Psychological climate and countertransference in psychiatric treatment homes.

The associations between milieu therapists' feelings towards patients and the unit's psychological climate were studied at 21 small treatment homes for severely disturbed psychiatric patients. The milieu therapists filled out self-report instruments where they rated their feelings towards patients on a feeling-word checklist and their opinion about the psychological climate on a Bion-based scale. Scores on the climate scale were used as independent variables in a series of regression analyses, with scores on the feelings as the dependent variables. It was found that a substantial component of the average differences between units with regard to feelings towards patients could be attributed to the unit's climate. Correlations showed that units characterized by "Work' and "Pairing' had high scores for helpful and autonomous feelings, while unhelpful feelings were evoked in units characterized by "Dependency' and "Fight'. Close feelings were evoked in units characterized by "Dependency'.