Project Details
Projekt
Negative Therapist Behavior in the Treatment of Personality Disorders
Applicant
Professor Dr. Christian Sell
Subject Area
Personality Psychology, Clinical and Medical Psychology, Methodology
Term
since 2025
Project identifier
Deutsche Forschungsgemeinschaft (DFG) - Project number 554905248
The project is situated within the framework of psychotherapy process-outcome research. It aims to model therapist contributions to negative treatment trajectories. We use observer-rating methods on recorded therapy sessions to capture negative therapist behavior (NTB). Additionally, we assess the quality of the therapeutic working alliance and the repair of ruptures within it. NTB refers to various types of therapy-interfering behavior by therapists. It is assumed to occur as a result of therapists' temporary or persistent failure to balance professional standards with their emotional responses to a patient. Therapists might, for example, become entangled in power struggles, withdraw from their patients emotionally, or show signs of boredom or cynicism. They will rarely be overtly inappropriate but rather show subtle deviations from what might be called 'good-enough' therapy. Therapists' overall ability to manage these deviations has been shown to correlate with therapeutic effectiveness, particularly in the treatment of personality disorders. This project is the first to systematically measure NTB through observer ratings and relate it to treatment process factors as well as treatment outcomes. Previous research on NTB has been very heterogeneous with regard to research paradigms and definitions. Therefore, the first part of the project comprises a systematic review of the antecedents, correlates, and consequences of NTB to date. For the two subsequent empirical studies, we will collaborate with a registered randomized controlled trial on cognitive behavioral therapy and psychoanalytic therapy for personality disorders. This collaboration grants us access to the study’s outcome data as well as recordings of all therapy sessions. Using a selection of these recordings, we will apply two observer-rating methods to assess NTB as well as rupture and repair processes in the therapeutic alliance. This approach has been successfully tested and refined by the applicant in three pilot studies. After the observer-rating procedure, the relationship between NTB, alliance rupture repair, and treatment outcome will be modeled statistically. While considerable research evidence exists on the phenomenon of NTB, openly admitting to its occurrence in one’s own everyday practice is still a taboo in large parts of the therapeutic community. In addition to advancing scientific knowledge about NTB, this project also aims to help lift the taboo surrounding it. Based on the study’s empirical results, we will elaborate on the clinical implications in scientist-practitioner workshops. Subsequently, we will derive detailed practitioner guidelines from the study’s results and complement them with a set of psychotherapy training videos on NTB, filmed with professional actors. This material will be made available online for teaching, therapist training, and ongoing professional development.
DFG Programme
Research Grants
International Connection
Austria, Switzerland, USA
