Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany.
Department of Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus Dresden, Technical University Dresden, Germany.
Clin Psychol Psychother. 2019 Jan;26(1):105-109. doi: 10.1002/cpp.2334. Epub 2018 Oct 16.
Several studies propose that patient attachment to therapist is associated with therapy outcome. However, the magnitude of the effect is diverse, which might be explicable by suppressor effects and the new concept of pseudo-security.
Associations between patient attachment to therapist (client-attachment-to-therapist-scale [CATS]) and psychotherapy outcome ("global severity index" of the Symptom Check List) were evaluated in N = 368 patients. Multilevel models were performed.
When tested in separate models, secure attachment to therapist was associated with a more favourable outcome (p < 0.05), whereas avoidant and preoccupied attachment to therapist were correlated with a less favourable outcome (both p < 0.05). Avoidant but not preoccupied attachment to therapist suppressed the association between secure attachment to therapist and the outcome. When controlling for the other two CATS scales, avoidant as well as preoccupied attachment to therapist remained associated with a less favourable outcome (p < 0.05).
Avoidant attachment to therapist suppresses the association between secure attachment to therapist and psychotherapy outcome. Pseudo-security has to be taken into consideration in self-report data on patient attachment to therapist.
多项研究表明，患者对治疗师的依恋与治疗效果相关。然而，效应的大小存在差异，这可能可以用抑制效应和新的伪安全感概念来解释。
对 N=368 名患者的患者对治疗师的依恋（治疗师依恋量表[CATS]）和心理治疗效果（症状检查表的“总体严重程度指数”）之间的关系进行评估。进行了多层次模型分析。
在单独的模型中进行测试时，治疗师的安全依恋与更有利的结果相关（p<0.05），而回避和专注依恋与不利的结果相关（两者均 p<0.05）。回避依恋而非专注依恋抑制了治疗师安全依恋与结果之间的关联。当控制其他两个 CATS 量表时，回避和专注依恋与不利的结果仍然相关（p<0.05）。
治疗师的回避依恋抑制了治疗师安全依恋与心理治疗效果之间的关联。在患者对治疗师的依恋的自我报告数据中，必须考虑伪安全感。
