Client attachment to therapist: Relation to client personality and symptomatology, and their contributions to the therapeutic alliance.

Abstract

This study examined the relation of client attachment to the therapist to diverse facets of the therapeutic alliance, client personality, and psychopathological symptoms, as well as the relative importance of therapeutic attachments, personality, and symptomatology in predicting the alliance. Eighty clients in ongoing therapy completed measures of client attachment to therapist (CATS), personality (6FPQ), psychopathological symptoms (BSI), and therapeutic alliance (WAI-Short, CALPAS, HAQ). Secure and Avoidant-Fearful attachment to the therapist correlated positively and negatively, respectively, with total and subscale alliance scores. Preoccupied-Merger therapeutic attachment was unrelated to the alliance. Exploratory analyses suggested however that the relationship between Preoccupied-Merger attachment and the alliance was moderated by the extent to which clients were distressed. Clients' therapeutic attachments were unrelated to basic personality dimensions. Preoccupied-Merger attachment to the therapist correlated significantly with several symptom dimensions. Clients' therapeutic attachments emerged as superior and more consistent predictors, relative to client personality and symptomatology, of the therapeutic alliance.

Attachment as a Predictor of the Therapeutic Alliance in Couple Therapy

“…However, studies that have differentiated between the two types of insecure attachment, have generally found a lack of association between anxious attachment and the therapeutic alliance. For example, one study (Bachelor et al, 2010) examined the effect of clients' anxious and avoidant attachment on the therapeutic alliance among 80 individuals in therapy and found that, although avoidant attachment was associated with lower level of alliance, anxious attachment was not a significant predictor. Thus, there seems to be pattern that anxious attachment is not predictive the therapeutic alliance in individual and couple therapy.…”

Therapeutic Alliance: Evolution and Relationship With Attachment in Psychotherapy

“…Asimismo, se evaluó el apego en las relaciones en general y no el apego específico con el terapeuta debido a que los instrumentos que evalúan este último han mostrado compartir una gran variancia con herramientas que miden la alianza terapéutica, mostrando no ser constructos significativamente diferentes (Bachelor et al, 2010).…”

“…Igualmente se ha informado que una menor severidad sintomática se asocia con un mayor reporte de apego seguro (Smith et al, 2010) y que más sintomatología se relacionó con apego ansioso. Las inconsistencias descritas en la asociación entre apego ansioso o evitativo y la alianza podrían deberse a la influencia de terceras variables (Bachelor et al, 2010), siendo la mejoría/ empeoramiento sintomático una de ellas.…”

“…En síntesis, pese a que se ha evidenciado una relación entre la alianza terapéutica y los resultados de los tratamientos, se sabe muy poco de cuáles son sus componentes, modelado y medición asociado a pacientes con un estilo de apego seguro global a una mejor calidad de alianza con el terapeuta, la evidencia sobre la relación entre apego inseguro y la alianza ha sido inconsistente (Bachelor et al, 2010 se plantea este estudio es: ¿cómo se comporta la alianza terapéutica a lo largo del tiempo?, ¿es facilitada/obstaculizada por ciertas características propias del estilo de apego del paciente? Para responder a estas preguntas se observará la alianza terapéutica a lo largo del proceso psicoterapéutico y se estudiará la relación entre la evolución de este vínculo terapeuta-paciente y el apego.…”

Sexual offenders’ parental and adult attachments and preferences for therapists’ interpersonal qualities

“…Secure attachment to the therapist has been strongly, positively correlated with the therapeutic alliance (Bachelor, Meunier, Laverdiére, & Gamache, 2010;Goldman & Anderson, 2007;Mallinckrodt, Gantt, & Coble, 1995;Mallinckrodt, King, & Coble, 1998;Mallinckrodt, Porter, & Kivlighan, 2005;Satterfield & Lyddon, 1998), which in turn is a good predictor of successful therapeutic outcome (e.g., Horvath, Del Re, Flückiger, & Symonds, 2011;Horvath & Luborsky, 1993) accounting for, on average, about a quarter of the variance (Horvath & Symonds, 1991). Individuals with fearful-avoidant attachment styles tend to have the lowest therapeutic alliance ratings (Eames & Roth, 2000;Satterfiled, & Lydodon, 1998).…”