When Is Transference Work Useful in Psychodynamic Psychotherapy? Main Results of the First Experimental Study of Transference Work (FEST)

Abstract

This article presents the main results of the First Experimental Study of Transference (FEST). The background of the study, as well as the aims, main hypotheses, and methods are described. The participants were 100 patients who were randomized to psychodynamic psychotherapy of one year's duration, with transference work or without transference work. The analyses of the effects of psychodynamic psychotherapy with transference work versus psychodynamic psychotherapy without transference work are presented. The two treatments were equally effective, but analyses of moderators revealed differential effects. Patients with low quality of object relations (QOR) and/or presence of personality disorder showed specific positive effects of transference work. Female patients responded better than men. Further analyses included mechanisms of change and three-way interactions among factors, with an impact on outcome. We also found that (1) insight was a mediator of change, and (2) that the specific effects of transference work were influenced by interaction of object relations and alliance, but in the direct opposite direction of what is generally maintained in mainstream clinical theory. For patients with more mature object relations and high alliance, a negative effect of transference work was observed.

Keywords:

• transference work
• psychodynamic
• alliance
• personality disorder
• insight
• quality of object relations

Additional information

Notes on contributors

Anne Grete Hersoug

Anne Grete Hersoug, Psy.D., Ph.D., is a specialist in clinical psychology. She works as a psychotherapist and psychotherapy supervisor, and as a senior researcher at the University of Oslo. Her recent research has focused on therapeutic alliance and the development of interpersonal relationships in psychodynamic psychotherapy with depressed adolescents.

Randi Ulberg

Randi Ulberg, M.D., Ph.D., is a specialist in psychiatry and works as a psychotherapy supervisor. She holds a research position in Vestfold Hospital Trust, Norway. Her research is mainly focused on the effects of transference work in adults and adolescents. She is the head of an ongoing study on psychodynamic psychotherapy for depressed adolescents.

Per Høglend

Per Høglend, M.D., Ph.D., is a professor of psychiatry at the University of Oslo, Norway. His research projects are within psychodynamic psychotherapy for adults, with a main focus on differential effects of transference work for different groups of patients. He has published 120 scientific papers with a broad range of subjects.