Associations among attachment characteristics, patients’ assessment of therapeutic factors, and treatment outcome following inpatient psychodynamic group psychotherapy

Abstract

Within a multisite study, including 289 inpatients from six different hospitals who underwent interpersonal-psychodynamic group psychotherapy, associations among attachment characteristics, therapeutic factors, and treatment outcome were investigated. Attachment characteristics were assessed with an interview-based measure (Adult Attachment Prototype Rating [AAPR]) as well as an attachment self-report (Bielefeld Questionnaire of Client Expectations [BQCE]). Therapeutic factors were measured retrospectively with the Dusseldorf Therapeutic Factors Questionnaire and treated as an individual- as well as a hospital-specific characteristic. On an individual level, only the group climate factor independently predicted treatment outcome (i.e., Symptom Checklist-90-R Global Severity Index and Inventory of Interpersonal Problems mean). If simultaneously but separately included into a path model, analyses revealed independent significant effects of AAPR-Security and BQCE-Security on group climate. If modeled as a latent variable (common attachment security), a substantially higher proportion of group climate variance could be explained. Further analyses revealed interactions between particular therapeutic factors and attachment characteristics, indicating a particular importance of these therapeutic factors for different attachment categories.

Attachment to the clinical team and its association with therapeutic relationships, social networks, and clinical well‐being

“…Mallinckrodt's (2000) model of 'social competencies in interpersonal process' proposes that attachment theory is helpful in explaining the development of social competencies (defined as both social skills needed in building relationships and dispositions that influence the acquisition of such skills), which are likely to have an impact on therapeutic relationships in psychotherapy. Consistent with this model, security of attachment has been found to be associated with good early therapeutic alliance (Goldman & Anderson, 2007) and with 'group climate' in group therapy (Kirchmann et al, 2009). There has also been some suggestion that attachment states of mind, though consistent over the lifespan (Thompson, 2000), may not be activated in every context, depending upon the inter-personal and affective qualities of that context (Mikulincer, Orbach, & Iavnieli, 1998;Tasca et al, 2007).…”

Changes of attachment status among women with personality disorders undergoing inpatient treatment

“…Goldman & Anderson, 2007;Reis & Grenyer, 2004), or a limited cohesion within group psychotherapy (e.g. Kirchmann et al, 2009), results regarding therapy outcome so far are inconsistent. Although most of the studies showed a higher benefit for more securely attached clients (e.g.…”

The role of attachment style, attachment to therapist, and working alliance in response to psychological therapy

“…Attachment representations may be related to improved therapy outcomes as a result of the relationship with greater WA. A number of studies have found that patterns of attachment predict therapy outcomes (Byrd, Patterson, & Turchik, 2010;Daniel, 2006;Forbes, Parslow, Fletcher, McHugh, & Creamer, 2010;Joyce, Ogrodniczuk, Piper, & Sheptycki, 2010;Saatsi, Hardy, & Cahill, 2007;Stalker, Gebotys, & Harper, 2005), although others have reported non-significant findings (Daniel, 2006;Kirchmann et al, 2009;Ravitz, Maunder, & McBride, 2008;Sauer et al, 2010;Strauss et al, 2006). Consequently, the relationship between attachment and therapy outcome remains currently unclear.…”