Transference Assessment in Psychotherapy: A Systematic Review

Abstract

Transference, initially introduced by Sigmund Freud, represents a crucial concept in psychoanalysis, referring to the displacement of feelings, fantasies, and desires from past relationships onto the therapist. Though central to psychoanalytic therapies, transference is acknowledged across many psychotherapeutic approaches, albeit with differing views on its clinical relevance. Empirical research has shown that transference phenomena occur in all close relationships, including therapeutic settings, and are influenced by factors like the patient's attachment style. While the relationship between transference and therapy outcomes remains ambiguous, insights gained from transference work—particularly through its interpretation—are seen as beneficial to therapeutic progress, enhancing patient's awareness and improving treatment results. This systematic review examines the development and validation of 15 assessment tools for measuring transference, offering a comprehensive overview of instruments used across various psychotherapies. The tools vary in their method of data collection, including observational ratings, clinician reports, and patient self-reports. The review highlights the need for further studies comparing these instruments, exploring their effectiveness across different patient populations, and addressing the relationship between transference and therapeutic alliance to improve clinical practice.