The influence of psychodynamically oriented therapists' attachment representations on outcome and alliance in inpatient psychotherapy

Abstract

The Adult Attachment Interview (AAI) was used to study 31 psychotherapists who treated 1,381 patients in intensive multimodal inpatient psychotherapy. AAI dimensional ratings of security versus insecurity and dismissiveness versus preoccupation were used to predict alliance and outcome via multilevel regression techniques (hierarchical linear modeling). There were no main effects of therapists' attachment dimensions. However, higher attachment security of the therapist was associated with both better alliance and outcome in more severely impaired patients. Implications of the findings as well as limitations of the study are discussed.

Experiences Learning Interpersonal Neurobiology: An Interpretative Phenomenological Analysis

“…Although little empirical support is available regarding IPNB specifically, aspects of IPNB including attachment theory, mindfulness, and psychoeducation have growing bodies of empirical support. Researchers have found evidence to substantiate links between counselors' attachment styles and aspects of the therapeutic process Saucer et al, 2003;Schauenburg et al, 2010;Tyrrell et al, 1999).…”

“…Exploring these orientations in training and supervision might be beneficial. Schauenburg et al (2010) examined the influence of therapists' attachment styles on the therapeutic alliance and therapeutic outcome in inpatient psychotherapy. The researchers assessed 31 psychotherapists using the AAI and the Helping Alliance Questionnaire.…”

Balancing clinical risk with countertransference management protects alliance

“…CT dynamics of this type may help illuminate the inconsistent findings concerning the effect of therapists' attachment patterns on alliance (see Daniel, 2006). Furthermore, such dynamics may be involved in the findings regarding the interaction between clinical severity and therapists' factors (Bucci et al, 2015;Schauenburg et al, 2010). The way therapists' relational orientations (such as attachment dimensions) concretely affect psychotherapy may be through therapists greater or lesser ability to manage the emotions transpiring within the dyad, or regulate the therapeutic distance, defined by Daly and Mallinckrodt (2009) The particular importance of clinical risk for alliance and CT management suggested by our results needs further exploration.…”

“…For instance, there is evidence that therapists' attachment insecurity may negatively affect the alliance and therapist empathy (e.g., Sauer, Lopez, & Gormley, 2003;Rubino, Barker, Roth, & Fearon, 2000), apparently indicating that therapists' unresolved personal issues are at stake. Additionally, some studies suggest that the severity of clients' problems interact with therapists' attachment dimensions in affecting the alliance, such that the relation of therapists' attachment with alliance only becomes relevant with the most severely impaired patients (Bucci, Seymour-Hide, Harris, & Berry, 2015;Schauenburg et al, 2010). Schauenburg et al (2010) wanted to predict alliance from therapists' dimensional ratings of the Adult Attachment Interview (AAI) in terms of security-insecurity and dismissivenesspreoccupation.…”

“…Additionally, some studies suggest that the severity of clients' problems interact with therapists' attachment dimensions in affecting the alliance, such that the relation of therapists' attachment with alliance only becomes relevant with the most severely impaired patients (Bucci, Seymour-Hide, Harris, & Berry, 2015;Schauenburg et al, 2010). Schauenburg et al (2010) wanted to predict alliance from therapists' dimensional ratings of the Adult Attachment Interview (AAI) in terms of security-insecurity and dismissivenesspreoccupation. They studied 31 psychodynamically oriented psychotherapists who treated 1381 clients and analyzed the data with multilevel regression analyses.…”