If you’re preparing for your ASWB Clinical Social Work Exam, transference and countertransference are two topics you definitely want to familiarize yourself with. As a coach I get a lot of questions on the differences between these two topics. Many social workers confuse the definitions of transference and countertransference and assume both warrant the same response. As we'll discuss throughout this blog, transference and countertransference require very different actions both on the exam and in real life.
What is Transference?
Transference is a dynamic that occurs in therapy between the client and the therapist. Transference is when the client redirects (transfers) an unconscious feeling, desire, or expectation from another person toward their therapist. For example, a therapist may remind a client of her mother. Then, without the client even realizing it, she begins engaging with the therapist as she does her own mother. Transference can actually help the therapist identify patterns of relational interaction occurring in the client's life.
Is Transference a Cause for Concern: How Should We Respond to Transference on the Exam?
When you see transference on the exam (or in real life), don't panic! Transference is a common occurrence in therapy and is not a cause for alarm. If you see a question on transference on the exam, you generally are not going to jump to anything drastic (like referring out to another therapist). Instead, you can actually use transference therapeutically. If a client is interacting with you as they interact with their mom (or dad or spouse or child or coworker, etc.), you can use this as an opportunity to explore these relational dynamics and patterns in therapy. Because transference is about the client and not about us, it is okay to use it therapeutically.
What is Countertransference?
So how does countertransference differ from transference? Countertransference is essentially the reverse of transference. In contrast to transference (which is about the client's emotional reaction to the therapist), countertransference can be defined as the therapist's emotional reaction to the client. Similarly to transference, countertransference is a common occurrence in therapy. Because of this, it is essential that we as therapists are aware of how countertransference may be showing up in therapy. We may observe countertransference occurring when we have a strong emotional reaction towards a client. One common example of countertransference is when a therapist finds herself feeling protective and parental towards a client, as that client may be reminding her of her own child (or someone else she feels protective of in her life). Another example is when a client rubs you the wrong way. This may actually be you experiencing countertransference towards the client as they remind you of another person in your life who incites a similar emotional response from you.
How Should We Respond to Countertransference on the Exam?
It is important to know that on the exam we are NOT going to respond to countertransference the same way we respond to transference. While we can use transference therapeutically with the client (because it is about the client) we do not use countertransference in therapy. Countertransference is about us, the therapist, so we are NOT going to discuss it with the client. On the exam, the most common FIRST action you will take in response to countertransference is seeking consultation/supervision. Seeking consultation/supervision allows you to work through your feelings of countertransference. This helps ensure our countertransference is dealt with appropriately and doesn't impact our client or the therapeutic relationship.
Additionally, there may be times a therapist seeks their own therapy in response to countertransference issues that arise. The hope is that consultation/supervision and/or our own therapy will be enough to manage our countertransference. However, if both of these techniques are utilized and the therapist is still unable to manage their emotional reaction to the client, it may be necessary to refer the client to another therapist. Know that this is a last resort and not the first step we would take on an exam question.
Finally, we are going to use the same LMSW/LCSW practice question to look at two different ways a question on transference/countertransference could show up on the exam. Let's see how you do on today's practice question:
ASWB Practice Question 1:
A social worker has been meeting with a 28-year-old woman for the past six months to work on issues of depression and suicidal ideation. The social worker observes that on days that she meets with this client, later in the day she spends a lot of time thinking about death and experiences a lower mood. What is this an example of?
A. Poor Boundaries.
D. Trauma Response.
(scroll down for answer)
The correct answer is C, countertransference. The therapist is having an emotional reaction to what the client is sharing.
ASWB Practice Question 2:
A social worker has been meeting with a 28-year-old woman for the past six months to work on issues of depression and suicidal ideation. The social worker observes that on days that she meets with this client, later in the day she spends a lot of time thinking about death and her mood is lower. What should the social worker do FIRST?
A. Use her emotional reaction to explore how the client’s suicidal ideation may be impacting those around her.
B. Seek supervision.
C. Begin meeting with an individual therapist.
D. Refer the client to someone who specializes in depression and suicide.
(scroll down for answer)
The correct answer is B, to seek supervision. A is inappropriate because we should not be using countertransference (which is about our emotional reactions as the therapist) in therapy. Although it is possible that the therapist may begin their own therapy (C) at some point, this isn’t the FIRST thing we would do. Individual therapy is something that could be discussed in supervision as one way to manage the therapist's countertransference. D is premature, as the therapist and client have been meeting for 6 months and have an established relationship. At this point, there is no need to refer out.
Masters and Clinical ASWB Exam Preparation
How did you do with these questions on transference/countertransference? Whether you’re preparing for your LMSW or LCSW exam, our ASWB social work exam prep programs will prepare you for any transference/countertransference questions on your exams. If you’re struggling with this topic (or any other topic), no worries! Every TDC customer is paired with a coach who you can email anytime you have questions or need additional explanations. TDC has helped THOUSANDS of social workers pass their ASWB clinical licensing exams and we can help you pass, too. If you haven’t already, be sure to check out our reviews from some of the THOUSANDS of social workers we have helped become LMSWs and LCSWs!
I have test anxiety and although I read clearly that countertranfernce was the most likely correct question on #1 i chose trauma response. I tend to second guess and get anxious.
Hi Tiffany, You are welcome to email me through the 'ask a coach' form in your study center or directly at email@example.com for some suggestions for managing test anxiety.
I like Tiffany chose trauma response. I thought they were saying the client spends a lot of time thinking about death and experiences a lower mood.
Countertransference is a stronger answer option. There is no evidence that the trauma has occurred; the DSM-5 definition of trauma requires “actual or threatened death, serious injury, or sexual violence” which is not described in the question stem.