OBJECTIVE The aim of this study was to investigate a sequence of associations between clients' pretreatment attachment style, the development of individuated-secure attachment to the therapist (i.e., therapeutic attachment), and the experience of increased comfort with emotional closeness (growing engagement) or independence (growing autonomy) in therapy. Moreover, the study explored whether clients' experience of growing engagement or growing autonomy was associated with a change in interpersonal problems at the end of therapy. METHOD Three hundred thirty adult clients (mean age 40.2, 75% female) were seen by 44 therapists in individual psychotherapy. The associations between pretreatment attachment insecurity measured on the Experiences in Close Relationships scale, repeated measures of therapeutic attachment measured on the Client Attachment to Therapist Scale, repeated measures of a growing engagement or growing autonomy measured on the Therapeutic Distance Scale, and pre-post measures of interpersonal problems measured on the Inventory for Interpersonal Problems were analyzed using multilevel modeling. Two types of therapeutic attachment were estimated, one controlling for anxious attachment characteristics and one for avoidant. RESULTS Significant associations between higher levels of therapeutic attachment controlled for avoidant attachment characteristics and lower levels of growing autonomy in therapy were found. Moreover, higher levels of growing engagement in therapy and higher levels of therapeutic attachment controlled for anxious attachment characteristics were associated with a decrease in interpersonal problems at the end of therapy. CONCLUSIONS Distinct types of therapeutic attachment may exert different influences on the process and outcome of therapy. Furthermore, therapists' attunement to clients' specific attachment needs in therapy may enhance interpersonal outcomes of treatment. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

中文翻译：

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成人心理治疗中依恋需求、获得的安全治疗依恋和结果之间的关系。


目的 本研究的目的是调查来访者治疗前的依恋风格、对治疗师的个性化安全依恋（即治疗依恋）的发展，以及随着情感亲密而增加的舒适度体验（不断增长的参与度）之间的一系列关联。或治疗中的独立性（增强自主性）。此外，该研究还探讨了来访者的参与度增加或自主性增加的经历是否与治疗结束时人际问题的变化有关。方法 44 名治疗师对 330 名成年客户（平均年龄 40.2 岁，75% 女性）进行个体心理治疗。根据亲密关系经历量表测量的治疗前依恋不安全感、根据客户对治疗师依恋量表测量的治疗依恋重复测量、根据治疗距离量表测量的不断增长的参与或不断增长的自主性的重复测量以及治疗前测量之间的关联使用多级建模对人际问题清单中测量的人际问题进行了分析。评估了两种类型的治疗依恋，一种控制焦虑依恋特征，另一种控制回避依恋特征。结果发现，回避依恋特征控制的较高水平的治疗依恋与较低水平的治疗自主性之间存在显着关联。此外，更高水平的治疗参与度和更高水平的控制焦虑依恋特征的治疗依恋与治疗结束时人际问题的减少有关。结论 不同类型的治疗依恋可能对治疗的过程和结果产生不同的影响。 此外，治疗师在治疗中对来访者特定依恋需求的调整可能会增强治疗的人际效果。 （PsycInfo 数据库记录 (c) 2024 APA，保留所有权利）。