Background. Recent research into attachment theory has suggested it provides a useful framework for understanding the psychological therapeutic process. Clinical application of attachment theory has been a recent development in adult mental health research. Previous studies have focused on patient attachment styles and a systematic review of the literature highlights the limited research that explores both patient and clinician attachment patterns. The reported study aims to explore both patient and therapist attachment and the dyadic interaction on the therapeutic process, and, in particular, how attachment influences the early engagement and development of the therapeutic alliance. Methods. Patient participants and clinician participants completed a self-report measure of attachment prior to commencing a psychological intervention. Early engagement was measured through appointment attendance and independent therapeutic alliance ratings from patients and clinicians were completed after the third appointment. Correlations and regression analysis explored the extent to which patient and clinician attachment predicts early engagement and the therapeutic alliance. Results. Fifty-five patients and 38 clinician’s self-report attachment styles indicate greater security amongst clinicians. Patients presenting to mental health services reported higher levels of anxious and avoidant attachment patterns, which were predictive of greater psychological distress. Patient avoidant attachment was associated with poor engagement and both patient anxiety and avoidance attachment were predictive of therapeutic alliance. No relationship was found between therapist attachment and early engagement or therapeutic alliance, and there were no significant interactions between patient and therapist attachments patterns. Conclusions. Findings from the current study suggest that patient attachment style is predictive of reported psychological distress, early engagement and therapeutic alliance. Applying the principles of attachment theory to clinical practice could therefore provide greater insight into the interpersonal dynamics between patient and therapist and help inform services as to how to improve engagement and alliance with insecure patients. The strengths and weaknesses of the study are discussed, which highlights the need for further research with larger samples to build on the current limited findings.

Nationally, nearly 40% of full-time community college students drop out before the second year, and drop-out rates for part-time students are even more astounding. In 2008, nearly 60% of part-time community college students dropped out before year two. As community colleges embrace President Obama’s call for a 50% increase in completion by 2020, it is imperative that community college leaders find ways to retain and graduate students. A number of community and technical colleges utilize the Survey of Entering Student Engagement (SENSE) to quantitatively measure early campus connections. Building on the institutional early connection benchmark score, this study qualitatively describes first-year, persisting, full- and part-time students’ perceptions of early campus experiences and the role that early connections play in their decision to persist. The study employs a qualitative research approach via a single case study. Twenty-four, first-year, second semester, consecutively enrolled, full- and part-time students, who mirrored the college’s population participated in semi-structured interviews and focus groups. Findings indicate that early connections, as defined by the SENSE were not instrumental in persistence; however, a number of other factors were impactful: academic support; social influences; family support; and academic success. This study may provide information that will enhance the understanding of community college student perceptions related to factors that encourage persistence, and it may provide community colleges that operate within similar conditions, resources, and constraints with useful information as they design early connection strategies. / text