. 25).
As the children grow, they will learn to accommodate their pattern of living, but at some point, they will be forced to choose either party. During this difficult time, their evaluator should be ready and willing to offer his expertise and knowledge. The most challenging part for parents is when they are not open to discuss their pattern of living. They should all be comfortable with their arrangements in order to facilitate growth and development of their child’s brain. If not noted, the child might end up having severe parental issues in future that spills down to his children and other generations to come. It is therefore evident that, evaluators, parents and children all contribute to the success of the arrangement made by the courts and adults.
Children and parents of negative countertransference also undergo difficult times in coping with their stressful occurrences but are given counseling sessions by mental health professionals. At all times confidentiality is maintained and therefore clients are advised to be relaxed and open. Mr. Z was awarded more time to spend with his children by the evaluator after identifying the countertransference conditions prevailing in his case. This also gave a chance for the evaluator to assess his past situation, which clouded his judgment concerning the father’s emotional state of mind. It is evident that most evaluators with the same situation will deny the father a chance to spend more time with children. However, in this case the consultation meeting helps the evaluator to assess critically the situation by using the additional data retrieved form the clients past.
It is rewarding for clients to testify in court. In general, there are a number of ways described by different authors applied to CCE as positive professional aspects to becoming involved in forensic practice and expert witness testimony. The public presentation that provides expert witness testimonials validates the evaluator’s personal and professional self. Cross-examination during court sessions is challenging, and the evaluator must be intellectually quick in thinking and maintain mental flexibility of the clients. Court testimonials exhilarate a time of meeting intellectual and professional challenges. Legal systems have mental health professional working in their offices and get great satisfaction in feeling their sense of effectiveness and competence in the courtroom. Criticism from parents and attorneys over the evaluators report is expected but he should not always heed to their criticism, which leads to poor evaluation (Barsky & Gould, 2002, p. 85).
Scientists and researchers have contributed to the success of solving countertransference situations among patients and clients. The advancement of technology and other electronic equipments has enabled scientists conduct their experiments at home and even during their vacations by using the Internet. Use of CCTVs in homes and offices has gone a long way in solving issues related to pretence. The evaluation process acquires footage of the office and home camera and analyses the behavior of the client. The process of supervision and that of normal life without outside interference show different individuals, but some do not change their behaviors. This becomes easy for evaluators to use in assessing their potential abilities and recommendations made will linger on their normal lifestyle.
If Mr. Z has a busy schedule, he will not have time for the children and therefore, the needed time extension requested for will be useless. Custodial parents should not have baby sitters around because this is their best time of bonding and getting to know their children better. Parents should minimize their movements in order to engage in activities with their children and avoid missing their life development process. Male children will need guidance and counsel from their fathers and others see them as their role models. It is therefore important for Mr. Z to go for anger management sessions in order to prevent instances where he will burst out at his children. In addition, it will help him in interacting with other members of the society and hence, he will be able to forgive those people who have wronged him in the past.
In conclusion, countertransference reactions are observed in our behavior, thoughts physical symptoms, and emotional experiences. The quintessence of this reaction belongs to previous experiences of the evaluator, which are in-adequately processed and thus is projected in current relationships. Avoidance and compensatory behaviors are mostly associated with countertransference reactions. By realizing countertransference, evaluators avoid the reaction during supervision thus crucial in establishing real relationships. The CCEs also become more objective in their supervisory and therapeutic work. Evaluators’ level of competence is developed through adequate supervision and self-reflection measures of one’s work. Supervision is one of the techniques applied in solving countertransference reactions because they aid in understanding a person’s counter transference reactions, and managing them. During supervision, self-reflection aids in overcoming the reactions hence are crucial for overcoming therapy stagnation.
Having consistent awareness of our own thoughts and attitudes is the only way individuals can recognize countertransference especially during supervisory sessions since they influence our responsive behavior. Many at times, evaluators like to control their own emotions, but it is advisable for them to notice them in him/her and be able to consider the form taken during supervisory work. The thoughts and attitudes they are related to are also important to note. The DSM-IV TR manual has been used by many clinicians around the globe in detecting the prevailing problems associate with their patients. The five axes linked to this manual include the clinical syndromes, personality and mental retardation, medical conditions, psychosocial and environmental problems, and global assessment of functioning. All axes have disorders associated to them with varying signs and symptoms. They also have different prognosis and treatments.
Patients or clients affected by negative countertransference reactions need to cope with it or find medical solutions. However, they do not last forever since it is something that is psychologically developed. Observations and supervisions conducted by evaluators and supervisors aids in the evaluation and assessment process. Education and self-awareness of the therapist is also vital in coming up with a conclusive evaluation program.
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