In the Process of Transference-Focused Psychotherapy: Application of an Observer Rating Grid for Object Relations Dyads on a Psychotherapy Session

Abstract Transference-Focused Psychotherapy is an evidence-based treatment for personality pathology developed within Kernberg’s object relations theory. To address severe identity disturbances, therapists identify pathological object relations dyads – self and other representations enacted in the therapeutic relationship – and facilitate their integration to promote a more coherent sense of self and others. Despite the central role of dyads in Transference-Focused Psychotherapy, no systematic assessment tool exists to evaluate their enactment in the therapeutic process. A reliable method for identifying specific self and other representations could support clinicians in maintaining adherence to Transference-Focused Psychotherapy and managing intense transference phenomena. We developed an observer rating grid inspired by the Core Conflictual Relationship Theme. This study presents the grid’s preliminary application to a psychotherapy session with a patient diagnosed with borderline personality disorder, comparing its outcome with the Core Conflictual Relationship Theme to highlight theoretical and methodological distinctions. Findings suggest that the dyads rating grid is a promising tool for Transference-Focused Psychotherapy, capturing complex relational dynamics that extend beyond the more explicit level of assessment of the Core Conflictual Relationship Theme, such as role reversal within a dyad or its pervasiveness. By promoting a detailed examination of psychotherapy processes, the grid may enhance case formulation and aid therapists in managing complex transference dynamics. Further application will refine and validate the tool, ultimately supporting research on Transference-Focused Psychotherapy effectiveness.