Transference-focused psychotherapy

Domain I · Psychodynamic & depth psychology · Yeomans, Clarkin, Kernberg · 2002

What it is

Transference-focused psychotherapy (TFP) is a manualised, twice-weekly psychodynamic therapy for borderline personality organisation, built on Kernberg's object relations theory. The model says the patient's inner world is organised as split, affect-charged dyads: a self-representation and an…

Format

• Format. Individual, face-to-face, two sessions a week (usually 45–50 min), typically lasting 1–3 years]. A contract is negotiated before therapy proper begins, and the therapist is supervised against an adherence/competence scale.
• Get parallel information from prior treaters.

Who practises it, and how they are trained or regulated

• Transference-focused psychotherapy (TFP) is a manualised, twice-weekly psychodynamic therapy for borderline personality organisation, built on Kernberg's object relations theory. The model says the patient's inner world is organised as split, affect-charged dyads: a self-representation and an object-representation linked by an affect, for example a victimised self with a sadistic persecutor, held together by fear…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Does it use a device, heat, cold, water or a physical procedure? Has a medical professional checked that it is safe for you?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• The therapist taking sides against other treaters.
• Abrupt termination by the patient as the final enactment.
• Shallow agreement (compliance dyad) or sudden devaluation, both of which are interpretable.
• Collusion. Pretending not to notice teaches that you can be deceived, which confirms the dyad.
• Early genetic interpretation can "foster regression". Blame of parents can replace self-reflection.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.