The unprecedented global crises of recent years have cast profound shadows over mental health practices worldwide, forcing psychotherapists to navigate not only their clients’ turbulent emotions but also their personal reactions as they provide care. Addressing this intricate dynamic, a groundbreaking multinational qualitative study led by Nassif, Radjack, Beaini, and colleagues delves deeply into the shared realities that emerge between therapists and clients during periods of widespread distress. Published in the latest issue of BMC Psychology, this comprehensive research illuminates the subtle yet powerful interplay of therapeutic settings and countertransference phenomena when societies face collective hardship.
Psychotherapy has traditionally been viewed through the lens of individual therapeutic dyads, with a focus on the patient’s inner world and the therapist’s professional stance. However, the COVID-19 pandemic, political upheavals, and environmental disasters have redefined this paradigm, creating a shared atmosphere of uncertainty and anxiety. This study underscores how therapists themselves become entwined in the global emotional landscape, influencing and being influenced by their clients’ narratives. By collecting and analyzing rich qualitative data from experts across different nations, the authors provide a nuanced understanding of how therapeutic boundaries are simultaneously challenged and reinforced when the therapist and client inhabit overlapping realities.
Central to the work is the exploration of countertransference—traditionally defined as the therapist’s unconscious emotional response to the client—which gains new dimensions in crisis contexts. Therapists report experiencing heightened emotional resonance and empathic distress, often exacerbated by remote therapy modalities necessitated by lockdowns. The authors reveal that the typical safeguards therapists rely upon become insufficient as personal and professional stressors merge, demanding therapists to develop innovative coping strategies and recalibrate their clinical approaches. This research vividly illustrates that countertransference in these times cannot merely be regarded as a clinical phenomenon but must be seen as a complex, multilayered process deeply embedded in sociocultural realities.
The multinational nature of the study grants a unique breadth to its insights. By including psychotherapists from diverse cultural and sociopolitical backgrounds, it documents how external stressors manifest heterogeneously yet reveal universal threads. For instance, therapists in countries experiencing political instability highlight the compounded emotional burdens arising from fears about safety and justice, while therapists in regions more heavily impacted by pandemic-related mortality describe pervasive grief and survivor guilt within their therapeutic practices. This comparative perspective enriches the study’s conclusions, advocating for a flexible, culturally sensitive understanding of therapeutic dynamics in crises rather than a one-size-fits-all model.
Notably, the study also scrutinizes how different therapeutic settings—ranging from in-person clinical offices to virtual platforms—transform the therapeutic encounter itself. The sudden necessity for digital teletherapy raised ethical and practical challenges, including managing confidentiality, addressing technological barriers, and preserving empathic attunement through screens. Therapists recount feelings of alienation and frustration yet also identify novel opportunities for connection, such as witnessing clients’ home environments or integrating creative digital tools into sessions. These technological adaptations reveal enduring resilience as therapists strive to maintain therapeutic efficacy despite profound alterations in setting and routine.
Beyond immediate clinical implications, the research highlights the broader systemic and institutional factors impacting psychotherapists during crises. Many report insufficient organizational support, increased workloads, and inadequate supervision, aggravating professional burnout. The authors call for enhanced structural frameworks that prioritize therapists’ mental health and provide resources tailored to crisis contexts. Such frameworks might include specialized training for managing collective trauma, peer support networks, and policies fostering work-life balance amid intensified demands. Recognizing therapists as vulnerable individuals—not only clinical agents—is crucial for sustaining the mental health workforce in ongoing and future crises.
Delving further, the study investigates the embodied experience of therapists, underscoring how physical and emotional exhaustion manifest somatically. Therapists describe manifestations such as disrupted sleep, heightened anxiety, and emotional numbness, mirroring the distress of their clients yet compounded by the responsibility to remain professional and available. This somatic dimension of countertransference reveals the bidirectional nature of therapeutic relationships, where therapist and client bodies are subtly attuned to one another’s states. The research advocates for embedding somatic awareness and self-care practices within therapeutic training as preventive measures against compassionate fatigue.
