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Countertransference, it is widely agreed can either deepen awareness of personal and relational dynamics to the benefit of the work or it can distort and become an impediment through the adoption of defences. The aim of this study was to explore what supported the development of countertransference awareness in an organisational context through a qualitative study. Semi-structured interviews were conducted with 15 therapists either face to face or online. The findings indicate that participants followed one of two pathways, a reflective pathway, where they developed their countertransference awareness to the benefit of the work, and a defensive pathway, the focus of the present paper. Here, the findings suggest that when the organisational setting, the supervisory relationship, and the adopted theoretical framework, did not support the thinking about the relational dynamics, including countertransferential responses, it resulted in the adoption of defences, to the detriment of the work with the client. The implication of the findings, including the limitations of the study and avenues for further research, are also discussed. [ABSTRACT FROM AUTHOR]

Background: Many people who experience mental distress will receive a psychiatric diagnosis following assessment. However, while the utility of diagnosis continues to be debated, the impact of diagnosis on the therapeutic relationship has yet to be considered. Aim: The purpose of this research was twofold: to explore how working with diagnosed clients is experienced by counselling psychologists; and to formulate an explanatory theory of this process. Methodology: This was a qualitative study using semi-structured interviews and a grounded theory methodology. Fourteen Chartered Counselling Psychologists and one Chartered Clinical Psychologist were interviewed about their experiences of working with diagnosed clients. Findings: Participants adopted one of three responses to diagnosis; 'uncritically adopting diagnosis', 'challenging diagnosis', and 'compromising through pragmatic positioning'. Attempting to integrate the opposing paradigms of the counselling psychology philosophy and the medical model resulted in ideological dilemmas and uncertainty which compromised the therapeutic relationship and undermined the counselling psychologists' professional identity. Conclusions: The process outlined in this study suggests that working with clients who have a psychiatric diagnosis creates uncertainty and ideological dilemmas. Clinical implications, limitations of the study, and suggestions for further research are discussed. [ABSTRACT FROM AUTHOR]