Processes involved in client-nominated relationship building incidents: Client attachment, attachment to therapist, and session impact.

Abstract

Thirty volunteer clients of trainee therapists nominated an incident that was critical in the development of their therapeutic relationship. Clients completed the Client Attachment to Therapist Scale (CATS), the Experiences in Close Relationships Scale (ECRS), and the Session Impacts Scale (SIS). Clients reported an increase in attachment security with their therapists, along with perceptions of support and relief and increasing exploration following the relationship building incident. While clients' avoidant attachment was unrelated to attachment to the therapist prior to the incidents, in subsequent sessions avoidance was related to a change in secure attachment to therapist. Finally, client attachment to therapist but not general attachment was significantly related to in-session exploration. Findings are discussed in light of attachment theory and convergence with findings from the field of social psychology. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

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

“…The latter subscale is similar to the construct of attachment anxiety, whilst the Avoidant-Fearful subscale measures aspects of attachment avoidance and anxiety. Studies using the CATS suggest that secure attachment towards the therapist is associated with better WA, whereas avoidant-fearful attachment is associated with poor WA (Fuertes et al, 2007;Janzen, Fitzpatrick, & Drapeau, 2008;Mallinckrodt et al, 2005;Romano, Fitzpatrick, & Janzen, 2008;Sauer, Anderson, Gormley, Richardson, & Preacco, 2010).…”

Psychotherapy process and relationship in the context of a brief attachment-based mother-infant intervention.

“…In the current study, internal consistency α coefficients were .82 for avoidance and .93 for anxiety. Because it may be useful to refer to benchmarks scores for dimensions of attachment for clients in previous research, we note that previous research with non-clinical samples of non-help-seeking, volunteer clients has found mean ECR scores on attachment anxiety ranging from M = 3.45 ( SD = 1.07) to M = 3.59 ( SD = 1.08) and on avoidance ranging from M = 2.53 ( SD = 1.19) to M = 2.62 ( SD = 1.18; Janzen, Fitzpatrick, & Drapeau, 2008; Romano, Fitzpatrick, & Janzen, 2008). Other research with clinical samples (i.e., treatment-seeking clients) has found mean ECR scores on attachment anxiety ranging from M = 4.13 ( SD = 1.07) to M = 4.35 ( SD = 1.24) and on avoidance ranging from M = 3.19 ( SD = 1.14) to M = 3.29 ( SD = 1.37; Mallinckrodt, Porter, & Kivlighan, 2005; Moore & Gelso, 2011).…”

Secure attachment to therapist, alliance, and outcome in psychoanalytic psychotherapy with young adults.

“…For example, Mallinckrodt, Porter, and Kivlighan (2005) found that secure attachment to therapist, as measured with the Secure subscale of the CATS, was related to patients' experience of depth, smoothness, and exploration in sessions. This finding has been replicated in two other studies using similar methodology (Janzen, Fitzpatrick, & Drapeau, 2008;Romano, Fitzpatrick, & Janzen, 2008). Also, in a study applying the CAQ-T, Saypol and Farber (2010) found that the quality of patient attachment to the therapist was associated with higher levels of patient self-disclosure in treatment.…”