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治疗师-来访者叙事中的治疗距离:来访者依附、治疗师依附和对偶影响。

Therapeutic distance in client-therapist narratives: client attachment, therapist attachment, and dyadic effects.

机构信息

University of Haifa, Haifa, Israel.

Hebrew University, Haifa, Israel.

出版信息

Psychother Res. 2021 Nov;31(8):963-976. doi: 10.1080/10503307.2021.1874069. Epub 2021 Jan 20.

Abstract

Based on the attachment framework, therapeutic distance conceptualization focuses on closeness-distance dynamics in the therapeutic relationship. We aimed to evaluate the psychometric properties of the Therapeutic-Distance-Scale, Observer-version (TDS-O) and apply a dyadic approach to examine associations between attachment characteristics and therapeutic distance experiences of clients, therapists, and mutual effects. Sixty-six clients and their 29 therapists completed the ECR and relational narratives collected in RAP interviews at early, mid, and late psychodynamic-therapy were rated on TDS-O scales: , , , and . The TDS-O showed good IRR, internal reliability and content validity. Client anxiety was not associated with therapeutic distance but associated with autonomy. Client avoidance associated with clients' experiencing therapist as too close, and lower engagement only at early therapy, but was not associated with therapists' experience. Therapist anxiety was not related to closeness-distance at early therapy but related to gaps between client and therapist experiences at mid and late therapy. Therapist avoidance related to clients experiencing therapists as too close and granting less autonomy at early and mid-therapy, and to therapist experience of distance at late therapy. The findings underscore the importance of therapists' regulating therapeutic distance through attunement to client's interpersonal needs and therapy phase.

摘要

基于附件框架,治疗距离概念化关注治疗关系中的亲近-距离动态。我们旨在评估治疗距离量表观察版本(TDS-O)的心理测量特性,并采用对偶方法来检验依恋特征与客户、治疗师的治疗距离体验之间的关联以及相互影响。66 名客户及其 29 名治疗师完成了 ECR,并在早期、中期和晚期动力治疗中通过 RAP 访谈收集了关系叙述,然后对 TDS-O 量表进行评分:、、、。TDS-O 显示出良好的内部一致性、内部可靠性和内容有效性。客户焦虑与治疗距离无关,但与自主性有关。客户回避与客户体验到治疗师过于亲近有关,仅在早期治疗时与参与度较低有关,但与治疗师的体验无关。治疗师焦虑与早期治疗时的亲近-距离无关,但与中期和晚期治疗时客户和治疗师体验之间的差距有关。治疗师回避与客户体验到治疗师过于亲近和在早期和中期治疗中给予较少自主性以及治疗师在晚期治疗中体验到距离有关。研究结果强调了治疗师通过对客户人际需求和治疗阶段的调节来调节治疗距离的重要性。

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