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Secure Attachment to Therapist, Alliance, and Outcome in Psychoanalytic Psychotherapy With Young Adults

Lilliengren, Peter; Falkenstrom, Fredrik; Sandell, Rolf LU ; Mothander, Pia Risholm and Werbart, Andrzej (2015) In Journal of Counseling Psychology 62(1). p.1-13
Abstract
Using a novel approach to assess attachment to therapist from patient narratives (Patient Attachment to Therapist Rating Scale; PAT-RS), we investigated the relationships between secure attachment to therapist, patient-rated alliance, and outcome in a sample of 70 young adults treated with psychoanalytic psychotherapy. A series of linear mixed-effects models, controlling for length of therapy and therapist effects, indicated that secure attachment to therapist at termination was associated with improvement in symptoms, global functioning, and interpersonal problems. After controlling for the alliance, these relationships were maintained in terms of symptoms and global functioning. Further, for the follow-up period, we found a suppression... (More)
Using a novel approach to assess attachment to therapist from patient narratives (Patient Attachment to Therapist Rating Scale; PAT-RS), we investigated the relationships between secure attachment to therapist, patient-rated alliance, and outcome in a sample of 70 young adults treated with psychoanalytic psychotherapy. A series of linear mixed-effects models, controlling for length of therapy and therapist effects, indicated that secure attachment to therapist at termination was associated with improvement in symptoms, global functioning, and interpersonal problems. After controlling for the alliance, these relationships were maintained in terms of symptoms and global functioning. Further, for the follow-up period, we found a suppression effect indicating that secure attachment to therapist predicted continued improvement in global functioning, whereas the alliance predicted deterioration when both variables were modeled together. Although limited by the correlational design, this study suggests that the development of a secure attachment to therapist is associated with treatment gains as well as predictive of posttreatment improvement in functioning. Future research should investigate the temporal development of attachment to therapist and its interaction with alliance and outcome more closely. To ensure differentiation from patient-rated alliance, observer-based measurement of attachment to therapist should be considered. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
attachment to therapist, therapeutic alliance, outcome, psychoanalytic, psychotherapy, young adults
in
Journal of Counseling Psychology
volume
62
issue
1
pages
1 - 13
publisher
American Psychological Association (APA)
external identifiers
  • wos:000348049200001
  • scopus:84925779803
ISSN
0022-0167
DOI
10.1037/cou0000044
language
English
LU publication?
yes
id
0ada2a7c-5077-495c-b764-56cb01a47f9a (old id 5070021)
date added to LUP
2015-02-25 15:47:09
date last changed
2017-02-12 03:42:41
@article{0ada2a7c-5077-495c-b764-56cb01a47f9a,
  abstract     = {Using a novel approach to assess attachment to therapist from patient narratives (Patient Attachment to Therapist Rating Scale; PAT-RS), we investigated the relationships between secure attachment to therapist, patient-rated alliance, and outcome in a sample of 70 young adults treated with psychoanalytic psychotherapy. A series of linear mixed-effects models, controlling for length of therapy and therapist effects, indicated that secure attachment to therapist at termination was associated with improvement in symptoms, global functioning, and interpersonal problems. After controlling for the alliance, these relationships were maintained in terms of symptoms and global functioning. Further, for the follow-up period, we found a suppression effect indicating that secure attachment to therapist predicted continued improvement in global functioning, whereas the alliance predicted deterioration when both variables were modeled together. Although limited by the correlational design, this study suggests that the development of a secure attachment to therapist is associated with treatment gains as well as predictive of posttreatment improvement in functioning. Future research should investigate the temporal development of attachment to therapist and its interaction with alliance and outcome more closely. To ensure differentiation from patient-rated alliance, observer-based measurement of attachment to therapist should be considered.},
  author       = {Lilliengren, Peter and Falkenstrom, Fredrik and Sandell, Rolf and Mothander, Pia Risholm and Werbart, Andrzej},
  issn         = {0022-0167},
  keyword      = {attachment to therapist,therapeutic alliance,outcome,psychoanalytic,psychotherapy,young adults},
  language     = {eng},
  number       = {1},
  pages        = {1--13},
  publisher    = {American Psychological Association (APA)},
  series       = {Journal of Counseling Psychology},
  title        = {Secure Attachment to Therapist, Alliance, and Outcome in Psychoanalytic Psychotherapy With Young Adults},
  url          = {http://dx.doi.org/10.1037/cou0000044},
  volume       = {62},
  year         = {2015},
}