Attachment and early working alliance in adult psychiatric inpatients

Abstract

Background: There is an increasing amount of research indicating that patient's attachment style is related to the development of working alliance. The earlier research is based mainly on outpatients or therapy clients.Aims: In this study, we studied the association between adult attachment styles and early working alliance among psychiatric inpatients.Method: The information was gathered using self-report questionnaires (Relationship Questionnaire and Working Alliance Inventory). The participants were 100 inpatients and their 21 case managers from a unit of acute psychiatry.Results: The results showed that adult attachment style was associated with working alliance, but the association was different in men and women. As hypothesized, securely attached women formed stronger emotional and relational alliance (bond) than women with fearful and dismissing attachment styles. Among men, however, not only secure but also fearful attachment was related to strong cognitive aspects of working alliance (task).Conclusions: Learning more about the links between attachment style and working alliance and the meaning of gender in these associations helps us consider the patients' strengths and weaknesses in planning psychotherapy and other interventions.Declaration of interest: The research was supported by grants from Finnish Cultural Foundation, the University of Tampere Foundation and Tampere University Hospital.