Counter-transference in psychiatric nurses caring for persons with dual diagnosis

2.50
Hdl Handle:
http://hdl.handle.net/10755/157418
Type:
Presentation
Title:
Counter-transference in psychiatric nurses caring for persons with dual diagnosis
Abstract:
Counter-transference in psychiatric nurses caring for persons with dual diagnosis
Conference Sponsor:Western Institute of Nursing
Conference Year:2003
Author:Dumas, Robert
P.I. Institution Name:Fitchburg State College,
Title:Assistant Professor
Contact Address:160 Pearl Street, Fitchburg, MA, 01420-2697, USA
Contact Telephone:978.665.3026
Co-Authors:Boersma, R. R.
Background: Annually, 10 million adults qualify for the "dual diagnosis" of a concurrent mental and addictive disorder. Persons with dual diagnosis (PWDD) have a more chronic illness course than those with a single diagnosis, and in 1998 accounted for 8.9% of national healthcare costs. Nurses care for PWDD in all settings, but most often in psychiatric settings. Central to providing quality psychiatric care is establishing and maintaining a therapeutic relationship with patients. Key to that relationship is attention to the concept of countertransference. The clinical conception of countertransference views it as a clinician's emotional response to a patient, and it is generally held that negative emotional responses to patients adversely influences treatment outcomes. The scant research on emotional responses to persons with the single diagnosis of addictive disorder by generalist nurses and non-nurse, addiction specialists indicates providers often have negative emotional reactions to this population that closely resemble the phenomenon of countertransference. Problem Statement: The first step in countering negative emotional responses is their identification. Currently, there is no published research on psychiatric nurses' emotional responses to PWDD. The purpose of this descriptive pilot study was to assess the feasibility of using the Rating of Emotional Attitudes to Clients by Therapists (REACT) scale (Najavits & Colson, 1992), to identify countertransference responses to PWDD by psychiatric nurses in the inpatient psychiatric setting. Methods: Peplau's interpersonal theory of nursing was the theoretical framework for this study: its central premise is that the nurse-patient relationship is an intervention that positively or negatively influences patient outcomes. A convenience sample of 11 psychiatric, inpatient-employed for more than 1 year, RNs completed the REACT; a 40-item, forced choice rating across 4 subscales of their emotional responses to caring for PWDD. The reported reliability of the REACT in studies of cognitive psychotherapists, supportive-expressive psychotherapists, and 12-step drug counselors emotional responses to persons with substance addiction was .82, .80, and .81 respectively (Najavits, et al., 1995). Findings: Participants reported no difficulties completing the REACT. Results indicate psychiatric nurses in this sample experienced many more negative than positive emotional responses to caring for persons with a dual diagnosis. Conclusions: The REACT is likely an appropriate instrument for assessing psychiatric nurses countertransference reactions to PWDD. Further testing of the REACT is required to establish its reliability and validity for determining countertransference responses in psychiatric nurses. Research on nurses' emotional responses to PWDD will benefit nursing practice by identifying the nature of countertransference with this population.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleCounter-transference in psychiatric nurses caring for persons with dual diagnosisen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157418-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Counter-transference in psychiatric nurses caring for persons with dual diagnosis</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2003</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Dumas, Robert</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Fitchburg State College,</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Assistant Professor</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">160 Pearl Street, Fitchburg, MA, 01420-2697, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">978.665.3026 </td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">rdumas@fsc.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Boersma, R. R. </td></tr><tr><td colspan="2" class="item-abstract">Background: Annually, 10 million adults qualify for the &quot;dual diagnosis&quot; of a concurrent mental and addictive disorder. Persons with dual diagnosis (PWDD) have a more chronic illness course than those with a single diagnosis, and in 1998 accounted for 8.9% of national healthcare costs. Nurses care for PWDD in all settings, but most often in psychiatric settings. Central to providing quality psychiatric care is establishing and maintaining a therapeutic relationship with patients. Key to that relationship is attention to the concept of countertransference. The clinical conception of countertransference views it as a clinician's emotional response to a patient, and it is generally held that negative emotional responses to patients adversely influences treatment outcomes. The scant research on emotional responses to persons with the single diagnosis of addictive disorder by generalist nurses and non-nurse, addiction specialists indicates providers often have negative emotional reactions to this population that closely resemble the phenomenon of countertransference. Problem Statement: The first step in countering negative emotional responses is their identification. Currently, there is no published research on psychiatric nurses' emotional responses to PWDD. The purpose of this descriptive pilot study was to assess the feasibility of using the Rating of Emotional Attitudes to Clients by Therapists (REACT) scale (Najavits &amp; Colson, 1992), to identify countertransference responses to PWDD by psychiatric nurses in the inpatient psychiatric setting. Methods: Peplau's interpersonal theory of nursing was the theoretical framework for this study: its central premise is that the nurse-patient relationship is an intervention that positively or negatively influences patient outcomes. A convenience sample of 11 psychiatric, inpatient-employed for more than 1 year, RNs completed the REACT; a 40-item, forced choice rating across 4 subscales of their emotional responses to caring for PWDD. The reported reliability of the REACT in studies of cognitive psychotherapists, supportive-expressive psychotherapists, and 12-step drug counselors emotional responses to persons with substance addiction was .82, .80, and .81 respectively (Najavits, et al., 1995). Findings: Participants reported no difficulties completing the REACT. Results indicate psychiatric nurses in this sample experienced many more negative than positive emotional responses to caring for persons with a dual diagnosis. Conclusions: The REACT is likely an appropriate instrument for assessing psychiatric nurses countertransference reactions to PWDD. Further testing of the REACT is required to establish its reliability and validity for determining countertransference responses in psychiatric nurses. Research on nurses' emotional responses to PWDD will benefit nursing practice by identifying the nature of countertransference with this population. </td></tr></table>en_GB
dc.date.available2011-10-26T19:51:17Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T19:51:17Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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