Folke Sofie, Daniel Sarah I F, Poulsen Stig, Lunn Susanne
a Department of Psychology , University of Copenhagen , Copenhagen , Denmark.
Psychother Res. 2016 Jul;26(4):459-71. doi: 10.1080/10503307.2015.1027319. Epub 2015 Apr 14.
This study investigated the relation between clients' attachment patterns and the therapeutic alliance in two psychotherapies for bulimia nervosa.
Data derive from a randomized clinical trial comparing cognitive-behavioral therapy (CBT) and psychoanalytic psychotherapy (PPT) for bulimia nervosa. Client attachment patterns were assessed with the Adult Attachment Interview. Independent raters scored audiotapes of early, middle, and late therapy sessions for 68 clients (175 sessions) using the Vanderbilt Therapeutic Alliance Scale.
Client attachment security was found to be a significant (p = .007) predictor of alliance levels at the three measured time points, with clients higher on attachment security developing stronger alliances with their therapists in both treatments as compared to clients higher on attachment insecurity. No evidence was found to support a hypothesized interaction whereby dismissing clients would develop weaker alliances in PPT and preoccupied clients would develop weaker alliances in CBT.
As the first study to examine client attachment and therapeutic alliance using observer-based instruments, this study supports the theoretical assumption that clients with secure attachment patterns are likely to develop stronger alliances with their therapist across different treatment settings.
本研究调查了神经性贪食症的两种心理治疗中来访者的依恋模式与治疗联盟之间的关系。
数据来源于一项比较神经性贪食症的认知行为疗法（CBT）和精神分析心理治疗（PPT）的随机临床试验。使用成人依恋访谈评估来访者的依恋模式。独立评分者使用范德比尔特治疗联盟量表对68名来访者（175次治疗 session）的早期、中期和后期治疗 session 的录音带进行评分。
发现来访者的依恋安全性是三个测量时间点联盟水平的显著（p = .007）预测因素，与依恋不安全程度较高的来访者相比，依恋安全性较高的来访者在两种治疗中与治疗师建立的联盟更强。没有证据支持这样一种假设的相互作用，即轻视型来访者在PPT中会建立较弱的联盟，而过度关注型来访者在CBT中会建立较弱的联盟。
作为第一项使用基于观察者的工具研究来访者依恋与治疗联盟的研究，本研究支持了这样一种理论假设，即具有安全依恋模式的来访者在不同的治疗环境中可能与他们的治疗师建立更强的联盟。