Another compelling aspect addressed is the role of shared realities—those collective understandings and emotional atmospheres co-constructed by therapists and clients within sociocultural milieus. During times of crisis, these shared realities become intensified and complex, mediating how clients narrate their experiences and how therapists interpret and respond. The study suggests that ethical mindfulness requires therapists to continuously negotiate these shared spaces without imposing personal biases, maintaining a delicate balance between empathy and professional distance. This conceptual expansion fosters a more dynamic view of psychotherapy, one that acknowledges the profound influence of collective contexts on individual healing processes.
The study’s methodological rigor stands out, employing in-depth interviews, thematic analysis, and cross-country comparisons to ensure robust qualitative data. The authors emphasize methodological reflexivity, acknowledging their own positionalities and pandemic-era limitations to preserve analytic transparency. This commitment strengthens the validity of the findings and models best practices for crisis-informed psychotherapy research. Moreover, by situating psychotherapy within global sociopolitical currents, the study bridges the gap between micro-level therapeutic phenomena and macro-level social realities.
Importantly, the findings advocate for integrating crisis-responsive frameworks into mainstream psychotherapeutic theory and practice. Traditional clinical models often prioritize intrapsychic factors divorced from external chaos, yet this study foregrounds the necessity of including systemic stressors and collective trauma. The authors propose that crisis adaptation requires therapists to adopt a flexible stance: honoring individual psychodynamics while acknowledging community-wide disruptions. Such integration might reshape therapeutic goals, laying greater emphasis on resilience-building, existential meaning-making, and adaptive coping within an unstable world.
The article also highlights the implications for supervision and training programs, encouraging the inclusion of crisis-specific curricula and the development of competencies related to countertransference awareness during shared trauma. Supervisors need to be particularly attuned to the evolving challenges therapists face, fostering environments for open dialogue and mutual support. Training programs should prepare early-career clinicians for the emotionally charged landscape of global crises, equipping them with tools for digital therapy and self-care. Ultimately, such educational reforms may strengthen the therapeutic alliance and safeguard practitioner well-being.
Discussion within the article extends to the ethical tensions emerging in crisis psychotherapy, such as managing confidentiality amid virtual sessions or balancing therapist transparency with professional boundaries. Therapists must continuously negotiate ethical dilemmas, often without clear guidelines adapted to unprecedented conditions. The authors call for professional bodies to update ethical standards and develop accessible protocols responsive to emerging challenges. By addressing these concerns, the psychological community can foster safer, more effective therapeutic environments that honor both client and therapist needs.
Additionally, the nuanced exploration of cultural variability in therapeutic responses enriches intercultural competence discourse. Therapists working in collectivist societies report a more pronounced sense of communal burden, whereas those in individualistic cultures may experience isolated professional vulnerabilities. These distinctions underscore the importance of context-sensitive interventions and highlight the interdependence of cultural values and therapeutic practices. Future research is encouraged to further dissect these cultural dynamics to optimize global mental health responses during crises.
Ultimately, the study by Nassif and colleagues serves as a catalyst for reimagining psychotherapy in the 21st century’s era of recurrent global upheaval. It elevates the voices of therapists at the frontline of emotional crises, revealing their resilience and humanity. In doing so, it calls on the mental health field to innovate clinical models, strengthen support infrastructures, and cultivate greater empathy for the professional caregivers entrusted with guiding individuals through shared trauma. This timely research provides a critical roadmap for sustaining psychotherapy’s transformative power amidst ongoing collective challenges.
Subject of Research: Psychotherapists’ experiences of shared realities, therapeutic settings, and countertransference during global crises.
Article Title: Shared realities, therapeutic settings, and countertransference in times of crisis: a multinational qualitative study of psychotherapists’ experiences.
Article References: Nassif, R.M., Radjack, R., Beaini, N. et al. Shared realities, therapeutic settings, and countertransference in times of crisis: a multinational qualitative study of psychotherapists’ experiences. BMC Psychol 13, 626 (2025). https://doi.org/10.1186/s40359-025-02962-z
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