Theoretical Paper Effects of therapists' attachment organisation on the process and outcome of therapy: A review of the empirical literature

Abstract

Content & FocusThe last two decades, in particular, have witnessed an increased interest in the clinical implications of attachment theory in individual adult psychotherapy. By and large, the majority of empirical studies on the importance of adult attachment patterns in individual psychotherapy have focused on exploring the effect of clients’ attachment organisation. The present paper reviewed the existing literature on the effects of therapists’ attachment organisation on the process and outcome of therapy. In particular, 14 known studies were reviewed, exploring how trainee and qualified therapists’, as well as other clinicians’, attachment styles could influence the working alliance, the depth of their interventions, their emotional empathy and psychological mindedness, their countertransference behaviours towards clients and finally the outcome of therapy.ConclusionsFindings from these studies showed that a secure attachment organisation in therapists could positively affect the process and outcome of therapy, whilst an insecure attachment organisation was negatively associated with both process and outcome of therapy. Nevertheless, a few studies provided us with different results. Overall, it can be suggested that the relationship between therapists’ attachment and the process of therapy is not as simple as we assume because other factors may interfere in this relationship.The findings, the methodological characteristics and limitations of the 14 reviewed studies are discussed throughout this paper.