This thesis explores the associations between therapist and client attachment styles and the working alliance. It is presented as three papers: a literature review, a report of the empirical research study, and a critical reflection of the research process. In the first paper, the author provides a systematic review of studies that have investigated the association between therapist attachment and the working alliance and therapist attachment and clinical outcome. A total of nine research studies met the inclusion criteria and were included in the final review. The studies varied considerably in terms of their design and methodology, as well as, the different tools used to measure the therapeutic alliance, attachment style and outcome. The findings were then organized in terms of the relationship between therapist attachment and client-rated therapeutic alliance; the relationship between therapist attachment and therapist-rated alliance; the relationship between therapist attachment and alliance as rated by an observer and finally, the relationship between therapist attachment and outcome. The key findings were that therapist attachment security was associated with client-rated and therapist-rated working alliance. However, the overall association between therapist attachment and alliance was not straight forward. There was evidence to suggest that the attachment style of therapist and the client interact to produce a combined effect on perceptions of the working alliance and outcome. The empirical research paper examined the extent to which client and therapist self-reported attachment styles were related to the working alliance. The study also investigated any role for client attachment to therapist and psychological mindedness. Both these variables were included as exploratory. It was hypothesised that psychological mindedness may be related to secure attachment and the alliance. Specifically, we investigated the extent to which self-reported attachment styles were related to the working alliance and assessed the relative contribution of psychological mindedness to attachment security and the quality of the working alliance. Thirty clients and 42 therapists from primary care services were recruited. Participants completed measures of anxiety and depression, attachment style, working alliance and psychological mindedness. Therapist attachment security was not related to the alliance. No significant relationships were found between client attachment style and the working alliance. However, therapists and clients with oppositional attachment styles had more favourable alliances. The clinical implications and future research directions is then discussed.The final paper provides a critical reflection of the research process. It begins by outlining the rationale for the development of the literature review and the empirical research paper, and goes on to discuss some of the methodological considerations of the research paper. The implications for therapeutic practice are then suggested, followed by the wider service-related issues. Attachment theory is then critiqued, and the clinical implications discussed. Finally recommendations are made for future research.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:574276 |
| Date | January 2012 |
| Creators | Seymour-Hyde, Annily Victoria |
| Contributors | Berry, Katherine |
| Publisher | University of Manchester |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | https://www.research.manchester.ac.uk/portal/en/theses/an-investigation-into-the-associations-between-therapist-and-client-attachment-styles-and-the-working-alliance(a66adb7d-c419-4d5c-88d9-c2acb4b0fb42).html |
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