Aafjes-van Doorn Katie, Békés Vera, Luo Xiaochen
Ferkauf Graduate School of Psychology, Yeshiva University, Rousso Building, 1165 Morris Park Avenue Bronx, New York, NY 10461, USA.
Department of Counseling Psychology, Santa Clara University, Santa Clara, CA 95053, USA.
Brain Sci. 2021 Sep 28;11(10):1288. doi: 10.3390/brainsci11101288.
The early months of the COVID-19 pandemic have been a challenging time for many psychotherapy patients. To understand why certain patients were more resilient, we examined the role of patients' attachment anxiety and attachment avoidance, as well as collaborative therapy experiences (perceived working alliance and therapeutic agency) in their online sessions on their COVID-related traumatic distress over a three-month period. A total of 466 patients in online psychotherapy completed a survey during the first weeks of the pandemic, and 121 of those completed a follow-up survey three months later. Lower distress at follow-up was predicted by patients' lower attachment anxiety and higher therapeutic agency in their online sessions after controlling for baseline distress and time of survey completion. Higher working alliance predicted less distress at follow-up only for patients with high attachment anxiety. For patients with low attachment avoidance (i.e., more securely attached), higher therapeutic agency predicted less distress. These findings suggest that patients' attachment anxiety and therapeutic agency may play significant roles also in online therapy during COVID-19 in patient's experienced traumatic distress, and that working alliance and therapeutic agency may be differentially important for patients with different levels of attachment anxiety and avoidance.
对许多心理治疗患者来说，新冠疫情的头几个月是充满挑战的时期。为了解为何某些患者更具复原力，我们考察了患者的依恋焦虑和依恋回避的作用，以及他们在为期三个月的在线治疗中，其合作性治疗体验（感知到的工作联盟和治疗能动性）对与新冠相关的创伤性痛苦的影响。共有466名接受在线心理治疗的患者在疫情的头几周完成了一项调查，其中121人在三个月后完成了随访调查。在控制了基线痛苦程度和调查完成时间后，患者在线治疗中较低的依恋焦虑和较高的治疗能动性预示着随访时较低的痛苦程度。较高的工作联盟仅对高依恋焦虑的患者预示着随访时较少的痛苦。对于低依恋回避（即依恋更安全）的患者，较高的治疗能动性预示着较少的痛苦。这些发现表明，在新冠疫情期间的在线治疗中，患者的依恋焦虑和治疗能动性在患者经历的创伤性痛苦中可能也发挥着重要作用，而且工作联盟和治疗能动性对具有不同依恋焦虑和回避水平的患者可能有着不同程度的重要性。
