The relationship between attachment needs, earned secure therapeutic attachment and outcome in adult psychotherapy.

IF 4.5 1区心理学 Q1 PSYCHOLOGY, CLINICAL Journal of consulting and clinical psychology Pub Date : 2024-07-01 DOI:10.1037/ccp0000900

C F Jacobsen, F Falkenström, L Castonguay, J Nielsen, S Lunn, L Lauritzen, S Poulsen

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Abstract

Objective: The aim of this study was to investigate a sequence of associations between clients' pretreatment attachment style, the development of individuated-secure attachment to the therapist (i.e., therapeutic attachment), and the experience of increased comfort with emotional closeness (growing engagement) or independence (growing autonomy) in therapy. Moreover, the study explored whether clients' experience of growing engagement or growing autonomy was associated with a change in interpersonal problems at the end of therapy.

Method: Three hundred thirty adult clients (mean age 40.2, 75% female) were seen by 44 therapists in individual psychotherapy. The associations between pretreatment attachment insecurity measured on the Experiences in Close Relationships scale, repeated measures of therapeutic attachment measured on the Client Attachment to Therapist Scale, repeated measures of a growing engagement or growing autonomy measured on the Therapeutic Distance Scale, and pre-post measures of interpersonal problems measured on the Inventory for Interpersonal Problems were analyzed using multilevel modeling. Two types of therapeutic attachment were estimated, one controlling for anxious attachment characteristics and one for avoidant.

Results: Significant associations between higher levels of therapeutic attachment controlled for avoidant attachment characteristics and lower levels of growing autonomy in therapy were found. Moreover, higher levels of growing engagement in therapy and higher levels of therapeutic attachment controlled for anxious attachment characteristics were associated with a decrease in interpersonal problems at the end of therapy.

Conclusions: Distinct types of therapeutic attachment may exert different influences on the process and outcome of therapy. Furthermore, therapists' attunement to clients' specific attachment needs in therapy may enhance interpersonal outcomes of treatment. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

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依恋需求、获得安全的治疗性依恋与成人心理治疗结果之间的关系。

研究目的本研究的目的是调查客户治疗前的依恋风格、对治疗师的个体化安全依恋（即治疗性依恋）的发展，以及在治疗过程中对情感亲密性（参与性不断增强）或独立性（自主性不断增强）的体验之间的一系列关联。此外，该研究还探讨了在治疗结束时，求助者的参与感增强或自主性增强是否与人际关系问题的改变有关：方法：33 名成年客户（平均年龄 40.2 岁，75% 为女性）接受了 44 名治疗师的个体心理治疗。我们使用多层次模型分析了治疗前依恋不安全感（通过亲密关系体验量表进行测量）、治疗依恋重复测量（通过客户对治疗师依恋量表进行测量）、治疗距离重复测量（通过治疗距离量表进行测量）和治疗前-治疗后人际问题测量（通过人际问题量表进行测量）之间的关系。对两种治疗依恋类型进行了估计，一种是控制焦虑依恋特征的治疗依恋类型，另一种是控制回避型治疗依恋类型的治疗依恋类型：结果：在控制回避型依恋特征的情况下，发现较高水平的治疗依恋与较低水平的治疗自主性增长之间存在显著关联。此外，在治疗结束时，较高水平的治疗参与和较高水平的治疗依恋（控制焦虑型依恋特征）与人际关系问题的减少有关：结论：不同类型的治疗依恋可能会对治疗过程和结果产生不同的影响。结论：不同的治疗依恋类型可能会对治疗过程和结果产生不同的影响。此外，治疗师在治疗过程中对客户特定依恋需求的调整可能会提高治疗的人际关系效果。(PsycInfo Database Record (c) 2024 APA, 版权所有）。

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来源期刊

Journal of consulting and clinical psychology PSYCHOLOGY, CLINICAL-

CiteScore

9.00

自引率

3.40%

发文量

期刊介绍： The Journal of Consulting and Clinical Psychology® (JCCP) publishes original contributions on the following topics: the development, validity, and use of techniques of diagnosis and treatment of disordered behaviorstudies of a variety of populations that have clinical interest, including but not limited to medical patients, ethnic minorities, persons with serious mental illness, and community samplesstudies that have a cross-cultural or demographic focus and are of interest for treating behavior disordersstudies of personality and of its assessment and development where these have a clear bearing on problems of clinical dysfunction and treatmentstudies of gender, ethnicity, or sexual orientation that have a clear bearing on diagnosis, assessment, and treatmentstudies of psychosocial aspects of health behaviors. Studies that focus on populations that fall anywhere within the lifespan are considered. JCCP welcomes submissions on treatment and prevention in all areas of clinical and clinical–health psychology and especially on topics that appeal to a broad clinical–scientist and practitioner audience. JCCP encourages the submission of theory–based interventions, studies that investigate mechanisms of change, and studies of the effectiveness of treatments in real-world settings. JCCP recommends that authors of clinical trials pre-register their studies with an appropriate clinical trial registry (e.g., ClinicalTrials.gov, ClinicalTrialsRegister.eu) though both registered and unregistered trials will continue to be considered at this time.