How the Therapeutic Alliance Influences Transference in Psychotherapy

Transference, or the act of transferring past experiences to someone or something else, namely, the therapeutic relationship, is a fundamental concept in psychotherapy. But the relationship between therapeutic alliance and transference has only recently been explored. In a new study led by P. Høglend of the University of Oslo, a team of researchers examined what effect the client-therapist relationship had on transference. “As psychoanalytic thinking has broadened to include more relational perspectives, the importance of the alliance has increased substantially,” said Høglend. “Most contemporary models of exploratory dynamic psychotherapy suggest that the effects of specific techniques are dependent on a positive therapeutic alliance.”

In their study, the team provided one year of psychotherapy to 100 clients exhibiting symptoms for anxiety, depression or personality disorders. Half of the group received therapy with transference methods and the other half received traditional psychotherapy. The clients were assessed using the Working Alliance Inventory and the Quality of Object Relations (QPR)-lifelong pattern. Additionally, the Psychodynamic Functioning Scales were used to assess the participants at baseline, at the conclusion of treatment and one year after. The results were in direct contrast to what they expected. “Unexpectedly, patients with more mature relationships and the ability to form a favorable alliance with the therapist did relatively better in the treatment that had no transference interpretations compared with the treatment that had transference interpretations,” said the team. “The conventional clinical wisdom in predicting psychotherapy outcome has been that patients with greater psychological resources and more mature relationships will benefit from transference interpretation.”

“However, this study indicates that transference work is crucial when treating patients with more severe and chronic difficulties in establishing stable and fulfilling relationships outside therapy and also difficulties in establishing a favorable alliance within therapy.” They added, “ Transference work may be helpful to the more disturbed patients’ understanding of the distortions they bring to the transference, such as fear of rejection, avoidance, dependency, need for over-control, and devaluation/idealization.”

Høglend, P., Hersoug, A. G., Bøgwald, K.-P., Amlo, S., Marble, A., Sørbye, Ø., Røssberg, J. I., Ulberg, R., Gabbard, G. O., & Crits-Christoph, P. (2011, August 22). Effects of Transference Work in the Context of Therapeutic Alliance and Quality of Object Relations. Journal of Consulting and Clinical Psychology. Advance online publication. doi: 10.1037/a0024863

© Copyright 2011 by By John Smith, therapist in Bellingham, Washington. All Rights Reserved. Permission to publish granted to

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  • Regan


    August 31st, 2011 at 1:07 PM

    Opening up to a therapist takes a lot of effort.Youre gonna have to say out everything that is on your mind and let the therapist into your mind and brain.So if there is a good relationship between you and the therapist you will find the process so much easier to go may even be impossible otherwise for some individuals.

  • zohra sadouni ghediri

    zohra sadouni ghediri

    September 2nd, 2011 at 1:15 AM

    Therapeutic alliance, transference, neutrality, countertransference,trust, opening up, etc….all need training and a long experience from therapists. Working with children, is another issue!

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