The Relationship Between Transference Interventions and Therapeutic Alliance in Psychodynamic Psychotherapy of an Adolescent

Abstract

Transference interpretations have the potential to address unconscious interpersonal conflicts that find reflection in the therapy relationship and improve the patient's psychosocial functioning; however, they should be practiced in the context of a strong therapeutic alliance so as to prevent adverse effects. Despite their conceptual relations, the impact of the therapeutic alliance on transference work in the treatment of adolescents has not been previously examined extensively. This study was the first to examine whether a strong therapeutic alliance predicted the use of transference interventions in a single case of adolescent psychodynamic psychotherapy. The case of the study was a 16-year-old Turkish adolescent male, with anxiety and attention problems. A total of 57 sessions that cover his entire treatment were transcribed and coded for both therapeutic alliance via the Therapy Process Observational Coding System-Alliance Scale and transference interventions by the Transference Work Scale. Time Series Granger Causality Tests indicated that transference interventions that address the therapist directly in the interpretation were used only when therapeutic alliance was stronger. Strong therapeutic alliance may provide the necessary context for the therapist to use transference interpretations that contain elements of the here-and-now relationship.