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在培训诊所从一位治疗师转至另一位治疗师后的工作联盟:治疗师依恋风格的影响

Working alliance after transferring from one therapist to another in a training clinic: Influence of therapist attachment style.

作者信息

An Mira, Kivlighan Dennis M, Hill Clara E

机构信息

Department of Counseling, Higher Education, and Special Education.

Department of Psychology.

出版信息

J Couns Psychol. 2023 Jan;70(1):67-80. doi: 10.1037/cou0000642. Epub 2022 Sep 8.

Abstract

This study investigated how client working alliance changed after transferring from one therapist to another: (a) When pre- and post-transfer therapists' attachment anxiety/avoidance were congruently higher or lower and (b) when the pretransfer therapists' attachment anxiety/avoidance were more or less discrepant from the posttransfer therapists. A Tau- analysis and a multilevel polynomial regression and response surface analysis were used to analyze longitudinal data about 23 transferred clients in open-ended psychodynamic psychotherapy with doctoral-level therapist trainees ( = 29). When first and second therapists' attachment anxiety/avoidance levels were congruent, the higher the two therapists' attachment anxiety and avoidance levels were, the greater was the decrement in clients' ratings of working alliance after transfers. When first and second therapists' attachment anxiety/avoidance levels were discrepant from each other, the more the first and second therapists' attachment were different from each other in terms of anxiety, the greater decrement in clients' ratings of working alliance there was after transfers. Meanwhile, the more the two therapists' attachment avoidance levels were different from each other, the less decrement in clients' ratings of working alliance there was after transfers. Therefore, the attachment orientations of the pre- and post-transfer therapists combined to influence client working alliance after transfers. Limitations and implications of the present research are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

摘要

本研究调查了来访者从一位治疗师转至另一位治疗师后工作联盟是如何变化的

(a) 转介前后治疗师的依恋焦虑/回避程度一致地更高或更低时,以及 (b) 转介前治疗师的依恋焦虑/回避程度与转介后治疗师的依恋焦虑/回避程度或多或少存在差异时。采用Tau分析、多级多项式回归和响应面分析,对23名转介来访者在与博士水平治疗师实习生进行的开放式心理动力心理治疗中的纵向数据进行分析(n = 29)。当第一和第二治疗师的依恋焦虑/回避水平一致时,两位治疗师的依恋焦虑和回避水平越高,转介后来访者对工作联盟的评分下降幅度就越大。当第一和第二治疗师的依恋焦虑/回避水平彼此存在差异时,第一和第二治疗师在焦虑方面的差异越大,转介后来访者对工作联盟的评分下降幅度就越大。同时,两位治疗师的依恋回避水平差异越大,转介后来访者对工作联盟的评分下降幅度就越小。因此,转介前后治疗师的依恋取向共同影响转介后来访者的工作联盟。讨论了本研究的局限性和意义。(PsycInfo数据库记录 (c) 2023美国心理学会,保留所有权利)

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