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Transference and Countertransference

Level of activity: Intermediate

Setting: APPE (Psychiatric)


ACPE Standards 2016: 1.1, 2.1, 3.5, 3.6, 4.1, 4.4

EPAs: Patient Care Provider (collect, analyze, care planning), Self-Developer (create CPD plan)

PPCP: Collect, Assess, Plan, Implement, Follow-up

Instructors can request access to the Instructor's Guide on AccessPharmacy. Email Customer Success ( for more information.


Melissa C. Palmer, PharmD, BCPS, BCPP, is Clinical Assistant Professor at the University of Missouri-Kansas City (UMKC) School of Pharmacy. Dr. Palmer received her Doctor of Pharmacy degree from UMKC School of Pharmacy. She completed a PGY1 pharmacy practice residency followed by a PGY2 psychiatry residency at the Chillicothe VA Medical Center in Chillicothe, Ohio. She became a Board-Certified Pharmacotherapy Specialist in 2017 and a Board-Certified Psychiatric Pharmacist in 2018. Dr. Palmer’s practice site is at North Kansas City Hospital (NKCH) in North Kansas City, Missouri, where she functions as the psychiatric pharmacist on a psychiatric consult liaison team. In addition to providing patient care, Dr. Palmer precepts Introductory Pharmacy Practice Experience (IPPE) students, Advanced Pharmacy Practice Experience (APPE) students, NKCH PGY1 residents, and psychiatry PGY2 residents from the Center for Behavioral Medicine.

Brief Overview and Setting

The purpose of this activity is to introduce the concepts of transference and countertransference to experiential students, as well as apply self-evaluation and reasoning skills to assess the impact of these concepts on patient communication. Transference is the unconscious process in which someone transfers previously experienced emotions in the context of historical life events onto a current interaction. In the health care setting, this pertains to patients transferring emotions onto health care professionals (HCPs).1 Conversely, countertransference is the emotions and feelings that occur in the HCP toward the patient.1 These emotions and feelings can impact patient communication, which in turn could affect outcomes. Currently, transference and countertransference are not topics covered in the didactic curriculum although fall P1 students take a course entitled Patient-Centered Care and Ethical Practice, which includes topics such as motivational interviewing, counseling for adherence, and holding difficult conversations. This activity currently takes place with two fourth-year APPE students during completion of a month-long psychiatric rotation with the chapter author. The primary purpose of the activity is to identify situations in which patient care is impacted by interpersonal factors.

Learning Objectives

  1. Explain and differentiate the concepts of transference and countertransference.

  2. Identify patient interactions that may be impacted by transference and/or countertransference.

  3. Describe the impact of transference and countertransference on the ability of the interviewer to build and maintain patient rapport.

  4. Devise strategies to overcome patient communication barriers secondary to countertransference.

Instructor Assignment Description

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Activity Requirements Details

Numbers and types of facilitators

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