Therapist Feelings of Incompetence: Their relationship to the Working Alliance and Treatment Outcome.

This study set out to explore therapist feelings of incompetence (FOI) in the therapeutic process from both a quantitative and qualitative perspective. While previous studies have explored therapist descriptions of such feelings, this is among the first attempts to look at the role of these specific feelings in an individual therapy session using therapist and patient data. The results revealed that therapist feelings of incompetence impact the working alliance directly and outcome change indirectly, through the working alliance. Furthermore, qualitative analysis suggested that therapist feelings of incompetence might be associated with specific avoidant behaviors which may negatively impact the working alliance. Next, this study proposed possible remedies for these avoidant behaviors, from training in reflective listening to deliberate practice focused on tolerating unpleasant emotions. Future directions for research might focus on looking at FOI across whole treatments and the role of these feelings in alliance rupture and repair