MFT & LCSW Exam Prep: Gain a Better Understanding of Transference and Countertransference

By Bethany Vanderbilt on September 19, 2012

a silhouette of two people conversing. It's Tuesday, so if you're studying for the LCSW exam or the MFT exam, it's time for a hot topic to keep your brain on its toes.  This week, we're looking at the topic of transference and countertransference in clinical work.  These are issues that you should be able to identify and manage -- not just on the exam, but in real life. Let's take a look at how it might come up on the MFT & LCSW exams.


A therapist begins working with a client around issues of career progress and conflicts with employees.  The client spends the first two sessions talking negatively about a particular employee who is gay, saying repeatedly, "I wish I could fire him -- I just don't want to be around those people, you know?"  The therapist, who is also gay, finds himself hoping that the client won't show up for subsequent sessions.  What should the therapist do NEXT to address the situation?

A. Disclose the therapist's sexual orientation to the client and explore the impact on treatment

B. Continue seeing the client without discussing the therapist's sexual orientation

C. Manage the countertransference through journaling exercises

D. Seek consultation to address the therapist's feelings

If you're interested in the Social Work Dictionary's definition of countertransference and a discussion about the term, see Emily Pellegrino's blog post here.  Beyond the definition, what do the folks making the MFT and LCSW exams want you to know?  Well, they want you to be able to identify situations in which a therapist is having feelings toward a client that may, if unattended, negatively impact the treatment.  These feelings could be positive or negative, conscious or unconscious -- it's important to monitor our work with clients and try to understand the feelings that come up in our work.  On the MFT and LCSW exams, this real-life skill translates quite easily -- if you see evidence of a therapist having feelings toward a client that are related to the therapist's own background or personal situation, you'll likely want to look for answers that involve managing and understanding these feelings.  In many cases, this will be achieved through consultation with colleagues.


The best answer to the question above is D: seek consultation to address the therapist's feelings.  A is not the best answer because self-disclosure on the therapist's part in this case may not be the best course of action, particularly if the therapist has negative feelings toward the client that have not been processed.  B is not the best answer because if left unattended, the therapist's negative feelings will almost certainly adversely affect the client's treatment.  C is not the best answer because the the therapist's feelings are already impacting treatment (in that the therapist is hoping he won't have to deal with the client) and so an intervention beyond personal journaling is necessitated.

Coming up next week: Records

Think our straightforward, sensible approach could help you PASS your social work or MFT exam? If you're preparing for a social work exam, check out our Social Work Study Materials. If you're preparing for an MFT exam, check out our MFT Study Materials. Learn more about our offerings at The Therapist Development Center.

Looking for more practice questions and some study tips? Check out our new Social Work Exam Study Guide:

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