Doctor-Patient Transference Matrix

Abstract

The Doctor Patient Transference Grid, developed by A. H. Crisp in 1964, is a specialized psychological instrument designed to quantify and assess an individual’s transference attitudes specifically directed toward medical doctors. This scale is fundamentally rooted in the repertory grid technique originally pioneered by George Kelly and subsequently adapted by Bannister.

The methodology requires participants to evaluate 20 significant individuals, known as elements, comprising 10 predefined obligatory figures and 10 self-chosen figures. These elements are then rated against various psychological constructs, such as “ideal dependable parent” or specific analogies like “like Dr. So-and-so.” A validation study conducted upon its initial development indicated that clinical predictions derived from the test results were substantially fulfilled, achieving either a statistically significant level or a strong trend, thereby supporting its utility in clinical settings.

Keywords

Doctor Patient Transference Grid, Transference, Repertory Grid, George Kelly, Clinical Assessment, Psychosomatic Research, Patient-Physician Relationship, Construct Assessment

Authors

Crisp, A. H.

Purpose

The primary purpose of the Doctor Patient Transference Grid is to provide a structured, quantifiable assessment of the psychoanalytic phenomenon of transference as it manifests in the therapeutic or medical relationship between a patient and their doctor. It seeks to operationalize complex relational dynamics that might influence treatment compliance, patient expectations, and overall engagement with healthcare providers.

By using the established framework of the repertory grid technique, the instrument aims to map the patient’s internalized relationship templates—often derived from early life figures—onto the figure of the physician, offering insights into potential counter-therapeutic relational patterns.

Construct

The core psychological construct measured is Doctor Patient Transference. Transference, in this context, refers to the unconscious redirection of feelings, attitudes, and expectations from significant past figures (such as parents or siblings) onto the doctor.

The grid structure allows for the measurement of how specific past relational patterns (represented by the 20 figures/elements) are projected onto the medical professional, thus providing an empirical measure of this key psychoanalytic concept within a medical context. The constructs used in the grid are designed to elicit these specific relational comparisons.

Validity

While formal, modern psychometrics validity coefficients (such as criterion or convergent validity indices) are not explicitly provided in the original source documentation, the initial validation study conducted by Crisp (1964) offered preliminary evidence of utility.

This study demonstrated that predictions made based on the results of the Transference Grid were largely borne out in subsequent observation or clinical outcomes. Specifically, these predictions were fulfilled either at a statistically significant level or indicated a strong predictive trend, suggesting that the grid possesses a degree of predictive validity relevant to clinical application.

Reliability

Information concerning the psychometric reliability of the Doctor Patient Transference Grid, such as measures of internal consistency (e.g., Cronbach’s alpha) or test-retest stability, was not indicated or published in the foundational research by Crisp (1964). Further research utilizing modern psychometrics would be required to establish the scale’s consistency and dependability across different administrations and populations.

Factor Analysis

No factor analytic studies or structural analyses were indicated in the available source material regarding the Doctor Patient Transference Grid. Since the instrument utilizes the repertory grid technique, which focuses on personal construct systems rather than fixed factor structures, traditional factor analysis might be less applicable, though principal components analysis is often used within grid methodology to explore underlying dimensions.

Instrument

Test Type: Task / Projective Technique (specifically based on the Repertory Grid)

Format: Structured Rating Grid Administration

Language Available: English

Population Group: Human

Age Group: Not specified, but generally applicable to adult patients capable of complex relational assessments.

Population Details: Sample primarily included Patients.

Test Methodology: The administration method is classified as “Other,” reflecting its unique basis in the repertory grid. Respondents are first presented with 20 cards representing different people (elements), which they number from 1 to 20 in any chosen order. For each provided psychological construct (e.g., “ideal dependable parent”), the respondent is required to select the 10 people (elements) who most closely fit that construct. These selections are then systematically recorded in a grid format for subsequent analysis.

Keywords

Crisp 1964, Therapeutic Process, Patient-Physician Dynamics, Transference Measurement, Repertory Grid, Clinical Prediction, Test Development

Authors

Author ORCID Identifier: Not provided in source material.

Affiliation Email addresses: Not provided in source material.

Correspondence Address: Not provided in source material.

Permissions & Fee and Test Year

Test Year: 1964

Permissions: The instrument may be used for Research/Teaching purposes.

Commercial Use: Use is explicitly designated as Non-Commercial.

Fee: No fee is associated with the use of the instrument for research or teaching, subject to obtaining the necessary materials.

Test Items Availability: The test items are not publicly available. To obtain the full set of test items or the administration manual, interested parties are advised to contact the original author, A. H. Crisp, or the original publisher directly.

Reference’s

Crisp, A. H. (1964). Development and application of a measure of “transference.” Journal of Psychosomatic Research, 8(3), 327–335. The DOI for this foundational work is: https://doi.org/10.1016/0022-3999(64)90062-5

The methodology is also significantly influenced by the work of George Kelly on Personal Construct Theory and the modifications introduced by Bannister.

Items of the Doctor Patient Transference Grid

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

The source content does not provide the full list of scale items, only examples of constructs and the procedure. To obtain the test items, you are advised to contact the author or publisher directly. Examples of constructs mentioned include “ideal dependable parent” and “like Dr. So-and-so.”

The methodology involves:

1. The individual considers 20 people they know or have known well (elements).
2. These 20 elements are divided into two groups: 10 obligatory figures and 10 self-chosen figures.
3. Respondents are asked to number the cards of ratings of people (elements) from 1-20, in any order they wish.
4. For each construct provided (e.g., “ideal dependable parent” or “like Dr. So-and-so”), the individual selects the 10 people most fitting that construct.
5. These selections are recorded in the grid for scoring and interpretation.